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JAMA Neurology

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https://read.qxmd.com/read/31515562/serum-neurofilament-light-chain-levels-in-patients-with-presymptomatic-multiple-sclerosis
#1
Kjetil Bjornevik, Kassandra L Munger, Marianna Cortese, Christian Barro, Brian C Healy, David W Niebuhr, Ann I Scher, Jens Kuhle, Alberto Ascherio
Importance: Unrecognized demyelinating events often precede the clinical onset of multiple sclerosis (MS). Identification of these events at the time of occurrence would have implications for early diagnosis and the search of causal factors for the disease. Objective: To assess whether serum neurofilament light chain (sNfL) levels are elevated before the clinical MS onset. Design, Setting, and Participants: Nested case-control study among US military personnel who have serum samples stored in the US Department of Defense Serum Repository...
September 13, 2019: JAMA Neurology
https://read.qxmd.com/read/31498378/scientific-advances-in-and-clinical-approaches-to-small-fiber-polyneuropathy-a-review
#2
Anne Louise Oaklander, Maria Nolano
Importance: Small-fiber polyneuropathy involves preferential damage to the thinly myelinated A-delta fibers, unmyelinated C sensory fibers, or autonomic or trophic fibers. Although this condition is common, most patients still remain undiagnosed and untreated because of lagging medical and public awareness of research advances. Chronic bilateral neuropathic pain, fatigue, and nausea are cardinal symptoms that can cause disability and dependence, including pain medication dependence. Observations: Biomarker confirmation is recommended, given the nonspecificity of symptoms...
September 9, 2019: JAMA Neurology
https://read.qxmd.com/read/31498376/association-of-intracranial-pressure-and-spontaneous-retinal-venous-pulsation
#3
Linda D'Antona, James A McHugh, Federico Ricciardi, Lewis W Thorne, Manjit S Matharu, Laurence D Watkins, Ahmed K Toma, Fion D Bremner
Importance: A convenient and reliable method for noninvasive intracranial pressure assessments is desirable to reduce the need for invasive procedures (eg, intracranial pressure monitoring and lumbar punctures) and allow clinicians to identify and treat patients with intracranial hypertension in a timely manner. Objective: To determine whether infrared video assessment of spontaneous retinal venous pulsation is associated with intracranial pressure and is a valid tool to indicate the presence or absence of raised intracranial pressure in patients without papilledema...
September 9, 2019: JAMA Neurology
https://read.qxmd.com/read/31498371/association-of-cavum-septum-pellucidum-and-cavum-vergae-with-cognition-mood-and-brain-volumes-in-professional-fighters
#4
Jonathan K Lee, Jenny Wu, Jennifer Bullen, Sarah Banks, Charles Bernick, Michael T Modic, Paul Ruggieri, Lauren Bennett, Stephen E Jones
Importance: Many studies have investigated the imaging findings showing sequelae of repetitive head trauma, with mixed results. Objective: To determine whether fighters (boxers and mixed martial arts fighters) with cavum septum pellucidum (CSP) and cavum vergae (CV) have reduced volumes in various brain structures or worse clinical outcomes on cognitive and mood testing. Design, Setting, and Participants: This cohort study assessed participants from the Professional Fighters Brain Health Study...
September 9, 2019: JAMA Neurology
https://read.qxmd.com/read/31479149/progressive-multifocal-leukoencephalopathy-incidence-and-risk-stratification-among-natalizumab-users-in-france
#5
Sandra Vukusic, Fabien Rollot, Romain Casey, Julie Pique, Romain Marignier, Guillaume Mathey, Gilles Edan, David Brassat, Aurélie Ruet, Jérôme De Sèze, Elisabeth Maillart, Hélène Zéphir, Pierre Labauge, Nathalie Derache, Christine Lebrun-Frenay, Thibault Moreau, Sandrine Wiertlewski, Eric Berger, Xavier Moisset, Audrey Rico-Lamy, Bruno Stankoff, Caroline Bensa, Eric Thouvenot, Olivier Heinzlef, Abdullatif Al-Khedr, Bertrand Bourre, Mathieu Vaillant, Philippe Cabre, Alexis Montcuquet, Abir Wahab, Jean-Philippe Camdessanché, Ayman Tourbah, Anne-Marie Guennoc, Karolina Hankiewicz, Ivania Patry, Chantal Nifle, Nicolas Maubeuge, Céline Labeyrie, Patrick Vermersch, David-Axel Laplaud
Importance: Risk of developing progressive multifocal leukoencephalopathy (PML) is the major barrier to using natalizumab for patients with multiple sclerosis (MS). To date, the association of risk stratification with PML incidence has not been evaluated. Objective: To describe the temporal evolution of PML incidence in France before and after introduction of risk minimization recommendations in 2013. Design, Setting, and Participants: This observational study used data in the MS registry OFSEP (Observatoire Français de la Sclérose en Plaques) collected between April 15, 2007, and December 31, 2016, by participating MS expert centers and MS-dedicated networks of neurologists in France...
September 3, 2019: JAMA Neurology
https://read.qxmd.com/read/31479116/prehospital-stroke-management-optimized-by-use-of-clinical-scoring-vs-mobile-stroke-unit-for-triage-of-patients-with-stroke-a-randomized-clinical-trial
#6
Stefan A Helwig, Andreas Ragoschke-Schumm, Lenka Schwindling, Michael Kettner, Safwan Roumia, Johann Kulikovski, Isabel Keller, Matthias Manitz, Daniel Martens, Daniel Grün, Silke Walter, Martin Lesmeister, Kira Ewen, Jannik Brand, Mathias Fousse, Jil Kauffmann, Valerie C Zimmer, Shrey Mathur, Thomas Bertsch, Jürgen Guldner, Achim Magull-Seltenreich, Andreas Binder, Elmar Spüntrup, Anastasios Chatzikonstantinou, Oliver Adam, Kai Kronfeld, Yang Liu, Christian Ruckes, Helmut Schumacher, Iris Q Grunwald, Umut Yilmaz, Thomas Schlechtriemen, Wolfgang Reith, Klaus Fassbender
Importance: Transferring patients with large-vessel occlusion (LVO) or intracranial hemorrhage (ICH) to hospitals not providing interventional treatment options is an unresolved medical problem. Objective: To determine how optimized prehospital management (OPM) based on use of the Los Angeles Motor Scale (LAMS) compares with management in a Mobile Stroke Unit (MSU) in accurately triaging patients to the appropriate hospital with (comprehensive stroke center [CSC]) or without (primary stroke center [PSC]) interventional treatment...
September 3, 2019: JAMA Neurology
https://read.qxmd.com/read/31479107/getting-the-right-patient-to-the-right-place-in-the-right-amount-of-time-a-role-for-both-mobile-stroke-units-and-prehospital-clinical-scales
#7
Jason McMullan, Pooja Khatri
No abstract text is available yet for this article.
September 3, 2019: JAMA Neurology
https://read.qxmd.com/read/31479105/safety-and-efficacy-of-dabigatran-etexilate-vs-dose-adjusted-warfarin-in-patients-with-cerebral-venous-thrombosis-a-randomized-clinical-trial
#8
José M Ferro, Jonathan M Coutinho, Francesco Dentali, Adam Kobayashi, Andrey Alasheev, Patrícia Canhão, Denis Karpov, Simon Nagel, Laura Posthuma, José Mário Roriz, Jorge Caria, Mandy Frässdorf, Holger Huisman, Paul Reilly, Hans-Christoph Diener
Importance: Patients with cerebral venous thrombosis (CVT) are at risk of recurrent venous thrombotic events (VTEs). Non-vitamin K oral anticoagulants have not been evaluated in randomized controlled trials in CVT. Objective: To compare the efficacy and safety of dabigatran etexilate with those of dose-adjusted warfarin in preventing recurrent VTEs in patients who have experienced a CVT. Design, Setting, and Participants: RE-SPECT CVT is an exploratory, prospective, randomized (1:1), parallel-group, open-label, multicenter clinical trial with blinded end-point adjudication (PROBE design)...
September 3, 2019: JAMA Neurology
https://read.qxmd.com/read/31479102/a-case-of-progressive-myelopathy-in-a-middle-aged-woman
#9
Alexandra Muccilli, Romain Cayrol, Kathryn A Kvam
No abstract text is available yet for this article.
September 3, 2019: JAMA Neurology
https://read.qxmd.com/read/31449296/association-of-concussion-symptoms-with-testosterone-levels-and-erectile-dysfunction-in-former-professional-us-style-football-players
#10
Rachel Grashow, Marc G Weisskopf, Karen K Miller, David M Nathan, Ross Zafonte, Frank E Speizer, Theodore K Courtney, Aaron Baggish, Herman A Taylor, Alvaro Pascual-Leone, Lee M Nadler, Andrea L Roberts
Importance: Small studies suggest that head trauma in men may be associated with low testosterone levels and sexual dysfunction through mechanisms that likely include hypopituitarism secondary to ischemic injury and pituitary axonal tract damage. Athletes in contact sports may be at risk for pituitary insufficiencies or erectile dysfunction (ED) because of the high number of head traumas experienced during their careers. Whether multiple symptomatic concussive events are associated with later indicators of low testosterone levels and ED is unknown...
August 26, 2019: JAMA Neurology
https://read.qxmd.com/read/31449293/trends-in-prices-market-share-and-spending-on-self-administered-disease-modifying-therapies-for-multiple-sclerosis-in-medicare-part-d
#11
Alvaro San-Juan-Rodriguez, Chester B Good, Rock A Heyman, Natasha Parekh, William H Shrank, Inmaculada Hernandez
Importance: Before 2009, only 4 self-administered disease-modifying therapies (DMTs) were approved for the treatment of multiple sclerosis (MS). Since then, 7 new agents have entered the market. Objective: To assess trends in prices, market share, and spending on self-administered DMTs for MS in Medicare Part D from 2006 through 2016. Design, Setting, and Participants: This cohort study used claims data from 2006 through 2016 from a 5% random sample of Medicare beneficiaries (a mean of 2...
August 26, 2019: JAMA Neurology
https://read.qxmd.com/read/31449289/addressing-the-rising-prices-of-disease-modifying-therapies-for-multiple-sclerosis
#12
Daniel M Hartung, Dennis Bourdette
No abstract text is available yet for this article.
August 26, 2019: JAMA Neurology
https://read.qxmd.com/read/31424491/effect-of-recombinant-activated-coagulation-factor-vii-on-hemorrhage-expansion-among-patients-with-spot-sign-positive-acute-intracerebral-hemorrhage-the-spotlight-and-stop-it-randomized-clinical-trials
#13
David J Gladstone, Richard I Aviv, Andrew M Demchuk, Michael D Hill, Kevin E Thorpe, Jane C Khoury, Heidi J Sucharew, Fahad Al-Ajlan, Ken Butcher, Dar Dowlatshahi, Gord Gubitz, Stephanie De Masi, Judith Hall, David Gregg, Muhammad Mamdani, Michel Shamy, Richard H Swartz, C Martin Del Campo, Brett Cucchiara, Peter Panagos, Joshua N Goldstein, Janice Carrozzella, Edward C Jauch, Joseph P Broderick, Matthew L Flaherty
Importance: Intracerebral hemorrhage (ICH) is a devastating stroke type that lacks effective treatments. An imaging biomarker of ICH expansion-the computed tomography (CT) angiography spot sign-may identify a subgroup that could benefit from hemostatic therapy. Objective: To investigate whether recombinant activated coagulation factor VII (rFVIIa) reduces hemorrhage expansion among patients with spot sign-positive ICH. Design, Setting, and Participants: In parallel investigator-initiated, multicenter, double-blind, placebo-controlled randomized clinical trials in Canada ("Spot Sign" Selection of Intracerebral Hemorrhage to Guide Hemostatic Therapy [SPOTLIGHT]) and the United States (The Spot Sign for Predicting and Treating ICH Growth Study [STOP-IT]) with harmonized protocols and a preplanned individual patient-level pooled analysis, patients presenting to the emergency department with an acute primary spontaneous ICH and a spot sign on CT angiography were recruited...
August 19, 2019: JAMA Neurology
https://read.qxmd.com/read/31424490/evaluation-of-the-central-vein-sign-as-a-diagnostic-imaging-biomarker-in-multiple-sclerosis
#14
Tim Sinnecker, Margareta A Clarke, Dominik Meier, Christian Enzinger, Massimiliano Calabrese, Nicola De Stefano, Alain Pitiot, Antonio Giorgio, Menno M Schoonheim, Friedemann Paul, Mikolaj A Pawlak, Reinhold Schmidt, Ludwig Kappos, Xavier Montalban, Àlex Rovira, Nikos Evangelou, Jens Wuerfel
Importance: The central vein sign has been proposed as a specific imaging biomarker for distinguishing between multiple sclerosis (MS) and not MS, mainly based on findings from ultrahigh-field magnetic resonance imaging (MRI) studies. The diagnostic value of the central vein sign in a multicenter setting with a variety of clinical 3 tesla (T) MRI protocols, however, remains unknown. Objective: To evaluate the sensitivity and specificity of various central vein sign lesion criteria for differentiating MS from non-MS conditions using 3T brain MRI with various commonly used pulse sequences...
August 19, 2019: JAMA Neurology
https://read.qxmd.com/read/31424488/time-for-neurologists-to-drop-the-reflex-hammer-on-hypertension
#15
John Betjemann, J Claude Hemphill, Urmimala Sarkar
No abstract text is available yet for this article.
August 19, 2019: JAMA Neurology
https://read.qxmd.com/read/31424481/outcomes-associated-with-clopidogrel-aspirin-use-in-minor-stroke-or-transient-ischemic-attack-a-pooled-analysis-of-clopidogrel-in-high-risk-patients-with-acute-non-disabling-cerebrovascular-events-chance-and-platelet-oriented-inhibition-in-new-tia-and-minor
#16
Yuesong Pan, Jordan J Elm, Hao Li, J Donald Easton, Yilong Wang, Mary Farrant, Xia Meng, Anthony S Kim, Xingquan Zhao, William J Meurer, Liping Liu, Dennis Dietrich, Yongjun Wang, S Claiborne Johnston
Importance: Dual antiplatelet therapy with clopidogrel and aspirin is effective for secondary prevention after minor ischemic stroke or transient ischemic attack (TIA). Uncertainties remained about the optimal duration of dual antiplatelet therapy for minor stroke or TIA. Objective: To obtain precise estimates of efficacy and risk of dual antiplatelet therapy after minor ischemic stroke or TIA. Design, Setting, and Participants: This analysis pooled individual patient-level data from 2 large-scale randomized clinical trials that evaluated clopidogrel-aspirin as a treatment to prevent stroke after a minor stroke or high-risk TIA...
August 19, 2019: JAMA Neurology
https://read.qxmd.com/read/31424478/is-hyperselection-of-patients-the-right-strategy
#17
Barbara Casolla, Charlotte Cordonnier
No abstract text is available yet for this article.
August 19, 2019: JAMA Neurology
https://read.qxmd.com/read/31424476/trends-in-location-of-death-for-individuals-with-cerebrovascular-disease-in-the-united-states
#18
Sarah H Cross, Brystana G Kaufman, Haider J Warraich
No abstract text is available yet for this article.
August 19, 2019: JAMA Neurology
https://read.qxmd.com/read/31403680/association-of-cag-repeats-with-long-term-progression-in-huntington-disease
#19
Douglas R Langbehn, Julie C Stout, Sarah Gregory, James A Mills, Alexandra Durr, Blair R Leavitt, Raymund A C Roos, Jeffrey D Long, Gail Owen, Hans J Johnson, Beth Borowsky, David Craufurd, Ralf Reilmann, G Bernhard Landwehrmeyer, Rachael I Scahill, Sarah J Tabrizi
Importance: In Huntington disease (HD), mutation severity is defined by the length of the CAG trinucleotide sequence, a well-known predictor of clinical onset age. The association with disease trajectory is less well characterized. Quantifiable summary measures of trajectory applicable over decades of early disease progression are lacking. An accurate model of the age-CAG association with early progression is critical to clinical trial design, informing both sample size and intervention timing...
August 12, 2019: JAMA Neurology
https://read.qxmd.com/read/31403674/association-of-chronic-active-multiple-sclerosis-lesions-with-disability-in-vivo
#20
Martina Absinta, Pascal Sati, Federica Masuzzo, Govind Nair, Varun Sethi, Hadar Kolb, Joan Ohayon, Tianxia Wu, Irene C M Cortese, Daniel S Reich
Importance: In multiple sclerosis (MS), chronic active lesions, which previously could only be detected at autopsy, can now be identified on susceptibility-based magnetic resonance imaging (MRI) in vivo as non-gadolinium-enhancing lesions with paramagnetic rims. Pathologically, they feature smoldering inflammatory demyelination at the edge, remyelination failure, and axonal degeneration. To our knowledge, the prospect of long-term in vivo monitoring makes it possible for the first time to determine their contribution to disability and value as a treatment target...
August 12, 2019: JAMA Neurology
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