Recent genetic studies on Alzheimer’s disease (AD) have brought microglia under the spotlight, as loci associated with AD risk are enriched in genes expressed in microglia. Several of these genes have been recognized for their central roles in microglial functions. Increasing evidence suggests that SHIP1, the protein encoded by the AD-associated gene INPP5D, is an important regulator of microglial

To the editor The APOE gene is a known genetic risk factor for neurodegeneration and cardiovascular disease (CVD) [1, 2]. Beyond the known effects of APOE ε2 and APOE ε4, several rare and protective APOE variants (R154S Christchurch (APOECh), V236E Jacksonville, and R251G) have been identified recently [3, 4]. The ultra-rare APOECh mutation (NM_000041.4(APOE):c.460C > A (p.Arg154Ser)), also known as

Social connectedness is associated with slower cognitive decline among older adults. Recent research suggests that distinct aspects of social networks may have differential effects on cognitive resilience, but few studies analyze brain structure.

Heart rate (HR) fragmentation indices quantify breakdown of HR regulation and are associated with atrial fibrillation and cognitive impairment. Their association with brain magnetic resonance imaging (MRI) markers of small vessel disease is unexplored.

This letter is in response to “Associations of blood cell indices and anemia with risk of incident dementia: A prospective cohort study of 313,448 participants” by Qiang and colleagues.1 Brain magnetic resonance imaging (MRI) is an important tool for understanding brain structure, offering an opportunity to evaluate the possible mechanisms underlying dementia progression.2, 3 In their recent article

We thank Dr Zhang and Dr Zhou for their thoughtful comments to our work and appreciate the opportunity to address the two important issues they raised. First, Dr Zhang and Dr Zhou pointed out that our study, while accounting for the history of stroke, might not have adequately addressed other chronic brain disorders that could potentially influence brain structure and function. However, given the vast

China has the world's largest number of older adults with cognitive impairment (CI). We aimed to examine secular trends in the prevalence of CI in China from 2002 to 2018.

Lackner et al. found science overconfidence peaks at intermediate levels of knowledge. Those with intermediate knowledge also hold the most negative attitudes toward scientists. In doing so, they provide a novel measure of overconfidence that measures the tendency to give incorrect answers as opposed to answering, ‘I don’t know’.

In their study "Initiation and Duration of Breastfeeding in the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs Study," Gerard et al. carefully studied the differences in breastfeeding for women with and without epilepsy.1 Women with epilepsy face many challenges; for mothers with epilepsy, questions arise surrounding breastfeeding. For instance, "If I am taking a medication

An 86-year-old man with hypertension, hyperlipidemia, type II diabetes, and atrial fibrillation (anticoagulated with low-dose rivaroxaban) presented with a 24-hour weakness of his left limbs, with difficulty in performing daily tasks.

A 44-year-old man with alcohol use disorder presented with unresponsiveness. Toxicology was positive for cocaine and fentanyl. Brain MRI showed multiple foci of restricted diffusion and extensive edema in the cerebellum, hippocampus, and basal ganglia (Figure). Imaging findings suggested cerebellar, hippocampal, and basal nuclei transient edema with restricted diffusion (CHANTER) syndrome, a rare radiographic

The broad differential diagnosis associated with progressive subacute encephalopathy can be intimidating, especially in a young, pregnant woman. In this case, a 24-year-old woman at 21 weeks of gestation presented with persistent, drug-resistant fronto-parietal headache, with subsequent progressive development of psychomotor lentification and inappropriate behavior. Physical examination was normal

Objectives Anti-IgLON5 disease is a recently discovered neurologic disorder combining autoimmunity and neurodegeneration. Core manifestations include sleep disorders, bulbar symptoms, gait abnormalities, and cognitive dysfunction, but other presentations have been reported. Hallmarks are autoantibodies targeting the neuronal surface protein IgLON5, a strong human leukocyte antigen system Class II association

Background and Objectives There are limited validated biomarkers in Parkinson disease (PD) which substantially hinders the ability to monitor disease progression and consequently measure the efficacy of disease-modifying treatments. Imaging biomarkers, such as vesicular monoamine transporter type 2 (VMAT2) PET, enable enhanced diagnostic accuracy and detect early neurodegenerative changes associated

Background and Objectives Prior observational studies for autoimmune encephalitis (AE) have mostly focused on outcomes after acute immunotherapies with better outcomes associated with earlier immunotherapy use. However, the impact of long-term immunotherapy and its association with clinical relapse is not well known. Methods We conducted a retrospective study of consecutive patients meeting published

Background and Objectives It has been suggested that higher triglyceride levels were associated with a lower risk of Alzheimer disease. This study aimed to examine the association of triglycerides with dementia and cognition change in community-dwelling older adults. Methods This prospective longitudinal study used data from the Aspirin in Reducing Events in the Elderly (ASPREE) randomized trial of

Background and Objectives To examine the association of whole grain consumption and longitudinal change in global cognition, perceptual speed, and episodic memory by different race/ethnicity. Methods We included 3,326 participants from the Chicago Health and Aging Project who responded to a Food Frequency Questionnaire (FFQ), with 2 or more cognitive assessments. Global cognition was assessed using

Background and Objectives Breastfeeding has important health benefits for both mother and child. We characterize breastfeeding initiation and duration in mothers with epilepsy relative to control mothers in a large prospective cohort. Methods The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a prospective, multicenter observational, US cohort study. Pregnant individuals

Background and Objectives We conducted a nationwide case-control study in Sweden to investigate the risk of sudden unexpected death in epilepsy (SUDEP) in relation to epilepsy duration, epilepsy type, and etiology in combination with occurrence and frequency of tonic-clonic seizures (TCS) and nocturnal TCS. Methods The study comprised 255 SUDEP cases and 1,148 epilepsy controls. Clinical information

Background and Objectives Epilepsy may result from various brain injuries, including stroke (ischemic and hemorrhagic), traumatic brain injury, and infections. Identifying shared common biological pathways and biomarkers of the epileptogenic process initiated by the different injuries may lead to novel targets for preventing the development of epilepsy. We systematically reviewed biofluid biomarkers

Background and Objectives Falls are a leading cause of head injury among older adults, but the risk of fall occurring after a head injury is less well-characterized. We sought to examine the association between head injury and subsequent risk of falls requiring hospital care among community-dwelling older adults. Methods This analysis included 13,081 participants in the Atherosclerosis Risk in Communities

Background and Objectives Predicting neurodevelopmental outcome for neonates with hypoxic-ischemic encephalopathy (HIE) is important for clinical decision-making, care planning, and parent communication. We examined the relationship between EEG background and neurodevelopmental outcome among children enrolled in a trial of erythropoietin or placebo for neonates with HIE treated with therapeutic hypothermia

Background and Objectives The association between socioeconomic status and acute ischemic stroke treatments remain uncertain, particularly in countries with universal health care systems. This study aimed to investigate the association between neighborhood-level material deprivation and the odds of receiving IV thrombolysis or thrombectomy for acute ischemic stroke within a single-payer, government-funded

Background and Objectives Trials of acute secondary prevention after minor stroke or transient ischemic attack (TIA), such as SOCRATES, POINT, and THALES, demonstrate a high initial rate of recurrence after ischemic events that drop quickly to a lower rate, suggesting a transient vulnerable clinical state, which may call for different treatments than the subsequent stabilized state. A kinetic model

We sincerely thank Wolfe et al. for the comments. The low rate of large artery atherosclerotic disease (LAD) in our atrial fibrillation (AF) cohort1 echoed our other study that among ischemic strokes, the proportion of intracranial atherosclerotic disease declined from 23.3% to 8.8% from 2004 to 2018 in Hong Kong.2 This difference may explain the disparity in LAD rates because the cohort of minor strokes/TIA

We applaud Ip et al.1 for their investigation of outcomes associated with patients with atrial fibrillation who had an ischemic stroke while on a direct oral anticoagulant (DOAC).

In a population-based, propensity score-weighted, retrospective cohort study, "Association of Alternative Anticoagulation Strategies and Outcomes in Patients With Ischemic Stroke While Taking a Direct Oral Anticoagulant," Ip et al. retrospectively identified 2,337 patients with nonvalvular atrial fibrillation who had an ischemic stroke while on a direct oral anticoagulant (DOAC) admitted to public

The evaluation of patients with disseminated processes with CNS and osseous involvement is often challenging. A 22-year-old healthy man developed left-sided weakness, paresthesias, and neck pain over several weeks. On clinical examination, he was noted to have decreased right eye visual acuity, left-sided pyramidal weakness and numbness, and bilateral hyperreflexia. MRI revealed multifocal widespread

An 80-year-old man from the Brazilian Midwest presented with tetraparesis with brachial predominance and hyperreflexia with 1 year of evolution. In investigation, cervical MRI showed intramedullary cystic formation (4.6 x 1.7 x 1.3 cm), and brain MRI was suggestive of neurocysticercosis (Figure 1). CT of the chest, abdomen, and pelvis and endoscopy and colonoscopy were normal. CSF showed hyperproteinorachia

A 61-year-old man with no neurologic history presented with 2 episodes of super-refractory left-sided focal motor status epilepticus 5 months apart. He developed a prolonged postictal left hemiparesis each time that improved over several weeks. He also experienced recurrent and transient left hemiplegia independently of any seizure after hypovolemic and septic shocks.

A 74-year-old woman with probable cerebral amyloid angiopathy was found unresponsive. Initial head CT showed a frontoparietal hematoma with intraventricular extension, edema, and mass effect on the right lateral ventricle. She was intubated, and hyperosmolar therapy was initiated. CT 2 days later showed a new hypodensity in the right frontal lobe extending from the lateral ventricle to the cortical

The integration of natural language processing (NLP) tools into neurology workflows has the potential to significantly enhance clinical care. However, it is important to address the limitations and risks associated with integrating this new technology. Recent advances in transformer-based NLP algorithms (e.g., GPT, BERT) could augment neurology clinical care by summarizing patient health information

Autoimmune encephalitides (AE) are a group of immune-mediated disorders affecting a range of CNS functions. These disorders are characterized by subacute onset of rapidly progressive memory deficits, altered mental status, and/or psychiatric symptoms.1,2 Additional neurologic symptoms can include seizures, abnormal movements, sleep disturbances, and autonomic dysfunction.1,2

Although there is an extensive literature on variable associations of different lipids with different health outcomes, dyslipidemia is more commonly viewed as a single entity. The literature on associations between dementia and lipids has been to a certain degree conflicting.1 U-shaped relations with dementia have been reported for low-density lipoprotein (LDL), high-density lipoprotein, and total

Stroke recurrence risk is highly concentrated in the period immediately after the index event. Why? What is the basis for the extreme clustering of recurrent events into this narrow sliver of time?

Alpha-synuclein (α-syn) aggregation into proteinaceous intraneuronal inclusions, called Lewy bodies (LBs), is the neuropathological hallmark of Parkinson’s disease (PD) and related synucleinopathies. However, the exact role of α-syn inclusions in PD pathogenesis remains elusive. This lack of knowledge is mainly due to the absence of optimal α-syn-based animal models that recapitulate the different

Idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) is associated with prodromal Parkinson's disease (PD), but the mechanisms linking phenoconversion of iRBD to PD have not yet been clarified. Considering the association between mitochondrial dysfunction and sleep disturbances in PD, we explored mitochondrial activity in fibroblasts derived from iRBD patients to identify a biochemical

Clinical presentation and progression dynamics are variable in patients with Parkinson's disease (PD). Disease course mapping is an innovative disease modelling technique that summarizes the range of possible disease trajectories and estimates dimensions related to onset, sequence, and speed of progression of disease markers.

Benign adult familial myoclonic epilepsy (BAFME) is an autosomal dominant disorder characterized by cortical tremors and seizures. Six types of BAFME, all caused by pentanucleotide repeat expansions in different genes, have been reported. However, several other BAFME cases remain with no molecular diagnosis.

Belova E, Semenova U, Gamaleya A, Tomskiy A, Sedov A. Excessive α-β Oscillations Mark Enlarged Motor Sign Severity and Parkinson's Disease Duration. Mov Disord. 2023 Jun;38(6):1027–1035. doi: 10.1002/mds.29393. Epub 2023 Apr 6. PMID: 37025075. The affiliation numbers were assigned in wrong order. The right affiliations for the authors are as follows: Elena Belova1, Ulia Semenova1, Anna Gamaleya2, Alexey

Patients with Parkinson's disease (PD) have consistently demonstrated brain structure abnormalities, indicating the presence of shared etiological and pathological processes between PD and brain structures; however, the genetic relationship remains poorly understood.

Identification of psychosocial-behavioral phenotypes to understand within-group heterogeneity in risk and resiliency to Alzheimer's disease (AD) within Black/African American and Hispanic/Latino older adults is essential for the implementation of precision health approaches.

While Parkinson’s disease remains clinically defined by cardinal motor symptoms resulting from nigrostriatal degeneration, it is now appreciated that Parkinson’s disease commonly consists of multiple pathologies, but it is unclear where these co-pathologies occur early in disease and whether they are responsible for the nigrostriatal degeneration. For the past number of years, we have been studying

It is increasingly evident that the association of glycans with the prion protein (PrP), a major post-translational modification, significantly impacts the pathogenesis of prion diseases. A recent bioassay study has provided evidence that the presence of PrP glycans decreases spongiform degeneration (SD) and disease-related PrP (PrPD) deposition in a murine model. We challenged (PRNPN181Q/197Q) transgenic

A new study indicates that African American people with multiple sclerosis have higher markers of humoral disease pathology than white people with multiple sclerosis. However, apparent differences in pathophysiology between ethnic groups cannot be fully interpreted without more comprehensive studies that examine the effects of social inequality on disease.

A 76-year-old woman with metastatic melanoma presented with a 3-day history of progressive diplopia approximately 3 weeks after her first ipilimumab and nivolumab therapy. Neurologic examination demonstrated bilateral nonfatigable ptosis and severe bilateral ophthalmoplegia without evidence of bulbar or neck weakness. Creatine kinase (CK) was 5213 U/L (normal:26-192). AChR and MuSK antibodies were

A 70-year-old man with a history of hypertension presented with sudden-onset dizziness, binocular horizontal diplopia, and crooked mouth. His blood pressure was 200/120 mm Hg. Neurologic examination revealed left internuclear ophthalmoplegia (INO) and left-sided peripheral facial palsy (Video 1). His pupillary accommodation reflex and binocular convergence reflection were intact. Head CT and susceptibility-weighted

A 68-year-old woman with a history of diabetes mellitus type 2, depression, and migraines presented with painless, acute, consecutive vision loss affecting the right eye for 1 week and the left eye for 2 weeks. Neuro-ophthalmic examination was notable for visual acuities of finger-counting peripherally, a central scotoma, anterior uveitis, vitritis, and placoid macular pigmentary changes in each eye

Background and Objectives To determine the relevance of minor neuropsychological deficits (MNPD) in patients with subjective cognitive decline (SCD) with regard to CSF levels of Alzheimer disease (AD) biomarkers, cognitive decline, and clinical progression to mild cognitive impairment (MCI). Methods This study included patients with clinical SCD and SCD-free, healthy control (HC) participants with

Background and Objectives The associations of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) with dementia risk in later life may be complex, and few studies have sufficient data to model nonlinearities or adequately adjust for statin use. We evaluated the observational associations of HDL-C and LDL-C with incident dementia in a large and well-characterized

Background and Objectives Patients with Alzheimer disease (AD) frequently suffer from various sleep disturbances. However, how sleep disturbance is associated with AD and its progression remains poorly investigated. We investigated the association of total sleep time with brain amyloid and tau burden, cortical atrophy, cognitive dysfunction, and their longitudinal changes in the AD spectrum. Methods

Background and Objectives Headache disorders are among the leading causes of disability worldwide. While an association between adverse childhood experiences and primary headaches has been reported, the pooled magnitude across studies and pathways of the association are unknown. Our objectives were (1) to estimate the pooled effect of ≥1 adverse childhood experience (ACE) on primary headache disorders

Background and Objectives Idiopathic intracranial hypertension (IIH) is associated with obesity; however, there is a lack of clinical consensus on how to manage weight in IIH. The aim of this systematic review was to evaluate weight loss interventions in people with IIH to determine which intervention is superior in terms of weight loss, reduction in intracranial pressure (ICP), benefit to visual and

Background and Objectives The optimal methods for predicting early infarct growth rate (EIGR) in acute ischemic stroke with a large vessel occlusion (LVO) have not been established. We aimed to study the factors associated with EIGR, with a focus on the collateral circulation as assessed by the hypoperfusion intensity ratio (HIR) on perfusion imaging, and determine whether the associations found are

Background and Objectives Despite notable advances in genetic understanding of stroke recovery, most studies focus only on candidate genes. To date, only 2 genome-wide association studies (GWAS) have focused on stroke outcomes, but they were limited to the modified Rankin Scale (mRS). The mRS maps poorly to biological processes. Therefore, we performed a GWAS to discover single nucleotide polymorphisms

Background and Objectives Spinal muscular atrophy (SMA) is a progressive neuromuscular disorder associated with continuous motor function loss and complications, such as scoliosis and contractures. Understanding the natural history of SMA is key to demonstrating the long-term outcomes of SMA treatments. This study reviews the natural history of motor function, scoliosis, and contractures in patients

Background and Objectives Guillain-Barré syndrome (GBS) has been inconsistently associated with some coronavirus disease 2019 (COVID-19) vaccines. We aimed to quantify the risk of GBS according to the type of COVID-19 vaccine in a large population. Methods Using the French National Health Data System linked to the COVID-19 vaccine database, we analyzed all individuals aged 12 years or older admitted

Background and Objectives Advanced therapies (ATs; deep brain stimulation [DBS] or pump therapies: continuous subcutaneous apomorphine infusion [CSAI], levodopa/carbidopa intestinal gel [LCIG]) are used in later stages of Parkinson disease (PD). However, decreasing efficacy over time and/or side effects may require an AT change or combination in individual patients. Current knowledge about changing