Journal of the Neurological Sciences issue 434 now available

Full Length Article

Endovascular thrombectomy with and without preceding intravenous thrombolysis for treatment of large vessel anterior circulation stroke: A cross-sectional analysis of 50,000 patients

The safety and efficacy of intravenous thrombolysis (IVT) before endovascular thrombectomy (EVT) for large vessel occlusion stroke remains a highly contested and unanswered clinical question. We aim to characterize the clinical profile, complications, and discharge disposition of EVT patients treated with and without preceding IVT using a large, nationally-representative sample.

Preceding IVT was associated with favorable functional outcomes following endovascular therapy. Prospective randomized clinical trials are warranted for further evaluation.

Full Length Article

Pattern analysis of peripheral-vestibular deficits with machine learning using hierarchical clustering

Disorders affecting the vestibular organs (semicircular canals, utriculus, sacculus), may result in distinct patterns of peripheral-vestibular loss that may facilitate the diagnostic assessment. When neuropathological tests of these sensors are available, it is possible to classify responses as being due to different deficit types.

The authors provide a topical review and to summarize recent advances in pattern-recognition of unilateral and bilateral vestibular disease by use of hierarchical cluster analysis (HCA) as published by the authors.

HCA significantly facilitates pattern-identification in unilateral and bilateral vestibulopathies and underlines the extensive range of vestibular end-organ damage in the different study populations and subgroups. The large number of existing clustering algorithms with distinct strengths and weaknesses emphasizes the need for careful selection of the most suitable algorithm.

Full Length Article

Increased homocysteine levels correlate with cortical structural damage in Parkinson's disease

Blood homocysteine appears to be increased in Parkinson's disease (PD) and may play a role in the development and progression of this disorder. However, the specific contribution of abnormal homocysteine levels to cortical degeneration in PD remains elusive.

This study aims to characterize the cortical structural correlates of homocysteine levels in PD.

Homocysteine in PD appears to be associated with cognitive performance and structural damage in the cerebral cortex. These findings not only reinforce the presence and importance of cortical degeneration in PD, but also suggest that homocysteine plays a role among the multiple pathological processes thought to be involved in its development.

Full Length Article

Clinical characteristics of patients with lateral medullary infarction who had fatal respiratory failure

Respiratory failure is a fatal complication of lateral medullary infarction (LMI). However, the clinical characteristics associated with respiratory failure in patients with LMI have not been fully elucidated. We aimed to evaluate the clinical characteristics associated with respiratory failure in patients with LMI.

Assessment of pre-stroke history and monitoring of neurological symptoms that occur during the first 10 days post-stroke onset would be useful for predicting the risk of respiratory failure in patients with acute LMI.