Pub Date : 2025-11-03DOI: 10.1001/jamaneurol.2025.4286
,Hyun Jin Han,Yun Seo Kim,Seoyeon Park,Jae Il Shin,Min Seo Kim,Ju Hyung Moon,Yong Bae Kim,Hazim S Ababneh,Ahmed Abu-Zaid,Demelash Areda,Santhosh Arul,Ahmed Y Azzam,Mainak Bardhan,Mohammad Amin Bayat Tork,Babak Behnam,Gokce Belge Bilgin,Prarthna V Bhardwaj,Soumitra S Bhuyan,Nima Broomand Lomer,Meng Xuan Chen,Suma Sri Chennapragada,Xiaochen Dai,Frances E Dean,Sindhura Deekonda,Xueting Ding,Ojas Prakashbhai Doshi,Abdel Rahman E'mar,Muhammed Elhadi,Jawad Fares,Patrick Fazeli,James L Fisher,Maryam Fotouhi,Ali Gholamrezanezhad,Fidelia Ida,Chidozie Declan Iwu,Mohamed Jalloh,Chinmay T Jani,Rizwan Kalani,Samuel Berchi Kankam,Foad Kazemi,Ariz Keshwani,Atulya Aman Khosla,Stephen S Lim,Riffat Mehboob,Tomislav Mestrovic,Ali H Mokdad,Christopher J L Murray,Gurudatta Naik,Zuhair S Natto,Dang Nguyen,Fred Nugen,Atakan Orscelik,Romil R Parikh,Louise Penberthy,Richard G Pestell,Disha Prabhu,Jagadeesh Puvvula,Shakthi Kumaran Ramasamy,Cameron John Sabet,Austin E Schumacher,Yigit Can Senol,Sunder Sham,Samendra P Sherchan,Gizeaddis Lamesgin Simegn,Jasvinder A Singh,Ranjan Solanki,Bahadar S Srichawla,Jabeen Taiba,Manoj Tanwar,Mike Tuffour Amirikah,Anjul Verma,Ismaeel Yunusa,David X Zheng,Dong Keon Yon,Keun Young Park
ImportancePrimary brain and central nervous system cancer (collectively referred to as CNS cancer) comprises 2% of all human cancers and poses significant health and economic challenges in the United States.ObjectiveTo analyze CNS cancer burden in the US, stratified by time, location (state and division), sex, age group, and Sociodemographic Index (SDI).Design, Setting, and ParticipantsThis cross-sectional study involved a repeated analysis of Global Burden of Disease Study (GBD) 2021 data in 2024. Using data from 183 sources, CNS cancer metrics in the US were estimated across states and years. US CNS cancer metrics across all sexes and age groups were included in the GBD.ExposureCNS cancer diagnosis.Main Outcomes and MeasuresOverall and age-standardized estimates of the incidence, prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost, and years lived with disability per 100 000 population, including 95% uncertainty intervals (UIs), and time trends.ResultsIn 2021, for all age groups and sexes across the US, there were 31 780 incident cases (95% UI, 29971.1 to 32843.9). Age-standardized incidence, DALYs, and mortality rates per 100 000 population were 6.91 (95% UI, 6.58 to 7.12), 134.38 (95% UI, 129.83 to 137.95), and 4.1 (95% UI, 3.87 to 4.22), respectively. Despite no significant change observed in the overall incidence between 1990 and 2021, DALY and mortality rates decreased by 15.77% (95% UI, -17.75% to -13.68%) and 8.41% (95% UI, -11.09% to -6.22%), respectively. Substantial geographic variability was noted. Mississippi, Alabama, Kentucky, and Kansas (West North Central and East South Central divisions) and West Virginia faced persistently high burdens over the past 30 years. Sex differences were evident; disease burden was consistently higher in males compared with females. Age-specific estimates showed a bimodal distribution: the youngest group (<5 years) showed a significant decrease in incidence rate (-34.42% to -11.56%), whereas older age groups (>70 years) experienced increasing trends. DALYs and mortality rates were negatively correlated with SDI (ρ = -0.6860 and ρ = -0.6391; P < .001).Conclusions and RelevanceThese findings provide valuable insights into the CNS cancer burden across the US by age, sex, location, and SDI, enabling better public health status assessments, health care policy restructuring, and resource redistribution for improved care.
{"title":"Burden of Central Nervous System Cancer in the United States, 1990-2021.","authors":" ,Hyun Jin Han,Yun Seo Kim,Seoyeon Park,Jae Il Shin,Min Seo Kim,Ju Hyung Moon,Yong Bae Kim,Hazim S Ababneh,Ahmed Abu-Zaid,Demelash Areda,Santhosh Arul,Ahmed Y Azzam,Mainak Bardhan,Mohammad Amin Bayat Tork,Babak Behnam,Gokce Belge Bilgin,Prarthna V Bhardwaj,Soumitra S Bhuyan,Nima Broomand Lomer,Meng Xuan Chen,Suma Sri Chennapragada,Xiaochen Dai,Frances E Dean,Sindhura Deekonda,Xueting Ding,Ojas Prakashbhai Doshi,Abdel Rahman E'mar,Muhammed Elhadi,Jawad Fares,Patrick Fazeli,James L Fisher,Maryam Fotouhi,Ali Gholamrezanezhad,Fidelia Ida,Chidozie Declan Iwu,Mohamed Jalloh,Chinmay T Jani,Rizwan Kalani,Samuel Berchi Kankam,Foad Kazemi,Ariz Keshwani,Atulya Aman Khosla,Stephen S Lim,Riffat Mehboob,Tomislav Mestrovic,Ali H Mokdad,Christopher J L Murray,Gurudatta Naik,Zuhair S Natto,Dang Nguyen,Fred Nugen,Atakan Orscelik,Romil R Parikh,Louise Penberthy,Richard G Pestell,Disha Prabhu,Jagadeesh Puvvula,Shakthi Kumaran Ramasamy,Cameron John Sabet,Austin E Schumacher,Yigit Can Senol,Sunder Sham,Samendra P Sherchan,Gizeaddis Lamesgin Simegn,Jasvinder A Singh,Ranjan Solanki,Bahadar S Srichawla,Jabeen Taiba,Manoj Tanwar,Mike Tuffour Amirikah,Anjul Verma,Ismaeel Yunusa,David X Zheng,Dong Keon Yon,Keun Young Park","doi":"10.1001/jamaneurol.2025.4286","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.4286","url":null,"abstract":"ImportancePrimary brain and central nervous system cancer (collectively referred to as CNS cancer) comprises 2% of all human cancers and poses significant health and economic challenges in the United States.ObjectiveTo analyze CNS cancer burden in the US, stratified by time, location (state and division), sex, age group, and Sociodemographic Index (SDI).Design, Setting, and ParticipantsThis cross-sectional study involved a repeated analysis of Global Burden of Disease Study (GBD) 2021 data in 2024. Using data from 183 sources, CNS cancer metrics in the US were estimated across states and years. US CNS cancer metrics across all sexes and age groups were included in the GBD.ExposureCNS cancer diagnosis.Main Outcomes and MeasuresOverall and age-standardized estimates of the incidence, prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost, and years lived with disability per 100 000 population, including 95% uncertainty intervals (UIs), and time trends.ResultsIn 2021, for all age groups and sexes across the US, there were 31 780 incident cases (95% UI, 29971.1 to 32843.9). Age-standardized incidence, DALYs, and mortality rates per 100 000 population were 6.91 (95% UI, 6.58 to 7.12), 134.38 (95% UI, 129.83 to 137.95), and 4.1 (95% UI, 3.87 to 4.22), respectively. Despite no significant change observed in the overall incidence between 1990 and 2021, DALY and mortality rates decreased by 15.77% (95% UI, -17.75% to -13.68%) and 8.41% (95% UI, -11.09% to -6.22%), respectively. Substantial geographic variability was noted. Mississippi, Alabama, Kentucky, and Kansas (West North Central and East South Central divisions) and West Virginia faced persistently high burdens over the past 30 years. Sex differences were evident; disease burden was consistently higher in males compared with females. Age-specific estimates showed a bimodal distribution: the youngest group (<5 years) showed a significant decrease in incidence rate (-34.42% to -11.56%), whereas older age groups (>70 years) experienced increasing trends. DALYs and mortality rates were negatively correlated with SDI (ρ = -0.6860 and ρ = -0.6391; P < .001).Conclusions and RelevanceThese findings provide valuable insights into the CNS cancer burden across the US by age, sex, location, and SDI, enabling better public health status assessments, health care policy restructuring, and resource redistribution for improved care.","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"69 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1001/jamaneurol.2025.4240
Sairah Bashir
This essay discusses the role of color psychology in hospital environments and how, by leveraging understanding of how color impacts emotional and psychological states, health care institutions can create spaces that not only treat the body but also support the mind and brain.
{"title":"Butter Yellow—A Soft Hue With Neurological Implications","authors":"Sairah Bashir","doi":"10.1001/jamaneurol.2025.4240","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.4240","url":null,"abstract":"This essay discusses the role of color psychology in hospital environments and how, by leveraging understanding of how color impacts emotional and psychological states, health care institutions can create spaces that not only treat the body but also support the mind and brain.","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"156 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1001/jamaneurol.2025.4224
Sara Hassani, Tonya Roberson, Nicole Rosendale, Lesli E. Skolarus
This essay advocates for community-engaged research as a means to help overcome the delay in disseminating research findings among the general population.
这篇文章提倡社区参与的研究作为一种手段，以帮助克服传播研究成果在普通人群中的延迟。
{"title":"Community-Engaged Research—A Path to More Representative, Efficient, and Impactful Research in Neurology","authors":"Sara Hassani, Tonya Roberson, Nicole Rosendale, Lesli E. Skolarus","doi":"10.1001/jamaneurol.2025.4224","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.4224","url":null,"abstract":"This essay advocates for community-engaged research as a means to help overcome the delay in disseminating research findings among the general population.","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"18 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1001/jamaneurol.2025.4192
Monica Mureb,Shaye Busse,John V Wainwright
{"title":"Intramedullary Hemorrhage Causing Quadriplegia in the Setting of a Type B Aortic Dissection.","authors":"Monica Mureb,Shaye Busse,John V Wainwright","doi":"10.1001/jamaneurol.2025.4192","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.4192","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"128 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1001/jamaneurol.2025.4232
Kimberly J. Waddell, S. Ryan Greysen, Mitesh S. Patel, Madison S. Smith, Abby Yuen Tsz Lau, Sharon X. Xie, Stephanie Wood, James F. Morley
This nonrandomized clinical trial tests the efficacy of a remote, automated gamification intervention for increasing daily steps in people with Parkinson disease.
这项非随机临床试验测试了远程、自动游戏化干预对帕金森病患者增加每日步数的效果。
{"title":"Remote, Automated Gamification and Community-Based Physical Activity in Parkinson Disease","authors":"Kimberly J. Waddell, S. Ryan Greysen, Mitesh S. Patel, Madison S. Smith, Abby Yuen Tsz Lau, Sharon X. Xie, Stephanie Wood, James F. Morley","doi":"10.1001/jamaneurol.2025.4232","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.4232","url":null,"abstract":"This nonrandomized clinical trial tests the efficacy of a remote, automated gamification intervention for increasing daily steps in people with Parkinson disease.","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"25 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1001/jamaneurol.2025.2562
Mark A Pacult
{"title":"It Ain't About You, Kid.","authors":"Mark A Pacult","doi":"10.1001/jamaneurol.2025.2562","DOIUrl":"10.1001/jamaneurol.2025.2562","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"1087-1088"},"PeriodicalIF":21.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1001/jamaneurol.2025.3151
Adam S Arthur, Babak S Jahromi, Paul S Saphier, Christopher M Nickele, Robert W Ryan, Peter Vajkoczy, Clemens M Schirmer, Christopher P Kellner, Charles C Matouk, Eric J Arias, Jamie S Ullman, Michael R Levitt, Ziad A Hage, David J Fiorella
Importance: It remains uncertain whether surgical evacuation improves functional outcomes in patients with supratentorial intracerebral hemorrhage (ICH).
Objective: To compare the safety and efficacy of minimally invasive surgery with the Artemis Neuro Evacuation Device to guideline-based medical management alone for spontaneous supratentorial ICH.
Design, setting, and participants: The MIND open-label, multicenter randomized clinical trial randomized patients with spontaneous supratentorial ICH in a 2:1 ratio to either minimally invasive surgery or medical management alone. Participants were enrolled at 32 participating global sites between February 6, 2018, and August 28, 2023. This article reports on the primary trial outcome. Of 4066 eligible adult patients (aged 18-80 years) with moderate- to large-volume supratentorial ICH (20-80 mL), baseline National Institutes of Health Stroke Scale score of 6 or higher, and Glasgow Coma Scale score between 5 and 15, 154 were randomized to minimally invasive surgery and 82 to medical management. Data were analyzed from February to September 2024.
Intervention: Minimally invasive surgery (within 72 hours of symptom onset) plus medical management or medical management alone.
Main outcomes and measures: The primary efficacy outcome was 180-day combined death and disability via ordinal modified Rankin Scale score (range, 0 [no symptoms] to 6 [death]). The primary safety outcome was 30-day mortality.
Results: Following an independent feasibility analysis prompted by the publication of positive results of a contemporaneous ICH trial, enrollment was stopped early at 236 participants. Overall median (IQR) participant age was 60 (50-70) years, 87 participants (36.9%) were female, 164 (69.5%) had primarily deep bleeds, and 72 (30.5%) had primarily lobar bleeds. Efficacy results of the primary model analysis suggested lack of evidence for the superiority of minimally invasive surgery over medical management (odds ratio [OR], 1.03; 96% CI, 0.62-1.72; P = .45). The adjusted model's mean OR was also nonsignificantly greater than 1 (OR, 1.10; 96% CI, 0.66-1.85; P = .35). By 30 days, 11 participants (7.2%) in the surgery group and 8 (9.8%) in the medical management group died (difference, -2.5%; 95% CI, -11.7% to 4.8%).
Conclusions and relevance: In the MIND randomized clinical trial, minimally invasive surgery within 72 hours did not significantly reduce 30-day mortality or improve 180-day disability in patients with supratentorial ICH compared to medical management alone.
{"title":"Minimally Invasive Surgery vs Medical Management Alone for Intracerebral Hemorrhage: The MIND Randomized Clinical Trial.","authors":"Adam S Arthur, Babak S Jahromi, Paul S Saphier, Christopher M Nickele, Robert W Ryan, Peter Vajkoczy, Clemens M Schirmer, Christopher P Kellner, Charles C Matouk, Eric J Arias, Jamie S Ullman, Michael R Levitt, Ziad A Hage, David J Fiorella","doi":"10.1001/jamaneurol.2025.3151","DOIUrl":"10.1001/jamaneurol.2025.3151","url":null,"abstract":"<p><strong>Importance: </strong>It remains uncertain whether surgical evacuation improves functional outcomes in patients with supratentorial intracerebral hemorrhage (ICH).</p><p><strong>Objective: </strong>To compare the safety and efficacy of minimally invasive surgery with the Artemis Neuro Evacuation Device to guideline-based medical management alone for spontaneous supratentorial ICH.</p><p><strong>Design, setting, and participants: </strong>The MIND open-label, multicenter randomized clinical trial randomized patients with spontaneous supratentorial ICH in a 2:1 ratio to either minimally invasive surgery or medical management alone. Participants were enrolled at 32 participating global sites between February 6, 2018, and August 28, 2023. This article reports on the primary trial outcome. Of 4066 eligible adult patients (aged 18-80 years) with moderate- to large-volume supratentorial ICH (20-80 mL), baseline National Institutes of Health Stroke Scale score of 6 or higher, and Glasgow Coma Scale score between 5 and 15, 154 were randomized to minimally invasive surgery and 82 to medical management. Data were analyzed from February to September 2024.</p><p><strong>Intervention: </strong>Minimally invasive surgery (within 72 hours of symptom onset) plus medical management or medical management alone.</p><p><strong>Main outcomes and measures: </strong>The primary efficacy outcome was 180-day combined death and disability via ordinal modified Rankin Scale score (range, 0 [no symptoms] to 6 [death]). The primary safety outcome was 30-day mortality.</p><p><strong>Results: </strong>Following an independent feasibility analysis prompted by the publication of positive results of a contemporaneous ICH trial, enrollment was stopped early at 236 participants. Overall median (IQR) participant age was 60 (50-70) years, 87 participants (36.9%) were female, 164 (69.5%) had primarily deep bleeds, and 72 (30.5%) had primarily lobar bleeds. Efficacy results of the primary model analysis suggested lack of evidence for the superiority of minimally invasive surgery over medical management (odds ratio [OR], 1.03; 96% CI, 0.62-1.72; P = .45). The adjusted model's mean OR was also nonsignificantly greater than 1 (OR, 1.10; 96% CI, 0.66-1.85; P = .35). By 30 days, 11 participants (7.2%) in the surgery group and 8 (9.8%) in the medical management group died (difference, -2.5%; 95% CI, -11.7% to 4.8%).</p><p><strong>Conclusions and relevance: </strong>In the MIND randomized clinical trial, minimally invasive surgery within 72 hours did not significantly reduce 30-day mortality or improve 180-day disability in patients with supratentorial ICH compared to medical management alone.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03342664.</p>","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"1113-1121"},"PeriodicalIF":21.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1001/jamaneurol.2025.1630
Ivan Martinez-Valbuena, M Carmela Tartaglia, Gabor G Kovacs, Anthony E Lang
{"title":"Copathology in Atypical Parkinsonism-The Rule Rather Than the Exception?","authors":"Ivan Martinez-Valbuena, M Carmela Tartaglia, Gabor G Kovacs, Anthony E Lang","doi":"10.1001/jamaneurol.2025.1630","DOIUrl":"10.1001/jamaneurol.2025.1630","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"1083-1084"},"PeriodicalIF":21.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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