Archives of neurology最新文献_第4页

Right eye droop. 右眼下垂。

Archives of neurology Pub Date : 2012-11-01 DOI: 10.1001/archneurol.2012.217

Aashish Anand, Smita I Negi

引用次数: 0

Association of neuromyelitis optica with severe and intractable pain. 视神经脊髓炎与严重和难治性疼痛的关系。

Archives of neurology Pub Date : 2012-11-01 DOI: 10.1001/archneurol.2012.768

Peiqing Qian, Samantha Lancia, Enrique Alvarez, Eric C Klawiter, Anne H Cross, Robert T Naismith

{"title":"Association of neuromyelitis optica with severe and intractable pain.","authors":"Peiqing Qian, Samantha Lancia, Enrique Alvarez, Eric C Klawiter, Anne H Cross, Robert T Naismith","doi":"10.1001/archneurol.2012.768","DOIUrl":"https://doi.org/10.1001/archneurol.2012.768","url":null,"abstract":"Objective: To contrast differences in pain and treatment outcomes between neuromyelitis optica (NMO) and multiple sclerosis (MS).Design: Retrospective, cross-sectional cohort study.Setting: Academic MS center.Patients: Complete ascertainment of an academic MS center cohort of NMO and an MS comparison sample cohort.Main outcome measures: Current pain was quantified by a 10-point scale and the McGill Pain Questionnaire.Expanded Disability Status Scale score and number of involved spinal cord levels were collected in addition to testing for cognition, fatigue, depression, and quality of life. Number and types of pain medications were tabulated.Results: Current pain was more common in subjects with NMO (n=29) vs MS (n=66) (86.2% vs 40.9%; P.001)and more severe on a 10-point scale (5.38 vs 1.85;P.001). Pain remained more common after controlling for disability and number of spinal cord segments(P=.03). Prescription pain medication was used more frequently in subjects with NMO compared with subjects with MS(75.9% vs 37.8%; P.001), often requiring more than 1 medication (65.5% vs 15.2%; P.001). No subject with NMO taking pain medication (22 of 29) rated their current pain as 0 of 10, whereas almost half of those taking pain medication with MS were currently free of pain (0% vs 48%; P=.006).Conclusions: Neuromyelitis optica is frequently associated with severe pain that appears insufficiently controlled by pharmacologic interventions. Future studies should evaluate the efficacy of a multidisciplinary and multimodal approach to pain management.","PeriodicalId":8321,"journal":{"name":"Archives of neurology","volume":"69 11","pages":"1482-7"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archneurol.2012.768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30861873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 84

Accuracy of a panel of 5 cerebrospinal fluid biomarkers in the differential diagnosis of patients with dementia and/or parkinsonian disorders. 5种脑脊液生物标志物在痴呆和/或帕金森病患者鉴别诊断中的准确性

Archives of neurology Pub Date : 2012-11-01 DOI: 10.1001/archneurol.2012.1654

Sara Hall, Annika Öhrfelt, Radu Constantinescu, Ulf Andreasson, Yulia Surova, Frederick Bostrom, Christer Nilsson, Widner Håkan, Hilde Decraemer, Katarina Någga, Lennart Minthon, Elisabet Londos, Eugeen Vanmechelen, Björn Holmberg, Henrik Zetterberg, Kaj Blennow, Oskar Hansson

{"title":"Accuracy of a panel of 5 cerebrospinal fluid biomarkers in the differential diagnosis of patients with dementia and/or parkinsonian disorders.","authors":"Sara Hall, Annika Öhrfelt, Radu Constantinescu, Ulf Andreasson, Yulia Surova, Frederick Bostrom, Christer Nilsson, Widner Håkan, Hilde Decraemer, Katarina Någga, Lennart Minthon, Elisabet Londos, Eugeen Vanmechelen, Björn Holmberg, Henrik Zetterberg, Kaj Blennow, Oskar Hansson","doi":"10.1001/archneurol.2012.1654","DOIUrl":"https://doi.org/10.1001/archneurol.2012.1654","url":null,"abstract":"Objective: To assess the ability of 5 cerebrospinal fluid(CSF) biomarkers to differentiate between common dementia and parkinsonian disorders.Design: A cross-sectional, clinic-based study.Participants: Cerebrospinal fluid samples (N=453) were obtained from healthy individuals serving as controls and from patients with Parkinson disease (PD), PD with dementia(PDD), dementia with Lewy bodies (DLB), Alzheimer disease (AD), progressive supranuclear palsy(PSP), multiple system atrophy (MSA), or corticobasal degeneration (CBD).Setting: Neurology and memory disorder clinics.Main outcome measures: Cerebrospinal fluid biomarker levels in relation to clinical diagnosis.Results: Cerebrospinal fluid levels of -synuclein were decreased in patients with PD, PDD, DLB, and MSA but increased in patients with AD. Cerebrospinal fluid levels of α-amyloid 1-42 were decreased in DLB and even further decreased in AD. Cerebrospinal fluid levels of total tau and hyperphosphorylated tau were increased in AD. Multivariate analysis revealed that these biomarkers could differentiate AD from DLB and PDD with an area under the curve of 0.90, with -synuclein and total tau contributing most to the model. Cerebrospinal fluid levels of neurofilament light chain were substantially increased in atypical parkinsonian disorders (ie, PSP, MSA,and CBD), and multivariate analysis revealed that the level of neurofilament light chain alone could differentiate PD from atypical parkinsonian disorders, with an area under the curve of 0.93.Conclusions: Ascertainment of the -synuclein level in CSF somewhat improves the differential diagnosis of AD vs DLB and PDD when combined with established AD biomarkers.The level of neurofilament light chain alone may differentiate PD from atypical parkinsonian disorders.","PeriodicalId":8321,"journal":{"name":"Archives of neurology","volume":"69 11","pages":"1445-52"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archneurol.2012.1654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30862552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 414

Erdheim-Chester disease. Erdheim-Chester疾病。

Archives of neurology Pub Date : 2012-11-01 DOI: 10.1001/archneurol.2012.180

Eric M Liotta, Miral D Jhaveri, John C Fox, Venugopal Parameswaran, Steven L Lewis

引用次数: 0

Low-molecular-weight heparin and early neurologic deterioration in acute stroke caused by large artery occlusive disease. 低分子肝素与大动脉闭塞性疾病引起的急性脑卒中的早期神经功能恶化。

Archives of neurology Pub Date : 2012-11-01 DOI: 10.1001/archneurol.2012.1633

Qiaoshu Wang, Christopher Chen, Xiang Yan Chen, Jing Hao Han, Yannie Soo, Thomas W Leung, Vincent Mok, Ka Sing Lawrence Wong

{"title":"Low-molecular-weight heparin and early neurologic deterioration in acute stroke caused by large artery occlusive disease.","authors":"Qiaoshu Wang, Christopher Chen, Xiang Yan Chen, Jing Hao Han, Yannie Soo, Thomas W Leung, Vincent Mok, Ka Sing Lawrence Wong","doi":"10.1001/archneurol.2012.1633","DOIUrl":"https://doi.org/10.1001/archneurol.2012.1633","url":null,"abstract":"Background: Patients with acute ischemic stroke and large artery occlusive disease (LAOD) have an increased risk for early neurologic deterioration (END) due to progressive stroke, early recurrent ischemic stroke(ERIS), or symptomatic intracranial cerebral hemorrhage(SICH). Low-molecular-weight heparin (LMWH)has been widely advocated to prevent venous thromboembolism,but its risks and benefits in early ischemic stroke are inadequately defined.Objective: To determine the efficacy and safety of LMWH in treating END in patients with acute ischemic stroke and LAOD.Design: Post hoc analysis of randomized, controlled trial.Setting: Academic research.Patients: Among 603 patients recruited, 353 patients(180 treated with LMWH, 173 with aspirin) had acute ischemic stroke and LAOD.Interventions: Patients were randomly assigned to receive either subcutaneous LMWH or oral aspirin within 48 hours after stroke onset for 10 days, then all received aspirin once daily for 6 months.Main outcome measures: We assessed whether LMWH was superior to aspirin for the prevention of END within the first 10 days after index stroke. Early neurologic deterioration was defined as a composite end point of progressive stroke, ERIS, and SICH.Results: Among 353 patients included in the study, END within the first 10 days occurred in 6.7% of LMWH allocated patients (12 of 180 patients) compared with 13.9% of aspirin-allocated patients (24 of 173). Low molecular-weight heparin was significantly associated with the reduction of END(absolute risk reduction, 7.2%; odds ratio [OR], 0.44; 95% CI, 0.21-0.92). When individual components of END were examined, LMWH was significantly associated with a lower frequency of stroke progression within the first 10 days compared with aspirin(5.0% [9 of 180] vs 12.7% [22 of 173]; OR, 0.36; 95%CI, 0.16-0.81). Meanwhile, among those taking LMWH vs aspirin, the frequency rates of ERIS were 1.1% (2 of 180) vs 0 (0); 0.6% (1 of 180) vs 1.2% (2 of 173) for SICH;and 2.2% (4 of 180) vs 2.9% (5 of 173) for symptomatic and asymptomatic cerebral hemorrhage, respectively; they showed nonsignificant trends. Early neurologic deterioration was significantly associated with 6-month disability with both LMWH(OR, 12.75; 95% CI, 3.27-49.79 on Barthel Index and OR, 18.15; 95% CI, 2.09-157.93 on modified Rankin Scale) and aspirin (OR, 6.09; 95% CI,2.44-15.20 on Barthel Index and OR, 7.50; 95% CI, 2.08-27.04 on modified Rankin Scale) groups.Conclusions: For patients with acute ischemic stroke and LAOD, treatment with LMWH within 48 hours of stroke may reduce END during the first 10 days, mainly by preventing stroke progression. The similar rate of cerebral hemorrhage between LMWH and aspirin demonstrated that LMWH may be safely used in acute ischemic stroke.","PeriodicalId":8321,"journal":{"name":"Archives of neurology","volume":"69 11","pages":"1454-60"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archneurol.2012.1633","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30834493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 29

Cerebrospinal fluid biomarkers for clinical trials: why markers for differential diagnosis are important. 临床试验的脑脊液生物标记物:为什么标记物对鉴别诊断很重要。

Archives of neurology Pub Date : 2012-11-01 DOI: 10.1001/archneurol.2012.2353

Richard J Perrin

引用次数: 3

Atlas of Inherited Metabolic Diseases, 3rd ed. 遗传代谢疾病图谱，第三版。

Archives of neurology Pub Date : 2012-11-01 DOI: 10.1001/archneurol.2012.2313

Juan M Pascual

引用次数: 1

Neurocritical care. Neurocritical护理。

Archives of neurology Pub Date : 2012-11-01 DOI: 10.1001/archneurol.2012.2316

Timea Hodics