JAMA neurology最新文献

{"title":"Sex Differences in Longitudinal Tau-PET in Preclinical Alzheimer Disease: A Meta-Analysis.","authors":"Gillian T Coughlan, Hannah M Klinger, Rory Boyle, Tobey J Betthauser, Alexa Pichet Binette, Luke Christenson, Trevor Chadwick, Oskar Hansson, Theresa M Harrison, Brian Healy, Heidi I L Jacobs, Bernard Hanseeuw, Erin Jonaitis, Clifford R Jack, Keith A Johnson, Rebecca E Langhough, Michael J Properzi, Dorene M Rentz, Aaron P Schultz, Ruben Smith, Mabel Seto, Sterling C Johnson, Michelle M Mielke, Zahra Shirzadi, Wai-Ying Wendy Yau, JoAnn E Manson, Reisa A Sperling, Prashanthi Vemuri, Rachel F Buckley","doi":"10.1001/jamaneurol.2025.0013","DOIUrl":"10.1001/jamaneurol.2025.0013","url":null,"abstract":"<p><strong>Importance: </strong>Alzheimer disease (AD) predominates in females at almost twice the rate relative to males. Mounting evidence in adults without AD indicates that females exhibit higher tau deposition than age-matched males, particularly in the setting of elevated β-amyloid (Aβ), but the evidence for sex differences in tau accumulation rates is inconclusive.</p><p><strong>Objective: </strong>To examine whether female sex is associated with faster tau accumulation in the setting of high Aβ (as measured with positron emission tomography [PET]) and the moderating influence of sex on the association between APOEε4 carrier status and tau accumulation.</p><p><strong>Data sources: </strong>This meta-analysis used data from 6 longitudinal aging and AD studies, including the Alzheimer's Disease Neuroimaging Initiative, Berkeley Aging Cohort Study, BioFINDER 1, Harvard Aging Brain Study, Mayo Clinic Study of Aging, and Wisconsin Registry for Alzheimer Prevention. Longitudinal data were collected between November 2004 and May 2022.</p><p><strong>Study selection: </strong>Included studies required available longitudinal [18F]flortaucipir or [18F]-MK-6240 tau-PET scans, as well as baseline [11C] Pittsburgh Compound B, [18F]flutemetamol or [18F]florbetapir Aβ-PET scans. Recruitment criteria varied across studies. Analyses began on August 7, 2023, and were completed on February 5, 2024.</p><p><strong>Data extraction and synthesis: </strong>In each study, primary analyses extracted estimates for the sex (female or male) and the sex by baseline Aβ-PET status (high or low) association with longitudinal tau-PET using a series of mixed-effects models. Secondary mixed-effects models extracted the interaction estimate for the association of sex by APOEε4 carrier status with longitudinal tau-PET. Study-specific estimates for each mixed-effects model were then pooled in a meta-analysis, and the global fixed effect (β) and total heterogeneity (I2) across studies were estimated. This study is reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.</p><p><strong>Main outcomes and measures: </strong>Seven tau-PET outcomes that showed cross-sectional sex differences were examined across temporal, parietal, and occipital lobes.</p><p><strong>Results: </strong>Among 6 studies assessed, there were 1376 participants (761 [55%] female; mean [range] age at first tau scan, 71.9 [46-93] years; 401 participants [29%] with high baseline Aβ; 412 APOEε4 carriers [30%]). Among individuals with high baseline Aβ, female sex was associated with faster tau accumulation localized to inferior temporal (β = -0.14; 95% CI, -0.22 to -0.06; P = .009) temporal fusiform (β = -0.13; 95% CI, -0.23 to -0.04; P = .02), and lateral occipital regions (β = -0.15; 95% CI, -0.24 to -0.06; P = .009) compared with male sex. Among APOEε4 carriers, female sex was associated with faster inferior-temporal tau accumulation (β = -0.10; 95%","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":""},"PeriodicalIF":20.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542029","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":"Location and Timing of Recurrent, Nontraumatic Intracerebral Hemorrhage.","authors":"Martina B Goeldlin, Simon Fandler-Höfler, Alessandro Pezzini, Anusha Manikantan, Janis Rauch, Stine Munk Hald, Mona Løgtholt Kristensen, Lena Obergottsberger, Jochen A Sembill, David Haupenthal, Kristin Tveitan Larsen, Nikolaos S Avramiotis, Alexandros A Polymeris, Charlotte Periole, Kitti Thiankhaw, Ida Rangus, Laurent Puy, Marco Pasi, Andrea Morotti, Giorgio Silvestrelli, Giacomo Giacalone, Maurizio Paciaroni, Marialuisa Zedde, Elisa Giorli, Rossana Tassi, Marc Delgado-Romeu, Urs Fischer, Bastian Volbers, Arsany Hakim, Werner J Z'Graggen, Christian H Nolte, David J Werring, Nicolas Raposo, Stefan T Engelter, Espen S Kristoffersen, Joji Kuramatsu, Thomas Gattringer, David Gaist, David J Seiffge","doi":"10.1001/jamaneurol.2025.0026","DOIUrl":"10.1001/jamaneurol.2025.0026","url":null,"abstract":"<p><strong>Importance: </strong>: The spatial and temporal distribution of intracerebral hemorrhage (ICH) recurrence are largely unknown.</p><p><strong>Objective: </strong>To assess timing and location of recurrent ICH events in relation to the index ICH event (adjacent ICH [adjICH] vs remote ICH [remICH]).</p><p><strong>Design, setting, and participants: </strong>This cohort study was a pooled analysis of individual cohort studies from 2002 to 2021 among hospital-based European cohorts. Patients with 2 or more clinically distinguishable (≥1 recurrent) small vessel disease-related ICH events were included. Data analysis was performed from December 2023 to December 2024.</p><p><strong>Exposures: </strong>ICH location and underlying small vessel disease type.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was adjICH, defined by anatomical ICH location and side, and the secondary outcome was time to recurrence. Multivariable regression analyses were conducted adjusting for ICH location, cerebral amyloid angiopathy according to Boston 2.0 or simplified Edinburgh criteria, convexity subarachnoid hemorrhage extension, hypertension, and antihypertensive treatment, including an interaction term for hypertension and antihypertensive treatment.</p><p><strong>Results: </strong>Among 733 patients (median [IQR] age, 72.4 [65.2 to 79.0] years; 346 female [47.2%]), there were 1616 ICH events, including 733 index and 883 recurrent ICH events (range, 1 to 6 recurrences) over a median (IQR) follow-up of 2.53 (0.66 to 4.92) years. There were 340 patients (46.4%) with adjICH and 393 patients (53.6%) with remICH. Among recurrent ICH events, there were 476 adjICH events and 407 remICH events. In multivariable regression analyses, lobar index ICH (adjusted odds ratio [aOR], 2.08; 95% CI, 1.32 to 3.27) and cerebral amyloid angiopathy at index ICH (aOR, 2.21; 95% CI, 1.57 to 3.11) were associated with higher odds of adjICH, while cerebellar index ICH was associated with lower odds of adjICH (aOR, 0.25; 95% CI, 0.07 to 0.89). The median (IQR) time to recurrence was 1.25 (0.36 to 3.38) years for adjICH and 2.21 (0.66 to 4.85) years for remICH. Previous lobar or convexity subarachnoid hemorrhage (coefficient, -0.75; 95% CI, -1.25 to -0.25; P = .003 ), adjICH (coefficient, -0.60; 95% CI, -1.02 to -0.18; P = .005), and the number of previous ICH events (coefficient per 1-event increase, -0.62; 95% CI, -0.93 to -0.32; P < .001) were independently associated with a shorter time to recurrence.</p><p><strong>Conclusions and relevance: </strong>This study found that early recurrence and cerebral amyloid angiopathy were associated with adjICH. These findings suggest that regional, tissue-based factors may facilitate recurrence and that identifying and targeting local vasculopathic changes may represent potential novel treatment targets.</p>","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":""},"PeriodicalIF":20.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541922","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":"Frailty and Implications for Multiple Sclerosis Management","authors":"Jorge Correale","doi":"10.1001/jamaneurol.2025.0023","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.0023","url":null,"abstract":"This Viewpoint discusses the unique needs of patients with multiple sclerosis and frailty and describes the gaps that should be addressed in frailty measurement and clinical management.","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"36 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532851","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":"Apixaban to Prevent Covert Infarcts After Cryptogenic Stroke in Patients With Atrial Cardiopathy: A Secondary Analysis of the ARCADIA Randomized Clinical Trial.","authors":"Maarten G Lansberg, Max Wintermark, Hui Chen, George Howard, Christy Cassarly, Qi Pauls, Stephanie Kemp, Tashia L Harris, Balaji Krishnaiah, Robert J Stanton, Michael J Lyerly, Benjamin R Miller, Eric E Smith, David L Tirschwell, Kevin N Sheth, Hooman Kamel, William T Longstreth, Mitchell S V Elkind, Joseph P Broderick, Ronald M Lazar","doi":"10.1001/jamaneurol.2024.4838","DOIUrl":"10.1001/jamaneurol.2024.4838","url":null,"abstract":"<p><strong>Importance: </strong>In the Atrial Cardiopathy and Antithrombotic Drugs in Prevention After Cryptogenic Stroke (ARCADIA) randomized clinical trial, anticoagulation did not prevent recurrent stroke among patients with a recent cryptogenic stroke and atrial cardiopathy. It is unknown whether anticoagulation prevents covert infarcts in this population.</p><p><strong>Objective: </strong>To test the use of apixaban vs aspirin for prevention of nonlacunar covert infarcts after cryptogenic stroke in patients with atrial cardiopathy.</p><p><strong>Design, setting, and participants: </strong>ARCADIA-MRI, an ancillary study to the ARCADIA trial with a median follow-up period of 27 months, enrolled participants from 75 sites in the US from November 14, 2019, until December 2, 2022. Participants in ARCADIA were invited to coenroll in ARCADIA-MRI if they had not permanently discontinued the study drug and had no contraindications on magnetic resonance imaging (MRI). A total of 310 (31%) of the 1015 ARCADIA participants enrolled in ARCADIA-MRI and of those 174 (56%) with adequate quality baseline and follow-up MRI were included in the present analyses.</p><p><strong>Interventions: </strong>MRI performed at the time of the index stroke served as the baseline image unless it was unavailable or of insufficient quality, in which case a new research MRI was obtained. A follow-up research MRI was performed upon each participant's completion of participation in the ARCADIA parent study.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was incident nonlacunar covert infarct on the follow-up MRI assessed by 2 independent raters who were masked to treatment assignment.</p><p><strong>Results: </strong>Baseline characteristics were balanced between the apixaban (n = 79) and aspirin (n = 95) arms. The mean (SD) age was 66 (10.6) years, and the median (IQR) modified Rankin Scale (mRS) score 1 (0-2). Ninety-one participants (52.3%) were male. During the median (IQR) follow-up of 811 (487-1288) days, the risk of incident nonlacunar covert infarcts was lower in the apixaban group (5.1%) than the aspirin group (17.9%) (weighted relative risk, 0.29; 95% CI, 0.10-0.83).</p><p><strong>Conclusions and relevance: </strong>Apixaban compared to aspirin was associated with fewer incident nonlacunar covert infarcts among a subset of patients with a recent cryptogenic ischemic stroke and atrial cardiopathy who were enrolled in ARCADIA.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03192215.</p>","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"220-227"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046720","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":"Cognitive Effects of MR-Guided Focused Ultrasound Thalamotomy-Time to Evaluation-Reply.","authors":"Michael G Kaplitt, Vibhor Krishna, Howard M Eisenberg","doi":"10.1001/jamaneurol.2024.4788","DOIUrl":"10.1001/jamaneurol.2024.4788","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"309-310"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046723","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":"Is It Really Itching?","authors":"William G Ondo","doi":"10.1001/jamaneurol.2024.4830","DOIUrl":"10.1001/jamaneurol.2024.4830","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"310-311"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079961","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":"Is It Really Itching?-Reply.","authors":"Rafi Hadad","doi":"10.1001/jamaneurol.2024.4833","DOIUrl":"10.1001/jamaneurol.2024.4833","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"311"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080024","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":"Equipping AI for Unbiased and Inclusive Neurology.","authors":"Nina F Schor","doi":"10.1001/jamaneurol.2024.3954","DOIUrl":"10.1001/jamaneurol.2024.3954","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"211-212"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709546","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":"Anticoagulation in ESUS-Back From the Dead?","authors":"Holly Elser, S Andrew Josephson","doi":"10.1001/jamaneurol.2024.4847","DOIUrl":"10.1001/jamaneurol.2024.4847","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"214-215"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046719","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":"Predicting Individual Pain Sensitivity Using a Novel Cortical Biomarker Signature.","authors":"Nahian S Chowdhury, Chuan Bi, Andrew J Furman, Alan K I Chiang, Patrick Skippen, Emily Si, Samantha K Millard, Sarah M Margerison, Darrah Spies, Michael L Keaser, Joyce T Da Silva, Shuo Chen, Siobhan M Schabrun, David A Seminowicz","doi":"10.1001/jamaneurol.2024.4857","DOIUrl":"10.1001/jamaneurol.2024.4857","url":null,"abstract":"<p><strong>Importance: </strong>Biomarkers would greatly assist decision-making in the diagnosis, prevention, and treatment of chronic pain.</p><p><strong>Objective: </strong>To undertake analytical validation of a sensorimotor cortical biomarker signature for pain consisting of 2 measures: sensorimotor peak alpha frequency (PAF) and corticomotor excitability (CME).</p><p><strong>Design, setting, and participants: </strong>This cohort study at a single center (Neuroscience Research Australia) recruited participants from November 2020 to October 2022 through notices placed online and at universities across Australia. Participants were healthy adults aged 18 to 44 years with no history of chronic pain or a neurological or psychiatric condition. Participants experienced a model of prolonged temporomandibular pain with outcomes collected over 30 days. Electroencephalography to assess PAF and transcranial magnetic stimulation (TMS) to assess CME were recorded on days 0, 2, and 5. Pain was assessed twice daily from days 1 through 30.</p><p><strong>Exposure: </strong>Participants received an injection of nerve growth factor (NGF) to the right masseter muscle on days 0 and 2 to induce prolonged temporomandibular pain lasting up to 4 weeks.</p><p><strong>Main outcomes and measures: </strong>The predictive accuracy of the PAF/CME biomarker signature was determined using a nested control-test scheme: machine learning models were run on a training set (n = 100), where PAF and CME were predictors and pain sensitivity was the outcome. The winning classifier was assessed on a test set (n = 50) comparing the predicted pain labels against the true labels.</p><p><strong>Results: </strong>Among the final sample of 150 participants, 66 were female and 84 were male; the mean (SD) age was 25.1 (6.2) years. The winning classifier was logistic regression, with an outstanding area under the curve (AUC = 1.00). The locked model assessed on the test set had excellent performance (AUC = 0.88; 95% CI, 0.78-0.99). Results were reproduced across a range of methodological parameters. Moreover, inclusion of sex and pain catastrophizing as covariates did not improve model performance, suggesting the model including biomarkers only was more robust. PAF and CME biomarkers showed good to excellent test-retest reliability.</p><p><strong>Conclusions and relevance: </strong>This study provides evidence for a sensorimotor cortical biomarker signature for pain sensitivity. The combination of accuracy, reproducibility, and reliability suggests the PAF/CME biomarker signature has substantial potential for clinical translation, including predicting the transition from acute to chronic pain.</p>","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"237-246"},"PeriodicalIF":20.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046776","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}