Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Mar 2012
Long term follow-up of deep brain stimulation of the caudal zona incerta for essential tremor.
The ventral intermediate nucleus of thalamus is the standard target for deep brain stimulation (DBS) in essential tremor (ET). However, favourable data have recently highlighted the caudal zona incerta (cZi) as an alternative target. Reports concerning the long-term results are however lacking, and we have therefore evaluated the long-term effects in our patients with ET and cZi DBS. ⋯ cZi DBS is a safe and effective treatment for the long term suppression of ET.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2012
Sera from neuromyelitis optica patients disrupt the blood-brain barrier.
In neuromyelitis optica (NMO), the destruction of the blood-brain barrier (BBB) has been considered to be the first step of the disease process. It is unclear whether sera from patients with NMO can open the BBB, and which component of patient sera is most important for this disruption. ⋯ Sera from NMO patients reduce expression of tight junction proteins and disrupt the BBB. Autoantibodies against BMECs other than anti-AQP4 antibodies may disrupt the BBB through upregulation of VEGF in BMECs.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2012
Subcortical white matter hyperintensities within the cholinergic pathways of Parkinson's disease patients according to cognitive status.
White matter hyperintensities (WMH) in the cholinergic pathways show a stronger correlation with cognitive performance than general WMH in Alzheimer's disease. However, the role of WMH within the cholinergic pathways in cognitive dysfunction has not been investigated in Parkinson's disease (PD). ⋯ This study demonstrated that the burden of WMH within cholinergic pathways was significantly higher in patients with PDD relative to other groups, and that cholinergic WMH was significantly correlated with a decline in frontal executive function and attention.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2012
Functional connectivity of dissociation in patients with psychogenic non-epileptic seizures.
Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures, but lack epileptiform brain activity. Instead, the cause is assumed to be psychogenic. An abnormal coping strategy may be exhibited by PNES patients, as indicated by their increased tendency to dissociate. Investigation of resting-state networks may reveal altered routes of information and emotion processing in PNES patients. The authors therefore investigated whether PNES patients differ from healthy controls in their resting-state functional connectivity characteristics and whether these connections are associated with the tendency to dissociate. ⋯ The abnormal, strong functional connectivity in PNES patients provides a neurophysiological correlate for the underlying psychoform and somatoform dissociation mechanism where emotion can influence executive control, resulting in altered motor function (eg, seizure-like episodes).
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J. Neurol. Neurosurg. Psychiatr. · Mar 2012
Subthalamic nucleus deep brain stimulation outcome in young onset Parkinson's disease: a role for age at disease onset?
Patients with young onset Parkinson's disease (YOPD) are often candidates for subthalamic nucleus-deep brain stimulation (STN-DBS). Nevertheless, few data have been reported on the long term STN-DBS clinical outcome of YOPD versus non-young onset Parkinson's disease (n-YOPD) patients. ⋯ In this series of STN-DBS treated patients, YOPD was associated with a medium to long term lower incidence of stimulation and medication resistant symptoms.