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Spotlight on the October 12 Issue
Merino, Jose G. MD, MPhil
doi : 10.1212/WNL.0000000000012672
Volume 97(15), 12 October 2021, p 705-706
Ensuring That an Equity, Diversity, Inclusion, and Anti-racism Pledge Promotes Meaningful Change: Words and Actions
Ebong, Ima M. MD, MS; Spector, Andrew R. MD
doi : 10.1212/WNL.0000000000012695
Volume 97(15), 12 October 2021, p 707-708
Prediagnostic Neurofilament Light Chain Levels in Amyotrophic Lateral Sclerosis
Bjornevik, Kjetil MD, PhD; O'Reilly, Eilis J. ScD; Molsberry, Samantha PhD; Kolonel, Laurence N. MD, PhD; Le Marchand, Loic MD, PhD; Paganoni, Sabrina MD, PhD; Schwarzschild, Michael A. MD, PhD; Benkert, Pascal PhD; Kuhle, Jens MD, PhD; Ascherio, Alberto MD, DrPH
doi : 10.1212/WNL.0000000000012632
Volume 97(15), 12 October 2021, p e1466-e1474
To assess whether plasma neurofilament light chain (NfL) levels are elevated before amyotrophic lateral sclerosis (ALS) diagnosis and to evaluate whether prediagnostic NfL levels are associated with metabolic alterations.
Longitudinal Assessment of Strength, Functional Capacity, Oropharyngeal Function, and Quality of Life in Oculopharyngeal Muscular Dystrophy
Kroon, Rosemarie H.M.J.M. MA; Kalf, Johanna G. PhD; de Swart, Bert J.M. PhD; van der Sluijs, Barbara M. MD, PhD; Glennon, Jeffrey C. PhD; Raz, Vered PhD; van Engelen, Baziel G. MD, PhD*; Horlings, Corinne G.C. MD, PhD*
doi : 10.1212/WNL.0000000000012640
Volume 97(15), 12 October 2021, p e1475-e1483
Oculopharyngeal muscular dystrophy (OPMD) is a late-onset, progressive muscle disease. Disease progression is known to be slow, but details on the natural history remain unknown. We aimed to examine the natural history of OPMD in a large nationwide cohort to determine clinical outcome measures that capture disease progression and can be used in future clinical trials.
VEGF and Immune Checkpoint Inhibition for Prevention of Brain Metastases: Systematic Review and Meta-analysis
Mansouri, Alireza MD; Padmanaban, Varun MD; Aregawi, Dawit MD; Glantz, Michael MD
doi : 10.1212/WNL.0000000000012642
Volume 97(15), 12 October 2021, p e1484-e1492
We conducted a systematic review and meta-analysis to investigate the role of vascular endothelial growth factor (VEGF) inhibitors and immune checkpoint inhibitors (ICIs) in preventing the development of brain metastases (BMs).
Prevalence and Risk Factors of Cerebral Microbleeds: Analysis From the UK Biobank
Lu, Dongwei MD, PhD; Liu, Junfeng MD, PhD; MacKinnon, Andrew D. FRCR; Tozer, Daniel J. PhD; Markus, Hugh S. FMedSci
doi : 10.1212/WNL.0000000000012673
Volume 97(15), 12 October 2021, p e1493-e1502
To determine the prevalence of and risk factors for cerebral microbleeds (CMBs) at different locations in a large healthy community population.
Association of Neighborhood-Level Material Deprivation With Health Care Costs and Outcome After Stroke
Yu, Amy Y.X. MD, MSc; Smith, Eric E. MD, MPH; Krahn, Murray MD, MSc; Austin, Peter C. PhD; Rashid, Mohammed MSc; Fang, Jiming PhD; Porter, Joan MSc; Vyas, Manav V. MBBS, PhD; Bronskill, Susan E. PhD; Swartz, Richard H. MD, PhD; Kapral, Moira K. MD, MSc
doi : 10.1212/WNL.0000000000012676
Volume 97(15), 12 October 2021, p e1503-e1511
To determine the association between material deprivation and direct health care costs and clinical outcomes following stroke in the context of a publicly funded universal health care system.
Combined Neurophysiologic and Neuroimaging Approach to Reveal the Structure-Function Paradox in Cervical Myelopathy
Scheuren, Paulina Simonne MSc; David, Gergely PhD; Kramer, John Lawrence Kipling PhD; Jutzeler, Catherine Ruth PhD; Hupp, Markus MD; Freund, Patrick MD, PhD; Curt, Armin MD; Hubli, Michele PhD*; Rosner, Jan MD*
doi : 10.1212/WNL.0000000000012643
Volume 97(15), 12 October 2021, p e1512-e1522
To explore the so-called structure-function paradox in individuals with focal spinal lesions by means of tract-specific MRI coupled with multimodal evoked potentials and quantitative sensory testing.
Association of EEG-fMRI Responses and Outcome After Epilepsy Surgery
Koupparis, Andreas MD, PhD; von Ellenrieder, Nicolas PhD; Khoo, Hui Ming MD, PhD; Zazubovits, Natalja MSc; Nguyen, Dang Khoa MD, PhD; Hall, Jeffery A. MD; Dudley, Roy W.R. MD; Dubeau, Francois MD; Gotman, Jean PhD
doi : 10.1212/WNL.0000000000012660
Volume 97(15), 12 October 2021, p e1523-e1536
To assess the utility of EEG-fMRI for epilepsy surgery, we evaluated surgical outcome in relation to the resection of the most significant EEG-fMRI response.
Adenovirus-Vectored COVID-19 Vaccine-Induced Immune Thrombosis of Carotid Artery: A Case Report
Walter, Uwe MD, FEAN; Fuchs, Mario; Grossmann, Annette MD; Walter, Michael MD; Thiele, Thomas MD; Storch, Alexander MD; Wittstock, Matthias MD
doi : 10.1212/WNL.0000000000012576
Volume 97(15), 12 October 2021, p 716-719
Venous thrombosis and thrombocytopenia after vaccination with the adenovirus-vectored COVID-19 vaccine ChAdOx1 nCov-19 (AstraZeneca) have been linked to serum antibodies against platelet factor 4 (PF4)-polyanion complexes. We here report vaccine-induced isolated carotid arterial thrombosis.
COVID-19 and Vaccination in the Setting of Neurologic Disease: An Emerging Issue in Neurology
Marsh, Elisabeth B. MD; Kornberg, Michael MD, PhD; Kessler, Kevin MD; Haq, Ihtsham MD; Patel, Anup D. MD; Nath, Avindra MD; Schierman, Becky MPH; Jones, Lyell K. Jr MD; on behalf of the Quality Committee of the American Academy of Neurology; on behalf of the Quality Committee of the American Academy of Neurology
doi : 10.1212/WNL.0000000000012578
Volume 97(15), 12 October 2021, p 720-728
The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has left many unanswered questions for patients with neurologic disorders and the providers caring for them. Elderly and immunocompromised patients are at increased risk for severe symptoms due to COVID-19, and the virus may increase symptoms of underlying neurologic illness, particularly for those with substantial bulbar and respiratory weakness or other neurologic disability. Emerging SARS-CoV-2 vaccines offer substantial protection from symptomatic infection, but both patients and providers may have concerns regarding theoretical risks of vaccination, including vaccine safety and efficacy in the context of immunotherapy and the potential for precipitating or exacerbating neurologic symptoms. In this statement on behalf of the Quality Committee of the American Academy of Neurology, we review the current literature, focusing on COVID-19 infection in adults with neurologic disease, in order to elucidate risks and benefits of vaccination in these individuals. Based on existing evidence, neurologists should recommend COVID-19 vaccination to their patients. For those patients being treated with immunotherapies, attention should be paid to timing of vaccination with respect to treatment and the potential for an attenuated immune response.
Development of an Equity, Diversity, Inclusion, and Anti-racism Pledge as the Foundation for Action in an Academic Department of Neurology
Gordon Perue, Gillian L. MBBS, DM; Fox-Rosellini, Susan E. MBA; Sur, Nicole B. MD; Marulanda-Londono, Erika MD; Margolesky, Jason MD; Tornes, Leticia MD; Bure, Annelly PhD; Kalika, Paige M. MD; Chileuitt, Abraham Andres MD; Allespach, Heidi PhD; Uthman, Basim M. MD; Alkhachroum, Ayham MD; Sacco, Ralph L. MD; Monteith, Teshamae S. MD
doi : 10.1212/WNL.0000000000012674
Volume 97(15), 12 October 2021, p 729-736
Recent racial inequities as illustrated by the health disparities in COVID-19 infections and deaths, the recent killings of Black men and women by law enforcement, and the widening socioeconomic inequality and have brought systemic racism into a national conversation. These unprecedented times may have deleterious consequences, increasing stress, and trauma for many members of the neurology workforce. The Equity, Diversity, Inclusion and Anti-Racism Committee within our Department of Neurology provides infrastructure and guidance to foster a culture of belonging and addresses the well-being of faculty, staff, and trainees. Here, we present the creation and implementation of our Equity, Diversity, Inclusion, and Anti-Racism (EDIA) Pledge, which was central to our committee's response to these unprecedented times. We outline the process of developing this unique EDIA Pledge and provide a roadmap for approaching these important topics through a Continuing Medical Education Neurology Grand Rounds aimed at fostering a diverse, inclusive, equitable, and antiracist work environment. Through the lived experiences of 4 faculty members, we identify the impact of bias and microaggressions and encourage allyship and personal development for cultural intelligence. We hope that these efforts will inspire neurology departments and other academic institutions across the globe to make a similar pledge.
Alzheimer's Villanelle
Li, Jimmy MD
doi : 10.1212/WNL.0000000000012612
Volume 97(15), 12 October 2021, p 737
Progressive Cognitive Decline With Bithalamic and Basal Ganglia Lesions Caused by Dural Arteriovenous Fistula
Han, Zongli MM*; Yang, Hongchun MM*; Du, Yanli MD, PhD; Zhang, Peng MD, PhD; Qi, Hui MD
doi : 10.1212/WNL.0000000000012677
Volume 97(15), 12 October 2021, p 738-739
Future of Neurology & Technology: Virtual and Augmented Reality in Neurology and Neuroscience Education: Applications and Curricular Strategies
Sandrone, Stefano PhD; Carlson, Chad E. MD
doi : 10.1212/WNL.0000000000012413
Volume 97(15), 12 October 2021, p 740-744
Virtual reality and augmented reality have become increasingly prevalent in our lives. They are changing the way we see and interact with the world and have started percolating through medical education. In this article, we reviewed the key applications of virtual and augmented realities in neurology and neuroscience education and discussed barriers and opportunities for implementation in the curriculum. Although the long-term benefits of these approaches over more traditional learning methods and the optimal curricular balance remain mostly unexplored, virtual and augmented reality can change how we teach neurology and neuroscience.
Pearls & Oy-sters: A 32-Year-Old Woman With Recurrent Weakness and Paresthesias
Zuflacht, Jonah P. MD; Boegle, Aimee K. MD, PhD
doi : 10.1212/WNL.0000000000012278
Volume 97(15), 12 October 2021, p e1537-e1540
Teaching NeuroImage: Nonalcoholic Wernicke Encephalopathy
Hansen, Grant BS*; Kim, Eunjee BA, MBA*; Thakolwiboon, Smathorn MD; Kim, Jongyeol MD
doi : 10.1212/WNL.0000000000012196
Volume 97(15), 12 October 2021, p e1541-e1542
Teaching NeuroImage: Notched Delta and Angelman Syndrome
Nascimento, Fabio A. MD; Thiele, Elizabeth A. MD, PhD; Thibert, Ronald L. DO, MsPH
doi : 10.1212/WNL.0000000000012201
Volume 97(15), 12 October 2021, p e1543-e1544
Teaching Video NeuroImage: Choreoathetosis and Focal Dystonia in Vitamin B12 Deficiency
Ng, Chen Fei MD, MRCP; Mohamed Ibrahim, Norlinah MBBCH, BAO, BMedSci, MRCP
doi : 10.1212/WNL.0000000000012190
Volume 97(15), 12 October 2021, p e1545
Editors' Note: Novel Score for Stratifying Risk of Critical Care Needs in Patients With Intracerebral Hemorrhage
Siegler, James E. III, MD; Galetta, Steven MD
doi : 10.1212/WNL.0000000000012678
Volume 97(15), 12 October 2021, p 745
Reader Response: Novel Score for Stratifying Risk of Critical Care Needs in Patients With Intracerebral Hemorrhage
Patel, Nikhil M.; Tran, Quincy K.; Badjatia, Neeraj; Morris, Nicholas A.
doi : 10.1212/WNL.0000000000012679
Volume 97(15), 12 October 2021, p 745-746
Author Response: Novel Score for Stratifying Risk of Critical Care Needs in Patients With Intracerebral Hemorrhage
Faigle, Roland; Gottesman, Rebecca
doi : 10.1212/WNL.0000000000012680
Volume 97(15), 12 October 2021, p 746
Reader Response: Novel Score for Stratifying Risk of Critical Care Needs in Patients With Intracerebral Hemorrhage
Chini Foroush, Noushin; Kempster, Peter; Seneviratne, Udaya
doi : 10.1212/WNL.0000000000012681
Volume 97(15), 12 October 2021, p 747
Author Response: Novel Score for Stratifying Risk of Critical Care Needs in Patients With Intracerebral Hemorrhage
Faigle, Roland
doi : 10.1212/WNL.0000000000012682
Volume 97(15), 12 October 2021, p 747-748
