Neurology. Clinical practice最新文献

{"title":"Industry Payments and Branded Glatiramer Acetate Prescribing in the US Medicare Program.","authors":"Daniel M Hartung, Sheila Markwardt, Dennis Bourdette","doi":"10.1212/CPJ.0000000000200424","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200424","url":null,"abstract":"<p><strong>Background and objectives: </strong>Generic formulations of glatiramer acetate have been available since 2015 yet remain underprescribed relative to the branded product. We sought to characterize the association between branded glatiramer prescribing in the Medicare program and financial payments from the manufacturer (Teva Pharmaceuticals).</p><p><strong>Methods: </strong>Using publicly available Medicare Part D and Open Payments data from the Centers for Medicare and Medicaid Services, we evaluated overall utilization from 2012 to 2021 and compared the prevalence, frequency, and magnitude of financial payments made in 2019 to neurologists who prescribed branded and generic versions of glatiramer in 2020. A multivariable logistic regression model assessed the association between receiving payments from the manufacturer and branded glatiramer prescribing while adjusting for neurologist demographic and practice characteristics.</p><p><strong>Results: </strong>In 2021, 52% of glatiramer prescriptions were for a branded formulation. Of 2,886 neurologists who prescribed glatiramer in 2020, 1,323 (46%) only prescribed branded, 364 (22%) only prescribed generic, and 929 (32%) prescribed both branded and generic versions of glatiramer. Of branded glatiramer prescribers, 53% (702 of 1,323) received a payment from the manufacturer compared with 39% (247 of 634) of generic-only prescribers (<i>p</i> < 0.001). Neurologists who received more than $120 per year had significantly increased odds ($121 to $230 per year, adjusted odds ratio [AOR]1.47, 95% CI 1.03-2.10; >$230 per year, AOR 1.87, 95% CI 1.28-2.73) of prescribing branded glatiramer compared with neurologists who received no payments.</p><p><strong>Discussion: </strong>Although branded drugs often rapidly lose market share with generic competition, branded glatiramer prescribing may persist because of ongoing financial relationships between neurologists and the manufacturer.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200424"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952404","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":"Antibiotic Exposure and Risk of Parkinson Disease in South Korea: A Nationally Representative Retrospective Cohort Study.","authors":"Minkyung Kim, Sun Jae Park, Young Jun Park, Jiwon Choi, Jihun Song, Hye Jun Kim, Jooyoung Chang, Sangwoo Park, Jaewon Kim, Hyeokjong Lee, Si Nae Oh, Seogsong Jeong, Kyae Hyung Kim, Joung Sik Son, Sang Min Park","doi":"10.1212/CPJ.0000000000200400","DOIUrl":"10.1212/CPJ.0000000000200400","url":null,"abstract":"<p><strong>Background and objectives: </strong>Recent studies have suggested that antibiotics could be a contributing factor to Parkinson disease (PD), but validation in other population cohorts, such as Asians, is needed. This study examined the association between exposure to antibiotics and PD risk in the Korean population.</p><p><strong>Methods: </strong>Using the National Health Insurance Service (NHIS) database, this population-level cohort research study from Korea included 298,379 people aged 40 years and older who underwent a national health examination in 2004-2005. Cumulative antibiotic exposure days were investigated over 4 years (2002-2005), and new cases of PD were followed for 14 years (2006-2019). Various covariates, such as infectious diseases, were considered in the analysis. Multivariable Cox proportional hazards regression was used to calculate adjusted hazard ratios (aHRs) and CIs for the PD risk from antibiotic exposure.</p><p><strong>Results: </strong>PD risk was statistically significantly higher in those exposed to antibiotics for ≥121 days than in those not exposed to antibiotics (aHR, 1.29; 95% CI 1.07-1.55). In addition, compared with those exposed to antibiotics for 1-14 days, those exposed to antibiotics for ≥121 days had a higher risk of PD (aHR, 1.37; 95% CI 1.17-1.61). The results of sensitivity analyses that applied washout periods or extended antibiotic exposure periods were consistent with those of the main analyses.</p><p><strong>Discussion: </strong>Extended usage of antibiotics was linked to a higher incidence of PD, even after controlling for several risk variables. Further research is needed to warrant the causation and mechanisms of antibiotic exposure and PD.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200400"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681903","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 Much More Time Neurologic Examination Adds to Outpatient Visits: A Study of Cross-Sectional Data.","authors":"John Ney, Andrew Michael Wilson, Marc Raphaelson, Adam de Havenon","doi":"10.1212/CPJ.0000000000200404","DOIUrl":"10.1212/CPJ.0000000000200404","url":null,"abstract":"<p><strong>Background and objectives: </strong>The neurologic examination is a key part of neurologist visits. The neurologic examination leads to more accurate diagnoses, avoidance of unnecessary tests and procedures, and a stronger doctor-patient relationship. However, the neurologic examination takes time to perform, leading to longer visits with neurologists than with other specialists. We hypothesize that the neurologic examination adds quantifiable time to patient visits to a neurologist.</p><p><strong>Methods: </strong>We examined a 5-year cross-section of the National Ambulatory Medical Care Survey, 2012-2016, selecting visits to a neurologist. We extracted an indicator for neurologic examination, time spent with the patient in minutes, patient demographics, new or established visit, reasons for visit, new vs chronic problems, insurance status, geographic region, collection year, and survey design variables. We report descriptive statistics among patient visits with and without neurologic examinations and built a generalized linear model of visit time and neurologic examination with patient and visit information as covariates and interaction terms between neurologic examination and new/established visits. A subgroup analysis was conducted by reasons for visit. All analyses incorporated survey design variables for accurate standard errors.</p><p><strong>Results: </strong>There were 4,009 patient visits among 211 neurologists, comprising 11.3 million annual visits in the weighted sample. Neurologic examination was reported in 58%, with no difference in demographics, geographic regions, or reasons for visit between those who did or did not receive a neurologic examination. The mean time spent with the patient in visits with a neurologic examination was 29.9 minutes, compared with 25.0 minutes without (<i>p</i> = 0.002). In the adjusted model, new visits with a neurologic examination were associated with 4.1 minutes greater time spent with the patient (95% CI + 0.6 minutes, +7.7 minutes, <i>p</i> = 0.02) and established visits with a neurologic examination were 4.6 minutes longer (95% CI + 1.5 minutes, +7.5 minutes, <i>p</i> = 0.006.) In subgroup analysis, association of neurologic examination with time spent with the patient was greatest for visits for pain (+6.7 minutes, 95% CI + 0.7 minutes, +12.9 minutes, <i>p</i> = 0.03) and known neurologic diagnoses (+7.5 minutes, 95% CI + 4.2 minutes, +10.7 minutes, <i>p</i> < 0.001).</p><p><strong>Discussion: </strong>This study demonstrates the association of neurologic examinations with increased time spent with the patient in ambulatory care. Further work is needed to assess the effects on medical decision making, costs of care, and patient access to neurologists.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200404"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795035","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":"Service Lines, Neurology, and Academic Medicine: Departmental Perspectives, Implementation Strategies, and Keys to Success.","authors":"Barbara G Vickrey, Augustin C Rubio, Matthew J Stowe, Tasha Ostendorf, Clifton L Gooch","doi":"10.1212/CPJ.0000000000200383","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200383","url":null,"abstract":"<p><p>Service lines are increasingly common for organizing multidisciplinary patient care. Concerns regarding impacts of neuroscience service lines were voiced at several national neurology department chair summits, prompting the American Academy of Neurology to convene a Service Lines Workgroup. Neurology department leaders nationally at institutions that had created or considered a neuroscience service line were interviewed to elicit their experiences and lessons learned. Potential benefits identified stemmed from additional resources that the service line structure yielded (patient navigators, quality improvement staff, technicians) and strengthening of cross-department collaboration. Potential pitfalls included top-down institutional decision-making regarding service line creation, lack of explicit goals, late involvement of neurology, imbalances in neurology representation in leadership, unclear impacts on department finances, and lack of education and research mission integration into service lines. Establishing a satisfactory decision-making structure in a matrixed arrangement and ensuring that funds flow allocations acknowledged neurology's \"upstream\" contributions were also challenges.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200383"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470881","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":"Practice Current-Surveys Navigating Equipoise in Clinical Neurology Worldwide: Stepping Outside of the Echo Chambers.","authors":"Jodie I Roberts, Alonso Gonzalo Zea Vera","doi":"10.1212/CPJ.0000000000200428","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200428","url":null,"abstract":"","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200428"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008872","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":"Reflections in Studying Impact of Functional Seizure Services on Health Care Utilization Outcomes.","authors":"Hamada H Altalib","doi":"10.1212/CPJ.0000000000200402","DOIUrl":"10.1212/CPJ.0000000000200402","url":null,"abstract":"","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200402"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731161","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":"Knowledge, Attitudes, and Decision-Making About Reproductive Health and Epilepsy: A Survey of Health Care Providers and Women With Epilepsy.","authors":"Laura Kirkpatrick, Irena I Bellinski, Elizabeth E Gerard, Thomas McElrath, Alison M Pack, Kimford J Meador, Page B Pennell","doi":"10.1212/CPJ.0000000000200420","DOIUrl":"10.1212/CPJ.0000000000200420","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cisgender women with epilepsy (WWE) have distinct reproductive health needs. It is unknown to what extent WWE and their health care providers (HCPs) are aware of recent research advances regarding the reproductive health of WWE. This study aimed to survey US health care providers and WWE about their knowledge, attitudes, and decision-making pertaining to reproductive health; their awareness of key findings from recent relevant research; and whether learning of these findings would change their decision-making.</p><p><strong>Methods: </strong>A market research firm conducted an online survey of US health care providers and WWE using a proprietary nationally representative panel. Eligible HCPs included physicians and advance practice providers in neurology, obstetrics-gynecology, and primary care, who treat WWE. Eligible WWE were 18-45 years old and reported an epilepsy diagnosis and taking antiseizure medication. Data were analyzed through descriptive statistics and logistic regression.</p><p><strong>Results: </strong>Four hundred one HCPs and 199 WWE completed the full survey. Among HCPs, 38% reported being very or extremely comfortable treating pregnant WWE. Seventy-nine percent of HCPs reported that recent relevant research findings were new to them, with 65% reporting that the findings seemed plausible and 49% reporting that the findings would probably or definitely change their management of pregnancy for WWE.Thirty percent of WWE reported that pregnancy is very or extremely safe for WWE, while 50% reported that it is somewhat safe, and 21% not at all or not very safe. Ninety-one percent of WWE reported that research findings were new to them, 37% reported that the findings seemed plausible, and 64% reported that the findings would probably or definitely influence their reproductive decision-making.</p><p><strong>Discussion: </strong>Survey findings suggest suboptimal awareness of recent research advances pertaining to the reproductive health of WWE among WWE and their HCPs. Findings also suggest that dissemination and implementation of such findings may be impactful on the medical decision-making of both HCPs and WWE. Findings may guide future initiatives to ensure prompt dissemination and implementation of research advances in epilepsy and reproductive health.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200420"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896305","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":"Unique Needs and Challenges Experienced by Young People With Stroke: An International Qualitative Analysis.","authors":"Marika Demers, Marina Charalambous, Li Khim Kwah, Shamala Thilarajah, Danira Bazadona, Sherita Chapman, Ahmed Nasreldein, Laetitia Yperzeele, Dinah Amoah, Carolee Winstein, Julie Bernhardt, Urvashy Gopaul","doi":"10.1212/CPJ.0000000000200406","DOIUrl":"10.1212/CPJ.0000000000200406","url":null,"abstract":"<p><strong>Background and objectives: </strong>Stroke in young adults has a lifelong impact on activities of daily life, including driving, leisure, and community-based activities; social participation; and reduced productivity. The needs of young people with stroke (YPwS) are likely to vary across different countries, and the development of age-adapted information and interventions is therefore critical in addressing those needs. This study aims to (1) identify the unmet needs of people with stroke aged 18 to 55 years across countries with varied income levels and cultural backgrounds and (2) determine their preferred means to access knowledge and information about stroke in the young.</p><p><strong>Methods: </strong>This international needs analysis used a phenomenologic qualitative design to gain in-depth perspectives about the experiences of YPwS. Participants were recruited from 9 countries of varied socioeconomic status. We interviewed 44 participants with stroke (men: 22; women: 21; transman: 1; mean age: 44.2 ± 8.5 years) living in the community (range of time since stroke: 0.5-10 years). The semistructured interview focused on lived stroke experience, unmet needs, helpful strategies to meet individual needs, hopes, and dreams. The interview was recorded, conducted in the participants' native language, and transcribed verbatim. Data were analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>Four main themes emerged from the interviews: (1) heterogeneity of unmet needs specific to YPwS, (2) invisible disability, (3) lack of age-specific stroke information, and (4) call for accessible information resources available in different formats. The results highlighted the need to provide long-term and contextually tailored support to YPwS, aligned with their recovery goals and age-specific needs. Initiatives such as peer-support groups, self-management or peer-mentoring programs, information resources in various formats, and participation in research projects could help address the unique needs of this population.</p><p><strong>Discussion: </strong>Our results emphasize the importance of raising awareness of stroke in the young and the unique challenges of this population. Future research could focus on the development of stroke care pathways specific to YPwS.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200406"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780485","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":"Impact of Continuous Ofatumumab Exposure During Pregnancy in Multiple Sclerosis.","authors":"Simon Hefner, Tiago Lerda Casaccia, Edda Hofstaetter, Ferdinand Otto, Kerstin Hellwig, Tobias Moser","doi":"10.1212/CPJ.0000000000200410","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200410","url":null,"abstract":"<p><strong>Objectives: </strong>Anti-CD20 therapies are highly effective treatment options for patients with multiple sclerosis (MS), an inflammatory disorder of the CNS commonly affecting women of childbearing age. Anti-CD20 therapies are however unlicensed for use in pregnancy. Belonging to the IgG1 family, anti-CD20 monoclonal antibodies are likely to cross the placenta, especially after the 20th week of gestation. Our objective was to analyze the impact of ofatumumab (OFA), a subcutaneous anti-CD20 monoclonal antibody, during pregnancy.</p><p><strong>Methods: </strong>We present the case of a woman with MS who accidentally administered OFA every 4 weeks until delivery. In addition to detailing the clinical and laboratory outcomes of both mother and child, we provide a summary of the available evidence regarding anti-CD20 treatment during pregnancy and breastfeeding.</p><p><strong>Results: </strong>Our patient gave birth to a healthy girl between estimated gestational weeks 32-35. Notably, at 3 months postpartum and 4 months after the last OFA administration, the mother remained fully B-cell depleted while the B-cell counts of the child were within the normal range.</p><p><strong>Discussion: </strong>Further data are necessary to confirm that OFA treatment during pregnancy does not affect neonatal B cells.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200410"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624853","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":"Frontotemporal Dementia Differential Diagnosis in Clinical Practice: A Single-Center Retrospective Review of Frontal Behavioral Referrals.","authors":"Natasha Krishnadas, Marcia Chew, Antony Sutherland, Maja Christensen, Kirrily A Rogers, Christopher Kyndt, Fariha Islam, David G Darby, Amy Brodtmann","doi":"10.1212/CPJ.0000000000200360","DOIUrl":"https://doi.org/10.1212/CPJ.0000000000200360","url":null,"abstract":"<p><strong>Background and objectives: </strong>Many neurodegenerative syndromes present with impairment of frontal networks, especially frontoinsular networks affecting social and emotional cognition. People presenting with frontal network impairments may be considered for a frontotemporal dementia (FTD) diagnosis. We sought to examine the diagnostic mix of patients referred with frontal network impairments to a single cognitive neurology service.</p><p><strong>Methods: </strong>A retrospective review was conducted of all patients seen between January 2010 and December 2019 at the Eastern Cognitive Disorders Clinic, a quaternary cognitive neurology clinic in Melbourne, Australia. Patients were included if they met the following criteria: (1) were referred for suspected FTD or with a preexisting diagnosis of a FTD syndrome, (2) were referred for 'frontal behaviors' (i.e., disinhibition, disorganization, poor judgment, loss of empathy, apathy) and/or had an informant report of behavior change, and (3) had available referral documents and clinical consensus diagnosis. Referral diagnosis was compared against final diagnosis adjudicated by a consensus multidisciplinary team. Case details including age of symptom onset, Cambridge Behavioural Inventory-Revised scores, psychiatric history, and Charlson Comorbidity Index were compared against the final diagnosis.</p><p><strong>Results: </strong>In total, 161 patients aged 42-82 years (mean = 64.5, SD = 9.0; 74.5% men) met inclusion criteria. The commonest final diagnosis was a FTD syndrome (44.6%: 26.7% behavioral variant FTD (bvFTD), 9.3% progressive supranuclear palsy, 6.2% semantic dementia, 1.2% corticobasal syndrome, and 1.2% FTD/motor neuron disease). A primary psychiatric disorder (PPD) was the next commonest diagnosis (15.5%), followed by vascular cognitive impairment (VCI, 10.6%), Alzheimer disease (AD, 9.9%), and other neurologic diagnoses (6.2%). A final diagnosis of bvFTD was associated with higher rates of medical comorbidities and more eating behavior abnormalities compared with a diagnosis of PPD. Screening cognitive tests and preexisting psychiatric history did not distinguish these 2 groups.</p><p><strong>Discussion: </strong>A broad spectrum of neurologic and psychiatric disorders may present with impairments to frontal networks. Almost half of patients referred had a final FTD syndrome diagnosis, with bvFTD the commonest final diagnosis. People with PPD, VCI, and AD present with similar clinical profiles but are distinguishable using MRI and FDG-PET imaging. Medical and psychiatric comorbidities are common in people with bvFTD.</p>","PeriodicalId":19136,"journal":{"name":"Neurology. Clinical practice","volume":"15 1","pages":"e200360"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470872","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}