Weekly Neurology Deep Dive - A review of recent impactful publications in the field of Neurology

Amer Ghavanini
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  • MEDICINE

A selection of recent neurology papers is summarized and discussed, with a focus on review articles and those that have the potential to change clinical practice. Please note that AI has been used in generating the content.

  1. 4D AGO

    TTR Familial Amyloidosis Genotype-Phenotype Correlation

    The two research articles reviewed here compare the clinical presentation of different variants of hereditary transthyretin-mediated amyloidosis (TTR familial amyloidosis), particularly focusing on the Val142Ile variant.

    15 min

  2. SEP 24

    Spinal Bulbar Muscular Atrophy: Canadian Best Practice Recommendations

    This episode reviews clinical practice guideline developed for the management of Spinal Bulbar Muscular Atrophy (SBMA), also known as Kennedy disease, in Canada. The guideline is prompted by the discovery of a substantially elevated prevalence of this rare X-linked recessive neuromuscular disorder among First Nations and Métis people in western Canada. It addresses the diagnosis and comprehensive, multidisciplinary management of SBMA, including motor, cardiac, and endocrine complications, while emphasizing the critical need for culturally appropriate care for Indigenous populations. The recommendations, which cover 41 aspects of care, were created using rigorous methodological frameworks by an interdisciplinary working group and informed by existing guidelines for SBMA (from France) and Amyotrophic Lateral Sclerosis (ALS).

    13 min

  3. SEP 21

    2025 Revised Criteria for Vascular Cognitive Impairment

    This episode reviews the VasCog-2-WSO Criteria, which is the 2025 revised consensus diagnostic guidelines for Vascular Cognitive Impairment and Dementia (VCID). Developed by an international consortium of experts using a Delphi consensus process, these criteria update the previous VasCog guidelines to incorporate recent advances in neuroimaging and biomarkers. The objective was to create an operationalized international standard for diagnosing VCID across preclinical, mild, and major dementia severity levels, addressing prior inconsistencies in terminology and assessment. Key updates include defining VCID as the overarching term, refining the neuroimaging criteria for establishing a vascular etiology, and introducing a category for preclinical/at-risk VCID for preventative measures. The World Stroke Organization (WSO) endorsed these criteria, which are designed to enhance diagnostic consistency for both clinicians and researchers.

    13 min

  4. SEP 21

    Idiopathic Normal Pressure Hydrocephalus: Incidence, Progression, Diagnosis and Treatment

    This episode reviews 5 publications on Idiopathic Normal Pressure Hydrocephalus (iNPH), specifically addressing diagnosis, patient selection for shunting, and long-term treatment outcomes. One article is a systematic review and consensus protocol from the International Parkinson and Movement Disorders Society, which addresses the lack of standardization in the large-volume lumbar puncture "tap test," reviewing extensive literature to propose a consistent protocol for volume removal, timing of reassessment, and clinical assessments for gait, cognition, and urination. The second source is a research article discussing long-term shunt responsiveness and the phenomenon of delayed shunt non-responders, presenting detailed clinical data on comorbidities and outcomes in patients categorized as early non-responders, late non-responders, and full responders to ventriculoperitoneal shunt surgery. All articles aim to refine clinical practice and future research efforts related to the diagnosis and management of iNPH. One article is a very recent clinical trial providing evidence for the benefit of shunting to improve gait in these patients.

    30 min

  5. SEP 21

    Glycine Receptor Antibody Associated Progressive Encephalomyelitis Clinical Outcomes (PREM)

    This 2025 article titled "Progressive Encephalomyelitis With Rigidity and Myoclonus With Glycine Receptor Antibodies" by Guasp et al., published in Neurology Neuroimmunology Neuroinflammation aims to detail the clinical features and long-term prognosis of patients suffering from Glycine Receptor (GlyR) antibody–mediated Progressive Encephalomyelitis with Rigidity and Myoclonus (PERM). Through a retrospective analysis of cases from a laboratory database and a systematic literature review, the authors identified 41 patients to understand the disease's characteristics, which included rapid onset, a male predominance, and frequent brainstem involvement. The findings conclude that GlyR antibody–mediated PERM is a distinct, rapidly progressive, and severe clinical entity, separate from other related stiff-person spectrum disorders, with older age and Intensive Care Unit (ICU) admission being independent predictors of poor outcome.

    15 min

  6. SEP 14

    Neurological complications of drug misuse

    The paper provides an extensive overview of the neurological complications stemming from drug misuse, encompassing both illicit substances and prescription medications. It addresses the global prevalence of drug-use disorders and the increasing complexity introduced by new psychoactive substances like synthetic cannabinoids and potent opioids such as fentanyl. The document details the acute and long-term neurological manifestations associated with various drug classes, including opiates, stimulants, hallucinogens, and inhalants, outlining specific syndromes of toxicity and withdrawal. Furthermore, it discusses complications such as trauma, infections, seizures, strokes, cognitive impairment, and movement disorders, emphasizing the disproportionate impact on young individuals. The text underscores the critical importance for neurologists to promptly identify acute toxicity and comprehend the lasting consequences of drug-use disorders for effective patient care.

    18 min

  7. SEP 14

    Minimally invasive surgery for intracerebral hemorrhage

    This document outlines the protocol for a multicenter, randomized clinical study evaluating the effectiveness and safety of minimally invasive surgery (MIS) using the Artemis Neuro Evacuation Device for treating supratentorial intracerebral hemorrhage (ICH) compared to conventional medical management (MM). The study employs an adaptive design with potential interim analyses to assess efficacy and possibly stop early for success or futility. It details the responsibilities of the sponsor and investigators, emphasizing ethical considerations like informed consent and subject data protection. Various neurological exams and stroke scales are used for assessment, and the document also covers risk analysis, adverse event reporting, and statistical procedures for analyzing outcomes, including 30-day mortality as a primary safety endpoint and 180-day global disability as a primary efficacy endpoint.

    48 min

  8. SEP 7

    A blood test to distinguish Parkinson's disease and Dementia with Lewy bodies

    This research investigates alpha-synuclein (aSyn) strains in Lewy body diseases (LBDs), specifically Parkinson's disease (PD) and Dementia with Lewy bodies (DLB). The study utilized monoclonal antibodies to detect distinct aSyn species, termed strain A and strain B, in various human biological samples. Significantly, higher levels of both strain A and B aSyn were found in the plasma of individuals with PD compared to those with DLB. The authors also found that lower levels of plasma aSyn strain A correlated with a faster rate of cognitive decline in PD patients. Importantly, these plasma aSyn species demonstrated pathogenic potential, capable of inducing aSyn fibrillization in vitro and aggregate formation in cell models, suggesting their role in disease progression and as potential biomarkers.

    13 min
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A selection of recent neurology papers is summarized and discussed, with a focus on review articles and those that have the potential to change clinical practice. Please note that AI has been used in generating the content.

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