Article
Clinical Neurology
Lynne P. Taylor, Jessica M. Besbris, William D. Graf, Michael A. Rubin, Salvador Cruz-Flores, Leon G. Epstein
Summary: Palliative care, introduced in 1974 by Dr. Balfour Mount, focuses on improving patients' quality of life through symptom control, rather than solely on the end-of-life care like hospice. However, many still confuse palliative care with hospice, leading to missed opportunities for early provision of palliative services.
Review
Clinical Neurology
Michael J. Young, Yelena G. Bodien, Joseph T. Giacino, Joseph J. Fins, Robert D. Truog, Leigh R. Hochberg, Brian L. Edlow
Summary: This thematic review discusses the neuroethical questions raised by recent advances in the diagnosis and treatment of disorders of consciousness, providing a clinically applicable framework for understanding the current taxonomy of these disorders and proposing an approach to identifying and evaluating actionable neuroethical issues in research and clinical care. The discussion highlights the importance of increased awareness about these issues and opportunities for optimizing ethically responsible care, especially in the context of the current surge in critically ill patients with disorders of consciousness associated with COVID-19 worldwide.
Article
Medicine, General & Internal
Chun Seng Phua, Aloysius Ng, Christopher Brooks, Zinta Harrington, Hima Vedam, Thang Huynh, Desi Seccombe, Patrick Aouad, Dennis Cordato
Summary: The study analyzed the prevalence of advanced care directives (ACDs) in a MND clinic and found that one-quarter of patients completed ACDs. There was no significant correlation between ACD completion and factors such as age, gender, MND subtype, symptom duration, treatment modalities, and location of death. Further research is needed to understand the factors influencing patients' decisions regarding ACDs.
POSTGRADUATE MEDICAL JOURNAL
(2021)
Review
Medicine, General & Internal
Ainsley Matthewson, Olena Bereznyakova, Brian Dewar, Alexandra Davis, Mark Fedyk, Vignan Yogendrakumar, Dean A. Fergusson, Sophia Gocan, Dar Dowlatshahi, Robert Fahed, Michel Shamy
Summary: This study aims to categorize women-only RCTs for conditions affecting both men and women, as well as to analyze the reasons for conducting them in medical and philosophical literature. Various justifications for conducting women-only trials are expected to be identified.
Article
Neurosciences
Michael J. S. Beauvais, Bartha Maria Knoppers, Judy Illes
Summary: Open Science is advocating for a radical rethinking of current scientific practices, with open data repositories and open lab notebooks emerging in the neuroimaging community. However, the broad sharing of data accompanying Open Science raises difficult ethical and legal issues. By using neuroethics as a focus, we explore central concerns posed by open data in human brain imaging studies, highlighting both challenges and potential benefits.
Editorial Material
Multidisciplinary Sciences
Brendan Parent
Summary: A study that restored some cell function in pigs one hour after death suggests that procedures used in life support and organ preservation of deceased human donors may need to be re-evaluated.
Article
Ethics
Louiza Kalokairinou, Laura Specker Sullivan, Anna Wexler
Summary: This paper discusses the ethical issues of using placebos without deception, focusing on the scenario where providers believe in the effectiveness of a treatment due to physiological mechanisms, even if the belief is not supported by scientific evidence. Using EEG neurofeedback for ADHD as a case study, the paper explores the ethics of offering therapies that may have some beneficial effects likely due to the placebo effect. The authors argue that providers have increased information provision obligations when offering treatments that deviate from standard care and make recommendations for mitigating unintentional deception.
JOURNAL OF MEDICAL ETHICS
(2022)
Review
Pediatrics
Roopali Soni, Charlotte Tscherning Wel-Wel, Nicola J. Robertson
Summary: This review discusses the impact of preterm birth on fetal brain development, highlighting the emergence of new preterm brain injury patterns and the importance of effective care strategies in improving neurodevelopmental outcomes for this population.
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
(2022)
Article
Neurosciences
Michael J. Young, Yelena G. Bodien, Brian L. Edlow
Summary: In the expanding landscape of clinical trials for patients with disorders of consciousness, it is increasingly important to consider the associated ethical challenges and opportunities. This requires proactive deliberation of unique ethical issues and adoption of robust protections to safeguard patients, surrogates, and other key stakeholders. Four central categories of ethical considerations in clinical trials involving participants with disorders of consciousness include autonomy, balancing unknown benefits and risks, disclosure of investigational results, and justice considerations for equitable access to clinical trial enrollment.
Article
Critical Care Medicine
Catherine Duclos, Charlotte Maschke, Yacine Mahdid, Danielle Nadin, Alexander Rokos, Caroline Arbour, Mohamed Badawy, Justin Letourneau, Adrian M. Owen, Gilles Plourde, Stefanie Blain-Moraes
Summary: Using electroencephalography (EEG) and propofol, researchers have developed an adaptive reconfiguration index that can accurately predict whether patients with disorders of consciousness will recover consciousness. This measure has significant implications for clinical decision-making and can be implemented in acute clinical settings.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Article
Clinical Neurology
Amanda R. Merner, Kristin Kostick-Quenet, Tiffany A. Campbell, Michelle T. Pham, Clarissa E. Sanchez, Laura Torgerson, Jill Robinson, Stacey Pereira, Simon Outram, Barbara A. Koenig, Philip A. Starr, Aysegul Gunduz, Kelly D. Foote, Michael S. Okun, Wayne Goodman, Amy L. McGuire, Peter Zuk, Gabriel Lazaro-Munoz
Summary: This study used a mixed-methods approach to examine patients' perspectives on the changes in personality, mood, and behavior following deep brain stimulation (DBS). The majority of patients reported positive experiences with these changes, which resulted in increased quality of life. Additionally, none of the participants expressed regret about undergoing DBS.
Article
Clinical Neurology
Michele Farisco, Rita Formisano, Olivia Gosseries, Yoko Kato, Shigeki Koboyashi, Steven Laureys, Nicolas Lejeune, Charlotte Martial, Amal Matar, Ann-Marie Morrisey, Caroline Schnakers, Maidinamu Yakufujiang, Tomohiro Yamaki, Vigneswaran Veeramuthu, Matteo Zandalasini, Nathan Zasler, Alfonso Magliacano, Anna Estraneo, IBIA Special Interest Group DoCs
Summary: Clinical practices for patients with prolonged disorders of consciousness (pDoCs) vary across countries and settings. Two international guidelines have been developed to promote consistent practice. The survey revealed that some recommendations are followed, while others need more clarity and utility.
JOURNAL OF NEUROLOGY
(2023)
Review
Clinical Neurology
Angus Livingstone, Laurent Servais, Dominic J. C. Wilkinson
Summary: In the past decade, crowdfunding has become a common way to raise funds for the treatment of rare disorders. However, it also raises ethical concerns. This review focuses on the ethical challenges crowdfunding poses in pediatric neurology, using gene therapy for spinal muscular atrophy as an example. The article discusses the responsibilities of physicians and suggests actions that can be taken to reduce harms.
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY
(2023)
Article
Clinical Neurology
Paola Vassallo, Jan Novy, Frederic Zubler, Kaspar Schindler, Vincent Alvarez, Stephan Ruegg, Andrea O. Rossetti
Summary: The occurrence of EEG spindles has been associated with favorable outcomes in ICU patients, especially in those with continuous EEG monitoring. This study further explores the correlation between spindle occurrence, clinical variables, and outcomes, finding that spindles are independently associated with EEG background reactivity and continuous EEG recording. Additionally, the study highlights the potential benefits of continuous EEG over routine EEG in identifying spindles and predicting outcomes in acutely ill patients.
ACTA NEUROLOGICA SCANDINAVICA
(2021)
Article
Medicine, General & Internal
Annabel Jones, Philippa Morgan-Jones, Monica Busse, Victoria Shepherd, Fiona Wood
Summary: The article discusses the ethical and methodological considerations of conducting focus group research in vulnerable populations with neurodegenerative diseases, highlighting potential challenges and offering recommendations to address them.
Meeting Abstract
Clinical Neurology
Ronald M. Lazar, Maarten G. Lansberg, George Howard, Kevin N. Sheth, David L. Tirschwell, Max Wintermark, Tashia Harris, Terina Myers, Stephanie M. Kemp, Christy Cassarly, Joseph P. Broderick, Hooman Kamel, Mitchell Elkind
Article
Clinical Neurology
Gregory W. Albers, Bruce C. Campbell, Maarten G. Lansberg, Joseph Broderick, Ken Butcher, Michael T. Froehler, Lee H. Schwamm, Amre M. Nouh, David S. Liebeskind, Florence Toy, Ming Yang, Lori Massaro, Megan Schoeffler, Barbara Purdon
Summary: The TIMELESS trial aims to investigate the safety and efficacy of tenecteplase for patients with large vessel occlusion stroke, particularly those who present beyond 4.5 hours after symptom onset.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Article
Endocrinology & Metabolism
Laurens Winkelmeier, Jeremy J. Heit, Gautam Adusumilli, Vincent Geest, Adrien Guenego, Gabriel Broocks, Julia Pruter, Nils-Ole Gloyer, Lukas Meyer, Helge Kniep, Maarten G. Lansberg, Gregory W. Albers, Max Wintermark, Jens Fiehler, Tobias D. Faizy
Summary: The study found that unfavorable cerebral venous outflow (VO) is associated with a higher incidence of reperfusion hemorrhage and worse clinical outcomes.
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
(2023)
Article
Clinical Neurology
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
Summary: The effect of anesthesia choice on endovascular thrombectomy (EVT) outcomes is unclear. This study compared the functional outcomes of general anesthesia (GA) vs non-GA in a pooled patient-level analysis and evaluated the association of collateral flow on perfusion imaging with anesthesia type and EVT outcomes.
Article
Neurosciences
Nicole Yuen, Michael Mlynash, Andrea Riordan, Maarten Lansberg, Soren Christensen, Carlo W. Cereda, Giovanni Bianco, Dan -Victor Giurgiutiu, Fana Alemseged, Marco Pileggi, Bruce Campbell, Gregory W. Albers, Jeremy J. Heit
Summary: Cerebral perfusion imaging can be used to predict the ischemic core after successful endovascular thrombectomy in patients with basilar artery occlusion. Tmax >8s and Tmax >10s were the strongest predictors of the final infarct volume after EVT.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2023)
Article
Clinical Neurology
Gabriel Broocks, Lukas Meyer, Sarah Elsayed, Rosalie McDonough, Matthias Bechstein, Tobias Djamsched Faizy, Peter Sporns, Gerhard Schoen, Jens Minnerup, Helge C. Kniep, Uta Hanning, Ewgenia Barow, Peter Schramm, Soenke Langner, Jawed Nawabi, Panagiotis Papanagiotou, Max Wintermark, Maarten G. Lansberg, Gregory W. Albers, Jeremy J. Heit, Jens Fiehler, Andre Kemmling
Summary: This study aimed to investigate the impact of mechanical thrombectomy on functional outcome in patients with low ASPECTS. The results showed that early lesion water uptake was independently associated with clinical outcome and could be a potential tool to select low ASPECTS patients for mechanical thrombectomy.
Article
Radiology, Nuclear Medicine & Medical Imaging
Yannan Yu, Soren Christensen, Jiahong Ouyang, Fabien Scalzo, David S. Liebeskind, Maarten G. Lansberg, Gregory W. Albers, Greg Zaharchuk
Summary: A deep learning model can predict the hypoperfusion lesion in stroke and identify patients with a target mismatch profile using only DWI and clinical information, outperforming the clinical-DWI mismatch approach.
Article
Clinical Neurology
Laurens Winkelmeier, Jeremy J. Heit, Gautam Adusumilli, Vincent Geest, Soren Christensen, Helge Kniep, Noel van Horn, Paul Steffen, Matthias Bechstein, Peter Sporns, Maarten G. Lansberg, Gregory W. Albers, Max Wintermark, Jens Fiehler, Tobias D. Faizy
Summary: This study found a correlation between the blood supply status of ischemic brain tissue and the risk of significant hematoma after endovascular treatment for ischemic stroke. The higher hypoperfusion intensity ratio (HIR) was associated with a higher incidence of hematoma. Therefore, measuring HIR can help assess the need for post-treatment medical care.
Article
Neuroimaging
Sanaz Nazari-Farsani, Yannan Yu, Rui Duarte Armindo, Maarten Lansberg, David S. Liebeskind, Gregory Albers, Soren Christensen, Craig S. Levin, Greg Zaharchuk
Summary: A deep convolutional neural network (DCNN) model trained with diffusion-weighted imaging obtained at admission was able to predict the final infarct volume and location in acute stroke patients 3-7 days after stroke onset. The prediction accuracy of the model was comparable to models that consider both diffusion-weighted imaging and perfusion-weighted imaging. This finding may help to reduce the time required for stroke imaging.
NEUROIMAGE-CLINICAL
(2023)
Article
Clinical Neurology
Pierre Seners, Lauranne Scheldeman, Soren Christensen, Michael Mlynash, Adrien Ter Schiphorst, Caroline Arquizan, Vincent Costalat, Hilde Henon, Martin Bretzner, Jeremy J. Heit, Jean-Marc Olivot, Maarten G. Lansberg, Gregory W. Albers
Summary: The study aimed to determine the clinical and imaging factors associated with fast infarct growth (IG) during inter-hospital transfer. It was found that intracranial carotid artery occlusion, exclusively deep infarct location at the primary center, and a hypoperfusion intensity ratio (HIR) > 0.40 were independently associated with fast progression. These findings are important for neuroprotection trial design and triage decisions at primary stroke centers.
ANNALS OF NEUROLOGY
(2023)
Article
Medicine, General & Internal
Amrou Sarraj, Ameer E. Hassan, Michael G. Abraham, Santiago Ortega-Gutierrez, Scott E. Kasner, M. Shazam Hussain, Michael Chen, Spiros Blackburn, Clark W. Sitton, Leonid Churilov, Sophia Sundararajan, Yin C. Hu, Nabeel A. Herial, Pascal Jabbour, Daniel Gibson, Adam N. Wallace, Juan F. Arenillas, Jenny P. Tsai, Ronald F. Budzik, William J. Hicks, Osman Kozak, Bernard Yan, Dennis J. Cordato, Nathan W. Manning, Mark W. Parsons, Ricardo A. Hanel, Amin N. Aghaebrahim, Teddy Y. Wu, Pere Cardona-Portela, Natalia Perez de la Ossa, Joanna D. Schaafsma, Jordi Blasco, Navdeep Sangha, Steven Warach, Chirag D. Gandhi, Timothy J. Kleinig, Daniel Sahlein, Lucas Elijovich, Wondwossen Tekle, Edgar A. Samaniego, Laith Maali, M. Ammar Abdulrazzak, Marios N. Psychogios, Ashfaq Shuaib, Deep K. Pujara, Faris Shaker, Hannah Johns, Gagan Sharma, Vignan Yogendrakumar, Felix C. Ng, Mohammad H. Rahbar, Chunyan Cai, Philip Lavori, Scott Hamilton, Thanh Nguyen, Johanna T. Fifi, Stephen Davis, Lawrence Wechsler, Vitor M. Pereira, Maarten G. Lansberg, Michael D. Hill, James C. Grotta, Marc Ribo, Bruce C. Campbell, Gregory W. Albers
Summary: This study is a trial on the efficacy and safety of endovascular thrombectomy in patients with large ischemic strokes. The results show that compared to medical care alone, endovascular thrombectomy can improve functional independence in patients, but it also carries the risk of vascular complications.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Clinical Neurology
Robert J. Stanton, David J. Robinson, Yasmin N. Aziz, Heidi Sucharew, Pooja Khatri, Joseph P. Broderick, L. Scott Janis, Stephanie Kemp, Michael Mlynash, Maarten G. Lansberg, Gregory W. Albers, Jeffrey L. Saver, Matthew L. Flaherty, Opeolu Adeoye, Daniel Woo, Simona Ferioli, Brett M. Kissela, Dawn O. Kleindorfer
Summary: Using epidemiological data for feasibility analyses can improve clinical trial recruitment and increase the chances of trial completion.
Editorial Material
Clinical Neurology
Kyle A. Lyman, Anirudh Sreekrishnan, Prateek Thatikunta, Ryan McConnell, Maarten G. Lansberg, Christina M. M. Mijalski Sells
Article
Clinical Neurology
Pierre Seners, Nicole Yuen, Michael Mlynash, Sarah J. Snyder, Jeremy J. Heit, Maarten G. Lansberg, Soren Christensen, Jean-Francois Albucher, Christophe Cognard, Igor Sibon, Michael Obadia, Julien Savatovsky, Jean-Claude Baron, Jean-Marc Olivot, GregoryW. Albers
Summary: The time from stroke symptom onset to imaging is associated with increasing core volume and decreasing penumbral volume in patients with acute ischemic stroke with large vessel occlusion.
Article
Engineering, Biomedical
Caitlyn E. Seim, Brandon Ritter, Thad E. Starner, Kara Flavin, Maarten G. Lansberg, Allison M. Okamura
Summary: Vibratory stimulation shows potential in improving post-stroke symptoms, and a wearable device can provide a more mobile form of this stimulation. However, there are challenges in device design, such as difficulties in finger donning and concerns about social comfort.
IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING
(2022)