BACKGROUND AND OBJECTIVES Despite effective secondary prevention, including oral anticoagulant (OAC) therapy, the risk of recurrent stroke (RS) in patients with atrial fibrillation (AF) remains substantial with an annualized risk of 3.2%-6.5% per year. The reasons for this high residual risk are unclear. There is growing need for improved risk prediction tools to identify patients at greatest risk

BACKGROUND AND OBJECTIVES Sleep disordered breathing (SDB) is a risk factor of stroke and Alzheimer disease and related dementias (ADRDs). Hispanic/Latino adults have higher risk of SDB and ADRDs, which emphasizes the need to better understand the association between SDB and brain health. Furthermore, results on SDB and brain aging are mixed, and there are limited data for Hispanic/Latino adults. The

BACKGROUND AND OBJECTIVES Facioscapulohumeral dystrophy (FSHD) is an inherited muscle disorder, with childhood onset in 20% of patients. Understanding the natural history of childhood FSHD and identifying clinical and functional outcome measures are crucial for clinical care and future trials. METHODS In a prospective nationwide FSHD cohort study (iFocus), 20 childhood-onset patients were assessed

OBJECTIVES Atypical variants are rare in genetically determined Alzheimer disease (AD). This case describes a patient with Down syndrome-associated Alzheimer disease (DSAD) who presented with symptoms of posterior cortical atrophy (PCA). METHODS We conducted a clinical and cognitive evaluation, APOE genotyping, determination of AD biomarkers in CSF, structural MRI, [18F]FDG-PET, and tau-PET ([18F]PI2620)

BACKGROUND AND OBJECTIVES Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most frequent small artery brain disease caused by pathogenic variants of the NOTCH3 gene. During the disease, we still do not know how the various deficits progress and develop with each other at different stages of the disease. We aim to model disease progression and

Neurologic conditions are a leading cause of morbidity and mortality within the United States and worldwide. Brain health is a global concern, and the American Academy of Neurology's Brain Health Initiative promises to drive progress in this field over the next decades. Neurologists with detailed training and insight into brain function are uniquely positioned to apply emerging preventive health data

BACKGROUND AND OBJECTIVES Abnormal glymphatic system-related proteins have been identified in a small-scale pathologic study of patients with Creutzfeldt-Jakob disease (CJD). However, it remains unclear whether glymphatic dysfunction occurs in vivo in patients with CJD and whether this decline begins during the preclinical stage. This study aimed to investigate the relationship between glymphatic dysfunction

OBJECTIVES Neurocritical illnesses occur disproportionately in countries with limited health care capacity. Identifying risk factors of reversible neurodeterioration may improve care in resource-limited settings. We investigated whether early neurodeterioration (END) predicted inpatient mortality at a resource-limited Zambian hospital. METHODS We conducted a prospective observational cohort study from

BACKGROUND AND OBJECTIVES Disease-related disability in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) is solely attributed to clinical attacks. However, few studies have assessed the relationship between attacks and residual disability in NMOSD. Thus, we aimed to quantify the contribution of clinical attacks to the residual disability in patients with AQP4-NMOSD

BACKGROUND AND OBJECTIVES In multiple sclerosis (MS), brain reserve serves as a protective factor against cognitive impairment. Previous research has suggested a structural counterpart in the spine-spinal cord reserve-seemed to be associated with physical disability. This study aimed to investigate the potential of the cervical canal area (CCaA) as a proxy for spinal cord reserve in a multicentric

OBJECTIVES Exploration of medical histories and medications associated with Alzheimer disease neuropathologic change (ADNC) absence and potential resistance may identify protective factors against ADNC. This was a retrospective examination of data from participants age ≥90 years who enrolled in The 90+ Study, a longitudinal study based in California. Participants underwent neuropathologic analysis

BACKGROUND AND OBJECTIVES Previous studies on incident myasthenia gravis (MG) have shown inconsistent results. In this study, we determined the MG incidence rates (IRs) over a 36-year period to detect potential trends in MG incidence over time and for different age groups. METHODS In this nationwide population-based study from 1985 to 2021, we identified patients aged 18 and older with a primary MG

BACKGROUND AND OBJECTIVES Persistent elevation of serum creatine kinase levels (hyperCKemia) as an isolated manifestation presents a diagnostic challenge. Genetic myopathies are frequently involved; however, studies using next-generation sequencing (NGS) in pediatric patients are lacking, and the significance of genetic aberrations remains poorly understood. This study, therefore, aimed to investigate

BACKGROUND AND OBJECTIVES Hypertension is a well-established cardiovascular risk factor for cognitive function. As blood pressure fluctuates because of aging-related changes, we examined the association between visit-to-visit blood pressure variability (BPV) and cognition in older adults. METHODS This prospective observational cohort study included 4,770 individuals aged older than 65 years with repeated

BACKGROUND AND OBJECTIVES Ocular myasthenia gravis (OMG) causes disabling ocular symptoms of ptosis and diplopia, but a validated disease-specific patient-reported outcome measure (PROM) has not been reported. We sought to validate a novel PROM for OMG, OMG Rating Scale Questionnaire (OMGRate-q), as a measure of visual functioning to support patient-centered care. METHODS This was a prospective study

Cognitive Dissonance-The Space Between Simulation and Reality is a fictionalized narrative describing a resident's first time caring for a patient diagnosed with brain death. On paper, the diagnosis seemed straightforward and made logical sense. Unfortunately, the reality of brain death is more complicated, especially in the days after diagnosis. Residency is a time to gain subspecialty knowledge,

BACKGROUND AND OBJECTIVES Post-ischemic stroke (IS) outcomes vary widely among individuals, independently of clinical factors. This variability could be related to epigenetic mechanisms that regulate biological processes involved in recovery after ischemia. While several microRNAs (miRNAs) and their target genes are implicated in the pathophysiology of IS, their role in functional outcomes remains

BACKGROUND AND OBJECTIVES There is seemingly contradictory evidence concerning relationships between day-of-injury biomarkers and outcomes after mild traumatic brain injury (mTBI). To address this issue, we examined the association between a panel of biomarkers and multidimensional TBI outcomes. METHODS Participants with mTBI (Glasgow coma scores [GCSs] 13-15) were selected from Collaborative European

BACKGROUND AND OBJECTIVES Randomized trials have proven the benefit of endovascular therapy (EVT) for acute large ischemic stroke. This study was to characterize the effect of time to treatment on benefit of EVT vs medical management (MM) among patients with large ischemic stroke. METHODS This was a post hoc analysis of the Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients

BACKGROUND AND OBJECTIVES Individuals aged 70 and older frequently experience an increased risk of deficits in both physical and cognitive functions. However, the natural progression and interrelationship of these deficits, as well as their neurologic correlates, remain unclear. We aimed to classify the data-driven physical-cognitive phenotypes and then investigate their associations with neuroimaging

BACKGROUND AND OBJECTIVES Disease-modifying treatments (DMTs) are a major unmet need in Parkinson disease (PD). To date, trials investigating DMT candidates in PD most often used a randomized controlled trial (RCT) design. Unfortunately, RCTs to date have not led to a breakthrough, in part because of the large sample sizes and length of follow-up required. In the interest of testing DMT candidates

We present the case of a 70-year-old man with a history of embolic stroke, atrial fibrillation, deep vein thrombosis, and polymyalgia rheumatica who presented as a stroke code with transient right-sided focal neurologic deficits (motor and sensory), mild alteration in consciousness, and mild aphasia. His cerebrovascular imaging revealed new multifocal intracranial stenoses. Despite best medical management

BACKGROUND AND OBJECTIVES There is a paucity of data directly comparing the outcome of surgical techniques available for the treatment of hypothalamic hamartomas (HHs). This study aims to evaluate the safety and efficacy of commonly used surgical approaches in the treatment of HH-related epilepsy. METHODS A systematic review and individual participant data (IPD) meta-analysis was conducted. The PubMed

BACKGROUND AND OBJECTIVES Survivors of stroke are at high risk of dementia, but it is unclear whether this elevated risk is due to other confounding factors. We sought to determine the magnitude and time course of dementia risk after stroke with robust comparison with matched nonstroke populations in an entire province. METHODS We conducted a population-wide analysis of over 15 million people in Ontario

BACKGROUND AND OBJECTIVES Early treatment of multiple sclerosis (MS) reduces disease activity and the risk of long-term disease progression. Effectiveness of ocrelizumab is established in relapsing MS (RMS); however, data in early RMS are lacking. We evaluated the 4-year effectiveness and safety of ocrelizumab as a first-line therapy in treatment-naive patients with recently diagnosed relapsing-remitting

BACKGROUND AND OBJECTIVES Migraine is linked to higher risks of myocardial infarction and ischemic stroke, but it is uncertain whether this risk is due to nonsteroidal anti-inflammatory drug (NSAID) use. This study aimed to examine the cardiovascular risks associated with migraine during time with and without NSAID use. METHODS We conducted a Danish nationwide population-based cohort study of individuals

BACKGROUND AND OBJECTIVES With targeted treatment trials on the horizon, identification of sensitive and valid outcome measures becomes a priority for >100 spastic ataxias. While digital-motor measures, assessed using wearable sensors, are considered prime outcome candidates for spastic ataxias, genotype-specific validation studies are lacking. We here aimed to identify candidate digital-motor outcomes

BACKGROUND AND OBJECTIVES Stiff person syndrome spectrum disorder (SPSD) is a rare autoimmune disorder characterized by progressive muscle stiffness and painful spasms with an estimated prevalence of 1-2 cases per million people. Population-based epidemiologic studies are lacking because of both poor patient capture and the lack of standardized diagnostic criteria. Objectives of this study were to

BACKGROUND AND OBJECTIVES Parkinson disease (PD) shows degeneration of dopaminergic neurons in the substantia nigra and characteristic changes in brain metabolism. However, how they correlated and affect motor and cognitive dysfunction in PD has not yet been well elucidated. METHODS In this single-site cross-sectional study, we enrolled patients with PD who underwent N-(3-[18F]fluoropropyl)-2β-car