30-Second Takeaway
- Teleneurology ward rounds outperformed on-site consults for guideline adherence in subacute inpatient stroke.
- High-efficacy DMTs reduced relapses across MS risk strata, with disability benefit clearest in high-risk patients already on HE-DMTs.
- CSVD—especially WMH burden—is higher in Parkinson disease, supporting aggressive vascular risk management.
- Any intracranial hemorrhage after minor stroke strongly increased 90-day mortality in TEMPO-2.
- Levetiracetam started post–ischemic stroke was often rapidly discontinued in older adults, with adherence varying by sex and race.
Week ending April 11, 2026
New data on teleneurology, MS treatment strategy, vascular contributions to PD, and risk prognostication across stroke, PD, and genetic AD
Teleneurology ward rounds beat on-site consults for guideline adherence in subacute stroke
In this multicenter, prospective nonrandomized trial, 501 hospitalized stroke/TIA patients received both teleneurology and on-site neurology ward rounds. Complete adherence to 6 prespecified guideline-based quality domains was achieved in 92% of teleneurology vs 54% of on-site consultations, a 38-point absolute difference. Superiority of teleneurology was consistent across domains, with the largest gain in secondary prevention documentation and recommendations. These data support deploying structured teleneurology ward rounds to standardize subacute stroke care quality, especially in hospitals with variable on-site expertise.
High-efficacy DMTs reduce relapses across MS risk strata, with selective disability benefit in high-risk patients
This observational cohort (10,405 patients; MSBase and OFSEP) compared continuous high-efficacy DMT (fingolimod, cladribine, monoclonals) vs non–high-efficacy states in relapse-onset MS. Continuous high-efficacy DMT reduced relapse risk in both high-risk and low-risk aggressive MS strata, without clear interaction by risk group. Overall, there was no difference in disability outcomes between treatment strategies across strata. In a secondary analysis restricted to high-efficacy DMT recipients, treatment reduced disability worsening in high-risk patients to levels seen in low-risk patients. These findings support using high-efficacy DMTs to curb relapses broadly and suggest particular disability benefit for those already at highest risk.
Parkinson disease is associated with higher WMH burden, implicating small-vessel pathology
This Neurology systematic review and meta-analysis included 46 mainly cross-sectional studies totaling 3,817 PD patients and 2,593 controls. PD was associated with higher white matter hyperintensity volume and visual WMH scores across global, periventricular, and deep regions. There were no significant pooled differences in cerebral microbleeds or lacunes between PD and controls. Enlarged perivascular spaces, especially in the midbrain, tended to be more prominent in PD, though results were heterogeneous. Despite low overall evidence quality, the data support a neurovascular contribution to PD and justify attention to vascular risk and CSVD on imaging.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.