Modern machine-learning can support diagnostic differentiation of central and peripheral acute vestibular disorders
ConclusionsEstablished clinical scores (such as HINTS) provide a valuable baseline assessment for stroke detection in acute vestibular syndromes. In addition, machine-learning methods may have the potential to increase sensitivity and selectivity in the establishment of a correct diagnosis. (Source: Journal of Neurology)
Source: Journal of Neurology - June 11, 2020 Category: Neurology Source Type: research

COVID-19 encephalopathy: detection of antibodies against SARS-CoV-2 in CSF
(Source: Journal of Neurology)
Source: Journal of Neurology - June 11, 2020 Category: Neurology Source Type: research

Respiratory function during enzyme replacement therapy in late-onset Pompe disease: longitudinal course, prognostic factors, and the impact of time from diagnosis to treatment start
ConclusionFVC stability over 5  years suggests that respiratory function is preserved during long-term ERT in real-world settings. Early initiation of alglucosidase alfa was associated with preservation of FVC in LOPD patients with better respiratory function at the time of treatment initiation. (Source: Journal of Neurology)
Source: Journal of Neurology - June 10, 2020 Category: Neurology Source Type: research

Dyspnea after subthalamic deep brain stimulation in Parkinson ’s disease: a case–control study
AbstractObjectiveDyspnea can be present as non-motor symptom in patients with Parkinson ’s disease (PD). Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor and non-motor symptoms in PD. However, new-onset dyspnea has been reported after DBS surgery. We have studied respiratory characteristics of PD patients with bilateral STN-DBS to assess the impact of DBS on pulmonary function.MethodsSTN-DBS PD patients with dyspnea after surgery (cases) were matched with STN-DBS PD patients without dyspnea (controls). Motor and pulmonary function were assessed with stimulation and without medication (on s...
Source: Journal of Neurology - June 10, 2020 Category: Neurology Source Type: research

Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis
DiscussionAntiplatelet –HTPR may predict risks of recurrent vascular events/outcomes in CVD patients. Given the heterogeneity between studies, further prospective, multi-centre studies are warranted. (Source: Journal of Neurology)
Source: Journal of Neurology - June 9, 2020 Category: Neurology Source Type: research

Sigmund Freud (1856 –1939)
(Source: Journal of Neurology)
Source: Journal of Neurology - June 8, 2020 Category: Neurology Source Type: research

Idiopathic RBD: the role of gender
(Source: Journal of Neurology)
Source: Journal of Neurology - June 7, 2020 Category: Neurology Source Type: research

Dimethyl fumarate vs Teriflunomide: an Italian time-to-event data analysis
AbstractBackgroundThe introduction of oral disease-modifying therapies (DMTs) for relapsing –remitting multiple sclerosis (RRMS) changed algorithms of RRMS treatment.ObjectivesTo compare the effectiveness of treatment with dimethyl fumarate (DMF) and teriflunomide (TRF) in a large multicentre Italian cohort of RRMS patients.Materials and MethodsPatients with RRMS who received treatment with DMF and TRF between January 1st, 2012 and December 31st, 2018 from twelve MS centers were identified. The events investigated were “time-to-first-relapse”, “time-to-Magnetic-Resonance-Imaging (MRI)-activity&rdquo...
Source: Journal of Neurology - June 6, 2020 Category: Neurology Source Type: research

Multifocal laminar cortical brain lesions: a consistent MRI finding in neuro-COVID-19 patients
(Source: Journal of Neurology)
Source: Journal of Neurology - June 6, 2020 Category: Neurology Source Type: research

Early diagnosis of secondary progressive multiple sclerosis: focus on fluid and neurophysiological biomarkers
ConclusionTo date, no neurophysiological or fluid biomarker is sufficiently validated to support the early diagnosis of SPMS. Neurophysiological measurements, including short interval intracortical inhibition and somatosensory temporal discrimination threshold, and the neurofilament light chain fluid biomarker seem to be the most promising. Cross-sectional studies on an adequate number of patients followed by longitudinal studies are needed to confirm the diagnostic and prognostic value of these biomarkers. A combination of neurophysiological and fluid biomarkers may be more sensitive in detecting SPMS conversion. (Source:...
Source: Journal of Neurology - June 5, 2020 Category: Neurology Source Type: research

A novel conversion prediction method of MCI to AD based on longitudinal dynamic morphological features using ADNI structural MRIs
AbstractMild cognitive impairment (MCI) is a pre-existing state of Alzheimer's disease (AD). An accurate prediction on the conversion from MCI to AD is of vital clinical significance for potential prevention and treatment of AD. Longitudinal studies received widespread attention for investigating the disease progression, though most studies did not sufficiently utilize the evolution information. In this paper, we proposed a cerebral similarity network with more progression information to predict the conversion from MCI to AD efficiently. First, we defined the new dynamic morphological feature to mine longitudinal informati...
Source: Journal of Neurology - June 4, 2020 Category: Neurology Source Type: research

Impaired speed-dependent modulation of the gait pattern in multiple sclerosis
ConclusionThe incapacity to modify specific elements of the walking pattern according to walking speed contributes to gait dysfunction in people with MS limiting activities of daily living. Gait modulation may serve as sensitive marker of walking function in MS.Trial registrationClinicaltrials.gov, NCT01576354; first posted April 12, 2012. (Source: Journal of Neurology)
Source: Journal of Neurology - June 4, 2020 Category: Neurology Source Type: research

Chance or challenge, spoilt for choice? New recommendations on diagnostic and therapeutic considerations in hereditary transthyretin amyloidosis with polyneuropathy: the German/Austrian position and review of the literature
AbstractHereditary transthyretin amyloidosis is caused by pathogenic variants (ATTRv) in theTTR gene. Alongside cardiac dysfunction, the disease typically manifests with a severely progressive sensorimotor and autonomic polyneuropathy. Three different drugs, tafamidis, patisiran, and inotersen, are approved in several countries, including the European Union and the United States of America. By stabilizing the TTR protein or degrading its mRNA, all types of treatment aim at preventing amyloid deposition and stopping the otherwise fatal course. Therefore, it is of utmost importance to recognize both onset and progression of ...
Source: Journal of Neurology - June 4, 2020 Category: Neurology Source Type: research

Vestibular evoked myogenic potentials in vestibular migraine and Meni ère’s disease: cVEMPs make the difference
AbstractObjectiveVestibular evoked myogenic potentials (VEMPs) have been suggested as biomarkers in the differential diagnosis of Meni ère’s disease (MD) and vestibular migraine (VM). The aim of this study was to compare the degree of asymmetry for ocular (o) and cervical (c) VEMPs in large cohorts of patients with MD and VM and to follow up the responses.Study designRetrospective study in an interdisciplinary tertiary center for vertigo and balance disorders.MethodscVEMPs to air-conducted sound and oVEMPs to bone-conducted vibration were recorded in 100 patients with VM and unilateral MD, respectively. Outcom...
Source: Journal of Neurology - June 3, 2020 Category: Neurology Source Type: research

COVID-19 in teriflunomide-treated patients with multiple sclerosis
We present five teriflunomide-treated patients with MS who subsequently developed active COVID-19 infection. The patients continued teriflunomide therapy and had self-limiting infection, without relapse of their MS. These observations have implications for the management of MS in the setting of the COVID-19 pandemic. (Source: Journal of Neurology)
Source: Journal of Neurology - June 3, 2020 Category: Neurology Source Type: research

Acute convexity subarachnoid hemorrhage (cSAH) in infectious endocarditis (IE): imaging features and follow-up
AbstractAimTo assess: (1) the prevalence of convexity subarachnoid hemorrhage (cSAH) in infective endocarditis (IE); (2) its relationship with IE features; (3) the associated lesions; (4) whether cSAH is a predictor of future hemorrhage; (5) whether cSAH could cause cortical superficial siderosis (cSS).MethodsWe retrospectively evaluated the MRI data in 240  IE-patients: At baseline, the location of cSAH and associated lesions; at follow-up, the occurrence of new lesions and of cSS. Patients with and without cSAH were compared.ResultsThere were 21 cSAH-IE patients without (Group 1a) and 10 with intracranial infectious...
Source: Journal of Neurology - June 3, 2020 Category: Neurology Source Type: research

Neurological complications of COVID-19: a preliminary review
(Source: Journal of Neurology)
Source: Journal of Neurology - June 3, 2020 Category: Neurology Source Type: research

A review of pathophysiology and neuropsychiatric manifestations of COVID-19
ConclusionThe neurological manifestations of the COVID-19 are varied and the data about this continue to evolve as the pandemic continues to progress. (Source: Journal of Neurology)
Source: Journal of Neurology - June 3, 2020 Category: Neurology Source Type: research

Direct admission versus secondary transfer for acute ischemic stroke patients treated with thrombectomy: a systematic review and  meta-analysis
AbstractBackground and purposeRandomized controlled trials have demonstrated that mechanical thrombectomy (MT) could provide more benefit than standard medical care for acute ischemic stroke (AIS) patients due to emergent large vessel occlusion. However, most primary stroke centers (PSCs) are unable to perform MT, and MT can only be performed in comprehensive stroke centers (CSCs) with on-site interventional neuroradiologic services. Therefore, there is an ongoing debate regarding whether patients with suspected AIS should be directly admitted to CSCs or secondarily transferred to CSCs from PSCs. This meta-analysis was aim...
Source: Journal of Neurology - June 3, 2020 Category: Neurology Source Type: research

Benign versus malignant Parkinson disease: the unexpected silver lining of motor complications
AbstractObjectiveWe sought to evaluate demographic, clinical, and habits/occupational variables between phenotypic extremes in Parkinson ’s disease (PD).MethodsDatabases from nine movement disorders centers across seven countries were retrospectively searched for subjects meeting criteria for very slowly progressive, benign, PD (bPD) and rapidly progressive, malignant, PD (mPD). bPD was defined as Hoehn and Yahr (H&Y) stage  ≤ 3, normal cognitive function, and Schwab and England (S&E) score  ≥ 70 after ≥ 20 years of PD (≥ 10 years if older...
Source: Journal of Neurology - June 2, 2020 Category: Neurology Source Type: research

Seizures in Alzheimer ’s disease are highly recurrent and associated with a poor disease course
AbstractBackgroundSeizures are an important comorbidity in Alzheimer ’s disease (AD). Conflicting results regarding clinical parameters associated with seizures in AD were previously reported. Data on seizure recurrence risk, a crucial parameter for treatment decisions, are lacking.MethodsNational Alzheimer ’s Coordinating Center data were analyzed. Seizure prevalence in AD and an association with disease duration were investigated. Associations of seizures with age of AD onset and with cognitive and functional performance, and seizure recurrence risk were studied.Results20,745 individuals were investigated. In...
Source: Journal of Neurology - June 2, 2020 Category: Neurology Source Type: research

Newly developed stroke in patients admitted to non-neurological intensive care units
This study aimed to investigate characteristics and outcomes of newly developed stroke in patients admitted to the non-neurological intensive care units (ICU-onset stroke, IOS).MethodsA consecutive series of adult patients who were admitted to the non-neurological ICU were included in this study. We compared neurological profiles, risk factors, and mortality rates between patients with IOS and those without IOS.ResultsOf 18,604 patients admitted to the ICU for non-neurological illness, 218 (1.2%) developed stroke (ischemic,n = 182; hemorrhagic,n = 36). The most common neurological presentation w...
Source: Journal of Neurology - June 2, 2020 Category: Neurology Source Type: research

Diagnostic accuracy of a smartphone bedside test to assess the fixation suppression of the vestibulo-ocular reflex: when nothing else matters
ConclusionThe smartphone bedside test is an easily performed, reliable, sensitive, specific, and inexpensive alternative for assessing FS-VOR. (Source: Journal of Neurology)
Source: Journal of Neurology - June 1, 2020 Category: Neurology Source Type: research

Nationwide survey of 780 Japanese patients with amyotrophic lateral sclerosis: their status and expectations from brain –machine interfaces
AbstractBackgroundAmyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that causes eventual death through respiratory failure unless mechanical ventilation is provided. Brain –machine interfaces (BMIs) may provide brain control supports for communication and motor function. We investigated the interests and expectations of patients with ALS concerning BMIs based on a large-scale anonymous questionnaire survey supported by the Japan Amyotrophic Lateral Sclerosis Associa tion.MethodsWe surveyed 1918 patients with ALS regarding their present status, tracheostomy use, interest in BMIs, and their...
Source: Journal of Neurology - June 1, 2020 Category: Neurology Source Type: research

Oxaliplatin-induced peripheral neuropathy: clinical features, mechanisms, prevention and treatment
AbstractOxaliplatin (OXA) is a commonly used platinum-based chemotherapy drug for colorectal cancer. OXA-induced peripheral neurotoxcity (OIPN) is a comprehensive adverse reaction of OXA. OIPN can be divided into acute and chronic types according to clinical features and different mechanisms. The main clinical features of acute OIPN are cold-sensitive sensory symptoms and neuropathic pain in limbs. In addition to the above symptoms, chronic OIPN also produces autonomic nerve dysfunction. The most important mechanism involved in acute OIPN is the alteration of voltage-gated Na  + channels, and nuclear DNA dama...
Source: Journal of Neurology - May 30, 2020 Category: Neurology Source Type: research

COVID-19-associated acute disseminated encephalomyelitis (ADEM)
AbstractA 51-year-old woman with COVID-19 infection developed coma and an impaired oculocephalic response to one side. MRI of the brain demonstrated acute multifocal demyelinating lesions, and CSF testing did not identify a direct cerebral infection. High-dose steroids followed by a course of IVIG was administered, and the patient regained consciousness over the course of several weeks. As more patients reach the weeks after initial infection with COVID-19, acute disseminated encephalomyelitis should be considered a potentially treatable cause of profound encephalopathy or multifocal neurological deficits. (Source: Journal of Neurology)
Source: Journal of Neurology - May 30, 2020 Category: Neurology Source Type: research

Association between dopaminergic medications and REM sleep behavior disorder in Parkinson ’s disease: a preliminary cohort study
ConclusionsOur study detected a significant association between doses of levodopa and RBD symptoms in PD patients. Future longitudinal studies are needed to establish what causal nexus may link these variables. (Source: Journal of Neurology)
Source: Journal of Neurology - May 29, 2020 Category: Neurology Source Type: research

Diagnosis and management of multiple sclerosis: MRI in clinical practice
ConclusionsThe proposed MRI protocol can adapt to a range of clinical settings, aiding the impetus towards standardisation of practice and offering an example of research-informed service improvement to support optimisation  of resources. Other neurological conditions, where a gap still exists between published guidelines and their clinical implementation, may benefit from this same approach. (Source: Journal of Neurology)
Source: Journal of Neurology - May 29, 2020 Category: Neurology Source Type: research

Mild COVID-19 symptoms despite treatment with teriflunomide and high-dose methylprednisolone due to multiple sclerosis relapse
(Source: Journal of Neurology)
Source: Journal of Neurology - May 28, 2020 Category: Neurology Source Type: research

Wearable sensors can reliably quantify gait alterations associated with disability in people with progressive multiple sclerosis in a clinical setting
This study aims to identify reliable and objective gait-based biomarkers to monitor progressive multiple sclerosis (MS) in clinical settings. During routine clinical visits, 57 people with secondary progressive MS and 24 healthy controls walked for 6  minutes wearing three inertial motion sensors. Fifteen gait measures were computed from the sensor data and tested for between-session reliability, for differences between controls and people with moderate and severe MS disability, and for correlation with Expanded Disability Status Scale (EDSS) s cores. The majority of gait measures showed good to excellent between-sess...
Source: Journal of Neurology - May 28, 2020 Category: Neurology Source Type: research

BOLD signal within and around white matter lesions distinguishes multiple sclerosis and non-specific white matter disease: a three-dimensional approach
In this study, we investigated the physiologic profiles within and around MS and NSWMD lesions and their ability to distinguish the two disease states. MS and NSWMD lesions were identified using three-dimensional (3D) T2-FLAIR images and segmented using geodesic active contouring. A dual-echo functional MRI sequence permitted near-simultaneous measurement of blood-oxygen-level-dependent signal (BOLD) and cerebral blood flow (CBF). BOLD and CBF were calculated within lesions and in 3D concentric layers surrounding each lesion. BOLD slope, an indicator of lesion metabolic capacity, was calculated as the change in BOLD from a...
Source: Journal of Neurology - May 28, 2020 Category: Neurology Source Type: research

Mechanical thrombectomy for ischaemic stroke in the anterior circulation: off-hours effect
ConclusionOur study did not show worse outcomes in patients treated at off-hours. This result suggests that the off-hours effect reported in other studies can be minimized by a coordinated organisation of stroke care providing similar levels of care at off-hours. (Source: Journal of Neurology)
Source: Journal of Neurology - May 28, 2020 Category: Neurology Source Type: research

EEG microstate architecture does not change during passive whole-body accelerations
(Source: Journal of Neurology)
Source: Journal of Neurology - May 28, 2020 Category: Neurology Source Type: research

Sural nerve biopsy: current role and comparison with serum neurofilament light chain levels
AbstractThe diagnosis of peripheral neuropathies can be challenging with consequent difficulties in patients ’ management. The aim of this study was to explore the current diagnostic role of sural nerve biopsy and to compare pathological findings with serum neurofilament light chain levels (NfL) as biomarkers of axonal damage. We collected demographic, clinical, and paraclinical data of patients referred over 1 year to the Neurology Unit, University of Verona, Italy, to perform nerve biopsy for diagnostic purposes, and we analyzed NfL levels in available paired sera using a high sensitive technique (Quanterix, S...
Source: Journal of Neurology - May 27, 2020 Category: Neurology Source Type: research

An update on idiopathic intracranial hypertension in adults: a look at pathophysiology, diagnostic approach and management
AbstractIdiopathic intracranial hypertension is a neurological syndrome determined by a rise in intracranial pressure without a detectable cause. Course and prognosis may be changeable, requiring a multidisciplinary approach for its diagnosis and management. Although its precise pathogenesis is still unknown, many studies have been carried out to define the possible causal and associated factors, such as retinoids, steroid hormones, body mass index and recent weight gains, cytokines and adipokines levels. The clinical presentation can be variable including chronic headache, disturbance of vision, diplopia and tinnitus. Eve...
Source: Journal of Neurology - May 27, 2020 Category: Neurology Source Type: research

Risk of acute brain lesions in dizzy patients presenting to the emergency room: who needs imaging and who does not?
AbstractThe usefulness of brain imaging studies in dizzy patients presenting to the emergency department (ED) is controversial. We aimed to assess the ‘real-world’ probability of ischemic stroke and other acute brain lesions (ABLs) in these patients to create an algorithm that helps decision-making on whether which and when brain imaging is needed. By reviewing medical records, we identified 610 patients presenting with dizziness, vertigo or i mbalance to our university hospital’s ED and receiving neurological workup. We collected timing/triggers of symptoms, ABCD2 score, focal neurological abnormalities,...
Source: Journal of Neurology - May 27, 2020 Category: Neurology Source Type: research

Key gait findings for diagnosing three syndromic categories of dynamic instability in patients with balance disorders
This article provides an overview of the potential of a quantitative gait analysis for decision support in three clinically relevant scenarios of early stage gait disorders: scenario I: gait ataxia and unsteadiness; scenario II: hypokinesia and slow gait; scenario III: apparently normal gait with a specific fall tendency in complex mobility situations. In a first part, we justify the advantages of standardized data collection and analysis procedures including data normalization and dimensionality reduction techniques that facilitate clinical interpretability of instrument-based gait profiles. We then outline typical patter...
Source: Journal of Neurology - May 27, 2020 Category: Neurology Source Type: research

Different EEG brain activity in right and left handers during visually induced self-motion perception
AbstractVisually induced self-motion perception (vection) relies on visual –vestibular interaction. Imaging studies using vestibular stimulation have revealed a vestibular thalamo-cortical dominance in the right hemisphere in right handers and the left hemisphere in left handers. We investigated if the behavioural characteristics and neural correlates of vection differ b etween healthy left and right-handed individuals. 64-channel EEG was recorded while 25 right handers and 25 left handers were exposed to vection-compatible roll motion (coherent motion) and a matched, control condition (incoherent motion). Behavioura...
Source: Journal of Neurology - May 27, 2020 Category: Neurology Source Type: research

Onset of Covid-19 with impaired consciousness and ataxia: a case report
(Source: Journal of Neurology)
Source: Journal of Neurology - May 27, 2020 Category: Neurology Source Type: research

A parsimonious score with a free web tool for predicting disability after an ischemic stroke: the Parsifal Score
ConclusionsThe Parsifal Score is a model that predicts disability at the third month, with only five variables, with good discrimination and calibration, and being replicated in an independent cohort. (Source: Journal of Neurology)
Source: Journal of Neurology - May 26, 2020 Category: Neurology Source Type: research

Neurological manifestations of COVID-19: a review of what we know so far
This study aims to give an overview of the neurological manifestations of COVID-19 and discuss the potential pathogenetic mechanisms of central nervous system (CNS) involvement. Clinicians and especially intern ists, neurologists, and infectious disease specialists should be aware of these symptoms and able to recognize them early. Prompt diagnosis and immediate management of the neurological manifestations of the novel coronavirus will not only improve the prognosis of COVID-19 patients but will also prev ent the dissemination of the disease due to misdiagnosed cases. (Source: Journal of Neurology)
Source: Journal of Neurology - May 26, 2020 Category: Neurology Source Type: research

Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms
AbstractCoronavirus disease 2019 (COVID-19), a disease caused by the novel betacoronavirus (SARS-CoV-2), has become a global pandemic threat. The potential involvement of COVID-19 in central nervous system (CNS) has attracted considerable attention due to neurological manifestations presented throughout the disease process. In addition, SARS-CoV-2 is structurally similar to SARS-CoV, and both bind to the angiotensin-converting enzyme 2 (ACE2) receptor to enter human cells. Thus, cells expressing ACE2, such as neurons and glial cells may act as targets and are thus vulnerable to SARS-CoV-2 infection. Here, we have reviewed ...
Source: Journal of Neurology - May 26, 2020 Category: Neurology Source Type: research

Upbeat vertical nystagmus after brain stem cavernoma resection: a rare case of nucleus intercalatus/nucleus of roller injury
ConclusionUpbeat nystagmus can be related to several lesions of the brainstem, including the medial longitudinal fasciculus, the pons, and the dorsal medulla. To our knowledge, this is the first case of an iatrogenic lesion of the nucleus intercalatus/nucleus of Roller resulting in an upbeat vertical nystagmus. For neurologists, it is important to be aware of the function of this nucleus for assessment of clinical manifestations due to lesions within this region. (Source: Journal of Neurology)
Source: Journal of Neurology - May 26, 2020 Category: Neurology Source Type: research

Post-infectious Guillain –Barré syndrome related to SARS-CoV-2 infection: a case report
(Source: Journal of Neurology)
Source: Journal of Neurology - May 26, 2020 Category: Neurology Source Type: research

Non-epileptic seizures in autonomic dysfunction as the initial symptom of COVID-19
(Source: Journal of Neurology)
Source: Journal of Neurology - May 26, 2020 Category: Neurology Source Type: research

Acute transverse myelitis after COVID-19 pneumonia
(Source: Journal of Neurology)
Source: Journal of Neurology - May 26, 2020 Category: Neurology Source Type: research

Miller –Fisher-like syndrome related to SARS-CoV-2 infection (COVID 19)
(Source: Journal of Neurology)
Source: Journal of Neurology - May 26, 2020 Category: Neurology Source Type: research

Long-term safety and efficacy of daclizumab beta in relapsing –remitting multiple sclerosis: 6-year results from the SELECTED open-label extension study
ConclusionsThe effects of daclizumab beta on clinical and radiologic outcomes were sustained for up to ~  8 years of treatment. No new safety concerns were identified in SELECTED.Trial registrationClinicaltrials.gov NCT01051349; first registered on January 15, 2010. (Source: Journal of Neurology)
Source: Journal of Neurology - May 25, 2020 Category: Neurology Source Type: research

Quantitative evaluation of olfactory dysfunction in hospitalized patients with Coronavirus [2] (COVID-19)
(Source: Journal of Neurology)
Source: Journal of Neurology - May 25, 2020 Category: Neurology Source Type: research

Anti-Hu-associated paraneoplastic syndromes triggered by immune-checkpoint inhibitor treatment
(Source: Journal of Neurology)
Source: Journal of Neurology - May 25, 2020 Category: Neurology Source Type: research