Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · May 2014
Review Meta AnalysisCan fMRI safely replace the Wada test for preoperative assessment of language lateralisation? A meta-analysis and systematic review.
Recent studies have shown that fMRI (functional magnetic resonance imaging) may be of value for pre-surgical assessment of language lateralisation. The aim of this study was to systematically review and analyse the available literature. A systematic electronic search for studies comparing fMRI with Wada testing was conducted in the PubMed database between March 2009 and November 2011. ⋯ Language production or language comprehension tasks and different regions of interest did not yield statistically significant different results. It can be concluded that fMRI is reliable when there is strong left-lateralised language. The Wada test is warranted when fMRI fails to show clear left-lateralisation.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2014
Meta AnalysisAPOE associations with severe CAA-associated vasculopathic changes: collaborative meta-analysis.
Cerebral amyloid angiopathy (CAA) is associated with lobar intracerebral haemorrhage (ICH). While only the ε4 allele of the apolipoprotein E (APOE) gene is associated with the presence of CAA, both APOE-ε4 and ε2 are associated with lobar ICH. The generally accepted explanation is that APOE-ε4 promotes vascular amyloid deposition, while APOE-ε2 promotes progression to severe CAA with associated vasculopathic changes that cause vessel rupture and ICH. We assessed the evidence for these allele-specific effects. ⋯ We found a possible association of severe CAA with APOE-ε4 but not APOE-ε2. However, our findings do not exclude a biologically meaningful association between APOE-ε2 and severe CAA. Further work is needed to elucidate fully the allele-specific associations of APOE with CAA and their mechanisms.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2014
Review Meta AnalysisScreening for poststroke major depression: a meta-analysis of diagnostic validity studies.
Major depression is common in stroke patients and associated with increased rates of disability and mortality. Identifying depression may improve mental and physical health. The aim of this review was to determine the most accurate tool for detecting poststroke depression. ⋯ There are a number of possible instruments that may help in screening for poststroke depression but none are satisfactory for case-finding. Preliminary data suggests the CESD, HDRS or the PHQ-9 as the most promising options. Although it should be noted such scales should not be used in isolation but followed up with a more detailed clinical assessment. While there is promising data for the PHQ-2 in other populations, it performed less well than other measures.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2013
Meta AnalysisThe heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis.
Several studies have reported heterogeneity in cognitive symptoms associated with specific characteristics of patients with Parkinson's disease (PD). Indeed, researchers have characterised subtypes of patients suffering from PD according to various criteria. Those most frequently used are the type of predominant motor symptoms (tremors or non-tremor symptoms), age at onset and presence of depression. ⋯ These results suggested that PD participants with non-tremor predominant motor symptoms or with depression had more or more severe cognitive impairments. Identification of different subtypes in PD is important for a better understanding of the cognitive symptoms associated with this disease. Better knowing the impact of different features of PD subgroups could help to design more appropriate treatments for patients with PD.