Clinical Neuroscience

[Neuropsychological outcome following bilateral pallidotomy in patients with Parkinson's disease]


AUGUST 20, 2002

Clinical Neuroscience - 2002;55(07-08)

[Introduction - Although significant improvement of motor function following bilateral pallidotomy for the treatment of Parkinsons's disease has been proved, the cognitive sequalae have not been clearly defined. There are recurrent loops interconnecting specific areas of the frontal cortex and the basal ganglia, suggesting the continuity or complementary functioning between these areas. Patients and methods - Pre- and postoperative cognitive function was evaluated in 19 Parkinsonian patients who underwent bilateral pallidotomy in order to clarify its effects on cognitive function. All patients were evaluated one day before the procedure and 12+ months after surgery using neuropsychological tests (Raven Progressive Matrices and Bergen Facial Recognition Test). Proper performance in these tests requires reasoning, abstraction and spatial memory, involving strongly the frontal functions. These functions could be described in terms of the ”working memory” concept. Hand Mental Rotation Test was used as comparing task not involving frontal functions. Scores were analyzed by Student’s t-test. Results - Modest improvement was observed in these cognitive functions as assessed by Raven Progressive Matrices (p<0.0688) and a significant change in the complex parts of Bergen Facial Recognition Test (p<0.0547; p<0.0468) was also noticed, but no change was registered in mental rotation tasks. Conclusion - Present data revealed that bilateral pallidotomy is associated with modest and long-lasting improvement in tasks involving the ”working memory”.]



Further articles in this publication

Clinical Neuroscience

[The molecular genetic control of bony developmental malformations affecting the craniocervical junction and the cervical spine]


[In this review a new interpretation of the origin of bony developmental malformations affecting the craniocervical junction and the cervical spine is presented based on recent advances in the understanding of embryonic development of the spine and its molecular genetic control. Radiographs, CT and MRI scans or CT myelograms of patients with Klippel-Feil syndrome were used for demonstration. Detailed clinical and radiologial analysis of these patients was published earlier [David KM, Stevens JM, Thorogood P, Crockard HA. The dysmorphic cervical spine in Klippel-Feil syndrome: interpretations from developmental biology. Neurosurg Focus 1999;6(6):1.]. Homeotic transformation due to mutations or disturbed expression of Hox genes is a possible mechanism responsible for C1 assimilation. Notochordal defects and/or signalling problems, that result in reduced or impaired Pax-1 gene expression, may underlie vertebral fusions. This, together with asymmetrical distribution of paraxial mesoderm cells and a possible lack of communication across the embryonic mid-line, could cause the asymmetrical fusion patterns. The wide and flattened shape of the fused vertebral bodies, their resemblance to the embryonic cartilaginous vertebrae and the process of progressive bony fusion with age suggest that the fusions occur before or, at the latest, during chondrification of vertebrae. The authors suggest that the aforementioned mechanisms are likely to be, at least in part, responsible for the origin of the bony developmental malformations affecting the craniocervical junction and the cervical spine.]

Clinical Neuroscience

[Application of kinematic parameters for the assessment of impairments due to central motoneuron damage]

FAZEKAS Gábor, FEHÉR Miklós, KOCSIS László, STEFANIK Györgyi, BOROS Zsuzsanna, JURÁK Mihály

[Evidence based medicine requires objective methods for the assessment of status of the patients. The method described by the authors makes it possible to assess motoric impairment of patients in an objective way. It is based on three-dimensional motion analysis. Authors present the case history of two patients with spastic hemiparesis due to central nervous system damage. Changes in motoric impairment were followed by three-dimensional motion analysis. This method can be adapted for the assessment of motor impairment arising from other reasons as well.]

Clinical Neuroscience

[The evolution of psychoneuroimmunology]


Clinical Neuroscience

[Percutaneous procedure for treatment of diseased vertebral bodies with different etiology: vertebroplasty]


[Percutaneous vertebroplasty is a radiologically guided invasive technique consisting of the injection of surgical cement into the diseased vertebral body. The procedure results in immediate pain relief and strengthening of the bone due to the polymerization process of the filling material hardening the vertebral body and preventing further collapse. This method is suitable for the treatment of osteoporotic vertebral fractures and of osteolytic vertebral body metastases without neurological signs, in multiple appearance as well. Authors present technical details of the procedure performed by bi-directional fluoroscopy and combined CT-fluoroscopy control as well as short-term experience obtained by treatment of 17 patients.]

Clinical Neuroscience


[Congress calendar 2002;55(07-08)]

All articles in the issue

Related contents

Clinical Neuroscience

Retinal morphological changes during the two years of follow-up in Parkinson’s disease

ATUM Mahmut, DEMIRYÜREK Enes Bekir

The study aims to investigate the relationship between the progression of idiopathic Parkinson’s disease (IPD) and retinal morphology. The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson’s Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit. The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p=0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05). Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.

Clinical Neuroscience

[The treatment of advanced Parkinson’s disease]


[The treatment of Parkinson’s disease depends on the symptoms of the patients and obviously the stage of the disease. Several different approaches can be found in the literature. Based on the published data, in this review we try to summarize the different approaches to the disease stages and theirs’ clinical relevance. Actually, one of the most important issue is the recognition of advanced stage and therefore we reviewed the device-aided therapies. ]

Clinical Neuroscience

[Dopamine agonists in Parkinson’s disease therapy - 15 years of experience of the Neurological Clinics from Tîrgu Mureș. A cross-sectional study ]

SZÁSZ József Attila, CONSTANTIN Viorelia, MIHÁLY István, BIRÓ István, PÉTER Csongor, ORBÁN-KIS Károly, SZATMÁRI Szabolcs

[Background and purpose - There is relatively few data regarding the usage of dopaminagonists for the treatment of Parkinson’s disease; furthermore, there are no publications regarding Central- and Eastern-European countries. The aim of the study was to evaluate the use of dopamine agonists as a therapeutic option amongst Parkinson’s disease patients admitted to the Neurological Clinics of Tîrgu Mures during the last 15 years. Methods - In our study we investigated the data of all Parkinson’s patients treated at our clinics between the 1st of January 2003 and the 31st of December 2017. We analyzed the particularities of dopamine agonists’ usage based on the therapeutic recommendations from the final report of these patients. Regarding time since the diagnosis, we divided the patients in two groups: less than or equal to 5 years and more than 5 years. Results - During the studied period a total of 2379 patients with Parkinson’s disease were treated at the Clinics. From the 1237 patients with disease duration under 5 years 665 received dopamine agonists: 120 as monotherapy, 83 together with monoamine oxidase inhibitors and in 234 cases associated with levodopa. The remaining 228 patients were treated with a triple combination of levodopa, dopamine agonists and monoamine oxidase inhibitors. In patients suffering from Parkinson’s disease for more than 5 years, in 364 cases out of 653 a dopamine agonist was part of the therapy. Conclusion - The usage of dopamine agonists was similar to the data presented in other studies. We consider that clinicians treating the disease should, with the necessary prudence, use the available and recommended dopamine agonist with the utmost courage to their maximum therapeutic potential.]

Clinical Neuroscience

[The applicability of 123I-FP-CIT SPECT dopamine transporter imaging in clinical practice]

PERLAKI Gábor, SZEKERES Sarolta, JANSZKY József, DEZSŐ Dániel, ASCHERMANN Zsuzsanna, ZÁMBÓ Katalin, KOVÁCS Norbert

[The 123I-FP-CIT dopamine transporter SPECT imaging is a sensitive method to assess functional dopaminergic neuron terminals in the striatum. The method has also been available in Hungary for years. There are two main indications: (i) to help differentiate essential tremor from clinically uncertain Parkinsonism, including patients with early symptoms and (ii) to help differentiate dementia with Lewy bodies from Alzheimer’s disease. The aim of this paper is to review 123I-FP-CIT SPECT imaging based on international data/guidelines and our own experiences, thereby assisting nuclear medicine practitioners and neurologists.]

Clinical Neuroscience

[Mentalizing deficit in neurological disorders: a review article]

HEROLD Róbert, VARGA Eszter, MIKE Andrea, TÉNYI Tamás, SIMON Mária, HAJNAL András, FEKETE Sándor, ILLÉS Zsolt

[Introduction – Mentalization is the ability to attribute mental states (intentions, desires, thoughts, emotions) to others, and hence to predict their behaviour. This ability fundamentally determines our participation in social relationships and adaptation to society. A significant proportion of the disorders of the central nervous system (CNS) affects those brain structures and neurotransmitter systems that play a role in the mentalizing processes. Accordingly, a number of CNS disorders may be associated with mentalizing deficits, which may affect the outcome of these diseases. Here, we review recent research on mentalizing abilities in neurological diseases. Methods – An internet database search was performed to identify publications on the subject. Results – Sixty-two publications in English corresponded to the search criteria. These publications reported impaired mentalization in several neurological disorders (e.g. epilepsy, Parkinson’s disease, multiple sclerosis, dementias, traumatic brain injury). Discussion – The results indicate that a number of neurological disorders associate with mentalizing deficit. This deficit is often present in the early stages of the diseases and has a prognostic value, which in turn emphasizes the importance of the early detection and adequate rehabilitation.]