Notable in Neurology This Week
This issue features an article that investigates the association of white matter hyperintensities on MRI with disease variables in patients with behavioral-variant frontotemporal dementia and Alzheimer disease; another compares the benefits and limitations of whole genome sequencing to exome sequencing or multigene panel for the diagnosis of developmental and epileptic encephalopathies. A featured Views & Reviews examines the publication rate of trials that evaluate poststroke motor rehabilitation, as well as the consistency of the outcomes included in the clinical trial registries and the publication.
Articles
Young Stroke Survivors' Preferred Methods of Meeting Their Unique Needs: Shaping Better Care
Young stroke survivors were asked what methods they prefer to have their unmet needs addressed to improve their quality of life. Preferences for methods varied depending on the domain of need (body/mind, emotions, information, daily life, relationships, or social), participants' demographics, and stroke-related characteristics. Alternative methods of meeting needs, not resource intensive or requiring a clinical appointment, are warranted.
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From editorialists Tan and Kirshner: “While these observations do not provide objective and comparative evidence for or against any particular method, they highlight receptiveness of young stroke survivors to unique and different means of support to improve their quality of life.”
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Nationwide Trends in Incidence and Mortality of Stroke Among Younger and Older Adults in Denmark
Investigation of nationwide stroke trends remains critical for targeted prevention efforts. In the population-based Danish Stroke Registry, incidence of stroke remained steady in younger adults between 2005 and 2018, but dropped in those aged ≥70 years. These findings underscore the continued need to focus on preventing first-time strokes in younger adults.
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Machine Learning–Based Automatic Rating for Cardinal Symptoms of Parkinson Disease
Careful controlled observation of Parkinson disease symptoms is essential for quantification of disease severity. The authors developed an automated machine learning rating method for resting tremor and bradykinesia. The model illustrated good reliability, higher or comparable to nontrained human raters, for resting tremor and finger tapping. Machine learning–based algorithms for Parkinson disease cardinal symptom rating are feasible.
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Traumatic Brain Injury and Incidence Risk of Sleep Disorders in Nearly 200,000 US Veterans
The authors provide insights into the long-term management of traumatic brain injury (TBI). In a cohort study of 197,418 veterans without sleep disorders, those with TBI had an increased risk of incident sleep disorders over 14 years. Early identification and prevention of sleep disorders after TBI is critical.
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NB: “Pearls & Oy-sters: A Journey Through Reversible Cerebral Vasoconstriction Syndrome: Sex, Drugs, and Headaches,” p. 632. To check out other Resident & Fellow Section Pearls & Oy-sters articles, point your browser to Neurology.org/N and click on the link to the Resident & Fellow Section. At the end of the issue, check out the NeuroImage detailing the clues that helped narrow in on the patient's primary diagnosis of alkaptonuria with a resulting severe neurologic complication of early adult-onset cervical spondylotic myelopathy. This week also includes a Resident & Fellow Section Training in Neurology article titled “Diagnostic Accuracy Among Neurology Residents: The ‘Close the Loop’ Project.”
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