Neurology
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Randomized Controlled Trial Multicenter Study Clinical Trial
Incidence and significance of neutralizing antibodies to interferon beta-1a in multiple sclerosis. Multiple Sclerosis Collaborative Research Group (MSCRG)
Interferon beta is an effective treatment for relapsing multiple sclerosis (MS). As with other protein drugs, neutralizing antibodies (NAB) can develop that reduce the effectiveness of treatment. ⋯ NAB directed against IFN-beta have in vivo biological consequences in patients with MS. The frequency with which MS patients develop NAB against IFN-beta is significantly greater with IFN-beta-1b therapy compared with IFN-beta-1a therapy. Treatment decisions in MS patients treated with IFN-beta should take into account development of NAB.
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Clinical Trial Controlled Clinical Trial
Cervical rib and median sternotomy-related brachial plexopathies: a reassessment.
The objective of this study was to identify electrodiagnostic and anatomic distinctions between true neurogenic thoracic outlet syndrome and median sternotomy-related brachial plexopathy, in reference to the pattern of abnormality of the medial antebrachial cutaneous sensory nerve conduction study (NCS) response. ⋯ The medial antebrachial cutaneous sensory response is sensitive in the diagnosis of neurogenic thoracic outlet syndrome. Our data suggest that medial antebrachial cutaneous nerve fibers are closely associated anatomically at the T1 root level with median motor fibers innervating the thenar muscles. Neurogenic thoracic outlet syndrome shows predominant damage in the T1 distribution, whereas sternotomy-related brachial plexopathy shows predominant damage in the C8 distribution, suggesting that these lesions are localized at the level of the anterior primary rami of the cervical roots, and not in the lower trunk of the brachial plexus.
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Case Reports
Dissociation between verbal and autonomic measures of memory following frontal lobe damage.
The objective of this study was to contrast overt verbal versus covert autonomic responses to facial stimuli in a patient with false recognition following frontal lobe damage. ⋯ Our findings provide further neuropsychological evidence that overt and covert forms of face recognition memory are dissociable. In addition, the failure to detect an autonomic correlate for the false recognition errors and misidentifications in J.S. suggests that these memory distortions were not related to the spurious activation of stored memory representations for specific familiar faces. Instead, these incorrect responses may have been driven by the sense of familiarity evoked by novel faces that had a general resemblance to faces encountered previously. We propose that false recognition in J.S. resulted from the breakdown of strategic frontal memory retrieval, monitoring, and decision functions critical for attributing the experience of familiarity to its appropriate source.