Archives of neurology
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Archives of neurology · Dec 2011
ReviewMagnetic resonance techniques in multiple sclerosis: the present and the future.
Magnetic resonance imaging (MRI) is sensitive to focal multiple sclerosis (MS) lesions. For this reason, conventional MRI measures of the burden of disease derived from dual-echo, fluid-attenuated inversion recovery and postcontrast T1-weighted sequences are regularly used to monitor disease course in patients with confirmed MS and have been included in the diagnostic workup of patients in whom MS is suspected. ⋯ More recently, the application of new imaging modalities capable of measuring pathological processes related to the disease that have been neglected in the past (eg, iron deposition and perfusion abnormalities) and the advent of high- and ultrahigh-field magnets have provided further insight into the pathobiological features of MS. After a brief summary of the main results obtained from the established and emerging MR methods, this review discusses the steps needed before the latter become suitable for widespread use in the MS research community.
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Archives of neurology · Dec 2011
Comparative StudyNeurodegeneration across stages of cognitive decline in Parkinson disease.
To assess regions and patterns of brain atrophy in patients with Parkinson disease (PD) with normal cognition (PD-NC), mild cognitive impairment (PD-MCI), and dementia-level cognitive deficits (PDD). ⋯ Hippocampal atrophy is a biomarker of initial cognitive decline in PD, including impaired memory encoding and storage, suggesting heterogeneity in the neural substrate of memory impairment. Use of a pattern classification approach may allow identification of diffuse regions of cortical gray and white matter atrophy early in the course of cognitive decline.
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Archives of neurology · Dec 2011
Comparative StudyTen-year outcome of subthalamic stimulation in Parkinson disease: a blinded evaluation.
To assess the 10-year motor outcome of deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson disease (PD). ⋯ This class III study provides evidence that stimulation-induced motor improvement was sustained overall at 10 years, although part of the initial benefit wore off mainly because of progressive loss of benefit on axial signs over time.
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Archives of neurology · Dec 2011
Thrombolytic treatment of patients with acute ischemic stroke related to underlying arterial dissection in the United States.
To determine the outcomes related to thrombolytic treatment of an acute ischemic stroke secondary to an arterial dissection in a large national cohort. ⋯ The adjusted rate of favorable outcomes is lower among patients with ischemic stroke with underlying arterial dissection following thrombolytic treatment compared with those without underlying dissections. However, the observed lower rates are not influenced by thrombolytic treatment.
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Archives of neurology · Dec 2011
Neurological injury in adults treated with extracorporeal membrane oxygenation.
Extracorporeal membrane oxygenation (ECMO) may be urgently used as a last resort form of life support when all other treatment options for potentially reversible cardiopulmonary injury have failed. ⋯ Severe neurological sequelae occur frequently in adult ECMO-treated patients with otherwise reversible cardiopulmonary injury (conservative estimate, 50%) and include a range of potentially fatal neurological diagnoses that may be due to the precipitating event and/or ECMO treatment.