[Articles] Use of brain diffusion tensor imaging for the prediction of long-term neurological outcomes in patients after cardiac arrest: a multicentre, international, prospective, observational, cohort study
In patients who are unconscious 7 days after cardiac arrest, the normalised WWM-FA value, measured by diffusion tensor imaging, could be used to accurately predict neurological outcome at 6 months. This evidence requires confirmation from future large-scale trials with a strict protocol of withdrawal or limitation-of-care decisions and time window for MRI. (Source: Lancet Neurology)
Source: Lancet Neurology - February 27, 2018 Category: Neurology Authors: Lionel Velly, Vincent Perlbarg, Thomas Boulier, Nicolas Adam, Sebastien Delphine, Charles-Edouard Luyt, Valentine Battisti, Gregory Torkomian, Charlotte Arbelot, Russell Chabanne, Betty Jean, Carol Di Perri, Steven Laureys, Giuseppe Citerio, Alessia Vargi Tags: Articles Source Type: research
[Comment] One step towards dementia prevention
Dementia prevention, which might have seemed unrealistic until a few years ago, now seems feasible, albeit still fraught with uncertainty and unknowns. In The Lancet Neurology, Bruno Dubois and colleagues1 present an assessment of associations between amyloid β deposition and cognitive decline in people with subjective memory complaints. The INSIGHT-preAD study offers interesting insights and highlights challenges that might be faced by clinicians in the future. (Source: Lancet Neurology)
Source: Lancet Neurology - February 27, 2018 Category: Neurology Authors: Giovanni B Frisoni, Frank Jessen Tags: Comment Source Type: research
[Comment] White matter is what matters after cardiac arrest
Patients who are successfully resuscitated after cardiac arrest usually remain comatose thereafter. These patients are usually sedated and artificially ventilated during the first 1 –2 days while their body temperature is regulated, further prolonging the period in a coma. (Source: Lancet Neurology)
Source: Lancet Neurology - February 27, 2018 Category: Neurology Authors: Tobias Cronberg Tags: Comment Source Type: research
[In Context] The hard problem of consciousness: understanding our reality
In the 17th century, the philosopher Ren é Descartes proposed that the very act of thinking about one's existence is evidence of the presence of a mind distinct from the body. This notion came to be known as Cartesian dualism, spawning the dictum “cognito ergo sum” (I think, therefore I am). According to Descartes, consciousness is ir refutable—even if everything else you think you know is an illusion—because consciousness is observed from within. The troubling aspect of consciousness is that it is very difficult to describe scientifically. (Source: Lancet Neurology)
Source: Lancet Neurology - February 26, 2018 Category: Neurology Authors: Jules Morgan Tags: In Context Source Type: research
[Corrections] Corrections
Ballard C, Banister C, Khan Z, et al. Evaluation of the safety, tolerability, and efficacy of pimavanserin versus placebo in patients with Alzheimer's disease psychosis: a phase 2, randomised, placebo-controlled, double-blind study. Lancet Neurol 2018; 17: 213 –22—In the online Appendix on page 5, a figure has been added showing the adjusted mean change from baseline to week 12 for NPI–NH psychosis score of 12 or more and the figure legend should read “Adjusted mean (SE) change from baseline in NPI-NH psychosis score for patients with baseline sco re ≥12.” Additionally on page 6 in the Appendix, a figure has be...
Source: Lancet Neurology - February 26, 2018 Category: Neurology Tags: Corrections Source Type: research
[Comment] Two steps forward for myelin repair in multiple sclerosis
Multiple sclerosis is a convolution of inflammation, degeneration, and variable repair, the timing and extent of which determines whether the clinical course is slow with periods of recovery or a progressive worsening of symptoms. Accordingly, to improve outcomes for patients with multiple sclerosis —particularly progressive multiple sclerosis—multipronged, combination therapies are probably needed. Existing therapies that modulate the immune system, such as alemtuzumab, are increasingly effective. (Source: Lancet Neurology)
Source: Lancet Neurology - February 26, 2018 Category: Neurology Authors: Andrew V Caprariello, Peter K Stys Tags: Comment Source Type: research
[Review] Advances in the diagnosis and treatment of fungal infections of the CNS
Fungal infections of the CNS are challenging to treat and their optimal management requires knowledge of their epidemiology, host characteristics, diagnostic criteria, and therapeutic options. Aspergillus and Cryptococcus species predominate among fungal infections of the CNS. Most of these fungi are ubiquitous, but some have restricted geographical distribution. Fungal infections of the CNS usually originate from primary sites outside the CNS (eg, fungal pneumonia) or occur after inoculation (eg, invasive procedures). (Source: Lancet Neurology)
Source: Lancet Neurology - February 21, 2018 Category: Neurology Authors: Stefan Schwartz, Dimitrios P Kontoyiannis, Thomas Harrison, Markus Ruhnke Tags: Review Source Type: research
[Correspondence] Increasing understanding of encephalitis
The work of the Encephalitis Society continues to raise important awareness of this condition globally. World Encephalitis Day (February 22) has been a key component of this awareness campaign, reaching more than 60 million people since its launch in 2014. Two reasons drive the campaign: first, the incidence of encephalitis is higher than the incidence of some other conditions (eg, amyotrophic lateral sclerosis and some forms of meningitis), which continue to have higher profiles among the public and clinicians. (Source: Lancet Neurology)
Source: Lancet Neurology - February 21, 2018 Category: Neurology Authors: Ava Easton Tags: Correspondence Source Type: research
[In Context] The birth of consciousness: I think, therefore I am?
Consciousness is an elusive concept, and efforts towards understanding it or its evolution oscillate between philosophy and neuroscience —between thought experiments and measurable tests of brain activity. Consequently, philosophers and scientists are continually coming up with new theories on why or how they think that the physical brain can bring the metaphysical mind into being. In American philosopher Daniel Dennett's latest bo ok, From Bacteria to Bach and Back: Evolution of Minds, he grandly attempts to unify a lifetime of his thoughts to convince the reader how human cognition has evolved. (Source: Lancet Neurology)
Source: Lancet Neurology - February 16, 2018 Category: Neurology Authors: Vijay Shankar Balakrishnan Tags: In Context Source Type: research
[Correspondence] The SeLECT score is useful to predict post-stroke epilepsy
We read with interest Josef Finsterer's Comment1 on our Article2 on the SeLECT score as a prognostic model for prediction of late seizures after ischaemic stroke. He does not take into account three major points about prognostic modelling3 and the differences from aetiological research.4 First, for a prognostic model to be clinically useful, the entry data have to be routinely and widely available and easily applicable in the clinical setting. Second, for a model to be relevant, it must provide outcome information satisfying the needs of the user at, or soon after, the event. (Source: Lancet Neurology)
Source: Lancet Neurology - February 15, 2018 Category: Neurology Authors: Marian Galovic, Nico D öhler, Mark R Keezer, John S Duncan, Josemir W Sander, Matthias J Koepp, Barbara Tettenborn, SeLECT Score Collaborators Tags: Correspondence Source Type: research
[Articles] The effect of LRRK2 mutations on the cholinergic system in manifest and premanifest stages of Parkinson's disease: a cross-sectional PET study
LRRK2 mutations are associated with significantly increased cholinergic activity in the brain in mutation carriers without Parkinson's disease compared with healthy controls and in LRRK2 mutation carriers with Parkinson's disease compared with individuals with idiopathic disease. Changes in cholinergic activity might represent early and sustained attempts to compensate for LRRK2-related dysfunction, or alteration of acetylcholinesterase in non-neuronal cells. (Source: Lancet Neurology)
Source: Lancet Neurology - February 15, 2018 Category: Neurology Authors: Shu-Ying Liu, Daryl J Wile, Jessie Fanglu Fu, Jason Valerio, Elham Shahinfard, Siobhan McCormick, Rostom Mabrouk, Nasim Vafai, Jess McKenzie, Nicole Neilson, Alexandra Perez-Soriano, Julieta E Arena, Mariya Cherkasova, Piu Chan, Jing Zhang, Cyrus P Zabeti Tags: Articles Source Type: research
[Comment] Hypercholinergic activity in LRRK2 Parkinson's disease
Mutations of the LRRK2 gene are a common cause of autosomal-dominant Parkinson's disease. The clinical features of manifest LRRK2 Parkinson's disease are generally indistinguishable from those of sporadic Parkinson's disease, although some features might be less prominent, including diminished hyposmia and less cognitive decline.1 Study of premanifest LRRK2 Parkinson's disease has the potential to identify early and important events in Parkinson's disease pathophysiology and pathogenesis. Cholinergic system changes are implicated in several non-motor features of idiopathic Parkinson's disease. (Source: Lancet Neurology)
Source: Lancet Neurology - February 15, 2018 Category: Neurology Authors: Nicolaas I Bohnen, Roger L Albin Tags: Comment Source Type: research
