Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Dec 2010
Meta AnalysisAn estimate of amyotrophic lateral sclerosis heritability using twin data.
Causative gene mutations have been identified in about 2% of those with amyotrophic lateral sclerosis (ALS), often, but not always, when there is a strong family history. There is an assumption that there is a genetic component to all ALS, but genome-wide association studies have yet to produce a robustly replicated result. A definitive estimate of ALS heritability is therefore required to determine whether ongoing efforts to find susceptibility genes are worth while. ⋯ Five monozygotic twin pairs were concordant-affected, and 44 discordant-affected. No dizygotic twin pairs were concordant-affected, and 122 discordant-affected. The heritability of sporadic ALS was estimated as 0.61 (0.38 to 0.78) with the unshared environmental component 0.39 (0.22 to 0.62). ALS has a high heritability, and efforts to find causative genes should continue.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2010
Review Comparative StudyAntidepressants for neuropathic pain: a Cochrane review.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2010
Sleep-wake disturbances 3 years after traumatic brain injury.
6 months after traumatic brain injury (TBI), almost three out of four patients suffer from sleep-wake disturbances (SWD) such as post-traumatic hypersomnia (increased sleep need of ≥2 h compared with before injury), excessive daytime sleepiness (EDS), fatigue and insomnia. The long-term course of post-traumatic SWD, however, is unknown. ⋯ This prospective study shows that 3 years after TBI, two out of three patients suffer from residual SWD, particularly fatigue and post-traumatic hypersomnia. In 45% of TBI patients, SWD appear directly related to the trauma itself.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2010
Early central atrophy rate predicts 5 year clinical outcome in multiple sclerosis.
To examine the predictive value of central atrophy in early multiple sclerosis (MS) patients, for medium term clinical outcome. ⋯ The rate of ventricular enlargement seems to be even more strongly predictive of disease progression after medium term follow-up than whole brain atrophy rate, and also outperforms lesion measures. Central atrophy rate could therefore be an important prognostic marker, especially in the early stages of MS.