JAMA NeurologyJAMA神经病学
JAMA Neurology(英文缩写 JAMA NEUROL),ISSN 2168-6149,eISSN 2168-6157,中文译名:JAMA神经病学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 29.907 | Q1 |
| 2022 | 29.000 | Q1 |
| 2023 | 20.400 | Q1 |
| 2024 | 21.300 | Q1 |
| 2025 | 23.600 | Q1 |
JAMA Neurology 最新收录文献
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1. When to Use the HINTS Examination in Patients With Dizziness: A Review.
1. 头晕患者何时应使用HINTS检查：一篇综述PMID:日期:2026-09-21The Head Impulse, Nystagmus, Test of Skew (HINTS) examination is a widely recognized bedside tool for distinguishing peripheral vestibular disorders from central causes, such as stroke, in patients presenting with acute vestibular syndrome. However, despite its introduction in 2009, confusion persists regarding its proper application. Misuse of the HINTS examination, particularly when applied to inappropriate patient populations, may lead to misdiagnosis, unnecessary imaging, or missed strokes. This review aims to clarify the appropriate use of the HINTS examination and to address misconceptions that contribute to diagnostic errors in emergency and clinical practice. HINTS is most effective when performed for patients with continuous dizziness and spontaneous nystagmus at rest. However, various guidelines and educational resources have failed to clearly define these criteria, leading to widespread misapplication of the test. Common errors include using HINTS for patients without nystagmus, failing to screen for central features before performing the examination, and misinterpreting test components. Studies show that the HINTS examination, when applied correctly, has high sensitivity for detecting stroke, but its diagnostic accuracy declines significantly when used for inappropriate patients. Furthermore, recent guidelines, such as the third Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-3), may have introduced ambiguities that may contribute to ongoing confusion in clinical practice. To optimize the diagnostic utility of the HINTS examination and reduce stroke misdiagnosis, clinicians should first screen for central features before applying HINTS and ensure it is only performed for patients with nystagmus at rest. Future guidelines should provide clearer recommendations to prevent inappropriate HINTS use and thus avoid inaccurate results. Emphasizing the correct application of HINTS in the right patient population will enhance its reliability as a critical tool for emergency physicians in distinguishing central from peripheral causes of dizziness, ultimately improving patient outcomes and reducing unnecessary investigations.
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2. A Harmonized Visual Reading Framework for Tau PET Staging in Alzheimer Disease.
PMID:日期:2026-09-21Tau positron emission tomography (PET) can detect and stage Alzheimer disease pathology; however, current binary regulatory-approved visual interpretation focuses on advanced disease, limiting early detection and patient stratification. To develop and validate a harmonized tau PET visual reading framework across radiotracers that stages tau burden into 5 classes: negative, low, moderate, high, and atypical. This prospective multicenter cross-sectional study among a cohort with head-to-head tau PET acquisitions was conducted from March 2022 to August 2025 and data analyzed from February to June 2026, with blinded visual reads performed by clinicians. The study was conducted at 9 sites across North America and Europe. Of those individuals enrolled in the HEAD (Head-to-Head Harmonization of Tau Tracers in Alzheimer's Disease) study, a proportion of participants aged 50 to 90 years who completed multitracer tau PET (2-4 scans) and cognitive assessments were included, spanning cognitively unimpaired to dementia. Tau PET with 18F-MK-6240 (TAUKLARIFY, n = 681), 18F-flortaucipir (Tauvid, n = 644), 18F-RO948 (n = 150), and 18F-PI-2620 (n = 149); all participants underwent amyloid-β (Aβ) PET and magnetic resonance imaging. The primary outcomes were interrater and intertracer agreement for 5-class tau classification; prevalence ratio (PR) vs the regulatory-approved 18F-flortaucipir framework; and associations with cognition, Aβ burden, and plasma phosphorylated tau 217 (p-tau217). Of 822 individuals enrolled in the HEAD study, 681 participants spanning cognitively unimpaired to dementia were included. Mean (SD) age was 69.3 (8.4) years, and 367 participants (53.9%) were female. The harmonized 5-class framework achieved excellent interrater agreement (κ = 0.77-0.85) and good to excellent intertracer agreement, highest between 18F-MK-6240 and 18F-flortaucipir (κ = 0.88). Compared with the regulatory-approved framework, the harmonized classification identified more tau-positive cognitively unimpaired participants (regulatory-approved binary: 26 of 364 participants; harmonized 18F-flortaucipir: 49 of 364 [PR = 1.89; 95% CI, 1.31-2.70; P = .001]; harmonized 18F-MK-6240: 71 of 364 [PR = 2.73; 95% CI, 1.95-3.83; P < .001]) and those with mild cognitive impairment (regulatory-approved binary: 100 of 223; harmonized 18F-flortaucipir: 123 of 223 [PR = 1.23; 95% CI, 1.12-1.35; P < .001]; harmonized 18F-MK-6240: 142 of 223 [PR = 1.42; 95% CI, 1.27-1.59; P < .001]), with convergence in dementia. Tau burden classes showed stepwise worsening of cognition, Aβ PET burden, and plasma p-tau217, with 1.4-fold, 3.2-fold, and 2.5-fold differences between the low and high tau classes, respectively. In this prospective multitracer cross-sectional study, a 5-class harmonized tau PET visual reading framework showed high interrater and intertracer agreement and detected more early-stage tau pathology than the regulatory-approved binary approach, with tau burden classes tracking stepwise with cognition and biomarkers. These findings support a standardized, tracer-agnostic framework for diagnostic categorization, therapeutic window identification, and clinical trial stratification.
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5. Portable Low-Field MRI of the Brain in Clinic and Community Settings.
PMID:日期:2026-09-21该文献暂无摘要。
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6. Cerebral Amyloid Angiopathy-Like Brain Imaging and Dural Arteriovenous Fistula.
PMID:日期:2026-09-14该文献暂无摘要。
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8. Intravenous Immunoglobulin Add-On in Newly Diagnosed Idiopathic Inflammatory Myopathies: A Randomized Clinical Trial.
PMID:日期:2026-09-14Preliminary evidence suggests that intravenous immune globulin (IVIG) may be valuable as an add-on treatment in newly diagnosed idiopathic inflammatory myopathies (IIMs), but a randomized clinical trial is warranted. To determine whether 3 cycles of add-on IVIG lead to superior improvement, with acceptable safety, in patients with newly diagnosed IIMs treated with high-dose prednisone (1 mg/kg/d; maximum 80 mg/d). This was a double-blind, randomized, placebo-controlled clinical trial conducted at a tertiary referral center for IIM between September 2021 and September 2025, with the primary end point at week 12. Adult patients with newly diagnosed IIMs, without (or with limited) prior immunosuppressive treatment, were assessed for inclusion; of 94 assessed, 50 were excluded or declined participation. All patients initiated treatment with standard of care high-dose prednisone and were assigned in a 1:1 ratio to receive add-on IVIG (2.0 g/kg body weight) or placebo at 0, 4, and 8 weeks. The primary outcome was the Total Improvement Score (TIS) at 12 weeks: a weighted composite score from 6 measures reflecting change in myositis activity over time. Secondary outcomes included moderate (TIS ≥40) and major (TIS ≥60; post hoc analysis) improvement, time to reach improvement, and safety outcomes. Of 44 adult patients with newly diagnosed IIMs included, 42 reached a primary end point (mean [SD] age, 58.7 [15.2] years; 21 [50%] female); 23 received IVIG and 19 received placebo. The mean TIS at 12 weeks was 60.0 (95% CI, 52.6-67.4) in the IVIG group and 42.5 (95% CI, 30.6-54.4) in the placebo group (P = .01). Moderate and major improvement were achieved in 21 participants in the IVIG group (91%; 95% CI, 79-100) vs 10 in placebo (53%; 95% CI, 28-78; P = .01) and 16 in the IVIG group (70%; 95% CI, 49-90) vs 5 in placebo (26%; 95% CI, 5-48; P = .005), respectively. The median time to moderate response was 4 (95% CI, 4-8) weeks in the IVIG group and 12 (95% CI, 4-12) weeks in the placebo group (P = .005). One asymptomatic deep venous thrombosis was found in the IVIG group. Adult patients with newly diagnosed IIMs treated with IVIG in addition to standard high-dose prednisone showed greater and faster improvement compared to patients who received standard high-dose prednisone. EudraCT Identifier: EUCTR2020-001710-37-NL.
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9. Clinical Characteristics, Neuroimaging Findings, and Mortality in Korsakoff Syndrome.
PMID:日期:2026-09-14Korsakoff syndrome is a severe neurocognitive disorder resulting from thiamine deficiency, most often associated with alcohol use disorder. Contemporary data describing its clinical presentation, neuroimaging findings, and long-term outcomes remain limited. To characterize the clinical features and outcomes of patients diagnosed with Korsakoff syndrome in routine clinical practice and to identify factors associated with mortality. This cohort study included electronic health records of adults with a diagnosis of Korsakoff syndrome between August 1, 2017, and December 31, 2022, from the Clinical Data Warehouse of the Greater Paris University Hospitals (AP-HP), which includes 39 hospitals. Data were analyzed March 2023. Korsakoff syndrome diagnosis. The primary outcome was all-cause mortality. Secondary outcomes included clinical manifestations, comorbidities, and neuroimaging findings in patients diagnosed with Korsakoff syndrome. Among 1320 patients with Korsakoff syndrome (mean [SD] age, 62.9 [11.1] years; 962 men [72.9%]), a well-documented subgroup of 114 patients most frequently presented with anterograde amnesia (61.4%). Among this subgroup, 22 patients (19%) had a reported history of Wernicke encephalopathy. Among patients who underwent brain magnetic resonance imaging, abnormalities involving the Papez circuit and vascular leukoencephalopathy were each observed in 40 patients (44.4%) each. During a median (IQR) follow-up of 3.1 (1.2-5.0) years, 398 patients (30.2%) died. In multivariable analyses, malnutrition (hazard ratio [HR], 1.54; 95% CI, 1.15-2.05), alcoholic liver disease (HR, 1.45; 95% CI, 1.10-1.91), male sex (HR, 1.45; 95% CI, 1.13-1.86), and age 80 to 89 years (HR, 1.89; 95% CI, 1.27-2.81) were associated with mortality. In this large clinical cohort, patients diagnosed with Korsakoff syndrome had a high burden of vascular comorbidities, frequent under-recognition of Wernicke encephalopathy, and substantial mortality. These findings highlight the need for earlier recognition and more standardized diagnostic evaluation of Korsakoff syndrome.
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10. Common MC1R Variants and Parkinson Disease Progression.
PMID:日期:2026-09-08Melanocortin 1 receptor (MC1R) is a key regulator of pigmentation and oxidative stress implicated in Parkinson disease (PD). MC1R loss-of-function variants, defined by experimentally demonstrated reductions in MC1R function, are carried by more than 60% of individuals of European descent. To determine whether MC1R loss-of-function variants are associated with accelerated PD progression. This longitudinal cohort study used data from July 2010 to January 2026 in the Parkinson Progression Markers Initiative (PPMI) cohort and June 2009 to June 2019 in a replication cohort using 3 US-based multicenter randomized clinical trials (SURE-PD phase 2, SURE-PD3, and STEADY-PD III), with up to 12 years of follow-up. Analysis was performed in May 2026. Of 926 PPMI participants with PD and available genomewide sequencing data, 66 without dopamine deficiency and 51 with pathogenic variants in known PD-associated genes were excluded. The remaining 809 participants were stratified by MC1R loss-of-function carrier status (505 carriers and 304 noncarriers) and classified as having sporadic PD (n = 383) or monogenic PD (n = 426) based on LRRK2 and GBA carrier status. The replication cohort included 587 participants with PD (410 carriers and 177 noncarriers). An additional 53 PPMI participants with prodromal PD (34 carriers and 19 noncarriers) were assessed. MC1R loss-of-function carrier status. Rate of motor decline per Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III score, assessed via linear mixed-effects models adjusted for age at onset, sex, race, baseline score, and levodopa equivalent daily dose. Phenoconversion risk, assessed via Fine-Gray subdistribution hazards model. Among 383 participants with sporadic PD, 130 were female, 253 were male, and the mean (SD) age at onset was 61.3 (9.9) years for MC1R loss-of-function carriers and 64.6 (10.5) for noncarriers. MC1R loss-of-function carriers exhibited 30% faster motor decline (β, 0.57 points/year; 95% CI, 0.16-0.98; P = .006) than noncarriers. In the replication cohort, MC1R loss-of-function carriers exhibited 50% faster motor decline than noncarriers (β, 1.37; 95% CI, 0.28-2.46; P = .01). In a small prodromal cohort, MC1R loss-of-function carriers showed a more than 4-fold increased risk of phenoconversion to PD (subdistribution hazard ratio, 4.75; 95% CI, 1.48-15.27; P = .009). The findings of this cohort study suggest that MC1R loss-of-function variants may define a large, readily identifiable genetic subgroup with accelerated progression, highlighting their utility for potential prognostic stratification and clinical trial enrichment in patients of European descent with PD.