The cholinergic system and EEG slow waves.
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Biomedical subjects
Publications and source records attributed to J Partanen.
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EEG studies of Parkinson's disease (PD) have shown that the incidence of EEG abnormalities is higher than in normal old individuals. The most common alteration in PD is generalized slowing of the EEG. We studied 18 patients with Parkinson dementia, 18 age-matched Parkinson patients without dementia and 20 controls. The absolute and relative amplitudes of delta, theta, alpha and beta bands and the peak and mean frequency were calculated from EEG spectra recorded from the T6-O2 derivation. All variables differed significantly in Parkinson dementia patients compared to controls. The most conspicuous finding was the increase of delta activity. Parkinsonian patients without dementia had more theta activity and the frequencies were slow compared to controls. We conclude that parkinsonian subgroups have distinct patterns of abnormality in EEG spectra: Parkinson patients with dementia have distinctly slower EEGs than patients without dementia.
We describe EEG findings and clinical outcomes of 24 Alzheimer (AD) patients over a 3 year follow-up period. Three records, baseline, 1 year and 3 year, were available for 13 patients. Although the majority of the patients showed slowing of the EEG over 3 years, evolutions of the EEG changes were not equal in all patients. In 12 (50%) of the patients the EEG from T6-O2 derivation was normal or slightly abnormal in the initial record and remained stable during 1 year. At year 3, only 2 patients still had normal EEGs and mild dementia, probably representing a subgroup of AD with a benign course, 7 patients needed institutional care and 3 had died. EEG slowing at the time of diagnosis was predictive of poor outcome at year 3; absolute theta amplitude was the best discriminating variable of outcome. The results support the idea of heterogeneity of AD patients and suggest that EEG may provide valuable information for prediction of outcome.
A slowly progressive myopathy was discovered in a family in four successive generations. Eight patients (four female, four male) from three generations were examined and they showed muscle weakness affecting predominantly proximal, but also distal, muscles. Two patients had unequivocal findings in childhood, the others showed myopathy in their twenties or thirties. Working ability was lost in physically demanding jobs in the thirties, but activities of daily living were still preserved. Elbow contractures, tight heel cords and contractures of the interphalangeal joints were frequent. Serum CK activity was usually mildly elevated and electromyographic examinations revealed myopathic changes. Histopathological changes were compatible with moderately advanced muscular dystrophy in two patients, the six others had mild myopathic changes.
Cortical functions and slow-wave activity in the spectral analysis of the electroencephalogram (EEG) have been studied in 19 patients with Alzheimer's disease (AD), 18 patients with Parkinson's disease with dementia (PD), and 14 control subjects (C) to determine which functions are explained by their relationship of slow-wave activity. Multiple regression analyses revealed that a variance in visual functions, praxia of the hand, automatic speech, speech understanding, and retrieval from semantic memory were explained by their relationship with slow-wave activity in EEG in the AD group but not in the PD or C groups. The PD and AD groups exhibited equal cortical dysfunctions and mean amplitudes of delta activity in EEG. The cholinergic system, disrupted in AD, has been shown to be important in the regulation of neocortical electrical activity and may be associated with the processing of cortical functions.
We have studied the absolute and relative power and amplitude of EEG spectra (T6-02) of 24 patients with "probable" Alzheimer's disease at the early stage of the disease and 1 year later and also compared the values to those of normal elderly controls. A remarkable variability of the absolute values was evident both for the patients and for the controls. The AD patients had significantly higher absolute theta amplitude and power and the absolute beta values tended to decrease compared to controls. Absolute delta and alpha values did not differ from those of the controls. The relative delta, theta and alpha power and amplitude, and beta amplitude showed significant changes in AD patients, whereas the relative beta power was unchanged. In the follow-up of AD patients at 1 year, absolute alpha values decreased and delta values tended to increase. As to relative values, both the alpha and the delta significantly changed but the theta and the beta were unaltered. We conclude that both absolute and relative power and amplitude values should be considered in EEG studies of dementia patients. Absolute values are especially useful in follow-up.
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To determine if the pattern of cognitive decline in Alzheimer's disease (AD) patients with normal EEG differs from that in patients with abnormal EEG at the early stage of the disease, we have followed 12 AD patients with normal EEG (NEEG) and 12 patients with deteriorating EEG (DEEG). The AD patients with DEEG showed a decline of praxic functions, confrontation naming, and automatic speech functions. In contrast, the AD patients with NEEG did not show a deterioration of these functions during the 3-year follow-up period. Visual functions, understanding of speech, and memory functions deteriorated similarly in both groups. The clinical severity of dementia increased in both groups. Patients with DEEG showed a tendency toward a higher frequency of extrapyramidal symptoms and a higher risk of institutionalization than the patients with NEEG. Thus, an abnormal EEG at the early stage of AD may predict a more severe decline in cognitive functions.
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Explore the source record for details and available documents.
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UNLABELLED: The functioning of low back muscles of back pain patients during flexion and reextension has not been properly investigated. In this study, we analyzed rectified, averaged electric activity (RMS EMG) and corresponding raw intramuscular (IM) EMG from lumbar paraspinal muscles to quantify the activity level during simple bending cycles in 87 back pain patients compared to 25 able-bodied controls. THE RESULTS: All functional phases seen in raw IM EMG were also shown in surface RMS EMG. Surface RMS EMG pattern seems to yield more information from activity level than IM EMG pattern. The RMS EMG patterns of back pain patients differed from those of controls as follows: (1) There was clearly noticeable activity during standing in back pain patients. (2) There was only a partial decrease of EMG activity after flexion in back pain patients with current pain. (3) The ratio of mean reached at maximal activity level during extension and flexion was less in patients (1.8, SD = 0.5, p less than .001) than able-bodied controls (3.2, SD = 0.8). (4) Segmental differences were observed in IM EMG activities in patients having hypermobility in bending x-ray. (5) Large peak potentials occurred during movements in patients having segmental hypermobility. THE RESULTS indicate that averaged surface recording is a valuable tool in the investigation of dynamic spine functions in back pain patients.
At present, 34 patients aged 15 to 63 years with newly diagnosed epilepsy have been randomly assigned to vigabatrin (n = 17) or carbamazepine (n = 17). Evaluation of clinical data, neuropsychological assessment, quantitative spectral electroencephalogram (EEG), and somatosensory- and visual-evoked potentials at baseline and after a 3 months' maintenance phase are presented for 12 patients on vigabatrin and for 11 patients on carbamazepine. Among these patients, retention rate in the maintenance phase of the study is 75% for vigabatrin patients (two noncompliant patients and one nonresponder dropped out) followed up for a mean of 11 months (range, 5 to 16 months). The retention rate for carbamazepine is 100% for the 11 patients, followed up for a mean of 9 months (range, 3 to 17 months). Patients receiving vigabatrin showed significant improvements in sustained concentration and tasks requiring flexible mental processing after the 3-month maintenance period, compared to baseline. In the carbamazepine group, there was improvement only in delayed list recall, and in contrast, errors in visuomotor tasks requiring processing increased significantly. Patients on carbamazepine demonstrated slowed occipital mean frequencies, but vigabatrin treatment was not associated with any significant quantitative EEG changes. Significant prolongation of somatosensory-evoked potential N19 latencies was seen with both carbamazepine and vigabatrin.
We have isolated a cDNA encoding a novel tyrosine kinase family member, named cyl (consensus tyrosine-lacking kinase), from the K562 human leukemia cell line. The deduced cyl protein lacks signal and transmembrane sequences but contains features of known cytoplasmic tyrosine kinases, including amino-terminal SH3 and SH2 domains. However, having very short amino and carboxy termini, cyl does not seem to belong to any of the previously characterized subfamilies of cytoplasmic tyrosine kinases. Furthermore, cyl lacks the highly conserved tyrosine autophosphorylation site (Y416src) in the tyrosine kinase catalytic domain. The cyl gene is located on human chromosome 15. It is expressed ubiquitously as two independently regulated mRNA species of 2.6 and 3.4 kb in human leukemia cell lines and fetal tissues.
Electroneurophysiological abnormalities have been reported in some patients with dementia, but the data available is rather limited and controversial. We studied nerve conduction velocities and electromyography in 59 patients with moderate to severe involvement of Alzheimer's disease. Except some occasional mono- and polyneuropathies, the patients showed no systemic dysfunction of the peripheral nervous system.
Molecular cloning has revealed that erythroid potentiating activity (EPA) and tissue inhibitor of metalloproteinases (TIMP) represent two distinct activities of a single protein. We have studied the expression of the EPA/TIMP gene at the mRNA and protein levels during 12-O-tetradecanoyl-phorbol-13-acetate (TPA)-induced megakaryoblastic differentiation of K562 human chronic myeloid leukemia cells. Northern hybridization analysis showed that the EPA/TIMP mRNA was increased within 3 hours of TPA-induction and reached maximal levels (about 50-fold induction) during the first day of treatment. The expression of mRNAs for two major metalloproteinases, collagenase-I and stromelysin, were activated in parallel in the differentiation-induced K562 cells. The increase of EPA/TIMP mRNA correlated with increased EPA/TIMP protein biosynthesis and secretion: the TPA-induced cells secreted substantially enhanced amounts of metabolically labeled proteins, of which EPA/TIMP represented up to 50% after the first day of treatment (over 100-fold induction). The induction of EPA/TIMP mRNA was associated with its increased transcription. EPA/TIMP induction required continuous protein synthesis, being completely inhibited by addition of the protein synthesis inhibitor cycloheximide simultaneously with TPA, but only partially inhibited in a time-dependent manner if cycloheximide was added after TPA. Unlike in other cells tested, the jun and c-fos transcription factor mRNAs showed a prolonged biphasic induction response in K562 cells during TPA treatment. This response was associated with enhanced activity of a transfected recombinant reporter plasmid containing binding sites for the jun/fos transcription factor complex (AP-1) similar to the TPA-responsive element (TRE) sequence we found in the EPA/TIMP gene promoter. We suggest that the induction of EPA/TIMP and several other genes specific for the differentiating K562 cells may be a consequence of the sustained activation of immediate early genes encoding transcription factors, such as jun and c-fos.