Lancet neurology
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Frontotemporal dementia (FTD) is a focal clinical syndrome characterised by profound changes in personality and social conduct and associated with circumscribed degeneration of the prefrontal and anterior temporal cortex. Onset is typically in the middle years of life and survival is about 8 years. ⋯ However, more than half of all patients with FTD, including some with a strong family history, show no apparent abnormality in the tau gene or protein, indicating pathological and aetiological heterogeneity. FTD provides a challenge both for clinical management and for theoretical understanding of its neurobiological substrate.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
The United Kingdom Infantile Spasms Study (UKISS) comparing hormone treatment with vigabatrin on developmental and epilepsy outcomes to age 14 months: a multicentre randomised trial.
Infantile spasms is a severe infantile seizure disorder that is difficult to treat and has a high morbidity. Absence of spasms on days 13 and 14 after randomisation is more common in infants allocated hormone treatments than in those allocated vigabatrin. We sought to assess whether early control of spasms is associated with improved developmental or epilepsy outcomes. ⋯ Hormone treatment controls spasms better than does vigabatrin initially, but not at 12-14 months of age. Better initial control of spasms by hormone treatment in those with no identified underlying aetiology may lead to improved developmental outcome.
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The traditional view of dementia is that the features most important to accurate diagnosis and management are cognitive decline and functional disability. Behavioural and psychological symptoms have generally been thought to be of secondary importance, but new evidence suggests that these are important determinants of patients' distress, carer burden, and outcome in dementia; they can also be valuable diagnostic pointers to the underlying pathological cause and disease diagnosis. ⋯ Although pharmacological management is a commonly used option, it is often limited in its effects and can be associated with a substantial risk of side-effects. Progress in understanding the pathophysiological mechanisms underpinning behavioural and psychological symptoms in dementia will assist in developing more effective treatment approaches.
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Randomized Controlled Trial Clinical Trial
Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease.
Physical activity may help maintain cognitive function and decrease dementia risk, but epidemiological findings remain controversial. The aim of our study was to investigate the association between leisure-time physical activity at midlife and the subsequent development of dementia and Alzheimer's disease (AD). ⋯ Leisure-time physical activity at midlife is associated with a decreased risk of dementia and AD later in life. Regular physical activity may reduce the risk or delay the onset of dementia and AD, especially among genetically susceptible individuals.