Neurology最新文献

{"title":"Teaching Video NeuroImage: Ictal Retching as a Localizing Sign in Temporal Lobe Epilepsy.","authors":"Nicole L Platti, Nadia Khalil, Natasha Llanes, Mark Jack, Ushtar Amin, Selim Benbadis","doi":"10.1212/WNL.0000000000209913","DOIUrl":"https://doi.org/10.1212/WNL.0000000000209913","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 1","pages":"e209913"},"PeriodicalIF":7.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801834","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":"Teratogenesis, Perinatal, and Neurodevelopmental Outcomes After In Utero Exposure to Antiseizure Medication: Practice Guideline From the AAN, AES, and SMFM.","authors":"","doi":"10.1212/WNL.0000000000210145","DOIUrl":"https://doi.org/10.1212/WNL.0000000000210145","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 1","pages":"e210145"},"PeriodicalIF":7.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801837","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":"Feasibility of Simon 2-Stage Futility Trials in Early Parkinson Disease: Analysis of the PRECEPT and DATATOP Trial Datasets.","authors":"Marcus Werner Koch, Lorraine V Kalia, Justyna R Sarna, Daryl Wile, Tiago A Mestre, Michael G Schlossmacher, Jop Mostert, Eva M M Strijbis, Bernard Uitdehaag, Amber Salter, Gary R Cutter","doi":"10.1212/WNL.0000000000210079","DOIUrl":"https://doi.org/10.1212/WNL.0000000000210079","url":null,"abstract":"<p><strong>Background and objectives: </strong>Disease-modifying treatments (DMTs) are a major unmet need in Parkinson disease (PD). To date, trials investigating DMT candidates in PD most often used a randomized controlled trial (RCT) design. Unfortunately, RCTs to date have not led to a breakthrough, in part because of the large sample sizes and length of follow-up required. In the interest of testing DMT candidates in a more efficient manner, it may be worthwhile to perform futility trials, which are smaller clinical trials that have originally been developed as phase 2 trials in oncology and more recently been used in progressive multiple sclerosis. In this investigation, we used original, patient-level data from DATATOP and PRECEPT, 2 large RCTs in early PD, to explore the feasibility of using the Simon 2-Stage futility trial design in early PD.</p><p><strong>Methods: </strong>This is a post hoc analysis of original, patient-level data from the DATATOP and PRECEPT RCTs in early PD. In our analyses, we use descriptive statistics, survival analysis, and binary logistic regression to explore thresholds of change in the Unified Parkinson Disease Rating Scale (UPDRS) motor score as the primary outcome measure, length of follow-up, inclusion and exclusion criteria, and projected sample sizes for Simon 2-Stage futility trials in early PD. We also performed bootstrapping experiments to illustrate the ability of trials using the Simon 2-Stage futility design to identify selegiline as nonfutile and tocopherol as futile.</p><p><strong>Results: </strong>PRECEPT included 806 participants (mean age 59.7 years, SD 10.3, 64.4% male), and DATATOP included 800 participants (mean age 61.1 years, SD 9.5, 64.4% male). Our analyses suggest that futility trials using the Simon 2-Stage methodology are feasible in PD. We propose a 5-point worsening on the UPDRS motor score as the primary outcome measure and a length of follow-up of 12 months. Trial simulations based on these data suggest the required sample size for such clinical trials to be lower than 200 participants.</p><p><strong>Discussion: </strong>Based on our analysis of DATATOP and PRECEPT, phase 2 clinical trials using the Simon 2-Stage methodology are feasible in PD and may offer an opportunity to expedite the discovery of promising treatments in early PD.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 1","pages":"e210079"},"PeriodicalIF":7.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789533","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":"Blood Pressure Variability and Cognition in Black and White Older Adults Over 18 Years of Follow-up: A Population-Based Cohort Study.","authors":"Anisa Dhana, Charles S DeCarli, Klodian Dhana, Pankaja Desai, Denis A Evans, Kumar B Rajan","doi":"10.1212/WNL.0000000000210151","DOIUrl":"10.1212/WNL.0000000000210151","url":null,"abstract":"<p><strong>Background and objectives: </strong>Hypertension is a well-established cardiovascular risk factor for cognitive function. As blood pressure fluctuates because of aging-related changes, we examined the association between visit-to-visit blood pressure variability (BPV) and cognition in older adults.</p><p><strong>Methods: </strong>This prospective observational cohort study included 4,770 individuals aged older than 65 years with repeated blood pressure assessment participating in the Chicago Health and Aging Project, a bi-racial population-based study lasting from 1993 to 2012. Blood pressure was measured by research staff every 3 years over 18 of follow-up. Systolic and diastolic BPV was calculated as the sum of the absolute difference in blood pressure between successive measurements, divided by the number (n - 1) of assessments. Cognition was assessed by standardized cognitive tests, and <i>z</i>-scores for the composite cognitive score were computed. Multivariable adjusted linear regression models were used to evaluate the association of systolic and diastolic BPV during the study period with cognition at the last visit.</p><p><strong>Results: </strong>Of 4,770 individuals, 2,998 (62.9%) were women, 3,146 (66.0%) were Black, and the mean (SD) age at baseline was 71.3 (5.3) years. The mean systolic BPV was 17.7 mm Hg in Black individuals and 16.0 mm Hg in White participants. Higher systolic and diastolic BPV was associated with lower cognitive scores at the end of follow-up. Compared with individuals in the first tertile of systolic BPV (lower BPV), participants with third tertile (higher BPV) had lower cognitive scores by 0.074 standardized units (β -0.074; 95% CI -0.131 to -0.018), corresponding to 1.8 years older in cognitive age. This relationship differed by race, being significant only in older Black adults. Black individuals in the third tertile of systolic BPV had lower cognitive scores by 0.115 standardized units (β -0.115; 95% CI -0.183 to -0.047) compared with those in the first tertile, corresponding to 2.8 years older in cognitive age. Similar findings were observed for diastolic BPV.</p><p><strong>Discussion: </strong>Elevated BPV, particularly in older Black adults, was associated with a lower cognitive score, suggesting routine assessment for blood pressure to identify and mitigate the adverse role of BPV in cognitive functioning in older adults.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 1","pages":"e210151"},"PeriodicalIF":7.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813894","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":"Author Response: Wall-Eyed Bilateral Internuclear Ophthalmoplegia Variant Syndrome Caused by Isolated Left Thalamic Infarction.","authors":"Brian Po-Sheng Wu,Feng Cheng Lin,Poyin Huang","doi":"10.1212/wnl.0000000000209734","DOIUrl":"https://doi.org/10.1212/wnl.0000000000209734","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"32 1","pages":"e209734"},"PeriodicalIF":9.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887813","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":"Clinical Reasoning: A 35-Year-Old Woman With Personality Change and Gait Impairment.","authors":"Catarina Bernardes,João M Lemos,Gustavo C Santo","doi":"10.1212/wnl.0000000000210252","DOIUrl":"https://doi.org/10.1212/wnl.0000000000210252","url":null,"abstract":"A 35-year-old woman presented with a progressive 3-year history of personality changes and gait impairment. Neurologic examination revealed bilateral optic atrophy, spastic paraparesis, and impaired vibratory sensation in all limbs, and neuropsychological evaluation identified a frontotemporal cognitive impairment. In this article, we review the differential diagnosis for a young woman with chronic frontotemporal dysfunction, optic atrophy, and dorsolateral myelopathy in a stepwise multidisciplinary approach. Critical information obtained from the medical history led to a final diagnosis.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"62 1","pages":"e210252"},"PeriodicalIF":9.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887814","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":"Reversible Unilateral Tongue Border Atrophy Associated With Anti-Acetylcholine Receptor Antibody-Positive Myasthenia Gravis.","authors":"Inês V Carvalho,Fábio Gomes,Luciano Almendra,Argemiro Geraldo,Anabela Matos","doi":"10.1212/wnl.0000000000210288","DOIUrl":"https://doi.org/10.1212/wnl.0000000000210288","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"5 1","pages":"e210288"},"PeriodicalIF":9.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887715","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":"Reader Response: Wall-Eyed Bilateral Internuclear Ophthalmoplegia Variant Syndrome Caused by Isolated Left Thalamic Infarction.","authors":"Eric R Eggenberger","doi":"10.1212/wnl.0000000000209673","DOIUrl":"https://doi.org/10.1212/wnl.0000000000209673","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"80 1","pages":"e209673"},"PeriodicalIF":9.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887703","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":"Reader Response: Teaching NeuroImage: Fundoscopic and Optical Coherence Tomography Changes in Primary CNS Lymphoma.","authors":"Huang Luwen,Li Linlin,Xu Lei,Yu Ming","doi":"10.1212/wnl.0000000000209712","DOIUrl":"https://doi.org/10.1212/wnl.0000000000209712","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"31 1","pages":"e209712"},"PeriodicalIF":9.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887713","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":"Clinical Reasoning: Clinical Manifestations and Diagnostic Challenges in a 16-Year-Old With Early-Onset Ataxia.","authors":"Deepak Chadha,Lakshminarayanapuram Gopal Viswanathan,Rashmi Santhoshkumar,Aditi Goyal,Doniparthi Venkata Seshagiri,Yasha T Chickabasaviah,Madhu Nagappa","doi":"10.1212/wnl.0000000000210253","DOIUrl":"https://doi.org/10.1212/wnl.0000000000210253","url":null,"abstract":"A 16-year-old adolescent girl presented with progressive walking imbalance, uncoordination of her limbs, impaired proprioceptive sensation distal to her wrists and ankles, and sensorineural hearing loss. Her evaluation revealed diffuse cerebellar atrophy, a demyelinating neuropathy, and hypergonadotropic hypogonadism. In this article, we present a systematic approach to a patient with early-onset ataxia, cerebellar atrophy, and demyelinating neuropathy.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"63 1","pages":"e210253"},"PeriodicalIF":9.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887704","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}