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Robert Paul

Publications and source records attributed to Robert Paul.

27 records · Page 2Linked to original sources
PubMed2003

Vascular dementia: a diagnostic conundrum for the clinical neuropsychologist.

The contribution of cerebrovascular disease (CVD) to cognitive impairment in older persons is an important determination rendered by clinical neuropsychologists. However, it is often difficult to determine the relationship between CVD and severe cognitive dysfunction in this population. As a result, whether a patient meets diagnostic criteria for vascular dementia (VaD) or not is difficult to establish with reasonable clinical certainty. Our position is that five clinical myths regarding VaD complicate the diagnostic process for clinical neuropsychologists. Specifically, beliefs regarding a stepwise course of decline, patchy neuropsychological profile, prominent memory deficit, specificity of neuroimaging findings, and distinctions between VaD and Alzheimer's disease all represent factors that potentially confuse rather than clarify the diagnostic process. In this article we review these factors and offer suggestions for future research.

Aged↗
PubMed2003

Using knockout mice to study experimental meningitis.

Despite the use of antibiotics, the prognosis of bacterial meningitis is still poor due to central nervous system (CNS) complications, such as brain edema formation, cerebrovascular alterations, and intracranial hemorrhage. Experimental studies with animal models have given new insights into its pathophysiology during the acute phase of the disease. In recent years, genetically engineered mice have become a powerful tool in investigating the role of particular genes by targeted deletion and have also been applied in bacterial meningitis research. By using knockout mice, new knowledge of the roles of the different cytokines, proteases, and oxidants involved in the inflammatory cascade has emerged. In the future, temporal and cell type-specific control of gene expression will provide even more information on the impact of a particular gene on meningitis-induced brain damage.

Animals↗
PubMed2002

Cognitive and motor impairments predict functional declines in patients with vascular dementia.

BACKGROUND: Vascular dementia (VaD) is associated with impairments in cognitive, motor, and functional domains. Patients with VaD display diverse cognitive and motor deficits, however, and relationships between these impairments and independent living abilities remain unclear. OBJECTIVES: The purpose of the present study was to investigate the contributions made by attentional/executive and motor functions in the prediction of basic and instrumental activities of daily living in 32 patients with VaD. We hypothesized that: (a) motor abilities would emerge as a significant predictor of basic activities of daily living, whereas attentional/executive abilities would not, and (b) both motor and attentional/executive abilities would emerge as significant predictors of instrumental activities of daily living. RESULTS: Stepwise regression analyses revealed that motor performance, but not attentional/executive abilities, accounted for a significant proportion of the variance in basic activities of daily living, and that both motor and attentional/executive abilities contributed significantly to the prediction of instrumental activities of daily living. CONCLUSIONS: These results suggest that attentional/executive and motor impairments may underlie specific aspects of functional disability among patients with VaD.

Activities of Daily Living↗
PubMed2002

Relationships between cognition and structural neuroimaging findings in adults with human immunodeficiency virus type-1.

Infection of the central nervous system with human immunodeficiency virus type-1 (HIV) is associated with cognitive impairments that range from mild cognitive and motor difficulties to dementia. Structural neuroimaging abnormalities are also common in HIV-infected patients both with and without cognitive disturbances. The most common abnormalities include high signal intensities in the white matter and atrophy. Research over the past 12 years has helped define the relationship between these neuroimaging abnormalities and the manifestation of cognitive disturbance in HIV. In the present paper, we provide a synopsis of these studies and report the current state of the literature. Our review revealed that atrophy of the caudate nucleus is most consistently associated with cognitive impairment in HIV. The current literature does not support a strong relationship between cortical atrophy or white matter abnormalities and cognitive dysfunction in this population, though methodological issues may have influenced the results. Suggestions for study design and new research directions are provided.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Behavioral problems as predictors of functional abilities of vascular dementia patients.

The relationship of behavioral disturbance and dementia severity to activities of daily living (ADLs) in vascular dementia (VaD) was examined in baseline data for 29 VaD patients. A series of stepwise regression analyses was conducted to examine the extent to which dementia severity, apathy, disinhibition, and executive dysfunction predict ADLs (total, basic, and instrumental). For total ADLs, apathy accounted for 36% of the variance and dementia severity accounted for an additional 15%. For basic ADLs, apathy accounted for 27% of the variance. Dementia severity, executive dysfunction, and disinhibition were not significantly associated with basic ADLs. For instrumental ADLs, dementia severity accounted for 37% of the variance and apathy accounted for an additional 14%. These findings highlight the importance of apathy as an independent factor associated with functional independence beyond general cognitive abilities.

Activities of Daily Living↗
PubMedDate not supplied

In vivo sampling for pharmacokinetic studies in small experimental animals: a combination of microdialysis, planar chromatography and digital autoradiography.

PURPOSE: We describe a method for measuring the pharmacokinetics of positron emission tomography (PET) tracers during rat studies using microdialysis (MD) in combination with planar chromatography and digital autoradiography with a phosphoimager plate (DAR). PROCEDURES: An MD probe was inserted into the jugular vein of the rat and perfused with physiological buffer solution (n>/=3). An (18)F-labeled radiopharmaceutical was injected intravenously, and dialysate fractions were collected, measured for radioactivity, and applied on a chromatography plate. This plate was exposed with an imaging plate for radioactivity imaging. RESULTS: Time activity curves for unbound, unchanged tracer and metabolites were determined. The amount of unchanged tracer in the last MD fraction was compared with the amount in the plasma sample collected after sacrifice of the animal. CONCLUSION: MD continuously samples and monitors the amount of unbound tracer in the blood from one single experimental animal. MD combined with planar chromatography and DAR is a highly sensitive and linear method for simultaneous analysis of PET tracers and their metabolites in blood.

Animals↗