Clinical Neuroscience



MAY 20, 2007

Clinical Neuroscience - 2007;60(05-06)

[The origin, nature and fate of ”dark“ (dramatically shrunken and hyperbasophilic) neurons are century-old problems in both human and experimental neuropathology. Until a few years ago, hardly any cell-biological conclusion had been drawn from their histological investigation. On the basis of light and electron microscopic findings in animal experiments performed during the past few years, my research team has put forward novel ideas concerning 1. the nature of ”dark“ neurons (malfunction of an energystoring gel-structure that is ubiquitously present in all intracellular spaces between the ultrastructural elements), 2. the mechanism of their formation (non-programmed initiation of a whole-cell phase-transition in this gel-structure), 3. their capability of recovery (programmed for some physiological purpose), 4. their death mode (neither necrotic nor apoptotic), and 5. their relationship with the apoptotic cell death (the gel structure in question is programmed for the morphological execution of ontogenetic apoptosis). Based on morphological observations, this paper revisits these ideas in order to bring them to the attention of researchers who are in a position to investigate their validity by means of experimental paradigms other than those used here.]



Further articles in this publication

Clinical Neuroscience


SISKA Éva, NEUWIRTH Magdolna, REBECCA Gooding, MOLNÁR Mária Judit

[The congenital cataracts facial dysmorphism neuropathy (CCFDN) syndrome (OMIM 604168) is a recently described autosomal recessive developmental disorder. It is almost completely restricted to an endogamous group of the European Vlax Roma population, called the Rudari. The CCFDN syndrome is a complex phenotype involving multiple systems, characterized by facial dysmorphism, congenital cataracts, microcorneae, delayed early motor and intellectual development, hypogonadotrop hypogonadism, hypomyelination of the peripheral nervous system, and serious complications related to general anaesthesia. This disorder is caused by a homozygous mutation of the carboxy-terminal domain phosphatase 1 (CTDP1) gene, localized to the 18q23 region. Authors present one genetically identified case in a large Roma family. The case documents that the CCFDN mutation is present also in the Hungarian Roma population. Underlie of antropomorphological data the authors presume that the CCFDN mutation reached Hungary as a result of emigration of Vlax Gypsies in the 18th century. The paper calls attention to the fact that molecular genetic diagnostics can replace invasive methods and makes possible the identification of heterozygotes without clinical symptoms. The introduction of the genetic screening enables us to perform genetic counselling and prevention in this high-risk population.]

Clinical Neuroscience

[100 years of riddle… X. Jubilee Alzheimer’s disease congress on the 100th anniversary of disease description]

Clinical Neuroscience


TÓTH Marianna, KUNDRA Olga, KULIN Árpád

[Introduction - While examining patients with headache, abnormalities of unknown significance may quite frequently be encountered. In migraine small, subcortical, white matter abnormalities (WMAs) can be visualized by magnetic resonance images. The connection of these WMAs with the migraine is unclear, but some studies report the higher incidence of WMA in migraine. Patients and method - The authors reviewed the MR scans of their new migraine patients younger than 55 years treated in period of 15 months, and compared the data with a control group. Results - The prevalence of WMA was 10.3% among the migraineurs (78 patients without comorbidities such as hypertension, atherosclerotic heart disease, diabetes mellitus, autoimmun disorder or demyelinating disease) and it was 3.1% in the group of controls (32 persons younger then 55 years, and without migraine or other disease mentioned above). There were patients with WMA both below and above the age of 40; all of them were suffering from migraine without aura with 1 or more attack per month in variable times; none of them had smoked, the majority hadn't used oral contraceptive, and only a few of them used triptan or ergotamin. Conclusion - The data presented here shows that there is a relationship between migraine and WMA. The association of WMA and the risk of following stroke is not cleared. There are well known studies analysing the prevalence of silent infarction too, but we need a long prospective study to answer this question exactly.]

Clinical Neuroscience

[Determining the term of schizencephaly]

KENÉZ József, LEEL-ŐSSY Lóránt

Clinical Neuroscience


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Clinical Neuroscience

[The importance of anticoagulant therapy in patients with artial fibrillation in stroke prevention – summary of international data and novel therapeutic modalities]


[The most common cardiogenic cause of ischaemic stroke is atrial fibrillation which increases the probability of stroke five-fold and doubles case fatality. Based on international data the incidence of atrial fibrillation is approx. 2% however this rapidly increases with age. The necessity of using oral anticoagulants in the prevention of non-valvular atrial fibrillation related stroke is decided based on estimated stroke risk. The CHADS2 and the more predictive CHA2DS2-VASc scales are used for this purpose while the bleeding risk of patients treated with anticoagulant may be estimated by the HAS-BLED scoring scale. For decades oral anticoagulation meant using vitamin-K antagonists. Based on international data we can see that rate of anticoagulation is unacceptably low, furthermore most of the anticoagulated patients aren’t within the therapeutic range of INR (INR: 2-3). A lot of disadvantages of vitamin-K antagonists are known (e.g. food-drug interaction, need for regular coagulation monitoring, increased risk of bleeding), therefore compounds with new therapeutic target have been developed. The novel oral anticoagulants (NOAC) can be divided in two major subgroups: direct thrombin inhibitors (dabigatran etexilate) and Xa-factor inhibitors (rivaroxaban, apixaban, edoxaban). These products are administered in fix doses, they less frequently interact with other medications or food, and regular coagulation monitoring is not needed when using these drugs. Moreover several studies have shown that they are at least as effective in the prevention of ischaemic stroke than the vitamin-K antagonists, with no more haemorrhagic complications.]

Lege Artis Medicinae

[Antidiabetic therapy of patients with type 2 diabetes - The role of incretin mimetics]

GERŐ László

[Incretin mimetics represent a new group of antidiabetic drugs. They bind to their own receptor on the beta-cell membrane and increase insulin secretion in a glucosedependent manner. Thus, they rarely cause hypoglycaemia. Furthermore, they significantly reduce body weight and other cardiovascular risk factors. Accordingly, they can be considered as an optimal group of antidiabetic drugs. The author reviews the clinical efficacy and safety of currently available incretin mimetics.]

Lege Artis Medicinae

[Depression from the aspect of polygenic studies: the role of the relationship between genes and the environment]


[Depression is a multifactorial disease with both genes and environmental factors as well as complex relationships between these factors playing a role in its background. However, in spite of several decades of research no genetic variants playing a straightforward and robust role in the background of depression have been identified. One reason behind this is the genetic and biological heterogeneity of depression, while another is that in the majority of studies environmental effects interacting with genetic variants have not been considered which may mask important genetic effects. Furthermore, relative contribution of genetic and environmental factors may vary in case of different manifestations and subtypes of depression which has not only etiopathological relevance but may also influence choice and efficiency of treatment. Consideration of heterogeneity of depressive syndromes, as well as environmental effects in case of both candidate gene and whole genome association studies, and qualitative analysis of environmental effects in depression and antidepressant research may extend our existing knowledge concerning the pathophysiology of depression and may also aid identification of new antidepressive therapeutic targets. ]

Lege Artis Medicinae


TÁLLAI Béla, MORSHED Ali Salah, FLASKÓ Tibor, PONYI Andrea, DANKÓ Katalin, TÓTH Csaba

[INTRODUCTION - In some cases of polymyositis/ dermatomyositis (PM/DM) of autoimmune origin, different malignant tumours can initiate the difficult cascade mechanisms at cell level leading to the rapid weakness of the skeletal muscles. Till now, in the international literature only four cases of PM/DM associated with cancer of prostate has been reported. CASE REPORT - Authors present a case of a 57 yearold male patient, where weakness in patient's movements developed leading to total immobility in 3 months. Purple discoloration developed on his hand and face. Significantly elevated creatin kinase (CK) levels and blood sediment rate with mild anaemia were observed during laboratory examinations. Dysphagia and lack of appetite resulted in the loss 10 kgs in body weight. Both clinical evaluation, elevated serum CK level, skin symptomes, positive electromyography and muscle biopsy confirmed acute definitive dermatomyositis. Urological examination revealed a palpable hard area at the right lobe of the prostate. Prostate biopsy confirmed the presence of carcinoma in the right lobe of the prostate. There was no sign or symptome referring to either local propagation or distant manifestation. Therefore, radical prostatectomy was performed, the tumorous prostate and both seminal vesicles were removed. Histological examination proved malignant focus in the right lobe of the prostate. After the operation patient gradually became stronger, corticosteroid medication were decreased then stopped. Patient's original muscle power and movement recovered and his previous body weight was regained. During the regular control examinations all results of laboratory tests are in normal range. CONCLUSION - In the background of some autoimmune diseases malignant tumours can be revealed. It is rare when urological neoplasms initiative the process. In men with PM/DM commencing beyond 50 years of age it is necessary to think of the presence of prostate cancer, which can be cured by performing radical operation in appropriate time.]

Lege Artis Medicinae

["Nowadays we know a great deal about the microscopic detail" - but do we know more about Axolotl than Antal Szerb?]


[In Antal Szerb’s novel, The Pendragon Legend, which was first published in 1934 (its first English translation came out in 1963), the excentric Earl of Gwynedd experiments with strange creatures. Rea­ding the book based on mystic elements as well as their mockery, the reader gets quite a bizarre knowledge of axolotls. In this re­view, a detailed history of this amphi­bian (Ambystoma mexicanum) in Western scientific research is offered; beside the scientific data, of which presumably Antal Szerb was aware, the main trends in the axolotl studies of the recent decades, both their successes and failures, are also de­fined.]