Notable in Neurology this week
This issue features an article that shows patients with cluster headaches have substantially more sickness absence and disability pension days compared to matched references; another investigates the association of aerobic exercise with improvements in cognition and cerebrovascular regulation. A featured Special Editorial discusses the effect of the global COVID-19 pandemic on the dissemination and implementation of telehealth services.
Articles
Liver transplantation as a rescue therapy for severe neurologic forms of Wilson disease
Liver transplantation (LT) for the management of patients with Wilson disease (WD) with severe neurologic worsening, but without liver failure, is controversial. Eighteen patients who underwent LT for pure neurologic indication were retrospectively studied. Most patients who were alive at last follow-up had moderate to major improvement in symptoms and less function impairment. LT may be a therapeutic option for patients with severe symptoms who are resistant to anticopper therapies.
Page 911
From editorialists Bandmann, Weiss, and Hedera: “The study by Poujois and coworkers also provides circumstantial evidence that restoration of copper homeostasis may be superior to chelation for removal of excessive copper from the CNS. Thus, other, hopefully less risky approaches such as gene therapy for WD may 1 day result in marked improvement of neurologic WD.”
Page 907
The implications of different approaches to define AT(N) in Alzheimer disease
CSF and imaging Alzheimer disease change biomarkers for amyloid (A), tau (T), and neurodegeneration (N) can be combined in a classification system [AT(N)] to classify individuals as cognitively unimpaired and impaired and to predict cognitive decline. Different biomarker combinations are not interchangeable, however, and lead to differences in classification and prediction that change as the disease progresses.
Page 915
Intracranial hemodynamic relationships in patients with cerebral small vessel disease
In an MRI-based study, changes in hemodynamic measures (decreased cerebrovascular reactivity, higher venous pulsatility, and lower foramen magnum CSF stroke volume vascular dynamic dysfunction) were associated with enlarged perivascular spaces and white matter hyperintensities in patients with small vessel disease (SVD). These finding suggest that the study of microvascular dysfunction and CSF dynamics may help identify potential interventions for preventing clinical and cognitive decline in patients with SVD.
Page 917
From editorialists Shaaban and Molad: “Developing effective interventions for SVD requires identifying targets for intervention and measurable biomarkers of the disease. Blair and colleagues have added important additional candidates for both with these novel and important results.”
Page 909
Views & Reviews
Imaging of the vulnerable carotid plaque: Role of imaging techniques and a research agenda
Carotid atherothrombosis is a main cause of stroke and may depend on plaque vulnerability. Several imaging modalities, including ultrasound, MRI, CT, and nuclear medicine, can help identify vulnerable carotid plaque. Yet, few studies have evaluated the diagnostic yield of each modality and their relationship with clinical stroke outcomes.
Page 922
NB: “Abnormal cerebellar foliation in EBF3 mutation,” p. 933. To check out other NeuroImages articles, point your browser to Neurology.org/N. At the end of the issue, check out the Resident & Fellow Section Teaching NeuroImages article illustrating an association of bilateral atrophic maculopathy with spinocerebellar ataxia type 3. This week also includes a Resident & Fellow Mystery Case titled “An infant with developmental delay, epileptic spasms, and acrocyanosis.”
COVID-19 Resources: NPub.org/COVID19
- © 2020 American Academy of Neurology
Disputes & Debates: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.