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Basic View | Expanded View
 Showing 1-20 of 75 Articles
Viewpoint 
Sara K. Rostanski, MD; Randolph S. Marshall, MD, MS

This Viewpoint discusses the future of precision medicine in the field of ischemic stroke, first looking at the current status of genetic approaches and then exploring the status of phenotype-based delineations.

“Do no harm” is the timeless tenet of the Hippocratic Oath. It applies not only to how patients tolerate prescribed treatments but also to how they tolerate treatments after discontinuation. The sum of both events must be considered in the overall risk-benefit ratio before starting any given treatment.

...
Original Investigation 
Anastasia Zekeridou, MD; Andrew McKeon, MD; Vanda A. Lennon, MD, PhD

Importance  Thymoma is commonly recognized in association with paraneoplastic autoimmune myasthenia gravis (MG), an IgG–mediated impairment of synaptic transmission targeting the nicotinic acetylcholine receptor of muscle. Newly identified synaptic autoantibodies may expand the serological profile of thymoma.

Objective  To investigate the frequency of potentially pathogenic neural ...

Original Investigation  FREE
Stacy Ellen Hatcher, BS; Emmanuelle Waubant, MD, PhD; Bardia Nourbakhsh, MD; Elizabeth Crabtree-Hartman, MD; Jennifer S. Graves, MD, PhD, MAS

Importance  The appropriate sequencing of agents with strong immune system effects has become increasingly important. Transitions require careful balance between safety and protection against relapse. The cases presented herein highlight that rebound events after ceasing fingolimod treatment may happen even with short washout periods (4 weeks) and ...

Review 
Roger N. Rosenberg, MD; Doris Lambracht-Washington, PhD; Gang Yu, PhD; Weiming Xia, PhD
Includes: Supplemental Content

Importance  To provide a comprehensive review of knowledge of the genomics of Alzheimer disease (AD) and DNA amyloid β 42 (Aβ42) vaccination as a potential therapy.

Observations  Genotype-phenotype correlations of AD are presented to provide a comprehensive appreciation of the spectrum of disease causation. Alzheimer disease ...

Comment & Response 
Tomoyuki Kawada, MD

To the Editor Fisher and colleagues1 conducted an evaluation of factors affecting the preventability of stroke, with special reference to treatment and comorbidity. Preventability of the presenting stroke was scored and univariate analysis was selected for the limited number of patients. I have some queries on their ...

Comment & Response 
Mark Fisher, MD; Lisa Moores, RN; Annlia Paganini-Hill, PhD

In Reply We appreciate the interest of Kawada in our work.1 Our study was designed to analyze the association between ischemic stroke prevention and treatment; we defined our variables and conducted our data analysis accordingly. We disagree with Kawada’s statement that the “empirical method is not suitable ...

Correction  FREE

In the Clinical Challenge titled “Leptomeningeal Enhancement in a Patient With Progressive Cranial Neuropathies and Lumbosacral Radiculopathies,”1 published online January 25, 2016, there was an error in author Richard L. Thomas’s degree listing. His affiliation should read “Robert L. Thomas, MD.” This article was corrected online.

The discovery by Dalmau and colleagues1 less than 10 years ago that antibodies targeting the N-methyl-d-aspartate receptor (NMDAR) cause autoimmune encephalitis has had serious implications. That discovery showed us a new type of disorder, which has led to the identification of more than 10 ...

Editorial 
Robert D. S. Pitceathly, MD, PhD

Mitochondrial disorders pose a major diagnostic challenge to clinicians given their significant phenotypic and genetic diversity. This dilemma is underpinned by the dual genomic expression of mitochondrial proteins, which are encoded by both nuclear and mitochondrial genetic material. Mitochondrial DNA (mtDNA)–related disease is further complicated by polyploidy, with ...

Editorial 
Paul Geha, MD; Stephen G. Waxman, MD, PhD

Acute or transient pain activates a large set of brain regions, including thalamus, primary and secondary somatosensory areas, insula, anterior cingulate cortex (ACC), and periaqueductal gray matter, areas collectively referred to as the pain matrix, with variable activation of striatum (dorsal and ventral), amygdala, and medial and ...

Original Investigation 
Takahiro Iizuka, MD; Juntaro Kaneko, MD; Naomi Tominaga, MD; Hidehiro Someko, MD; Masaaki Nakamura, MD; Daisuke Ishima, MD; Eiji Kitamura, MD; Ray Masuda, MD; Eiichi Oguni, MD, PhD; Toshiyuki Yanagisawa, MD; Naomi Kanazawa, BS; Josep Dalmau, MD, PhD; Kazutoshi Nishiyama, MD, PhD
Includes: Supplemental Content

Importance  Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an immune-mediated disorder that occurs with IgG antibodies against the GluN1 subunit of NMDAR. Some patients develop reversible diffuse cerebral atrophy (DCA), but the long-term clinical significance of progressive brain and cerebellar atrophy is unknown.

Objective  ...

Editorial: Prognosis of Anti-N-Methyl-d-Aspartate Receptor Encephalitis; Maarten J. Titulaer, MD, PhD
Original Investigation 
Mika H. Martikainen, MD, PhD; Yi Shiau Ng, MRCP; Gráinne S. Gorman, PhD, FRCP; Charlotte L. Alston, BSc (Hons); Emma L. Blakely, PhD, FRCPath; Andrew M. Schaefer, MRCP; Patrick F. Chinnery, PhD, FRCP; David J. Burn, PhD, FRCP; Robert W. Taylor, PhD, FRCPath; Robert McFarland, PhD, MRCP, MRCPCH; Doug M. Turnbull, PhD, FRCP
Includes: Supplemental Content

Importance  Extrapyramidal movement disorders associated with mitochondrial disease are difficult to treat and can lead to considerable disability. Moreover, potential new treatment trials on the horizon highlight the importance of genotype-phenotype associations and deep phenotyping of the movement disorders related to mitochondrial disease.

Objective  To describe ...

Editorial: Mitochondrial Extrapyramidal Syndromes; Robert D. S. Pitceathly, MD, PhD
Original Investigation 
Miguel A. Santos-Santos, MD; Maria Luisa Mandelli, PhD; Richard J. Binney, PhD; Jennifer Ogar, MS; Stephen M. Wilson, PhD; Maya L. Henry, PhD; H. Isabel Hubbard, PhD; Minerva Meese, MS, CCC-SLP; Suneth Attygalle, BS; Lynne Rosenberg, BS; Mikhail Pakvasa, BS; John Q. Trojanowski, MD; Lea T. Grinberg, MD, PhD; Howie Rosen, MD; Adam L. Boxer, MD, PhD; Bruce L. Miller, MD; William W. Seeley, MD; Maria Luisa Gorno-Tempini, MD, PhD
Includes: Supplemental Content

Importance  We provide novel evidence of specific clinical and neuroimaging features that may help for the in vivo prediction of underlying pathology in patients with nonfluent/agrammatic primary progressive aphasia (nfvPPA) and progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD) proved by autopsy.

Objective  To characterize the ...

Review 
Nicole Reams, MD; James T. Eckner, MD, MS; Andrea A. Almeida, MD; Andrea L. Aagesen, DO; Bruno Giordani, PhD; Hank Paulson, MD; Matthew T. Lorincz, MD, PhD; Jeffrey S. Kutcher, MD

Importance  Chronic traumatic encephalopathy (CTE) refers to pathologic changes that have been found in some individuals with a history of repetitive traumatic impact to the head (hereinafter referred to as head trauma). These changes cannot be assessed during the clinical evaluation of a living patient.

Observations  ...

Research Letter 
Tim V. Salomons, PhD; Gian Domenico Iannetti, MD, PhD; Meng Liang, PhD; John N. Wood, PhD

This study administered noxious mechanical stimuli to individuals with congenital insensitivity to pain and sampled their brain activity with functional magnetic resonance imaging.

Editorial: Pain Perception; Paul Geha, MD; Stephen G. Waxman, MD, PhD
Comment & Response 
Robert H. Howland, MD

To the Editor In their analysis of data from a prospective cohort study, Miller and colleagues1 found that cross-sectional differences in cognitive ability were only weakly associated with vitamin D concentrations at baseline, whereas they found small statistically significant differences in trajectories of cognitive performance during follow-up ...

In this issue of JAMA Neurology, Yokoyama et al1 provide a major intellectual and technological advance in our understanding of the relationship between the immune system and Alzheimer disease.

Editorial 
Juan M. Pascual, MD, PhD

Voltage-gated sodium channels are among the most active and ubiquitous molecular machines found in animals. Residing in the cell membranes of excitable and other cells, they derive energy for their opening and closing from changes in membrane potential. In some cells, particularly those in sensory information–encoding structures of ...

Using intravenous thrombolysis in a stroke patient with cerebral microbleeds represents one of the most challenging clinical decisions in acute stroke neurology. In this setting, the implications of coexisting ischemic and hemorrhagic cerebrovascular disease (mixed cerebrovascular disease)1 must be confronted and urgently addressed. The clinical ...

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