European neurology
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Randomized Controlled Trial
Effect of methylphenidate and/or levodopa combined with physiotherapy on mood and cognition after stroke: a randomized, double-blind, placebo-controlled trial.
Stimulant medications can enhance mood and cognition in stroke rehabilitation, but human clinical trial results are inconclusive. We sought to prospectively study the effects of levodopa (LD) and/or methylphenidate (MPH) in combination with physiotherapy on mood and cognition following stroke in human subjects. ⋯ A 15-day course of daily MPH + LD combined with physiotherapy over a 3-week period was safe and significantly improved mood status in ischemic stroke patients. Future studies are needed which determine the optimal therapeutic window for and dosage of psychostimulants as well as identify those stroke patients who might benefit the most from treatment.
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Multicenter Study
Effects of medial temporal atrophy and white matter hyperintensities on the cognitive functions in patients with Alzheimer's disease.
We conducted this study to investigate the independent association of medial temporal atrophy (MTA) and white matter hyperintensities (WMH) with cognitive impairments of Alzheimer's disease (AD) patients and the interaction between MTA and WMH. ⋯ MTA and WMH independently affected cognitive deficits in AD patients, with somewhat different patterns where MTA was associated mostly with memory and language, while WMH were associated with attention and frontal executive functions. This study also showed interactions between MTA and WMH on some cognitive deficits and dementia severity, suggesting that they synergistically contribute to cognitive impairment in AD.
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Clinical Trial
Long-term controlled-release oxycodone and pregabalin in the treatment of non-cancer pain: an observational study.
This study evaluates the efficacy and tolerability of long-term controlled-release (CR) oxycodone + pregabalin in patients with non-cancer pain, in a real-life setting. ⋯ The combination of CR oxycodone + pregabalin could represent a valuable long-term therapeutic addition to existing pharmacological options for the treatment of non-cancer pain.
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Letter Review Case Reports
Ischemic stroke presenting as thunderclap headache: report of two cases and review of the literature.
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Recent research has suggested that a perfusion-weighted image (PWI) relative cerebral blood volume (rCBV) map after acute ischemic stroke (AIS) provides information about the collateral circulation in the ischemic region. In this study, we demonstrate the usefulness of the rCBV ratio in PWI in predicting poor outcome after using IV t-PA in AIS. We recruited 58 stroke patients who were treated with IV t-PA after diagnostic magnetic resonance imaging (MRI). ⋯ Poor outcome also correlated with diffusion-weighted MR images of the lesion volume (p < 0.01), lower rCBV ratio on PWI (p < 0.01), and non-recanalization (p < 0.01). Among these, non-recanalization (p < 0.01), reduced rCBV ratio on PWI (p < 0.01), age (p = 0.04), and serum glucose level (p = 0.01) had an independent significance for predicting it. This suggests that the rCBV ratio on PWI may be used to determine prognosis after thrombolysis in AIS.