Neurology最新文献

{"title":"The Language That Does Not Yet Exist.","authors":"Rocío Mesa Martínez","doi":"10.1212/WNL.0000000000218698","DOIUrl":"https://doi.org/10.1212/WNL.0000000000218698","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218698"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183479","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":"Bilateral Anomalous Ophthalmic Artery Course With an Internal Carotid Artery Configuration Mimicking Moyamoya Angiopathy.","authors":"Ayumu Yamaoka, Katsuya Komatsu, Shogo Misumi, Yukinori Akiyama, Nobuhiro Mikuni","doi":"10.1212/WNL.0000000000218629","DOIUrl":"https://doi.org/10.1212/WNL.0000000000218629","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218629"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137722","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":"Physical Activity and Motor and Cognitive Progression in Parkinson Disease: A Longitudinal Cohort Study.","authors":"Dong-Woo Ryu, Kevin R Duque, Luca Marsili, Jesus Abanto, Nathaly Chinchihualpa Paredes, Heba A Deraz, Andrea Herrera Gorriti, Emily J Hill, Abhimanyu Mahajan, Andrew Duker, Alberto J Espay","doi":"10.1212/WNL.0000000000218682","DOIUrl":"https://doi.org/10.1212/WNL.0000000000218682","url":null,"abstract":"<p><strong>Background and objectives: </strong>Evidence for the effect of physical activity on disease progression in Parkinson disease (PD) remains limited. We aimed to examine whether physical activity is associated with the rate of motor and cognitive progression in PD and to identify specific components of physical activity underlying these associations.</p><p><strong>Methods: </strong>In this longitudinal cohort study, we analyzed data from individuals with mild-to-moderate PD enrolled in the Cincinnati Cohort Biomarker Program between January 2019 and February 2025. Physical activity was assessed using standardized interviews and quantified as total physical activity time (TPT), total physical activity volume (TPV), and vigorous physical activity time (VPT). Longitudinal associations between physical activity and annual changes in Movement Disorder Society-Unified Parkinson's Disease Rating Scale, part III (MDS-UPDRS-III; higher is worse) and Montreal Cognitive Assessment (MoCA; higher is better) scores were assessed using linear mixed-effects models adjusted for demographic and disease-related covariates. We compared predicted severity trajectories across tertiles of TPT and used residualized analyses to evaluate the independent effects of activity intensity and timing.</p><p><strong>Results: </strong>A total of 294 individuals with PD (mean age, 66.4 years; 33.0% female) were included, with up to 5 years of follow-up for MoCA and 7 years for MDS-UPDRS-III. Higher TPT, TPV, and VPT were each associated with slower cognitive decline and motor progression. The annual MoCA change was -0.478, -0.090, and -0.007 points in the low, mid, and high TPT tertiles, respectively, with corresponding annual MDS-UPDRS-III changes of 0.143, -0.225, and -0.783. Compared with the lowest tertile, the highest tertile showed slower cognitive (β = 0.470; 95% CI 0.203-0.737; <i>p</i> < 0.001) and motor (β = -0.926; 95% CI -1.835 to -0.017; <i>p</i> = 0.048) progression. In residualized analyses, recent physical activity remained associated with longitudinal changes in both MoCA and MDS-UPDRS-III scores after accounting for previous 10-year physical activity, whereas vigorous physical activity was no longer associated with outcomes after adjustment for total physical activity time.</p><p><strong>Discussion: </strong>Higher levels of physical activity were associated with slower cognitive and motor progression in PD. The beneficial associations of moderate-to-vigorous physical activity may be related to activity duration and ongoing engagement. Limitations include the observational design, self-reported physical activity, and potential selection bias.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218682"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128283","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":"Midlife and Late-Life Alzheimer Disease Blood Biomarkers and 11-Year Cognitive Decline.","authors":"Jason R Smith, James Russell Pike, Yifei Lu, Keenan A Walker, Kevin J Sullivan, B Gwen Windham, Bharat Thyagarajan, Michelle M Mielke, Pamela L Lutsey, Timothy M Hughes, David S Knopman, Rebecca F Gottesman, Thomas H Mosley, Josef Coresh, Jennifer A Deal, A Richey Sharrett, Priya Palta","doi":"10.1212/WNL.0000000000218692","DOIUrl":"https://doi.org/10.1212/WNL.0000000000218692","url":null,"abstract":"<p><strong>Background and objectives: </strong>Plasma biomarkers of Alzheimer disease (AD) neuropathology (amyloid-β42 to amyloid β40 [Aβ42/40] ratio, phosphorylated tau at threonine [p-tau181]), neurodegeneration (neurofilament light [NfL]), and neuroinflammation (glial fibrillary acidic protein [GFAP]) in late-life are associated with cognitive decline. Whether these biomarkers in midlife are predictive of subsequent cognitive decline, and whether they are associated with different cognitive domains, is uncertain. In this study, we investigated associations of midlife and late-life plasma Aβ42/40, p-tau181, NfL, and GFAP with late-life change in domain-specific (memory, language, and executive function) and global cognitive function.</p><p><strong>Methods: </strong>We performed a prospective cohort analysis of the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS). Outcome follow-up was from ARIC visit 5 (2011-2013) to visit 9 (2021-2022). We included all individuals from ARIC field centers (Jackson, Mississippi; Forsyth County, North Carolina; Washington County, Maryland; and Minneapolis suburbs, Minnesota) with biomarkers measured from stored specimens in midlife (visit 3, 1993-1995, mean age 59.0 years) and late-life (visit 5, 2011-2013, mean age 76.8 years). Aβ42/40, p-tau181, NfL, and GFAP were measured with the Quanterix Simoa platform and standardized to visit 3 to facilitate cross-biomarker comparisons of their rate of change from midlife to late-life. We estimated change in memory, language, executive function, and global cognition factor scores from visit 5 to visit 9 with linear mixed-effect models.</p><p><strong>Results: </strong>In 1,515 included participants, 60.7% (n = 920) were female and 25.5% (n = 387) were Black. Each SD increase in p-tau181 in midlife was significantly associated with faster late-life memory decline (β = -0.030 [95% CI -0.059 to -0.001] SD. Midlife Aβ42/40, NfL, and GFAP were not associated with subsequent decline in any cognitive domain. In late-life, p-tau181, NfL, and GFAP were significantly associated with faster decline in different cognitive domains, with the strongest associations seen with memory (β = -0.091 [95% CI -0.123 to -0.058] SD; β = -0.064 [95% CI -0.106 to -0.023] SD; and β = -0.048 [95% CI -0.082 to -0.013] SD, respectively).</p><p><strong>Discussion: </strong>Midlife p-tau181 was associated with faster 11-year memory decline beginning 20 years later in the ARIC cohort, which underscores a potentially long prodromal phase of cognitive decline that could precede dementia onset. In late-life, biomarkers for AD, neurodegeneration, and neuroinflammation were associated with faster decline across different cognitive domains, but associations remained strongest for p-tau181 and memory.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218692"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207712","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":"Hemorrhagic Recurrence of Cerebral Cortical Encephalitis in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease After 11 Years.","authors":"Louis Cousyn, Natalia Shor, Elisabeth Maillart","doi":"10.1212/WNL.0000000000218620","DOIUrl":"https://doi.org/10.1212/WNL.0000000000218620","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218620"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128250","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":"Confessions of an Introvert at #AANAM.","authors":"Lealani Mae Y Acosta","doi":"10.1212/WNL.0000000000218678","DOIUrl":"https://doi.org/10.1212/WNL.0000000000218678","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218678"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137732","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":"\"Railroad Track\" Brain Fluorodeoxyglucose-PET Sign in Antiphospholipid Syndrome-Related Posterior Cortical Atrophy.","authors":"Yahel Segal, Allen J Aksamit, Stuart J McCarter, Stephanie B Syc-Mazurek, John J Chen, Gregory D Cascino, Floranne C Ernste, Samantha A Banks","doi":"10.1212/WNL.0000000000218621","DOIUrl":"https://doi.org/10.1212/WNL.0000000000218621","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218621"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128195","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":"Spinal Cord and Nerve Root Involvement in Histiocytic Neoplasms: A Retrospective Observational Cohort Study.","authors":"Andreu Vilaseca, Carla Borre, Ronald Go, Jithma P Abeykoon, Karen Rech, Samantha A Banks, Eoin P Flanagan, Gaurav Goyal, Matthew J Koster, Jay H Ryu, Rob Vassallo, Mithun V Shah, N Nora Bennani, W Oliver Tobin","doi":"10.1212/WNL.0000000000218559","DOIUrl":"10.1212/WNL.0000000000218559","url":null,"abstract":"<p><strong>Background and objectives: </strong>Histiocytic neoplasms, including Erdheim-Chester disease (ECD), Langerhans cell histiocytosis (LCH), and Rosai-Dorfman-Destombes disease (RDD), have frequent nervous system involvement. The aim of this study was to characterize the neurologic, radiologic, and laboratory features of spinal cord and nerve root involvement in histiocytic neoplasms.</p><p><strong>Methods: </strong>We evaluated patients with biopsy-proven ECD, LCH, or RDD seen at a tertiary referral center between January 1996 and December 2024. Patients were included if spinal MRI demonstrated spinal cord or nerve root involvement. Spinal MRI was performed for evaluation of myelopathic or radicular symptoms or as part of staging in patients with CNS involvement. We collected demographic variables, neurologic syndromes and imaging patterns, treatment characteristics, and outcomes including disability (Expanded Disability Status Scale [EDSS] score) and ambulatory status. The primary outcome was neurologic disability at nadir and last follow-up; secondary outcomes included radiographic patterns and clinical response to treatment. Data were summarized descriptively, with exploratory group comparisons performed using parametric or nonparametric tests as appropriate.</p><p><strong>Results: </strong>Among 415 patients with ECD (n = 183), LCH (n = 144), or RDD (n = 88), spinal cord or nerve root involvement was identified in 42 (ECD, 27; LCH, 4; RDD, 11). The median age at onset was 43.1 years (interquartile range 32.1-58.5), and 18 (43%) were female. Most cases were symptomatic (36/42, 86%), with myelopathy as the first neurologic manifestation in 26 (72%). Parenchymal infiltration predominated in the ECD group (17/27, 63%), compared with LCH (2/4, 50%) and RDD (2/11, 18%) groups (Fisher exact test across groups, <i>p</i> = 0.035). Root involvement was more frequent in the RDD group (8/11, 73%) than in the ECD (7/27, 26%) or LCH (1/4, 25%) group (Fisher exact test across groups, <i>p</i> = 0.021). The median EDSS score at nadir was 4.0; 43% required ambulatory aid or worse. After treatment, 22 of 36 symptomatic patients (61%) improved clinically and radiographically, more often in RDD (10/11, 91%) and LCH (2/3, 67%) groups than in the ECD group (10/22, 46%; Fisher exact test across groups, <i>p</i> = 0.022). At a median 5.8-year follow-up, 8 of 38 survivors (21%) required ambulatory assistance or were nonambulatory.</p><p><strong>Discussion: </strong>Spinal cord and nerve root involvement occurs in histiocytic neoplasms. These findings support prioritizing spinal MRI in patients with neurologic symptoms or high-risk disease features because early identification may inform diagnosis and management.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218559"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195524","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":"More Than a Daughter: Margaret A. Lennox-Buchthal (1913-2001), Epileptologist.","authors":"Alison Christy","doi":"10.1212/WNL.0000000000218630","DOIUrl":"https://doi.org/10.1212/WNL.0000000000218630","url":null,"abstract":"<p><p>In a 2010 book chapter on the pioneering encephalographer Mary A.B. Brazier, PhD (1904-1995), a photo of a smiling woman is labeled \"Margaret Lennox-Buchthal, wife of Fritz, daughter of William Lennox.\" Yet, like most women, Margaret Lennox-Buchthal, MD (1913-2001), was more than a wife and a daughter. She was an assistant professor at the Yale School of Medicine and associate professor at the University of Copenhagen Institute of Neurophysiology, and she was editor-in-chief of the journal <i>Epilepsia</i> (1969-1975). Her work had a lasting impact on our current concept of and approach to febrile seizures. She advocated for people with epilepsy and challenged stigmas as an educated divorced woman with a diagnosis of epilepsy. The story of Lennox-Buchthal's life illustrates the unsung roles women played in medicine and research in the mid-1900s, and how their achievements continue to be eclipsed by the men in their lives.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218630"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207222","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":"Predictors of Antiamyloid Medication Utilization and Adherence Among People With Alzheimer Disease and Mild Cognitive Impairment.","authors":"Evan Lee Reynolds, Melissa A Elafros, Lavanya Muthukumar, Ernie Shippey, Joshua Amit Budhu, Samuel W Terman, James F Burke, Brian C Callaghan","doi":"10.1212/WNL.0000000000218594","DOIUrl":"https://doi.org/10.1212/WNL.0000000000218594","url":null,"abstract":"<p><strong>Background and objectives: </strong>From 2021 to 2024, 3 amyloid monoclonal antibody medications (aducanumab, lecanemab, and donanemab) were approved by the US Food and Drug Administration for treatment of mild cognitive impairment (MCI) and mild dementia due to Alzheimer disease (AD). We determined the demographics and social drivers of health associated with utilization and initial adherence of these medications.</p><p><strong>Methods: </strong>We used the Vizient database to identify patients with MCI or dementia using an ICD-10 coding definition. Propensity score matching was used to match patients who received an antiamyloid medication to those who did not, based on date of MCI/dementia diagnosis and follow-up. Social drivers of health were assessed using the Vizient Vulnerability Index (VVI), a neighborhood-level measure of socioeconomic vulnerability. Logistic regression determined associations between demographics, Elixhauser comorbidity, and VVI, with utilization of antiamyloid medications. Poisson regression determined associations between demographic, Elixhauser comorbidity, and VVI and initial adherence (measured as days supplied) of antiamyloid medications.</p><p><strong>Results: </strong>We identified 1,198,362 participants with MCI/dementia, of whom 2,427 (0.2%) were prescribed an antiamyloid medication. Of those prescribed an antiamyloid medication, 1,696 (69.9%) were matched to participants with MCI/dementia that were not prescribed antiamyloid medications (mean age 75.5 [SD 9.5], 56.1% female, 80.1% non-Hispanic White). We found that higher age (odds ratio [OR] 0.93, 95% CI 0.92-0.94), higher Elixhauser comorbidity index (OR 0.56, 95% CI 0.52-0.59), being non-Hispanic Black (OR 0.14, 95% CI 0.09-0.23), and being Hispanic (OR 0.21, 95% CI 0.13-0.36) associated with lower odds of receiving an antiamyloid medication. Furthermore, having greater VVI was associated with lower odds of receiving an antiamyloid medication. By contrast, only higher Elixhauser comorbidity score was associated with lower initial medication adherence (rate ratio 0.94, 95% CI 0.93-0.96), but not age, sex, race/ethnicity, and overall vulnerability.</p><p><strong>Discussion: </strong>We found that younger, non-Hispanic White patients, with fewer comorbidities, and lower vulnerability, were more likely to receive antiamyloid medications. By contrast, among patients receiving an antiamyloid medication, only higher comorbidity score associated with lower initial medication adherence. These findings indicate a potential disparity in medication access for US patients with MCI/dementia that could become problematic barriers to care as medications for dementia continue to evolve.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"107 9","pages":"e218594"},"PeriodicalIF":8.9,"publicationDate":"2026-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195400","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}