Visual stimulation and frequency of focal neurological symptoms engage distinctive neurocognitive resources in migraine with aura patients. A study of resting-state functional networks

Introduction: Several functional neuroimaging studies on healthy controls and patients with migraine with aura have shown that the activation of functional networks during visual stimulation is not restricted to the striate system, but also includes several extrastriate networks. Methods: Before and after 4 min of visual stimulation with a checkerboard pattern, we collected functional MRI in 21 migraine with aura (MwA) patients and 18 healthy subjects (HS). For each recording session, we identified independent resting-state networks in each group and correlated network connection strength changes with clinical disease features. Results: Before visual stimulation, we found reduced connectivity between the default mode network and the left dorsal attention system (DAS) in MwA patients compared to HS. In HS, visual stimulation increases functional connectivity between the independent components of the bilateral DAS and the executive control network (ECN). In MwA, visual stimulation significantly improved functional connectivity between the independent component pairs salience network and DAS, and between DAS and ECN. The ECN Z-scores after visual stimulation were negatively related to the monthly frequency of aura. Conclusions: In individuals with MwA, 4 min of visual stimulation had stronger cognitive impact than in healthy people. A higher frequency of aura may lead to a diminished ability to obtain cognitive resources to cope with transitory but important events like aura-related focal neurological symptoms

Abnormal quiescent neovascularization in a patient with large colloid drusen visualized by optical coherence tomography angiography

PURPOSE: We report a case of large colloid drusen complicated by extensive quiescent choroidal neovascularization in both eyes. METHODS: Case report. RESULTS: A 46-year old woman was referred to our department with diagnosis of early-onset retinal drusen. Review of examinations performed 16 years before along with current multimodal imaging evaluation showed the presence of numerous large colloid drusen, subsequently replaced by quiescent choroidal neovascularization in both eyes, nicely visualized by optical coherence tomography angiography. CONCLUSION: This case suggests progressive development of quiescent neovascularization beneath the drusen as a possible late evolution of degenerating large colloid drusens

Residual phenotypic susceptibility to doravirine in multidrug-resistant HIV-1 from subjects enrolled in the PRESTIGIO Registry

Objectives: Doravirine shows a rather distinct resistance profile within the nonnucleoside reverse tran-scriptase inhibitor (NNRTI) class. This study aimed to evaluate the phenotypic susceptibility to doravirine, rilpivirine and etravirine in a panel of multidrug-resistant (MDR) HIV-1 isolates collected from people living with HIV (PLWH) enrolled in the PRESTIGIO Registry.Methods: Recombinant viruses expressing PLWH-derived protease, reverse transcriptase coding regions were generated from plasma samples at virological failure with documented resistance to protease in-hibitors, nucleoside reverse transcriptase inhibitors, NNRTIs and integrase strand transfer inhibitors. In vitro susceptibility was assessed through a phenotypic assay measuring fold-change values with respect to the reference NL4-3 virus. Genotypic susceptibility was computed by the Stanford HIVdb algorithm 8.9-1.Results: Plasma samples were collected from 22 PLWH: 20 (91%) were male, median age 55 years (IQR 50-58), time since HIV-1 diagnosis 27 years (23-31) and time on antiretroviral treatment 23 years (22- 26). Median doravirine, etravirine and rilpivirine fold-change values were 9.8 (2.9-40.4), 42.9 (3.1-100.0) and 100.0 (17.9-100.0), respectively. According to the fold-change cut-offs, full susceptibility was observed in five (23%), four (18%) and one (5%) cases with doravirine, etravirine and rilpivirine, respectively. Ir-respective of the presence of specific doravirine mutations, higher numbers of NNRTI mutations corre-lated with higher fold-change values for doravirine. By comparing the distribution of fold-change values with the Stanford HIVdb predicted susceptibility, a significant correlation was detected for doravirine and rilpivirine but not etravirine.Conclusion: Despite extensive cross-resistance among NNRTIs, doravirine can be a valid option in a pro-portion of PLWH with MDR HIV-1. Doravirine activity appeared to be inferred with fair accuracy by the HIVdb algorithm.(c) 2023 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved