eLetters

616 e-Letters

  • Sufficient power to detect a slight effect?
    Bernhard J Connemann

    Dear Editor

    The report by Hausmann et al.[1] adds to negative experiences with rTMS as an add-on strategy in patients with major depression.[2] However, again, the evidence is not completely convincing. In this study, only "slight" effects were expected, but the sample size did not appear to account for that. 25 vs. 13 patients may not suffice to detect - and even less to refute - slight effects.

    Thi...

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  • On the non-specific link between migraine and depression
    Vinod K Gupta

    Dear Editor

    Williams and colleagues underscore the non-specific relationship between depression and pain in patients seen early at neurology clinics in wide range of unconnected disorders; patients with primary headaches constituted a substantial cohort in this study.[1] This clinical study makes an important contribution to maintain perspective in primary headache research.

    Several epidemiological studies...

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  • Passive Vasodilation and Cerebral Blood Flow
    Michael L. Daley

    Dear Editor

    The authors' proposed physiological models of the relationship between arterial blood pressure (ABP) and cerebral blood flow (CBF) illustrated in Figures 1 and 2 are not entirely correct. In particular, as depicted in each figure the apparent average radius of the vascular bed and CBF appear to increase linearly with ABP during passive vasodilation. Since flow is laminar and vascular resistance is i...

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  • Concerns on fibromuscular dysplasia endovascular treatment
    Jose E Cohen

    Dear Editor

    I have read with interest the article written by Finsterer et al. However, I do have several concerns and remarks in relation to it.

    First, the authors describe a stenotic lesion at the L-ICA that I do not actually see in the diagnostic angiogram. Moreover, this lesion was treated wih a stent-graft. Second, the image of the R-ICA corresponds to a classic carotid artery dissection, probabl...

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  • Response to Dr Levyman
    Phillip A Low

    Dear Editor

    We thank Dr Celio Levyman for his supportive comments.[1]

    We fully agree with him that, in patients with baroreflex failure, it is necessary to adopt approaches to combat orthostatic hypotension without increasing supine hypertension. It is also important to follow up an open study with a blinded study. We expect to complete, within the next month, a double- blind placebo controlled study, funded by...

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  • A new light to orthostatyc hypotension
    Celio Levyman MD ScM

    Dear Editor

    The issue of orthostatic hypotension is a very common an important diseable picture of many diseases, as Singer et al. points. Parkinson disease and diabetic neuropathy are the most common clinical situation of these cases, and even the very well controlled patient, with tilt-test table measures to the choice of therapeutic strategies in most cases shows frustanting results.

    This novel...

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  • Does MS-related plasma beta-endorphin vary in circadian manner?
    J. Christopher Sullivan

    Dear Editor

    As it is well known, endorphin levels change in different circumstances, for example, in injury, illness, or as a result of circadian influences, among others.[1-7] It would be helpful to know which was the primary stimulus for endorphin level changes in MS patients. Perhaps a further experiment can show that it is or is not circadian.

    References

    (1) Covelli V, Massari F, Falla...

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  • Authors' response to Gupta
    Massimo Filippi

    Dear Editor

    We read with interest the letter by Dr Gupta on our paper entitled “A diffusion tensor magnetic resonance imaging study of brain tissue from patients with migraine”.[1] Nevertheless, we believe that he missed the main result of this study as well as the scope for which it was designed and conducted. The aim of this study was to investigate whether occult’ tissue damage, which goes undetected when usin...

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  • Diffusion tensor magnetic resonance imaging in migraine: clinical perspective.
    Vinod K Gupta

    Dear Editor

    Rocca and colleagues, using diffusion tensor magnetic resonance imaging (DT-MRI) found white matter abnormalities in normal appearing brain tissue occult to conventional MRI.[1] As these authors underscore, the nature of such abnormalities remain obscure and are unlikely to ever be resolved by histopathological studies. The biological significance of these subtle white matter abnormalities, nevertheless, w...

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  • Immune vasculopathy mediated neural damage in diabetes: link to occult sarcoidosis?
    Vinod K Gupta

    Dear Editor

    Kelkar and Parry [1] regard perivascular inflammatory infiltrates as indicative of an immune microvasculitis that contributes to nerve damage in diabetes mellitus (DM), in particular mononeuritis multiplex. These authors believe that the variable therapeutic responses to corticosteroids alone or in combination with chlorambucil that they observed support the concept of immunopathogenesis of neural damage...

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