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Jong-Ling Fuh

Publications and source records attributed to Jong-Ling Fuh.

At least 37 records · Page 2Linked to original sources
PubMed2004

Benchmarking a test of temporal orientation with data from american and taiwanese persons with Alzheimer's disease and american normal elderly.

Orientation questions are readily incorporated into longitudinal population surveys, but their value as a screening tool for cognitive impairment is uncertain. We evaluated the screening value of four orientation-to-time items (TTO) from the Mini-Mental State Examination (MMSE) by determining their association with full-scale MMSE scores. Data collected under protocols with strict eligibility criteria in the US (64 normal elderly, 242 persons with probable Alzheimer's disease) and Taiwan (241 persons with probable Alzheimer's disease) were analyzed. The TTO and full-scale MMSE scores were significantly correlated (p < 0.05) in persons with a Clinical Dementia Rating (CDR) score of 0 or 1; this was not significant in persons with a CDR of >1 (p > 0.05). Both TTO and MMSE were significantly associated with education in persons with 0-7 years of education; some MMSE items, but none of the TTO items, were associated with education in persons with more than 7 years of education. TTO may be a useful component of cognitive screening efforts.

Aged↗
PubMed2004

Cardiac cephalalgia. Case report and review of the literature with new ICHD-II criteria revisited.

We report a patient with cardiac cephalalgia and review reported cases from the English-language literature based on the new diagnostic criteria published in the International Classification of Headache Disorders, ed 2. Twenty-two patients, including ours, with headaches of cardiac origin were reviewed. The cases fit three of the four new criteria well: Criteria B (acute myocardial ischemia has occurred, 100%), C (headache developed concomitantly with acute myocardial ischemia, 100%), and D (headache resolved and does not recur after effective medical or surgical treatment for myocardial ischemia, 83%). The cases in which we had exceptions were to the proposed headache features (criterion A), which were generally not fulfilled, with nausea as the least frequent finding (27%); this criterion might not be mandatory for diagnosis.

Adult↗
PubMed2004

Measuring Alzheimer's disease progression with transition probabilities in the Taiwanese population.

BACKGROUND: The transition probability of Alzheimer's disease (AD) is defined as the likelihood that the disease progresses from one stage to another in a given time period. OBJECTIVE: To estimate the separate stage-to-stage and stage-to-death transition probabilities for Taiwanese patients with AD and to evaluate the hazard ratios of age, sex, behavioral symptoms, and medications on disease progression. METHOD: We examined data (severity of dementia, hallucinations or delusions, use of cholinesterase inhibitors [CEIs], survival) in 365 patients with probable AD at baseline and at follow-Gup (mean +/- SD 29 +/- 17 months, range 3-109 months). RESULTS: Modified survival analysis revealed that transition probabilities of Taiwanese patients were similar to those of Western patients. The probability of dementia remaining at the same stage was higher in patients taking CEIs than in other. Men had a higher probability of dying in the mild stage. CONCLUSION: Transition probabilities can be used to measure AD progression. CEIs used to treat AD might alter the disease course.

Age Factors↗
PubMed2004

Primary cough headache is associated with posterior fossa crowdedness: a morphometric MRI study.

The aetiology of primary cough headache (PCH) is obscure. The aim of this study was to investigate the magnetic resonance (MR) morphometric characteristics of the posterior cranial fossa (PCF) in patients with PCH. Eighteen consecutive patients with PCH (14M/4F, mean age 75.1 +/- 6.0 years) and 18 sex- and age-matched control subjects were recruited for study. Based on the midline sagittal MR images, parameters indicating posterior fossa crowdedness were measured. Compared with controls, patients with PCH had a similar size of hindbrain tissue area but a significantly smaller PCF area, resulting in a higher mean hindbrain/PCF ratio (0.78 +/- 0.04 vs. 0.73 +/- 0.06, P = 0.005). In addition, these patients also had a lower position of the cerebellar tonsillar tip, a shorter clivus length and shorter distances from the clivus to the mid-pons and from the basion to the medulla than the control group. Patients with PCH were associated with a more crowded PCF, which might be a contributing factor for the pathogenesis of this headache syndrome.

Aged↗
PubMed2004

Headache profile in patients with idiopathic hypertrophic cranial pachymeningitis.

BACKGROUND: Idiopathic hypertrophic cranial pachymeningitis (IHCP) is an uncommon disorder due to localized or diffuse thickening of the dura mater. While headache is the most common manifestation, the clinical characteristics of the headache in IHCP have not been well characterized. METHODS: From 1996 to 2002, 6 consecutive patients with IHCP presenting with headache were reviewed (3 women, 3 men; mean age: 49 years). Diagnosis was based on characteristic neuroimaging findings and the exclusion of secondary causes of cranial pachymeningitis. This study reported the headache characteristics, neuroimaging features, and longitudinal follow-up. RESULTS: Chronic daily headache, especially chronic migraine, was the most common headache pattern observed (4/6 patients). Lateralization of headache location appeared to correlate with the distribution of the hypertrophied dural lesions. Diagnostic delay was due to failure to evaluate with gadolinium-enhanced MRI. After treatment, headache (5/6, 83%) and neurologic deficits (2/3, 67%) improved in most patients; however, follow-up MRIs (n = 5) showed deterioration in 3 patients. CONCLUSION: The headache of IHCP is typically a chronic daily headache, often resembling chronic migraine. Correspondingly, IHCP should be considered in the differential diagnosis of refractory chronic daily headache, with or without associated cranial neuropathy or other associated neurologic deficits. The typical imaging finding on gadolinium-enhanced MRI is localized or diffuse pachymeningitis and failure to order a gadolinium-enhanced MRI is the primary reason for delayed diagnosis. Despite symptomatic improvement on longitudinal follow-up, the MRI abnormalities may not improve in parallel with the clinical symptoms.

Adult↗
PubMed2003

High frequency of primary Sjögren's syndrome in Taiwanese patients presenting as relapsing-remitting multiple sclerosis.

Primary Sjögren's syndrome (PSS) with central nervous system involvement may mimic the manifestations of multiple sclerosis (MS). The prevalence of PSS in MS patients varies in the published literature (0-16.6%), but has not yet been investigated in Asia, having a much lower MS prevalence than Western countries. Twelve consecutive patients presenting with a relapsing-remitting MS-like syndrome were recruited to assess the presence of PSS according to the American-European consensus group criteria. Six patients (50%) fulfilled the diagnostic criteria of PSS. The preliminary result suggests that PSS is an important differential diagnosis in patients with MS-like syndrome in Taiwan. The prevalence of 'pure MS' in Taiwan might be even lower than expected. A further large-scale study is warranted to confirm this finding in Taiwan as well as other Asian countries.

Adult↗
PubMed2003

Bathing headache: a variant of idiopathic thunderclap headache.

Bathing headache is rarely described in literature. We report four middle-aged Taiwanese women who developed severe throbbing headache with maximum intensity of onset during bathing. Diffuse cerebral vasospasm was demonstrated in one of them. All their headaches resolved spontaneously (n = 1) or after nimodipine treatment (n = 3). Except for one patient with vasospasm in whom reversible posterior leukoencephalopathy and an asymptomatic cerebellar infarction developed, the others recovered without any complications. The clinical profile of bathing headache points to idiopathic thunderclap headache. It may not be as benign as previously reported. Nimodipine might be effective in treatment of this special headache syndrome.

Adult↗
PubMed2003

Ice-cream headache--a large survey of 8359 adolescents.

We conducted a self-administered questionnaire to investigate ice-cream headache in school adolescents aged 13-15 in Taiwan. The target population was 8789 students in 6 public junior high schools. A total of 8359 students completed the questionnaire (response rate 95.1%). The prevalence of ice-cream headache was 40.6%. It was significantly higher in boys than in girls, and increased with grade. Students with migraine had a higher frequency of ice-cream headache compared with the students without migraine (55.2% vs. 39.6%, P < 0.0001). The prevalence of ice-cream headache increased among students with more migrainous features. Approximately one third of students decreased their intake of ice cream, or abstained completely, especially the younger students. Our study suggests ice-cream headache is very common in Taiwanese adolescents, and it is more common in students who experienced migraine.

Adolescent↗
PubMed2003

Migraine prevalence during menopausal transition.

BACKGROUND: The effect of menopausal transition on the frequency of migraine has never been the focus of a community-based study. METHODS: A cross-sectional community-based survey was undertaken among Chinese women aged 40 to 54 years in Kinmen, Taiwan. Neurologists diagnosed migraine based on the 1988 International Headache Society classification criteria. Menstrual history including a past or current history of premenstrual syndrome was obtained. Serum levels of estradiol and follicle-stimulating hormone were measured. RESULTS: The 1-year prevalence of migraine was 16.5% in the 1436 participants. Among the women who had not had hysterectomies and did not report symptoms of premenstrual syndrome, migraine prevalence did not vary according to menopausal status. In contrast, in women with self-reported premenstrual syndrome, menopausal status was a factor in migraine prevalence: the late perimenopausal group had the highest prevalence (31%) and the spontaneous menopausal group had the lowest (7%). Among all menopausal groups, women who had had hysterectomies reported the highest migraine prevalence (27%), with the highest occurring in those with premenstrual syndrome (44%). The presence of low estrogen (<50 pg/mL) and high follicle-stimulating hormone levels (>30 mIU/mL) was associated with lower migraine prevalence, even in the premenopausal and early perimenopausal women. CONCLUSIONS: Our data supported the clinical impression that migraine prevalence increases before menopause and declines after spontaneous menopause. However, in this study, this trend occurred only in women with increased vulnerability to hormonal change, such as those with premenstrual syndrome. The presence of low estrogen and high follicle-stimulating hormone levels predicted lower migraine prevalence, whereas a history of hysterectomy was related to higher prevalence.

Adult↗
PubMed2003

Smoking and cognitive performance in the community elderly: a longitudinal study.

This prospective study investigated the association between smoking and cognitive performance in a community of nondemented elderly subjects aged 65 or older. All subjects were categorized as current smokers, former smokers, or never smokers. The lifetime cigarette exposure was computed. At baseline, we found the abstainers from smoking had better cognitive performances; however, the differences were not significant after adjusting for age, education, hypertension, diabetes, and vascular events. The lifetime cigarette exposure was not predictive of the cognitive status. At a 3-year follow-up, neither the smoking status nor the lifetime cigarette exposure predicted the declination of cognition.

Aged↗
PubMed2003

Diameter of the superior ophthalmic vein in relation to intracranial pressure.

BACKGROUND AND PURPOSE: Bilateral engorged superior ophthalmic veins (SOV) have been reported in patients with diffuse brain swelling. We investigated the relationship between the diameter of the SOV on brain MR images and the intracranial pressure (ICP). METHODS: We reviewed the medical records of neurologic inpatients who had undergone both MR imaging of the brain and lumbar puncture. MR imaging had to have been performed before lumbar puncture, and the two studies had to have occurred within 2 days. The diameters of the SOV were measured on coronal contrast-enhanced fat-saturated T1-weighted MR images. For this, the image nearest the rear of the globe of the eye was chosen. RESULTS: Sixty-nine patients (32 male, 37 female; mean age, 46 years +/- 19) were included. The average diameters of the SOV and the ICP were positively correlated (r = 0.58, P <.001), if an SOV diameter of <1 mm was treated as 0.5 mm for calculations. In patients with increased ICP (CSF pressure >200 mm H(2)O), SOV diameters were larger than those of patients with a normal CSF pressure (3.0 vs 1.6 mm, P <.001). Frequencies of increased ICP were 3% among patients with an average SOV diameter of 0.5-1 mm, 15% for 1.5-2 mm, and 58% for 2.5-5 mm (P <.001). CONCLUSION: This study showed that the SOV diameter, determined on the basis on MR imaging, was positively correlated with ICP. Dilatation of the SOV should alert physicians to the possibility of increased ICP.

Adult↗
PubMed2003

Radiological manifestations of cryptococcal infection in central nervous system.

BACKGROUND: Cryptococcus neoformans is one of the most common infectious agents causing central nervous system (CNS) infections in immunocompromised patients. Patients with CNS cryptococcosis commonly present with non-specific manifestations such as headache, fever, seizure and conscious disturbance. This article presents the computerized tomography scans (CT) and magnetic resonance images (MRI) findings of cryptococcal infection in CNS and displays the image difference between immunocompromised and non-immunocompromised patients. METHODS: CNS cryptococcal infection was found in 26 cases over the past 14 years in Taipei Veterans General Hospital, including 18 males and 8 females. Ten patients were immunocompromised. In all cases, the CNS cryptococcosis was diagnosed by positive cryptococcal antigen titer and India ink stain from cerebral spinal fluid (CSF). Their clinical data and findings from CT and MRI were retrospectively studied. RESULTS: The most common CT manifestation is ventricular dilatation; other common findings include leptomeningeal enhancement, infarction (half of them revealed dilatation of Virchow-Robin spaces in subsequent MRI study) and normal appearance. Less common findings are ventriculitis and abscess formation. The most common MRI pattern is Virchow-Robin space dilatation and leptomeningeal enhancement. Other common appearance includes ventricular dilatation. Less common manifestations include cryptococcoma, hemorrhagic infarction and pontine abscess. There is no significant difference in image patterns between immunocompromised and non-immunocompromised patients (p > 0.05). CONCLUSIONS: The most common pattern ofCNS cryptococcosis is ventricular dilatation in CT and Virchow-Robin space dilatation in MRI. MRI is more sensitive in detecting CNS cryptococcal infection like Virchow-Robin space dilatation and leptomeningeal enhancement. There is no significant pattern difference between immunocompromised and non-immunocompromised patients with CNS cryptococcosis.

Adolescent↗
PubMed2002

The Alzheimer's Disease Assessment Scale: findings from a low-education population.

We constructed a Chinese version of the cognitive component of the Alzheimer's Disease Assessment Scale (ADAS-Cog). In order to accommodate illiteracy, the Chinese version used pictures instead of words for assessing recall and recognition. The Chinese ADAS-Cog was administered to 125 individuals with no dementia, 127 with questionable dementia, and 77 with Alzheimer's disease (AD). Their age range was 51-92 years and their education range was 0-20 years. The Chinese ADAS-Cog had high internal consistency (Cronbach's alpha = 0.87) and very high interrater reliability (intraclass correlation coefficient, or ICC, = 0.99) and test-retest reliability (ICC = 0.96). It had high correlations with scores on the Clinical Dementia Rating Scale (Pearson's r = 0.85), the Cognitive Abilities Screening Instrument (CASI, Pearson's r = -0.88), and CASI-estimated scores on the Mini-Mental State Examination (Pearson's r = -0.85). Performance on the Chinese ADAS-Cog was uninfluenced by age or gender, nor by education level except within the low education range of 0-6 years. Its memory items were best for early detection of dementia; its language items were best for monitoring the progression of dementia. This study found that the Chinese ADAS-Cog is a good instrument for use with Chinese AD patients.

Aged↗
PubMed2002

Performance on the cognitive abilities screening instrument at different stages of Alzheimer's disease.

The Cognitive Abilities Screening Instrument (CASI) contains nine cognitive domains. Its total score has been used to screen for dementia in epidemiological studies conducted in the US, Japan and Taiwan, but its usefulness in distinguishing different levels of dementia has not been examined. This study was conducted to compare CASI scores of patients with Alzheimer's disease (AD) with different levels of severity of dementia. The CASI was administered to 475 AD patients with mild, moderate or severe dementia according to the Clinical Dementia Rating Scale. The patients' scores were compared to the scores of 475 age-, education- and gender-matched control subjects. More specifically, each patient's score, X, was transformed to a z score with reference to the mean and SD of the scores of the control group, where z = (X - mean)/SD. Then, the mean of the z scores and the percentage of patients with z scores of <-2.0 were compared among the three patient groups. For the CASI total score and all of its nine domain scores, the mean z score decreased (except that for short-term memory) and a higher percentage of patients scored below the normal range with increasing severity of dementia. This study validates the usefulness of the CASI for assessing the severity of dementia. The domain scores differed in their relative usefulness for detecting dementia and for distinguishing in different levels of dementia.

Alzheimer Disease↗
PubMed2002

Which level of care is preferred for end-stage dementia? Survey of Taiwanese caregivers.

In Western countries, most family caregivers view some degree of palliative care as appropriate for severely demented care recipients. In Asian countries, caregivers' attitudes toward such an important issue have not been sufficiently investigated. Therefore, we surveyed Taiwanese caregivers' attitudes toward the terminal care of demented care recipients by questionnaire. In 115 (48 men, 67 women; mean age 73.7+/-9.5 years) caregivers who completed the questionnaire, most caregivers (61%) preferred highly aggressive care, whereas only 3% preferred solely palliative care at the end of the demented care recipients' life. Caregivers having a lower education level (< or = 12 vs > 12 years) or having care recipients of a younger age (< or =75 vs >75 years) exhibited a higher preference for cardiopulmonary resuscitation (CPR) (P = .020 and P = .010, respectively). Sixteen percent of caregivers accepted postmortem autopsy for their care recipients. Twenty-eight percent of caregivers of home-resident recipients anticipated institutionalization, especially those with care recipients having moderate to severe stages of dementia. Co-surrogate caregivers, including the spouse and the offspring, were the most common proxies (39%) for care recipients with end-stage dementia. By comparison with Western countries, the low acceptance rate of CPR refusal and nursing home placement by our caregivers might result from cultural differences.

Age Factors↗
PubMed2002

A transcultural study of agitation in dementia.

Agitation is one of the most troublesome behaviors in demented patients. It is etiologically heterogeneous and has varied associated behaviors. To explore the transcultural differences in the manifestation of agitation, we evaluated 50 consecutive Alzheimer's disease (AD) patients in three countries (Taiwan, Italy, and the United States) using the Neuropsychiatric Inventory (NPI) and the Mini-Mental State Examination (MMSE). In a focused analysis, only patients with composite NPI scores > 2 for agitation were selected, with similar levels of disease severity as measured by the MMSE, from the three groups (n = 15 per group) to evaluate culturally specific correlates of agitation. Agitated Taiwanese had significantly more hallucinations than either Italian or American patients. Agitated Italian patients had significantly more apathy than both Taiwanese and American patients. Cultural factors may influence the manifestation of agitation more than a common underlying neuropathology. Management strategies targeting unique behavioral instigators of agitation may be specific for different ethnic groups.

Aged↗