BACKGROUND AND PURPOSE: Impairment of fiber integrity of the corticospinal tract in the subacute and chronic phases after ischemic stroke has been linked to poor motor outcome. The aim of the study was an assessment of fiber integrity in the acute poststroke phase and an evaluation of its association with the clinical course dependent on the infarction pattern (subtypes: peripheral versus basal ganglia infarction). MATERIALS AND METHODS:All patients who underwent mechanical recanalization of a large-vessel occlusion in the anterior circulation and postinterventional DTI were included (n ¼ 165). The fractional anisotropy index of the patient-specific corticospinal tract within the posterior limb of the internal capsule was correlated to clinical parameters (NIHSS scores/mRS at 90 days), and the interaction of stroke subtype (peripheral infarcts versus basal ganglia infarction) was tested in a moderation analysis. RESULTS:The fractional anisotropy index was reduced in the acute poststroke phase with a correlation to clinical presentation, especially in case of peripheral infarcts (eg, with the NIHSS motor subscore: r ¼ -0.4, P , .001). This correlation was absent for basal ganglia infarction (r ¼ -0.008, P . .05). There was a significant association between the fractional anisotropy index and clinical outcome (mRS after 90 days, P , .01), which is moderated by stroke subtype with significant effects only for peripheral infarcts.CONCLUSIONS: Corticospinal tract abnormalities can be observed in the early stage after mechanical recanalization and have prognostic capacity. This finding increases the clinical value of early DTI imaging parameters. Because the effects observed were limited to peripheral infarcts, further and longitudinal evaluation of fiber integrities within basal ganglia infarction is required.ABBREVIATIONS: BGI ¼ basal ganglia infarction; CST ¼ corticospinal tract; FA ¼ fractional anisotropy; IQR ¼ interquartile range; mNIHSS ¼ motor subindex scores of NIHSS; mNIHSS-AL ¼ sum of arm (A) and leg (L) symptom values of the affected side; mNIHSS-ALF ¼ the sum of arm (A), leg (L) and facial (F) symptoms value of the affected side; mTICI ¼ modified TICI; PED ¼ cerebral peduncle; PLIC ¼ posterior limb of the internal capsule

Age-related hearing loss (ARHL, formerly presbycusis) is due to a variety of lifetime damages to the auditory system and is characterized by bilateral sensorineural hearing loss, impaired speech understanding in noise and central sound processing deficits. Despite its commonness, the pathogenesis has not been completely clarified yet; especially the existence of an independent central ARHL component still remains controversial. We present the results of a cross-sectional topodiagnostic test battery study which aimed at separating aging-and hearing loss-related effects on all parts of the auditory system by current test procedures. Three groups of 30 participants each underwent extensive topodiagnostic test procedures (otoscopy, tympanometry, questionnaires, pure-tone audiometry, DPOAE threshold measurements, auditory brainstem response, central auditory discrimination tests, and speech-in-noise test).By comparing the results of the normally hearing young (18-26 years) and healthy control group, the normally hearing elderly group (60-80 years) and the hearingimpaired elderly group (60-80 years), we deduced aging and hearing loss-related effects on auditory performance. All measurements indicated a significant deterioration of auditory performance in the elderly, partly associated with aging and partly with age-related hearing loss. Our study thereby contributes to a multifocal concept of ARHL. All parts of the auditory system are impaired by aging, age-related hearing loss, or a combination of both. Further evidence for an independent central ARHL component, not attributable to peripheral hearing loss, is provided by the results of the central auditory discrimination test.

Background The coronavirus disease 2019 (COVID‐19) pandemic has heavily impacted medical care of patients with Parkinson's disease (PwP). Objective To assess the longitudinal impact of the COVID‐19 pandemic on PwP and their relatives in Germany. Methods Two online, nationwide, cross‐sectional surveys were conducted from December 2020 to March 2021 and from July to September 2021. Results A total of 342 PwP and 113 relatives participated. Despite partial resumption of social and group activities, healthcare was continuously disrupted during times of loosened restrictions. Respondents’ willingness to use telehealth infrastructure increased, yet the availability remained low. PwP reported worsened symptoms and further deterioration during the pandemic, resulting in an increase in new symptoms and relatives’ burden. We identified patients at particular risk: young patients and those with long disease duration. Conclusions The COVID‐19 pandemic persistently disrupts the care and quality of life of PwP. Although willingness to use telemedicine services has increased, its availability needs to be improved.