Exodeviated Ophthalmoplegia in a Patient with Progressive Supranuclear Palsy

We report a patient with progressive supranuclear palsy (PSP) with his serial photographs before the onset of ocular symptoms and after the onset with two year intervals. These photographs show his progressive eyeball deviations toward complete exotropia. There were no effective voluntary eyeball movements, Bell's phenomenon, doll's eye movements, and vestibulo-ocular reflexes. These signs indicate the involvement of the oculomotor nuclear complex by the disease. We suggest that PSP may cause not only 'supranuclear' but also 'nuclear' complete ophthalmoplegia with exodeviation of the eyes.

The Usefulness of The Cambridge Neuropsychological Test Automated Battery (CANTAB) for Assessing Cognitive Functions in the Elderly: a Pilot Study

BACKGROUND: We selected a computerized neuropsychological test, the Cambridge Neuropsychological Test Automated Battery (CANTAB), along with other conventional neuropsychological tests. The aim of this study was to assess CANTAB's usefulness in diagnosing dementia in the elderly and to compare it with conventional neuropsychological assessment kits. METHODS: We recruited 17 dementia patients diagnosed with Alzheimer's disease or vascular dementia for the dementia group and 52 healthy persons who met our criteria for the control group. We administered four CANTAB subtests to assess their cognitive functions along with the conventional Seoul Neuropsychological Screening Battery, which includes the Rey-Osterreith Complex Figure Test (RCFT) to assess visual memory. The four CANTAB subtests chosen were big/little circle (BLC), paired associates learning (PAL), spatial recognition memory (SRM), and spatial span (SSP). RESULTS: The dementia group showed impairment on the PAL and SRM tasks. The results of the other two subtests were not different between the two groups. The mean adjusted total errors on the PAL task was higher in the dementia group (130.88) than in the control group (51.38), which was statistically significant (p<0.01). The percentage of correct response on the SRM task was lower in the dementia group (58.75%) than in the control group (67.25%), also statistically significant (p=0.03). We also compared the correlations of the CANTAB subtests with the RCFT parameters (immediate recall, delayed recall, and recognition). Again, the results showed that the PAL task correlated well with these three parameters (r=-0.59, -0.60, and -0.56, respectively). CONCLUSION: The CANTAB was useful for assessing cognition in the elderly. In particular, the PAL task, which correlated well with the RCFT parameters, can be used to assess visual memory. It showed to be a valuable tool in diagnosing dementia.

Involvements of Oxidative Stress in beta-amyloid Peptide: induced Cytotoxicity in PC12 Cells

BACKGROUND: Alzheimer's disease is a neurodegenerative disorder characterized by the extracellular deposition of beta-amyloid peptide(Abeta) in the brain, presumed to play a pathogenic role. However, the precise molecular mechanisms of its neurotoxicity are not fully understood. METHODS: Abeta-mediated cytotoxicity in neuronal cell lines (PC12, SH-SY5Y, IMR32, and U87) was measured by an MTT assay. NF-kappaB activation by Abetawas examined by a luciferase assay and apoptosis induced by Abetawas measured by cytoplasmic DNA fragmentations. RESULTS: Abetacytotoxicity in the tested cell lines was more prominent in the absence of serum than in the presence of serum in culture media. PC12 cells showed the highest sensitivity to Abetacytotoxicity among the cell lines. The Abeta(25-35) cytotoxicity in PC12 cells was increased in a dose-dependent manner. For convincing oxidative stress involved in Abetacytotoxicity, antioxidants such as DTT, GSH, vitamin C, or NAC were pretreated. GSH protected PC12 cells from Abetacytotoxicity, but DTT or NAC did not. Abeta (25-35) treatment to PC12 cells increased the NF-kappaB activity in a dose-dependent manner. Cytoplasmic DNA fragmentations, one of the apoptotic indicators, were increased at lower concentrations of Abeta(25-35) from 0.01 to 0.1 microM, however, dose-dependent increments of DNA fragmentations were not observed at higher concentrations from 1 to 10 microM. CONCLUSIONS: From these results, Abeta-induced cytotoxicity in PC12 cells might be mediated by oxidative stress.