Interprofessional consultations ("eConsults"), which facilitate asynchronous specialist consultations, remain understudied in neurological disorders. We aimed to describe the patient population receiving eConsult services for neurological disorders nationwide and to conduct a comparative analysis between rural and urban patients within this eConsult cohort. We analyzed a dataset of U.S. outpatient claims from employer-sponsored commercial and Medicare plans. Using standardized mean differences, we compared clinical and sociodemographic patient characteristics between urban and rural patients within the eConsult group. We identified 1,374 patients who had an eConsult order for a neurological disorder. Overall eConsult volume increased by 548.5% between 2019 and 2021. A majority of the cohort were aged 65 years or older (23.7%), had an eConsult order in 2021 (52.4%), and live in an urban area (90.4%). The primary diagnosis for our cohort was likely to be a sleep-wake disorder (21.9%), cerebrovascular disease (14.3%), neurological sign or symptom (14.2%), or headache (13.7%). In the secondary analysis, rural eConsult patients exhibited higher rates of primary diagnoses for traumatic brain injury, neuroophthalmic disorders, or neuropathy than their urban counterparts. In this national sample of commercially insured patients, the utilization of eConsults for neurological conditions increased nationwide since 2019, especially for patients living in rural areas.
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http://dx.doi.org/10.1089/tmj.2023.0598 | DOI Listing |
Invest Ophthalmol Vis Sci
January 2025
Department of Ophthalmology, University of California, Los Angeles, California, United States.
Purpose: The optic nerve (ON) is mechanically perturbed by eye movements that shift cerebrospinal fluid (CSF) within its surrounding dural sheath. This study compared changes in ON length and CSF volume within the intraorbital ON sheath caused by eye movements in healthy subjects and patients with optic neuropathies.
Methods: Twenty-one healthy controls were compared with 11 patients having primary open angle glaucoma (POAG) at normal intraocular pressure (IOP), and 11 with chronic non-arteritic anterior ischemic optic neuropathy (NA-AION).
JAMA Netw Open
January 2025
Center of Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
Importance: Congenital Zika syndrome (CZS) can lead to a range of developmental and neurological issues, which increases the risk of early death. However, the all-cause and cause-specific mortality in children with CZS in the first 5 years of life remain unknown.
Objective: To compare the hazard of all-cause and cause-specific mortality before age 5 years among children with and without CZS in Brazil.
Proc Natl Acad Sci U S A
January 2025
National Institute of Biological Sciences, Beijing 102206, China.
Sleep need accumulates during waking and dissipates during sleep to maintain sleep homeostasis (process S). Besides the regulation of daily (baseline) sleep amount, homeostatic sleep regulation commonly refers to the universal phenomenon that sleep deprivation (SD) causes an increase of sleep need, hence, the amount and intensity of subsequent recovery sleep. The central regulators and signaling pathways that govern the baseline and homeostatic sleep regulations in mammals remain unclear.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2025
Shenzhen Key Laboratory of Biomolecular Assembling and Regulation, Department of Neuroscience, School of Life Sciences, Southern University of Science and Technology, Shenzhen 518055, China.
Ankyrin Repeat Domain-containing Protein 11 () is a causative gene for KBG syndrome, a significant risk factor for Cornelia de Lange syndrome (CdLS), and a highly confident autism spectrum disorder gene. Mutations of lead to developmental abnormalities in multiple organs/tissues including the brain, craniofacial and skeletal bones, and tooth structures with unknown mechanism(s). Here, we find that ANKRD11, via a short peptide fragment in its N-terminal region, binds to the cohesin complex with a high affinity, implicating why mutation can cause CdLS.
View Article and Find Full Text PDFJ Appl Genet
January 2025
Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Koodakyar Avenue, Daneshjoo Blvd, Evin, Tehran, 1985713834, Iran.
Perrault syndrome (PS) is an extremely rare autosomal recessive condition characterized primarily by bilateral sensorineural hearing loss in both genders and primary or secondary ovarian failure in females. Neurological features such as cerebral ataxia, peripheral neuropathy, epilepsy, and intellectual disability are frequent manifestations of PS. To date, six genes have been reported to cause PS, and nearly 100 families have been identified worldwide with this syndrome.
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