Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Dec 2014
ReviewBiomarkers in dementia: clinical utility and new directions.
Imaging, cerebrospinal fluid (CSF) and blood-based biomarkers have the potential to improve the accuracy by which specific causes of dementia can be diagnosed in vivo, provide insights into the underlying pathophysiology, and may be used as inclusion criteria and outcome measures for clinical trials. While a number of imaging and CSF biomarkers are currently used for each of these purposes, this is an evolving field, with numerous potential biomarkers in varying stages of research and development. We review the currently available biomarkers for the three most common forms of neurodegenerative dementia, and give an overview of research techniques that may in due course make their way into the clinic.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2014
Clinical TrialTreatment of sleep apnoea syndrome decreases cognitive decline in patients with Alzheimer's disease.
It is essential to detect and then treat factors that aggravate Alzheimer's disease (AD). Here, we sought to determine whether or not continuous positive airway pressure (CPAP) therapy for sleep apnoea syndrome (SAS) slows the rate of cognitive decline in mild-to-moderate AD patients. ⋯ In this pilot study, CPAP treatment of severe SAS in mild-to-moderate AD patients was associated with significantly slower cognitive decline over a three-year follow-up period. Our results emphasise the importance of detecting and treating SAS in this population.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2014
Long-term outcome of subthalamic nucleus deep brain stimulation for Parkinson's disease using an MRI-guided and MRI-verified approach.
Subthalamic nucleus (STN) deep brain stimulation (DBS) represents a well-established treatment for patients with advanced Parkinson's disease (PD) insufficiently controlled with medical therapies. This study presents the long-term outcomes of patients with PD treated with STN-DBS using an MRI-guided/MRI-verified approach without microelectrode recording. ⋯ Our data confirm that STN-DBS, using an MRI-guided/MRI-verified technique, remains an effective treatment for motor 'off' symptoms of PD in the long term with low morbidity.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2014
Measuring functional recovery in stroke patients: the responsiveness of ACTIVLIM-stroke.
To determine the efficacy of the ACTIVLIM-Stroke questionnaire in detecting changes in functional status of stroke patients. ⋯ ACTIVLIM-Stroke showed good responsiveness and can detect accurately clinical changes in the functional status of stroke patients. The BI and the 6MWT were also responsive and may provide complementary information while investigating change in functional status. However, in addition to being highly sensitive to change, ACTIVLIM-Stroke presents significant methodological advantages for quantifying functional changes in stroke patients.