Citations 2
Promoting Growth in Behavioral Neurology: A Path Forward
Josephy‐Hernandez, Sylvia , Apostolova, Liana G. , Budson, Andrew E. , Chemali, Zeina , Lin, Chi‐Ying , Daffner, Kirk R. , Geschwind, Michael D., Heilman, Kenneth M. , Holden, Samantha K. , Jaffee, Michael S., Kletenik, Isaiah , Love, Marissa Natelson , Moo, Lauren R. , Pelak, Victoria S. , Press, Daniel Z. , Ramírez-Gómez, Liliana , Rosen, Howie, Vaishnavi, Sanjeev , Windon, Charles , Hamilton, Roy H. , Perez, David L. , Hamilton, Roy , Windon, Charles , Hamilton, Roy H , Bateman, James R. , Benjamin, Sheldon , Barrett, Anna M. , Boeve, Bradley F. , Hillis, Argye Elizabeth , Schmahmann, Jeremy Dan
Cognitive and Behavioral Neurology | May 8, 2024 | Volume: 37 | Issue: 2 | Pages: 49-56
Behavioral neurology & neuropsychiatry (BNNP) is a field that seeks to understand brain–behavior relationships, including fundamental brain organization principles and the many ways that brain structures and connectivity can be disrupted, leading to abnormalities of behavior, cognition, emotion, perception, and social cognition. In North America, BNNP has existed as an integrated subspecialty through the United Council for Neurologic Subspecialties since 2006. Nonetheless, the number of behavioral neurologists across academic medical centers and community settings is not keeping pace with increasing clinical and research demand. In this commentary, we provide a brief history of BNNP followed by an outline of the current challenges and opportunities for BNNP from the behavioral neurologist’s perspective across clinical, research, and educational spheres. We provide a practical guide for promoting BNNP and addressing the shortage of behavioral neurologists to facilitate the continued growth and development of the subspecialty. We also urge a greater commitment to recruit trainees from diverse backgrounds so as to dismantle persistent obstacles that hinder inclusivity in BNNP—efforts that will further enhance the growth and impact of the subspecialty. With rapidly expanding diagnostic and therapeutic approaches across a range of conditions at the intersection of neurology and psychiatry, BNNP is well positioned to attract new trainees and expand its reach across clinical, research, and educational activities.
Etiology of White Matter Hyperintensities in Autosomal Dominant and Sporadic Alzheimer Disease
Shirzadi, Zahra , Schultz, Stephanie A. , Yau, Wai‐Ying Wendy , Fitzpatrick, Colleen , Levin, Raina, Kantarci, Kejal , Preboske, Gregory M., Jack, Clifford R. , Farlow, Martin R. , Hassenstab, Jason , Morris, John C. , Xiong, Chengjie , Levey, Allan I. , Gordon, Brian A. , Salloway, Stephen , Perrin, Richard J. , Xiong, Chengjie , Fox, Nick C. , Goate, Alison , Day, Gregory S. , Chui, Helena C., Berman, Sarah , Mori, Hiroshi , Ruthirakuhan, Myuri , Wu, Che‐Yuan , Sohrabi, Hamid R. , Martins, Ralph N. , Johnson, Keith A. , Greenberg, Steven M. , Chhatwal, Jasmeer P. , Initiative, Dominantly Inherited Alzheimer Network and the Alzheimer’s Disease Neuroimaging, Weiner, Michael W. , Aisen, Paul, Petersen, Ronald , Jack, Clifford R., Jagust, William J. , Trojanowki, John Q., Morris, John C., Shaw, Leslie M. , Khachaturian, Zaven S., Carrillo, Maria, Potter, William Z., Bernard, Marie , Jackson, Jonathan , Masliah, Eliezer , Masterman, Donna, Okonkwo, Ozioma C. , Ryan, Laurie, Silverberg, Nina, Fleisher, Adam , Sacrey, Diana Truran, Fockler, Juliet , Conti, Cat, Jin, Chengshi , Nosheny, Rachel L. , Ashford, Miriam T. , Flenniken, Derek , Kormos, Adrienne, Montine, Tom, Raman, Rema , Jiménez, Gustavo , Gessert, Devon, Salazar, Jennifer, Zimmerman, Caileigh, Cabrera, Yuliana, Walter, Sarah , Miller, Garrett, Coker, Godfrey, Clanton, Taylor, Hergesheimer, Lindsey, Adegoke, Olusegun, Mahboubi, Payam, Moore, Shelley, Pizzola, Jeremy, Shaffer, Elizabeth , Sloan, Brittany, Forghanian-Arani, Arvin, Borowski, Bret, Ward, Chad, Gunter, Jeff, Jahanshad, Neda , DeCarli, Charles, Knaack, Alexander , Chen, Stephanie Rossi, Choe, Mark, Crawford, Karen , Reiman, Eric M. , Mathis, Chet, Landau, Susan, Cairns, Nigel J., Householder, Erin, Franklin, Erin , Bernhardt, Haley, Taylor‐Reinwald, Lisa, Korecka, Magdalena , Figurski, Michael, Neu, Scott, Apostolova, Liana G. , Foroud, Tatiana M., Faber, Kelley, Wilmes, Kristi, Thal, Leon J., Lind, Betty, Crissey, Rachel, Carter, Raina, Dolen, Sara, Schneider, Lon S. , Pawluczyk, Sonia, Becerra, Mauricio, Teodoro, Liberty, Dagerman, Karen, Spann, Bryan M., Brewer, James B., Vanderswag, Helen, Ziolkowski, Jaimie, Heidebrink, Judith L. , Zbizek-Nulph, Lisa, Mason, Sara S., Albers, Colleen S., Johnson, Kris , Villaneuva-Meyer, Javier, Pavlik, Valory , Pacini, Nathaniel, Lamb, Ashley, Kass, Joseph S. , Doody, Rachelle S., Shibley, Victoria, Chowdhury, Munir , Rountree, Susan, Dang, Mimi, Mintz, Akiva , Winkfield, David, Carroll, Maria , Stobbs-Cucchi, Georgia , Oliver, Angela , Creech, Mary L., Mintun, Mark A., Schneider, Stacy, Geldmacher, David , Love, Marissa Natelson , Griffith, Randall, Clark, David, Brockington, John, Marson, Daniel , Grossman, Hillel, Goldstein, Martin , Mitsis, Effie, Samuels, Patricia, Duara, Ranjan , Greig‐Custo, Maria T., Rodriguez, Rosemarie, Albert, Marilyn, Onyike, Chiadi, Farrington, Leonie, Rudow, Scott, Brichko, Rottislav, Kielb, Stephanie , Smith, Amanda , Raj, Balebail Ashok, Fargher, Kristin, Shulman, Melanie , Faustin, Arline , Rao, Julia, Castro, Karen M. , Ulysse, Anaztasia, Chen, Shannon, Sheikh, Mohammed O., Singleton-Garvin, Jamika, Doraiswamy, P. Murali , Petrella, Jeffrey R. , James, Olga, Borges‐Neto, Salvador , Karlawish, Jason , Vaishnavi, Sanjeev , Clark, Christopher M. , Arnold, Steven E. , Smith, Charles D. , Khouli, Riham El , Raslau, Flavius D., Oakley, MaryAnn, Simpson, Donna M., Martin, Kim, Kowalski, Nancy, Keltz, Melanie, Goldstein, Bonnie S., Makino, Kelly M., Ismail, M. Saleem , Brand, Connie, Thai, Gaby , Pierce, Aimee, Witbracht, Megan , Mathews, Dana, Quiceno, Mary , Hajjar, Ihab , Cellar, Janet S., Swerdlow, Russell H. , Kremen, Sarah , Tingus, Kathleen, Lu, Po H. , Bartzokis, George, Woo, Ellen, Graff‐Radford, Neill R. , Parfitt, Francine, Poki-Walker, Kim, Hake, Ann Marie , Matthews, Brandy R., Herring, Scott, Dyck, Christopher H. van , Mecca, Adam P. , Good, Susan P., MacAvoy, Martha G., Carson, Richard E. , Varma, Pradeep, Chertkow, Howard , Vaitekunis, Susan, Hosein, Chris, Mudge, Benita, Assaly, Michele, Rachinsky, Irina, Kertesz, Andrew, Drost, Dick, Rogers, John, Grant, Ian , Muse, Brittanie, Rogalskı, Emily , Robson, Jordan, Mesulam, M.‐Marsel, Kerwin, Diana , Wu, Chuang‐Kuo, Johnson, Nancy E., Lipowski, Kristine, Weıntraub, Sandra , Bonakdarpour, Borna , Hernando, Raymundo, Sarrael, Antero, Rosen, Howard J., Johnson, Kathleen, Reynolds, Brigid, Poe, Jessica, Sperling, Reisa A., Marshall, Gad A. , Yesavage, Jerome A. , Taylor, Joy L. , Chao, Steven, Coleman, Jaila, White, Jessica D. , Lane, Barton , Rosen, Allyson , Tinklenberg, Jared, Belden, Christine M. , Clark, Kelly, Zamrini, Edward , Sabbagh, Marwan, Kowall, Neil W. , Budson, Andrew E. , Ntekim, Oyonumo, Wolday, Saba, Khan, Javed , Nwulia, Evaristus , Nadarajah, Sheeba , Lerner, Alan J. , Ogrocki, Paula, Tatsuoka, Curtis , Fatica, Parianne, Olichney, John , Bates, Vernice, Capote, Horacio, Rainka, Michelle, Borrie, Michael, Lee, T‐Y, Asthana, Sanjay , Carlsson, Cynthia M., Perrin, Allison, Burke, Anna , Kataki, Maria , Hart, David , Zimmerman, Earl A. , Celmins, Dzintra, Smith, Karen Ekstam, Shim, Hyungsub , Nam, Ki Won , Schtulz, Susan K., Williamson, Jeff D. , Craft, Suzanne , Cleveland, Jo, Ott, Brian R. , Drake, Jonathan, Tremont, Geoffrey , Daiello, Lori A. , Ritter, Aaron, Bernick, Charles , Munic, Donna, O’Connell, Abigail, Mintzer, Jacobo , Wiliams, Arthur, Masdeu, Joseph C. , Shi, Jiong , Garcia, Angelica, Newhouse, Paul , Salloway, Steven, Malloy, Paul, Correia, Stephen , Kittur, Smita, Blank, Karen, Anderson, Karen, Flashman, Laura A. , Seltzer, Marc, Hynes, Mary L. , Santulli, Robert B. , Relkin, Norman , Chiang, Gloria, Lee, Athena, Lin, Michael, Ravdin, Lisa , Sood, Ajay, Blanchard, Kimberly S., Fleischman, Debra , Varon, Daniel, Greig, Maria T., Martin, Kimberly S., Reist, Christopher , Sadowsky, Carl, Villena, Teresa, Rosen, Howard, Peskind, Elaine R. , Li, Gail, Vöglein, Jonathan , Méndez, Patricio Chrem, Ikonomović, Snežana, Nadkarni, Neelesh K. , Ramírez, Laura, Leon, Yudy Milena, Ramos, Cláudia , Alzate, Diana, Baena, Ana , Londono, Natalia, Laske, Christoph , Kuder-Buletta, Elke, Gräber‐Sultan, Susanne, Preische, Oliver, Hofmann, Anna, Ishii, Kenji , Senda, Michio , Riddle, Meghan C., Menard, William, Bodge, Courtney, Surti, Mustafa, Sanchez-Gonzalez, VJ, Orozco-Barajas, Maribel, Esposito, Bianca, Fernanadez, Victoria, Jerome, Gina, Herries, Elizabeth, Seyfried, Nicholas T. , Bechara, Jacob , Chen, Allison , Hantler, Nancy, Hornbeck, Russ C. , Jarman, Steve, Keefe, Sarah , Koudelis, Deborah, Massoumzadeh, Parinaz , Nicklaus, Joyce , Pulizos, Christine, Mishall, Sheetal, Sabaredzovic, Edita, Deng, Emily , Candela, Madison, Smith, Hunter , Scott, Jalen , Gremminger, Emily, Ma, Yinjiao , Bui, Ryan , Lu, Ruijin , Daniels, Alisha , Courtney, Laura, Supnet, Charlene , Xu, Jinbin , Ringman, John M. , Barthélemy, Nicolas R. , Jack, Clifford R , Gordon, Brian A , Kantarci, Kejal , Day, Gregory S , Vöglein, Jonathan , Xiong, Chengjie , Fox, Nick C , Hassenstab, Jason , Morris, John C , Goate, Alison M , Supnet-Bell, Charlene , Berman, Sarah , Levey, Allan I , Kremen, Sarah , Joseph‐Mathurin, Nelly , Jucker, Mathias , Xiong, Chengjie , Karch, Celeste M. , Schofield, Peter R. , McDade, Eric , Cruchaga, Carlos , Allegri, Ricardo , Koeppe, Robert A. , Chui, Helena C. , Sánchez‐Valle, Raquel , Lee, Jae‐Hong , Rosa-Neto, Pedro , Swardfager, Walter , Benzinger, Tammie L.S. , Bateman, Randall J. , Sperling, Reisa 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JAMA Neurology | October 16, 2023 | Volume: 80 | Issue: 12 | Pages: 1353
ImportanceIncreased white matter hyperintensity (WMH) volume is a common magnetic resonance imaging (MRI) finding in both autosomal dominant Alzheimer disease (ADAD) and late-onset Alzheimer disease (LOAD), but it remains unclear whether increased WMH along the AD continuum is reflective of AD-intrinsic processes or secondary to elevated systemic vascular risk factors.ObjectiveTo estimate the associations of neurodegeneration and parenchymal and vessel amyloidosis with WMH accumulation and investigate whether systemic vascular risk is associated with WMH beyond these AD-intrinsic processes.Design, Setting, and ParticipantsThis cohort study used data from 3 longitudinal cohort studies conducted in tertiary and community-based medical centers—the Dominantly Inherited Alzheimer Network (DIAN; February 2010 to March 2020), the Alzheimer’s Disease Neuroimaging Initiative (ADNI; July 2007 to September 2021), and the Harvard Aging Brain Study (HABS; September 2010 to December 2019).Main Outcome and MeasuresThe main outcomes were the independent associations of neurodegeneration (decreases in gray matter volume), parenchymal amyloidosis (assessed by amyloid positron emission tomography), and vessel amyloidosis (evidenced by cerebral microbleeds [CMBs]) with cross-sectional and longitudinal WMH.ResultsData from 3960 MRI sessions among 1141 participants were included: 252 pathogenic variant carriers from DIAN (mean [SD] age, 38.4 [11.2] years; 137 [54%] female), 571 older adults from ADNI (mean [SD] age, 72.8 [7.3] years; 274 [48%] female), and 318 older adults from HABS (mean [SD] age, 72.4 [7.6] years; 194 [61%] female). Longitudinal increases in WMH volume were greater in individuals with CMBs compared with those without (DIAN: t = 3.2 [P = .001]; ADNI: t = 2.7 [P = .008]), associated with longitudinal decreases in gray matter volume (DIAN: t = −3.1 [P = .002]; ADNI: t = −5.6 [P < .001]; HABS: t = −2.2 [P = .03]), greater in older individuals (DIAN: t = 6.8 [P < .001]; ADNI: t = 9.1 [P < .001]; HABS: t = 5.4 [P < .001]), and not associated with systemic vascular risk (DIAN: t = 0.7 [P = .40]; ADNI: t = 0.6 [P = .50]; HABS: t = 1.8 [P = .06]) in individuals with ADAD and LOAD after accounting for age, gray matter volume, CMB presence, and amyloid burden. In older adults without CMBs at baseline, greater WMH volume was associated with CMB development during longitudinal follow-up (Cox proportional hazards regression model hazard ratio, 2.63; 95% CI, 1.72-4.03; P < .001).Conclusions and RelevanceThe findings suggest that increased WMH volume in AD is associated with neurodegeneration and parenchymal and vessel amyloidosis but not with elevated systemic vascular risk. Additionally, increased WMH volume may represent an early sign of vessel amyloidosis preceding the emergence of CMBs.