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Biomedical subjects

L Gustafson

Publications and source records attributed to L Gustafson.

At least 73 records · Page 4Linked to original sources
PubMed1992

Cycloid psychosis: regional cerebral blood flow correlates of a psychotic episode.

Eight patients meeting Leonhard's criteria for cycloid psychosis were investigated on repeated occasions during a psychotic episode, with regional cerebral blood flow measurements and clinical ratings. The results showed that, at admission to the hospital, when the patients were clinically exacerbated, the mean hemispheric blood flow was significantly elevated compared with values from a normal control group. The hemispheric blood flow level covaried significantly with the degree of clinical symptoms, such that the more elevated the cortical blood flow was, the more behaviorally disturbed was the patient. At discharge from the hospital, the patients had no residual symptoms and the cortical blood flow was normal. These findings differ distinctly from those commonly made in other psychoses, such as schizophrenia.

Adult↗
PubMed1992

Frontal lobe degeneration of non-Alzheimer type.

In a longitudinal prospective study of dementias, several hundred cases have been examined from a clinical, brain imaging, neurochemical and neuropathological point of view. Frontal lobe degeneration of non-Alzheimer type (FLD) was the second most common primary degenerative dementia found in about 10% of the material. FLD has a consistent pathology and a characteristic clinical picture, which have been described by several independent research groups. The cortical degeneration mainly involves frontal or frontotemporal grey matter, without the circumscribed or knife-blade atrophy seen in Pick's disease. The degeneration involves predominantly frontal areas, including the insula and cingulate gyrus in its anterior parts. The striate body is normal or only slightly altered. The pathological changes are non-specific, with neuronal loss, slight gliosis and spongiosis but none or few senile plaques, tangles, congophilic vessels or Pick cells. Pathological changes are in some respects similar to those in amyotrophic lateral sclerosis. FLD is a slowly progressive dementia with personality changes, lack of insight, disinhibition, stereotypy and later apathy. There is also progressive dynamic aphasia which ends in mutism and amimia. Memory, spatial ability and receptive language functions are comparatively spared. Psychotic symptoms, emotional reactions, hypochondriasis and a Klüver-Bucy-like syndrome are sometimes observed. Electroencephalography is normal, at least during the early stage, while functional brain imaging such as regional cerebral blood flow reflects the frontal pathology. It is possible to achieve early diagnosis and differentiation from Alzheimer's disease and cerebrovascular dementia by clinical examination with neuropsychological assessment supported by brain imaging, and in the future probably various biological markers. The aetiology is unknown but there is a positive family history for dementia of similar type in about 50% of post-mortem verified cases.

Cerebrovascular Circulation↗
PubMed1991

[Dementia is not the only mental problem among the elderly. Long-term perspective is important for care].

The entire 1902 and 1903 birthyear cohorts in the catchment area of Dalby Community Health Centre in southern Sweden have been followed with health examinations and interviews every second year since 1969-70. Of the total of 192 subjects, complete data are available for 153. Of 65 subjects surviving at the age of 83, 6 per cent were advanced dementia cases, 11 per cent were in the early stages of dementia, and a further 17 per cent were afflicted with other mental problems requiring help and care. Of those who died before the age of 83, 11 per cent were afflicted with dementia, with a further 4 per cent in the early stages, and 17 per cent had other mental problems. Thus, the overall risk of dementia is at least 16 per cent, but may eventually turn out to be as high as 30 per cent, while those with other forms of mental dysfunction, serious enough to require help in ADL, account for a similar proportion. The annual incidence of dementia is 7.5 per mill (10.6 per mill including those in early stages). The risk of institutionalisation and death was much higher among the dementia victims, most of whom had had little support from the social services, and some none at all, before being institutionalised. Dementia victims came into contact with the medical services much earlier than did mentally healthy patients with other, often vague and more varied symptoms. It is argued in the article that current concern with dementia should not be allowed to divert our attention from the needs, diagnosis and care of the many elderly patients with other mental problems.

Aged↗
PubMed1990

Neuropeptide levels in Alzheimer's disease and dementia with frontotemporal degeneration.

The CSF levels of somatostatin-LI (SLI), neuropeptide Y (NPY-LI) and Delta Sleep Inducing Peptide (DSIP-LI) have been measured in patients with dementia of Alzheimer type (DAT) and dementia with frontotemporal degeneration of non-Alzheimer type (FTD). The distribution pattern of cortical degeneration differs between these two types of dementia. DAT shows degeneration of mainly temporo-parietal and temporo-limbic structures, whereas FTD discloses its main degeneration in the frontotemporal regions (Brun, 1987). The somatostatin-LI was significantly reduced both in DAT and FTD. NPY-LI showed a significant reduction in DAT but not in FTD. A tendency to a reduction with duration of the disease was observed in DAT whereas the contrary was noted in FTD. The DSIP-LI levels were reduced in DAT and slightly increased in FTD. The study provides an evidence of neurochemical differences between the two primary degenerative dementias.

Adult↗
PubMed1990

Regional cerebral blood flow in schizophrenia: repeated studies during a psychotic episode.

Regional cerebral blood flow (rCBF) measurements and clinical ratings were performed on 17 schizophrenic patients and a subgroup of 10 medication-free patients before and after treatment. While clinically exacerbated patients had normal blood flow, patients in remission showed a redistribution of flow with lower values in frontal areas. Anteroposterior ratios correlated with the degree of behavioral disturbances, suggesting that the level of frontal lobe activity in schizophrenia may be a function of the patient's clinical state at the time of study.

Adult↗
PubMed1990

Pharmacokinetics of remoxipride in elderly psychotic patients.

The pharmacokinetics of remoxipride when given as single doses of 50 mg and repeated doses of 50 mg, 100 mg, and 200 mg twice daily to 10 elderly psychotic patients (71-89 years) were compared with the findings of two other studies to reveal any age-related differences. The three studies comprised a total of 38 patients in three distinct age groups: elderly (71-89 years), middle-aged (46-69 years) and young (19-36 years). AUC, Cmax and Cmin of both total and unbound remoxipride increased with increasing age. The unbound fraction was similar in the three age groups. The half-life was prolonged in the elderly, most probably caused by a decrease in intrinsic clearance. A two-fold increase in AUC of both total and unbound concentrations was observed in the elderly group compared to the young, suggesting that patients over 70 years in general require half the dose needed by young adult patients. In general, the pharmacokinetics of remoxipride in the elderly are linear.

Adult↗
PubMed1990

Intramuscular hemangioma. Case report and literature review.

A case was presented in which a 28-year-old male presented with tenderness and stiffness in the posterior muscle group of his right leg. The patient's symptoms had been present intermittently for nearly 23 years. Recently, the pain had progressed to the point of limiting his normal daily activities. Initial conservative therapy, which consisted of Zorprin, heel lifts, and low Dye strapping, failed to alleviate the symptoms. Magnetic resonance imaging was used to identify a mass of an unknown etiology. Following orthopedic and oncologic consultation, surgical excision was advised and performed. Pathologic examination of the mass confirmed that the tumor was an intramuscular hemangioma. Classically, with intramuscular hemangiomas, patients may have soft tissue complaints, such as pain and swelling, present for years. Patients usually defer medical attention until the primary symptom of pain occurs. When a patient complains of a painful soft tissue mass of the leg, and intramuscular hemangioma should be included in the differential diagnosis. The appropriate radiographic studies and consultations should be performed, and surgical excision should be carried out.

Adult↗
PubMed1987

Changes in psychiatric symptoms related to EEG and cerebral blood flow following electroconvulsive therapy in depression.

Changes in psychiatric symptoms following electroconvulsive therapy (ECT) were related to alterations in global EEG and cerebral blood flow (CBF) in 21 in-patients suffering from depression. They were examined by clinical ratings, EEG, and CBF immediately before and 1 to 3 h after treatments during an ECT series and at follow-up. Four symptom clusters from a factor analysis of symptoms in depression, representing different dimensions of emotion, cognition, and psychomotor retardation, were used for clinical description. The changes in the separate symptom clusters showed different patterns and also different correlations with neurophysiological (EEG and CBF) changes during the course of serial ECT. Furthermore, acute clinical and neurophysiological effects following single ECT's were found to be different from non-acute changes, building up during the treatment course. Acute relief in symptoms of anxiety, depressed mood, and psychomotor retardation correlated with an acute slowing of the EEG. Regarding non-acute effects a reversed relationship was found, i.e. improvement in symptoms of depressed mood and psychomotor retardation was related to less EEG slowing. As opposed to the acute clinical changes, the non-acute changes, found following the first two or three treatments of a series, contained predictive information about the individual clinical outcome of the patients.

Aged↗
PubMed1987

Intravenous physostigmine treatment of Alzheimer's disease evaluated by psychometric testing, regional cerebral blood flow (rCBF) measurement, and EEG.

Ten patients with Alzheimer's disease were treated with intravenous infusion of physostigmine for 2 h. The acute effects on cognitive function, regional cerebral blood flow, and EEG were compared to placebo (isotonic glucose) using a double-blind cross-over design. Physostigmine causes a limited improvement of psychomotor performance and EEG and an increase of blood flow in the most severely affected cortical areas, predominantly in an early phase of Alzheimer's disease.

Aged↗
PubMed1987

Frontal lobe degeneration of non-Alzheimer type. II. Clinical picture and differential diagnosis.

In a longitudinal prospective study of dementia, 158 patients were investigated post mortem. Sixteen patients were classified as frontal lobe dementia (FLD) of non-Alzheimer type and four cases as Pick's disease. Positive heredity for dementia was reported in 50% of these cases compared to 30% in a reference group of patients with Alzheimer's disease (AD). The typical clinical picture in FLD and Pick's disease was that of a slowly progressive dementia, at an early stage dominated by personality change, lack of insight, disinhibition, and later on stereotypy and increased apathy. There was also a progressive dynamic aphasia ending in mutism and amimia. Memory and spatial functions were comparatively spared. Disinhibition, oral/dietary hyperactivity, and echolalia were more consistently found in Pick's disease compared to FLD. The differential diagnosis against AD, cerebrovascular dementia, and other degenerative dementias and against affective disorders and psychotic reactions are discussed.

Adult↗
PubMed1987

Screening of patients admitted to a geriatric hospital with supposed organic dementia.

75 patients, aged 69 to 97 (mean 84) years, admitted to a geriatric clinic with symptoms or signs of organic brain failure, were examined with a wide test battery including chemical analyses, electroencephalogram (EEG), regional cerebral blood flow (rCBF) measurement, and psychometric tests. There was a prevalence of 89% organic dementia, 3% treatable dementia, and 8% non-dementia conditions. Thus the prevalence of treatable conditions was rather low (11%). Multi-infarct dementia was more prevalent (52%) than dementia of Alzheimer type (31%). All but one of the non-dementia conditions were due to confusional reaction. In no case was depression, drug intoxication, or deafness the only cause of symptoms. After a follow-up period of 6 months, 33% of the patients had died. An autopsy was performed in 80% of these cases, and the clinical diagnosis was confirmed in all but four cases.

Aged↗
PubMed1986

Behavioral observations during performance of the WAIS Block Design Test related to abnormalities of regional cerebral blood flow in organic dementia.

Twenty-one patients with symptoms of organic dementia were studied concerning the relationship between the behaviour when solving the Wechsler Block Design Test and the localization of cerebral dysfunction as indicated by the regional cerebral blood flow (rCBF). Eleven patients with decreases of rCBF in frontal regions (Group A) were compared with 10 patients with postcentral decreases (Group B). Conventional Block Design scores were about equal in the two groups. Group A patients showed significantly less anxiety and self-criticism, were less systematic and made fewer attempts at completion. Rotations were displayed more often in Group B. The results illustrate the significance of information obtained by behaviour observation in the test situation.

Aged↗