The social and economic burden of frontotemporal degeneration
Conclusions:
The economic burden of FTD is substantial. Counting productivity-related costs, per-patient costs for FTD appear to be greater than per-patient costs reported for AD. There is a need for biomarkers for accurate and timely diagnosis, effective treatments, and services to reduce this socioeconomic burden. (Source: Neurology)
Source: Neurology - November 13, 2017 Category: Neurology Authors: Galvin, J. E., Howard, D. H., Denny, S. S., Dickinson, S., Tatton, N. Tags: Cost effectiveness/economic, Quality of life, All Cognitive Disorders/Dementia, Frontotemporal dementia ARTICLE Source Type: research
Weighting and standardization of frequencies to determine prevalence of AD imaging biomarkers
Conclusions:
These prevalence estimates are important for understanding age-related trends in amyloid positivity and AD signature cortical thickness in the population, and for potentially projecting the future burden of biomarkers in elderly persons. (Source: Neurology)
Source: Neurology - November 13, 2017 Category: Neurology Authors: Roberts, R. O., Knopman, D. S., Syrjanen, J. A., Aakre, J. A., Vassilaki, M., Kremers, W. K., Mielke, M. M., Machulda, M. M., Graff-Radford, J., Geda, Y. E., Vemuri, P., Lowe, V., Jack, C. R., Petersen, R. C. Tags: MRI, PET, Alzheimer's disease, MCI (mild cognitive impairment), Prevalence studies ARTICLE Source Type: research
In vivo staging of regional amyloid deposition
Conclusions:
The highly consistent regional hierarchy of PET-evidenced amyloid deposition across participants resembles neuropathologic observations and suggests a predictable regional sequence that may be used to stage an individual's progress of amyloid pathology in vivo. (Source: Neurology)
Source: Neurology - November 13, 2017 Category: Neurology Authors: Grothe, M. J., Barthel, H., Sepulcre, J., Dyrba, M., Sabri, O., Teipel, S. J., For the Alzheimer's Disease Neuroimaging Initiative Tags: PET, Alzheimer's disease ARTICLE Source Type: research
Amyloid PET scan: Staging beyond reading?
The advent of in vivo β-amyloid (Aβ) PET imaging has revolutionized the field of Alzheimer disease (AD). The opportunity to visualize, during life, one of the main neuropathologic hallmarks of the disease, i.e., Aβ deposition, has yielded considerable hope for diagnosis and treatment efficacy. From a clinical perspective, although the presence of Aβ deposition in the brain is not a sufficient criterion for AD dementia diagnosis, Aβ PET imaging is used to support or rule out the diagnosis, especially in patients with a complicated clinical course.1 Moreover, Aβ PET imaging is a powerful to...
Source: Neurology - November 13, 2017 Category: Neurology Authors: Chetelat, G., Murray, M. E. Tags: EDITORIALS Source Type: research
The new Neurology: Redesigns, short articles for print, full articles online, and data availability policies
Readers will note sweeping changes in Neurology® as of the January 2, 2018, issue, changes that were carefully considered as the Editors reimagined the journal in the context of changes in scientific publishing in general, and supported by extensive research in readers' habits and preferences. The most notable changes occur both in print and online, for which there are new designs, the result of 2 years' work and crafting. For print, we are publishing articles in a short format, allowing a more comprehensive reading experience in a shorter time. For the online, canonical version of the journal, we are now able to accom...
Source: Neurology - November 13, 2017 Category: Neurology Authors: Baskin, P. K., Gross, R. A. Tags: SPECIAL EDITORIALS Source Type: research
Spotlight on the November 14 issue
(Source: Neurology)
Source: Neurology - November 13, 2017 Category: Neurology Authors: Gross, R. A. Tags: IN FOCUS Source Type: research
Teaching Video NeuroImages: The pathologic deep abdominal reflex
A 68-year-old man presented with progressive asymmetric limb weakness and muscle wasting over 12 months. There were profuse fasciculations and hyperreflexia in the limbs and abdominal muscles (see video at Neurology.org), consistent with amyotrophic lateral sclerosis. (Source: Neurology)
Source: Neurology - November 13, 2017 Category: Neurology Authors: Kee, R., O'Gorman, C. M. Tags: Clinical neurology examination, Anterior nerve cell disease, All Education RESIDENT AND FELLOW SECTION Source Type: research
Clinical Reasoning: Prognostication after cardiac arrest: What do we really know?
A 43-year-old woman with a history of hypertension had a witnessed collapse while smoking crack cocaine. Immediate bystander cardiopulmonary resuscitation was performed for 15 minutes; total downtime was estimated at 30 minutes with return of spontaneous circulation (ROSC) achieved after defibrillation of ventricular fibrillation and a total of 5 mg IV epinephrine. Cardiac catheterization showed normal coronary vasculature. Initial neurologic examination 2 hours after fentanyl and vecuronium boluses was significant for nonreactive pupils, absent gag reflex, and no motor response to noxious stimulation, but intact...
Source: Neurology - November 13, 2017 Category: Neurology Authors: Beekman, R. B., Greer, D. M., Brooks, D. C., Maciel, C. B. Tags: RESIDENT AND FELLOW SECTION Source Type: research
Author response: Education Research: Positive effect of scheduled faculty modeling on clerkship student bedside skills exposure and learning
We thank Dr. Sethi for his letter on our article.1 Dr. Sethi advocates for a scheduled assessment of bedside skills by a faculty member during the last week of the clerkship. Indeed, at the University of Rochester, all clerkship students participate in a faculty-observed bedside skills examination of a neurology inpatient during the final week of the clerkship. The examination is scheduled for 1 hour, during which the student is observed taking a complete history, performing a complete neurologic examination, and presenting and discussing the case with the attending physician. Feedback is provided following the examination...
Source: Neurology - November 6, 2017 Category: Neurology Authors: Thompson Stone, R., Tollefson, T., Epstein, R., Jozefowicz, R. F., Mink, J. W. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Letter re: Education Research: Positive effect of scheduled faculty modeling on clerkship student bedside skills exposure and learning
I read with interest the Education Research article by Thompson Stone et al.,1 which evaluated the effect of scheduled bedside skills modeling on the neurology clerkship of third-year medical students. (Source: Neurology)
Source: Neurology - November 6, 2017 Category: Neurology Authors: Sethi, N. K. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Author response: Evaluating the safety of {beta}-interferons in MS: A series of nested case-control studies
I thank Dr. Jongen for the interest in our article,1 and agree with the points made. While space precluded us from citing all the relevant literature in the main text of our article, interested readers can access an extensive review, including the article by Jongen et al.,2 as an appendix to our article (appendix e-1).1 The appendix includes over 100 studies and case reports related to potential adverse effects of the β-interferons and outlines the article referred to by Dr. Jongen.2 (Source: Neurology)
Source: Neurology - November 6, 2017 Category: Neurology Authors: Tremlett, H. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Letter re: Evaluating the safety of {beta}-interferons in MS: A series of nested case-control studies
In a series of case-control studies of patients with multiple sclerosis (MS), de Jong et al.1 found that exposure to β-interferons was associated with a 1.8-fold increased risk of stroke. The authors rightfully state that stroke is not well-recognized as a potential adverse event of β-interferons, referring to cases reported in 2006 and 2008.2,3 (Source: Neurology)
Source: Neurology - November 6, 2017 Category: Neurology Authors: Jongen, P. J. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Editors' Note
: In "Evaluating the safety of β-interferons in MS: A series of nested case-control studies," de Jong et al. found that exposure to β-interferons was associated with a 1.8-fold increased risk of stroke. Commenting on the study, Dr. Jongen shares his own prospective study on adverse events in 284 patients with multiple sclerosis treated with intramuscular interferon-β-1a: one patient died from a stroke sinus thrombosis 22 months after start of treatment. (Source: Neurology)
Source: Neurology - November 6, 2017 Category: Neurology Authors: Karam, C., Griggs, R. C. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Ping-pong gaze and ocular nodding in bacterial meningitis
A 27-year-old man presented with fever, somnolence, seizure, and nuchal rigidity. CSF culture indicated Streptococcus pneumoniae, confirming the diagnosis of bacterial meningitis. Ping-pong gaze was observed initially, and then replaced by what we called ocular nodding after IV administration of diazepam (video at Neurology.org). The eyes went downward and returned to primary position slowly, smoothly, and periodically (with a cycle lasting 12–17 seconds and a pause between 2 cycles), resembling a nodding head. He became alert with free eye movement within 3 days of antibiotic treatment. Ping-pong gaze has been repor...
Source: Neurology - November 6, 2017 Category: Neurology Authors: Wang, Y., Huang, Y.-H., Yang, S.-L. Tags: Meningitis, Clinical neurology examination, Ocular motility VIDEO NEUROIMAGES Source Type: research
Granulocytic sarcoma of the choroid plexus complicating acute leukemia
A 38-year-old patient with type 5 acute myeloid leukemia relapsed after 4 years of treatment including chemotherapy and bone marrow transplant. He underwent imaging for vertigo, with an otherwise normal neurologic examination. Brain MRI showed diffuse choroid plexus enlargement, without hydrocephalus, a rare typical image of granulocytic sarcoma (figure, A).1 The patient also had spine MRI, to explore right L5 radiculopathy, which showed signs of meningitis with radicular and diffuse epidural enhancement (figure, B). (Source: Neurology)
Source: Neurology - November 6, 2017 Category: Neurology Authors: Apra, C., Bourdillon, P. Tags: MRI, Hematologic NEUROIMAGES Source Type: research
