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Biomedical subjects

L Gustafson

Publications and source records attributed to L Gustafson.

At least 91 records · Page 5Linked to original sources
PubMed1985

On diagnosis of dementia: psychometric investigation and clinical psychiatric evaluation in relation to verified diagnosis.

Patients with early as well as manifest dementia were studied in a longitudinal way with psychometric and psychiatric methods. Tests such as vocabulary, attention test, block design test, verbal and spatial memory tests, reaction time test and examination for aphasia were used as well as a qualitative analysis of behaviour and personality. The differential diagnosis of Alzheimer's disease, Pick's disease and other dementias with fronto-temporal degeneration and multi-infarct dementia was based on diagnostic rating scales. Differences in cognitive profiles, qualities of behaviour and scores on combinations of psychiatric rating scales were identified for pathoanatomically verified cases with Alzheimer's disease, fronto-temporal degeneration and multi-infarct dementia.

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PubMed1984

The effects of bromvincamine and vincamine on regional cerebral blood flow and mental functions in patients with multi-infarct dementia.

The effects of vincamine and bromvincamine (BV 26-723) on mental functions and regional cerebral blood flow (rCBF) measured by the 133Xe inhalation method, were investigated in ten patients with mild to severe symptoms of multi-infarct dementia. The double blind cross over design included three treatment periods, each of 2 weeks' duration. The patients were drug free at the time of the first investigation in each treatment period. Then placebo, vincamine or bromvincamine was given orally (4 X 20 mg/day). Psychiatric evaluation, psychometric assessment and measurement of rCBF were done at start of medication and after 1 and 2 weeks during medication. There were 2 drug-free weeks between the first and second, and second and third treatment periods. Results from treatment with vincamine showed a significant increase in the global CBF level and reduction of initial right-left asymmetry of hemispheric means. No effects were seen in regional flow patterns. Performance score on a verbal memory test increased significantly. No significant effect on the global rCBF level was indicated for bromvincamine. However, the number of ischemic regions decreased significantly during treatment. Performance on two memory tests improved significantly. No significant changes in overall psychiatric ratings were observed for any of the treatment periods.

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PubMed1982

Differential diagnosis of presenile dementia on clinical grounds.

Fifty-seven patients were studied for differential diagnosis between dementias. Three rating-scales were used for identification of Alzheimer's disease (AD), Pick's disease (PD) and multi-infarct dementia (MID). Their validity was tested against verified diagnoses in 28 patients. The rating-scale of ischemic score consisting of 13 items such as abrupt onset, stepwise progression, fluctuating course, history of strokes and neurological symptoms and signs, identifies patients with MID. This can also be achieved by the two rating-scales for diagnosis of AD (12 items) and PD (9 items), which, however, can also be used for the differentiation between these two dementias. The rating-scale for diagnosis of AD contains clinical features such as early spatial disorientation, apraxia, aphasia, agnosia, logoclonia and increased muscular tension. The rating-scale for PD contains i.a. early loss of insight, early signs of disinhibition, echolalia, mutism and amimia. The results show that the differentiation between the major types of presenile dementia can be achieved by a systematic rating of the clinical features.

Adult↗
PubMed1981

rCBF measurements by 133Xe inhalation: applications in neuropsychology and psychiatry.

This review describes recent advances in the application of rCBF measurements by the 133Xe-inhalation method to neuropsychological and psychiatric research. Studies mapping cortical activity, as indicated by flow variations during visual, auditory and tactile tasks of varying complexity are described. The bilateral rCBF measurements do also offer information concerning lateralization of mental processes. Some clinical applications in psychiatry are finally reviewed demonstrating the use of the technique in differential diagnosis of dementia of organic ethiology (Alzheimer's disease, multi-infarct dementia) against pseudodementia due to psychosis. The method is also very useful in the study of cases with toxic influence by alcohol and other agents.

Auditory Perception↗
PubMed1979

EEG and cognitive impairment in presenile dementia.

EEG and psychometric findings were studied in a group of 57 patients consisting of 19 cases of Alzheimer's disease, 7 cases of Pick's disease, 24 cases of cerebrovascular dementia (CVD) and a group of 7 cases with dementia of various other etiology. The diagnoses have so far been confirmed by autopsy in 23 out of 57 cases. EEG was evaluated by means of visual inspection. Psychometric studies enabled a classification into 5 psychometric defect groups according to the degree of dementia. An overall good correlation was found between the degree of dementia and EEG abnormality. A significant correlation between the test socre and the EEG was found only for the vocabulary test and paired associates test. However, on the reaction time test, color word test, and Koh's block design test, large patient groups were untestable, and a highly significant correlation was found between non-testability and severely abnormal EEG. The Alzheimer and the CVD groups differed distinctly, most of the Alzheimer cases showing a severe or moderate degree of EEG abnormality and dementia, whereas in the CVD cases, the dementia was less pronounced and the EEG often normal or only slightly abnormal. Four out of seven cases of Pick's disease had a normal EEG, which distinguished them from the Alzheimer cases which had a comparable psychometric defect.

Adult↗
PubMed1979

Amnestic-confabulatory syndrome in hydrocephalic dementia and Korsakoff's psychosis in alcoholism.

The clinical course of six alcoholics with Korsakoff's psyter shunt operation. The initial clinical state as well as the symptom improvement showed important similarities between the Korsakoff group and the hydrocephalic dementia group, who improved after shunt operation. Fantastic confabulation and appraxia were only observed in the hydrocephalic dementia group. Psychometrically, both groups showed a similar degree of improvement of the initially impaired verbal memory while only the hydrocephalic dementia group showed impairment of spatial abilities indicating a constructional apraxia. It is suggested that the similarities of the two conditions are related to dysfunction of diencephalic and temporal-limbic structures. The constructional and general apraxia as well as the fantastic confabulation in hydrocephalic dementia indicate a cortical, especially frontal cortical, dysfunction in this disorder.

Adult↗
PubMed1978

Limbic lobe involvement in presenile dementia.

Limbic lobe involvement in presenile dementia was studied from a neuropathological and neuropsychiatric viewpoint. The material consisted of seven cases of Alzheimer's disease, four cases of Pick's disease, and four cases of Jacob-Creutzfeldt's disease. These three groups showed different patterns of distribution of the degeneration characteristic for each group, in particular for the first two. Among the groups, these patterns differed with regard to involvement both of nonlimbic and limbic areas. Thus the Alzheimer group had a mainly temporoparieto-occipital and posterior cingulate gyrus involvement. The Pick group in many respects showed an inverse distribution with frontotemporal and anterior cingulate gyrus accentuation of the damage. Basal temporal limbic areas were involved in both groups. The Jacob-Creutzfeldt group had a less schematic lesion pattern, without involvement of limbic areas. From a neuropsychiatric aspect, these differences were reflected in symptoms that could be referred both to areas spared and those more pronouncedly destroyed by the degenerative process. Thus the Alzheimer group long retained emotional qualities that were lost early in the Pick group. The possible relationship between neurotransmitters and regional accentuation of the degeneration is discussed.

Aged↗
PubMed1978

Effects of piracetam on regional cerebral blood flow and mental functions in patients with organic dementia.

The effects of piracetam (Nootropil, UCB6215) on mental functions and on regional cerebral blood flow (rCBF) were investigated in eight patients in the presenile age who displayed symptoms of moderate dementia. The double-blind crossover design included nine measurement occasions, each involving rCBF measurement by the 133-Xe inhalation method, ratings of symptoms of dementia, personality changes, and side effects, and a psychometric investigation. Three investigations were included in each of three treatment periods. The first investigation in a period was made without medication. Then either placebo or piracetam 4.8 g/day or 9.6 g/day was given during four weeks with measurements after 2 weekks and 4 weeks. There were intervals of 4 weeks without medication between the treatment periods. Piracetam had no significant effect on either mental functions or rCBF.

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PubMed1978

Recovery in hydrocephalic dementia after shunt operation.

Twenty-three patients with hydrocephalic dementia were studied before and after shunt operation, and improvement was found in 12. Before operation, the improved cases showed more symptoms of confabulation, gait disturbance, urinary incontinence, lack of insight, and constructional apraxia. The improvement was also most marked in these symptoms. The significance of general versus specific symptoms, duration, and aetiology is discussed from a differential diagnostic standpoint, and we conclude that the adequate and early diagnosis of hydrocephalic dementia is essential for good outcome after shunt operation, and that psychiatric and psychometric evaluation enable such a diagnosis to be made.

Adult↗