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Andrew B Buletko, Tapan Thacker, Sung-Min Cho, Jason Mathew, Nicolas R Thompson, Natalie Organek, Jennifer A Frontera, Ken Uchino
OBJECTIVE: To determine the incidence and predictors of acute cerebral ischemia and neurologic deterioration in intracerebral hemorrhage (ICH) patients after an institutional protocol change in systolic blood pressure (SBP) target from <160 to <140 mm Hg. METHODS: We retrospectively compared persons admitted with primary ICH before and after a protocol change in SBP target from <160 to <140 mm Hg. The primary outcomes were presence of acute cerebral ischemia on MRI completed within 2 weeks of ICH and acute neurologic deterioration...
August 10, 2018: Neurology
Emily L Johnson, Anne E Burke, Anqi Wang, Page B Pennell
OBJECTIVE: To compare the proportions of unintended pregnancies, prenatal vitamin or folic acid (PNVF) use, adequate prenatal care visits, and breastfeeding among women with epilepsy (WWE) to women without epilepsy (WWoE). METHODS: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an annual survey of randomly sampled postpartum women administered by the Centers for Disease Control and Prevention. We used PRAMS data from 13 states from 2009 to 2014 to compare the primary outcomes in WWE and WWoE, as well as our secondary outcomes of contraception practices, newborn outcomes, and time to recognition of pregnancy...
August 10, 2018: Neurology
Gregory Kapinos, Daniel F Hanley
No abstract text is available yet for this article.
August 10, 2018: Neurology
Kathrin Reetz, Imis Dogan, Christian Hohenfeld, Claire Didszun, Paola Giunti, Caterina Mariotti, Alexandra Durr, Sylvia Boesch, Thomas Klopstock, Francisco Javier Rodríguez de Rivera Garrido, Ludger Schöls, Ilaria Giordano, Katrin Bürk, Massimo Pandolfo, Jörg B Schulz
OBJECTIVE: To provide a systematic evaluation of the broad clinical variability in Friedreich ataxia (FRDA), a multisystem disorder presenting mainly with afferent ataxia but also a complex phenotype of nonataxia symptoms. METHODS: From the large database of the European Friedreich's Ataxia Consortium for Translational Studies, 650 patients with genetically confirmed FRDA were included. Detailed data of medical history documentation, questionnaires, and reports on clinical features were analyzed to provide in-depth description of the clinical profile and frequency rates of phenotypical features with a focus on differences between typical-onset and late-onset FRDA...
August 10, 2018: Neurology
Wyatt P Bensken, Alexandra K Hansen, Gina Norato, John D Heiss, Avindra Nath, Omar I Khan
OBJECTIVE: The objective of this study was to evaluate the methods by which neurology physician-scientists are quantified through applying author-level metrics to commonly used definitions when discussing funding efforts aimed at the attrition of the physician-scientist workforce. METHODS: Neurology residency alumni from institutions with the highest National Institute of Neurological Disorders and Stroke funding were identified for 2003-2005, and their funding records, publishing history, and impact factor ( h -index) were obtained via the NIH Research Portfolio Online Reporting Tools and Scopus Author Profile...
August 10, 2018: Neurology
Susan R Criswell, Mark N Warden, Susan Searles Nielsen, Joel S Perlmutter, Stephen M Moerlein, Lianne Sheppard, Jason Lenox-Krug, Harvey Checkoway, Brad A Racette
OBJECTIVE: To investigate the associations between manganese (Mn) exposure, D2 dopamine receptors (D2Rs), and parkinsonism using [11 C](N-methyl)benperidol (NMB) PET. METHODS: We used NMB PET to evaluate 50 workers with a range of Mn exposure: 22 Mn-exposed welders, 15 Mn-exposed workers, and 13 nonexposed workers. Cumulative Mn exposure was estimated from work histories, and movement disorder specialists examined all workers. We calculated NMB D2R nondisplaceable binding potential (BPND) for the striatum, globus pallidus, thalamus, and substantia nigra (SN)...
August 10, 2018: Neurology
Seo Young Choi, Ji-Yeong Jang, Eun Hye Oh, Jae-Hwan Choi, Ji Yun Park, Seong-Han Lee, Kwang-Dong Choi
OBJECTIVE: To determine the prevalence of central lesions in persistent geotropic positional nystagmus, and characteristics and anatomical substrates of the nystagmus in cerebellar lesions. METHODS: We prospectively recruited 58 patients with persistent geotropic positional nystagmus at the Dizziness Clinic of Pusan National University Hospital. Seven patients with unilateral cerebellar lesions were subjected to analysis of clinical characteristics, oculographic data, and MRI lesions...
August 10, 2018: Neurology
Mark W Mahowald, Carlos H Schenck
No abstract text is available yet for this article.
August 8, 2018: Neurology
Joseph J Fins, James L Bernat
This essay complements the scientific and practice scope of the American Academy of Neurology Guideline on Disorders of Consciousness by providing a discussion of the ethical, palliative, and policy aspects of the management of this group of patients. We endorse the renaming of "permanent" vegetative state to "chronic" vegetative state given the increased frequency of reports of late improvements but suggest that further refinement of this class of patients is necessary to distinguish late recoveries from patients who were misdiagnosed or in cognitive-motor dissociation...
August 8, 2018: Neurology
Ronald C Petersen
A seismic shift in our understanding of the ability to diagnose Alzheimer disease (AD) is occurring. For the last several decades, AD has been a clinical-pathologic diagnosis, and this conceptualization of the disease has served the field well. Typically, the clinician would identify a syndrome such as mild cognitive impairment or dementia, and label the condition as "probable AD" since the diagnosis of definite AD could not be made until an autopsy revealed the presence of amyloid plaques and tau-based neurofibrillary tangles...
August 8, 2018: Neurology
Mehdi Touat, Thierry Maisonobe, Samuel Knauss, Omar Ben Hadj Salem, Baptiste Hervier, Karine Auré, Tali-Anne Szwebel, Nora Kramkimel, Claire Lethrosne, Jean-Frédéric Bruch, Pauline Laly, Jacques Cadranel, Nicolas Weiss, Anthony Béhin, Yves Allenbach, Olivier Benveniste, Timothée Lenglet, Dimitri Psimaras, Werner Stenzel, Sarah Léonard-Louis
OBJECTIVE: To report the clinicopathologic features and outcome of myositis in patients treated with immune checkpoint inhibitors (ICIs) (irMyositis). METHODS: We retrospectively analyzed patients diagnosed with irMyositis in tertiary centers in Paris, France, and Berlin, Germany, from January 2015 to July 2017. Main outcomes were clinical manifestations and muscle histology, which included major histocompatibility complex class I (MHC-I), C5b-9, CD3, CD4, CD8, CD20, CD68, programmed death-1 receptor (PD-1), programmed death ligand (PD-L) 1, and PD-L2 immunohistochemical stains...
August 8, 2018: Neurology
Joseph T Giacino, Douglas I Katz, Nicholas D Schiff, John Whyte, Eric J Ashman, Stephen Ashwal, Richard Barbano, Flora M Hammond, Steven Laureys, Geoffrey S F Ling, Risa Nakase-Richardson, Ronald T Seel, Stuart Yablon, Thomas S D Getchius, Gary S Gronseth, Melissa J Armstrong
OBJECTIVE: To update the 1995 American Academy of Neurology (AAN) practice parameter on persistent vegetative state and the 2002 case definition on minimally conscious state (MCS) and provide care recommendations for patients with prolonged disorders of consciousness (DoC). METHODS: Recommendations were based on systematic review evidence, related evidence, care principles, and inferences using a modified Delphi consensus process according to the AAN 2011 process manual, as amended...
August 8, 2018: Neurology
Joseph T Giacino, Douglas I Katz, Nicholas D Schiff, John Whyte, Eric J Ashman, Stephen Ashwal, Richard Barbano, Flora M Hammond, Steven Laureys, Geoffrey S F Ling, Risa Nakase-Richardson, Ronald T Seel, Stuart Yablon, Thomas S D Getchius, Gary S Gronseth, Melissa J Armstrong
OBJECTIVE: To update the 1995 American Academy of Neurology (AAN) practice parameter on persistent vegetative state and the 2002 case definition for the minimally conscious state (MCS) by reviewing the literature on the diagnosis, natural history, prognosis, and treatment of disorders of consciousness lasting at least 28 days. METHODS: Articles were classified per the AAN evidence-based classification system. Evidence synthesis occurred through a modified Grading of Recommendations Assessment, Development and Evaluation process...
August 8, 2018: Neurology
Svetlana Lorenzano
No abstract text is available yet for this article.
August 8, 2018: Neurology
Gennaro Pagano, Rosa De Micco, Tayyabah Yousaf, Heather Wilson, Avinash Chandra, Marios Politis
OBJECTIVE: To investigate whether REM sleep behavior disorder (RBD) is associated with worse motor and cognitive decline in Parkinson disease (PD) METHODS: Four-hundred twenty-one drug-naive patients with early-stage PD and 196 controls without PD were included in this study. All participants underwent a [123 I]FP-CIT SPECT scan, CSF assessment, 3-tesla MRI, and thorough clinical assessments. RESULTS: At cross-sectional analyses, patients with PD and probable RBD (PD-RBD) had lower CSF β-amyloid 1-42 (Aβ42 ) levels and higher total tau to Aβ42 CSF ratio, higher nonmotor symptoms burden, and worse scores on neuropsychological tests of processing speed, visuospatial functioning, and delayed recognition memory compared to patients with PD without RBD...
August 8, 2018: Neurology
Anxin Wang, Jie Xu, Guojuan Chen, David Wang, S Claiborne Johnston, Xia Meng, Jinxi Lin, Hao Li, Yibin Cao, Nan Zhang, Caiyun Ma, Liye Dai, Xingquan Zhao, Liping Liu, Yongjun Wang, Yilong Wang
OBJECTIVE: To investigate the association between oxidized low-density lipoprotein (oxLDL) and recurrent stroke in patients with minor stroke or TIA. METHODS: In the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) trial, baseline oxLDL levels were blindly measured in plasma with the 4E6 antibody in the core laboratory. The primary outcome was any stroke within 90 days. The secondary outcomes included any stroke within 1 year and ischemic stroke and combined vascular events within 90 days and 1 year...
August 8, 2018: Neurology
Mohamad Habes, Aristeidis Sotiras, Guray Erus, Jon B Toledo, Deborah Janowitz, David A Wolk, Haochang Shou, Nick R Bryan, Jimit Doshi, Henry Völzke, Ulf Schminke, Wolfgang Hoffmann, Susan M Resnick, Hans J Grabe, Christos Davatzikos
OBJECTIVES: To investigate spatial heterogeneity of white matter lesions or hyperintensities (WMH). METHODS: MRI scans of 1,836 participants (median age 52.2 ± 13.16 years) encompassing a wide age range (22-84 years) from the cross-sectional Study of Health in Pomerania (Germany) were included as discovery set identifying spatially distinct components of WMH using a structural covariance approach. Scans of 307 participants (median age 73.8 ± 10.2 years, with 747 observations) from the Baltimore Longitudinal Study of Aging (United States) were included to examine differences in longitudinal progression of these components...
August 3, 2018: Neurology
Trevor Thompson, Damian Poulter, Clare Miles, Marco Solmi, Nicola Veronese, André F Carvalho, Brendon Stubbs, Ergun Y Uc
OBJECTIVES: To provide the best possible evidence base for guiding driving decisions in Parkinson disease (PD), we performed a meta-analysis comparing patients with PD to healthy controls (HCs) on naturalistic, on-the-road, and simulator driving outcomes. METHODS: Seven major databases were systematically searched (to January 2018) for studies comparing patients with PD to HCs on overall driving performance, with data analyzed using random-effects meta-analysis...
August 3, 2018: Neurology
David A Loewenstein, Rosie E Curiel, Steven DeKosky, Russell M Bauer, Monica Rosselli, Salvador M Guinjoan, Malek Adjouadi, Ailyn Peñate, William W Barker, Sindy Goenaga, Todd Golde, Maria T Greig-Custo, Kevin S Hanson, Chunfei Li, Gabriel Lizarraga, Michael Marsiske, Ranjan Duara
OBJECTIVE: Semantic intrusion (SI) errors may highlight specific breakdowns in memory associated with preclinical Alzheimer disease (AD); however, there have been no investigations to determine whether SI errors occur with greater frequency in persons with amnestic mild cognitive impairment (aMCI) confirmed as amyloid positive (Amy+) vs those who have clinical symptoms of aMCI-AD with negative amyloid scans (suspected non-AD pathology [SNAP]) or persons who are diagnosed with other brain disorders affecting cognition...
August 3, 2018: Neurology
Irene de Boer, Anine H Stam, Linde Buntinx, Ronald Zielman, Iris van der Steen, Arn M J M van den Maagdenberg, Eelco J P de Koning, Michel D Ferrari, Jan N de Hoon, Gisela M Terwindt
OBJECTIVE: We aimed to evaluate the role of endothelial-dependent and endothelial-independent vascular reactivity in retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), both cerebral small vessel diseases are considered models for stroke, vascular dementia, and migraine. METHODS: RVCL-S (n = 18) and CADASIL (n = 23) participants with TREX1 and NOTCH3 mutations, respectively, were compared with controls matched for age, body mass index, and sex (n = 26)...
August 3, 2018: Neurology
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