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Source: Lancet Neurology

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Total 215 results found since Jan 2013.

Comment A new era of multiple sclerosis rehabilitation: lessons from stroke
Just over 20 years ago, no treatments were available for multiple sclerosis, a disease characterised by two overlapping processes of nervous system injury: inflammatory destruction of myelin and neurodegeneration of grey and white matter.1 Disease-modifying drugs, particularly the new oral medications, have changed the prognosis of multiple sclerosis, contributing to increased periods of disease stability and greater potential for rehabilitative therapies to reduce impairment.2 In The Lancet Neurology, Robert Motl and colleagues3 argue that exercise can be a beneficial rehabilitation strategy for people with multiple scler...
Source: Lancet Neurology - September 13, 2017 Category: Neurology Authors: Michelle Ploughman Tags: Comment Source Type: research

Series The chronic and evolving neurological consequences of traumatic brain injury
Traumatic brain injury (TBI) can have lifelong and dynamic effects on health and wellbeing. Research on the long-term consequences emphasises that, for many patients, TBI should be conceptualised as a chronic health condition. Evidence suggests that functional outcomes after TBI can show improvement or deterioration up to two decades after injury, and rates of all-cause mortality remain elevated for many years. Furthermore, TBI represents a risk factor for a variety of neurological illnesses, including epilepsy, stroke, and neurodegenerative disease.
Source: Lancet Neurology - September 13, 2017 Category: Neurology Authors: Lindsay Wilson, William Stewart, Kristen Dams-O'Connor, Ramon Diaz-Arrastia, Lindsay Horton, David K Menon, Suzanne Polinder Tags: Series Source Type: research

Review Prediction of motor recovery after stroke: advances in biomarkers
Stroke remains a leading cause of adult disability, and the recovery of motor function after stroke is crucial for the patient to regain independence. However, making accurate predictions of a patient's motor recovery and outcome is difficult when based on clinical assessment alone. Clinical assessment of motor impairment within a few days of stroke can help to predict subsequent recovery, while neurophysiological and neuroimaging biomarkers of corticomotor structure and function can help to predict both motor recovery and motor outcome after stroke.
Source: Lancet Neurology - September 13, 2017 Category: Neurology Authors: Cathy M Stinear Tags: Review Source Type: research

Comment Low risk of ischaemic stroke in hyperhomocysteinaemia
Whether elevated serum homocysteine concentrations (ie, hyperhomocysteinaemia) are a risk factor for ischaemic stroke and if normalising hyperhomocysteinaemia might reduce stroke risk are controversial issues. Hyperhomocysteinaemia can be primary (ie, hereditary) or secondary (ie, due to vitamin B12 deficiency, diabetes, etc). The effect of both primary and secondary hyperhomocysteinaemia on putative stroke risk is debated. One study1 has shown that hyperhomocysteinaemia is an independent risk factor for ischaemic stroke, whereas other studies have reached different conclusions.
Source: Lancet Neurology - August 9, 2017 Category: Neurology Authors: Josef Finsterer Tags: Comment Source Type: research

Personal View B vitamins in stroke prevention: time to reconsider
B vitamin therapy lowers plasma total homocysteine concentrations, and might be a beneficial intervention for stroke prevention; however, cyanocobalamin (a form of vitamin B12) can accelerate decline in renal function and increase the risk of cardiovascular events in patients with impaired renal function. Although early trials did not show benefit in reduction of stroke, these results might have been due to harm in participants with impaired renal function. In patients with diabetic nephropathy, cyanocobalamin is harmful, whereas B vitamins appear to reduce cardiovascular events in study participants with normal renal function.
Source: Lancet Neurology - August 9, 2017 Category: Neurology Authors: J David Spence, Qilong Yi, Graeme J Hankey Tags: Personal View Source Type: research

Comment NOR-TEST-ing tenecteplase in acute ischaemic stroke
Despite the transformational impact of endovascular treatment on patients with acute ischaemic stroke from proximal cerebral artery occlusion, thrombolysis with intravenous alteplase remains the mainstay of reperfusion therapy because it is widely available and the standard of care upon which the evidence for endovascular treatment has been based.1 However, because alteplase has well recognised limitations, including reduced efficacy in large clots, risk of major intracranial haemorrhage, and requirement for a continuous infusion, there is an imperative to continue efforts to find more efficient, more effective, and safer ...
Source: Lancet Neurology - August 8, 2017 Category: Neurology Authors: Craig S Anderson Tags: Comment Source Type: research

Articles Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial
Tenecteplase was not superior to alteplase and showed a similar safety profile. Most patients enrolled in this study had mild stroke. Further trials are needed to establish the safety and efficacy in patients with severe stroke and whether tenecteplase is non-inferior to alteplase.
Source: Lancet Neurology - August 2, 2017 Category: Neurology Authors: Nicola Logallo, Vojtech Novotny, J örg Assmus, Christopher E Kvistad, Lars Alteheld, Ole Morten Rønning, Bente Thommessen, Karl-Friedrich Amthor, Hege Ihle-Hansen, Martin Kurz, Håkon Tobro, Kamaljit Kaur, Magdalena Stankiewicz, Maria Carlsson, Åse Mor Tags: Articles Source Type: research

Review Music-based interventions in neurological rehabilitation
During the past ten years, an increasing number of controlled studies have assessed the potential rehabilitative effects of music-based interventions, such as music listening, singing, or playing an instrument, in several neurological diseases. Although the number of studies and extent of available evidence is greatest in stroke and dementia, there is also evidence for the effects of music-based interventions on supporting cognition, motor function, or emotional wellbeing in people with Parkinson's disease, epilepsy, or multiple sclerosis.
Source: Lancet Neurology - June 26, 2017 Category: Neurology Authors: Aleksi J Sihvonen, Teppo S ärkämö, Vera Leo, Mari Tervaniemi, Eckart Altenmüller, Seppo Soinila Tags: Review Source Type: research

Correspondence Atrial fibrillation in high-risk patients with ischaemic stroke
In their Article, Rolf Wachter and colleagues1 report important evidence for secondary prevention after stroke and show that, after non-large-artery stroke, three 10-day Holter-electrocardiograms (ECGs) increased the detection rate of atrial fibrillation by 9% compared with standard care involving only one 24 h Holter-ECG. The authors point out that long-term Holter-ECGs were easier to integrate into the routine work-up than specialised external loop recorders or implanted devices because they were widely available, familiar to most physicians, and inexpensive.
Source: Lancet Neurology - June 14, 2017 Category: Neurology Authors: Stefan Knecht, Sebastian Petsch, Bettina Studer Tags: Correspondence Source Type: research

Correspondence Atrial fibrillation in high-risk patients with ischaemic stroke – Authors' reply
We agree with Stefan Knecht and colleagues that the rehabilitation setting is ideal for doing prolonged Holter-electrocardiogram monitoring for the detection of atrial fibrillation. We think that this approach should be studied in a randomised trial.
Source: Lancet Neurology - June 14, 2017 Category: Neurology Authors: Rolf Wachter, Klaus Gr öschel, Find-AF Investigators and Coordinators Tags: Correspondence Source Type: research

Policy View Increasing value and reducing waste in stroke research
Stroke is a major burden to patients and society, and resources spent on stroke research must be used efficiently and produce good value in terms of improvements in human health. However, many instances of poor value from stroke research funding have resulted from the way in which stroke research topics have been chosen and how studies have been designed, conducted, analysed, regulated, managed, disseminated, or reported. A cooperative effort of European stroke researchers aimed to identify sources of inefficiency and waste, recommend approaches to increase value, and highlight examples of best practice in stroke research.
Source: Lancet Neurology - April 12, 2017 Category: Neurology Authors: Eivind Berge, Rustam Al-Shahi Salman, H Bart van der Worp, Christian Stapf, Peter Sandercock, Nikola Sprigg, Malcolm R Macleod, Peter J Kelly, Paul J Nederkoorn, Gary A Ford, European Stroke Organisation Trials Network Committee Tags: Policy View Source Type: research

Editorial Vascular disease and neurodegeneration: advancing together
On Feb 19, 2017, immediately before the International Stroke Conference, the MarkVCID consortium held its first meeting in Houston (TX, USA). The focus of this new research consortium is on understanding small vessel disease and its contributions to vascular cognitive impairment and dementia (VCID). For too long, research in dementia has neglected the most common comorbidity in elderly patients: cerebrovascular disease. Funders are now reversing this trend and encouraging research into the role of brain vessels in neurodegeneration, and MarkVCID is a momentous initiative in that direction.
Source: Lancet Neurology - April 12, 2017 Category: Neurology Authors: The Lancet Neurology Tags: Editorial Source Type: research

Comment Optimisation of stroke research
Stroke is the second most common cause of death, and the leading cause of disability-adjusted life-years (DALYs) worldwide.1 –3 It imposes a huge burden on patients, their families, and society. This devastating burden will not be alleviated unless national and international collaborations prioritise stroke as one of the most important public health issues in the world.
Source: Lancet Neurology - April 12, 2017 Category: Neurology Authors: Mahmoud Reza Azarpazhooh, Vladimir Hachinski Tags: Comment Source Type: research

Articles Safety and efficacy of multipotent adult progenitor cells in acute ischaemic stroke (MASTERS): a randomised, double-blind, placebo-controlled, phase 2 trial
Administration of multipotent adult progenitor cells was safe and well tolerated in patients with acute ischaemic stroke. Although no significant improvement was observed at 90 days in neurological outcomes with multipotent adult progenitor cells treatment, further clinical trials evaluating the efficacy of the intervention in an earlier time window after stroke (
Source: Lancet Neurology - March 17, 2017 Category: Neurology Authors: David C Hess, Lawrence R Wechsler, Wayne M Clark, Sean I Savitz, Gary A Ford, David Chiu, Dileep R Yavagal, Ken Uchino, David S Liebeskind, Alexander P Auchus, Souvik Sen, Cathy A Sila, Jeffrey D Vest, Robert W Mays Tags: Articles Source Type: research

Comment Can allogeneic stem cells improve outcomes after stroke?
Stroke is the second leading cause of death1 and the third leading cause of disability2 worldwide. Acute reperfusion therapies can improve outcomes but are only accessed by about one in 20 patients with ischaemic stroke in the USA. The need exists for additional therapies that are accessible and effective for most patients.3 One strategy in this regard is to develop new therapies that have a longer time window than the 3 –6 h window of reperfusion therapies.
Source: Lancet Neurology - March 17, 2017 Category: Neurology Authors: Steven C Cramer Tags: Comment Source Type: research