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Spotlight on the September 28 Issue
Merino, Jose G. MD, MPhil; Editor-in-Chief, Neurology(R)
doi : 10.1212/WNL.0000000000012605
Volume 97(13), 28 September 2021, p 611-612
Pimavanserin: A Friend or Foe in Parkinson Disease Psychosis
Ali, Farwa MBBS
doi : 10.1212/WNL.0000000000012656
Volume 97(13), 28 September 2021, p 613-614
Cognition and Neuropsychiatric Symptoms in Alzheimer Disease: A Century-Old Problem
Sanders, Amy E. MD, MS, FAAN
doi : 10.1212/WNL.0000000000012616
Volume 97(13), 28 September 2021, p 615-616
Assessment of Biological Interactions Between Multiple Sclerosis Status and Depression for Mortality
Salter, Amber PhD
doi : 10.1212/WNL.0000000000012615
Volume 97(13), 28 September 2021, p 617-618
Risk of Hospitalization and Death Associated With Pimavanserin Use in Older Adults With Parkinson Disease
Hwang, Y. Joseph MD, MSc; Alexander, G. Caleb MD, MS; An, Huijun MS; Moore, Thomas J. AB; Mehta, Hemalkumar B. PhD
doi : 10.1212/WNL.0000000000012601
Volume 97(13), 28 September 2021, p e1266-e1275
To determine the risk of hospitalization and death associated with pimavanserin use.
Neuropsychiatric and Cognitive Symptoms Across the Alzheimer Disease Clinical Spectrum: Cross-sectional and Longitudinal Associations
Eikelboom, Willem S. MSc; van den Berg, Esther PhD; Singleton, Ellen H. MSc; Baart, Sara J. PhD; Coesmans, Michiel PhD; Leeuwis, Annebet E. PhD; Teunissen, Charlotte E. PhD; van Berckel, Bart N.M. PhD; Pijnenburg, Yolande A.L. PhD; Scheltens, Philip PhD; van der Flier, Wiesje M. PhD; Ossenkoppele, Rik PhD; Papma, Janne M. PhD
doi : 10.1212/WNL.0000000000012598
Volume 97(13), 28 September 2021, p e1276-e1287
Data-Driven vs Consensus Diagnosis of MCI: Enhanced Sensitivity for Detection of Clinical, Biomarker, and Neuropathologic Outcomes
Edmonds, Emily C. PhD; Smirnov, Denis S. BS; Thomas, Kelsey R. PhD; Graves, Lisa V. PhD; Bangen, Katherine J. PhD; Delano-Wood, Lisa PhD; Galasko, Douglas R. MD; Salmon, David P. PhD; Bondi, Mark W. PhD
doi : 10.1212/WNL.0000000000012600
Volume 97(13), 28 September 2021, p e1288-e1299
Given prior work demonstrating that mild cognitive impairment (MCI) can be empirically differentiated into meaningful cognitive subtypes, we applied actuarial methods to comprehensive neuropsychological data from the University of California San Diego Alzheimer's Disease Research Center (ADRC) in order to identify cognitive subgroups within ADRC participants without dementia and to examine cognitive, biomarker, and neuropathologic trajectories.
Associations of the Lifestyle for Brain Health Index With Structural Brain Changes and Cognition: Results From the Maastricht Study
Heger, Irene S. MSc; Deckers, Kay PhD; Schram, Miranda T. PhD; Stehouwer, Coen D.A. MD, PhD; Dagnelie, Pieter C. PhD; van der Kallen, Carla J.H. PhD; Koster, Annemarie PhD; Eussen, Simone J.P.M. PhD; Jansen, Jacobus F.A. PhD; Verhey, Frans R.J. MD, PhD; van Boxtel, Martin P.J. PhD; Kohler, Sebastian PhD
doi : 10.1212/WNL.0000000000012572
Volume 97(13), 28 September 2021, p e1300-e1312
Observational research has shown that a substantial proportion of all dementia cases worldwide are attributable to modifiable risk factors. Dementia risk scores might be useful to identify high-risk individuals and monitor treatment adherence. The objective of this study was to investigate whether a dementia risk score, the Lifestyle for Brain Health (LIBRA) index, is associated with MRI markers and cognitive functioning/impairment in the general population.
Association of Silent Cerebrovascular Disease Identified Using Natural Language Processing and Future Ischemic Stroke
Kent, David M. MD, MS; Leung, Lester Y. MD, MSc; Zhou, Yichen MS; Luetmer, Patrick H. MD; Kallmes, David F. MD; Nelson, Jason MS; Fu, Sunyang MHI; Zheng, Chengyi PhD; Liu, Hongfang PhD; Chen, Wansu PhD
doi : 10.1212/WNL.0000000000012602
Volume 97(13), 28 September 2021, p e1313-e1321
Silent cerebrovascular disease (SCD), comprising silent brain infarction (SBI) and white matter disease (WMD), is commonly found incidentally on neuroimaging scans obtained in routine clinical care. Their prognostic significance is not known. We aimed to estimate the incidence of and risk increase in future stroke in patients with incidentally discovered SCD.
Interface of Multiple Sclerosis, Depression, Vascular Disease, and Mortality: A Population-Based Matched Cohort Study
Palladino, Raffaele MD, PhD; Chataway, Jeremy FRCP, PhD; Majeed, Azeem MD; Marrie, Ruth Ann MD, PhD
doi : 10.1212/WNL.0000000000012610
Volume 97(13), 28 September 2021, p e1322-e1333
To assess whether the association among depression, vascular disease, and mortality differs in people with multiple sclerosis (MS) compared with age-, sex-, and general practice-matched controls.
Association of Age With Contrast-Enhancing Lesions Across the Multiple Sclerosis Disease Spectrum
Koch, Marcus W. MD, PhD; Mostert, Jop MD, PhD; Zhang, Yinan MD; Wolinsky, Jerry S. MD; Lublin, Fred D. MD; Strijbis, Eva MD, PhD; Cutter, Gary PhD
doi : 10.1212/WNL.0000000000012603
Volume 97(13), 28 September 2021, p e1334-e1342
To investigate the association of age and the presence of contrast-enhancing lesions (CELs) on cranial MRI scans in different disease courses of multiple sclerosis (MS), we describe the frequency of CELs as a function of age in 4 large randomized controlled trial (RCT) datasets.
Definitions of Drug-Resistant Epilepsy for Administrative Claims Data Research
Hill, Chloe E. MD, MS; Lin, Chun Chieh PhD, MBA; Terman, Samuel W. MD, MS; Rath, Subhendu MBBS; Parent, Jack M. MD; Skolarus, Lesli E. MD, MS; Burke, James F. MD, MS
doi : 10.1212/WNL.0000000000012514
Volume 97(13), 28 September 2021, p e1343-e1350
To assess the accuracy of definitions of drug-resistant epilepsy applied to administrative claims data.
CNS Demyelinating Attacks Requiring Ventilatory Support With Myelin Oligodendrocyte Glycoprotein or Aquaporin-4 Antibodies
Zhao-Fleming, Hannah H. MD, PhD; Valencia Sanchez, Cristina MD, PhD; Sechi, Elia MD; Inbarasu, Jery MD; Wijdicks, Eelco F. MD, PhD; Pittock, Sean J. MD; Chen, John J. MD, PhD; Wingerchuk, Dean M. MD; Weinshenker, Brian G. MD; Lopez-Chiriboga, Sebastian MD; Dubey, Divyanshu MBBS; Tillema, Jan-Mendelt MD; Toledano, Michel MD; Yadav, Hemang MD; Flanagan, Eoin P. MD
doi : 10.1212/WNL.0000000000012599
Volume 97(13), 28 September 2021, p e1351-e1358
Severe attacks of myelin oligodendrocyte glycoprotein (MOG) antibody-associated disorder (MOGAD) and aquaporin-4 (AQP4) antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) may require ventilatory support, but data on episodes are limited, particularly for MOGAD. We sought to compare the frequency, characteristics, and outcomes of MOGAD and AQP4-NMOSD attacks requiring ventilatory support.
Rituximab-Lenalidomide-Ibrutinib Combination for Relapsed/Refractory Primary CNS Lymphoma: A Case Series of the LOC Network
Houillier, Caroline MD; Chabrot, Cecile Molucon MD; Moles-Moreau, Marie-Pierre MD; Willems, Lise MD; Ahle, Guido MD; Waultier-Rascalou, Agathe MD; Fornecker, Luc-Matthieu MD, PhD; Hoang-Xuan, Khe MD, PhD; Soussain, Carole MD, PhD
doi : 10.1212/WNL.0000000000012515
Volume 97(13), 28 September 2021, p 628-631
To evaluate the efficacy and tolerance of the association rituximab-lenalidomide-ibrutinib (R2I) in relapsed/refractory (R/R) primary CNS lymphoma (PCNSL).
Guidelines for Conducting Ethical Artificial Intelligence Research in Neurology: A Systematic Approach for Clinicians and Researchers
Chiang, Sharon MD, PhD; Picard, Rosalind W. ScD; Chiong, Winston MD, PhD; Moss, Robert BS; Worrell, Gregory A. MD, PhD; Rao, Vikram R. MD, PhD; Goldenholz, Daniel M. MD, PhD
doi : 10.1212/WNL.0000000000012570
Volume 97(13), 28 September 2021, p 632-640
Preemptive recognition of the ethical implications of study design and algorithm choices in artificial intelligence (AI) research is an important but challenging process. AI applications have begun to transition from a promising future to clinical reality in neurology. As the clinical management of neurology is often concerned with discrete, often unpredictable, and highly consequential events linked to multimodal data streams over long timescales, forthcoming advances in AI have great potential to transform care for patients. However, critical ethical questions have been raised with implementation of the first AI applications in clinical practice. Clearly, AI will have far-reaching potential to promote, but also to endanger, ethical clinical practice. This article employs an anticipatory ethics approach to scrutinize how researchers in neurology can methodically identify ethical ramifications of design choices early in the research and development process, with a goal of preempting unintended consequences that may violate principles of ethical clinical care. First, we discuss the use of a systematic framework for researchers to identify ethical ramifications of various study design and algorithm choices. Second, using epilepsy as a paradigmatic example, anticipatory clinical scenarios that illustrate unintended ethical consequences are discussed, and failure points in each scenario evaluated. Third, we provide practical recommendations for understanding and addressing ethical ramifications early in methods development stages. Awareness of the ethical implications of study design and algorithm choices that may unintentionally enter AI is crucial to ensuring that incorporation of AI into neurology care leads to patient benefit rather than harm.
Carpet Neurons and the Bottom Line
Kostyk, Sandra K. MD, PhD
doi : 10.1212/WNL.0000000000012066
Volume 97(13), 28 September 2021, p 641
Slit Lamp Demonstration of Heartbeat Nystagmus Due to Superior Canal Dehiscence
Karam, Emely Zoraida MD, PhD; Moreno, Asdrubal F. MD; Benavides, Maria Alejandra MD
doi : 10.1212/WNL.0000000000012470
Volume 97(13), 28 September 2021, p 642-643
Resident & Fellow Rounds: September 2021
Strowd, Roy E. III MD, MEd, MS, FAAN; Editor; Aamodt, Whitley MD, MPH; Deputy Editor
doi : 10.1212/WNL.0000000000012608
Volume 97(13), 28 September 2021, p 644-646
Opinion & Special Articles: Maximizing Inclusiveness and Diversity Through Virtual Residency Applications and Interviews
Budhu, Joshua A. MD; Velazquez, Ana I. MD, MSc; Said, Rana R. MD; Jordan, Justin T. MD, MPH
doi : 10.1212/WNL.0000000000012487
Volume 97(13), 28 September 2021, p 647-650
Teaching NeuroImage: Dynamic MRI in the Evaluation of Cervical Myelopathy
Quintas-Neves, Miguel MD; Carneiro, Angelo MD, MSc
doi : 10.1212/WNL.0000000000012181
Volume 97(13), 28 September 2021, p e1359-e1360
Teaching NeuroImage: Nitromethane-Induced Acute Reversible Encephalopathy
Palumbo, Giovanni MD; Besana, Michele MD; Ananiadou, Sofia MD; Giordano, Carolina MD; Maccabelli, Gloria MD; Riccio, Mario MD; Campana, Chiara MD; Giossi, Alessia MD; Piovan, Enrico MD; Lonati, Davide MD; Pinelli, Lorenzo MD
doi : 10.1212/WNL.0000000000012178
Volume 97(13), 28 September 2021, p e1361-e1362
Alzheimer Disease and Mood
Kim, Yee Jung; Karceski, Steven MD
doi : 10.1212/WNL.0000000000012607
Volume 97(13), 28 September 2021, p e1363-e1366
Editors' Note: Opinion and Special Articles: Remote Evaluation of Acute Vertigo: Strategies and Technological Considerations
Lewis, Ariane MD; Galetta, Steven MD
doi : 10.1212/WNL.0000000000012629
Volume 97(13), 28 September 2021, p 651
Reader Response: Opinion and Special Articles: Remote Evaluation of Acute Vertigo: Strategies and Technological Considerations
Tjell, Carsten
doi : 10.1212/WNL.0000000000012628
Volume 97(13), 28 September 2021, p 651
Author Response: Opinion and Special Articles: Remote Evaluation of Acute Vertigo Strategies and Technological Considerations
Green, Kemar E.; Pogson, Jacob M.; Otero-Millan, Jorge; Gold, Daniel R.; Tevzadze, Nana; Saber Tehrani, Ali S.; Zee, David S.; Newman-Toker, David E.; Kheradmand, Amir
doi : 10.1212/WNL.0000000000012630
Volume 97(13), 28 September 2021, p 652
Editors' Note: Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders: A Multinational Prospective Cohort Study
Lewis, Ariane MD; Galetta, Steven MD
doi : 10.1212/WNL.0000000000012631
Volume 97(13), 28 September 2021, p 652-653
Reader Response: Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders: A Multinational Prospective Cohort Study
Ubhi, Tim; Chang, Kiki; Gupta, Rajat; Cunningham, Janet; Spalice, Alberto; Van der Spek, Peter J.
doi : 10.1212/WNL.0000000000012637
Volume 97(13), 28 September 2021, p 653-654
Author Response: Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders: A Multinational Prospective Cohort Study
Martino, Davide
doi : 10.1212/WNL.0000000000012638
Volume 97(13), 28 September 2021, p 654
