96 e-Letters

published between 2011 and 2014

  • Response to "Incident dementia and cognitive decline in patients with stroke/TIA" by Professor Tomoyuki Kawada
    Perminder Sachdev

    Professor Kawada expresses three concerns regarding the outcomes of our study into how cognitive deficits progress in the years following a stroke [1]. Firstly, he cites Rajan et al. [2] as finding that cognitive decline was greater after stroke than before stroke, and suggests that our study should have considered pre-stroke cognitive decline. How doing so would have affected our outcomes or their interpretation is uncle...

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  • Incident dementia and cognitive decline in patients with stroke/TIA
    Tomoyuki Kawada

    Sachdev et al. conducted a 3-year follow-up study to know the progress of cognitive deficits after stroke or transient ischemic attack (TIA) (1). The authors gathered 183 stroke/TIA patients and 97 healthy controls, and concluded that cognitive decline in post-stroke patients was not greater than in controls, except for verbal memory, although rates of incident dementia were 5.9% per year in patients and 0.4% in controls,...

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  • Rapid cognitive decline in attention, executive function and memory: the gold standard for delirium?
    Paul J Regal

    I endorse the authors' use of multiple information sources to identify prevalent delirium in medical and surgical inpatients 1-2: family and other informants, junior and senior physicians, medical case notes and nurses. Although the authors did not use the model I developed, I suggest that their paper is about distinguishing rapid cognitive decline (RCD, one form being delirium) from slow cognitive decline (SCD) in dementia...

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  • Control arms in brain stimulation trials and experiments
    Nick J. Davis

    The JNNP recently published an interesting study which used magnetic stimulation to the spine of people with Parkinson's disease, and showed a promising improvement in camptocormia compared to a group receiving 'sham' stimulation [1]. In an Editorial Comment, Caslake [2] argued that the participants in this particular study may not have been sufficiently blinded as to the group to which they had been assigned. Although th...

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  • Reply to Letter: Which target is best for patients with Parkinson's disease? A meta-analysis of pallidal and subthalamic stimulation
    Wataru Sako

    We are pleased that Dr. Cyron agrees with our statement. Although our meta-analysis revealed that depression was more frequent in STN DBS relative to GPi DBS, additional randomized trials which investigate long- term outcome including UPDRS, quality of life and adverse events are required to determine which target is more appropriate for patients with PD. We hope our findings and suggestions would be useful for future stu...

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  • STN revisted
    Donatus Cyron

    This is a timely contribution to an issue overdue. STN-stimulation has been the undisputed mainstay of DBS for Pakinson's disease more than a decade. Reports on deleterious side effects mainly in the field of cognition and emotion however accumulate. While the rather subtle effects on cognitive abilities have been the subject of a plethora of publications, changes in personality and behavior remain underreported. Yet it...

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  • Temozolomide for seizure control in low-grade gliomas: role of malignant degeneration
    Wang-Ming Zhang

    We were particularly appreciated the paper by Koekkoek and colleagues1 on temozolomide (TMZ) and seizure frequency after low-grade gliomas (LGG) in a retrospective study. Interestingly, seizure frequency in patients with LGG was remarkably reduced after 6-month TMZ therapy, which was also "an independent prognostic factor for progression-free survival and overall survival",1 indicating associations between seizure reduc...

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  • Serial electrophysiology in Guillain-Barre syndrome: how crucial and of how much clinical relevance?
    Yusuf A Rajabally

    We thank Kokubun et al. [1], for their interest in our study. First, as we stated in our paper [2], our new proposed criteria provided, with a single study, globally, similar proportions and diagnostic shifts, to those found with older criteria and serial studies [3, 4]. There could be no indication from our study that in each and every single individual patient, similar diagnoses would be reached.

    Uncini et a...

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  • Appropriate baseline setting for the evaluation of treatment
    Tomoyuki Kawada

    Troussiere et al. conducted an interesting survey to prevent the progress of Alzheimer's disease in patients with sleep apnoea syndrome (SAS) by continuous positive airway pressure (CPAP) therapy (1). I fundamentally agree with their study outcome. I have a query on the setting of CPAP and non-CPAP groups.

    The cut-off point of 23 for Mini Mental State Examination (MMSE) is widely accepted. The authors mentioned...

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  • CT-negative, lumbar puncture-positive and CTA-negative patients have a low risk of aneurysms.
    Arnab K. Rana

    Dear Editor,

    We are grateful to Bakker et al. for their prospective study in this area.[1]

    Two months prior to this, we published on the topic of CT-negative, lumbar puncture-positive and CT-angiography (CTA) negative patients.[2] Such patients had been reported in 98 published cases. No causative aneurysms were found in neither these nor in the 9 cases which we identified.

    Bakker et al rep...

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