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Author(s): N. D. Schiff [1]; J. T. Giacino [2, 3]; K. Kalmar [2]; J. D. Victor [1]; K. Baker [4]; M. Gerber [2]; B. Fritz [2]; B. Eisenberg [2]; J. [...]

Arising from: N. D. Schiff et al. Nature 448, 600-603 (2007) Schiff et al. (1) show that deep-brain stimulation of the unspecific thalamocortical system through certain midline thalamic nuclei produces [...]

Nature 448, 600-603 (2007) In this Letter, Tracey Biondi was omitted from the author list. In addition, a sentence in the Author Contributions statement should be revised to read: 'M.G., [...]

Trautner C (Department of Biometrics and Epidemiology, Diabetes Research Institute at Heinrlch Heine University, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany), Icks A, Haastert B, Plum F, Berger M and Giani G. Diabetes as a predictor of mortality in a cohort of blind subjects.International Journal of Epidemiology 1996; 25: 1038–1043.Background There is only a little information about survival in newly registered blind subjects. Methods A closed cohort of blind subjects (n =2680, 1803 of them women), newly registered between 1990 and 1993 in the district of Württemberg-Hohenzollern, Germany, was observed for up to 48 months. Mortality was compared to that of the general population. Predictors of mortality within that cohort were identified by Cox proportional hazards regression analysis. Results Before 1 February 1994, 582 of the subjects had died. Diabetes had been diagnosed in 772 of the subjects, 226 of them died. The overall incidence rate of death was 12 179 per 100 000 per year. The probability of survival after 47 months was 0.64 (95% confidence interval (Cl) : 0.59–0.70) In the non-diabetic, and 0.48 (95% Cl : 0.37–0.55) in the diabetic subjects. Predictors of mortality in the regression model were age (risk ratio [RR] per year of age 1.047), sex (RR for men 1.247) and diabetes (RR when blindness was unrelated to diabetes: 1.448, RR when diabetes was the only cause of blindness: 2.253). Compared with the entire population, mortality was considerably increased in the blind cohort (comparative mortality figure [CMF] 4.79), particularly in individuals with diabetes (CMF = 6.55) The relative risks decreased wtth Increasing age. Conclusions Overall mortality in this cohort was high, even higher than in previous studies on the mortality of the blind. Diabetes increased the risk of death. In addition, the cause of blindness in diabetic individuals was a major predictor of mortality. [ABSTRACT FROM PUBLISHER]

The clinical utility of selected brief cognitive screening instruments in detecting dementia in an elderly nursing home population was examined. One hundred twenty nursing home residents (mean age 87.9) were administered the Mini-Mental State Exam (MMSE) and the Modified Mini-Mental State Exam (3MS). The majority of the subjects (75%) were also administered the Dementia Rating Scale (DRS). Both clinically diagnosed demented (n = 57) and non-demented (n = 63) subjects participated in the study. Dementia was diagnosed in accordance with DSM-III-R criteria by physicians specializing in geriatric medicine. Using standard cutoffs for impairment, the 3MS, MMSE, and DRS achieved high sensitivity (82% to 100%) but low specificity (33% to 52%) in the detection of dementia among nursing home residents. Positive predictive values ranged from 52% to 61%, and negative predictive values from 77% to 100%. Higher age, lower education, and history of depression were significantly associated with misclassification of non-demented elderly subjects. Receiver Operating Characteristic (ROC) curve analyses revealed optimal classification of dementia with cutoff values of 74 for the 3MS, 22 for the MMSE, and 110 for the DRS. The results suggest that the 3MS, MMSE, and DRS do not differ significantly with respect to classification accuracy of dementia in a nursing home population. Elderly individuals of advanced age (i.e., the oldest-old) with lower education and a history of depression appear at particular risk for dementia misclassification with these instruments. Revised cutoff values for impairment should be employed when these instruments are applied to elderly residents of nursing homes and the oldest-old. [ABSTRACT FROM AUTHOR]

Approximately 40% of gerbils subjected to one hour of unilateral carotid artery occlusion displayed neurological abnormalities during that time. Most such animals were subsequently found to have ischaemic neuronal alterations within the territory of the ipsilateral middle cerebral artery. In contrast, impaired reperfusion ('no-reflow') rarely occurred and cannot therefore be implicated in the pathogenesis of ischaemic brain damage. [ABSTRACT FROM AUTHOR]

We conducted serial neurologic examinations on 500 patients in nontraumatic coma to identify factors predicting recovery. Overall, 81 patients (16%) led an independent life at some point within the first year; the remainder either died without recovery from coma (61%), never improved beyond the vegetative state (12%), or regained consciousness but remained dependent on others for daily activities (11%). Functional recovery did not depend on age but was to some degree related to the cause of coma (subarachnoid hemorrhage and other cerebrovascular disease having the worst recovery; hypoxia-ischemia, intermediate; and hepatic and miscellaneous causes, best) and especially to early clinical signs of brain dysfunction. Even within hours of the onset of coma, only one of 120 patients lacking two of corneal, pupillary, and oculovestibular responses ever regained independent function. The study identifies clinical features of comatose patients that appear within the first week and that are important for predicting recovery and designing future therapeutic trials. [ABSTRACT FROM AUTHOR]