Sport-Related Concussion: A Cognitive Perspective
In this study, we review the epidemiology, neuropathophysiology, clinical symptoms, and long-term consequences of SRC with a specific focus on cognition. Recent Findings Repeated concussions are associated with an increased risk of several neurologic diseases and long-term cognitive deficits. To improve cognitive outcomes in athletes with SRC, standardized guidelines for the assessment and management of SRC are vital. However, current concussion management guidelines lack procedures for rehabilitating acute and long-term cognitive symptoms. Summary Increased awareness for the management and rehabilitation of cognitive sy...
Source: Neurology Clinical Practice - February 21, 2023 Category: Neurology Authors: Hallock, H., Mantwill, M., Vajkoczy, P., Wolfarth, B., Reinsberger, C., Lampit, A., Finke, C. Tags: Diagnostic test assessment, All Rehabilitation, Brain trauma Review Source Type: research
Childhood Trauma and Parkinson Disease: Associations of Adverse Childhood Experiences, Disease Severity, and Quality of Life
Discussion These data suggest childhood trauma is associated with a mild increase in overall patient-reported PD severity, specifically mood and other nonmotor and motor symptoms. While the associations were statistically significant, the impact of trauma was less robust than previously described predictors of severity, such as diet, exercise, and social connection. Future research should attempt to include more diverse populations, attempt to improve the response rate of these sensitive questions, and, most importantly, determine whether the adverse outcomes associated with childhood trauma can be mitigated with lifestyle...
Source: Neurology Clinical Practice - February 20, 2023 Category: Neurology Authors: Subramanian, I., McDaniels, B., Farahnik, J., Mischley, L. K. Tags: Parkinson's disease/Parkinsonism, Other trauma, Structural and social determinants of health Research Article Source Type: research
Meaningful Clinical Changes in Alzheimer Disease Measured With the iADRS and Illustrated Using the Donanemab TRAILBLAZER-ALZ Study Findings
Purpose of Review To provide relevant background of the Integrated Alzheimer's Disease Rating Scale (iADRS), with examples, to assist the reader with the interpretation of iADRS findings from the TRAILBLAZER-ALZ study. Recent Findings The iADRS is an integrated measure of global Alzheimer disease (AD) severity for use in the clinical trial environment. It provides a single score that captures commonalities across cognitive and functional ability domains, reflecting disease-related impairment, while minimizing noise not related to disease progression that may exist within each domain. In AD, disease-modifying therapies (DM...
Source: Neurology Clinical Practice - February 16, 2023 Category: Neurology Authors: Wessels, A. M., Dennehy, E. B., Dowsett, S. A., Dickson, S. P., Hendrix, S. B. Tags: Review Source Type: research
Early Discontinuation of Phenobarbital After Acute Symptomatic Neonatal Seizures in the Term Newborn
In this study, we present a unified framework for phenobarbital discontinuation after resolution of acute symptomatic seizures in the setting of brain injury of the newborn. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - February 16, 2023 Category: Neurology Authors: Carrasco, M., Bonifacio, S. L., deVeber, G., Chau, V., on behalf of the Newborn Brain Society Guidelines, and Publications Committee Tags: EEG, Neonatal seizures Commentary Source Type: research
Cenobamate in Generalized Epilepsy and Combined Generalized and Focal Epilepsy
This study provides Class IV evidence that CNB in generalized epilepsy and combined generalized and focal epilepsy reduces seizure frequency. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - February 15, 2023 Category: Neurology Authors: Agashe, S., Worrell, G., Britton, J., Noe, K., Ritaccio, A., Wirrell, E. C., Nickels, K. C., Cascino, G. D., Burkholder, D. Tags: EEG; see Epilepsy/Seizures, All Epilepsy/Seizures, Antiepileptic drugs, Generalized seizures Research Article Source Type: research
Fifteen Patients Who Can Be Helped by Medicare: Insurance Policy Changes in the Coverage of CPAP Therapy for Obstructive Sleep Apnea
We present 15 patients who fail to meet Centers for Medicare and Medicaid Services' (CMS) criteria, highlighting policies that do not support patient care. Finally, we review expert panel recommendations to improve CMS policies, and we suggest ways that physicians can better support CPAP access within the current regulatory restrictions. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - January 20, 2023 Category: Neurology Authors: Johnson, K. G., Raphaelson, M. Tags: Commentary Source Type: research
Carotid Intimal Sarcoma Presenting as Large Vessel Occlusion and Diagnosed by Embolus Histopathology: Case Report
We report the case of a patient who presented with acute embolic ischemic stroke and was found to have IS based on a histopathologic evaluation of his embolectomy specimen. Subsequent comprehensive imaging studies failed to detect a primary tumor site. Multidisciplinary interventions including a course of radiotherapy were performed. The patient died of recurrent multifocal strokes 92 days after diagnosis. Discussion Meticulous histopathologic analysis should be conducted on cerebral embolectomy specimens. Histopathology may be useful in diagnosing IS. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - January 19, 2023 Category: Neurology Authors: Johnson, M. D., Rogers, E. J., Khan, M. W., McMullen, P. D., Akkipeddi, S. M. K., Mattingly, T., Benesch, C. G., Bender, M. T. Tags: Clinical/Scientific Note Source Type: research
Phlebology Implications in Amyotrophic Lateral Sclerosis
Franciscan Guillaume de Saint Pathus (1250-1315) described a patient with deep vein thrombosis in his work "La vie et les miracles de Saint Louis,"1 but from then, science has developed, and now we are aware of the most relevant risk factors for this frequent medical complication: aging; pregnancy; chronic medical diseases; viral and bacterial infections; immobilization; surgeries, particularly major orthopedic and vascular interventions; trauma; malignancies; iatrogenic, especially hormonal and intravenous treatments; and inherited thrombophilias. In most of these risk conditions, a proinflammatory reaction is present. (S...
Source: Neurology Clinical Practice - January 19, 2023 Category: Neurology Authors: de Carvalho, M. Tags: Editorial Source Type: research
Increased Risk of Venous Thromboembolism in Patients With Amyotrophic Lateral Sclerosis: Results From a US Insurance Claims Database Study
The objective of this study was to investigate the incidence of VTE in patients with ALS compared with controls without ALS. Methods Patients were identified from a US health insurance claims database, Optum's deidentified Clinformatics Data Mart Database, between 2004 and 2019. ALS cases were defined as patients aged 18 years or older with (1) 2 or more ALS claims at least 27 days apart including at least 1 claim from a neurologist visit or (2) 1 or more ALS claims and a prescription for riluzole or edaravone. Each ALS case was matched on age and sex to 5 controls without ALS. VTE was defined as at least 1 claim for VTE ...
Source: Neurology Clinical Practice - January 19, 2023 Category: Neurology Authors: Kupelian, V., Viscidi, E., Hall, S., Li, L., Eaton, S., Dilley, A., Currier, N., Ferguson, T., Fanning, L. Tags: Research Article Source Type: research
Institutional Evaluation of Fetal Neurology Consults and Postnatal Outcomes: A 10-Year Retrospective Cohort Review
The objectives were to summarize clinical characteristics, agreement of prenatal and postnatal diagnoses based on best available imaging, and postnatal outcomes. Results Of the 174 maternal-fetal neurology consults placed, 130 qualified for inclusion based on data available for review. Of the 131 anticipated fetuses, 5 experienced fetal demise, 7 underwent elective termination, and 10 died in the postnatal period. The majority were admitted to the neonatal intensive care unit; 34 (31%) required supportive intervention for feeding, breathing, or hydrocephalus, and 10 (8%) experienced seizures during their neonatal intensiv...
Source: Neurology Clinical Practice - January 19, 2023 Category: Neurology Authors: Gumayan, R. L. F., Klamer, B., Ream, M. Tags: Research Article Source Type: research
Pediatric Moyamoya Syndrome Secondary to Tuberculous Meningitis: A Case Report
We report the case of a female patient who initially presented at 6 years of age with TBM and developed moyamoya syndrome requiring revascularization surgery. Results She was found to have basilar meningeal enhancement and right basal ganglia infarcts. She was treated with 12 months of antituberculosis therapy and 12 months of enoxaparin and maintained on daily aspirin indefinitely. However, she developed recurrent headaches and transient ischemic attacks and was found to have progressive bilateral moyamoya arteriopathy. At age 11 years, she underwent bilateral pial synangiosis for the treatment of her moyamoya syndrome. ...
Source: Neurology Clinical Practice - January 18, 2023 Category: Neurology Authors: Kappel, A. D., Lehman, L. L., Northam, W. T., See, A. P., Smith, E. R. Tags: Clinical/Scientific Note Source Type: research
Enrollment of Participants From Marginalized Racial and Ethnic Groups: A Comparative Assessment of the STEADY-PD III and SURE-PD3 Trials
This study used data from The Safety, Tolerability, and Efficacy Assessment of Isradipine for Parkinson Disease (STEADY-PD III; NCT02168842) and the Study of Urate Elevation in Parkinson’s Disease (SURE-PD3; NCT02642393). (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - January 18, 2023 Category: Neurology Authors: Di Luca, D. G., Macklin, E. A., Hodgeman, K., Lopez, G., Pothier, L., Callahan, K. F., Lowell, J., Chan, J., Videnovic, A., Lungu, C., Lang, A. E., Litvan, I., Schwarzschild, M. A., Simuni, T. Tags: Parkinson's disease/Parkinsonism, Clinical trials Methodology/study design, Inclusion, Diversity, Equity, Anti-racism, and Social Justice (IDEAS), Health disparities, Structural and social determinants of health RESEARCH ARTICLE Source Type: research
Exploring Stroke Risk Factors and Outcomes in Sexual and Gender Minority People
Discussion SGM people may have different risk factors, different mechanisms of stroke, and higher risk of recurrent stroke compared with non-SGM people. Standardized collection of sexual orientation and gender identity would enable larger studies to further understand disparities, leading to secondary prevention strategies. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - January 18, 2023 Category: Neurology Authors: Diaz, M. A., Rosendale, N. Tags: Research Article Source Type: research
Howl: Nightmare or REM Sleep Behavior Disorder?
We present the case of a 41-year-old man referred for vivid and unpleasant dreams, beginning in the last year, related to work stress. Results The polysomnography showed the loss of atony in the REM phase and emission of a prolonged howl after which the patient continues in the REM phase. Discussion Prolonged howling is a very rare symptom in sleep disorders, and very atypical in RSBD, so polysomnography is essential to confirm the diagnosis and rule out other parasomnias. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - January 18, 2023 Category: Neurology Authors: Abenza-Abildua, M. J., Lores-Gutierrez, V., Gutierrez-Cueto, G., Suarez-Gisbert, E., Perez-Lopez, C. Tags: Clinical/Scientific Note Source Type: research
Sleep Assessment in Long COVID Clinics: A Necessary Tool for Effective Management
As we adapt to SARS-CoV-2, it has become apparent that the acute illness is not the only threat from this virus. Long COVID has emerged as a potentially disabling condition with multiple varied symptoms. We propose that querying patients about their sleep may allow for the assessment of a sleep-related disorder that is amenable to treatment. In addition, hypersomnolence is a prominent feature and may mimic other organic hypersomnias; therefore, inquiring about COVID-19 infection in sleepy patients is suggested. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - January 18, 2023 Category: Neurology Authors: Khosla, S., Cheung, J., Gurubhagavatula, I., on behalf of the COVID-19 Task Force of the American Academy of Sleep Medicine Tags: Commentary Source Type: research