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Biomedical subjects

B Croisile

Publications and source records attributed to B Croisile.

At least 19 recordsLinked to original sources
PubMed2003

[Routine clinical diagnosis of primary progressive non-fluent aphasia].

It may be difficult to distinguish between a primary progressive aphasia at a very mild stage from the beginning of Alzheimer's disease (AD). However, this may be achieved by carrying out simple neuro-psychological tests. Nine non-fluent PPA (NFPPA) and 76 AD patients with comparable MMSE as well as 58 control subjects were evaluated using simple tests: MMSE, fluency, apraxia, naming, digital span, story memory, 5 words memory test. NFPPA patients had significantly impaired functions during the semantic category fluency and naming tests as compared to AD patients, whereas they showed a better delayed recall of the 5 words and story memory tests. As compared to AD, MMSE of NFPPA patients was also better in the time orientation and word recall sub-tests, although inferior in words repetition and language items. Thus, with comparable MMSE, NFPPA patients have more lexico-semantic difficulties, but a better delayed verbal memory than AD patients. These simple tests easily confirm the language impairment of NFPPA patients as opposed to the mnestic difficulties of AD, even at very early stages of these pathologies.

Adult↗
PubMed2001

Rating of different olfactory judgements in Alzheimer's disease.

Using simple successive tasks we assessed the influence of Alzheimer's disease on the processing of different odours. Fifteen patients with Alzheimer's disease, 15 old control subjects and 15 young control subjects were tested. The experiment included two sessions. Initially 12 odorants were presented, one odorant every minute. For each odour the subjects were asked to rate intensity, pleasantness, familiarity and edibility using linear rating scales. The odorants were then presented a second time and the subjects were asked to identify them. The results show that the intensity scores were lower in old control subjects and Alzheimer patients than in the young control subjects and that familiarity and identification scores were lower in Alzheimer patients than in old control and young control subjects. When we compared the five olfactory tasks the impairment of performance in Alzheimer patients was relatively higher for identification than familiarity, itself higher than the intensity judgement. No difference was observed between the three groups of subjects for pleasantness and edibility judgements.

Adult↗
PubMed2000

Total recovery after bilateral paramedian thalamic infarct.

Bilateral paramedian thalamic infarcts are characterised initially by the association of acute vigilance disorders and vertical gaze palsy, followed by persisting dementia with severe mnemic disturbance, global aspontaneity and apathy. We describe a patient with a dramatic neuropsychological recovery, confirmed by testing examination and completed by a cerebral metabolism study. The pathophysiology of this type of cognitive deficit is discussed.

Akinetic Mutism↗
PubMed1999

The relation of putamen and caudate nucleus 18F-Dopa uptake to motor and cognitive performances in Parkinson's disease.

The contribution of striatal (caudate nucleus-putamen) dopaminergic deficiency to the severity of motor signs is well established in Parkinson's disease (PD), while its role in the occurrence of cognitive and mood changes remains unresolved. We therefore measured in 27 non-demented PD patients and 10 age-matched controls striatal uptake of [18F]-6-fluoro-L-Dopa (F-Dopa) with PET, and mood (Beck depression), memory (Grober-Buschke), frontal executive functions (verbal fluency and Wisconsin card sorting), and attentional processing of sensory stimuli (N2-P3 auditory event-related potentials--ERPs). Locomotor disability of patients was assessed by Hoehn and Yahr score and Unified Parkinson's Disease Rating Scale (UPDRS). ANOVA showed that memory, but neither frontal lobe functions nor ERPs, was significantly altered in PD patients, whereas indices of depression were found only in advanced PD. The F-Dopa rate constant Ki was significantly reduced in the striatum, more in putamen than caudate nucleus, and inversely correlated with disease duration. A significant inverse correlation was found between both putamen and caudate nucleus Ki and Hoehn and Yahr score, and between putamen--but not caudate nucleus Ki --and UPDRS motor score. Principal components analysis (PCA) of PD patients Ki values and mood, cognitive and ERP parameters gave a three-factor solution. Variables contributing to factor 1 were memory score and N2-P3 ERP latencies, those to factor 2 were striatal Ki values, and those to factor 3 frontal executive performances. Depression did not segregate with any variable. Our findings suggest that unlike locomotor disability, cognitive abilities and mood state of non-demented PD patients are for the most part unrelated to striatal dopaminergic depletion and may result from dysfunction of extra-striatal dopaminergic or from non-dopaminergic systems.

Adult↗
PubMed1996

Comparative study of oral and written picture description in patients with Alzheimer's disease.

Oral and written picture descriptions were compared in 22 patients with Alzheimer's disease (AD) and 24 healthy elderly subjects. AD patients had a significant reduction of all word categories, which, similarly to controls, was more pronounced in written than in oral texts. They also reported fewer information units than controls, but without task difference. At the syntactic level, written descriptions of AD subjects were characterized by a diminution of subordinate clauses and a reduction of functors. More grammatical errors were present in written descriptions by AD and control subjects. AD and control groups produced an equivalent number of semantic errors in both tasks. However, in oral description, AD patients had more word-finding difficulties. In sum, AD descriptions were always shorter and less informative than control texts. Additionally, written descriptions of AD patients appeared shorter and more syntactically simplified than, but as informative as oral descriptions. Whereas no phonemic paraphasias were observed in either group, AD patients produced many more graphemic paragraphias than controls produced. Furthermore, written descriptions had more irrelevant semantic intrusions. Thus, as compared to oral descriptions, written texts appeared to be a more reliable test of semantic and linguistics difficulties in AD.

Aged↗
PubMed1996

Comparison between oral and written spelling in Alzheimer's disease.

Written and oral spelling were compared in 33 patients with Alzheimer's disease (AD) and 25 control subjects. AD patients had poorer spelling results which were influenced by orthographic difficulty and word frequency, but not by grammatical word class. Lexical spelling was also more deteriorated than phonological spelling. Moreover, oral spelling was more impaired than written spelling in AD patients, whereas no difference was present between oral and written spelling of controls. Analysis of spelling errors showed that, for controls, errors were predominantly phonologically accurate in both spelling tasks. Significantly, AD patients produced more phonologically accurate than inaccurate errors in written spelling, whereas these errors did not differ in oral spelling. In contrast to controls who produced more constant than variable responses in oral and written spelling, AD patients made more variable responses (words correctly spelled in one task but incorrectly in the other) and they showed many instances of variable errors (different misspellings from one spelling task to the other). Two stepwise regression procedures showed that written misspellings were specifically correlated with language impairment, whereas oral spelling errors were correlated with attentional and language disorders. These results suggest that AD increases the attentional demands of oral spelling process as compared to written spelling. This dissociation argues, either for a unique Graphemic Buffer in which oral spelling requires more attentional resources than written spelling or for the hypothesis of separate buffers for oral and written spelling.

Aged↗
PubMed1996

A phase II trial of fotemustine and cisplatin in central nervous system metastases from non-small cell lung cancer.

A phase II study was conducted in order to determine the feasibility and toxicity of cisplatin combined with the nitrosourea fotemustine in central nervous system metastases from non-small cell lung cancer. 31 chemotherapy-naïve patients were included between November 1990 and April 1993. Computed tomography scan-documented tumour regression in brain metastases was observed in 7 of the 25 evaluable patients, but only 4 of these (16%) lasted more than 4 weeks. In 2 of these 4 patients, the response on central nervous system metastases was considered as complete. The median duration of response was 20.5 weeks and the median survival was 16 weeks overall and 28.5 weeks for responding patients. The limiting toxicity of this regimen was haematological. 2 patients died from infectious pneumonitis while in neutropenia. Treatment delays due to haematological toxicity occurred in 57% of patients. Despite the rather encouraging response rate, such toxicity appears too high when compared to the overall bad prognosis of this population of patients. Cranial radiotherapy remains the standard treatment in this setting and should only be compared in the future to less aggressive schedules.

Adult↗
PubMed1995

[Progressive lupus dementia. 2 cases with or without antiphospholipid antibodies].

Two cases of lupus dementia presented many points of particular interest: 1) the progressive installation of intellectual deterioration, inaugural for the first observation; 2) the diagnostic difficulties of neurolupus with the ARA criteria; 3) the appearance of cerebral magnetic resonance imaging with confluent hypersignals of the periventricular white matter on T2-weighted images; 4) the patholophysiological hypotheses: vascular disease? immunologic disease?; 5) the clinical improvement and SPECT amelioration for the second patient with corticosteroids.

Antibodies, Antiphospholipid↗
PubMed1994

Striatocapsular infarction: MRI and MR angiography.

We present a case of left striatocapsular infarction manifest clinically as a transient right hemiparesis. MRI showed a left striatocapsular infarct. Striatocapsular infarction, unlike lacunar infarction, is often associated with occlusive disease of the carotid artery. In order to screen the carotid vessels, cervical MR angiography (MRA) was performed during the same examination, demonstrating a left internal carotid artery occlusion, confirmed by contrast arteriography. MRA, a noninvasive modality, can be a useful adjunct to MRI, when diagnostic information concerning the cervical carotid artery is needed.

Adult↗
PubMed1993

Idiopathic intracranial hypertension after ofloxacin treatment.

We report the occurrence of idiopathic intracranial hypertension in a patient treated with ofloxacin, a fluoroquinolone antimicrobial agent, for 16 months. The withdrawal of ofloxacin and acetazolamide therapy were followed by a complete recovery of visual function.

Acetazolamide↗
PubMed1993

Long-term and high-dose piracetam treatment of Alzheimer's disease.

Preclinical research suggests that piracetam (a nootropic drug) may improve cognitive functions, but previous studies have failed to demonstrate a clear benefit for the treatment of Alzheimer's disease (AD). We report a 1-year, double-blind, placebo-controlled, parallel-group study with a high dose of piracetam (8 g/d per os) in 33 ambulant patients with early probable AD. Thirty subjects completed the 1-year study. No improvement occurred in either group, but our results support the hypothesis that long-term administration of high doses of piracetam might slow the progression of cognitive deterioration in patients with AD. The most significant differences concerned the recall of pictures series and recent incident and remote memory. The drug was well-tolerated.

Aged↗
PubMed1993

[Arnold-Chiari malformation in adults. Development of diagnostic conditions since the availability of MRI].

We reviewed retrospectively 47 patients with a Chiari malformation (CM) who had been admitted to the Clinique de Neurologie of Lyon from 1971 to 1991. The purpose of this report is to assess the possible influence on the frequency and the clinical pattern at presentation of CM since 1985 when Magnetic Resonance Imaging (MRI) became available to us. A diagnosis of CM was made for 21 patients before 1985 (group 1) and for 26 patients thereafter (group 2), i.e., a 2.5 increase of incidence of CM frequency (1.5 patients/year before 1985 vs 3.7 patients/year thereafter). This increase was even more striking for cases without syringomyelic symptoms and signs (SSS) (42.9% in group 1, vs 76.9% in group 2). The accuracy of clinical diagnosis was 68.1% for the total surveyed period (90.5% before 1985 and 50% thereafter). For cases with SS at presentation, a syringomyelic cavity was radiologically demonstrated in 80% of the cases in the pre-MRI period and 90.9% of the cases since MRI was available. On the other hand, when a syringomyelic cavity was radiologically demonstrated, there was a related clinical SS in 70% of group 1 patients and 50% of group 2 patients.

Adolescent↗
PubMed1992

Progressive amusia and aprosody.

We report a case of slowly progressive amusia and aprosody in association with orofacial and eyelid apraxias. The patient was independent in daily living activities. Insight, judgment, and behavior were intact. Her language was normal, and she demonstrated no limb, dressing, or constructional apraxia. She had no prosopagnosia, no visuospatial disturbances, and no memory impairment. Imaging studies (computed tomography, magnetic resonance imaging, single photon emission computed tomography) indicated a selective disorder of the right frontal and temporal regions. Review of the literature shows an increasing number of reports of this degenerative syndrome affecting the left dominant hemisphere and language areas, whereas cases of the syndrome affecting the right hemisphere are rare. To our knowledge, this is the first case in which aprosody and amusia were associated with a focal cortical degeneration.

Brain↗
PubMed1992

[Cerebral metastasis disclosing primary bronchogenic cancers].

We report the cases of 37 patients with carcinoma of the lung revealed by brain metastases. The most frequent clinical manifestation was focal neurological symptoms associated with headache and vomiting in 50% of the cases. X-ray films of the chest were abnormal in 34 patients. At the time of diagnosis 11 patients also presented with extra-cerebral metastases. The histological type of the primary lung tumor was obtained by examination of the thorax in 32 cases and in 5 cases from brain or lymph node metastases: 11 patients had small-cell lung carcinoma and 26 had non small-cell lung carcinoma. The overall actuarial median survival was 4.5 months, irrespective of the histological type. The group of 20 patients who underwent neurosurgery had a longer median survival (10 months versus 4.5, p < 0.05), and in the subgroup where brain and lung resections were combined the median survival was even longer (13 months). Cerebral relapses occurred in 12 patients: in 7 out of 15 patients with brain surgery but without adjuvant brain radiotherapy, and in 5 out of 16 patients with brain radiotherapy without neurosurgery. No cerebral relapse was observed in the group of 5 patients who had complete resection followed by radiotherapy of the brain. This demonstrated a clear benefit from postoperative radiotherapy. Conventional chemotherapy induced objective responses only in the small-cell carcinoma group and could be too toxic when combined with simultaneous radiotherapy, but it proved a useful adjuvant treatment in patients with radiotherapy of the brain.

Brain Neoplasms↗
PubMed1992

Progressive cognitive disorders due to focal cortical atrophy.

Aphasia is a common feature of dementia of the Alzheimer type (DAT) in association with behavioural change and other cognitive abnormalities. The clinical syndrome of primary progressive aphasia corresponds to the gradual onset and worsening of language dysfunction in patients who otherwise remained independent for many years in daily living activities, insight, judgement and behaviour. Characteristically, memory and other neuropsychological functions are relatively spared. Brain imaging studies indicate cortical atrophy of the left temporal region, and measures of regional cerebral metabolism show localized deficit in the corresponding region. Other progressive focal disorders due to degenerative cortical diseases have been also reported. In each case, localized atrophy and hypometabolism were observed, depending on the nature of the neuropsychological deficit. The underlying histology of focal cortical degeneration is heterogeneous, suggesting that these slowly progressive disorders represent either atypical variants of DAT or Pick's disease, or distinct neurological entities characterized by spongiform change and astrocytic gliosis.

Alzheimer Disease↗