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Teaching Video NeuroImage: Diagonal Saccade Testing Can Localize Slow Saccades Neurology (IF 9.9) Pub Date : 2023-12-05 Usman F. Ashraf, Chao Wang, Gabor M. Halmagyi
A 24-year-old woman presented with blurry vision. Examination showed left eye esotropia and slow horizontal saccades bilaterally. Vertical saccade velocity was normal, and there was a "round the houses" sign on diagonal saccades (Video 1). Video head impulse testing (vHIT) reduced gains in the posterior canals bilaterally with relative preservation of anterior and horizontal canal function bilaterally
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Teaching Video NeuroImage: Rectus Femoris Muscle Fibrosis Presenting as Abnormal Gait in Childhood With a Positive Ely Maneuver Neurology (IF 9.9) Pub Date : 2023-12-05 Fatima Al-Maadid, Faisal Hadid, Ali Mohamedzain, Farhan Ali, Farouq Thabet
A 7-year-old boy presented with abnormal gait since age 3 years. Examination showed left-sided limping with external rotation. On passive flexion of the knees while the patient lied prone, the left heel could not reach the buttock and the left hip rose up (Video 1). This indicated a positive Ely test indicating limited flexibility of the rectus femoris muscle.1 Neurological examination was otherwise
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Teaching NeuroImage: Bing-Neel Syndrome Mimicking a Meningioma With a Frontal Subcutaneous Lesion Neurology (IF 9.9) Pub Date : 2023-12-05 Ge, R., Wang, J., Wang, S., Li, J.
A 66-year-old woman presented with dizziness and anemia. Brain MRI revealed an intradural lesion with adjacent vasogenic edema in the right frontal and parietal lobes with a dural tail sign and an arc-shaped homogenously enhancing mass in the subcutaneous soft tissue of the frontal region (Figure 1). Differential diagnosis for this lesion included meningioma, glioma, CNS lymphoma, or autoimmune disorders
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Agreement Between Published Reference Resources for Neurofilament Light Chain Levels in People With Multiple Sclerosis Neurology (IF 9.9) Pub Date : 2023-12-05 Elias S. Sotirchos, Chen Hu, Matthew D. Smith, Hannah-Noelle Lord, Anna L. DuVal, Georgina Arrambide, Xavier Montalban, Katja Akgün, Tjalf Ziemssen, Robert T. Naismith, Carrie M. Hersh, Megan Hyland, Lauren B. Krupp, Jacqueline A. Nicholas, Robert A. Bermel, Ellen M. Mowry, Peter A. Calabresi, Kathryn C. Fitzgerald
Objectives To examine the agreement between published reference resources for neurofilament light chain (NfL) applied to a large population of people with multiple sclerosis (MS). Methods Six published reference resources were used to classify NfL in participants in the Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) network as elevated or normal and to derive age-specific
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Association of Blood-Based DNA Methylation Markers With Late-Onset Alzheimer Disease: A Potential Diagnostic Approach Neurology (IF 9.9) Pub Date : 2023-12-05 Blanca Acha, Jon Corroza, Javier Sánchez-Ruiz de Gordoa, Carolina Cabello, Maitane Robles, Iván Méndez-López, Mónica Macías, Sara Zueco, Miren Roldan, Amaya Urdánoz-Casado, Ivonne Jericó, Maria Elena Erro, Daniel Alcolea, Alberto Lleo, Idoia Blanco-Luquin, Maite Mendioroz, for the iBEAS Study Group
Background and Objectives There is an urgent need to identify novel noninvasive biomarkers for Alzheimer disease (AD) diagnosis. Recent advances in blood-based measurements of phosphorylated tau (pTau) species are promising but still insufficient to address clinical needs. Epigenetics has been shown to be helpful to better understand AD pathogenesis. Epigenetic biomarkers have been successfully implemented
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Association of Clinical and Neuroanatomic Factors With Response to Ventral Tegmental Area DBS in Chronic Cluster Headache Neurology (IF 9.9) Pub Date : 2023-12-05 Cheema, S., Ferreira, F., Parras, O., Lagrata, S., Kamourieh, S., Pakzad, A., Zrinzo, L., Matharu, M., Akram, H.
Background and Objectives Deep brain stimulation (DBS) of the ventral tegmental area (VTA) is a surgical treatment option for selected patients with refractory chronic cluster headache (CCH). We aimed to identify clinical and structural neuroimaging factors associated with response to VTA DBS in CCH. Methods This prospective observational cohort study examines consecutive patients with refractory CCH
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Quality of Life in Patients With Confirmed and Suspected Spinal CSF Leaks Neurology (IF 9.9) Pub Date : 2023-12-05 Victor Liaw, Morgan McCreary, Deborah I. Friedman
Background and Objectives Spontaneous intracranial hypotension (SIH) is a debilitating condition typically producing orthostatic headache limiting upright time. SIH is often difficult to diagnose and treat, negatively affecting quality of life (QoL) in patients with the disorder. We studied QoL in patients with confirmed and suspected SIH using standardized instruments, including suicidality. Methods
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Relationship Between Neonatal Brain Injury and Objective Measures of Head Trauma: A Case-Control Study Neurology (IF 9.9) Pub Date : 2023-12-05 Dunbar, M., Norris, A., Craig, B. T., Chaput, K., Mohammad, K., Cole, L., Esser, M. J., Caughey, A., Carlson, H., Kirton, A.
Background and Objectives Neonatal brain injury is a common and devastating diagnosis conferring lifelong challenges for children and families. The role of mechanical forces applied to the head, often referred to as "birth trauma," are often considered although evidence for this association is lacking. The objective of this study was to investigate the association between common types of neonatal brain
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Effectiveness of Yoga Intervention in Reducing Felt Stigma in Adults With Epilepsy: A Randomized Controlled Trial Neurology (IF 9.9) Pub Date : 2023-12-05 Kaur, K., Sharma, G., Dwivedi, R., Nehra, A., Parajuli, N., Upadhyay, A. D., Deepak, K. K., Jat, M. S., Ramanujam, B., Sagar, R., Mohanty, S., Tripathi, M.
Background and Objectives Persons with epilepsy are afflicted with comorbidities such as stigma, anxiety, and depression which have a significant impact on their quality of life. These comorbidities remain largely unaddressed in resource-limited countries. This randomized controlled trial (RCT) aimed to investigate whether yoga and psychoeducation were effective in reducing felt stigma (primary outcome)
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Altered Sleep Microarchitecture and Cognitive Impairment in Patients With Temporal Lobe Epilepsy Neurology (IF 9.9) Pub Date : 2023-12-05 Alex C. Bender, Afareen Jaleel, Kyle R. Pellerin, Sebastian Moguilner, Rani A. Sarkis, Sydney S. Cash, Alice D. Lam
Background and Objectives To investigate the spatiotemporal characteristics of sleep waveforms in temporal lobe epilepsy (TLE) and examine their association with cognition. Methods In this retrospective, cross-sectional study, we examined overnight EEG data from adult patients with TLE and nonepilepsy comparisons (NECs) admitted to the epilepsy monitoring unit at Mass General Brigham hospitals. Automated
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REM Sleep Behavior Disorder and Its Possible Prodromes in General Population: Prevalence, Polysomnography Findings, and Associated Factors Neurology (IF 9.9) Pub Date : 2023-12-05 Lee, W.-J., Baek, S.-H., Im, H.-J., Lee, S.-K., Yoon, J.-E., Thomas, R. J., Wing, Y.-K., Shin, C., Yun, C.-H.
Background and Objectives To evaluate the prevalence of REM sleep behavior disorder (RBD) and its possible prodromal conditions, isolated dream enactment behavior (DEB) and isolated REM without atonia (RWA), in a general population sample, and the factors associated with diagnosis and symptom frequency. Methods From a population-based prospective cohort in Korea, 1,075 participants (age 60.1 ± 7.0
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Measures of Aging Biology in Saliva and Blood as Novel Biomarkers for Stroke and Heart Disease in Older Adults Neurology (IF 9.9) Pub Date : 2023-12-05 Waziry, R., Gu, Y., Boehme, A. K., Williams, O. A.
Background and Objectives The role of aging biology as a novel risk factor and biomarker for vascular outcomes in different accessible body tissues such as saliva and blood remain unclear. We aimed to (1) assess the role of aging biology as a risk factor of stroke and heart disease among individuals of same chronologic age and sex and (2) compare aging biology biomarkers measured in different accessible
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Mediation Analyses of the Mechanisms by Which Socioeconomic Status, Comorbidity, Stroke Severity, and Acute Care Influence Stroke Outcome Neurology (IF 9.9) Pub Date : 2023-12-05 Anita Lindmark, Marie Eriksson, David Darehed
Background and Objectives Low socioeconomic status (SES) is associated with increased risk of death and disability after stroke, but interventional targets to minimize disparities remain unclear. We aim to assess the extent to which SES-based disparities in the association between low SES and death and dependency at 3 months after stroke could be eliminated by offsetting differences in comorbidity
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Teaching NeuroImage: Severe Amyloid-Related Imaging Abnormalities After Anti-{beta}-Amyloid Monoclonal Antibody Treatment Neurology (IF 9.9) Pub Date : 2023-12-05 Samuele Bonomi, Amjad Samara, Noah Balestra, Arjun Padalia, Tammie L. Benzinger, Peter Kang
A 74-year-old woman with mild Alzheimer disease joined a clinical trial of anti–amyloid-β therapy. Three weeks after receiving remternetug, a N3pH-Aβ monoclonal antibody, a scheduled brain MRI showed new periventricular and subcortical FLAIR hyperintensities (Figure, A) suggestive of mild amyloid-related imaging abnormalities (ARIA).1,2 Two weeks later, she was hospitalized for rapid cognitive and
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Enlarged Virchow-Robin Spaces Contributing to Ventriculomegaly in a 37-Year-Old Woman Neurology (IF 9.9) Pub Date : 2023-12-05 Caren M. Stuebe, Nancy M. Gonzalez, L. Gerard Toussaint
A 37-year-old woman with an 8-year history of asymptomatic giant tumefactive Virchow-Robin spaces (GTVRS) followed with annual MRI presented with new-onset skull base pain and nausea. MRI showed growth of cystic spaces in bilateral thalami and midbrain, with slight cerebral aqueduct narrowing and mild ventriculomegaly (Figure 1).
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MR Spectroscopy in a Patient With Isolated Brainstem Posterior Reversible Encephalopathy Syndrome Neurology (IF 9.9) Pub Date : 2023-12-05 Zerweck, L., Bombach, P., Hucker, S., Tabatabai, G., Ernemann, U., Bender, B.
A 34-year-old patient presented with visual disturbance, headache, and vomiting. Physical examination revealed severe hypertension (RRsystolic 240 mm Hg) with secondary organ manifestations (hypertensive cardiomyopathy, renal failure, and hypertensive retinopathy). MR imaging showed T2/fluid-attenuated inversion recovery hyperintensities in the cerebellar peduncles, pons, and medulla oblongata with
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Uric Acid: A Translational Journey in Cerebroprotection That Spanned Preclinical and Human Data Neurology (IF 9.9) Pub Date : 2023-12-05 Enrique C. Leira, Anna M. Planas, Anil K. Chauhan, Angel Chamorro
Uric acid (UA) is a strong endogenous antioxidant that neutralizes the toxicity of peroxynitrite and other reactive species on the neurovascular unit generated during and after acute brain ischemia. The realization that a rapid reduction of UA levels during an acute ischemic stroke was associated with a worse stroke outcome paved the way to investigate the value of exogenous UA supplementation to counteract
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Large Language Models in Neurology Research and Future Practice Neurology (IF 9.9) Pub Date : 2023-12-05 Michael F. Romano, Ludy C. Shih, Ioannis C. Paschalidis, Rhoda Au, Vijaya B. Kolachalama
Recent advancements in generative artificial intelligence, particularly using large language models (LLMs), are gaining increased public attention. We provide a perspective on the potential of LLMs to analyze enormous amounts of data from medical records and gain insights on specific topics in neurology. In addition, we explore use cases for LLMs, such as early diagnosis, supporting patient and caregivers
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Scalp Swelling, a Proxy for "Birth Trauma," Is Not Associated With Neonatal Brain Injury Neurology (IF 9.9) Pub Date : 2023-12-05 Bonifacio, S. L., de Vries, L. S.
The issue of so called "birth trauma" and its potential association with neonatal brain injury is incompletely explored in the literature but of interest to parents, obstetricians, pediatricians, neonatologists, child neurologists, and lawyers. The study presented by Dunbar et al.1 in this issue of Neurology® provides a method to address the potential relationship or causal association of external
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Simulating Equity for Stroke Outcomes: How Much Do We Stand to Gain From Reduction of Disparities Due to Socioeconomic Status? Neurology (IF 9.9) Pub Date : 2023-12-05 Regina Royan, Tracy E. Madsen
It is hard to imagine a world where inequities in stroke risk factors, incidence, and care do not exist. Numerous studies have shown that lower household income or socioeconomic status (SES) is associated with more severe strokes,1 worse access to care,2 and worse functional outcomes.3 Increased incidence of cardiovascular risk factors account for approximately half of the differences in short-term
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The Role of Deployment History on the Association Between Epilepsy and Traumatic Brain Injury in Post-9/11 Era U.S. Veterans. Neurology (IF 9.9) Pub Date : 2023-11-29 Amy K Henion,Chen-Pin Wang,Megan Amuan,Hamada H Altalib,Alan R Towne,Sidney R Hinds,Christine Baca,W Curt LaFrance,Anne C Van Cott,Jacob Kean,Ali Roghani,Eamonn Kennedy,Samin Panahi,Mary Jo V Pugh
BACKGROUND AND OBJECTIVES Traumatic brain injury (TBI) is a well-established epilepsy risk factor and is common among service members. Deployment related TBI, where combat/blast may be more common, may have different outcomes than non-deployment related TBI. This work examined associations of all TBI exposures (not just combat), and epilepsy, while adjusting for comorbidities associated with epilepsy
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Millions of Migraine Attacks, Many Answers, More Questions. Neurology (IF 9.9) Pub Date : 2023-11-29 Sarah A Friedman,Matthew S Robbins
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Simultaneous Comparisons of 25 Acute Migraine Medications Based on 10 Million Users' Self-Reported Records From a Smartphone Application. Neurology (IF 9.9) Pub Date : 2023-11-29 Chia-Chun Chiang,Xuemin Fang,Zsolt Horvath,Francois Cadiou,Alexandre Urani,Weijie Poh,Hiroto Narimatsu,Yu Cheng,David W Dodick
BACKGROUND Many acute treatment options exist for migraine. However, large-scale, head-to-head comparisons of treatment effectiveness from real-world patient experience reports are lacking. METHODS This is a retrospective analysis of 10,842,795 migraine attack records extracted from an e-diary smartphone application between June 30, 2014, and July 2, 2020. We analyzed 25 acute medications among seven
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Breastfeeding and Mothers With Epilepsy Neurology (IF 9.9) Pub Date : 2023-11-28 Steven Karceski, Helene Quinn
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
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Teaching Video NeuroImage: The Digiti Quinti Sign as the Sole Objective Sign of Mild Hemiparesis Neurology (IF 9.9) Pub Date : 2023-11-28 Julia Peris-Subiza, Sergio Vidal-Notari, Elisa Cuadrado-Godia, Angel Ois, Ana Rodriguez-Campello, Daniel Guisado-Alonso
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.
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Teaching NeuroImage: CHANTER Syndrome Neurology (IF 9.9) Pub Date : 2023-11-28 Beatriz Rizkallah Alves, Daniel B. Rubin
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
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Clinical Reasoning: A 24-Year-Old Pregnant Woman With Headache and Behavioral Change Progressing to Coma Neurology (IF 9.9) Pub Date : 2023-11-28 Catarina Bernardes, Ricardo Pires, Cláudia Farinha, João Lemos, Cláudia Lima, Sónia Batista
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
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In Vivo Measurement of Tau Depositions in Anti-IgLON5 Disease Using [18F]PI-2620 PET Neurology (IF 9.9) Pub Date : 2023-11-28 Theis, H., Bischof, G. N., Brüggemann, N., Dargvainiene, J., Drzezga, A., Grüter, T., Lewerenz, J., Leypoldt, F., Neumaier, B., Wandinger, K.-P., Ayzenberg, I., van Eimeren, T.
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
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Using 18F-AV-133 VMAT2 PET Imaging to Monitor Progressive Nigrostriatal Degeneration in Parkinson Disease Neurology (IF 9.9) Pub Date : 2023-11-28 Leah C. Beauchamp, Vincent Dore, Victor L. Villemagne, SanSan Xu, David Finkelstein, Kevin J. Barnham, Christopher Rowe
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
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Survival Analysis of Immunotherapy Effects on Relapse Rate in Pediatric and Adult Autoimmune Encephalitis Neurology (IF 9.9) Pub Date : 2023-11-28 Jennifer H. Yang, Emilie N. Liu, Linda Nguyen, Anastasie Dunn-Pirio, Jennifer S. Graves
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
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Association Between Triglycerides and Risk of Dementia in Community-Dwelling Older Adults: A Prospective Cohort Study Neurology (IF 9.9) Pub Date : 2023-11-28 Zhen Zhou, Joanne Ryan, Andrew M. Tonkin, Sophia Zoungas, Paul Lacaze, Rory Wolfe, Suzanne G. Orchard, Anne M. Murray, John J. McNeil, Chenglong Yu, Gerald F. Watts, Sultana Monira Hussain, Lawrence J. Beilin, Michael E. Ernst, Nigel Stocks, Robyn L. Woods, Chao Zhu, Christopher M. Reid, Raj C. Shah, Trevor T.-J. Chong, Ajay Sood, Kerry M. Sheets, Mark R. Nelson
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
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Association of Whole Grain Consumption and Cognitive Decline: An Investigation From a Community-Based Biracial Cohort of Older Adults Neurology (IF 9.9) Pub Date : 2023-11-28 Xiaoran Liu, Todd Beck, Klodian Dhana, Pankaja Desai, Kristin R. Krueger, Christy C. Tangney, Thomas M. Holland, Puja Agarwal, Denis A. Evans, Kumar B. Rajan
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
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Initiation and Duration of Breastfeeding in the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs Study Neurology (IF 9.9) Pub Date : 2023-11-28 Elizabeth E. Gerard, Kimford J. Meador, Chelsea P. Robalino, Carrie Anne Brown, Abigail G. Matthews, P. Emanuela Voinescu, Laura A. Kalayjian, Evan Gedzelman, Julie Hanna, Jennifer Cavitt, Maria Sam, Jacqueline A. French, Alison M. Pack, Sean T. Hwang, Jeffrey J. Tsai, Cora Taylor, Page B. Pennell, for the MONEAD Investigator Study Group
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
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Type, Etiology, and Duration of Epilepsy as Risk Factors for SUDEP: Further Analyses of a Population-Based Case-Control Study Neurology (IF 9.9) Pub Date : 2023-11-28 Olafur Sveinsson, Tomas Andersson, Sofia Carlsson, Torbjörn Tomson
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
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Common Pathways of Epileptogenesis in Patients With Epilepsy Post-Brain Injury: Findings From a Systematic Review and Meta-analysis Neurology (IF 9.9) Pub Date : 2023-11-28 Shubham Misra, Erum I. Khan, TuKiet T. Lam, Rajarshi Mazumder, Kapil Gururangan, L. Brian Hickman, Vaibhav Goswami, Melissa C. Funaro, Ece Eldem, Lauren H. Sansing, Jason J. Sico, Terence J. Quinn, David S. Liebeskind, Joan Montaner, Patrick Kwan, Nishant K. Mishra
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
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Associations Between Head Injury and Subsequent Risk of Falls: Results From the Atherosclerosis Risk in Communities (ARIC) Study Neurology (IF 9.9) Pub Date : 2023-11-28 Katherine J. Hunzinger, Connor A. Law, Holly Elser, Alexa E. Walter, B. Gwen Windham, Priya Palta, Stephen P. Juraschek, Caitlin W. Hicks, Rebecca F. Gottesman, Andrea L.C. Schneider
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
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Association of EEG Background and Neurodevelopmental Outcome in Neonates With Hypoxic-Ischemic Encephalopathy Receiving Hypothermia Neurology (IF 9.9) Pub Date : 2023-11-28 Glass, H. C., Numis, A. L., Comstock, B. A., Gonzalez, F. F., Mietzsch, U., Bonifacio, S. L., Massey, S., Thomas, C., Natarajan, N., Mayock, D. E., Sokol, G. M., Van Meurs, K. P., Ahmad, K. A., Maitre, N., Heagerty, P. J., Juul, S. E., Wu, Y. W., Wusthoff, C. J.
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
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Association of Neighborhood Deprivation With Thrombolysis and Thrombectomy for Acute Stroke in a Health System With Universal Access Neurology (IF 9.9) Pub Date : 2023-11-28 Taghdiri, F., Vyas, M. V., Kapral, M. K., Lapointe-Shaw, L., Austin, P. C., Tse, P., Porter, J., Chen, Y., Fang, J., Yu, A. X.
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
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Vulnerable and Stabilized States After Cerebral Ischemic Events: Implications of Kinetic Modeling in the SOCRATES, POINT, and THALES Trials Neurology (IF 9.9) Pub Date : 2023-11-28 James R. Brorson, Mihai Giurcanu, Shyam Prabhakaran, S. Claiborne Johnston
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
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Author Response: Association of Alternative Anticoagulation Strategies and Outcomes in Patients With Ischemic Stroke While Taking a Direct Oral Anticoagulant Neurology (IF 9.9) Pub Date : 2023-11-28 Ip, Y. M. B., Hong Leung, T. W.
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
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Reader Response: Association of Alternative Anticoagulation Strategies and Outcomes in Patients With Ischemic Stroke While Taking a Direct Oral Anticoagulant Neurology (IF 9.9) Pub Date : 2023-11-28 Jared Wolfe, James E. Siegler
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).
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Editors' Note: Association of Alternative Anticoagulation Strategies and Outcomes in Patients With Ischemic Stroke While Taking a Direct Oral Anticoagulant Neurology (IF 9.9) Pub Date : 2023-11-28 Lewis, A., Ganesh, A., Galetta, S.
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
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Clinical Reasoning: A 22-Year-Old Man With Multifocal Brain and Osseous Lesions Neurology (IF 9.9) Pub Date : 2023-11-28 Reddy, S., Cha, S., LaHue, S. C.
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
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Intramedullary Neurocysticercosis: A Case Report Neurology (IF 9.9) Pub Date : 2023-11-28 Stefano Machado, Egon Ewaldo Lindorfer Neto, Bruno de Carvalho Dornelas, Andrea de Martino Luppi, Elder Henrique de Oliveira, Paulo Cesar Marinho Dias, Maykell Queiroz dos Reis, Diogo Fernandes dos Santos
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
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Late-Onset Status Epilepticus Associated With Isolated Leptomeningeal Angioma and Sturge-Weber Syndrome-Related GNA11 Pathogenic Variation Neurology (IF 9.9) Pub Date : 2023-11-28 Louis Cousyn, Delphine Leclercq, Minh Chau Ta, François Gilbert, Lucas Di Meglio, Clémence Marois, Andrei Haddad, Bertrand Mathon, Mélanie Eyries, Vincent Navarro
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.
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CSF Volcano Due to Lateral Ventricle Entrapment and Rupture Neurology (IF 9.9) Pub Date : 2023-11-28 Marinos G. Sotiropoulos, Christine A. Eckhardt, Brian L. Edlow
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
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Improving Neurology Clinical Care With Natural Language Processing Tools Neurology (IF 9.9) Pub Date : 2023-11-28 Wendong Ge, Hunter J. Rice, Irfan S. Sheikh, M. Brandon Westover, Allison L. Weathers, Lyell K. Jones, Lidia Moura
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
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Immunotherapy in Autoimmune Encephalitis: So Many Options, So Few Guidelines Neurology (IF 9.9) Pub Date : 2023-11-28 Isha N. Srivastava, Keith P. Van Haren
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
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Triglycerides and Cognition: Are All Lipids the Same? Neurology (IF 9.9) Pub Date : 2023-11-28 Nikolaos Scarmeas, Babak Hooshmand
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
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Is Recurrent Stroke More Like a Campfire or a Light Switch? Neurology (IF 9.9) Pub Date : 2023-11-28 Christopher J. Becker, James F. Burke
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?
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Teaching Video NeuroImage: Response to IVIg in a Patient With Steroid-Refractory Immune Checkpoint Inhibitor-Related Ocular Myopathy Neurology (IF 9.9) Pub Date : 2023-11-21 Sara J. Hooshmand, Catarina Aragon Pinto, Teerin Liewluck, Marcus V. Pinto
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
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Teaching Video NeuroImage: Seven-and-a-Half Syndrome Neurology (IF 9.9) Pub Date : 2023-11-21 Wei Li, Chanjuan Chen, Wengping Gu, Hong Tan
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
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Clinical Reasoning: A Woman With Progressive Painless Sequential Monocular Vision Loss Neurology (IF 9.9) Pub Date : 2023-11-21 Joseph Ditrapani, Hayley Price, Christine Shrock, Shuodan Zhang, Patricia E. Greenstein, Marc Bouffard
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
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Relevance of Minor Neuropsychological Deficits in Patients With Subjective Cognitive Decline Neurology (IF 9.9) Pub Date : 2023-11-21 Stark, M., Wolfsgruber, S., Kleineidam, L., Frommann, I., Altenstein, S., Bartels, C., Brosseron, F., Buerger, K., Burow, L., Butryn, M., Ewers, M., Fliessbach, K., Gabelin, T., Glanz, W., Goerss, D., Gref, D., Hansen, N., Heneka, M. T., Hinderer, P., Incesoy, E. I., Janowitz, D., Kilimann, I., Kimmich, O., Laske, C., Munk, M. H., Perneczky, R., Peters, O., Preis, L., Priller, J., Rauchmann, B.-S.
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
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Low- and High-Density Lipoprotein Cholesterol and Dementia Risk Over 17 Years of Follow-up Among Members of a Large Health Care Plan Neurology (IF 9.9) Pub Date : 2023-11-21 Ferguson, E. L., Zimmerman, S. C., Jiang, C., Choi, M., Swinnerton, K., Choudhary, V., Meyers, T. J., Hoffmann, T. J., Gilsanz, P., Oni-Orisan, A., Whitmer, R. A., Risch, N., Krauss, R. M., Schaefer, C. A., Glymour, M. M.
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
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Association of Sleep Disturbances With Brain Amyloid and Tau Burden, Cortical Atrophy, and Cognitive Dysfunction Across the AD Continuum Neurology (IF 9.9) Pub Date : 2023-11-21 So Hoon Yoon, Han-Kyeol Kim, Jae-Hoon Lee, Joong-Hyun Chun, Young H. Sohn, Phil Hyu Lee, Young Hoon Ryu, Hanna Cho, Han Soo Yoo, Chul Hyoung Lyoo
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
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Adverse Childhood Experiences and Primary Headache Disorders: A Systematic Review, Meta-analysis, and Application of a Biological Theory Neurology (IF 9.9) Pub Date : 2023-11-21 Claudia Sikorski, Anna C. Mavromanoli, Karishma Manji, Danial Behzad, Catherine Kreatsoulas
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
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Weight Management Interventions for Adults With Idiopathic Intracranial Hypertension: A Systematic Review and Practice Recommendations Neurology (IF 9.9) Pub Date : 2023-11-21 Abbott, S., Chan, F., Tahrani, A. A., Wong, S. H., Campbell, F. E. J., Parmar, C., Pournaras, D. J., Denton, A., Sinclair, A. J., Mollan, S. P.
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
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Factors Associated With Fast Early Infarct Growth in Patients With Acute Ischemic Stroke With a Large Vessel Occlusion Neurology (IF 9.9) Pub Date : 2023-11-21 Pierre Seners, Nicole Yuen, Jean-Marc Olivot, Michael Mlynash, Jeremy J. Heit, Soren Christensen, José Bernardo Escribano-Paredes, Emmanuel Carrera, Davide Strambo, Patrik Michel, Alexander Salerno, Max Wintermark, Hui Chen, Jean-François Albucher, Christophe Cognard, Igor Sibon, Michael Obadia, Julien Savatovsky, Maarten G. Lansberg, Gregory W. Albers, for Mismatch Prevalence
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
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Single Nucleotide Polymorphisms Associated With Motor Recovery in Patients With Nondisabling Stroke: GWAS Study Neurology (IF 9.9) Pub Date : 2023-11-21 Chad M. Aldridge, Robynne Braun, Keith L. Keene, Fang-Chi Hsu, Bradford B. Worrall
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