JNS.jpgThe September issue of the Journal of the Neurological Sciences Vol 404 is now available online.

 

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Issue highlights

Artificial intelligence in neurocritical care

Neurocritical care combines the management of extremely complex disease states with the inherent limitations of clinically assessing patients with brain injury. As the management of neurocritical care patients can be immensely complicated, the automation of data collection and basic management by artificial intelligence systems have garnered interest.

In this opinion article, we highlight the potential artificial intelligence has in monitoring and managing several aspects of neurocritical care, specifically intracranial pressure, seizure monitoring, blood pressure, and ventilation.


Cost of disease-modifying therapies for multiple sclerosis: Is front-loading the answer?

The literature on the cost-effectiveness of these is often confusing and contradictory. There is a lack of quality evidence enabling the comparison of different DMTs.

This review looks at the different DMTs available for MS and attempts to draw some conclusions on their cost-effectiveness. It also considers the costs and benefits of front-loading the cost of treatment for MS by using more expensive and effective treatment earlier on.

  • There are now over a dozen DMTs available to treat MS.
  • The literature on the cost-effectiveness of DMTs is often confusing and contradictory.
  • Currently, the drugs with the most benefit tend to be those that carry the most risk and highest price tag.
  • CEAs support the idea that using more aggressive measures earlier on may mean the cost of long term disability is reduced. Abstract There are now over a dozen disease-modifying therapies (DMTs) available to treat multiple sclerosis (MS). They vary in efficacy and safety as well as in cost.

Cerebral imaging in adult mitochondrial disorders

Among the organs/tissues affected in mitochondrial disorders (MIDs), the brain is the second most frequently affected. Cerebral imaging may correlate with clinical findings but not necessarily.

This review summarises and discusses current knowledge and recent advances concerning cerebral abnormalities on imaging in adult MIDs (≥18y).

  • The most common cerebral abnormalities on imaging in adult MIDs are white matter lesions, grey matter lesions, atrophy, optic atrophy, stroke-like lesions, and calcifications.
  • Cerebral imaging is of paramount importance for diagnosing and monitoring cerebral involvement in MIDs.
  • Cerebral imaging in MIDs contributes to the understanding of the pathogenesis of cerebral involvement in MIDs.

 


Impact of cerebral large-artery disease and blood flow in the posterior cerebral artery territory on cognitive function

The purpose of this study was to elucidate the association of cerebral large artery disease (CLAD) with cerebral blood flow (CBF) in the posterior cerebral artery (PCA) territory and cognitive performance.

We prospectively registered 60 patients with CLAD who had internal carotid or middle cerebral artery (MCA) with the degree of stenosis ≥50%. Automated brain segmentation was used to quantify CBF in the thalamus, hippocampus, and PCA and MCA territories.

CBF of the PCA territory was significantly inversely correlated with the degree of stenosis in CLAD patients. Low CBF of the PCA territory was significantly associated with reduced cognitive and memory functions.