Neurology最新文献

{"title":"Validation of the Boston Criteria Version 2.0 for Cerebral Amyloid Angiopathy in Patients Presenting With Intracerebral Hemorrhage.","authors":"Margaret H Downes, Roshini Kalagara, Christina P Rossitto, Vikram Vasan, Devarshi Vasa, Susmita Chennareddy, Daniel R Lefton, Sema Yildiz, Melissa Umphlett, Carolyn Brockington, Christopher P Kellner","doi":"10.1212/WNL.0000000000213460","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213460","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cerebral amyloid angiopathy (CAA) is a leading cause of lobar intracerebral hemorrhage (ICH) in older individuals, associated with significant morbidity and recurrence. The updated Boston criteria version 2.0 (v2.0) incorporate new MRI biomarkers to improve diagnostic accuracy. This study aimed to validate the diagnostic performance of v2.0 compared with version 1.5 (v1.5) in patients with spontaneous ICH undergoing surgical evacuation and brain biopsy.</p><p><strong>Methods: </strong>This retrospective single-center cohort study was conducted at the Mount Sinai Health System from 2015 to 2021. Patients with spontaneous ICH who underwent surgical evacuation with brain biopsy and preoperative MRI were included. MRI markers assessed included lobar hemorrhagic lesions (ICH, cerebral microbleeds [CMBs], cortical siderosis [cSS]) and nonhemorrhagic markers (severe visible perivascular spaces in the centrum semiovale [CSO-PVS] and multispot white matter hyperintensities [WMHs]). Pathologic confirmation of CAA was based on modified Vonsattel grading, which evaluates β-amyloid deposition in vessel walls. Diagnostic performance of v2.0 was compared with v1.5 using sensitivity, specificity, and predictive values. Logistic regression models calculated odds ratios (ORs) and 95% CIs for associations between MRI biomarkers and pathologically confirmed CAA.</p><p><strong>Results: </strong>Among 186 patients (median age: 63 years; 38% female), 24% had confirmed CAA. The Boston criteria v2.0 demonstrated higher sensitivity for probable CAA (0.75 vs 0.57) while maintaining specificity (0.96 vs 0.99). For possible CAA, sensitivity improved modestly (0.82 vs 0.77) with comparable specificity (0.84 vs 0.87). Among hemorrhagic markers, cSS (OR 4.14, 95% CI 1.35-13.00, <i>p</i> = 0.013) and lobar CMBs (OR 3.03, 95% CI 1.31-7.10, <i>p</i> = 0.009) were significantly associated with CAA. Among nonhemorrhagic markers, CSO-PVS was strongly associated (OR 5.49, 95% CI 2.37-13.06, <i>p</i> < 0.001) while multispot WMHs were not (OR 1.10, 95% CI 0.45-2.56, <i>p</i> = 0.834).</p><p><strong>Discussion: </strong>The Boston criteria v2.0 enhance sensitivity for diagnosing probable CAA without compromising specificity, largely due to the inclusion of nonhemorrhagic markers such as CSO-PVS. Limitations include the retrospective design, the absence of formal inter-rater reliability measures, and the modest sample size. These findings underscore the potential of v2.0 to improve the diagnostic framework for CAA.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 7","pages":"e213460"},"PeriodicalIF":7.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605937","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":"Initiating or Resuming Cancer Treatment After Ischemic Stroke and Clinical Outcomes.","authors":"Gianluca Costamagna, Andreas F Hottinger, Davide Strambo, Françoise Livio, Babak Benjamin Navi, Patrik Michel","doi":"10.1212/WNL.0000000000213458","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213458","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients with acute ischemic stroke (AIS) and active cancer (AC) are at high risk of mortality and stroke recurrence. While cancer characteristics are key prognostic factors, the impact of initiating or resuming active cancer treatment (ACT) after AIS remains unclear. This study aimed to estimate the proportion of patients initiating or resuming ACT after AIS and evaluate their clinical characteristics and outcomes.</p><p><strong>Methods: </strong>Using 2003-2021 data from the Acute STroke Registry and Analysis of Lausanne, we retrospectively analyzed patients with AC who initiated or resumed ACT within 3 months of index AIS vs those who did not. Exclusion criteria included patients with no or inactive cancer, insufficient data on ACT, and posthospitalization cancer diagnoses and those who died or entered palliative care before decisions on ACT. Outcomes included the modified Rankin Scale (mRS) score, mortality, and cerebrovascular recurrences at 3 and 12 months. Analyses comprised multivariable regressions, adjusting for prognostic variables, and propensity score matching (PSM).</p><p><strong>Results: </strong>Among 6,686 patients with AIS, 260 had AC and met eligibility criteria, with 117 (45%) initiating or resuming ACT. The median age was 73 years (interquartile range 16-5); 101 (39%) were women. Chemotherapy was the most prescribed ACT. Lower stroke severity was associated with initiating or resuming ACT (adjusted odds ratio [aOR] 0.93, 95% CI 0.88-0.98). Initiating or resuming ACT was associated with reduced mortality at 3 months before (adjusted hazard ratio [aHR] 0.39, 95% CI 0.28-0.56) and after (aHR 0.33, 95% CI 0.13-0.80) PSM and at 12 months before PSM (aHR 0.81, 95% CI 0.67-0.98). Mortality at 12 months after PSM (aHR 0.73, 95% CI 0.45-1.20), mRS scores at 3 months (aOR 0.96, 95% CI 0.58-1.59) and 12 months (aOR 0.66, 95% CI 0.36-1.19), and cerebrovascular recurrence risk at 3 months (subdistribution hazard ratio [sHR] 0.69, 95% CI 0.28-1.69) and 12 months (sHR 0.71, 95% CI 0.28-1.78) remained similar across groups before and after PSM.</p><p><strong>Discussion: </strong>In a nearly 2-decade stroke registry, almost half of the patients with AC initiated or resumed ACT within 3 months after AIS, with reduced medium-term and potentially long-term mortality but no differences in functional outcomes or cerebrovascular recurrence risk.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 7","pages":"e213458"},"PeriodicalIF":7.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625429","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":"Moyamoya Across the Lifespan: Current Neurologic Care and Future Directions.","authors":"Lisa R Sun, Arastoo Vossough, Manoëlle Kossorotoff, Oh Young Bang, Edward Smith, Ji Hoon Phi, Nomazulu Dlamini, Gary K Steinberg, Laura L Lehman, Sarah Lee","doi":"10.1212/WNL.0000000000213484","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213484","url":null,"abstract":"<p><p>Moyamoya arteriopathy is an important cause of stroke across the lifespan, with high rates of incident and recurrent stroke in affected individuals. Although it affects adults and children globally, moyamoya is more prevalent in East Asian countries, particularly Japan and Korea. The R4810K variant of the <i>RNF213</i> gene, most common in Asian populations, is associated with severe, early onset, multisystem vasculopathy. Neuroimaging is critical for moyamoya diagnosis and treatment planning, with conventional imaging, catheter angiography, perfusion imaging, and cerebrovascular reactivity assessment all having a place within moyamoya care. Medical management of moyamoya entails reducing the competing risks of ischemic and hemorrhagic stroke as well as managing coexisting conditions, such as headache, epilepsy, and neuropsychological sequelae. Antiplatelet therapy is commonly prescribed to prevent thromboembolic stroke, although data supporting this practice are limited and practice patterns vary globally. Promoting cerebral oxygen and nutrient delivery with sufficient fluid intake, maintaining adequate blood pressure, and avoiding anemia and hypoglycemia aid in stroke prevention in moyamoya. Definitive treatment of moyamoya is predicated on surgical revascularization, which aims to augment perfusion to at-risk brain tissue and decrease the risk of hemorrhage from fragile moyamoya collaterals. Although surgery is highly effective in appropriately selected patients, perioperative ischemic events occur following 4%-18% of cases. Perioperative medical management aims to mitigate this risk by optimizing brain oxygen delivery through adequate cerebral perfusion and blood oxygenation, pain/nausea control, minimizing metabolic demand, and preventing thrombosis. Long-term neuroimaging surveillance, evaluation of the neuropsychological effect of moyamoya, and screening for and management of headache and epilepsy resulting from moyamoya are important aspects of the chronic care of all patients with moyamoya. In this review, we summarize key aspects of neurologic evaluation and management for moyamoya across the lifespan, highlight key differences between adult and pediatric moyamoya, and discuss ongoing research efforts that aim to improve care of children and adults with moyamoya.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 7","pages":"e213484"},"PeriodicalIF":7.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557415","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":"Risk of Ischemic and Hemorrhagic Stroke in Individuals With Type 1 and Type 2 Diabetes: A Nationwide Cohort Study in Sweden.","authors":"Anastasios Mavridis, Adam Viktorisson, Björn Eliasson, Mia von Euler, Katharina S Sunnerhagen","doi":"10.1212/WNL.0000000000213480","DOIUrl":"10.1212/WNL.0000000000213480","url":null,"abstract":"<p><strong>Background and objectives: </strong>Diabetes significantly increases the risk of cardiovascular events, including stroke. Although the association with ischemic stroke is well established, the relationship with hemorrhagic stroke remains unclear. This study aimed to evaluate the risk of ischemic and hemorrhagic stroke in individuals with type 1 and type 2 diabetes compared with diabetes-free controls from the general population.</p><p><strong>Methods: </strong>This cohort study included individuals with type 1 or type 2 diabetes from the Swedish National Diabetes Register between 2005 and 2019, matched to diabetes-free controls by age and sex. Data on baseline characteristics, comorbidities, medications, and outcomes were collected from multiple national registers. Stroke incidence rates and adjusted hazard ratios were estimated using Cox proportional hazard models, stratified by diabetes type, for ischemic and hemorrhagic stroke.</p><p><strong>Results: </strong>The study included 47,720 individuals with type 1 diabetes (mean age 34.4, 44.8% female) and 686,158 with type 2 diabetes (mean age 65.3, 43.3% female), matched to 143,160 and 2,058,474 controls, respectively. In individuals with type 1 diabetes, the ischemic stroke risk was 2.54 times higher (95% CI 2.36-2.73) and the hemorrhagic stroke risk was 1.88 times higher (95% CI 1.57-2.26) compared with controls. In individuals with type 2 diabetes, the ischemic stroke risk was 1.37 times higher (95% CI 1.35-1.38) while the hemorrhagic stroke risk was not significantly increased (HR: 0.99, 95% CI 0.96-1.02). Higher HbA1c levels were associated with increased ischemic stroke risk for both diabetes types. For hemorrhagic stroke, individuals with type 1 diabetes had significantly higher risk starting at HbA1c > 52 mmol/mol while in those with type 2 diabetes, a modest risk increase was observed only at HbA1c > 72 mmol/mol.</p><p><strong>Discussion: </strong>The risk of ischemic stroke was higher for both diabetes types. Individuals with type 1 diabetes also exhibited a higher risk of hemorrhagic stroke compared with diabetes-free controls while type 2 diabetes was significantly associated with risk of hemorrhagic stroke only when HbA1c was higher than 72 mmol/mol. These findings highlight the increased stroke risk in diabetes, with distinct patterns by stroke subtype and diabetes type. Tailored prevention strategies are essential to address these differences.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 7","pages":"e213480"},"PeriodicalIF":7.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625435","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":"The Transdiagnostic Value of Plasma Biomarkers for Neurodegenerative and Cerebrovascular MRI Findings.","authors":"Luigi Lorenzini, Frederik Barkhof","doi":"10.1212/WNL.0000000000213531","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213531","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 7","pages":"e213531"},"PeriodicalIF":7.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597289","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":"\"Jack-Knife\" Dystonia in Pantothenate Kinase-Associated Neurodegeneration.","authors":"Manali Chaudhari, Koustubh Bavdhankar, Shailina Ali, Shruti Agrawal, Mayur Thakkar, Neeraj Jain, Sangeeta Ravat, Pankaj Agarwal","doi":"10.1212/WNL.0000000000213482","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213482","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 7","pages":"e213482"},"PeriodicalIF":7.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605845","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":"Uncovering Subclinical Neural Alterations in Sport-Related Concussion: The Added Value of Longitudinal Neuroimaging.","authors":"Aurore Thibaut, Géraldine Martens","doi":"10.1212/WNL.0000000000213513","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213513","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 7","pages":"e213513"},"PeriodicalIF":7.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616545","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":"Underestimation of Follow-Up Infarct Volume by Acute CT Perfusion Imaging.","authors":"Jelle Demeestere, Benjamin F J Verhaaren, Soren Christensen, Anke Wouters, Gregory W Albers, Maarten G Lansberg, Robin Lemmens","doi":"10.1212/WNL.0000000000213439","DOIUrl":"10.1212/WNL.0000000000213439","url":null,"abstract":"<p><strong>Background and objectives: </strong>It is unknown whether acute CT perfusion (CTP) core imaging may underestimate the follow-up infarct. We hypothesize that infarct underestimation occurs especially in late-presenting patients and that underestimated infarct can partially be detected on baseline noncontrast CT (NCCT).</p><p><strong>Methods: </strong>We included patients with acute anterior circulation ischemic stroke who underwent baseline NCCT and CTP imaging, complete endovascular reperfusion, and follow-up MRI from the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke (DEFUSE 3) trial and a consecutive, monocenter cohort. We divided patients into early (<6 hours) and late (6-24 hours) presenters. We performed semiautomated segmentations of the acute ischemic lesion on NCCT using 5% relative density difference (<i>rNCCT</i>_<i>>5%</i>) and used the relative cerebral blood flow <30% to segment the CTP core. On coregistered images, we performed volumetric and voxel-based analyses to compare infarct estimations by imaging modality. Spatial accuracy for the follow-up infarct was assessed using the Dice similarity coefficient (DSC) and balanced accuracy.</p><p><strong>Results: </strong>We included 109 patients with a median age of 70 (interquartile range [IQR] 31-93) years of whom 52% were female. The follow-up infarct was underestimated by the CTP core (mean absolute volume difference [MAVD] = 14 mL [SD 36], <i>p</i> < 0.001), but not by the union lesion (MAVD = 3 mL [SD 32], <i>p</i> = 0.76). Infarct underestimation was greater in late presenters (median 17 mL [IQR 7-33] vs 7 mL [IQR 4-25] in early presenters, <i>p</i> < 0.01) and in patients with poor collaterals (median 20 mL [IQR 8-56] vs 8 mL [IQR 4-20] in patients with good collaterals, <i>p</i> < 0.01). Median 25% of the infarct missed by the CTP core could be detected on baseline rNCCT in late presenters (vs. median 3% in early presenters). The combined <i>rNCCT</i>_<i>>5%</i> and CTP core lesion more accurately detected the follow-up infarct compared with the CTP core alone (median DSC 0.37 [IQR 0.06-0.55] vs 0.18 [IQR 0-0.42] and median balanced accuracy 0.67 [IQR 0.53-0.75] vs 0.56 [IQR 0.50-0.67], <i>p</i> < 0.001 for both).</p><p><strong>Discussion: </strong>Underestimation of follow-up infarct by CTP is substantial and the follow-up infarct can partially be detected by baseline NCCT, especially in patients with stroke with delayed presentation. Combining <i>rNCCT</i>_<i>>5%</i> and CTP increases the accuracy for predicting the follow-up infarct.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 7","pages":"e213439"},"PeriodicalIF":7.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605936","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":"Cost Trends of New-To-Market Neurologic Medications: An Insurance Claims Database Analysis.","authors":"Amanda V Gusovsky Chevalier, Chun Chieh Lin, Kevin Kerber, Evan Lee Reynolds, Brian C Callaghan, James F Burke","doi":"10.1212/WNL.0000000000213428","DOIUrl":"10.1212/WNL.0000000000213428","url":null,"abstract":"<p><strong>Background and objectives: </strong>Costs for neurologic medications have increased considerably in recent years. Since 2014, more than 30 neurologic medications have been approved by the US Food and Drug Administration (FDA) for neurologic conditions. This study aims to characterize recent trends in annual costs and aggregate spending from 2012 to 2021 for new-to-market (NTM) medications for 9 neurologic conditions.</p><p><strong>Methods: </strong>We used the Merative MarketScan commercial and Medicare supplemental databases to observe patients seen by a neurologist with neurologic diseases with newly FDA-approved medications from 2014 to 2021: amyotrophic lateral sclerosis (ALS), transthyretin amyloidosis (ATTR), Duchenne muscular dystrophy (DMD), Huntington disease (HD), myasthenia gravis (MG), migraine, orthostatic hypotension (OH), tardive dyskinesia (TD), and spinal muscular atrophy (SMA). Patients were included if they had ≥1 disease-related prescription medication fill from 2012 to 2021. NTM (medications approved from 2014 to 2021) and older evidence-based guideline-supported medications were observed annually. Outcomes examined were annual and aggregate out-of-pocket (OOP) and total medication costs.</p><p><strong>Results: </strong>We identified 2,687 unique individuals with ALS, 38 with ATTR, 69 with DMD, 884 with HD, 9,984 with MG, 441,099 with migraine, 4,723 with OH, 1,266 with TD, and 17 with SMA. The youngest population was DMD (mean = 25 years [SD = 7]), and the oldest was TD (mean = 66 years [SD = 14]). For DMD, the population was 99% male and for migraine, the population was 84% female, and the other conditions had more relatively even sex divides. Collectively, migraine medications had the largest increase in aggregate costs (1993%) and had a substantial increase in OOP costs on average by 234% ($86-$288). Eculizumab for MG was an extreme outlier, with OOP costs increasing by 4,099% ($413-$17,359) and aggregate OOP costs by 7,005% ($5,375-$381,894). OOP costs of edaravone ($304-$5,707) and deutetrabenazine ($670-$7,170) sharply increased by 1,775% and 971%, respectively.</p><p><strong>Discussion: </strong>NTM medications for neurologic conditions have substantial and increasing individual and societal costs, which was not observed for older generic medications. These data suggest a need for policies to limit the financial burden of NTM medications on patients with neurologic conditions.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 6","pages":"e213428"},"PeriodicalIF":7.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523921","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":"Teaching NeuroImage: Isolated Rosai-Dorfman Disease Resembling a Staghorn in the Spine.","authors":"Siyuan Pang, Zhimin Li, Yang Zhang, Yongning Li, Jun Gao","doi":"10.1212/WNL.0000000000213432","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213432","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 6","pages":"e213432"},"PeriodicalIF":7.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458731","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}