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Biomedical subjects

E Salmon

Publications and source records attributed to E Salmon.

At least 91 records · Page 5Linked to original sources

Positron emission tomographic study in Alzheimer's disease and Pick's disease.

Positron Emission Tomography has been used to compare patients with Alzheimer's disease and 3 patients with biopsy-proved Pick's disease to age-matched volunteers. In Alzheimer's disease, there was a trend to a decrease of the metabolism parallel to the severity of the affection. The hypometabolism was predominant in the temporo-parieto-occipital and the middle temporal regions. In 2 cases of Pick's disease with a classical "frontal syndrome", there was an important fronto-temporal hypometabolism, very suggestive of the diagnosis owing to both its location and intensity. A third patient presented with a slowly progressive dysphasia. A left perisylvian hypometabolism was observed before any evident anatomical abnormality. The clinical symptoms evolved to a dementia and the hypometabolism extended to both frontal lobes.

Alzheimer Disease↗

[Study of regional cerebral glucose metabolism, in man, while awake or asleep, by positron emission tomography].

Measurements of regional cerebral glucose uptake by the 18F-fluorodeoxyglucose technique (18FDG) and positron emission tomography (PET) along with polygraph recordings were made serially during relaxed wakefulness and different stages of nocturnal sleep in two right-handed normal volunteers. During stage III-IV sleep, values declined diffusely in both hemispheric regions (-31%), thalamus (-33%), cerebellum (-33%) and brain stem (-25%). During paradoxical sleep regional values increased diffusely compared with slow wave sleep. Compared to wakefulness, regional metabolic values seemed to increase but the results were more variable from one volunteer to the other. These preliminary data indicate important regional alterations in cerebral metabolism between sleep states.

Adult↗

[Paraneoplastic limbic encephalopathy, inappropriate ADH secretion and recurrent subclinical epileptic seizures. Clinical, anatomo-pathological and metabolic correlations by positron emission tomography].

We report a case of limbic encephalopathy clinically characterized by a progressive amnestic syndrome and many EEG seizures mainly localized on the left temporal area. Biological investigations revealed diabetes mellitus and a syndrome of inappropriate antidiuretic hormone secretion (IADH). Haemodynamic and metabolic studies by positron-emission tomography showed an important increase in cerebral blood flow (CBF) and cerebral metabolic rate of oxygen on the left anterior temporal region precisely where the electrical seizures were recorded. Nine months later, severe disorders of memory and a dramatic decrease in CBF and CMRO2 on the same area region were present. At autopsy, a small size oat cell bronchial carcinoma was found with metastases in two small adjacent lymph nodes. Neuropathological examination showed atrophy (neuronal loss, protoplasmic gliosis) in the amygdala; where there was in addition an area of nodular gliosis. The hippocampus and parahippocampal gyrus lesions were severe on the left and moderate on the right side. The authors discuss the nosology of their case in the paraneoplastic syndromes and, with a review of the literature, the role of ADH and cellular hyperactivity in the pathogenesis of specifically localized neuronal alterations.

Amnesia↗

[Allergologic investigation of asthma in infants. Apropos of 153 cases of infants aged 5 to 36 months].

153 asthmatic children from 5 to 36 months (mean age: 26 months) were investigated. The aim of the study was twofold: 1) to determine the reliability and limits of an allergologic diagnosis before 36 months of age; 2) to compare the predictive value of skin-tests with other allergologic tests. Results were expressed according to a score involving 5 parameters derived from the allergologic investigation. Each parameter represented one point: atopic past history, increased level of total IgE antibodies related to the age, presence of blood specific IgE antibodies, blood hypereosinophilia. Infants were considered allergic if their score level was greater than or equal to 3. Concordance between this score level and each parameter was as follows: Positive skin-test 83%; Blood hypereosinophilia 82%; Presence of specific IgE antibodies 80%; Increased level of total IgE 78%; Familial history of atopy 54%. It is concluded that, in allergic infants, a significative link exists between positive skin-test plus the presence of specific IgE antibodies and an atopic disease. However, more children have to be enrolled in a multivariant analysis to assess definitively the predictive value to this score.

Asthma↗

[Study of cerebral metabolism and blood flow in partial complex epilepsy and status epilepticus in man using positron emission tomography].

Positron Emission Tomography (PET) with the oxygen-15 steady state inhalation technique was used to provide quantitative values of regional cerebral blood flow (CBF), oxygen consumption (CMRO2) and oxygen extraction ratio (OER) in 25 patients with partial complex seizures during the interictal state, in 1 patient with recurrent temporal seizures and in 3 patients whose EEGs were characterized by periodic lateralized epileptiform discharges (PLEDs). Interictal scans showed temporal zone(s) of hypoperfusion and hypometabolism in 80% of patients with normal X-ray CT Scan. In all cases, ictal scans revealed a focal or multifocal increase in CBF and CMRO2. The localization of the most affected regions correlated well with the spatial distribution of the EEG abnormalities. Comparison of the different values of CBF, CMRO2 and OER showed that the increase in perfusion always exceeded that of oxygen consumption and hence was accompanied by a significant decrease in OER, the latter was always the most prominent in the region of the focus determined by serial EEG recordings. The observed imbalance between blood flow and oxidative glucose metabolism could suggest an impairment of O2 utilization by the mitochondria in the epilepticus focus during seizures or status epilepticus.

Brain↗

Regional cerebral blood flow and metabolic rates in human focal epilepsy and status epilepticus.

Positron emission tomography with the oxygen-15 steady state or bolus inhalation technique was used to provide quantitative values of regional cerebral blood flow (CBF), oxygen extraction ratio (OER) and oxygen consumption (CMRO2) in 25 patients with partial complex seizures during the interictal state and in 5 patients during status epilepticus. Glucose utilization (CMRglu) was also studied in one case of status epilepticus with the 18F-fluorodeoxyglucose technique (18FDG). Interictal scans showed zone(s) of hypoperfusion and hypometabolism without significant variation of the OER in approximately 80% of patients. In 62%, there was a strong correlation between the overall EEG localization and the area(s) of hypoperfusion and hypometabolism. In all cases, ictal scans revealed a focal or multifocal increase in CBF and CMRO2. The localization of the most affected regions correlated well with the spatial distribution of the electroencephalograph (EEG) abnormalities. Comparison of the different values of CBF, CMRO2, and OER showed that the increase in perfusion always exceeded that of oxygen consumption and hence was accompanied by a significant decrease of OER; the latter was always the most prominent in the region of the epilepticus focus determined by serial EEG recordings. These results showed that the supply of oxygen by blood flow is large enough to meet metabolic demand. When comparing these values with CMRglu, it appeared that the relative changes in CMRglu and CBF were very similar, indicating that the increase in blood flow correlated with the enhancement in glucose utilization. The observed imbalance between blood flow, glucose utilization, and oxygen consumption could suggest that an impairment of oxygen utilization by the mitochondria could occur in the epileptic focus during prolonged status epilepticus.

Cerebrovascular Circulation↗

[Hemodynamic and metabolic study using positron emission tomography in a case of right thalamo-capsular ischemic stroke].

The authors report the results of a Positron Emission Tomographic (PET) study of local cerebral blood flow and oxygen consumption in one patient with a right capsulo-thalamic ischemic lesion. That lesion is well demonstrated using X-ray CT Scan. PET study demonstrates a decreased perfusion and metabolism at three levels: first in right thalamus region, second in whole right hemisphere, more marked at orbitofrontal area and third at the level of the left cerebellar hemisphere. The authors point out the usefulness of PET studies which allow a better understanding of clinical signs by demonstrating functional consequences of damage in deeply located structures such as thalamus and internal capsule on cerebral and cerebellar cortices.

Brain↗

[First elements of comparison between blood-tissue barriers at cerebral, genital and urinary levels].

Fluorescence microscope observations of Trypan Blue distribution gives the demonstration of the blood-tissue barriers. It reveals the similitude between the barriers in choroid plexus, in testis, epididymis and bladder and the difference with the blood-brain barrier. Electron microscope investigations afford a statistical view of relations between structure and vascular permeability and stress the opposition reported above. Membrane specializations of each epithelium often bring forward those which are involved in the barrier. This function is principally assigned to thight junctions. The different morphological aspects encountered lead to the problem of dynamic variations in the configuration of the junctions.

Animals↗

Role of guar and dietary fibre in the management of diabetes mellitus.

High-fibre diets, particularly with the addition of guar gum, have been reported to improve control of blood glucose concentration in diabetics. These studies are reviewed, and the results of a study of 22 obese, poorly controlled, poorly compliant diabetic outpatients are presented. In a random, single-blind controlled trial, either guar, or bran, or placebo were added to the previous diet. Over a three-month period, there were no changes in weight, fasting blood glucose levels, or random blood glucose levels. Problems of tolerance were experienced with guar gum. Therefore, supplementation of the diet of such patients with guar gum or bran does not produce long-term improvements in diabetic control in a clinical context. The use of naturally occurring high-fibre foods may slightly improve diabetic control in motivated patients, but further long-term trials are required to establish whether dietary fibre will have any significant role in the practical management of diabetes.

Blood Glucose↗

Contribution of lexico-semantic processes to verbal short-term memory tasks: a PET activation study.

Recent studies have demonstrated the intervention of long-term memory processes in verbal STM tasks and several cognitive models have been proposed to explain these effects. A PET study was performed in order to determine whether supplementary cerebral areas are involved when subjects have to execute short-term memory tasks for items having representations in long-term memory (in comparison to items without such representations: words vs non-words). Results indicate that verbal STM for words specifically involves the left middle temporal gyrus (BA 21) and temporo-parietal junction (BA 39). These areas can be associated with lexical and semantic processes. These results are in agreement with cognitive models that postulate the simultaneous influence of lexical and semantic long-term representations on verbal STM processes and/or a lexico-semantic buffer.

Adolescent↗

The neural correlates of updating information in verbal working memory.

The aim of the present study was to re-examine cerebral areas subserving the updating function of the central executive with a running span task requiring subjects to watch strings of consonants of unknown length and then to recall serially a specific number of recent items. In order to dissociate more precisely the updating process from the storage function, a four-item instead of a six-item memory load was used, contrary to our previous study (Salmon et al., 1996). In addition, a serial recall procedure was preferred to a recognition procedure in order to suppress the use of visuospatial strategies. The most significant increase of rCBF occurred in the left frontopolar cortex (Brodmann's area 10), spreading to the left middle frontal (Brodmann's area 46). Results suggest that frontopolar activation underlies an updating process in working memory.

Adult↗

Landau-Kleffner syndrome: a clinical and EEG study of five cases.

In five children with normal initial psychomotor development, a Landau-Kleffner syndrome appeared at age 3-7 years. No neuroanatomic lesions were noted. Aphasia and hyperkinesia were isolated in three patients and associated with global regression of higher cortical functions in one patient. Massive intellectual deterioration and psychotic behavior were associated with transient aphasia in one patient. The epilepsy (focal motor and generalized tonic-clonic seizures, subclinical EEG focal seizures during sleep, and atypical absences) always regressed spontaneously or with antiepileptic drug (AED) treatment. The EEG in waking patients showed focal and generalized spike-wave discharges on a normal background rhythm. Discharge topography and pattern changed frequently. During sleep, discharges always increased. At some time during syndrome development, all patients had bilateral spike-waves for greater than 85% of the sleep period, while at other times the discharges were discontinuous or continuous but focal or unilaterally hemispheric. Discharge topography and abundance changed from night to night. The abnormal EEG and the impaired higher functions developed and regressed together, but not with strict temporal correlation. Our own experience suggests that the Landau-Kleffner syndrome and epilepsy with continuous spike-wave activity in slow-wave sleep cannot be clearly differentiated. They may be different points on the spectrum of a single syndrome.

Aphasia↗

Landau-Kleffner syndrome: a pharmacologic study of five cases.

Five children with Landau-Kleffner syndrome (epilepsy, acquired aphasia, and continuous spike-wave discharges during sleep), were treated with antiepileptic drugs (AEDs), sleep-modifying drugs, and corticosteroids. The pharmacologic profiles differed from those observed in focal epilepsies, resembling instead those of certain generalized epilepsies, such as West or Lennox-Gastaut syndromes. Phenobarbital (PB), carbamazepine (CBZ), and phenytoin (PHT) were ineffective or worsened the EEG and neuropsychological symptoms, whereas valproate (VPA), ethosuximide (ESM), and benzodiazepines were partially or transiently efficacious. Dextroamphetamine produced a dramatic but transient improvement in waking and sleep EEG in one of two children; aphasia did not change. Corticosteroid treatment resulted in improved speech, suppression of seizures, and normalization of the EEG in three of three children. Our own experience and data from the literature suggest that corticosteroids should be given in high doses as soon as the diagnosis is firmly established and should be continued in maintenance dose for several months or years to avoid escape. Early diagnosis, before mutism or global deterioration develops, appears to be essential for effective therapy with minimal neuropsychological sequelae.

Adrenal Cortex Hormones↗

Cerebral glucose utilization during sleep in Landau-Kleffner syndrome: a PET study.

Three right-handed male children (aged 5, 6, and 11 years) with signs, symptoms and/or history of the syndrome of acquired aphasia-epilepsy (Landau-Kleffner syndrome) were studied during drug-induced, electroencephalographically (EEG)-monitored sleep by positron-emission tomography (PET) and the [18F]fluorodeoxyglucose (FDG) method. Our data demonstrate that in Landau-Kleffner syndrome, cerebral glucose utilization is not normal during sleep. The metabolic pattern varied between the children but the metabolic disturbances always predominated over the temporal lobes. They were right-sided, left-sided, or bilateral. In the two first patients, EEG recordings showed continuous spike-and-wave discharges during sleep and a right-greater-than-left asymmetry was observed in temporal areas. In patient 1, the asymmetry was associated with a relative increase of glucose utilization of the right posterior temporal region. In patient 2, the glucose utilization was relatively decreased in the left anterotemporal and left perisylvian regions. In patient 3, the sleep EEG showed no discharge and no significant asymmetry was observed; however, glucose utilization of both temporal lobes was decreased. Lower metabolic rates in subcortical structures than in cortex were also noted in the three children. This metabolic pattern may be related to the maturation of the central nervous system (CNS).

Aphasia↗