Abstract:
BACKGROUND:Given that vagal afferents project to brainstem regions that promote alertness, the authors tested the hypothesis that vagus nerve stimulation (VNS) would improve daytime sleepiness in patients with epilepsy. METHODS:Sixteen subjects with medically refractory seizures underwent polysomnography and multiple sleep latency tests (MSLT) and completed the Epworth Sleepiness Scale (ESS), a measure of subjective daytime sleepiness, before and after 3 months of VNS. Most subjects (>80%) were maintained on constant doses of antiepileptic medications. RESULTS:In the 15 subjects who completed baseline and treatment MSLT, the mean sleep latency (MSL) improved from 6.4 +/- 4.1 minutes to 9.8 +/- 5.8 minutes (+/- SD; p = 0.033), indicating reduced daytime sleepiness. All subjects with stimulus intensities of < or =1.5 mA showed improved MSL. In the 16 subjects who completed baseline and treatment ESS, the mean ESS score decreased from 7.2 +/- 4.4 to 5.6 +/- 4.5 points (p = 0.049). Improvements in MSLT and ESS were not correlated with reduction in seizure frequency. Sleep-onset REM periods occurred more frequently in treatment naps as compared to baseline naps (p < 0.008; Cochran-Mantel-Haenszel test). The amount of REM sleep or other sleep stages recorded on overnight polysomnography did not change with VNS treatment. CONCLUSIONS:Treatment with VNS at low stimulus intensities improves daytime sleepiness, even in subjects without reductions in seizure frequency. Daytime REM sleep is enhanced with VNS. These findings support the role of VNS in activating cholinergic and other brain regions that promote alertness.
journal_name
Neurologyjournal_title
Neurologyauthors
Malow BA,Edwards J,Marzec M,Sagher O,Ross D,Fromes Gdoi
10.1212/wnl.57.5.879subject
Has Abstractpub_date
2001-09-11 00:00:00pages
879-84issue
5eissn
0028-3878issn
1526-632Xjournal_volume
57pub_type
杂志文章相关文献
NEUROLOGY文献大全abstract:OBJECTIVES:To test the hypothesis that neuropsychiatric symptomatology is predictive of the success of seizure control in patients newly treated with antiepileptic drugs (AEDs), and that this predictive value adds to that provided by other clinical, imaging, and genomic factors in a multivariate model. METHODS:One hun...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3181f25b16
更新日期:2010-09-14 00:00:00
abstract::A case-control study was conducted on 64 cases of "probable Alzheimer's disease" with late onset of illness (after age 70 years) and 64 controls matched by age (+/- 3 years), race, and sex. Information was obtained on birth order, lifetime medical and surgical history, personal characteristics, exposure to toxins and ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.37.8.1295
更新日期:1987-08-01 00:00:00
abstract:OBJECTIVES:To establish the role of high-resolution CT imaging and tests of vestibulocollic reflexes in diagnosing and understanding the pathogenesis of the Tullio phenomenon. BACKGROUND:The Tullio phenomenon is a syndrome in which acoustic stimulation produces symptoms and signs of vestibular activation. It has previ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.54.3.722
更新日期:2000-02-08 00:00:00
abstract:OBJECTIVE:To determine whether the CT angiography (CTA) spot sign marks bleeding complications during and after surgery for spontaneous intracerebral hemorrhage (ICH). METHODS:In a 2-center study of consecutive spontaneous ICH patients who underwent CTA followed by surgical hematoma evacuation, 2 experienced readers (...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/WNL.0000000000000747
更新日期:2014-09-02 00:00:00
abstract:OBJECTIVE:To investigate botulinum toxin (BTX) effects on central and peripheral motor excitability in writer's cramp. METHODS:Using transcranial magnetic stimulation over the motor cortex and brainstem and peripheral electrical stimulation, the authors investigated measures of motor cortical and peripheral motor exci...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000095965.36574.0f
更新日期:2003-12-09 00:00:00
abstract::We studied the interrater variability among three neurologists of the diagnosis of a seizure in 100 patients evaluated for a possible "first seizure." We found that use of simple descriptive diagnostic criteria and discussion among the neurologists themselves improved the diagnostic agreement. ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.39.2.267
更新日期:1989-02-01 00:00:00
abstract::The most consistent electroencephalographic finding in 16 cases of Sturge-Weber syndrome was a unilateral reduction of background amplitude in the waking record. Comparable asymmetries were noted in those patients in whom sleep recording also was done. Physiologic responses (to hyperventilation and photic driving) usu...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.26.7.629
更新日期:1976-07-01 00:00:00
abstract:OBJECTIVE:To analyze the relationship between retinal thinning and nigral dopaminergic loss in de novo Parkinson disease (PD). METHODS:Forty-nine patients with PD and 54 age-matched controls were analyzed. Ophthalmologic examination and macula optical coherence tomography scans were performed with additional microperi...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000006157
更新日期:2018-09-11 00:00:00
abstract:OBJECTIVE:To investigate the presenting characteristics of new-onset afebrile seizures in infants (age 1-24 months) and the yield of neuroimaging. METHODS:Prospective data were obtained from a standardized evaluation and management plan mandated by a critical care pathway. A total of 317 infants presented with new-ons...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3181c91847
更新日期:2010-01-12 00:00:00
abstract:OBJECTIVE:As ALS progresses, extensive supportive care is required, including multidisciplinary outpatient care and hospitalization. The authors studied the causes, health care utilization, and outcomes for hospitalized patients with ALS. METHODS:With use of the 1996 Nationwide Inpatient Sample, an administrative data...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.56.6.753
更新日期:2001-03-27 00:00:00
abstract::Serum ratios of monoclonal immunoglobulin (Ig) to total protein, monoclonal immunoglobulin to albumin, CSF/serum Ig-albumin index, and CSF to serum monoclonal immunoglobulin were obtained in 21 patients with multiple myeloma and 2 with Waldenström's macroglobulinemia. Twelve patients (3 with CNS complications) showed ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.33.11.1411
更新日期:1983-11-01 00:00:00
abstract::Tolcapone is a potent, reversible inhibitor of catechol O-methyltransferase (COMT) intended for use as an adjunct to levodopa therapy for Parkinson's disease (PD). Findings from the first pharmacokinetics/pharmacodynamics and tolerability studies of tolcapone in volunteers are reviewed. Following linear and dose-propo...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.50.5_suppl_5.s31
更新日期:1998-05-01 00:00:00
abstract::Because hereditary hyperekplexia results from a defect in the glycine receptor, we studied in five patients several spinal inhibitory pathways that are thought to use either glycine or gamma-aminobutyric acid as a neurotransmitter. Three patients had a mutation in the alpha1 subunit of the glycine receptor, whereas tw...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.46.3.766
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To determine the diagnostic accuracy of confrontation visual field testing and to compare the accuracy of confrontation tests both individually and in combination. METHODS:Patients were prospectively recruited from ophthalmology clinics over a 6-month period. All patients underwent SITA-standard 24-2 Humphre...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3181d90017
更新日期:2010-04-13 00:00:00
abstract:OBJECTIVE:We performed propensity score (PS) models to compare the outcome of patients with myasthenia gravis (MG) submitted to 2 different surgical approaches: extended transsternal (T-3b) or thoracoscopic extended thymectomy (VATET). METHODS:Patients' clinical data were retrieved from the MG database of the C. Besta...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000004082
更新日期:2017-07-11 00:00:00
abstract:OBJECTIVES:To examine whether preadmission use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) influenced 30-day stroke mortality. METHODS:We conducted a nationwide population-based cohort study. Using medical databases, we identified all first-time stroke hospitalizations in Denmark between 2004 and 2012 ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000001024
更新日期:2014-11-25 00:00:00
abstract::Retarded mental and motor development was observed during the first year of life of a full-term female who had been delivered with difficulty. Generalized psychomotor seizures and dysplastic "acromegalic" facial changes began to develop when she was 8 years old, and generalized amyotrophy developed over the next sever...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.26.9.869
更新日期:1976-09-01 00:00:00
abstract:OBJECTIVE:To visualize the sites involved in audiovestibular dysfunction during bacterial meningitis in adults and to relate these findings to the extent of hearing impairment and vestibular dysfunction. BACKGROUND:Hearing impairment is among the most frequent complications of bacterial meningitis. METHODS:High-resol...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.52.5.1003
更新日期:1999-03-23 00:00:00
abstract::Several drugs that inhibit the effects of serotonin may reduce or prevent experimental CNS ischemic damage, but these drugs are not approved for human use in the United States. Administration of cyproheptadine (which is available for clinical use) 15 minutes before or 5 minutes after the onset increased the duration o...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.35.4.584
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:To study and provide an update on the state of clinical research in neurology in the United States. METHODS:US American Academy of Neurology members and chairs of departments of neurology were surveyed regarding clinical research in 2016. NIH data on the neuroscience pipeline and extramural grant funding wer...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000005295
更新日期:2018-04-10 00:00:00
abstract::The extracranial carotid systems of 105 patients with retinal ischemia were examined using B-mode ultrasonography with integrated pulsed Doppler. Sixty-four patients had amaurosis fugax (AF), 17 central retinal artery occlusions (CRAO), and 21 branch retinal artery occlusions (BRAO). The prevalence of carotid stenosis...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.38.6.858
更新日期:1988-06-01 00:00:00
abstract::We performed a retrospective study on a series of 119 of our patients who have Friedreich's disease to assess the predictive value of age at onset, gender, and left ventricular hypertrophy in regard to disease progression. Outcome variables were survival, time to loss of independent gait, and time to confinement in a ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.47.5.1260
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Cerebral infarctions are common in older persons but their relationship with dementia and cognitive function remains controversial. METHODS:Participants were 164 older Catholic nuns, priests, and brothers who underwent annual clinical evaluation and brain autopsy at death. The authors quantified number and ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000055863.87435.b2
更新日期:2003-04-08 00:00:00
abstract::Increased urinary levels of the polyamines, putrescine, spermidine, and spermine are present in Duchenne muscular dystrophy (DMD) patients. Alterations in excretion are detectable when based on nanomoles per milligram creatinine, micromoles per 24-hour urine collection, or nanomoles per kilogram body weight per 24-hou...
journal_title:Neurology
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Antiretroviral therapy has improved survival for HIV-1-infected individuals. The neuroepidemiologic implications of HIV-1 in an aging population are not well known, particularly the prevalence of HIV-associated dementia (HAD). METHODS:The authors report a baseline cross-sectional analysis of 202 HIV-1-serop...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000134665.58343.8d
更新日期:2004-09-14 00:00:00
abstract::Acute global aphasia without hemiparesis has been considered pathognomonic of embolic stroke. During 1 year, we encountered six patients with this syndrome. Two had multiple strokes, probably embolic. One had atrial fibrillation; at autopsy, there were metastases as well as multiple infarcts in the left hemisphere. On...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.37.2.201
更新日期:1987-02-01 00:00:00
abstract::Manipulation of afferent inputs may temporarily modulate dystonic spasms. Ten patients with writer's cramp were enrolled in a double-blind, randomized, crossover study in which the effects of transcutaneous electrical stimulation (TENS) and placebo treatment were compared. Patients were evaluated using four measures o...
journal_title:Neurology
pub_type: 杂志文章,随机对照试验
doi:10.1212/01.WNL.0000163851.70927.7E
更新日期:2005-06-14 00:00:00
abstract::The authors describe a patient with bilateral papilledema, visual field abnormalities, poorly reactive pupils, meningeal enhancement on cranial MRI, and diffuse brain parenchymal hypervascularity. The opening pressure at the time of lumbar puncture was normal, and results of other CSF studies were normal. All abnormal...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.53.9.2204
更新日期:1999-12-10 00:00:00
abstract:BACKGROUND:Clinical trials involving patients with glioblastoma (GBM) distinguish cohorts who are treated with enzyme-inducing anticonvulsants (EIAC). Such anticonvulsants induce hepatic P450 microsomal enzymes, which accelerate the metabolism of certain chemotherapy and molecular targeted agents. However, the resultan...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3181bbfeca
更新日期:2009-10-13 00:00:00
abstract:BACKGROUND:Oculopharyngodistal myopathy (OPDM) has been reported as a rare, adult-onset hereditary muscle disease with putative autosomal dominant and autosomal recessive inheritance. Patients with OPDM present with progressive ocular, pharyngeal, and distal limb muscle involvement. The genetic defect causing OPDM has ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e318207b043
更新日期:2011-01-18 00:00:00