Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Jun 2014
Resting-state fMRI study on drug-naive patients with Parkinson's disease and with depression.
This study used resting-state functional MRI (fMRI) to evaluate regional and network alterations in patients with Parkinson's disease (PD) with and without depression. ⋯ Our study demonstrates that PD-Dep patients are characterised by increased regional spontaneous neural activity in the orbitofrontal area and decreased functional integration within the prefrontal-limbic network. These findings may be helpful for facilitating further understanding of the potential mechanisms underlying depression in PD.
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J. Neurol. Neurosurg. Psychiatr. · Jun 2014
Randomized Controlled TrialTime to 12-month remission and treatment failure for generalised and unclassified epilepsy.
To develop prognostic models for time to 12-month remission and time to treatment failure after initiating antiepileptic drug monotherapy for generalised and unclassified epilepsy. ⋯ The models described within this paper can be used to identify patients most likely to achieve 12-month remission and most likely to have treatment failure, aiding individual patient risk stratification and the design and analysis of future epilepsy trials.
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J. Neurol. Neurosurg. Psychiatr. · Jun 2014
A proposal of new diagnostic pathway for fatal familial insomnia.
In absence of a positive family history, the diagnosis of fatal familial insomnia (FFI) might be difficult because of atypical clinical features and low sensitivity of diagnostic tests. FFI patients usually do not fulfil the established classification criteria for Creutzfeldt-Jakob disease (CJD); therefore, a prion disease is not always suspected. ⋯ The proposed scheme may help to improve the clinical diagnosis of FFI. As the sensitivity of all diagnostic tests investigated but polysomnography is low in FFI, detailed clinical investigation is of special importance.
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J. Neurol. Neurosurg. Psychiatr. · Jun 2014
Plasma phosphorylated TDP-43 levels are elevated in patients with frontotemporal dementia carrying a C9orf72 repeat expansion or a GRN mutation.
About a half of patients with frontotemporal dementia (FTD) has deposition of phosphorylated TDP-43 protein (pTDP-43) in the brain. We studied pTDP-43 and total TDP-43 levels in plasma and cerebrospinal fluid (CSF) in healthy controls and patients with FTD, including those carrying a repeat expansion in the C9orf72 gene or a mutation in GRN. ⋯ Our study shows that plasma pTDP-43 levels may be increased in some genetic forms of FTD known to be associated with TDP-43 proteinopathies.
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J. Neurol. Neurosurg. Psychiatr. · Jun 2014
Does surgery accelerate progression of amyotrophic lateral sclerosis?
Surgery is not a recognised potential amyotrophic lateral sclerosis (ALS) risk factor that might modify the onset or course of ALS. ⋯ The site of surgery before ALS onset correlates with the region of onset of ALS. Patients with slower disease progression are at an increased risk of undergoing surgery, probably as part of initial difficulty in diagnosis. We noted accelerated disease progression during the 3-month period after surgery. Definite diagnosis is important to avoid unnecessary surgical trauma and subsequent more rapid deterioration.