Journal of neurology, neurosurgery, and psychiatry
-
J. Neurol. Neurosurg. Psychiatr. · Dec 2016
Randomized Controlled TrialEarly blood pressure lowering in patients with intracerebral haemorrhage and prior use of antithrombotic agents: pooled analysis of the INTERACT studies.
Antithrombotic agents increase risks of intracerebral haemorrhage (ICH) and associated adverse outcomes. We determined differential effects of early blood pressure (BP) lowering in patients with/without antithrombotic-associated ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trials (INTERACT1 and 2). ⋯ In patients with ICH, prior antithrombotic therapy is associated with greater haematoma growth, which may be reduced by early intensive BP-lowering treatment.
-
J. Neurol. Neurosurg. Psychiatr. · Dec 2016
Multicenter StudyCognitive reserve moderates long-term cognitive and functional outcome in cerebral small vessel disease.
Cerebral small vessel disease (SVD) is characterised by progressive white matter hyperintensities (WMH), cognitive decline and loss of functional independence. The correspondence between neuroimaging findings and the severity of clinical symptoms has been modest, however, and thus the outcome may be affected by various host factors. We investigated the predictive value of educational and occupational attainments as proxy measures of cognitive reserve on long-term cognitive and functional outcome in patients with different degrees of WMH. ⋯ The results support the presumption that cognitive reserve plays a significant role as a buffer against the clinical manifestations of SVD and may in part explain high individual variability in outcome.
-
J. Neurol. Neurosurg. Psychiatr. · Dec 2016
Multicenter Study Comparative StudyHigher latitude is significantly associated with an earlier age of disease onset in multiple sclerosis.
Age at onset (AAO) in multiple sclerosis (MS) is an important marker of disease severity and may have prognostic significance. Understanding what factors can influence AAO may shed light on the aetiology of this complex disease, and have applications in the diagnostic process. ⋯ An earlier AAO in higher latitude regions was found in this worldwide European-descent cohort and correlated inversely with variation in latitudinal UVR. These results suggest that environmental factors which act at the population level may significantly influence disease severity characteristics in genetically susceptible populations.
-
J. Neurol. Neurosurg. Psychiatr. · Dec 2016
Defining and validating a short form Montreal Cognitive Assessment (s-MoCA) for use in neurodegenerative disease.
Screening for cognitive deficits is essential in neurodegenerative disease. Screening tests, such as the Montreal Cognitive Assessment (MoCA), are easily administered, correlate with neuropsychological performance and demonstrate diagnostic utility. Yet, administration time is too long for many clinical settings. ⋯ Early detection of cognitive impairment is an important clinical and public health concern, but administration of screening measures is limited by time constraints in demanding clinical settings. Here, we provide as-MoCA that is valid across neurological disorders and can be administered in approximately 5 min.
-
J. Neurol. Neurosurg. Psychiatr. · Dec 2016
The contribution of lesion location to upper limb deficit after stroke.
Motor deficit after stroke is related to regional anatomical damage. ⋯ Quantification of structural damage can add to models explaining motor outcome after stroke, but assessment of corticospinal tract damage alone is unlikely to be sufficient when considering patients with stroke with a wide range of lesion topography.