Neurology
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Multicenter Study
Practice variability in brain death determination: a call to action.
To characterize the present state of brain death (BD) determination in actual practice relative to contemporary American Academy of Neurology (AAN) guidelines. ⋯ There is wide variability in the documentation of BD determination, likely reflecting similar variability in practice. This is a call for improved documentation, better uniformity of policies, and comprehensive and strategically targeted educational initiatives to ensure consistently contemporary approaches to BD determination in every patient.
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To determine the rate of progression of mild cognitive impairment (MCI) to dementia with Lewy bodies (DLB). ⋯ In a clinical sample, patients with nonamnestic MCI were more likely to develop DLB, and those with amnestic MCI were more likely to develop probable AD.
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To investigate whether the presence of cerebral microbleeds, which present as focal lesions on imaging, is associated with a diffuse loss of white matter microstructural integrity in the brain. ⋯ Presence of microbleeds relates to poorer microstructural integrity of brain white matter, even after adjusting for cardiovascular risk and other markers of cerebral small-vessel disease. Our data suggest that microbleeds reflect diffuse brain pathology, even when only a single microbleed is present.
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Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease causing motor neuron loss and weakness. Worldwide prevalence is 4-6/100,000. Incidence is 1.5-2.7/100,000 per year and may be increasing. ⋯ A major roadblock for comparison across populations is the lack of epidemiologic data about ALS from many underdeveloped regions. In these regions, ALS is often undertreated due to health care disparities. This article discusses challenges for ALS research in South America (SA) and examines the ALS scientific record to explore the interactions and synergies of research, clinical care, and patient advocacy in underdeveloped regions.