Neurology. Clinical practice最新文献

{"title":"Approach to Managing the Initial Presentation of Multiple Sclerosis: A Worldwide Practice Survey.","authors":"Jodie I Roberts, Aravind Ganesh, Luca Bartolini, Tomas Kalincik","doi":"10.1212/CPJ.0000000000200376","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200376","url":null,"abstract":"<p><strong>Background and objectives: </strong>Available disease-modifying therapies (DMTs) for multiple sclerosis (MS) are rapidly expanding; although escalation approaches aim to balance safety and efficacy, emerging evidence suggests superior outcomes for people with MS who are exposed to early high-efficacy therapies. We aimed to explore practice differences in prevailing management strategies for relapsing-remitting MS.</p><p><strong>Methods: </strong>We used a worldwide electronic survey launched by the Practice Current section of <i>Neurology® Clinical Practice</i>. Questions pertained to a case of a 37-year-old woman presenting with optic neuritis. Respondents were asked to indicate their initial investigations, relapse management strategy, choice of disease-modifying therapy, and plan for follow-up imaging (contrast/noncontrast). Survey responses were stratified by key demographic variables along with 95% confidence intervals (95% CIs).</p><p><strong>Results: </strong>We received 153 responses from 42 countries; 32.3% responders identified as MS specialists. There was a strong preference for intravenous delivery of high-dose corticosteroids (87.7%, 95% CI 80.7-92.5), and most of the responders (61.3%, 95% CI 52.6-69.4) indicated they would treat a nondisabling (mild sensory) MS relapse. When asked to select a single initial DMT, 56.6% (95% CI 47.6-65.1) selected a high-efficacy therapy (67.5% MS specialists vs 53.7% non-MS specialists). The most selected agents overall were fingolimod (14.7%), natalizumab (15.5%), and dimethyl fumarate (20.9%). Two-thirds of respondents indicated they would request contrast-enhanced surveillance MRI.</p><p><strong>Discussion: </strong>Although there is a slight preference for initiating high-efficacy DMT at the time of initial MS diagnosis, opinions regarding the most appropriate treatment paradigm remain divided.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200376"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coprophenomena Associated With Worse Individual and Family Function for Youth With Tourette Syndrome: A Cross-Sectional Study.","authors":"Samantha P Myers, Kathleen D Meeks, Heather Adams, Amy E Vierhile, Erika Augustine, Alyssa Collins, Adam B Lewin, Tanya K Murphy, Jonathan W Mink, Jennifer Vermilion","doi":"10.1212/CPJ.0000000000200369","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200369","url":null,"abstract":"<p><strong>Background and objectives: </strong>Tourette syndrome (TS) is defined by multiple motor tics and one or more phonic tics with a symptom duration of >1 year. Coprophenomena are uncommon tics characterized by obscene sounds, words, or gestures. Youth with TS commonly have psychiatric co-occurring conditions such as attention-deficit hyperactivity disorder or obsessive-compulsive disorder and have reported lower scores on measures of individual and family functioning than youth without TS. This study aimed to determine associations among co-occurring condition symptoms, tic severity, and function in youth with TS and coprophenomena compared with those with TS without coprophenomena.</p><p><strong>Methods: </strong>Data were collected through a multicenter, cross-sectional study. Youth with TS were recruited from 2 referral centers, and data were collected from youth and their parents or caregivers. Tic severity was assessed using the Yale Global Tic Severity Scale, and individual function was measured with the Children's Global Assessment Scale. Family impact was measured using the Family Impact Module in domains of parent health-related quality of life (HRQOL), family functioning, and total family impact. We compared individual and family function in youth with TS with coprophenomena (TS+copro) and without coprophenomena (TS-copro). Wilcoxon rank-sum tests were used to compare scores on individual function and family function measures.</p><p><strong>Results: </strong>Of 169 participants, 17 (10.1%) reported coprophenomena. Participants with TS and coprophenomena had higher tic severity scores than those without coprophenomena (TS+copro mean = 36.9, TS-copro = 20.8). Youth with coprophenomena had lower scores for global function (TS+copro median = 51, TS-copro = 60), family functioning (TS+copro = 43.8, TS-copro = 59.4), parent HRQOL (TS+copro = 57, TS-copro = 72), and total family QOL (TS+copro = 50.7, TS-copro = 65.3).</p><p><strong>Discussion: </strong>Youth with TS and coprophenomena had lower individual function, family function, and parent HRQOL than youth without coprophenomena. Coprophenomena presence may indicate that youth have a more severe phenotype of TS, and youth with copropheneomena may benefit from additional caregiver or family supports.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200369"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Movement Disorders and Deep Brain Stimulation: A Review.","authors":"Alexandra Boogers, Alfonso Fasano","doi":"10.1212/CPJ.0000000000200367","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200367","url":null,"abstract":"<p><strong>Purpose of the review: </strong>The aim of this narrative review was to explore the interplay between functional movement disorders (FMDs) and deep brain stimulation (DBS).</p><p><strong>Recent findings: </strong>Patients with unrecognized FMD who are referred for DBS usually present with functional dystonia. By contrast, patients who present with FMD after DBS are mostly presenting with functional tremor, in keeping with non-DBS FMD cohorts. Comorbid presentation of FMD in established DBS indications makes the decision to opt for surgery challenging. Many contributing factors can play a role in the development of FMD, including the trauma caused by awake neurosurgery and/or extensive DBS programming.</p><p><strong>Summary: </strong>FMDs in the context of DBS are often overlooked and should be diagnosed promptly because they determine surgical outcome. The approach to DBS candidates with comorbid FMD and the risk factors of FMD after DBS should be further explored.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200367"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Post-Neurointensive Care Recovery Clinic: Design, Utilization, and Clinician Perspectives.","authors":"Julia M Carlson, Galina Gheihman, Kristi Emerson, Haitham S Alabsi, W Taylor Kimberly, Michael J Young, David J Lin","doi":"10.1212/CPJ.0000000000200364","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200364","url":null,"abstract":"<p><strong>Background and objectives: </strong>Despite increasing interest in post-intensive care unit (ICU) clinical care and management, there have been limited descriptions focused on the post-neurologic (neuro)-ICU population. Here, we describe the design of a post-neuro-ICU Neurorecovery Clinic (NRC) and present data collected regarding the clinic's population, referrals, visits, and clinician satisfaction.</p><p><strong>Methods: </strong>This is a single-institution experience with a NRC designed to provide an infrastructure for post-ICU care to patients recovering from acute neurologic disorders or systemic conditions with neurologic sequelae. The clinic offers 2 visit types with different frequencies: a weekly visit and a monthly multidisciplinary visit. This study assessed clinical utilization and clinician perspectives regarding the clinic. Data on clinic referrals, no-show frequency, visit types, and diagnoses for both weekly and monthly visits were collected. A survey was conducted to assess clinician satisfaction and perspectives. Qualitative thematic analysis was performed to identify major themes among survey free responses.</p><p><strong>Results: </strong>In a 2-year period, 225 patients were referred from the Massachusetts General Hospital neuro-ICU to the NRC. Of those, 105 (47%) were seen in clinic for at least one visit. The most common reasons for loss to follow-up were no shows (38%) and noncontracted insurance (21%). Twenty percent of visits were in-person (the rest were by telehealth). Forty-eight percent were new patients compared with return visits. The most common diagnoses were other (36%), ischemic stroke (26%), and traumatic brain injury (17%). An additional monthly multidisciplinary clinic has seen 14 patients with one no show. Clinicians found their experience in the NRC valuable. Identified benefits included interdisciplinary collaboration, being a more well-rounded and better clinician, improving effectiveness in managing post-ICU problems, and influencing ICU prognosis. Clinicians' greatest challenge was navigating resource limitations for patients.</p><p><strong>Discussion: </strong>A postneuro-ICU NRC is a feasible model of care delivery for patients after severe acute neurologic disorders. Patients with a broad variety of diagnoses were seen in a 2-year period. Providers valued their clinic time and experiences. Future studies should evaluate whether this model of care improves patients' postneuro-ICU outcomes.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200364"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The New Frontier of Adult Neurodevelopmental Care: Individual and Caregiver Values.","authors":"Jessica S Sanders, Ashley Dafoe, Chloe Glaros, Brooke Dorsey Holliman","doi":"10.1212/CPJ.0000000000200384","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200384","url":null,"abstract":"<p><strong>Background and objectives: </strong>There are few specialists that serve adults with neurodevelopmental disabilities (NDD), and most adults with NDD receive care from providers without specialty training in NDD. Care for this population is highly variable, and patient and caregiver priorities in this age group are not well known. We aimed to explore individual and caregiver values around adult neurodevelopmental care.</p><p><strong>Methods: </strong>In this qualitative study, a qualitative analyst conducted 22 semistructured virtual interviews from September 2021 to February 2022 with randomly selected adults with NDD and/or their caregivers. Each individual with NDD had at least one appointment in the adult NDD clinic, which started in October 2020. Interviews were recorded and professionally transcribed. An inductive codebook was developed and reconciled through an iterative process; transcripts were coded in Atlas.ti with 20% double-coding. Major themes were developed through team discussion.</p><p><strong>Results: </strong>Most interviewees were caregivers of patients with NDD (12); 9 interviews were with patient/caregiver dyads; 1 interview was with a patient alone. Three main themes emerged from the interviews. (1) Value in providers who are curious, engaged, and knowledgeable about NDD-related conditions, which individuals and caregivers referred to as \"Unicorn Providers.\" (2) Value in a connected and coordinated web of care. (3) Value in comfortable and adaptable clinic spaces. They value clinical environments that foster patient success during visits.</p><p><strong>Discussion: </strong>The need for adult neurodevelopmental care is growing as more individuals with NDD are living into adulthood. Better understanding of patient and caregiver values can help shape this emerging field to meet the needs of this unique, often overlooked and underserved, population.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200384"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Design and Write Your Quality Improvement Study for Publication: Pearls and Pitfalls.","authors":"Anup D Patel, Laurice Yang, Kathryn Kvam, Christine Baca, Lyell K Jones","doi":"10.1212/CPJ.0000000000200419","DOIUrl":"10.1212/CPJ.0000000000200419","url":null,"abstract":"<p><strong>Objective: </strong>To describe a pragmatic process for translating quality improvement (QI) projects into published manuscripts.</p><p><strong>Scope: </strong>Types of QI work that are generalizable and have broad relevance (to journals and readers), design principles that are important for publishable QI work, how QI manuscript organization might differ from biomedical manuscripts, how to use and not to use Standards for Quality Improvement Reporting Excellence and other guidelines, pitfalls, and how to avoid/repair them.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200419"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Cavum Septum Pellucidum in Former American Football Players: Findings From the DIAGNOSE CTE Research Project.","authors":"","doi":"10.1212/CPJ.0000000000200414","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200414","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1212/CPJ.0000000000200324.].</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200414"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REM Sleep Behavior Disorder Diagnostic Code Accuracy and Implications in the Real-World Setting.","authors":"Lana M Chahine, Deena Ratner, Aaron Palmquist, Gayatri Dholakia, Anne B Newman, Richard D Boyce, Caterina Rosano, Maria Brooks","doi":"10.1212/CPJ.0000000000200387","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200387","url":null,"abstract":"<p><strong>Background and objectives: </strong>Isolated REM sleep behavior disorder (iRBD) carries increased risk of neurodegenerative parkinsonian disorder or dementia (NPD) but is difficult to accurately screen for in the community. Health care data offer the opportunity to identify large numbers of iRBD cases among outpatients. We aimed to determine the positive predictive value (PPV) of an RBD <i>International Classification of Disorders</i> (ICD) code for actual iRBD based on manual review of the electronic health record (EHR), examine risk of NPD diagnosis, and explore whether a statistical model developed using selected EHR data can identify individuals with the RBD ICD code who have high probability for actual iRBD.</p><p><strong>Methods: </strong>In this retrospective cohort study, a search of the EHR at a single health care system was conducted to identify outpatients who received the ICD9 or ICD10 RBD code in 2011-2021. The EHR for each case was manually reviewed. Secondary RBD cases were excluded. Remaining cases were classified as no iRBD or actual iRBD (possible, probable, or definite). Incident cases of NPD were identified. PPV of presence of the RBD ICD code for actual iRBD was calculated. Cumulative incidence of NPD with death as a competing event was compared in those with vs without iRBD. Least absolute shrinkage and selection operator (LASSO) regression was used to build a prediction model for iRBD, and the model was validated in an independent data set.</p><p><strong>Results: </strong>Among 1,130 cases with the RBD ICD code, 499 had secondary causes of RBD. For the remaining 628 cases, EHR review indicated no iRBD in 168 (26.8%). PPV of the RBD ICD code was 73.25%. Over a median follow-up of 4.7 years, compared with the no iRBD group, the iRBD group had a higher risk of NPD (subdistribution hazard ratio = 10.4 [95% CI 2.5-43.1]). The LASSO prediction model for iRBD had an area under the receiver operating characteristic curve of 0.844 (95% CI 0.806-0.880).</p><p><strong>Discussion: </strong>PPV of an RBD ICD code is moderate. In the real-world setting, patients with iRBD had a high risk of incident diagnosis of NPD over 4.7 years. Results indicate feasibility of using statistical models developed using EHR data to accurately predict iRBD.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200387"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticobasal Syndrome: Are There Central or Peripheral Triggers?","authors":"Abhishek Lenka, Joseph Jankovic","doi":"10.1212/CPJ.0000000000200365","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200365","url":null,"abstract":"<p><strong>Background and objectives: </strong>Corticobasal syndrome (CBS) is a complex of symptoms and signs comprising limb rigidity, bradykinesia, dystonia, myoclonus, apraxia, cortical sensory loss, and a variety of cognitive and language impairments. CBS is commonly seen in tauopathies. Striking asymmetry in clinical and imaging findings in CBS raises questions about potential triggers initiating neurodegeneration. The objective of this study was to investigate potential central or peripheral triggers preceding CBS symptoms.</p><p><strong>Methods: </strong>In this retrospective observational study, we reviewed medical records of patients with CBS at our Parkinson's Disease Center and Movement Disorders Clinic, focusing on evidence of possible central or peripheral \"trigger\" occurring within a year before the onset of CBS. We also reviewed records of patients with Parkinson disease (PD) for comparison.</p><p><strong>Results: </strong>Of the 72 patients with CBS, 15 (20.8%) reported potential focal triggers before the onset of CBS-related neurologic symptoms. By contrast, only 1 of 72 patients with PD (1.4%) had a documented trigger before the onset of PD-related symptoms (<i>p</i> < 0.001). Of potential triggers, 13 were peripheral (related to hand or shoulder surgeries or trauma) and 2 were central (stroke and head trauma). Patients with CBS with triggers were younger, had earlier symptom onset, comprised a higher proportion of men, and had a higher likelihood of limb onset of symptoms than those without.</p><p><strong>Discussion: </strong>Our finding of relatively high frequency of focal triggers in CBS compared with PD suggests potential central or peripheral triggers initiating neurodegeneration, possibly explaining asymmetric clinical and imaging features in CBS. Further research is necessary to validate and explore this observation's implications for CBS pathogenesis.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200365"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissemination of VMAT-2 Inhibitors: A New Class Drug for Tardive Dyskinesia and Huntington Disease.","authors":"Erica Ma, Emma Krening, Michiko K Bruno","doi":"10.1212/CPJ.0000000000200392","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200392","url":null,"abstract":"<p><strong>Background and objectives: </strong>In 2017, the FDA approved deutetrabenazine (AUSTEDO) for the treatment of tardive dyskinesia (TD) and chorea associated with Huntington disease (HD). Concurrently, valbenazine (INGREZZA) was approved specifically for TD. The adoption of new medications is influenced by various factors, including patient's medical needs, the prescriber's adoption of new practice, and external environmental factors (e.g., cost). Our analysis aims to examine the dissemination of 2 vesicular monoamine transporter 2 (VMAT-2) inhibitors, deutetrabenazine and valbenazine, in the market.</p><p><strong>Methods: </strong>In this cross-sectional study, we conducted a descriptive statistical analysis of the 2017-2020 prescription records for deutetrabenazine and valbenazine using the Centers for Medicare & Medicaid Services Medicare Provider Utilization and Payment Data: Part D Prescriber public use file. In addition, we linked this data set to the Open Payment database to analyze industry payments.</p><p><strong>Results: </strong>We identified a total of 3,706 deutetrabenazine prescribers and 4,895 valbenazine prescribers. Prescription volume (standardized 30-day prescription) increased annually across different specialties for both VMAT-2 inhibitors from 2017 to 2020. Neurologists were the highest contributors to deutetrabenazine prescriptions (N = 50,017; 35.2%), and psychiatrists were the highest contributors to valbenazine prescriptions (N = 77,799; 42.3%). A total of 1,217 deutetrabenazine physician prescribers (47.5%) and 1,509 valbenazine physician prescribers (49.7%) received industry payments from TEVA Pharmaceuticals and Neurocrine Biosciences, respectively. Receipt of industry payments was associated with higher prescription volume for both deutetrabenazine (<i>p</i> < 0.001) and valbenazine (<i>p</i> < 0.001). Approximately three-quarters of the industry payments were used in nonconsulting services, with a median payment value per physician of $18,101 for deutetrabenazine and $25,920 for valbenazine.</p><p><strong>Discussion: </strong>The findings illustrate a yearly increase in Medicare prescription volume for deutetrabenazine and valbenazine after FDA approval, with neurologists and psychiatrists as primary prescribers of deutetrabenazine and valbenazine, respectively. There was a statistical difference in the prescription volume between those who received industry payments and those who did not, suggesting that receipt of payments may be associated with prescription volume. Nonconsulting services constituted the largest sum of industry payments for both medications. Further research exploring the causative factors of new medication uptake is needed to better understand how medications disseminate across the market.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200392"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}