摘要:

Geographical variations in the age‐adjusted death rate from Parkinson's disease (PD) were analyzed using Japanese vital statistics for 1977–1985. The highest age‐adjusted PD death rate was 2.7 times higher in Tottori (2.9 per 100000 population aged 25 years and over) than Fukushima (1.1) prefectures. The overall age‐adjusted PD death rate was 1.8. The age‐adjusted PD death rate was higher in urban (2.0) than in rural (1.7) areas during the period 1979–1985. The age‐adjusted PD death rate was higher in the southwest than in the northeast. Correlation coefficients between the age‐adjusted PD death rate, and the mean physician‐population ratio and the mean neurologist‐population ratio were positive, but not statistically significant. The regional variations in the age‐adjusted PD death rate were not entirely explained by the availability of medical facilities. Environmental risk factors for PD might differ regionally. Further investigation is needed to explain the differential age‐adjusted

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07013.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

To elucidate the possible role of manganese in the risk of developing Parkinson's disease (PD), we compared serum levels of manganese, and 24‐h manganese excretion by urine in 29 PD patients and in 27 matched controls. We also measured chromium and cobalt in the same samples. All these values did not differ significantly between the groups, they were not influenced by antiparkinsonian drugs, and they did not correlate with age, age at onset and duration of the PD, scores of the Unified PD Rating Scale or the Hoehn&Yahr staging in the PD group. These results might suggest that serum levels and urinary excretion of manganese are apparently unrelated to the risk of developing P

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07014.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

As of 1991 we had ascertained 42 native resident Faroese plus 12 non‐resident “migrant” Faroese with clinical onset of MS in this century. The resident series comprised four successive epidemics beginning in 1943 and then at 13‐year intervals thereafter, a separation of very high statistical significance (p<0.00001). We concluded that the first epidemic in the Faroes resulted from the introduction of a specific but unknown infection which we call the “primary MS affection” (PMSA) by occupying British troops during World War II. Clinical neurologic MS (CNMS) is then the rare late sequel of infection with PMSA. The first epidemic defined age of susceptibility to PMSA as age 11 to 45 at onset of exposure. Models of transmission used for the first three epidemics included the need for two years of exposure before PMSA acquisition and limitation of transmissibility of PMSA to age 13 to 26. With these conditions successive cohorts of susceptible Faroese were defined to account for the second and third epidemics, and they also predicted the occurrence of the fourth epidemic. Further consideration of these models suggests transmissibility is even more limited, perhaps to age 20

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07015.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

This report describes a multiple sclerosis (MS)‐like disorder in a male patient with Leber's hereditary optic neuropathy (LHON) harbouring the mitochondrial DNA 11778 base pair mutation. Given the population frequencies of MS and LHON, coincidental occurrence is unlikely. Hypothetically the mitochondrial mutation underlying LHON may contribute to presumably immunologically mediated involvement of other myelinated axons in the central nervous system in susceptible individuals, producing a disorder indistinguishable from MS. We recommend that investigation for oligoclonal bands in CSF, evoked potentials and MR brain scan in these patients be supplemented with mitochondrial DNA analysi

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07016.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

This review assesses the evidence of the efficacy of hyperbaric oxygen in multiple sclerosis.Material&methods– We used a list of predefined criteria for good methodology and interpreted the results of 14 identified controlled trials with emphasis on the quality.Results– At least eight trials can be considered to have a reasonable to high quality. In one of these 8 trials the results were in favour of hyperbaric oxygen treatment; the others found no clear positive effects. The patients had chronic progressive or chronic stable multiple sclerosis. In most trials, hyperbaric oxygen was supplied at pressures of 1.75 – 2 ATA, during 20 sessions of 90 min in 4 weeks. The principle endpoint was the (Expanded) Disability Status Score [(E)DSS] and the Functional Status Score as described by Kurtzke. Also specific outcomes such as evoked potentials were frequently used, but no consistent positive effects were demonstrated. Side effects were generally minor, ear and visual problems predominated.Conclusions– The majority of controlled trials could not show positive effects. Further evidence might consist of trials in patients with disease of recent onset or with other dosing regimens but the case for such further trials is not strong. Considering the state of affairs we cannot recommend the use of hyperbaric oxygen in the treatment of multiple sc

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07017.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The discrepancy between current and premorbid ability is a relevant indicator of acquired mental impairment, which itself is closely related to general cerebral dysfunction. The use of tests sensitive to cerebral dysfunction, raises relatively few problems compared with tests being resistent that are used to estimate premorbid mental ability. For premorbid ability, verbal tests assessing knowledge, especially vocabulary, have been shown to be valid. A test, possibly more insensitive to brain dysfunction than the ones usually administered, is the multiple choice vocabulary test (MWT = Mehrfachwahl‐Wortschatz‐Test). At present only German versions are available. They are presented in some detail because of their advantages. Construction of the MWT is simple, and it can be easily administered in about five minutes. The results correlate fairly well with global IQ in healthy adults (median of r = 0.72 in 22 samples) and are more insensitive to current disturbances than such tests as the WAIS vocabulary test. The limitations of premorbid tests with respect to diagnostic validity are discussed. It is concluded, that studies which do not control premorbid intelligence have to be considered as a “malpractice” and should not be accepted by sci

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07018.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Attentional functioning and memory of common whiplash patients were evaluated during the first two years after experiencing injury. The study was based on a non‐selected sample of 117 whiplash patients referred from primary care and recruited according to a strict injury definition. All patients had a similar socioeconomic background, all being injured in automobile accidents and fully covered by insurance plans. Two years following initial trauma, 21 patients remained symptomatic. For each of these 21 patients, a counterpart matched by age, educational attainment and gender was selected from the group of patients who had fully recovered during the follow‐up period. Symptomatic patients and matched controls were compared with regard to baseline, six‐months and two‐years findings. Examinations included testing of different aspects of attention (i.e. Digit Span, Corsi Block‐Tapping Test, Trail Making Test, Number Connection Test, Paced Auditory Serial Addition Task) and memory functioning (California Verbal Learning Test). Cognitive functioning was assessed in conjunction with self‐ratings of cognitive abilities (Cognitive Failures Questionnaire), well‐being (Well‐being Scale), headache and neckpain intensity, utilized medication and subjective complaints. Results show no impairment of memory in symptomatic patients. In attentional functioning, different levels of improvement were found for symptomatic patients and matched counterparts, with the former showing difficulty at follow‐up with tasks of divided attention. Utilized medication and pain intensity could not explain this difference in recovery of attentional functioning between the groups. These findings suggest problems in selective aspects of attentional functioning after common whiplash, which under real life circumstances may explain these patients' cognitive complaints and cause adaptational probl

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07019.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

We studied long‐term cognitive deficits in 20 patients with previously diagnosed Lyme borreliosis several years (average 51.6 months) after their acute phase of illness. Compared with an age‐ and education matched control group Lyme patients revealed deficits of verbal memory, mental flexibility, verbal associative functions and articulation, but performed adequately on tests of intellectual and problem solving skills, sustained attention, visuoconstructive abilities and mental speed. The late cognitive outcome was unrelated to disease variables from the acute stage of illness, but also to the interval elapsed since infection withB.burgdorferi. These and similar observations (Krupp et al. 1991) suggest that the so‐called Lyme encephalopathy may be associated with a long‐lasting neuropsychological deficit predominantly affecting mnestic fu

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07020.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

A study of auditory P300 was performed on 24 patients with cirrhosis of the liver: 13 patients with hepatic encephalopathy (HE grade 1–2) and 11 patients without clinical encephalopathy (HE grade 0). The patients were also assessed using spontaneous EEG and neuropsychological methods: Mini Mental State, Digit Span and Number Connection Test. The P3 latency was found to be significantly increased in all patients (100%) with HE grade 1–2 and in 6 patients (54.5%) with HE grade 0. The clinical value of using the P300 latency in the hepatic encephalopathy is subsequently discus

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07021.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Auditory event related magnetic fields were measured using an odd‐ball paradigm in which the rare event was a tone of short duration, D2, and the frequent one a tone of longer duration, D1. The subjects were required to attend to and count the number of rare stimuli. In the average across target stimuli a mismatch field (MMF) occurs and the dependence of the MMF, especially its latency, on the tone duration D2 is examined in detail. The location of an equivalent current dipole for the MMF‐source is found and turns out to be at variance with earlier results. In addition to the MMF we propose a new component, here called MMF, which in time overlaps the magnetic equivalent of the P200 signal and which has a source location (equivalent current dipole) lying rather close to the MMF‐source. The two sources are, however, active at latencies differing by a time equal to D2. We speculate that MMF indicates the onset of the process: “evaluation of tone‐duration” while the MMF indicates the end of t

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1995.tb07022.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY