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TEMPORAL CORRELATION OF CSF AND NEUROIMAGING IN THE Objective: Temporal correlations between CSF and neuroimaging (PET and MRI) measures of amyloid, tau, and neurodegeneration were evaluated in relation to Alzheimer disease (AD) progression. Methods: Three hundred seventy-one cognitively unimpaired and impaired participants enrolled in longitudinal studies of AD had both CSF (amyloid-β42, phosphorylated tau181, total tau, and CLINICAL, NEUROIMMUNOLOGIC, AND CSF INVESTIGATIONS IN Purchase access. For assistance, please contact: AAN Members (800) 879-1960 or (612) 928-6000 (International) Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international) Sign Up. Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here. KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent NUTRITIONAL STATUS IS A PROGNOSTIC FACTOR FOR SURVIVAL IN Objective: To evaluate the occurrence of malnutrition in patients with ALS, to assess the relation of malnutrition to the neurologic deficit, and to determine the impact of nutritional status on patient survival. Background: Although ALS may be associated with significant malnutrition, the relative impact on patient survival has not yet beenwell established.
A PHASE 1, MULTIPLE-DOSE STUDY OF ELEZANUMAB (ABT-555) IN Objective: The current study evaluated multiple doses of elezanumab to determine its safety and tolerability in patients with relapsing forms of MS. Background: Elezanumab is a fully humanized monoclonal antibody directed against repulsive guidance molecule A (RGMa). Studies in patients with multiple sclerosis (MS) demonstrate RGMa upregulation, which inhibits axonal growth and myelination THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. MIGRAINE IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME Objective: Headache characteristics were prospectively studied in 41 consecutive patients with postural orthostatic tachycardia syndrome (POTS). Background: POTS, the most prevalent form of orthostatic intolerance, is a heterogeneous disorder that is associated with a number of symptoms, including headache. The prevalence and clinical features of headache and how it relates to clinical GENERALIZED MYOCLONUS IN COVID-19 Objective To report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus. Methods Patient data were obtained from medical records from the University Hospital “12 de Octubre,” Madrid, Spain. Results Three patients (2 men and 1 woman, aged 63–88 years) presented with mild hypersomnia and generalized myoclonus NEUROLOGY® RESIDENT & FELLOW SECTION CLINICAL REASONING Clinical Reasoning in Neurology: A Case-Based Approach Cases from the Neurology® Resident & Fellow Section. The new Clinical Reasoning Book edited by Aaron Berkowitz, Sashank Prasad and Mitchell Elkind available as a FREE pdf download or on the Neurology app for the iPadand Android
TEMPORAL CORRELATION OF CSF AND NEUROIMAGING IN THE Objective: Temporal correlations between CSF and neuroimaging (PET and MRI) measures of amyloid, tau, and neurodegeneration were evaluated in relation to Alzheimer disease (AD) progression. Methods: Three hundred seventy-one cognitively unimpaired and impaired participants enrolled in longitudinal studies of AD had both CSF (amyloid-β42, phosphorylated tau181, total tau, and CLINICAL, NEUROIMMUNOLOGIC, AND CSF INVESTIGATIONS IN Purchase access. For assistance, please contact: AAN Members (800) 879-1960 or (612) 928-6000 (International) Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international) Sign Up. Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here. KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent NUTRITIONAL STATUS IS A PROGNOSTIC FACTOR FOR SURVIVAL IN Objective: To evaluate the occurrence of malnutrition in patients with ALS, to assess the relation of malnutrition to the neurologic deficit, and to determine the impact of nutritional status on patient survival. Background: Although ALS may be associated with significant malnutrition, the relative impact on patient survival has not yet beenwell established.
A PHASE 1, MULTIPLE-DOSE STUDY OF ELEZANUMAB (ABT-555) IN Objective: The current study evaluated multiple doses of elezanumab to determine its safety and tolerability in patients with relapsing forms of MS. Background: Elezanumab is a fully humanized monoclonal antibody directed against repulsive guidance molecule A (RGMa). Studies in patients with multiple sclerosis (MS) demonstrate RGMa upregulation, which inhibits axonal growth and myelination THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. MIGRAINE IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME Objective: Headache characteristics were prospectively studied in 41 consecutive patients with postural orthostatic tachycardia syndrome (POTS). Background: POTS, the most prevalent form of orthostatic intolerance, is a heterogeneous disorder that is associated with a number of symptoms, including headache. The prevalence and clinical features of headache and how it relates to clinical CRANIAL NEUROPATHIES AND COVID-19 The coronavirus disease 2019 (COVID-19) global pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began in late 2019. Like its predecessors, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 binds to angiotensin converting enzyme 2 (ACE2) receptors to facilitate tissue THE IMPACT OF COVID-19 ON DEVELOPING NEUROLOGIC DISORDERS One of the greatest challenges of treating a new virus is the lack of information about it. When little is known about a virus, patients affected by it, as well as their families, are left with uncertainty. In an article appearing in this issue of Neurology® , Dr. Frontera and her team aimed to determine how often patients hospitalized with coronavirus disease 2019 (COVID-19) developed new LONG-TERM OUTCOMES (15 YEARS) AFTER SUBTHALAMIC NUCLEUS Objective: To evaluate the effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson disease (PD) patients on motor complications beyond 15 years after surgery. Methods: Data about motor complications, quality of life (QoL), activities of daily living, the UPDRS motor scores, dopaminergic treatment, stimulation parameters, and side effects of STN-DBS were EFFICACY OF ERENUMAB IN THE TREATMENT OF TRIGEMINAL Objective Trigeminal neuralgia (TN) is a chronic, often refractory, pain condition, which adversely affects the lives of patients. Current treatments are only mildly effective. Anti–calcitonin gene-related peptide (CGRP) monoclonal antibodies have been successfully studied in the treatment of migraines. CGRP plays a role in both TN and migraine. DIFFERENTIAL DIAGNOSIS OF MULTIPLE SCLEROSIS A diagnosis of multiple sclerosis (MS) requires not only the demonstration of CNS lesions disseminated in time and space but also the active exclusion of alternative diagnoses.1 This requirement for “no better explanation” represents a substantial challenge given the varied clinical manifestations of MS, and the absence of a diagnostic test that readily distinguishes MS from other DIAGNOSING MRI-NEGATIVE AUTOIMMUNE DISEASES The diagnosis of MS requires demonstration of disease dissemination in space and time and is based on diagnostic criteria such as the recently revised McDonald criteria.1 With their 2001 revision, the McDonald criteria formally have included MRI in the diagnostic workup of patients with suspected MS.2 Since then, the relevance of MRI for diagnosis and disease monitoring has further increased ACCURACY OF CARDIAC INNERVATION SCINTIGRAPHY FOR MILD Objective To provide evidence that cardiac I-123-metaiodobenzylguanidine sympathetic innervation imaging (MIBG) scintigraphy differentiates probable mild cognitive impairment with Lewy bodies (MCI-LB) from mild cognitive impairment due to Alzheimer disease (MCI-AD), we scanned patients with MCI and obtained consensus clinical diagnoses of their MCI subtype. NEUROLOGY: VOLUME 96, NUMBER 23, JUNE 8, 2021 EXAM #1 Neurology: Volume 96, Number 23, June 8, 2021 Exam #1 - Perinatal Depression and Anxiety in Women With Multiple Sclerosis: A Population-Based Cohort Study DIZZINESS AS A SIGN OF STROKEABOUT STROKE Dizziness as a sign of stroke. About stroke. Dizziness is a common medical complaint. It “is the third most common medical symptom reported in general medical clinics and accounts for about 3%–5% of visits across care settings. In the United States, this translates to 10 million ambulatory visits per year because of dizziness, withroughly
ANTIPLEXIN D1 ANTIBODIES RELATE TO SMALL FIBER NEUROPATHY Objectives To assess the prevalence of antiplexin D1 antibodies (plexin D1-immunoglobulin G ) in small fiber neuropathy (SFN) and the effects of these antibodies in vivo. Methods We developed an ELISA for plexin D1-IgG using a recombinant extracellular domain of human plexin D1 containing the major epitope and sera from 58 subjects previously studied with a standard tissue CLINICAL, NEUROIMMUNOLOGIC, AND CSF INVESTIGATIONS IN Objectives: To report the neuropsychiatric features and frequency of N-methyl-d-aspartate receptor (NMDAR) and other neuronal IgG antibodies in patients with first episode psychosis (FEP), and assess the performance of reported warning signs and criteria for autoimmune psychosis (AP). Methods: Prospective observational study of patients with FEP assessed for neuropsychiatric symptoms, serum DIFFERENTIAL DIAGNOSIS OF MULTIPLE SCLEROSIS A diagnosis of multiple sclerosis (MS) requires not only the demonstration of CNS lesions disseminated in time and space but also the active exclusion of alternative diagnoses.1 This requirement for “no better explanation” represents a substantial challenge given the varied clinical manifestations of MS, and the absence of a diagnostic test that readily distinguishes MS from other NEUROLOGY® RESIDENT & FELLOW SECTION CLINICAL REASONING Clinical Reasoning in Neurology: A Case-Based Approach Cases from the Neurology® Resident & Fellow Section. The new Clinical Reasoning Book edited by Aaron Berkowitz, Sashank Prasad and Mitchell Elkind available as a FREE pdf download or on the Neurology app for the iPadand Android
GENERALIZED MYOCLONUS IN COVID-19 Objective To report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus. Methods Patient data were obtained from medical records from the University Hospital “12 de Octubre,” Madrid, Spain. Results Three patients (2 men and 1 woman, aged 63–88 years) presented with mild hypersomnia and generalized myoclonus KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis A PHASE 1, MULTIPLE-DOSE STUDY OF ELEZANUMAB (ABT-555) IN Objective: The current study evaluated multiple doses of elezanumab to determine its safety and tolerability in patients with relapsing forms of MS. Background: Elezanumab is a fully humanized monoclonal antibody directed against repulsive guidance molecule A (RGMa). Studies in patients with multiple sclerosis (MS) demonstrate RGMa upregulation, which inhibits axonal growth and myelination THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. NUTRITIONAL STATUS IS A PROGNOSTIC FACTOR FOR SURVIVAL IN Objective: To evaluate the occurrence of malnutrition in patients with ALS, to assess the relation of malnutrition to the neurologic deficit, and to determine the impact of nutritional status on patient survival. Background: Although ALS may be associated with significant malnutrition, the relative impact on patient survival has not yet been well established. Methods: In a prospective 7-month ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent MIGRAINE IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME Objective: Headache characteristics were prospectively studied in 41 consecutive patients with postural orthostatic tachycardia syndrome (POTS). Background: POTS, the most prevalent form of orthostatic intolerance, is a heterogeneous disorder that is associated with a number of symptoms, including headache. The prevalence and clinical features of headache and how it relates to clinical CLINICAL, NEUROIMMUNOLOGIC, AND CSF INVESTIGATIONS IN Objectives: To report the neuropsychiatric features and frequency of N-methyl-d-aspartate receptor (NMDAR) and other neuronal IgG antibodies in patients with first episode psychosis (FEP), and assess the performance of reported warning signs and criteria for autoimmune psychosis (AP). Methods: Prospective observational study of patients with FEP assessed for neuropsychiatric symptoms, serum DIFFERENTIAL DIAGNOSIS OF MULTIPLE SCLEROSIS A diagnosis of multiple sclerosis (MS) requires not only the demonstration of CNS lesions disseminated in time and space but also the active exclusion of alternative diagnoses.1 This requirement for “no better explanation” represents a substantial challenge given the varied clinical manifestations of MS, and the absence of a diagnostic test that readily distinguishes MS from other NEUROLOGY® RESIDENT & FELLOW SECTION CLINICAL REASONING Clinical Reasoning in Neurology: A Case-Based Approach Cases from the Neurology® Resident & Fellow Section. The new Clinical Reasoning Book edited by Aaron Berkowitz, Sashank Prasad and Mitchell Elkind available as a FREE pdf download or on the Neurology app for the iPadand Android
GENERALIZED MYOCLONUS IN COVID-19 Objective To report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus. Methods Patient data were obtained from medical records from the University Hospital “12 de Octubre,” Madrid, Spain. Results Three patients (2 men and 1 woman, aged 63–88 years) presented with mild hypersomnia and generalized myoclonus KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis A PHASE 1, MULTIPLE-DOSE STUDY OF ELEZANUMAB (ABT-555) IN Objective: The current study evaluated multiple doses of elezanumab to determine its safety and tolerability in patients with relapsing forms of MS. Background: Elezanumab is a fully humanized monoclonal antibody directed against repulsive guidance molecule A (RGMa). Studies in patients with multiple sclerosis (MS) demonstrate RGMa upregulation, which inhibits axonal growth and myelination THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. NUTRITIONAL STATUS IS A PROGNOSTIC FACTOR FOR SURVIVAL IN Objective: To evaluate the occurrence of malnutrition in patients with ALS, to assess the relation of malnutrition to the neurologic deficit, and to determine the impact of nutritional status on patient survival. Background: Although ALS may be associated with significant malnutrition, the relative impact on patient survival has not yet been well established. Methods: In a prospective 7-month ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent MIGRAINE IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME Objective: Headache characteristics were prospectively studied in 41 consecutive patients with postural orthostatic tachycardia syndrome (POTS). Background: POTS, the most prevalent form of orthostatic intolerance, is a heterogeneous disorder that is associated with a number of symptoms, including headache. The prevalence and clinical features of headache and how it relates to clinical FINDING TREATMENT EFFECTS IN ALZHEIMER TRIALS IN THE FACE Objective To investigate the influence of heterogeneity in disease progression for detecting treatment effects in Alzheimer disease (AD) trials, using a simulation study. Methods Individuals with an abnormal amyloid PET scan, diagnosis of mild cognitive impairment or dementia, baseline Mini-Mental State Examination (MMSE) score ≥24, global Clinical Dementia Rating (CDR) score of 0.5, and THE IMPACT OF COVID-19 ON DEVELOPING NEUROLOGIC DISORDERS One of the greatest challenges of treating a new virus is the lack of information about it. When little is known about a virus, patients affected by it, as well as their families, are left with uncertainty. In an article appearing in this issue of Neurology® , Dr. Frontera and her team aimed to determine how often patients hospitalized with coronavirus disease 2019 (COVID-19) developed newTABLE OF CONTENTS
Karine Eid, Øivind Fredvik Torkildsen, Jan Aarseth, Heidi Øyen Flemmen, Trygve Holmøy, Åslaug Rudjord Lorentzen, Kjell-Morten Myhr, Trond Riise, Cecilia Simonsen, Cecilie Fredvik Torkildsen, Stig Wergeland, Johannes Sverre Willumsen, Nina Øksendal, Nils Erik Gilhus, Marte-Helene BjørkZOSTER SINE HERPETE
Varicella zoster virus (VZV) is an exclusively human neurotropic herpesvirus that causes varicella (chickenpox) during primary infection, after which the virus becomes latent in cranial nerve, dorsal root, and autonomic ganglia along the entire neuraxis.1 Decades later, virus may reactivate to cause herpes zoster (shingles), an extremely painful vesicular skin rash confined to one or more A RETROSPECTIVE STUDY EVALUATING THE USE OF ANTI Objective: To examine the use of oral/transdermal anti-parkinsonian medications in advanced Parkinson’s disease (APD) patients who have a history of or current treatment with deep brain stimulation (DBS), and are receiving levodopa-carbidopa intestinal gel (LCIG). Background: As PD progresses, oral drug regimens may become inadequate for symptom control. NEW EVIDENCE FOR REDUCED LEG OXYGEN LEVELS IN RESTLESS Restless legs syndrome (RLS), also now known as Willis-Ekbom disease (WED), is common and affects about 10% of the general population. It affects women more than men. RLS/WED causes an uncomfortable urge to move the legs. It is often worse in the evening, especially around bedtime, and is temporarily improved by leg movement. PERINATAL DEPRESSION AND ANXIETY IN WOMEN WITH MULTIPLE People with multiple sclerosis (MS) have an increased prev-alence of depression and anxiety compared to the general population.1 Several factors contribute, including pathobio- logical mechanisms of MS itself.2,3 Perinatal depression is the most common complication of pregnancy and is often NEUROPATHOLOGY, AND COGNITIVE DECLINE Views & Reviews 1080 Intraprocedural Angiographic Signs Observed During Endovascular Thrombectomy in Patients With Acute Ischemic Stroke: A Systematic Review W. Liang, Y. FIVE UNAPPROVED DRUGS FOUND IN COGNITIVE ENHANCEMENT Objective To identify the presence of unapproved pharmaceutical drugs in over-the-counter dietary supplements marketed to improve memory and cognitive function. Methods Supplements were identified by searching 2 supplement databases for products labeled as containing omberacetam, aniracetam, phenylpiracetam, or oxiracetam, 4 drugs not approved for human use in the United States. READER RESPONSE: TEACHING VIDEO NEUROIMAGES: PATHOLOGIC With interest, we read the article by Birca et al.1 describing a 15-year-old adolescent boy with acute disseminated encephalomyelitis (ADEM) and a dorsal brainstem lesion who presented with pathologic yawning. We previously reported a 20-year-old man with antimyelin oligodendrocyte glycoprotein (MOG) antibody-associated brainstem encephalitis that involved the dorsal brainstem and AMERICAN ACADEMY OF NEUROLOGY JOURNALSNEUROLOGYCLINICAL PRACTICEGENETICSNEUROIMMUNOLOGY & NEUROINFLAMMATIONCOVID-19 Neurology ® Neuroimmunology & Neuroinflammation. CLINICAL/SCIENTIFIC NOTES | Autoimmune Diseases. Reversible Cerebral Vasculopathy, Transverse Myelitis, and Active Systemic Lupus Erythematosus in Aquaporin-4 Antibody–Positive. ARTICLE |Multiple Sclerosis. Incidence and Impact of COVID-19 in MS: A Survey From a Barcelona MSUnit.
NEUROLOGIC SYNDROMES RELATED TO ANTI-GAD65 Objective Antibodies against glutamic acid decarboxylase 65 (anti-GAD65) are associated with a number of neurologic syndromes. However, their pathogenic role is controversial. Our objective was to describe clinical and paraclinical characteristics of anti-GAD65 patients and analyze their response to immunotherapy. Methods Retrospectively, we studied patients (n = 56) with positive anti-GAD65 PAIN IN GUILLAIN-BARRÉ SYNDROME Background: Pain in Guillain-Barré syndrome (GBS) may be pronounced and is often overlooked. Objectives: To obtain detailed information about pain in GBS and its clinical variants. Methods: This was a prospective cohort study in 156 patients with GBS (including 18 patients with Miller Fisher syndrome ). We assessed the location, type, and intensity of pain using questionnaires at MEMORY LOSS AFTER STROKE Memory loss commonly occurs as a result of the loss of nerve cells in the brain. When memory loss is so severe that it interferes with normal daily functioning, it is called dementia. People with dementia may have difficulty learning new things or remembering names of people they just met. They may get lost in places that were previously very familiar or have trouble finding words. THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. NUTRITIONAL STATUS IS A PROGNOSTIC FACTOR FOR SURVIVAL IN Objective: To evaluate the occurrence of malnutrition in patients with ALS, to assess the relation of malnutrition to the neurologic deficit, and to determine the impact of nutritional status on patient survival. Background: Although ALS may be associated with significant malnutrition, the relative impact on patient survival has not yet been well established. Methods: In a prospective 7-month DIZZINESS AS A SIGN OF STROKEABOUT STROKE Dizziness as a sign of stroke. About stroke. Dizziness is a common medical complaint. It “is the third most common medical symptom reported in general medical clinics and accounts for about 3%–5% of visits across care settings. In the United States, this translates to 10 million ambulatory visits per year because of dizziness, withroughly
VITAMIN B6 TOXICITY REVISITED: A CASE OF REVERSIBLE Objective: To present the salient features, and reversibility of pyridoxine (vitamin B6) induced peripheral neuropathy, in conjunction with its electrodiagnostic correlate. Background: B-Complex vitamins are essential for functioning of the nervous system, and supplementation is generally well tolerated. Although rare, excess pyridoxine can lead to paradoxical neurotoxicity— resulting in FRONTOTEMPORAL DEMENTIA VERSUS ALZHEIMER'S DISEASE Frontotemporal dementia (FTD) is a common neurodegenerative dementia that can be difficult to distinguish clinically from Alzheimer's disease (AD).The differential distribution of pathology in FTD and AD predicts the presence of differential cognitive features on mental status examination. We compared 39 FTD patients with 101 AD patients on the Consortium to Establish a Registry in AD MIGRAINE IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME Objective: Headache characteristics were prospectively studied in 41 consecutive patients with postural orthostatic tachycardia syndrome (POTS). Background: POTS, the most prevalent form of orthostatic intolerance, is a heterogeneous disorder that is associated with a number of symptoms, including headache. The prevalence and clinical features of headache and how it relates to clinical AMERICAN ACADEMY OF NEUROLOGY JOURNALSNEUROLOGYCLINICAL PRACTICEGENETICSNEUROIMMUNOLOGY & NEUROINFLAMMATIONCOVID-19 Neurology ® Neuroimmunology & Neuroinflammation. CLINICAL/SCIENTIFIC NOTES | Autoimmune Diseases. Reversible Cerebral Vasculopathy, Transverse Myelitis, and Active Systemic Lupus Erythematosus in Aquaporin-4 Antibody–Positive. ARTICLE |Multiple Sclerosis. Incidence and Impact of COVID-19 in MS: A Survey From a Barcelona MSUnit.
NEUROLOGIC SYNDROMES RELATED TO ANTI-GAD65 Objective Antibodies against glutamic acid decarboxylase 65 (anti-GAD65) are associated with a number of neurologic syndromes. However, their pathogenic role is controversial. Our objective was to describe clinical and paraclinical characteristics of anti-GAD65 patients and analyze their response to immunotherapy. Methods Retrospectively, we studied patients (n = 56) with positive anti-GAD65 PAIN IN GUILLAIN-BARRÉ SYNDROME Background: Pain in Guillain-Barré syndrome (GBS) may be pronounced and is often overlooked. Objectives: To obtain detailed information about pain in GBS and its clinical variants. Methods: This was a prospective cohort study in 156 patients with GBS (including 18 patients with Miller Fisher syndrome ). We assessed the location, type, and intensity of pain using questionnaires at MEMORY LOSS AFTER STROKE Memory loss commonly occurs as a result of the loss of nerve cells in the brain. When memory loss is so severe that it interferes with normal daily functioning, it is called dementia. People with dementia may have difficulty learning new things or remembering names of people they just met. They may get lost in places that were previously very familiar or have trouble finding words. THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. NUTRITIONAL STATUS IS A PROGNOSTIC FACTOR FOR SURVIVAL IN Objective: To evaluate the occurrence of malnutrition in patients with ALS, to assess the relation of malnutrition to the neurologic deficit, and to determine the impact of nutritional status on patient survival. Background: Although ALS may be associated with significant malnutrition, the relative impact on patient survival has not yet been well established. Methods: In a prospective 7-month DIZZINESS AS A SIGN OF STROKEABOUT STROKE Dizziness as a sign of stroke. About stroke. Dizziness is a common medical complaint. It “is the third most common medical symptom reported in general medical clinics and accounts for about 3%–5% of visits across care settings. In the United States, this translates to 10 million ambulatory visits per year because of dizziness, withroughly
VITAMIN B6 TOXICITY REVISITED: A CASE OF REVERSIBLE Objective: To present the salient features, and reversibility of pyridoxine (vitamin B6) induced peripheral neuropathy, in conjunction with its electrodiagnostic correlate. Background: B-Complex vitamins are essential for functioning of the nervous system, and supplementation is generally well tolerated. Although rare, excess pyridoxine can lead to paradoxical neurotoxicity— resulting in FRONTOTEMPORAL DEMENTIA VERSUS ALZHEIMER'S DISEASE Frontotemporal dementia (FTD) is a common neurodegenerative dementia that can be difficult to distinguish clinically from Alzheimer's disease (AD).The differential distribution of pathology in FTD and AD predicts the presence of differential cognitive features on mental status examination. We compared 39 FTD patients with 101 AD patients on the Consortium to Establish a Registry in AD MIGRAINE IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME Objective: Headache characteristics were prospectively studied in 41 consecutive patients with postural orthostatic tachycardia syndrome (POTS). Background: POTS, the most prevalent form of orthostatic intolerance, is a heterogeneous disorder that is associated with a number of symptoms, including headache. The prevalence and clinical features of headache and how it relates to clinical AMERICAN ACADEMY OF NEUROLOGY JOURNALS Dr. Jeff Ratliff discusses primary care management for acute sciatica and physical therapy referrals with Dr. Julie Fritz. Dr. Andy Southerland talks with Dr. Amrou Sarraj about direct endovascular thrombectomy in patients with large vessel occlusions. NEUROLOGY | THE MOST WIDELY READ AND HIGHLY CITED PEER Automated, Quantitative Pupillometry in the Critically Ill: A Systematic Review of the Literature. Petra Opic, Stephan Rüegg, Stephan Marsch, et al. May 27, 2021. Video NeuroImages. Treatment of Painless Legs and Moving Toes Syndrome Associated With Multiple System Atrophy With Levodopa. Takeya Araki, Tatsuya Mukai, Takehisa Araki.TABLE OF CONTENTS
Karine Eid, Øivind Fredvik Torkildsen, Jan Aarseth, Heidi Øyen Flemmen, Trygve Holmøy, Åslaug Rudjord Lorentzen, Kjell-Morten Myhr, Trond Riise, Cecilia Simonsen, Cecilie Fredvik Torkildsen, Stig Wergeland, Johannes Sverre Willumsen, Nina Øksendal, Nils Erik Gilhus, Marte-Helene Bjørk WELCOME TO NEUROLOGY: GENETICS The powers of human genetics and genetic technologies have transformed the complexities of neurology and neuroscience at the basic, translational, and now also the clinical level. We have left an era of black and white views of causative genetic variation and are entering a period of more than 50 shades of grey, fascinated with DNA variants that increase or decrease risk, epigenetic DIZZINESS AS A SIGN OF STROKEABOUT STROKE Dizziness as a sign of stroke. About stroke. Dizziness is a common medical complaint. It “is the third most common medical symptom reported in general medical clinics and accounts for about 3%–5% of visits across care settings. In the United States, this translates to 10 million ambulatory visits per year because of dizziness, withroughly
ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent FRONTOTEMPORAL DEMENTIA VERSUS ALZHEIMER'S DISEASE Frontotemporal dementia (FTD) is a common neurodegenerative dementia that can be difficult to distinguish clinically from Alzheimer's disease (AD).The differential distribution of pathology in FTD and AD predicts the presence of differential cognitive features on mental status examination. We compared 39 FTD patients with 101 AD patients on the Consortium to Establish a Registry in AD SEIZURES AFTER BLEEDING INTO THE BRAIN In their article, “Electrographic seizures and periodic discharges after intracerebral hemorrhage,” Dr. Claassen and colleagues discuss several important issues that affect people who have bleeding into the brain (Neurology 2007;69:1356–1365). They used a retrospective review to study problems associated with bleeding within the brain. SYNAPTIC EFFECTS OF CANNABINOIDS The discovery of (−)-Δ9-tetrahydrocannabinol (Δ9 THC) as the main psychoactive ingredient in cannabis (marijuana), the cloning of the cannabinoid receptors CB1R and CB2R, and the identification of the endocannabinoids as their endogenous ligands has stimulated extensive research on the role of the cannabinoid system in synaptic regulation in the CNS. The 2 major endocannabinoids in the A PROPOSED CLINICAL CLASSIFICATION AND A DIAGNOSTIC Purpose of Review This review proposes a clinical classification for congenital ataxias based on clinical features, neuroimaging, and course of the disease. Recent Findings Congenital ataxias are an unusual group of neurologic disorders, with heterogeneous clinical and genetic presentation. Typical clinical features of congenital ataxias include variable degrees of motor developmental delay NEUROLOGY | THE MOST WIDELY READ AND HIGHLY CITED PEERLOG INLATEST ARTICLESCURRENT ISSUEPAST ISSUESRESIDENTS & FELLOWS Automated, Quantitative Pupillometry in the Critically Ill: A Systematic Review of the Literature. Petra Opic, Stephan Rüegg, Stephan Marsch, et al. May 27, 2021. Video NeuroImages. Treatment of Painless Legs and Moving Toes Syndrome Associated With Multiple System Atrophy With Levodopa. Takeya Araki, Tatsuya Mukai, Takehisa Araki. KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis PAIN IN GUILLAIN-BARRÉ SYNDROME Background: Pain in Guillain-Barré syndrome (GBS) may be pronounced and is often overlooked. Objectives: To obtain detailed information about pain in GBS and its clinical variants. Methods: This was a prospective cohort study in 156 patients with GBS (including 18 patients with Miller Fisher syndrome ). We assessed the location, type, and intensity of pain using questionnaires at MEMORY LOSS AFTER STROKE Memory loss commonly occurs as a result of the loss of nerve cells in the brain. When memory loss is so severe that it interferes with normal daily functioning, it is called dementia. People with dementia may have difficulty learning new things or remembering names of people they just met. They may get lost in places that were previously very familiar or have trouble finding words. WELCOME TO NEUROLOGY: GENETICS The mission of Neurology® Genetics is the publication of high-quality original contributions that elucidate the role of genetic and epigenetic variation in diseases of the central and peripheral nervous systems. The journal will publish original articles in all areas of neurogenetics, including rare and common genetic variation, genotype-phenotype correlations, outlier phenotypes as a result NEUROLOGIC SYNDROMES RELATED TO ANTI-GAD65 Objective Antibodies against glutamic acid decarboxylase 65 (anti-GAD65) are associated with a number of neurologic syndromes. However, their pathogenic role is controversial. Our objective was to describe clinical and paraclinical characteristics of anti-GAD65 patients and analyze their response to immunotherapy. Methods Retrospectively, we studied patients (n = 56) with positive anti-GAD65 ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent VITAMIN B6 TOXICITY REVISITED: A CASE OF REVERSIBLE Objective: To present the salient features, and reversibility of pyridoxine (vitamin B6) induced peripheral neuropathy, in conjunction with its electrodiagnostic correlate. Background: B-Complex vitamins are essential for functioning of the nervous system, and supplementation is generally well tolerated. Although rare, excess pyridoxine can lead to paradoxical neurotoxicity— resulting in THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. MIGRAINE IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME Objective: Headache characteristics were prospectively studied in 41 consecutive patients with postural orthostatic tachycardia syndrome (POTS). Background: POTS, the most prevalent form of orthostatic intolerance, is a heterogeneous disorder that is associated with a number of symptoms, including headache. The prevalence and clinical features of headache and how it relates to clinical NEUROLOGY | THE MOST WIDELY READ AND HIGHLY CITED PEERLOG INLATEST ARTICLESCURRENT ISSUEPAST ISSUESRESIDENTS & FELLOWS Automated, Quantitative Pupillometry in the Critically Ill: A Systematic Review of the Literature. Petra Opic, Stephan Rüegg, Stephan Marsch, et al. May 27, 2021. Video NeuroImages. Treatment of Painless Legs and Moving Toes Syndrome Associated With Multiple System Atrophy With Levodopa. Takeya Araki, Tatsuya Mukai, Takehisa Araki. KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis PAIN IN GUILLAIN-BARRÉ SYNDROME Background: Pain in Guillain-Barré syndrome (GBS) may be pronounced and is often overlooked. Objectives: To obtain detailed information about pain in GBS and its clinical variants. Methods: This was a prospective cohort study in 156 patients with GBS (including 18 patients with Miller Fisher syndrome ). We assessed the location, type, and intensity of pain using questionnaires at MEMORY LOSS AFTER STROKE Memory loss commonly occurs as a result of the loss of nerve cells in the brain. When memory loss is so severe that it interferes with normal daily functioning, it is called dementia. People with dementia may have difficulty learning new things or remembering names of people they just met. They may get lost in places that were previously very familiar or have trouble finding words. WELCOME TO NEUROLOGY: GENETICS The mission of Neurology® Genetics is the publication of high-quality original contributions that elucidate the role of genetic and epigenetic variation in diseases of the central and peripheral nervous systems. The journal will publish original articles in all areas of neurogenetics, including rare and common genetic variation, genotype-phenotype correlations, outlier phenotypes as a result NEUROLOGIC SYNDROMES RELATED TO ANTI-GAD65 Objective Antibodies against glutamic acid decarboxylase 65 (anti-GAD65) are associated with a number of neurologic syndromes. However, their pathogenic role is controversial. Our objective was to describe clinical and paraclinical characteristics of anti-GAD65 patients and analyze their response to immunotherapy. Methods Retrospectively, we studied patients (n = 56) with positive anti-GAD65 ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent VITAMIN B6 TOXICITY REVISITED: A CASE OF REVERSIBLE Objective: To present the salient features, and reversibility of pyridoxine (vitamin B6) induced peripheral neuropathy, in conjunction with its electrodiagnostic correlate. Background: B-Complex vitamins are essential for functioning of the nervous system, and supplementation is generally well tolerated. Although rare, excess pyridoxine can lead to paradoxical neurotoxicity— resulting in THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. MIGRAINE IN POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME Objective: Headache characteristics were prospectively studied in 41 consecutive patients with postural orthostatic tachycardia syndrome (POTS). Background: POTS, the most prevalent form of orthostatic intolerance, is a heterogeneous disorder that is associated with a number of symptoms, including headache. The prevalence and clinical features of headache and how it relates to clinical AMERICAN ACADEMY OF NEUROLOGY JOURNALS Dr. Jeff Ratliff discusses primary care management for acute sciatica and physical therapy referrals with Dr. Julie Fritz. Dr. Andy Southerland talks with Dr. Amrou Sarraj about direct endovascular thrombectomy in patients with large vessel occlusions. NEUROLOGY | THE MOST WIDELY READ AND HIGHLY CITED PEER Automated, Quantitative Pupillometry in the Critically Ill: A Systematic Review of the Literature. Petra Opic, Stephan Rüegg, Stephan Marsch, et al. May 27, 2021. Video NeuroImages. Treatment of Painless Legs and Moving Toes Syndrome Associated With Multiple System Atrophy With Levodopa. Takeya Araki, Tatsuya Mukai, Takehisa Araki.TABLE OF CONTENTS
Karine Eid, Øivind Fredvik Torkildsen, Jan Aarseth, Heidi Øyen Flemmen, Trygve Holmøy, Åslaug Rudjord Lorentzen, Kjell-Morten Myhr, Trond Riise, Cecilia Simonsen, Cecilie Fredvik Torkildsen, Stig Wergeland, Johannes Sverre Willumsen, Nina Øksendal, Nils Erik Gilhus, Marte-Helene Bjørk SHORTCOMINGS OF RAPID CLINICAL INFORMATION DISSEMINATION The coronavirus disease 2019 (COVID-19) pandemic has led to an acceleration of clinical information dissemination to unprecedented speeds, a phenomenon only partially explained by formal efforts of the scientific community. These have ranged from the establishment of open-source platforms for review of article preprints to the elimination of journal paywalls for COVID-19–related publications. DIFFERENTIAL DIAGNOSIS OF MULTIPLE SCLEROSIS A diagnosis of multiple sclerosis (MS) requires not only the demonstration of CNS lesions disseminated in time and space but also the active exclusion of alternative diagnoses.1 This requirement for “no better explanation” represents a substantial challenge given the varied clinical manifestations of MS, and the absence of a diagnostic test that readily distinguishes MS from other THE BRAIN AND THE KIDNEY CONNECTION Patients with chronic kidney disease (CKD) exhibit tremendously high levels of symptomatic and occult cerebrovascular disease and associated inflammatory factors, homocysteine, anemia, hypertension, and diabetes.1–4 As these risk factors overshadow aging and nonvascular factors, patients with CKD represent a potential model of accelerated vascular cognitive impairment.4 TheZOSTER SINE HERPETE
Varicella zoster virus (VZV) is an exclusively human neurotropic herpesvirus that causes varicella (chickenpox) during primary infection, after which the virus becomes latent in cranial nerve, dorsal root, and autonomic ganglia along the entire neuraxis.1 Decades later, virus may reactivate to cause herpes zoster (shingles), an extremely painful vesicular skin rash confined to one or more NEUROLOGIC SYNDROMES RELATED TO ANTI-GAD65 Objective Antibodies against glutamic acid decarboxylase 65 (anti-GAD65) are associated with a number of neurologic syndromes. However, their pathogenic role is controversial. Our objective was to describe clinical and paraclinical characteristics of anti-GAD65 patients and analyze their response to immunotherapy. Methods Retrospectively, we studied patients (n = 56) with positive anti-GAD65 LONG-TERM OUTCOMES (15 YEARS) AFTER SUBTHALAMIC NUCLEUS Objective: To evaluate the effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson disease (PD) patients on motor complications beyond 15 years after surgery. Methods: Data about motor complications, quality of life (QoL), activities of daily living, the UPDRS motor scores, dopaminergic treatment, stimulation parameters, and side effects of STN-DBS were A PROPOSED CLINICAL CLASSIFICATION AND A DIAGNOSTIC Purpose of Review This review proposes a clinical classification for congenital ataxias based on clinical features, neuroimaging, and course of the disease. Recent Findings Congenital ataxias are an unusual group of neurologic disorders, with heterogeneous clinical and genetic presentation. Typical clinical features of congenital ataxias include variable degrees of motor developmental delay AMERICAN ACADEMY OF NEUROLOGY JOURNALSNEUROLOGYCLINICAL PRACTICEGENETICSNEUROIMMUNOLOGY & NEUROINFLAMMATIONCOVID-19 This month's replay of past episodes showcases a selection of interviews on updates in Alzheimer's disease diagnostics and the impact of future therapies, featuring Drs. Michael Weiner, Randall Bateman, Erik Musiek, Joseph Therriault, and Yvette Sheline. NEUROLOGY | THE MOST WIDELY READ AND HIGHLY CITED PEERLOG INLATEST ARTICLESCURRENT ISSUEPAST ISSUESRESIDENTS & FELLOWS Automated, Quantitative Pupillometry in the Critically Ill: A Systematic Review of the Literature. Petra Opic, Stephan Rüegg, Stephan Marsch, et al. May 27, 2021. Video NeuroImages. Treatment of Painless Legs and Moving Toes Syndrome Associated With Multiple System Atrophy With Levodopa. Takeya Araki, Tatsuya Mukai, Takehisa Araki. NEUROLOGY® RESIDENT & FELLOW SECTION CLINICAL REASONING Clinical Reasoning in Neurology: A Case-Based Approach Cases from the Neurology® Resident & Fellow Section. The new Clinical Reasoning Book edited by Aaron Berkowitz, Sashank Prasad and Mitchell Elkind available as a FREE pdf download or on the Neurology app for the iPadand Android
TEMPORAL CORRELATION OF CSF AND NEUROIMAGING IN THE Objective: Temporal correlations between CSF and neuroimaging (PET and MRI) measures of amyloid, tau, and neurodegeneration were evaluated in relation to Alzheimer disease (AD) progression. Methods: Three hundred seventy-one cognitively unimpaired and impaired participants enrolled in longitudinal studies of AD had both CSF (amyloid-β42, phosphorylated tau181, total tau, and KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent MEMORY LOSS AFTER STROKE Memory loss commonly occurs as a result of the loss of nerve cells in the brain. When memory loss is so severe that it interferes with normal daily functioning, it is called dementia. People with dementia may have difficulty learning new things or remembering names of people they just met. They may get lost in places that were previously very familiar or have trouble finding words. CAFFEINE AND PARKINSON DISEASE Most cases of Parkinson disease (PD) over age 50 are sporadic, and twin studies strongly suggest a predominance of environmental over genetic etiologies.1 However, few factors have been found consistently in epidemiologic studies to have major effects, protective in all cases: smoking, urate,2 and caffeine consumption.3 The protective effect of caffeine (found not only in coffee, but also THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. ARE WHITE MATTER SIGNAL ABNORMALITIES CLINICALLY RELEVANT How often have you read, “There are small scattered foci of signal abnormalities (T2 hyperintensities or increased FLAIR signal) in the cerebral white matter indicative of demyelinating disease, chronic white matter ischemia due to microvascular disease, or gliosis from an infectious/inflammatory disease process,” or words just like them in your MRI reports of your elderly AMERICAN ACADEMY OF NEUROLOGY JOURNALSNEUROLOGYCLINICAL PRACTICEGENETICSNEUROIMMUNOLOGY & NEUROINFLAMMATIONCOVID-19 This month's replay of past episodes showcases a selection of interviews on updates in Alzheimer's disease diagnostics and the impact of future therapies, featuring Drs. Michael Weiner, Randall Bateman, Erik Musiek, Joseph Therriault, and Yvette Sheline. NEUROLOGY | THE MOST WIDELY READ AND HIGHLY CITED PEERLOG INLATEST ARTICLESCURRENT ISSUEPAST ISSUESRESIDENTS & FELLOWS Automated, Quantitative Pupillometry in the Critically Ill: A Systematic Review of the Literature. Petra Opic, Stephan Rüegg, Stephan Marsch, et al. May 27, 2021. Video NeuroImages. Treatment of Painless Legs and Moving Toes Syndrome Associated With Multiple System Atrophy With Levodopa. Takeya Araki, Tatsuya Mukai, Takehisa Araki. NEUROLOGY® RESIDENT & FELLOW SECTION CLINICAL REASONING Clinical Reasoning in Neurology: A Case-Based Approach Cases from the Neurology® Resident & Fellow Section. The new Clinical Reasoning Book edited by Aaron Berkowitz, Sashank Prasad and Mitchell Elkind available as a FREE pdf download or on the Neurology app for the iPadand Android
TEMPORAL CORRELATION OF CSF AND NEUROIMAGING IN THE Objective: Temporal correlations between CSF and neuroimaging (PET and MRI) measures of amyloid, tau, and neurodegeneration were evaluated in relation to Alzheimer disease (AD) progression. Methods: Three hundred seventy-one cognitively unimpaired and impaired participants enrolled in longitudinal studies of AD had both CSF (amyloid-β42, phosphorylated tau181, total tau, and KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent MEMORY LOSS AFTER STROKE Memory loss commonly occurs as a result of the loss of nerve cells in the brain. When memory loss is so severe that it interferes with normal daily functioning, it is called dementia. People with dementia may have difficulty learning new things or remembering names of people they just met. They may get lost in places that were previously very familiar or have trouble finding words. CAFFEINE AND PARKINSON DISEASE Most cases of Parkinson disease (PD) over age 50 are sporadic, and twin studies strongly suggest a predominance of environmental over genetic etiologies.1 However, few factors have been found consistently in epidemiologic studies to have major effects, protective in all cases: smoking, urate,2 and caffeine consumption.3 The protective effect of caffeine (found not only in coffee, but also THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. ARE WHITE MATTER SIGNAL ABNORMALITIES CLINICALLY RELEVANT How often have you read, “There are small scattered foci of signal abnormalities (T2 hyperintensities or increased FLAIR signal) in the cerebral white matter indicative of demyelinating disease, chronic white matter ischemia due to microvascular disease, or gliosis from an infectious/inflammatory disease process,” or words just like them in your MRI reports of your elderly AMERICAN ACADEMY OF NEUROLOGY JOURNALS This month's replay of past episodes showcases a selection of interviews on updates in Alzheimer's disease diagnostics and the impact of future therapies, featuring Drs. Michael Weiner, Randall Bateman, Erik Musiek, Joseph Therriault, and Yvette Sheline. NEUROLOGY JOURNALS AUTHOR CENTER Every member of the study group is an author and fulfills the Neurology journals’ criteria for authorship. All members of the group complete authorship, disclosure, and publication agreement forms. The byline will list all authors with the addition of “and the X Study Group” at the end.NEUROLOGY GENETICS
This month's replay of past episodes showcases a selection of interviews on updates in Alzheimer's disease diagnostics and the impact of future therapies, featuring Drs. Michael Weiner, Randall Bateman, Erik Musiek, Joseph Therriault, and Yvette Sheline. CATEGORIES OF THE RESIDENT AND FELLOW SECTION Categories of the Resident and Fellow Section. This information must be used in conjunction with all policies and specifications outlined in the Author Center. The Resident & Fellow Section (RFS) publishes papers that further the education of medical students, residents, fellows, and other trainees. Papers in the RFS are relevant totrainees
TABLE OF CONTENTS
Karine Eid, Øivind Fredvik Torkildsen, Jan Aarseth, Heidi Øyen Flemmen, Trygve Holmøy, Åslaug Rudjord Lorentzen, Kjell-Morten Myhr, Trond Riise, Cecilia Simonsen, Cecilie Fredvik Torkildsen, Stig Wergeland, Johannes Sverre Willumsen, Nina Øksendal, Nils Erik Gilhus, Marte-Helene Bjørk CURRENT STATUS AND FUTURE STRATEGIES FOR MENTORING WOMEN The American Academy of Neurology’s (AAN) 2017 Gender Disparity Report identified improving mentorship as a key intervention to fill the leadership and pay gaps for women in neurology. Here we summarize the literature on mentoring women, provide an outline of ideal components of programs geared toward closing gender gaps, and present a mentoring program for AAN members. MORE ARTICLES FROM ARTICLES The most widely read and highly cited peer-reviewed neurology journalTABLE OF CONTENTS
Health-Related Quality of Life May Predict Disease Staging in 10 Years in Parkinson Disease With Hoehn-Yahr Stage III LOG IN | NEUROLOGY CLINICAL PRACTICE For assistance, please contact: AAN Members (800) 879-1960 or (612) 928-6000 (International) Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international) SOCIOECONOMIC AND GEOGRAPHIC DISPARITIES IN IDIOPATHIC Objective To identify relationships between idiopathic intracranial hypertension (IIH) and socioeconomic determinants of health, such as low-income status and proximity to healthy food. Methods This retrospective case–control study of adult female neuro-ophthalmology patients from one institution identified 223 women with and 4,783women without IIH.
AMERICAN ACADEMY OF NEUROLOGY JOURNALSNEUROLOGYCLINICAL PRACTICEGENETICSNEUROIMMUNOLOGY & NEUROINFLAMMATIONCOVID-19 This month's replay of past episodes showcases a selection of interviews on updates in Alzheimer's disease diagnostics and the impact of future therapies, featuring Drs. Michael Weiner, Randall Bateman, Erik Musiek, Joseph Therriault, and Yvette Sheline. NEUROLOGY | THE MOST WIDELY READ AND HIGHLY CITED PEERLOG INLATEST ARTICLESCURRENT ISSUEPAST ISSUESRESIDENTS & FELLOWS This month's replay of past episodes showcases a selection of interviews on updates in Alzheimer's disease diagnostics and the impact of future therapies, featuring Drs. Michael Weiner, Randall Bateman, Erik Musiek, Joseph Therriault, and Yvette Sheline. NEUROLOGY® RESIDENT & FELLOW SECTION CLINICAL REASONINGCLINICAL REASONING CONFERENCECLINICAL REASONING IN NURSINGCLINICAL REASONING MODELWHAT IS CLINICAL REASONINGCLINICAL REASONING CYCLECLINICAL REASONING IN MEDICINE Clinical Reasoning in Neurology: A Case-Based Approach Cases from the Neurology® Resident & Fellow Section. The new Clinical Reasoning Book edited by Aaron Berkowitz, Sashank Prasad and Mitchell Elkind available as a FREE pdf download or on the Neurology app for the iPadand Android
TEMPORAL CORRELATION OF CSF AND NEUROIMAGING IN THE Objective: Temporal correlations between CSF and neuroimaging (PET and MRI) measures of amyloid, tau, and neurodegeneration were evaluated in relation to Alzheimer disease (AD) progression. Methods: Three hundred seventy-one cognitively unimpaired and impaired participants enrolled in longitudinal studies of AD had both CSF (amyloid-β42, phosphorylated tau181, total tau, and KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent MEMORY LOSS AFTER STROKE Memory loss commonly occurs as a result of the loss of nerve cells in the brain. When memory loss is so severe that it interferes with normal daily functioning, it is called dementia. People with dementia may have difficulty learning new things or remembering names of people they just met. They may get lost in places that were previously very familiar or have trouble finding words. CAFFEINE AND PARKINSON DISEASE Most cases of Parkinson disease (PD) over age 50 are sporadic, and twin studies strongly suggest a predominance of environmental over genetic etiologies.1 However, few factors have been found consistently in epidemiologic studies to have major effects, protective in all cases: smoking, urate,2 and caffeine consumption.3 The protective effect of caffeine (found not only in coffee, but also THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. ARE WHITE MATTER SIGNAL ABNORMALITIES CLINICALLY RELEVANT How often have you read, “There are small scattered foci of signal abnormalities (T2 hyperintensities or increased FLAIR signal) in the cerebral white matter indicative of demyelinating disease, chronic white matter ischemia due to microvascular disease, or gliosis from an infectious/inflammatory disease process,” or words just like them in your MRI reports of your elderly AMERICAN ACADEMY OF NEUROLOGY JOURNALSNEUROLOGYCLINICAL PRACTICEGENETICSNEUROIMMUNOLOGY & NEUROINFLAMMATIONCOVID-19 This month's replay of past episodes showcases a selection of interviews on updates in Alzheimer's disease diagnostics and the impact of future therapies, featuring Drs. Michael Weiner, Randall Bateman, Erik Musiek, Joseph Therriault, and Yvette Sheline. NEUROLOGY | THE MOST WIDELY READ AND HIGHLY CITED PEERLOG INLATEST ARTICLESCURRENT ISSUEPAST ISSUESRESIDENTS & FELLOWS This month's replay of past episodes showcases a selection of interviews on updates in Alzheimer's disease diagnostics and the impact of future therapies, featuring Drs. Michael Weiner, Randall Bateman, Erik Musiek, Joseph Therriault, and Yvette Sheline. NEUROLOGY® RESIDENT & FELLOW SECTION CLINICAL REASONINGCLINICAL REASONING CONFERENCECLINICAL REASONING IN NURSINGCLINICAL REASONING MODELWHAT IS CLINICAL REASONINGCLINICAL REASONING CYCLECLINICAL REASONING IN MEDICINE Clinical Reasoning in Neurology: A Case-Based Approach Cases from the Neurology® Resident & Fellow Section. The new Clinical Reasoning Book edited by Aaron Berkowitz, Sashank Prasad and Mitchell Elkind available as a FREE pdf download or on the Neurology app for the iPadand Android
TEMPORAL CORRELATION OF CSF AND NEUROIMAGING IN THE Objective: Temporal correlations between CSF and neuroimaging (PET and MRI) measures of amyloid, tau, and neurodegeneration were evaluated in relation to Alzheimer disease (AD) progression. Methods: Three hundred seventy-one cognitively unimpaired and impaired participants enrolled in longitudinal studies of AD had both CSF (amyloid-β42, phosphorylated tau181, total tau, and KIDNEY FUNCTION, KIDNEY FUNCTION DECLINE, AND THE RISK OF Objective: Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods: We analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis ETHICAL ISSUES IN STROKE MANAGEMENT A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent MEMORY LOSS AFTER STROKE Memory loss commonly occurs as a result of the loss of nerve cells in the brain. When memory loss is so severe that it interferes with normal daily functioning, it is called dementia. People with dementia may have difficulty learning new things or remembering names of people they just met. They may get lost in places that were previously very familiar or have trouble finding words. CAFFEINE AND PARKINSON DISEASE Most cases of Parkinson disease (PD) over age 50 are sporadic, and twin studies strongly suggest a predominance of environmental over genetic etiologies.1 However, few factors have been found consistently in epidemiologic studies to have major effects, protective in all cases: smoking, urate,2 and caffeine consumption.3 The protective effect of caffeine (found not only in coffee, but also THE FINAL MONTH OF LIFE IN PATIENTS WITH ALS Objective: To study the health care experiences and palliative care needs of patients with ALS in their final month of life. Methods: Caregivers of decedent patients with ALS completed a single survey focused on the final month of life. They reported the patients’ physical and emotional symptoms, preferences for end-of-life care, completion of advance directives, and preparation for death. ARE WHITE MATTER SIGNAL ABNORMALITIES CLINICALLY RELEVANT How often have you read, “There are small scattered foci of signal abnormalities (T2 hyperintensities or increased FLAIR signal) in the cerebral white matter indicative of demyelinating disease, chronic white matter ischemia due to microvascular disease, or gliosis from an infectious/inflammatory disease process,” or words just like them in your MRI reports of your elderly AMERICAN ACADEMY OF NEUROLOGY JOURNALS This month's replay of past episodes showcases a selection of interviews on updates in Alzheimer's disease diagnostics and the impact of future therapies, featuring Drs. Michael Weiner, Randall Bateman, Erik Musiek, Joseph Therriault, and Yvette Sheline. NEUROLOGY JOURNALS AUTHOR CENTER Clinical Reasoning. Clinical Reasoning articles focus on case presentations with the aim of developing reasoning skills among trainees. Appropriate cases for publication include uncommon presentations of common neurological disorders and typical presentations of more exotic disorders (see Clinical Reasoning Author Guide). Unstructured abstract withDetails
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