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- Author Response. [Comment, Journal Article]
- Neurology 2013 Oct 22; 81(17):1558-9.
- Author Response. [Comment, Letter]
- Neurology 2013 Oct 22; 81(17):1558.
- Reflections: Neurology and the Humanities:personal health information in verse. [Journal Article]
- Neurology 2013 Oct 22; 81(17):e123.
- The ReSPonD trial - rivastigmine to stabilise gait in Parkinson's disease a phase II, randomised, double blind, placebo controlled trial to evaluate the effect of rivastigmine on gait in patients with Parkinson's disease who have fallen. [JOURNAL ARTICLE]
- BMC Neurol 2013 Dec 3; 13(1):188.
Gait impairment is common in people with Parkinson's disease. There is a lack of effective interventions to target this debilitating complication and therefore a need to identify new therapeutic options. An underlying cholinergic deficit contributes to both the gait and cognitive dysfunction seen in Parkinson's disease. The combined impact of both impairments can be assessed in gait tasks performed with concomitant cognitive tasks. The aim of this trial is to evaluate the impact of a cholinesterase inhibitor on cognitive function and gait performance in people with established Parkinson's disease.Methods/design: This is a single centre, double-blind, randomised placebo-controlled trial in 130 people with Hoehn and Yahr stage 2--3 idiopathic Parkinson's disease who have fallen in the past year. Participants will be randomised to two groups, receiving either rivastigmine capsules or identical placebo capsules for 8 months. Assessment will be undertaken at baseline and at the end of medication prescription (i.e. 8 months) with participants remaining enrolled in the trial for a further 4 months to monitor for falls and adverse events. The primary outcome is step time variability, assessed with and without the addition of concurrent cognitive tasks. Secondary outcomes will include other gait parameters, sensorimotor and balance performances, cognitive indices, falls and fall related injury, fear of falling, Parkinson's symptoms and data pertaining to possible harms.This randomised controlled trial will examine the effect of cholinesterase inhibitor therapy on gait, balance and falls in Parkinson's disease. If effective, it would offer a new therapeutic option to ameliorating gait and cognitive deficits in a population at high risk of falls.Trial registration: ISRCTN19880883, UTN U1111-1124-0244.
- Teaching NeuroImages: Thalamic aphasia syndrome. [Journal Article]
- Neurology 2013 Dec 3; 81(23):e177.
An 83-year-old right-handed woman presented with sudden right-sided hemiparesis, somnolence, and loss of normal speech. Speech was nonfluent with semantic paraphasias and word-finding difficulties. Word repetition and comprehension was normal. MRI brain showed an area of restricted diffusion in the left thalamus consistent with acute infarction (figure 1). Speech fluency returned to normal after 2 days with occasional dysnomia and paraphasias.
- Teaching NeuroImages: Isolated sphenoiditis: An uncommon cause of abducens nerve palsy. [Journal Article]
- Neurology 2013 Dec 3; 81(23):e176.
A 35-year-old woman presented with a headache lasting 2 weeks and complained of recent diplopia. Neurologic examination showed limited left eye abduction. Initial brain CT scan was considered normal (figure, A). Brain MRI showed left sphenoiditis (figure, B). The patient was treated with amoxicillin/clavulanic acid and corticosteroids with rapid symptom improvement which deferred endoscopy that could provide a bacteriologic diagnosis.
- Journal Club: Default-mode network connectivity in cognitively unimpaired patients with Parkinson disease. [Journal Article]
- Neurology 2013 Dec 3; 81(23):e172-5.
This Journal Club article looks at a study by Tessitore et al.,(1) who investigated functional connectivity (FC) within the default-mode network (DMN) in cognitively unimpaired patients with Parkinson disease (PD). PD is the second most common neurodegenerative disorder after Alzheimer disease (AD) and is expected to become progressively more prevalent in our aging societies. Thus, its social and economic burden on societies is expected to be even greater in the future.(2) Cognitive impairment is one of the most disabling nonmotor symptoms of PD, further affecting functioning and quality of life, as well as increasing caregivers' burden and health-related costs.(3) When an individual is alert but not actively engaged in cognitive tasks, organized neural activity occurs in a set of brain regions called DMN (figure), which involves the posterior cingulate cortex (PCC), parts of the ventromedial prefrontal cortex, and the precuneus.(4) Interestingly, DMN abnormalities have been linked to cognitive profiles in several neurologic and psychiatric disorders, such as AD, autism, frontotemporal dementia, multiple sclerosis, and vegetative states(5); however, contradictory results have been reported in PD.(1) This study, for the first time, cogently demonstrates decreased FC within the DMN in cognitively unimpaired patients with PD.
- Provocation of migraine with aura using natural trigger factors. [Journal Article]
- Neurology 2013 Dec 3; 81(23):2057.
- Treatment with statins and ischemic stroke severity: Does the dose matter? [Journal Article]
- Neurology 2013 Dec 3; 81(23):2056-7.
- Nonmelanoma skin cancer is associated with reduced Alzheimer disease risk. [Journal Article]
- Neurology 2013 Dec 3; 81(23):2056.