Clinical Neuroscience



JANUARY 22, 2008

Clinical Neuroscience - 2008;61(01-02)

[The triple combination of levodopa, DDCI and entacapone (Stalevo) is used to treat motor complication in Parkinsonian patients with fluctuation. An observational investigation has been conducted in Hungary to study the effects of Stalevo on the “wearing off” phenomenon and on the quality of life in patients, who are to be treated with. The introduction of Stalevo to the treatment resulted in no changes in the number of patients taking selegiline, amantadine and dopamin agonists, while the number of patients taking anticholinergic drugs were slightly increased. This treatment significantly decreased the average Hoehn-Yahr stadium, as well as the non-motor symptoms, without any remarkable side effect. Stalevo also improved the quality of life, detected by the EQ-5D questionare and the visual analoge scale.]



Further articles in this publication

Clinical Neuroscience

[Occlusive hydrocephalus caused by a fourth ventricle arachnoid cyst (in English language)]

SZŰCS Anna, VÁRADY Péter, PESTALITY Péter, FABÓ Dániel, LALIT Narula, KENÉZ József

[The case history of a woman with occlusive hydrocephalus caused by a fourth ventricle cyst is presented. She had slowly progressive complaints and symptoms - concentration and memory disturbances, low-tempered mood, then slight dizziness, loss of appetite and progressive headache - transitorily misinterpreted for signs of depression. She had been treated by psychotherapy and antidepressants for months. Since she did not improve she was referred to a psychiatric hospital. The rapidly progressing neurological syndrome with worsening headache, gait disturbance and vomiting was finally identified and it turned out to be caused by a fourth ventricle CSF blockage of unknown aetiology. An acute neurosurgical intervention was indicated. It revealed a huge fourth ventricle cyst, undetectable on MRI, occupying the whole ventricle. The resection of its walls resulted in complete recovery. We conclude that since unspecific mental complaints and symptoms suggesting depression may be misleading, their organic origin has to be excluded.]

Clinical Neuroscience

[Péter Rajna : Aging brain - aging mind - ageless (?) soul]

KOPP Mária

Clinical Neuroscience


BENEDEK Krisztina, PÁLFFY Andrea, BENCSIK Krisztina, FEJES Imre, RAJDA Cecília, TUBOLY Gábor, LISZLI Péter

[Objective - To survey the role of pattern electroretinography (PERG) and pattern visual evoked potentials (VEPs) in the process of clinical evaluation of neuro-ophthalmological cases. The study is illustrated with the electrophysiological findings of 231 patients sent to our laboratory in 2005 because of the suspicion of damage in the optic pathway. Methods - The RETIport program of the ROLAND equipment (Wiesbaden - Germany) was used to record PERGs and VEPs. The recordings were done according to the recommendations of the International Society for Clinical Electrophysiology of Vision. Results - The combined application of PERG and VEP provided useful data on the retino-cortical conduction time and hence demyelinisation. The comparison of the N35/P50 and P50/N90 amplitudes of the PERG recordings greatly promoted the diagnostic procedure. Conclusions - The combined application of PERG and VEP methods is recommended in the assessment of optic nerve function of neuro-ophthalmological patients.]

Clinical Neuroscience


KOVÁCS Gábor Géza, KŐVÁRI Viktor, NAGY Zoltán

[Background - Dementia is an increasing problem of the society. The underlying cause of dementia may be difficult to diagnose during life. Only neuropathological examination gives definite diagnosis. Differences in the reported frequency may be related to factors such as the age or gender of subjects with dementia. Materials and methods - In our neuropathology-based study we examined 156 consecutive subjects clinically diagnosed with dementia during a 3-year period. Using histopathological criteria we calculated the frequencies of various disorders causing dementia. We studied the effect of age and gender on these frequencies. Results - Alzheimer’s disease was the most frequent pathologic finding (57.7%) followed by vascular dementia (43%); diffuse Lewy body disease (15.4%); argyrophilic grain dementia (12.1%), various forms of frontotemporal dementia (5.7%); and other (4.5%). The latter comprise prion disease, alcoholic encephalopathy, and hippocampal sclerosis. Mixed pathology was common: concomitant Alzheimer’s disease was present in 41.6% of diffuse Lewy body disease cases and in 49.2% of vascular dementia patients. Pure disease forms are rare: Alzheimer’s disease: 26.3%, vascular dementia: 17.3%, diffuse Lewy body disease: 5.1%, argyrophilic grain dementia: 2.5%. Females were overrepresented among those with Alzheimer’s disease with age at death above 75 years (p <0.02), while males were overrepresented in patients below 75 years with vascular dementia (p <0.05). Conclusions - Our study indicates that the frequency of neurodegenerative dementias is high in the examined patients, but vascular pathology frequently influences the clinical course.]

Clinical Neuroscience


NYÁRY István

[History of the measurement of local cerebral blood flow may cover a period of one and a half centuries. Parallel forthcoming of both theoretical and technical development were the key elements of ensuing progress resulting in the present state, when by the aid of in vivo blood flow and metabolic maps, we can visualize locales of brain functioning and their interconnections. Two theoretical landmarks should be mentioned in this historic process. First, the work of Adolf Fick, as the starter of quantitative measurements in this field, and Seymour Kety’s model of a single, homogenously perfused tissue element. The solution of this model, in the form of Kety’s equation is still fundamental to present day blood flow mapping techniques. Among the numerous investigators over the past years, two Hungarian scientist can be named as major contributors. Kálmán Sántha made substantial studies with continuous registration of local cerebral blood flow by the aid of thermocouples, while Emil Pásztor invented the hydrogen clearance method for the measurement of local cerebral blod flow both in human and in animal studies.]

All articles in the issue

Related contents

Clinical Neuroscience

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


[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.]

Lege Artis Medicinae


SZEGEDI Andrea, KISS Flóra, GAÁL János

[Psoriasis is one of the most common dermatological disorders. It is an immune-mediated chronic inflammatory disease that primarily affects the skin and the joints, and substantially reduces the quality of life. It occurs worldwide, with a prevalence of about 2% in developed countries. Today numerous studies are continuously published on psoriasis. Important progress has been made especially on its genetics, pathomechanism and comorbidity. In the past few years, several efficient therapeutic approaches have been developed and applied. With the appearance of biological therapies, the inflammatory process can be targeted more selectively than before. The paper reviews most recent data on the pathogenesis, immunological background, comorbidity and reduced quality of life associated with psoriasis, and presents therapeutic approaches with special focus on recent advances. The increased knowledge allows of a more efficient treatment and care of patients with proriasis, thus significantly increasing their quality of life.]

Hypertension and nephrology

[Protein-energy wasting and quality of life in kidney transplant recipients]

UJSZÁSZI Ákos, VÁRADY Tímea, CZIRA Mária Eszter, FORNÁDI Katalin, Novák Márta, MUCSI István, MOLNÁR Miklós Zsolt

[Chronic kidney disease has profound effects on the health related quality of life (HRQoL) of patients with serious physiological, psychological and socio-economic implications. The co-occurrence of protein-energy wasting (PEW) and inflammation in end stage renal disease patients is associated with worse HRQoL and increased mortality. We designed this study to examine the relationship between nutritional and inflammatory status and HRQoL in kidney transplant recipients. Data from 100 randomly selected kidney transplant patients were analyzed in a crosssectional survey. Socio-demographic parameters, laboratory results, transplantation related data, co-morbidities, medication and malnutrition-inflammation score (MIS) (Kalantar Score) were tabulated at baseline. Patients completed the Kidney Disease Quality of Life-SF (KDQoL-SFTM) self-administered questionnaire. Mean age was 51±13 years, median (interquartile range, IQR) time since transplantation 66 (83) months, 57% were males and 19% had diabetes. The median (IQR) MIS was 3 (3). MIS significantly and negatively correlated with almost all HRQoL domains analyzed, and this association remained significant in multivariate linear regression analysis for the log-transformed scores on energy/fatigue (β=-0.059, p<0.001), bodily pain (β=-0.056, p=0.004), physical functioning (β=-0.029, p=0.022), and symptoms/problems (β=-0.023, p=0.005) domains after statistical correction for age, gender, eGFR, dialysis vintage, Charlson Comorbidity Index and occupational status. Additionally, cubic spline analyses revealed linearly increasing, “dose-response” relationship between almost all domains of KDQoL-SFTM and the MIS. Malnutrition Inflammation Score is independently associated with different dimensions of health related quality of life in kidney transplant recipients.]

Clinical Neuroscience

[Tension-type headache in ulcerative colitis]

TAJTI Jr. János, LÁTOS Melinda, ÁBRAHÁM Szabolcs, SIMONKA Zsolt, PASZT Attila, LÁZÁR György

[Background and purpose - Tension-type headache is a very common disease with a high socio-economic impact as its lifetime prevalence is 30-78% in the general population. The incidence of inflammatory bowel diseases is continuously rising. Limited data are accessible on quality of life in patients with surgically treated ulcerative colitis. The aim of our study is to examine quality of life, concerning headache, among patients who had undergone surgery due to ulcerative colitis. Methods - Between 1 January 2005 and 1 March 2016, surgery was performed due to ulcerative colitis in 75 patients. During this retrospective analysis the average duration of the follow-up was 46 (1-124) months. The pre-sence of headache was evaluated by the use of Brief Illness Perception and Headache Questionnaires. Results - Among the primary headache disorders (n=27), tension-type headache occurred in 19 (70.4%) cases, and 8 (29.6%) patients had migraine (without aura). Among tension-type headache cases 17 (89.5%) patients experienced episodic form and 2 (10.5%) suffered from chronic form. Patients with headache had obtained a significantly higher score on Brief Illness Perception Questionnaire. Conclusions - According to our study tension-type headache is common among patients with ulcerative colitis. This observation raises the question whether stress plays role in the pathogenesis of both diseases, which influences and worsens considerably quality of life. Neurological examination, psychological and psychiatric guidance are worth considering in patients with ulcerative colitis.]

Clinical Neuroscience

[Selection of the optimal device-aided therapy in Parkinson’s disease]

KOVÁCS Norbert, ASCHERMANN Zsuzsanna, JUHÁSZ Annamária, HARMAT Márk, PINTÉR Dávid, JANSZKY József

[For the treatment of advanced Parkinson’s disease the deep brain stimulation (DBS) and the levodopa/carbidopa intestinal gel (LCIG) therapies are available in Hungary. Although they may have similar impact on the health-related quality of life and disabilities associated with the disease, they have different indications, and inclusion- and exclusion criteria. Consequently, the patient population treated with DBS and LCIG may be different. In the present review, the authors try to help the process of selection of the optimal device-aided therapy for the patients with advanced Parkinson’s disease. ]