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Antiseizure Medication Use and Outcomes After Suspected or Confirmed Acute Symptomatic Seizures JAMA Neurol. (IF 20.4) Pub Date : 2024-09-23 Sahar F. Zafar, Adithya Sivaraju, Clio Rubinos, Neishay Ayub, Phillip O. Awodutire, Zachary McKee, Pradeep Chandan, MarieElena Byrnes, Sakhi A. Bhansali, Hunter Rice, Arthor Smith-Ayala, Muhammad Adnan Haider, Elizabeth Tveter, Natalie Erlich-Malona, Fernando Ibanhes, Alexis DeMarco, Skylar Lewis, Monica B. Dhakar, Vineet Punia
ImportanceAntiseizure medications (ASMs) are frequently prescribed for acute symptomatic seizures and epileptiform abnormalities (EAs; eg, periodic or rhythmic patterns). There are limited data on factors associated with ASM use and their association with outcomes.ObjectivesTo determine factors associated with ASM use in patients with confirmed or suspected acute symptomatic seizures undergoing continuous
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Perceived Chronic Traumatic Encephalopathy and Suicidality in Former Professional Football Players JAMA Neurol. (IF 20.4) Pub Date : 2024-09-23 Rachel Grashow, Douglas P. Terry, Grant L. Iverson, Heather DiGregorio, Inana Dairi, Cheyenne Brown, Paula S. Atkeson, Alicia J. Whittington, LeRoy Reese, Jonathan H. Kim, Niki Konstantinides, Herman A. Taylor, Frank E. Speizer, Daniel H. Daneshvar, Ross D. Zafonte, Marc G. Weisskopf, Aaron L. Baggish
ImportanceParticipation in American-style football (ASF) has been linked to chronic traumatic encephalopathy neuropathological change (CTE-NC), a specific neuropathologic finding that can only be established at autopsy. Despite being a postmortem diagnosis, living former ASF players may perceive themselves to have CTE-NC. At present, the proportion and clinical correlates of living former professional
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Comorbidity and Disease Activity in Multiple Sclerosis JAMA Neurol. (IF 20.4) Pub Date : 2024-09-18 Amber Salter, Samantha Lancia, Kaarina Kowalec, Kathryn C. Fitzgerald, Ruth Ann Marrie
ImportanceMultiple studies suggest that comorbidity worsens clinically relevant outcomes in multiple sclerosis (MS), including the severity of disability at diagnosis and rate of disability worsening after diagnosis. However, less is known regarding the association of comorbidity with measures of disease activity, such as relapse rate and magnetic resonance imaging lesion accrual, which are relevant
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Intracranial Pressure Elevation and MOGAD JAMA Neurol. (IF 20.4) Pub Date : 2024-09-16 Nanthaya Tisavipat, Natthapon Rattanathamsakul, Abdul-Rahman Salman, Laura Cacciaguerra, Sean J. Pittock, Eoin P. Flanagan, John J. Chen
This cross-sectional study examines the frequency of increased intracranial pressure and its association with myelin oligodendrocyte glycoprotein antibody-associated disease in patients of various ages.
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Differential Diagnosis of Suspected Multiple Sclerosis in Pediatric and Late-Onset Populations JAMA Neurol. (IF 20.4) Pub Date : 2024-09-16 Le H. Hua, Andrew J. Solomon, Silvia Tenembaum, Antonio Scalfari, Àlex Rovira, Kevin Rostasy, Scott D. Newsome, Ruth Ann Marrie, Melinda Magyari, Orhun Kantarci, Bernhard Hemmer, Cheryl Hemingway, Mary Pat Harnegie, Jennifer S. Graves, Jeffrey A. Cohen, Riley Bove, Brenda Banwell, John R. Corboy, Emmanuelle Waubant
ImportanceWhile the typical onset of multiple sclerosis (MS) occurs in early adulthood, 2% to 10% of cases initially present prior to age 18 years, and approximately 5% after age 50 years. Guidance on approaches to differential diagnosis in suspected MS specific to these 2 age groups is needed.ObservationsThere are unique biological factors in children younger than 18 years and in adults older than
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Efficacy and Safety of Erenumab for Nonopioid Medication Overuse Headache in Chronic Migraine JAMA Neurol. (IF 20.4) Pub Date : 2024-09-16 Stewart J. Tepper, David W. Dodick, Michel Lanteri-Minet, David Dolezil, Raquel Gil-Gouveia, Christian Lucas, Karolina Piasecka-Stryczynska, Gyöngyi Szabó, Daniel D. Mikol, Mahan Chehrenama, Denise E. Chou, Yiping Yang, Gabriel Paiva da Silva Lima
ImportancePatients with chronic migraine and medication overuse headaches (CM-MOH) represent a particularly burdened subpopulation. This trial provides first, to our knowledge, American Academy of Neurology class I evidence for a preventive therapy in CM-MOH.ObjectiveTo assess erenumab efficacy and safety in patients with nonopioid CM-MOH.Design, Settings, and ParticipantsThis randomized, double-blind
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Role of the X Chromosome in Alzheimer Disease Genetics JAMA Neurol. (IF 20.4) Pub Date : 2024-09-09 Michael E. Belloy, Yann Le Guen, Ilaria Stewart, Kennedy Williams, Joachim Herz, Richard Sherva, Rui Zhang, Victoria Merritt, Matthew S. Panizzon, Richard L. Hauger, J. Michael Gaziano, Mark Logue, Valerio Napolioni, Michael D. Greicius
ImportanceThe X chromosome has remained enigmatic in Alzheimer disease (AD), yet it makes up 5% of the genome and carries a high proportion of genes expressed in the brain, making it particularly appealing as a potential source of unexplored genetic variation in AD.ObjectivesTo perform the first large-scale X chromosome–wide association study (XWAS) of AD.Design, Setting, and ParticipantsThis was a
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Time to Treat First Acute Attack of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease JAMA Neurol. (IF 20.4) Pub Date : 2024-09-03 Young Nam Kwon, Boram Kim, Jun-Soon Kim, Kyung Seok Park, Da-Young Seo, Hyunjin Kim, Eun-Jae Lee, Young-Min Lim, Hyunjin Ju, Yeon Hak Chung, Ju-Hong Min, Tai-Seung Nam, Sooyoung Kim, Eunhee Sohn, Kyong Jin Shin, Jin Myoung Seok, Sunyoung Kim, Jong Seok Bae, Sukyoon Lee, Seong-il Oh, Yu Jin Jung, Jinseok Park, Seung Hyun Kim, Ki Hoon Kim, Ho Jin Kim, Jae Ho Jung, Seong-Joon Kim, Seung Woo Kim, Myoung-jin
ImportanceA proportion of people with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) have a relapsing disease course and persistent anti–myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) seropositivity. Few studies have investigated whether treatment of the first MOGAD attack is associated with the long-term disease course and/or MOG-IgG seronegative conversion
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Expanding the Prion Paradigm to Include Alzheimer and Parkinson Diseases JAMA Neurol. (IF 20.4) Pub Date : 2024-08-19 Carlo Condello, David Westaway, Stanley B. Prusiner
This Viewpoint describes the evidence for iatrogenic disease based on amyloid-β prions and the possibility that Alzheimer disease has an iatrogenic form wherein amyloid β and tau behave as prions that transmit the disease.
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Localized Nicardipine Release Implants for Prevention of Vasospasm After Aneurysmal Subarachnoid Hemorrhage JAMA Neurol. (IF 20.4) Pub Date : 2024-08-19 Lars Wessels, Stefan Wolf, Tiziana Adage, Jörg Breitenbach, Claudius Thomé, Johannes Kerschbaumer, Martin Bendszus, Matthias Gmeiner, Andreas Gruber, Dorothee Mielke, Veit Rohde, Maria Wostrack, Bernard Meyer, Jens Gempt, Gerhard Bavinzski, Dorian Hirschmann, Peter Vajkoczy, Nils Hecht
ImportanceCerebral vasospasm largely contributes to a devastating outcome after aneurysmal subarachnoid hemorrhage (aSAH), with limited therapeutic options.ObjectiveTo investigate the safety and efficacy of localized nicardipine release implants positioned around the basal cerebral vasculature at risk for developing proximal vasospasm after aSAH.Design, Setting, and ParticipantsThis single-masked randomized
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Lecanemab and Vascular-Amyloid Deposition in Brains of People With Down Syndrome JAMA Neurol. (IF 20.4) Pub Date : 2024-08-19 Lei Liu, Adriana Saba, Jesse R. Pascual, Michael B. Miller, Elizabeth L. Hennessey, Ira T. Lott, Adam M. Brickman, Donna M. Wilcock, Jordan P. Harp, Frederick A. Schmitt, Dennis J. Selkoe, Jasmeer P. Chhatwal, Elizabeth Head
ImportanceAnti-β-amyloid immunotherapy using lecanemab is becoming increasingly available to patients with Alzheimer disease (AD). Individuals with Down syndrome (DS) develop AD neuropathology by age 40 years, representing a significant cohort of genetically determined AD.ObjectiveTo investigate the binding properties of lecanemab in the brains of people with DS, in anticipation of their inclusion
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It Is Time for Medicare to Cover Driving Safety Assessments. JAMA Neurol. (IF 20.4) Pub Date : 2024-08-12 Kirk R Daffner, Margaret O'Connor
This Viewpoint advocates for Medicare coverage of driving assessments for older individuals.
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Parkinsonism Following Chimeric Antigen Receptor T Cell Therapy JAMA Neurol. (IF 20.4) Pub Date : 2024-08-12 Jonas A. Gudera, Joachim M. Baehring, Philipp Karschnia
This case report describes a 67-year-old woman who had received adoptive immunotherapy with chimeric antigen receptor T cells for multiple myeloma and was experiencing parkinsonism-like symptoms.
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Apixaban vs Aspirin in Patients With Cancer and Cryptogenic Stroke JAMA Neurol. (IF 20.4) Pub Date : 2024-08-12 Babak B. Navi, Cenai Zhang, Benjamin Miller, Mary Cushman, Scott E. Kasner, Mitchell S. V. Elkind, David L. Tirschwell, W. T. Longstreth, Richard A. Kronmal, Morin Beyeler, Jordan Elm, Richard M. Zweifler, Joseph Tarsia, Carlo W. Cereda, Giovanni Bianco, Gianluca Costamagna, Patrik Michel, Joseph P. Broderick, David J. Gladstone, Hooman Kamel, Christopher Streib
ImportanceApproximately 10% to 15% of ischemic strokes are associated with cancer; cancer-associated stroke, particularly when cryptogenic, is associated with high rates of recurrent stroke and major bleeding. Limited data exist on the safety and efficacy of different antithrombotic strategies in patients with cancer and cryptogenic stroke.ObjectiveTo compare apixaban vs aspirin for the prevention
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Endovascular Stroke Thrombectomy for Patients With Large Ischemic Core JAMA Neurol. (IF 20.4) Pub Date : 2024-08-12 Huanwen Chen, Jin Soo Lee, Patrik Michel, Bernard Yan, Seemant Chaturvedi
ImportanceRecently, 6 randomized clinical trials—RESCUE-Japan-LIMIT (Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism—Japan Large Ischemic Core Trial), ANGEL-ASPECT (Trial of Endovascular Therapy for Acute Ischemic Stroke With Large Infarct), SELECT2 (Trial of Endovascular Thrombectomy for Large Ischemic Strokes), TESLA (Thrombectomy for Emergent Salvage of Large Anterior Circulation
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Limitations of the α-Synuclein Seed Amplification Assay in Clinical Practice JAMA Neurol. (IF 20.4) Pub Date : 2024-08-05 Huw R. Morris, Andrew J. Lees
This Viewpoint cautions against premature adoption of the α-synuclein seed amplification assay as a biomarker test for Parkinson disease in general neurology practice.
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Risk of Perinatal and Maternal Morbidity and Mortality Among Pregnant Women With Epilepsy JAMA Neurol. (IF 20.4) Pub Date : 2024-08-05 Neda Razaz, Jannicke Igland, Marte-Helene Bjørk, K. S. Joseph, Julie Werenberg Dreier, Nils Erik Gilhus, Mika Gissler, Maarit K. Leinonen, Helga Zoega, Silje Alvestad, Jakob Christensen, Torbjörn Tomson
ImportanceMaternal epilepsy is associated with adverse pregnancy and neonatal outcomes. A better understanding of this condition and the associated risk of mortality and morbidity at the time of delivery could help reduce adverse outcomes.ObjectiveTo determine the risk of severe maternal and perinatal morbidity and mortality among women with epilepsy.Design, Setting, ParticipantsThis prospective population-based
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Combined Physiotherapy and Cognitive Behavioral Therapy for Functional Movement Disorders JAMA Neurol. (IF 20.4) Pub Date : 2024-08-05 Daniel Macías-García, Marta Méndez-Del Barrio, Manuel Canal-Rivero, Laura Muñoz-Delgado, Astrid Adarmes-Gómez, Silvia Jesús, Elena Ojeda-Lepe, Fátima Carrillo-García, Francisco J. Palomar, Francisco Javier Gómez-Campos, Juan Francisco Martin-Rodriguez, Benedicto Crespo-Facorro, Miguel Ruiz-Veguilla, Pablo Mir
ImportanceFunctional movement disorders (FMDs) are frequent and disabling neurological disorders with a substantial socioeconomic impact. Few randomized studies have analyzed the effectiveness of combined physiotherapy and psychotherapy in patients’ quality of life.ObjectiveTo assess the efficacy of multidisciplinary treatment (physiotherapy plus cognitive behavioral therapy) in FMDs.Design, Setting
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Pain Phenotypes and Pain Multimorbidity Among Medicare Beneficiaries With Cerebral Palsy. JAMA Neurol. (IF 20.4) Pub Date : 2024-08-05 Mark D Peterson, Kathryn Ashbaugh, Michael O'Leary, Mary Schmidt, Heidi Haapala, Neil Kamdar, Edward A Hurvitz
This cohort study assesses the association of pain phenotypes and pain multimorbidity with cerebral palsy subtypes among Medicare beneficiaries.
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Safety and Efficacy of Staged, Bilateral Focused Ultrasound Thalamotomy in Essential Tremor JAMA Neurol. (IF 20.4) Pub Date : 2024-07-29 Michael G. Kaplitt, Vibhor Krishna, Howard M. Eisenberg, W. Jeffrey Elias, Pejman Ghanouni, Gordon H. Baltuch, Ali Rezai, Casey H. Halpern, Brian Dalm, Paul S. Fishman, Vivek P. Buch, Shayan Moosa, Harini Sarva, Ann Marie Murray
ImportanceUnilateral magnetic resonance–guided focused ultrasound ablation of ventralis intermedius nucleus of the thalamus for essential tremor reduces tremor on 1 side, but untreated contralateral or midline symptoms remain limiting for some patients. Historically, bilateral lesioning produced unacceptable risks and was supplanted by deep brain stimulation; increasing acceptance of unilateral focused
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Fecal Microbiota Transplantation for Treatment of Parkinson Disease JAMA Neurol. (IF 20.4) Pub Date : 2024-07-29 Filip Scheperjans, Reeta Levo, Berta Bosch, Mitja Lääperi, Pedro A. B. Pereira, Olli-Pekka Smolander, Velma T. E. Aho, Nora Vetkas, Lotta Toivio, Veera Kainulainen, Tatyana D. Fedorova, Perttu Lahtinen, Rebekka Ortiz, Valtteri Kaasinen, Reetta Satokari, Perttu Arkkila
ImportanceDysbiosis has been robustly demonstrated in Parkinson disease (PD), and fecal microbiota transplantation (FMT) has shown promising effects in preclinical PD models.ObjectiveTo assess the safety and symptomatic efficacy of colonic single-dose anaerobically prepared FMT.Design, Setting, and ParticipantsThis was a double-blind, placebo-controlled, randomized clinical trial conducted between
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MRI Signature of α-Synuclein Pathology in Asymptomatic Stages and a Memory Clinic Population. JAMA Neurol. (IF 20.4) Pub Date : 2024-07-28 Laura E M Wisse, Nicola Spotorno, Marcello Rossi, Michel J Grothe, Angela Mammana, Pontus Tideman, Simone Baiardi, Olof Strandberg, Alice Ticca, Danielle van Westen, Niklas Mattsson-Carlgren, Sebastian Palmqvist, Erik Stomrud, Piero Parchi, Oskar Hansson
The lack of an in vivo measure for α-synuclein (α-syn) pathology until recently has limited thorough characterization of its brain atrophy pattern, especially during early disease stages.
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Plasma Phosphorylated Tau 217 and Aβ42/40 to Predict Early Brain Aβ Accumulation in People Without Cognitive Impairment JAMA Neurol. (IF 20.4) Pub Date : 2024-07-28 Shorena Janelidze, Nicolas R. Barthélemy, Gemma Salvadó, Suzanne E. Schindler, Sebastian Palmqvist, Niklas Mattsson-Carlgren, Joel B. Braunstein, Vitaliy Ovod, James G. Bollinger, Yingxin He, Yan Li, Cyrus A. Raji, John C. Morris, David M. Holtzman, Nicholas J. Ashton, Kaj Blennow, Erik Stomrud, Randall J. Bateman, Oskar Hansson
ImportancePhase 3 trials of successful antiamyloid therapies in Alzheimer disease (AD) have demonstrated improved clinical efficacy in people with less severe disease. Plasma biomarkers will be essential for efficient screening of participants in future primary prevention clinical trials testing antiamyloid therapies in cognitively unimpaired (CU) individuals with initially low brain β-amyloid (Aβ)
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Lesioning the Brain—From Serendipity to Science JAMA Neurol. (IF 20.4) Pub Date : 2024-07-22 Leo P. Sugrue, Samuel Lashof-Regas, Doris D. Wang
This case report describes use of high-intensity focused ultrasound as a method to create spatially precise thermal lesions in the brain without a craniotomy.
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Prevalence of Epilepsy in People of Sexual and Gender Minoritized Groups JAMA Neurol. (IF 20.4) Pub Date : 2024-07-22 Emily L. Johnson, Esther Bui, Karina Tassiopoulos, Maya Overby Koretzky, Rodrigo Zepeda, Ernesto Gonzalez-Giraldo, Rebecca F. Gottesman
ImportanceEpilepsy is a highly treatable condition for many people, but there are large treatment gaps with suboptimal seizure control in minoritized groups. The sexual and gender minority (SGM) community is at risk for health disparities, yet the burden of epilepsy in this community is not known.ObjectiveTo estimate the prevalence of active epilepsy among SGM people in the United States.Design, Setting
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Itching Frequency and Neuroanatomic Correlates in Frontotemporal Lobar Degeneration JAMA Neurol. (IF 20.4) Pub Date : 2024-07-22 Rafi Hadad, Maria Luisa Mandelli, Katherine P. Rankin, Charlie Toohey, Virginia E. Sturm, Shireen Javandel, Andjelika Milicic, Marguerite Knudtson, Isabel Elaine Allen, Nathalia Hoffmann, Adit Friedberg, Katherine Possin, Victor Valcour, Bruce L. Miller
ImportanceItching is common in geriatric populations and is frequently linked to dermatological or systemic conditions. Itching engages specific brain regions that are implicated in the pathogenesis of frontotemporal lobar degeneration spectrum disorders (FTLD-SD). Thus, itching of undetermined origin (IUO) may indicate the presence of a neurodegenerative process.ObjectiveTo compare the frequency of
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Centers for Medicare and Medicaid Services Coverage of Amyloid PET JAMA Neurol. (IF 20.4) Pub Date : 2024-07-15 Joshua D. Grill, Jennifer H. Lingler
This Viewpoint discusses the ambiguity of amyloid positron emission tomography coverage in the era of anti-amyloid therapeutics and the considerations and consequences of narrow coverage.
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Substantia Nigra Pathology, Contact Sports Play, and Parkinsonism in Chronic Traumatic Encephalopathy JAMA Neurol. (IF 20.4) Pub Date : 2024-07-15 Jason W. Adams, Daniel Kirsch, Samantha M. Calderazzo, Fatima Tuz-Zahra, Yorghos Tripodis, Jesse Mez, Michael L. Alosco, Victor E. Alvarez, Bertrand R. Huber, Caroline Kubilus, Kerry A. Cormier, Raymond Nicks, Madeline Uretsky, Evan Nair, Eva Kuzyk, Nurgul Aytan, Jonathan D. Cherry, John F. Crary, Daniel H. Daneshvar, Christopher J. Nowinski, Lee E. Goldstein, Brigid Dwyer, Douglas I. Katz, Robert
ImportanceParkinsonism is associated with traumatic brain injury and chronic traumatic encephalopathy (CTE), a neurodegenerative disease associated with repetitive head impact (RHI) exposure, but the neuropathologic substrates that underlie parkinsonism in individuals with CTE are yet to be defined.ObjectiveTo evaluate the frequency of parkinsonism in individuals with CTE and the association of RHI
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Tapping the Brakes on New Parkinson Disease Biological Staging. JAMA Neurol. (IF 20.4) Pub Date : 2024-07-08 Njideka U Okubadejo, Michael S Okun, Joseph Jankovic
This Viewpoint cautions against the premature adoption and implementation of biological definitions for Parkinson disease proposed in February 2024.
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Direct-Acting Oral Anticoagulants and Antiseizure Medications for Atrial Fibrillation and Epilepsy and Risk of Thromboembolic Events JAMA Neurol. (IF 20.4) Pub Date : 2024-07-08 Emily K. Acton, Sean Hennessy, Michael A. Gelfand, Charles E. Leonard, Warren B. Bilker, Di Shu, Allison W. Willis, Scott E. Kasner
ImportanceDirect-acting oral anticoagulants (DOACs) are commonly prescribed with antiseizure medications (ASMs) due to concurrency of and the association between atrial fibrillation (AF) and epilepsy. However, enzyme-inducing (EI) ASMs may reduce absorption and accelerate metabolism of DOACs, potentially lowering DOAC levels and elevating thromboembolism risk.ObjectiveTo assess the rates of thromboembolic
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Acute Clinical Events Identified as Relapses With Stable Magnetic Resonance Imaging in Multiple Sclerosis. JAMA Neurol. (IF 20.4) Pub Date : 2024-07-01 Antoine Gavoille, Fabien Rollot, Romain Casey, Anne Kerbrat, Emmanuelle Le Page, Kevin Bigaut, Guillaume Mathey, Laure Michel, Jonathan Ciron, Aurelie Ruet, Elisabeth Maillart, Pierre Labauge, Hélène Zephir, Caroline Papeix, Gilles Defer, Christine Lebrun-Frenay, Thibault Moreau, Eric Berger, Bruno Stankoff, Pierre Clavelou, Eric Thouvenot, Olivier Heinzlef, Jean Pelletier, Abdullatif Al-Khedr, Olivier
Understanding the association between clinically defined relapses and radiological activity in multiple sclerosis (MS) is essential for patient treatment and therapeutic development.
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Steroid-Responsive Myorhythmia in Pectoralis Muscles JAMA Neurol. (IF 20.4) Pub Date : 2024-07-01 Bing Zhao, Cuiping Zhao, Yuying Zhao
This case report describes a patient experiencing involuntary contractions in his right pectoralis muscles with anti-Tr antibodies in his serum, which is characteristic of myorhythmia.
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Derivation and Validation of ICD-10 Codes for Identifying Incident Stroke JAMA Neurol. (IF 20.4) Pub Date : 2024-07-01 Jesse A. Columbo, Natalie Daya, Lisandro D. Colantonio, Zhixin Wang, Kathryn Foti, Hyacinth I. Hyacinth, Michelle C. Johansen, Rebecca Gottesman, Phillip P. Goodney, Virginia J. Howard, Paul Muntner, Andrea L. C. Schneider, Elizabeth Selvin, Caitlin W. Hicks
ImportanceClaims data with International Statistical Classification of Diseases, Tenth Revision (ICD-10) codes are routinely used in clinical research. However, the use of ICD-10 codes to define incident stroke has not been validated against expert-adjudicated outcomes in the US population.ObjectiveTo develop and validate the accuracy of an ICD-10 code list to detect incident stroke events using Medicare
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Slowing Down-A Family's Experience With ALS. JAMA Neurol. (IF 20.4) Pub Date : 2024-06-24 Andrea M Shamaskin-Garroway, Joel Shamaskin
This essay discusses the author’s experience after her father was diagnosed with amyotrophic lateral sclerosis.
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Sleep, 24-Hour Activity Rhythms, and Subsequent Amyloid-β Pathology JAMA Neurol. (IF 20.4) Pub Date : 2024-06-24 Phuong Thuy Nguyen Ho, Sanne J. W. Hoepel, Maria Rodriguez-Ayllon, Annemarie I. Luik, Meike W. Vernooij, Julia Neitzel
ImportanceSleep disturbances are common among older adults and have been associated with the development of Alzheimer disease (AD), such as amyloid-β (Aβ) pathology. For effective AD prevention, it is essential to pinpoint the specific disturbances in sleep and the underlying 24-hour activity rhythms that confer the highest risk of Aβ deposition.ObjectiveTo determine the associations of 24-hour activity
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Circadian Motor Improvement in MS and Core Body Temperature Dipping JAMA Neurol. (IF 20.4) Pub Date : 2024-06-24 Milan Nigam, Alain Créange, Smaranda Leu-Semenescu
This case report describes a man with multiple sclerosis and insomnia who noticed improved motor function during nocturnal awakenings compared with daytime.
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Recurrent Ischemic Stroke in Patients With Atrial Fibrillation While Receiving Oral Anticoagulants JAMA Neurol. (IF 20.4) Pub Date : 2024-06-24 Mette Foldager Hindsholm, Luis Alberto García Rodríguez, Axel Brandes, Jesper Hallas, Birgit Bjerre Høyer, Sören Möller, Mahmut Edip Gurol, Claus Ziegler Simonsen, David Gaist
ImportancePatients with atrial fibrillation (AF) can have an ischemic stroke (IS) despite oral anticoagulant (OAC) treatment. Knowledge regarding the association between OAC discontinuation and the subsequent risk of recurrent IS in patients with AF is limited.ObjectivesTo determine the risk of recurrent IS in patients with AF receiving OAC and to evaluate the association between OAC discontinuation
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Parental History of Memory Impairment and β-Amyloid in Cognitively Unimpaired Older Adults JAMA Neurol. (IF 20.4) Pub Date : 2024-06-17 Mabel Seto, Timothy J. Hohman, Elizabeth C. Mormino, Kathryn V. Papp, Rebecca E. Amariglio, Dorene M. Rentz, Keith A. Johnson, Aaron P. Schultz, Reisa A. Sperling, Rachel F. Buckley, Hyun-Sik Yang
ImportanceStudies have suggested that maternal history of late-onset Alzheimer disease, but not paternal, predisposes individuals to higher brain β-amyloid (Aβ) burden, reduced brain metabolism, and lower gray matter volumes.ObjectiveTo characterize maternal vs paternal history of memory impairment in terms of brain Aβ-positron emission tomography (Aβ-PET) and baseline cognition among a large sample
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Angiotensin Receptor Blockers for Hypertension and Risk of Epilepsy JAMA Neurol. (IF 20.4) Pub Date : 2024-06-17 Xuerong Wen, Marianne N. Otoo, Jie Tang, Todd Brothers, Kristina E. Ward, Nicole Asal, Kimford J. Meador
ImportanceAnimal and human studies have suggested that the use of angiotensin receptor blockers (ARBs) may be associated with a lower risk of incident epilepsy compared with other antihypertensive medications. However, observational data from the US are lacking.ObjectiveTo evaluate the association between ARB use and epilepsy incidence in subgroups of US patients with hypertension.Design, Setting,
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Medical Forecasting—A Skill Set Worthy of Attention JAMA Neurol. (IF 20.4) Pub Date : 2024-06-17 Claire J. Creutzfeldt, Robert G. Holloway
This Viewpoint discusses the importance of developing medical forecasting skills to improve clinician/patient/family communications regarding prognosis.
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Acetaminophen and Ibuprofen in Pediatric Central Nervous System Malaria JAMA Neurol. (IF 20.4) Pub Date : 2024-06-10 Gretchen L. Birbeck, Karl B. Seydel, Suzanna Mwanza, Derby Tembo, Moses Chilombe, Arthur Watts, Ifunanya Ume-Ezeoke, Manoj Mathews, Archana A. Patel, Musaku Mwenechanya, Paul Pensulo, Michael P. McDermott
ImportanceA third of children who survive malaria with neurological involvement (central nervous system [CNS] malaria) develop sequelae. A higher maximum temperature (Tmax) and seizures are risk factors for sequelae.ObjectiveTo compare aggressive antipyretic therapy using scheduled acetaminophen and ibuprofen vs usual care with acetaminophen alone given only for a temperature of 38.5 °C or higher.Design
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Bilateral Calcification of the Meckel Cave Causing Hemicrania Continua JAMA Neurol. (IF 20.4) Pub Date : 2024-06-10 Cristian Eduardo Navarro
This case report describes a woman with bilateral orbital and frontal throbbing pain with stabbing exacerbations and dystrophic calcification of dura mater and arachnoid granulations.
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Tau Positron Emission Tomography for Predicting Dementia in Individuals With Mild Cognitive Impairment JAMA Neurol. (IF 20.4) Pub Date : 2024-06-10 Colin Groot, Ruben Smith, Lyduine E. Collij, Sophie E. Mastenbroek, Erik Stomrud, Alexa Pichet Binette, Antoine Leuzy, Sebastian Palmqvist, Niklas Mattsson-Carlgren, Olof Strandberg, Hanna Cho, Chul Hyoung Lyoo, Giovanni B. Frisoni, Debora E. Peretti, Valentina Garibotto, Renaud La Joie, David N. Soleimani-Meigooni, Gil Rabinovici, Rik Ossenkoppele, Oskar Hansson
ImportanceAn accurate prognosis is especially pertinent in mild cognitive impairment (MCI), when individuals experience considerable uncertainty about future progression.ObjectiveTo evaluate the prognostic value of tau positron emission tomography (PET) to predict clinical progression from MCI to dementia.Design, Setting, and ParticipantsThis was a multicenter cohort study with external validation
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Type 1 Myocardial Infarction in Patients With Acute Ischemic Stroke JAMA Neurol. (IF 20.4) Pub Date : 2024-06-03 Christian H. Nolte, Regina von Rennenberg, Simon Litmeier, David M. Leistner, Kristina Szabo, Stefan Baumann, Annerose Mengel, Dominik Michalski, Timo Siepmann, Stephan Blankenberg, Gabor C. Petzold, Martin Dichgans, Hugo Katus, Burkert Pieske, Vera Regitz-Zagrosek, Tim Bastian Braemswig, Ida Rangus, Amra Pepic, Eik Vettorazzi, Andreas M. Zeiher, Jan F. Scheitz, Karl Wegscheider, Ulf Landmesser, Matthias
ImportanceElevated values of high-sensitivity cardiac troponin (hs-cTn) are common in patients with acute ischemic stroke and are associated with poor prognosis. However, diagnostic and therapeutic implications in patients with ischemic stroke remain unclear.ObjectiveTo identify factors indicative of myocardial infarction (MI) in patients with acute ischemic stroke and hs-cTn elevation. The primary
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Temperature Control After Cardiac Arrest—A Rational Approach JAMA Neurol. (IF 20.4) Pub Date : 2024-06-03 Daniel S. Harrison, David M. Greer
This Viewpoint discusses hypothermic temperature control for neuroprotection among survivors of out-of-hospital cardiac arrest and offers a rational approach to treating such patients as investigations continue.
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Time From Hospital Arrival Until Endovascular Thrombectomy and Patient-Reported Outcomes in Acute Ischemic Stroke. JAMA Neurol. (IF 20.4) Pub Date : 2024-06-03 Raed A Joundi, Eric E Smith, Aravind Ganesh, Raul G Nogueira, Ryan A McTaggart, Andrew M Demchuk, Alexandre Y Poppe, Jeremy L Rempel, Thalia S Field, Dar Dowlatshahi, Jim Sahlas, Richard Swartz, Ruchir Shah, Eric Sauvageau, Volker Puetz, Frank L Silver, Bruce Campbell, René Chapot, Michael Tymianski, Mayank Goyal, Michael D Hill
The time-benefit association of endovascular thrombectomy (EVT) in ischemic stroke with patient-reported outcomes is unknown.
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Status Epilepticus Identification and Treatment Among Emergency Medical Services Agencies. JAMA Neurol. (IF 20.4) Pub Date : 2024-06-03 Andrew J Wood, James F Burke, Daniel H Lowenstein, Elan L Guterman
This cross-sectional study examines the association between unidentified status epilepticus and prehospital benzodiazepine treatment.
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Early vs Late Anticoagulation in Minor, Moderate, and Major Ischemic Stroke With Atrial Fibrillation: Post Hoc Analysis of the ELAN Randomized Clinical Trial. JAMA Neurol. (IF 20.4) Pub Date : 2024-05-28 Martina B Goeldlin, Arsany Hakim, Mattia Branca, Stefanie Abend, Markus Kneihsl, Waldo Valenzuela Pinilla, Sabine Fenzl, Beata Rezny-Kasprzak, Roman Rohner, Daniel Strbian, Maurizio Paciaroni, Goetz Thomalla, Patrik Michel, Krassen Nedeltchev, Thomas Gattringer, Else Charlotte Sandset, Leo Bonati, Diana Aguiar de Sousa, P N Sylaja, George Ntaios, Masatoshi Koga, Zuzana Gdovinova, Robin Lemmens, Natan
Whether infarct size modifies the treatment effect of early vs late direct oral anticoagulant (DOAC) initiation in people with ischemic stroke and atrial fibrillation is unknown.
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Time Windows Between Symptom Onset and Treatment-An Outdated Myth. JAMA Neurol. (IF 20.4) Pub Date : 2024-05-28 Louis R Caplan
This Viewpoint discusses how time windows between symptom onset and treatment have evolved and why more factors need to be considered.
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Immediate- or Delayed-Intensive Statin in Acute Cerebral Ischemia: The INSPIRES Randomized Clinical Trial. JAMA Neurol. (IF 20.4) Pub Date : 2024-05-28 Ying Gao, Lingling Jiang, Yuesong Pan, Weiqi Chen, Jing Jing, Chunjuan Wang, S Claiborne Johnston, Pierre Amarenco, Philip M Bath, Yingying Yang, Tingting Wang, Shangrong Han, Xia Meng, Jinxi Lin, Xingquan Zhao, Liping Liu, Jinguo Zhao, Ying Li, Yingzhuo Zang, Shuo Zhang, Hongqin Yang, Jianbo Yang, Yuanwei Wang, Dali Li, Yanxia Wang, Dongqi Liu, Guangming Kang, Yongjun Wang, Yilong Wang
Comparisons are limited for immediate-intensive and delayed-intensive statin for secondary stroke prevention and neuroprotection in patients with acute mild ischemic stroke or transient ischemic attack (TIA) from atherosclerosis.
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Isolated Diffuse Precentral Gyrus Signals in Creutzfeldt-Jakob Disease. JAMA Neurol. (IF 20.4) Pub Date : 2024-05-28 Zhongyun Chen, Zhen Wang, Liyong Wu
This case report describes a woman with Creutzfeldt-Jakob disease with findings largely confined to the right precentral gyrus on initial imaging.
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Early Access to First-Seizure Clinics, Subsequent Outcomes, and Factors Associated With Attendance JAMA Neurol. (IF 20.4) Pub Date : 2024-05-23 Yingtong Li, Tianrui Ren, Michael Burgess, Zhibin Chen, Patrick W. Carney, Terence J. O’Brien, Patrick Kwan, Emma Foster
ImportanceFirst-seizure clinics (FSCs) aim to deliver prompt specialist care to patients with new-onset undifferentiated seizure events.ObjectiveTo determine whether FSC attendance and time to FSC are associated with subsequent health care utilization and mortality and to investigate factors associated with FSC nonattendance.Design, Setting, and ParticipantsThis was a record-linkage, retrospective
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Contemporary Prestroke Dual Antiplatelet Use and Symptomatic Intracerebral Hemorrhage Risk After Thrombolysis JAMA Neurol. (IF 20.4) Pub Date : 2024-05-20 Teng J. Peng, Lee H. Schwamm, Gregg C. Fonarow, Ameer E. Hassan, Michelle Hill, Steven R. Messé, Fatima Coronado, Guido J. Falcone, Richa Sharma
ImportanceIntravenous alteplase (IV-tPA) can be administered to patients with acute ischemic stroke but is associated with symptomatic intracerebral hemorrhage (sICH). It is unclear if patients taking prestroke dual antiplatelet therapy (DAPT) are at higher risk of sICH.ObjectiveTo determine the associated risk of sICH in patients taking prestroke dual antiplatelet therapy receiving alteplase for acute
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Effect of Sleep Restriction on Adolescent Cognition by Adiposity JAMA Neurol. (IF 20.4) Pub Date : 2024-05-20 Lindsay M. Stager, Caroline S. Watson, Edwin W. Cook, Aaron D. Fobian
ImportancePediatric obesity is associated with impaired cognitive function; however, the mechanisms underlying this association demand assessment. Sleep may be a relevant moderator, as poor sleep predicts both increased adiposity and impaired cognitive function.ObjectiveTo determine the effects of adiposity and sleep on adolescent cognitive function.Design, Setting, and ParticipantsThis single-blind
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Antithrombotic Treatment for Cervical Artery Dissection: A Systematic Review and Individual Patient Data Meta-Analysis. JAMA Neurol. (IF 20.4) Pub Date : 2024-05-13 Josefin E Kaufmann, Eric L Harshfield, Henrik Gensicke, Susanne Wegener, Patrik Michel, Georg Kägi, Krassen Nedeltchev, Lars Kellert, Sverre Rosenbaum, Christian H Nolte, Hanne Christensen, Marcel Arnold, Philippe Lyrer, Christopher Levi, Philip M Bath, Stefan T Engelter, Christopher Traenka, Hugh S Markus
Cervical artery dissection is the most common cause of stroke in younger adults. To date, there is no conclusive evidence on which antithrombotic therapy should be used to treat patients.
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Zoey's First Haircut. JAMA Neurol. (IF 20.4) Pub Date : 2024-05-13 Eunice Stallman
This essay describes the author’s experience with her daughter’s brain cancer and her reflections on her responsibilities as a physician.
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Expanding Clinical Spectrum of Anti-GQ1b Antibody Syndrome JAMA Neurol. (IF 20.4) Pub Date : 2024-05-13 Sun-Uk Lee, Hyo-Jung Kim, Jeong-Yoon Choi, Kwang-Dong Choi, Ji-Soo Kim
ImportanceThe discovery of the anti-GQ1b antibody has expanded the nosology of classic Miller Fisher syndrome to include Bickerstaff brainstem encephalitis, Guillain-Barré syndrome with ophthalmoplegia, and acute ophthalmoplegia without ataxia, which have been brought under the umbrella term anti-GQ1b antibody syndrome. It seems timely to define the phenotypes of anti-GQ1b antibody syndrome for the
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Staged Bilateral MRI-Guided Focused Ultrasound Subthalamotomy for Parkinson Disease JAMA Neurol. (IF 20.4) Pub Date : 2024-05-13 Raúl Martínez-Fernández, Elena Natera-Villalba, Rafael Rodríguez-Rojas, Marta del Álamo, Jose A. Pineda-Pardo, Ignacio Obeso, Pasqualina Guida, Tamara Jiménez-Castellanos, Diana Pérez-Bueno, Alicia Duque, Jorge U. Mañez-Miró, Carmen Gasca-Salas, Michele Matarazzo, Fernando Alonso-Frech, Jose A. Obeso
ImportanceUnilateral magnetic resonance imaging (MRI)–guided focused ultrasound subthalamotomy (FUS-STN) improves cardinal motor features among patients with asymmetrical Parkinson disease (PD). The feasibility of bilateral FUS-STN is as yet unexplored.ObjectiveTo assess the safety and effectiveness of staged bilateral FUS-STN to treat PD.Design, Setting, and ParticipantsThis prospective, open-label
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Ghrelin for Neuroprotection in Post-Cardiac Arrest Coma: A Randomized Clinical Trial. JAMA Neurol. (IF 20.4) Pub Date : 2024-05-06 Sjoukje Nutma, Albertus Beishuizen, Walter M van den Bergh, Norbert A Foudraine, Joost le Feber, P Margreet G Filius, Alexander D Cornet, Job van der Palen, Michel J A M van Putten, Jeannette Hofmeijer
Out-of-hospital cardiac arrest survival rates have markedly risen in the last decades, but neurological outcome only improved marginally. Despite research on more than 20 neuroprotective strategies involving patients in comas after cardiac arrest, none have demonstrated unequivocal evidence of efficacy; however, treatment with acyl-ghrelin has shown improved functional and histological brain recovery
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Distinct Magnetic Resonance Imaging in a Child With a TACO1 Variant. JAMA Neurol. (IF 20.4) Pub Date : 2024-05-06 Maria Neimann Herskind, Jakob Bie Granild-Jensen, Mette Thorup Bendixen
This case report describes a unique magnetic resonance imaging result in a young boy with a TACO1 variant.