Correction to: Minimally conscious state “plus”: diagnostic criteria and relation to functional recovery
Following electronic publication of the above-referenced manuscript, we discovered that one of the three criteria we proposed to establish command-following in the MCS+  syndrome was inadvertently omitted in some parts of the manuscript. (Source: Journal of Neurology)
Source: Journal of Neurology - March 18, 2020 Category: Neurology Source Type: research

Management of functional neurological disorder
AbstractFunctional neurological disorder (FND) is a common cause of persistent and disabling neurological symptoms. These symptoms are varied and include abnormal control of movement, episodes of altered awareness resembling epileptic seizures and abnormal sensation and are often comorbid with chronic pain, fatigue and cognitive symptoms. There is increasing evidence for the role of neurologists in both the assessment and management of FND. The aim of this review is to discuss strategies for the management of FND by focusing on the diagnostic discussion and general principles, as well as specific treatment strategies for v...
Source: Journal of Neurology - March 18, 2020 Category: Neurology Source Type: research

‘Minimal symptom expression’ in patients with acetylcholine receptor antibody-positive refractory generalized myasthenia gravis treated with eculizumab
ConclusionsPatients with AChR+ refractory gMG who receive eculizumab can achieve sustained ‘minimal symptom expression’ based on patient-reported outcomes. ‘Minimal symptom expression’ may be a useful tool in measuring therapy effectiveness in gMG.Trial registrationClinicalTrials.gov NCT01997229, NCT02301624. (Source: Journal of Neurology)
Source: Journal of Neurology - March 17, 2020 Category: Neurology Source Type: research

Retraction Note to: Meni ère’s disease: combined pharmacotherapy with betahistine and the MAO-B inhibitor selegiline—an observational study
The authors have retracted this article. (Source: Journal of Neurology)
Source: Journal of Neurology - March 17, 2020 Category: Neurology Source Type: research

Liliana Lubi ńska (1904–1990)
(Source: Journal of Neurology)
Source: Journal of Neurology - March 15, 2020 Category: Neurology Source Type: research

Genetic correlations and causal inferences in ischemic stroke
ConclusionsShared genetic overlaps might exist between ischemic stroke and physical activity, cardiometabolic factors, smoking, and lung function. We provided suggestive evidence for a potential causal role of LDL.P and LDL.C in ischemic stroke, particularly in large artery stroke. Future researches are required to confirm these findings. (Source: Journal of Neurology)
Source: Journal of Neurology - March 13, 2020 Category: Neurology Source Type: research

Concussion-related deficits in the general population predict impairments in varsity footballers
AbstractObjectiveWe investigated the long-term cognitive effects of concussion in 19,261 members of the general population and a cohort of varsity American football players with a history of frequent head impacts, using tests that are known to be sensitive to small changes in performance.MethodsWe asked 19,261 participants to complete a demographic questionnaire and 12 cognitive tests measuring aspects of executive function, including inhibitory control. We compared the performance of those reporting a history of concussion (post-concussion) to those reporting no history of concussion (non-concussed) on the cognitive batte...
Source: Journal of Neurology - March 13, 2020 Category: Neurology Source Type: research

Spatial metabolic profiles to discriminate dementia with Lewy bodies from Alzheimer disease
ConclusionsSpatial metabolic profile that could discriminate DLB from AD emphasized different imaging features and eliminated common findings between DLB and AD. Neither cognitive function nor core features were associated with the profile. (Source: Journal of Neurology)
Source: Journal of Neurology - March 12, 2020 Category: Neurology Source Type: research

GCH-1 genetic variant may cause Parkinsonism by unmasking the subclinical nigral pathology
ConclusionOur case suggests that GCH-1 variant causes Parkinsonism by unmasking the subclinical nigral pathology, not by causing the nigral neurodegeneration. (Source: Journal of Neurology)
Source: Journal of Neurology - March 12, 2020 Category: Neurology Source Type: research

Laparoscopic sleeve gastrectomy improves brain connectivity in obese patients
ConclusionLSG might induce weight loss in part by increasing SC and FC between DLPFC and ACC, and thus strengthening top-down control over food intake. (Source: Journal of Neurology)
Source: Journal of Neurology - March 12, 2020 Category: Neurology Source Type: research

Autonomic dysfunction is associated with neuropsychological impairment in Lewy body disease
This study aimed to analyze the association of autonomic dysfunction with cognition, depression, apathy, and fatigue in Lewy body disease (LBD).MethodsWe included 61 patients [49 with idiopathic Parkinson ’s disease, 7 with dementia with Lewy bodies, and 5 E46K-SNCA mutation carriers] and 22 healthy controls. All participants underwent a comprehensive battery of neuropsychological and clinical measures, autonomic symptom assessment with the SCOPA-AUT, analysis of non-invasive hemodynamic parameters during deep breathing, the Valsalva maneuver, and a 20-min tilt test, and electrochemical skin conductance measurement a...
Source: Journal of Neurology - March 12, 2020 Category: Neurology Source Type: research

A wearable sensor identifies alterations in community ambulation in multiple sclerosis: contributors to real-world gait quality and physical activity
AbstractPeople with multiple sclerosis (pwMS) often suffer from gait impairments. These changes in gait have been well studied in laboratory and clinical settings. A thorough investigation of gait alterations during community ambulation and their contributing factors, however, is lacking. The aim of the present study was to evaluate community ambulation and physical activity in pwMS and healthy controls and to compare in-lab gait to community ambulation. To this end, 104 subjects were studied: 44 pwMS and 60 healthy controls (whose age was similar to the controls). The subjects wore a tri-axial, lower back accelerometer du...
Source: Journal of Neurology - March 11, 2020 Category: Neurology Source Type: research

Predictors of cognitive impairment in Parkinson ’s disease: a systematic review and meta-analysis of prospective cohort studies
AbstractIntroductionCognitive impairment is a debilitating manifestation in Parkinson ’s disease (PD). We sought to investigate predictors of PD-CI (PD with cognitive impairment).MethodsWe systematically searched PubMed and Cochrane Library for prospective cohort studies and pooled estimates via random-effects models. Primary analyses for all types of cognitive impairments and subgroup analyses by separate outcomes were conducted.ResultsA total of 28,009 studies were identified, of which 57 studies with 31 factors were included in the meta-analysis. In the primary analysis, 13 factors were associated with PD-CI, comp...
Source: Journal of Neurology - March 11, 2020 Category: Neurology Source Type: research

Autonomic failure in Parkinson ’s disease is associated with striatal dopamine deficiencies
AbstractAutonomic dysfunction is a common non-motor symptom in Parkinson ’s disease (PD). Dopamine and serotonin are known to play a role in autonomic regulation, and, therefore, PD-related degeneration of serotonergic and dopaminergic neurons in these regions may be associated with autonomic dysfunction. We sought to clarify the association between extrastriatal serot onergic and striatal dopaminergic degeneration and the severity of autonomic symptoms, including gastrointestinal, pupillomotor, thermoregulatory, cardiovascular, and urinary dysfunction. We performed hierarchical multiple regression analyses to determ...
Source: Journal of Neurology - March 11, 2020 Category: Neurology Source Type: research

Diagnostic utility of fluid biomarkers in multiple system atrophy: a systematic review and meta-analysis
ConclusionThe findings of our meta-analysis demonstrated diagnostic biomarkers for MSA. Moreover, three biomarkers could be used in differential diagnosis of MSA and PD. The results could be helpful for the early diagnosis of MSA and the accuracy of MSA diagnosis. (Source: Journal of Neurology)
Source: Journal of Neurology - March 10, 2020 Category: Neurology Source Type: research

Pediatric ischemic stroke
(Source: Journal of Neurology)
Source: Journal of Neurology - March 10, 2020 Category: Neurology Source Type: research

Primary DQ effect in the association between HLA and neurological syndromes with anti-GAD65 antibodies
AbstractThe primary cause of neurological syndromes with antibodies against glutamic acid decarboxylase 65 (GAD65-Ab) is unknown, but genetic predisposition may exist as it is suggested by the co-occurrence in patients and their relatives of other organ-specific autoimmune diseases, notably type 1 diabetes mellitus (T1DM), and by the reports of a few familial cases. We analyzed the human leukocyte antigen (HLA) in 32 unrelated patients and compared them to an ethnically matched sample of 137 healthy controls. Four-digit resolution HLA alleles were imputed from available Genome Wide Association data, and full HLA next-gener...
Source: Journal of Neurology - March 8, 2020 Category: Neurology Source Type: research

Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson ’s disease
ConclusionsIn this multicenter study with a 24  months follow-up, we report significant sustained improvements after bilateral STN-DBS using a PD-specific sleep scale and a significant relationship between sleep and QoL improvements. This highlights the importance of sleep in holistic assessments of DBS outcomes. (Source: Journal of Neurology)
Source: Journal of Neurology - March 8, 2020 Category: Neurology Source Type: research

CT angiography vs echocardiography for detection of cardiac thrombi in ischemic stroke: a systematic review and meta-analysis
AbstractBackground and purpose Cardiac thrombi are an important cause of embolic stroke. We studied the diagnostic yield and diagnostic accuracy of cardiac CT angiography (CTA) compared to echocardiography for detection of cardiac thrombi in ischemic stroke patients.MethodsWe performed a systematic review and meta-analysis of the literature on cardiac CTA versus echocardiography for detection of cardiac thrombi in ischemic stroke patients. We included studies (N ≥ 20) in which both cardiac CTA (index test) and echocardiography (reference test) were performed and data on cardiac thrombi were reported. Resul...
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Axonal variants of Guillain –Barré syndrome: an update
AbstractAxonal variants of Guillain –Barré syndrome (GBS) mainly include acute motor axonal neuropathy, acute motor and sensory axonal neuropathy, and pharyngeal-cervical-brachial weakness. Molecular mimicry of human gangliosides by a pathogen's lipooligosaccharides is a well-established mechanism forCampylobacter jejuni-associated GBS. New triggers of the axonal variants of GBS (axonal GBS), such as Zika virus, hepatitis viruses, intravenous administration of ganglioside, vaccination, and surgery, are being identified. However, the pathogenetic mechanisms of axonal GBS related to antecedent bacterial or viral...
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Predictive factors of outcome in cervical dystonia following deep brain stimulation: an individual patient data meta-analysis
AbstractBackgroundDeep brain stimulation (DBS) therapy has been suggested to be a beneficial alternative in cervical dystonia (CD) for patients who failed nonsurgical treatments. This individual patient data meta-analysis compared the efficacy of DBS in the globus pallidus internus (GPi) versus subthalamic nucleus (STN) and identified possible predictive factors for CD.MethodsThree electronic databases (PubMed, Embase and Web of Science) were searched for studies with no publication date restrictions. The primary outcomes were normalized by calculating the relative change in TWSTRS total scores and subscale scores at the l...
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Depression in myasthenia gravis: a heterogeneous and intriguing entity
ConclusionsDepression and fatigue are highly prevalent and largely overlapping comorbidities in MG, but only fatigue increased with disease severity, and only depression was milder in thymectomized patients. Comparative use of BDI subscales in MG reveals distinct depression phenotypes with distinct correlations to other disease features. (Source: Journal of Neurology)
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Cerebellar gray matter lesions are common in pediatric multiple sclerosis at clinical onset
ConclusionAt clinical onset, cerebellar GML are common in pedMS, are very often asymptomatic, do not correlate with physical and cognitive disability, and more frequently affect the posterior lobe. (Source: Journal of Neurology)
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Administration of subcutaneous interferon beta 1a in the evening: data from RELIEF study
ConclusionIFN- β1a evening injections in the first 8 weeks of treatment led to an improvement in FLS; when continuing therapy, time of administration could be decided according to patient’s lifestyle and preference. (Source: Journal of Neurology)
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Outcomes of mechanical thrombectomy with pre-intravenous thrombolysis: a systematic review and meta-analysis
AbstractBackground and purposeWhether pre-intravenous thrombolysis (IVT) provides any extra benefits to mechanical thrombectomy (MT) remains controversial. We conducted a systematic review and meta-analysis to compare MT with pre-IVT (IVT  + MT) and MT without pre-IVT (MT) for acute ischemic stroke of large vessel occlusion.MethodsWe systematically searched PubMed, EMBASE and Cochrane Library to identify studies comparing outcomes between IVT  + MT and MT from inception to Jan 24, 2019. Random effects mode was used to pool relative risk (RR) with confidence intervals (CI) to compare functional i...
Source: Journal of Neurology - March 4, 2020 Category: Neurology Source Type: research

Altered cerebral blood flow in patients with anti-NMDAR encephalitis
This study aimed to identify to resting-state cerebral blood flow (CBF) connectivity alterations in patients with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis.MethodsThree-dimensional pseudo-continuous arterial spin labeling (pcASL) imaging was performed to measure the resting-state CBF in 23 patients with anti-NMDAR encephalitis at the peak stage of the disease and 32 healthy subjects. CBF was normalized to reduce variations among subjects. CBF was compared between the groups, and the correlations between the CBF alterations and clinical parameters were assessed. Differences in CBF connectivity in specific...
Source: Journal of Neurology - March 3, 2020 Category: Neurology Source Type: research

Neurological update: dizziness
AbstractThe diagnosis and management of vertigo remains a challenge for clinicians, including general neurology. In recent years there have been advances in the understanding of established vestibular  syndromes, and the development of treatments for existing vestibular diagnoses. In this ‘update’ I will review how our understanding of previously “unexplained” dizziness in the elderly is changing, explore novel insights into the pathophysiology of vestibular migraine, and its relationshi p to the newly coined term ‘persistent postural perceptual dizziness’, and finally discuss how a...
Source: Journal of Neurology - March 3, 2020 Category: Neurology Source Type: research

Impact of anti-epileptic drug choice on discharge in acute traumatic brain injury patients
ConclusionIn this cohort, using Phenytoin for acute TBI, seizure prophylaxis was associated with longer length of stay and more dizziness compared to Levetiracetam. Given their equivalent AED efficacy in acute TBI seizure prophylaxis, our data suggest that Levetiracetam is preferable to Phenytoin for early seizure prophylaxis in TBI. This requires evaluation in larger, prospective studies. (Source: Journal of Neurology)
Source: Journal of Neurology - March 3, 2020 Category: Neurology Source Type: research

Other primary headaches —thunderclap-, cough-, exertional-, and sexual headache
This article reviews the disorders of thunderclap, cough, exertional and sexual headache. These are a group of paroxysmal and precipitated headaches, which often occur in bouts with prolonged remissions. Indometacin seems to be the most effective preventative. Each can occur in primary and secondary form. Thunderclap headache is the most frequently reported headache syndrome associated with a secondary pathology. Discussed are the complexities of whether all patients with thunderclap headache should have further investigation if timely computerised tomography is normal and, the relevance of abnormal imaging in these disord...
Source: Journal of Neurology - March 3, 2020 Category: Neurology Source Type: research

Patient reported outcome measures (PROMs) in amyotrophic lateral sclerosis
The objective of this study was to examine the feasibility of PROM collection in an academic ALS clinic and to measure correlations between PROMs and standard ALS clinical outcome measures.MethodsPROMs were gathered from tablet-based surveys offered to adult patients in the waiting room, prior to ALS outpatient clinic visits. They included a demographic section and two validated surveys: the patient reported outcome measurement information system (PROMIS-10), which generates physical health and mental health subscores, and the quality of life in neurological disorders-fatigue subscale (NeuroQoL-fatigue). The ALS functional...
Source: Journal of Neurology - March 2, 2020 Category: Neurology Source Type: research

A review of anticoagulation in patients with central nervous system malignancy: between a rock and a hard place
AbstractThe incidence and prevalence of patients who develop primary and secondary metastatic central nervous system cancer (CNS) is increasing. This is a consequence of advancements in the sensitivity and availability of diagnostic imaging, and improved therapeutic options, leading to increased detection of CNS malignancies and improved survival. These patients are at very high risk of thrombosis as well as haemorrhage, and the optimum management of anticoagulation can be challenging for treating clinicians, particularly as robust prospective evidence is sparse. In this focused review, we discuss (1) risk factors for thro...
Source: Journal of Neurology - March 1, 2020 Category: Neurology Source Type: research

Efficacy of inpatient personalized multidisciplinary rehabilitation in multiple sclerosis: behavioural and functional imaging results
ConclusionMultidisciplinary rehabilitation may improve highly impacting symptoms through more efficient recruitment of brain regions and therefore positively influence MS patients ’ quality of life. (Source: Journal of Neurology)
Source: Journal of Neurology - March 1, 2020 Category: Neurology Source Type: research

Predictors of Nabiximols (Sativex ® ) discontinuation over long-term follow-up: a real-life study
In conclusion, higher physical and cognitive disability predicted Nabiximols treatment discontinuation over 2 years in MS patients suffering from spasticity. Nabiximols should be started earlier to decrease the likelihood of treatment discontinuation over time. (Source: Journal of Neurology)
Source: Journal of Neurology - March 1, 2020 Category: Neurology Source Type: research

Dysregulation of multisensory processing stands out from an early stage of migraine: a study in pediatric patients
AbstractResting state (RS) functional connectivity (FC) abnormalities of brain networks involved in pain- and multisensory processing have been disclosed in adult-migraine patients. We explored RS FC of large-scale brain networks in pediatric-migraine patients and their correlation with patients ’ clinical characteristics. RS functional MRI data was acquired from 13 pediatric-migraine patients and 14 age- and sex-matched controls. Intra- and inter-network RS FC differences between patients and controls were evaluated. Correlations between RS FC abnormalities and patients’ clinical chara cteristics were also ass...
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

Exit strategies for “needle fatigue” in multiple sclerosis: a propensity score-matched comparison study
AbstractPatients with multiple sclerosis on long-term injectable therapies may suffer from the so-called “needle fatigue”, i.e., a waning commitment to continue with the prescribed injectable treatment. Therefore, alternative treatment strategies to enhance patients’ adherence are warranted. In this independent, multicentre post-marketing study, we sought to directly compare switching to either t eriflunomide (TFN), dimethyl fumarate (DMF), or pegylated interferon (PEG) on treatment persistence and time to first relapse over a 12-month follow-up. We analyzed a total of 621 patients who were free of relaps...
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

Optical coherence tomography shows neuroretinal thinning in myelopathy of adrenoleukodystrophy
In this study, we investigated whether myelopathy in ALD is associated with retinal neurodegeneration on optical coherence tomography (OCT), which could serve as a surrogate outcome measure.MethodsSixty-two patients (29 men and 33 women) and 70 age-matched and sex-matched controls (33 men and 37 women) were included in this cross-sectional study. We compared retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) and peripapillary retinal nerve fiber layer (pRNFL) thickness between ALD patients and controls. In addition, we correlated these OCT measurements with clinical parameters of severity of myelopathy.ResultsPati...
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

Using personalized medicine in gliomas: a genomic approach to diagnosis and overcoming treatment resistance in a case with pleomorphic xanthoastrocytoma
ConclusionThis is the first report of a PXA patient receiving therapy with BRAF MEKi and an autophagy inhibitor with prolonged stable disease. This patient highlights the importance of a molecular interrogation in gliomas to provide an integrated diagnosis and effective treatment. This may be useful in up to 3% of glioma patients withBRAF mutations. Molecular testing in neuro-oncology is providing new avenues of diagnosis and treatment, and detailed molecular interrogation should be considered routine. (Source: Journal of Neurology)
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

Classic ataxia-telangiectasia: the phenotype of long-term survivors
ConclusionsPaucity of descriptions in the literature, and withdrawal from medical care complicate the acquisition of follow-up data on the natural history of long-term survivors. Irrespective of these limitations, we have obtained impression of the many problems that these patients face when surviving beyond 30  years of age. Awareness of these problems is needed to guide follow-up, counselling, and (palliative) care; decisions about life-prolonging treatments should be well considered. (Source: Journal of Neurology)
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

Intravenous cyclophosphamide monthly pulses in refractory myasthenia gravis
ConclusionsCYC was effective in all patients with refractory MG for a mean of 9  months, with worsening thereafter, which could be associated with low cumulative dose. The symptomatic improvement with CYC was noted within the 1st month. We conclude that CYC is effective as an induction to remission therapy, although our data suggest it is not effective as a long-term therapy. (Source: Journal of Neurology)
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

Wake-up stroke: thrombolysis reduces ischemic lesion volume and neurological deficit
This study aimed to investigate the effects of rTPA in WUS patients during every day clinical scenarios, by measuring ischemic lesion volume and functional outcomes compared to non-treated WUS patients.MethodsWe retrospectively analyzed clinical and imaging data of 149 (75  rTPA; 74 non-rTPA) patients with acute ischemic WUS. Ischemic volume was calculated on follow-up CT and functional outcomes were the NIHSS and mRS comparing rTPA and non-rTPA WUS. Patients were selected using ASPECTS >  6 on CT and/or ischemic penumbra >  50% of hypoperfused tissue on CTP.ResultsA reduced volu...
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

Cerebrospinal fluid total protein in Guillain –Barré syndrome variants: correlations with clinical category, severity, and electrophysiology
AbstractThe discriminative value of CSF total protein (CSF-TP) in subtypes of Guillain –Barré syndrome has not been well documented in North-American patients. We reviewed 173 cases from a single institution, comprising the following clinical categories of neuropathy: 134 Sensorimotor (SM) GBS, 13 Motor (M) GBS, 8 Localized (L) GBS, and 18 Miller Fisher syndrome (MFS). We grouped t he electrophysiological interpretation in primarily demyelinating, primarily axonal and normal / equivocal categories. Mean CSF-TP were substantially higher for SM and L-GBS, as well as cases classified as Acute-onset chronic inflam...
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

A multimodal approach to assess the validity of atrophied T2-lesion volume as an MRI marker of disease progression in multiple sclerosis
ConclusionAtrophied T2-LV is associated with disability accrual in MS, and to several multimodal markers of disease evolution. (Source: Journal of Neurology)
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

Ji ří Procháska (1749–1820)
(Source: Journal of Neurology)
Source: Journal of Neurology - February 21, 2020 Category: Neurology Source Type: research

Evolution of the vestibular function during head impulses in spinocerebellar ataxia type 6
This study aimed to determine temporal evolution in the findings of head impulse tests (HITs) in SCA type 6 (SCA6). We serially evaluated HITs in 12 patients with SCA6 using video-oculography for 3  months to 5 years [median = 12 months, interquartile range (IQR) = 9–50] at two university hospitals in South Korea. Patients (8/12, 67%) usually showed abnormal responses at least for one semicircular canal during video-HITs. The gains of the vestibulo-ocular reflex (VOR) for the ante rior canals (ACs) were larger than those for the posterior canals (PCs,p = 0.005)...
Source: Journal of Neurology - February 16, 2020 Category: Neurology Source Type: research

Physical activity in myotonic dystrophy type 1
The objective of this study is to assess physical activity and predictors of physical activity in individuals with DM1.MethodsSixty-seven adults with DM1 and 39 healthy adults were recruited. Physical activity was monitored by accelerometry and assessed using the International Physical Activity Questionnaire. Age, marital status, education, apathy, cognition, fatigue, and muscle strength were assessed as predictors of physical activity in DM1.ResultsThe individuals with DM1 were on average − 187 min (p 
Source: Journal of Neurology - February 16, 2020 Category: Neurology Source Type: research

Pallidal lead placement in dystonia: leads of non-responders are contained within an anatomical range defined by responders
AbstractBackgroundDeep brain stimulation (DBS) within the pallidum represents an effective and well-established treatment for isolated dystonia. However, clinical outcome after surgery may be variable with limited response in 10 –25% of patients. The effect of lead location on clinical improvement is still under debate.ObjectiveTo identify stimulated brain regions associated with the most beneficial clinical outcome in dystonia patients.Methods18 patients with cervical and generalized dystonia with chronic DBS of the internal pallidum were investigated. Patients were grouped according to their clinical improvement in...
Source: Journal of Neurology - February 16, 2020 Category: Neurology Source Type: research

Outcome of patients with large vessel occlusion in the anterior circulation and low NIHSS score
ConclusionsOur data indicate that primary IVT and/or EVT may be better than primary conservative therapy in patients with LVO in the anterior circulation and low NIHSS score. Furthermore, primary EVT was better than secondary EVT in case of neurological deterioration. There is an unmet need for RCTs to find the optimal therapy for this patient group. (Source: Journal of Neurology)
Source: Journal of Neurology - February 14, 2020 Category: Neurology Source Type: research

A study of susceptibility-weighted imaging in patients with Wilson disease during the treatment of metal chelator
ConclusionsTherapy with DMPS and DMSA improves neurological symptoms of WD patients more quickly and leads to less aggravation, compared with therapy with DPA. The metal content in the brain of WD patients was at a low level after 3  years of treatment. DMPS and DMSA can remove metal from brain tissue faster than DPA. (Source: Journal of Neurology)
Source: Journal of Neurology - February 13, 2020 Category: Neurology Source Type: research

MOG encephalomyelitis: distinct clinical, MRI and CSF features in patients with longitudinal extensive transverse myelitis as first clinical presentation
ConclusionsWe identify common pathological findings in patients with LETM as first clinical presentation of MOG-EM which distinguishes it from other forms of LETM and should lead to testing for MOG-IgG in these cases. (Source: Journal of Neurology)
Source: Journal of Neurology - February 12, 2020 Category: Neurology Source Type: research

Long-term effects of bilateral pallidal deep brain stimulation in dystonia: a follow-up between 8 and 16  years
ConclusionsPallidal DBS is a safe and efficacious long-term treatment for dystonia with sustained effects on motor impairment and disability, accompanied by a robust improvement in mood and quality of life. (Source: Journal of Neurology)
Source: Journal of Neurology - February 12, 2020 Category: Neurology Source Type: research