PubMed Health⌕ Search

Biomedical subjects

C G Gottfries

Publications and source records attributed to C G Gottfries.

At least 19 recordsLinked to original sources
PubMed1997

Confusional State Evaluation (CSE): an instrument for measuring severity of delirium in the elderly.

BACKGROUND: Delirium or confusional state is a common mental disorder in the elderly. To follow changes in symptoms over time and to evaluate the efficacy of treatment of delirium, a reliable and valid instrument for measuring degrees of delirium is essential. METHOD: An observer's rating scale with 22 items, the Confusional State Evaluation (CSE), was developed. Scores on 12 of the items were summarised to a "confusion score". Based on ratings of 71 demented and non-demented elderly patients with delirium, the interrater reliability and validity of the scale was studied. RESULTS: Agreement between two independent raters was fair to excellent (weighted kappa 0.38-0.93). The correlation between the "confusion score" of the scale and the global rating by a psychogeriatrician was good (r = 0.79). CONCLUSIONS: The CSE seems to be a reliable and valid measuring instrument which can be useful in following the course of confusion in elderly patients.

Aged↗
PubMed1997

Increased concentrations of homocysteine in the cerebrospinal fluid in patients with fibromyalgia and chronic fatigue syndrome.

Twelve outpatients, all women, who fulfilled the criteria for both fibromyalgia and chronic fatigue syndrome were rated on 15 items of the Comprehensive Psychopathological Rating Scale (CPRS-15). These items were chosen to constitute a proper neurasthenic subscale. Blood laboratory levels were generally normal. The most obvious finding was that, in all the patients, the homocysteine (HCY) levels were increased in the cerebrospinal fluid (CSF). There was a significant positive correlation between CSF-HCY levels and fatiguability, and the levels of CSF-B12 correlated significantly with the item of fatiguability and with CPRS-15. The correlations between vitamin B12 and clinical variables of the CPRS-scale in this study indicate that low CSF-B12 values are of clinical importance. Vitamin B12 deficiency causes a deficient remethylation of HCY and is therefore probably contributing to the increased homocysteine levels found in our patient group. We conclude that increased homocysteine levels in the central nervous system characterize patients fulfilling the criteria for both fibromyalgia and chronic fatigue syndrome.

Adult↗
PubMed1996

Cholecystokinin peptides and receptor binding in Alzheimer's disease.

Cholecystokinin (CCK) is a peptide that can be found in the cerebral cortex in high concentrations and is involved in learning and memory as well as neurodegenerative processes. Cortical brain samples from 9 patients with Alzheimer's disease and 9 matched control cases were studied with respect to the concentrations of various molecular forms of CCK and the CCK receptor binding characteristics. No differences were found between patients and controls in any of these measures. Significant correlations were found between the concentrations of CCK-8 sulphated and the three nonsulphated CCK peptides measured. In addition, the concentrations of CCK-4 and CCK-5 showed a highly significant and positive correlation.

Age of Onset↗
PubMed1996

Influence of vitamin B12 on brain methionine adenosyltransferase activity in senile dementia of the Alzheimer's type.

The influence of vitamin B12 on the activity of methionine adenosyltransferase (MAT) in postmortem brains of patients with senile dementia of the Alzheimer's type (SDAT) was investigated. In samples of cortex gyrus frontalis from SDAT patients with normal and low levels of serum B12, MAT Vmax was significantly increased by 25% and 19%, respectively. MAT Vmax from a SDAT group chronically treated with B12 was similar to controls. In contrast to cortex gyrus frontalis, no significant alterations were seen in MAT activity in nucleus caudatus. This study provides evidence that SDAT is associated with significant alterations in transmethylation mechanisms in specific regions of the brain. The relationship between blood levels of B12 and the actual status of this vitamin in the brain influencing the rates of synthesis of both methionine and SAM may, however, be far more complex and cannot be directly clarified on the basis of the present human brain results.

Age of Onset↗
PubMed1996

Membrane components separate early-onset Alzheimer's disease from senile dementia of the Alzheimer type.

Brain tissue from 12 subjects with pure Alzheimer's disease (AD) and 21 subjects with senile dementia of the Alzheimer type (SDAT) was investigated for membrane lipids and compared with that in age-matched controls. In brain tissue from the patients with AD, phospholipids were significantly decreased compared with that from SDAT patients and controls, cholesterol was reduced compared with that in controls, and gangliosides were significantly reduced in all gray-matter areas investigated compared with those in both SDAT subjects and controls. A reduction in gangliosides also occurred in the SDAT group, but it was smaller. In the white matter, the pattern of changes was the opposite. Phospholipids, cholesterol, cerebroside, and sulfatide were significantly reduced in the frontal-lobe white matter in the SDAT group compared with that in age-matched controls and AD patients. Gangliosides in the cerebrospinal fluid also separated AD from SDAT and controls. The findings indicate synapse degeneration as an important pathogenetic factor in AD. This disorder should be separated from SDAT, in which white-matter degeneration appears to be more prominent.

Aged↗
PubMed1996

Long-term treatment of elderly individuals with emotional disturbances: an open study with citalopram.

In the present open study, the long-term safety, tolerability, and efficacy of citalopram in the treatment of elderly people with emotional disturbances were studied. One hundred twenty-three elderly patients with symptoms of depression-anxiety were included. Most of the patients (76%) were demented. Fifty-two patients completed a 12-month treatment. Irritability, depressed mood, anxiety, restlessness, and fear-panic were significantly reduced. The severity of illness from baseline to Month 9 was rated as significantly improved. The side effects were infrequent and mostly mild.

Affective Symptoms↗
PubMed1996

Reductions in membrane proteins and lipids in basal ganglia of classic Alzheimer disease patients.

Gangliosides and major membrane components were determined in caudate nucleus, putamen, and hippocampus of 12 cases with Alzheimer disease (AD) type I, also termed presenile or pure AD, and in age-matched controls. The concentration of gangliosides, a marker for axodendritic arborization, was reduced to 71% in caudate nucleus, 82% in putamen, and 66% in hippocampus of that in the controls. Significant diminution of total dry solids, protein, and phospholipids was also found in caudate nucleus and was most pronounced in hippocampus. The early signs of extrapyramidal features have been emphasized in AD type I. We now provide evidence that the neostriatum is affected in AD type I (the putamen, however, to a lesser extent than the caudate nucleus). The biochemical changes in these nuclei can be significantly related to scores of impairment of motor performance.

Adult↗
PubMed1996

Scandinavian experience with citalopram in the elderly.

Depression is a common disorder among the elderly. Its prevalence is estimated at 12-15%. A multifactorial genesis must be considered. Depression in the elderly often manifests itself in an atypical way, with a somatized clinical picture. As tricyclics are generally too toxic for elderly people, the use of selective serotonin reuptake inhibitors (SSRIs) must be considered in this patient group. Citalopram is an SSRI drug with an attractive pharmacokinetic profile, i.e. few side effects and a low potential for interaction with other drugs. In two inter-Nordic studies, this drug significantly improved emotional disturbances in patients with dementia disorders. Significant improvement, with a response rate of 53%, was also seen in elderly people with depression as assessed using the Hamilton Depression Rating Scale. Sixty-six per cent of these patients also suffered from physical illness and had other drug treatment. The drug was well tolerated.

Age Factors↗
PubMed1996

Stepwise comparative status analysis (STEP): a tool for identification of regional brain syndromes in dementia.

A method for clinical examination of patients with dementia, stepwise comparative status analysis (STEP), is presented. It combines psychiatric and neurologic status examination methods to identify certain common dementia symptoms by which the patient's regional brain symptom profile can be determined. Fifty status variables (items) are estimated with respect to occurrence and severity. The analysis is performed in three steps. The scores on the 'primary' variables reflect observations of single dementia symptoms. These scores form the basis for the assessment of the 'compound' variables, which in turn form the basis for evaluation of the 'complex' variables, one of which describes the patient's regional (predominant) brain syndrome (subcortical, frontosubcortical, frontal, frontoparietal, parietal, or global). In 96 mildly and moderately demented inpatients, the global (42%) and frontosubcortical (31%) were the most common. Ninety-one percent of the patients with vascular dementia had a predominant frontal and/or subcortical symptomatology.

Aged↗
PubMed1995

Neuropeptides and Alzheimer's disease.

Numerous neuropeptides have been isolated from the human brain and postulated as neurotransmitter candidates. Their biochemical characteristics and anatomical distribution have been elucidated in some detail, but their possible physiological and pathophysiological roles, as well as their utility as diagnostic markers in brain disorders, have been more difficult to establish. The concentrations of several neuropeptides have been measured in postmortem human brain studies and in cerebrospinal fluid (CSF) of patients with Alzheimer's disease. Here we critically review these findings with focus on: (1) the relation between brain tissue and CSF neuropeptide alterations; (2) the specificity of neuropeptide alterations in Alzheimer's disease in relation to other degenerative brain diseases; (3) possible functional implications.

Alzheimer Disease↗
PubMed1995

Activities of daily living ratings of elderly people using Katz' ADL Index and the GBS-M scale.

Instruments for measuring activities of daily living (ADL) are useful in estimating institutionalized elderly ill people's need of care. The aim of the present study was to investigate to what extent the GBS-M scale measures ADL status, as determined by Katz' ADL Index. Forty-two elderly patients in long-term care in a psychiatric hospital were rated independently using each of the two scales. The correlation coefficient between results of the ratings was r = 0.93, i.e., high scores on one of the scales gave high scores on the other scale. Fifty per cent of severely demented patients had maximal scores on measures of ADL.

Activities of Daily Living↗
PubMed1994

Regulation of the hypothalamic-pituitary-adrenal axis in dementia disorders.

In 163 patients with dementia disorders, subdivided into Alzheimer's disease with early onset (AD; n = 40), senile dementia of the Alzheimer type (SDAT; n = 56), vascular dementia (VAD; n = 45) and dementia of unspecified type (NUD; n = 22) the dexamethasone suppression test (DST) was performed. The patients were rated according to the DSM-III-R criteria as having mild, moderate or severe dementia and were also assessed using the GBS scale which gives a profile of the dementia syndrome. In the total group of dementia there were significant correlations between severity of dementia and post-DST levels. The frequency of pathological DST also correlated significantly with the severity of dementia. In the subgroups of dementia a strong correlation between severity of dementia and high post-DST cortisol levels was found only in the VAD group. Between the subgroups of dementia disorders there were no significant differences in basal cortisol levels. The percentage of pathological DST was lowest in the AD group (40%). It was somewhat higher in the VAD group (49%), still higher in the SDAT group (54%) and highest in the NUD group (59%). When the relationship between post-DST cortisol levels and GBS scores was analyzed, significant correlations were found mainly in the VAD group. There intellectual impairment, anxiety, fear-panic and restlessness correlated significantly with post-DST cortisol levels. The results indicate hypothalamic overactivity in a substantial number of demented patients. In VAD and to a certain extent also in SDAT a disconnection between cortical areas, including the hippocampus, and the hypothalamus is assumed. Overactivity in the hypothalamic-pituitary-adrenal (HPA) axis is due to stress, and an insufficient feedback system leads to chronic stress adaptation failure.

Aged↗
PubMed1994

Evidence for biochemical heterogeneity in schizophrenia: a multivariate study of monoaminergic indices in human post-mortal brain tissue.

A previously performed post-mortem study comparing monoaminergic indices in the brains of 14 schizophrenic patients and 10 patients with psychosis not diagnosed as schizophrenia, with age-matched control cases without any known neuropsychiatric illness, was re-investigated, using multivariate analysis. The monoaminergic patterns showing up in this analysis suggested the existence of at least two different forms of the disease, both of which could be distinguished from the controls as well as from each other. One of the schizophrenic groups consisted of paranoid cases, and had a relatively mild family history, whereas the other group, mainly consisting of hebephrenic cases, had a severe family history. The former group showed low levels of dopamine and high levels of serotonergic precursor and metabolite, whereas the latter group in some respects tended to show the opposite aberrations. Neuroleptic treatment did not seem to account for the different biochemical profiles, unless one assumes that this treatment can cause completely different monoaminergic aberrations in different individuals. Instead, one could argue that the different biochemical profiles found are characteristic of the disease.

Adult↗