Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Nov 2016
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of the diagnostic utility of physician-diagnosed with algorithm-defined stroke-associated pneumonia.
Diagnosing stroke-associated pneumonia (SAP) is challenging and may result in inappropriate antibiotic use or confound research outcomes. This study evaluates the diagnostic accuracy of algorithm-defined versus physician-diagnosed SAP in 1088 patients who had dysphagic acute stroke from 37 UK stroke units between 21 April 2008 and 17 May 2014. ⋯ Algorithm-based approaches can standardise SAP diagnosis for clinical practice and research.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2016
Randomized Controlled Trial Multicenter Study Comparative Study Pragmatic Clinical TrialPeer support and reminiscence therapy for people with dementia and their family carers: a factorial pragmatic randomised trial.
The objective of this study was to evaluate peer support and reminiscence therapy, separately and together, in comparison with usual care for people with dementia and their family carers. ⋯ There is no evidence from the trial that either peer support or reminiscence is effective in improving the quality of life.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2016
Review Comparative StudyComparing neurostimulation technologies in refractory focal-onset epilepsy.
For patients with pharmacoresistant focal epilepsy in whom surgical resection of the epileptogenic focus fails or was not feasible in the first place, there were few therapeutic options. Increasingly, neurostimulation provides an alternative treatment strategy for these patients. Vagal nerve stimulation (VNS) is well established. ⋯ Intracranial neurostimulation had a greater side effect profile compared with extracranial stimulation, though all forms of stimulation are safe. Methodological differences between the studies mean that direct comparisons are not straightforward. We have synthesised the findings of this review into a pragmatic decision tree, to guide the further management of the individual patient with pharmacoresistant focal-onset epilepsy.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2016
ReviewNeuronal network disintegration: common pathways linking neurodegenerative diseases.
Neurodegeneration refers to a heterogeneous group of brain disorders that progressively evolve. It has been increasingly appreciated that many neurodegenerative conditions overlap at multiple levels and therefore traditional clinicopathological correlation approaches to better classify a disease have met with limited success. ⋯ In addition, evidence that may support the existence of large-scale networks that might be contributing to phenotypic differentiation will be considered across a neurodegenerative spectrum. Disintegration of neuronal networks through different pathological processes, such as prion-like spread, may provide a better paradigm of disease and thereby facilitate the identification of novel therapies for neurodegeneration.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2016
Utility of testing for apraxia and associated features in dementia.
Existing literature suggests that the presence or absence of apraxia and associated parietal deficits may be clinically relevant in differential diagnosis of dementia syndromes. ⋯ Disease-specific profiles of limb apraxia and associated deficits can be observed. FTD and AD spectrum disorders can be difficult to differentiate due to overlapping cognitive symptoms, and measures of apraxia, in particular, appear to be a promising discriminator.