Cerebral small vessel disease (cSVD) is a common cause of stroke (lacunar stroke), is the most common cause of vascular cognitive impairment, and impairs mobility and mood but has no specific treatment.

It is important to determine the added clinical value for tau positron emission tomography (PET) in the diagnostic workup of patients with cognitive symptoms before widespread implementation in clinical practice.

This case report describes segmental uniparental isodisomy causing an “inside-to-outside” limb-girdle muscular dystrophy due to a homozygous mutation in POGLUT1.

Dual thrombolytic treatment with small bolus alteplase and mutant prourokinase has the potential to be a safer and more efficacious treatment for ischemic stroke than alteplase alone because mutant prourokinase is designed to act only on degraded fibrin without affecting circulating fibrinogen.

This Viewpoint describes barriers to comprehensive dementia care and proposes strategies for overcoming them.

An increased risk of Parkinson disease (PD) has been associated with exposure to the solvent trichloroethylene (TCE), but data are limited. Millions of people in the US and worldwide are exposed to TCE in air, food, and water.

Racial, ethnic, and geographic differences in multiple sclerosis (MS) are important factors to assess when determining the disease burden and allocating health care resources.

This Viewpoint calls for comprehensive investigations into sex differences associated with treatments in existing Alzheimer disease and integration into future Alzheimer disease and related dementia clinical trials.

Longitudinal tau positron emission tomography (PET) is a relevant outcome in clinical trials evaluating disease-modifying therapies in Alzheimer disease (AD). A key unanswered question is whether the use of participant-specific (individualized) regions of interest (ROIs) is superior to conventional approaches where the same ROI (group-level) is used for each participant.

Amyloid positron emission tomography (PET) allows the direct assessment of amyloid deposition, one of the main hallmarks of Alzheimer disease. However, this technique is currently not widely reimbursed because of the lack of appropriately designed studies demonstrating its clinical effect.

This case report describes the computed tomography (CT) characteristic findings and evolution of a hyperacute spontaneous midbrain hemorrhage.

Mesial temporal lobe epilepsy (MTLE) is the most common focal epilepsy subtype and is often refractory to antiseizure medications. While most patients with MTLE do not have pathogenic germline genetic variants, the contribution of postzygotic (ie, somatic) variants in the brain is unknown.

Although it has been postulated that chronic inflammation caused by rheumatoid arthritis (RA) contributes to the development of Parkinson disease (PD), the association between these 2 conditions has yet to be determined.

A physician in his 70s describes his path to a diagnosis of inflammatory arthritis, which included completely normal laboratory results.

This Viewpoint discusses the benefits of clinical trials with a delayed-start design and analysis of downstream biomarkers to examine whether antimyeloid immunotherapy changes the course of early Alzheimer disease.

This case report describes muscle vibration during muscle contraction caused by an MYBPC1 variant.

Progressive multifocal leukoencephalopathy can occur in the context of systemic sarcoidosis (S-PML) in the absence of therapeutic immune suppression and can initially be mistaken for neurosarcoidosis or other complications of sarcoidosis. Earlier recognition of S-PML could lead to more effective treatment of the disease.

This cross-sectional study estimates trends in stroke prevalence representative of the noninstitutionalized civilian population of US adults 20 years and older using data from the 1999 to 2018 National Health and Nutrition Examination Surveys.

This case report describes a patient with a 3-day history of acute blindness after using alcohol and methamphetamine for 3 consecutive nights before onset of visual impairment.

Prenatal antiseizure medication (ASM) exposure has been associated with adverse early neurodevelopment, but associations with a wider range of psychiatric end points have not been studied.

The levels of glycemic control associated with the lowest risk of dementia in people with type 2 diabetes are unknown. This knowledge is critical to inform patient-centered glycemic target setting.

This Viewpoint discusses incorporating the central vein sign into the diagnostic criteria for multiple sclerosis.

Acute symptomatic seizures occurring within 7 days after ischemic stroke may be associated with an increased mortality and risk of epilepsy. It is unknown whether the type of acute symptomatic seizure influences this risk.

In the previously reported Comparative Enzyme Replacement Trial With neoGAA Versus rhGAA (COMET) trial, avalglucosidase alfa treatment for 49 weeks showed clinically meaningful improvements in upright forced vital capacity (FVC) percent predicted and 6-minute walk test (6MWT) compared with alglucosidase alfa.

This case report describes a patient who presented with headache, fever, quadriparesis, and reduced visual acuity in the left eye and 6 months later presented with persistent quadriparesis and new-onset cognitive deficits.

This Viewpoint discusses the need for diverse physicians to manage sleep health.

For the large population of people with drug-refractory epilepsy, alternative treatment approaches are needed. Clinical trial outcomes of a novel stimulation device, which is newly available in Europe for the treatment of patients with a predominant seizure focus, are reported for the first time.

General anesthesia and procedural sedation are common practice for mechanical thrombectomy in acute ischemic stroke. However, risks and benefits of each strategy are unclear.

Postmenopausal females represent around 70% of all individuals with Alzheimer disease. Previous literature shows elevated levels of tau in cognitively unimpaired postmenopausal females compared with age-matched males, particularly in the setting of high β-amyloid (Aβ). The biological mechanisms associated with higher tau deposition in female individuals remain elusive.

Plasma phosphorylated tau217 (p-tau217), a biomarker of Alzheimer disease (AD), is of special interest in corticobasal syndrome (CBS) because autopsy studies have revealed AD is the driving neuropathology in up to 40% of cases. This differentiates CBS from other 4-repeat tauopathy (4RT)-associated syndromes, such as progressive supranuclear palsy Richardson syndrome (PSP-RS) and nonfluent primary progressive

This Viewpoint describes the benefits and limitations of using neurofilament light chain (NfL) as a marker of real-time disease activity and treatment response in multiple sclerosis.

Chronic kidney disease (CKD) has been associated with increased plasma concentrations of phosphorylated tau (p-tau) 217 and p-tau181, which potentially decreases their usefulness in the diagnostic workup of Alzheimer disease (AD).

This essay describes a physician’s opinion of why using only a first name can be confusing rather than aiding in resolving inequalities between physicians and other hospital staff or patients.

Epilepsy has been associated with cognitive impairment and potentially dementia in older individuals. However, the extent to which epilepsy may increase dementia risk, how this compares with other neurological conditions, and how modifiable cardiovascular risk factors may affect this risk remain unclear.

Carotid artery stenting has been limited to use in patients with high surgical risk; outcomes in patients with standard surgical risk are not well known.

The degree to which more intensive blood pressure reduction is better than less intensive for secondary stroke prevention has not been delineated.

The benefit of reperfusion therapies for acute ischemic stroke decreases over time. This decreasing benefit is presumably due to the disappearance of salvageable ischemic brain tissue (ie, the penumbra).

Pregnant women who have epilepsy need adequate engagement, information, and pregnancy planning and management to improve pregnancy outcomes.

This case report describes a spontaneous dissection of the basilar artery in a 53-year-old man presenting with ischemic stroke.

This Viewpoint reports on the results of the Clarity AD trial, a phase 3 randomized clinical trial of lecanemab for patients with early Alzheimer disease, in which lecanemab’s clinical efficacy was demonstrated using well-established outcome measures.

This Viewpoint discusses the findings of the Clarity AD trial, which studied lecanemab for patients with early-stage Alzheimer disease.

Cross-sectional evidence implicates high prevalent frailty in patients with Parkinson disease (PD), whereas the longitudinal association remains unknown.

Blood phosphorylated tau (p-tau) and amyloid-β peptides (Aβ) are promising peripheral biomarkers of Alzheimer disease (AD) pathology. However, their potential alterations due to alternative mechanisms, such as hypoxia in patients resuscitated from cardiac arrest, are not known.

This case report describes noncontiguous overflow dystonia in a patient with diabetes, hypertension, and a history of left putaminal hemorrhage and right hemiparesis.

This Viewpoint describes the pressure on neurology residents to pursue subspecialty training in a fellowship program even though the need for general neurologists is sizable and increasing.

The neurological substrates of visual artistic creativity (VAC) are unknown. VAC is demonstrated here to occur early in frontotemporal dementia (FTD), and multimodal neuroimaging is used to generate a novel mechanistic hypothesis involving dorsomedial occipital cortex enhancement. These findings may illuminate a novel mechanism underlying human visual creativity.

The value of serum neurofilament light chain (sNfL) levels for predicting long-term disability in patients with multiple sclerosis (MS) remains controversial.

For walking rehabilitation after stroke, training intensity and duration are critical dosing parameters that lack optimization.

With rapid aging of the US population, understanding trends over time in dementia occurrence is essential to public health planning and intervention; this understanding includes trends in neuropathologies underlying clinical dementia.

This case report describes a patient with bibrachial amyotrophy due to spontaneous spinal cerebrospinal fluid leak.

Higher educational attainment is associated with reduced dementia risk, but the role of educational quality is understudied, presenting a major evidence gap, especially as it may contribute to racial inequities.

Currently, disease-modifying therapies for multiple sclerosis (MS) use 4 mechanisms of action: immune modulation, suppressing immune cell proliferation, inhibiting immune cell migration, or cellular depletion. Over the last decades, the repertoire substantially increased because of the conceptual progress that not only T cells but also B cells play an important pathogenic role in MS, fostered by the

This essay describes the author’s experience as a physician-parent of a chronically ill child.

This case-control study investigates the positivity rates of the most prevalent neuroglial surface antibodies during the COVID-19 pandemic.

Alzheimer disease (AD) pathology starts with a prolonged phase of β-amyloid (Aβ) accumulation without symptoms. The duration of this phase differs greatly among individuals. While this disease phase has high relevance for clinical trial designs, it is currently unclear how to best predict the onset of clinical progression.

This Viewpoint discusses the concept of “mommy brain” and why it needs to change.

This case report describes a patient with status epilepticus and neuroimaging features of fleeting T2 fluid-attenuated inversion recovery hyperintense lesions on magnetic resonance imaging.

There is a lack of validated biomarkers for disability progression independent of relapse activity (PIRA) in multiple sclerosis (MS).

Vascular risk factors are associated with cognitive decline but studies addressing individual risk factors have not demonstrated an effect of risk factor management on the preservation of cognition. Few trials have examined the effect of vascular risk factor management on function.

Diagnostic incidence data for syndromes associated with frontotemporal lobar degeneration (FTLD) in multinational studies are urgent in light of upcoming therapeutic approaches.