ABSTRACT
The prevalence and characteristics of interictal headache, epilepsy and headache/epilepsy comorbidity were assessed in 858 women and 309 men aged 18-81 years from headache and epilepsy centers in Italy. The research hypothesis was that comorbidity among patients with either disorder would be expected to be higher than in the general population. Interictal headache was diagnosed in 675 cases (migraine 482; tension-type headache 168; other types 25), epilepsy in 336 (partial 171; generalized 165) and comorbidity in 156 (1.6% from headache centers; 30.0% from epilepsy centers). Patients with epilepsy, headache and comorbidity differed in a number of demographic and clinical aspects. However, for both headache and epilepsy, a family history of the same clinical condition was equally prevalent in patients with and without comorbidity. These findings do not support the purported association between headache and epilepsy.
Subject(s)
Epilepsy/epidemiology , Headache Disorders, Primary/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Chi-Square Distribution , Comorbidity , Cross-Sectional Studies , Epilepsy/diagnosis , Female , Headache Disorders, Primary/classification , Headache Disorders, Primary/diagnosis , Humans , Italy/epidemiology , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
In the present study we assessed the presence and severity of unconventional affective symptoms (apathy, anhedonia and emotional lability) and depression in 33 elderly patients with first ever stroke and evidence of a single supratentorial lesion at neuroimaging. Patients were submitted to neurological, functional, and affective assessment at a mean interval of 2 weeks after stroke onset. Given the putative role of the frontal lobes in the pathogenesis of these symptoms, we also performed a cognitive assessment focused on executive functions. The prevalence of the various affective symptoms was as follows:apathy 15.2 %, anhedonia 6.1 %, emotional lability 48.5 %, depression 57.6 % of cases. Patients had a normal global cognitive level (mean short portable mental status questionnaire: 8.4 +/- 1.0, range 7-10). Apathy and anhedonia showed significant reciprocal correlations and they were also correlated with the executive score and the Barthel index;apathy was also correlated with depression; emotional lability, instead, was correlated only with depression. The study of possible anatomo-functional correlates between unconventional affective symptoms and lesion site did not show significant differences (stroke in the right versus left hemisphere, anterior versus posterior and cortical versus subcortical locations).
Subject(s)
Cognition Disorders/etiology , Mood Disorders/etiology , Stroke/complications , Aged , Aged, 80 and over , Brain/diagnostic imaging , Brain/pathology , Brain/physiopathology , Cognition Disorders/diagnosis , Cognition Disorders/epidemiology , Female , Functional Laterality/physiology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Mood Disorders/diagnosis , Mood Disorders/epidemiology , Neuropsychological Tests , Severity of Illness Index , Stroke/diagnosis , Stroke/physiopathology , Surveys and Questionnaires , Tomography, X-Ray ComputedABSTRACT
Physiological age-related cognitive decline, practice effect and regression to the mean may interfere with the interpretation of psychometric changes between subsequent neuropsychological evaluations. The standardized regression-based (SRB) change score allows investigators to define clinically relevant cognitive change on an individual basis controlling for these confounding factors. We performed a preliminary study to test its applicability and usefulness in the neuropsychological diagnosis of dementia. We derived a regression equation for the tests of a widely used Italian battery for global cognitive assessment, the Mental Deterioration Battery, in a sample of 20 normal elderly and we tested the potential clinical application of the SRB methodology in two cases of questionable dementia.
