Cortical excitability in amyotrophic; lateral sclerosis

The primary purpose of this study was to provide insight into the central changes that occur in amyotrophic lateral sclerosis with a view to pointing out that these could contribute to symptoms, Seventeen patients with definite ALS and 17 control healthy volunteers were included in the study. Clinical examination, amyotrophic lateral sclerosis severity score [ALSSS] and transonic magnetic stimuli investigations including measurement of resting and active motor threshold [RMT, and AMT], motor evoked potential [MEP], input-output curve, contralateral silent period and transcallosal inhibition [CSP and TI] were measured for each participant. There were no significant differences in RMT or AMT in either hemisphere between patients and the control group. Despite this there was a significant negative correlation between ALSSS and RMT, and AMT meaning that increased seventy was associated with higher thresholds. MEPs were significantly smaller in ALS patients in comparison to the control group [P=0.03]. There was a significant decrease in the slope of the I/O relationship of MEP amplitude to TMS intensity in patients group in comparison to controls. ALS patients had a significant prolongation of CSP and TI for both hemispheres. There was a tendency for there to be a significant negative correlation between left TI and ALSSS [P= 0.051]. Measurements of cortical motor excitatory and inhibitory changes in ALS confirm the presence of hypoexcitability and GABAb dysfunction, that was correlated with the severity of ALS

Acute ischemic cerebrovascular accident and new onset voiding dysfunction: a prospective correlation of CT findings with urodynamic findings

New onset voiding dysfunction after a stroke is a difficult problem for all persons involved in the care of those patients. We evaluated the effects of an acute cerebrovascular accident on the lower urinary tract and correlated the site, size and side of cerebrovascular accident with the urodynamic findings. This study included 103 patients [56 males and 47 females] with acute cerebrovascular accident from September 2001 to August 2003. All patients with disturbance of conscious level or mental changes or previous history of stroke were excluded from the study, The included patients were assessed neurologically and urologically. Computerized Tomography [CT] was done for all patients. A total of 56 patients underwent urodynamic study with electromyography within one week of cerebrovascular accident. Patients were divided into 5 different groups based on urodynamic findings. 59.2% of the patients had urinary.symptoms and the most common symptom was incontinence [42.6%], followed by retention [41%]. We found a correlation between voiding disturbance with hemiparesis [P<0.01], not with hemianopia. Urodynamic studies of 56 patients revealed that 31 patients [55.4%] had detrusor hyperreflexia and 17 patients [39.1] had detrusor areflexia. The majority of the lesions responsible for detrusor hyperreflexia were from frontoparietal region and internal capsule whereas thalamic, pontine and cerebelluar lesions were associated more with detrusor hyporeflexia. There was no effect of laterality or dominance on the urinary symptoms or urodynamic findings

Impact of stress on cognitive functions

This work was designed to study the effect of mental [exam] stress on the memory performance and on other cognitive functions. This was carried out through the evaluation of the cognitive aspects of 61 volunteer students [28 males and 33 females] during basal state by cognitive ability screening instrument [CASI] and Wechsler memory scale [WMS] together with an assessment of their anxiety levels by Hamilton anxiety scale and an estimation of the serum levels of catecholamines and cortisol. These estimates were reevaluated two months later immediately after exposure to mental [exam] stress. It was found that immediately after exposure to mental stress, there was a significant decline in all memory functions and total cognitive scales together with a significant increase in the perceived levels of anxiety symptoms and a significant rise in the serum levels of stress hormones. Stress hormones levels were found to have differential effects on memory and other cognitive functions with an end result of total impairment of these functions