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Biomedical subjects

B Reinhart

Publications and source records attributed to B Reinhart.

33 records · Page 2Linked to original sources

EEG mapping in middle aged normal volunteers: the impact of cerebrovascular risk factors.

The impact of major risk factors for stroke on EEG mapping and routine EEG findings was evaluated in volunteers with no clinical signs of cerebrovascular or other neuropsychiatric disease. Focal changes were seen in 22 subjects (30%) by means of EEG mapping, but in only 12 cases (16%) when routine-EEG was used (p < .05). 4/35 (11%) volunteers without RF had focal changes while this was seen in 18/39 (46%) subjects in whom risk factors (RF) were found (p < .01). An association was seen between the presence of EEG foci and number of RF. 59% of subjects with 2 or 3 RF had focal abnormalities as opposed to 36% of those with 1 RF and 11% of RF free individuals (p < .05). The findings could be confirmed by averaging the EEG data according to the different number of RF revealing statistically significant differences between each of the 3 groups. Using routine EEG alone no significant correlation to the presence or number of RF was found. Our data demonstrate EEG abnormalities in a considerable portion of normal middle aged individuals which in part may be attributed to the presence of RF.

Aged↗

Neuropsychologic correlates of MRI white matter hyperintensities: a study of 150 normal volunteers.

To determine the effects of MRI white matter hyperintensities (WMH) on cognitive functioning, we used neuropsychologic tests and MRI to study 150 elderly volunteers free of neuropsychiatric or general disease. There were 76 (50.3%) individuals without and 74 (49.7%) with WMH. The latter subset was older (61.3 +/- 6.6 years versus 58.5 +/- 5.8 years, p = 0.005), had a higher mean arterial blood pressure (103.7 +/- 11.4 mm Hg versus 99.9 +/- 10.3 mm Hg, p = 0.03), and a larger ventricular-to-intracranial-cavity ratio (6.3 +/- 5.6% versus 4.7 +/- 1.6%, p = 0.02). Individuals with WMH performed worse than their counterparts without such abnormalities on all tests administered. After adjusting for the group differences in age, arterial blood pressure, and ventricular size, we noted statistically significant results on form B of the Trail Making Test (121.8 +/- 37.8 msec versus 100.3 +/- 47.9 msec, p = 0.04), a complex reaction time task (680.8 +/- 104.9 msec versus 607.1 +/- 93.9 msec, p = 0.001), and the assembly procedure of the Purdue Peg-board Test (27.5 +/- 5.8 versus 30.6 +/- 5.9, p = 0.02). Partial correlations did not reveal any relationship between test scores and the semiautomatically assessed total area of WMH. Our data suggest that the presence of WMH exerts a subtle effect on neuropsychologic performance of normal elderly individuals, which becomes particularly evident on tasks measuring the speed of more complex mental processing.

Adult↗

Cerebrovascular risk factors in an elderly Austrian population: first year results of the Austrian Stroke Prevention Study (ASPS).

During the first year the Austrian Stroke Prevention Study enrolled 599 volunteers without clinical signs or symptoms of cerebrovascular disease aged 50 to 70 years. Study participants were randomly selected from the official register of the city of Graz. The rate of positive response was 26.9 percent. All subjects underwent an extensive risk factor screening with Duplex scanning of the carotid arteries obtained from a subset of 176 individuals. The prevalence of well-documented cerebrovascular risk factors was 40.6% for arterial hypertension, 35.4% for cardiac disease, 8.5% for diabetes mellitus und 3% for elevated haematocrit. The less well-documented cerebrovascular risk factors dyslipidemia, overweight, physical inactivity, hyperfibrinogenemia and smoking were noted in 75%, 33.7%, 27.2%, 14.9% and 12.2% of subjects, respectively. Multiple well-documented risk factors were noted in 23.7% of the examined volunteers. Multiple linear regression analysis revealed body mass index (p < 0.0001) and age (p < 0.0001) as independent predictors of the frequency of well-documented risk factors observed in any individual. Atherosclerotic carotid disease occurred in 61.9% of study participants investigated by Doppler sonography and was significantly associated with age (p < 0.00001), life-time tobacco consumption (p < 0.0001) and the concentration of apolipoprotein B (p < 0.05). This study demonstrates high prevalence rates of vascular risk factors in an elderly Austrian community. Implications for stroke prevention result from the conjunction of overweight and frequency of risk factors noted in any study participant, as well as from the relationship of carotid atherosclerosis to smoking and dyslipidemia.

Aged↗

[Cosmetic lower eyelid blepharoplasties].

Between April 1988 and December 1991 42 patients underwent a bilateral lower eyelid blepharoplasty. Depending on the etiology either a skin-muscle-flap or a skin-flap technique was used. When the lid was lax, it was shortened by a wedge-resection to prevent postoperative ectropion. The results were satisfactory with either technique.

Adipose Tissue↗

Sleep-inducing effect of L-tryptophane.

Night sleep recordings were performed in 10 patients with sleep disturbance in falling asleep as well as in maintaining sleep using a mobile 4-channel EEG registration system. Three consecutive nights, which were spent under different conditions, were evaluated automatically. The first night without treatment was used as a baseline night to objectify the disturbed sleep, the second night was measured following an infusion of a physiological saline solution and prior to the third recording 5 g l-tryptophane were applied to the patients. Besides a significant decrease of delayed latency times until the appearance of the light sleep stages, an influence was seen on the quantitative sleep parameters such as sleep period time and total sleep time. In parallel, an improvement of the subjective feeling measured by a self-rating scale resulted after l-tryptophane. On the other hand, no definite influence on the other sleep parameters such as an increase of slow wave sleep was observed, so that the use of this treatment might be recommended in disturbances in falling asleep particularly.

Adolescent↗

Sleep alterations in ischemic stroke.

In 19 patients with cerebral infarctions in the middle cerebral artery territory, investigations of sleep using a mobile EEG recording system were performed. Sleep was found to be markedly altered compared to a normal group. Although an increase of time in bed and sleep period time was observed, total sleep time did not rise in a parallel manner, so that a distinct reduction of the sleep efficiency index was found. This increase of quantitative parameters was particularly caused by a higher amount of NREM time, whereas REM sleep was found to be deeply suppressed. Regarding the different NREM sleep stages, stage 0 (time spent awake during the night) and stage 1 had increased, whereas stage 4 was reduced. Interhemispheric differences were noticed referring to the sleep period time, which was found to be increased particularly in right-sided infarctions (because of an increase of NREM time) and a reduction of REM sleep in lesions of the right hemisphere (worsening of the REM to NREM ratio). Slow-wave sleep (stage 4), on the contrary, was found to be decreased in infarctions of the left hemisphere. These results support the hypothesis of a REM-inducing and regulating function of the right hemisphere and will lead to a new understanding of sleep-controlling mechanisms.

Adult↗

Distribution of muscle activity during sleep in bruxism.

10 outpatients with bruxism were investigated by polygraphic recordings during night sleep. Electromyogram, electrooculogram and electroencephalogram derivations were used to evaluate the activities of masseter muscle and the different stages of sleep. The results of the bruxist group were compared to those of an age-matched control group. The amount and the length of pressing and grinding jaw movements were correlated with the sleep period time as well as with the different sleep stages. In comparison to the control group, a significant difference of muscle activity longer than 5 s was found, but there was no difference regarding activities of 3-5 s duration. The highest level of activity was found in sleep stage two and during awakening times. No difference was seen with regard to percentages of the sleep stages.

Adult↗

Mobile long-term EEG monitoring in generalized seizure disorders of different etiology.

Eighteen EEG long-term recordings were carried out in patients with generalized fits of different etiologies using a mobile 4-channel monitoring system in order to observe individual patterns of epileptic activity. In patients with idiopathic tonic-clonic seizures (A) no connection of frequency of spike-wave bursts with the sleep-wakefulness cycle was observed. In patients suffering from fits of organic nature (B) a peak of paroxysms was obtained in the hours before sleep onset, whereas in patients with absence seizures (C) a maximum was found in the morning hours after awakening. In patients with idiopathic fits (tonic-clonic and absence seizures) the minimum of bursts was observed in REM sleep, whereas stage 0 (tonic-clonic) and stage 1 (absence) were most prone to discharges. Patients with secondary generalized epilepsy had most spike-wave bursts in deep sleep. In the absence seizure group the transitional periods within the light non-REM-sleep stages were more susceptible to paroxysms than the retained stages. In patients with idiopathic grand mal seizures, the highest frequency of paroxysmal discharges was found during time spent awake in the night when retained over a longer period of time. The group including cases with attacks of organic nature did not show any preference to shifting times or preservation episodes of sleep stages.

Adolescent↗

[Nocturnal sleep studies of bruxism].

Polygraphic recordings during two nights sleep in 7 selected outpatients prior to and following treatment of bruxism were carried out using EMG-, EEG and EOG-recordings to evaluate the activities of the masseter muscle and the different sleep stages. The results thus obtained were compared to those of an age-matched control group. Following treatment with occlusal splints the recordings were repeated eleven weeks later. The length and the amount of grinding and pressing activities were correlated with the total night sleep as well as with the different sleep stages. The highest incidence of muscle activity was found in stage two and during awakening. Furthermore muscle activities were observed immediately before the beginning of REM-sleep and in particular during the change from REM- to NREM-sleep and in sleep stage one. After treatment with occlusal splints there was a decrease of total muscle activity, thus indicating efficiency of the treatment.

Adult↗

[Changes in pattern evoked visual potentials in multiple sclerosis in respect to development of illness].

In 43 patients (28 female, 15 male) with a definitive diagnosis of disseminated sclerosis visual evoked potentials were tested several times with pattern stimulation. The average duration of the disease was 7 years before the first pattern evoked potential. The latency of the evoked potential, estimated from the first positive peak, was in the pathological range in 30 patients in the first investigation, whereas in 38 patients there was a delayed latency in the last measurement. There was an average period of 1.5 years between the first and last investigation. In 20 cases the evoked potentials showed a continuous delay in the latency. Two patients maintained the original pathological values and in 7 cases the control results were below that of the first investigation. In 9 cases it was not possible to show a definite result because of the marked fluctuation in the values. 5 times in the entire investigation was a pathological result absent. There was a clear correlation between both the duration of the disease and the presence of a delayed latency, and the frequency of episodes and a pathological latency.

Adolescent↗

[Night sleep studies: mobile recording in comparison to conventional laboratory recording].

Night sleep registrations were made in a group of 11 persons in a laboratory using both traditional polygraphic methods and a portable home recording system. A significantly higher value in the evaluation of the sleep efficiency index (quotient of total sleep time and total time in bed) was found with the mobile recording system. Apart from these findings the latency to the beginning of the particular sleep stages (classification of Dement and Kleitman) were diminished. Furthermore there was found a significant decrease of stage 1 in favour of the REM-sleep. Regarding the relation between the REM and the NREM-time, a distinct difference could also be shown. As to the subjective sensitivity, 10 of the 11 tested persons preferred the mobile recording system.

Adult↗

[Clinical diagnosis of normal pressure hydrocephalus (author's transl)].

5 patients are described in which normal pressure hydrocephalus was diagnosed. The criteria on which the diagnosis was based were a cerebrospinal fluid perfusion test and an air study. Pathological verification was additionally obtained in 2 patients. The clinical picture in all patients was characterized by dementia. 4 patients were incontinent and 3 were paraspastic.

Adult↗