Journal of the neurological sciences
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Randomized Controlled Trial
New approach to the rehabilitation of post-stroke focal cognitive syndrome: effect of levodopa combined with speech and language therapy on functional recovery from aphasia.
Few studies confirm that pharmacological treatments support post-stroke recovery. The purpose of this study was to determine whether the combination of levodopa with language therapy improves aphasia rehabilitation. ⋯ Supplementing language therapy with levodopa may improve recovery from aphasia in patients with frontal lesions.
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Migraine is an independent risk factor for ischemic stroke, mainly in the subpopulation of women with migraine with aura who are younger than 45 years, particularly those that use estrogen containing oral contraceptives. Migraine however should be considered a benign condition as the absolute increase of stroke risk is small. Migraine is also associated with a high prevalence of cerebral white matter hyperintensities, occurring in the deep and periventricular white matter as well as infratentorial, mainly pontine. ⋯ A population-based twin study showed that a lifetime migraine diagnosis was not associated with cognitive deficits in middle-aged subjects. A long-term prospective study, assessing cognitive and memory changes in ageing individuals with and without a history of migraine, showed that migraineurs do not exhibit more decline on cognitive tests over time versus controls. Migraine is certainly not a recognized risk factor for (vascular) dementia.
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Prospective memory (ProM) involves remembering to perform actions after a delay, such as buying groceries on the way home from work. Retrospective memory (RetM) involves remembering events from the past. It is known that the memory impairment in Alzheimer's disease (AD) generalizes across (a) these two types of memory, and (b) encoding, storage, and retrieval within RetM. ⋯ From a population-based study, 21 persons with VaD, 79 with AD, and 352 controls were included. Both dementia groups were impaired on all ProM and RetM variables, but did not differ from one another on any measure. The results are discussed relative to a network view of episodic memory, in which alterations at different sites may result in similar functional impairments.
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The organ most frequently affected in mitochondrial disorders, particularly respiratory chain diseases (RCDs), in addition to the skeletal muscle, is the central nervous system (CNS). CNS manifestations of RCDs comprise stroke-like episodes, epilepsy, migraine, ataxia, spasticity, movement disorders, psychiatric disorders, cognitive decline, or even dementia (mitochondrial dementia). So far mitochondrial dementia has been reported in MELAS, MERRF, LHON, CPEO, KSS, MNGIE, NARP, Leigh syndrome, and Alpers-Huttenlocher disease. ⋯ Therapy of mitochondrial dementia relies on symptomatic measures. Only single patients profit from cholinesterase inhibitors or memantine, antioxidants, vitamins, coenzyme-Q, or other substitutes. Overall, mitochondrial dementia is an important differential of dementias and should be considered in patients with multi-system disease.
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Randomized Controlled Trial
Gray matter atrophy and disability progression in patients with early relapsing-remitting multiple sclerosis: a 5-year longitudinal study.
We assessed the relationship between gray matter (GM) and white matter (WM) atrophy and clinical status in early relapsing-remitting multiple sclerosis (MS) patients over 5 years. A group of 181 patients who participated in the ASA (Avonex-Steroid-Azathioprine) study and had complete clinical and MRI assessments over 2 and 5 years was investigated. One hundred seventy (170) patients completed the 12-month follow-up, 147 the 24-month, 98 the 36-month, 65 the 48-month and 47 the 60-month. ⋯ Decline in PBVC and GMV were predictive markers of disability deterioration. Correlation of T2-LV with clinical status was weaker and decreased over time. Higher number of relapses was associated with faster decline in whole brain volume.