Neurology and Therapy最新文献

{"title":"Dysphagia Management is Associated with Reduced Mortality in Patients with Moderate to Severe Acute Ischemic Stroke.","authors":"Julian Frederic Hotz, Lisa Kaindl, Lisa Schneider, Stefan Krebs, Anel Karisik, Dominika Mikšová, Maximilian Bichler, Lavinia Ritscher, Moritz Staudacher, Heimo Lagler, Heinz Burgmann, Wilfried Lang, Julia Ferrari, Michael Knoflach, Marek Sykora","doi":"10.1007/s40120-025-00783-1","DOIUrl":"10.1007/s40120-025-00783-1","url":null,"abstract":"<p><strong>Introduction: </strong>Dysphagia and pneumonia are common complications in patients with acute ischemic stroke (AIS), contributing to increased morbidity and mortality. This study evaluated the impact of pneumonia and dysphagia management strategies (including dysphagia screening, speech therapy, and nasogastric tube use) on patients with AIS outcomes.</p><p><strong>Methods: </strong>This nationwide, multicenter study included 181,704 patients with AIS from the Austrian Stroke Unit Registry (2006-2024). The impact of pneumonia and the influence of dysphagia management on favorable functional outcome (modified Rankin Scale ≤ 1) and mortality of patients with AIS were calculated using multivariable Poisson regression models.</p><p><strong>Results: </strong>Pneumonia occurred in 15.7% of severely and in 6.7% of moderately affected patients with AIS and was associated with increased mortality (RR 1.61, 95% CI 1.50-1.72, p < 0.05) and inversely with favorable functional outcome (RR 0.37, 95% CI 0.31-0.44, p < 0.05). Dysphagia management was significantly (p < 0.05) associated with reduced mortality, especially in moderately to severely affected patients with AIS, but had a limited impact on functional outcome. After implementation of dysphagia screening, a significant (p < 0.05) decrease in pneumonia prevalence was noted.</p><p><strong>Conclusion: </strong>Among patients with severe acute ischemic stroke, early dysphagia management strategies are associated with reduced mortality, while stroke-associated pneumonia remains a persistent predictor of poor prognosis. These findings underscore the important role of standardized dysphagia management in improving stroke care and patient outcomes.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1539-1552"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248913","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":"Patient Experience of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Qualitative Patient and Clinician Interviews Informing the Development of a Conceptual Model.","authors":"Jeffrey L Bennett, Asha Paireddy, Charlotte Cox, Megan Mayhew, Julia Stein, Teresa Gasalla, Béatrice Tugaut","doi":"10.1007/s40120-025-00770-6","DOIUrl":"10.1007/s40120-025-00770-6","url":null,"abstract":"<p><strong>Introduction: </strong>Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare, autoimmune demyelinating central nervous system disease. Currently, little is known about the signs, symptoms, and health-related quality of life (HRQoL) impact of MOGAD from the patient perspective. This study explored the patient experience of MOGAD through concept elicitation interviews with patients with MOGAD and clinicians to develop a conceptual model of MOGAD.</p><p><strong>Methods: </strong>A preliminary conceptual model of MOGAD signs, symptoms, treatments, and HRQoL impacts was developed based on a review of the published literature. Thematic analysis of semi-structured interviews with patients and clinicians was used to develop the final conceptual model.</p><p><strong>Results: </strong>Twelve patients with MOGAD and two clinicians were interviewed. The most common patient-reported symptoms were eye pain, fatigue, body aches/pain, headaches, and blurred vision. Eye pain and body aches/pain were reported as the most bothersome symptoms and most important to improve with treatment. The HRQoL impacts most commonly reported by patients were difficulty with carrying out household chores, inability to work, depression, and difficulty walking. Impacts on work/school were considered by patients as the most bothersome to their HRQoL and the most important to resolve. Following the interviews, a final conceptual model was produced that reported 32 symptoms across seven domains (constitutional; visual; general neurological; sensory-motor neurological; genitourinary; gastrointestinal; and chest-related, respiratory, and throat) and 50 HRQoL impacts across eight domains (emotional wellbeing, activities of daily living, physical functioning, social functioning, work/school, cognitive functioning, sleep, and financial).</p><p><strong>Conclusions: </strong>This study provides important insights into the patient experience of MOGAD from patient and clinician perspectives, highlighting the underappreciated burden of the disease. The final conceptual model demonstrates the heterogeneity of MOGAD symptoms and their impact on patients' HRQoL. Future treatment trials should consider including appropriate measures to evaluate the key symptoms and HRQoL impacts identified in this study.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1569-1587"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285809","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":"From Headache to Heart Health: Investigating the Migraine-Cardiovascular Disease Connection.","authors":"Claudio Tana, Dilara Onan, Roberta Messina, Marta Waliszewska-Prosół, David Garcia-Azorin, Luis Leal-Vega, Maria Begoña Coco-Martin, Raffaele Ornello, Bianca Raffaelli, Marcio Nattan Portes Souza, William Wells-Gatnik, Paolo Martelletti","doi":"10.1007/s40120-025-00785-z","DOIUrl":"10.1007/s40120-025-00785-z","url":null,"abstract":"<p><p>Migraine, particularly with aura, has been consistently associated with an increased risk of cardiovascular disease, including ischemic stroke and myocardial infarction. Shared pathophysiological mechanisms such as endothelial dysfunction, platelet aggregation, systemic inflammation, and autonomic imbalance suggest that migraine may act as an early clinical marker of systemic vascular vulnerability. Psychiatric comorbidities, frequently present in chronic migraine, further compound disability and may contribute to long-term cardiovascular risk. This narrative review discusses the evolving understanding of migraine as a multisystem disorder, emphasizing its vascular and neuropsychiatric dimensions. Emerging data on calcitonin gene-related peptide (CGRP)-targeting monoclonal antibodies highlight their efficacy not only in reducing headache burden but also their favorable cardiovascular safety profile. Moreover, preliminary evidence suggests these agents may have a positive effect on mood symptoms in patients with comorbid depression and anxiety. Recognizing migraine as a condition that intersects neurological, cardiovascular, and psychiatric pathways may support earlier risk stratification and guide integrated treatment approaches in complex patient populations.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1229-1268"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333612","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":"Case Report: Acute Psychiatric Behavioral Disturbance in a Patient with Presenilin 1 Gene Mutation Associated with Familial Alzheimer's Disease.","authors":"Yong Xia, Xiaoyan Liu, Wenjing Cui, Qianna Zhi, Yuyong Sun","doi":"10.1007/s40120-025-00787-x","DOIUrl":"10.1007/s40120-025-00787-x","url":null,"abstract":"<p><p>Familial Alzheimer's disease (FAD), often linked to presenilin 1 (PSEN1) mutations, is characterized by an autosomal dominant inheritance and earlier onset compared to sporadic Alzheimer's disease. We report a 48-year-old female patient diagnosed with early-onset FAD carrying a PSEN1 (p.Met139Leu) mutation, who initially presented with cognitive decline and later developed acute psychotic symptoms. Despite combined antipsychotic and anti-dementia treatment, her cognitive function rapidly deteriorated, resulting in significant functional loss. This case highlights the atypical early psychiatric manifestations of FAD, emphasizing the importance of genetic testing and prompt intervention in younger patients presenting with cognitive and psychiatric symptoms.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1729-1741"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529059","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":"Early Introduction of Cenobamate in Uncontrolled Focal Epilepsy: Insights from a Structured Controversy.","authors":"Angelo Labate, Claudio Liguori, Elena Tartara, Gemma Tumminelli, Annacarmen Nilo, Marta Piccioli, Filippo Dainese, Luigi Del Gaudio, Carlo Di Bonaventura","doi":"10.1007/s40120-025-00781-3","DOIUrl":"10.1007/s40120-025-00781-3","url":null,"abstract":"<p><strong>Introduction: </strong>Drug-resistant focal epilepsy, as defined by the International League Against Epilepsy (ILAE), is characterized by the failure to achieve seizure control despite the use of at least two appropriately chosen and adequately dosed antiseizure medications (ASMs). This condition affects approximately 30% of patients and represents a significant clinical challenge. Cenobamate, a novel ASM with a unique dual mechanism of action-enhancing inhibitory GABAergic currents and attenuating persistent sodium currents-has emerged as a promising therapeutic option for drug-resistant focal epilepsy.</p><p><strong>Methods: </strong>This expert consensus document was developed using a structured controversy methodology, integrating real-world experience and a narrative review of the literature focusing on the role of cenobamate in the management of drug-resistant focal epilepsy. This manuscript synthesizes current evidence on cenobamate and provides clinical recommendations for its integration into epileptological practice.</p><p><strong>Results: </strong>The expert panel findings support the early use of cenobamate following the failure of two ASMs, emphasizing its efficacy in achieving substantial seizure reduction and increasing the likelihood of seizure freedom. Early prescription of cenobamate may offer a valuable therapeutic opportunity for patients with refractory focal epilepsy, potentially reducing seizure-related complications and improving quality of life. Identified challenges include limited long-term safety data in specific populations and regional disparities in drug access.</p><p><strong>Conclusion: </strong>Cenobamate represents a significant advancement in the treatment of drug-resistant focal epilepsy. Its early adoption in clinical practice has the potential to enhance patient outcomes. The expert panel provides recommendations that underscore individualized treatment planning, close monitoring during titration, and advocacy for improved accessibility. Continued research and policy initiatives are essential to fully realize the therapeutic potential of cenobamate.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1671-1684"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529060","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":"Advancing Future Amyotrophic Lateral Sclerosis Medicines by Incorporating The Patient Voice Into Patient-Centered Holistic Measurement Strategies for Clinical and Real-World Studies: Results from Targeted Literature Reviews.","authors":"Diana Rofail, Michael Chladek, Betsy Williams, Nick Patel, William B Nowell, Stella Karantzoulis, Oren Levy","doi":"10.1007/s40120-025-00740-y","DOIUrl":"10.1007/s40120-025-00740-y","url":null,"abstract":"<p><strong>Introduction: </strong>This analysis sought to understand the patient experience in amyotrophic lateral sclerosis (ALS) and to assess whether commonly used clinical outcome assessments (COAs) reliably and validly capture that experience.</p><p><strong>Methods: </strong>Two targeted literature reviews were conducted to identify and describe key concepts potentially important to patients (signs, symptoms, impacts), and identify commonly used COAs in ALS. Insights gained were used to map target COAs to concepts identified as potentially relevant to patients and their caregivers. COAs of interest were further examined to evaluate evidence of their validity and reliability within ALS.</p><p><strong>Results: </strong>Forty-three articles were identified for concept extraction. Signs and symptoms were identified across multiple themes: motor; non-motor; respiratory; cognitive; and behavioral. Patient impacts were identified across multiple themes: physical; functional; emotional; social; and other aspects of well-being. Caregiver impacts were identified across four themes: general; emotional; social; and physical. Of 236 unique COAs identified, 6 were found to provide the greatest coverage of potentially important concepts. Closer examination of these showed some evidence gaps supporting content validity and/or psychometric properties.</p><p><strong>Conclusions: </strong>Several concepts related to ALS were identified that are relevant to patients in their daily lives. We identified and reviewed COAs commonly used in assessing these concepts, and found gaps in their content validity and/or psychometric properties. These findings suggest the need for further testing/refinement of existing tools, and the opportunity to use other instruments alongside those most frequently used (e.g., ALSFRS-R) to comprehensively capture the patient experience of ALS in future clinical trial and real-world studies.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1311-1343"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972120","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":"Understanding the Patient Experience of Advanced Parkinson's Disease: Qualitative Research with Patients and Expert Clinicians to Identify Symptoms and Associated Health-Related Quality of Life Impacts.","authors":"Nicola Williamson, Thomas Morel, Helena Bradley, Aoife Lydon, Molly Clifford, Patrick Cronin, Milton Biagioni","doi":"10.1007/s40120-025-00747-5","DOIUrl":"10.1007/s40120-025-00747-5","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease (PD) is a progressive neurodegenerative condition, characterized by motor symptoms (MS) and non-motor symptoms (NMS). Currently, there is no global definition of advanced PD, but those in advanced stages experience diverse and severe symptomatology, and significant impacts to their health-related quality of life (HRQoL). This qualitative interview study aimed to explore the experience of symptoms and HRQoL impacts of advanced PD from the patient and clinician perspective and identify key concepts for assessment in PD clinical trials.</p><p><strong>Methods: </strong>A targeted review of literature and qualitative concept elicitation interviews conducted with people with advanced PD (N = 20) and expert clinicians (N = 3) in the US aimed to identify symptoms of advanced PD and their impact on HRQoL. People with advanced PD (PwP) were defined as those diagnosed ≥ 5 years, experiencing ON/OFF motor fluctuations despite levodopa therapy, and classified as modified Hoehn and Yahr stages 2-4.</p><p><strong>Results: </strong>In total, 65 symptoms (48 NMS, 17 MS) were identified across the reviewed literature and qualitative interviews. The most frequently reported MS included tremor, rigidity, balance issues, and slowness of movement. Several NMS were also frequently reported by participants, including fatigue, cognitive dysfunction (e.g., difficulty thinking), neuropsychiatric symptoms (e.g., apathy), pain, sleep problems, urinary dysfunction, autonomic dysfunction, excessive daytime sleepiness, gastrointestinal dysfunction, and sensory dysfunction. Participants reported these to impact HRQoL, including daily activities, emotional functioning, physical functioning, social functioning, work/study, and financial well-being.</p><p><strong>Conclusion: </strong>The study provides in-depth insights into the symptoms and HRQoL impacts experienced by those with advanced PD. A comprehensive conceptual model of the patient experience of advanced PD was developed to support the identification of relevant concepts for assessment in PD clinical trials.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1383-1417"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007092","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":"The Modified Functional Status Questionnaire for Assessing Patients with Parkinson's Disease Psychosis Treated with Pimavanserin: A Post Hoc Analysis.","authors":"Virgilio G H Evidente, Lambros Chrones, Ratna Revankar, Dilesh Doshi, Victor Abler, Nazia Rashid","doi":"10.1007/s40120-025-00757-3","DOIUrl":"10.1007/s40120-025-00757-3","url":null,"abstract":"<p><strong>Introduction: </strong>Over half of patients with Parkinson's disease experience psychosis (PDP) symptoms over the course of their disease. In addition to significantly impacting patients' health-related quality of life and cognitive abilities, these symptoms impact patients' activities of daily living (ADLs) and overall functional status. Clinical assessment of how psychosis impacts these measures is crucial; however, few studies have assessed functional status among patients with PDP. A previous phase 4 study assessing the impact of pimavanserin on ADLs in patients with PDP demonstrated that a modified version of the Functional Status Questionnaire (mFSQ) could be used for this purpose. This post hoc analysis aimed to demonstrate the utility of the mFSQ as a patient-reported outcomes tool and to expand on initial study findings by showing the impact of pimavanserin on ADLs and functional status for each mFSQ subscale.</p><p><strong>Methods: </strong>An analysis of mFSQ data was conducted on patients with PDP treated with pimavanserin. This analysis evaluated the least-squares mean (LSM) change from baseline to week 16 on the mFSQ by subscale (basic ADL, intermediate ADL, psychological function, quality of interaction, and social activity). Pearson's correlation was used to assess the relationship between results from the mFSQ and the well-established Schwab and England ADL scale.</p><p><strong>Results: </strong>In this assessment (n = 29), treatment with pimavanserin was associated with improvements on all 5 domains of the mFSQ, highlighting a broad improvement in ADLs and function. The greatest LSM (SE) improvement was seen in the social activity subscale [25.8 (7.52); 95% CI 10.2-41.5; p = 0.0026]. The mFSQ results demonstrated positive correlations with patient- and caregiver-rated Schwab and England ADL scales.</p><p><strong>Conclusion: </strong>This analysis provides additional information about the impact of treatment with pimavanserin on specific mFSQ subscales. Additionally, the mFSQ was significantly correlated with the patient- and the caregiver-rated Schwab and England ADL scales.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1299-1309"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014814","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":"Impact of Early Antipsychotic Prescription Choice on Weight Gain in the First 5 Years of Psychotic Illness: a Retrospective Cohort Study.","authors":"Adrian Heald, George Tilston, John Julian Warner-Levy, Loren Wilkins, Richard Williams, Toby Pillinger, William Deakin, Damien Longson, Lamiece Hassan, Caroline Dalton, Gavin P Reynolds, Joseph Firth","doi":"10.1007/s40120-025-00780-4","DOIUrl":"10.1007/s40120-025-00780-4","url":null,"abstract":"<p><strong>Introduction: </strong>We analysed the effects of antipsychotic drug prescribing in year 1 of treatment for psychosis on future weight gain over 5 years.</p><p><strong>Methods: </strong>We studied how weight changed over 5 years after the first diagnosis of psychosis/schizophrenia/schizoaffective disorder/delusional disorder/affective psychosis in 17,570 individuals and investigated its association with antipsychotic drug treatments prescribed in year 1 following diagnosis, over 30 years.</p><p><strong>Results: </strong>The majority (65%) were aged 20-59 years at the time of first antipsychotic prescription. Mean baseline body-mass-Index (BMI) was similar in women versus men. Substantial increases in BMI were observed, with the greatest categorical changes seen in the obese (BMI ≥ 30 kg/m²) subjects, increasing from 30 to 43% for women and from 26% to 39% for men, while 42% of people did not significantly increase their weight. Individuals prescribed perphenazine/fluphenazine/amisulpride were most likely to remain at normal-BMI, while individuals prescribed aripiprazole/quetiapine/olanzapine/risperidone in the first year were most likely to gain weight/transition to overweight (25.0-29.9 kg/m²)/obese (≥ 30.0 kg/m²) from a normal BMI. The 'typical' agents thioridazine/chlorpromazine/flupenthixol/trifluoperazine/haloperidol were associated with an intermediate likelihood of BMI category change. In multivariate linear regression, factors associated with weight-gain were younger age/female sex(both p < 0.001), number of antipsychotic agents prescribed in 1st year (p < 0.001), plus specific agents aripiprazole (including 75% co-prescription or as 2nd line/3rd line)/olanzapine/thioridazine (p < 0.001), risperidone/quetiapine (p < 0.05). In multivariate logistic regression (weight increase ≥ 7%), the specific medication factors were similar, with odds ratios(OR) for specific medications ranging from quetiapine 1.09 (CI 1.00-1.21) to thioridazine 1.45 (CI 1.20-1.74).</p><p><strong>Conclusion: </strong>Younger women were at elevated risk for weight gain as were people prescribed multiple antipsychotics in the 1st year. Some older antipsychotics associated with as much weight gain as the newer prescribed agents. More than 40% of people did not put on weight.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1657-1670"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326352","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":"Feasibility of Identifying Acute Nontraumatic Intracerebral Hemorrhage Events Using Diagnostic Coding Among Veterans with Mild Cognitive Impairment or Alzheimer's Dementia.","authors":"Dan Berlowitz, Ying Wang, Joel Reisman, Donald Miller, Peter J Morin, Vanesa Carlota Andreu Arasa, Brant Mittler, Raymond Zhang, Amir Abbas Tahami Monfared, Michael Irizarry, Quanwu Zhang, Weiming Xia","doi":"10.1007/s40120-025-00746-6","DOIUrl":"10.1007/s40120-025-00746-6","url":null,"abstract":"<p><strong>Introduction: </strong>Based on manual review of clinical notes of using the International Classification of Diseases, Tenth Revision coding, we evaluated the feasibility and validity for monitoring, recording, and reporting intracerebral hemorrhage (ICH) events in patients with all-cause mild cognitive impairment or Alzheimer's dementia including, but not limited to, patients eligible for anti-amyloid therapy.</p><p><strong>Methods: </strong>Principal and first-position hospital discharge codes for ICH events for 200 patients were identified from the Veterans Affairs Health System structured administrative database. Clinician manual review of discharge summary notes assessed and confirmed the presence of coded events. Available documentation of bleed locations was further reviewed, and the extent of event adjudication for potential etiology was assessed. Additionally, 25 acute ICH cases were randomly identified by reviewing discharge notes to confirm corresponding diagnostic code-based reporting.</p><p><strong>Results: </strong>Of the 200 identified patients, 161 with acute ICH events were confirmed, resulting in a positive predictive value (PPV) of 80.5% for ICH event presence identified by diagnostic coding. Bleed locations were described for 151 of 161 patients with confirmed events. Of 110 cases whose diagnostic codes indicated an event location, 79 had location descriptions in discharge summaries that were consistent with the coding (PPV = 71.8%). Possible etiology was described in 56/161 patients' discharge summaries. Among the 25 acute ICH cases identified from discharge notes, 8 had corresponding ICH diagnostic codes.</p><p><strong>Conclusion: </strong>This study supports the feasibility and validity of the ICD-10 coding system for monitoring, recording, and reporting ICH event presence. When location is specified in the codes, the ICD-10 coding has an acceptable PPV. Overall, the current diagnostic coding system provides a reasonable framework for initial reporting and may allow for only limited inference of etiology such as differentiating nontraumatic versus traumatic events. Coding accuracy for ICH can be expected to further improve with the availability of guidelines, training, and standardization across clinical practices.</p>","PeriodicalId":19216,"journal":{"name":"Neurology and Therapy","volume":" ","pages":"1287-1298"},"PeriodicalIF":3.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012881","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}