Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Nov 2010
The role of cerebrospinal fluid 14-3-3 and other proteins in the diagnosis of sporadic Creutzfeldt-Jakob disease in the UK: a 10-year review.
It is 10 years since the detection of cerebrospinal fluid (CSF) 14-3-3 was included in the diagnostic criteria for sporadic Creutzfeldt-Jakob disease (sCJD) by the WHO. Since that time, other CSF proteins, such as S100b and tau protein, have been proposed as surrogate markers for sCJD. The authors aimed to investigate the diagnostic value of each of these three proteins. ⋯ CSF 14-3-3 had the greatest sensitivity (86%) when compared with tau protein (81%) and S100b (65%). The combination of a positive CSF 14-3-3 or an elevated tau protein with a raised S100b had the highest positive predictive power for sCJD. During the study period, 100 patients were classified as probable sCJD solely on the basis of the clinical features and a positive CSF 14-3-3. The most sensitive marker for sCJD was a positive CSF 14-3-3. The analysis of CSF 14-3-3 plays a crucial role in the case classification of sCJD.
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J. Neurol. Neurosurg. Psychiatr. · Nov 2010
Predicting intracranial lesions by antiplatelet agents in subjects with mild head injury.
The effect of pre-injury antiplatelet treatment in the risk of intracranial lesions in subjects after mild head injury (Glasgow Coma Scale (GCS) 14-15) is uncertain. ⋯ Antiplatelet drugs need to be considered in future prediction models on mild head injury, considering their increasing use and progressive ageing of the trauma population.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2010
ReviewPsychological approaches to treatment of postconcussion syndrome: a systematic review.
Postconcussion syndrome (PCS) is a term used to describe the complex, and controversial, constellation of physical, cognitive and emotional symptoms associated with mild brain injury. At the current time, there is a lack of clear, evidence-based treatment strategies. In this systematic review, the authors aimed to evaluate the potential efficacy of cognitive behavioural therapy (CBT) and other psychological treatments in postconcussion symptoms. ⋯ There was evidence that CBT may be effective in the treatment of PCS. Information, education and reassurance alone may not be as beneficial as previously thought. There was limited evidence that multifaceted rehabilitation programmes that include a psychotherapeutic element or mindfulness/relaxation benefit those with persisting symptoms. Further, more rigorous trials of CBT for postconcussion symptoms are required.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2010
CSF amyloid-beta and tau proteins, and cognitive performance, in early and untreated Parkinson's disease: the Norwegian ParkWest study.
Alzheimer's disease (AD) pathology is found in a considerable portion of patients with Parkinson's disease (PD), particularly those with early dementia (PDD). Altered cerebrospinal fluid (CSF) levels of amyloid-β (Aβ) and tau proteins have been found in PDD, with intermediate changes for Aβ42 in non-demented PD. The authors investigated whether AD-related CSF protein levels are altered and relate to neuropsychological performance in early, untreated PD. ⋯ CSF Aβ levels are altered in a subset of patients with early PD and relate to memory impairment. Our study suggests that alterations in Aβ protein metabolism may contribute to the heterogeneity in pattern and course of cognitive decline associated with PD. Longitudinal studies are needed to clarify the clinical significance of CSF Aβ peptides as prognostic biomarkers in PD.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2010
ReviewMild traumatic brain injury and Postconcussion Syndrome: a neuropsychological perspective.
Symptoms of mild traumatic brain injury typically resolve within days or weeks. However, a significant group of patients may report symptoms of Post-concussional Syndrome (PCS) weeks, months and years postinjury. This review presents an overview of the pathogenesis, diagnosis and treatment options for PCS. ⋯ At early phases, there are associations between neurological signs and symptoms, neurocognitive functions and self reports. Over time, such associations become less coherent, and psychological issues become particularly relevant. An accurate understanding of neurological and psychosocial factors at play in PCS is crucial for appropriate management of symptoms at various points postinjury.