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Mashup Score: 21
The integration of natural language processing (NLP) tools into neurology workflows has the potential to significantly enhance clinical care. However, it is important to address the limitations and risks associated with integrating this new technology. Recent advances in transformer-based NLP algorithms (e.g., GPT, BERT) could augment neurology clinical care by summarizing patient health information, suggesting care options, and assisting research involving large datasets. However, these NLP platforms have potential risks including fabricated facts and data security and substantial barriers for implementation. Although these risks and barriers need to be considered, the benefits for providers, patients, and communities are substantial. With these systems achieving greater functionality and the pace of medical need increasing, integrating these tools into clinical care may prove not only beneficial but necessary. Further investigation is needed to design implementation strategies, mitig
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Mashup Score: 78CSF Volcano Due to Lateral Ventricle Entrapment and Rupture - 5 month(s) ago
A 74-year-old woman with probable cerebral amyloid angiopathy was found unresponsive. Initial head CT showed a frontoparietal hematoma with intraventricular extension, edema, and mass effect on the right lateral ventricle. She was intubated, and hyperosmolar therapy was initiated. CT 2 days later showed a new hypodensity in the right frontal lobe extending from the lateral ventricle to the cortical gray-white matter junction (Figure 1). On MRI, this lesion was T2-hyperintense and fluid-attenuated inversion recovery–attenuated, representing a CSF “volcano” dehiscing the frontal lobe due to ventricular entrapment and rupture (Figure 2). The course of hyperosmolar therapy was extended based on this finding. Porencephaly, a CSF cyst due to ventricular rupture, has been described in fetuses because of antenatal intraventricular hemorrhage or developmental anomalies.1 There are also rare reports of ventricular rupture in adults with chronic hydrocephalus.2 However, compression from intrapare
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Mashup Score: 55Using 18F-AV-133 VMAT2 PET Imaging to Monitor Progressive Nigrostriatal Degeneration in Parkinson Disease - 5 month(s) ago
Background and Objectives There are limited validated biomarkers in Parkinson disease (PD) which substantially hinders the ability to monitor disease progression and consequently measure the efficacy of disease-modifying treatments. Imaging biomarkers, such as vesicular monoamine transporter type 2 (VMAT2) PET, enable enhanced diagnostic accuracy and detect early neurodegenerative changes associated with prodromal PD. This study sought to assess whether 18F-AV-133 VMAT2 PET is sensitive enough to monitor and quantify disease progression over a 2-year window. Methods 18F-AV-133 PET scans were performed on participants with PD and REM sleep behavior disorder (RBD) and neurologic controls (NC). All participants were scanned twice ∼26 months apart. Regional tracer retention was calculated with a primary visual cortex reference region and expressed as the standard uptake volume ratio. Regions of interest included caudate, anterior, and posterior putamen. At the time of scanning, participant
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Mashup Score: 13Breastfeeding and Mothers With Epilepsy - 6 month(s) ago
In their study “Initiation and Duration of Breastfeeding in the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs Study,” Gerard et al. carefully studied the differences in breastfeeding for women with and without epilepsy.1 Women with epilepsy face many challenges; for mothers with epilepsy, questions arise surrounding breastfeeding. For instance, “If I am taking a medication for my seizures, should I breastfeed? How will the medication affect my baby? Will they get sick from it? Will the medication affect their development and learning?”
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Mashup Score: 9Impairments and comorbidities of polyneuropathy revealed by population-based analyses - 6 month(s) ago
Objective: To quantify polyneuropathy impairments and comorbidities utilizing the Rochester Epidemiology Project (2010 census = 148,201). Methods: ICD-9-CM coding identified polyneuropathy cases (2006–2010) and their 5:1 age- and sex-matched controls. Mortality and impairments were evaluated while identifying and adjusting for Charlson Index comorbidities. Results: Overall prevalence of polyneuropathy was 1.66%, and markedly rose to 6.6% in persons older than 60 years. Cases (n = 2,892) had more comorbidities than controls (n = 14,435) with higher median Charlson Index (6 vs 3, p < 0.001). Diabetes with end-organ disease represented the largest increased comorbidity in cases compared with controls (46.8% vs 6.5%). Diabetic polyneuropathy was the most common specific subtype (38.2%). Miscoded idiopathic cases and false-negative controls also commonly had diabetic polyneuropathy. Median modified Rankin Scale score was considerably higher for cases than controls (4 vs 1, p < 0.001). Multi
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Mashup Score: 210Teaching NeuroImage: CHANTER Syndrome - 6 month(s) ago
A 44‐year‐old man with alcohol use disorder presented with unresponsiveness. Toxicology was positive for cocaine and fentanyl. Brain MRI showed multiple foci of restricted diffusion and extensive edema in the cerebellum, hippocampus, and basal ganglia (Figure). Imaging findings suggested cerebellar, hippocampal, and basal nuclei transient edema with restricted diffusion (CHANTER) syndrome, a rare radiographic pattern observed in acute intoxication.1 Diagnosis is based on these specific MRI findings. In contrast to anoxic‐ischemic injury, patients exhibit relative sparing of the cerebral cortex and subcortical white matter. Early recognition allows for aggressive edema management and may obviate unnecessary testing or inappropriate treatment. Prognosis is variable with reports ranging from complete recovery to progressive cerebellar edema and herniation.2 In this case, despite hyperosmolar therapy, ventriculostomy placement, and suboccipital craniectomy, the patient’s clinical status co
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Mashup Score: 30Association of Whole Grain Consumption and Cognitive Decline - 6 month(s) ago
Background and Objectives To examine the association of whole grain consumption and longitudinal change in global cognition, perceptual speed, and episodic memory by different race/ethnicity. Methods We included 3,326 participants from the Chicago Health and Aging Project who responded to a Food Frequency Questionnaire (FFQ), with 2 or more cognitive assessments. Global cognition was assessed using a composite score of episodic memory, perceptual speed, and the Mini Mental State Examination (MMSE). Diet was assessed by a 144-item FFQ. Linear mixed-effects models were used to estimate the association of intakes of whole grains and cognitive decline. Results This study involved 3,326 participants (60.1% African American [AA], 63.7% female) with a mean age of 75 years at baseline and a mean follow-up of 6.1 years. Higher consumption of whole grains was associated with a slower rate of global cognitive decline. Among AA participants, those in the highest quintile of whole grain consumption
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Mashup Score: 13Simultaneous Comparisons of 25 Acute Migraine Medications Based on 10 Million Users’ Self-Reported Records From a Smartphone Application - 6 month(s) ago
Background Many acute treatment options exist for migraine. However, large-scale, head-to-head comparisons of treatment effectiveness from real-world patient experience reports are lacking. Methods This is a retrospective analysis of 10,842,795 migraine attack records extracted from an e-diary smartphone application between June 30, 2014, and July 2, 2020. We analyzed 25 acute medications among seven classes- acetaminophen, NSAIDs, triptans, combination analgesics, ergots, anti-emetics, and opioids. Gepants and ditan were not included in this analysis. Different doses and formulations of each medication, according to the generic names, were combined in this analysis. We employed a two-level nested logistic regression model to analyze the odds ratio (OR) of treatment effectiveness of each medication by adjusting concurrent medications and the covariance within the same user. Subgroup analyses were conducted for users in the United States (US), the United Kingdom (UK), and Canada (CAN).
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Mashup Score: 79Late-Onset Status Epilepticus Associated With Isolated Leptomeningeal Angioma and Sturge-Weber Syndrome–Related GNA11 Pathogenic Variation - 6 month(s) ago
A 61-year-old man with no neurologic history presented with 2 episodes of super-refractory left-sided focal motor status epilepticus 5 months apart. He developed a prolonged postictal left hemiparesis each time that improved over several weeks. He also experienced recurrent and transient left hemiplegia independently of any seizure after hypovolemic and septic shocks.
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Mashup Score: 3The Role of Deployment History on the Association Between Epilepsy and Traumatic Brain Injury in Post-9/11 Era U.S. Veterans - 6 month(s) ago
Background and Objectives: Traumatic brain injury (TBI) is a well-established epilepsy risk factor and is common among service members. Deployment related TBI, where combat/blast may be more common, may have different outcomes than non-deployment related TBI. This work examined associations of all TBI exposures (not just combat), and epilepsy, while adjusting for comorbidities associated with epilepsy, among Veterans by deployment status. Methods: The cohort included post-9/11 Veterans with ≥ 2 years of care in both Veterans Health Administration (VHA) and Defense Health Agency (DHA) systems. We identified epilepsy using ICD-9/10-CM codes, anti-seizure medication, and service-connected disability for epilepsy. We conducted a logistic regression model with interaction terms for conditions by deployment history that adjusted for demographics and military characteristics. Results: The cohort (n=938,890) included post-9/11 Veterans of which 27,436 (2.92%) had epilepsy. Most Veterans had a
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In this Contemporary Issues article, Ge & colleagues discuss the potential benefits natural language processing tools pose for neurologic care, as well as risks, limitations, & barriers that exist across various use cases. Learn more: https://t.co/JJPdclZuAO #NeuroTwitter #AI https://t.co/EDDFvqOZmq