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Ciclosporin A alone or in combination with intermittent prednisone does not improve muscle strength or functional abilities in ambulant boys with Duchenne muscular dystrophy, but is safe and well tolerated.
The Lancet Neurology - Mon, 25 October 2010
http://www.thelancet.com/journals/laneur
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Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterised by progressive paralysis and death from respiratory failure, typically within 3 years of symptom onset. The cause of the disease is not well understood, but genetic factors are thought to have an important role in its pathogenesis. Genome-wide association studies (GWAS) have failed to identify a single locus that clearly achieves significance after Bonferroni correction for multiple testing and that is successfully replicated in independent cohorts, probably because of the genetic and allelic heterogeneity associated with the disease. One approach to increase power to find a genetic locus when there is such heterogeneity is to target isolated populations, in which the genetic background is more homogeneous.
The Lancet Neurology - Tue, 5 October 2010
http://www.thelancet.com/journals/laneur
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Epidemiological studies suggest that raised plasma concentrations of total homocysteine might be a risk factor for major vascular events. Whether lowering total homocysteine with B vitamins prevents major vascular events in patients with previous stroke or transient ischaemic attack is unknown. We aimed to assess whether the addition of once-daily supplements of B vitamins to usual medical care would lower total homocysteine and reduce the combined incidence of non-fatal stroke, non-fatal myocardial infarction, and death attributable to vascular causes in patients with recent stroke or transient ischaemic attack of the brain or eye.
The Lancet Neurology - Thu, 23 September 2010
http://www.thelancet.com/journals/laneur
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Idiopathic Parkinson's disease can present with symptoms similar to those of multiple system atrophy or progressive supranuclear palsy. We aimed to assess whether metabolic brain imaging combined with spatial covariance analysis could accurately discriminate patients with parkinsonism who had different underlying disorders.
The Lancet Neurology - Fri, 22 January 2010
http://www.thelancet.com/journals/laneur
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Optimum management of Duchenne muscular dystrophy (DMD) requires a multidisciplinary approach that focuses on anticipatory and preventive measures as well as active interventions to address the primary and secondary aspects of the disorder. Implementing comprehensive management strategies can favourably alter the natural history of the disease and improve function, quality of life, and longevity. Standardised care can also facilitate planning for multicentre trials and help with the identification of areas in which care can be improved. Here, we present a comprehensive set of DMD care recommendations for management of rehabilitation, orthopaedic, respiratory, cardiovascular, gastroenterology/nutrition, and pain issues, as well as general surgical and emergency-room precautions. Together with part 1 of this Review, which focuses on diagnosis, pharmacological treatment, and psychosocial care, these recommendations allow diagnosis and management to occur in a coordinated multidisciplinary fashion.
The Lancet Neurology - Fri, 22 January 2010
http://www.thelancet.com/journals/laneur
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Moderate hypothermia in neonates with hypoxic–ischaemic encephalopathy might improve survival and neurological outcomes at up to 18 months of age, although complete neurological assessment at this age is difficult. To ascertain more precisely the effect of therapeutic hypothermia on neonatal cerebral injury, we assessed cerebral lesions on MRI scans of infants who participated in the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) trial.
The Lancet Neurology - Fri, 15 January 2010
http://www.thelancet.com/journals/laneur
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Many patients with Parkinson's disease are treated with physiotherapy. We have developed a community-based professional network (ParkinsonNet) that involves training of a selected number of expert physiotherapists to work according to evidence-based recommendations, and structured referrals to these trained physiotherapists to increase the numbers of patients they treat. We aimed to assess the efficacy of this approach for improving health-care outcomes.
The Lancet Neurology - Thu, 7 January 2010
http://www.thelancet.com/journals/laneur
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For childhood-onset arterial ischaemic stroke (AIS), treatment trials are lacking and practices vary from country to country and centre to centre. We aimed to describe frequencies and predictors of acute treatments and early outcomes in the International Pediatric Stroke Study (IPSS), a large international series of childhood AIS.
The Lancet Neurology - Fri, 13 November 2009
http://www.thelancet.com/journals/laneur
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Cerebral palsy (CP) with dystonia-choreoathetosis is a common cause of disability in children and in adults, and responds poorly to medical treatment. Bilateral pallidal deep brain stimulation (BP-DBS) of the globus pallidus internus (GPi) is an effective treatment for primary dystonia, but the effect of this reversible surgical procedure on dystonia-choreoathetosis CP, which is a subtype of secondary dystonia, is unknown. Our aim was to test the effectiveness of BP-DBS in adults with dystonia-choreoathetosis CP.
The Lancet Neurology - Mon, 20 July 2009
http://www.thelancet.com/journals/laneur
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Treatment strategies for acute basilar artery occlusion (BAO) are based on case series and data that have been extrapolated from stroke intervention trials in other cerebrovascular territories, and information on the efficacy of different treatments in unselected patients with BAO is scarce. We therefore assessed outcomes and differences in treatment response after BAO.
The Lancet Neurology - Mon, 20 July 2009
http://www.thelancet.com/journals/laneur