Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Aug 2019
ReviewNeurofilament light chain as a biomarker in neurological disorders.
In the management of neurological diseases, the identification and quantification of axonal damage could allow for the improvement of diagnostic accuracy and prognostic assessment. Neurofilament light chain (NfL) is a neuronal cytoplasmic protein highly expressed in large calibre myelinated axons. ⋯ Evidence that both CSF and blood NfL may serve as diagnostic, prognostic and monitoring biomarkers in neurological diseases is progressively increasing, and NfL is one of the most promising biomarkers to be used in clinical and research setting in the next future. Here we review the most important results on CSF and blood NfL and we discuss its potential applications and future directions.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2019
High plasma concentrations of organic pollutants negatively impact survival in amyotrophic lateral sclerosis.
To determine whether persistent organic pollutants (POP) affect amyotrophic lateral sclerosis (ALS) survival. ⋯ Higher concentrations of POPs in plasma are associated with reduced ALS survival, independent of age, gender, segment of onset and other covariates. This study helps characterise and quantify the combined effects of POPs on ALS and supports the concept that environmental exposures play a role in disease pathogenesis.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2019
Corticolimbic fast-tracking: enhanced multimodal integration in functional neurological disorder.
Some individuals with functional neurological disorder (FND) exhibit motor and affective disturbances, along with limbic hyper-reactivity and enhanced motor-limbic connectivity. Given that the multimodal integration network (insula, dorsal cingulate, temporoparietal junction (TPJ)) is implicated in convergent sensorimotor, affective and interoceptive processing, we hypothesised that patients with FND would exhibit altered motor and amygdalar resting-state propagation to this network. Patient-reported symptom severity and clinical outcome were also hypothesised to map onto multimodal integration areas. ⋯ These neuroimaging findings suggest potential candidate neurocircuit pathways in the pathophysiology of FND.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2019
Gait worsening and the microlesion effect following deep brain stimulation for essential tremor.
To investigate the effects of unilateral thalamic deep brain stimulation (DBS) on walking in persons with medication-refractory essential tremor (ET). ⋯ Global gait worsening occurred in 25% of participants with unilateral DBS for medication-refractory ET. The effect was present on and off stimulation, likely indicating a microlesion effect.