Archives of neurology
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Archives of neurology · Jun 2009
Multicenter Study Meta AnalysisDefining survival as an outcome measure in amyotrophic lateral sclerosis.
To examine how respiratory interventions affect survival as an outcome measure and to define survival rate for trials in amyotrophic lateral sclerosis. ⋯ Tracheostomy and permanent assisted ventilation are not equivalent to death in amyotrophic lateral sclerosis. The use of respiratory interventions differs between centers, leading to variability in combined outcome assessments. The time to the end point can differ significantly depending on its definition, and combining outcomes does not reduce the estimated sample size of a trial. The death rate alone is the least variable and most easily identifiable measure of survival rate in amyotrophic lateral sclerosis.
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Archives of neurology · May 2009
Multicenter StudyA single, early magnetic resonance imaging study in the diagnosis of multiple sclerosis.
A diagnosis of multiple sclerosis in patients who present for the first time with a clinically isolated syndrome (CIS) can be established with brain magnetic resonance imaging (MRI) if the MRI demonstrates demyelinating lesions with dissemination in space (DIS) and dissemination in time (DIT). ⋯ A single brain MRI study that demonstrates DIS and shows both gadolinium-enhancing and nonenhancing lesions that suggest DIT is highly specific for predicting the early development of CDMS, even when the MRI is performed within the first 3 months after the onset of a CIS.
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Archives of neurology · May 2009
Randomized Controlled Trial Multicenter Study Comparative StudyLong-term effect of initiating pramipexole vs levodopa in early Parkinson disease.
To compare the long-term outcomes of subjects initially treated with pramipexole dihydrochloride with those of subjects initially treated with levodopa in the Comparison of the Agonist Pramipexole With Levodopa on Motor Complications of Parkinson's Disease (CALM-PD) trial. ⋯ The policies of initial pramipexole and initial levodopa use followed by open-label levodopa use resulted in similar self-reported disability 6 years after randomization. Persistent differences favoring initial pramipexole were seen in the rates of dopaminergic motor complications, with less severe somnolence favoring initial levodopa. Trial Registration clinicaltrials.gov Identifier: NCT00804479.
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Archives of neurology · Oct 2008
Multicenter Study Clinical TrialSodium oxybate for excessive daytime sleepiness in Parkinson disease: an open-label polysomnographic study.
Many patients with Parkinson disease (PD) have excessive daytime sleepiness and numerous nocturnal sleep abnormalities. ⋯ Nocturnally administered sodium oxybate improved excessive daytime sleepiness and fatigue in PD.
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Archives of neurology · Oct 2008
Multicenter Study Comparative StudyPrevalence of vitamin d insufficiency in patients with Parkinson disease and Alzheimer disease.
A role for vitamin D deficiency in Parkinson disease (PD) has recently been proposed. ⋯ This report of 25(OH)D concentrations in a predominantly white PD cohort demonstrates a significantly higher prevalence of hypovitaminosis in PD vs both healthy controls and patients with AD. These data support a possible role of vitamin D insufficiency in PD. Further studies are needed to determine the factors contributing to these differences and elucidate the potential role of vitamin D in pathogenesis and clinical course of PD.