Neurological research
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Neurological research · Dec 2013
Meta AnalysisRepetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: a meta-analysis of stimulus parameter effects.
Studies comparing the antidepressant effects of electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) have reported mixed results, as the choice of rTMS stimulus parameters is essential to its antidepressive effect. This meta-analysis aimed at assessing how rTMS stimulus parameters influence the efficacy of rTMS relative to ECT in treating major depression. ⋯ The results indicate that the efficacy of rTMS is tied to its stimulus parameters. Varying stimulus parameters can result in varying antidepressive effects. Consequently, future research on rTMS or rTMS versus ECT should take the influence of rTMS stimulus parameters into consideration.
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Neurological research · Dec 2013
Patients undergoing surgery of intracranial metastases have different outcomes based on their primary pathology.
Patients with a variety of different primary cancers can develop intracranial metastases. Patients who develop intracranial metastases are often grouped into the same study population, and therefore an understanding of outcomes for patients with different primary cancers remain unclear. ⋯ These differences between patients with different primary cancers support the fact that patients with intracranial disease are not all the same and should be studied by their primary pathology.
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Neurological research · Dec 2013
Stent, balloon-assisted coiling and double microcatheter for treating wide-neck aneurysms in anterior cerebral circulation.
To investigate the clinical application of adjuvant coiling techniques in treating anterior-circulation wide-necked aneurysms. ⋯ Double microcatheter was better for distal aneurysms with dome/neck ratio of 1·1-1·2, while stent was better for proximal aneurysms with an extremely wide neck (≥ 7 mm) and for loudspeaker-shaped aneurysms (dome/neck ratio < 1·0) with poor vessel condition. For emergency cases, both balloon remodeling and double microcatheter are better choices than stent.
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Neurological research · Dec 2013
Neuropeptide Y - an early biomarker for cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
In the human brain, the potent vasoconstrictive neuropeptide Y (NPY) is abundantly expressed. Neuropeptide Y, which is stored in perivascular nerve fibers of the cerebral arteries, regulates the cerebral vascular diameter as well as cerebral blood flow. However, the role of NPY in the pathogenesis of cerebral vasospasm (CV) related to subarachnoid hemorrhage (SAH) is unclear. We prospectively analyzed and compared the release of endogenous NPY in the cerebrospinal fluid (CSF) of 66 patients with SAH to NPY release in a control group. Additionally, we correlated the levels of NPY with CV and consecutive ischemic stroke. ⋯ Our data indicate that NPY is involved in the pathogenesis of SAH-related CV and ischemia. Neuropeptide Y represents an early and reliable biomarker for the prediction of CV and consecutive stroke due to aneurysmal SAH.
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Neurological research · Dec 2013
Surgical management of epilepsy due to cerebral cavernomas using neuronavigation and intraoperative MR imaging.
Cure from seizures due to cavernomas might be surgically achieved dependent on both, the complete removal of the cavernoma as well as its surrounding hemosiderin rim. High field intraoperative MRI imaging (iopMRI) and neuronavigation might play a crucial role to achieve both goals. We retrospectively investigated the long-term results and impact of intraoperative 1·5T MRI (iopMRI) and neuronavigation on the completeness of surgical removal of a cavernous malformation (CM) and its perilesional hemosiderin rim as well as reduction of surgical morbidity. ⋯ We report excellent long-term seizure control with minimal surgical morbidity after complete resection of CM using our multimodal approach.