616 e-Letters

  • 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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  • A radiological curiosity of hyperammonaemia!
    Michael Kinney

    We would like to draw attention to one important point in regard to hyperammonaemic encephalopathy which was not mentioned in the recent excellent article by Sutter and Kaplan discussing the imaging features of encephalopathy.

    The cases of hyperammonaemic encephalopathy with neuroimaging features number less than 10 in the reported literature. As the authors stated they can develop cortical signal abnormalitie...

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  • New Insights on AD: Comment on The identification of cognitive subtypes in Alzheimer's disease dementia using latent class analysis
    Ashima Nehra

    We read with interest the recent article published by Scheltens et. al. [1] The article helped us in understanding greater insights about AD dementia. As rightly stated by the authors that one magic bullet will never be found, but different therapeutic agents may benefit different subgroups of patients. The identification and importance of cognitive AD subtypes for making differentiated diagnoses will also help in the fu...

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  • IgG subclass in combined central and peripheral demyelination associated with anti-neurofascin 155 antibodies
    Nobuhiro Yuki

    At paranodes of both central and peripheral nerves, neurofascin-155 (NF155) is expressed by the terminal loops of myelin and associates with the axonal cell adhesion molecules contactin-1 and contactin-associated protein-1. They are important in maintaining the integrity of axo-glial junction and forming barrier against lateral diffusion of nodal channels. Human IgG antibodies consist of four subclasses (IgG1-4) with dif...

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  • Sensory Ataxia and Anti-contactin-1 IgG4-Associated Paranodopathy
    Nobuhiro Yuki

    With interest, we read an excellent paper written by a German group, in which four patients with chronic inflammatory demyelinating polyneuropathy (CIDP) carried IgG autoantibodies against contactin-1 (CNTN1) expressed at the paranodes in the peripheral nerves.[1] Human IgG antibodies consist of four subclasses (IgG1-4) with different structural and functional characteristics. IgG4 are generally believed to be non- infla...

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