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JAMA Neurology

Barry W Rovner, Robin J Casten, Mark T Hegel, Benjamin Leiby
Importance: Mild cognitive impairment (MCI) is a transition state between normal cognitive aging and dementia that increases the risk for progressive cognitive decline. Preventing cognitive decline is a public health priority. Objective: To determine whether behavioral activation prevents cognitive and functional decline over 2 years in black individuals with MCI. Design, Setting, and Participants: Single-center, single-masked, attention-controlled randomized clinical trial...
September 10, 2018: JAMA Neurology
Kubéraka Mariampillai, Benjamin Granger, Damien Amelin, Marguerite Guiguet, Eric Hachulla, François Maurier, Alain Meyer, Aline Tohmé, Jean-Luc Charuel, Lucile Musset, Yves Allenbach, Olivier Benveniste
Importance: Idiopathic inflammatory myopathies are heterogeneous in their pathophysiologic features and prognosis. The emergence of myositis-specific autoantibodies suggests that subgroups of patients exist. Objective: To develop a new classification scheme for idiopathic inflammatory myopathies based on phenotypic, biological, and immunologic criteria. Design, Setting, and Participants: An observational, retrospective cohort study was performed using a database of the French myositis network...
September 10, 2018: JAMA Neurology
Nicholas L Zalewski, Alejandro A Rabinstein, Waleed Brinjikji, Timothy J Kaufmann, Deena Nasr, Michael W Ruff, Eoin P Flanagan
Importance: Spinal dural arteriovenous fistula (sDAVF) is often misdiagnosed as an inflammatory or a neoplastic myelopathy, often because of intraparenchymal gadolinium enhancement on magnetic resonance imaging (MRI); proper early diagnosis is important because deficits are reversible and a delay in treatment is associated with permanent morbidity. Tortuous flow voids on MRI are not universally present; thus, recognition of a unique gadolinium enhancement pattern may also aid in the early recognition and treatment of sDAVF...
September 10, 2018: JAMA Neurology
Xueyan Zhang, Jun Li
No abstract text is available yet for this article.
September 10, 2018: JAMA Neurology
Jessalyn K Holodinsky, Tyler S Williamson, Andrew M Demchuk, Henry Zhao, Luke Zhu, Michael J Francis, Mayank Goyal, Michael D Hill, Noreen Kamal
Importance: Ischemic stroke with large-vessel occlusion can be treated with alteplase and/or endovascular therapy; however, the administration of each treatment is time sensitive. Objective: To identify the optimal triage and transport strategy: direct to the endovascular center (mothership) or immediate alteplase treatment followed by transfer to the endovascular center (drip and ship), for all patients with suspected large-vessel occlusion stroke. Design Setting, and Participants: This was a theoretical, conditional probability modeling study...
September 4, 2018: JAMA Neurology
(no author information available yet)
No abstract text is available yet for this article.
September 4, 2018: JAMA Neurology
Garrett S Gibbons, Virginia M Y Lee, John Q Trojanowski
Importance: Intracellular tau protein aggregates are a pathological hallmark of neurodegenerative tauopathies, including Alzheimer disease (AD), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and Pick disease. Emerging evidence supports a model of cell-to-cell transmission of proteinaceous pathological tau seeds, which leads to recruitment and templated fibrillization of endogenous cellular tau followed by the spread of abnormal tau throughout the brain. These findings lead to the strain hypothesis, which predicts that distinct conformational strains or polymorphs of tau may underlie the clinical and neuropathological heterogeneity and cell-type specificity of tauopathies...
September 4, 2018: JAMA Neurology
Sheela Maru
No abstract text is available yet for this article.
September 4, 2018: JAMA Neurology
Lee H Schwamm
No abstract text is available yet for this article.
September 4, 2018: JAMA Neurology
Larry B Goldstein, Laura Lennihan, Meheroz J Rabadi, David C Good, Michael J Reding, Alexander W Dromerick, Gregory P Samsa, John Pura
Importance: Data from animal models show that the administration of dextroamphetamine combined with task-relevant training facilitates recovery after focal brain injury. Results of clinical trials in patients with stroke have been inconsistent. Objectives: To collect data important for future studies evaluating the effect of dextroamphetamine combined with physiotherapy for improving poststroke motor recovery and to test the efficacy of the approach. Design, Setting, Participants: This pilot, double-blind, block-randomized clinical trial included patients with cortical or subcortical ischemic stroke and moderate or severe motor deficits from 5 rehabilitation hospitals or units...
August 27, 2018: JAMA Neurology
Barney J Stern, Walter Royal, Jeffrey M Gelfand, David B Clifford, Jinny Tavee, Siddharama Pawate, Joseph R Berger, Allen J Aksamit, Allan Krumholz, Carlos A Pardo, David R Moller, Marc A Judson, Marjolein Drent, Robert P Baughman
Importance: The Neurosarcoidosis Consortium Consensus Group, an expert panel of physicians experienced in the management of patients with sarcoidosis and neurosarcoidosis, engaged in an iterative process to define neurosarcoidosis and develop a practical diagnostic approach to patients with suspected neurosarcoidosis. This panel aimed to develop a consensus clinical definition of neurosarcoidosis to enhance the clinical care of patients with suspected neurosarcoidosis and to encourage standardization of research initiatives that address this disease...
August 27, 2018: JAMA Neurology
Robert W Regenhardt, Alvin S Das, Eng H Lo, Louis R Caplan
Importance: Stroke is the second leading cause of death in the world, and nearly one-third of ischemic strokes are lacunar strokes (LSs) or small subcortical infarcts. Although smaller in size, they create large problems, leaving many patients with intellectual and physical disabilities. Because there are limitations in understanding the underlying pathophysiology of LS, the development of novel therapies has been slow. Observations: When the term lacune was described in the 1800s, its underlying pathophysiological basis was obscure...
August 27, 2018: JAMA Neurology
Deborah A Levine, James F Burke, Colman F Shannon, Bailey K Reale, Lena M Chen
Importance: Among adults with chronic disease, survivors of stroke have high out-of-pocket financial burdens. The US government enacted the Affordable Care Act (ACA) in 2010 and implemented the law in 2014 to provide more low-income adults with health insurance coverage. Objective: To assess whether ACA implementation is associated with cost-related nonadherence (CRN) to medication among adult survivors of stroke. Design, Setting, and Participants: This study analyzed data from the 2000 to 2016 National Health Interview Survey, an in-person household survey of the noninstitutionalized US population conducted annually by the National Center for Health Statistics...
August 27, 2018: JAMA Neurology
Fei Xiao, Xin Tian, Xue-Feng Wang
No abstract text is available yet for this article.
August 27, 2018: JAMA Neurology
Eileen Roulis, Catherine Hyland, Robert Flower, Christoph Gassner, Hans H Jung, Beat M Frey
Importance: McLeod syndrome, encoded by the gene XK, is a rare and progressive disease that shares important similarities with Huntington disease but has widely varied neurologic, neuromuscular, and cardiologic manifestations. Patients with McLeod syndrome have a distinct hematologic presentation with specific transfusion requirements. Because of its X-linked location, loss of the XK gene or pathogenic variants in this gene are principally associated with the McLeod blood group phenotype in male patients...
August 20, 2018: JAMA Neurology
Steven C Cramer
No abstract text is available yet for this article.
August 20, 2018: JAMA Neurology
Zarina Abdul Assis, Robert Sevick
No abstract text is available yet for this article.
August 20, 2018: JAMA Neurology
Julius Fridriksson, Chris Rorden, Jordan Elm, Souvik Sen, Mark S George, Leonardo Bonilha
Importance: Aphasia is a debilitating language disorder for which behavioral speech therapy is the most efficient treatment, but therapy outcomes are variable and full recovery is not always achieved. It remains unclear if adjunctive brain stimulation (anodal transcranial direct current stimulation [A-tDCS]) applied during aphasia therapy can improve outcomes. Objective: To examine the futility of studying A-tDCS as an adjunctive intervention during speech therapy to improve speech production (naming) for individuals with long-term poststroke aphasia...
August 20, 2018: JAMA Neurology
Wen-Yi Huang, Daniel E Singer, Yi-Ling Wu, Chern-En Chiang, Hsu-Huei Weng, Meng Lee, Bruce Ovbiagele
Importance: Non-vitamin K antagonist oral anticoagulants (NOACs) might be an attractive choice for stroke prevention in people without atrial fibrillation who may harbor a potential source of cardiac emboli, but not if certain individual NOACs carry risks of intracranial hemorrhage that are heightened relative to aspirin. Objective: To conduct a systematic review and meta-analysis of randomized clinical trials to assess the risk of intracranial hemorrhage with individual NOACs vs aspirin across all indications...
August 13, 2018: JAMA Neurology
Usha K Misra, Jayantee Kalita, Mritunjai Kumar
Importance: Tuberculous meningitis is associated with high frequency of cerebral salt wasting. There is a paucity of objective information regarding the best method of treatment of this condition. Objective: To evaluate the efficacy and safety of fludrocortisone in the treatment of cerebral salt wasting in patients with tuberculous meningitis. Design, Setting, and Participants: This is a single-center, open-label, randomized clinical trial conducted from October 2015 to April 2017 in India...
August 13, 2018: JAMA Neurology
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