Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Jul 2011
Multicenter StudyDisability, distress and unemployment in neurology outpatients with symptoms 'unexplained by organic disease'.
To determine the disability, distress and employment status of new neurology outpatients with physical symptoms unexplained by organic disease and to compare them with patients with symptoms explained by organic disease. ⋯ New neurology patients with symptoms unexplained by organic disease have more disability-, distress- and disability-related state financial benefits than patients with symptoms explained by disease.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2011
Are subjects with spondylotic cervical cord encroachment at increased risk of cervical spinal cord injury after minor trauma?
The aim of the study was to analyse the risk of symptomatic myelopathy after minor trauma in patients with asymptomatic spondylotic cervical spinal cord encroachment (ASCCE). In a cohort of 199 patients with ASCCE, previously followed prospectively in a study investigating progression into symptomatic myelopathy, the authors looked retrospectively for traumatic episodes that may have involved injury to the cervical spine. A questionnaire and data file analysis were employed to highlight whatever hypothetical relationship might emerge with the development of symptomatic myelopathy. ⋯ Furthermore, 56 traumatic spinal cord events were found before the diagnosis of cervical cord encroachment was established, with no correlation to either type of compression (discogenic vs osteophytic). In conclusion, the risk of spinal cord injury after minor trauma of the cervical spine in patients with ASCCE appeared to be low in our cohort provided risky activities in these individuals are restricted. Implementation of preventive surgical decompression surgery into clinical practice in these individuals should be postponed until better-designed studies provide proof enough for it to take precedence over a conservative approach.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2011
Interpersonal traits change as a function of disease type and severity in degenerative brain diseases.
Different degenerative brain diseases result in distinct personality changes as a result of divergent patterns of brain damage; however, little is known about the natural history of these personality changes throughout the course of each disease. ⋯ Specific changes in affiliative interpersonal traits differentiate degenerative brain diseases even at a very mild disease stage, and patterns of personality change differ across bvFTD, SemD and AD with advancing disease. This study describes the typical progression of change of interpersonal traits in each disease, improving the ability of clinicians and caregivers to predict and plan for symptom progression.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2011
Reduced thalamic N-acetylaspartate in idiopathic normal pressure hydrocephalus: a controlled 1H-magnetic resonance spectroscopy study of frontal deep white matter and the thalamus using absolute quantification.
Patients with idiopathic normal pressure hydrocephalus (INPH) frequently have a reduction in cerebral blood flow in the subcortical frontal lobe/basal ganglia/thalamic areas. With magnetic resonance spectroscopy, the metabolism in the brain can be examined. The aim of this study was to investigate if there was a compromised metabolism in the thalamus and in the subcortical frontal areas in INPH patients. This was done by measuring total creatine, myo-inositol, total choline, N-acetylaspartate (NAA), total N-acetylaspartate (tNA), glutamate and lactate levels. A comparison was made with healthy individuals (HI). ⋯ Reduced thalamic NAA and tNA in INPH patients suggest a compromised metabolic neuronal function in these regions. Thus, the thalamus might have an important role in the pathogenesis of INPH.
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J. Neurol. Neurosurg. Psychiatr. · Jul 2011
Predictors of cognitive and psychosocial outcome after STN DBS in Parkinson's Disease.
To find predictors of cognitive decline and quality of life 1 year after bilateral subthalamic nucleus deep brain stimulation (STN DBS) in Parkinson's disease (PD). ⋯ STN DBS improves quality of life. However, a profile of cognitive decline can be found in a significant number of patients. l-dopa response, age and attention at baseline are predictors of cognitive and psychosocial outcome.