Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Nov 2015
ReviewUsing visual rating to diagnose dementia: a critical evaluation of MRI atrophy scales.
Visual rating scales, developed to assess atrophy in patients with cognitive impairment, offer a cost-effective diagnostic tool that is ideally suited for implementation in clinical practice. By focusing attention on brain regions susceptible to change in dementia and enforcing structured reporting of these findings, visual rating can improve the sensitivity, reliability and diagnostic value of radiological image interpretation. ⋯ Careful consideration of atrophy rating scales is needed to verify their diagnostic potential and encourage uptake among clinicians. Determining the added value of combining scores from visual rating in different brain regions may also increase the diagnostic value of these tools.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2015
Randomized Controlled TrialThe MITOS system predicts long-term survival in amyotrophic lateral sclerosis.
The choice of adequate proxy for long-term survival, the ultimate outcome in randomised clinical trials (RCT) assessing disease-modifying treatments for amyotrophic lateral sclerosis (ALS), is a key issue. The intrinsic limitations of the ALS Functional Rating Scale-Revised (ALSFRS-R), including non-linearity, multidimensionality and floor-effect, have emerged and its usefulness argued. The ALS Milano-Torino staging (ALS-MITOS) system was proposed as a novel tool to measure the progression of ALS and overcome these limitations. This study was performed to validate the ALS-MITOS as a 6-month proxy of survival in 200 ALS patients followed up to 18 months. ⋯ The ALS-MITOS system can reliably predict the course of ALS up to 18 months and can be considered a novel and valid outcome measure in RCTs.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2015
Multicenter StudyPerformance characteristics of methods for quantifying spontaneous intracerebral haemorrhage: data from the Efficacy of Nitric Oxide in Stroke (ENOS) trial.
Poor prognosis after intracerebral haemorrhage (ICH) is related to haemorrhage characteristics. Along with developing therapeutic interventions, we sought to understand the performance of haemorrhage descriptors in large clinical trials. ⋯ ISRCTN9941422.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2015
ReviewLifting the veil: how to use clinical neuropsychology to assess dementia.
Neurologists often struggle to interpret the results of neuropsychological testing, even though cognitive assessments are an integral component of the diagnostic process in dementia syndromes. This article reviews the principles underlying clinical neuropsychology, background on common neuropsychological tests, and tips on how to interpret the results when assessing patients with dementia. ⋯ Finally, the pattern of deficits, helpful in defining clinical dementia phenotypes and sometimes in predicting the underlying molecular pathology, are outlined. Such clinicopathological associations will become invaluable as disease-modifying treatments for dementia are developed and implemented.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2015
Randomized Controlled TrialFactors influencing long-term outcomes in relapsing-remitting multiple sclerosis: PRISMS-15.
An exploratory study of the relationship between cumulative exposure to subcutaneous (sc) interferon (IFN) β-1a treatment and other possible prognostic factors with long-term clinical outcomes in relapsing-remitting multiple sclerosis (RRMS). ⋯ These findings suggest that higher cumulative exposure to sc IFN β-1a may be associated with better clinical outcomes, and early change in EDSS score may have prognostic value, over many years, in RRMS.