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Biomedical subjects

T A Treves

Publications and source records attributed to T A Treves.

45 records · Page 3Linked to original sources
PubMed1991

EEG and topographic frequency analysis in common and classic migraine.

Electroencephalographic (EEG) changes occurring in patients with migraine have received much attention. However, almost equal number of reports indicate the predominance of normal and abnormal findings. We studied the EEG in symptom-free, otherwise healthy, unmedicated 18-28 year-old patients: 22 with common migraine, 20 with classic migraine, and 20 age-matched controls. The routine EEG findings in the three groups revealed mild non-specific slowing in 2 (9%), 3 (15%) and 2 (10%), respectively. Simultaneously, topographic EEG mapping and frequency analysis were performed in 13 consecutive patients with common migraine, 10 patients with classic migraine and 11 age-matched controls. EEG mapping showed minimal regional differences with lower power in the alpha range in patients with eyes closed. The peak alpha power, as well as its reactivity, were lower among patients than controls. This difference reached statistical significance only for patients with classic migraine versus controls in the left occipital region. Patients also had slightly faster peak alpha frequency. No frank right-left asymmetry was observed in the peak alpha power, neither among the controls, nor the patients. All the findings were rather minor. They may suggest some difference in the posterior background activity in the EEG in migraine patients as compared to the controls, but are not useful in differentiating migraine from non-migraine patients.

Adolescent↗
PubMed1991

Parkinsonism mortality in the US, 1. Time and space distribution.

We studied the time-space variations of mortality for parkinsonism in the US during the periods 1962-1985 and 1971-1978 from statistics on primary cause-of-death and multiple causes-of-death, respectively. Linear regression analysis and a test for significance of spatial clustering were used. For parkinsonism as a primary cause-of-death, up to the late 1970's there was a decrease in mortality for the age groups below 75 and stable rates for the age group 75 years and over. A moderate decrease among those below 75 years, and a sharp increase in mortality among those over 74, were observed for the period since the late 1970s. The variation of the age-specific mortality during the period 1962-1985 ranged from 100% in the age group 35-44 years to +98% in those aged over 84 years. Within the same age group, the variations across time of mortality due to, and related to parkinsonism, for the period 1971-1978, were similar. In the spatial analysis, an association between mortality related to parkinsonism and geographical latitude was found. We conclude that: 1) parkinsonism at death is widely distributed; 2) the changes across time can not be explained by a reduction in general mortality; 3) improvements in diagnostic ascertainment and reporting among the elderly may have particularly occurred during the last decade; and 4) the disorder has been progressively confined to the elderly by diminishing in the younger birth cohorts.

Adult↗
PubMedDate not supplied

Germline mutational analysis of presenilin 1 and APP genes in Jewish-Israeli individuals with familial or early-onset Alzheimer disease using denaturing gradient gel electrophoresis (DGGE).

Germ line mutations in three genes have been detected in patients with familial Alzheimer's disease (FAD) and sporadic, early onset disease: amyloid precursor protein (APP), presenilin 1 (PS-1), and presenilin 2 (PS-2). The relative proportions in which mutations in these genes occur among AD patients in Israel has not been evaluated. To that end, we screened 52 Jewish-Israeli patients with AD: 22 with sporadic, early-onset disease (below 65 years), and 30 with FAD. Mutation screen employed denaturing gradient gel electrophoresis (DGGE) of exon-specific PCRs and restriction enzyme digest. Five patients from three different families displayed mutations within the PS-1 gene: three patients of one family showed a mis-sense mutation in codon 120 (Glu 120Lys), and two other unrelated patients showed an identical mis-sense mutation in codon 318 (Glu318Gly). No patient showed an abnormal migration on DGGE (for APP) or mutant restriction digest pattern (for PS-2) genes. These data may indicate the existence of another familial Alzheimer disease (FAD) gene locus in the Israeli Jewish population.

Adult↗
PubMedDate not supplied

Recruitment rate to drug trials for dementia of the Alzheimer type.

Sample size calculations are important for planning drug trials and require anticipation of the proportion of potential patients finally recruited. Because most recent drug studies for dementia have similar requirements, it could be helpful to analyze the recruitment rate of recent studies. Records of demented patients candidates for drug trials for treatment of dementia of the Alzheimer type in 1994-1995 were analyzed for recruitment rate and reasons for nonrecruitment. From 279 patients with dementia of the Alzheimer type, only 13% were finally included in drug studies. The main reasons for non-enrollment included (1) cognitive test scores out of range for study inclusion criteria (Mini-Mental State Examination [MMSE] <12 [30%], MMSE >24 [5%]), (2) behavioral disturbances (25%), and (3) concomitant diseases (12%). Consent was refused in 8% of those to whom the experimental drug was offered. This low rate of enrollment, 13% of potential candidates, does not include postrecruitment drop-out cases, nor the availability of nonexperimental therapy for DAT. Further, the high selection may limit the generalizability of the results of such studies.

Aged↗
PubMedDate not supplied

Denbufylline in dementia: a double-blind controlled study.

The xanthine derivative denbufylline has been evaluated in the treatment of cognitive dysfunction in 110 patients with vascular or mixed dementia (VD) and 226 patients with dementia of the Alzheimer type (DAT). After a run-in period of 4 weeks, during which all patients received placebo, the patients were randomly allocated to denbufylline 25, 50 or 100 mg or to placebo given twice daily for 16 weeks. By the end of the study (completed by 68% of the patients), but also at enrollment, the scores obtained on the Mini-Mental State Examination (MMSE) were higher among those who had received denbufylline than among those who had received placebo, but the differences were not statistically significant; a dose effect of denbufylline was not observed and there was no significant difference in the mean scores of the digit substitution subtest (DSST) of the Wechsler memory test. The responses of patients with VD were similar to those of patients with DAT. When patients were compared in terms of those who received denbufylline versus those who received placebo, improvement in the MMSE scores was observed in 46% of the patients who received placebo and 67% among those who received denbufylline (p < 0.05). An inverse relationship was found between the improvement that occurred during the run-in period and that observed by the end of the study, had the patients received denbufylline or placebo. No major adverse event was ascribed to denbufylline. In conclusion, denbufylline was not deemed efficacious in the treatment of DAT or VD, although patients who received denbufylline tended to improve in terms of cognitive scores, but the effects were not statistically significant. MMSE scores were found to be higher among patients who received denbufylline when these latter were combined as a single group, regardless of their diagnosis or dosage regimen. A placebo effect was observed in about half the patients who completed the study. Copyrightz1999S.KargerAG, Basel

Aged↗
PubMedDate not supplied

Dementia and antiphospholipid antibodies.

Antiphospholipid antibodies (aPLAb) may cause both focal ischemic and diffuse brain damage and may be associated with dementia. We have examined the relationship of aPLAb to dementia in the elderly. Blood samples were obtained from 87 consecutive patients with dementia (74 +/- 11 years old) and 69 controls (78 +/- 9 years old), residents of an old age home who were not overtly demented. Levels of aPLAb were measured by a standardized ELISA, utilizing cardiolipin as antigen, and we considered levels above 20 IgG antiphospholipid units (GPLU) as significantly elevated. We found that 5 of the 87 demented patients (6%), but none of the 69 controls, had significantly elevated aPLAb levels (p = 0.03, one-tailed Fisher's exact test). All the patients with high aPLAb levels were diagnosed clinically as having dementia of the Alzheimer type, except for 1 who had mixed dementia, and none had features of an immune-mediated disease. Thus, a small but significant number of patients with dementia have high levels of aPLAb. The role of the aPLAb in these patients, with apparently diffuse brain disease, is currently unknown.

Aged↗
PubMedDate not supplied

Intravascular malignant lymphomatosis: a cause of subacute dementia.

Intravascular malignant lymphomatosis (IML) is a rare disease characterized by proliferation of neoplastic cells of lymphoid origin within small blood vessels. The median survival of IML patients is only 6 months. Any organ can be affected, with or without clinical expression. Although skin lesions are classic, they are relatively uncommon (28%). Neurological symptomatology (which evolves over a few weeks) is the most common clinical expression (83%). Dementia is the most common neurological symptom that occurs in about half of the patients with central nervous system pathology, and is associated with poorer prognosis. The diagnosis is confirmed by histology but, except for lung, biopsies are not sensitive and are helpful only when performed in the symptomatic organs; furthermore, when associated with anesthesia, they can be followed by dramatic worsening of the patient's condition. Elevated LDH is a good indicator of IML in patients with subacute neurological symptomatology, especially if associated with signs suggestive of other organ involvement.

Brain Neoplasms↗