Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Nov 2013
Changes to anti-JCV antibody levels in a Swedish national MS cohort.
The anti-JC virus (JCV) antibody status has been introduced to stratify patients with multiple sclerosis (MS) for higher or lower risk of progressive multifocal leukoencephalopathy (PML). ⋯ Treatment initiation with NAT may lead to a slight decrease in anti-JCV and anti-VZV antibody levels, suggestive of a mild suppressive effect of NAT on antibody levels. Our findings in five cases of PML demonstrate that the onset of PML can be accompanied by increasing anti-JCV antibodies in serum. Monitoring of anti-JCV antibody levels could potentially be used as a tool for prediction or earlier diagnosis of PML during NAT treatment for MS. Further studies are warranted.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2013
Meta AnalysisThe heterogeneity of cognitive symptoms in Parkinson's disease: a meta-analysis.
Several studies have reported heterogeneity in cognitive symptoms associated with specific characteristics of patients with Parkinson's disease (PD). Indeed, researchers have characterised subtypes of patients suffering from PD according to various criteria. Those most frequently used are the type of predominant motor symptoms (tremors or non-tremor symptoms), age at onset and presence of depression. ⋯ These results suggested that PD participants with non-tremor predominant motor symptoms or with depression had more or more severe cognitive impairments. Identification of different subtypes in PD is important for a better understanding of the cognitive symptoms associated with this disease. Better knowing the impact of different features of PD subgroups could help to design more appropriate treatments for patients with PD.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2013
Bilateral stereotactic anterior capsulotomy for obsessive-compulsive disorder: long-term follow-up.
Psychosurgery, such as anterior capsulotomy, is a therapeutic option for treatment-resistant obsessive-compulsive disorder (OCD). In this paper, we present a prospective, long-term follow-up study aimed at evaluating both the efficacy and the safety of anterior capsulotomy for the treatment of severe, refractory OCD. ⋯ Anterior capsulotomy is an effective and safe technique for the treatment of severe refractory OCD in patients who have no other alternative to improve their symptoms.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2013
ReviewClinical utility of dopamine transporter single photon emission CT (DaT-SPECT) with (123I) ioflupane in diagnosis of parkinsonian syndromes.
The diagnosis of movement disorders including Parkinson's disease (PD) and essential tremor is determined through clinical assessment. The difficulty with diagnosis of early PD has been highlighted in several recent clinical trials. ⋯ In some patients with suspected parkinsonian syndromes, SPECT imaging with ((123)I)ioflupane is useful to assist in the diagnosis and to help guide prognosis and treatment decisions, including avoiding medications that are unlikely to provide benefit. Clinicians ordering ((123)I)ioflupane SPECT should be aware of its limitations and pitfalls and should order scans when there is diagnostic uncertainty or when the scan will be helpful in clinical decision making.