Neurology Commons^™

Thrombectomy Outcomes With General Vs Nongeneral Anesthesia: A Pooled Patient-Level Analysis From The Extend-Ia Trials And Select Study., Amrou Sarraj, Gregory W Albers, Peter J Mitchell, Ameer E Hassan, Michael G Abraham, Spiros Blackburn, Gagan Sharma, Nawaf Yassi, Timothy J Kleinig, Darshan G Shah, Teddy Y Wu, Muhammad Shazam Hussain, Wondwoseen G Tekle, Santiago Ortega Gutierrez, Amin Nima Aghaebrahim, Diogo C Haussen, Gabor Toth, Deep Pujara, Ronald F Budzik, William Hicks, Nirav Vora, Randall C Edgell, Sabreena Slavin, Colleen G Lechtenberg, Laith Maali, Abid Qureshi, Lee Rosterman, Mohammad Ammar Abdulrazzak, Tareq Almaghrabi, Faris Shaker, Osman Mir, Ashish Arora, Sheryl Martin-Schild, Clark W Sitton, Leonid Churilov, Rishi Gupta, Maarten G Lansberg, Raul G Nogueira, James C Grotta, Geoffrey Alan Donnan, Stephen M Davis, Bruce C V Campbell

Neuroscience Articles

BACKGROUND AND OBJECTIVES: The effect of anesthesia choice on endovascular thrombectomy (EVT) outcomes is unclear. Collateral status on perfusion imaging may help identify the optimal anesthesia choice.

METHODS: In a pooled patient-level analysis of EXTEND-IA, EXTEND-IA TNK, EXTEND-IA TNK part II, and SELECT, EVT functional outcomes (modified Rankin Scale score distribution) were compared between general anesthesia (GA) vs non-GA in a propensity-matched sample. Furthermore, we evaluated the association of collateral flow on perfusion imaging, assessed by hypoperfusion intensity ratio (HIR) - Tmax > 10 seconds/Tmax > 6 seconds (good collaterals - HIR < 0.4, poor collaterals - HIR ≥ 0.4) on the association between anesthesia type and EVT outcomes.

RESULTS: Of 725 treated with EVT, 299 (41%) received GA …

Associations Of Snfl With Clinico-Radiological Measures In A Large Ms Population., Elias S Sotirchos, Kathryn C Fitzgerald, Carol M Singh, Matthew D Smith, Maria Reyes-Mantilla, Carrie M Hersh, Megan H Hyland, Ryan Canissario, Sarah B Simmons, Georgina Arrambide, Xavier Montalban, Manuel Comabella, Robert T Naismith, Min Qiao, Lauren B Krupp, Jacqueline A Nicholas, Katja Akgün, Tjalf Ziemssen, Richard Rudick, Elizabeth Fisher, Robert A Bermel, Ellen M Mowry, Peter A Calabresi

Neuroscience Articles

OBJECTIVE: Evaluation of serum neurofilament light chain (sNfL), measured using high-throughput assays on widely accessible platforms in large, real-world MS populations, is a critical step for sNfL to be utilized in clinical practice.

METHODS: Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) is a network of healthcare institutions in the United States and Europe collecting standardized clinical/imaging data and biospecimens during routine clinic visits. sNfL was measured in 6974 MS and 201 healthy control (HC) participants, using a high-throughput, scalable immunoassay.

RESULTS: Elevated sNfL levels for age (sNfL-E) were found in 1238 MS participants (17.8%). Factors associated with …

Organization Of Sensorimotor Activity In Anterior Cruciate Ligament Reconstructed Individuals: An Fmri Conjunction Analysis., Amber J Schnittjer, Howon Kim, Adam S Lepley, James A Onate, Cody R Criss, Janet E Simon, Dustin R Grooms

Neuroscience Articles

INTRODUCTION: Anterior cruciate ligament reconstruction (ACLR) is characterized by persistent involved limb functional deficits that persist for years despite rehabilitation. Previous research provides evidence of both peripheral and central nervous system adaptations following ACLR. However, no study has compared functional organization of the brain for involved limb motor control relative to the uninvolved limb and healthy controls. The purpose of this study was to examine sensorimotor cortex and cerebellar functional activity overlap and non-overlap during a knee motor control task between groups (ACLR and control), and to determine cortical organization of involved and uninvolved limb movement between groups.

METHODS: Eighteen …

A Novel Pulsed Stimulation Pattern In Spinal Cord Stimulation: Clinical Results And Postulated Mechanisms Of Action In The Treatment Of Chronic Low Back And Leg Pain., Mehul J Desai, John Salmon, Paul Verrills, Bruce Mitchell, Neels Du Toit, Dan Bates, Girish Vajramani, Adam Williams, Sarah Love-Jones, Nikunj Patel, Serge Nikolic, Vivek Mehta, Alia Ahmad, James Yu, Nick Christellis, Sam Harkin, Ganesan Baranidharan, Robert Levy, Peter Staats, Mark N Malinowski, James Makous, Nicholas Sullivan, Shilpa Kottalgi, Melissa Hartley, Lakshmi Narayan Mishra

Neuroscience Articles

OBJECTIVES: The aim of this article is to discuss the possible mechanisms of action (MOAs) and results of a pilot study of a novel, anatomically placed, and paresthesia-independent, neurostimulation waveform for the management of chronic intractable pain.

MATERIALS AND METHODS: A novel, multilayered pulsed stimulation pattern (PSP) that comprises three temporal layers, a Pulse Pattern layer, Train layer, and Dosage layer, was developed for the treatment of chronic intractable pain. During preliminary development, the utility was evaluated of anatomical PSP (aPSP) in human subjects with chronic intractable pain of the leg(s) and/or low back, compared with that of traditional spinal …

Video Game Rehabilitation For Outpatient Stroke (Vigorous): A Multi-Site Randomized Controlled Trial Of In-Home, Self-Managed, Upper-Extremity Therapy., Lynne V Gauthier, Deborah S Nichols-Larsen, Gitendra Uswatte, Nancy Strahl, Marie Simeo, Rachel Proffitt, Kristina Kelly, Roger Crawfis, Edward Taub, David Morris, Linda Pax Lowes, Victor Mark, Alexandra Borstad

Neuroscience Articles

BACKGROUND: Integrating behavioral intervention into motor rehabilitation is essential for improving paretic arm use in daily life. Demands on therapist time limit adoption of behavioral programs like Constraint-Induced Movement (CI) therapy, however. Self-managed motor practice could free therapist time for behavioral intervention, but there remains insufficient evidence of efficacy for a self-management approach.

METHODS: This completed, parallel, five-site, pragmatic, single-blind trial established the comparative effectiveness of using in-home gaming self-management as a vehicle to redirect valuable therapist time towards behavioral intervention. Community-dwelling adults with post-stroke (>6 months) mild/moderate upper extremity hemiparesis were randomized to receive one of 4 different …

Behavioral Adverse Events With Brivaracetam, Levetiracetam, Perampanel, And Topiramate: A Systematic Review., Bernhard J Steinhoff, Pavel Klein, Henrik Klitgaard, Cédric Laloyaux, Brian D Moseley, Kristen Ricchetti-Masterson, Felix Rosenow, Joseph I Sirven, Brien Smith, John M Stern, Manuel Toledo, Patricia A Zipfel, Vicente Villanueva

Neuroscience Articles

PURPOSE: To understand the currently available post-marketing real-world evidence of the incidences of and discontinuations due to the BAEs of irritability, anger, and aggression in people with epilepsy (PWE) treated with the anti-seizure medications (ASMs) brivaracetam (BRV), levetiracetam (LEV), perampanel (PER), and topiramate (TPM), as well as behavioral adverse events (BAEs) in PWE switching from LEV to BRV.

METHODS: A systematic review of published literature using the Cochrane Library, PubMed/MEDLINE, and Embase was performed to identify retrospective and prospective observational studies reporting the incidence of irritability, anger, or aggression with BRV, LEV, PER, or TPM in PWE. The incidences of …