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Biomedical subjects

G Gatterer

Publications and source records attributed to G Gatterer.

12 recordsLinked to original sources
PubMed1991

Prospective neuropathological validation of Hachinski's Ischaemic Score in dementias.

The sensitivity and specificity of Hachinski's Ischaemic Score (IS) in the diagnosis of the vascular aetiology of dementia was studied in a series of 32 demented patients, dementia of the Alzheimer type (16), multi-infarct dementia (7), mixed dementia (6), Pick's disease (3), with neuropathological diagnosis as the point of reference. The IS distinguished between primary degenerative dementia and multi-infarct or mixed dementia. As single features of the IS "a positive history of stroke" and "a fluctuating course" showed differing prevalences in the latter two diagnostic categories. The IS labelled 21% of patients with primary degenerative dementia as having a vascular aetiology. The uncritical application of the IS to large samples in epidemiological studies may cause incorrect labelling of a significant proportion of patients with primary degenerative dementia as vascular dementia. These results are based on observations of long-term inpatients and depend on neuropathological criteria. While the definite diagnosis of DAT by threshold criteria concerning plaque and tangle counts is well established, neither clinical nor pathological evidence of stroke necessarily means that cerebrovascular disease has anything to do with a patient's dementia.

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PubMed1991

[Alzheimer dementia. A clinical long-term study with quantitative neuropathology].

Alzheimer's disease causes about 80% of dementias in old age. The pathological hallmarks of Alzheimer's disease are senile plaques (SP) and neurofibrillary tangles (NFT), which to a lesser degree can also be found in the brains of mentally intact elderly. The question whether SP or NFT or any other process are primarily correlated to severity of dementia can only be answered in prospective longitudinal clinical and neuropsychological studies with quantitative neuropathological investigation. We report the correlations between mini-mental-state scores and lesion counts in 3 isocortical and 3 hippocampal areas in a consecutive series of 19 Alzheimer's patients studied prospectively in the Vienna Longitudinal Study on Dementia. Lesion counts increased at very late stages of dementia and were rather low in mild to moderate severity of dementia. Mildly demented patients with very slow progression of dementia also had rather high lesion counts. Neurofibrillary changes in NFT and neuritic plaques were correlated with severity of dementia, but diffuse plaques, i.e. SP without neuritic degeneration, were not at all correlated with severity of dementia. We speculate that NFT and SP do not represent the primary process which leads to dementia.

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PubMed1991

[Differential diagnosis of dementia diseases. A prospective clinical study with neuropathologic diagnostic verification].

We present clinico-pathological correlations for a consecutive series of 44 demented patients in the Vienna longitudinal study on dementia. Prospective clinical diagnosis used the DSM-III-R and the NINCDS-ADRDA criteria. Not only the clinical, but also the neuropathological diagnosis of DAT is based on exclusion criteria, and depends on the interpretation of minimal vascular lesions. Although we did not exclude atypical cases from the study, 80% of diagnoses could be validated at autopsy. Nevertheless, our set of clinical criteria needs further validation in patients in the earliest stages of dementia.

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PubMed1990

Memory deficits in advanced Parkinson's disease.

Apart from global dementia various isolated cognitive deficits have been described in Parkinson's disease (PD). We investigated 31 non-demented Parkinsonian patients in their late stages of disease and 50 control subjects with regard to verbal memory. Eleven patients suffered from an isolated verbal memory deficit as defined by two list learning tasks using the Buschke selective reminding procedure. The isolated memory impairment did not depend on depression but was associated with longer duration of PD. Twelve demented PD patients were comparable to PD patients with isolated memory impairment with regard to age at onset and duration of PD. We speculate that the isolated memory impairment in PD is associated with isolated neuronal loss in the nucleus basalis of Meynert, without cortical or limbic pathology of the Alzheimer's type.

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PubMed1990

Course characteristics in the differentiation of dementia of the Alzheimer type and multi-infarct dementia.

Clinico-pathological studies have shown that the clinical diagnosis of multi-infarct dementia (MID) is even more difficult than that of dementia of the Alzheimer type (DAT). The study evaluated the significance of course characteristics for the diagnosis of MID and DAT. Course characteristics were rated when 57 demented patients were admitted to our neurogeriatric department. Diagnosis of MID and DAT, respectively, was established after a follow-up study with repeated neurological, psychiatric and neuropsychological investigations. In 21 cases diagnosis was confirmed by postmortem neuropathology. MID lacked the typical course of the disease in about two thirds of patients, while most DAT patients presented with the typical course of primary degenerative dementia. Features of the "typical" clinical course of MID (abrupt onset, stepwise deterioration) helped to exclude DAT, whereas MID could not be excluded on the basis of a history of insidious onset and gradual decline.

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PubMed1988

Nonspecificity of semantic impairment in dementia of Alzheimer's type.

Two psychometric tests designed to evaluate "verbal fluency" and "naming" as a measure of semantic memory were presented to 18 patients with Alzheimer's-type dementia, 16 other patients with multi-infarct dementia, and 14 age-matched control subjects. The diagnosis of multi-infarct dementia and Alzheimer's-type dementia was based on the commonly accepted criteria of the Diagnostic and Statistical Manual of Mental Disorders, ed 3. Although the patients with Alzheimer and multi-infarct dementias, respectively, suffered from a comparable degree of dementia (as determined by the Mini-Mental State examination), semantic memory was not specifically impaired in Alzheimer's-type dementia as opposed to multi-infarct dementia. In contrast semantic memory was correlated with the degree of dementia in both disease entities.

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PubMed1987

[Panic attacks and cardiac phobia].

In this study 36 patients with cardiac phobia were examined prior to hospitalisation and 29 of them were re-examined after 2.5 years. An analysis of the clinical pictures showed that all of the patients met the DSM III criteria for panic disorder. The follow-up results indicated that the anxiety attacks often recurred despite treatment; on the other hand, the patients felt significantly less threatened by the symptoms and consequently showed less help-seeking behaviour. The attack symptomatology was characterized by a uniform picture and thus played, at best, a limited role in predicting the course of the illness. According to DSM III cardiac phobia is listed under the somatoform disorders as hypochondriasis; this seems to be an unfortunate decision and ought to be revised.

Adolescent↗
PubMed1986

[Behavior medicine intervention strategies in nursing home patients with manifestations of dementia of multiple origins].

The present study is an attempt to throw light on the possibilities and scope of different therapeutic applications concerning geriatric patients. Guide-lines are presented for the absolving of general animation programmes as well as also a specific "training in realism, orientation and memory" to modify the symptoms of chronic brain syndromes. First results show that with both intervention strategies a better integration of demented patients is possible in the department. Furthermore some improvements in the cognitive area can be attained by means of selective training.

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PubMedDate not supplied

[The Geriatric Concentration Test and correlations with intelligence, memory ability, orientation and professional assessment in geriatric patients between 60 and 85 years of age in a nursing home].

In view of the lack of standardised psychometric procedures in establishing the cerebral efficiency of geriatric patients, it was attempted to develop an aptitude test for this group of patients. The "AUT" was tested on 140 patients at the 1st Medical Department of the Vienna-Lainz nursing home. The values examined, such as completion time, number of correctly cancelled figures, mistakes, as well as the combined result total amount and error percentage correspond, with regard to objectivity and reliability, with the requirements of psychometric procedures. Initial findings show the test to be a good indicator of "general cerebral efficiency" of those questioned, but it is to be noted that most of all the varying ability to concentrate, ability to remember, intelligence, orientation, activity and independence have an influence on the test results.

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PubMedDate not supplied

The A-K-T ("Alters-Konzentrations-Test") a new psychometric test for geriatric patients.

The A-K-T is a newly developed concentration test for geriatric patients. First results in demented patients show the test to be a good indicator of severity of dementia. Since the method is non-verbal, it can be applied to aphatic patients too. But, comparing results of patients suffering either from dementia of Alzheimer's type, multi-infarct dementia or Parkinson's disease with dementia, we are not able to objectify specific deficits of a certain dementing disease.

Aging↗
PubMedDate not supplied

Semantic memory in DAT, MID and parkinsonism.

Previous studies found the semantic system particularly affected in Dementia of Alzheimer's Type (DAT), which would have important implications for the clinical diagnosis of this disease. We compared 14 non-demented parkinsonian patients and 14 controls on one hand and demented patients suffering from multi-infarct dementia (n = 17), DAT (n = 18) and Parkinsonism + dementia (n = 7) on the other. Demented groups were well matched regarding severity of dementia. Two tasks of semantic memory (naming, word fluency) did not differentiate within demented groups, but were correlated with severity of dementia.

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