| 1. |
- Nebuchennykh, M., et al.
(författare)
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Quantitative sensory testing in patients with polyneuropathy and healthy individuals
- 2008
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Ingår i: Acta Neurologica Scandinavica, Supplementum. - : Hindawi Limited. - 0065-1427 .- 1600-5449 .- 0001-6314 .- 1600-0404. ; 117:188, s. 56-61
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Tidskriftsartikel (refereegranskat)abstract
- AIMS Elderly individuals and patients with polyneuropathy often feel heat pain or burning sensation on quantitative sensory testing (QST) of warm perception distally in the lower limbs. We therefore studied heat pain threshold (HPT), warm perception threshold (WPT) and the difference between heat pain and warm perception thresholds in 48 patients with symptoms and signs of polyneuropathy matched according to age and gender with 48 healthy persons. METHODS QST (using method of limits) was performed on the distal calf and the dorsal foot. RESULTS Particularly in the neuropathy group several individuals (58%) had an unpleasant feeling, often burning, when the thresholds according to the WPT algorithm were recorded. Difference between heat pain and warm perception thresholds in the lower calf of the patients was 3.9 +/- 3.5 and 5.8 +/- 3.4 degrees C in the controls (P = 0.012), and on the foot 3.8 +/- 2.8 vs 5.3 +/- 3.6 degrees C (P = 0.02). CONCLUSIONS When performing QST it is important to assess also quality features of warm perception, such as burning and heat pain sensation.
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| 2. |
- Ahlgren, Cecilia, 1946, et al.
(författare)
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Multiple sclerosis incidence in the era of measles-mumps-rubella mass vaccinations.
- 2009
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 119:5, s. 313-20
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Viral childhood infections may be involved in the multiple sclerosis (MS) pathogenesis. Following national Swedish vaccination programs, measles sharply declined in the 1970s, and measles, mumps, and rubella were virtually eliminated in cohorts born from 1981. OBJECTIVES: To examine whether the vaccination induced reduction in these infections influences the MS incidence. In addition, the public health aspect justified an early evaluation of beneficial as well as harmful effects of mass vaccinations. MATERIALS AND METHODS: From an incidence material of 534 MS patients, born 1959-1990, we selected one unvaccinated cohort and four cohorts, each corresponding to a vaccination program (MS patients = 251). RESULTS: With the ability to detect a decrease by 30-35%, and an increase by 37-48% in the MS incidence in the first three cohorts, we found no vaccination related MS incidence changes. The background MS incidence showed a significant gradual age dependent increase. CONCLUSIONS: While the present follow-up provided limited power in the last cohort, there is no evidence as yet that the radical decline in three viral infections influenced the MS incidence. However, the increasing background MS incidence of unknown cause may have concealed a reduction in MS risk associated with mass vaccinations.
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| 3. |
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| 4. |
- Anckarsäter, Henrik, 1966, et al.
(författare)
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Increased CSF/serum albumin ratio: a recurrent finding in violent offenders.
- 2005
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 112:1, s. 48-50
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To test the hypothesis that cerebrospinal fluid (CSF)/ serum albumin ratios are increased in violent offenders. SUBJECTS AND METHODS: In a previous study of violent offenders, we found significantly higher CSF/serum album ratios (as a sign of increased blood-brain barrier permeability) in violent offenders than in healthy controls. For the present replication study, we recruited a new group of 28 violent offenders, aged 45 years or younger, and 20 new control subjects. RESULTS: The albumin ratio was again significantly higher in the offender group (mean 6.2) than in the control group (mean 4.6) (P = 0.012). Substance abuse or current medication did not appear to explain this finding. CONCLUSION: Increased CSF/serum albumin ratios are an unspecific sign of neurological dysfunction in subgroups of violent offenders.
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| 5. |
- Anckarsäter, Rolf, 1956, et al.
(författare)
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Cerebrospinal fluid protein reactions during non-neurological surgery.
- 2007
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 115:4, s. 254-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study changes in cerebrospinal fluid (CSF) protein markers of blood-CSF barrier integrity and immunological reactions during surgical stress. SUBJECTS AND METHODS: Thirty-five patients without neurological or psychiatric disorders undergoing knee replacements had CSF and serum samples drawn from spinal and arterial catheters before, 3 h after and the morning after surgery. RESULTS: Serum albumin decreased during surgery and CSF albumin decreased during and after surgery, and, as a consequence, the CSF/serum albumin ratio decreased significantly during the study period, especially after the intervention. In contrast, CSF concentrations of beta-2-microglobuline (beta2M) increased significantly during surgery and remained high. The CSF general marker beta-trace protein (betaTP) remained unchanged. CONCLUSIONS: Central nervous system protein reactions to a non-neurological surgical intervention include sharply decreased permeability of albumin into the CSF and signs of intrathecal inflammatory activity.
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| 6. |
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| 7. |
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| 8. |
- Axelson, Hans W., et al.
(författare)
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No benefit of treatment with cyclophosphamide and autologous blood stem cell transplantation in multifocal motor neuropathy
- 2008
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 117:6, s. 432-434
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Tidskriftsartikel (refereegranskat)abstract
- Introduction - Patients with multifocal motor neuropathy (MMN) usually respond to intravenous immunoglobulin (IVIG), but because of the short-lasting effect the treatment must be given repeatedly. Remission after treatment with high-dose cyclophosphamide has recently been reported in one patient refractory to IVIG. Case report - Here we report on a patient who responded to IVIG, but temporarily deteriorated dramatically after treatment with high-dose cyclophosphamide and autologous blood stem cell transplantation. Today the situation is the same as before the treatment with cyclophosphamide and blood stem cell transplantation, i.e. IVIG is given every 4 weeks. Conclusion - Our patient did not benefit from the treatment with high-dose cyclophosphamide and autologous blood stem cell transplantation. The effect of treatment with high-dose cyclophosphamide in MMN seems to be difficult to predict and that should be paid attention to if this type of treatment is considered.
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| 9. |
- Bauer, J, et al.
(författare)
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Levetiracetam: a long-term follow-up study of efficacy and safety.
- 2006
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 114:3, s. 169-76
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the efficacy and safety of long-term add-on treatment with levetiracetam 1,000-4,000 mg/day. PATIENTS AND METHODS: In this multicenter, open-label follow-up study, 505 patients, from 10 European countries, who had benefited from previous add-on treatment with levetiracetam in a clinical trial or compassionate-use program were enrolled; 274 (54.3%) stayed to the end. Most then continued levetiracetam by prescription or in a named patient program, where it was not yet commercially available. Mean treatment duration was 1,045 days (range: 24 days to >7 years). Median daily dosage was 3,000 mg/day (range: 250-6,000 mg/day), with 250 (49.5%) patients receiving levetiracetam for >3 years. RESULTS: Median total and partial seizure frequency per week over the evaluation period were 0.8 and 0.7; seizure frequency per week was generally stable over time and remained low. There was a probability of 6.6% of remaining seizure-free for the first 3 years, and of 18.9% of having a seizure-free period of at least 3 years at any time. Most adverse events were mild or moderate and unrelated to study drug. Levetiracetam was well tolerated, and provided stable seizure control during long-term treatment.
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| 10. |
- Ben-Menachem, Elinor, 1945
(författare)
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Data from regulatory studies: What do they tell? What don't they tell?
- 2005
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Ingår i: Acta neurologica Scandinavica. Supplementum. - : Hindawi Limited. - 0065-1427 .- 0001-6314 .- 1600-0404. ; 181, s. 21-5
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Tidskriftsartikel (refereegranskat)abstract
- Phase III studies of antiepileptic drugs (AEDs) are specifically designed to satisfy strict regulatory criteria. As they are conducted in protocol-restricted patient populations over short treatment periods and employ fixed study designs and dosing schedules, they are not fully representative of 'real-life' clinical practice. Therefore, in order to provide an overall assessment of clinical performance, regulatory studies must be backed up by post-marketing clinical experience. Phase IV studies provide information on a drug's performance in a setting more closely representing real clinical practice, with broader patient populations and a more flexible approach to individual treatment. Prospective long-term studies allow the determination of efficacy and safety (and cost-effectiveness) over extended treatment periods; these studies and audit data provide a means of assessing idiosyncratic side effects, unusual interactions and the effects of an AED in rare patient groups. By complementing regulatory evidence with real-life clinical experience, a comprehensive assessment of the risks and benefits of an AED can be made.
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| 11. |
- Ben-Menachem, Elinor, 1945, et al.
(författare)
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Role of valproate across the ages. Treatment of epilepsy in adults.
- 2006
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Ingår i: Acta neurologica Scandinavica. Supplementum. - : Hindawi Limited. - 0065-1427 .- 0001-6314 .- 1600-0404. ; 184, s. 14-27
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Forskningsöversikt (refereegranskat)abstract
- A workshop was held in Göteborg in June 2005 to discuss the place of valproate in treating adult epilepsies. Consensus positions were developed on the epilepsy types for which the drug is most suitable and the use of valproate in women of child-bearing age, in men and in patients with psychiatric comorbidity. Valproate was considered to be effective across a broad variety of epilepsy syndromes and seizure types and should be considered a suitable choice for first-line monotherapy of juvenile myoclonic epilepsy and other idiopathic generalized epilepsies. The use of valproate by women of child-bearing age is associated with potential harm to the foetus. A conservative approach to treatment is recommended in these patients whereby alternative antiepileptic drugs should be proposed to women planning pregnancies wherever satisfactory seizure control can be thereby maintained. In cases where valproate is used during pregnancy, either because the pregnancy was unplanned or because alternative treatment options of equivalent efficacy are unavailable, appropriate counselling, precautionary measures and monitoring should be provided. The evidence for an impact of valproate on male reproductive health is equivocal and considerations of male fertility should not be taken into account in deciding whether to prescribe valproate to men. Valproate can be proposed safely to patients with comorbid psychiatric disease or underlying psychiatric vulnerability.
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| 12. |
- Bjorkhem, I, et al.
(författare)
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Oxysterols and Alzheimer's disease
- 2006
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Ingår i: Acta neurologica Scandinavica. Supplementum. - : Hindawi Limited. - 0065-1427 .- 0001-6314 .- 1600-0404. ; 114185, s. 43-49
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Tidskriftsartikel (refereegranskat)
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| 13. |
- Blomstedt, P, et al.
(författare)
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Pallidal deep brain stimulation in the treatment of Meige syndrome.
- 2008
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 118:3, s. 198-202
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Pallidal deep brain stimulation (DBS) of globus pallidus internus (Gpi) has emerged as an effective treatment for dystonia. The experience is however limited concerning focal dystonias and to date only a few cases of pallidal DBS in the treatment of Meige syndrome have been published. METHODS/RESULTS: We here present a patient with Meige syndrome in whom unilateral pallidal DBS failed to improve the axial symptoms, but bilateral stimulation resulted in a major improvement. The Burke-Fahn-Marsden score (BFM) improved by 71.5% and the patient's blepharospasm was abolished. CONCLUSIONS: The results suggest bilateral pallidal DBS may be an effective treatment for Meige syndrome.
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| 14. |
- Broeren, Jurgen, et al.
(författare)
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Neglect assessment as an application of virtual reality.
- 2007
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 116:3, s. 157-63
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: In this study a cancellation task in a virtual environment was applied to describe the pattern of search and the kinematics of hand movements in eight patients with right hemisphere stroke. METHODS: Four of these patients had visual neglect and four had recovered clinically from initial symptoms of neglect. The performance of the patients was compared with that of a control group consisting of eight subjects with no history of neurological deficits. RESULTS: Patients with neglect as well as patients clinically recovered from neglect showed aberrant search performance in the virtual reality (VR) task, such as mixed search pattern, repeated target pressures and deviating hand movements. The results indicate that in patients with a right hemispheric stroke, this VR application can provide an additional tool for assessment that can identify small variations otherwise not detectable with standard paper-and-pencil tests. CONCLUSION: VR technology seems to be well suited for the assessment of visually guided manual exploration in space.
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| 15. |
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| 16. |
- Caceres, R., et al.
(författare)
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Editorial: Application of a vagal nerve stimulator in an epilepsy patient with cardiac pacemaker after post-ictal cardiac arrest
- 2009
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Ingår i: Acta Neurologica Scandinavica. - : Wiley-Blackwell Publishing Inc.. - 0001-6314 .- 1600-0404. ; 120:2, s. 139-142
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In this case report we present a patient with temporal lobe epilepsy (TLE) showing partial complex seizures and secondary generalization, and treated with several antiepileptic drugs. After two consecutive seizures she had an episode of cardiac arrest followed by AV-block III which led to the implantation of a cardiac pacemaker. She subsequently received a vagal nerve stimulator because of poor response to epilepsy treatment. Combined treatment with two different electromagnetic stimulators raises the question of safety during surgery which is discussed.
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| 17. |
- Caragounis, Eva Corina, et al.
(författare)
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Comparison of HIV-1 pol and env sequences of blood, CSF, brain and spleen isolates collected ante-mortem and post-mortem
- 2008
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Ingår i: Acta Neurol Scand. - : Hindawi Limited. - 1600-0404. ; 117:2, s. 108-16
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: HIV-1 infects the central nervous system (CNS) early in the course of infection. However, it is not known to what extent the virus evolves independently within the CNS and whether the HIV-RNA in cerebrospinal fluid (CSF) reflects the viral population replicating within the brain parenchyma or the systemic infection. The aim of this study was to investigate HIV-1 evolution in the CNS and the origin of HIV-1 in CSF. MATERIALS AND METHODS: Longitudinally derived paired blood and CSF samples and post-mortem samples from CSF, brain and spleen were collected over a period of up to 63 months from three HIV-1 infected men receiving antiretroviral treatment and presenting with symptoms of AIDS dementia complex (ADC). RESULTS: Phylogenetic analyses of HIV-1 V3, reverse transcriptase (RT) and protease sequences from patient isolates suggest compartmentalization with distinct viral strains in blood, CSF and brain. We found a different pattern of RT and accessory protease mutations in the systemic infection compared to the CNS. CONCLUSIONS: We conclude that HIV-1 may to some extent evolve independently in the CNS and the viral population in CSF mainly reflects the infection in the brain parenchyma in patients with ADC. This is of importance in understanding HIV pathogenesis and can have implications on treatment of HIV-1 patients.
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| 18. |
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| 19. |
- Dahlin, Lars, et al.
(författare)
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Sequelae following sural nerve biopsy in type 1 diabetic subjects.
- 2008
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 118, s. 193-197
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Tidskriftsartikel (refereegranskat)abstract
- Objectives - To detect post-operative sequelae of sural nerve biopsy. Materials and methods-- A questionnaire mailed to type 1 diabetic patients (n = 24; male/female 23/1; reply n = 23) 2 years after biopsy. Results - Type 1 diabetic patients (age 56 [11]; median [interquartile range]) had a long duration of diabetes (DM; 20 [19] years) and all had neuropathy. Three out of 24 patients developed infection (two superficial and one deep) and one had a post-operative bleeding. Less frequent pain among the patients were reported from one centre. About one-third or more of the patients still complained of pain, mostly mild, in the biopsy area and paraesthesia in the foot 2 years after surgery. More than two-thirds of the patients were reluctant for further biopsy; a crucial information in drug trial planning. Conclusions - Sequelae of a sural nerve biopsy occur in type 1 DM. The risk for wound infections should be considered.
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| 20. |
- Daving, Yvonne, 1954, et al.
(författare)
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Agreement in activities of daily living performance after stroke in a postal questionnaire and interview of community-living persons.
- 2009
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 119:6, s. 390-6
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Tidskriftsartikel (refereegranskat)abstract
- Daving Y, Claesson L, Sunnerhagen KS. Agreement in activities of daily living performance after stroke in a postal questionnaire and interview of community-living persons. Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2008.01113.x. (c) 2008 The Authors Journal compilation (c) 2008 Blackwell Munksgaard.Objective - To compare assessments of activities of daily living (ADL) made in a postal questionnaire and an interview. Design - Comparative study of a convenience sample. Subjects - Results in 36 persons with stroke >10 years previously. Methods - Data on ADL were gathered in a self-administered postal questionnaire followed by a semi-structured interview (within 1-2 weeks) using items in the Functional Independence Measure, combined with instrumental items, Instrumental Activity Measure or the ADL taxonomy (personal and instrumental items). Results - There was generally moderate to good agreement between the postal questionnaire and the interview. Other dependence identified was reported during the interviews. Although the operational descriptions of the items varied between the ADL indices, they primarily identified ADL independence in the same persons. Conclusion - The use of a self administrated postal ADL questionnaire was feasible for studying ADL performance. However, in some persons, interviews may be needed to complement the results.
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| 21. |
- Egge, A, et al.
(författare)
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Outcome 1 year after aneurysmal subarachnoid hemorrhage: relation between cognitive performance and neuroimaging
- 2005
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 112:2, s. 76-80
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Tidskriftsartikel (refereegranskat)abstract
- Objective - To assess the cognitive impairment and the association between neuropsychological measures and neuroimaging 1 year after aneurysmal subarachnoid hemorrhage (SAH). Method - Forty-two patients were examined clinically according to Glasgow Outcome Scale (GOS). Computed tomography (CT), single photon emission computed tomography (SPECT) and neuropsychological examination were performed. Results - There were no association between GOS and cognitive impairment index based on the neuropsychological examination. CT showed no sign of cerebral ischemia in 17 (40%) and low attenuating areas indicating cerebral infarction(s) in 25 (60%) patients. A significant correlation (P = 0.01) was observed between the cognitive impairment index and the SPECT index (r = 0.6). SPECT measurement was the only independent predictor for cognitive impairment. Conclusion - GOS is a crude outcome measure and patients classified with good recoveries may have significant cognitive deficits. Neuropsychological examination is the preferred method for outcome evaluation as this method specifically addresses the disabilities affecting patients' everyday life.
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| 22. |
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| 23. |
- Eriksson, Bengt, et al.
(författare)
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EEG with triphasic waves in Borrelia burgdorferi meningoencephalitis.
- 2007
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 116:2, s. 133-136
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Tidskriftsartikel (refereegranskat)abstract
- We describe a case of encephalopathy in Which the clinical picture and triphasic waves in the EEG indicated a metabolic cause. However, the illness was caused by neuroborreliosis. The occurrence of triphasic waves in the EEG is a strong evidence of metabolic encephalopathy, but triphasic waves are not specific for metabolic encephalopathy. Triphasic waves have been described in a number of non-metabolic encephalopaties and structural brain lesions. To our knowledge, this is the first report of triphasic waves in Borrelia burgdorferi meningoencephalitis.
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| 24. |
- Eriksson, S H, et al.
(författare)
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Microdysgenesis in epilepsy.
- 2005
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314. ; 111:5, s. 279-90
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Tidskriftsartikel (refereegranskat)abstract
- Microdysgenesis is a microscopic malformation of cortical development characterized by heterotopic neurones and abnormal cortical architecture. It has been described in primary generalized and partial epilepsy. Its significance in epileptogenesis is controversial, partly due to lack of consensus of diagnostic criteria. Different terms have also been used for the malformation. Several quantitative studies have been performed of the histopathological aberrations associated with microdysgenesis. A majority of the studies have revealed an increased number of heterotopic neurones in specimens from epilepsy patients. However, the quantitative values given for abnormal numbers of white matter neurones vary greatly between studies and there is no consensus yet on quantitative criteria for microdysgenesis. There have also been conflicting results from studies correlating microdysgenesis with clinical data. Both favourable and worse outcome after epilepsy surgery have been reported in patients with increased numbers of white matter neurones and microdysgenesis. While some studies have shown earlier seizure onset and increased frequency of mental retardation in patients with microdysgenesis, others have not. Differences in inclusion criteria and definition might contribute to the contradictory results. There is some evidence that microdysgenesis could be important in epileptogenesis, but the mechanisms involved remain unknown and difficult to investigate. A consensus on what histopathological criteria to use for the diagnosis of microdysgenesis is needed to explore this further and enable comparisons between centres. There are advantages and disadvantages both with quantitative stereological and with qualitative assessments. It is necessary to evaluate these in the decision on diagnostic criteria, if possible taking both qualitative and quantitative aspects into account.
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| 25. |
- Eriksson, S H, et al.
(författare)
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Parenchymal lesions in pharmacoresistant temporal lobe epilepsy: dual and multiple pathology.
- 2005
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 112:3, s. 151-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Dual pathology is reported in 5-30% of temporal lobe resections performed in pharmacoresistant epilepsy. Dual pathology may be of importance for surgical planning and also for the understanding of the pathogenesis of epilepsy. We describe the frequency of dual or multiple pathology, i.e. more than one histopathological diagnosis, in adults with temporal lobe resections. MATERIAL AND METHODS: Surgical specimens from 33 consecutive patients with resections including mesial as well as neocortical temporal structures were reviewed. All histopathological findings were recorded. Post-mortem specimens from 11 control subjects were also reviewed. RESULTS: Dual or multiple pathology was found in almost half of the epilepsy patients (48%). Hippocampal sclerosis was found in 25 patients (76%), malformations of cortical development in 15 (46%), of which 12 (36%) were microdysgenesis, and low-grade tumours in seven (21%). Apart from mild gliosis, there were no histopathological changes in the control specimens. CONCLUSION: Dual or multiple pathology was a common finding in this group of adults with temporal lobe resections. In order to increase our understanding of how aetiological factors may combine in the development of seizures, we consider it relevant and important to report all histopathological findings in epilepsy surgery series.
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| 26. |
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| 27. |
- Frisén, Lars, 1939, et al.
(författare)
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How robust is the optic chiasm? Perimetric and neuro-imaging correlations
- 2008
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 117:3, s. 198-204
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Tidskriftsartikel (refereegranskat)abstract
- Objectives - Analysis of form and function relationships with tumour-mediated dislocations and deformations of the optic chiasm Materials and methods - Results of magnetic resonance tomography and two forms of quantitative, computerized perimetry were contrasted in 31 patients with pituitary adenomata impinging on the chiasm, prior to treatment Results - Perimetric abnormalities ranged from none to modest High-pass Resolution Perimetry (HRP) produced abnormal results in 10 cases and RareBit perimetry (RBP) in 15 cases Overall, field defects and qualitative stages of deformation and dislocation of the chiasm were well correlated Among quantitative indices, the best correlations were obtained by a measure of the cranio-caudal position of the chiasm Conclusions - On average, an elevation of the chiasm by 6 mm will be associated with abnormal visual fields in 50% of the cases An additional elevation of 5 mm will raise the incidence of field defects to 90%
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| 28. |
- H-Stenstam, B., et al.
(författare)
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Neuropathological postmortem evaluation of BNCT for GBM
- 2007
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 116:3, s. 169-176
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Tidskriftsartikel (refereegranskat)abstract
- Background - Thirty patients with glioblastoma multiforme (GBM) were treated by boron neutron capture therapy (BNCT) at the Studsvik facility in Sweden, in a clinical trial exploring a procedure in which 900 mg p-boronophenylalanine (BPA) per kilo body weight was infused in 6 h. Objective - The present study was designed to assess tumor efficacy and radiation damage to the brain for the seven patients in the Studsvik trial that were available for postmortem neuropathological examination. Method - Whole brain slices containing the initial tumor site and other regions showing pathological changes were chosen for microscopy and selected areas were studied by immunological methods. Results - Local control of GBM was observed in all cases. Conclusive evidence for radiation induced brain damage was not found. Conclusion - Using a novel procedure for BPA infusion, BNCT achieves local control of GBM for minimum tumor doses as low as 15 wGy, allowing treatment with very low concomitant doses to surrounding healthy tissues.
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| 29. |
- Hallström, Björn, et al.
(författare)
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Lund Stroke Register: hospitalization pattern and yield of different screening methods for first-ever stroke
- 2007
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 115:1, s. 49-54
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore case ascertainment, hospitalization, characteristics of both hospitalized and non-hospitalized patients in a population-based group of stroke patients. Materials and methods One-year screening in Lund-Orup district for first-ever strokes using multiple prospective and retrospective methods. Results A total of 456 patients with first-ever stroke (n = 412 prospective screening methods, n = 17 primary care, n = 12 hospital registers, n = 10 death register, n = 2 autopsy registers, n = 3 other). Hospitalization proportion within 14 days was 84%. Patients sent home from emergency unit (n = 36) were often males (75%), had low 28-day case-fatality (0%), and less severe strokes (median National Institute of Health Stroke Scale score 2 vs 4 for all). Patients managed solely within primary care (n = 18) were elderly (median age 89 vs 77 years for all), resided in nursing homes (86% vs 8% for all) and had high 28-day-case-fatality (61%). Conclusions Hospitalization was lower than expected. Two main categories of patients were not hospitalized: elderly patients at nursing homes with high case-fatality and patients with mild stroke.
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| 30. |
- Hariz, Gun-Marie, et al.
(författare)
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Long-term effect of deep brain stimulation for essential tremor on activities of daily living and health-related quality of life
- 2008
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 118:6, s. 387-394
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To report long-term effects of thalamic deep brain stimulation (DBS) on activities of daily living (ADL) and health-related quality of life (HRQoL) in patients with essential tremor (ET).MATERIALS AND METHODS: Nineteen consecutive patients were evaluated at baseline, at a mean of 1 year, then at a mean of 7 years after DBS using Tremor Rating Scale, Mini Mental Test, ADL Taxonomy, Nottingham Health Profile, Life Satisfaction Checklist, Visual Analogue Scale and interview.RESULTS: There was a decrease of DBS efficacy on tremor between 1 and 7 years post-operatively. The marked improvement in ADL at 1 year was no longer sustained at long-term, except for the ability to eat. Social life remained improved.CONCLUSION: Although there is a decrease of DBS effect on tremor at 7 years, and even though further ageing and co-morbidities may impact on the well-being of patients, there is still relevant benefit of DBS on few aspects of ADL and HRQoL in patients with ET.
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| 31. |
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| 32. |
- Hofgren, Caisa, 1952, et al.
(författare)
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Recovery after stroke: cognition, ADL function and return to work.
- 2007
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 115:2, s. 73-80
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine the recovery of cognitive function, activities of daily living (ADL) ability and vocational situation after stroke. MATERIALS AND METHODS: Subjects below 65 years of age were included. Cognitive function and personal and instrumental ADL were assessed at discharge and at 1 year. Pre-stroke vocational situation was recorded at baseline and at 1 and 3 years after discharge. RESULTS: Fifty-eight patients participated. During the first year after discharge, cognitive function and ADL ability improved. At 1 year after discharge, 83% still had cognitive dysfunction, 20% were dependent in ADL and few had returned to work. Only 20% returned to gainful employment 3 years later. CONCLUSIONS: There was a recovery of cognition and ADL function after stroke but few persons returned to work. Good neurological status was found to be a significant factor and recovery of cognitive function a near-significant factor for return to work.
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| 33. |
- Höglund, Kina, 1976, et al.
(författare)
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Effect of statins on beta-amyloid metabolism in humans: potential importance for the development of senile plaques in Alzheimer's disease.
- 2006
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Ingår i: Acta neurologica Scandinavica. Supplementum. - : Hindawi Limited. - 0065-1427 .- 0001-6314 .- 1600-0404. ; 185, s. 87-92
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Tidskriftsartikel (refereegranskat)abstract
- According to the amyloid cascade hypothesis, both familial and sporadic Alzheimer's disease (AD) is caused by the toxic effect of over-production and/or aggregation of beta-amyloid (Abeta). Recent cell and animal studies have linked the production of Abeta to high levels of cholesterol and the use of statins, compounds inhibiting the de novo synthesis of cholesterol. Epidemiological studies have also supported such linkage by showing a reduced prevalence of AD for subjects taking statins. A limited number of clinical studies have been published trying to elucidate the effect of statin treatment on amyloid precursor protein (APP) processing and metabolism of brain cholesterol in AD in humans and this review focuses on the current state of these clinical studies. The results are contradictory, but the overall interpretation suggests that statin treatment probably does not have a direct impact through lowering of cholesterol on the APP processing and Abeta production in humans. To confirm this, further clinical studies needs to be performed with extended treatment periods and where several parameters (lipid profile, lipoproteins, sterols, biomarkers related to AD and APP metabolites) are analyzed, both in the cerebrospinal fluid and plasma. The pleiotropic effects of statins should be investigated further. One approach is presented in this review.
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| 34. |
- Isacson, D, et al.
(författare)
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Fluctuating functions related to quality of life in advanced Parkinson disease : effects of duodenal levodopa infusion
- 2008
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 118:6, s. 379-86
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess fluctuations in quality of life (QoL) and motor performance in patients with advanced Parkinson disease (PD) treated with continuous daytime duodenal levodopa/carbidopa infusion or conventional therapy. METHODS: Of 18 patients completing a 6-week trial (DIREQT), 12 were followed for up to 6 months and assessed using electronic diaries and the PD Questionnaire-39 (PDQ-39). RESULTS: During the trial and follow-up, major diurnal fluctuations were observed, especially for hyperkinesia, 'off' time, ability to walk and depression. Duodenal infusion was associated with significantly more favourable outcomes compared with conventional treatment for satisfaction with overall functioning, 'off' time and ability to walk, with improved outcomes with PDQ-39. CONCLUSIONS: Relative to conventional treatment, infusion therapy may stabilize and significantly improve motor function and patient's QoL. The potential for daily fluctuation in PD symptoms means single measures of treatment effectiveness can result in bias in effect estimates and hence repeated measures are recommended.
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| 35. |
- Jacobsson, Lars, et al.
(författare)
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Demographics, injury characteristics and outcome of traumatic brain injuries in northern Sweden
- 2007
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 116:5, s. 300-306
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Tidskriftsartikel (refereegranskat)abstract
- Objectives - To describe demographics, injury characteristics and outcome of traumatic brain injury (TBI) in northern Sweden over 10 years. Materials and methods - Data were retrospectively collected on those individuals (n = 332) in Norrbotten, northern Sweden, with a TBI who had been transferred for neurosurgical care from 1992 to 2001. Results - A majority were older men with a mild TBI and an acute or chronic subdural hematoma following a fall. Younger individuals were fewer but had more often a severe TBI from a traffic accident. Most individuals received post-acute care and brain injury rehabilitation. A majority had a moderate or severe disability, but many were discharged back home with no major changes in their physical or social environment. Conclusions - Our data confirm the relationship between age, cause of injury, injury severity and outcome in relation to TBI and underscore the need for prevention as well as the importance of TBI as a cause of long-term disability.
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| 36. |
- Jacobsson, Lars, et al.
(författare)
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Functioning and disability 6-15 years after traumatic brain injuries in northern Sweden
- 2009
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 120:6, s. 389-395
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Tidskriftsartikel (refereegranskat)abstract
- Objectives - To assess long-term functioning and disability after traumatic brain injury (TBI). Material and methods - Individuals (n = 88) in Norrbotten, northern Sweden, who had been transferred for neurosurgical care were assessed with internationally established TBI outcome measures 6-15 years post-injury. Results - There was an improvement in overall outcome from discharge from inpatient rehabilitation to follow-up. Many individuals had a high degree of motor and cognitive functioning, which enabled them to live independently in their own home without assistance, but there remained a disability related to community reintegration and social participation. This affected their productivity and to some degree their marital stability. The remaining disability and reduced productivity were related to the age at injury and the injury severity. Conclusions Our data showed that individuals with a TBI can achieve and maintain a high degree of functioning many years after the injury. Increasing age and a greater injury severity contributed to their long-term disability.
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| 37. |
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| 38. |
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| 39. |
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| 40. |
- Kim, M.-Y., et al.
(författare)
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Respondent burden and patient-perceived validity of the PDQ-39
- 2006
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Ingår i: Acta Neurologica Scandinavica. - : Wiley-Blackwell. - 0001-6314 .- 1600-0404. ; 113:2, s. 132-137
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the respondent burden and patient-perceived content validity of the Parkinson's disease (PD)-specific health status questionnaire PDQ-39, and the linguistic validity of its revised Swedish version.MATERIALS AND METHODS: Eighteen PD patients completed the revised Swedish version of the PDQ-39. Respondent burden was assessed by recording the time taken to complete the questionnaire. Content and linguistic validity was evaluated qualitatively.RESULTS: Patients with mild, moderate and advanced PD needed a mean time of 9.5, 11.3 and 20.1 min, respectively, to complete the PDQ-39. One-third of the patients identified irrelevant items and 50% identified important health-related areas that were missing. Revisions had eliminated previous linguistic problems with the Swedish PDQ-39.CONCLUSIONS: Undue respondent burden challenged the appropriateness of the PDQ-39 among patients with more advanced disease. Overall content validity was acceptable but compromised by lack of important content areas. Observations supported the linguistic validity of the revised Swedish PDQ-39.
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| 41. |
- Kim, M-Y, et al.
(författare)
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Respondent burden and patient-perceived validity of the PDQ-39.
- 2006
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 113:2, s. 132-137
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Tidskriftsartikel (refereegranskat)abstract
- Evaluation of various methods in clinical practice is often based on interpretations by two or more observers. Such data need to be analysed with correct statistics, or the results and conclusions may be misleading. In this study, the use of measures of agreement for ordinal data in five international nursing journals is reviewed and various methods for measuring agreement are presented and discussed. Analyses of agreement did not seem to be very common in nursing research, but a great variation was found regarding the choice of method for analysing agreement. Both acceptable and unacceptable methods were found in the articles reviewed. When choosing among various methods for agreement the weighted κ-coefficient is probably the most useful for ordinal data, but several issues of concern arise and need to be taken into consideration when using these types of analyses.
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| 42. |
- Kivipelto, M, et al.
(författare)
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Alzheimer's Disease: back to the future
- 2006
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Ingår i: Acta neurologica Scandinavica. Supplementum. - : Hindawi Limited. - 0065-1427 .- 0001-6314 .- 1600-0404. ; 114185, s. 119-120
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Tidskriftsartikel (refereegranskat)
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| 43. |
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| 44. |
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| 45. |
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| 46. |
- Koskinen, Lars-Owe D, et al.
(författare)
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Sympathicotomy affects cutaneous blood flow, temperature, and sympathicus-mediated reflexes
- 2008
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Ingår i: Acta Neurologica Scandinavica. - : Wiley-Blackwell. - 0001-6314 .- 1600-0404. ; 118:6, s. 402-406
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the sympathetically mediated effects of transthoracic endoscopic sympathicotomy (TES) in the treatment of severe primary palmar hyperhidrosis.MATERIALS AND METHODS: The effects of TES, on sympathetic ganglia at the thoracic level of 2-3, finger blood flow, temperature, and on heat and cold provocation were investigated. Middle cerebral artery (MCA) blood flow velocities were studied by transcranial Doppler.RESULTS: The finger blood flow increased by about 700% after TES and finger temperature by 7.0 +/- 0.5 degrees C. Several autonomic reflexes were dramatically affected. A finger pulp-shrinking test showed a major decrease after surgery. MCA mean blood flow velocities were not affected by TES.CONCLUSIONS: Besides the high success rate of good clinical effect of TES on palmar hyperhidrosis, major effects on local blood flow and temperature are elicited by TES. Complex autonomic reflexes are also affected. The patient should be completely informed before surgery of the side effects elicited by TES.
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| 47. |
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| 48. |
- Kwast-Rabben, O, et al.
(författare)
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Digital nerve somatosensory evoked potentials and MRI. Correlation analysis in patients with symptomatic cervical spine disorders.
- 2008
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 117:2, s. 122-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Analysis of the relationship between the symptoms, digital nerve somatosensory evoked potentials (D-SEP) and MRI, in patients with symptomatic cervical spine disorders (CSD). MATERIALS AND METHODS: MRI and D-SEP following electrical stimulation of digits I, III and V in 44 patients. RESULTS: Symptoms in the fingers correlated significantly with disk herniation at the corresponding cervical level and with spinal cord impingement at one or two adjacent rostral segments on MRI. D-SEP was abnormal in 52% of all patients. Among them, the groups with multiple and single level involved on MRI had 62% and 30% of abnormal somatosensory evoked potentials (SEP), respectively. Digit I-SEP abnormality was more often localized at the root level, while digit V-SEP at the spinal cord level above the dorsal nucleus. D-SEP correlated best with compression of the spinal cord at adjacent upper and especially the most rostral (C3-5) levels on MRI. CONCLUSIONS: Accurate correlation of D-SEP and symptoms with MRI is essential for correct localization of lesions in patients with CSD.
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| 49. |
- Landtblom, Anne-Marie, 1953-, et al.
(författare)
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Further considerations on the distribution of multiple sclerosis in Sweden
- 2005
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 111:4, s. 238-246
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Tidskriftsartikel (refereegranskat)abstract
- Objectives - The geographic distribution of multiple sclerosis (MS) in Sweden over time was compared in order to analyze homogeneity. Methods - The distribution of MS was compared among three nationwide resources: 1301 hospital cases 1925-1934, 5425 deaths 1952-1992, and 11,371 disability pension recipients 1971-1994. Results - Distributions by county (län) were markedly non-homogenous, with greatest variations in the early prevalence series (16-232% of the national mean), less within the death data (75-170%), and least for the disability series (87-128%). Maximal rates for MS in the early prevalence series were found for the cluster of seven counties surrounding the two major lakes of south central Sweden, as well as for one region on the northern shore of the Bay of Bothnia, and another also off the Bay north of Stockholm. Conclusion - Though the epidemiologic sources are quite different, they are internally consistent and thus provide three consecutive cross-sectional views of the distribution over time. When considered together the data may be compatible with a thesis of the origin and spread of MS within Sweden from the south-central inland lake regions of the country. Such spread within a half century is too rapid for a genetic cause, including HLA patterns. Copyright © Blackwell Munksgaard 2005.
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| 50. |
- Lehmann, Kirsten, 1953, et al.
(författare)
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Postural control in persons with late effects of polio.
- 2006
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 113:1, s. 55-61
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Persons who have suffered from acute poliomyelitis may decades later experience reduction of balance and gait capacity due to muscle weakness, fatigue and/or pain. This may affect the activity level in daily life of these persons. AIMS OF THE STUDY: The aim of this study was to describe observer assessed and subjectively perceived postural control in persons with late effects of polio and to evaluate the correlation between postural control and gait velocity for this population. METHOD: 50 persons (mean age 59.8 yrs) with diagnosed polio disease and without other causes of mobility disorders were included. Balance was tested with the Timed Up and Go test (TUG), the Functional Reach test (FR) and the Falls Efficacy Scale (FES) (Swedish Version). Gait velocity over 30 m was measured for convenient and maximal velocity. RESULTS: The subjects had reduced balance (TUG mean 9.0 sec, FR mean 23.5 cm) and perceived balance problems in ADL items (FES(S) median 119.5, normal value 130). They also showed reduced gait velocity compared to healthy persons of the same age (mean 1.01 m/s compared to 1.30 m/s, convenient speed). Correlations were demonstrated between the reduced balance and decreased convenient and maximal gait velocity (TUG/gait velocity: r = -0.7 (convenient), r = -0.8 (maximal), p
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