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PubMed · 3801852

Alloaesthesia.

M Kawamura·K Hirayama·Y Shinohara·Y Watanabe·M Sugishita
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Abstract

Alloaesthesia is a condition in which a sensory stimulus given on one side of the body is perceived at the corresponding area on the other side. We observed this in 20 out of 123 patients with hypertensive cerebral haemorrhage in the acute stage (within twenty days), all except 1 in the right hemisphere. This phenomenon was observed in 17 out of 35 patients with right putaminal haemorrhage and only 1 out of 30 patients with right thalamic haemorrhage, suggesting it may be useful in differentiating putaminal from thalamic haemorrhage in the right hemisphere. Three patients, with cervical tumour, cervical disc herniation and multiple sclerosis also showed alloaethesia. They had anterolateral lesions of the spinal cord. The cerebral and spinal cord lesions presented similar symptomatic characteristics of alloaesthesia. It is suggested that as alloaesthesia is produced by noxious stimuli not only in spinal cord but also in cerebral lesions it may represent an elementary sensory disturbance of sensory pathways, and not a higher cortical dysfunction.

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Cerebral HemorrhageFemaleHumansMaleMiddle AgedNervous System DiseasesPain MeasurementSensationSpinal Cord DiseasesCase ReportsJournal ArticleResearch Support, Non-U.S. Gov't

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M Kawamura, K Hirayama, Y Shinohara, Y Watanabe, M Sugishita. 1987. Alloaesthesia.. https://doi.org/10.1093/brain%2F110.1.225

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Genetically predicted on-statin LDL response is associated with higher intracerebral haemorrhage risk.

Statins lower low-density lipoprotein cholesterol and are widely used for the prevention of atherosclerotic cardiovascular disease. Whether statin-induced low-density lipoprotein reduction increases risk of intracerebral haemorrhage has been debated for almost two decades. Here, we explored whether genetically predicted on-statin low-density lipoprotein response is associated with intracerebral haemorrhage risk using Mendelian randomization. Using genomic data from randomized trials, we derived a polygenic score from 35 single nucleotide polymorphisms of on-statin low-density lipoprotein response and tested it in the population-based UK Biobank. We extracted statin drug and dose information from primary care data on a subset of 225 195 UK Biobank participants covering a period of 29 years. We validated the effects of the genetic score on longitudinal low-density lipoprotein measurements with generalized mixed models and explored associations with incident intracerebral haemorrhage using Cox regression analysis. Statins were prescribed at least once to 75 973 (31%) of the study participants (mean 57 years, 55% females). Among statin users, mean low-density lipoprotein decreased by 3.45 mg/dl per year [95% confidence interval (CI): (-3.47, -3.42)] over follow-up. A higher genetic score of statin response [1 standard deviation (SD) increment] was associated with significant additional reductions in low-density lipoprotein levels [-0.05 mg/dl per year, (-0.07, -0.02)], showed concordant lipidomic effects on other lipid traits as statin use and was associated with a lower risk for incident myocardial infarction [hazard ratio per SD increment 0.98 95% CI (0.96, 0.99)] and peripheral artery disease [hazard ratio per SD increment 0.93 95% CI (0.87, 0.99)]. Over a 11-year follow-up period, a higher genetically predicted statin response among statin users was associated with higher intracerebral haemorrhage risk in a model adjusting for statin dose [hazard ratio per SD increment 1.16, 95% CI (1.05, 1.28)]. On the contrary, there was no association with intracerebral haemorrhage risk among statin non-users (P = 0.89). These results provide further support for the hypothesis that statin-induced low-density lipoprotein reduction may be causally associated with intracerebral haemorrhage risk. While the net benefit of statins for preventing vascular disease is well-established, these results provide insights about the personalized response to statin intake and the role of pharmacological low-density lipoprotein lowering in the pathogenesis of intracerebral haemorrhage.

Cerebral Hemorrhage↗