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Tropical Medicine & International Health, Volume 11, Number 9, September 2006, pp. 1341-1349(9)
Cerebral malaria results in short- to long-term cognitive impairments in many of its child survivors. Although some of the risk factors for impairments have been identified, no attempts have been made to address the plight of those who develop cognitive impairments.
Intracranial venous thrombosis (ICVT) commonly presents with seizures in the acute period, and some patients may develop recurrent seizures in the long term. The prophylactic use of antiepileptic drugs
(AEDs) for the management of post-ICVT seizures is controversial and there is currently no consensus on the optimal management of
Intracranial artery stenosis causes up to 10% of all ischaemic strokes. The rate of recurrent vascular ischaemic events is very high. Angioplasty with or without stent placement is a feasible procedure to dilate the vessel affected. However, its safety and efficacy have not been systematically studied.
The National Institute for Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network
(CSN) convened researchers in clinical diagnosis, epidemiology,
neuropsychology, brain imaging, neuropathology, experimental models, biomarkers, genetics, and clinical trials to recommend minimum, common, clinical and research standards for the description and study of vascular cognitive impairment.
Platelet activation plays a crucial role in the pathophysiology of cerebral ischemia. The aim of this study was to investigate the contribution of platelet activation and leukocyte-platelet interactions to the disease.
Plaque characteristics are suggested to play a potentially important role as risk factors for poor outcome after carotid artery stenting
(CAS). We therefore correlated objectively and subjectively determined carotid plaque morphology with neurological complications after
Stroke care is complex, requiring input from professionals, patients and carers. Identifying and developing appropriate intervention components to meet these complex needs is difficult. The Medical Research Council
(MRC) Framework for developing and evaluating complex
(nonpharmacological) interventions aims to improve intervention development. This study uses the Framework to review complex interventions in stroke care.
To aid decisions for thromboprophylaxis in atrial fibrillation (AF), several risk stratification schemes that predict stroke risk according to clinical and echocardiographic features have been published. von Willebrand factor
(vWf) is a plasma markers of endothelial damage/dysfunction and is associated with the risk of stroke and vascular events in AF patients. This study determined the additive role of plasma vWf levels to clinical factors for risk stratification in patients with AF.
Women have poorer outcomes from stroke than men. Women also have risk factors that are unique, including pregnancy and hormone therapy. Hormone therapy for postmenopausal replacement increased the risk of ischemic stroke according to results of the Womens Health Initiative clinical trials.
Few and conflicting data exist on the case fatality rate in stroke patients with basilar artery
dolichoectasia. We analyzed basilar artery characteristics (diameter, height of bifurcation, transverse position) and 5-year mortality (all-cause, nonstroke vascular, and stroke) in patients with brain infarction.
A review of the medical literature for evidence of whether the use of intravenous antibiotics, or devices impregnated with antibiotics, reduce the risks of infection during the surgical placement of catheters for the drainage of excess fluid from the brain.
We wished to ascertain whether a new contract based on financial incentives for general practitioners has been associated with improved recording of quality indicators for patients with stroke and whether there was evidence of any difference in change between sex, age, and deprivation groups.
Current Opinion in Neurology. 19(4):350-357, August 2006
The introduction of West Nile virus to North America illustrates the potential emergence of novel encephalitic agents in unexpected settings. There has been continued recognition of emerging neurotropic viruses in both the developed and developing world and novel modes of transmission of these agents.
Current Opinion in Neurology. 19(4):401-406, August 2006
This article reviews the most significant advances concerning the neural correlates of decision-making with emphasis on those imaging studies investigating the neural implementation of evaluative judgment processes. This is done against the background of current concepts from the field of judgment and decision-making.
Cognitive Neuropsychology Volume 23, Number 7 / October 1003 - 1014
When responding to a suddenly appearing stimulus, we are slower and/or less accurate when the stimulus occurs at the same location of a previous event than when it appears in a new location. This phenomenon, often referred to as inhibition of return
(IOR), has fostered a huge amount of research in the last 20 years.
Cognitive Neuropsychology Volume 23, Number 7 / October 1015 - 1034
In the present series of experiments, peripheral informative cues were used in order to dissociate endogenous and exogenous orienting of spatial attention using the same set of stimuli. For each block of trials, the cue predicted either the same or the opposite location of target appearance.
Cognitive Neuropsychology Volume 23, Number 7 / October 2006 1035 - 1048
Inhibition of return (IOR)the automatic bias against returning attention or gaze to recently visited locationsis thought to have both collicular and cortical components and has been associated with the oculomotor system.
Cognitive Neuropsychology Volume 23, Number 7 / October 2006 1065 - 1074
In recent years much work has been devoted to the study of a behavioural phenomenon in visual reaction time, called inhibition of return
(IOR), which has been linked to the orienting of visuo-spatial attention.
Cognitive Neuropsychology Volume 23, Number 7 / October 2006 1049 - 1064
The study of the performance of patients with neurological disorders has been fruitful in revealing the nature and neural basis of inhibition of return
(IOR). Thus, in recent years, studies have reported abnormal IOR in patients with Alzheimer's disease, patients diagnosed with schizophrenia, and brain-damaged patients.
The Journal of Neuroscience, August 23, 2006, 26(34):8734-8747
Subtle cellular phenotypes in the CNS may evade detection by routine histopathology. Here, we demonstrate the value of primary culture for revealing genetically determined neuronal phenotypes at high resolution. Gamma neurons of Drosophila melanogaster mushroom bodies
(MBs) are remodeled during metamorphosis under the control of the steroid hormone 20-hydroxyecdysone (20E).
The Journal of Neuroscience, August 23, 2006, 26(34):8702-8706
Trace conditioning, a form of classical conditioning in which the presentation of the conditioned stimulus (CS) and the unconditioned stimulus (US) is separated in time by an interstimulus interval, requires an intact hippocampus. In contrast, classical conditioning procedures in which the CS and US are not separated by an interstimulus interval (i.e., delay conditioning procedures) typically do not (Solomon et al., 1986).
Health Policy Volume 78, Issues 2-3 , October 2006, Pages 353-359
In 1997, the National Health Insurance Board of the Netherlands (CVZ) introduced a guideline for the use of a new anti-epileptic drug,
Lamotrigine. The goal was to limit the use of this relatively expensive drug to patients with difficult-to-treat epilepsy.
Journal of Trauma-Injury Infection & Critical Care. 61(2):322-329, August 2006
There has been an enormous focus on the discovery and development of neuroprotective agents that might have clinical relevance after traumatic brain injury
(TBI). Based on experimental facts, we studied administration of creatine to patients with
By far the largest known kindred with an inherited prion disease caused by a prion protein
(PrP) octapeptide repeat insertion mutation originates from southeast England. This extended family shows very marked phenotypic heterogeneity and provides a unique opportunity to characterize this diversity and examine possible modifying factors amongst a large number of individuals in whom prion disease has been initiated by the same defined genetic mutation.
Spinocerebellar ataxia 17 (SCA17) is a rare genetic disorder characterized by
cerebellar, extrapyramidal, pyramidal as well as psychiatric signs. The pathoanatomical basis of this disorder is still not well known. A total of 12 patients and 12 age- and sex-matched controls were examined by in vivo MRI
voxel-based morphometry (VBM).
In bacterial meningitis, chemokines lead to recruitment of polymorphonuclear leucocytes
(PMN) into the CNS. At the site of infection in the subarachnoid space, PMN release reactive oxygen species, reactive nitrogen intermediates
(RNI) and interleukin-1ß (IL-1ß).
The National Institutes of Health Stroke Scale (NIHSS) provides a standardized measure of stroke severity and is frequently captured to assess 3-month outcome. Other outcome measures have been assessed for the relationship to dependence; a clinically relevant outcome.
PEDIATRICS Vol. 118 No. 2 August 2006, pp. 536-548
The aim was to survey the range of cerebral injury and abnormalities of cerebral development in infants born between 23 and 30 weeks gestation using serial MRI scans of the brain from birth, and to correlate those findings with neurodevelopmental outcome after 18 months corrected age.
Clinical Cancer Research Vol. 12, 4899-4907, August 15, 2006
Phase I: To determine the maximum tolerated doses, toxicities, and pharmacokinetics of imatinib mesylate
(Gleevec) in patients with malignant gliomas taking enzyme-inducing antiepileptic drugs
(EIAED) or not taking EIAED. Phase II: To determine the therapeutic efficacy of
Journal of Trauma-Injury Infection & Critical Care. 61(2):318-321, August 2006
Preinjury warfarin anticoagulation has been shown to increase the mortality of traumatic intracranial hemorrhage. We have evaluated the impact on patient mortality of the rapid triage of patients at risk for warfarin associated traumatic intracranial hemorrhage.
Journal of Hypertension. 24(9):1849-1856, September 2006
Studies on the prognostic significance of blood pressure (BP) increases during the acute phase of ischemic stroke give contradictory results. The aim of this study was to evaluate BP response during the acute phase in different ischemic stroke subtypes, and to assess the prognostic value, considering long-term outcome, of different BP patterns recorded.
The authors investigated the effect of oxcarbazepine on cognitive function in children and adolescents (6 to younger than 17 years of age) with newly diagnosed partial seizures in an open-label comparison with standard antiepileptic drug therapy
(carbamazepine and valproate).
The Journal of Neuroscience, August 16, 2006, 26(33):8465-8476
Cognitive processes depend on synchronization and propagation of electrical activity within and between neuronal assemblies. In vivo measurements show that the size of individual assemblies depends on their function and varies considerably, but the timescale of assembly activation is in the range of 0.10.2 s and is primarily independent of assembly size.
To report the incidence of procedural complications of coiling of ruptured intracranial aneurysms leading to permanent disability or death in a consecutive series of 681 patients and to identify risk factors for these events.
Results from cerebral proton 1H-MR spectroscopy studies of neonates with perinatal hypoxic-ischemic injury have generally been presented as metabolite peak-area ratios, which are T1- and T2-weighted, rather than absolute metabolite concentrations. We hypothesized that compared with 1H-MR spectroscopy peak-area ratios, calculation of absolute metabolite concentrations and relaxation times measured within the first 4 days after birth (1) would improve prognostic accuracy and (2) enhance the understanding of underlying neurochemical changes in neonates with neonatal encephalopathy.
Hyperglycemia independently predicts poor outcome after acute ischemic stroke. CLOTBUST (Combined Lysis Of Thrombus in Brain ischemia using transcranial Ultrasound and Systemic
tPA) demonstrated that ultrasound-augmented thrombolysis improves recanalization and 24-hour outcome in patients with acute ischemic stroke. We hypothesized that ultrasound would preferentially benefit hyperglycemic patients, and reviewed CLOTBUST with respect to admission glucose and good outcome.
Transsphenoidal encephaloceles have often been attributed to persistence of the craniopharyngeal canal. The craniopharyngeal (or
transsphenoidal) canal is a vertical midline defect in the skull base. Its diameter is usually less than 1.5 mm. The defect extends from the floor of the sella turcica to the
nasopharynx. Only rarely are craniopharyngeal canals visible on radiographs of the skull.
Viable tissues at risk of infarction in acute stroke patients have been hypothesized to be detectable as volumetric mismatches between lesions on perfusion-weighted
(PWI) and diffusion-weighted magnetic resonance imaging (DWI). Because tissue response to ischaemic injury and to therapeutic intervention is tissue- and patient-dependent, changes in infarct progression due to treatment may be better detected with
voxel-based methods than with volumetric mismatches.
Clinical Nuclear Medicine. 31(9):538-540, September 2006
The Tc-99m MIBI uptake index of 27 metastatic brain tumors was assessed by setting ROIs over the tumor and contralateral normal brain areas. The mean Tc-99m MIBI uptake index among the 27 tumors was very high (28.3 +/- 23.8) with wide variability in individual measurements (range, 3.3-85).
American Journal of Neuroradiology 27:1412-1418, August 2006
Echo time (TE) can have a large influence on the spectra in proton MR spectroscopy (1H-MR spectroscopy). The purpose of this study was to comparatively assess the diagnostic value of 3T
single-voxel 1H-MR spectroscopy with short or intermediate TEs in grading cerebral
Short latency somatosensory evoked potential (SSEP) (N20) is a good predictor of poor outcome in postanoxic coma. It has been suggested that the long latency response (N70) may increase the sensitivity of SSEPs for predicting poor outcome.
Mutations in the gene encoding the 2 subunit of the -aminobutyric acid type A receptor (GABRG2) have been reported to cause childhood absence epilepsy (CAE), febrile seizures (FS), and generalized epilepsy with FS plus
Expert Review of Cardiovascular Therapy July 2006, Vol. 4, No. 4, Pages 487-502
Stroke is an important cause of morbidity and mortality, and is an economic burden. Diabetes and obesity are two important modifiable risk factors for stroke. Patients with diabetes have a higher incidence of stroke and a poorer prognosis after stroke. Risk-factor modification is the most important aspect of prevention of stroke in diabetes and obesity.
The benefit of intravenous recombinant tissue plasminogen activator (rtPA) in acute stroke is linked to clot lysis and artery
recanalization. Argatroban is a direct thrombin inhibitor that safely augments the benefit of rtPA in animal stroke models. There are no human data on this combination.
We constructed a concise multidimensional care burden scale that reflects circumstances unique to Japan, with a focus on intractable neurological diseases. We surveyed 646 family caregivers of patients with intractable neurological diseases or stroke using 28 preliminary care burden scale items obtained from qualitative research. The results were used to finalize the feeling of care burden scale
(BIC: burden index of caregivers), and verify its reliability and validity.
Clinical assessment is insensitive to the degree of cerebral involvement in amyotrophic lateral sclerosis
(ALS). Regional brain concentrations N-acetylaspartylglutamate (NAA) plus myo-inositol (Ins), as measured by magnetic resonance spectroscopy, are respectively decreased and increased, suggesting that these compounds may provide a biomarker of the degree of cerebral involvement in
Injury Extra Volume 37, Issue 10 , October 2006, Pages 375-378
The sport of boxing is a well known cause of brain injury. These injuries can be acute, such as intracranial
haematoma, or chronic, such as dementia pugilistica. Acute subdural haematoma
(SH) is the most common acute brain injury in boxing, and is the leading cause of boxing fatalities.
Recent developments in our understanding of the pathophysiological events that follow acute ischaemic stroke suggest an important role for angiogenesis which, through new blood vessel formation, results in improved collateral circulation and may impact on the medium-to-long term recovery of patients.
PEDIATRICS Vol. 118 No. 2 August 2006, pp. 483-492
The goal was to examine the influence of sociodemographic characteristics and health care system factors on the utilization of hospital resources by US children 17 years of age with a diagnosis of traumatic brain injury.
Journal of Neurology, Neurosurgery, and Psychiatry 2006;77:1054-1059
Severe head injury (SHI) is one of the most important health, social and economic problems in industrialised countries. Unfortunately, none of the neuroprotection trials for traumatic brain injury have shown efficacy. One of the reasons for this failure could be the inclusion of patients with high probability of early death. A population-based, retrospective study was conducted to develop a prognostic model for identification of these patients.
Journal of Head Trauma Rehabilitation. Technologies of Prognostication. 21(4):361-374, July/August 2006
It is becoming increasingly clear that genetic factors modify outcome after traumatic brain injury
(TBI). The best known example of this is the association between the apolipoprotein E4 allele
(APOE 4 [varepsilon]) and poorer outcomes.
Journal of Head Trauma Rehabilitation. Technologies of Prognostication. 21(4):350-360, July/August 2006
Clinicians are often expected to project patients' clinical outcomes to allow effective planning for future care. This can be a challenge in patients with moderate to severe traumatic brain injury
(TBI) who are often unable to participate reliably in clinical evaluations.
Journal of Head Trauma Rehabilitation. Technologies of Prognostication. 21(4):334-349, July/August 2006
Proton magnetic resonance spectroscopy (MRS) is being used to evaluate individuals after acute traumatic brain injury. These studies have shown that changes in certain brain metabolites are associated with poor neurologic outcomes. The majority of MRS studies have been obtained relatively late after injury, but there have been a few reports of use early after injury to assist with outcome prediction.
Journal of Head Trauma Rehabilitation. Technologies of Prognostication. 21(4):315-333, July/August 2006
Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in adults and children. Predicting outcome after TBI is difficult, but it is important for acute management, counseling of family members, and provision of rehabilitation services. Serum biomarkers may be useful alone or in combination with clinical variables to predict outcome after
Journal of Head Trauma Rehabilitation. Technologies of Prognostication. 21(4):298-314, July/August 2006
This study compared the accuracy of artificial neural networks to multiple regression and classification and regression trees in predicting outcomes of 1644 patients in the Traumatic Brain Injury Model Systems database 1 year after injury.
Sensed presence, a religious emotion, has been the focus of recent neurotheological research because it has been claimed that weak transcranial magnetic stimulation can evoke such experiences. Some researchers have recently questioned this claim. However, religion and epilepsy have been linked through history, clinical observations, and research.
Neurobiology of Disease Volume 23, Issue 1 , July 2006, Pages 206-218
It is well known that epileptogenesis is associated with widespread neuronal network changes in brain regions adjacent to the seizure focus but also in remote structures including basal ganglia. Besides the superior
colliculus, the pedunculopontine tegmental nucleus (PPN) is one of three main target regions of basal ganglia output activity and is reciprocally connected with the substantia nigra pars reticulata
(SNr), which is critically involved in seizure propagation and manipulation.
Atherosclerosis Volume 187, Issue 1 , July 2006, Pages 170-176
In a population-based case-control study, we investigated the association of acute ischaemic stroke with
lipoprotein(a) (Lp(a)) levels and apolipoprotein (Apo) (a) isoform size in subjects aged older than 70 years. A total of 163 patients with a first-ever-in-a-lifetime acute
ischaemic/nonembolic stroke and 166 controls were included.
We describe a woman with intractable temporal lobe epilepsy secondary to dysgenesis of the left temporal lobe who had a marked and long-term exacerbation of her preexisting vocal tics after a temporal lobectomy that completely controlled her seizures.
A case of cerebral meningioangiomatosis with rare cyst formation is reported. A 14-year-old boy without any stigmata of neurofibromatosis type 2 presented intractable complex partial and generalized seizures since the age of 12 years.
Secretin infused into rats activates neurons located in brain areas controlling autonomic function and emotion. The brain activity of secretin is mediated, at least in part, through vagal pathways. It is known that afferent stimulation of the vagus nerve results in considerable antiepileptic effects. Whether or not secretin has an effect on seizures is unknown.
Clinicians are often confronted with the self-report of memory difficulties by patients. This study explored the possible correlates of subjective memory in 67 adult Chinese patients with epilepsy in Hong Kong.
The objective of this study was to correlate health-related quality of life
(HRQOL) after surgery for mesial temporal lobe epilepsy, as revealed by a postoperative screening tool, to different modalities of seizure outcome classification (Engel, International League Against Epilepsy
Executive dysfunction is common in patients with frontal lobe damage and may depend on the location of pathology within the frontal lobes. However, it is unclear how specific brain regions contribute to different aspects of executive functioning.
Transsylvian selective amygdalohippocampectomy (TSA) is an operative technique designed to spare unaffected brain tissue during surgical treatment for mesial temporal lobe epilepsy. In contrast to standard anterior temporal lobectomy
(ATL), the advantages of TSA with respect to postoperative cognitive outcome are equivocal.
A 67-year-old, right-handed woman became unable to recognize familiar faces following a period of nonconvulsive status
epilepticus. Neuropsychological assessment revealed a relatively selective impairment of familiar face recognition in the absence of low-level visual deficits or widespread cognitive impairment.
Statins reduce the incidence of strokes among patients at increased risk for cardiovascular disease; whether they reduce the risk of stroke after a recent stroke or transient ischemic attack (TIA) remains to be established.