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Biomedical subjects

E Kokmen

Publications and source records attributed to E Kokmen.

121 records · Page 7Linked to original sources
PubMed1977

Neurological manifestations of aging.

A group of 51 socially active, self-declared neurologically normal subjects ranging from 61 to 84 years of age were studied with a battery of clinical neurological examinations and a semiquantitative vibration perception test. None of the subjects showed a consistent pattern of neurological deficit that could be identified as pathological. On review of systems, the most frequent complaints were difficulty remembering names, numbness and tingling of fingers and toes, and headaches. In the neurological examination, the most commonly observed abnormalities were positive palmomental reflex, snout reflex, abnormalities in pursuit eye movements, convergence insufficiency, and minor mistakes in perception of light touch. There was no apparent trend of worsening of symptoms and signs with advancing age. In the semiquantitative testing of vibration perception, there was a slight trend toward worsening of vibration perception in the upper and lower extremities with advancing age. Motor abnormalities were absent, and there were relatively few subjects who showed reflex abnormalities. This study confirms the previously reported diminution of vibration perception with aging. Caution must be exercised before attributing myotatic reflex and motor abnormalities to the aging process alone.

Aged↗
PubMed1977

Antibodies to human caudate nucleus neurons in Huntington's chorea.

Antibodies reacting with neuronal cytoplasmic antigens present in normal human caudate and subthalamic nuclei were detected in 37 of 80 probands afflicted with Huntington's disease (HD). IgG antibodies were detected by immunofluorescence using frozen sections of unfixed normal human and rat brain. Specificity of IgG binding was confirmed using pepsin F(ab')2 fragments of IgG isolated from positive sera. In vitro complement fixation of IgG antibody was detected in 22 of 31 sera tested. Neuronal cytoplasmic antigens reacting with positive HD sera were diminished after trypsin or RNAase treatment of tissue sections but were not removed by DNAase, neuraminidase, EDTA, or dithiothreitol treatment. Antibody staining of neurons could be removed after absorption with isolated caudate nucleus neurons or by using perchloroacetic acid extracts of caudate nucleus. Prevalence of antibody reacting with neuronal cytoplasm was 3% in 60 normal controls and 6% among a wide variety of patients with diverse neurological disorders. However, one-third of 33 patients with Parkinson's disease showed presence of antineuronal antibody. Among patients with HD, a significant association was noted between duration of clinical disease greater than 7 yr and titers of antibody of 1:2 or greater (P less than 0.001). When 115 family members of HD probands were tested, 30% of unaffected spouses showed presence of antineuronal antibody. 23.2% of first-degree relatives at risk for developing HD was also positive (P less than 0.001). 10.5% of second-degree relatives showed presence of antineuronal antibody. These data may support an environmental or infectious factor somehow involved in the ultimate expression of HD.

Adult↗
PubMed1977

Paradoxical response to dopamine agonists in tardive dyskinesia.

The authors conducted an extensive pharmacological analysis of a patient severely affected by tardive dyskinesia. No drug treatment gave lasting clinical improvement. Several agents recently recommended for this condition, dimethyl aminoethanol, clozapine, and thioridazine, failed to modify the dyskinesia. Reserpine caused a worsening of the symptoms. A paradoxical and unexpected improvement was observed with apomorphine injections and with low-dosage oral L-dopa. These two drugs may have acted by stimulating presynaptic inhibitory dopamine receptors.

Adrenergic alpha-Agonists↗
PubMed1975

The 'empty' sella.

Records of all patients diagnosed as having an "empty" sella turcica at the University of Michigan Medical Center after 1972 were retrospectively reviewed. Nineteen patients satisfied the two criteria, absence of prior surgical or radiotherapeutic intervention and air within the sella turcica at pneumoencephalography. Associated clinical signs and symptoms were varied and nonspecific. Two patients had relative visual field deficits without increased intracranial pressure. Three patients had papilledema and were diagnosed as having had benign increased intracranial pressure. Increased intracranial pressure was not a consistent enough finding to be considered an etiology for the empty sella syndrome.

Adolescent↗
PubMedDate not supplied

Primary progressive aphasia. An uncommon masquerader of psychiatric disorders.

Primary progressive aphasia is a recently described, uncommon language disorder with unclear etiological and clinical boundaries. The infrequency and ambiguity of the syndrome may prompt psychiatric consultation. The authors review the pertinent features of one such referral, including a brief literature review of the salient aspects of the differential diagnosis, and note the implications for appropriate treatment.

Agnosia↗
PubMedDate not supplied

The paramedian diencephalic syndrome: a dynamic phenomenon.

The paramedian diencephalic syndrome is characterized by a clinical triad: hypersomnolent apathy, amnesic syndrome, and impaired vertical gaze. We studied 4 cases with computed tomography evidence of bilateral diencephalic infarctions. Each case began abruptly with hypersomnolent apathy followed by fluctuations from appropriate affect, full orientation, and alertness to labile mood, confabulation, and apathy. Speech varied from hypophonia to normal; handwriting varied from legible script to gross scrawl. Psychological testing revealed poor learning and recall, with low performance scores. In 3 patients the predominant abnormality was in downward gaze.

Affective Symptoms↗
PubMedDate not supplied

Comparison of EEG background frequency analysis, psychologic test scores, short test of mental status, and quantitative SPECT in dementia.

Fourteen patients who had cognitive dysfunction were studied with quantitative electroencephalography (EEG), single-photon emission computed tomography (SPECT), and several tests of intellectual and memory function, including the Wechsler Adult Intelligence Scale (WAIS), the Auditory Verbal Learning Test, and the Short Test of Mental Status, to determine whether EEG background frequency content correlates with degree of dementia and with regional uptake of radioisotope on SPECT. The factors from spectral analysis that correlated best with psychometric data were mean frequency in the 1.5- to 20-Hz range and percentage power in the 13- to 20-Hz band (positive correlation) or the 1.5- to 8-Hz band (negative correlation). The WAIS subtest scores that correlated most with the EEG data were performance IQ and perceptual organization. Correlations between percentage power and amplitude ratio in the EEG frequency bands and regional SPECT counts were found, but most were not statistically significant.

Aged↗
PubMedDate not supplied

Psychiatric symptoms in cases of clinically diagnosed Alzheimer's disease.

All incident cases of clinically diagnosed Alzheimer's disease were identified through the unique record linkage system of the Mayo Clinic. Thirty-nine (32%) of the sample of 122 had a psychiatric history that preceded the onset of CDAD by at least 3 years. Twenty-five percent of the study population had had an episode of delirium within 2 years of the onset of CDAD. Eighty-four percent of the cases had psychiatric symptoms in the course of CDAD that were documented in their medical records. Specific symptom patterns included agitation, combativeness, confusion and disorientation, depression, psychosis, and wandering. These symptoms occurred more frequently in clusters than singularly.

Aged↗
PubMedDate not supplied

Frequency and distribution of vascular dementia.

It remains difficult to draw conclusions about the frequency and distribution of vascular dementia (VaD). The data from current studies cannot be compared and reconciled easily. Disagreement on diagnostic criteria and their field implementation remains the major problem. In particular, there is uncertainty about the classification of patients who show both vascular and degenerative features, about the advantages and disadvantages of using brief clinical scales (e.g., the Hachinski Ischemic Score), about the use of imaging findings in defining VaD, and about the minimal level of severity to be included in epidemiologic studies. Nevertheless, we can tentatively summarize current epidemiologic data in four points. (1) Both the prevalence and the incidence of VaD increase steeply with age. (2) The prevalence of VaD is generally higher among men than among women; the sex difference is more controversial for incidence. (3) There are sizeable differences in both incidence and prevalence across countries. (4) A declining trend in both the prevalence and the incidence of VaD was reported from one population; however, the decline was restricted to the age class 80-89 years. No trends data are available after the 1970s.

Age Distribution↗