RESUMEN
The Stroop color and word test (SCWT) is widely used to evaluate attention, information processing speed, selective attention, and cognitive flexibility. Normative values for the Italian population are available only for selected age groups, or for the short version of the test. The aim of this study was to provide updated normal values for the full version, balancing groups across gender, age decades, and education. Two kinds of indexes were derived from the performance of 192 normal subjects, divided by decade (from 20 to 90) and level of education (4 levels: 3-5; 6-8; 9-13; >13 years). They were (i) the correct answers achieved for each table in the first 30 s (word items, WI; color items, CI; color word items, CWI) and (ii) the total time required for reading the three tables (word time, WT; color time, CT; color word time, CWT). For each index, the regression model was evaluated using age, education, and gender as independent variables. The normative data were then computed following the equivalent scores method. In the regression model, age and education significantly influenced the performance in each of the 6 indexes, whereas gender had no significant effect. This study confirms the effect of age and education on the main indexes of the Stroop test and provides updated normative data for an Italian healthy population, well balanced across age, education, and gender. It will be useful to Italian researchers studying attentional functions in health and disease.
Asunto(s)
Test de Stroop , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Atención , Escolaridad , Función Ejecutiva , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Actividad Motora , Valores de Referencia , Análisis de Regresión , Factores Sexuales , Test de Stroop/estadística & datos numéricos , Percepción Visual , Adulto JovenRESUMEN
According to the new research criteria for the diagnosis of Alzheimer's disease, episodic memory impairment, not significantly improved by cueing, is the core neuropsychological marker, even at a pre-dementia stage. The FCSRT assesses verbal learning and memory using semantic cues and is widely used in Europe. Standardization values for the Italian population are available for the colored picture version, but not for the 16-item printed word version. In this study, we present age- and education-adjusted normative data for FCSRT-16 obtained using linear regression techniques and generalized linear model, and critical values for classifying sub-test performance into equivalent scores. Six scores were derived from the performance of 194 normal subjects (MMSE score, range 27-30, mean 29.5 ± 0.5) divided per decade (from 20 to 90), per gender and per level of education (4 levels: 3-5, 6-8, 9-13, >13 years): immediate free recall (IFR), immediate total recall (ITR), recognition phase (RP), delayed free recall (DFR), delayed total recall (DTR), Index of Sensitivity of Cueing (ISC), number of intrusions. This study confirms the effect of age and education, but not of gender on immediate and delayed free and cued recall. The Italian version of the FCSRT-16 can be useful for both clinical and research purposes.
Asunto(s)
Señales (Psicología) , Trastornos de la Memoria/diagnóstico , Recuerdo Mental/fisiología , Pruebas Neuropsicológicas/normas , Aprendizaje Verbal/fisiología , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/complicaciones , Enfermedad de Alzheimer/diagnóstico , Estudios de Casos y Controles , Escolaridad , Femenino , Humanos , Italia , Masculino , Trastornos de la Memoria/etiología , Persona de Mediana Edad , Tiempo de Reacción/fisiología , Valores de Referencia , Adulto JovenRESUMEN
Chronic Fatigue Syndrome (CFS) represents a disabling condition characterized by persistent mental and physical fatigue, bodily discomfort and cognitive difficulties. To date the neural bases of CFS are poorly understood; however, mono-aminergic abnormalities, sleep-wake cycle changes and prefrontal dysfunctions are all thought to play a role in the development and maintenance of this condition. Here we explored in a group of 62 CFS subjects the impact on fatigue levels of agomelatine, an antidepressant with agonist activity at melatonin receptors (MT1 and MT2) and antagonist activity at serotoninergic 2C receptors (5HT2C). To tease out the relative effects of MT-agonism and 5HT2C antagonism on fatigue, we compared agomelatine 50mg u.i.d. with sustained release melatonin 10mg u.i.d. in the first 12-week-long phase of the study, and then switched all melatonin-treated subjects to agomelatine in the second 12-week-long phase of the study. Agomelatine treatment, but not melatonin, was associated with a significant reduction of perceived fatigue and an increase in perceived quality of life. Moreover the switch from melatonin to agomelatine was associated with a reduction of fatigue levels. Agomelatine was well tolerated by all enrolled subjects. Our data, albeit preliminary, suggest that agomelatine treatment could represent a novel useful approach to the clinical care of subjects with CFS.
Asunto(s)
Acetamidas/uso terapéutico , Antidepresivos/uso terapéutico , Síndrome de Fatiga Crónica/tratamiento farmacológico , Síndrome de Fatiga Crónica/psicología , Fatiga/tratamiento farmacológico , Melatonina/uso terapéutico , Acetamidas/efectos adversos , Adulto , Antidepresivos/efectos adversos , Fatiga/fisiopatología , Síndrome de Fatiga Crónica/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Melatonina/efectos adversos , Proyectos Piloto , Escalas de Valoración Psiquiátrica , Calidad de Vida , Receptor de Melatonina MT1/antagonistas & inhibidores , Receptor de Melatonina MT1/metabolismo , Receptor de Melatonina MT2/antagonistas & inhibidores , Receptor de Melatonina MT2/metabolismo , Receptor de Serotonina 5-HT2C/metabolismo , Antagonistas del Receptor de Serotonina 5-HT2/uso terapéutico , Resultado del TratamientoAsunto(s)
Trastornos del Conocimiento/etiología , Estado Epiléptico/diagnóstico , Estado Epiléptico/patología , Enfermedad Aguda , Anciano , Diagnóstico Diferencial , Electroencefalografía , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
Some evidence would indicate that a serotonergic deficit may be involved in epileptogenesis. A preliminary trial of citalopram, a selective inhibitor of serotonin reuptake, was carried out. Citalopram 20mg/day was given to 11 non-depressed patients with poorly controlled epilepsy as an add on treatment with an open label design for 8-10 months. The median seizure frequency dropped by 55.6% in the whole group, with nine patients improving by at least 50%. No adverse reactions occurred with the exception of mild drowsiness. There were no changes of post-treatment as compared to pre-treatment AED serum concentrations. Although controlled studies are required to confirm the anticonvulsant effect of citalopram, these findings may be regarded as an indirect evidence of serotonergic impairment in human epileptogenesis.
Asunto(s)
Anticonvulsivantes/administración & dosificación , Citalopram/administración & dosificación , Electroencefalografía/efectos de los fármacos , Epilepsia Parcial Compleja/tratamiento farmacológico , Epilepsia Parcial Compleja/fisiopatología , Epilepsia Generalizada/tratamiento farmacológico , Epilepsia Generalizada/fisiopatología , Inhibidores Selectivos de la Recaptación de Serotonina/administración & dosificación , Serotonina/deficiencia , Adulto , Corteza Cerebral/efectos de los fármacos , Corteza Cerebral/fisiopatología , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Serotonina/fisiología , Resultado del TratamientoRESUMEN
OBJECTIVES: Reversible posterior leucoencephalopathy syndrome (RPLS) may develop in patients with renal insufficiency, hypertension, and immunosuppression, and is managed by prompt antihypertensive and anticonvulsant treatment. Four patients with renal insufficiency and fluid overload associated with Wegener's granulomatosis (one patient) and systemic lupus erythematosus (SLE) (three patients) are described, whose clinical picture and neuroimaging indicated RPLS. CASE REPORTS: All patients had headache, seizures, visual abnormalities, and transient motor deficit, and were hypertensive at the onset of the symptoms. Head computed tomography (CT) scan and magnetic resonance imaging showed predominantly posterior signal abnormalities, which were more conspicuous on T(2) weighted spin echo images than on CT scan. All patients had some form of cytotoxic treatment shortly before the syndrome developed, and dramatically responded to blood pressure control and anticonvulsant treatment. In two patients with SLE, dialysis was required for renal insufficiency. DISCUSSION: Follow up neuroimaging studies showed almost complete resolution of signal abnormalities, and suggested that RPLS was associated with cerebral oedema without concomitant infarction. The treatment of hypertension and neurotoxic condition such as uraemia appears of primary importance, while immunosuppressive treatment may cause further damage of the blood-brain barrier.
Asunto(s)
Encefalopatías/complicaciones , Granulomatosis con Poliangitis/complicaciones , Hipertensión/complicaciones , Lupus Eritematoso Sistémico/complicaciones , Vasculitis/complicaciones , Enfermedad Aguda , Lesión Renal Aguda/complicaciones , Adulto , Anticonvulsivantes/uso terapéutico , Antihipertensivos/uso terapéutico , Encéfalo/patología , Encefalopatías/diagnóstico , Encefalopatías/tratamiento farmacológico , Femenino , Humanos , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Imagen por Resonancia Magnética , Masculino , Síndrome , Tomografía Computarizada por Rayos XRESUMEN
STUDY DESIGN: A case report is presented. OBJECTIVE: This report documents one case of intraspinal migration of a metal foreign body. SUMMARY OF BACKGROUND DATA: The migration and penetration of foreign bodies into the spine have been described, but there are only three reports of a needle as the causative object. METHODS: This case report included a chart review, an examination of the patient, and a literature search. RESULTS: The patient successfully underwent surgery, in which the foreign body (a sewing needle) was removed. CONCLUSION: It is important to be aware of the possible delayed penetration of a foreign body into the spine even in patients with few or no symptoms.
Asunto(s)
Vértebras Cervicales/lesiones , Migración de Cuerpo Extraño/complicaciones , Agujas , Traumatismos de la Médula Espinal/etiología , Traumatismos Vertebrales/complicaciones , Adulto , Vértebras Cervicales/diagnóstico por imagen , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/cirugía , Humanos , Laminectomía , Masculino , Traumatismos de la Médula Espinal/diagnóstico por imagen , Traumatismos de la Médula Espinal/cirugía , Traumatismos Vertebrales/diagnóstico por imagen , Traumatismos Vertebrales/cirugía , Factores de Tiempo , Tomografía Computarizada por Rayos XAsunto(s)
Duramadre/cirugía , Duramadre/trasplante , Adolescente , Adulto , Anciano , Cadáver , Niño , Duramadre/lesiones , Fascia/trasplante , Femenino , Liofilización , Humanos , Masculino , Persona de Mediana Edad , Músculos/trasplante , Prótesis e Implantes , Elastómeros de Silicona , Trasplante AutólogoRESUMEN
Subacute measles encephalitis occurred 1 month after measles onset in a 26-year-old HIV-negative man undergoing immunosuppressive treatment for ankylosing spondylitis. He had seizures, a decline in mental status, and progressive impairment of consciousness, with a fatal outcome. Despite severely deficient cellular immunity, the elevated antimeasles antibody titers and CSF findings indicated that humoral immunity was not impaired. Histologic, electron microscopic, and immunocytochemical studies revealed the typical intranuclear inclusions of paramyxovirus nucleocapsids, and measles virus antigen in neurons and oligodendrocytes.
Asunto(s)
Encefalitis Viral/complicaciones , Terapia de Inmunosupresión , Sarampión/complicaciones , Espondilitis Anquilosante/complicaciones , Adulto , Encéfalo/patología , Encefalitis Viral/patología , Humanos , Imagen por Resonancia Magnética , MasculinoRESUMEN
Although the incidence of seizures in neurosyphilis ranges from 14 to 60%, status epilepticus (SE) as a presenting complaint of neurosyphilis is definitely rare. A 44-year-old human immunodeficiency virus (HIV)-negative man with no history of epilepsy suddenly presented with acute mental confusion and was diagnosed as having a de novo complex partial nonconvulsive SE. Cerebrospinal fluid (CSF) findings, neuroimaging, and clinical course indicated that SE was the presenting symptom of an undiagnosed syphilitic meningovasculitis. The case is presented with a review of previous reports to emphasize the differential features and to underscore the importance of considering neurosyphilis among the possible causes of de novo SE.
Asunto(s)
Neurosífilis/complicaciones , Estado Epiléptico/etiología , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Leucocitosis/diagnóstico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neurosífilis/líquido cefalorraquídeo , Neurosífilis/diagnóstico , Estado Epiléptico/sangre , Estado Epiléptico/diagnóstico , Serodiagnóstico de la SífilisAsunto(s)
Anticonvulsivantes/uso terapéutico , Epilepsia Tipo Ausencia/inducido químicamente , Epilepsia Tónico-Clónica/tratamiento farmacológico , Ácido gamma-Aminobutírico/análogos & derivados , Adulto , Anticonvulsivantes/efectos adversos , Asfixia/complicaciones , Daño Encefálico Crónico/complicaciones , Carbamazepina/uso terapéutico , Quimioterapia Combinada , Electroencefalografía , Epilepsia Tipo Ausencia/fisiopatología , Epilepsia Tónico-Clónica/etiología , Epilepsia Tónico-Clónica/fisiopatología , Humanos , Masculino , Fenobarbital/uso terapéutico , Vigabatrin , Ácido gamma-Aminobutírico/efectos adversosAsunto(s)
Presión del Líquido Cefalorraquídeo , Hidrocéfalo Normotenso/fisiopatología , Derivación Ventriculoperitoneal/métodos , Anciano , Femenino , Humanos , Hidrocéfalo Normotenso/cirugía , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Selección de Paciente , Valor Predictivo de las Pruebas , Procedimientos Quirúrgicos Operativos , Resultado del TratamientoRESUMEN
A 52-year-old man presented with sudden onset of severe headache, fever, mental confusion and mild signs of left hemisphere dysfunction. Computed tomographic and magnetic resonance imaging findings suggested a preoperative diagnosis of subependymoma of the left lateral ventricle, which was subsequently confirmed by surgery. The neoplasm could be totally removed and the postoperative clinical course was favourable. The reported case is unusual because symptomatic subependymomas of the lateral ventricle are definitely rare, and almost invariably present with a progressive clinical course over a period of weeks to years.