Neurology

Tobias Djamsched Faizy, Reza Kabiri, Soren Christensen, Michael Mlynash, Gabriella Kuraitis, Marius Marc-Daniel Mader, Gregory W. Albers, Maarten G. Lansberg, Jens Fiehler, Max Wintermark, Michael P. Marks, Jeremy J. Heit

doi : 10.1212/WNL.0000000000012106

vol. 96 no. 24 e2903-e2911

Robust arterial collaterals are associated with successful reperfusion after thrombectomy treatment of acute ischemic stroke due to large vessel occlusion (AIS-LVO). Excellent venous outflow (VO) reflects excellent tissue perfusion and collateral status in patients with AIS-LVO. The goal of this study was to determine whether favorable VO profiles assessed on pretreatment CT angiography (CTA) images correlate with successful vessel reperfusion after thrombectomy in patients with AIS-LVO.

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Early Risk of Readmission Following Hospitalization for Reversible Cerebral Vasoconstriction Syndrome

Aayushi Garg, Matthew Starr, Marcelo Rocha, Santiago Ortega-Gutierrez

doi : 10.1212/WNL.0000000000012107

vol. 96 no. 24 e2912-e2919

For evaluation of 90-day readmissions after an inpatient admission for reversible cerebral vasoconstriction syndrome (RCVS), hospitalizations due to RCVS were identified from the Nationwide Readmissions Database from 2016 to 2017.

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Mediterranean Diet, Alzheimer Disease Biomarkers, and Brain Atrophy in Old Age

Tommaso Ballarini, Debora Melo van Lent, Julia Brunner, Alina Schr?der, Steffen Wolfsgruber, Slawek Altenstein, Frederic Brosseron, Katharina Buerger, Peter Dechent, Laura Dobisch, Emrah Düzel, Birgit Ertl-Wagner, Klaus Fliessbach, Silka Dawn Freiesleben, Ingo Frommann, Wenzel Glanz, Dietmar Hauser, John Dylan Haynes, Michael T. Heneka, Daniel Janowitz, Ingo Kilimann, Christoph Laske, Franziska Maier, Coraline Danielle Metzger, Matthias H. Munk, Robert Perneczky, Oliver Peters, Josef Priller, Alfredo Ramirez, Boris-Stephan Rauchmann, Nina Roy, Klaus Scheffler, Anja Schneider, Annika Spottke, Eike Jakob Spruth, Stefan J. Teipel, Ruth Vukovich, Jens Wiltfang, Frank Jessen, Michael Wagner, on behalf of the DELCODE Study Group

doi : 10.1212/WNL.0000000000012067

vol. 96 no. 24 e2920-e2932

To determine whether following a Mediterranean-like diet (MeDi) relates to cognitive functions and in vivo biomarkers for Alzheimer disease (AD), we analyzed cross-sectional data from the German DZNE-Longitudinal Cognitive Impairment and Dementia Study.

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Comparing PET and MRI Biomarkers Predicting Cognitive Decline in Preclinical Alzheimer Disease

Danielle V. Mayblyum, J. Alex Becker, Heidi I.L. Jacobs, Rachel F. Buckley, Aaron P. Schultz, Jorge Sepulcre, Justin S. Sanchez, Zoe B. Rubinstein, Samantha R. Katz, Kirsten A. Moody, Patrizia Vannini, Kathryn V. Papp, Dorene M. Rentz, Julie C. Price, Reisa A. Sperling, Keith A. Johnson, Bernard J. Hanseeuw

doi : 10.1212/WNL.0000000000012108

vol. 96 no. 24 e2933-e2943

To compare how structural MRI, fluorodeoxyglucose (FDG), and flortaucipir (FTP) PET signals predict cognitive decline in high-amyloid vs low-amyloid participants with the goal of determining which biomarker combination would result in the highest increase of statistical power for prevention trials.

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Astrocyte Biomarkers in Alzheimer DiseaseA Systematic Review and Meta-analysis

Bruna Bellaver, Jo?o Pedro Ferrari-Souza, Lucas Uglione da Ros, Stephen F. Carter, Elena Rodriguez-Vieitez, Agneta Nordberg, Luc Pellerin, Pedro Rosa-Neto, Douglas Teixeira Leffa, Eduardo R. Zimmer

doi : 10.1212/WNL.0000000000012109

vol. 96 no. 24 e2944-e2955

To perform a systematic review and meta-analysis to determine whether fluid and imaging astrocyte biomarkers are altered in Alzheimer disease (AD).

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Kidney Function, Kidney Function Decline, and the Risk of Dementia in Older AdultsA Registry-Based Study

Hong Xu, Sara Garcia-Ptacek, Marco Trevisan, Marie Evans, Bengt Lindholm, Maria Eriksdotter, Juan Jesus Carrero

doi : 10.1212/WNL.0000000000012113

vol. 96 no. 24 e2956-e2965

Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. The aim of this study is to investigate the links among kidney function, kidney function decline, and dementia incidence.

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Clinical Utility of Striational Antibodies in Paraneoplastic and Myasthenia Gravis Paraneoplastic Panels

Shahar Shelly, John R. Mills, Divyanshu Dubey, Andrew McKeon, Anastasia Zekeridou, Sean J. Pittock, C. Michel Harper, Elie Naddaf, Margherita Milone, Jay Mandrekar, Christopher J. Klein

doi : 10.1212/WNL.0000000000012050

vol. 96 no. 24 e2966-e2976

To critically assess the clinical utility of striational antibodies (StrAbs) within paraneoplastic and myasthenia gravis (MG) serologic evaluations.

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Systematic Assessment of Medical Diagnoses Preceding the First Diagnosis of Multiple Sclerosis

Christiane Gasperi, Alexander Hapfelmeier, Tanja Daltrozzo, Antonius Schneider, Ewan Donnachie, Bernhard Hemmer

doi : 10.1212/WNL.0000000000012074

vol. 96 no. 24 e2977-e2988

To explore the occurrence of diseases and symptoms in the 5 years before diagnosis in patients with multiple sclerosis (MS) in a case-control study.

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Natalizumab, Fingolimod, and Dimethyl Fumarate Use and Pregnancy-Related Relapse and Disability in Women With Multiple Sclerosis

Wei Zhen Yeh, Putu Ayu Widyastuti, Anneke Van der Walt, Jim Stankovich, Eva Havrdova, Dana Horakova, Karolina Vodehnalova, Serkan Ozakbas, Sara Eichau, Pierre Duquette, Tomas Kalincik, Francesco Patti, Cavit Boz, Murat Terzi, Bassem I. Yamout, Jeannette Lechner-Scott, Patrizia Sola, Olga G. Skibina, Michael Barnett, Marco Onofrj, Maria José S?, Pamela Ann McCombe, Pierre Grammond, Radek Ampapa, Francois Grand'Maison, Roberto Bergamaschi, Daniele L.A. Spitaleri, Vincent Van Pesch, Elisabetta Cartechini, Suzanne Hodgkinson, Aysun Soysal, Albert Saiz, Melissa Gresle, Tomas Uher, Davide Maimone, Recai Turkoglu, Raymond M.M. Hupperts, Maria Pia Amato, Franco Granella, Celia Oreja-Guevara, Ayse Altintas, Richard A. Macdonell, Tamara Castillo-Trivino, Helmut Butzkueven, Raed Alroughani, Vilija G. Jokubaitis, on behalf of the MSBase Study Group

doi : 10.1212/WNL.0000000000012084

vol. 96 no. 24 e2989-e3002

To investigate pregnancy-related disease activity in a contemporary multiple sclerosis (MS) cohort.

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A Shortage of Neurologists – We Must Act NowA Report From the AAN 2019 Transforming Leaders Program

Jennifer J. Majersik, Aiesha Ahmed, I-Hweii A. Chen, Holly Shill, Gregory P. Hanes, Victoria S. Pelak, Jennifer L. Hopp, Antonio Omuro, Benzi Kluger, Thabele Leslie-Mazwi

doi : 10.1212/WNL.0000000000012111

vol. 96 no. 24 1122-1134

In nearly every US state, a large mismatch exists between the need for neurologists and neurologic services and the availability of neurologists to provide these services. Patients with neurologic disorders are rising in prevalence and require access to high-level care to reduce disability. The current neurology mismatch reduces access to care, worsens patient outcomes, and erodes career satisfaction and quality of life for neurologists as they face increasingly insurmountable demands. As a community, we must address this mismatch in the demand and supply of neurologic care in an aggressive and sustained manner to ensure the future health of our patients and our specialty. The American Academy of Neurology has multiple ongoing initiatives to help reduce and resolve the existing mismatch. With the intent of raising awareness and widening the debate nationally, we present a strategic plan that the Academy could implement to coordinate and expand existing efforts. We characterize the suggested strategies as shaping the demand, enhancing the workforce, and advocating for neurologist value. The proposed framework is based on available data and expert opinion when data were lacking. Prioritization of strategies will vary by geography, practice setting, and local resources. The time to act is now to allow concerted effort and targeted interventions to avert this looming public health crisis.

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Adjunctive Intra-arterial Thrombolysis in Endovascular ThrombectomyA Systematic Review and Meta-analysis

William K. Diprose, Michael T.M. Wang, Kaustubha Ghate, Stefan Brew, James R. Caldwell, Ben McGuinness, P. Alan Barber

doi : 10.1212/WNL.0000000000012112

vol. 96 no. 24 1135-1143

To evaluate the safety and efficacy of intra-arterial thrombolysis (IAT) as an adjunct to endovascular thrombectomy (EVT) in ischemic stroke, we performed a systematic review and meta-analysis of the literature.

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Resident & Fellow Rounds

Roy E. Strowd, Whitley Aamodt

doi : 10.1212/WNL.0000000000012117

vol. 96 no. 24 1144-1145

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Clinical Reasoning: A 71-Year-Old Man With Horizontal Gaze Palsy, Anarthria, and Quadriparesis

Ikreet Cheema, Nicole Ng, Tychicus Chen

doi : 10.1212/WNL.0000000000012048

vol. 96 no. 24 1146-1150

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Teaching NeuroImages: A Ruptured Lumbar Disc Mimicking Spinal Tumor

Chia-En Wong, Po-Hsuan Lee, Chi-Chen Huang, Hui-Wen Chen, Chih-Hao Tien, Chih-Yuan Huang, Jung-Shun Lee

doi : 10.1212/WNL.0000000000011720

vol. 96 no. 24 e3003-e3004

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Teaching Video NeuroImages: Multisystemic Erdheim-Chester Disease Presenting as a Cerebellar Ataxia

Marcelo Houat de Brito, Marcos Castello Barbosa de Oliveira, Yuri Reis Casal, Andre Neder Ramires Abdo, Leandro Tavares Lucato, Mateus Mistieri Simabukuro

doi : 10.1212/WNL.0000000000011714

vol. 96 no. 24 e3005-e3006

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Training in Neurology: How Lessons Learned on Teaching, Well-being, and Telemedicine During the COVID-19 Pandemic Can Shape the Future of Neurology Education

Stefano Sandrone, Dara V.F. Albert, S. Richard Dunham, Jessica Kraker, Ika Noviawaty, Michael Palm, Hani Kushlaf

doi : 10.1212/WNL.0000000000012010

vol. 96 no. 24 e3007-e3010

The COVID-19 pandemic has a disruptive effect on neurology education, necessitating creative adjustments in the delivery of education, clinical training, and well-being. In this article, a group of educators reflects on challenges and lessons learned on teaching, well-being, and telemedicine, and how these can shape the future of neurology education. Developing standardized, rigorous evaluation of teaching methods and telemedicine, reinforcing well-being resources, and promoting international educational collaborations can improve neurology training during and after the pandemic.

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Editors' Note: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan

James E. Siegler, Steven Galetta

doi : 10.1212/WNL.0000000000012114

vol. 96 no. 24 1151

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Reader Response: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan

Lea Pollak

doi : 10.1212/WNL.0000000000012115

vol. 96 no. 24 1151-1152

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Author Response: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan

Aravind Ganesh, Sina Marzoughi, Amro Qaddoura, Pouya Motazedian, Simerpreet S. Bal

doi : 10.1212/WNL.0000000000012116

vol. 96 no. 24 1152

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Reader Response: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan

Fu-Liang Zhang, Yao Yu, Zhen-Ni Guo, Yi Yang

doi : 10.1212/WNL.0000000000012118

vol. 96 no. 24 1152-1153

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Author Response: Pearls & Oy-sters: Isolated Oculomotor Nerve Palsy due to Pituitary Apoplexy Missed on CT Scan

Sina Marzoughi, Aravind Ganesh, Amro Qaddoura, Pouya Motazedian, Simerpreet S. Bal

doi : 10.1212/WNL.0000000000012119

vol. 96 no. 24 1153

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