ImportancePrevious studies have described a potential association between epilepsy and frontotemporal dementia (FTD), but no systematic data are available.ObjectiveTo determine whether epilepsy is more prevalent in patients with FTD than in healthy controls (HCs) or patients with Alzheimer disease (AD).Design, Setting, and ParticipantsIn this case-control study, we compared the prevalence of epilepsy

This study investigates outcomes in patients undergoing surgery for chronic subdural hematoma comparing those receiving vs not receiving antithrombotic therapy.

ImportanceMidlife vascular risk factors are associated with an elevated risk of dementia. However, the total contribution of vascular risk factors in midlife and late life with incident dementia is uncertain.ObjectiveTo quantify the proportion of incident dementia attributable to modifiable vascular risk factors measured in midlife and late life and to examine differences by apolipoprotein ε4 genotype

ImportanceRecent research suggests a plausible biological link between autism spectrum disorder (ASD) and Parkinson disease (PD). Nonetheless, large longitudinal studies examining the risk of PD following ASD are lacking.ObjectiveTo examine the association between ASD and future PD risk.Design, Setting, and ParticipantsA nationwide population-based prospective cohort study was performed using data

Importance Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure. Objective To estimate the worldwide burden of SAH. Design, Setting, and Participants Based on the repeated cross-sectional

ImportanceAtrial fibrillation (AF) is a leading cause of stroke, and oral anticoagulants (OAC) reduce this risk. However, there are limited data on the residual risk of recurrent stroke in patients with AF.ObjectiveTo determine the recurrent stroke risk in patients with AF by performing a systematic review and meta-analysis.Data SourcesEligible studies were identified by searching Ovid MEDLINE and

ImportanceCluster headache, characterized by bouts of excruciating pain attacks, detrimentally affects health and quality of life. Eptinezumab is an anticalcitonin gene-related peptide monoclonal antibody approved for migraine prevention.ObjectiveTo evaluate the efficacy and safety of eptinezumab in the preventive treatment of episodic cluster headache.Design, Setting, and ParticipantsThis double-blind

This case report describes a unilateral basal ganglia hemorrhage passing through the anterior commissure within the canal of Gratiolet to the contralateral side.

ImportanceTwo monoclonal antibodies targeting amyloid plaques, lecanemab and donanemab, have received traditional US Food and Drug Administration (FDA) approval for the treatment of early symptomatic Alzheimer disease (AD). The most significant adverse events associated with these therapies are infusion-related reactions and amyloid-related imaging abnormalities (ARIA) with edema/effusion (ARIA-E)

ImportanceDelandistrogene moxeparvovec is a recombinant adeno-associated virus rhesus isolate serotype 74 vector-based gene transfer therapy for the treatment of Duchenne muscular dystrophy (DMD) in patients with a confirmed pathogenic variant of the DMD gene. In a subset of patients in the EMBARK (A Gene Transfer Therapy Study to Evaluate the Safety and Efficacy of Delandistrogene Moxeparvovec [SRP-9001]

ImportanceVestibular migraine has no established treatments.ObjectiveTo test the efficacy of rizatriptan for treating vestibular migraine attacks.Design, Setting, and ParticipantsThis double-blind, randomized clinical trial of rizatriptan vs placebo was conducted from December 2014 through July 2020 (data analyses in 2021 and sensitivity analyses in 2022 and 2024) at 2 tertiary neurotologic centers

ImportanceIn 2019, an alleged “mystery” neurological illness emerged in New Brunswick, Canada. Despite extensive media attention, no case description has been published to date.ObjectiveTo report on 25 patients with a diagnosis of New Brunswick neurological syndrome of unknown cause (NSUC) who subsequently received a second, independent clinical reassessment or neuropathological examination between

Importance MR CLEAN-LATE (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands for Late Arrivals) showed efficacy of endovascular treatment (EVT) in the late window (6-24 hours after stroke symptom onset or time last seen well) among patients with ischemic stroke selected based on collateral flow. Therefore, the future role of computed tomography

This Viewpoint urges neurology stakeholders to consider the potential dangers of the proliferation of artificial intelligence (AI) in neurology, as well as across the wider health care field.

ImportanceMigraine and major depressive disorder are frequently comorbid; however, evidence evaluating the efficacy of preventive migraine therapy in patients with both diseases is limited.ObjectiveTo evaluate the efficacy and safety of fremanezumab in adults with migraine and comorbid major depressive disorder.Design, Setting, and ParticipantsThe UNITE study was a double-blind, placebo-controlled

ImportanceThe defining pathological features of Alzheimer disease (AD) may also be contributing factors in other dementias.ObjectiveTo examine the prevalence of β-amyloid (Aβ) and tau pathophysiological changes as indicated by cerebrospinal fluid biomarkers, as well as their association with clinical disease progression, across a broad range of dementias.Design, Setting, and ParticipantsIn this cross-sectional

This Viewpoint examines whether neurologists, like psychiatrists, should adopt a Goldwater Rule, an ethical principle prohibiting comments about and diagnoses of public persons they have not personally examined.

Importance Discontinuation of low-dose acetylsalicylic acid (ASA) during the perioperative phase of treatment for chronic subdural hematoma (cSDH) may reduce recurrence rates but may also increase the risk of cardiovascular or thromboembolic events. However, the efficacy and safety of discontinuing ASA in this patient population remain unclear. Objective To assess the risk of recurrence of cSDH and

ImportanceDiffusion-weighted imaging (DWI) lesions have been demonstrated in patients with subacute intracerebral hemorrhage (ICH), suggesting ischemic injury, which may be related to blood pressure (BP) reduction.ObjectiveTo test the hypothesis that acute intensive BP lowering is associated with DWI lesions after ICH.Design, Setting, and ParticipantsThe Intracerebral Hemorrhage Acutely Decreasing

Importance Progression independent of relapse activity (PIRA) is a significant contributor to long-term disability accumulation in relapsing-remitting multiple sclerosis (MS). Prior studies have used varying PIRA definitions, hampering the comparability of study results. Objective To compare various definitions of PIRA. Design, Setting, and Participants This cohort study involved a retrospective analysis

ImportancePoststroke epilepsy (PSE) is a major complication among young adults and is associated with problems with functional recovery and daily life. Although scores have been developed to predict risk of PSE, they have not been validated among patients with stroke at a young age.ObjectivesTo investigate both the risk of and risk factors for PSE at a young age and validate current PSE risk scores

This case report discusses a man who tested positive for IgLON5-IgG antibody after intermittent episodes of paresthetic feeling involving the throat and jaw, associated with subtle dysarthria and dysphagia, and upper-extremity paresthesia with piloerection of the forearms.

ImportanceThe risk of developing epilepsy substantially increases after the age of 60 years (late-onset epilepsy [LOE]), particularly in people with cognitive decline ([PWCD] ie, dementia and/or mild cognitive impairment). Epilepsy is associated with worse cognitive and mortality outcomes in PWCD. Identifying PWCD at risk for developing LOE can facilitate early screening and treatment of epilepsy.ObjectiveTo

ImportanceCannabis use is associated with short-term memory impairment and long-term changes in brain structure; however, little is known about whether disordered cannabis use is associated with an increased risk of a dementia diagnosis.ObjectiveTo investigate the association between emergency department visits or hospitalizations (acute care encounters) due to cannabis and future dementia diagnosis

This case report describes a 61-year-old man with myasthenia gravis initially diagnosed with blepharospasm who was later found to have the nonparalytic disorder apraxia of eyelid opening.

This Viewpoint discusses regulatory shifts and their effects on access to innovative diagnostic tests and provides ways to address regulatory barriers for clinical metagenomic testing.

ImportanceAlthough diabetes is a risk factor for dementia, the effect of glucose-lowering therapy for prevention of incident dementia is uncertain.ObjectiveTo determine whether cardioprotective glucose-lowering therapy (sodium-glucose cotransporter-2 inhibitors [SGLT2is], glucagon-like peptide-1 receptor agonists [GLP-1RAs], metformin, and pioglitazone), compared with controls, was associated with

This observational study examines the feasibility and safety of a new preloaded robot-assisted thrombectomy system specifically designed for mechanical thrombectomy.

This essay details the author’s personal experience with poison ivy itch and the synchronicity of a similar realization for a patient at his former facility.

ImportanceThe association between glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) and risk of Alzheimer disease and related dementias (ADRD) remains to be confirmed.ObjectiveTo assess the risk of ADRD associated with GLP-1RAs and SGLT2is in people with type 2 diabetes (T2D).Design, Setting, and ParticipantsThis target trial emulation study

Importance Blood phosphorylated tau 217 (p-tau217) showed good performance in predicting brain amyloidosis. However, the importance of detailed cognitive phenotyping in patients without dementia when interpreting p-tau217 results remains unclear. Objective To assess whether accuracy, negative predictive value (NPV), and positive predictive value (PPV) in predicting brain amyloidosis using p-tau217

This cross-sectional study examines the increase in positive results for John Cunningham virus antibodies and higher risk for progressive multifocal leukoencephalopathy among patients with multiple sclerosis receiving natalizumab.

ImportanceHereditary cystatin C amyloid angiopathy (HCCAA) is a lethal, dominantly inherited disease primarily affecting Icelandic young adults that leads to severe cerebral amyloid angiopathy, with no effective therapy.ObjectiveTo investigate safety, tolerance, and therapeutic potential of N-acetylcysteine (NAC) in lowering disease-associated biomarkers in sequence variation carriers.Design, Setting

ImportanceClinical practice guidelines recommend initiation of anticoagulation within 2 weeks after stroke with atrial fibrillation. It is unknown whether there is an optimal starting day within the 14-day period that balances the risks of recurrent embolic events against serious hemorrhagic events.ObjectiveTo determine if there is an optimal delay time to initiate treatment with a direct oral anticoagulant

Importance Treatment options for amyotrophic lateral sclerosis (ALS) remain suboptimal. Results from a phase 2 study of reldesemtiv in ALS suggested that it may slow disease progression. Objective To assess the effect of reldesemtiv vs placebo on functional outcomes in ALS. Design, Setting, and Participants A Study to Evaluate the Efficacy and Safety of Reldesemtiv in Patients With Amyotrophic Lateral

This case report describes a diagnosis of muscle infiltration of mycosis fungoides in a female aged 36 years with initial disease manifesting as pigmented skin patches.

This Viewpoint discusses the importance of the diagnosis of brain death/death by neurologic criteria and provides context and history of the diagnosis.

This case report describes a patient with spontaneous, arrhythmic, spasmodic contractions of the abdominal muscles whose imaging confirmed involvement of the genu, body, and splenium of the corpus callosum.

ImportanceAmyloid-related imaging abnormalities (ARIA) are the major adverse event associated with amyloid-targeting immunotherapy. Identifying clinical features and individual risk factors for ARIA could facilitate effective prediction and prevention strategies.ObjectiveTo characterize ARIA in participants treated with donanemab.Design, Setting, and ParticipantsThese prespecified and post hoc exploratory

This case report describes cerebral white matter abnormalities from encephalitis caused by Angiostrongylus cantonensis in a 60-year-old woman.