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Inflammation as a Target for Epilepsy Therapy: The Case of Natalizumab
Miller, John W. MD, PhD
doi : 10.1212/WNL.0000000000012768
Volume 97(18), 2 November 2021, p 845-846
Representation of Women in Stroke Clinical Trials: A Review of 281 Trials Involving More Than 500,000 Participants
Carcel, Cheryl MD*; Harris, Katie PhD*; Peters, Sanne A.E. PhD; Sandset, Else Charlotte MD; Balicki, Grace MIPH; Bushnell, Cheryl D. MD; Howard, Virginia J. PhD; Reeves, Mathew J. PhD; Anderson, Craig S. MD; Kelly, Peter J. MD; Woodward, Mark PhD
doi : 10.1212/WNL.0000000000012767
Volume 97(18), 2 November 2021, p e1768-e1774
Women have been underrepresented in cardiovascular disease clinical trials but there is less certainty over the level of disparity specifically in stroke. We examined the participation of women in trials according to stroke prevalence in the population.
Biomarkers for Atrial Fibrillation Detection After Stroke: Systematic Review and Meta-analysis
Cameron, Alan PhD, MB ChB, BSc*; Cheng, Huen Ki BSc*; Lee, Ren-Ping MB ChB; Doherty, Daniel MB ChB, BSc; Hall, Mark MB ChB, BSc; Khashayar, Pouria MD; Lip, Gregory Y. H. DFM, FACC, FESC, FEHRA; Quinn, Terence MD, MB ChB, BSc; Abdul-Rahim, Azmil MD, MB ChB+; Dawson, Jesse MD, MB ChB, BSc+
doi : 10.1212/WNL.0000000000012769
Volume 97(18), 2 November 2021, p e1775-e1789
To identify clinical, ECG, and blood-based biomarkers associated with atrial fibrillation (AF) detection after ischaemic stroke or TIA that could help inform patient selection for cardiac monitoring.
Risk of Aneurysm Rupture After Thrombolysis in Patients With Acute Ischemic Stroke and Unruptured Intracranial Aneurysms
Virta, Jyri Juhani MD, PhD; Strbian, Daniel MD, PhD; Putaala, Jukka MD, PhD; Korja, Miikka MD, PhD
doi : 10.1212/WNL.0000000000012771
Volume 97(18), 2 November 2021, p e1790-e1798
Unruptured intracranial aneurysms (UIAs) are considered to be a relative contraindication for IV thrombolysis (IVT) in acute ischemic stroke (AIS). Currently, however, data are limited on the risk of UIA rupture after IVT. Our objective was to assess whether IVT for AIS can lead to a UIA rupture and intracranial hemorrhages (ICHs) in patients with unruptured UIAs.
Spontaneous ARIA-like Events in Cerebral Amyloid Angiopathy-Related Inflammation: A Multicenter Prospective Longitudinal Cohort Study
Antolini, Laura PhD*; DiFrancesco, Jacopo C. MD, PhD*; Zedde, Marialuisa MD*; Basso, Gianpaolo MD; Arighi, Andrea MD; Shima, Atsushi MD; Cagnin, Annachiara MD; Caulo, Massimo MD, PhD; Carare, Roxana O. MD, PhD; Charidimou, Andreas MD, PhD; Cirillo, Mario MD; Di Lazzaro, Vincenzo MD; Ferrarese, Carlo MD, PhD, FAAN; Giossi, Alessia MD; Inzitari, Domenico MD, PhD; Marcon, Michela MD; Marconi, Roberto MD; Ihara, Masafumi MD, PhD, FACP; Nitrini, Ricardo MD, PhD; Orlandi, Berardino MD; Padovani, Alessandro MD, PhD; Pascarella, Rosario MD; Perini, Francesco MD; Perini, Giulia MD; Sessa, Maria MD; Scarpini, Elio MD; Tagliavini, Fabrizio MD; Valenti, Raffaella MD, PhD; Vazquez-Costa, Juan Francisco MD; Villarejo-Galende, Alberto MD, PhD; Hagiwara, Yuta MD, PhD; Ziliotto, Nicole PhD; Piazza, Fabrizio PhD
doi : 10.1212/WNL.0000000000012778
Volume 97(18), 2 November 2021, p e1809-e1822
Predicting Symptom Onset in Sporadic Alzheimer Disease With Amyloid PET
Schindler, Suzanne E. MD, PhD; Li, Yan PhD; Buckles, Virginia D. PhD; Gordon, Brian A. PhD; Benzinger, Tammie L.S. MD, PhD; Wang, Guoqiao PhD; Coble, Dean PhD; Klunk, William E. MD, PhD; Fagan, Anne M. PhD; Holtzman, David M. MD; Bateman, Randall J. MD; Morris, John C. MD; Xiong, Chengjie PhD
doi : 10.1212/WNL.0000000000012775
Volume 97(18), 2 November 2021, p e1823-e1834
To predict when cognitively normal individuals with brain amyloidosis will develop symptoms of Alzheimer disease (AD).
Blood-Brain Barrier Permeability in Patients With Reversible Cerebral Vasoconstriction Syndrome Assessed With Dynamic Contrast-Enhanced MRI
Wu, Chia-Hung MD; Lirng, Jiing-Feng MD; Wu, Hsiu-Mei MD; Ling, Yu-Hsiang MD; Wang, Yen-Feng MD, PhD; Fuh, Jong-Ling MD; Lin, Chung-Jung MD; Ling, Kan MD; Wang, Shuu-Jiun MD*; Chen, Shih-Pin MD, PhD*
doi : 10.1212/WNL.0000000000012776
Volume 97(18), 2 November 2021, p e1847-e1859
Blood-brain barrier (BBB) disruption has been proposed to be important in the pathogenesis of reversible cerebral vasoconstriction syndrome (RCVS), but not all patients present an identifiable macroscopic BBB disruption; that is, visible contrast leakage on contrast-enhanced T2 fluid-attenuated inversion recovery imaging. This study aimed to evaluate microscopic BBB permeability and its dynamic change in patients with RCVS.
Applying Propensity Score Methods in Clinical Research in Neurology
Austin, Peter C. PhD; Xin Yu, Amy Ying MD, MSc; Vyas, Manav V. MD, PhD; Kapral, Moira K. MD, MSc
doi : 10.1212/WNL.0000000000012777
Volume 97(18), 2 November 2021, p 856-863
Propensity score-based analysis is increasingly being used in observational studies to estimate the effects of treatments, interventions, and exposures. We introduce the concept of the propensity score and how it can be used in observational research. We describe 4 different ways of using the propensity score: matching on the propensity score, inverse probability of treatment weighting using the propensity score, stratification on the propensity score, and covariate adjustment on the propensity score (with a focus on the first 2). We provide recommendations for the use and reporting of propensity score methods for the conduct of observational studies in neurologic research.
The Dancing Tongue
Dash, Santosh Kumar MD, DM
doi : 10.1212/WNL.0000000000012708
Volume 97(18), 2 November 2021, p 874
Child Neurology: Hypotonia and Delayed Teeth Eruption in a 2-Year-Old Girl
Dinov, Darina DO; Vorona, Gregory MD; Harper, Amy MD
doi : 10.1212/WNL.0000000000012445
Volume 97(18), 2 November 2021, p 875-878
Clinical Reasoning: A 28-Year-Old Woman With Vision Loss and an Unusual Gait
Dohlman, Jenny C. MD; Chwalisz, Bart K. MD; Stephen, Christopher D. MB ChB, MRCP (UK), MS
doi : 10.1212/WNL.0000000000012446
Volume 97(18), 2 November 2021, p e1860-e1865
Teaching NeuroImage: Intracerebral Seroma Secondary to Arterial-Venous Malformation
Ma, Chun MD; Li, Jie MD; Lui, Su MD, PhD
doi : 10.1212/WNL.0000000000012275
Volume 97(18), 2 November 2021, p e1866-e1867
Teaching Video NeuroImage: Bilateral Horizontal Gaze Palsies With Vertical Ocular Dysmetria From a Demyelinating Lesion of the Pontine Tegmentum
Fok, Anthony MBBS, FRACP; Barton, Jason J.S. MD, PhD, FRCP(C)
doi : 10.1212/WNL.0000000000012328
Volume 97(18), 2 November 2021, p e1868-e1869
Editors' Note: Risk and Predictors of Depression Following Acute Ischemic Stroke in the Elderly
Ganesh, Aravind MD, DPhil, FRCPC; Galetta, Steven MD
doi : 10.1212/WNL.0000000000012785
Volume 97(18), 02 November 2021, p 879
Reader Response: Risk and Predictors of Depression Following Acute Ischemic Stroke in the Elderly
Patel, Krupa; Trivedi, Chintan; Mansuri, Zeeshan; Jain, Shailesh
doi : 10.1212/WNL.0000000000012788
Volume 97(18), 02 November 2021, p 879-880
Author Response: Risk and Predictors of Depression Following Acute Ischemic Stroke in the Elderly
Stein, Laura K.; Mayman, Naomi; Dhamoon, Mandip S.
doi : 10.1212/WNL.0000000000012789
Volume 97(18), 02 November 2021, p 880
Editors' Note: Skeletal Muscle and Peripheral Nerve Histopathology in COVID-19
Ganesh, Aravind MD, DPhil, FRCPC; Galetta, Steven MD
doi : 10.1212/WNL.0000000000012787
Volume 97(18), 02 November 2021, p 880-881
Reader Response: Skeletal Muscle and Peripheral Nerve Histopathology in COVID-19
Machado, Calixto; Brock, Brandon; Schiff, Arthur D.
doi : 10.1212/WNL.0000000000012790
Volume 97(18), 02 November 2021, p 881-882
Author Response: Skeletal Muscle and Peripheral Nerve Histopathology in COVID-19
Solomon, Isaac H.; Amato, Anthony A.; Suh, Joome
doi : 10.1212/WNL.0000000000012791
Volume 97(18), 02 November 2021, p 882
Spotlight on the November 2 Issue
Merino, Jose G. MD, MPhil; Editor-in-Chief, Neurology(R)
doi : 10.1212/WNL.0000000000012772
Volume 97(18), 2 November 2021, p 843-844
Hypothalamic Hamartomas: Evolving Understanding and Management
Cohen, Nathan T. MD; Cross, J. Helen MB ChB, PhD; Arzimanoglou, Alexis MD; Berkovic, Samuel F. MD; Kerrigan, John F. MD; Miller, Ilene Penn JD, LLM; Webster, Erica; Soeby, Lisa MBA; Cukiert, Arthur MD, PhD; Hesdorffer, Dale K. PhD; Kroner, Barbara L. PhD; Saper, Clifford B. MD, PhD; Schulze-Bonhage, Andreas MD, PhD; Gaillard, William D. MD; on behalf of the Hypothalamic Hamartoma Writing Group; on behalf of the Hypothalamic Hamartoma Writing Group; Berkovic, Samuel Frank MD; Berl, Madison PhD, ABPP; Biesecker, Leslie G. MD; Boerwinkle, Varina L. MD; Brandt, Carrin; Bulteau, Christine MD PhD; Chen, Xi; Cohen, Nathan T. MD; Cross, J. Helen MB ChB PhD; Cukiert, Arthur MD; Curry, Daniel J. MD; Dacks, Penny PhD; De Palma, Luca MD; Ferrand-Sorbets, Sarah MD; Fulton, John B. MD, PhD, ABPP/CN; Gaillard, William Davis MD; Geiger, Maximilian J. MD; Grinspan, Zachary MD; Gupta, Ajay MD; Hamdi, Hussein M. MD; Hauptman, Jason MD, PhD, FAANS; Hildebrand, Michael S. PhD; Jacobs, Julia MD; Kerrigan, John (Jack) F. MD; Klotz, Kerstin Alexandra MD; Koh, Sookyong MD PhD; Liang, HoLan MD; Mathern, Gary W. MD; Mbwana, Juma MD; Miller, Ian MD; Miller, Ilene Penn; Not, Emma; Oatman, Oliver J. DO; Oluigbo, Chima MD, FRCSC; Packer, Roger J. MD; Ragheb, John MD; Regis, Jean MD; Rekate, Harold MD; Rizk, Tamer MD; Rosenfeld, Jeffrey V. MD, MS; Roth, Christian L. MD; Salpekar, Jay A. MD FANPA, FAES; Saper, Clifford B. MD PhD; Schulze-Bonhage, Andreas MD; Shirozu, Hiroshi MD PhD; Soeby, Lisa MBA; Tatsi, Christina MD; Theodore, William H. MD; Vezina, Gilbert MD; Webster, Erica; West, Peter J. PhD; Yang, Zhiquan MD PhD; Yuen, Kevin C. J. MD, FRCP, FACE
doi : 10.1212/WNL.0000000000012773
Volume 97(18), 2 November 2021, p 864-873
Hypothalamic hamartomas (HH) are rare, basilar developmental lesions with widespread comorbidities often associated with refractory epilepsy and encephalopathy. Imaging advances allow for early, even prenatal, detection. Genetic studies suggest mutations in GLI3 and other patterning genes are involved in HH pathogenesis. About 50%-80% of children with HH have severe rage and aggression and a majority of patients exhibit externalizing disorders. Behavioral disruption and intellectual disability may predate epilepsy. Neuropsychological, sleep, and endocrine disorders are typical. The purpose of this article is to provide a summary of the current understanding of HH and to highlight opportunities for future research.
Safety and Efficacy of Natalizumab as Adjunctive Therapy for People With Drug-Resistant Epilepsy: A Phase 2 Study
French, Jacqueline A. MD; Cole, Andrew J. MD; Faught, Edward MD; Theodore, William H. MD; Vezzani, Annamaria PhD; Liow, Kore MD; Halford, Jonathan J. MD; Armstrong, Robert MD; Szaflarski, Jerzy P. MD, PhD; Hubbard, Sarah BSc; Patel, Jagdish PhD; Chen, Kun PhD; Feng, Wei PhD; Rizzo, Marco MD, PhD; Elkins, Jacob MD; Knafler, Gabrielle PhD; Parkerson, Kimberly A. MD, PhD; on behalf of the OPUS Study Group; on behalf of the OPUS Study Group; Klein, Pavel MD; Benbadis, Selim MD; Tecoma, Evelyn MD, PhD; Balabanov, Antoaneta MD; Vossler, David MD; Husain, Aatif MD; Boro, Alex MD; Oster, Joel MD; Gelfand, Michael MD, PhD; Koubeissi, Mohamad MD; Sirven, Joseph MD; Harvey, Jay DO; Kassab, Mounzer MD, MA; Hogan, Edward MD; Lee, Ki Hyeong MD, MS; Beach, Robert MD; Shin, Hae MD; Sarkis, Rani MD, MSc; Flitman, Stephen MD; Honeycutt, William MD; Ayala, Ricardo MD; Bautista, Ramon MD, MBA; Berg, Michel MD; Carran, Melissa MD; Kudrow, David MD; Ting, Tricia MD; Rafecas, Jose MD
doi : 10.1212/WNL.0000000000012766
Volume 97(18), 2 November 2021, p e1757-e1767
To explore efficacy/safety of natalizumab, a humanized monoclonal anti-[alpha]4-integrin antibody, as adjunctive therapy in adults with drug-resistant focal epilepsy.
Cerebral Amyloid Angiopathy Pathology and Its Association With Amyloid-[beta] PET Signal
McCarter, Stuart J. MD; Lesnick, Timothy G. MS; Lowe, Val MD; Mielke, Michelle M. PhD; Constantopoulos, Eleni MHS, PA(ASCP); Rabinstein, Alejandro A. MD; Przybelski, Scott A. BS; Botha, Hugo MB ChB; Jones, David T. MD; Ramanan, Vijay K. MD, PhD; Jack, Clifford R. MD; Petersen, Ronald C. MD, PhD; Knopman, David MD; Boeve, Bradley F. MD; Murray, Melissa E. PhD; Dickson, Dennis W. MD; Vemuri, Prashanthi PhD; Kantarci, Kejal MD, MS; Reichard, R. Ross MD; Graff-Radford, Jonathan MD
doi : 10.1212/WNL.0000000000012770
Volume 97(18), 2 November 2021, p e1799-e1808
To determine the contribution of cerebral amyloid angiopathy (CAA) to Pittsburgh compound B (PiB)-PET tracer retention.
Association of Clinically Evident Eye Movement Abnormalities With Motor and Cognitive Features in Patients With Motor Neuron Disorders
Poletti, Barbara PhD; Solca, Federica PhD; Carelli, Laura PhD; Diena, Alberto MD; Colombo, Eleonora MD; Torre, Silvia MSc; Maranzano, Alessio MD; Greco, Lucia PhD; Cozza, Federica BS; Lizio, Andrea MSc; Ferrucci, Roberta PhD; Girotti, Floriano MD; Verde, Federico MD; Morelli, Claudia MD; Lunetta, Christian MD; Silani, Vincenzo MD; Ticozzi, Nicola MD, PhD
doi : 10.1212/WNL.0000000000012774
Volume 97(18), 2 November 2021, p e1835-e1846
Although oculomotor abnormalities (OMAs) are not usually considered prominent features of amyotrophic lateral sclerosis (ALS), they may represent potential clinical markers of neurodegeneration, especially when investigated together with cognitive and behavioral alterations. The aim of our study was to identify patterns of clinically evident OMAs in patients with ALS and to correlate such findings with cognitive-behavioral data.
