摘要:

Two major sources of dissatisfaction with the quality of life among Parkinsonian patients are the “locomotor disability” and the “nature of their sleep”. The main focus of research was directed towards the locomotor disability, but in the last two decades some progress has been made towards the understanding of sleep in PD patients. Sleep in Parkinson's disease is light and fragmented due to an increased skeletal muscle activity, disturbed breathing, impaired biological rhythm and REM‐nonREM variations of the dopaminergic receptor se

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04095.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The aim of this study was to examine the influence of response fluctuations with dyskinesia on the 24‐h motor activity pattern and measures of diurnal and nocturnal activity and immobility. Motor activity was recorded during 5 successive days in 5 patients with advanced Parkinson's disease (PD) suffering from severe response fluctuations with dyskinesia, as well as in 10 PD patients with a stable levodopa response and 10 healthy subjects. The 24‐h motor activity pattern of the patients with response fluctuations provides insight into the relationship between the therapeutic regimen and 1) the frequency and duration of “on” and “off” periods, 2) the severity of the dyskinesias, and 3) the degree of sleep disruption. In accordance with the severity of their motor fluctuations, patients with response fluctuations showed a large intra‐ and interindividual variability of diurnal motor activity measures. Overall, the nocturnal motor activity measures in the patients with response fluctuations indicated a severely disturbed sleep when compared with the two control groups. Factors as simplicity and the potential to record unrestrained motor activity for several days continuously in all settings, make activity monitoring a welcomed acquisition in the assessment of response fluct

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04096.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Simple reaction, single choice reaction, and paired choice reaction tasks were examined in 11 patients with Parkinson's disease (PD) and 12 controls. Subjects were given an auditory go/no‐go signal in the single choice reaction task, and paired visual and auditory go/no‐go signals in the paired choice reaction task. The response following the auditory go/no‐go signal was analyzed. The reaction and movement times were prolonged in patients with PD. Differences between simple and choice reaction times in PD patients did not differ from those in control subjects. The difference in movement time between simple and paired choice reaction tasks in PD patients was longer than that in control subjects, although the difference between simple and single choice reaction tasks was not significant between PD and control subjects. Sequential choices of visual and auditory stimulation may disturb the motor activity in PD pat

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04097.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

There is considerable debate about the increasing mortality from motor neurone disease (MND). However, examination of the relationship between increased life expectancy (through decreased general mortality) and increased mortality in both England and Wales and the United States indicates a close association between the two variables. Using a statistical model, defined sub‐populations susceptible to MND can be identified in both countries. The size of such a sub‐population has been estimated from the 1989 mortality data to be approximately 160 000 people in England and Wales. The proportion of this sub‐population dying from MND has increased over the last 30 years, rather than, as previously, dying at an earlier age from other conditions. On this basis, deaths from MND are expected to increase by a further 20% in this sub‐population between 1991‐2021 because of continuing changes in life expectancy. MND is a condition made increasingly visible in mortality statistics through decreased general mortality, rather than one in which the underlying population at risk has substantially changed. Aetiological extrapolations from the data indicate that susceptibility to the disease is acquired early in life, and that it is unlikely, given the relative stability of the underlying sub‐population, that either changed environmental circumstances or artifactual factors can account in themselves for the rise i

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04098.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In order to get to clues about T‐cell independent versus T‐cell dependent immune mechanism in ALS, we measured IgG subclasses in 25 ALS‐patients: 16 patients had deficiency of T‐cell dependent expressed IgG1 or IgG3 or both with essentially normal levels of T‐cell independent expressed IgG2 and IgG4. Ten of these patients had no prior treatment and five of these 10 had normal total IgG. Six patients had some immunosuppressive treatment before measurements of subclasses were done and all of them had deficiency of total IgG. Eight of 14 patients who underwent a d‐xylose breath test, had evidence of small bowel overgrowth, which was confirmed by cultures of duodenal aspirate. IgG1 and IgG3 are T‐cell dependent antibodies against protein antigens with close linkage on chromosome 14. The findings suggest a defect in the IgG subclass expr

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04099.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A new method for measurement of water self‐diffusion compensating for zeroth and first order movements was used to study the apparent diffusion coefficient (ADC) in 15 patients with chronic multiple sclerosis (MS) and in two patients with acute MS. Ten healthy volunteers served as controls. A significantly higher ADC was found within chronic plaques compared to the apparently normal white matter of the chronic patients. The ADC was higher in the acute plaques compared to the chronic plaques. The ADC in apparently normal white matter of the chronic patients were significantly higher than in white matter of healthy volunteers. We hypothesize that an increase of the ADC in plaques may be related to an increase in the extracellular space due to oedema and demyelination. The increased ADC in apparently normal white matter suggests that there may be a change in the composition of the white matter of chronic MS patients, perhaps related to oedema and expanded extracellular spac

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04100.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Among industrial solvents in present use trichloroethylene belongs to those which have been the concern of most neurological and occupational investigations since the beginning of this century. Reports on a broad spectrum of neurotoxicity are however mostly based on case‐studies and accidental circumstances. The object of this study was to examine clinical neurological manifestations after long‐term exposure to degreasing solvents, mainly trichloroethylene. The population was 99 metal degreasers, the design a historical cohort study. The most marked finding was a highly significant dose‐response relation between solvent exposure and motor dyscoordination ‐ a finding that was retained after multivariate control of relevant confounders. Vibration thresholds increased by solvent exposure at bivariate level, but the multivariate analysis showed that age was explaining most of the increase. No significant cranial nerve dysfunction wa

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04101.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Brain damage from carbon monoxide intoxication has not been extensively studied with magnetic resonance imaging. We report the clinical outcome and brain magnetic resonance imaging in three individuals simultaneously exposed to toxic levels of carbon monoxide four years previously. Lesions are seen in multiple locations and do not correlate well with the clinical condition.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04102.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Twenty‐three drug abusers and seventeen controls underwent clinical neurological examinations and magnetic resonance imaging (MRI) of the brain. The drug abuse encompassed cannabis, inhalants, opiates, psychedelics, amphetamines, and cocaine but not necessarily all drugs in all persons. The drug abuse was always combined with heavy alcohol consumption. One drug abuser had abnormal neurological findings which consisted of lower limb ataxia and 3 others had mild imbalance. MRI examinations did not show differences in width of the third, fourth or lateral ventricles nor the diameter of the cerebral aqueduct but the drug abusers had significantly smaller vermes cerebelli compared to controls. White matter changes also occurred more often in the drug abuser group. These findings are not consistent with known side‐effects of the narcotic drugs but more probably a result of very high alcohol consumptions in parallel with drug abuse. Alcohol is clearly a much more potent brain toxic agent than are the most commonly abused narcotic dr

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04103.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In the Danish Aneurysm Study 948 patients had a ruptured intracranial aneurysm (RA) revealed by cerebral angiography. Unilateral carotid angiography (UCA) with or without vertebral angiography (VA) demonstrated the RA in 206 patients, and 16 (7.8%) unruptured aneurysms (UA) were disclosed by UCA and 1 UA by VA. In 740 patients with at least bilateral carotid angiography (BCA) 164 UA (22.2%) were disclosed by BCA and 10 by VA. I.e. the number of UA demonstrated in patients with RA is not only doubled by BCA compared to ipsilateral UCA, but tripled demonstrating that an additional UA is more likely situated on the opposite side of the RA. Pan‐angiography (or at least BCA) is therefore recommended in patients with R

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04104.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY