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Biomedical subjects

I Reinvang

Publications and source records attributed to I Reinvang.

At least 19 recordsLinked to original sources
PubMed1995

[Language disorders].

Language is the basis for acquisition and execution of communicative skills. The neurological structures underlying language can be localized through clinical-pathological studies and neuroimaging studies. The classical language areas (Broca and Wernicke areas) are involved in lesions causing aphasia, and the main types of aphasia are motor (Broca), sensory (Wernicke), global and anomic aphasia. In stable lesions a negatively accelerated recovery curve is observed. Age and severity of aphasia are important prognostic factors. Treatment consists of broadly targeted language stimulation, but specialists services are important for assessment, education, and selection of patients for special forms of therapy.

Adolescent↗
PubMed1995

A follow-up study of neuropsychological functioning in AIDS-patients. Prognostic significance and effect of zidovudine therapy.

Thirty-three patients with AIDS were subjected to neuropsychological and immunological testing with semi-annual examinations over a two year period. No patient had signs of opportunistic infections or neoplasms in the CNS. Patients who were neuropsychologically impaired at the time of AIDS diagnosis (n = 12) survived for a significantly shorter period than did the non-impaired subjects (n = 21), and neuropsychological function at first test had a significant predictive value concerning survival time. The poor prognosis associated with impaired neuropsychological status was seen also in patients treated with zidovudine (ZDV). Of the 21 patients who started ZDV treatment shortly after the first neuropsychological examination, 12 were retested. Follow-up data showed that this group of patients had a significant improvement in neuropsychological functioning during the first 6 months. However, a decrease in performance was observed at second follow-up. In the group not treated with ZDV (n = 7), two initially normal patients developed signs of HIV-encephalopathy, while none of the initially normal ZDV-treated patients did so. This might suggest a prophylactic effect of ZDV on development of neuropsychological dysfunction. Changes in neuropsychological test results were correlated with changes in serum concentration of neopterin irrespective of ZDV treatment, suggesting that monocyte/macrophage activation may be involved in the pathogenesis of HIV-encephalopathy.

AIDS Dementia Complex↗
PubMed1995

Variability in cognitive function among persons at high genetic risk of Huntington's disease.

The present study explores cognitive variability and specificity of cognitive decline in persons at high genetic risk (AR+ persons) of Huntington's disease (HD). Risk status was determined by RFLP markers. Three subgroups were defined according to neuropsychological test performance. One subgroup showed a typical HD pattern of impairment, a second group selectively impaired verbal memory function, and a third group was more heterogeneous. Verbal memory function was frequently impaired among AR+ persons. The specificity of verbal memory dysfunction was evaluated by using a multivariate statistical clustering procedure. While 60% of the AR+ persons were allocated to clusters typical of "subcortical dementia", most AR- persons were allocated to a "normal" cluster. However, the variability was wide within both the AR+ and AR- group. The heterogeneity among AR+ persons was consistent with findings in genetic, neuroimaging, and neuropathological studies of HD. Multidisciplinary studies should be performed to better understand biological determinants of cognitive variability, and to facilitate clinical diagnosis and councelling in individual AR+ persons.

Adult↗
PubMed1994

Effects of cholinergic blockade on language in healthy young women. Implications for the cholinergic hypothesis in dementia of the Alzheimer type.

To investigate the effect of cholinergic blockade on language, 22 healthy young women performed tests of reading, spelling and oral language after a subcutaneous injection of 0.4 or 0.6 mg scopolamine. The results were compared with the performance after 0.6 mg methylscopolamine, which produce no central cholinergic effects. The reading and spelling tests were constructed to evaluate the lexical and phonological strategies for reading and spelling of single words. After scopolamine there were dose-dependent impairments in reading, spelling, verbal fluency and object naming. In 25-60% of the subjects receiving 0.6 mg scopolamine there were clinically significant impairments on tests assessing the lexical and phonological strategies. This pattern is similar to the deficits in reading and spelling observed in patients with dementia of the Alzheimer type. Cholinergic loss may be associated with the language impairments found in dementia of the Alzheimer type.

Acetylcholine↗
PubMed1994

Characteristic patterns of verbal memory function in patients with Huntington's disease.

Various aspects of verbal memory in patients with Huntington's disease (HD) were studied using the California Verbal Learning Test (CVLT). We tested if the level and interplay between 5 parameters of different memory mechanisms and processes were sufficiently specific to allow acceptable discrimination between patients with HD, patients with Parkinson's disease (PD), and patients without known CNS disease or injury. The HD-patients were characterized by a deficit in acquisition, elevated rates of recall errors and increased use of a passive learning strategy. Preserved aspects were shown in retention over time, interference effects and recognition relative to recall. Employing multivariate classification and validation techniques, the 5 CVLT-features demonstrated good separability between the HD-patients and the control patients. Qualitative similarities between subgroups were suggested, but more disease-specific data seemed necessary in further studies. A number of findings suggested a defect in the active organization of items to be encoded and recalled in HD. Similar findings in the PD-group might indicate that this trait is common in several types of 'subcortical dementia'.

Adult↗
PubMed1994

Assessment of 'subcortical dementia' in patients with Huntington's disease, Parkinson's disease, multiple sclerosis and AIDS by a neuropsychological screening battery.

Four diagnostic groups categorized as 'subcortical dementia' were studied using a neuropsychological screening battery. The specificity of the battery in disclosing characteristic patterns of impairment in subgroups within the category, and the correspondence between natural subgroups generated by an unsupervised statistical classification technique and the diagnostic labels were investigated. All cognitive affected subgroups demonstrated impairment on tests of sensomotor function, cognitive efficiency and/or memory, and were characterized in terms of severity of impairment as well as a progressive involvement of functional areas. The diagnostic groups were not evenly represented in all natural subgroups. Affected AIDS-patients seemed to resemble patients with Huntington's disease more than the other diagnostic groups. The screening battery could give a general characterization of the pattern of 'subcortical dementia' and different levels of impairment, but more specific process-oriented tasks are needed to contrast diagnostic groups within the concept of 'subcortical dementia'.

AIDS Dementia Complex↗
PubMed1994

HIV-related neuropsychological impairment and immunodeficiency. CD8+ lymphocytes and neopterin are related to HIV-encephalopathy.

The relationship between neuropsychological test performance and immunological parameters was studied in 52 HIV-positive patients within different stages of the infection. All subjects were neuropsychologically tested, the CD4+ and CD8+ lymphocyte count were measured in peripheral blood, and the concentration of neopterin and HIV-p24 antigen were measured in serum. Ten patients with AIDS were defined as neuropsychologically impaired. The CD8+ cell count was the only immunological parameter that could significantly discriminate between AIDS patients with and without neuropsychological impairment. For the total group, significant positive correlations were found between neuropsychological test results and the number of CD8+ and CD4+ lymphocytes, and significant negative correlations were observed between serum concentration of neopterin and neurocognitive function. Regression analyses showed that up to 51% of the variance in test performance could be explained by CD8+ cells and neopterin concentration. The possible role of CD8+ lymphocytes and neopterin in the pathogenesis of HIV-related CNS-dysfunction is discussed.

AIDS Dementia Complex↗
PubMed1994

Neuropsychological findings in a non-clinical sample of workers exposed to solvents.

The risk of long-term damage to the CNS after exposure to mixed solvents in work environments is controversial. Thirty-six workers were studied who had been exposed to organic solvents for more than 10 years (mean 24.5 years) in a working environment. The workers and unexposed controls were studied with a battery of neuropsychological and cognitive tests. Significant group differences were observed for the Wechsler adult intelligence scale (WAIS) digit span and symbol digit substitution, and on paired associate learning and continuous word recognition. The results suggest that long-term work-related exposure to organic solvents may have chronic toxic effects.

Adult↗
PubMed1993

A follow-up study of neuropsychological function in asymptomatic HIV-infected patients.

A group of asymptomatic HIV-infected patients (CDC II and III) was followed-up over a two year period with semi-annual neuropsychological testing. Of the total sample of 36 subjects, all were retested at test two (T2), 19 at test three (T3) and 13 at test four (T4). A subgroup of subjects was further tested on a simple and a complex task of reaction time. The CD4+ and CD8+ lymphocyte counts were measured in peripheral blood. According to our criteria, no patient could be defined as neuropsychologically impaired. A significant improvement in performance was found from T1 to T2 and from T2 to T3, with a leveling off between T3 and T4. No associations were observed between reaction time and changes in neuropsychological test results and immunological parameters. Our results indicate that neuropsychological impairment does not develop gradually in the asymptomatic stages of HIV-infection. Furthermore, measurements of reaction time do not seem to have any prognostic significance neither for neurocognitive function nor for immunological status as measured by us.

AIDS Dementia Complex↗
PubMed1992

Slowed reaction time in asymptomatic HIV-positive patients.

A total of 24 asymptomatic HIV-infected patients (CDC II/III) and 27 HIV-negative controls were tested for speed of reaction and for general neuropsychological functioning. Reaction time was assessed with two computerized tests with differing levels of cognitive complexity. The results show that the asymptomatic HIV-positive patients have a significantly longer mean reaction time to simple and complex stimuli (SRT p < 0.001, CPT p < 0.05), and a significantly greater standard deviation (SD) (SRT-SD p < 0.005). No significant differences were observed on any of the clinical neuropsychological tests, or in the number of false positive (FP) or non-responses to stimuli (NR) from the CPT. The results indicate that asymptomatic HIV-infected patients are slower and have a greater intra-subject variability in speed using a simple test for reaction time. The difference is less pronounced when doing a more demanding cognitive task and not significant in a test of visuo-motor coordination or on other clinical neuropsychological tests. Emotional state or cognitive strategies affecting speed/accuracy trade-off do not account for the findings.

AIDS Dementia Complex↗
PubMed1991

Neuropsychological findings and depressive symptoms in patients with Huntington's disease.

Twenty patients with Huntington's disease (HD) and a comparison group were studied by a depression scale (MADRS) and a neuropsychological test-battery assessing central areas of cognitive function. The main purpose was to analyze the consistency of findings across patients and focus on the role of specific factors in the impairments. The HD-patients are impaired relative to norms and the comparison-group in all areas but verbal conceptual function. We further divided the HD-patients into subgroups according to severity of neuropsychological impairment. The groups generally show a pattern of increasing deficits. Early changes are found in tests of cognitive efficiency, memory and sensomotor function, but the pattern of impairment is variable. The more severely affected subgroups show an increased decline in performance and progressive involvement of a broader range of functions. The pattern of depressive symptoms in HD-patients indicates that cognitive symptoms of concentration difficulties and lassitude are prominent in all subgroups.

Adult↗
PubMed1991

Prevalence of neuropsychological deficit in HIV infection. Incipient signs of AIDS dementia complex in patients with AIDS.

The present study attempts to estimate the prevalence of Aids Dementia Complex assessed by neuropsychological testing in Norwegian patients with AIDS using a clinical control group with acute leukemia and an asymptomatic HIV-positive group as reference groups. Newly diagnosed patients with AIDS and not receiving zidovudine or other anti-viral drugs, patients with asymptomatic HIV infection, and newly diagnosed patients with acute leukemia, were studied with a battery of neuropsychological tests. Speeded tests and composite non-verbal measures discriminated significantly between groups. The results indicate higher than 50% prevalence of ADC in newly diagnosed Norwegian patients with AIDS. Our findings indicate that the AIDS population may contain two distinct groups, a subgroup with ADC and a subgroup with persistently normal neuropsychological function. The group with asymptomatic HIV infection showed normal neuropsychological performance.

AIDS Dementia Complex↗
PubMed1990

The relation between integration, sequence of information, short-term memory, and Token Test performance of aphasic subjects.

Fifty-two aphasic patients were tested with a modification of part II of the Token Test. Three experimental variables were investigated: (a) the temporal sequence of information in the instructions, comparing instructions with preposition versus the ordinary postoposition of noun; (b) the spatial organization of the target objects, comparing an organization with color as the primary organizational factor to the ordinary organization primarily based on form; and (c) the specific timing of the presentation of instructions and tokens, comparing a successive presentation of instructions and tokens to the ordinary simultaneous presentation. Neither token organization nor instruction timing affected test performance. Sequence of information was important, however, and it is suggested that the effect can be explained by better opportunities for integration for preposition versus postposition instructions. The patients were also tested with several memory-span tests, and these results are related to those from the modified Token Test.

Adolescent↗
PubMed1988

Neuropsychological predictors in stroke rehabilitation.

A mailed questionnaire, sent routinely to discharged stroke patients, divided left-hemisphere (n = 68) and right-hemisphere (n = 77) patients into three groups of general help dependency in basic activities-of-daily-life skills. A subsample of 29 patients was visited at home and asked to reanswer the questionnaire under guidance of a trained occupational therapist. The reliability of the questionnaire was considered satisfactory. Both neurological deficits and neuropsychological syndromes correlated significantly with the level of help needed for managing alone at home. Multiple regression analysis revealed a major gain in explained variance in help dependency when neuropsychological test results were added to information on degree of hemiplegia and hemianopia. Keeping in mind the subject characteristics of the study sample, apraxia and pathological emotional reactions were the more important variables in the left-hemisphere and right-hemisphere groups respectively. The challenge from rehabilitation psychology is discussed and the need for developing more sophisticated methods for assessing rehabilitation potential is stressed.

Activities of Daily Living↗