Journal of the Neurological Sciences最新文献

{"title":"Frequency of subclavian steal syndrome in a sample of non-Western population","authors":"Ahmed Elhfnawy ,&nbsp;Hazem Abdelkhalek ,&nbsp;Alaa Elkordy","doi":"10.1016/j.jns.2024.123353","DOIUrl":"10.1016/j.jns.2024.123353","url":null,"abstract":"<div><h3>Background</h3><div>Subclavian steal syndrome (SSS) is not rarely found during ultrasound examinations. Previous reports demonstrated a relation between ethnic factors and SSS. Data regarding SSS in non-Western population are still lacking. We aimed to investigate the frequency of SSS in a sample of Egyptian population.</div></div><div><h3>Methods</h3><div>In a single-center observational study, we conducted a retrospective analysis of successive patients with competent ultrasound examinations of the brain supplying vessels. The patients presented to our neurovascular laboratory in the context of routine clinical practice.</div></div><div><h3>Results</h3><div>We enrolled 514 patients in our study. SSS was detected in 9 patients (1.8 %) with a median (IQR) age of 58 (56–63) years. One patient with second-degree SSS received a subclavian stent. Among patients with SSS, 4 patients (44.4 %) had carotid atherosclerosis, 4 patients (44.4 %) had ischemic vascular events in the posterior circulation, and two (22.2 %) had hemodynamically significant carotid stenosis ≥50 %. Using a ROC curve, an interarm SBP (systolic blood pressure) difference of ≥10 mmHg had a sensitivity of 77.8 % and specificity of 66 %, whereas a difference of ≥20 mmHg was associated with a sensitivity of 55.6 % and specificity of 92.4 % for SSS (AUC 0.79, 95 % CI 0.6–0.97, <em>p</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>SSS is not rare among Egyptian population and should be in mind during ultrasound examination, especially for patient with ischemic events in the posterior circulation and those with significant interarm SBP difference.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123353"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term changes in carotid intima-media thickness according to baseline blood pressure level: J-STARS Echo study","authors":"Shinichi Wada ,&nbsp;Masatoshi Koga ,&nbsp;Tatsuo Kagimura ,&nbsp;Kazunori Toyoda ,&nbsp;Yoji Nagai ,&nbsp;Shiro Aoki ,&nbsp;Tomohisa Nezu ,&nbsp;Naohisa Hosomi ,&nbsp;Hideki Origasa ,&nbsp;Toshiho Ohtsuki ,&nbsp;Hirofumi Maruyama ,&nbsp;Masahiro Yasaka ,&nbsp;Kazuo Kitagawa ,&nbsp;Shinichiro Uchiyama ,&nbsp;Kazuo Minematsu ,&nbsp;Masayasu Matsumoto ,&nbsp;On behalf of the Japan Statin Treatment Against Recurrent Stroke (J-STARS) Echo Study Collaborators","doi":"10.1016/j.jns.2024.123342","DOIUrl":"10.1016/j.jns.2024.123342","url":null,"abstract":"<div><h3>Background and aims</h3><div>We aimed to investigate long-term changes in carotid intima-media thickness (IMT) based on baseline blood pressure (BP) levels in non-cardioembolic stroke patients.</div></div><div><h3>Methods</h3><div>Patients aged 45–80 years with dyslipidemia who were not on statins before enrollment and had experienced a non-cardioembolic stroke were assigned to either the pravastatin group or the control group in a randomized trial. Patients were classified into three groups according to BP levels: normal BP (N-group: systolic BP [sBP] &lt;140 mmHg and diastolic BP [dBP] &lt;90 mmHg), highly elevated BP (G2 group: sBP ≥160 mmHg or dBP ≥100 mmHg), and mildly elevated BP (G1 group: the remaining patients). Mixed effect models were used to examine differences in slope of mean carotid IMT increases annually over the 5-year observation period among three groups, and for two groups divided based on whether they were above or below certain BP cut-off levels set at every 1 mmHg, ranging between 139 and 161 mmHg for sBP, and 89–101 mmHg for dBP.</div></div><div><h3>Results</h3><div>Of 792 patients, baseline mean carotid IMT in the G1-group (0.908 ± 0.152 mm) and G2-group (0.905 ± 0.145 mm) was significantly higher than the N-group (0.870 ± 0.153 mm) (<em>P</em> &lt; 0.01, for both respectively). Although there was no significant difference in the increase among three groups (<em>P</em> = 0.091), the increase in patients above sBP 154, 159 and 160 mmHg or dBP 101 mmHg at baseline was higher than others (<em>P</em> &lt; 0.05 for all).</div></div><div><h3>Conclusions</h3><div>High baseline BP correlated with a high baseline carotid IMT and its subsequent 5-year increase in non-cardioembolic stroke patients.</div></div><div><h3>Clinical trial registration</h3><div><span><span>http://www.clinicaltrials.gov</span><svg><path></path></svg></span>.</div></div><div><h3>Unique identifier</h3><div><span><span>NCT00361530</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123342"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ofatumumab for multiple sclerosis with disability accumulation","authors":"Masahiro Mimori ,&nbsp;Atsuko Katsumoto ,&nbsp;Tomoko Okamoto ,&nbsp;Wakiro Sato ,&nbsp;Youwei Lin ,&nbsp;Takashi Yamamura ,&nbsp;Yuji Takahashi","doi":"10.1016/j.jns.2024.123356","DOIUrl":"10.1016/j.jns.2024.123356","url":null,"abstract":"<div><h3>Background</h3><div>The ASCLEPIOS/APLIOS/APOLITOS/ALITHIOS trials highlighted the benefits of ofatumumab in reducing relapse rates and disability progression in multiple sclerosis (MS). However, its effects on patients with severe disability status remains uncertain. This study aimed to clarify the outcomes of ofatumumab in MS patients with high Expanded Disability Status Scale (EDSS) scores and prolonged disease durations.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study of MS patients treated with ofatumumab at an MS center in Japan. At 12 months of treatment, patients with MS starting ofatumumab were classified into the treatment-responsive or treatment-resistant groups based on ofatumumab continuity, incidence of relapses with EDSS worsening, progression independent of relapse activity (PIRA). We used logistic regression analysis to identify factors associated with ofatumumab response.</div></div><div><h3>Results</h3><div>Seventy patients were included in the analysis; 39 (56 %) patients were relapsing-remitting (RR), and 31 (44 %) patients were secondary progressive (SP) MS. Mean age at ofatumumab initiation, age at onset, and disease duration were 48.0, 33.9, and 14.1 years, respectively. The median EDSS was 4.5 (3.0–6.5); 38(56 %) patients were classified as resistant. The resistant rates by disease type were 33 % (13/39) and 81 % (26/31) for RR and SP MS, respectively. On multivariate analysis, EDSS and No evidence of disease activity (NEDA) 3 were independent factors for ofatumumab responsiveness (OR, 1.74, 0.04; 95 % CI, 1.17–2.73, 0.00–0.47; <em>p</em> = 0.01, 0.04).</div></div><div><h3>Conclusion</h3><div>Ofatumumab may yield more favorable effects when initiated in patients with MS with lower EDSS scores.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123356"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-regression of optic nerve imaging and visual outcome in myelin oligodendrocyte glycoprotein antibody optic neuritis","authors":"Brendan K. Tao ,&nbsp;Natalie Chen ,&nbsp;Adrien Lusterio ,&nbsp;Minj Shah ,&nbsp;Chia-Chen Tsai ,&nbsp;Sumana Naidu ,&nbsp;Armin Handzic ,&nbsp;Edward Margolin","doi":"10.1016/j.jns.2024.123362","DOIUrl":"10.1016/j.jns.2024.123362","url":null,"abstract":"<div><h3>Background</h3><div>Few predictors of visual outcome after myelin oligodendrocyte glycoprotein (MOG) auto-antibody disease optic neuritis (ON) have been reliably elucidated. We evaluate whether between-study differences in ON neuroimaging regional enhancement features may underlie heterogeneity in reported visual prognosis.</div></div><div><h3>Methods</h3><div>PROSPERO (CRD42024580123). We systematically review within-study analyses correlating neuroimaging ON findings with visual outcome. Between studies, a meta-regression was conducted using ON segmental and regional inflammation (intraorbital, pre-chiasmal, intra- or post-chiasmal, and longitudinal extension) as predictors of final and change-from-baseline visual acuity (VA; LogMAR).</div></div><div><h3>Results</h3><div>We identified 26 reports (<em>n</em> = 1197 participants), eleven of which reported VA analyses or data stratified by enhancement region. Despite conflicting reports on the association between final VA and enhancement region, most studies report against this association. Meta-regression across all studies similarly determined that, at the study level, there was no significant association of any ON segment nor region with final or change-from-baseline VA. Risk of bias analysis indicated generally favourable quality across included studies.</div></div><div><h3>Conclusion</h3><div>Studies with poorer VA outcome did not significantly differ in the proportion of patients with various ON regional enhancement patterns. Future studies stratifying VA by neuroimaging findings with raw data reported are needed.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123362"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRZ-reaction maybe influenced by immunization status and is not exclusive to multiple sclerosis","authors":"Mary Anitha D'Cunha,&nbsp;Lekha Pandit,&nbsp;Akshatha Sudhir","doi":"10.1016/j.jns.2024.123365","DOIUrl":"10.1016/j.jns.2024.123365","url":null,"abstract":"<div><h3>Background</h3><div>Among white populations, a poly-specific antibody response against measles (M), rubella (R) and varicella zoster(Z) otherwise known as MRZR is seen in ∼70 % of MS and rarely in other demyelinating disorders. While the basis for MRZR is unclear, vaccination exposure / community acquired infections may have an influence on its frequency.</div></div><div><h3>Objective</h3><div>To determine the frequency and specificity of MRZR in MS and related disorders in a non- white population with historically low vaccinations and to contrast against oligoclonal bands (OCB).</div></div><div><h3>Methods</h3><div>In all, 167 consecutive patients (MS -96, MOGAD-33, AQP4-IgG + NMOSD-12 &amp; double seronegative disorders[DSD] -26) were included. Clinical diagnosis, vaccination history and past infections contributing to MRZR were queried, OCB results were reviewed and MRZR measured.</div></div><div><h3>Result</h3><div>MRZR+ response was seen in 50 % MS, 21.2 % MOGAD, 8.3 %NMOSD and 3.8 % of DSN disease. Vaccination history was limited, a past history of Z was notably associated (p 0.005) with MRZR-Z+ and a high median antibody index was detected for Z and R (p 0.001) in MS. Among MRZR+ patients with MOGAD, a disseminated disease that included LETM (p 0.007), relapsing course (p 0.02), higher relapse rate (p 0.001) and lumbar puncture performed after 2 or more attacks(p 0.009) were significant. CSF specific OCB was more sensitive (71.9 %;95 %CI 61.8–80.6) and specific (94.4 %;95 %CI 86.2–98.4) than MRZR (sensitivity 50 % [95 %CI 39.62–60.4] and specificity 87.3 %(95 %CI 77.3–94.04) for MS patients.</div></div><div><h3>Conclusion</h3><div>In this south Indian cohort with historically low vaccination status, community acquired immunity may have in part influenced MRZR+ results, especially MRZR-Z. A chronic inflammatory state is a likely pre-requisite, that may not be disease specific, for MRZR positivity in immunologically overlapping CNS disorders such as MS, MOGAD and others.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123365"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early deterioration of CIDP following transition from IVIG to FcRn inhibitor treatment","authors":"Todd Levine ,&nbsp;Suraj Muley","doi":"10.1016/j.jns.2024.123313","DOIUrl":"10.1016/j.jns.2024.123313","url":null,"abstract":"<div><div>Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune mediated demyelinating neuropathy that can lead to secondary axonal degeneration and irreversible weakness and disability. Early effective treatment is therefore necessary to minimize the degree of axonal degeneration. Prior to 2024 the only FDA approved therapy for CIDP was intravenous immunoglobulin (IVIg). In 2024, efgartigimod (Vyvgart-Hytrulo), a FCRn inhibiting therapy (FIT) was approved for treatment of CIDP based on the phase II Adhere study. In the controlled setting of the phase II clinical study patients who were stable on IVIg were taken off treatment to ensure that their disease was active, and patients who worsened were then treated with efgartigimod. The responders were then randomized (in phase B) to either placebo or continued efgartigimod treatment. In the real world setting it is not feasible to stop IVIg and let patients worsen before starting a FIT, thus the transition from IVIG to efgartigimod in a real world setting was not studied in the pivotal trial. We have treated nine patients with FIT in our practice and report findings of four of those patients who had severe relapse of CIDP after treatment. Five of the other patients neither improved nor declined with FIT. This raises questions about the issues related to transitioning patients from IVIG to efgartigimod.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123313"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No clear relationship between circadian rhythm and cerebral perfusion parameters in pediatric and early adult populations","authors":"Ronda Lun ,&nbsp;Anirudh Sreekrishnan ,&nbsp;Sarah Lee ,&nbsp;Gregory W. Albers","doi":"10.1016/j.jns.2024.123351","DOIUrl":"10.1016/j.jns.2024.123351","url":null,"abstract":"<div><h3>Background</h3><div>Recent literature suggests circadian rhythm influences cerebral perfusion parameters in adults experiencing an acute large vessel occlusion, but this has never been investigated in the pediatric and young adult populations.</div></div><div><h3>Methods</h3><div>We queried the United States RAPID Insights database (10/05/2018–09/29/2023) for unique patients between 2 and 25 years with computed tomography perfusion (CTP). Included scans had a minimum ischemic core volume (rCBF &lt;30 %) of &gt;0 cc and a Tmax volume of &gt;0 cc. Intracerebral hemorrhage cases were excluded. Anterior circulation large vessel occlusion cases were segregated and reported separately. Imaging time was subdivided into three epochs: Night (23:00 h-06:59 h), Day (07:00 h-14:59 h), and Evening (15:00 h-22:59 h). Age was analyzed by pre-defined strata: 2–5, 6–11, 12–18, and 19–25 years. Perfusion parameters were stratified by age and time epochs. We used non-parametric testing for variables with non-normal distributions.</div></div><div><h3>Results</h3><div>We included 2415 CTP scans, with 307 identified as LVO. There were 637 patients 18 or younger, with 85 LVOs. In the overall cohort, LVOs had higher penumbral volumes (75.0 cc [25.0–156.0] vs 26.0 cc [8.0–78.0], <em>p</em> &lt; 0.0001) and mismatch volumes (54.0 cc [18.0–120.0] vs 21.0 cc [7.0–62.0], p &lt; 0.0001). In the LVO subgroup, there was a trend towards higher mismatch volumes at night (58.0 cc [IQR 19.5–139.8]) compared to evening (50.0 cc [IQR 18.8–114.3]) or daytime (55.0 cc [17.0–126.0]), but these differences were not significant (<em>p</em> = 0.72).</div></div><div><h3>Conclusion</h3><div>Contrary to reports in adults, we did not find a clear association between time of day and cerebral perfusion parameters among pediatric and young adult patients.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123351"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper-extremity motor recovery after stroke: A systematic review and meta-analysis of usual care in trials and observational studies","authors":"Mia Kolmos M.D. ,&nbsp;Maria Munoz-Novoa MSc.PT ,&nbsp;Katharina Sunnerhagen Professor, M.D. ,&nbsp;Margit Alt Murphy Ph.D. ,&nbsp;Christina Kruuse Professor, M.D","doi":"10.1016/j.jns.2024.123341","DOIUrl":"10.1016/j.jns.2024.123341","url":null,"abstract":"<div><h3>Background</h3><div>A better knowledge of upper-extremity (UE) recovery in patients with stroke receiving usual care (UC) is crucial for informing clinicians on expected recovery and serves as reference for future studies.</div></div><div><h3>Objectives</h3><div>This systematic review and meta-analysis aimed to assess rate and amount of recovery of UE with UC in the subacute phase of stroke and identify covariates of UE recovery.</div></div><div><h3>Methods</h3><div>PRISMA-guidelines were used for search in PubMed, Cinahl and PEDro. Observational studies (OS) and UC groups of randomized control trials (RCT) of adults with subacute stroke and UE paresis were included, each reporting UE function at least at two time points. Placebo-, sham-controlled, dose-matched trials and trials with &lt;10 participants were excluded.</div></div><div><h3>Results</h3><div>From 1220 records, 54 papers (19 OS and 35 RCTs) involving 2774 subacute stroke patients were included. Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) were most frequently reported UE outcomes. Across RCTs, FMA-UE and ARAT improved 10 and 8 points, respectively, on average at 4-weeks from baseline. In OS, FMA-UE, improved 12 points at 12 weeks and 16 points at 24 weeks from baseline. Stroke severity, UE function, and lesion load of the cortico-spinal tract at baseline were associated with UE recovery.</div></div><div><h3>Conclusions</h3><div>UE function in subacute stroke showed improvements that exceeded the threshold for clinically important change across RCTs and OS. This review provides estimates of expected change in UC groups for sample size calculations and planning of future trials, thereby enhancing statistical power and comparability of findings.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123341"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “C9orf72 gene repeat expansion phenotype profile of motor neurone disease in Portugal” [Journal of the Neurological Sciences volume 465 (2024), 123208]","authors":"Cláudia Santos Silva ,&nbsp;Marta Gromicho ,&nbsp;Sara Simão ,&nbsp;Ana Catarina Pronto-Laborinho ,&nbsp;Inês Alves ,&nbsp;Susana Pinto ,&nbsp;Miguel Oliveira Santos ,&nbsp;Mamede de Carvalho","doi":"10.1016/j.jns.2024.123363","DOIUrl":"10.1016/j.jns.2024.123363","url":null,"abstract":"","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123363"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaching neuro-palliative care with historically minoritized groups in the United States: A literature review and actionable recommendations","authors":"Sahily Reyes-Esteves ,&nbsp;Alvin Singh ,&nbsp;Kylie Ternes ,&nbsp;Adys Mendizabal","doi":"10.1016/j.jns.2024.123333","DOIUrl":"10.1016/j.jns.2024.123333","url":null,"abstract":"<div><div>This review critically examines neuro-palliative care disparities in historically minoritized groups in the U.S., particularly in Asian, Black, and Latino communities. Addressing a gap in the 2022 American Academy of Neurology guidelines, this review synthesizes current literature and our clinical experiences as neurologists who identify as members of these communities in diverse care settings. We identify common barriers to palliative care access and acceptance, influenced by cultural heterogeneity, mistrust, and systemic disparities. The review offers targeted, actionable recommendations at the provider, healthcare system, and policy level to improve care and reduce disparities.</div></div>","PeriodicalId":17417,"journal":{"name":"Journal of the Neurological Sciences","volume":"468 ","pages":"Article 123333"},"PeriodicalIF":3.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}