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Biomedical subjects

J B Lanser

Publications and source records attributed to J B Lanser.

29 records · Page 2Linked to original sources

Cognition in patients with multiple sclerosis After four years.

This study reports on a 4-year follow-up of cognitive functioning in 33 MS patients and 18 healthy control subjects. As a group, and in agreement with the results in the previous assessment. MS patients have significantly weaker performances than controls in motor speed, reaction time, learning tasks, reading aloud and figure copying. Tasks addressing visuospatial problem solving, behavioural flexibility, and linguistic aspects of oral and written communication do not distinguish between the two groups. Influence of impaired movement is acknowledged in performances utilising speech and reading under instructions of speed, and in figure copying. Cognition per sé remained undisturbed in 25 patients (76%). A uniform MS-related development of cognitive deficits could not be identified, improvement, stability and further deterioration being found at reassessment.

Cognition Disorders↗

Hereditary cerebral haemorrhage with amyloidosis--Dutch type. Magnetic resonance imaging findings in 7 cases.

The clinical history and magnetic resonance imaging (MRI) findings are presented of 7 patients with hereditary cerebral haemorrhage with amyloidosis--Dutch type (HCHWA-D). The diagnosis was based on clinical and genealogical data, was confirmed in 3 patients at autopsy and in 2 others by biopsy. Focal neurological signs, and at least some degree of global cognitive deterioration, were observed in all patients, with unequivocal dementia in 4. MRI showed haemorrhages and areas of gliosis and, to a variable extent, hyperintensity of the white matter in T2-weighted images. Neuropathological examination revealed a large recent haemorrhage together with residual lesions from previous haemorrhages or infarcts in all patients examined. The white matter lesions, present on MRI, turned out to be areas of 'incomplete infarction' with demyelination. It is concluded that (hereditary) amyloid angiopathy can lead to strokes, but also to subcortical ischaemic encephalopathy. Amyloid angiopathy should therefore be considered in the differential diagnosis of white matter lesions, found on CT or MRI, especially when patients present with a cerebral haemorrhage. The relationship between HCHWA-D and Alzheimer's disease, another disease with cerebral amyloid deposition and diffuse white matter involvement, is discussed.

Adult↗

[Neuropsychological findings in children with Gilles de la Tourette syndrome].

Eight children with the syndrome of Gilles de la Tourette underwent a neuropsychological assessment. The results were compared with those of eight children with proven lesions of the right cerebral hemisphere and with eight children with learning disabilities without neurological disturbances. Our findings do not support organicity or dysfunctions of the right hemisphere in children with Gilles de la Tourette syndrome.

Adolescent↗

Visuospatial problem solving, conceptual reasoning and sorting behaviour in multiple sclerosis out-patients.

Visuospatial problem solving, conceptual reasoning and shifting of set were studied in out-patients with definite and probable MS. The sample of MS patients was homogeneous with respect to 2 important dimensions. All were out-patients, leading a normal although handicap-restricted social life. Furthermore, in all patients relapse or obvious instability of the disease were absent for at least a month. On Raven's Progressive Matrices, the Category test and the Wisconsin Modified Card Sorting test, no significant differences were found between the group of MS patients and a control group of healthy volunteers. However, 18% of MS patients and 4% of controls were rated as performing slightly below the expected levels of cognition. Stepwise regression analysis failed to reveal effects of illness variables, and no difference between patients with definite and probable MS could be detected. Clearly, most socially integrated MS patients in stable disease stages are capable of normal visuospatial problem solving, abstract reasoning and shifting of set.

Adolescent↗

Reaction time in ambulant multiple sclerosis patients. Part I. Influence of prolonged cognitive effort.

Reaction times (RT) were measured in 39 multiple sclerosis (MS) patients and 25 healthy controls, before and after comprehensive neuropsychological assessment lasting at least 4 h. The assessment required prolonged mental effort, which was assumed to induce fatigue. Simple and disjunctive RT were measured for visual and auditory stimuli. RT before and after prolonged effort were significantly longer in MS than in control subjects (with exception of auditory RT). This effect was related to disease duration and to simultaneous presence of brainstem, cerebellar and/or pyramidal signs. Age did not significantly contribute to the explanation of RT increase. In female patients, increasing distribution of functional lesions in the central nervous system was related with greater RT increase than in male patients. RT of MS and controls changed after prolonged mental effort and effort-related fatigue was experienced subjectively. Yet no differences in direction or degree of change in RT were found between controls and ambulant patients with stable MS who apparently had resources to overcome fatigue.

Adolescent↗

Reaction time in ambulant multiple sclerosis patients. Part II. Influence of task complexity.

Effects of task variables on reaction time (RT) were investigated in 39 multiple sclerosis (MS) patients and 25 matched control subjects, based on the premise that RT is sensitive to (subtle) changes of cognitive efficiency. The hypothesis to be tested held that inefficient cognitive processing in MS would be reflected in differences between RT patterns of MS and control subjects, and in inordinate RT increase in MS patients with increase of task complexity. No difference was found between MS patients and controls, or between MS subgroups, in (1) response to time uncertainty of stimulus presentations, (2) RT behaviour over stimulus presentations, and (3) RT change from simple to more complex conditions. No evidence of slowed cognitive processing was found in this sample of outpatients with relatively mild and stable MS. It is emphasised that executive and cognitive slowness have to be disentangled in research on MS and on so-called 'subcortical dementia', of which mental slowing is a key concept.

Adolescent↗

A clinical trial with desglycinamide arginine vasopressin for the treatment of memory disorders in man.

In a double-blind cross-over trial the memory effect of the neuropeptide desglycinamide arginine vasopressin (DGAVP) was selected because of its well-documented facilitatory effects on memory components in rodents. Patients with stabilized or progressive amnesic disorders (Korsakoff disease, early stages of Alzheimer dementia, head injuries and other central nervous system diseases) did not respond to the drug. Factors possibly explaining the discrepancy with animal research are discussed.

Adult↗

Carbamazepine (CBZ) controlled release compared with conventional CBZ: a controlled study of attention and vigilance in children with epilepsy.

To compare the effects on attention and vigilance of conventional carbamazepine (CBZ) and CBZ controlled release (CBZ-CR), 15 schoolchildren with epilepsy and normal intelligence receiving CBZ were switched to CBZ-CR. Psychological examination was performed on the day before (day A) and 1 month after substitution (day B). Measurements of attention and vigilance were repeated throughout the day at 2-h intervals. Both on days A and B, CBZ plasma levels were monitored during a 12-h period. Fifteen matched healthy controls were submitted to identical test programs, allowing comparisons within subjects as well as between patients and control children. Variability of performance over sessions was neither increased nor decreased with CBZ-CR. Consistent differences over sessions did not exist between patients and controls with either drug. No relation was noted between reaction time and CBZ plasma level. The pharmacologic data confirm results of earlier studies in children. We noted a reduction in intradose fluctuations of CBZ level with CBZ-CR as compared with conventional CBZ. The neuropsychological results do not show a difference between the drugs. Neither were differences noted with respect to antiepileptic efficacy and side effects. At the end of the study, all but one of the children (and their parents) opted to receive CBZ-CR for ease of dosage administration and overall satisfaction.

Adolescent↗