Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · May 2009
Randomized Controlled TrialEfficacy of methylphenidate in the rehabilitation of attention following traumatic brain injury: a randomised, crossover, double blind, placebo controlled inpatient trial.
Most previous studies evaluating the use of methylphenidate following traumatic brain injury (TBI) have been conducted many years post-injury. This study evaluated the efficacy of methylphenidate in facilitating cognitive function in the inpatient rehabilitation phase. ⋯ Methylphenidate enhances information processing speed in the inpatient rehabilitation phase following TBI. This trial is registered with the Australian New Zealand Clinical Trials Registry (12607000503426).
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J. Neurol. Neurosurg. Psychiatr. · May 2009
Prospective study of chemical exposures and amyotrophic lateral sclerosis.
Although environmental toxins, including pesticides, are suspected of contributing to the risk of amyotrophic lateral sclerosis (ALS), no data exist from large prospective investigations. This study assessed the association between exposure to chemicals and risk of ALS in a prospective cohort study. ⋯ There was little evidence for any association between pesticides/herbicide exposure and ALS. In contrast, evidence was found, suggesting an increased risk of ALS with formaldehyde exposure. Because of the longitudinal design, this result is unlikely to be due to bias, but it should nevertheless be interpreted cautiously and needs to be verified independently.
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J. Neurol. Neurosurg. Psychiatr. · May 2009
Towards an understanding of fatigue in Parkinson disease.
To gain an improved understanding of fatigue in Parkinson disease (PD) by exploring possible predictors among a wide range of motor and non-motor aspects of PD. ⋯ This study found fatigue to be primarily associated with symptoms of depression and anxiety, and with compromised motivation, parkinsonism (particularly axial/postural/gait impairment) and pain. These results are in agreement with findings in other disorders and imply that fatigue should be considered a separate PD entity differing from, for example, excessive daytime sleepiness. Fatigue may have a distinguished neurobiological background, possibly related to neuroinflammatory mechanisms. This implies that novel treatment options, including anti-inflammatory therapies, could be effective.
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J. Neurol. Neurosurg. Psychiatr. · May 2009
Population-based study of baseline ethanol consumption and risk of incident essential tremor.
Recent postmortem studies have demonstrated pathological changes, including Purkinje cell loss, in the cerebellum in essential tremor (ET). Toxic exposures that compromise cerebellar tissue could lower the threshold for developing ET. Ethanol is a well-established cerebellar toxin, resulting in Purkinje cell loss. ⋯ Higher levels of chronic ethanol consumption increased the risk of developing ET. Ethanol is often used for symptomatic relief; studies should explore whether higher consumption levels are a continued source of underlying cerebellar neurotoxicity in patients who already manifest this disease.
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J. Neurol. Neurosurg. Psychiatr. · May 2009
Surgical treatment of independent bitemporal lobe epilepsy defined by invasive recordings.
Bitemporal lobe epilepsy is commonly encountered in the evaluation of pharmacoresistant epilepsy. Yet the role of surgery in the management of these patients is unclear. This study evaluates the impact of surgery on seizure tendency and quality of life, as well as prognostic indicators in individuals with proven ictal onset bitemporal lobe epilepsy. ⋯ Surgical resection is an important treatment option for medically intractable bitemporal epilepsy. The proportion of seizures arising from one temporal lobe is not reliable as a single indicator to prognosticate the results of surgery on seizure tendency. In addition, individuals who achieved only palliation by reducing seizure frequency experienced improvement in quality of life.