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Biomedical subjects

L Deecke

Publications and source records attributed to L Deecke.

At least 127 records · Page 7Linked to original sources

Cortical DC potential shifts accompanying auditory and visual short-term memory.

Negative DC potential shifts appeared over the scalp during the performance of verbal and non-verbal short-term memory tasks. Three items were successively presented (presentation of memory items) and then had to be retained in memory for 3 sec (memory retention) before being compared to a probe which was either a member (in set) or not a member (out of set) of the memory set. Verbal items (the digits "1" through "9") were tested in the auditory and visual modality and non-verbal items (musical notes) were tested in the auditory modality. Stimulus modality had a significant effect on DC potential shifts during both presentation of memory items and memory retention. There was a sustained negative shift during these periods which was larger over frontal regions with auditory than with visual material whereas the negative shift was larger over posterior temporal regions with visual than with auditory material. Out of 21 subjects who participated in the study, 9 reported the use of visual images in the auditory task, 5 used subvocal auditory rehearsal in the visual task and 7 used imagery concordant with the stimulus modality being memorized. These different strategies had a significant effect on the amplitudes and distribution of the DC potential shifts. The speed of response affected the amplitude of the DC potential shifts in the frontal regions, being larger with fast RTs than with slow RTs but only when verbal items were being processed. These results indicate that stimulus modality, modality of mental imagery, and speed of scanning of the memory store affect DC potential shifts during a 3 sec period of memory retention.

Acoustic Stimulation↗

Regional cerebral blood flow patterns related to verification of low- and high-imagery sentences.

Although several SPECT studies have shown left inferior occipital activation with visual imagery, the reliability of this finding remains doubtful. The present study replicated two conditions of a previous SPECT-study exploring rCBF in subjects verifying the correctness of low- and high-imagery sentences. As in the previous study, verification of high-imagery sentences was associated with higher flow rates in the left inferior occipital region and lower flow rates in the right anterior frontal region. By contrast, a bilateral increase of thalamic flow rates with imagery was not replicated, and there was a higher flow rate in the left inferior temporal region with low-imagery sentences which had not been found in the original study.

Adult↗

Different risk factor profiles in young and elderly stroke patients with special reference to cardiac disorders.

The risk factors of ischemic cerebrovascular disorders in 77 young patients (< or = 40 years) were compared to those in 138 older patients (> 40 years). The risk factor profile of patients with juvenile stroke was considerably different from that of older patients. Migrainous headache and mitral valve prolapse occurred more frequently in the younger age group, whereas hypertension, diabetes mellitus, high levels of cholesterol and triglycerides were found more often in older patients with stroke. 65% of the women under the age of 40 took oral contraceptives which compares to the baseline community value of 28% of women in childbearing age in this country. Cardiac disorders such as atrial fibrillation, left ventricular hypertrophy, coronary heart disease including a history of myocardial infarction, as well as mitral valve disease were demonstrated more often in the group of elderly patients. 7 out of 77 younger patients (9.1%), and 59 out of 138 older patients (42.8%) were considered to belong to a group with "high cardiac risk for stroke". The results of this study indicate that electrocardiographic screening is of prime importance for detecting cardiac risk factors. However, echocardiographic examination often yields additional diagnostic information, particularly in younger patients. The conflicting opinions concerning the relevance of certain risk factors for ischemic stroke could partly be explained by the fact that these risk factors are distributed unevenly depending on age.

Adolescent↗

Behavioural and psychosocial sequelae of severe closed head injury and regional cerebral blood flow: a SPECT study.

Thirty six patients (31 male, 5 female) who had suffered severe closed head injury were re-examined at an average of 39.3 (SD 12.8, range 7-66) months after the injury. Behavioural symptoms were measured using the Giessen test. The relatives' reports were used for data analysis to ensure that results were valid. The neurophysical impairment subscale of the Glasgow assessment schedule was completed by two neurologists, and the number connection test was completed by each patient. The adjective mood scale was completed by each relative. All patients were investigated by single photon emission computerised tomography (SPECT). Exploratory factor analysis using the principal components method was carried out separately for SPECT results and psychological measures and correlations were sought between the resulting factors. Factor analysis of the data from the Giessen test identified social isolation, disinhibition, and aggressive behaviour as major components of post-traumatic personality changes; it indicates that these behavioural features are independent of the level of neurological and neuropsychological impairment, which loaded on a single independent factor. Relatives' psychic health seemed to be relatively resistant to physical and cognitive disability and was mainly affected by disinhibitive behaviour. The highest correlation was between frontal flow indices and disinhibitive behaviour (p less than 0.01): the severity of disinhibition increased with lower frontal flow rates. There was a significant but somewhat weaker correlation (p less than 0.05) between flow indices of the left cerebral hemisphere and social isolation. Low flow values of the right brain regions were related to aggressive behaviour (p less than 0.05). Neurological and cognitive impairment correlated negatively with the thalamus; worse neurological and cognitive performance indicate by raised scores on the neurophysical scale and on the number connection test was associated with low thalamic flow values. The results support the importance of lesion location in the production of post traumatic behavioural disorders.

Adolescent↗

Spontaneous body sway as a function of sex, age, and vision: posturographic study in 30 healthy adults.

Detailed neurological examinations and body sway measurements with a stable force measuring platform were carried out on 30 healthy adults between 21 and 63 years of age. The results were analyzed for sex- and age-associated changes with regard to three different sway components (total sway, anterio-posterior sway, lateral sway) and two different conditions (eyes open, eyes closed). Sex-associated differences were highly significant for all sway components in the oldest age group (51-65 years) in which men exhibited more spontaneous postural sway than women in the condition eyes open. With eyes closed these differences increased. Middle-aged men (36-50 years) also exhibited significantly more postural sway than women of the same age. In the condition eyes open especially total sway and anterioposterior sway were increased, whereas in the condition eyes closed total sway and lateral sway were predominantly higher in men than in women. In the youngest age group (21-35 years) no sex-related differences in postural sway were found. Age-associated differences were significant for anterioposterior sway (eyes open) in men, increasing continuously from the young to the middle-aged, and again from the middle-aged to the older age group. Anterioposterior sway in women, on the contrary, did not change with age. Age-associated differences in women were found for total sway (eyes open) and lateral sway (eyes closed). However, the highest values for total sway and lateral sway within the female group were obtained from young women in both conditions eyes open and eyes closed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Speech arrest as first symptom of a tumour in the supplementary motor area.

There are only few reports in the literature on isolated episodes of speech arrest as first symptom of a tumour in the supplementary motor area. These episodes of speech arrest are due to seizure activity and must be distinguished from speech arrest due to transient ischaemic attacks. The diagnosis may be difficult because the tumour may erroneously be suspected in the lower portion of the sensorimotor strip and may, hence, be missed on CT if apical sections of the regions are not performed. Clinical and experimental aspects of this problem are discussed on the basis of a case report and a review of the literature.

Aged↗

[Etiology of Alzheimer's disease].

The major factor that causes problems in studies on the aetiology of Alzheimer's disease (AD) is the clinical heterogeneity of the condition. Familial early-onset AD and familial late-onset AD are differentiated from sporadic AD. Aetiologically a genetic defect on chromosome 21 is the most important factor, at least in some cases of AD. In familial AD and autosomal dominant inheritance with complete penetrance in old age is thought to be possible. In sporadic AD the role of genetic and exogenous factors (infectious agents, aluminium) is unknown. The current status of knowledge about the aetiology of Alzheimer's disease is reviewed with reference to the literature.

Aged↗

Human somatosensory cortical finger representation as studied by combined neuromagnetic and neuroelectric measurements.

We studied somatotopy of human hand somatosensory cortex using evoked responses recorded on magnetoencephalogram (MEG) and scalp-electroencephalogram (EEG) in conjunction with dipole modeling. We found a somatotopic arrangement of cortical digit representations with a sensory sequence from lateral inferior to medial superior in the anatomical order thumb, index finger, middle finger, ring finger, and little finger. MEG alone was able to reproduce this sensory sequence more accurately than scalp-EEG alone. However, the combined information provided by both techniques improved localization accuracy even further. As MEG and scalp-EEG are complementary and confirmatory techniques, this combined approach was useful to get more complete information on the functional organization of human hand somatosensory cortex.

Brain Mapping↗

Distribution of ischemic cerebrovascular events in cardiac embolism.

Distribution and number of ischemic cerebrovascular events were studied in 57 patients who suffered from heart disorders with proven or highly probable source of cardiac embolism and compared to 39 patients with ulcerations of the craniocervical vessels. Patients with coexisting lesions were excluded from the present study. Out of the 57 patients with cardiac disorders, a single episode of cerebral embolism occurred in 33 patients. Of the 24 patients with recurrent ischemic episodes, different vascular territories were involved in only six cases. There was no evidence of a distinct distribution of vascular territories involved in cerebral embolism. The left middle cerebral artery was affected in 42.9%, the right middle cerebral artery in 23.8%, the vertebrobasilar territory in 19%, and the ophthalmic arteries in 14.2%. Statistical analysis revealed no significant differences in lesion localization between the group with a cardiac source of embolism and the group with ulcerations of the craniocervical vessels. There was a high frequency of patients with recurrent cardiogenic emboli in the ophthalmic (6 of 9 patients) as well as in the vertebrobasilar (6 of 12 patients) circulation who experienced a delayed initiation of cardiac assessment. The possibility of cardiac embolism should be considered in any patient with cerebral ischemia, independently of the vascular territory affected.

Adult↗

Localization of brain activity during auditory verbal short-term memory derived from magnetic recordings.

We have studied magnetic and electrical fields of the brain in normal subjects during the performance of an auditory verbal short-term memory task. On each trial 3 digits, selected from the numbers 'one' through 'nine', were presented for memorization followed by a probe number which could or could not be a member of the preceding memory set. The subject pressed an appropriate response button and accuracy and reaction time were measured. Magnetic fields recorded from up to 63 sites over both hemispheres revealed a transient field at 110 ms to both the memory item and the probe consistent with a dipole source in Heschl's gyrus; a sustained magnetic field between 300 and 800 ms to just the memory items localized to the temporal lobe slightly deeper and posterior to Heschl's gyri; and a sustained magnetic field between 300 and 800 ms to just the probes localized bilaterally to the medio-basal temporal lobes. These results are related to clinical disorders of short-term memory in man.

Adult↗

[Prognosis after transient ischemic attacks].

Transient ischemic attacks (TIAs) are reversible neurological deficits due to cerebral ischemia in a vascular territory lasting less than 24 hours, usually less than one hour. The natural course of TIAs is variable. One third of the patients suffer from a subsequent completed stroke with lasting disability, one third of the patients continues to experience TIAs and in one third no further symptoms are encountered. TIAs are a warning symptom of a generalized vascular process, myocardial infarction being the most common cause of mortality and ischemic brain infarction being the most common cause of morbidity. Clinical parameters--besides age--seem to be of minor prognostic relevance. Vascular risk factors should be evaluated in all TIA patients; especially, a cardiac work up including 2D-echocardiography and an exercise stress test should be performed. Duplex sonography of craniocervical vessels shows atherosclerotic lesions in a considerable proportion of patients with TIA; however, localization of these lesions does not always correspond to clinical symptomatology. Some angiographic features are of prognostic relevance. Computed tomography (CT) and magnetic resonance imaging (MRI) show ischemic lesions in a considerable proportion of patients, which connects TIAs directly to ischemic brain infarcts. The extent and localization of these lesions are of some prognostic relevance. Blow flow studies on single photon emission computed tomography (SPECT) and studies of brain metabolism on positron emission tomography (PET) are abnormal in many TIA patients for prolonged periods and also have some prognostic impact. TIA patients probably are a heterogeneous group with a common symptom. A detailed diagnostic work-up may have implications on a more specific and efficient therapy.

Aged↗

[Neurologic and psychiatric complications after heart surgery].

In 63 patients undergoing heart operations with extracorporeal circulation (47 males, 16 females, mean age 54 years; coronary artery bypass in 38 cases, valvular surgery in the rest) postoperative neurological and psychiatric complications were evaluated. 18 patients (29%) had no complications, whereas 35 patients (56%) showed minor or transient neurological symptoms, and 9 patients (14%) exhibited severe symptoms. Nine of the patients had slight psychiatric disturbances (affective disturbances, disorientation). No correlation was found between risk factors (age, nicotine abuse, hypertension, hypercholesteremia, neurologic and cardiac history), intraoperative parameters (duration of extracorporeal bypass, aortic clamp time, deviation of mean arterial pressure), postoperative parameters (internal complications) and the complication rate. Therefore no predisposing factors could be identified.

Adult↗

On the functionality of the visually deprived occipital cortex in early blind persons.

In early blind mammals, the deprived visual cortex undergoes anatomical and functional alterations. Its functional role was investigated in the early human blind by using patterns of cortical activation as measured by scalp-recorded event-related slow negative DC potential shifts. The blind showed higher occipital negativity than did sighted persons both during a tactile reading task and a non-reading tactile control task. Results point to a possible role for the blind's visual cortex in tactile processes.

Adult↗

Homuncular organization of human motor cortex as indicated by neuromagnetic recordings.

Sources of neural activity identified using non-invasive measurements of cerebral magnetic fields (magnetoencephalography) were found to confirm the somatotopic organization of primary motor cortex for movements of different parts of the body in normal human subjects. Somatotopic maps produced with this technique showed slight differences to the 'classic' homunculus obtained from studies using direct cortical stimulation. These findings indicate that neuromagnetic recordings are capable of localizing cortical activity associated with voluntarily produced movements without the use of external stimulation and provide a new method for studying the functional organization of human motor cortex and its role in voluntary movement.

Brain Mapping↗

[The significance of laboratory findings in long-term antiepileptic therapy].

A retrospective study of 316 patients (173 men, 143 women; mean age 39 [17-87] years) who had taken antiepileptics (phenytoin, phenobarbital, carbamazepine, valproic acid) for at least six months, was carried out to assess the biochemical and haematological changes in relation to the drug used, the therapeutic programme and the drug serum levels. The most frequent change was isolated elevation of gamma-GT (9-89% of cases depending on the drug), followed by elevation of alkaline phosphatase (16-44%). Increases in the transaminases GOT (4-13%) and GPT (4-19%) were infrequent and minor. Changes in the blood picture were very infrequent and never more than minimal. Correlation between all these changes and serum drug levels was poor (r less than 0.15). Correlations between drug serum level and dose were found in the case of phenobarbital (r = 0.6) and valproic acid (r = 0.5). There was hence no evidence of any clear connection between the biochemical findings and the serum concentrations of antiepileptic drugs or their-dosage. The results indicate that undue importance has previously been attached to routine checks of biochemical parameters; abnormal biochemical findings by themselves are not usually enough to necessitate changes in treatment. Determination of biochemical and haematological parameters is necessary only if there are clinical grounds for it such as suspicion of side effects, the occurrence of epileptic attacks despite therapy, or change from one drug to another.

Adolescent↗

Galanthamine treatment in Alzheimer's disease.

18 patients who had fulfilled the NINCDS-ADRDA criteria for "possible AD" took part in a clinical study to evaluate the effect of the cholinesterase inhibitor Galanthamine, 30 mg/day. Neuropsychological und social parameters were rated. This open clinical pilot-study showed no statistic significant change in neuropsychological test-results. However after 1 year treatment 6 patients are still taking the drug. According to their care-persons there was a positive changes in competence of everyday-routine and/or in the emotional situation.

Aged↗

Physiology of short-term verbal memory.

These studies document a series of brain events accompanying short-term memory functions. For auditory verbal material the sequence involves at least two different sites within auditory cortex subserving sensory and cognitive processes of memorization. During the scanning of the short-term store structures within the medial temporal lobes, presumably the hippocampus, are active. There is an inconsistency between these results and the clinical observations of the need for an intact dominant parietal lobe for auditory short-term memory to function normally. Magnetic recordings showed no focal dipolar source of activity in the parietal lobe during any aspect of auditory short-term memory. The discrepancy could be accounted for by considering the parietal lobe lesion as "disconnecting" the lateral temporal cortex from the deep medial hippocampal structures thereby impeding auditory short-term functions (Geschwind, 1965). These studies show that the physiological analysis of brain events in the msec range can provide information about relatively complex cognitive processes underlying short-term memory. The magnetic and electrical recording methods provide a noninvasive way to study human brain functions involved in cognition that can then be correlated with behavioral measures of specific cognitive activities.

Brain↗