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 Showing 1-20 of 57 Articles
Amie W. Hsia, MD

This Viewpoint discusses the need to reorganize prehospital triage of stroke patients to stroke centers to improve patient outcome.

Roy N. Alcalay, MD, MS

The role of the immune system in Parkinson disease (PD) has perplexed multiple researchers. Supporting evidence for an association includes the presence of inflammatory cells (reactive microglia) in the substantia nigra in PD autopsies1 and in animal models of PD.2 Also, the association of nonsteroidal anti-inflammatory ...

Original Investigation 
Valentina Damato, MD; Amelia Evoli, MD; Raffaele Iorio, MD, PhD

Importance  Neuromyelitis optica spectrum disorders (NMOSDs) are autoimmune astrocytopathies characterized by predominant involvement of the optic nerves and spinal cord. In most patients, an IgG autoantibody binding to astrocytic aquaporin 4, the principal water channel of the central nervous system, is detected. Rituximab, a chimeric monoclonal antibody ...

Original Investigation 
Xiao-Yan Qin, MD; Shu-Ping Zhang, PhD; Chang Cao, BS; Y. Peng Loh, PhD; Yong Cheng, PhD
Includes: Supplemental Content

Importance  The association of nonmotor features and Parkinson disease (PD) is increasingly recognized. Evidence suggests that inflammation may play a role in PD pathologic features and symptoms.

Objective  To quantitatively summarize the peripheral inflammatory cytokine data available for patients with PD.

Data Source  A systematic ...

Review  FREE
Chengzu Long, PhD; Leonela Amoasii, PhD; Rhonda Bassel-Duby, PhD; Eric N. Olson, PhD

Importance  Muscle weakness, the most common symptom of neuromuscular disease, may result from muscle dysfunction or may be caused indirectly by neuronal and neuromuscular junction abnormalities. To date, more than 780 monogenic neuromuscular diseases, linked to 417 different genes, have been identified in humans. Genome-editing methods, especially ...

Comment & Response 
Martin Merschhemke, MD, PhD, MBA; Davorka Tomic, DVM, MSc, PhD; Norman Putzki, MD, PhD

To the Editor In 5 of 46 patients (10.9%) at their center, Hatcher and colleagues1 reported “unexpectedly severe clinical relapses” that they described as “clinical rebound syndrome confirmed on magnetic resonance imaging within 4 to 16 weeks after ceasing fingolimod treatment” for multiple sclerosis. The postulated frequency ...

Comment & Response 
Stacy Ellen Hatcher, BS; Emmanuelle Waubant, MD, PhD; Jennifer S. Graves, MD, PhD, MAS

In Reply We thank Merschhemke et al and Andrade for their interest in our article.1 We appreciate Merschhemke et al highlighting that data have been collected on patients participating in fingolimod trials for up to 3 months after drug cessation. However, these data have not, to our ...

Comment & Response 
Chittaranjan Andrade, MD

To the Editor Hatcher et al1 reported that 5 of 46 patients with multiple sclerosis who discontinued fingolimod treatment experienced severe relapse 4 to 16 weeks after discontinuation. A discerning reader would ask whether the relapses occurred in the context of a treatment switch or a complete ...

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease characterized by a distinct deposition of hyperphosphorylated tau (p-tau) in a pattern that is unique from other diseases including Alzheimer disease.1,2 The pathognomonic lesions of CTE include perivascular accumulation of p-tau in neurons, astrocytes, and cell processes ...

Original Investigation 
Pashtun Shahim, MD, PhD; Yelverton Tegner, MD, PhD; Bengt Gustafsson, MD; Magnus Gren, MD; Johan Ärlig, MD; Martin Olsson, MD; Niklas Lehto, PhD; Åsa Engström, PhD; Kina Höglund, PhD; Erik Portelius, PhD; Henrik Zetterberg, MD, PhD; Kaj Blennow, MD, PhD
Includes: Supplemental Content

Importance  Evidence is accumulating that repeated mild traumatic brain injury (mTBI) incidents can lead to persistent, long-term debilitating symptoms and in some cases a progressive neurodegenerative condition referred to as chronic traumatic encephalopathy. However, to our knowledge, there are no objective tools to examine to which degree ...

Original Investigation 
Stephen N. Gomperts, MD, PhD; Joseph J. Locascio, PhD; Sara J. Makaretz, BS; Aaron Schultz, PhD; Christina Caso, BS; Neil Vasdev, PhD; Reisa Sperling, MD; John H. Growdon, MD; Bradford C. Dickerson, MD; Keith Johnson, MD
Includes: Supplemental Content

Importance  The causes of cognitive impairment in dementia with Lewy bodies (DLB) and Parkinson disease (PD) are multifactorial. Tau pathologic changes are commonly observed at autopsy in individuals with DLB and PD dementia, but their contribution to these diseases during life is unknown.

Objective  To contrast ...

Clinical Implications of Basic Neuroscience Research 
Kun Ping Lu, MD, PhD; Asami Kondo, PhD; Onder Albayram, PhD; Megan K. Herbert, PhD; Hekun Liu, PhD; Xiao Zhen Zhou, MD

Alzheimer disease (AD) and chronic traumatic encephalopathy (CTE) share a common neuropathologic signature—neurofibrillary tangles made of phosphorylated tau—but do not have the same pathogenesis or symptoms. Although whether traumatic brain injury (TBI) could cause AD has not been established, CTE is shown to be associated with TBI. Until ...

Research Letter 
Brian Nils Lundstrom, MD, PhD; Jamie Van Gompel, MD; Jeffrey Britton, MD; Katherine Nickels, MD; Nicholas Wetjen, MD; Gregory Worrell, MD, PhD; Matt Stead, MD, PhD

This study reports on 13 patients treated with continuous subthreshold electrical cortical stimulation, which suppressed interictal epileptiform discharges and improved clinical seizures.

Comment & Response 
Uzma Samadani, MD, PhD; Molly Hubbard, MD

To the Editor We agree with Reams and colleagues’ review1 finding that because mislocalized phosphorylated tau is neither pathognomic nor causative for clinical neurodegenerative disease, efforts focusing on identification of chronic traumatic encephalopathy in living people are not clinically useful. Chronic traumatic encephalopathy is present in equal ...

Comment & Response 
Nicole Reams, MD; Matthew L. Lorincz, MD, PhD; Jeffrey S. Kutcher, MD

In Reply We thank Samadani and Hubbard for their review and comment on our article.1 Traumatic encephalopathy syndrome (TES) is a clinical diagnosis with unknown correlation with the pathologic findings of chronic traumatic encephalopathy (CTE). We proposed working criteria for TES to serve as a clinical starting ...

During the past 20 to 30 years, disorders of the nervous system, previously of unknown origin, associated with antibodies to self-antigens have been increasing. Some of these antigens are components of the cell surface, including components of synapses, such as ion channels and receptors for neurotransmitters.1 Other ...

Jonathan M. Coutinho, MD, PhD

The publication of 5 randomized trials in 2015 unequivocally established that mechanical thrombectomy is the new standard of care for patients with acute ischemic stroke and an occlusion of the proximal anterior circulation.1 Although those trials mark a huge advancement in the field of stroke, important questions ...

Original Investigation 
Boyan Fang, MD, PhD; Andrew McKeon, MD; Shannon R. Hinson, PhD; Thomas J. Kryzer, AA; Sean J. Pittock, MD; Allen J. Aksamit, MD; Vanda A. Lennon, MD, PhD
Includes: Supplemental Content

Importance  A novel astrocytic autoantibody has been identified as a biomarker of a relapsing autoimmune meningoencephalomyelitis that is immunotherapy responsive. Seropositivity distinguishes autoimmune glial fibrillary acidic protein (GFAP) meningoencephalomyelitis from disorders commonly considered in the differential diagnosis.

Objective  To describe a novel IgG autoantibody found in ...

Original Investigation 
Amrou Sarraj, MD; Navdeep Sangha, MD; Muhammad Shazam Hussain, MD; Dolora Wisco, MD; Nirav Vora, MD; Lucas Elijovich, MD; Nitin Goyal, MD; Michael Abraham, MD; Manoj Mittal, MD; Lei Feng, MD; Abel Wu, MD; Vallabh Janardhan, MD; Suman Nalluri, MD; Albert J. Yoo, MD; Megan George, MD; Randall Edgell, MD; Rutvij J. Shah, MD; Clark Sitton, MD; Emilio Supsupin, MD; Suhas Bajgur, MD; M. Carter Denny, MD; Peng R. Chen, MD; Mark Dannenbaum, MD; Sheryl Martin-Schild, MD; Sean I. Savitz, MD; Rishi Gupta, MD
Includes: Supplemental Content

Importance  Randomized clinical trials have shown the superiority of endovascular therapy (EVT) compared with best medical management for acute ischemic strokes with large vessel occlusion (LVO) in the anterior circulation. However, of 1287 patients enrolled in 5 trials, 94 with isolated second (M2) segment occlusions were randomized ...

Images in Neurology 
Yara Dadalti Fragoso, MD, MSc, PhD; Joseph Bruno Bidin Brooks, MD, MSc

This case report describes a man in his 20s who was admitted with a clinical demyelination syndrome and a recent diagnosis of dengue fever.

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