Current neurology and neuroscience reports
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Curr Neurol Neurosci Rep · Jan 2014
ReviewEvolving role of endovascular treatment of acute ischemic stroke.
The perceived advantages of endovascular treatment for acute ischemic stroke in terms of recanalization, the multimodal and targeted approaches, and perhaps the more permissive rules on devices than on medications for their licensing favored the assumption that endovascular treatment is superior to intravenous thrombolysis for acute treatment of ischemic stroke, and its adoption in more advanced stroke centers. However, this assumption has been questioned by recent clinical trial experience showing that endovascular treatment is not superior to intravenous thrombolysis. ⋯ The new challenge is how to study the latest generation of devices called stent retrievers, which are faster in recanalizing and easier to use, in selected patients with acute ischemic stroke. In the meantime, the available evidence does not provide support for the use of endovascular treatment of acute ischemic stroke in clinical practice.
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Curr Neurol Neurosci Rep · Jan 2014
Review Meta AnalysisThe effects of Mozart's music on interictal activity in epileptic patients: systematic review and meta-analysis of the literature.
Mozart's music has been shown to have promising effects on nervous system functions. In this study, the effects of Mozart's work on epilepsy were reviewed. Articles were obtained from a variety of sources. ⋯ A noteworthy response to music therapy in patients with a higher intelligence quotient, generalized or central discharges, and idiopathic epilepsy was demonstrated. The effect of Mozart's music on epilepsy seems to be significant. However, more randomized control studies are needed to determine its clinical efficacy.
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Curr Neurol Neurosci Rep · Dec 2013
ReviewChronic traumatic encephalopathy: where are we and where are we going?
Chronic traumatic encephalopathy (CTE, previously called punch drunk and dementia pugilistica) has a rich history in the medical literature in association with boxing, but has only recently been recognized with other contact sports, such as football and ice hockey, as well as with military blast injuries. CTE is thought to be a neurodegenerative disease associated with repeated concussive and subconcussive blows to the head. There is characteristic gross and microscopic pathology found in the brain, including frontal and temporal atrophy, axonal degeneration, and hyperphosphorylated tau and TAR DNA-binding protein 43 pathology. ⋯ Here we review the CTE literature to date. We also draw on the literature from mild traumatic brain injury and other neurodegenerative dementias, particularly when these studies provide guidance for future CTE research. We conclude by suggesting seven essential areas for future CTE research.
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Curr Neurol Neurosci Rep · Dec 2013
ReviewMisdiagnosis of multiple sclerosis: frequency, causes, effects, and prevention.
A diagnosis of multiple sclerosis is heavily influenced by clinical judgment. Misdiagnosis of multiple sclerosis is common and has important consequences for patients and the cost of healthcare. Although rigorous data about the frequency and causes of misdiagnosis are lacking, misinterpretation and misapplication of clinical and radiographic diagnostic criteria and terminology are likely important factors. Appropriate and stringent application of diagnostic criteria and continued vigilance for "red flags" suggesting alternative diagnoses are strategies critical for prevention of misdiagnosis.
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Curr Neurol Neurosci Rep · Nov 2013
ReviewConscious awareness in patients in vegetative states: myth or reality?
Do vegetative state (VS) and minimally conscious state (MCS) patients experience emotions and have conscious awareness of themselves and their surroundings? Can neuroimaging clarify these questions? Neuroimaging responses to stimuli are classified into four levels: level 0 indicates no response; level 1 indicates responses limited to the primary sensory cortices; level 2 indicates activation of primary sensory cortices and higher-order associative areas; level 3 indicates activation of cortical regions to either mental imagery tasks or high-level language stimuli requiring distinction of ambiguous from unambiguous words. Level 0 or level 1 was noted in 125 of 193 VS patients (65 %) and 46 of 121 MCS patients (38 %), suggesting no evidence of conscious awareness. ⋯ These data may denote the presence of conscious awareness or may simply identify neuronal processing without phenomenological awareness. The pro and cons of these conflicting interpretations are discussed.