Clinical Neuroscience

[Forum of Young Neurologists - Debrecen, September 13-14., 2002]

APRIL 20, 2003

Clinical Neuroscience - 2003;56(03-04)

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Clinical Neuroscience

[Farewell to dr. Edit Martini]

NAGY Zoltán

[Farewell to dr. Edit Martini memorial 2003;56(03-04)]

Clinical Neuroscience

[Facts and memories of Kálmán Sántha]

CSILLAG Mária

[Facts and memories of Kálmán Sántha 2003;56(03-04)]

Clinical Neuroscience

[Dr. Ilona Jelencsik (1944-2002)]

CSANDA Endre

[Dr. Ilona Jelencsik (1944-2002), memorial 2003;56(03-04]

Clinical Neuroscience

[Occipital spectral EEG-parameters in newly diagnosed, untreated epilepsy patients]

CLEMENS Béla, BESSENYEI Mónika

[Introduction - Minor spectral EEG alterations hidden to the naked eye may be of interest in the field of epileptology, cognitive performances, and drug effects. In order to introduce new scientific results of brain wave research into the clinical field of epilepsy- and drug-related cognitive problems, a normative quantitative EEG database for epilepsy was constructed. Patients and methods - 171 newly referred, five to 50 years old patients with untreated ”new” epilepsy (that is, clinical, EEG, MRI investigations had been done in 24 months after the first unprovoked seizure) were collected. EEG was recorded with closed eyes, in the waking-relaxed state. Effects that are known to influence EEG spectra (nearby seizures, drugs, etc.) were excluded as far as possible. A total of two minutes of waking-resting EEG activity was chosen for spectral analysis. Fast Fourier transformation of the selected samples were calculated resulting in absolute power, percent power and mean alpha frequency (AA, RA, and AMF respectively) for the right and left occipital derivations. For each patient (and also for 37 healthy controls), the deviation of the individual values from the age-adjusted normative mean was expressed in Z-score. Main diagnostic epilepsy categories were compared to the control group as well as to each other. In addition, effects of MRI-defined cerebral lesions and interictal spiking on spectral EEG parameters were investigated. Results - All group averages were within the 95 per cent confidence interval. Overwhelming majority of the individual data fell within a 3Z range. Statistically significant differences were found for AA and RA, but seldom for AMF. Right and left alpha-parameters were surprisingly symmetrical in all groups. The main difference between epilepsy groups and controls was less AA and RA power in the epilepsy groups. MRI-defined lesions and interictal epileptiform activity did not significantly influence EEG spectral variables. Conclusion - These results might serve as reference data and might help planning of further quantitative EEG studies in the triangle of epilepsy, cognitive problems, and drug effects.]

Clinical Neuroscience

[Neuropsychological applications of the Rey Complex Figure and Recognition Test]

F. FÖLDI Rita, TOMASOVSZKI László

[The authors describe the clinical applications of the Rey Complex Figure and Recognition Test and explain how the individual abilities and information-processing characteristics are reflected. Sequential and quantitative evaluation methods are presented. Summarizing the relation between IQ and RCFT they evaluate the differencies in task completion strategies of healthy subjects and subjects with brain damage, suggesting that these differences originate in changes of the information-processing capacity. Application of the RCFT in clinical child psychology is also suggested, primarily in differential diagnostics of children with attention disorder and disruptive disorder. The authors illustrate the protocols of the neuropsychological examination and the role of the RCFT with a case study.]

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Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

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[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

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[The connection between the socioeconomic status and stroke in Budapest]

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[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

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[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

Clinical Neuroscience

Neuroscience highlights: Main cell types underlying memory and spatial navigation

KRABOTH Zoltán, KÁLMÁN Bernadette

Interest in the hippocampal formation and its role in navigation and memory arose in the second part of the 20th century, at least in part due to the curious case of Henry G. Molaison, who underwent brain surgery for intractable epilepsy. The temporal association observed between the removal of his entorhinal cortex along with a significant part of hippocampus and the developing severe memory deficit inspired scientists to focus on these regions. The subsequent discovery of the so-called place cells in the hippocampus launched the description of many other functional cell types and neuronal networks throughout the Papez-circuit that has a key role in memory processes and spatial information coding (speed, head direction, border, grid, object-vector etc). Each of these cell types has its own unique characteristics, and together they form the so-called “Brain GPS”. The aim of this short survey is to highlight for practicing neurologists the types of cells and neuronal networks that represent the anatomical substrates and physiological correlates of pathological entities affecting the limbic system, especially in the temporal lobe. For that purpose, we survey early discoveries along with the most relevant neuroscience observations from the recent literature. By this brief survey, we highlight main cell types in the hippocampal formation, and describe their roles in spatial navigation and memory processes. In recent decades, an array of new and functionally unique neuron types has been recognized in the hippocampal formation, but likely more remain to be discovered. For a better understanding of the heterogeneous presentations of neurological disorders affecting this anatomical region, insights into the constantly evolving neuroscience behind may be helpful. The public health consequences of diseases that affect memory and spatial navigation are high, and grow as the population ages, prompting scientist to focus on further exploring this brain region.