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 Showing 1-20 of 41 Articles
The Oxford English Dictionary defines opportunistic as “exploiting chances offered by immediate circumstances.”1 The term was applied to pathogens, notably fungi, first in the early 1950s, and it came into increasingly widespread use after an International Symposium on Fungal Infections led by Utz in 19622 and a meeting of the ...
Original Investigation 
Kara M. Smith, MD; Eli Eyal, MSc; Daniel Weintraub, MD; for the ADAGIO Investigators
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Importance  Depression, cognitive impairment, and other nonmotor symptoms (NMSs) are common early in Parkinson disease (PD) and may be in part due to disease-related dopamine deficiency. Many patients with PD are treated with antidepressants for NMSs, and the effect of the combination of PD medications that enhance ...

Original Investigation 
Ann M. Arvin, MD; Jerry S. Wolinsky, MD; Ludwig Kappos, MD, PhD; Michele I. Morris, MD; Anthony T. Reder, MD; Carlo Tornatore, MD, PhD; Anne Gershon, MD; Michael Gershon, MD; Myron J. Levin, MD; Mauritz Bezuidenhoudt, MSc; Norman Putzki, MD
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Importance  Varicella-zoster virus (VZV) infections increasingly are reported in patients with multiple sclerosis (MS) and constitute an area of significant concern, especially with the advent of more disease-modifying treatments in MS that affect T-cell–mediated immunity.

Objective  To assess the incidence, risk factors, and clinical characteristics of ...

Case Report/Case Series 
Gráinne S. Gorman, MRCP; Gerald Pfeffer, MD; Helen Griffin, PhD; Emma L. Blakely, PhD; Marzena Kurzawa-Akanbi, PhD; Jessica Gabriel, BSc; Kamil Sitarz, PhD; Mark Roberts, MD, FRCP; Benedikt Schoser, MD; Angela Pyle, PhD; Andrew M. Schaefer, MRCP; Robert McFarland, PhD, MRCP; Douglass M. Turnbull, PhD, FRCP; Rita Horvath, MD; Patrick F. Chinnery, PhD, FRCP; Robert W. Taylor, PhD, FRCPath
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Importance  Progressive external ophthalmoplegia (PEO) is a common feature in adults with mitochondrial (mt) DNA maintenance disorders associated with somatic mtDNA deletions in muscle, yet the causal genetic defect in many patients remains undetermined.

Observations  Whole-exome sequencing identified a novel, heterozygous p.(Gly671Trp) mutation in the AFG3L2...

Steven Warach, MD, PhD
Soon after thrombolytic therapy was established as a therapy for ischemic stroke, our colleague Anthony Furlan, MD, famously circulated a cartoon of a computed tomographic (CT) scanner visible through the back doors of an ambulance, where a happy stroke physician had hung a bottle dripping tissue plasminogen activator (tPA) into ...
Original Investigation 
Ilir Agalliu, MD, ScD; Marta San Luciano, MD; Anat Mirelman, MD; Nir Giladi, MD; Bjorg Waro, MD; Jan Aasly, MD, PhD; Rivka Inzelberg, MD; Sharon Hassin-Baer, MD; Eitan Friedman, MD; Javier Ruiz-Martinez, MD; Jose Felix Marti-Masso, MD; Avi Orr-Urtreger, MD; Susan Bressman, MD; Rachel Saunders-Pullman, MD
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Importance  Patients with Parkinson disease (PD) who harbor LRRK2 G2019S mutations may have increased risks of nonskin cancers. However, the results have been inconsistent across studies.

Objectives  To analyze pooled data from 5 centers to further examine the association between LRRK2 G2019S mutation and cancer among ...

Original Investigation  FREE
Martin Ebinger, MD; Alexander Kunz, MD; Matthias Wendt, MD; Michal Rozanski, MD; Benjamin Winter, MD; Carolin Waldschmidt, MD; Joachim Weber, MD; Kersten Villringer, MD; Jochen B. Fiebach, MD; Heinrich J. Audebert, MD

Importance  The effectiveness of intravenous thrombolysis in acute ischemic stroke is time dependent. The effects are likely to be highest if the time from symptom onset to treatment is within 60 minutes, termed the golden hour.

Objective  To determine the achievable rate of golden hour ...

Case Report/Case Series 
Lorraine V. Kalia, MD, PhD; Anthony E. Lang, MD; Lili-Naz Hazrati, MD, PhD; Shinsuke Fujioka, MD; Zbigniew K. Wszolek, MD; Dennis W. Dickson, MD; Owen A. Ross, PhD; Vivianna M. Van Deerlin, MD, PhD; John Q. Trojanowski, MD, PhD; Howard I. Hurtig, MD; Roy N. Alcalay, MD; Karen S. Marder, MD, MPH; Lorraine N. Clark, PhD; Carles Gaig, MD; Eduardo Tolosa, MD, PhD; Javier Ruiz-Martínez, MD, PhD; Jose F. Marti-Masso, MD, PhD; Isidre Ferrer, MD, PhD; Adolfo López de Munain, MD, PhD; Samuel M. Goldman, MD, MPH; Birgitt Schüle, MD; J. William Langston, MD; Jan O. Aasly, MD; Maria T. Giordana, MD, PhD; Vincenzo Bonifati, MD, PhD; Andreas Puschmann, MD, PhD; Margherita Canesi, MD; Gianni Pezzoli, MD; Andre Maues De Paula, MD; Kazuko Hasegawa, MD; Charles Duyckaerts, MD, PhD; Alexis Brice, MD, PhD; A. Jon Stoessl, MD; Connie Marras, MD, PhD
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Importance  Mutations in leucine-rich repeat kinase 2 (LRRK2) are the most common cause of genetic Parkinson disease (PD) known to date. The clinical features of manifesting LRRK2 mutation carriers are generally indistinguishable from those of patients with sporadic PD. However, some PD cases associated with ...

Ivan Rocha Ferreira Da Silva, MD; Jennifer A. Frontera, MD

Importance  The disparity between patients awaiting organ transplantation and organ availability increases each year. As a consequence, organ trafficking has emerged and developed into a multibillion-dollar-a-year industry.

Objective  To identify and address barriers to organ donation in the United States and globally.

Evidence Review  Evidence-based ...

Original Investigation 
Eoin P. Flanagan, MBBCh; Brian G. Weinshenker, MD; Karl N. Krecke, MD; Vanda A. Lennon, MD, PhD; Claudia F. Lucchinetti, MD; Andrew McKeon, MBBCh; Dean M. Wingerchuk, MD; Elizabeth A. Shuster, MD; Yujuan Jiao, MD; Erika S. Horta, MD; Sean J. Pittock, MD

Importance  Short transverse myelitis (STM; <3 vertebral segments) is considered noncharacteristic of neuromyelitis optica (NMO) spectrum disorders (NMOSDs). Nonappreciation of the potential for STM to occur in NMOSD may lead to increased disability from delay in diagnosis and appropriate treatment.

Objectives  To determine the frequency of ...

Original Investigation 
Nimeshan Geevasinga, MBBS; Parvathi Menon, MBBS; James Howells, PhD; Garth A. Nicholson, PhD; Matthew C. Kiernan, DSc; Steve Vucic, PhD

Importance  Abnormalities of axonal excitability characterized by upregulation of persistent sodium (Na+) conductances and reduced potassium (K+) currents have been reported in sporadic amyotrophic lateral sclerosis (SALS) phenotypes and linked to the development of clinical features such as fasciculations and neurodegeneration.

Objective  ...

Original Investigation 
Enyinna L. Nwachuku, BS; Jeffrey R. Balzer, PhD; Jonathan G. Yabes, PhD; Miguel E. Habeych, MD, MPH; Donald J. Crammond, PhD; Parthasarathy D. Thirumala, MD, MS
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Importance  Perioperative stroke is a persistent complication of carotid endarterectomy (CEA) for patients with symptomatic carotid stenosis (CS).

Objective  To evaluate whether changes in somatosensory evoked potential (SSEP) during CEA are diagnostic of perioperative stroke in patients with symptomatic CS.

Design, Setting, and Participants  We ...

Original Investigation 
Feng-Cheng Lin, MD; Ching-Piao Tsai, MD; Johnny Kuang-Wu Lee, PhD; Ming-Tsang Wu, MD, DSc; Charles Tzu-Chi Lee, PhD

Importance  Although several studies have shown that use of angiotensin-converting enzyme inhibitors (ACEIs) potentially decreased amyotrophic lateral sclerosis (ALS) risk in animal models, to our knowledge, there has been no human study in the literature discussing this issue.

Objective  To investigate the association between the use ...

Case Report/Case Series 
Robert Fleischmann, MD; Harald Prüss, MD; Berit Rosche, MD; Markus Bahnemann, MD; Harald Gelderblom, MD; Katrin Deuschle, MD; Lutz Harms, MD; Ute Kopp, MD; Klemens Ruprecht, MD
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Importance  Some patients with multiple sclerosis (MS) can either present with or develop severe cognitive impairment during the course of their disease. However, the mechanisms underlying severe cognitive dysfunction in MS are not well understood.

Observations  We report on a woman who was diagnosed as having ...

Takayuki Itoh, MD, PhD; David Pleasure, MD
This viewpoint focuses on the technological advances in nucleotide sequencing and genetic engineering and on our deepening understanding of the molecular processes underlying Schwann cell–axon interactions and axonal degeneration.
Bryan J. Traynor, MD, PhD; Alan E. Renton, PhD
Genome-wide association studies have been tremendously successful at unraveling the genetic architecture of neurological disorders (see http://www.genome.gov/gwastudies/ for an updated list). Alzheimer disease is a particularly good example of the power of this technology, with multiple loci already identified.1 Although the publication of a susceptibility locus is an important milestone ...
Original Investigation 
Jeffrey M. Gelfand, MD, MAS; Gillian Genrich, MD, MPH; Ari J. Green, MD, MAS; Tarik Tihan, MD, PhD; Bruce A. C. Cree, MD, PhD, MAS

Importance  Brain biopsy specimens that exhibit encephalitis without specific histopathologic features pose a diagnostic challenge to neuropathologists and neurologists. Such cases are generally referred to pathologically as encephalitis, not otherwise specified (ENOS). A systematic approach to diagnostic evaluation in such patients is challenging, and currently there is ...

Original Investigation 
Lei Yu, PhD; Lori B. Chibnik, PhD; Gyan P. Srivastava, PhD; Nathalie Pochet, PhD; Jingyun Yang, PhD; Jishu Xu, MS; James Kozubek, MS; Nikolaus Obholzer, PhD; Sue E. Leurgans, PhD; Julie A. Schneider, MD; Alexander Meissner, PhD; Philip L. De Jager, MD, PhD; David A. Bennett, MD
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Importance  Recent large-scale genome-wide association studies have discovered several genetic variants associated with Alzheimer disease (AD); however, the extent to which DNA methylation in these AD loci contributes to the disease susceptibility remains unknown.

Objective  To examine the association of brain DNA methylation in 28 reported ...

Clinical Implications of Basic Neuroscience Research 
Netanel Korin, PhD; Matthew J. Gounis, PhD; Ajay K. Wakhloo, MD, PhD; Donald E. Ingber, MD, PhD

Obstruction of normal blood flow, which occurs in a variety of diseases, including thromboembolism in stroke and atherosclerosis, is a leading cause of death and long-term adult disability in the Western world. This review focuses on a novel nanotherapeutic drug-delivery platform that is mechanically activated within blood vessels ...

Steven T. DeKosky, MD
In Alois Alzheimer’s day, medical students studied Greek and Latin to better understand the derivation (and sometimes the function) of organs and processes, since they form the roots of so many of our medical terms. While not studied as widely now, every person in the United States learns the Latin ...

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