Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Apr 2006
ReviewClinical trials in mild cognitive impairment: lessons for the future.
Mild cognitive impairment (MCI) is an operational definition for a cognitive decline in individuals with a greater risk of developing dementia. The amnestic subtype of MCI is of particular interest because these individuals most likely progress to Alzheimer's disease (AD). ⋯ The design of clinical trials in MCI is influenced by study objectives and definition of primary end points: time to clinical diagnosis of dementia, and AD in particular, or symptom progression. As none of the drugs previously shown to have clinical efficacy in AD trials or benefit in everyday practice have met the primary objectives of the respective trials, design of future clinical trials in MCI should be further developed particularly as regards the selection of more homogeneous samples at entry, optimal treatment duration, and multidimensional and reliable outcomes.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2006
Usefulness of the Rowland Universal Dementia Assessment scale in South India.
The number of older people with cognitive impairment being seen in out patient settings is increasing. A brief screening test, which is culturally and educationally fair, would be very useful for clinicians for identifying dementia in these settings. ⋯ RUDAS is a useful brief screening test in clinical settings.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2006
Multicenter StudyClinical and economic results of bilateral subthalamic nucleus stimulation in Parkinson's disease.
High frequency stimulation of the subthalamic nucleus (STN) is an alternative but expensive neurosurgical treatment for parkinsonian patients with levodopa induced motor complications. ⋯ STN stimulation has good outcomes with relatively low risk and little cost burden in PD patients with levodopa induced motor complications.
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J. Neurol. Neurosurg. Psychiatr. · Apr 2006
Origin of ICU acquired paresis determined by direct muscle stimulation.
Acquired diffuse paresis in an intensive care unit (ICU) can result from critical illness myopathy or polyneuropathy. Clinical examination and conventional neurophysiological techniques may not distinguish between these entities. ⋯ A neurophysiological approach combining DMS and conventional techniques revealed myopathic processes in a majority of ICU patients. Reduced muscle fibre excitability may be a leading cause for this. The diagnosis of myopathy in ICU acquired paralysis can be established by a combination of DMS, needle EMG, and plasma creatine kinase.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2006
Community walking activity in neurological disorders with leg weakness.
The aims of this study were to determine walking mobility in the community in individuals with lower limb weakness and to establish the extent to which some clinic based measures predict such activity. ⋯ Measures of muscle strength, timed STS, and RMI do not appear to closely reflect community walking activity in these patient groups. Self selected gait speed was partially predictive. Measurement of community walking activity may add a new dimension to evaluating the impact of interventions in neurological disorders.