Clinical Neuroscience

[Society members]

JULY 10, 2004

Clinical Neuroscience - 2004;57(07-08)

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Clinical Neuroscience

[Differentiation of parkinsonian and essential tremor by the use of electrophysiological methods]

GERTRÚD Tamás, FELYÉR Dénes, MAGYAR András, PÁLVÖLGYI László, TAKÁTS Annamária, SZIRMAI Imre, KAMONDI Anita

[Objective - Tremor is one of the most common movement disorders. Different tremors are induced by central and/or peripheral oscillators. The motor cortex plays a significant role in the generation of parkinsonian tremor but its function in essential tremor is not clear. We examined the effect of motor cortex activation on parkinsonian and essential tremor during movement of the contralateral hand. Our aim was to study the role of interhemispheric motor connections in genesis of different tremors. Patients and methods - We recorded the tremor of nine Parkinson patients and seven patients suffering from essential tremor using accelerometry. After Fast Fourier-transformation of digitized tremor signal we measured the power changes at the peak frequency after flash triggered movement (FM) and self-paced movement (SPM). For control we used flash signal without movement. Results - Peak frequency of parkinsonian and essential tremor was not different. The power decrease of parkinsonian tremor was significant during flash triggered and self-paced movement compared to the effect of flash (pFlash-FM=0.0008; pFlash-SPM=0.002), changes during the different movement protocols were not different (pFM-SPM=0.33). During self-paced movement parkinsonian tremor became significantly smaller than essential tremor (p<0.05). The effect of movement was not significant on the power of essential tremor (p=0.42), probably due to high standard deviation of individual data. Conclusions - Voluntary movement of the contralateral hand decreases parkinsonian tremor suggesting that its generator can be inhibited via the activation of the motor cortex. The diverse reaction of essential tremor may reflect various connections between its generator system and the motor areas, therefore it is not a separate disease entity.]

Clinical Neuroscience

[“From brain - through mind - to society“ XIII. International Semmelweis Symposium]

Clinical Neuroscience

[Prognosis and classification of hypertensive striatocapsular haemorrhages]

HORNYÁK Csilla, KOVÁCS Tibor, PAJOR Péter, SZIRMAI Imre

[Introduction - Nontraumatic intracerebral haemorrhage accounts for 10 to 15% of all cases of stroke. Patients and method - In our study hypertensive striatocapsular haemorrhages were divided into six types on the basis of arterial territories: posterolateral, lateral, posteromedial, middle, anterior and massive (where the origin of the hemorrhage can not be defined due to the extensive damage of the striatocapsular region) type. We analysed laboratory data, clinical presentations and risk factors as alcoholism, smoking and hypertension of 111 cases. The size of the hematoma, midline shift and severity of ventricular propagation were measured on the acute CT-scan. The effect on the 30-day clinical outcome of these parameters were examined Results and conclusion - According to our results, the most important risk factor of hypertensive intracerebral haemorrhage was chronic alcoholism. Blood cholesterol, triglyceride levels and coagulation status had no effect on the prognosis, but high blood glucose levels Significantly worsen the clinical outcome. In our study, lateral striatocapsular haemorrhage was the most common while middle one was the least common type. The overall mortality is 42%, but differs by the type. The 30-day outcome significantly depends on the type of the haemorrhage, the initial level of consiousness, the size of the haematoma, the severity of ventricular propagation, the midline shift and the blood glucose levels. The clinical outcome proved to be the best in the anterior type, good in the posteromedial and lateral types. The prognosis of the massive type is poor. In our study, the classes and the mortality of the striatocapsular haemorrhages was different from the literature data. The higher mortality in our cohort could be due to the longer follow-up and the severe accompanying diseases of our patients.]

Clinical Neuroscience

[Alcohol as a risk factor for hemorrhagic stroke (in English language)]

DANIEL Sajjan Bereczki Dániel

[Purpose - Whereas the protective effect of mild-to-moderate alcohol consumption against ischemic stroke has been well recognized, there is conflicting evidence regarding the link between alcohol consumption and hemorrhagic strokes. The aim of the present study is to summarize the results of case-control and cohort studies published on this issue. Methods - Recent epidemiologic articles on the relationship between alcohol consumption and hemorrhagic stroke were identified by Medline searches limited to title words using the following search terms: ”alcohol AND cerebrovascular dis*”, ”alcohol AND stroke”, ”alcohol AND cerebral hemorrhage” and ”alcohol AND hemorrhagic stroke”. Results - Most case-control and cohort studies either repor-ted only on total strokes or on a combined group of hemorr-hagic strokes including intracerebral as well as subarachnoid hemorrhages. There was a consensus among reports that heavy alcohol consumption was associated with a higher risk of hemorrhagic strokes. Controversy remains regarding the effect of mild-to-moderate alcohol consumption: while some studies reported a protective effect, others found a dose-dependent linear relationship between the amount of alcohol consumed and the risk of hemorrhagic stroke. The differential effect of moderate alcohol consumption on hemorrhagic compared to ischemic strokes is mostly attributed to alcohol- and withdrawal- induced sudden elevations of blood pressure, and coagulation disorders. Conclusions - Heavy drinking should be considered as one of the risk factors for hemorrhagic stroke. In contrast to the protective effect of mild-to-moderate alcohol use against ischemic strokes, moderate drinking might result in an increased risk of hemorrhagic strokes.]

Clinical Neuroscience

[PhD thesis Asphyxia-induced brain oedema formation in newborn pigs: a particular role for histamine]

KOVÁCS József

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Clinical Neuroscience

Evaluation of anxiety, depression and marital relationships in patients with migraine

DEMIR Fıgen Ulku, BOZKURT Oya

Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.

Clinical Neuroscience

[Earlier and more efficiently: the role of deep brain stimulation for parkinson’s disease preserving the working capabilities]

DELI Gabriella, BALÁS István, KOMOLY Sámuel, DÓCZI Tamás, JANSZKY József, ASCHERMANN Zsuzsanna, NAGY Ferenc, BOSNYÁK Edit, KOVÁCS Norbert

[Background – The recently published “EarlyStim” study demonstrated that deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD) with early fluctuations is superior to the optimal pharmacological treatment in improving the quality of life and motor symptoms, and preserving sociocultural position. Our retrospective investigation aimed to evaluate if DBS therapy was able to preserve the working capabilities of our patients. Methods – We reviewed the data of 39 young (<60 years-old) PD patients who underwent subthalamic DBS implantation at University of Pécs and had at least two years follow-up. Patients were categorized into two groups based on their working capabilities: Patients with active job (“Job+” group, n=15) and retired patients (without active job, “Job-” group, n=24). Severity of motor symptoms (UPDRS part 3), quality of life (EQ-5D) and presence of active job were evaluated one and two years after the operation. Results – As far as the severity of motor symptoms were concerned, similar (approximately 50%) improvement was achieved in both groups. However, the postoperative quality of life was significantly better in the Job+ group. Majority (12/15, 80%) of Job+ group members were able to preserve their job two years after the operation. However, only a minimal portion (1/24, 4.2%) of the Job- group members was able to return to the world of active employees (p<0.01, McNemar test). Conclusion – Although our retrospective study has several limitations, our results fit well with the conclusions of “EarlyStim” study. Both of them suggest that with optimal timing of DBS implantation we may preserve the working capabilities of our patients.]

Hungarian Radiology

[Interdisciplinary mummy research - Paleoradiology and paleopathology research of the Archbishop of Kalocsa Pál Széchényi’s mummy]

KRISTÓF Lilla Alida, POHÁRNOK László, KERÉNYI Tibor, TÓTH Vilmos, ISTÓK Roland, HARGITTAI Péter, FORNET Béla, PAP Ildikó, PÁLFI György

[Purpose - The scientific study of Pál Széchényi’s mummy was carried out by our research team composed of the members of several institutions in 2007 April. The scientific examinations represented a milestone, since up till now it was unclear whether it was a natural or artificial mummy and the century-old question whether Pál Széchényi was in fact a victim of arsenic poisoning in 1710 or it was only a legend could also be answered. Methods - The non-invasive examinations were carried out with multislice CT, traditional X-ray, biopsy, toxicology, energy-dispersive X-ray, X-ray fluorescens analysis, 3D optical digitalization indicator system, endoscope and 3D rapid-prototyping printing. Results - The examinations proved that Archbishop Pál Széchényi’s death was natural, and his body was artificially mummified. The CT examinations were carried out in a slice thickness of under 1 mm facilitating printed skull copy made by 3D rapid-prototyping method which provided the exact and detailed basis for the facial reconstruction.]

Hypertension and nephrology

[Hungary’s anthropometric position based on national public health screening (2010-2017). Data and correlation analysis - Part I.]

KÉKES Ede, BARNA István, DAIKI Tenno, Dankovics Gergely, †KISS István

[The aim of the study is to present a Hungarian anthropometric profile on a full-scale basis (body mass, BMI, waist circumference, waist/hip ratio, percentage of body fat, abdominal fat mass) based on the data of the “Nationwide Comprehensive Health Screening Program in Hungary 2010-2020” collected over 8 years. In the analysis we processed 70,094 women and 67,549 men. We found, that in the Hungarian society, overweight and obesity was on the rise between 2010 and 2017, and beyond 2014 its rate was ever higher. Growth of body fat and abdominal fat is characteristic for both sexes, but abdominal obesity in relative terms of waist size, waist/hip ratio and percentage of body fat is significantly higher in morbid obese women. The fact is particularly worrying that these growth trends are already present in age groups of 18-26. These signs warn us definitely that we need to take a greater part in influencing the lifestyle, eating habits of individuals and in the promotion of physical activity.]

Hypertension and nephrology

[The 18th Congress of the Hungarian Society of Hypertension]