Letters

RESEARCH LETTER 156 [3.2%]; Table), 27 belonged to cognitive neurology. The

most talked about research topics included neurocognition
Comparison of Attention for Neurological along with lifestyle changes affecting brain health. There was
Research on Social Media vs Academia:
An Altmetric Score Analysis
The omnipresence of social media in modern life is undeni- Table. Characteristics of All the Research Articles and the Top 100
AAS Articles Published in 2016
able but its value to society remains to be determined; thus, we
aimed to investigate the recognition received by neurological All Articles Top 100 Articles
Characteristic (N = 1050) (based on AAS)
research on social media. We used the Altmetric attention score
Journals, No. (%)
(AAS), a weighted count of online attention received by an ar-
Neurology 512 (48.8) 45
ticle, as a marker of the popularity (“buzz”) of neurological
JAMA Neurology 120 (11.4) 28
research in the public and compared it with the academic at- Brain 215 (20.5) 13
tention marker (citations). The Lancet Neurology 47 (4.5) 9
Annals of Neurology 156 (14.9) 5
Methods | The impact factor–based top 5 journals that publish Altmetric score, median (IQR) 18 (9-40) 269 (197-441)
research on all neurological subspecialties were identified Citations, median (IQR) 20 (11-35) 33 (18-54)
using the Journal Citations Reports for 2016 (Table). All origi- Open access, median (%) 769 (73.2) 88 (88)
nal research articles (no opinion/editorial and single-case Social media mentions, median (IQR)
reports/neuroimages) published in 2016 in these journals Twitter 12 (5-22) 41 (21-75)
were extracted and tabulated. Dimensions (Digital Science & News outlet 1 (0-3) 30 (21-46)
Research Solutions Inc), an online searchable platform that Facebook 1 (0-2) 5 (2-10)
aggregates data on more than 99 million publications,1 was Read on Mendeley 40 (24-66) 59 (39-111)
used to identify the AAS of the included publications (ac- Neurological subspecialty, No. (%)
cessed from April 1, 2019 to April 7, 2019), their individual Cognitive neurology 187 (17.8) 27
engagement on various social media platforms, and their Cerebrovascular neurology 189 (18.0) 12
open access status. The total citations accrued over the Neuroimmunology 123 (11.7) 11
3-year period was obtained through Web of Science2 (ac- Movement disorders 128 (12.2) 9
cessed from April 1, 2019 to April 7, 2019). Abstracts and full- Neuromuscular 127 (12.1) 9
text articles were reviewed to categorize the neurological Epilepsy 97 (9.2) 6
subspecialty, article topic, and study design. The top 100 Neurotrauma 23 (2.2) 7
publications with the highest AAS were considered as receiv- Headache 25 (2.4) 4
ing the highest recognition on social media (“buzz”) and ana- Pediatric 36 (3.4) 1
lyzed separately. Institutional review board approval was Miscellaneous 115 (11.0) 14

waived because institutional policies did not consider this Study design, No. (%)

work as human research. Observational studies 895 (85.2) 83

Categorical variables were described using percentages and Clinical trials 63 (6.0) 11
Basic research 92 (8.8) 6
continuous variables using medians and interquartile ranges
Article topic, No. (%)
(IQRs). The Mann-Whitney U test and the Spearman rank cor-
Neurocognition 58 (5.5) 14
relation coefficient were used for assessing the correlation of
Lifestyle 25 (2.4) 14
AAS with the open access status and the number of citations,
Pharmacological therapies 96 (9.1) 13
respectively. The statistical analysis was performed using SPSS,
Genetics 126 (12.0) 9
version 20 (IBM Corporation).
Natural history of disease 137 (13.0) 7
Non-pharmacological therapies 58 (5.5) 7
Results | A total of 1050 articles were included in the final analy-
Etiopathogenesis 85(8.1) 1
sis. The median AAS was 18 (IQR, 9-40) and the median
Diagnosis 90 (8.6) 3
citations were 20 (IQR, 11-35) (Table). Of these, 493 articles
Imaging 100 (9.5) 0
(47%) achieved an AAS of 20 or higher. Open access was avail-
Outcomes 75 (7.1) 2
able for 1050 articles (73.2%), which was significantly associ-
Epidemiology 46 (4.4) 9
ated with a higher AAS (median, 20 vs 15; P < .01). Among the Brain networks 45 (4.3) 6
articles with the top 100 AAS (JAMA Neurology = 28/120 Others/miscellaneous 109 (10.4) 15
[23.3%]; The Lancet Neurology = 9/47 [19.1%]; Neurology = 45/
Abbreviations: AAS, Altmetric attention score; IQR, interquartile range.
512 [8.9%]; Brain = 13/215 [6.0%]; and Annals of Neurology = 5/

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 Letters
Figure. Correlation Between Altmetric Score and Number of Citations of
All Research Articles Published in 2016 on a Nonlinear Scale
1000
316
100
Citations, No.
32
10
3
1 (Punia); Department of Public Health, Surendra Dental College and Research
1 3 10 32 100 316
Altmetric Score
Each point represents 1 of the 1050 articles published (r= 0.32; P< .01).
a significant (P < .01), but weak correlation (r = 0.32) be-
tween the AAS and the number of citations garnered by all 1050
research articles over 3 years (Figure).
Discussion | There is a high degree of engagement with neuro-
logical research on social media. The median AAS for all the
research articles combined was 18 (IQR, 9-40). For context, an
AAS of 20 or higher corresponds to the top 5% of the entire re-
search output3 (achieved by close to half of these articles). A
similar study of cardiovascular research articles published in
2014 found a median AAS of 8 (IQR, 2-37).4 One of 4 articles
that achieved a top 100 AAS came from the cognitive neurol-
ogy field and the topic that gained the maximum attention in
this subset was also neurocognition. This high public interest
suggests possible social anxiety about the coming “dementia
epidemic.”5 Unlike other specialties,3 open access status seems
to correlate with a higher AAS in neurological research. There
is a weak correlation between the attention generated on so-
cial media and the citations accrued by the articles over a 3-year
period, which is similar to the association noted in cardiovas-
cular research.4 The subspecialty, interspecialty, or journal-
based differences in the proportion of articles achieving a high
AAS or their association with citations may depend on sev-
E2 JAMA Neurology Published online July 1, 2019 (Reprinted)
© 2019 American Medical Association. All rights reserved.
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eral factors, including the online engagement of the indi-
vidual members of a field and the efforts at the journal level
to promote their output.
Citations are accrued over long periods and this may be a
limitation of this study. However, the effect of a weak align-
ment in the perceptions about research among the public and
academia deserves further investigation, along with the even-
tual effect of the “buzz” on social media about neurological
research on clinical outcomes.
Vineet Punia, MD, MS
Vikram Aggarwal, MDS
Ryan Honomichl, PhD
Appaji Rayi, MD
Author Affiliations: Neurological Institute, Cleveland Clinic, Cleveland, Ohio
1000 Institute, Rajasthan, India (Aggarwal); Quantitative Health Sciences, Cleveland
Clinic, Cleveland, Ohio (Honomichl); Department of Neurology, The Ohio State
University Wexner Medical Center, Columbus (Rayi).
Accepted for Publication: May 4, 2019.
Corresponding Author: Vineet Punia, MD, MS, Cleveland Clinic, 9500 Euclid
Ave, S51, Cleveland, OH 44195 (puniav@ccf.org).
Published Online: July 1, 2019. doi:10.1001/jamaneurol.2019.1791
Author Contributions: Dr Punia had full access to all of the data in the study
and takes responsibility for the integrity of the data and the accuracy of the data
analysis.
Concept and design: Punia.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Punia.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Punia, Aggarwal, Honomichl.
Administrative, technical, or material support: Honomichl.
Conflict of Interest Disclosures: None reported.
1. Digital Science & Research Solutions Inc. Re-imagining discovery and access
to research: grants, publications, citations, clinical trials, patents and policy
documents in one place. https://www.dimensions.ai/. Accessed April 1, 2019.
2. Clarivate Analytics. Web of Science: trust the difference. https://clarivate.
com/products/web-of-science/. Accessed April 1, 2019.
3. Patel RB, Vaduganathan M, Bhatt DL, Bonow RO. Characterizing
high-performing articles by Altmetric score in major cardiovascular journals
[published online November 21, 2018]. JAMA Cardiol. doi:10.1001/jamacardio.
2018.3823
4. Barakat AF, Nimri N, Shokr M, et al. Correlation of Altmetric attention score
with article citations in cardiovascular research. J Am Coll Cardiol. 2018;72(8):
952-953. doi:10.1016/j.jacc.2018.05.062
5. Larson EB, Yaffe K, Langa KM. New insights into the dementia epidemic.
N Engl J Med. 2013;369(24):2275-2277. doi:10.1056/NEJMp1311405
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