550 e-Letters

  • Cholinesterase inhibitors and falls in Parkinson's disease
    Martijn L.T.M. Muller

    We read with great interest the paper by Pagano et al. who conducted a systematic review of prospective, randomised placebo-controlled trials (RCT), in order to assess the efficacy and safety of cholinesterase inhibitors (ChIs) in patients with Parkinson's disease (PD).[1] They concluded that ChIs are effective in the treatment of cognitive impairment in patients with PD. We concur with the authors' nuanced conclusion in...

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  • Comments on "Meta-analysis of modifiable risk factors for Alzheimer's disease"
    Yu-Tzu Wu

    The meta-analysis by Xu et al., (2015)[1] reviews over 300 papers and identified 93 modifiable risk factors for Alzheimer's disease. Among these risk factors, population attributable risks (PAR) of nine important factors were estimated to contribute to up to 66% of Alzheimer's disease cases globally. We acknowledge the great effort of this massive review but there are some substantial analytical issues which should be highl...

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  • Treatment of neuropsychiatric syndromes in Alzheimer's disease (AD): In search of evidence?
    Amir A. Sepehry

    We read with interest the recent systematic review and meta-analysis, "Pharmacological treat-ment of neuropsychiatric symptoms in Alzheimer's disease"(1). By examining the evidence for treating heterogeneous range of neuropsychiatric syndromes in persons with Alzheimer's disease (AD), this study found favorable results for the use of cholinesterase inhibitors (ChEIs) and atyp-ical antipsychotics albeit with risk of side ef...

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  • Hazards of formaldehyde in the workplace.
    Irene Campbell-Taylor

    The article by Roberts and colleagues on formaldehyde and ALS, is important for its contribution to job related hazards of formaldehyde exposure. One occupation that would be interesting to examine, is wood working/carpentry using mainly plywood. At the core of its manufacture, is formaldehyde. Plywood for indoor use generally uses urea-formaldehyde glue, which has limited water resistance, while outdoor and marine-grade...

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  • Paralympics and Conversion Disorder - "secondary gain" should not be a reason for exclusion
    Jon Stone

    Anthony David's article on Paralympics and conversion disorder opens an important and useful debate about the legitimacy of physical disability when related to a functional (psychogenic) disorder and the extent to which patients with these disorders should have access to the normal rights of a disabled person(3). If functional disorders, and to be clear we are talking here specifically about functional limb weakness, are...

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  • HIV and lower risk of multiple sclerosis: protective or subjugating effect?
    Tatiana Koudriavtseva

    Dear Sirs, Gold and colleagues recently found a significantly decreased risk of developing multiple sclerosis (MS) after the onset of HIV infection in a large cohort of national linked data set of English Hospital Episode Statistics.(1) The possible causes of this negative association have been hypothesized to be immunodeficiency and antiretroviral treatment (ART) as MS is usually treated with immunosuppressive drugs and...

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  • The strange case of bilirubin in Parkinson's disease
    Paolo Barone

    Hatano and colleagues recently published a paper of considerable interest, investigating possible metabolic pathways associated with Parkinson's disease (PD) by using metabolomic technologies [1]. Their results on redox homeostasis deserve to be further discussed, since oxidative stress is possibly involved in PD risk and progression. In particular, authors found bilirubin, a strong natural antioxidant, to be significan...

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  • Role of advanced MR techniques such as Diffusion Tensor Imaging in Leber's hereditary optic neuropathy and Multiple Sclerosis
    Deepa Anand

    As a research intern aspiring to be a neurologist, I found Dr. Mathew et al. article highly interesting and thought provoking [1]. Multiple sclerosis is a complex neurological condition to manage, given its numerous phenotypes.

    It was very interesting to note that the authors found similar imaging features on conventional MR brain scan in patients with multiple sclerosis (MS)-like disease in association with LH...

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  • Re:New Insights on AD: Comment on The identification of cognitive subtypes in Alzheimer's disease dementia using latent class analysis
    Nienke M.E. Scheltens

    Thank you for your enthusiasm for our study, and for your questions.

    In our opinion, an extensive neuropsychological test battery is mandatory for diagnosis of probable AD dementia. An MMSE score alone is not sufficient for the assessment of cognitive impairment.

    We used MMSE as indicator for disease severity, within our sample of already diagnosed probable AD patients. It is an interesting suggestion t...

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  • Pathogenesis of anti-contactin-1 associated paranodopathy
    Kathrin Doppler

    We thank Drs. Yuki and Wong for their interest in our paper. We agree that the finding that anti-CNTN1 autoantibodies in patients are mostly of the IgG4 subtype is important for our understanding of the pathophysiology of anti-CNTN1-associated neuropathy. However, in the study by Miura as well as in our study, IgG2 and IgG3 autoantibodies were detected in some patients (1, 2). The two patients from our study with predomina...

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