Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 24
Filter
1.
J Microsc ; 264(1): 22-33, 2016 10.
Article in English | MEDLINE | ID: mdl-27148703

ABSTRACT

When producing asphalt concrete mixture with high amounts of reclaimed asphalt pavement (RAP), the mixing temperature plays a significant role in the resulting spatial distribution of the components as well as on the quality of the resulting mixture, in terms of workability during mixing and compaction as well as in service mechanical properties. Asphalt concrete containing 50% RAP was investigated at mixing temperatures of 140, 160 and 180°C, using a multiscale approach. At the microscale, using energy dispersive X-ray spectroscopy the RAP binder film thickness was visualized and measured. It was shown that at higher mixing temperatures this film thickness was reduced. The reduction in film thickness can be attributed to the loss of volatiles as well as the mixing of RAP binder with virgin binder at higher temperatures. X-ray computer tomography was used to characterize statistically the distribution of the RAP and virgin aggregates geometric features: volume, width and shape anisotropy. In addition using X-ray computer tomography, the packing and spatial distribution of the RAP and virgin aggregates was characterized using the nearest neighbour metric. It was shown that mixing temperature may have a positive effect on the spatial distribution of the aggregates but did not affect the packing. The study shows a tendency for the RAP aggregates to be more likely distributed in clusters at lower mixing temperatures. At higher temperatures, they were more homogeneously distributed. This indicates a higher degree of blending both at microscale (binder film) and macroscale (spatial distribution) between RAP and virgin aggregates as a result of increasing mixing temperatures and the ability to quantify this using various imaging techniques.

2.
AJNR Am J Neuroradiol ; 19(2): 239-44, 1998 Feb.
Article in English | MEDLINE | ID: mdl-9504472

ABSTRACT

PURPOSE: Our goal was to evaluate the intraobserver and interobserver reproducibility of measurements of brain lesion load in multiple sclerosis (MS) by using two proposed acquisition schemes. METHODS: Three-millimeter-thick conventional spin-echo (CSE) and fast fluid-attenuated inversion-recovery (FLAIR) sequences were obtained and the lesions segmented using a semiautomated technique based on local thresholding to calculate intraobserver and interobserver reproducibility. These were compared with images obtained from two separate MR units in which 5-mm CSE sequences were obtained and segmented by using the local thresholding technique and also by manual outlining. RESULTS: The intraobserver coefficient of variation was 4.0% (95% confidence interval [CI], 3.0% to 4.5%) for the 5-mm CSE sequence measured with manual outlining, 3.1% (95% CI, 2.5% to 3.2%) and 5.1% (95% CI, 4.1% to 5.6%) for the two sets of 5-mm CSE sequences measured using the local thresholding technique, 5.7% (95% CI, 3.9% to 6.6%) for the 3-mm CSE sequence, and 2.6% (95% CI, 2.1% to 2.7%) for the fast FLAIR sequence. The interobserver coefficient of variation was 7.1% (95% CI, 4.9% to 8.7%) and 8.3% (95% CI, 6.4% to 9.6%) for the two sets of 5-mm CSE sequences, 7.3% (95% CI, 4.7% to 9.1%) for the 3-mm CSE sequence, and 2.9% (95% CI, 2.3% to 3.3%) for the fast FLAIR sequence. The intraobserver and interobserver reproducibility of measurements obtained with the fast FLAIR technique was significantly better than those obtained with the other techniques. CONCLUSIONS: Our data indicate that the intraobserver and interobserver variability in quantifying MS lesions can be reduced significantly with the use of fast FLAIR sequences, while no significant improvement is gained by reducing the section thickness from 5 mm to 3 mm.


Subject(s)
Brain/pathology , Magnetic Resonance Imaging/methods , Multiple Sclerosis/diagnosis , Adult , Confidence Intervals , Female , Humans , Magnetic Resonance Imaging/statistics & numerical data , Male , Middle Aged , Multiple Sclerosis/classification , Neurologic Examination , Observer Variation , Sensitivity and Specificity
3.
Neurology ; 49(2): 371-7, 1997 Aug.
Article in English | MEDLINE | ID: mdl-9270564

ABSTRACT

We evaluated the effect of interscanner variation on brain MRI-measured lesion volumes and measurement reproducibility in MS. Twenty clinically definite MS patients were each scanned on two or three scanners (a total of 14 scanners were used). In addition, a formalin-fixed MS brain was studied on eight scanners from different manufacturers and with different field strengths. For the formalin-fixed MS brain, on each machine we obtained two scans with slice thicknesses of 5 and 3 mm. Only 5-mm-thick slices were obtained from patients. The lesion volume present on each scan was evaluated three times by a single observer in random order, using a local thresholding technique. In two groups of eight patients scanned on machines with different field strengths, the mean lesion volumes present on scans obtained at 1.5 T were significantly higher than those measured on scans obtained with machines operating at 0.5 and 1.0 T (p < 0.01). When a single observer repeatedly evaluated the same scan, a median introbserver agreement of 98.7% (95% CI, 97.9 to 99.1) was achieved. However, when the observer evaluated the scans from different MRI scanners, the agreement (an interscanner agreement) fell to 91.1% (CI, 90.2 to 94.1). When only scanners operating at 1.5 T were considered, the median interscanner agreement was 96.7% (CI, 95 to 97.5). Also, for the formalin-fixed MS brain, the intraobserver agreements obtained with both slice thicknesses were significantly higher than the corresponding interscanner agreements. The interscanner agreement, but not the intraobserver agreement, obtained with a slice thickness of 3 mm was higher than that obtained with a slice thickness of 5 mm. Our results indicate that lesion volume measurements in MS are influenced significantly by the use of different MR scanners and that a patient included in a serial study should be always scanned with the same MR machine using 3-mm thick slices.


Subject(s)
Brain/pathology , Magnetic Resonance Imaging/instrumentation , Multiple Sclerosis/diagnosis , Adult , Artifacts , Clinical Trials as Topic , Female , Fixatives , Formaldehyde , Humans , Male , Observer Variation , Reproducibility of Results
4.
Mult Scler ; 3(4): 226-30, 1997 Aug.
Article in English | MEDLINE | ID: mdl-9372504

ABSTRACT

In this study we evaluated and compared the inter-rater variabilities in detecting enhancing lesions in patients with MS after injection of a standard dose (s.d.) and a triple dose (TD) of gadolinium (Gd). Enhanced magnetic resonance imaging (MRI) were obtained in 15 patients, consisting of T1-weighted images 5 to 7 min after the injection of the s.d. (0.1 mmol/kg) of Gd and, after an interval of 6 to 24 h, 5 to 7 min after the injection of the TD (0.3 mmol/kg). An additional scan 1 h after the TD injection (delayed scanning-DS) was obtained in 11 patients. The scans were independently evaluated in a random order by four observers. Lesions were counted and scored according to size and location. The level of inter-observer observer concordance was very high for reporting the total numbers of enhancing lesions, their sizes and sites for the three experimental conditions. No significant differences were found in inter-observer variability in reporting the total number of enhancing lesions and their location in different brain sites in the three conditions. Our data indicate that the gain in sensitivity in detecting enhancing lesions in MS with the TD is not counteracted by a loss in reproducibility. This is important in planning clinical trials in which the number of enhancing lesions is used as a measure of outcome.


Subject(s)
Brain/pathology , Gadolinium , Magnetic Resonance Imaging , Multiple Sclerosis/pathology , Chi-Square Distribution , False Positive Reactions , Humans , Observer Variation , Reproducibility of Results
5.
Brain Lang ; 56(1): 55-67, 1997 Jan.
Article in English | MEDLINE | ID: mdl-8994698

ABSTRACT

The neural correlates of recovery from aphasia are largely unknown. Several different sources of evidence, from clinical studies to neurophysiological investigations, have suggested a contribution of the contralateral, undamaged hemisphere in recovery from aphasia. Eight patients with unilateral left hemispheric stroke were submitted to a standard language examination and to a [18F]FDG PET study in the recent phase after stroke (within 2 weeks) and 6 months later. All patients had a substantial recovery of specific aspects of language functions at the follow-up. Analysis of regional glucose metabolism showed hypometabolism in structurally unaffected regions both in the left and in the right hemisphere (diaschisis), in the acute stage. Glucose metabolism increased significantly on both sides in all patients at the second PET study. Regional analysis showed significant positive correlations between changes in metabolic values in several cortical and subcortical regions in the right hemisphere and changes in language performance at follow-up. The present findings show that an extensive, bihemispheric depression of metabolism is found in the acute stage after stroke in aphasic patients. Language recovery in the first months after aphasia onset is associated with regression of functional depression (diaschisis) in structurally unaffected regions, in particular in the right hemisphere.


Subject(s)
Aphasia/physiopathology , Brain Ischemia/physiopathology , Brain/metabolism , Tomography, Emission-Computed , Acute Disease , Adult , Aged , Aphasia/etiology , Brain/physiopathology , Brain Ischemia/complications , Female , Follow-Up Studies , Functional Laterality , Glucose/metabolism , Humans , Male , Middle Aged
6.
J Psychosom Res ; 41(6): 551-9, 1996 Dec.
Article in English | MEDLINE | ID: mdl-9032718

ABSTRACT

The 20-item Toronto Alexithymia Scale (TAS-20) has been shown in previous research to measure a general dimension of alexithymia with three intercorrelated factors. This study evaluated the reliability and factorial validity of an Italian translation of the TAS-20 in a group of normal adults (N = 206) and in a mixed group of medical and psychiatric outpatients (N = 642). Using confirmatory factor analyses, the previously established three-factor model of the TAS-20 was found to be replicable in both groups. In addition, the Italian TAS-20 demonstrated adequate estimates of internal reliability and test-retest reliability. Although evaluation of the convergent, discriminant, and concurrent validity of the TAS-20 is required in Italian populations, the present results support the use of the Italian translation of the scale for clinical and research purposes.


Subject(s)
Affective Symptoms/diagnosis , Psychiatric Status Rating Scales/standards , Psychometrics/standards , Adult , Aged , Chi-Square Distribution , Factor Analysis, Statistical , Female , Humans , Italy , Male , Middle Aged , Models, Psychological , Reproducibility of Results , Sampling Studies , Translating
7.
Acta Neurol Scand ; 94(3): 172-6, 1996 Sep.
Article in English | MEDLINE | ID: mdl-8899050

ABSTRACT

UNLABELLED: The basal ganglia are thought to be involved in the primary dystonias, largely because of the repeated demonstration of neuropathological changes in these nuclei in the secondary dystonias. A hyperactivity of a network involving basal ganglia has been suggested in experimental animal dystonia. To test this hypothesis in humans, we studied the functional correlates of primary cervical dystonia using [18F]FDG and PET. MATERIAL AND METHODS: Regional cerebral glucose metabolism (rCMRglc) was measured in 10 patients with idiopathic torticollis (6 drug-free and 4 drug-naive) and in 15 normal controls, using 2-[18F]-fluoro-2-deoxy-D-glucose ([18F]FDG) and positron emission tomography (PET). RESULTS: A significant hypermetabolism in the basal ganglia, thalamus, premotor-motor cortex and cerebellum in the patients compared with normal controls was found. The patients were correctly assigned to their clinical category by a discriminant function analysis with a total accuracy of 96%. CONCLUSION: The results support the hypothesis that a dysfunction of a subcortical-cortical motor network may play a role in the pathogenesis of focal dystonia, in agreement with the experimental dystonia models.


Subject(s)
Basal Ganglia/diagnostic imaging , Blood Glucose/metabolism , Cerebral Cortex/physiopathology , Energy Metabolism/physiology , Thalamus/diagnostic imaging , Tomography, Emission-Computed , Torticollis/diagnostic imaging , Adult , Aged , Basal Ganglia/physiopathology , Brain Mapping , Cerebellum/diagnostic imaging , Cerebellum/physiopathology , Deoxyglucose/analogs & derivatives , Deoxyglucose/metabolism , Female , Fluorodeoxyglucose F18 , Humans , Male , Middle Aged , Motor Cortex/diagnostic imaging , Motor Cortex/physiopathology , Nerve Net/diagnostic imaging , Nerve Net/physiopathology , Thalamus/physiopathology , Torticollis/physiopathology
8.
Dementia ; 7(2): 63-8, 1996.
Article in English | MEDLINE | ID: mdl-8866677

ABSTRACT

We evaluated pattern visual evoked potentials (PVEPs) in patients with Alzheimer's disease (AD) and correlated the neurophysiological results with visuospatial performances in order to understand better the underlying causes of visual disturbances. Latencies and topographical distribution of PVEP components were evaluated in 20 AD patients who underwent an extensive battery of neuropsychological tests. Mean latencies of N70 and P100 were normal in AD patients, while mean latencies of N140 and P200 were significantly increased in comparison with age-matched healthy controls. The topographical distribution of PVEP components did not show any significant difference between the two groups. Visuospatial impairment was detected in 8 patients (40%). Statistically significant positive correlations were observed between P200 amplitude (posterior right hemisphere mean z score) and performance in visuospatial tests. Our data are consistent with a sparing of foveal retinocortical pathways and with the selective dysfunction of either corticocortical connections between the striate cortex and the visual associative structures or of right temporo-parieto-occipital visual analyzers.


Subject(s)
Alzheimer Disease/physiopathology , Evoked Potentials, Visual/physiology , Age of Onset , Aged , Alzheimer Disease/psychology , Brain Mapping , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Photic Stimulation
9.
Neurology ; 46(2): 379-84, 1996 Feb.
Article in English | MEDLINE | ID: mdl-8614498

ABSTRACT

We studied whether a triple dose of gadolinium-DTPA alone or in combination with delayed scanning increases the sensitivity of brain MRI for detecting enhancing lesions in patients with MS. We obtained T1-weighted brain MRI scans in two sessions for 22 patients with clinically definite MS. In the first session, we obtained one scan 5 to 7 minutes after the injection of 0.1 mmol/kg gadolinium-DTPA (standard dose). In the second session, 6 to 24 hours later, we obtained one scan before the two scans 5 to 7 minutes (for all patients) and one hour (for 11 patients) after the injection of 0.3 mmol/kg gadolinium-DTPA (triple dose). We detected 83 enhancing lesions in 14 patients when the standard dose of gadolinium-DTPA was used. The numbers of enhancing lesions increased to 138 (average increase 66%; p = 0.001) and the numbers of patients with such lesions to 18 (increase 28%) when we used the triple dose of gadolinium-DTPA. In addition, the total area per patient occupied by such lesions was greater (p < 0.0001) and lesion signal intensity higher (p = 0.0001) on the triple-dose scans than the standard-dose scans. There was an increase in the number of large enhancing lesions (p = 0.03) in the scans obtained 1 hour after the injection of the triple dose of gadolinium-DTPA. These data indicate that in patients with MS, a triple dose of gadolinium-DTPA can reveal many more enhancing lesions, which also appear larger. This suggests that the pathologic nature of "active" lesions in MS is heterogeneous, which might have impact on planning clinical trials.


Subject(s)
Gadolinium , Magnetic Resonance Imaging/methods , Multiple Sclerosis/pathology , Organometallic Compounds , Pentetic Acid/analogs & derivatives , Spinal Cord/pathology , Contrast Media , Dose-Response Relationship, Drug , Gadolinium DTPA , Humans , Multiple Sclerosis/physiopathology , Time Factors
10.
Brain ; 118 ( Pt 6): 1593-600, 1995 Dec.
Article in English | MEDLINE | ID: mdl-8595488

ABSTRACT

The measurement of MRI lesion load in multiple sclerosis is increasingly being used to evaluate the natural history of the disease and to monitor the efficacy of treatments. If, as might occur in multicentre studies, lesion load is measured by several observers in different patients or by the same observer in serial scans, it would be necessary to utilize a technique which provides results with high inter- and intra-observer agreements. This study was performed to evaluate the intra- and inter-observer agreement of semi-automated lesion volume measurement using thresholding, and to compare them with those obtained using an arbitrary scoring system (ASS) and a quantitative manual tracing method (MTM). Brain MRIs were obtained for 20 clinically definite multiple sclerosis patients and were evaluated independently by three observers. The median intra- and inter-observer agreements were, respectively, 88.5% (range 69.0-96.8%) and 79.0% (range 73.3-98.3%) using the ASS, 95.0% (range 85.1-99.4%) and 93.4% (range 77.3-98.3%) for the MTM, 96.3% (range 94.2-98.9%) and 93.7% (range 83.8-98.3%) for the semi-automated technique. The intra- and inter-observer agreements for the semi-automated technique increased to 98.5% (range 96.3-99.8%) and 96.1% (range 90.5-98.6%) when a consensus in the choice of threshold for lesion segmentation was reached. The intra- and inter-observer agreements were significantly greater for the semi-automated method compared with both the arbitrary scoring and the MTMs. The intra-observer variability for the semi-automated technique was significantly lower (P < 0.0001) than the inter-observer variability obtained using the same technique. These data indicate that it is possible to obtain high intra- and inter-observer agreements using a semi-automatic thresholding technique to quantify lesion volumes in multiple sclerosis. The technique may prove useful in multicentre studies, in which a single observer is still preferable.


Subject(s)
Brain/pathology , Magnetic Resonance Imaging , Multiple Sclerosis/diagnosis , Humans , Magnetic Resonance Imaging/methods , Observer Variation
11.
J Neurol Neurosurg Psychiatry ; 59(4): 427-31, 1995 Oct.
Article in English | MEDLINE | ID: mdl-7561924

ABSTRACT

Positron emission tomography with [18F]-2-fluoro-2-deoxy-D-glucose ([18F]FDG) has been used to assess the pattern of cerebral metabolism in different types of epilepsies. However, PET with [18F]FDG has never been used to evaluate drug naive patients with cryptogenic temporal lobe epilepsy, in whom the mechanism of origin and diffusion of the epileptic discharge may differ from that underlying other epilepsies. In a group of patients with cryptogenic temporal lobe epilepsy, never treated with antiepileptic drugs, evidence has been found of significant interictal glucose hypermetabolism in a bilateral neural network including the temporal lobes, thalami, basal ganglia, and cingular cortices. The metabolism in these areas and frontal lateral cortex enables the correct classification of all patients with temporal lobe epilepsy and controls by discriminant function analysis. Other cortical areas--namely, frontal basal and lateral, temporal mesial, and cerebellar cortices--had bilateral increases of glucose metabolism ranging from 10 to 15% of normal controls, although lacking stringent statistical significance. This metabolic pattern could represent a pathophysiological state of hyperactivity predisposing to epileptic discharge generation or diffusion, or else a network of inhibitory circuits activated to prevent the diffusion of the epileptic discharge.


Subject(s)
3-O-Methylglucose/analogs & derivatives , Brain/metabolism , Epilepsy, Temporal Lobe/metabolism , Glucose/metabolism , Nerve Net/metabolism , Adolescent , Adult , Analysis of Variance , Brain/diagnostic imaging , Epilepsy, Temporal Lobe/diagnostic imaging , Female , Fluorine Radioisotopes , Humans , Male , Methylglucosides , Middle Aged , Nerve Net/diagnostic imaging , Tomography, Emission-Computed
12.
Neuroreport ; 6(12): 1637-41, 1995 Aug 21.
Article in English | MEDLINE | ID: mdl-8527731

ABSTRACT

Using positron emission tomography, we mapped brain activity in normal volunteers during the recognition of visual stimuli representing living (animals) and non-living (artefacts) entities. The subjects had to decide whether pairs of visual stimuli were different representations of the same object, or different objects. Animal recognition was associated with activations in the inferior temporo-occipital areas, bilaterally, whereas artefact recognition engaged a predominantly left hemispheric network, involving the left dorsolateral frontal cortex. These findings, which concur with clinical observations in neurological patients, provide in vivo evidence for a fractionation of the neural substrates of semantic knowledge in man.


Subject(s)
Cerebral Cortex/physiology , Discrimination, Psychological/physiology , Models, Neurological , Semantics , Visual Perception/physiology , Adult , Brain Mapping , Cognition/physiology , Frontal Lobe/physiology , Functional Laterality/physiology , Humans , Male , Neurons/physiology , Occipital Lobe/physiology , Photic Stimulation , Temporal Lobe/physiology , Tomography, Emission-Computed
13.
Am J Psychiatry ; 152(6): 876-82, 1995 Jun.
Article in English | MEDLINE | ID: mdl-7755117

ABSTRACT

OBJECTIVE: The purpose of the study was to compare regional cerebral blood flow (CBF) in schizophrenic patients never treated with psychotropic drugs (drug-naive) and in schizophrenic patients free from drugs for various amounts of time. METHOD: Seventeen schizophrenic patients (nine who were drug naive and eight who had been drug free for at least 3 weeks) and 12 healthy volunteers were included in the study. Regional cerebral perfusion was studied with the use of a head-dedicated, high-resolution single photon emission computed tomography (SPECT) system. Cerebral SPECT scans were performed with technetium-99m-hexamethyl-propyleneamine oxime as a tracer. Regional CBF was measured as a ratio of regional tracer uptake to either cerebellar or whole brain tracer uptake. RESULTS: When the cerebellum was taken as the reference region, the drug-naive patients showed a significant bilateral reduction of perfusion in the mesial, dorsolateral, and basal prefrontal cortex, in the temporal cortex, and in the subcortical gray structures: thalamus, caudate nucleus, and putamen/pallidum complex. No significant differences emerged in the comparison between the drug-free patients and the healthy subjects. With correction for whole brain activity, some of the differences that had been found disappeared, but a significant hypoperfusion persisted in the basal ganglia and thalamus of the drug-naive, but not the drug-free, patients. Few correlations between symptom presentation and regional CBF perfusion were observed in the schizophrenic patients. CONCLUSIONS: These results suggest a pattern of cerebral hypoperfusion in schizophrenic patients never treated with neuroleptics that was not detectable in patients who had undergone various periods of pharmacological washout.


Subject(s)
Antipsychotic Agents/therapeutic use , Brain/blood supply , Schizophrenia/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Adolescent , Adult , Age of Onset , Basal Ganglia/blood supply , Brain/diagnostic imaging , Cerebellum/blood supply , Female , Frontal Lobe/blood supply , Humans , Male , Middle Aged , Occipital Lobe/blood supply , Organotechnetium Compounds , Oximes , Parietal Lobe/blood supply , Schizophrenia/diagnosis , Schizophrenia/drug therapy , Technetium Tc 99m Exametazime , Temporal Lobe/blood supply , Thalamus/blood supply
14.
Br J Psychiatry ; 166(2): 244-50, 1995 Feb.
Article in English | MEDLINE | ID: mdl-7728370

ABSTRACT

BACKGROUND: We used [18F]FDG and PET in patients with obsessive-compulsive disorder (OCD) to evaluate cerebral metabolic involvement before and after treatment with serotonin-specific reuptake inhibitors. METHOD: In 11 untreated, drug-free adults, regional cerebral metabolic rate for glucose (rCMRglu) was compared with that of 15 age-matched normal controls. RESULTS: rCMRglu values were significantly increased in the cingulate cortex, thalamus and pallidum/putamen complex. After treatment a significant improvement in obsessive-compulsive symptoms on the Y-BOC scale (t = 3.59, P < 0.01) was associated with a significant bilateral decrease of metabolism in the whole cingulate cortex (P < 0.001). Clinical and metabolic data were significantly intercorrelated (Kendall's tau = 0.65; P < 0.01). CONCLUSIONS: These findings indicate that OCD is associated with functional hyperactivity of a selected neuronal network and that treatment to reduce symptoms may have a selective neuromodulatory effect on cingulate cortex.


Subject(s)
Brain/diagnostic imaging , Brain/metabolism , Obsessive-Compulsive Disorder/diagnostic imaging , Obsessive-Compulsive Disorder/metabolism , Tomography, Emission-Computed/methods , Adolescent , Adult , Female , Functional Laterality , Gyrus Cinguli/metabolism , Humans , Male , Obsessive-Compulsive Disorder/drug therapy , Putamen/metabolism , Selective Serotonin Reuptake Inhibitors/therapeutic use , Thalamus/metabolism
15.
Arch Neurol ; 52(2): 179-85, 1995 Feb.
Article in English | MEDLINE | ID: mdl-7848128

ABSTRACT

OBJECTIVE: To evaluate the regional cerebral metabolic involvement; the relationships among regional brain metabolism, clinical features, and quantitative measures of disease severity; and the patterns of brain involvement that can be related to the different types of onset: striatonigral degeneration vs olivopontocerebellar atrophy. DESIGN: Fludeoxyglucose F 18 positron emission tomography (PET) studies performed in patients with multiple system atrophy (MSA) were evaluated for their clinical features at the onset of the disease and at the time of the PET study. CASES: Seventeen patients diagnosed as having probable MSA and 10 age-matched controls. RESULTS: The hypometabolism in the putamen-pallidum complex and in the cerebellum was the best discriminant for disease classification. The efficacy of levodopa treatment was positively correlated with the metabolic activity of the putamen-pallidum complex. The patients with olivopontocerebellar atrophy type (N = 8) had a prevalent hypometabolism in the cerebellum, while the patients with striatonigral degeneration type (N = 9) had a prevalent impairment in the pallidum-putamen complex. We demonstrated a negative correlation between (1) severity of parkinsonism and metabolic values of putamen and caudate; (2) severity of cerebellar signs and metabolism in the cerebellum; and (3) autonomic dysfunction and metabolic activity in the thalamus, frontal, and temporal regions, bilaterally. CONCLUSIONS: These findings support the selective metabolic reduction in the putamen and cerebellum as a marker of MSA. The clinical/metabolic correlations, demonstrating the expected dependence of extrapyramidal and cerebellar signs by dysfunction of basal ganglia and cerebellum, also support a possible involvement of central nervous system structures in autonomic control.


Subject(s)
Brain Diseases/metabolism , Corpus Striatum/metabolism , Corpus Striatum/pathology , Glucose/metabolism , Olivopontocerebellar Atrophies/metabolism , Substantia Nigra/metabolism , Substantia Nigra/pathology , Atrophy , Brain Diseases/diagnostic imaging , Brain Diseases/pathology , Corpus Striatum/diagnostic imaging , Deoxyglucose/analogs & derivatives , Female , Fluorodeoxyglucose F18 , Humans , Levodopa/therapeutic use , Male , Middle Aged , Olivopontocerebellar Atrophies/diagnostic imaging , Olivopontocerebellar Atrophies/pathology , Parkinson Disease/diagnostic imaging , Parkinson Disease/drug therapy , Parkinson Disease/metabolism , Parkinson Disease/pathology , Substantia Nigra/diagnostic imaging , Tomography, Emission-Computed
16.
Dementia ; 6(1): 32-8, 1995.
Article in English | MEDLINE | ID: mdl-7728217

ABSTRACT

In a previous transcranial Doppler (TCD) study, we demonstrated a decrease in blood flow velocity in the proximal tract of the middle cerebral artery (MCA) in patients with Alzheimer's disease (AD). In these patients there was also an asymmetry in blood flow velocity which positively correlated with the cognitive asymmetry often seen in the early phase of AD. In this study we found a correlation between the absolute values and asymmetry indexes of MCA blood flow velocity with adjusted metabolic values and asymmetry indexes of the relative cortical frontotemporoparietal (FTP) areas, evaluated by FDG-PET, and with neuropsychological asymmetry indexes. Patients with prevalent visuospatial deficits (right hemisphere dysfunction) showed significant decreases in right MCA blood flow velocity and right FTP cortical glucose hypometabolism, whereas in patients with prevalent language deficits (left hemisphere dysfunction), these signs were observed on the other side. In AD patients, the decrease of blood flow velocity in MCA might be due to reduced metabolic demands in the temporoparietal cortical areas primarily affected by AD.


Subject(s)
Alzheimer Disease/diagnosis , Cerebral Arteries/physiopathology , Cerebral Cortex/metabolism , Cognition Disorders/diagnosis , Glucose/metabolism , Aged , Alzheimer Disease/metabolism , Alzheimer Disease/physiopathology , Blood Flow Velocity , Cognition Disorders/metabolism , Cognition Disorders/physiopathology , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Tomography, Emission-Computed
17.
Eur Neurol ; 34(6): 324-8, 1994.
Article in English | MEDLINE | ID: mdl-7851453

ABSTRACT

The effects of age, educational level, duration and course of the disease, physical disability and mood status on several cognitive functions (short- and long-term memory, frontal functions, attention, language and visuospatial skills) have been evaluated in 42 multiple sclerosis (MS) patients. The Hamilton Depression Rating Scale (HDRS) scores and a secondary progressive disease course significantly influenced neuropsychological performance. Factorial analysis revealed that indexes of (1) frontal function impairment, (2) long-term verbal memory and language function impairment, and (3) visuospatial short- and long-term memory and visuoperceptive function impairment accounted for 85% of the variance in neuropsychological performance. Only the first factor was significantly related to the presence of depressive symptomatology, as assessed by the HDRS. These results indicate that both the course of the disease and the presence of affective disorders must be taken into account when evaluating the natural history of cognitive impairment in MS and suggest that depressive symptomatology and cognitive dysfunction in MS are related to the involvement of at least partially overlapping anatomofunctional circuits.


Subject(s)
Cognition Disorders/diagnosis , Multiple Sclerosis/diagnosis , Neuropsychological Tests , Adult , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Disability Evaluation , Educational Status , Female , Humans , Male , Middle Aged , Multiple Sclerosis/psychology , Psychiatric Status Rating Scales
18.
Brain ; 116 ( Pt 4): 903-19, 1993 Aug.
Article in English | MEDLINE | ID: mdl-8353715

ABSTRACT

Patients with global amnesia of different aetiologies (n = 11), and patients with probable Alzheimer's disease of recent onset and mild to moderate severity (n = 18) underwent extensive neuropsychological examination, which included the evaluation of multiple components of memory, and a measurement of regional cerebral glucose metabolism with [18F]fluoro-deoxyglucose ([18F]FDG) and PET. In the neuropsychological tests, both global amnesia and Alzheimer's disease patients had impaired episodic long-term memory, while deficits of short-term, semantic and implicit memory were present only in Alzheimer's disease. When local metabolic rates for glucose were compared with values from age- and education-matched normal controls, a common pattern of bilateral hypometabolism was present in the hippocampus, cingulate and frontal basal cortex of both global amnesia and Alzheimer's disease patients. On the other hand, significant hypometabolism was found in the thalamus in only global amnesia, and in the frontal, parietal and temporal associative cortex in only Alzheimer's disease. The results of a multivariate regression analysis of test scores with metabolic data indicated that different clusters of cerebral areas were associated with each of the main components of memory function. These data are in agreement with 'neural network' models of the neural basis of cognition, according to which complex functions are subserved by multiple interconnected cortical and subcortical structures.


Subject(s)
Brain/metabolism , Memory , Aged , Brain/diagnostic imaging , Deoxyglucose/analogs & derivatives , Deoxyglucose/metabolism , Fluorodeoxyglucose F18 , Humans , Middle Aged , Tomography, Emission-Computed
19.
J Neurol Neurosurg Psychiatry ; 56(6): 665-71, 1993 Jun.
Article in English | MEDLINE | ID: mdl-8509781

ABSTRACT

Two cases of aphasia after right hemispheric stroke in right handed patients are described. The first patient had a severe mixed transcortical aphasia, apraxia and neglect after a lesion involving the right lenticular nucleus and periventricular white matter; aphasia was still present after three months. The second patient had a mild, transient fluent aphasia after a small right hemispheric periventricular lesion. Studies with [18F]FDG and positron emission tomography (PET) showed functional depression extending to the structurally unaffected left hemisphere in both patients in the acute stage. After three months, in the patient with persistent aphasia, metabolism was still reduced in the right hemisphere, with some recovery of hypometabolism on the left, while metabolic values had returned to normal in the patient with full language recovery. A close parallelism between glucose metabolism and clinical course in crossed aphasia is shown, as well as the presence of a functional involvement of the structurally unaffected left hemisphere in the acute stage.


Subject(s)
Aphasia/diagnostic imaging , Brain/diagnostic imaging , Cerebrovascular Disorders/complications , Aged , Analysis of Variance , Aphasia/etiology , Female , Follow-Up Studies , Functional Laterality , Humans , Male , Middle Aged , Radiography , Tomography, Emission-Computed
20.
Psychopharmacology (Berl) ; 110(4): 421-6, 1993.
Article in English | MEDLINE | ID: mdl-7870912

ABSTRACT

The scopolamine model of amnesia has been used to test the pharmacodynamic efficacy of oxiracetam in 12 healthy volunteers. The subjects were divided into four experimental groups, according to a double-blind cross over incomplete randomized block design. After a baseline neuropsychological examination, each subject received in two separate sessions one of the following treatments, as acute oral doses: oxiracetam 800, 1600, 2400 mg or placebo. One hour after treatment scopolamine hydrobromide (0.5 mg) was given subcutaneously. The cognitive performance was tested before and 1, 2, 3 and 25 h after scopolamine administration. Scopolamine caused a deterioration of performance of verbal episodic memory, semantic memory and attention tests. In comparison to placebo, oxiracetam improved the overall test performance, with a statistically significant difference at the dose of 1600 mg on delayed recall of word lists, and showed dose-related antagonism of scopolamine-induced effects also on semantic memory and attention. The efficacy of an acute dose of oxiracetam in reducing scopolamine-induced cognitive impairment supports the potential usefulness of this pharmacological model of amnesia for studying the effects of cognition enhancers in humans.


Subject(s)
Amnesia/psychology , Psychotropic Drugs/pharmacology , Pyrrolidines/pharmacology , Scopolamine/antagonists & inhibitors , Adult , Amnesia/chemically induced , Attention/drug effects , Cross-Over Studies , Dose-Response Relationship, Drug , Double-Blind Method , Female , Humans , Male , Memory/drug effects , Memory, Short-Term/drug effects , Mental Recall/drug effects , Neuropsychological Tests , Reading , Scopolamine/pharmacology
SELECTION OF CITATIONS
SEARCH DETAIL
...