Neurology




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Spotlight on the April 6 Issue

José G. Merino

doi : 10.1212/WNL.0000000000011696

April 06, 2021; 96 (14) 

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Connecting Upper Limb Functional Stroke Recovery to Global Disability Measures

Keith W. Muir, Jennifer J. Majersik

doi : 10.1212/WNL.0000000000011671

April 06, 2021; 96 (14) 

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HIV in the BrainFrom Devastating Dementia to White Matter Hyperintensities

Jessica Robinson-Papp, Deanna Saylor

doi : 10.1212/WNL.0000000000011735

April 06, 2021; 96 (14) 

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Early Detection of Incipient Alzheimer Pathology

Frederik Barkhof, Peter S. Pressman

doi : 10.1212/WNL.0000000000011739

April 06, 2021; 96 (14) 

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Is Cerebrospinal Fluid Responsible for Innate Immune Cell Activation and Neurotoxicity in Multiple Sclerosis?

Grigorios KalaitzidisPeter A. Calabresi

doi : 10.1212/WNL.0000000000011694

April 06, 2021; 96 (14) 

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Intense Arm Rehabilitation Therapy Improves the Modified Rankin Scale Score

Steven C. Cramer, Vu Le, Jeffrey L. Saver, Lucy Dodakian, Jill See, Renee Augsburger, Alison McKenzie, Robert J. Zhou, Nina L. Chiu, Jutta Heckhausen, Jessica M. Cassidy, Walt Scacchi, Megan Therese Smith, A.M. Barrett, Jayme Knutson, Dylan Edwards, David Putrino, Kunal Agrawal, Kenneth Ngo, Elliot J. Roth, David L. Tirschwell, Michelle L. Woodbury, Ross Zafonte, Wenle Zhao, Judith Spilker, Steven L. Wolf, Joseph P. Broderick, Scott Janis

doi : 10.1212/WNL.0000000000011667

April 06, 2021; 96 (14) 

Objective To evaluate the effect of intensive rehabilitation on the modified Rankin Scale (mRS), a measure of activities limitation commonly used in acute stroke studies, and to define the specific changes in body structure/function (motor impairment) most related to mRS gains.

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Association of White Matter Hyperintensities With HIV Status and Vascular Risk Factors

Yair Mina, Tianxia Wu, Hsing-Chuan Hsieh, Dima A. Hammoud, Swati Shah, Chuen-Yen Lau, Lillian Ham,  View ORCID ProfileJoseph Snow, Elizabeth Horne, Anuradha Ganesan, Stanley I. Rapoport, Edmund C. Tramont,Daniel S. Reich, Brian K. Agan,  View ORCID ProfileAvindra Nath, Bryan R. Smith, for the NIH-DOD NeuroHIV Consortium

doi : 10.1212/WNL.0000000000011702

April 06, 2021; 96 (14) 

Objective To test the hypothesis that brain white matter hyperintensities (WMH) are more common in people living with HIV (PLWH), even in the setting of well-controlled infection, and to identify clinical measures that correlate with these abnormalities.

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Association of Position Played and Career Duration and Chronic Traumatic Encephalopathy at Autopsy in Elite Football and Hockey Players

Nicole Schwab, Richard Wennberg, Karl Grenier, Carmela Tartaglia, Charles Tator,Lili-Naz Hazrati

doi : 10.1212/WNL.0000000000011668

April 06, 2021; 96 (14) 

Objective To determine whether an association exists between career duration or position played and the presence of chronic traumatic encephalopathy (CTE) at autopsy in a series of elite football and hockey players.

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Association of Digital Clock Drawing With PET Amyloid and Tau Pathology in Normal Older Adults

Dorene M. Rentz, Kathryn V. Papp, Danielle V. Mayblyum, Justin S. Sanchez, Hannah Klein, William Souillard-Mandar, Reisa A. Sperling, Keith A. Johnson

doi : 10.1212/WNL.0000000000011697

April 06, 2021; 96 (14) 

Objective To determine whether a digital clock-drawing test, DCTclock, improves upon standard cognitive assessments for discriminating diagnostic groups and for detecting biomarker evidence of amyloid and tau pathology in clinically normal older adults (CN).

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Cognitive Profile and Markers of Alzheimer Disease–Type Pathology in Patients With Lewy Body Dementias

Erica Howard, David J. Irwin, Katya Rascovsky, Naomi Nevler, Sanjana Shellikeri, Thomas F. Tropea,Meredith Spindler, Andres Deik, Alice Chen-Plotkin, Andrew Siderowf, Nabila Dahodwala, Daniel Weintraub, Leslie M. Shaw, John Q. Trojanowski, Sanjeev N. Vaishnavi, David A. Wolk, Dawn Mechanic-Hamilton, James F. Morley, John E. Duda, Murray Grossman, Katheryn A.Q. Cousins

doi : 10.1212/WNL.0000000000011699

April 06, 2021; 96 (14) 

Objective To determine whether patients with Lewy body dementia (LBD) with likely Alzheimer disease (AD)–type copathology are more impaired on confrontation naming than those without likely AD-type copathology.

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Structural and Clinical Correlates of a Periventricular Gradient of Neuroinflammation in Multiple Sclerosis

Emilie Poirion,Matteo Tonietto, François-Xavier Lejeune, Vito A.G. Ricigliano, Marine Boudot de la Motte, Charline Benoit, Géraldine Bera, Bertrand Kuhnast, Michel Bottlaender, Benedetta Bodini,Bruno Stankoff

doi : 10.1212/WNL.0000000000011700

April 06, 2021; 96 (14) 

Objectives To explore in vivo innate immune cell activation as a function of the distance from ventricular CSF in patients with multiple sclerosis (MS) using [18F]-DPA714 PET and to investigate its relationship with periventricular microstructural damage, evaluated by magnetization transfer ratio (MTR), and with trajectories of disability worsening.

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Quantifying Treatment-Related Fluctuations in CIDP

Jeffrey A. Allen, Mamatha Pasnoor,Mazen M. Dimachkie, Senda Ajroud-Driss, Thomas H. Brannagan, Albert A. Cook, Timothy Walton, Mark B. Fiecas, John T. Kissel, Ingemar Merkies, Kenneth C. Gorson, Richard A. Lewis

doi : 10.1212/WNL.0000000000011703

April 06, 2021; 96 (14) 

Objective The objective of this study was to explore the extent of IV immunoglobulin (IVIG) treatment-related fluctuations (TRFs) by using home collection of daily grip strength in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and to use that information to develop evidence-based treatment optimization strategies.

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DYT-TUBB4A (DYT4 Dystonia)

Julien F. Bally, Sarah Camargos, Camila Oliveira dos Santos, Drew S. Kern, Teresa Lee, Francisco Pereira da Silva-Junior, Renato David Puga, Francisco Cardoso, Egberto Reis Barbosa, Rachita Yadav, Laurie J. Ozelius, Patricia de Carvalho Aguiar, Anthony E. Lang

doi : 10.1212/WNL.0000000000010882

April 06, 2021; 96 (14) 

Objective To report 4 novel TUBB4A mutations leading to laryngeal and cervical dystonia with frequent generalization.

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Speech, Language, and Oromotor Skills in Patients With Polymicrogyria

Ruth O. Braden,Jessica O. Boyce, Chloe A. Stutterd, Kate Pope, Himanshu Goel, Richard J. Leventer, Ingrid E. Scheffer,Angela T. Morgan

doi : 10.1212/WNL.0000000000011698

April 06, 2021; 96 (14) 

Objective To determine whether specific speech, language, and oromotor profiles are associated with different patterns of polymicrogyria, we assessed 52 patients with polymicrogyria using a battery of standardized tests and correlated findings with topography and severity of polymicrogyria.

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Financial Conflicts of Interest of United States–Based Authors in Neurology Journals

Jade E. Smith, Charlotte Wahle, James L. Bernat, Nathaniel M. Robbins

doi : 10.1212/WNL.0000000000011701

April 06, 2021; 96 (14) 

Objective To detail the scope, nature, and disclosure of financial conflicts of interest (COI) between the pharmaceutical and medical device industries (Industry) and authors in high-impact clinical neurology journals.

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What's Happening in Neurology® Clinical Practice

doi : 10.1212/WNL.0000000000011705

April 06, 2021; 96 (14) 

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What's Happening in Neurology® Genetics

doi : 10.1212/WNL.0000000000011707

April 06, 2021; 96 (14) 

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What's Happening in Neurology® Neuroimmunology & Neuroinflammation

doi : 10.1212/WNL.0000000000011706

April 06, 2021; 96 (14) 

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The 5 Pillars in Tourette Syndrome Deep Brain Stimulation Patient Selection

Davide Martino, Wissam Deeb,Joohi Jimenez-Shahed, Irene Malaty, Tamara M. Pringsheim, Alfonso Fasano, Christos Ganos, Winifred Wu, Michael S. Okun

doi : 10.1212/WNL.0000000000011704

April 06, 2021; 96 (14) 

The selection of patients with Tourette syndrome (TS) for deep brain stimulation (DBS) surgery rests on 5 fundamental pillars. However, the operationalization of the multidisciplinary screening process to evaluate these pillars remains highly diverse, especially across sites. High tic severity and tic-related impact on quality of life (first 2 pillars) require confirmation from objective, validated measures, but malignant features of TS should per se suffice to fulfill this pillar. Failure of behavioral and pharmacologic therapies (third pillar) should be assessed taking into account refractoriness through objective and subjective measures supporting lack of efficacy of all interventions of proven efficacy, as well as true lack of tolerability, adherence, or access. Educational interventions and use of remote delivery formats (for behavioral therapies) play a role in preventing misjudgment of treatment failure. Stability of comorbid psychiatric disorders for 6 months (fourth pillar) is needed to confirm the predominant impact of tics on quality of life, to prevent pseudo-refractoriness, and to maximize the future DBS response. The 18-year age limit (fifth pillar) is currently under reappraisal, considering the potential impact of severe tics in adolescence and the predictive effect of tic severity in childhood on tic severity when transitioning into adulthood. Future advances should aim at a consensus-based definition of failure of specific, noninvasive treatment strategies for tics and of the minimum clinical observation period before considering DBS treatment, the stability of behavioral comorbidities, and the use of a prospective international registry data to identify predictors of positive response to DBS, especially in younger patients.

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Mills Syndrome

William Huynh, Sicong Tu, Colin J. Mahoney, Raymond Schwartz, Matthew C. Kiernan

doi : 10.1212/WNL.0000000000011710

April 06, 2021; 96 (14) 

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Child Neurology: Intractable Epilepsy and Transient Deficits in a Patient With a History of Herpes Simplex Virus Encephalitis

Giovanna S. Manzano,  Husain H. Danish,Catherine J. Chu, Eyal Y. Kimchi

doi : 10.1212/WNL.0000000000011606

April 06, 2021; 96 (14) 

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Pearls & Oy-sters: Upbeat Nystagmus and Quadriplegia in a Young Girl with Bilateral Medial Medullary Syndrome

Intan Aaroni Md Isa,Sanihah Abdul Halim, Chee Yong Chuan

doi : 10.1212/WNL.0000000000011493

April 06, 2021; 96 (14) 

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Teaching NeuroImages: An Imaging Clue in a Boy With Developmental Delay

A.S. Jyotsna, K.P. Vinayan, Arun Grace Roy

doi : 10.1212/WNL.0000000000011286

April 06, 2021; 96 (14) 

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Teaching Video NeuroImages: Atypical Abnormal Eye Movements in PNPO-Related Epilepsy

Sara Pavitt, Amanda G. Sandoval Karamian, Gaurav Chattree, Jenna Klotz,Shannon Beres

doi : 10.1212/WNL.0000000000010861

April 06, 2021; 96 (14) 

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Editors' Note: Characterizing Opioid Use in a US Population With Migraine: Results From the CaMEO Study

Aravind Ganesh, Steven Galetta

doi : 10.1212/WNL.0000000000011709

April 06, 2021; 96 (14) 

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Reader Response: Characterizing Opioid Use in a US Population With Migraine: Results From the CaMEO Study

Vinod K. Gupta

doi : 10.1212/WNL.0000000000011708

April 06, 2021; 96 (14) 

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Author Response: Characterizing Opioid Use in a US Population With Migraine: Results From the CaMEO Study

Richard B. Lipton, Dawn C. Buse, Benjamin W. Friedman

doi : 10.1212/WNL.0000000000011718

April 06, 2021; 96 (14) 

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Reader Response: Characterizing Opioid Use in a US Population With Migraine: Results From the CaMEO Study

Andrew Blumenfeld

doi : 10.1212/WNL.0000000000011721

April 06, 2021; 96 (14) 

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Author Response: Characterizing Opioid Use in a US Population With Migraine: Results From the CaMEO Study

Richard B. Lipton, Dawn C. Buse, Benjamin W. Friedman

doi : 10.1212/WNL.0000000000011722

April 06, 2021; 96 (14) 

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Reader Response: Characterizing Opioid Use in a US Population With Migraine: Results From the CaMEO Study

Mia T. Minen

doi : 10.1212/WNL.0000000000011723

April 06, 2021; 96 (14) 

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Author Response: Characterizing Opioid Use in a US Population With Migraine: Results From the CaMEO Study

Richard B. Lipton, Dawn C. Buse, Benjamin W. Friedman

doi : 10.1212/WNL.0000000000011724

April 06, 2021; 96 (14) 

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