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Biomedical subjects

B Pillon

Publications and source records attributed to B Pillon.

At least 109 records · Page 6Linked to original sources

Acetylcholinesterase and butyrylcholinesterase activity in the cerebrospinal fluid of patients with neurodegenerative diseases involving cholinergic systems.

Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) were assayed in the cerebrospinal fluid (CSF) of subjects with neurodegenerative diseases (dementing and non-dementing, with and without known cholinergic lesions), to determine whether CSF AChE is a valid marker of central cholinergic activity. The relative proportions of the different forms of each enzyme and of AChE to BChE were similar in CSF and brain. AChE decreased in Huntington's chorea (degeneration of striatal cholinergic interneurons) but also in multiple sclerosis (not known to affect cholinergic systems). BChE paralleled AChE, although the enzymes were dissociated in some patients. It is concluded that CSF AChE activity may globally reflect brain AChE, but pathology-induced changes may not be directly reflected.

Acetylcholinesterase↗

Disappearance of parkinsonian signs after spontaneous vascular 'thalamotomy'.

Disappearance of parkinsonian symptoms was observed in a 57-year-old patient with Parkinson's disease after a contralateral thalamopeduncular infarct. From analysis of stereotaxic data in parkinsonian patients, this may be explained by lesion of the ventro-oral internal nucleus or of Forel's field, both of which are involved in thalamopeduncular infarcts.

Female↗

Human autonomy and the frontal lobes. Part I: Imitation and utilization behavior: a neuropsychological study of 75 patients.

A type of pathological behavior, imitation behavior (IB), is newly described. In this behavior patients imitate the examiner's gestures, although not instructed to do so. Patients explain that they thought they had to imitate the examiner. IB is the first stage of utilization behavior (UB). Neuropsychological examination of 40 patients with IB, of 35 with UB, and of 50 disease controls demonstrates the existence of a frontal syndrome and two determining features of such behavior: dependence on (1) the social and (2) the physical environments. Loss of intellectual control was also required for the occurrence of such behavior. UB and/or IB were present in 96% of the 29 patients with focal lesions of the frontal lobes. Computed tomographic scans in 26 of these patients showed involvement of the inferior half of the anterior part of one or both frontal lobes. IB and UB are interpreted as release of parietal lobe activities, resulting from impairment of frontal lobe inhibition.

Behavior↗

Heterogeneity of cognitive impairment in progressive supranuclear palsy, Parkinson's disease, and Alzheimer's disease.

Patterns of cognitive and behavioral impairment were analyzed in patients with progressive supranuclear palsy (PSP), Parkinson's disease (PD), and senile dementia of Alzheimer's type (SDAT), matched for age, sex, manual laterality, educational level, and degree of intellectual deterioration. The scores of the three groups of patients were significantly lower than those of controls and were comparable on tests of verbal and visuospatial functions as well as global memory. Patients with SDAT could be distinguished by the severity of verbal memory disorders; patients with PSP, and to a lesser degree those with PD, by impaired performances on tests sensitive to frontal lobe dysfunction.

Aged↗

[Loss of psychic self-activation. Compulsive activity of obsessional type. Bilateral lenticular lesion (author's transl)].

After a carbon monoxide intoxication with coma of short duration, a 25 years-old man sustained a demential state and during the first weeks, a mild extrapyramidal syndrome. One year later, the mental state had progressively improved, although with a severe anterograde amnesia but the clinical picture had become unique. Let without external stimulation, the patient remained inert without any activity, often lying on his bed but not sleeping. He had lost any initiative. At the opposite, if he was stimulated, his physical, intellectual and affective performances were nearly normal, verbal fluency remaining however poor. Psychic self-activation appeared to be lost but psychic possibilities after external stimulation were nearly normal. When inactive, the patient was occupied with a mental compulsive activity. C.A.T. showed bilateral necrotizing lesions in the globus pallidus. The present case is very similar to a previously reported one. (D. Laplane et al., Rev. Neurol., 1981, 137 : 269-276) in which bilateral lenticular lesions produced the same syndrome. The pallidal area seems to play a determinant role in the processes of self-activation of psychic life.

Adult↗

[Obsessional-type compulsive behavior caused by bilateral circumscribed pallidostriatal necrosis. Encephalopathy caused by a wasp sting].

A previously healthy young man developed encephalopathy after a wasp sting in 1968. Neurological complications included chorea, currently of a minor degree, replaced by buccofacial dyskinesias and compulsive movements. The most disabling consequences were of psychic nature, the patient presenting an unusually marked compulsive activity of an obsessional type. The whole psychic picture however was quite different from that of the usual neurosis, since there was neither anxiety nor doubt, but a mental vacuum contrasting with almost normal intellectual and affective capacities. It was as though there was a loss of the auto-activation system of psychic life, postulated by dynamic psychologists. C.A.T. demonstrated bilateral pallidostriatal necrosis. This suggests that the striatum plays a motor and psychic role. In the field of motor control, its hypoactivity appears to determine not only chorea but dyskinesias similar to tics and compulsive movements. In the psychic field, the striatum appears to play the very general role of an auto-activation system of intellectual and affective life, its deficiency leading to mental activity of a compulsive nature. Improvement in knowledge of striatal biology should clarify not only the basic mechanisms of chorea, but those of tics and obsessions.

Brain Diseases↗

[Associative visual agnosia: role of the left hemisphere in visual perception (author's transl)].

Visual agnosia following ischaemic accidents of the left posterior cerebral artery is often associated with intellectual deficiencies, memory disorders, elementary perceptive disturbances and elements of visuoverbal disconnection, with the result that some authors reject the notion of visual agnosia. By using a relatively simple examination procedure it is, however, possible to clearly differentiate the various disturbances, as shown by the case of a right-handed 66-year-old man in whom this type of vascular accident occurred. Neither the reduced intellectual capacities nor the memory disorders can explain the differences observed in the treatment of visual stimuli, which was very disturbed, and the normal treatment of other types of stimulus. Elementary difficulties are not sufficient to prevent correct discrimination, as all tests of matching object, images, colours, and graphic signs were successfully accomplished. Identification was disturbed however: the patient could not show the use of objects presented visually, and this disorder is related to the visual characteristics of the stimuli, which excludes a simple visuogestural disconnection; results of tests of classifying types of object images, colours, and graphic signs were markedly abnormal. Naming of these stimuli was also affected, even when they were correctly identified; this results from the visuoverbal disconnection associated with the agnosia, but it is insufficient to account for it, as the patient could correctly use objects that had been wrongly named, but could not use those that had been poorly identified. This case, therefore, has enabled a visual identification disorder to be isolated independently from a discrimination problem, and visuoverbal or visuogestural disconnections. It is the significance of ths stimulus that is disturbed. In contrast, functional or categorical classification is respected in right temporo-occipital lesions. It is the individuality of a stimulus within a physical category which is disturbed.

Aged↗

[Possible effects of drawing on the language and re-education of an aphasic patient (author's transl)].

Various studies have demonstrated that the ability to draw may be unaffected in motor aphasia, and even in some cases of sensory aphasia when there is no associated constructive apraxia. An artist, who was both a satirist and a caricaturist, was followed up for three years during re-educational therapy following the onset of an overall aphasia, and this raises the problem of the possible effects of drawing on recuperation of language, and the role of the right hemisphere in this recuperation. The question arises as to whether drawing should be restricted to certain particular cases during re-education or be employed in a more general manner?

Adult↗

[Crossed aphasia with jargon aphasia in two right-handed patients (author's transl)].

Two cases of crossed aphasia in right-handed patients are reported. The oral language of these two patients was characterized by a reduction in its lexical and grammatical content. Their written language, however, was a veritable jargon with anosognosia. The jargon aphasia of the first patient consisted mainly of neologisms. The written language of the second patient was slightly less disorganized and corresponded to an asemantic jargon. The existence of this jargon aphasia gives these two observations an exceptional character in relation to other cases of crossed aphasia in right-handed patients. It supplies new information which can be the basis for discussion on the relations between cerebral laterlization of language functions and manual preference.

Aged↗

[The radiological phenomenon of lumbar vacuum-disc (author's transl)].

Profile films of the lumbar region show the vacuum-disc phenomenon fairly frequently especially at the L5-S1 level and when there is disc degeneration. Two varieties can be distinguished : one with a well-defined enlarged medial image, and a more limited type which is often anterior, at the fibrous ring level and in contact with the vertebral plates. The latter is seen less frequently, but needs to be considered, as it precedes the changes seen in the nucleus pulposus in the intersomatic alteration. It has been shown that this image is of gaseous origin. It is caused by the liberation of gas into a newly-formed intersomatic cavity situated either in the nucleus pulposus or fibrous ring levels. The vacuum-disc phenomenon is of great diagnostic value as it is usually found in relation to degenerated discs and permits orientation of diagnosis towards classical arthrosis or Pott's pseudo-arthrosis when atypical radiological images are seen.

Adult↗