Clinical Neuroscience

[Hungarian Spine Association]

PENTELÉNYI Tamás

SEPTEMBER 20, 1993

Clinical Neuroscience - 1993;46(09-10)

[Summary of the 1993 events of the Hungarian Spine Society.]

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Clinical Neuroscience

[Pharmaco-EEG investigation on sedative effect of antiallergic drugs. Setastin is a non-sedative antihistamina]

RAJNA Péter, VERES Judit

[Effect of setastine on pharmaco-EEG was investigated in a double blind placebo controlled study in ten healthy volunteers. Changes caused by setastine were compared with those of two referent antihistamine drugs (chloropyramine and hismanal) having great differences in their sedative side effect. The themporo-occipital alpha per theta ratio was the most sensitive EEG marker in differentiating the two referent drugs. The EEG effect showed by setastine was very similar to that to hismanal and opposite to that of chloropyramine. In addition an increase of the total power and the power of beta was also measured. The latter changes might refer to an inherent EEG effect of setastine. EEG changes of setastine cannot be evaluated as signs of hypovigilance and the similarity of EEG effect of hismanal and setastine also supports the non-sedative nature of setastine estabilished by clinical studies. The pharmaco-EEG method utilized gives possibility for an objective investigation of psychotropic side effects of the particular drugs. ]

Clinical Neuroscience

[Efficacy of cinolazepam on insomnia generated under shift-work conditions]

KÖVES Péter

[The efficacy of cinolazepam (a benzodiazepine with middle half life time and light pharmacological potential) on insomnia generated under shift-work conditions was investigated, and shown to be an efficent hypnotic. Cinolazepam (daytime dose 20 mg, night dose 40 mg) improved significantly both sleep and awakening quality: there were no hangover effects, drug provoked intrasleep or early morning insomnia. During the time cinolazepam was administered drug tolerance was not observed. The structure of cinolazepam-induced sleep could be characterised by shortened sleep latency, increase of deep slow wave sleep, improvment of sleep continuity and unchange of REM sleep parameters both during night- and daytime.]

Clinical Neuroscience

[Observation of embolic events during carotis constructive surgery]

RÓZSA András, ENZT László, JÁRÁNYI Zsuzsa

[The changes of middle cerebral artery circulation during carotid artery surgery in 65 patients were monitored, and the observed embolic events are discussed. Of the 65 patients, 37 were operated with shunt protection (group A) and 28 without (group B). In 31 of all cases 55 embolic events were noted. In 22 of the group A patients 37 embolic events were observed, one of them occured during the declamping of the external caruiid circulation. Eighteen emboli were observed in 9 of the Group B cases. There were embolic events in 5 cases due to external declamping. All the above mentioned embolic events occured without postoperative clinical sings.]

Clinical Neuroscience

[Experiences with carotid-doppler examinations on patients with arterial bypass operation on the lower extremities]

OLÁH László, FÜLESDI Béla, VALIKOVICS Atilla, CSIBA László, OLVASZTÓ Sándor, BÁNFI Csaba, KOZLOVSZKI Bertalan

[Carotis-Doppler examinations were performed on 83 patients with severe, obliterative disease of the arteries of the lower extremities and on 96 age-matched controls without signs and symptoms. In the group with obliterative arterial disease, severe or moderate stenosis of the carotid arteries was found in 20 and 40% of the patients, respectively, whereas in the control group the proportion of moderate carotid-stenosis was 2% and no case of severe stenosis was found. The role of risk factors was also studied. Based on their results the authors suggest, that because patients with obliterative disease on the arteries of the lower extremities have higher risk for stenosis, ultrasound investigations and regular follow up of the carotid arteries are needed.]

Clinical Neuroscience

[Brachioradial syndrome: superficial radial neuropathy]

KISS Gábor

[Damage of the superficial branch of the radial nerve represents a rare, and rarely recognized, mononeuropathy. The first three cases in the Hungarian literature are presented. The essential role of electrodiagnosis in detecting of the disease is stressed. Special attention should be paid to avoid any lesion which might result from improper patient-care.]

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Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

Clinical Neuroscience

Electrophysiological investigation for autonomic dysfunction in patients with myasthenia gravis: A prospective study

NALBANTOGLU Mecbure, AKALIN Ali Mehmet, GUNDUZ Aysegul, KIZILTAN Meral

Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission. Autonomic dysfunction is not a commonly known association with MG. We conducted this study to evaluate autonomic functions in MG & subgroups and to investigate the effects of acetylcholinesterase inhibitors. This study comprised 30 autoimmune MG patients and 30 healthy volunteers. Autonomic tests including sympathetic skin response (SSR) and R-R interval variation analysis (RRIV) was carried out. The tests were performed two times for patients who were under acetylcholinesterase inhibitors during the current assessment. The RRIV rise during hyperventilation was better (p=0.006) and Valsalva ratio (p=0.039) was lower in control group. The SSR amplitudes were lower thereafter drug intake (p=0.030). As much as time went by after drug administration prolonged SSR latencies were obtained (p=0.043).Valsalva ratio was lower in the AchR antibody negative group (p=0.033). The findings showed that both ocular/generalized MG patients have a subclinical parasympathetic abnormality prominent in the AchR antibody negative group and pyridostigmine has a peripheral sympathetic cholinergic noncumulative effect.

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Clinical Neuroscience

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

VASTAGH Ildikó, SZŐCS Ildikó, OBERFRANK Ferenc, AJTAY András, BERECZKI Dániel

[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. ]

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]