Publications by authors named "Whitley W Aamodt"

9 Publications

  • Page 1 of 1

Neurofilament Light Chain as a Biomarker for Cognitive Decline in Parkinson Disease.

Mov Disord 2021 Sep 4. Epub 2021 Sep 4.

Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Background: Neurofilament light chain protein (NfL) is a promising biomarker of neurodegeneration.

Objectives: To determine whether plasma and CSF NfL (1) associate with motor or cognitive status in Parkinson's disease (PD) and (2) predict future motor or cognitive decline in PD.

Methods: Six hundred and fifteen participants with neurodegenerative diseases, including 152 PD and 200 healthy control participants, provided a plasma and/or cerebrospinal fluid (CSF) NfL sample. Diagnostic groups were compared using the Kruskal-Wallis rank test. Within PD, cross-sectional associations between NfL and Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) and Mattis Dementia Rating Scale (DRS-2) scores were assessed by linear regression; longitudinal analyses were performed using linear mixed-effects models and Cox regression.

Results: Plasma and CSF NfL levels correlated substantially (Spearman r = 0.64, P < 0.001); NfL was highest in neurocognitive disorders. PD participants with high plasma NfL were more likely to develop incident cognitive impairment (HR 5.34, P = 0.005).

Conclusions: Plasma NfL is a useful prognostic biomarker for PD, predicting clinical conversion to mild cognitive impairment or dementia. © 2021 International Parkinson and Movement Disorder Society.
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http://dx.doi.org/10.1002/mds.28779DOI Listing
September 2021

Hospital Magnet Status Associates With Inpatient Safety in Parkinson Disease.

J Neurosci Nurs 2021 Jun;53(3):116-122

Abstract: BACKGROUND: Persons with Parkinson disease (PD) have complex care needs that may benefit from enhanced nursing care provided in Magnet-designated hospitals. Our primary objective was to determine whether an association exists between hospital Magnet status and patient safety events for PD inpatients in the United States. METHODS: We conducted a retrospective cohort study using the Nationwide Inpatient Sample and Agency for Healthcare Research and Quality databases from 2000 to 2010. Parkinson disease diagnosis and demographic variables were retrieved, along with Magnet designation and other hospital characteristics. Inpatient mortality and preventable adverse events in hospitals with and without Magnet status were then compared using relevant Agency for Healthcare Research and Quality patient safety indicators. RESULTS: Between 2000 and 2010, 493 760 hospitalizations among PD patients were identified. Of those, 40 121 (8.1%) occurred at one of 389 Magnet hospitals. When comparing PD patients in Magnet versus non-Magnet hospitals, demographic characteristics were similar. Multivariate regression models adjusting for patient and hospital characteristics identified a 21% reduction in mortality among PD inpatients in Magnet hospitals (adjusted odds ratio [AOR], 0.79; 95% confidence interval [CI], 0.74-0.85). PD inpatients in Magnet hospitals also had a lower odds of experiencing any patient safety indicator (AOR, 0.74; 95% CI, 0.68-0.79), pressure ulcers (AOR, 0.60; 95% CI, 0.55-0.67), death from a low mortality condition (AOR, 0.74; 95% CI, 0.68-0.79), and a higher odds of postoperative bleeding (AOR, 1.45; 95% CI, 1.04-2.04). CONCLUSIONS: PD patients had a reduced risk of inpatient mortality and several nursing-sensitive patient safety events, highlighting the possible benefits of Magnet status on inpatient safety in PD.
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http://dx.doi.org/10.1097/JNN.0000000000000582DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106621PMC
June 2021

Global & Community Health: Neurologic care for Latinos in South Philadelphia: Global health at home.

Neurology 2019 09;93(10):461-462

From the Department of Neurology, New York University, New York.

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http://dx.doi.org/10.1212/WNL.0000000000008073DOI Listing
September 2019

Teaching NeuroImages: A fuzzy determination of stroke onset.

Neurology 2019 05;92(20):e2395-e2396

From the Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia.

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http://dx.doi.org/10.1212/WNL.0000000000007511DOI Listing
May 2019

Cerebral fat embolism syndrome in sickle cell disease without evidence of shunt.

eNeurologicalSci 2019 Mar 22;14:19-20. Epub 2018 Nov 22.

Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107, USA.

Fat embolism syndrome (FES) is a known complication of sickle cell disease (SCD) that occurs secondary to vaso-occlusive crises, bone marrow infarction, and the subsequent release of fat globules into the venous circulation. Although neurologic involvement is common, the pathophysiology of cerebral fat emboli remains controversial. While fat microemboli can enter the arterial circulation through right-to-left shunts, the systemic release of free fatty acids may also cause indirect endothelial damage and disruption of the blood-brain-barrier. We present an unusual case of cerebral fat emboli in SCD that occurred in the absence of acute chest syndrome or right-to-left shunt, favoring a biochemical etiology. Treatment of FES includes supportive care and emergent red cell exchange transfusions.
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http://dx.doi.org/10.1016/j.ensci.2018.11.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275165PMC
March 2019

Late onset progressive multifocal leukoencephalopathy in Hodgkin lymphoma.

J Clin Neurosci 2017 Sep 16;43:132-134. Epub 2017 May 16.

Department of Neurology, Hospital of the University of Pennsylvania, 3W Gates Building, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address:

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease resulting from infection of oligodendrocytes in the central nervous system with John Cunningham virus. Although PML is commonly diagnosed in immunocompromised patients with human immunodeficiency virus, it can also arise in other immunodeficient states. In this report, we present an unusual case of PML occurring 40years after chemoradiation therapy for Hodgkin lymphoma in a patient with normal total lymphocyte counts on annual surveillance. Although current guidelines recommend annual complete blood counts for patients in remission, this testing may be insufficient to monitor patients with chronic CD4+ lymphopenia.
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http://dx.doi.org/10.1016/j.jocn.2017.04.030DOI Listing
September 2017

Teaching Neuro: Acute infarction of the left medial lemniscus masquerading as a peripheral neuropathy.

Neurology 2017 04;88(17):e178

From the Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia.

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http://dx.doi.org/10.1212/WNL.0000000000003873DOI Listing
April 2017

Executive function impairment and recidivism in adult protective services clients referred for a decision making capacity assessment.

J Elder Abuse Negl 2015 11;27(2):91-9. Epub 2014 Dec 11.

a Department of Psychiatry , The University of Texas Health Science Center at San Antonio , San Antonio , Texas , USA.

The objective of this study was to determine if recidivistic Adult Protective Services (APS) cases referred for a decision-making capacity assessment were more cognitively impaired than nonrecidivistic cases. A retrospective medical record review of neuropsychological and demographic data was gathered during decisional capacity assessments. Recidivistic clients were those referred to APS more than once; those with a single open case were nonrecidivistic. Mean neuropsychological test scores were compared between recidivistic (n = 138) and nonrecidivistic (n = 95) subjects. No significant differences were found for age, gender, ethnicity, education, or dwelling status. Both recidivistic and nonrecidivistic cases performed poorly in all cognitive domains. Recidivistic clients performed significantly worse on measures of executive function (CLOX1, EXIT25). Executive function impairments seem to be one risk factor for recidivism in APS referrals. With 60% of cases referred for decision capacity assessments being recidivistic, identifying risk factors may help identify when targeted interventions are indicated to preclude recurrence of abuse.
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http://dx.doi.org/10.1080/08946566.2014.976894DOI Listing
January 2016

Cognitive profiles of elder adult protective services clients living in squalor.

J Elder Abuse Negl 2015 24;27(1):65-73. Epub 2014 Nov 24.

a Department of Psychiatry , The University of Texas Health Science Center at San Antonio , San Antonio , Texas , USA.

The purpose of this study was to determine whether squalor-dwelling Adult Protective Services (APS) clients were more cognitively impaired than non-squalor-dwelling APS clients referred for decision-making capacity assessments. The authors performed a retrospective medical record review of neuropsychological and demographic data gathered during decisional capacity assessments. Squalor dwelling was defined by unsanitary living conditions that posed a danger to the occupant's health or safety. Mean neuropsychological test scores were compared between squalor-dwelling (n = 50) and non-squalor-dwelling (n = 180) subjects. Squalor-dwelling clients were significantly younger than non-squalor-dwelling clients. There were no distribution differences among gender, education, race, or rural-dwelling status. Although both groups performed poorly on each neuropsychological measure, squalor dwellers demonstrated better memory and general cognitive performance. Cognition, depression, gender, race, education, dementia diagnosis, and rural-dwelling status seem insufficient to explain squalor-dwelling behaviors. Other biological and psychosocial variables should be considered.
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http://dx.doi.org/10.1080/08946566.2014.952484DOI Listing
August 2015
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