Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Early pathological changes in the parkinsonian brain demonstrated by diffusion tensor MRI.
To determine whether the fractional anisotropy (FA) of magnetic resonance diffusion tensor imaging is decreased in the nigrostriatal projection in parkinsonian patients. ⋯ Assuming that the loss of FA parallels the neuronal change in the brain, the results are consistent with the view that more than half the dopaminergic neurones in the nigrostriatal projection are lost before the onset of Parkinson's disease. Close comparison of FA in the basal ganglia may contribute to the early diagnosis of Parkinson's disease.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Clinical TrialThe exercise test as a monitor of disease status in hypokalaemic periodic paralysis.
To evaluate exercise test responses in hypokalaemic periodic paralysis (HPP), to determine its value as a diagnostic tool and the factors that could affect the responses. ⋯ The exercise test is a useful diagnostic test for periodic paralysis, but in the absence of recent weakness negative results must be viewed with caution. It has advantages over the DNA test in being a non-invasive functional test that can provide insights into abnormalities of muscle excitability.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Clinical TrialRemoval of large acoustic neurinomas (vestibular schwannomas) by the retrosigmoid approach with no mortality and minimal morbidity.
To evaluate the safety and efficacy of removing large acoustic neurinomas (> or =3 cm) by the retrosigmoid approach. ⋯ The method resulted in a high rate of functional facial nerve preservation, a low incidence of complications, and good functional outcomes, with no mortality and minimal morbidity. Very favourable results can be obtained using the retrosigmoid approach for the removal of large acoustic neurinomas.
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J. Neurol. Neurosurg. Psychiatr. · Mar 2004
Clinical TrialDiffusion tensor MRI correlates with executive dysfunction in patients with ischaemic leukoaraiosis.
Cerebral small vessel disease is a common cause of vascular dementia. Both discrete lacunar infarcts and more diffuse ischaemic changes, seen as confluent high signal (leukoaraiosis) on T2 weighted magnetic resonance imaging (MRI), occur. However, there is a weak correlation between T2 lesion load and cognitive impairment. Diffusion tensor MRI (DTI) is a new technique that may provide a better index of white matter damage. ⋯ Diffusion tensor measurements correlate better with cognition than conventional MRI measures. They may be useful in monitoring disease progression and as a surrogate marker for treatment trials. The findings support the role of white matter damage and disruption of white matter connections in the pathogenesis of cognitive impairment in cerebral small vessel disease.