A Neuropsychological and Neurophysiological Study of Memory Impairments in Patients with Left-Hemispheric Stroke during Rehabilitation

The informative and prognostic value of assessing the brain functional state and memory functions with neurophysiological, electrophysiological, and clinical methods was demonstrated in patients with consequences of ischemic stroke. The character and degree of memory impairments were associated with the localization and extent of the postischemic lesion and correlated with the markedness of pathological signs in the bioelectrical activity of the brain. This allowed identification of predictors of an adverse outcome and yielded valuable information for neurorehabilitation of poststroke patients.     

Neurophysiological Indicators of Voluntary and Involuntary Visual Attention in a Human

The visual evoked potentials (EPs) in response to lateralized and central visual symbols under the conditions of involuntary (passive viewing) and selective attention (when one of the symbols was a target and required a rapid and precise motor reaction) are considered. The evoked potentials in the occipital, parietal, and frontal derivations were recorded in 20 healthy subjects. It was shown that the EP during selective attention are most pronounced and more alike in the parietal derivations. A strong positive correlation was revealed between the EP amplitude ([N1–P3] component) and the EP stability (correlation between the repeated EP). The involuntary and voluntary forms of attention supplement each other: the more expressed the involuntary attention (assessed by the [N1–P3] component) the higher the EP to target stimuli during voluntary attention and the shorter the reaction time. It is suggested that the role of visual attention consists in the increase and stabilization of cortical activity (primarily, the parietal regions) engaged in solving a visual task.     

Electromyographic Parameters of Muscle Fatigue in Patients with Parkinsonism

The authors studied muscle fatigue in patients with parkinsonism receiving pathogenetic therapy and in elderly healthy subjects by means of turn-amplitude analysis of surface electromyography (EMG). The healthy subjects reacted to fatigue with a significant increase in the amplitude and number of EMG turns during static exercise and a decrease in the peak ratio. In patients with parkinsonism, fatigue began after an exercise that was half of that in the healthy subjects with a decrease in the number of turns and mean amplitude and an increase in peak ratio. These data show that dynamics of strength and EMG parameters differs in patients with parkinsonism and healthy subjects.     

帕金森病患者睡眠障碍与脑电图活动、神经心理学指标和健康相关生活质量的关系研究

摘要 目的：研究帕金森病（PD）患者睡眠障碍与脑电图活动、神经心理学指标和健康相关生活质量的关系。方法：选择我院2018年5月～2021年5月收治100例PD患者。将其根据匹兹堡睡眠质量指数（PSQI）评分的差异分作睡眠障碍组（PSQI评分＞7分）68例及无睡眠障碍组（PSQI评分≤7分）32例。比较两组脑电图活动、神经心理学指标以及39项帕金森病生活质量调查表（PDQ39）评分,并分析PSQI评分与脑电图活动、神经心理学指标及PDQ39评分的相关性。结果：睡眠障碍组的δ波和θ波相对功率值高于无睡眠障碍组,而β1、β2两个频段的相对功率值低于无睡眠障碍组（P＜0.05）;睡眠障碍组脑电图轻度异常、中度异常以及重度异常的患者比例高于无睡眠障碍组,而脑电图正常的患者比例低于无睡眠障碍组（P＜0.05）。睡眠障碍组蒙特利尔认知评估中文量表（MoCA）评分低于无睡眠障碍组,而汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评分均高于无睡眠障碍组（P＜0.05）。睡眠障碍组PDQ39各项目评分及总分均高于无睡眠障碍组（P＜0.05）。经Pearson及Spearman相关性分析可得：PD患者的PSQI评分与脑电图异常程度、HAMA评分、HAMD评分及PDQ39评分均呈正相关,而与MoCA评分呈负相关（P＜0.05）。结论：睡眠障碍可能对PD患者认知功能造成损害,加剧焦虑、抑郁等负性情绪,并降低其健康相关生活质量,监测脑电图活动可在一定程度上判断PD患者睡眠障碍严重程度。     

Rehabilitation of Patients with Through-knee Amputation

One hundred and one patients with through-knee amputations attending the Manchester limb-fitting centre are reviewed. Most amputations were performed for trauma or vascular disease. The interval from amputation to measurement for the first prosthesis averaged 12 weeks in cases of primary healing, and 21 weeks when healing was delayed. Artificial limbs were successfully fitted to 83%, and only 10% failed to use either a limb or a pylon. Three-quarters of those with outdoor mobility returned to work.Disarticulation through the knee has several advantages over above-knee amputation: in particular, the long end-bearing stump facilitates balance and control of the prosthesis. Disadvantages are a tendency to slow healing of the wound, lack of an internal knee mechanism in the artificial limb, and the bulky appearance of the limb. The results of rehabilitation could be improved by careful selection of patients and attention to operative detail; stump bandaging and exercises; earlier attendance at the limb-fitting centre to be measured for pylon or artificial limb; and improvements in design and production of prostheses.     

Clinical Problems: Levodopa Therapy of Patients with Parkinsonism and Heart Disease

Forty patients with Parkinsonism and heart disease were studied before and during the administration of levodopa. Patients with increasing angina, myocardial infarction within the previous year, pre-existing severe postural hypotension, or transient cerebral ischaemia were excluded. Thirty-eight patients showed no adverse effects; angina improved in one patient but later worsened; one patient died of myocardial infarction after a severe gastrointestinal haemorrhage. Therapy with levodopa appears to pose little increased hazard to patients with most forms of heart disease. Inpatient monitoring is recommended at the beginning of therapy, and antiarrhythmic agents should be used when required.     

Neurophysiological and Psychophysiological Effects of Sulpiride in the Norm and in Patients with Opiate Addiction

We studied characteristics of the EEG activity and psychophysiological indices in healthy persons and patients with opiate addiction (in the states of abstinence and remission) before and after peroral introduction of 200 mg sulpiride. In the initial state, spectral characteristics of EEG in patients with opiate addiction differed from those in the control (in healthy tested subjects) by higher relative powers of low- and high-frequency components (delta and beta waves) and a considerable depression of the alpha rhythm. Treatment with sulpiride evoked changes in the spectral characteristics of EEG, which showed a significant intergroup specificity; intensification of alpha oscillations was a general effect in all groups. We conclude that the effects of sulpiride on the EEG activity comprised components typical of both neuroleptics and antidepressants; in the group of patients in the abstinence state, the pattern of effects of sulpiride was close in its profile to the effect of anxiolytics. Dynamics of the indices of psychophysiological testing after sulpiride treatment demonstrated that the drug exerts mostly positive regulating effects on the state of higher nervous functions in patients with opiate addiction.     

Decision-Making in Patients with Hyperthyroidism: A Neuropsychological Study

Introduction

Cognitive and behavioral impairments are common in patients with abnormal thyroid function; these impairments cause a reduction in their quality of life. The current study investigates the decision making performance in patients with hyperthyroidism to explore the possible mechanism of their cognitive and behavioral impairments.

Methods

Thirty-eight patients with hyperthyroidism and forty healthy control subjects were recruited to perform the Iowa Gambling Task (IGT), which assessed decision making under ambiguous conditions.

Results

Patients with hyperthyroidism had a higher score on the Zung Self-Rating Anxiety Scale (Z-SAS), and exhibited poorer executive function and IGT performance than did healthy control subjects. The patients preferred to choose decks with a high immediate reward, despite a higher future punishment, and were not capable of effectively using feedback information from previous choices. No clinical characteristics were associated with the total net score of the IGT in the current study.

Conclusions

Patients with hyperthyroidism had decision-making impairment under ambiguous conditions. The deficits may result from frontal cortex and limbic system metabolic disorders and dopamine dysfunction.     

Neuropsychological Investigation in Chinese Patients with Progressive Muscular Atrophy

Background

Progressive muscular atrophy (PMA) is a rare type of degenerative motor neuron disease (MND) of which the onset happens in adult period. Despite its well-defined clinical characteristics, its neuropsychological profile has remained poorly understood, considering the consensus of cognitive and behavioral impairment reached in amyotrophic lateral sclerosis (ALS).

Methods

We conducted a cross-sectional evaluation of Chinese PMA patients with a series of comprehensive batteries emphasizing the executive and attention function, and covering other domains of memory, language, visuospatial function, calculation and behavior as well. Their performances were compared with those of age- and education-matched ALS and healthy controls (HC).

Results

21 patients newly diagnosed with PMA were consecutively enrolled into our ALS and other MND registry platform, accounting for 14.7% of all the incident MND cases registered during the same period. 20 patients who completed the neuropsychological batteries were included into analysis. Compared with HC, PMA performed significantly worse in maintenance function of attention, while they exhibited quantitative similarity to ALS in all behavioral inventories and neuropsychological tests except the time for Stroop interference effect.

Conclusion

PMA could display mild cognitive dysfunction in the same frontal-mediated territory of ALS but in a lesser degree, whereas they did not differ from ALS behaviorally.     

Neurophysiological Characteristics of Compensatory Brain Processes in Rehabilitation of Impairments of the Visual and Acoustic Systems

Compensatory rehabilitative reorganization of brain functions upon medical modulating electric treatment directed at afferent inputs of the impaired visual or acoustic systems is considered. General and specific characteristics of the reorganization of brain functioning aimed at compensating visual or hearing defects were revealed by estimating the electroencephalogram (EEG) dynamics and evoked potentials (EP). Electrographic correlates of the transitory and compensated states of the brain in rehabilitation of the disturbed sensory functions were established. Short-term functional structures sharing , , and synchronization patterns were revealed. These structures reflect sequential participation of specific and nonspecific brain systems in the reorganization of brain functioning. Specific interactions between the damaged and the intact sensory systems were found, which indicated common nonspecific mechanisms for processing acoustic and visual afference. The existence of a programmed central mechanism that compensates the disturbed functions of the sensory systems is suggested.     

CSF Biomarkers and Neuropsychological Profiles in Patients with Cerebral Small-Vessel Disease

Despite existing criteria, differential diagnosis of Vascular Dementia (VD) and Alzheimer''s disease (AD) remains difficult. The aim of this study is to figure out cognitive and biomarker profiles that may help to distinguish between VD, AD and AD + Cerebral Small Vessel Disease (CSVD). We examined a cohort of patients with CSVD (n = 92). After stratification of cognitive impaired patients (n = 59) using the standard CSF beta-amyloid 42/40 ratio cut-off point of 0.975, we obtained two groups which differed with respect to several features: 32 patients with normal beta-amyloid 42/40 ratio (>0.975) showed markedly impaired blood-brain-barrier function as indicated by an elevated albumin ratio (median 8.35). They also differed in cognitive profiles when compared to 27 patients with AD typical beta-amyloid ratio and normal albumin ratio. We also enrolled an additional group of patients with AD (no significant CSVD on MRI, n = 27) which showed no impairment of the blood-brain-barrier. We showed a negative correlation between the albumin ratio and executive cognitive function (p = 0.016) and a negative correlation between memory function and typical AD markers like Tau (p = 0.004) and p181-Tau (p = 0.023) in our cohort. We suppose that the group of patients with normal beta-amyloid ratio represents VD while patients in the other groups represent AD+CSVD and pure AD. Our results support the idea that a dysfunction of the blood-brain-barrier might be contributing factor in the development of cognitive decline in CSVD as it seems to be of more importance than the severity of white matter lesions.     

Neuropsychological Correlates of Brain Perfusion SPECT in Patients with Macrophagic Myofasciitis

Background

Patients with aluminum hydroxide adjuvant-induced macrophagic myofasciitis (MMF) complain of arthromyalgias, chronic fatigue and cognitive deficits. This study aimed to characterize brain perfusion in these patients.

Methods

Brain perfusion SPECT was performed in 76 consecutive patients (aged 49±10 y) followed in the Garches-Necker-Mondor-Hendaye reference center for rare neuromuscular diseases. Images were acquired 30 min after intravenous injection of 925 MBq ^99mTc-ethylcysteinate dimer (ECD) at rest. All patients also underwent a comprehensive battery of neuropsychological tests, within 1.3±5.5 mo from SPECT. Statistical parametric maps (SPM12) were obtained for each test using linear regressions between each performance score and brain perfusion, with adjustment for age, sex, socio-cultural level and time delay between brain SPECT and neuropsychological testing.

Results

SPM analysis revealed positive correlation between neuropsychological scores (mostly exploring executive functions) and brain perfusion in the posterior associative cortex, including cuneus/precuneus/occipital lingual areas, the periventricular white matter/corpus callosum, and the cerebellum, while negative correlation was found with amygdalo-hippocampal/entorhinal complexes. A positive correlation was also observed between brain perfusion and the posterior associative cortex when the time elapsed since last vaccine injection was investigated.

Conclusions

Brain perfusion SPECT showed a pattern of cortical and subcortical changes in accordance with the MMF-associated cognitive disorder previously described. These results provide a neurobiological substrate for brain dysfunction in aluminum hydroxide adjuvant-induced MMF patients.     

Neuropsychological and Brain Volume Differences in Patients with Left- and Right-Beginning Corticobasal Syndrome

Background

Corticobasal Syndrome (CBS) is a rare neurodegenerative syndrome characterized by unilaterally beginning frontoparietal and basal ganglia atrophy. The study aimed to prove the hypothesis that there are differences in hemispheric susceptibility to disease-related changes.

Methods

Two groups of CBS patients with symptoms starting either on the left or right body side were investigated. Groups consisted of four patients each and were matched for sex, age and disease duration. Patient groups and a group of eight healthy age-matched controls were analyzed using deformation field morphometry and neuropsychological testing. To further characterize individual disease progression regarding brain atrophy and neuropsychological performance, two female, disease duration-matched patients differing in initially impaired body side were followed over six months.

Results

A distinct pattern of neural atrophy and neuropsychological performance was revealed for both CBS: Patients with initial right-sided impairment (r-CBS) revealed atrophy predominantly in frontoparietal areas and showed, except from apraxia, no other cognitive deficits. In contrast, patients with impairment of the left body side (l-CBS) revealed more widespread atrophy, extending from frontoparietal to orbitofrontal and temporal regions; and apraxia, perceptional and memory deficits could be found. A similar pattern of morphological and neuropsychological differences was found for the individual disease progression in l-CBS and r-CBS single cases.

Conclusions

For similar durations of disease, volumetric grey matter loss related to CBS pathology appeared earlier and progressed faster in l-CBS than in r-CBS. Cognitive impairment in r-CBS was characterized by apraxia, and additional memory and perceptional deficits for l-CBS.     

Assessment of the Efficiency of a Metal Phytoextraction Process with Biological Indicators of Soil Health

The ultimate goal of any soil remediation process should be not only to remove the contaminant(s) from the polluted site but to restore soil health as well. In consequence, reliable indicators of soil health are needed if we are to properly evaluate the efficiency of a soil remediation process. The aim of the current work was to determine the effect of metal phytoextraction, through the utilization of the Zn hyperaccumulator T. caerulescens, on biological parameters of soil health, on the assumption that biological indicators of soil health might be valid monitoring tools to assess the efficiency of a metal phytoextraction process. To this end, a short-term microcosm phytoextraction study was carried out, with two heavy metal polluted soils collected from an abandoned mine, to determine the effect of metal phytoextraction on soil biological parameters. Higher values of biomass C, basal respiration, substrate induced respiration, and β-glucosidase activity were observed in the presence of T. caerulescens plants, as compared to unplanted pots. Our data confirm the great capacity of T. caerulescens to phytoextract Zn from polluted soils and, interestingly, suggest that metal phytoextraction has indeed a beneficial effect on soil biological activity. It was concluded that the revegetation of these metal polluted soils with T. caerulescens could help activate their biochemical and microbial functionality.