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Biomedical subjects

A Kertesz

Publications and source records attributed to A Kertesz.

At least 19 recordsLinked to original sources
PubMed1992

Anatomical asymmetries and functional laterality.

Anatomical and functional asymmetries were measured using MRI and dichotic, visual field and hand performance laterality tasks in 104 normal right- and left-handed male and female adults. Comprehensive linear and area measures showed consistently larger brains when handedness and language laterality were in the same direction. Right-handers with left cerebral dominance for dichotic listening and left-handers with right cerebral dominance had larger structures. Hand performance was the strongest functional laterality related to anatomical asymmetries. Left hemisphere dominance on this task was associated with larger right frontal and left occipital widths. Dichotic listening or visual field laterality alone was not associated with contralaterally larger temporal, parietal or occipital measurements. Left visual field dominance for reading, interacting with right-handedness, was associated with wider left parietal width. The complex associations between anatomical and functional asymmetries contribute to individual differences in cerebral organization. The demonstrated association of coincident hand performance and language laterality measures with larger anatomical structures may confer biological advantage. Morphometric analysis in vivo may have increasing importance in interpreting behaviour.

Adult↗
PubMed1991

A factor analysis of the human's corpus callosum.

We have recently developed a computer program for measuring midsagittal sections of the human corpus callosum, similar to one used for the rat. Callosal area, perimeter, axis length, and 99 widths for 104 subjects were entered into a factor analysis in order to define regional clusters. Seven width factors were obtained. Regional widths were found to be sensitive to Sex X Handedness interactions in the anterior body, with right-handed females and left-handed males being larger. In the posterior body males had wider callosa than females. A further analysis within the 'isthmus' region compared consistent and non-consistent right-handed males and females. Consistent right-handed males and both female groups had smaller callosa than non-consistent right-handed males. These findings confirmed the use of consistency of handedness as an important independent variable with respect to human callosal morphology.

Adult↗
PubMed1991

On drawing impairment in Alzheimer's disease.

Spontaneous drawings of 38 patients, diagnosed by the National Institute of Neurological Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria as "probable Alzheimer's disease," and of 39 normal control subjects were analyzed by two independent observers using a standardized scoring system. Drawings of patients with Alzheimer's disease displayed fewer angles, impaired perspective and spatial relations, simplification, and overall impairment compared with those of the control subjects. This represents a combination of the deficits seen following right- and left-hemisphere lesions. Neglect, tremor, and perseveration were not prominent. Drawing impairment was relatively independent of language or memory impairment, but drawing performance was related to perceptual and executive dysfunction in the visuospatial domain. Deterioration was followed up for up to 3 years.

Aged↗
PubMed1991

Corpus callosum: multiple parameter measurements in rodents and humans.

A magnified drawing of a human or a rodent corpus callosum is traced on a digitizing tablet. From this tracing the computer calculates callosal area, perimeter, length, and 99 widths, one for each percentile location along the longitudinal axis of the callosum. In addition, the human program encloses the callosum within a rectangle to obtain several other measures. The use of percentile widths allows one to generate a callosum profile to compare different clinical groups or different species. The human callosum program is compared to one recently reported by another research group.

Algorithms↗
PubMed1991

Dementia with leukoencephalopathy in systemic lupus erythematosus.

Neurologic manifestations, afflicting up to 70% of SLE patients, include psychosis, seizures, chorea, neuropathies, and stroke. MRI is useful in evaluation of lupus patients and several reports have documented cerebral atrophy or focal hyperintensities. We report an unusual MRI appearance in a 56-year-old woman with SLE, diagnosed on the basis of pleuritis, lymphopenia, anti-DNA antibodies, and neurologic involvement. She reported recent onset of Raynaud's phenomenon and generalized macular rash. She presented after two months of gradual deterioration with memory loss, flattened affect, dysphagia, dysarthria, anomia, and somnolence, without focal neurologic signs. Investigations included elevated ESR, reduced complement, normal CSF without oligoclonal bands, negative viral serology, normal hormone and vitamin levels, normal renal and hepatic function. Neuropsychologic testing showed widespread impairment (WAIS-R: FSIQ-63; WMS-69; DRS-98; RCPM-14; WAB AQ-78.8). CT was normal but MRI showed strikingly symmetric, confluent hyperintensities extensively involving cerebral and cerebellar white matter on T1 and T2 weighted scans. Basal ganglia and subependymal and subcortical white matter were spared. Treated with prednisone, the patient made a gradual, but incomplete, recovery. These MRI findings may reflect widespread vasculopathy or direct immunologic brain insult with or without immunologic blood-brain barrier disruption.

Brain Diseases↗
PubMed1990

Sex, handedness, and the morphometry of cerebral asymmetries on magnetic resonance imaging.

Cerebral morphometry of linear measurements and hemispheric, frontal, temporal and parietal areas on MRI of 104 normal adults was analyzed for sex and handedness and right-left differences. The right hemisphere was significantly larger across all groups, but the left frontal width and area was larger in left handers. MANOVA showed separate effects of hand and sex for linear measures; right-handers had larger right anterior frontal, and left parietal and occipital widths. Ratios of L - R/L + R eliminated sex differences related to overall brain size, however, a significant sex-by-hand interaction was shown by the parietal area ratios, indicating larger left side in right-handed males and left-handed females. A 3-dimensional 'torque' was postulated, where the upper and rostral portions of the hemispheres were larger on the right and the lower and caudal parts equal, or slightly larger on the left. The relationship of anatomical asymmetries, sex and handedness is multi-dimensional, and may explain some of the variability of normal cognitive functions and deficits after brain damage.

Adolescent↗
PubMed1990

Cognition and white matter changes on magnetic resonance imaging in dementia.

In a prospective magnetic resonance imaging and cognitive study of 38 demented patients and 15 control subjects, 11 of 27 patients with Alzheimer's disease and 8 of 11 patients with vascular dementia had significant periventricular hyperintensities. Memory and language testing in the early investigation of dementia is useful to distinguish patients with or without periventricular hyperintensities on magnetic resonance imaging. Patients without periventricular hyperintensities are worse on memory and conceptualization tests than patients with periventricular hyperintensities, who tend to be worse on comprehension and attention tests. These differences in cognitive pattern are present between patients with different pathogenesis who are otherwise matched for dementia severity. Language and some nonverbal cognitive deficits correlate with the extent of cortical and ventricular atrophy in Alzheimer's disease.

Aged↗
PubMed1990

Lesion localization in acquired deficits of emotional expression and comprehension.

This study investigated the relationship between intrahemispheric location of lesion and disturbances of emotional expression and comprehension. Twenty-eight right hemisphere strokes, 18 left hemisphere strokes, and 20 controls were examined on a standardized test of the expression, repetition, and comprehension of emotional prosody as well as the visual recognition of emotional situations and faces. The patients were classified into aprosodic syndromes according to the test scores. The lesions were independently traced, and overlapped for each aprosodic syndrome. The results, for lesions in either hemisphere, indicated involvement of the basal ganglia most frequently in aprosodic syndromes followed by anterior temporal lobe and insula lesions. Basal ganglia damage was also seen most frequently in patients with impaired comprehension of emotional facial expressions and situations. The anterior temporal lobe was also frequently involved in patients with such deficits. The basal ganglia emerged as a structure of particular importance in the mediation of emotional expression and comprehension.

Aged↗
PubMed1989

Hemispheric contributions to drawing.

The drawings of 69 consecutive stroke patients with single cerebral lesions on CT and of 33 normal controls, were analyzed by two independent observers using a standardized scoring system. The drawings of left brain damaged subjects (LBD) were more impaired overall than those of right brain damaged subjects (RBD). RBD drawings displayed hemispatial neglect and impaired spatial relationships. LBD drawings were simplified and exhibited low level errors of execution. Lesion size correlated significantly with drawing impairment in RBD but not in LBD. No relationship between intrahemispheric lesion location and drawing quality was found. However, severity of hemiparesis correlated significantly with drawing impairment in LBD. Performance on a visuospatial perceptual task correlated better with overall drawing quality for RBD than for LBD. Our data suggest that neglect and a visuospatial deficit impair drawing in RBD while dominant hand paresis and a conceptual impairment which parallels comprehension impairment contribute to LBD drawing disability.

Aged↗
PubMed1989

Sex equality in intrahemispheric language organization.

Sex differences in inter- and intrahemispheric cerebral organization, found in previous studies, have been used to explain sex differences in cognitive abilities. This study highlights data to contradict such widely held beliefs. Intrahemispheric language organization was examined by determining the location of lesions causing aphasia by computed tomography. No sex differences in the incidence of anterior, posterior, or central lesions was found. The distribution of left-hemisphere lesions in stroke patients, with or without aphasia, was also equal among the sexes. This study does not support the postulated gender difference in intrahemispheric cerebral organization.

Anomia↗
PubMed1989

Abnormalities in iron metabolism in multiple sclerosis.

High iron concentrations have been reported in the brains of multiple sclerosis victims. To determine if there are abnormalities in general iron metabolism indicative of iron overload in MS, measurements of transferrin saturation, serum ferritin and red cell ferritin in 31 female and 18 male patients were compared to the results in 49 age- and sex-matched healthy controls. Compared to controls, mean serum ferritin in MS was high, whereas transferrin saturation and red cell ferritin were similar. High values in one or more individual test results were observed in eleven MS patients. They were prevalent in patients who required bilateral assistance to walk or were confined to a chair, and appeared to be related to the severity of the disease. An investigation was made into the relationship of the high serum ferritin values in MS to the HLA-A3 histocompatibility antigen, a marker of the hemochromatosis gene which is prevalent in MS. A statistically significant interaction was not found between serum ferritin and the presence of HLA-A3.

Adult↗
PubMed1988

Periventricular and subcortical hyperintensities on magnetic resonance imaging. 'Rims, caps, and unidentified bright objects'.

Magnetic resonance imaging hyper-intensities were classified as periventricular rim, caps, and unidentified bright objects (UBOs). These were quantitated in 100 acute stroke and 23 hemorrhage patients and 59 control subjects selected from 590 consecutive scans. The rims, caps, and ventricular size were rated on a scale from 0 to 3 for severity, and the UBOs were counted. The results indicated that the rim is also frequent in control subjects and increases with age. Unidentified bright objects, caps, and severe rims usually signify pathology, occurring much more frequently in patients with strokes and hemorrhages than in control subjects. Hypertension is a significant risk factor in UBOs and caps, but in rims, the incidence of diabetes is higher. The clinical and pathologic significance of these hyperintensities and their relationship to Binswanger's disease, lacunar state, and "état criblé" is discussed.

Acute Disease↗
PubMed1988

Kluver Bucy syndrome with severe amnesia secondary to herpes encephalitis.

The authors present a case of Kluver Bucy syndrome with severe amnesia secondary to herpes encephalitis. The clinical features, neuropsychological test results and magnetic resonance images in this case also elucidate important aspects of limbic system pathology that are discussed in light of the literature.

Adult↗
PubMed1988

What do we learn from recovery from aphasia?

1. Recovery rates are different from outcome measures, and therefore paradoxically positive correlation between the recovery of comprehension and lesion size can be found particularly in Broca's aphasia or in populations that are skewed toward nonfluent aphasics. 2. Outcome, in terms of recovery from aphasia, correlates significantly with lesion size in the expected direction regardless of initial severity for the total aphasic group, but not as much in Wernicke's aphasia. 3. Outcome correlates well with initial test scores, but, particularly in Broca's aphasics, lesion size is as good a predictor as initial severity. 4. The rate of recovery differs in different types of aphasia, and Broca's aphasics recover most. 5. The initial recovery period between 0 and 3 months is significantly steeper than subsequent periods, but it does not correlate as well as outcome with lesion size. 6. Cerebral asymmetry or torque may be less typical in more recovered Broca's aphasics, but this failed to reach statistical significance and seems not be a factor for Wernicke's aphasics. 7. Age and gender are not as significant as lesion size and location. 8. Surrounding intact ipsilateral structures are more important for the recovery of some of the language functions, such as motor output and phonemic assembly, than homologous contralateral structures. Comprehension and semantic processing may have more contralateral or right hemisphere compensation than other language functions.

Aphasia↗
PubMed1987

The effect of magnetic resonance imaging on human cognition.

Potential effects of MRI exposure on aspects of human cognition were investigated out of concern that possible safety hazards associated with the procedure may exist. One hundred and fifty-seven volunteer subjects were randomly assigned to either an imaged, sham-imaged or nonimaged control condition. The following psychological tests were administered in a double blind procedure at pretreatment, post-treatment and follow-up time periods: the Wechsler Adult Intelligence Scale-Revised (Digit Span, Block Design and Digit Symbol), the Wechsler Memory Scale Paired Associate Learning test, the Benton Revised Visual Retention test, the Vandenberg Mental Rotation test, the Sternberg memory scanning paradigm and the State Anxiety Inventory. The overall analysis of results indicated that MRI at 0.15 T has no significant effect upon the cognitive functions assessed.

Adolescent↗
PubMed1987

Comparative classification of aphasic disorders.

This study compares aphasia classification of 20 aphasics who were evaluated with the Western Aphasia Battery (WAB) and the Lisbon Aphasia Examination Battery (LAEB). High correlations were found between tests evaluating the same functions in both batteries. Aphasia types derived from these two batteries showed only a partial overlap. This was due to the use of different numerical diagnostic criteria. When these criteria were used to specify aphasia types of 179 acute and 113 chronic aphasics grouped by cluster analysis, similar discrepancies were noted. Two major differences were found: some LAEB global aphasics turned out to be WAB Broca's and some LAEB anomics were classified as WAB conduction aphasics. These disagreements reflect difficulties in delimiting Broca's and conduction aphasia. The importance of the numerical approach to aphasia classification is stressed, as it is a reliable method to classify aphasic patients in order to allow comparison of data from different centers.

Adult↗
PubMed1987

The sensitivity and specificity of MRI in stroke.

We compared MRI and CT in a study of 175 patients; 87 infarcts within a week, 40 from 1 to 40 weeks, 25 a year after onset, and 23 hemorrhages, 18 within 2 weeks and 5 in 4 to 8 weeks. Fifty-nine infarcts and eight hemorrhages had sequential scanning. MRI is more sensitive than CT in the early detection of cerebral infarcts. CT is the method of choice to rule out intracerebral bleeding, but MRI is more specific in later stages of hemorrhage. Periventricular hyperintensity is seen more frequently with diabetes than without. Hyperintense white matter patches are often unrelated to clinical events. MRI is useful in following the evolution of strokes and distinguishing acute and chronic infarcts without contrast agents.

Aged↗