Clinical Neuroscience

[EEG investigations in cognitive impairments]


JANUARY 30, 2011

Clinical Neuroscience - 2011;64(01-02)

[The EEG is an indicator of all physiological and neuropsychological activity. The α rhythm was considered as a key phenomenon in research of human mentation from the discovery of EEG. Two methods are known for the estimation of cognitive deficit by the use of quantitative EEG (QEEG). The first is based on the hypothesis, that the mean values of the normal EEG from healthy volunters can be used as reference, and deviation from the normal values of EEG parameters may suggest disease. This kind of “neurometry” was elaborated by R. E. John. The second method asseses event related (ER) transients evoked by somatosensory and mental stimuli. Quantity and localization of signals may refer to the functional state of the cortex. These reactions depend strongly on the test-paradigms. Recognition of the attention-intention cycle disclosed the psysiological mechanism of ERD (event related desynchronisation) and ERS (event related synchronisation). In contrast with the classical “stimulus-reaction” model, both perception and voluntary movement are iniciated by the brain itself, and not by the environment. Human behavior and conscious actions depend on the intention. QEEG analysis proved that the attention and intention localize in segregate areas of the brain. Both “static” and “dinamic” neurometric methods are able to differenciate the EEG records of demented patients from healthy controls, furthermore some dementias from each other. We conclude that with the help of sofisticated methods of QEEG analysis minimal functional deficit of the electrogenesis can be recognized, which could be helpful in the differential diagnosis Notwithstanding the EEG can not explain the evolution neither the normal or the diseased mental processes. The only “instrument” which is able to approach the human mind is the human cogitation itself with the aids of appropriate tests. The QEEG can be conclusive in the analysis of particular processes of mental activity, such as timing, state of activation, hierarchical organisation of cortical territories and mechanism of electrogenesis.]



Further articles in this publication

Clinical Neuroscience

[Dinamics of craniopharyngeomas reduction after Yttrium-90 colloid brachytherapy]


[Objective - The aim of this study is to reveal the long-term effect of Yttrium-90 colloid radioisotope brachytherapy applied for the treatment of cystic craniopharyngiomas. To provide a mathematical expression that can describe the cyst reduction as a function of time in an accurate matter. Methods - Fourteen cystic craniopharyngiomas were selected for intracavital irradiation with stereotactically implanted beta-emitting radioisotope Yttrium-90 silicate colloid. The cumulative dose aimed at the inner surface of the cyst wall was ranging between 180-300 Gy. Volumes of the cysts were measured on image-fused control CT/MRI images for a 28-month period. Dose planning was done with our own software, while stereotactic calculations, volume calculations and image fusion were done with the BrainLab Target 1.19 software. Mathematical and statistical computations were carried out with the Matlab numeric computation and visualization software. To determine the volumes, the control images were fused with the planning images. Results - Relative volumes normalized with respect to the volume of cysts before irradation were determined from the patients’ measured data, the mean values of volumes were calculated, then a polynomial was fitted to the mean values using the polynomial curve fitting method. We have found that the dynamics describing the reduction of cysts can be expressed mathematically by the polynomial V=93.627-18.091t+1.473t2-0.054t3+0.0007t4, where „t” denotes the time in months passed after irradiation. The accuracy of our results was verified by correlating the predicted data with the measured ones. Conclusions - Our long-term results support the view, that intracavitary Yttrium-90 irradiation is a non invasvive and very effective method for treatment of craniopharyngioma cysts. The derived polynomial helps to 1. design the best treatment, 2. follow up patients’ condition and 3. plan a reirradiation if necessary.]

Clinical Neuroscience

[Some thoughts about the presumed death of classical neurology and the neurology to come]


[In my opinion Hungarian medicine, and not just neurology, is in a critical state. This is the consequence of various factors, such as the overemphasizing of medicine’s economic aspects, the malfunctions of patient care caused by inadequate source allocation, and the misinterpretation of the doctors’ role by the society. The vastly increased knowledge base and the huge amount of information we can gather about our patients are an unparalleled chance, rather than a deathly wound, for neurology as a discipline. The challenge the future’s neurology has to face is high-quality patient care, which necessitates dedicating the necessary time for patients, rationally using our ever-increasing diagnostic arsenal, and continuously updating our knowledge about the therapeutic possibilities.]

Clinical Neuroscience

[Vascular compression syndromes of the cranial nerves]


[The blood vessels which are running nearby the cranial nerves and the brainstem can be elongated; curves and loops of the vessels may develop mostly due to the degenerative alterations of ageing and these vessels can compress the surrounding neural elements. The authors report a review of vascular compression syndromes based on the literature and their own experience. The typical clinical symptoms of the syndromes subserving the proper diagnosis, the pathomechanism, the significance of imaging especially the magnetic resonance angiography, the experience with the surgical technique of microvascular decompression which is the only causal treatment of the syndromes are discussed. In cases of non-responsible medical treatment the microvascular decompression should be the eligible treatment in certain syndromes (trigeminal and glossopharyngeal neuralgia, hemifacial spasm) for it is a highly effective and low risk method.]

Clinical Neuroscience

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Clinical Neuroscience

[Tolosa-Hunt syndrome]


[Both men and women are affected by the rare disease called Tolosa-Hunt syndrome. We don’t know exactly what causes it to evolve. It is usually put into the categories of either idiopathic inflammation or pseudotumor. Its patological feature is a non-specific inflammatory process with fibroblastic, lymphocytic, plasmocytic infiltration, which can be found, for the most part, in the wall of the sinus cavernosus. Granulocytic and giant-cell infiltrations have been described too. The possibility of autoimmune disease has also come up. In our current study we describe the case of a female patient who recovered with the help of a steroid therapy. Through examining her, we also found immunological alterations, which should urge us to thoroughly examine the further observations of this kind.]

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Clinical Neuroscience

[The first identified Central-Eastern European patient with genetically confirmed dentatorubral-pallidoluysian atrophy]


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Clinical Neuroscience

Pulmonary physiotherapy and aerobic exercise programs can improve cognitive functions and functional ability

TEKESIN Aysel, TUNC Abdulkadir, GÜNGEN Dogan Belma, AVCI Nalan, BAKIS Muhammed, PERK Seyma

Objective - The increasing prevalence of dementia over the previous decades has been accompanied by numerous social and economic problems. The importance of exercise in the prevention of dementia coupled with the impact of aspiration pneumonia on the mortality and morbidity of dementia patients cannot be overstated. This study investigates the effects of pulmonary rehabilitation combined with aerobic stretching exercises on the cognitive function, life quality, effort capacity, and level of depression in patients with mild cognitive impairment (MCI) in the early stages of dementia. Methods - Sixty-nine patients with MCI diagnosis were routinely monitored, and six were excluded because they did not attend the follow-up appointments. The remaining 63 patients undertook pulmonary physiotherapy (PPT) and extremity exercises for six months. The mini-mental state examination (MMSE), six-minute walk test (6MWT), Nottingham health profile (NHP), and Beck depression inventory (BDI) scores were evaluated before and after exercise. Results - PPT plus extremity exercises appeared to significantly improve the MMSE scores and increase the 6MWT (p < 0.001) by an average of 25 m. No significant improvement was observed in the BDI and NHP scores. Conclusion - PPT and aerobic exercise positively affected the cognitive ability of MCI patients and improved their walking distance. These results underscore the importance of combining medical treatment with physical rehabilitation at the onset of dementia, a disease which exerts a significantly negative impact on the economy.

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Clinical Neuroscience

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