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Spotlight on the February 8 Issue

Merino, Jose G. MD, MPhil; Editor-in-Chief, Neurology(R)

doi : 10.1212/WNL.0000000000013197

Volume 98(6), 8 February 2022, p 217-218

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The Collateral Damage of COVID-19

Tannous, Jonika PhD; Vahidy, Farhaan S. PhD, MBBS, MPH

doi : 10.1212/WNL.0000000000013196

Volume 98(6), 8 February 2022, p 219-220

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Glial Fibrillary Acidic Protein Immunoglobulin G in CSF: A Biomarker of Severe but Reversible Encephalitis

McKeon, Andrew MD

doi : 10.1212/WNL.0000000000013089

Volume 98(6), 8 February 2022, p 221-222

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Changes in the Diagnosis of Stroke and Cardiovascular Conditions in Primary Care During the First 2 COVID-19 Waves in the Netherlands

Velek, Premysl MSc; Splinter, Marije J. MSc; Ikram, M. Kamran PhD; Ikram, M. Arfan PhD; Leening, Maarten J.G. PhD; van der Lei, Johan PhD; olde Hartman, Tim PhD; Peters, Lilian L. PhD; Tange, Huibert PhD; Rutten, Frans H. PhD; van Weert, Henk PhD; Wolters, Frank J. PhD; Bindels, Patrick J.E. PhD; Licher, Silvan PhD; de Schepper, Evelien I.T. PhD

doi : 10.1212/WNL.0000000000013145

Volume 98(6), 8 February 2022, p e564-e572

Although there is evidence of disruption in acute cerebrovascular and cardiovascular care during the coronavirus disease 2019 (COVID-19) pandemic, its downstream effect in primary care is less clear. We investigated how the pandemic affected utilization of cerebrovascular and cardiovascular care in general practices (GPs) and determined changes in GP-recorded diagnoses of selected cerebrovascular and cardiovascular outcomes.

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Global Differences in Risk Factors, Etiology, and Outcome of Ischemic Stroke in Young Adults-A Worldwide Meta-analysis: The GOAL Initiative

Jacob, Mina A. MD; Ekker, Merel S. MD; Allach, Youssra BsC; Cai, Mengfei MD; Aarnio, Karoliina MD; Arauz, Antonio MD; Arnold, Marcel MD; Bae, Hee-Joon MD; Bandeo, Lucrecia MD; Barboza, Miguel A. MD; Bolognese, Manuel MD; Bonardo, Pablo MD; Brouns, Raf MD; Chuluun, Batnairamdal MD; Chuluunbatar, Enkhzaya MD; Cordonnier, Charlotte MD; Dagvajantsan, Byambasuren MD; Debette, Stephanie MD; Don, Adi MD; Enzinger, Chris MD; Ekizoglu, Esme MD; Fandler-Hofler, Simon MD; Fazekas, Franz MD; Fromm, Annette MD; Gattringer, Thomas MD; Hora, Thiago F. MD; Jern, Christina MD; Jood, Katarina MD; Kim, Young Seo MD; Kittner, Steven MD; Kleinig, Timothy MD; Klijn, Catharina J.M. MD; Korv, Janika MD; Kumar, Vinod MD; Lee, Keon-Joo MD; Lee, Tsong-Hai MD; Maaijwee, Noortje A.M. MD; Martinez-Majander, Nicolas MD; Marto, Joao P. MD; Mehndiratta, Man M. MD; Mifsud, Victoria MD; Montanaro, Vinicius MD; Pacio, Gisele MD; Patel, Vinod B. MD; Phillips, Matthew C. MD; Piechowski-Jozwiak, Bartlomiej MD; Pikula, Aleksandra MD; Ruiz-Sandoval, Jose MD; von Sarnowski, Bettina MD; Swartz, Richard H. MD; Tan, Kay-Sin MD; Tanne, David MD; Tatlisumak, Turgut MD; Thijs, Vincent MD; Viana-Baptista, Miguel MD; Vibo, Riina MD; Wu, Teddy Y. MD; Yesilot, Nilufer MD; Waje-Andreassen, Ulrike MD; Pezzini, Alessandro MD; Putaala, Jukka MD; Tuladhar, Anil M. MD; de Leeuw, Frank-Erik MD

doi : 10.1212/WNL.0000000000013195

Volume 98(6), 8 February 2022, p e573-e588

There is a worldwide increase in the incidence of stroke in young adults, with major regional and ethnic differences. Advancing knowledge of ethnic and regional variation in causes and outcomes will be beneficial in implementation of regional health care services. We studied the global distribution of risk factors, causes, and 3-month mortality of young patients with ischemic stroke, by performing a patient data meta-analysis from different cohorts worldwide.

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Memory Trajectories Before and After First and Recurrent Strokes

Lu, Wentian PhD; Richards, Marcus PhD; Werring, David FRCP, PhD; Bobak, Martin MD, PhD

doi : 10.1212/WNL.0000000000013171

Volume 98(6), 8 February 2022, p e589-e600

Evidence on timing of memory change after first and recurrent strokes is limited and inconsistent. We investigated memory trajectories before and after first and recurrent strokes in 18 European countries and tested whether the country-level acute stroke care was associated with memory change after stroke.

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Characterization of Subarachnoid Hyperdensities After Thrombectomy for Acute Stroke Using Dual-Energy CT

Renu, Arturo MD, PhD*; Laredo, Carlos MSc*; Rodriguez-Vazquez, Alejandro MD; Santana, Daniel MD; Werner, Mariano MD; Llull, Laura MD, PhD; Lopez-Rueda, Antonio MD; Urra, Xabier MD, PhD; Rudilosso, Salvatore MD, PhD; Obach, Victor MD; Amaro, Sergi MD, PhD; Chamorro, Angel MD, PhD

doi : 10.1212/WNL.0000000000013198

Volume 98(6), 8 February 2022, p e601-e611

The presence of postinterventional subarachnoid hyperdensities (SA-HD) is a relatively common finding after mechanical thrombectomy (MT). We aimed to assess the incidence, characteristics, clinical relevance, and predictors of SA-HD after MT as categorized through the use of postinterventional dual-energy CT (DE-CT).

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Association Between Cerebral Cortical Microinfarcts and Perilesional Cortical Atrophy on 3T MRI

Ferro, Doeschka A. MD, PhD; Kuijf, Hugo J. PhD; Hilal, Saima PhD; van Veluw, Susanne J. PhD; van Veldhuizen, Danielle MSc; Venketasubramanian, Narayanaswamy FRCP; Tan, Boon Yeow MMED; Biessels, Geert Jan MD, PhD; Chen, Christopher FRCP

doi : 10.1212/WNL.0000000000013140

Volume 98(6), 8 February 2022, p e612-e622

Cerebral cortical microinfarcts (CMIs) are a novel MRI marker of cerebrovascular disease (CeVD) that predicts accelerated cognitive decline. Presence of CMIs is known to be associated with global cortical atrophy, although the mechanism linking the two is unclear. Our primary objective was to examine the relation between CMIs and cortical atrophy and to establish possible perilesional atrophy surrounding CMIs. Our secondary objective was to examine the role of cortical atrophy in CMI-associated cognitive impairment.

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Sex Differences in the Association Between Midlife Cardiovascular Conditions or Risk Factors With Midlife Cognitive Decline

Huo, Nan MD, PhD; Vemuri, Prashanthi PhD; Graff-Radford, Jonathan MD; Syrjanen, Jeremy MS; Machulda, Mary PhD; Knopman, David S. MD; Jack, Clifford R. Jr MD; Petersen, Ronald MD, PhD; Mielke, Michelle M. PhD

doi : 10.1212/WNL.0000000000013174

Volume 98(6), 8 February 2022, p e623-e632

The prevalence of midlife cardiovascular conditions and risk factors is higher in men than women. Associations between midlife cardiovascular conditions or risk factors and midlife cognitive decline have been reported, but few studies have assessed sex differences in these associations.

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Association Between Occupational Exposure to Formaldehyde and Cognitive Impairment

Letellier, Noemie PhD; Gutierrez, Laure-Anne MSc; Pilorget, Corinne PhD; Artaud, Fanny PhD; Descatha, Alexis PhD; Ozguler, Anna PhD; Goldberg, Marcel PhD; Zins, Marie PhD; Elbaz, Alexis PhD; Berr, Claudine PhD

doi : 10.1212/WNL.0000000000013146

Volume 98(6), 8 February 2022, p e633-e640

To our knowledge, no study has investigated the effect of exposure to formaldehyde on cognition in the general population. Our objective was to examine the association between occupational exposure to formaldehyde and cognitive impairment in middle-aged and young-old adults (>=45 years).

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Lifestyle Factors and Parkinson Disease Risk: Korean Nationwide Cohort Study With Repeated Health Screening Data

Yoon, Seo Yeon MD, PhD; Park, You Hyun MPH; Lee, Hyo Jeong MD; Kang, Dae Ryong PhD*; Kim, Yong Wook MD, PhD*

doi : 10.1212/WNL.0000000000012942

Volume 98(6), 8 February 2022, p e641-e652

Many previous studies, mostly performed in Western countries, on the effects of lifestyle factors on Parkinson disease (PD) used baseline lifestyle characteristics without directly accounting for changes in covariate values over time. The objective of this study was to evaluate the association of repeatedly measured lifestyle factors with PD risk in a Korean population.

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Glial Fibrillary Acidic Protein Autoimmunity: A French Cohort Study

Gravier-Dumonceau, Alice MD; Ameli, Roxana MD; Rogemond, Veronique PhD; Ruiz, Anne MsC; Joubert, Bastien MD, PhD; Muniz-Castrillo, Sergio MD; Vogrig, Alberto MD; Picard, Geraldine; Ambati, Aditya MD, PhD; Benaiteau, Marie MD; Rulquin, Florence MD; Ciron, Jonathan MD; Deiva, Kumaran MD, PhD; de Broucker, Thomas MD, PhD; Kremer, Laurent MD; Kerschen, Philippe MD; Sellal, Francois MD, PhD; Bouldoires, Bastien MD; Genet, Roxana MD; Biberon, Julien MD; Bigot, Adrien MD; Duval, Fanny MD; Issa, Nahema MD; Rusu, Elena-Camelia MD; Goudot, Mathilde MD; Dutray, Anais MD; Devoize, Jean Louis MD; Hopes, Lucie MD; Kaminsky, Anne-Laure MD; Philbert, Marion MD; Chanson, Eve MD; Leblanc, Amelie MD; Morvan, Erwan MD; Andriuta, Daniela MD; Diraison, Philippe MD; Mirebeau, Gabriel MD; Derollez, Celine MD; Bourg, Veronique MD; Bodard, Quentin MD; Fort, Clementine MD; Grigorashvili-Coin, Irina MD; Rieul, Guillaume MD; Molinier-Tiganas, Daniela MD; Bonnan, Mickael MD; Tchoumi, Thierry MD; Honnorat, Jerome MD, PhD*; Marignier, Romain MD, PhD*

doi : 10.1212/WNL.0000000000013087

Volume 98(6), 8 February 2022, p e653-e668

To report the clinical, biological, and imaging features and clinical course of a French cohort of patients with glial fibrillary acidic protein (GFAP) autoantibodies.

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Progression of Nigrostriatal Denervation in Cerebellar Multiple System Atrophy: A Prospective Study

Wirth, Thomas MD, MS; Namer, Izzie Jacques MD, PhD; Monga, Ben PhD; Bund, Caroline MD PhD; Iosif, Andra Valentina MD; Gebus, Odile MD, MS; Montaut, Solveig MD, MS; Bogdan, Thomas MD; Robelin, Laura PhD; Renaud, Mathilde MD, PhD; Kremer, Stephane MD, PhD; Tranchant, Christine MD, PhD; Anheim, Mathieu MD, PhD

doi : 10.1212/WNL.0000000000013172

Volume 98(6), 8 February 2022, p 232-236

Nigrostriatal dopaminergic denervation (NSDD) remains poorly characterized in cerebellar multiple system atrophy (MSA-C). We aimed to study NSDD progression in MSA-C and evaluate the capacity for [123I]-FP-CIT-SPECT and parkinsonism to differentiate MSA-C from idiopathic late-onset cerebellar ataxia (ILOCA).

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Comment: Introducing Artificial Intelligence and the Practice of Neurology in 2035

Jones, Lyell K. Jr MD; Gross, Robert A. MD, PhD

doi : 10.1212/WNL.0000000000013199

Volume 98(6), 8 February 2022, p 237

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Artificial Intelligence and the Practice of Neurology in 2035: The Neurology Future Forecasting Series

Artificial Intelligence and the Practice of Neurology in 2035: The Neurology Future Forecasting Series

doi : 10.1212/WNL.0000000000013200

Volume 98(6), 8 February 2022, p 238-245

High-quality health care delivery relies on a complex orchestration of the flow of patient data. Incorporating advanced artificial intelligence (AI) technologies into this delivery system has tremendous potential to improve health care, but also carries with it unique challenges. The nature of neurologic disease, and the current state of neurologic care delivery, makes this area of medicine well positioned for AI-driven innovation by 2035. Business, ethics, regulation, and medical education will need to evolve in concert. The information technology and data standards requirements for this potential transformation are underappreciated and will be a major driver of changes across the industry. Using AI on patient data to drive health care innovation to improve patients' lives as the primary goal will facilitate widespread acceptance and adoption of the practices required for a successful AI transformation in neurology. In planning the incorporation of AI into clinical practice, the tenets of rigorous research will need to be vigilantly applied to prevent unwarranted costs and inconveniences while promoting meaningful health outcomes.

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I Wasn't There: Caring for a Patient With Trisomy 21, Alzheimer Disease, and Epilepsy Until His Final Days With COVID-19

Acosta, Lealani Mae MD, MPH

doi : 10.1212/WNL.0000000000013109

Volume 98(6), 8 February 2022, p 246-248

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Rare Occurrence of Microsporidial Myositis Involving Masticatory Muscles

Malhotra, Kiran Preet MD*; Malhotra, Hardeep Singh DM*; Sahoo, Rasmi Ranjan DM; Gupta, Priyanka MD; Chand Chaudhary, Shyam MD

doi : 10.1212/WNL.0000000000013147

Volume 98(6), 8 February 2022, p 249-250

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Clinical Reasoning: Rare Cause of Hemiparesis and Ataxia in a 36-Year-Old Man

Decker, Jessica DO; Singh, Mini MD

doi : 10.1212/WNL.0000000000013142

Volume 98(6), 8 February 2022, p 251-255

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Clinical Reasoning: A 67-Year-Old Woman With Progressive Diplopia, Vertigo, and Ataxia

Sakoda, Marissa MD; Sarhadi, Kasra MD, MPH; Weisner, P. Annie MD, PhD; Tierney, Shannon MD; Wang, Yujie MD

doi : 10.1212/WNL.0000000000013141

Volume 98(6), 8 February 2022, p e669-e674

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Teaching NeuroImage: Syringomyelia Secondary to Posterior Fossa en Plaque Meningioma

Wang, Meng MD; Zhao, Shengqi MD; Hu, Yan MD; Zuo, Yuchao MD; Zhao, Peichao MD; Guo, Fuyou MD

doi : 10.1212/WNL.0000000000013106

Volume 98(6), 8 February 2022, p e675-e676

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Teaching NeuroImage: Seizures as the Initial Symptom of Relapsing Polychondritis

Xu, Yingying MD; Meng, Yujie Postgraduate; Wang, Ping MD; Sun, Lin MD; Xu, Shunliang MD

doi : 10.1212/WNL.0000000000013144

Volume 98(6), 8 February 2022, p e677-e678

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Editors' Note: Teaching NeuroImage: Palindromic Rheumatoid Meningitis: A Tale of 2 Hemispheres

Lewis, Ariane MD; Galetta, Steven MD

doi : 10.1212/WNL.0000000000013202

Volume 98(6), 8 February 2022, p 256

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Reader Response: Teaching NeuroImage: Palindromic Rheumatoid Meningitis: A Tale of 2 Hemispheres

Hung, Sheng-Che

doi : 10.1212/WNL.0000000000013203

Volume 98(6), 8 February 2022, p 256

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Author Response: Teaching NeuroImage: Palindromic Rheumatoid Meningitis: A Tale of 2 Hemispheres

Itrat, Ahmed

doi : 10.1212/WNL.0000000000013204

Volume 98(6), 8 February 2022, p 256-257

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