Abstract:
PURPOSE OF REVIEW:This review aims to determine whether it is cost-effective to replace aspirin and warfarin with more effective, yet more costly, treatments for secondary stroke prevention. RECENT FINDINGS:For preventing recurrent stroke of arterial origin, clopidogrel and the combination of aspirin and extended-release dipyridamole are equally effective and more effective than aspirin. However, limited data only support their incremental cost-effectiveness, compared with aspirin, in nondisabled patients at high risk of a recurrent ischaemic event (e.g. >20% per year) and when used for short periods (e.g. <2 years). Clopidogrel is also cost-effective for patients who are intolerant of aspirin. For preventing recurrent stroke due to atrial fibrillation, warfarin is cost-effective. Although the combination of clopidogrel and aspirin is more effective than aspirin, it is unlikely to be more cost-effective. Dabigatran is at least as effective and well tolerated as warfarin, but its eventual cost will determine its incremental cost-effectiveness. For atrial fibrillation patients in whom anticoagulation is contraindicated, percutaneous closure of the left atrial appendage may be an alternative strategy. Dronedarone may prove to be a cost-effective adjunct to antithrombotic therapy in patients with atrial fibrillation. SUMMARY:The incremental cost-effectiveness of newer antithrombotic treatments for secondary stroke prevention, compared with aspirin or warfarin, remains to be established.
journal_name
Curr Opin Neuroljournal_title
Current opinion in neurologyauthors
Hankey GJdoi
10.1097/WCO.0b013e328334e67bsubject
Has Abstractpub_date
2010-02-01 00:00:00pages
65-72issue
1eissn
1350-7540issn
1473-6551journal_volume
23pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:To summarize the currently known side effects of the approved therapies of multiple sclerosis and to suggest monitoring procedures. RECENT FINDINGS:The progress in the treatment of multiple sclerosis with new very effective therapies is accompanied by a number of side effects. Some of these have alre...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000824
更新日期:2020-06-01 00:00:00
abstract:PURPOSE OF REVIEW:This review highlights recent work using advanced imaging approaches that have improved our understanding of the underlying neural mechanisms associated with disrupted brain development or demonstrated the potential of MRI to provide objective biomarkers of cerebral injury that relate to subsequent ne...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000073
更新日期:2014-04-01 00:00:00
abstract::Primary germ-cell tumors of the central nervous system are rare neoplasms that are seen primarily in the pediatric age group. Because of their frequent location in the pituitary and suprasellar regions, they present with typical neuro-ophthalmologic and neuroendocrine symptoms. Sophisticated imaging and surgical biops...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199912000-00006
更新日期:1999-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an update on the major advances in inflammatory myopathies. RECENT FINDINGS:Polymyositis is an uncommon disorder that can be misdiagnosed when the old, and never validated, criteria of Bohan and Peter are used. New diagnostic criteria were recently introduced, in which the MHC/CD8 complex ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200410000-00006
更新日期:2004-10-01 00:00:00
abstract::Recent positron emission tomography investigations found spreading oligemia in the early phases of a human migraine attack. During the headache phase, increased cerebral blood flow was found in cortical sensory association areas and unilaterally in the brainstem. The brainstem activation persisted after complete relie...
journal_title:Current opinion in neurology
pub_type: 社论,评审
doi:10.1097/00019052-199606000-00007
更新日期:1996-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Health-related quality of life is a new outcome variable in neurology. Several generic measures aim at assessing this variable in adults with neurological diseases. Disease-specific measures are still rare; however, individuals with neurological diseases frequently suffer from cognitive impairment, ye...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/01.wco.0000194140.56429.75
更新日期:2005-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize the application of advanced MRI sequences such as magnetic resonance spectroscopy, diffusion tensor imaging and functional MRI for the evaluation of patients with altered consciousness. RECENT FINDINGS:Magnetic resonance spectroscopy, volumetry and diffusion tensor imaging have shown pro...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e3282f169ec
更新日期:2007-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe the background, principles and implementation of the Stroke Action Plan for Europe 2018--2030 (SAP-E) in the perspective of the current COVID-19 pandemic. RECENT FINDINGS:SAP-E sets targets for the implementation of evidence-based preventive actions and stroke services to 2030. A recent m...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000893
更新日期:2021-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Although cluster headache has traditionally been thought of as a vascular headache disorder, its periodicity suggests an involvement of central areas such as the hypothalamus. This review covers the past 3 years, which have seen remarkable progress in understanding the pathophysiology of circadian hea...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/01.wco.0000073934.19076.0e
更新日期:2003-06-01 00:00:00
abstract:PURPOSE OF REVIEW:There is an urgent need for effective therapies to restore neurologic function and decrease disability following traumatic brain injury (TBI). Here, emerging findings on the mechanisms of post-TBI neural repair and regeneration, as well as therapeutic implications, are selectively reviewed. RECENT FI...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000265
更新日期:2015-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This review summarizes key findings of the current literature on functional neuroimaging in migraine and describes how these studies have changed our view of the disorder. RECENT FINDINGS:Recent studies have started not only to investigate the global cerebral activation pattern during migraine attack...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e3283532ca3
更新日期:2012-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Serum IgG autoantibodies against the myelin oligodendrocyte glycoprotein (MOG) are present in atypical demyelinating disorders such as neuromyelitis optica spectrum disorders (NMOSD) or acute disseminated encephalomyelitis. Whereas the role of aquaporin-4 antibodies as diagnostic markers for NMOSD is ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000446
更新日期:2017-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Prospective and retrospective incidence cohort studies have been consistent in identifying an increased mortality in patients with epilepsy, although risk ratios vary considerably. Standardized mortality ratios in these populations range from 1.6 to 5.3, but they tend to be higher in studies in select...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200404000-00010
更新日期:2004-04-01 00:00:00
abstract:PURPOSE OF REVIEW:For a long time, cognitive impairment in multiple sclerosis patients has been considered less important than, for instance, physical disability. This is no longer true because of the crucial role that cognitive deficits play in the good day-to-day adjustment of patients. This review highlights recent ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e32810c8e87
更新日期:2007-06-01 00:00:00
abstract::An increasing number of mutations in the CACNA1A gene have been identified, which are associated with a broad clinical spectrum, including familial hemiplegic migraine. Transfection studies and mouse model analyses are currently being undertaken to study the correlation between CACNA1A mutations and disease. ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200206000-00014
更新日期:2002-06-01 00:00:00
abstract::In multifocal motor or sensorimotor neuropathy with persistent conduction block, most of the recent research has concerned treatment. Open trials show that intravenous immunoglobulin is effective, providing a rapid and often marked clinical improvement, accompanied by a significant reduction of conduction block in som...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199510000-00006
更新日期:1995-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim is to systematically and critically review the relationship between migraine and estrogen, the predominant female sex hormone, with a focus on studies published in the last 18 months. RECENT FINDINGS:Recent functional MRI (fMRI) studies of the brain support the existence of anatomical and fun...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000091
更新日期:2014-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Stroke thrombolysis is in the process of moving from academic centers into community-based standard therapy in experienced centers. Recently published data on patient selection, imaging and other technical or organizational advances are reviewed in order to improve the safety and efficacy of stroke th...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/01.wco.0000053584.70044.65
更新日期:2003-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Severe childhood traumatic brain injury (TBI) is the leading cause of death and acquired disability in children, causing impairments in children's sensory-motor, cognitive and behavioural functioning, with devastating consequences on community integration. Community integration is the ultimate goal of...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e328340296f
更新日期:2010-12-01 00:00:00
abstract::The review intends to draw the attention of researchers working in retinal degenerations on the fact that classical apoptosis, for example, apoptosis triggering caspase activation, may not be the main pathway of cellular demise in this tissue.Former work already showed the difficulty of proving the activation of apopt...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000272
更新日期:2016-02-01 00:00:00
abstract::This paper reviews current knowledge about epileptogenesis in the developing brain. Animal studies indicate that the maturational balance of excitatory and inhibitory neurotransmitter systems should result in an increased susceptibility to seizures. However, the reason for specific age-locked syndromes and the high ra...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199804000-00006
更新日期:1998-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Cerebral amyloid angiopathy (CAA) is diagnosed primarily as a cause of lobar intracerebral hemorrhages (ICH) in elderly patients. With improving MRI techniques, however, the role of CAA in causing other symptoms has become clear. Recognizing the full clinical spectrum of CAA is important for diagnosis...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000510
更新日期:2018-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The demyelinating disease multiple sclerosis has an autoimmune inflammatory component, which has dominated the description of multiple sclerosis. A degenerative component to multiple sclerosis was always apparent, but was underappreciated until recently. Recent work has brought axonal pathology and br...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/01.wco.0000073925.19076.f2
更新日期:2003-06-01 00:00:00
abstract:PURPOSE OF REVIEW:In multiple sclerosis as the most common inflammatory demyelinating disease in Western countries, major therapeutic success has been achieved with regard to strategies targeting immunological master switches. These approaches effectively reduce inflammatory disease activity but fail to address ongoing...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000327
更新日期:2016-06-01 00:00:00
abstract:PURPOSE OF REVIEW:We present an overview of recent concepts in mechanisms underlying cognitive decline associated with brain aging and neurodegeneration from the perspective of MRI. RECENT FINDINGS:Recent findings challenge the established link between neuroimaging biomarkers of neurodegeneration and age-related or di...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000029
更新日期:2013-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronic and often disabling neuropathy, which often responds to immune therapies including corticosteroids, plasma exchange, and high-dose intravenous immunoglobulin (IVIg). The reasons for choosing one of these therapies and the fa...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000232
更新日期:2015-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Multiple sclerosis (MS) is an autoimmune and inflammatory disease of the central nervous system (CNS) that causes neurological disability in young adults and that to date has no cure. Until now, expensive and only partially efficacious therapies have become available. For this reason, researchers, cli...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e32833960f6
更新日期:2010-06-01 00:00:00
abstract::Continuing advances have rendered the neural control of eye movements one of the best understood motor systems, from molecules to complex behaviors. Nevertheless, new discoveries have required re-evaluation of established concepts, from the genetics of disorders that affect extraocular muscles to the way in which the ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200202000-00008
更新日期:2002-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The successful motor rehabilitation of stroke, traumatic brain-injured and spinal cord-injured patients requires an intensive and task-specific therapy approach. Budget constraints limit a hand-to-hand therapy approach, so that intelligent machines may offer a solution to promote motor recovery and ob...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/01.wco.0000102630.16692.38
更新日期:2003-12-01 00:00:00
abstract::This article reviews the current knowledge with regard to neurotoxicity of conventional radiation, including recent understanding of the pathophysiology, molecular biology, diagnostic evaluation and clinical presentations, as well as proposed treatment modalities and possible protective agents. ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200112000-00008
更新日期:2001-12-01 00:00:00