Staging β-Amyloid Pathology With Amyloid Positron Emission Tomography
This multicenter longitudinal cohort study of 741 participants uses in vivo β-amyloid cerebrospinal fluid and positron emission tomography findings to track progression of Alzheimer disease across 6 years of follow-up. (Source: JAMA Neurology)
Source: JAMA Neurology - July 17, 2019 Category: Neurology Source Type: research

Associations of Physical Activity and β-Amyloid With Cognition and Neurodegeneration in Clinically Normal Older Adults
This study examines whether physical activity moderates the association of β-amyloid burden with longitudinal cognitive decline and neurodegeneration in clinically normal individuals. (Source: JAMA Neurology)
Source: JAMA Neurology - July 16, 2019 Category: Neurology Source Type: research

A Case of Muscle Twitching With Psoriasis
A 42-year-old man presents with a 2-month history of persistent muscle twitching in his abdomen and bilateral calves during wakefulness and sleep accompanied with excessive sweating, as well as mild bilateral lower extremity weakness after prolonged walking. What is your diagnosis? (Source: JAMA Neurology)
Source: JAMA Neurology - July 15, 2019 Category: Neurology Source Type: research

The Challenge of Defining Alzheimer Disease Based on Biomarkers in the Absence of Symptoms
The search for biomarkers in Alzheimer disease (AD) has been driven by the expectation that such markers will facilitate diagnosis in advance of significant clinical impairment, as well as serve as surrogate markers for clinical trials. The leading biomarkers now in practice are directed at early identification of the 2 neuropathologic hallmarks of the disorder, namely, amyloid plaques and neurofibrillary tangles. The widely defended view is that these pathologic changes silently accumulate in the brain over years if not decades before symptoms occur. Therefore, having meaningful biomarkers would have the potential to shap...
Source: JAMA Neurology - July 15, 2019 Category: Neurology Source Type: research

Combined Cerebral Microbleeds With Lacunar Infarctions in Familial Cerebral Cavernous Malformations
This case report describes a 62-year-old man who presented with dizziness, right-sided numbness, and mild weakness for 10 days. (Source: JAMA Neurology)
Source: JAMA Neurology - July 15, 2019 Category: Neurology Source Type: research

Dysregulation of the Reward and Learning Systems in Tourette Syndrome
To the Editor In their cohort study, Brander et al observed an increased risk of metabolic and cardiovascular diseases in patients with Tourette syndrome (TS) and chronic tic disorder. This risk was even higher in patients with comorbid attention-deficit/hyperactivity disorder. Interestingly, metabolic and cardiovascular risks were already present at an early stage of the disorder and were actually decreased in patients that used antipsychotic medication for a longer time. These data are relevant for the field because they were previously unknown in this form and must be considered in the future care of these patients. (So...
Source: JAMA Neurology - July 15, 2019 Category: Neurology Source Type: research

Prevalence of Biologically vs Clinically Defined Alzheimer Spectrum Entities
This population-based cohort study estimates the sex- and age-specific prevalence of 3 imaging biomarker –based definitions of the Alzheimer disease spectrum from the National Institute on Aging–Alzheimer’s Association research framework and compares these entities with clinically defined diagnostic entities commonly linked with Alzheimer disease. (Source: JAMA Neurology)
Source: JAMA Neurology - July 15, 2019 Category: Neurology Source Type: research

Association of Obesity With MS Risk and First-line Drug Response in Children
This study examines whether high body mass index in children and adolescents is a factor in the onset of multiple sclerosis and in treatment response. (Source: JAMA Neurology)
Source: JAMA Neurology - July 15, 2019 Category: Neurology Source Type: research

Association of Extracellular Vesicle Biomarkers With Alzheimer Disease
This case-control study examines neuronal-enriched extracellular vesicles as predictors of Alzheimer disease. (Source: JAMA Neurology)
Source: JAMA Neurology - July 15, 2019 Category: Neurology Source Type: research

Association of Lifespan Cognitive Reserve Indicator With Dementia Risk in the Presence of Brain Pathologies
This cohort study examines the association of lifespan cognitive reserve with dementia risk. (Source: JAMA Neurology)
Source: JAMA Neurology - July 14, 2019 Category: Neurology Source Type: research

Association Between Idiopathic Intracranial Hypertension and Cardiovascular Risk in Women
This study analyzes the electronic medical records stored in The Health Improvement Network database of UK women with idiopathic intracranial hypertension to identify their cardiometabolic risks and outcomes. (Source: JAMA Neurology)
Source: JAMA Neurology - July 8, 2019 Category: Neurology Source Type: research

Association Between Caregiver Depression and Emergency Department Use Among Patients With Dementia
This cohort study uses data from the Care Ecosystem study to investigate whether caregiver depression is associated with increased use of the emergency department among patients with dementia. (Source: JAMA Neurology)
Source: JAMA Neurology - July 8, 2019 Category: Neurology Source Type: research

Safety and Efficacy of Edonerpic Maleate for Patients With Mild to Moderate Alzheimer Disease
This phase 2 randomized clinical trial assesses the efficacy, safety, and tolerability of edonerpic maleate for patients with mild to moderate Alzheimer disease. (Source: JAMA Neurology)
Source: JAMA Neurology - July 8, 2019 Category: Neurology Source Type: research

Why Do You Want To Be A Physician?
This essay describes a standard question from medical school interviews that first annoyed and then held special insight for the author. (Source: JAMA Neurology)
Source: JAMA Neurology - July 8, 2019 Category: Neurology Source Type: research

Recurrent Stroke With Rivaroxaban Compared With Aspirin According to Predictors of Atrial Fibrillation
This secondary analysis of a randomized clinical trial investigates whether rivaroxaban is associated with a reduction in recurrent stroke among patients with embolic stroke of undetermined source who have an increased risk of atrial fibrillation. (Source: JAMA Neurology)
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

July 2019 Issue Highlights
(Source: JAMA Neurology)
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

JAMA Neurology
Mission Statement: The mission of JAMA Neurology is to publish scientific information primarily important for those physicians caring for people with neurologic disorders but also for those interested in the structure and function of the normal and diseased nervous system. These specific aims are (1) to make timely publication of original research of the nervous system, (2) to record observations of single patients or groups of patients that will provide new information and insights, (3) to report more basic research that is pertinent to the understanding of disease, (4) to introduce topics of practice, ethics, teaching, a...
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Errors in Table 2 and Table 3
This article has been corrected online. (Source: JAMA Neurology)
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Comparison of Attention for Neurological Research on Social Media vs Academia
This study compared Altmetric scores of neurological research as a marker of “buzz” with citations as a marker of academic attention. (Source: JAMA Neurology)
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Dancing Dorsal Quadrilaterals —Organic or Functional?
To the Editor We read with interest the article by Lizarraga et al describing 4 patients with a novel peripherally induced movement disorder (PIMD) labeled as “dancing dorsal quadrilaterals (DDQ).” However, there are several concerns regarding the pathogenesis of these movements. First, in 2 of 4 cases (50%) presented by the authors, abnormal movements appeared over a period of 2 years after spine instrumentation. The diagnostic criteria for PIMD, whi le never validated, typically suggest 1 year as a maximum time delay between the injury and the onset of the movement. This is important in establishing an associ...
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Dancing Dorsal Quadrilaterals —Organic or Functional?—Reply
In Reply We thank Chouksey et al for their interest and the opportunity to further discuss the similarities and differences between functional movement disorders (FMD) and peripherally induced movement disorders (PIMD), particularly the dancing dorsal quadrilaterals (DDQ) syndrome that we described. As they indicate, the diagnostic criteria for PIMD have not been validated. Indeed, many potential examples of PIMD are eventually considered to represent FMD, and the concept of posttraumatic abnormal movements remains controversial. Nonetheless, FMD tend to occur immediately or shortly after minor peripheral trauma in a nonan...
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Progressive Cortical Thinning in Patients With Focal Epilepsy
This case-control study examines whether progressive cortical thinning in patients with focal epilepsy is distinct from cortical thinning associated with normal aging. (Source: JAMA Neurology)
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Effect of Stroke Education Pamphlets vs a 12-Minute Culturally Tailored Stroke Film
This cluster randomized clinical trial of stroke preparedness among black and Hispanic churchgoers evaluates the effect of culturally tailored 12-minute stroke films on stroke preparedness vs the usual care practice of distributing stroke education pamphlets. (Source: JAMA Neurology)
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Dilemma of Diagnosing Idiopathic Intracranial Hypertension Without Papilledema in Chronic Migraine
This Viewpoint discusses the management of idiopathic intracranial hypertension without papilledema in patients with chronic migraine. (Source: JAMA Neurology)
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Blood-Based Biomarkers in Alzheimer Disease
Blood-based biomarkers have the potential to revolutionize clinical practice and clinical trials in Alzheimer disease (AD). However, to date, this “holy grail” opportunity has not been realized owing to a broad range of issues, including the lack of a clearly defined context of use (COU), lack of standardization of methods, and numerous failures at replication. Recently, however, a shift in the paradigm has occurred, with my colleagues and I proposing specific COUs for blood-based biomarkers along with potential paradigms for advancing from discovery to clinic and potential acceptable standards. (Source: JAMA Neurology)
Source: JAMA Neurology - June 24, 2019 Category: Neurology Source Type: research

Food Insecurity and Migraine Among US Young Adults
This study examines the association between food insecurity and migraine in a nationally representative sample of US young adults. (Source: JAMA Neurology)
Source: JAMA Neurology - June 24, 2019 Category: Neurology Source Type: research

Efficacy of Home-Based Telerehabilitation In-Clinic Therapy After Stroke
This randomized clinical trial examines whether a treatment targeting arm movement delivered via a home-based telerehabilitation system has comparable efficacy with dose-matched, intensity-matched therapy delivered in a traditional in-clinic setting for adults following stroke. (Source: JAMA Neurology)
Source: JAMA Neurology - June 24, 2019 Category: Neurology Source Type: research

Automated Plasma Assays for Alzheimer Disease –Related β-Amyloid Status
This corss-sectional diagnostic study evaluates the accuracy of fully automated plasma assays in measuring plasma β-amyloid and tau in patients with and without cognitive impairment in the Swedish BioFINDER study and an independent validation cohort. (Source: JAMA Neurology)
Source: JAMA Neurology - June 24, 2019 Category: Neurology Source Type: research

Long-term Cognitive Consequences for Patients With Pediatric-Onset Multiple Sclerosis
In this issue ofJAMA Neurology, McKay and colleagues found that adults with pediatric-onset multiple sclerosis (POMS) vs those with adult-onset MS (AOMS) performed more slowly on a widely used cognitive screening measure that tests information-processing speed. Patients were drawn from a Swedish nationwide cohort of 5704 adults with definite MS, of whom 300 had POMS. The Symbol Digit Modalities Test (SDMT) was serially administered during neurology visits. Early in their course, those with POMS performed somewhat better than those with AOMS. However, the 2 groups diverged by the time the POMS patients reached 30 years of a...
Source: JAMA Neurology - June 17, 2019 Category: Neurology Source Type: research

Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology
This systematic review and meta-analysis assesses the associations of age, sex, and diagnosis with neurofilament light in cerebrospinal fluid and evaluates its potential in discriminating clinically similar conditions. (Source: JAMA Neurology)
Source: JAMA Neurology - June 17, 2019 Category: Neurology Source Type: research

Long-term Cognitive Outcomes in Patients With Pediatric-Onset Multiple Sclerosis
This cohort study compares long-term information-processing efficiency between patients with pediatric-onset and adult-onset multiple sclerosis in Sweden. (Source: JAMA Neurology)
Source: JAMA Neurology - June 17, 2019 Category: Neurology Source Type: research

The Art of Caregiving
This essay discusses lessons learned by being a caretaker for a grandparent with Alzheimer disease. (Source: JAMA Neurology)
Source: JAMA Neurology - June 17, 2019 Category: Neurology Source Type: research

Error in Abstract
This article has been corrected online. (Source: JAMA Neurology)
Source: JAMA Neurology - June 10, 2019 Category: Neurology Source Type: research

Absolute Risk Estimates of the Association Between Concussion and Suicide
This study summated the evidence on suicidality following concussion, and we commend the authors on their comprehensive review. The authors reported a relative risk of suicide associated with a history of concussion of 2.03 (95% CI, 1.47-2.80;P 
Source: JAMA Neurology - June 10, 2019 Category: Neurology Source Type: research

Absolute Risk Estimates of the Association Between Concussion and Suicide —Reply
In Reply We appreciate the comments that Lawrence and Hutchinson have provided regarding our recent systematic review and meta-analysis that identified a higher rate of suicide among those who received a diagnosis of concussion compared with those who did not. We agree that providing absolute and relative risk estimates is ideal. For this reason, we provided the absolute rate of suicide in both groups when these data were available. However, we did not meta-analyze these results for 2 reasons. First, each study had a different duration of follow-up, which limited our ability to easily pool these results. Based on this, we ...
Source: JAMA Neurology - June 10, 2019 Category: Neurology Source Type: research

Analysis of Whole-Exome Sequencing Data for Alzheimer Disease Stratified by APOE Genotype
This case-control study evaluatesAPOE associations with variants, using whole-exome sequencing, in participants with and withoutAPOEε4 alleles. (Source: JAMA Neurology)
Source: JAMA Neurology - June 10, 2019 Category: Neurology Source Type: research

Association of Cortical Stimulation –Induced Seizure With Surgical Outcome in Drug-Resistant Focal Epilepsy
This cohort study examines the cortical stimulation of the epileptogenic zone and its association with good or poor outcomes in patients with focal epilepsy. (Source: JAMA Neurology)
Source: JAMA Neurology - June 10, 2019 Category: Neurology Source Type: research

Interferon Therapy for Hepatitis C Infection
Parkinson disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as bradykinesia, tremor, and gait and postural abnormalities as well as neuropsychiatric and other nonmotor symptoms. It is more common in older adults and increases in prevalence with age, although it can also affect younger individuals. Worldwide, approximately 7.5 million people are estimated to be living with PD, and by 2040 this number is expected to double over the next 2 decades. (Source: JAMA Neurology)
Source: JAMA Neurology - June 5, 2019 Category: Neurology Source Type: research

Association of Antiviral Therapy With Parkinson Disease Risk in Hepatitis C Infection
This cohort study uses claims data and diagnostic coding in a large national database of Taiwanese patients to identify the association between the hepatitis C virus, treatment regimens for this infection, and Parkinson disease prescriptions. (Source: JAMA Neurology)
Source: JAMA Neurology - June 5, 2019 Category: Neurology Source Type: research

Drooping Eyelid After Vomiting
This case report describes a woman with a drooping eyelid that appeared shortly after vomiting, which was caused by an unusual but nondangerous mechanism. (Source: JAMA Neurology)
Source: JAMA Neurology - June 3, 2019 Category: Neurology Source Type: research

Inclusivity of Diverse Patient Groups
To the Editor I would like to congratulate Howard et al on their article that addresses differences in sex and race, issues that have been systemically overlooked in medical research. It is applaudable and necessary that this article promotes a discussion around sex differences and race differences in medical research, considering there exists significant race and sex bias in research studies. (Source: JAMA Neurology)
Source: JAMA Neurology - June 3, 2019 Category: Neurology Source Type: research

Inclusivity of Diverse Patient Groups —Reply
In Reply We thank Reddy for his commendation of our report examining risk factors for incident stroke in black and white men and women in the US National Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study. His comments align with our call for more epidemiologic studies to report sex-specific and race/ethnicity-specific research findings. Other epidemiologic studies, including the Cardiovascular Health Study and the Atherosclerosis Risk in Communities study, examined sex differences in the association of risk factors with cardiovascular outcomes (but not stroke alone) in blacks and white individu...
Source: JAMA Neurology - June 3, 2019 Category: Neurology Source Type: research

Recovery After Mild Traumatic Brain Injury in Patients Presenting to US Level I Trauma Centers
This cohort study examines the physical and neuropsychological outcomes in patients with mild traumatic brain injury up to 12 months after presentation. (Source: JAMA Neurology)
Source: JAMA Neurology - June 3, 2019 Category: Neurology Source Type: research

Amyloid, Tau, and Cognition in Preclinical Alzheimer Disease
This cohort study assesses the associations among amyloid- β, tau, and cognition, measured during different observation periods for 7 years. (Source: JAMA Neurology)
Source: JAMA Neurology - June 3, 2019 Category: Neurology Source Type: research

Error in Abstract
This article was corrected online. This article was also corrected in April 2019 to fix a group author that was incorrectly categorized. (Source: JAMA Neurology)
Source: JAMA Neurology - June 1, 2019 Category: Neurology Source Type: research

June 2019 Issue Highlights
(Source: JAMA Neurology)
Source: JAMA Neurology - June 1, 2019 Category: Neurology Source Type: research

JAMA Neurology
Mission Statement: The mission ofJAMA Neurology is to publish scientific information primarily important for those physicians caring for people with neurologic disorders but also for those interested in the structure and function of the normal and diseased nervous system. These specific aims are (1) to make timely publication of original research of the nervous system, (2) to record observations of single patients or groups of patients that will provide new information and insights, (3) to report more basic research that is pertinent to the understanding of disease, (4) to introduce topics of practice, ethics, teaching, an...
Source: JAMA Neurology - June 1, 2019 Category: Neurology Source Type: research

Error in Table
This article was corrected online. (Source: JAMA Neurology)
Source: JAMA Neurology - May 28, 2019 Category: Neurology Source Type: research

Error in Author Byline
This article was corrected online. (Source: JAMA Neurology)
Source: JAMA Neurology - May 28, 2019 Category: Neurology Source Type: research

Apolipoprotein B as a New Link Between Cholesterol and Alzheimer Disease
Advanced age is the largest risk factor for developing Alzheimer disease (AD), with the incidence of AD increasing dramatically with age, and nearly all patients with AD manifesting symptoms after age 65 years (late-onset AD [LOAD]). However, approximately 5% of those with AD experience onset before age 65 years and are classified as having early-onset AD (EOAD). Despite the low prevalence of EOAD compared with LOAD, studying EOAD has led to seminal discoveries in AD. The most famous example is Dr Alois Alzheimer ’s examination of the brain of Auguste D., a patient who initially presented with symptoms of dementia at...
Source: JAMA Neurology - May 28, 2019 Category: Neurology Source Type: research