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- Gauthier, S, et al.
(författare)
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Mild cognitive impairment
- 2006
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Ingår i: Lancet (London, England). - 1474-547X. ; 367:9518, s. 1262-1270
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Tidskriftsartikel (refereegranskat)
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- McKeith, IG, et al.
(författare)
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Diagnosis and management of dementia with Lewy bodies - Third report of the DLB consortium
- 2005
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Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 1526-632X .- 0028-3878. ; 65:12, s. 1863-1872
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Forskningsöversikt (refereegranskat)abstract
- The dementia with Lewy bodies (DLB) Consortium has revised criteria for the clinical and pathologic diagnosis of DLB incorporating new information about the core clinical features and suggesting improved methods to assess them. REM sleep behavior disorder, severe neuroleptic sensitivity, and reduced striatal dopamine transporter activity on functional neuroimaging are given greater diagnostic weighting as features suggestive of a DLB diagnosis. The 1-year rule distinguishing between DLB and Parkinson disease with dementia may be difficult to apply in clinical settings and in such cases the term most appropriate to each individual patient should be used. Generic terms such as Lewy body (LB) disease are often helpful. The authors propose a new scheme for the pathologic assessment of LBs and Lewy neurites (LN) using alpha-synuclein immunohistochemistry and semiquantitative grading of lesion density, with the pattern of regional involvement being more important than total LB count. The new criteria take into account both Lewy-related and Alzheimer disease (AD)-type pathology to allocate a probability that these are associated with the clinical DLB syndrome. Finally, the authors suggest patient management guidelines including the need for accurate diagnosis, a target symptom approach, and use of appropriate outcome measures. There is limited evidence about specific interventions but available data suggest only a partial response of motor symptoms to levodopa: severe sensitivity to typical and atypical antipsychotics in similar to 50%, and improvements in attention, visual hallucinations, and sleep disorders with cholinesterase inhibitors.
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- Winblad, B, et al.
(författare)
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Safety and efficacy of galantamine in subjects with mild cognitive impairment.
- 2008
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Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 1526-632X .- 0028-3878. ; 70:22, s. 2024-35
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the safety of galantamine in subjects with mild cognitive impairment (MCI), the ability of galantamine to benefit cognition and global functioning in subjects with MCI, and the ability of galantamine to delay conversion to dementia. METHODS: In two studies, 2,048 subjects, 990 in Study 1 and 1,058 in Study 2, with a Clinical Dementia Rating (CDR) = 0.5, CDR memory score > or =0.5, without dementia were randomized to double-blind galantamine (16-24 mg/day) or placebo for 24 months. Primary efficacy endpoint at month 24 was number (%) of subjects who converted from MCI to dementia (CDR > or = 1.0). RESULTS: There were no differences between galantamine and placebo in 24-month conversion rates (Study 1: 22.9% [galantamine] vs 22.6% [placebo], p = 0.146; Study 2: 25.4% [galantamine] vs 31.2% [placebo], p = 0.619). Mean CDR-sum of boxes declined less with galantamine than placebo at 12 and 24 months in Study 1 (p = 0.024 [12 months] and p = 0.028 [24 months]), but not in Study 2 (p = 0.662 [12 months] and p = 0.056 [24 months]). Digit Symbol Substitution Test scores improved with galantamine in Study 1 at 12 months and in Study 2 at 24 months (Study 1: p = 0.009 [month 12] and p = 0.079 [Month 24]; Study 2: p = 0.154 [month 12] and p = 0.020 [month 24]). The most frequently reported adverse event was nausea (galantamine, 29%; placebo, 10%). Serious AEs occurred in 19% of each group. Mortality of the cohort after retrospectively determining the status of subjects (98.3%) at 24 months was 1.4% (galantamine) and 0.3% (placebo); RR (95% CI), 1.70 (1.00, 2.90). CONCLUSIONS: Galantamine failed to significantly influence conversion to dementia. Galantamine was generally well tolerated. Whereas recorded mortality was greater in the galantamine group than in the placebo group in the original per-protocol assessment, a post hoc analysis of the cohort was consistent with no increased risk.
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- Mayoral, M. -L, et al.
(författare)
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Overview of Recent Results on Heating and Current Drive in the JET tokamak
- 2009
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Ingår i: RADIO FREQUENCY POWER IN PLASMAS. - : AIP. - 9780735407534 ; , s. 39-46
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Konferensbidrag (refereegranskat)abstract
- In this paper, significant results in the heating and current drive domains obtained at JET in the past few years following systems upgrade and dedicated experimental time, will be reviewed. Firstly, an overview of the new Ion Cyclotron Resonance Frequency (ICRF) heating capabilities will be presented i.e. results from the ITER-Like ICRF antenna (ILA), the use of External Conjugate-T and 3dB hybrid couplers to increase the ICRF power during ELMy H-mode, Furthermore, experiments to study the influence of the phasing of the ICRF antenna on power absorption and coupling will be described. Looking at Low Hybrid (I-H) issues for ITER, the effect of the location of gas injection on the LH coupling improvement at large launcher-separatrix distances will be discussed as the possibility to operate at ITER-relevant power densities. Experiments to characterise the LH power losses in the Scrape-Off-Layer (SOL) and to determine the LH wave absorption and current drive using power modulation will be shown. Finally, plasma rotation studies in the presence of ICRF heating with standard and enhanced JET toroidal field ripple will be presented.
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| 13. |
- Murari, A., et al.
(författare)
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JET new diagnostic capability on the route to ITER
- 2007
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Ingår i: Fusion engineering and design. - : Elsevier BV. - 0920-3796 .- 1873-7196. ; 82:14-maj, s. 1161-1166
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Tidskriftsartikel (refereegranskat)abstract
- The JET scientific programme is directed towards the development of ITER relevant scenarios. In support of this, significant effort has been made to develop diagnostics to better characterise the power deposition on the plasma facing components, to investigate in more detail the radiation losses particularly in the divertor region and to better detect Magneto Hydrodynamic Modes (MHD) instabilities and their effects on fast ion confinement. A new wide-angle infrared camera provides for the first time the opportunity to perform infrared thermography in the JET main chamber, even during fast events like ELMs and disruptions. A completely new bolometric system, with better spatial resolution particularly in the divertor, is now used to investigate the total radiation losses and their influence on the ELM behaviour. A new set of microwave waveguides has improved by 20 dB the signal to noise ratio of the JET X-mode reflectometers, that are now routinely used to detect MHD instabilities and in particular to localise the location of Alfven Eigenmodes. This improved diagnostic capability to monitor MHD instabilities is complemented by two new diagnostics to detect lost fast particles. Both the new scintillator probe and a poloidal array of Faraday cups have already shown clear correlations between MHD activity and ion losses at the edge.
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