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Spotlight on the June 15 Issue
José G. Merino
doi : 10.1212/WNL.0000000000012110
vol. 96 no. 24 1107-1108
Venous Information in CT-Based Stroke Selection
Thabele M. Leslie-Mazwi, Michelle P. Lin
doi : 10.1212/WNL.0000000000012126
vol. 96 no. 24 1109-1110
Early Diagnosis of Multiple Sclerosis
Andrew J. Solomon, Alberto Ascherio
doi : 10.1212/WNL.0000000000012087
vol. 96 no. 24 1111-1112
Association of Venous Outflow Profiles and Successful Vessel Reperfusion After Thrombectomy
Tobias Djamsched Faizy, Reza Kabiri, Soren Christensen, Michael Mlynash, Gabriella Kuraitis, Marius Marc-Daniel Mader, Gregory W. Albers, Maarten G. Lansberg, Jens Fiehler, Max Wintermark, Michael P. Marks, Jeremy J. Heit
doi : 10.1212/WNL.0000000000012106
vol. 96 no. 24 e2903-e2911
Robust arterial collaterals are associated with successful reperfusion after thrombectomy treatment of acute ischemic stroke due to large vessel occlusion (AIS-LVO). Excellent venous outflow (VO) reflects excellent tissue perfusion and collateral status in patients with AIS-LVO. The goal of this study was to determine whether favorable VO profiles assessed on pretreatment CT angiography (CTA) images correlate with successful vessel reperfusion after thrombectomy in patients with AIS-LVO.
Early Risk of Readmission Following Hospitalization for Reversible Cerebral Vasoconstriction Syndrome
Aayushi Garg, Matthew Starr, Marcelo Rocha, Santiago Ortega-Gutierrez
doi : 10.1212/WNL.0000000000012107
vol. 96 no. 24 e2912-e2919
For evaluation of 90-day readmissions after an inpatient admission for reversible cerebral vasoconstriction syndrome (RCVS), hospitalizations due to RCVS were identified from the Nationwide Readmissions Database from 2016 to 2017.
Mediterranean Diet, Alzheimer Disease Biomarkers, and Brain Atrophy in Old Age
Tommaso Ballarini, Debora Melo van Lent, Julia Brunner, Alina Schr?der, Steffen Wolfsgruber, Slawek Altenstein, Frederic Brosseron, Katharina Buerger, Peter Dechent, Laura Dobisch, Emrah Düzel, Birgit Ertl-Wagner, Klaus Fliessbach, Silka Dawn Freiesleben, Ingo Frommann, Wenzel Glanz, Dietmar Hauser, John Dylan Haynes, Michael T. Heneka, Daniel Janowitz, Ingo Kilimann, Christoph Laske, Franziska Maier, Coraline Danielle Metzger, Matthias H. Munk, Robert Perneczky, Oliver Peters, Josef Priller, Alfredo Ramirez, Boris-Stephan Rauchmann, Nina Roy, Klaus Scheffler, Anja Schneider, Annika Spottke, Eike Jakob Spruth, Stefan J. Teipel, Ruth Vukovich, Jens Wiltfang, Frank Jessen, Michael Wagner, on behalf of the DELCODE Study Group
doi : 10.1212/WNL.0000000000012067
vol. 96 no. 24 e2920-e2932
To determine whether following a Mediterranean-like diet (MeDi) relates to cognitive functions and in vivo biomarkers for Alzheimer disease (AD), we analyzed cross-sectional data from the German DZNE-Longitudinal Cognitive Impairment and Dementia Study.
Comparing PET and MRI Biomarkers Predicting Cognitive Decline in Preclinical Alzheimer Disease
Danielle V. Mayblyum, J. Alex Becker, Heidi I.L. Jacobs, Rachel F. Buckley, Aaron P. Schultz, Jorge Sepulcre, Justin S. Sanchez, Zoe B. Rubinstein, Samantha R. Katz, Kirsten A. Moody, Patrizia Vannini, Kathryn V. Papp, Dorene M. Rentz, Julie C. Price, Reisa A. Sperling, Keith A. Johnson, Bernard J. Hanseeuw
doi : 10.1212/WNL.0000000000012108
vol. 96 no. 24 e2933-e2943
To compare how structural MRI, fluorodeoxyglucose (FDG), and flortaucipir (FTP) PET signals predict cognitive decline in high-amyloid vs low-amyloid participants with the goal of determining which biomarker combination would result in the highest increase of statistical power for prevention trials.
Astrocyte Biomarkers in Alzheimer DiseaseA Systematic Review and Meta-analysis
Bruna Bellaver, Jo?o Pedro Ferrari-Souza, Lucas Uglione da Ros, Stephen F. Carter, Elena Rodriguez-Vieitez, Agneta Nordberg, Luc Pellerin, Pedro Rosa-Neto, Douglas Teixeira Leffa, Eduardo R. Zimmer
doi : 10.1212/WNL.0000000000012109
vol. 96 no. 24 e2944-e2955
To perform a systematic review and meta-analysis to determine whether fluid and imaging astrocyte biomarkers are altered in Alzheimer disease (AD).
Kidney Function, Kidney Function Decline, and the Risk of Dementia in Older AdultsA Registry-Based Study
Hong Xu, Sara Garcia-Ptacek, Marco Trevisan, Marie Evans, Bengt Lindholm, Maria Eriksdotter, Juan Jesus Carrero
doi : 10.1212/WNL.0000000000012113
vol. 96 no. 24 e2956-e2965
Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. The aim of this study is to investigate the links among kidney function, kidney function decline, and dementia incidence.
Clinical Utility of Striational Antibodies in Paraneoplastic and Myasthenia Gravis Paraneoplastic Panels
Shahar Shelly, John R. Mills, Divyanshu Dubey, Andrew McKeon, Anastasia Zekeridou, Sean J. Pittock, C. Michel Harper, Elie Naddaf, Margherita Milone, Jay Mandrekar, Christopher J. Klein
doi : 10.1212/WNL.0000000000012050
vol. 96 no. 24 e2966-e2976
To critically assess the clinical utility of striational antibodies (StrAbs) within paraneoplastic and myasthenia gravis (MG) serologic evaluations.
Systematic Assessment of Medical Diagnoses Preceding the First Diagnosis of Multiple Sclerosis
Christiane Gasperi, Alexander Hapfelmeier, Tanja Daltrozzo, Antonius Schneider, Ewan Donnachie, Bernhard Hemmer
doi : 10.1212/WNL.0000000000012074
vol. 96 no. 24 e2977-e2988
To explore the occurrence of diseases and symptoms in the 5 years before diagnosis in patients with multiple sclerosis (MS) in a case-control study.
Natalizumab, Fingolimod, and Dimethyl Fumarate Use and Pregnancy-Related Relapse and Disability in Women With Multiple Sclerosis
Wei Zhen Yeh, Putu Ayu Widyastuti, Anneke Van der Walt, Jim Stankovich, Eva Havrdova, Dana Horakova, Karolina Vodehnalova, Serkan Ozakbas, Sara Eichau, Pierre Duquette, Tomas Kalincik, Francesco Patti, Cavit Boz, Murat Terzi, Bassem I. Yamout, Jeannette Lechner-Scott, Patrizia Sola, Olga G. Skibina, Michael Barnett, Marco Onofrj, Maria José S?, Pamela Ann McCombe, Pierre Grammond, Radek Ampapa, Francois Grand'Maison, Roberto Bergamaschi, Daniele L.A. Spitaleri, Vincent Van Pesch, Elisabetta Cartechini, Suzanne Hodgkinson, Aysun Soysal, Albert Saiz, Melissa Gresle, Tomas Uher, Davide Maimone, Recai Turkoglu, Raymond M.M. Hupperts, Maria Pia Amato, Franco Granella, Celia Oreja-Guevara, Ayse Altintas, Richard A. Macdonell, Tamara Castillo-Trivino, Helmut Butzkueven, Raed Alroughani, Vilija G. Jokubaitis, on behalf of the MSBase Study Group
doi : 10.1212/WNL.0000000000012084
vol. 96 no. 24 e2989-e3002
To investigate pregnancy-related disease activity in a contemporary multiple sclerosis (MS) cohort.
A Shortage of Neurologists – We Must Act NowA Report From the AAN 2019 Transforming Leaders Program
Jennifer J. Majersik, Aiesha Ahmed, I-Hweii A. Chen, Holly Shill, Gregory P. Hanes, Victoria S. Pelak, Jennifer L. Hopp, Antonio Omuro, Benzi Kluger, Thabele Leslie-Mazwi
doi : 10.1212/WNL.0000000000012111
vol. 96 no. 24 1122-1134
In nearly every US state, a large mismatch exists between the need for neurologists and neurologic services and the availability of neurologists to provide these services. Patients with neurologic disorders are rising in prevalence and require access to high-level care to reduce disability. The current neurology mismatch reduces access to care, worsens patient outcomes, and erodes career satisfaction and quality of life for neurologists as they face increasingly insurmountable demands. As a community, we must address this mismatch in the demand and supply of neurologic care in an aggressive and sustained manner to ensure the future health of our patients and our specialty. The American Academy of Neurology has multiple ongoing initiatives to help reduce and resolve the existing mismatch. With the intent of raising awareness and widening the debate nationally, we present a strategic plan that the Academy could implement to coordinate and expand existing efforts. We characterize the suggested strategies as shaping the demand, enhancing the workforce, and advocating for neurologist value. The proposed framework is based on available data and expert opinion when data were lacking. Prioritization of strategies will vary by geography, practice setting, and local resources. The time to act is now to allow concerted effort and targeted interventions to avert this looming public health crisis.
Adjunctive Intra-arterial Thrombolysis in Endovascular ThrombectomyA Systematic Review and Meta-analysis
William K. Diprose, Michael T.M. Wang, Kaustubha Ghate, Stefan Brew, James R. Caldwell, Ben McGuinness, P. Alan Barber
doi : 10.1212/WNL.0000000000012112
vol. 96 no. 24 1135-1143
To evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) as an adjunct to endovascular thrombectomy (EVT) in ischemic stroke, we performed a systematic review and meta-analysis of the literature.
Resident & Fellow Rounds
Roy E. Strowd, Whitley Aamodt
doi : 10.1212/WNL.0000000000012117
vol. 96 no. 24 1144-1145
Clinical Reasoning: A 71-Year-Old Man With Horizontal Gaze Palsy, Anarthria, and Quadriparesis
Ikreet Cheema, Nicole Ng, Tychicus Chen
doi : 10.1212/WNL.0000000000012048
vol. 96 no. 24 1146-1150
Teaching NeuroImages: A Ruptured Lumbar Disc Mimicking Spinal Tumor
Chia-En Wong, Po-Hsuan Lee, Chi-Chen Huang, Hui-Wen Chen, Chih-Hao Tien, Chih-Yuan Huang, Jung-Shun Lee
doi : 10.1212/WNL.0000000000011720
vol. 96 no. 24 e3003-e3004
Teaching Video NeuroImages: Multisystemic Erdheim-Chester Disease Presenting as a Cerebellar Ataxia
Marcelo Houat de Brito, Marcos Castello Barbosa de Oliveira, Yuri Reis Casal, Andre Neder Ramires Abdo, Leandro Tavares Lucato, Mateus Mistieri Simabukuro
doi : 10.1212/WNL.0000000000011714
vol. 96 no. 24 e3005-e3006
Training in Neurology: How Lessons Learned on Teaching, Well-being, and Telemedicine During the COVID-19 Pandemic Can Shape the Future of Neurology Education
Stefano Sandrone, Dara V.F. Albert, S. Richard Dunham, Jessica Kraker, Ika Noviawaty, Michael Palm, Hani Kushlaf
doi : 10.1212/WNL.0000000000012010
vol. 96 no. 24 e3007-e3010
The COVID-19 pandemic has a disruptive effect on neurology education, necessitating creative adjustments in the delivery of education, clinical training, and well-being. In this article, a group of educators reflects on challenges and lessons learned on teaching, well-being, and telemedicine, and how these can shape the future of neurology education. Developing standardized, rigorous evaluation of teaching methods and telemedicine, reinforcing well-being resources, and promoting international educational collaborations can improve neurology training during and after the pandemic.
Editors' Note: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan
James E. Siegler, Steven Galetta
doi : 10.1212/WNL.0000000000012114
vol. 96 no. 24 1151
Reader Response: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan
Lea Pollak
doi : 10.1212/WNL.0000000000012115
vol. 96 no. 24 1151-1152
Author Response: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan
Aravind Ganesh, Sina Marzoughi, Amro Qaddoura, Pouya Motazedian, Simerpreet S. Bal
doi : 10.1212/WNL.0000000000012116
vol. 96 no. 24 1152
Reader Response: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan
Fu-Liang Zhang, Yao Yu, Zhen-Ni Guo, Yi Yang
doi : 10.1212/WNL.0000000000012118
vol. 96 no. 24 1152-1153
Author Response: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan
Sina Marzoughi, Aravind Ganesh, Amro Qaddoura, Pouya Motazedian, Simerpreet S. Bal
doi : 10.1212/WNL.0000000000012119
vol. 96 no. 24 1153
