638 e-Letters

  • DAT-SPECT. All that glitters is not gold.
    Paul K Morrish

    Kagi and colleagues (1) provide a review but not a critique of a controversial technique. For a technique to have diagnostic utility it needs sensitivity to the disease and reproducibility; DAT-SPECT unfortunately falls down on each. The review describes the test as around 100% sensitive as a diagnostic tool in detecting PD. The authors conclude that the normal scans in 5-15% of patients with de-novo PD are normal becau...

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  • Thiamine compounds in humans
    Marco Poloni

    I have some comments concerning the report by S. Jesse, D.R. Thal and A.C. Ludolph, recently published in JNNP September 15 2015, pag. 1166-1168 "Thiamine deficiency in Amyotrophic Lateral Sclerosis". In a research dated 1981 Rindi et al. showed that in 12 CSF samples obtained from different healthy subjects, without any clinical disorder involving thiamin status, the only thiamin compounds detected after electrophoretic...

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    Khichar Shubhakaran


    OLD IS STILL GOOD IF NOT GOLD The review article on use of aspirin for acute migraine headaches in adults and an editorial on the same is worth appreciation and is an excellent documentations, specially for poor patients of third world countries. Of course the authors have revised and given the message through an esteemed journal to the neurologists in particular...

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  • Re:DAT-SPECT. All that glitters is not gold.
    Eduardo Tolosa
    We wish to thank Dr. Morrish for his comments to our review. He argues in his letter that for diagnostic purposes a technique needs to be sensitive to the disease and reproducible and that DAT-SPECT unfortunately falls down on each. Sensitivity is poor, he says, since DAT-SPECT imaging has been found to be normal in about 5 to 15% of individuals with parkinsonism. Such individuals ( SWEDDs ("scans without evidence of dopaminergic...
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  • "Correction to odds ratio"
    Alessandra Solari

    I enjoyed reading the paper of Sascha Kopke et al. [1] on the efficacy of an evidence-based information program for people with recently diagnosed multiple sclerosis. I noticed, however that the odds ratio (OR) for the primary endpoint (achieving 'informed choice') is incorrect, both in the Abstract and in the Results.

    Abstract: 'For the primary endpoint, a significant difference was shown with 50 of 85 (59%) pa...

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  • The role of dopamine transporter single photon emission CT (DaT-SPECT) in the diagnosis of drug-induced Parkinsonism.
    John J McKinley

    I would like to commend the authors on this informative review on the utility of dopamine transporter SPECT in the diagnostic workup of Parkinsonian syndromes. I acknowledge that this review is set in the context of the labelled indications for DaTSCAN as outlined by the EMA and FDA however from a pragmatic perspective I would like to highlight the utility of dopamine transporter SPECT in differentiating drug-induced Par...

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  • Re:Metabolic syndrome and the dementias: a link between Alzheimer disease and vascular dementia?
    Vincenzo Solfrizzi

    Metabolic Syndrome and Alzheimer's Disease: Contrasting Epidemiological Evidence and Possible Underlying Mechanisms

    We thank Giannopoulos and colleagues for their interesting Letter. At present, cumulative evidence suggested that metabolic syndrome (MetS), a constellation of interrelated metabolic derangements increasing the risk of cerebrovascular disease (CVD) and diabetes, has been shown to be in...

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  • Re:"Correction to odds ratio"
    Sascha K?pke

    Dear Editor,

    We thank Dr. Solari for pointing out an aspect of possible misunderstanding, but surely not incorrectness. We agree that the reverse odds ratio of 5.63 (95% CI 2.87 to 11.05, p<0.001) would more clearly refer to the odds of achieving informed choice. Still the reported odds ratio of 0.18 (95% CI 0.09 to 0.35, p<0.001) gives exactly the same information and is probably more intuitively underst...

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  • Re:Protocol violations and conclusions
    Felix Rosenow

    We would like to thank Mr Rajendran his detailed and elaborate comment regarding our trial on the initial monotherapy of epilepsy with levetiracetam or lamotrigine (Rosenow et al JNNP 2012) . It is always a good sign when a clinical study finds the interest not only of those already actively contributing to a field of research but also of junior colleagues which have not previously published in the area of clinical epil...

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  • Re:Transcranial magnetic stimulation is a useful diagnostic test in psychogenic paralysis
    Ruth Geraldes

    I thank Dr. Civardi and his group, who have demonstrated a large experience with the practical use of Motor Evoked Potentials, for their interest in our article describing a patient with presumed psychogenic left hemiparalysis and abnormal transcranial magnetic stimulation (TMS) (1). Our initial aim in performing TMS to our patient was exactly to prove that MEPs were normal, as suggested by other authors (including Dr. C...

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