JAMA Neurology

Neurodegenerative disease mortality is higher among former professional soccer players than general population controls. However, the factors contributing to increased neurodegenerative disease mortality in this population remain uncertain.

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Assessment of Optimal Patient Selection for Endovascular Thrombectomy Beyond 6 Hours After Symptom Onset: A Pooled Analysis of the AURORA Database

Gregory W. Albers, MD1,2; Maarten G. Lansberg, MD, PhD1,2; Scott Brown, PhD3; Ashutosh P. Jadhav, MD, PhD4; Diogo C. Haussen, MD5; Sheila O. Martins, MD, PhD6; Leticia C. Rebello, MD5; Andrew M. Demchuk, MD7,8; Mayank Goyal, MD, PhD7,8; Marc Ribo, MD9; Aquilla S. Turk, DO10; David S. Liebeskind, MD11,12; Jeremy J. Heit, MD, PhD13; Michael P. Marks, MD13; Tudor G. Jovin, MD14; Raul G. Nogueira, MD5; for the AURORA Investigators

doi : 10.1001/jamaneurol.2021.2319

JAMA Neurol. 2021;78(9):1064-1071

The optimal imaging approach for identifying patients who may benefit from endovascular thrombectomy (EVT) beyond 6 hours after they were last known well is unclear. Six randomized clinical trials (RCTs) have evaluated the efficacy of EVT vs standard medical care among patients with ischemic stroke.

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Depression Outcomes Among Patients Treated With Fluoxetine for Stroke Recovery: The AFFINITY Randomized Clinical Trial

Osvaldo P. Almeida, PhD1; Graeme J. Hankey, MD2; Andrew Ford, PhD1; Christopher Etherton-Beer, PhD2; Leon Flicker, PhD2; Maree Hackett, PhD3; for the Assessment of Fluoxetine in Stroke Recovery (AFFINITY) Trial Collaboration

doi : 10.1001/jamaneurol.2021.2418

JAMA Neurol. 2021;78(9):1072-1079

One in 3 adults experiences clinically significant symptoms of depression during the first year after a stroke, but evidence to support the use of antidepressants in this population remains scant.

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Global Prevalence of Young-Onset Dementia: A Systematic Review and Meta-analysis

Stevie Hendriks, MSc1; Kirsten Peetoom, PhD1; Christian Bakker, PhD2,3,4; Wiesje M. van der Flier, PhD5,6; Janne M. Papma, PhD7; Raymond Koopmans, PhD2,4; Frans R. J. Verhey, MD, PhD1; Marjolein de Vugt, PhD1; Sebastian Köhler, PhD1; and the Young-Onset Dementia Epidemiology Study Group

doi : 10.1001/jamaneurol.2021.2161

JAMA Neurol. 2021;78(9):1080-1090

Reliable prevalence estimates are lacking for young-onset dementia (YOD), in which symptoms of dementia start before the age of 65 years. Such estimates are needed for policy makers to organize appropriate health care.

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Efficacy and Safety of Ticagrelor and Aspirin in Patients With Moderate Ischemic Stroke: An Exploratory Analysis of the THALES Randomized Clinical Trial

Yongjun Wang, MD1,2; Yuesong Pan, PhD1,2; Hao Li, PhD1,2; Pierre Amarenco, MD3; Hans Denison, MD, PhD4; Scott R. Evans, PhD5; Anders Himmelmann, MD, PhD4; Stefan James, MD, PhD6; Filip Birve, BSc4; Per Ladenvall, MD, PhD4; Carlos A. Molina, MD, PhD7; S. Claiborne Johnston, MD, PhD8; for the THALES Steering Committee and Investigators

doi : 10.1001/jamaneurol.2021.2440

JAMA Neurol. 2021;78(9):1091-1098

Prior trials of dual antiplatelet therapy excluded patients with moderate ischemic stroke. These patients were included in the Acute Stroke or Transient Ischaemic Attack Treated With Ticagrelor and ASA for Prevention of Stroke and Death (THALES) trial, but results have not been reported separately, raising concerns about safety and efficacy in this subgroup.

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Direct to Angiography Suite Without Stopping for Computed Tomography Imaging for Patients With Acute Stroke: A Randomized Clinical Trial

Manuel Requena, PhD1,2; Marta Olivé-Gadea, MD1,2; Marian Muchada, PhD1,2; David Hernández, MD3; Marta Rubiera, PhD1,2; Sandra Boned, PhD1,2; Carlos Piñana, MD3; Matías Deck, MD1,2; Álvaro García-Tornel, MD1,2; Humberto Díaz-Silva, MD3; Noelia Rodriguez-Villatoro, PhD1,2; Jesús Juega, MD1,2; David Rodriguez-Luna, PhD1,2; Jorge Pagola, PhD1,2; Carlos Molina, PhD1,2; Alejandro Tomasello, MD3; Marc Ribo, MD, PhD1,2

doi : 10.1001/jamaneurol.2021.2385

JAMA Neurol. 2021;78(9):1099-1107

Direct transfer to angiography suite (DTAS) for patients with suspected large vessel occlusion (LVO) stroke has been described as an effective and safe measure to reduce workflow time in endovascular treatment (EVT). However, it is unknown whether DTAS improves long-term functional outcomes.

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Comparison of Plasma Phosphorylated Tau Species With Amyloid and Tau Positron Emission Tomography, Neurodegeneration, Vascular Pathology, and Cognitive Outcomes

Michelle M. Mielke, PhD1,2; Ryan D. Frank, MS1; Jeffrey L. Dage, PhD3; Andreas Jeromin, PhD4,5; Nicholas J. Ashton, PhD6,7,8,9,10; Kaj Blennow, MD, PhD6,10,11; Thomas K. Karikari, PhD6,10; Eugene Vanmechelen, PhD12; Henrik Zetterberg, MD, PhD6,10,11,13,14; Alicia Algeciras-Schimnich, PhD15; David S. Knopman, MD2; Val Lowe, MD16; Guojun Bu, PhD17; Prashanthi Vemuri, PhD16; Jonathan Graff-Radford, MD2; Clifford R. Jack Jr, MD16; Ronald C. Petersen, MD, PhD1,2

doi : 10.1001/jamaneurol.2021.2293

JAMA Neurol. 2021;78(9):1108-1117

Cerebrospinal fluid phosphorylated tau (p-tau) 181, p-tau217, and p-tau231 are associated with neuropathological outcomes, but a comparison of these p-tau isoforms in blood samples is needed.

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Suicidality Risk of Newer Antiseizure Medications: A Meta-analysis

Pavel Klein, MBBChir1; Orrin Devinsky, MD2; Jacqueline French, MD2; Cynthia Harden, MD3; Gregory L. Krauss, MD4; Robert McCarter, ScD5; Michael R. Sperling, MD6

doi : 10.1001/jamaneurol.2021.2480

JAMA Neurol. 2021;78(9):1118-1127

Most antiseizure medications (ASMs) carry a US Food and Drug Administration–mandated class label warning of increased suicidality risk, based on a meta-analysis comparing suicidality between individuals treated with medications vs placebo in randomized clinical trials done before 2008. ASMs approved since then carry this warning although they were not similarly studied.

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Seizure Prophylaxis After Spontaneous Intracerebral Hemorrhage

Felipe J. S. Jones, MD1; Paula R. Sanches, MD1,2; Jason R. Smith, BA1,3; Sahar F. Zafar, MBBS1,4; Deborah Blacker, MD, ScD5,6,7; John Hsu, MD, MBA, MSCE8,9,10; Lee H. Schwamm, MD1,4; Joseph P. Newhouse, PhD8,11,12,13; Michael B. Westover, MD, PhD1,4; Lidia M. V. R. Moura, MD, MPH1,4

doi : 10.1001/jamaneurol.2021.2249

JAMA Neurol. 2021;78(9):1128-1136

Limited evidence is available concerning optimal seizure prophylaxis after spontaneous intracerebral hemorrhage (sICH).

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Pathological Computed Tomography Features Associated With Adverse Outcomes After Mild Traumatic Brain Injury: A TRACK-TBI Study With External Validation in CENTER-TBI

Esther L. Yuh, MD, PhD1,2; Sonia Jain, PhD3; Xiaoying Sun, MS3; Dana Pisic?, MD4,15; Mark H. Harris, BS1,5; Sabrina R. Taylor, PhD1,5; Amy J. Markowitz, JD1,5; Pratik Mukherjee, MD, PhD1,2; Jan Verheyden, MS6; Joseph T. Giacino, PhD7,18; Harvey S. Levin, PhD8; Michael McCrea, PhD9; Murray B. Stein, MD, MPH10,11; Nancy R. Temkin, PhD12; Ramon Diaz-Arrastia, MD, PhD13; Claudia S. Robertson, MD14; Hester F. Lingsma, PhD15; David O. Okonkwo, MD, PhD16; Andrew I.R. Maas, MD, PhD17; Geoffrey T. Manley, MD, PhD1,5; and the TRACK-TBI Investigators for the CENTER-TBI Investigators

doi : 10.1001/jamaneurol.2021.2120

JAMA Neurol. 2021;78(9):1137-1148

A head computed tomography (CT) with positive results for acute intracranial hemorrhage is the gold-standard diagnostic biomarker for acute traumatic brain injury (TBI). In moderate to severe TBI (Glasgow Coma Scale [GCS] scores 3-12), some CT features have been shown to be associated with outcomes. In mild TBI (mTBI; GCS scores 13-15), distribution and co-occurrence of pathological CT features and their prognostic importance are not well understood.

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