ABSTRACT
Although Parkinson's disease (PD) and essential tremor (ET) are distinct clinical disorders, their coexistence can sometimes cause diagnostic problems. In this study, we conducted detailed investigations of patients with both ET and PD (ET-PD) and compared their clinical and cognitive profiles with those of patients with only ET or only PD. This study examined three groups of patients: the first group had ET-PD concomitantly (n = 9); the second group had only ET (n = 9); the third group had only PD (n = 10). The groups were compared in terms of demographic characteristics, clinical features, and cognitive functions. With the exception of positive family histories, which were more common in ET-PD than in PD patients, we found no differences among the groups with respect to demographic characteristics (p = 0.044). PD-only patients had more akinetic-rigid type Parkinsonism (p = 0.016), and their levodopa response was better than that of ET-PD patients (p = 0.017). Patients with ET-PD obtained significantly lower scores than those with pure ET on several cognitive tests, suggesting a prominent frontal-type cognitive dysfunction. In conclusion ET-PD patients differed from PD patients, showing more frequent familial tremor histories and lower levodopa responsiveness. This patient population also demonstrated more severe cognitive impairments than pure-ET patients. This result suggests that ET-PD patients are a subset of ET patients with more widespread neurodegeneration, which may indicate the presence of a syndrome that includes overlap between ET and PD.
Subject(s)
Cognition Disorders/complications , Cognition/physiology , Essential Tremor/complications , Nerve Degeneration/complications , Parkinson Disease/complications , Aged , Aged, 80 and over , Anticonvulsants/therapeutic use , Antiparkinson Agents/therapeutic use , Attention/physiology , Cognition Disorders/drug therapy , Cognition Disorders/physiopathology , Essential Tremor/drug therapy , Essential Tremor/physiopathology , Executive Function/physiology , Female , Humans , Levodopa/therapeutic use , Male , Memory/physiology , Middle Aged , Nerve Degeneration/drug therapy , Nerve Degeneration/physiopathology , Neuropsychological Tests , Parkinson Disease/drug therapy , Parkinson Disease/physiopathology , Primidone/therapeutic use , Space Perception/physiologyABSTRACT
BACKGROUND AND PURPOSE: Systemic sclerosis (SSc) is a connective-tissue disorder characterized by microvascular damage and tissue fibrosis. Although overt nervous system involvement is unusual in SSc, imaging studies have shown cerebral hypoperfusion. We evaluated cognitive functions in patients with SSc who had no history of neurological involvement, to seek cognitive impairment caused by the suggested cerebral hypoperfusion. METHODS: We performed a comprehensive neuropsychological test battery on 31 patients with SSc and on 2 groups of age-adjusted, sex-adjusted, and education-adjusted controls: 15 patients with rheumatoid arthritis and 20 healthy volunteers. RESULTS: The patients with SSc scored significantly worse on most of the measures of executive function than the 2 control groups (P<0.05). However, both patient groups did worse than the healthy controls on measures of attention and memory (P<0.005). CONCLUSIONS: Our results suggest that patients with SSc have a specific pattern of cognitive impairment: the dysexecutive syndrome. Attentional and memory problems, however, may arise from other confounders such as disease duration and chronic medication use. SSc may be a rare cause of vascular cognitive impairment.
Subject(s)
Cognition Disorders/etiology , Cognition Disorders/physiopathology , Scleroderma, Systemic/physiopathology , Adult , Aged , Attention/physiology , Executive Function/physiology , Female , Humans , Male , Memory , Middle Aged , Neuropsychological Tests/statistics & numerical data , Scleroderma, Systemic/complications , Young AdultABSTRACT
OBJECTIVES/HYPOTHESIS: Verbal fluency deteriorates with normal aging, but is much more severe in Alzheimer's Disease (AD). Verbal functions were analyzed to find differences between normal aging subjects in patients with mild cognitive impairment (MCI), and in patients with early and moderate stages of AD. This study measured the verbal response time in patients with AD, MCI, and in control subjects STUDY DESIGN: This study measured the verbal response time in patients with AD, MCI, and in control subjects METHODS: Fifteen patients with MCI, 15 patients with early AD, 8 patients with moderate AD, and 15 subjects for controls were included in the study. Word length in milliseconds, reaction time to a phoneme, word, or sentence and acoustic analysis of voice quality and speech diadochokinetic rate (DDK) were measured. RESULTS: Reaction time for a phoneme, word, or sentence especially the initiation period for them were longer in patients with early AD compared to patients with MCI (P < .001). The mean DDK rate was lower with increased severity of the disease, and was much more severe in patients with moderate AD. CONCLUSIONS: Clinical discrimination of the early stages of AD and MCI is challenging. Unfortunately, there are no laboratory markers present for the diagnosis of preclinical cases of AD. With the results of this study, the assessments of verbal reaction time may helpful for diagnosis of early AD.
Subject(s)
Alzheimer Disease/complications , Cognition Disorders/complications , Reaction Time/physiology , Speech Disorders/etiology , Verbal Behavior/physiology , Age Factors , Aged , Aged, 80 and over , Alzheimer Disease/diagnosis , Analysis of Variance , Case-Control Studies , Cognition Disorders/diagnosis , Educational Status , Female , Humans , Male , Neuropsychological Tests , Prognosis , Severity of Illness Index , Speech Disorders/physiopathology , Speech Perception/physiology , Speech Production Measurement , Voice QualityABSTRACT
Herpes simplex encephalitis (HSE) is a serious viral infection with a high rate of mortality. The most commonly seen complications are behavioral changes, seizures and memory deficits. We report the case of a 37-year-old man with HSE in the right temporal lobe and a severe midline shift who was treated with acyclovir. The patient underwent anterior temporal lobe resection. Although HSE can cause permanent cognitive deficits, in this case, early surgical intervention minimized any deficit, as determined by detailed neuropsychological examination. Surgical decompression is indicated as early as possible in severe cases. This case report emphasizes the effect of surgical decompression for HSE on cognitive function, which has rarely been mentioned before.
