Selective brain activity in response to one's own name in the persistent vegetative state.
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Cerebral Cortex↗
Biomedical subjects
G Ladurner
Publications and source records attributed to G Ladurner.
Brain perfusion SPECT in patients with mild cognitive impairment and Alzheimer's disease: comparison of a semiquantitative and a visual evaluation.
Due to the increasing importance of early recognition and differential diagnosis of dementias, cerebral perfusion scans using "single photon emission computed tomography" (SPECT) are increasingly integrated into the examination routine. The goal of this study was to check the diagnostic validity of SPECT scans of MCI- and DAT-patients, two subgroups out of 369 persons with etiologically unclear cognitive dysfunction, which underwent an assessment program for probable dementia including cognitive testing, cranial computed tomography, ultrasound, routine laboratory testing including vascular risk factors. After exclusion of patients with no or other forms of dementia we analyzed SPECT data of patients with mild cognitive impairment (MCI; n = 85) and dementia of the Alzheimer type (DAT; n = 78) in comparison with a healthy control group (n = 34).Visual assessment as well as a manual "regions of interest" (ROI) regionalization of the cortex were performed, whereby a ROI/cerebellum ratio was calculated as a semi-quantitative value. Association cortex areas were assessed regarding frontal, temporal, and parietal lobes of both hemispheres. When comparing the ratios of patients with DAT and controls, we found a statistically significant reduction of the cerebral perfusion in all measured cortex areas (p < 0.001). The comparison of patients with MCI with the selected control group also established a statistically significant difference in the cerebral perfusion for the evaluated cortex areas with the exception of the left hemispheric frontal and parietal cortex.A considerable number of the MCI patients showed an MMSE-score within the normal range, but with regard to the perfusion in the right hemispheric association cortex these patients also could be distinguished unambiguously from controls. Sensitivity levels found by visual assessment were at least as high as those found by the ROI method (pathological assessment: visual 49.4% vs. ROI 47.1% for MCI; visual 75.6% vs. ROI 73.1% for DAT). High experienced visual assessment of cerebral perfusion scans using SPECT provides an useful additional tool in diagnosis of cognitive impairment. The used semiquantitative ROI-method is nearly equivalent and does not depend on the experience of the investigator.
Aged↗
Neuroprotective treatment with cerebrolysin in patients with acute stroke: a randomised controlled trial.
BACKGROUND AND PURPOSE: Cerebrolysin is a compound with neurotrophic and neuroprotective activity. It is produced by enzymatic breakdown of purified brain proteins and consists of low molecular weight peptides and amino acids. Cellular and animal models of cerebral ischaemia have shown that it is a potent neuroprotective agent. We explored the safety and preliminary outcome of Cerebrolysin treatment in patients with acute stroke. METHODS: Randomised, placebo-controlled, parallel group trial. Patients with acute stroke were randomised within 24 h of stroke onset to IV therapy with placebo or Cerebrolysin 50 mL/day for 21 days. Both groups received concomitant treatment with ASA 250 mg/day PO and pentoxifylline 300 mg/day IV. Clinical examinations were performed on days 1, 3, 7, 21 and 90 post baseline. Outcome measures were the Canadian Neurological Scale, the Barthel Index, the Clinical Global Impressions, the Mini-Mental State Examination, and the Syndrome Short Test. Treatment emergent adverse events, lab tests, and vital signs were recorded to assess the safety of Cerebrolysin. RESULTS: 146 patients were enrolled in two groups: 78 Cerebrolysin and 68 placebo. At baseline, no significant group differences were observed. Patients in the Cerebrolysin group had no significant improvement in the CNS score, the Barthel Index and the Clinical Global Impressions when compared to the placebo group. A significant improvement of cognitive function of the patients on Cerebrolysin was observed in the Syndrome Short Test when compared to the placebo group. Cerebrolysin was well tolerated and safe. Adverse events occurred with a similar frequency in both groups. CONCLUSION: The results demonstrate that neurotrophic treatment with Cerebrolysin is safe and well tolerated by patients with acute stroke. The findings, despite the small sample size, also indicate a potential treatment effect of Cerebrolysin in acute stroke. Larger studies, however, are needed to confirm and extend these findings.
Aged↗
Cholesteryl ester transfer protein TaqIB polymorphism and its relation to parameters of the insulin resistance syndrome in an Austrian cohort.
The cholesteryl ester transfer protein (CETP) is responsible for the exchange of triglycerides and cholesteryl esters between lipoprotein particles leading to an increased hepatic clearance of HDL-cholesteryl esters. A high CETP activity reduces serum HDL levels, whereas persons without CETP activity have high HDL levels. We investigated the association of the TaqIB CETP polymorphism and various parameters of the insulin resistance syndrome in a cross sectional population based study. We included 1029 persons without known cardiovascular disease or diabetes mellitus consecutively enrolled in our SAPHIR program (Salzburg Atherosclerosis Prevention program in persons with a High Infarction Risk). Numerous clinical and laboratory data were accomplished. Insulin sensitivity was measured by a short insulin tolerance test. The TaqIB CETP polymorphism was determined by PCR, TaqI restriction and electrophoresis. 35.2% were homozygous for the prevalence (B1B1), 46.7% were heterozygous (B1B2), and 18.1% homozygous for the absence (B2B2) of the restriction site. HDL cholesterol and apolipoprotein A1 were lower and small dense low-density lipoproteins (sdLDL) higher in B1B1 compared to B2B1 and B2B2 persons. In women, we found a significant interaction effect between CETP genotype and adiposity for HDL cholesterol. B1B1 women with a BMI and a waist circumference above the median had 9.7 mg/dl lower HDL than B1B2 and 9.1 mg/dl lower HDL than B2B2 women (P < 0.001). In men, no interaction effect but a marked genotype to HDL correlation was found. There was a high CETP effect on sdLDL detected in men (P = 0.001). B1B1 men had sdLDL in 36%, B1B2 in 24.6%, and B2B2 in only 14.5%. Men with adiposity and insulin resistance had twice as many sdLDL as insulin sensitive men. We found a significant sex specific effect of the TaqIB CETP polymorphism on the insulin resistance parameters HDL-cholesterol and sdLDL in an Austrian population based study.
Adult↗
Inadequate management of cerebrovascular risk factors in participants of a public stroke prevention program in Austria.
The aim of our investigation was to identify frequencies and treatment quality of stroke risk factors in participants of a stroke prevention program in the province of Salzburg (Austria). A total of 9356 participants free of previous stroke were classified in three risk categories for suffering from ischemic stroke within the next 10 years and analyzed referring to history, therapy, and treatment quality of cerebrovascular risk factors. A total of 6519 (69.7%) participants were classified to be at low (<10%), 2232 (23.9%) at intermediate (10-20%) and 605 (6.5%) at high risk (>20%). Elevated blood pressure with the need for follow-up investigations was found in 5193 persons (55.5%); of 3713 (39.7%) persons with a history of hypertension, 3204 (86.3%) are under medical treatment, which is sufficient only in 765 patients (23.9%). Similar results were present for other well documented modifiable risk factors. In the investigated population there is high presence of stroke risk factors with inadequate treatment in most cases.
Aged↗
Cognitive function and fMRI in patients with multiple sclerosis: evidence for compensatory cortical activation during an attention task.
Mild cognitive impairment has frequently been reported for patients in the early stages of multiple sclerosis. The aim of the present study was to measure whether altered cortical activation during a sustained attention task occurs along with limited extent of neuropsychological problems. Expanded brain activation of multiple sclerosis patients with normal motor function compared with healthy controls during a finger tapping paradigm has previously been reported. Compensatory brain activation in patients with multiple sclerosis compared with normal controls may also be observed when the subjects are performing cognitive functions. In 21 patients with clinically definite relapsing-remitting multiple sclerosis, a psychometric assessment was performed using the Wechsler Memory Scale (WMS) and the Multiple Sclerosis Functional Composite Score (MSFC). In addition, functional MRI was performed during a Paced Visual Serial Addition Task (PVSAT), a visual analogue of the Paced Auditory Serial Addition Task (PASAT). All patients were within 3 years of diagnosis and were not suffering from a relapse at the time of investigation. The multiple sclerosis patients were compared with a control group of 21 healthy volunteers matched for handedness, age, years of education and sex. With regard to psychometric results, the WMS general memory score showed statistically significant differences between patients and controls. We did not find differences for either the MSFC or the PASAT scores. A group analysis of the functional imaging data during the PVSAT revealed different activation patterns for patients compared with control subjects. In healthy volunteers, the main activation was found in the frontal part of the right gyrus cinguli (Brodmann area 32). In patients, the main activation was detected at the right hemispheric frontal cortex (Brodmann areas 6, 8 and 9). In addition, the left hemispheric Brodmann area 39 was activated. We interpret the different patterns of activation, accompanied with intact performance in a sustained attention task of our multiple sclerosis sample compared with healthy controls, as the consequence of compensatory mechanisms. This is an expression of neuronal plasticity during early stages of a chronic disease.
Adolescent↗
[Stress management in heart diseases, obesity, nicotine and alcohol use].
INTRODUCTION: Heart diseases, obesity, nicotine and alcohol abuse are all relevant stroke risk factors. Some studies refer to stress stimuli and coping strategies as modulators for stroke risk factors. AIM: This study investigated differences between stroke prevention patients with heart complaints, obesity, nicotine or alcohol abuse and stroke prevention patients without these risk factors. METHOD: 5993 stroke prevention patients participated in a medical-psychological stroke risk investigation at the Christian Doppler Clinic in Salzburg. The differences in coping strategies between groups of patients with risk factors and groups without were investigated by means of multivariate analysis of covariance. RESULTS: Significant differences in stress coping were found for every risk factor (split by sex). Men suffering from heart diseases showed higher values in the coping strategy tendency to flee. Women with heart complaints demonstrated significantly lower values in minimising by comparison. Obese/adipose patients performed significantly higher values in the coping strategies vicarious satisfaction and aggression (men). Nicotine abusing prevention patients showed significantly higher values in drug intake and lower scores in continued thoughts. Non-smoking men furthermore reached higher values in vicarious satisfaction and non-smoking women in minimising. Persons not consuming alcohol demonstrated higher drug intake and aggression (men). Wine drinkers showed lower scores of self-pity and increased situation control attempts (women). CONCLUSION: Prevention patients with risk factors demonstrated significant differences in coping strategies in comparison to those without risk factors. Persons with heart diseases demonstrate a more defensive behaviour. The risk factors obesity, nicotine and alcohol consumption are associated with a risk factor supporting stress coping behaviour. The modification of the coping strategies drug intake and vicarious satisfaction towards a more active confrontation could probably influence various risk factors (nicotine, alcohol consumption, obesity) simultaneously.
Adaptation, Psychological↗
[Coping with stress and blood viscosity in stroke prevention patients].
INTRODUCTION: Hematocrit, fibrinogen and blood viscosity influence blood fluidity and are well known stroke risk factors. Studies have shown relationships between these factors and psychological stress. AIM: The aim of this study was to investigate how stroke risk patients with increased hematocrit, increased fibrinogen, or increased plasma viscosity differ from patients free of these risk factors in their ways of stress coping. METHOD: 6503 persons participated in the following stroke risk investigations: biographical and risk factor orientated anamnesis, neurological status investigation, laboratory investigation, sonographic investigation and psychological investigation. After assessment of several risk factors, differences in stress coping between risk factor and non-risk factor groups were investigated by means of the t-test and the Wilcoxon-test. RESULTS: Men with pathological hematocrit showed significantly higher scores in the coping strategy resignation and a tendency to less positive self instruction and response control attempts. Women with higher values of hematocrit demonstrated higher values in resignation and drug intake. Men with higher fibrinogen showed significantly higher scores in distraction, vicarious satisfaction, minimising by comparison and tendency to flee as well as a tendency towards drug intake. Women with increased fibrinogen showed no differences. Men with normal plasma viscosity had significantly higher values in tendency to flee and tendencially in desire for social support and lower values in minimising by comparison. Women with increased plasma viscosity demonstrated higher scores in resignation and aggression. CONCLUSIONS: The presence of elevated values in parameters of blood viscosity coincides with increased passive and defensive coping mechanisms, whereas non-risk factor persons show raised values in active coping styles.
Adaptation, Psychological↗
A common polymorphism in the promoter of UCP2 is associated with decreased risk of obesity in middle-aged humans.
Obesity is the most common nutritional disorder in Western society. Uncoupling protein-2 (UCP2) is a recently identified member of the mitochondrial transporter superfamily that is expressed in many tissues, including adipose tissue. Like its close relatives UCP1 and UCP3, UCP2 uncouples proton entry in the mitochondrial matrix from ATP synthesis and is therefore a candidate gene for obesity. We show here that a common G/A polymorphism in the UCP2 promoter region is associated with enhanced adipose tissue mRNA expression in vivo and results in increased transcription of a reporter gene in the human adipocyte cell line PAZ-6. In analyzing 340 obese and 256 never-obese middle-aged subjects, we found a modest but significant reduction in obesity prevalence associated with the less-common allele. We confirmed this association in a population-based sample of 791 middle-aged subjects from the same geographic area. Despite its modest effect, but because of its high frequency (approximately 63%), the more-common risk allele conferred a relatively large population-attributable risk accounting for 15% of the obesity in the population studied.
3' Untranslated Regions↗
Multimodal P3 under different attentional states in mesial temporal lobe epilepsy.
BACKGROUND: Several studies demonstrate that the P3 component of the event-related potentials (ERP) is generated by mesial temporal structures. The P3 is considered as endogenous information processing component independent from modality. PURPOSE: The aim of this investigation was to study whether the P3 latency elicited by auditory and visual stimuli under different attentional states is influenced by the mesial temporal lobe epilepsy (mTLE). METHODS: The event related P3 component of 10 right handed patients (7 m/3 f, mean age 31.3 years (SD 7.3), median 31.5, range 20-47) with unilateral mTLE were studied and compared with 10 age matched controls (5 m/5 f, mean age 36.6 years (SD 12.6), median 32.1, range 22-48). Diagnosis of mTLE was based on seizure description, clinical history and examination, prolonged video-EEG monitoring, magnetic resonance imaging (MRI), interictal and ictal SPECT. P3 potentials were elicited with a visual and auditory three stimulus discrimination paradigm. RESULTS: The latency of the P3 response to the auditory stimulus under automatic and effortful attention was delayed (423.3 ms (SD 60.4) and 436.9 ms (SD 83.4)) compared with a control group (359 ms (SD 42.4) and 354.2 ms (SD 39.7); P = 0.039 and P = 0.012, ANOVA), while the P3 latencies to visual stimuli under both tested attentional states (407.3 ms (SD 52.9) and 390.6 ms (SD 40.2)) did not differ from controls (378.2 ms (SD 48.6) and 378.2 ms (SD 55.4)). P3 latencies to auditory novel paradigm in patients with right sided mTLE, but not left sided mTLE, differed significantly from controls (P = 0.01). CONCLUSION: The results suggest a modality dependence of the P3 component in patients with mTLE. The novelty processing of auditory stimuli is disturbed in patients with right sided mTLE.
Adult↗
A case of Ohtahara syndrome with olivary-dentate dysplasia and agenesis of mamillary bodies.
We report a patient with early infantile epileptic encephalopathy (EIEE) with suppression-burst (Ohtahara syndrome) associated with olivary-dentate dysplasia and agenesis of mamillary bodies is reported. Although those with Ohtahara syndrome are a heterogeneous group, virtually all reported cases are secondary to neuronal migrational disorders, sometimes only identified by detailed neuropathologic examination, as in this case report, which describes mamillary body agenesis as a not-yet-recognized anomaly associated with Ohtahara syndrome. All children with Ohtahara syndrome should have high-resolution magnetic resonance imaging (MRI) and detailed postmortem neuropathologic examinations.
Cerebellar Nuclei↗
Comparison of second lumbrical and interosseus latencies with standard measures of median nerve function across the carpal tunnel: a prospective study of 450 hands.
The second lumbrical-interosseus distal motor latency (2LI-DML) was compared prospectively in 450 hands. Median nerve function was assessed by standard motor and sensory electrophysiological tests. In a control group of 100 hands the upper limit of normal for the 2LI-DML was 0.5 ms. In all hands studied the correlation coefficients of 2LI-DML were higher with sensory nerve tests than with motor studies. Carpal tunnel syndrome (CTS) was diagnosed clinically in 276 hands, and 174 showed no clinical signs of CTS. The 2LI-DML was prolonged in 269 of the 276 hands, with clinical signs of CTS and normal in 170 of 174 non-CTS hands. Thus the 2LI-DML resulted in a sensitivity of 97.5%. On the other hand, combining the standard tests yielded a sensitivity of 98.5 %. In 31 of 36 additional hands a lumbrical response was recorded, although motor and sensory responses form standard median nerve conduction studies were absent, and the 2LI-DML was substantially prolonged. The 2LI-DML therefore represents a highly sensitive, fast, easy-to-perform, and cost-efficient method to study median nerve function across the wrist and may help to localize the lesion in cases in which standard electrophysiological methods fail.
Adolescent↗
Measuring the progression of idiopathic Parkinson's disease with [123I] beta-CIT SPECT.
UNLABELLED: Idiopathic Parkinson's disease (PD) is the most common neurodegenerative disorder. An important step in diagnosing the disease has been achieved with the development of the cocaine derivative [123I] beta-CIT for single photon emission computed tomography (SPECT). The aim of this study was to demonstrate the disease progression by repeated measuring presynaptic dopamine transporter density and relating it to clinical data. METHODS: The presynaptic dopamine transporter density of 15 PD patients was measured two times with a mean interval of 15 months. All patients were clinically assessed at the time of the experiments according to the classification scheme of Hoehn and Yahr. 11 healthy volunteers were used as a control group. [123I] [-CIT was injected intravenously and measured with a triple-headed camera twenty hours later. The pictures were evaluated semiquantitatively by using the ratio of specific to non-displaceable binding. RESULTS: Presynaptic dopamine transporter density differed significantly between controls and PD patients. A significant correlation between imaging data and clinical stages (H/Y I -27%, H/Y II -40%, H/Y III -58%) was observed for the patient group in the initial experiment. The subsequent decrease of dopamine transporter binding depended on the initial clinical stage (H/Y I -6.81%; H/Y II -6.05%; H/Y III -1.25%) of the patients, and regression analysis revealed that. 91.4% of the variance of the second measurement were predicted by the initial measurement. No correlations were found for age, gender and disease progression. All patients were treated with L-DOPA and those given a higher dose showed a more rapid decrease of dopamine transporter density. This result could be interpreted as an indication for in vivo neurotoxicity of high concentrations of L-DOPA. CONCLUSION: We conclude that combining [123I] beta-CIT with SPECT imaging is not only a powerful tool for diagnosing PD patients, but may also be used to demonstrate neurodegeneration in vivo.
Aged↗
Multimodal event-related potential P3 after transient global amnesia.
The putative generators of the event-related P3 component are still a matter of debate. There is reasonable evidence that the mesial temporal lobe structures are crucial in the generation of event-related potentials. Transient global amnesia (TGA) is characterized by anterograde and retrograde amnesia without neurological deficits in which a temporal hypoperfusion is the most likely pathomechanism. The aim of this study is to evaluate a possible delay in the P3 latency in a cohort of patients with TGA (n = 18). We used classic oddball paradigms with visual and auditory stimuli. The P3 latencies were compared to 18 age-matched patients with transient ischaemic attacks (TIAs) in the carotid artery territory and 23 age-matched controls. The mean age of the patients was 60.1 years (SD 14.1), in the TIA group 64.7 (SD 12.1) and 57.7 (SD 10.1) in the controls; the mean time interval between onset of TGA symptoms and performance of P3 investigations was 4.3 days (range 1-7 days); and the mean latencies measured at the vertex (Cz electrode) were 422.9 ms (SD 44.6) for the TGA patients, 436.4 ms (SD 62.1) for the TIA group, and 409.3 ms (SD 48.5) for the controls in the visual paradigm and 371.7 ms (SD 41.7), 399.7 ms (SD 51.2) and 385.3 ms (SD 46.5) in the auditory paradigm for the TGA, the TIA and the control groups. The P-values were not significant. These results suggest different neuronal networks in the generation of scalp P3 from those responsible for the disturbance of episodic memory in TGA.
Acoustic Stimulation↗
Delayed visual P3 in unilateral thalamic stroke.
The P3 potential is accepted as a neurophysiological correlate of memory and attention. Delayed latencies were reported in different forms of dementias. Although the generator sites are still under debate, the thalamus may play a crucial role. The aim of this study was to investigate the influence of an unilateral thalamic ischaemic infarction on P3 generation. The event-related P3 component of six patients (2 male, four female; mean age 47 years, range 22-63 years) with unilateral thalamic ischaemic infarction was studied and compared to age-matched controls (five male, nine female; mean age 45.8 years; range 22-69 years). All patients underwent full clinical examination, CCT, and MRI scan. P3 potentials were recorded with a visual three stimulus discrimination paradigm. The mean P3 latency of the patient group to the target stimulus was delayed (469.7 ms, SD = 36.8) compared with the controls (378.8 ms, SD = 51.5; P < 0. 05). The mean P3 latency to the unexpected stimulus was delayed in patients with thalamic infarction compared with controls [477 ms (SD = 46.6) vs. 381.2 ms (SD = 48.5); P < 0.001). Delayed P3 components of the event-related potential (ERP) were recorded in six patients with unilateral thalamic infarction, suggesting an important role of the thalamus in the generation of the P3 potential.
Adult↗
Gabapentin-induced mood changes with hypomanic features in adults.
We report two adults who received gabapentin (GBP) and subsequently developed behavioural side effects. Indications for GBP treatment were newly diagnosed epilepsy in one and painful paraesthesiae in the other. Both had no past history of psychiatric or behavioural disorder. Abnormal behaviour consisted of elevated mood, euphoria, and increased energy in both patients, and pressure of speech and decreased need for sleep in one of them. These symptoms were transient and fully reversible. One patient had to discontinue GBP. Behavioural changes were not related to seizure activity. They should be recognized as a possible side effect of GBP treatment in adults.
Acetates↗
[Improving the visibility of intracranial vessels with the echo-enhancing substance Levovist in duplex sonography].
AIM: To evaluate the diagnostic advantages of Levovist for contrast enhancement of intracranial arteries in a routine clinical setting. METHOD: Routine cerebrovascular extracranial Doppler- and duplex-sonography was performed in 3990 patients (1791 female, 2189 male, mean age 50.4 years). In addition 879 trans-temporal, 990 trans-foraminal and 99 trans-orbital trans-cranial colour-coded duplex investigations were performed on these patients. Signal quality was classified in the categories: 'no signal', 'insufficient signal' and 'sufficient signal'. Patients classified as having 'no' or 'insufficient' signal quality underwent an additional examination after application of Levovist. RESULTS: 879 patients underwent trans-temporal examination. In 89 (9.1%) of these patients signal quality in the trans-temporal examination proved to be insufficient, thus indicating the use of Levovist. 346 of the examined vessels (72%) were originally classified as showing 'no signal'; this number could be reduced to 82 (23.9%) after applying Levovist. Of the 99 arteries (21%) falling into the category 'insufficient signal', only 4 (4%) did not show signal improvement after application of Levovist. 990 patients were examined by the trans-foraminal approach, and Levovist was given to just 26 patients (2.6%). Without enhancement, 20 basilar arteries (77%) showed 'no' or 'insufficient' signal, whereas after injecting Levovist only 4 (13.25%) remained in these categories. Of 13 vertebral arteries (25%) with 'no' or 'insufficient' signal intensity, 3 (5.8%) showed no improvement in imaging quality after application of Levovist. CONCLUSION: Imaging problems of intracranial arteries are dramatically reduced by Levovist.
Adult↗
[123I] beta-CIT binding and SPET compared with clinical diagnosis in parkinsonism.
The largest group of neurodegenerative disorders are extrapyramidal diseases, especially parkinsonism. The development of the cocaine derivative [123I] beta-CIT and single photon emission tomography (SPET) may help in the diagnosis of these patients. The aim of this study was to demonstrate the diagnostic value of this method and its relationship with clinical data. Ninety-eight individuals were investigated: 11 healthy volunteers, 58 patients with idiopathic Parkinson's disease (IPD) and 29 patients with symptomatic parkinsonism (SPD). All patients with parkinsonism were staged according to the clinical classification of Hoehn and Yahr. [123I] beta-CIT was injected intravenously and a triple-headed camera was used to obtain images 20 h later. The images were evaluated visually and semi-quantitatively to obtain comparable values (ratio: specific to non-displaceable binding). The ratios differed significantly between controls and IPD patients. A significant correlation also existed between the ratios and clinical stages. In 11 hemiparkinsonian patients, a significantly diminished ratio was demonstrated not only contralateral to the affected side, but also in the clinically silent striatum. A clinical threshold at a reduction of 34% [123I] beta-CIT binding was calculated in this group. The ratios of all SPD patients in our study did not differ significantly from those of the healthy volunteers. According to the clinical degree of symptoms, the more severe subgroup showed a diminished mean ratio of 22% and therefore could not be clearly differentiated from mild IPD. In contrast, ratios were significantly different when comparing groups of the same clinical severity. We conclude that this method is not only a powerful diagnostic tool in IPD patients, but it is also possible to differentiate between IPD and SPD patients, if clinical aspects are also included.
Adult↗