Neurology最新文献

{"title":"Use of Advanced Vessel Wall Imaging to Detect Vertebral Artery Dissection.","authors":"Xinyan Hu, Qianmei Jiang, Qian Jia, Jing Jing","doi":"10.1212/WNL.0000000000213542","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213542","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e213542"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching Video NeuroImage: String Hallucinations in Parkinson Disease.","authors":"Jacky Ganguly, Shubhrangshu Banerjee, Purba Basu, Soumava Mukherjee, Nilam Singh, Hrishikesh Kumar","doi":"10.1212/WNL.0000000000213611","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213611","url":null,"abstract":"<p><strong>Statement of the clinical problem addressed by the case: </strong>String hallucination, a complex multimodal hallucination in patients with advanced Parkinson disease (PD).</p><p><strong>Brief description of case presentation: </strong>Two older patients with advanced PD and dementia presented with a peculiar type of hallucination, in the form of seeing and feeling threads on the surfaces or coming out from the fingers. They continued manipulating these imaginary threads before putting them aside. Quetiapine was helpful in both cases.</p><p><strong>Summary of the key teaching point in the case: </strong>Apart from the commonly described passage (a brief hallucination of a person, animal, or object passing sideways, within the periphery of the visual field) and presence (sensation of someone or something being present nearby, in the absence of seeing it) hallucinations, a multimodal (visual and tactile) hallucination can be seen in patients with advanced PD, mostly with dementia. The patients described here did not have any fluctuating cognition or other well-formed visual hallucinations as seen in dementia with Lewy bodies (DLB). An atypical antipsychotic like quetiapine is helpful to control such complex forms of hallucinations.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e213611"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence Trends and Risk of Recurrent Stroke of Cervical Artery Dissections in the United States Between 2005 and 2019.","authors":"Liqi Shu, Lukas Strelecky, Adam de Havenon, Thanh N Nguyen, Nils Henninger, Zafer Keser, Muhib Khan, James Ernest Siegler, Mary Penckofer, Setareh Salehi Omran, Thalia S Field, Lily Zhou, Han Xiao, Austin Jacobson, Eric D Goldstein, Christoph Stretz, Farhan Khan, Elizabeth Perelstein, Karen Furie, Shadi Yaghi","doi":"10.1212/WNL.0000000000213548","DOIUrl":"10.1212/WNL.0000000000213548","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cervical artery dissection (CeAD) is a common cause of acute ischemic stroke (AIS), especially in patients younger than 55 years, but data regarding trends and subsequent AIS risk after CeAD remain scarce. We aimed to determine national trends in CeAD admissions and examine post-CeAD risk of ischemic stroke.</p><p><strong>Methods: </strong>We used the National Inpatient Sample (2005-2019), National Readmission Database (2015-2019), and State Inpatient Database for New York (2011-2017) and Florida (2011-2019). Adult patients with spontaneous CeAD were identified using <i>International Classification of Diseases, Ninth Revision, Clinical Modification</i> and <i>International Classification of Diseases, Tenth Revision, Clinical Modification</i> codes. Survey-weighted annual CeAD cases were combined with US census data to estimate annual incidence. National estimates were verified with state-level data, which allows for the removal of duplicate admissions for a single patient through a unique patient identifier. Joinpoint regression was used to quantify the average annual percent change (AAPC) of CeAD incidence. AIS readmission risk after CeAD without concurrent AIS was assessed with death as a competing risk using Fine and Gray competing risk methodology.</p><p><strong>Results: </strong>From 2005 to 2019, we identified 125,102 patients (46.09% female, mean age 51.4 years) with spontaneous CeAD. CeAD incidence increased from 10.7 cases per million population in 2005 to 45.6 cases per million population in 2019, revealing an AAPC of 10.21% (95% CI 9.67%-10.76%). This substantial increase in CeAD admissions was particularly high in the older, Black, and Hispanic populations. Statewide data corroborated this upward trend with an AAPC of 8.47% (95% CI 7.97%-9.48%). Among patients with CeAD without AIS, vertebral artery dissection was the sole major predictor of subsequent ischemic stroke risk within 90 days (adjusted subdistributed hazard ratio 1.77, 95% CI 1.18-2.64, <i>p</i> = 0.006). Interaction and subgroup analyses were performed and demonstrated similar results.</p><p><strong>Discussion: </strong>There was an almost 5-fold increase in CeAD hospitalizations and an upward incidence trend from 2005 to 2019, particularly in racial minorities, which may be attributed to increased imaging and awareness of CeAD. Our study also revealed a small but significant risk of AIS in patients with vertebral artery dissection without concurrent ischemic stroke. These findings underscore the importance of studying acute treatment and secondary prevention strategies in patients with CeAD.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e213548"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AAN Position: Opioids.","authors":"Umer Najib, Eric M Cheng, Rashmi B Halker Singh, Neishay Ayub, Sarah E Nelson, Patrick J Bushard, Justin T Jordan, Jason J Sico, Madeline Turbes, Wayne E Anderson","doi":"10.1212/WNL.0000000000213544","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213544","url":null,"abstract":"<p><p>This position statement serves to establish the American Academy of Neurology (AAN)'s stance on neurology care team's needs for safe prescribing of opioids and research for nonopioid pain alternatives so that the AAN can continue to advocate effectively for its members. While considerable improvements have been made in prescribing practices to address patient pain, opioids remain the most misused prescription medication in the United States. Neurology care teams often care for patients with chronic, complex conditions that include pain disorders such as migraine, peripheral neuropathy, traumatic brain injury, multiple sclerosis, and low back pain and are the 14th most frequent group to prescribe opioids. The AAN is dedicated to upstream approaches to prevent opioid misuse through research aimed at finding alternative therapies for chronic pain, reducing opioid addiction and misuse, and using tools such as electronic prescribing of controlled substances and state prescription monitoring programs to improve the safety of opioid prescribing when opioid treatment is necessary.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e213544"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Collateral Status, Blood Pressure During Thrombectomy, and Clinical Outcomes in Patients With Basilar Artery Occlusion.","authors":"Cong Luo, Thanh N Nguyen, Rui Li, Chunrong Tao, Xiaozhong Jing, Pengfei Xu, Li Wang, Anmo Wang, Feiyang Gao, Ming Cai, Keyi Zhang, Min Chen, Xia Jiang, Nan Shen, Mohamad Abdalkader, Patrik Michel, Jeffrey L Saver, Raul G Nogueira, Xinfeng Liu, Wei Hu","doi":"10.1212/WNL.0000000000213504","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213504","url":null,"abstract":"<p><strong>Background and objectives: </strong>We investigated the relationship between intraprocedural blood pressure (BP) and clinical outcomes in patients with basilar artery occlusion (BAO) undergoing endovascular treatment (EVT), exploring whether it is modifiable by collateral status.</p><p><strong>Methods: </strong>Patient data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) randomized trial were analyzed for those with BAO who received EVT. Intraprocedural BP data were extracted, with collateral status assessed using the Basilar Artery on CT Angiography (BATMAN) score (BATMAN score ≥7 favorable collateral status, <7 unfavorable). Associations between BP parameters and outcomes were assessed using multivariable logistic regression and restricted cubic splines. The effect modification was assessed using an interaction term between BP parameters and collateral status. The primary outcome was a favorable outcome defined by a modified Rankin Scale (mRS) score of 0-3 at 90 days.</p><p><strong>Results: </strong>There were 212 patients included (median age 68 years, 32.1% female). Restricted cubic spline analysis showed that the SDs of systolic BP (SBP) and mean arterial pressure (MAP) had J-shaped relationships with favorable outcome (<i>p</i> for nonlinearity = 0.004 and <0.001, respectively), with inflection points at 12 and 8 mm Hg, respectively. Multivariable logistic regression showed that MAP of 80-110 mm Hg (adjusted odds ratio [aOR] 3.00, 95% CI 1.46-6.35) and MAP SD <8 mm Hg (aOR 2.28, 95% CI 1.24-4.25) were associated with favorable outcome. Significant interactions with collateral status were observed for MAP SD <8 mm Hg, SBP SD <12 mm Hg, MAP drop >20%, and minimum MAP and SBP (all <i>p</i>_interaction < 0.05). After Holm-Bonferroni correction, only the interaction between collateral status and MAP <80 mm Hg remained significant (corrected <i>p</i>_interaction = 0.036). In patients with unfavorable collateral status, MAP <80 mm Hg was associated with decreased probability of favorable outcome (aOR 0.04, 95% CI 0.00-0.21) while this association was not observed in patients with favorable collaterals.</p><p><strong>Discussion: </strong>For patients with BAO undergoing EVT, intraprocedural MAP between 80 and 110 mm Hg was associated with favorable outcome while MAP <80 mm Hg was associated with a lower probability of favorable outcome, especially in patients with unfavorable collateral status.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e213504"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Radiologic Progression in Sporadic and Hereditary Cerebral Amyloid Angiopathy.","authors":"Maaike C van der Plas, Emma A Koemans, Manon R Schipper, Sabine Voigt, Ingeborg Rasing, Reinier G J van der Zwet, Kanishk Kaushik, Rosemarie van Dort, Sanne Schriemer, Thijs W van Harten, Erik van Zwet, Ellis S van Etten, Matthias J P van Osch, Gisela M Terwindt, Marianne van Walderveen, Marieke J H Wermer","doi":"10.1212/WNL.0000000000213546","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213546","url":null,"abstract":"<p><strong>Background and objectives: </strong>Knowledge on the short-term progression of cerebral amyloid angiopathy (CAA) is important for clinical practice and the design of clinical treatment trials. We investigated the 1-year progression of CAA-related MRI markers in sporadic (sCAA) and Dutch-type hereditary (D-CAA).</p><p><strong>Methods: </strong>Participants were included from 2 prospective cohort studies. 3T-MRI was performed at baseline and after 1 year. We assessed macrobleeds, cerebral microbleeds (CMBs), cortical superficial siderosis (cSS), convexity subarachnoid hemorrhages (cSAHs), white matter hyperintensities (WMH), enlarged centrum semiovale perivascular spaces (CSO-EPVS), and visually stimulated blood oxygenation level-dependent (BOLD) fMRI parameters. Progression was defined as increase in number of macrobleeds or CMBs, new focus or extension of cSS, increase in CSO-EPVS category, or volume increase of >10% of WMH. Multivariable regression analyses were performed to determine factors associated with progression and the association between events related to parenchymal injury (cSAH, macrobleeds) and radiologic progression.</p><p><strong>Results: </strong>We included 98 participants (47% women): 55 with sCAA (mean age 70 years), 28 with symptomatic D-CAA (mean age 59 years), and 15 with presymptomatic D-CAA (mean age 45 years). Progression of >1 MRI markers was seen in all 83 (100%) participants with sCAA and symptomatic D-CAA and in 9 (60%) with presymptomatic D-CAA. The number of CMBs showed the largest progression in sCAA (98%; median increase 24) and symptomatic D-CAA (100%; median increase 58). WMH volume (>10% increase in 70%; mean increase 1.2 mL) was most progressive in presymptomatic D-CAA. A decrease in the upslope of the visually evoked BOLD response was observed for most patients. Symptomatic D-CAA status was associated with more overall progression (adjusted odds ratio [aOR] 9.7; 95% CI 1.7-54.2), CMB (adjusted relative risk [aRR] 2.47; 95% CI 1.5-4.1), and WMH volume progression (β 2.52; 95% CI 0.3-4.8). Baseline CMB count (aRR 1.002; 95% CI 1.001-1.002) was associated with CMB progression and cSS presence at baseline (aOR 8.16; 95% CI 2.6-25.4) with cSS progression. cSS progression was also associated with cSAH and macrobleeds (aOR 21,029; 95% CI 2.042-216.537).</p><p><strong>Discussion: </strong>CAA is a radiologically progressive disease even in the short-term. After 1 year, all symptomatic and most of the presymptomatic participants showed progression of at least 1 MRI-marker. CMBs and WMH volume (in symptomatic CAA) and WMH volume (in presymptomatic CAA) are the most promising markers to track short-term progression in future trials.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e213546"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amyloid Spikes on Optical Coherence Tomography Demonstrating Ocular Involvement in ATTRv Amyloidosis.","authors":"Rebecca T Hsu, James Wilson, Chafic Karam","doi":"10.1212/WNL.0000000000213481","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213481","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e213481"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability and Accuracy of a Diagnosis of Parkinson Disease Over 10 Years.","authors":"Valtteri Räty, Tomi Kuusimäki, Joonas Majuri, Tero Vahlberg, Maria Gardberg, Tommi Noponen, Marko Seppänen, Anna-Maija Tolppanen, Valtteri Kaasinen","doi":"10.1212/WNL.0000000000213499","DOIUrl":"10.1212/WNL.0000000000213499","url":null,"abstract":"<p><strong>Background and objectives: </strong>Accurate diagnosis of Parkinson disease (PD) remains challenging, with variability and clinical uncertainty, especially in nonspecialized settings. Despite advancements in diagnostic criteria and biological markers, misdiagnosis continues to affect patient care and research. This study aimed to assess the long-term diagnostic stability of PD and evaluate the accuracy of initial diagnoses over time in a large, consecutive cohort diagnosed by neurologists, with or without movement disorder specialization.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal analysis of patients diagnosed with PD between 2006 and 2020. Patient records were reviewed over a median follow-up period of 10 years, with more than half of the cohort tracked from motor symptom onset to death. Diagnostic evaluations included dopamine transporter (DAT) imaging and neuropathologic examinations for a subset of patients, based on clinical indications. Two movement disorder specialists cross-validated diagnoses through retrospective chart reviews.</p><p><strong>Results: </strong>The cohort included 1,626 patients (mean age 69.0 years, 44.1% female). Of these, 10.6% (n = 172) had their diagnoses revised by treating neurologists, and 2.7% (n = 44) were revised based on chart reviews or neuropathologic findings. The median time to diagnosis revision was 22 months (interquartile range = 43). The most common revised diagnoses were vascular parkinsonism, progressive supranuclear palsy, and multiple system atrophy, with 4.7% (n = 77) classified as clinically undetermined parkinsonism. In a secondary analysis separating PD and dementia with Lewy bodies (DLB), the revision rate increased to 17.7%. DAT imaging had been performed on 588 patients and was more frequently used in revised cases. Postmortem neuropathologic examinations had been conducted in only 3% of deceased patients, with 64% confirming the initial PD diagnosis.</p><p><strong>Discussion: </strong>This study demonstrates significant diagnostic instability in PD, with 13.3% of diagnoses revised, primarily within 2 years. When DLB is considered separately, the revision rate increases to 17.7%. Despite frequent DAT imaging and limited postmortem examinations, clinical uncertainty persists among practicing neurologists, contrasting with lower misdiagnosis rates in specialized centers. These findings highlight the need for systematic application of diagnostic criteria, regular reevaluation of diagnoses, more frequent autopsies, and the development of accessible diagnostic biomarkers.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e213499"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 Annual Meeting Abstracts.","authors":"","doi":"10.1212/WNL.0000000000209922","DOIUrl":"https://doi.org/10.1212/WNL.0000000000209922","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e209922"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective Criteria for Subtle Cognitive Decline in Aging and Preclinical Alzheimer Disease: A Systematic Review.","authors":"Kelsey R Thomas, Emily C Edmonds","doi":"10.1212/WNL.0000000000213536","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213536","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although the Alzheimer's Association (AA) biomarker-only Alzheimer disease (AD) criteria and the International Working Group clinical-pathologic AD criteria differ, both approaches appreciate the need for early detection efforts. Within the AA approach, clinical stage 2 recognizes that someone can be cognitively unimpaired but still experience \"subtle cognitive decline\" (SCD) measured by subjective report or objective decline using neuropsychological measures. While significant attention has been given to subjective cognitive decline methods, there are no systematic examinations of the operational definition of SCD using objective neuropsychological measures. Therefore, the primary aim of this review was to identify and describe the approaches used to classify objective SCD.</p><p><strong>Methods: </strong>A systematic literature search was performed using PubMed/MEDLINE, Web of Science, and PsycInfo databases for articles with dates ranging from the start of the database through November 1, 2023. Included studies were peer-reviewed, described a discrete objective SCD category, included participants aged 50+ without mild cognitive impairment (MCI) or dementia, and focused on aging or AD. A modified Newcastle-Ottawa Scale was used to assess the quality of included studies. Data were extracted by the 2 authors who then categorized and described the classification approaches.</p><p><strong>Results: </strong>Of the 1,361 publications initially identified, 70 case-control studies met criteria for inclusion. SCD definitions generally fell into 6 categories based on using similar methodology: (1) SCD based on a specified cutoff on a single cognitive test (n = 6); (2) SCD based on a cutoff (e.g., 10th percentile) on a cognitive composite score (n = 9); (3) objectively defined SCD (Obj-SCD) using cutoffs (e.g., -1 SD) on multiple individual neuropsychological measures (n = 24); (4) \"Pre-MCI\" criteria defined using a Clinical Dementia Rating of 0.5 but normal performance on neuropsychological testing (n = 12); (5) cutoff based on longitudinal rate of cognitive decline (e.g., over 1 year) (n = 13); and (6) data-driven/clustering approach to classification (n = 8). Two studies used multiple classification approaches.</p><p><strong>Discussion: </strong>Six promising classification approaches were identified in the existing literature, with the Obj-SCD and Pre-MCI approaches being the most commonly applied. Additional work is needed to compare SCD approaches head-to-head to identify the most prognostically useful, particularly within racially/ethnically diverse older adults.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 9","pages":"e213536"},"PeriodicalIF":7.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}