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Spotlight on the January 18 Issue
José G. Merino
doi : 10.1212/WNL.0000000000013073
vol. 98 no. 3 91-92
The Perivascular Space Race
Susanne J. van Veluw, Valentina Perosa
doi : 10.1212/WNL.0000000000013105
vol. 98 no. 3 95-96
Epilepsy-Related Mortality in Children and Young Adults in Denmark
Marius Kløvgaard, Thomas Hadberg Lynge, Ioannis Tsiropoulos, Peter Vilhelm Uldall, Jytte Banner, Bo Gregers Winkel, Philippe Ryvlin, Jacob Tfelt-Hansen, Anne Sabers
doi : 10.1212/WNL.0000000000013068
vol. 98 no. 3 e213-e224
Mortality is increased in epilepsy, but the important issue is that a proportion of epilepsy-related death is potentially preventable by optimized therapy and therefore needs to be identified. A new systematic classification of epilepsy-related mortality has been suggested to identify these preventable deaths. We applied this classification to an analysis of premature mortality in persons with epilepsy who were <50 years of age.
Development and Validation of Prediction Models for Developmental and Intellectual Outcome Following Pediatric Epilepsy Surgery
doi : 10.1212/WNL.0000000000013065
vol. 98 no. 3 e225-e235
To identify predictors of postoperative intelligence and developmental quotients (IQ/DQ) and develop and validate clinically applicable IQ/DQ prediction models.
Seizure Outcome After Surgery for MRI-Diagnosed Focal Cortical Dysplasia
doi : 10.1212/WNL.0000000000013066
vol. 98 no. 3 e236-e248
Focal cortical dysplasia (FCD) has been associated with poorer postsurgical seizure outcomes compared to other pathologies. FCD surgical series have been assembled on the basis of a histologic diagnosis, including patients with abnormal and normal preoperative MRI. However, in clinical workflow, patient selection for surgery is based on preoperative findings, including MRI. We performed a systematic review and meta-analysis of the literature to determine the rate and predictors of favorable seizure outcome after surgery for MRI-detected FCD.
Functional Connectivity as a Potential Mechanism for Language Plasticity
doi : 10.1212/WNL.0000000000013071
vol. 98 no. 3 e249-e259
Task fMRI is a clinical tool for language lateralization, but has limitations, and cannot provide information about network-level plasticity. Additional methods are needed to improve the precision of presurgical language mapping. We investigate language resting-state functional connectivity (RS fMRI; FC) in typically developing children (TD) and children with epilepsy. Our objectives were to (1) understand how FC components differ between TD children and those with epilepsy; (2) elucidate how the location of disease (frontal/temporal epilepsy foci) affects FC; and (3) investigate the relationship between age and FC.
Causes of Death and End-of-Life Care in Patients With Intracranial High-Grade Gliomas
doi : 10.1212/WNL.0000000000013057
vol. 98 no. 3 e260-e266
To understand patterns of care and circumstances surrounding end of life in patients with intracranial gliomas.
Association Between Time Spent Outdoors and Risk of Multiple Sclerosis
doi : 10.1212/WNL.0000000000013045
vol. 98 no. 3 e267-e278
This study aims to determine the contributions of sun exposure and ultraviolet radiation (UVR) exposure to risk of pediatric-onset multiple sclerosis (MS).
Global, Regional, and National Burden of Ischemic Stroke, 1990–2019
doi : 10.1212/WNL.0000000000013115
vol. 98 no. 3 e279-e290
To the best of our knowledge, no comprehensive update of the descriptive epidemiology and trends of ischemic stroke has been released since Global Burden of Disease (GBD) 2017. Thus, our objective was to examine ischemic stroke burden at the global, regional, and national levels in terms of sex, age, and social development index (SDI).
Blood Pressure After Endovascular Thrombectomy and Outcomes in Patients With Acute Ischemic Stroke
doi : 10.1212/WNL.0000000000013049
vol. 98 no. 3 e291-e301
To explore the association between blood pressure (BP) levels after endovascular thrombectomy (EVT) and the clinical outcomes of patients with acute ischemic stroke (AIS) patients with large vessel occlusion (LVO).
Cerebral Microbleeds and Treatment Effect of Intravenous Thrombolysis in Acute Stroke
doi : 10.1212/WNL.0000000000013055
vol. 98 no. 3 e302-e314
Cerebral microbleeds (CMBs) are common in patients with acute ischemic stroke and are associated with increased risk of intracerebral hemorrhage (ICH) after intravenous thrombolysis. Whether CMBs modify the treatment effect of thrombolysis is unknown.
Disorders of Consciousness Associated With COVID-19
doi : 10.1212/WNL.0000000000013067
vol. 98 no. 3 e315-e325
In patients with severe coronavirus disease 2019 (COVID-19), disorders of consciousness (DoC) have emerged as a serious complication. The prognosis and pathophysiology of COVID-DoC remain unclear, complicating decisions about continuing life-sustaining treatment. We describe the natural history of COVID-DoC and investigate its associated brain connectivity profile.
Physiology and Clinical Relevance of Enlarged Perivascular Spaces in the Aging Brain
doi : 10.1212/WNL.0000000000013077
vol. 98 no. 3 107-117
Perivascular spaces (PVS) are fluid-filled compartments that are part of the cerebral blood vessel wall and represent the conduit for fluid transport in and out of the brain. PVS are considered pathologic when sufficiently enlarged to be visible on MRI. Recent studies have demonstrated that enlarged PVS (ePVS) may have clinical consequences related to cognition. Emerging literature points to arterial stiffening and abnormal protein aggregation in vessel walls as 2 possible mechanisms that drive ePVS formation. We describe the clinical consequences, anatomy, fluid dynamics, physiology, risk factors, and in vivo quantification methods of ePVS. Given competing views of PVS physiology, we detail the 2 most prominent theoretical views and review ePVS associations with other common small vessel disease markers. Because ePVS are a marker of small vessel disease and ePVS burden is higher in Alzheimer disease, a comprehensive understanding about ePVS is essential in developing prevention and treatment strategies.
Infliximab to Treat Severe Paradoxical Reaction in HIV-Negative Tuberculous Meningoencephalitis
doi : 10.1212/WNL.0000000000013047
vol. 98 no. 3 118-119
Clinical Reasoning: Progressive Proximal Weakness in a 61-Year-Old Man
Margaret Yu, Mireille Bitar, Michael Collins, Jinny Tavee
doi : 10.1212/WNL.0000000000013000
vol. 98 no. 3 122-127
Teaching NeuroImage: Pseudo–Figure-of-4 Sign
doi : 10.1212/WNL.0000000000013003
vol. 98 no. 3 e326-e327
Teaching Video NeuroImage: Carbamazepine Improves Gait Initiation in Autosomal Recessive Myotonia Congenita
Yasuhiro Fuseya, Nana Ishikawa, Ryogen Sasaki, Hirofumi Yamashita
doi : 10.1212/WNL.0000000000013010
vol. 98 no. 3 e328
Follow-up Editors' Note: Intravenous Immunoglobulin Therapy in Patients With Painful Idiopathic Small Fiber Neuropathy
Ariane Lewis, Steven Galetta
doi : 10.1212/WNL.0000000000013075
vol. 98 no. 3 128
Follow-up Reader Response: Intravenous Immunoglobulin Therapy in Patients With Painful Idiopathic Small Fiber Neuropathy
Einar Wilder-Smith, Julia Spoendlin
doi : 10.1212/WNL.0000000000013076
vol. 98 no. 3 128-129
Follow-up Author Response: Intravenous Immunoglobulin Therapy in Patients With Painful Idiopathic Small Fiber Neuropathy
Catharina G. Faber, Margot Geerts, Janneke G. Hoeijmakers, Bianca T. de Greef
doi : 10.1212/WNL.0000000000013083
vol. 98 no. 3 129-130
