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Biomedical subjects

A P Moore

Publications and source records attributed to A P Moore.

At least 19 recordsLinked to original sources
PubMed1997

A prospective survey of the causes of non-traumatic spastic paraparesis and tetraparesis in 585 patients.

OBJECTIVE: To ascertain the relative frequencies of the causes of non-traumatic paraparesis and tetraparesis in adults. DESIGN: Survey of patients enrolled prospectively over a 3 year period between 1986 and 1989 and review of their case notes 1 year after enrollment ceased (mean duration of follow up 30 months). SETTING: Regional neurosciences centre in the UK serving over three million people in Merseyside and North Wales. PATIENTS: Experienced clinicians from the centre saw most patients in the region with non-traumatic spastic paraparesis or tetraparesis. Primary investigation of patients was by myelography, for which patients were admitted to the centre. 585 consecutive patients with spastic paraparesis or tetraparesis were identified by daily screening of all 2104 patients undergoing myelography or radiculography during the 3 year period, ie selection by the intention to investigate them for myelopathy. EXCLUSIONS: age under 15 years, previous myelography for myelopathy. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Numbers and proportions of patients with each condition or category of disease. RESULTS: Commonest diagnoses were cervical spondylotic myelopathy (23.6%), extrinsic neoplastic or developmental tumour (16.4%), multiple sclerosis (9.1% rising to 17.8% after MRI of a selected group), and motor neurone disease (4.1%). Diagnosis was uncertain in 27.4%, falling to 18.6% after MRI. CONCLUSIONS: This survey shows the pattern of diseases producing non-traumatic myelopathy in the Mersey Region and in North Wales. Changing patterns of referral, investigation in peripheral hospitals and by non neurologically trained practitioners, and increasing use of outpatient MRI for primary investigation may make comparable surveys impossible in the future.

Adolescent↗
PubMed1996

Visually and posturally mediated tilt illusion in Parkinson's disease and in labyrinthine defective subjects.

We tested 24 normal subjects, 24 patients with idiopathic Parkinson's disease (PD), and eight patients with bilateral absence of vestibular function (labyrinthine defective [LD] subjects) in their ability to set a straight line to the perceived gravitational vertical (visual vertical). Measurements were taken in static conditions, sitting upright, and lying down on the right side, and during visual background motion at constant angular velocities around the line of sight (roll-motion) in both sitting upright and sideways position. Aims of the study were to determine if the reported increased "visual dependence" in PD was present in a psychophysical task that is independent of motor performance, and to examine the interaction between visual motion and proprioceptive cues in the perception of verticality, in the absence of vestibular function. LD patients showed abnormally large deviations of the visual vertical induced both by lateral body tilt and by visual roll-motion. This suggests that vestibular cues play a significant part in counterbalancing visually and proprioceptive mediated biases on the perception of verticality. In contrast, PD patients were normal in all these tasks indicating that visual dependence in PD is not present at an afferent/perceptual level.

Adult↗
PubMed1995

P300 assessment of chronic fatigue syndrome.

The P3(00) event-related brain potential (ERP) was elicited with an auditory tone-discrimination paradigm in 25 patients diagnosed with chronic fatigue syndrome (CFS) and 25 matched normal control subjects. Target stimulus probability was varied systematically (0.20, 0.50, 0.80) in different task conditions. No differences between the CFS and control subjects were found for either P3 amplitude or latency. No group effects were observed for the N1, P2, and N2 components. Despite the attentional and immediate memory deficits reported in CFS, the P3 ERP from auditory stimuli does not reliably discriminate CFS from matched control subjects.

Acoustic Stimulation↗
PubMed1994

How convincing is the evidence for cognitive slowing in Parkinson's disease?

The issue of whether or not Parkinson's disease (PD) patients process information more slowly than normal is unresolved. Across a range of paradigms the evidence for slowing is scant, and many show no slowing. Even the results of a single experimental paradigm can be conflicting; some studies have obtained evidence for slowed memory scanning in subgroups of PD patients whereas others have not. The present study sought the cause of these discrepant results. Old-old (n = 11) and young-old (n = 7) PD subjects and controls (n = 16, n = 9) completed both fixed and varied set versions of the memory scanning task. No evidence for slowing in PD was found. These results indicated that PD did not interact with age or task version in its effects on information processing rates in the memory scanning task. It was concluded that PD patients do not have any cognitive slowing that is detectable with the memory scanning task.

Aged↗
PubMed1991

Value of a programmed investigation unit: an audit study.

A programmed investigation unit (PIU) was set up in a regional neuroscience centre. Its effects were assessed by measuring the savings associated with one particular investigation, myelography, which accounted for 50% of admissions to the PIU. Substantial savings appear to be possible, but accounting techniques allow wide variations in the estimated amounts. These benefits have to be measured against improvements which occurred simultaneously on the other wards.

Cost Control↗
PubMed1991

A double blind trial of botulinum toxin "A" in torticollis, with one year follow up.

A double blind placebo controlled crossover trial was performed of botulinum toxin "A" in 20 patients with spasmodic torticollis. There was a statistically significant benefit for those treated with toxin; 12 on toxin improved objectively, compared with four on placebo (p less than 0.04). After a follow up period of one year, 16 still seemed to benefit from repeated toxin injections. The main side effect was dysphagia, which appeared to be dose related in individual patients.

Adult↗
PubMed1990

Long-term double masked trial of early treatment with L-dopa plus bromocriptine versus L-dopa alone in Parkinson's disease. Interim results.

The quality and duration of control in two groups of parkinsonian patients under treatment with an L-dopa-based drug alone or L-dopa-based drug which has been partially substituted with bromocriptine are being compared over a 5-year period using a double-blind placebo-controlled study design. The aim is to establish whether early addition of bromocriptine will minimise late L-dopa complications. Results are presented after 1 year. Of 31 patients randomised, 13 were treated with combined L-dopa/bromocriptine and 14 with L-dopa/placebo. 4 patients were withdrawn for various reasons. In both groups any dose adjustments were aimed at maintaining the pre-entry clinical condition. In the group receiving bromocriptine combination therapy, progressive reduction of L-dopa was possible without deterioration of the patients' condition. In patients receiving L-dopa alone, the dose of L-dopa at 12 months was almost similar to that recorded on entry to the study. The total number of patients reporting adverse events in the L-dopa/bromocriptine combination and L-dopa alone groups were 8 and 7, respectively. At the present interim stage of the study it is not possible to compare the incidence of L-dopa long-term complications in either group.

Bromocriptine↗