Annals of Neurology最新文献

{"title":"Annals of Neurology: Volume 97, Number 6, June 2025","authors":"","doi":"10.1002/ana.26983","DOIUrl":"https://doi.org/10.1002/ana.26983","url":null,"abstract":"","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"97 6","pages":"C1"},"PeriodicalIF":8.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ana.26983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Intravenous Thrombolysis in Patients Taking Direct Oral Anticoagulation Treatment before Stroke Onset: Results from the Safe Implementations of Treatments in Stroke International Stroke Registry” Recently Published by Matusevicius and Colleagues","authors":"Senta Frol MD, PhD, Peter Alan Barber MD, PhD","doi":"10.1002/ana.27254","DOIUrl":"10.1002/ana.27254","url":null,"abstract":"","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"98 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to “Letter to the Editor, Regarding ‘Intravenous Thrombolysis in Patients Taking Direct Oral Anticoagulation Treatment Before Stroke Onset: Results from the Safe Implementations of Treatments in Stroke International Stroke Registry’” recently Published by Matusevicius et al.","authors":"Marius Matusevicius, Malin Säflund MD, Niaz Ahmed","doi":"10.1002/ana.27256","DOIUrl":"10.1002/ana.27256","url":null,"abstract":"","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"98 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to “Revolutionizing Neuroprognostication: The Enduring Value of Pupillary Reflexes Enhanced by Quantitative Pupillometry”","authors":"Yili Du MS, Charlene J. Ong MD, MPHS","doi":"10.1002/ana.27257","DOIUrl":"10.1002/ana.27257","url":null,"abstract":"","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"98 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing Neuroprognostication: The Enduring Value of Pupillary Reflexes Enhanced by Quantitative Pupillometry","authors":"Calixto Machado MD, PhD, FAAN, Jose Jesus Sanchez MD","doi":"10.1002/ana.27255","DOIUrl":"10.1002/ana.27255","url":null,"abstract":"","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"98 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Cerebral Amyloid Angiopathy and Associated Risk of Subsequent Ischemic and Hemorrhagic Stroke and Mortality in a Nationwide Cohort","authors":"Samuel S. Bruce MD, MA,&nbsp;Cenai Zhang MS,&nbsp;Ava L. Liberman MD,&nbsp;Alexander E. Merkler MD, MS,&nbsp;Babak B. Navi MD, MS,&nbsp;Gloria C. Chiang MD,&nbsp;Costantino Iadecola MD,&nbsp;Hooman Kamel MD, MS,&nbsp;Santosh B. Murthy MD, MPH","doi":"10.1002/ana.27253","DOIUrl":"10.1002/ana.27253","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>There are limited population-based data regarding the prevalence of cerebral amyloid angiopathy (CAA) and associated risks of mortality and incident cerebrovascular events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study using inpatient and outpatient claims from 2008 to 2022 from a 5% national sample of Medicare beneficiaries. CAA and ischemic and hemorrhagic stroke were identified using validated International Classification of Diseases 10th Revision (ICD-10) codes. We ascertained CAA from October 1, 2015 through 2022, and used data from 2008 through September 30, 2015 to ascertain comorbidities including prevalent stroke. We used Cox regression to examine the association of CAA with subsequent death and incident stroke subtypes after adjustment for demographics, vascular risk factors, and Charlson comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1,920,312 Medicare beneficiaries in our sample, 2,161 (11.3 per 10,000) had a diagnosis of CAA. In adjusted Cox regression analysis, there was an association between CAA and subsequent mortality (HR 4.9; 95% CI 4.6–5.2). Among 1,872,474 patients without prevalent stroke, including 900 of the CAA patients, there was a significant association between CAA and an increased risk of any stroke (HR 8.0; 95% CI 6.7–9.6), ischemic stroke (HR 4.6; 95% CI 3.6–6.0), intracerebral hemorrhage (HR 26.9; 95% CI 20.3–35.6), and subarachnoid hemorrhage (HR 21.6; 95% CI 12.2–38.1). After a diagnosis of CAA, absolute risks of ischemic stroke and intracerebral hemorrhage were broadly similar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>In a large, nationwide cohort of Medicare beneficiaries, the prevalence of clinically diagnosed CAA was approximately 11 per 10,000. CAA was associated with an increased risk of mortality and incident stroke, both hemorrhagic and ischemic. ANN NEUROL 2025;98:249–257</p>\u0000 </section>\u0000 </div>","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"98 2","pages":"249-257"},"PeriodicalIF":8.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated α-Synuclein Aggregate Levels in the Urine of Patients with Isolated REM Sleep Behavior Disorder and Parkinson's Disease","authors":"Laura Müller MS,&nbsp;Pelin Özdüzenciler MS,&nbsp;Charlotte Schedlich-Teufer MD,&nbsp;Aline Seger MD,&nbsp;Hannah Jergas MD,&nbsp;Gereon R. Fink MD,&nbsp;Dieter Willbold PhD,&nbsp;Michael Sommerauer MD,&nbsp;Michael T. Barbe MD,&nbsp;Gültekin Tamgüney PhD","doi":"10.1002/ana.27250","DOIUrl":"10.1002/ana.27250","url":null,"abstract":"<p>Parkinson's disease (PD) is a neurodegenerative disorder characterized by α-synuclein aggregation in neurons. Recent advances suggest α-synuclein aggregates could serve as a biomarker for PD and related synucleinopathies. This study used surface-based fluorescence intensity distribution analysis (sFIDA) to measure α-synuclein aggregates in urine. Patients with PD and isolated rapid eye movement sleep behavior disorder, a precursor to PD, had elevated concentrations compared with healthy controls. Sensitivity and specificity were 83% and 65% for PD versus controls and 89% and 62% for isolated rapid eye movement sleep behavior disorder versus controls. The findings highlight sFIDA's potential for diagnosing synucleinopathies. ANN NEUROL 2025;98:147–151</p>","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"98 1","pages":"147-151"},"PeriodicalIF":8.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ana.27250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phosphatemia is an Independent Prognostic Factor in Amyotrophic Lateral Sclerosis","authors":"Rosario Vasta MD, PhD,&nbsp;Emanuele Koumantakis MD,&nbsp;Antonio Canosa MD, PhD,&nbsp;Umberto Manera MD, PhD,&nbsp;Maurizio Grassano MD, PhD,&nbsp;Francesca Palumbo MD,&nbsp;Sara Cabras MD,&nbsp;Enrico Matteoni MD,&nbsp;Francesca Di Pede MD,&nbsp;Filippo De Mattei MD,&nbsp;Filippo Vergnano,&nbsp;Jessica Mandrioli MD,&nbsp;Cecilia Simonini BSc,&nbsp;Ilaria Martinelli MD,&nbsp;Fabiola De Marchi MD, PhD,&nbsp;Letizia Mazzini MD,&nbsp;Cristina Moglia MD, PhD,&nbsp;Andrea Calvo MD, PhD,&nbsp;Adriano Chiò MD, FAAN","doi":"10.1002/ana.27252","DOIUrl":"10.1002/ana.27252","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to evaluate the prognostic value of several muscle damage biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from Piemonte and Valle d'Aosta Amyotrophic Lateral Sclerosis (PARALS) were considered for this study. Survival was defined as the time from diagnosis to death, tracheostomy, or the censoring date. Blood levels of potassium, creatinine, creatine kinase, phosphorus, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) diagnosis were evaluated as potential prognostic biomarkers. A Cox model was developed for each biomarker and adjusted for sex, onset age, onset site, and diagnostic delay. Significant findings from PARALS were evaluated in the Pooled Resource Open-Access Amyotrophic Lateral Sclerosis Clinical Trials (PRO-ACT) database. Additionally, a joint model was constructed to evaluate the prognostic role of phosphatemia slope over time using longitudinal data from PRO-ACT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1,444 and 1,023 patients were included in the PARALS and PRO-ACT cohorts, respectively. Only creatinine (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.50–0.85) and phosphorus (HR = 1.14, 95% CI = 1.04–1.24) showed a significant association with survival in the PARALS cohort. These findings were further validated in the PRO-ACT cohort (creatinine HR = 0.21, 95% CI = 0.13–0.35, <i>p</i> &lt; 0.0001; phosphorus HR = 2.35, 95% CI = 1.13–4.88, <i>p</i> = 0.02). Longitudinal data from the PRO-ACT database showed that an increase of 0.1 mmol/l per month in phosphate levels was also associated with a HR of 8.26 (95% CI = 1.07–96.6, <i>p</i> = 0.044).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Creatininemia was confirmed as a prognostic marker in amyotrophic lateral sclerosis (ALS). Additionally, both phosphatemia levels at diagnosis and its rate of change over time were identified as a potential prognostic marker for ALS. As with other blood biomarkers, phosphate levels are cost-effective and minimally invasive to measure, supporting their potential use in clinical trials. ANN NEUROL 2025;98:286–293</p>\u0000 </section>\u0000 </div>","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"98 2","pages":"286-293"},"PeriodicalIF":8.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ana.27252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting New Lesions Using a Large Language Model: Applications in Real-World Multiple Sclerosis Datasets","authors":"Shane Poole BS,&nbsp;Nikki Sisodia BS,&nbsp;Kanishka Koshal MPH,&nbsp;Kyra Henderson BA,&nbsp;Jaeleene Wijangco BS,&nbsp;Danelvis Paredes MD,&nbsp;Chelsea Chen BA,&nbsp;William Rowles BS,&nbsp;Amit Akula BA,&nbsp;Jens Wuerfel MD, PhD,&nbsp;Vishakha Sharma PhD,&nbsp;UCSF Multiple Sclerosis and Neuroinflammation Center clinicians,&nbsp;Andreas M. Rauschecker MD, PhD,&nbsp;Roland G. Henry PhD,&nbsp;Riley Bove MD","doi":"10.1002/ana.27251","DOIUrl":"10.1002/ana.27251","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Neuroimaging is routinely utilized to identify new inflammatory activity in multiple sclerosis (MS). A large language model to classify narrative magnetic resonance imaging reports in the electronic health record (EHR) as discrete data could provide significant benefits for MS research. The objectives of the current study were to develop such a prompt and to illustrate its research applications through a common clinical scenario: monitoring response to B-cell depleting therapy (BCDT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An institutional ecosystem that securely connects healthcare data with ChatGPT4 was applied to clinical MS magnetic resonance imaging reports in a single institutional EHR (2000–2022). A prompt (msLesionprompt) was developed and iteratively refined to classify the presence or absence of new T2-weighted lesions (newT2w) and contrast-enhancing lesions (CEL). The multistep validation included evaluating efficiency (time and cost), comparison with manually annotated reports using standard confusion matrix, and application to identifying predictors of newT2w/CEL after BCDT start.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Accuracy of msLesionprompt was high for detection of newT2w (97%) and CEL (96.8%). All 14,888 available reports were categorized in 4.13 hours ($28); 79% showed no newT2w or CEL. Data extracted showed expected suppression of new activity by BCDT (&gt;97% monitoring magnetic resonance images after an initial “rebaseline” scan). Neighborhood poverty (Area Deprivation Index) was identified as a predictor of inflammatory activity (newT2w: OR 1.69, 95% CI 1.10–2.59, <i>p</i> = 0.017; CEL: OR 1.54, 95% CI 1.01–2.34, <i>p</i> = 0.046).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Extracting discrete information from narrative imaging reports using an large language model is feasible and efficient. This approach could augment many real-world analyses of MS disease evolution and treatment response. ANN NEUROL 2025;98:308–316</p>\u0000 </section>\u0000 </div>","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"98 2","pages":"308-316"},"PeriodicalIF":8.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ana.27251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nitrilase 1 Associated Cerebrovascular Small Vessel Disease","authors":"Seby John MD,&nbsp;Praveen Kesav DM,&nbsp;Syed Irteza Hussain MD","doi":"10.1002/ana.27249","DOIUrl":"10.1002/ana.27249","url":null,"abstract":"","PeriodicalId":127,"journal":{"name":"Annals of Neurology","volume":"98 1","pages":"197-198"},"PeriodicalIF":8.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}