2024
Case-Control Study of Individuals With Small Fiber Neuropathy After COVID-19
McAlpine L, Zubair A, Joseph P, Spudich S. Case-Control Study of Individuals With Small Fiber Neuropathy After COVID-19. Neurology Neuroimmunology & Neuroinflammation 2024, 11: e200244. PMID: 38630952, PMCID: PMC11087026, DOI: 10.1212/nxi.0000000000200244.Peer-Reviewed Original ResearchConceptsInvasive cardiopulmonary exercise testingSmall fiber neuropathyCase-control studyFiber neuropathySkin biopsiesClinical response to treatmentNeurovascular dysregulationTreated with IVIGRetrospective chart reviewCase-control study of individualsRetrospective cohort studyResponse to treatmentCardiopulmonary exercise testingClass III evidenceMyalgic encephalomyelitis/chronic fatigue syndromeIVIG groupClinical responseNeuropathic symptomsChart reviewIVIGStudy of individualsCohort studyIII evidenceClinical trialsCOVID-19 illness
2022
Correlation between CD4/CD8 ratio and neurocognitive performance during early HIV infection
Le LT, Price RW, Gisslén M, Zetterberg H, Emu B, Fabre R, Christian P, Andersen S, Spudich S, Vassallo M. Correlation between CD4/CD8 ratio and neurocognitive performance during early HIV infection. HIV Medicine 2022, 24: 442-452. PMID: 36134890, DOI: 10.1111/hiv.13411.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Retroviral AgentsCD4-CD8 RatioCD8-Positive T-LymphocytesHIV InfectionsHumansRetrospective StudiesConceptsCD4/CD8 ratioPrimary HIV infectionCD8 ratioImmune activationHIV infectionNeuronal injuryAntiretroviral treatmentNeurocognitive performanceMean CD4/CD8 ratioCSF neurofilament light chainART-naïve participantsEarly HIV infectionCerebrospinal fluid markersNeurofilament light chainNeuropsychological testing performancePsychomotor speed performancePHI participantsStudy cohortCSF markersChronic infectionBrain injuryRetrospective analysisFluid markersInfectionInjuryImmunological, Cognitive, and Psychiatric Outcomes After Initiating Efavirenz- and Dolutegravir-based Antiretroviral Therapy During Acute Human Immunodeficiency Virus Infection
Chan P, Yoon B, Colby D, Kroon E, Sacdalan C, Sriplienchan S, Pinyakorn S, Ananworanich J, Valcour V, Vasan S, Hsu D, Phanuphak N, Paul R, Spudich S. Immunological, Cognitive, and Psychiatric Outcomes After Initiating Efavirenz- and Dolutegravir-based Antiretroviral Therapy During Acute Human Immunodeficiency Virus Infection. Clinical Infectious Diseases 2022, 76: e718-e726. PMID: 35687498, PMCID: PMC9907536, DOI: 10.1093/cid/ciac466.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-HIV AgentsBenzoxazinesCognitionFemaleHeterocyclic Compounds, 3-RingHIV InfectionsHumansMaleRetrospective StudiesConceptsAcute HIV-1 infectionT-cell countsDTG-based antiretroviral therapyAntiretroviral therapyDTG groupEFV groupWeek 96Week 24CD4/CD8 ratioNucleoside reverse transcriptase inhibitorHuman immunodeficiency virus type 1Immunodeficiency virus type 1Fiebig stages IPlasma viral suppressionAcute HIV infectionTreatment-naive individualsHIV-1 infectionPatient Health QuestionnaireReverse transcriptase inhibitorVirus type 1Greater incrementART regimensCD8 ratioViral suppressionHIV infection
2021
Ischemic Stroke, Inflammation, and Endotheliopathy in COVID-19 Patients
McAlpine LS, Zubair AS, Maran I, Chojecka P, Lleva P, Jasne AS, Navaratnam D, Matouk C, Schindler J, Sheth KN, Chun H, Lee AI, Spudich S, Sharma R, Sansing LH. Ischemic Stroke, Inflammation, and Endotheliopathy in COVID-19 Patients. Stroke 2021, 52: e233-e238. PMID: 33966492, PMCID: PMC8140646, DOI: 10.1161/strokeaha.120.031971.Peer-Reviewed Original Research
2020
Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitals
2018
CSF concentrations of soluble TREM2 as a marker of microglial activation in HIV-1 infection
Gisslén M, Heslegrave A, Veleva E, Yilmaz A, Andersson LM, Hagberg L, Spudich S, Fuchs D, Price RW, Zetterberg H. CSF concentrations of soluble TREM2 as a marker of microglial activation in HIV-1 infection. Neurology Neuroimmunology & Neuroinflammation 2018, 6: e512. PMID: 30568991, PMCID: PMC6278890, DOI: 10.1212/nxi.0000000000000512.Peer-Reviewed Original ResearchConceptsHIV-1 infectionHIV-negative controlsMicroglial activationNeuronal injuryCSF concentrationsUntreated HIV-1-infected patientsHIV-1 disease severityHIV-1-infected adultsMacrophage/microglial activationHIV-1-infected patientsRetrospective cross-sectional studyUntreated HIV-1 infectionCNS immune activationCSF sTREM2 levelsSuppressive antiretroviral treatmentT-cell countsMicroglial activation markersT cell lossLevels of CSFNeurofilament light proteinCross-sectional studyCSF sTREM2STREM2 levelsAntiretroviral treatmentActivation markersAnti-Human Immunodeficiency Virus Antibodies in the Cerebrospinal Fluid: Evidence of Early Treatment Impact on Central Nervous System Reservoir?
Burbelo PD, Price RW, Hagberg L, Hatano H, Spudich S, Deeks SG, Gisslén M. Anti-Human Immunodeficiency Virus Antibodies in the Cerebrospinal Fluid: Evidence of Early Treatment Impact on Central Nervous System Reservoir? The Journal Of Infectious Diseases 2018, 217: 1024-1032. PMID: 29401308, PMCID: PMC5939835, DOI: 10.1093/infdis/jix662.Peer-Reviewed Original ResearchConceptsCentral nervous systemHuman immunodeficiency virusAntiretroviral therapyLong-term treatmentCerebrospinal fluidHIV antibodiesCSF antibodiesEarly infectionBlood antibodyChronic infectionVirus antibodiesCentral nervous system reservoirAnti-human immunodeficiency virus antibodiesHuman immunodeficiency virus (HIV) antibodyEarly ART initiationMarkers of persistenceEffective antiretroviral therapySuppressive antiretroviral therapyPre-exposure prophylaxisART initiationHIV persistenceCNS infectionHIV reservoirImmunodeficiency virusBerlin patient
2013
Cerebrospinal fluid neopterin decay characteristics after initiation of antiretroviral therapy
Yilmaz A, Yiannoutsos CT, Fuchs D, Price RW, Crozier K, Hagberg L, Spudich S, Gisslén M. Cerebrospinal fluid neopterin decay characteristics after initiation of antiretroviral therapy. Journal Of Neuroinflammation 2013, 10: 828. PMID: 23664008, PMCID: PMC3657550, DOI: 10.1186/1742-2094-10-62.Peer-Reviewed Original ResearchConceptsCSF neopterin levelsAntiretroviral therapyNeopterin levelsCerebrospinal fluidCSF neopterinHAD patientsMacrophage activationART-mediated viral suppressionCommencement of ARTHigher pre-ART levelsCSF neopterin concentrationsPre-ART levelsProlonged antiretroviral therapySuppressive antiretroviral therapySet-point levelsBlood neopterinHAD subjectsART initiationAsymptomatic HIVTreatment-naïveViral suppressionNeopterin concentrationsImmune activationMost HIVHIV
2012
Cerebrospinal fluid HIV escape associated with progressive neurologic dysfunction in patients on antiretroviral therapy with well controlled plasma viral load
Peluso MJ, Ferretti F, Peterson J, Lee E, Fuchs D, Boschini A, Gisslén M, Angoff N, Price RW, Cinque P, Spudich S. Cerebrospinal fluid HIV escape associated with progressive neurologic dysfunction in patients on antiretroviral therapy with well controlled plasma viral load. AIDS 2012, 26: 1765-1774. PMID: 22614889, PMCID: PMC3881435, DOI: 10.1097/qad.0b013e328355e6b2.Peer-Reviewed Original ResearchConceptsCSF HIV RNAAntiretroviral therapyHIV RNACopies/CSF escapeNeurologic abnormalitiesCerebrospinal fluidMedian CD4 T-cell countDetectable CSF HIV RNAMedian plasma HIV RNACD4 T-cell countCentral nervous system exposureNew neurologic abnormalitiesPlasma HIV levelsPlasma HIV RNAProgressive neurologic abnormalitiesStable ART regimenPlasma viral loadT-cell countsElevated CSF proteinRetrospective case seriesProgressive neurologic dysfunctionUrban medical centerCSF RNAHIV escape
2007
Immune Activation of the Central Nervous System Is Still Present after >4 Years of Effective Highly Active Antiretroviral Therapy
Edén A, Price RW, Spudich S, Fuchs D, Hagberg L, Gisslén M. Immune Activation of the Central Nervous System Is Still Present after >4 Years of Effective Highly Active Antiretroviral Therapy. The Journal Of Infectious Diseases 2007, 196: 1779-1783. PMID: 18190258, DOI: 10.1086/523648.Peer-Reviewed Original ResearchConceptsHIV RNA levelsCopies/mLActive antiretroviral therapyIntrathecal immunoactivationNeopterin levelsCerebrospinal fluidIgG indexAntiretroviral therapyPlasma HIV RNA levelsMacrophage/microglia activationHuman immunodeficiency virus (HIV) RNAUpper normal reference valueIntrathecal immunoglobulin productionYears of treatmentCentral nervous systemNormal reference valuesMicroglia activationImmune activationImmunoglobulin productionEffective treatmentCSF samplesPatientsNervous systemCell countHAART