Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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Review Meta Analysis
Voxelwise meta-analysis of white matter abnormalities in progressive supranuclear palsy.
White matter deficits constitute one element of the network dysfunction that underlies progressive supranuclear palsy (PSP). Cumulative evidence of white matter abnormalities in patients with PSP has been reported using voxel-based morphometry (VBM), but these studies have not been quantitatively reviewed and not all findings have been entirely concordant. Whole-brain VBM studies comparing PSP patients with healthy controls (HC) were systematically searched in the PubMed and EMABSE databases from January 1990 to April 2013. ⋯ No WMV increase was reported. Meta-regression showed both MMSE and UPDRS III scores correlated with WM changes in the regions from bilateral midbrain to basal ganglia. Our findings provide evidence for white matter atrophy in the midbrain, pons and several regions near the basal ganglia, representing the main pathophysiology of PSP.
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Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a rare neurodegenerative disorder characterized by ataxia, spastic paraparesis, polyneuropathy, and evidence of superior cerebellar vermis atrophy at magnetic resonance imaging (MRI). Reports of atypical presentations and additional clinical or MRI findings have been recently published, but psychiatric disturbances have never been associated with ARSACS. We describe four ARSACS patients manifesting severe psychiatric symptoms including psychosis, panic disorder, and depression during the course of the disease. Our case reports further expand the ARSACS phenotype and add clinical data in favor of the hypothesized relationship between cerebellar dysfunction and psychiatric disorders.
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Whether arterial or venous compression or arachnoid adhesions are primarily responsible for compression of the trigeminal nerve in patients with trigeminal neuralgia is unclear. The aim of this study was to determine the causes of trigeminal nerve compression in patients with trigeminal neuralgia. The surgical findings in patients with trigeminal neuralgia who were treated by micro vascular decompression were compared to those in patients with hemifacial spasm without any signs or symptoms of trigeminal neuralgia who were treated with microvascular decompression. ⋯ After adjustment for age, gender, and other factors, patients with vein compression of nerve or with artery compression of nerve were more likely to have trigeminal neuralgia (OR = 5.21 and 42.54, p = 0.026 and p < 0.001, respectively). Patients with arachnoid adhesions were less likely to have trigeminal neuralgia (OR = 0.15, p = 0.038). Arterial compression of the trigeminal nerve is the primary cause of trigeminal neuralgia and therefore, decompression of veins need not be a priority when performing microvascular dissection in patients with trigeminal neuralgia.
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In recent years, increasing evidence has shown that individuals with Parkinson's disease (PD) have lower levels of 25-hydroxyvitamin D [25(OH) D] relative to healthy controls. We therefore evaluated the relationship between serum 25(OH) D levels and severity in Chinese patients with a Parkinson's disease. From July 2010 to June 2012, consecutive PD patients admitted to the Department of Neurology of General Hospital, Tianjin Medical University, were identified. ⋯ There was a negative correlation between levels of 25(OH) D and the disease duration [r (spearman) = -0.124, P = 0.041]. There was a significant negative relationship between circulating serum 25(OH) D levels and severity of Parkinson's disease evaluated by HY stage (P = 0.030) and UPDRS Stage (P = 0.000) even after multivariate adjustment for possible confounders: age, gender, disease duration, levels of Ca, ALP, blood glucose, and seasons. These results suggest that lower 25(OH) D levels may be associated with severity of PD in Chinese patients.