Romanian journal of neurology and psychiatry = Revue roumaine de neurologie et psychiatrie最新文献

This paper summarizes research work done on the non-motor and behavioural functions of the cerebellum. In 73 patients with bilateral cerebellar damage deficits in visuo-spatial organization for concrete tasks as well as in planning and programming of daily activities were found. Deficits in spatial learning were also observed in mutant mice with cerebellar damage. The studies suggest that the cerebellum is involved in cognition through the cerebello-frontal and cerebello-parietal loops.

Our study is based on 102 patients who underwent 104 carotid endarterectomies between 1980 and 1992. Sixty-three patients (61.8%) has surgery at left carotid artery bifurcation. 37 (36.2%) at right carotid artery bifurcation and in 2 cases (1.96%) the operation was performed at both carotid bifurcations. The patients' age ranged from 33 years to 73 years. The most frequently affected age group was between 41 and 50 years (47 cases). Postoperative death due to myocardial infarction occurred in one patient and other patient developed thrombosis of the internal carotid artery operated on. The remaining patients had a good surgical outcome.

An 85-year-old man developed in the last 5 years three attacks on Ménière's syndrome associated with facial paralysis. The syndrome could be interpreted as a transient ischemic attack in the territory of the anterior inferior cerebellar artery. An alternative hypothesis could be to admit a Ménière's disease with compression of the facial nerve during the attacks of labyrinthine hydrops.

The purpose of this study was to analyze some aspects of communicative capacities in 25 predominantly Wernicke's aphasics. The patients with moderate and mild deficits were compared with severely affected patients. Answers in a standard interview were studied for two aspects: answer adequacy to question and conceptual thinking fluency. An initial examination was carried out in the first stage of aphasia and the second examination took place after 3 or 4 months since onset. Both parameters showed more important deficits in the group with severe disorders at onset. An improvement of communicative capacity was also noticed in both groups. The factors involved were discussed pointing out that wrong answers were not exclusively determined by a difficulty of auditory comprehension but by some deficits of conceptual thinking fluency or some other cognitive processes.

The local involvement of complement (C) in the pathophysiology of tissue lesions in several neurological diseases is known, but it has never been studied whether or not in neurological disorders the C activity in the circulation is altered as well. This was the aim of the present investigations. We measured in blood plasma, with an automatic device for analysis and quantitation of the haemolytic activity of the terminal complement complex, the variables T1, T2 and T3 which define the latter quantitatively. We did this, on the one hand, in 100 patients who had 46 neurological disorders systematized in 16 nosological groups, and, on the other hand, in a control group of 40 healthy blood-donors. The mean values of all variables found in the patients have not been statistically different from those found in the controls. This demonstrates that in neurological disorders possible activations of C remain restricted to the local tissue lesions and do not occur in blood, probably due to the opposition against C activation of the known inhibitor system.

In a relatively young sample of 108 nonbipolar patients with major depressive disorder and at least moderately severe depression, the contribution of a comprehensive set of socio-demographic, psychosocial, clinical and personality trait variables toward the prediction of short-term, multidimensionally evaluated response to tricyclic antidepressants was investigated by univariate and multivariate analyses. There is a naturalistic study without a standard treatment protocol, but treatment type, duration and dosage were controlled. Only patients who received at least moderate dosages of tricyclic antidepressants for minimum four weeks were included in this study. A relatively low number of predictors emerged. Initial severity of both symptoms and impairment of functioning were the most powerful predictors for all outcome criteria. Illness history was also relevant. Personality traits reflecting vulnerable personality style at the emotional and interpersonal level proved their predictive value. The combination of independent variables by multivariate regression analyses improve the prediction of treatment response.

The study aims to observe whether subjects with a primary affective disease and manic attacks show modifications of serum concentration of creatine-kinase conferring it the role of a biologic marker. Serum concentration of creatine-kinase was determined for 122 men with mono- and bipolar affective disease during the different stages as well as for schizophrenic men with different clinical forms excepting the affective form. The control group included 60 men. Data indicated that enzyme concentration can constitute a biological marker for a primary affective disease also showing the differences between the different stages of the disease (mania, hypomania, depression and the symptom-free intervals).

In 30 patients with the diagnosis of definite multiple sclerosis (MS) established on clinical criteria (CDMS-A1 patients), who were in a severe clinical state of MS, i.e., in whom one or more MS clinical signs or symptoms had become obvious during the last 10 days, the integrated concentration of plasma glucose over long-term (the last 6-8 weeks) was established by measurement of the percent of the glycosylated fraction of hemoglobin (Hb A1). This was also investigated in two control groups: CG-1, which consisted in 33 registered healthy blood donors matched for sex and age with the MS patients, and CG-2, consisting in 7 patients with diabetic neuropathy. The mean-value of Hb A1 of 5.1% (SD = 0.82) in the MS patients and that of 5.12% (SD = 0.96) in CG-1 controls are not statistically different (t = 0.09). The Hb A1 mean-value of 10.53% (SD = 3.5) found in the CG-2 controls is different (p < 0.001) from both the mean-values in MS patients and CG-1 controls, which validates the reliability of the HB A1 investigation. The findings indicate that clinical activation in definite MS is not associated with disturbances of glucose metabolism.

The effect of amitriptyline on catecholamine (CA) response to light of 20 migrainous patients was studied. The drug was given orally, 36 mg daily (12 mg x 3), for ten days. Before therapy, the migraineurs responded to light by an increase in epinephrine (E) excretion and not by the rise in norepinephrine (NE) excretion, noticed in controls. The NE excretion of migrainous subjects underwent very often a depression after photostimulation. Amitriptyline therapy prevented the post-photic rise in E excretion of migraineurs, without influencing significantly the variation in NE excretion produced in them by light. In other 8 migrainous subjects the effect of flunarizine, a selective calcium channel blocker, on CA response to light was tested. The dosage was of 5 mg daily, for ten days. Flunarizine had similar effects to those displayed by amitriptyline; the drug prevented the rise in E excretion produced by light without normalizing the NE response to light of migrainous subjects. The results suggest that the efficiency of these two drugs in migraine prophylaxis is connected with the ability of these substances to block the E discharge produced in migraineurs by light or by other stimuli. The interpretation is all the more likely as propranolol, another drug applied in migraine prophylaxis also blocks the post-photic E discharge of migraineurs.