A unified form for neurological scoring of hemispheric stroke with motor impairment.
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Cerebrovascular Disorders↗
Biomedical subjects
J M Orgogozo
Publications and source records attributed to J M Orgogozo.
Occupation during life and memory performance in nondemented French elderly community residents.
Using data obtained during the baseline screening of the PAQUID cohort, an epidemiologic study on brain aging conducted in the Bordeaux area of France, we studied the relationship between lifetime occupation and memory performance in visual recognition (Benton Visual Retention Test; BVRT) and verbal induced recall (Wechsler Paired Associates Test; WPAT) in 2,720 elderly community residents. Occupational category was strongly correlated with poor memory performance for both the BVRT and the WPAT. Independent of the educational level, the risk of having poor memory performance was two to three times greater for farmers, domestic service employees, and blue-collar workers than for professionals/managerials. Occupational category should be taken into account in future cross-national studies on brain aging.
Aged↗
[Pilot study of Ginkgolide B, a PAF-acether specific inhibitor in the treatment of acute outbreaks of multiple sclerosis].
Ten patients with relapsing-remitting multiple sclerosis in acute relapse were treated with a five-day course of intravenous ginkgolide B, a specific inhibitor of PAF-acether. Eight patients had improvement of their neurological score, beginning 2 to 6 days after the initiation of therapy. This improvement was sustained in 5 patients and only transient in 3. Two out of these 3 patients with secondary failure and the other 2 who did not respond to ginkgolide therapy, received i.v. methylprednisolone. Three patients experienced mild side effects under ginkgolide therapy but none of the patients had any serious adverse effect. A controlled randomized study is underway, in order to confirm these results and test higher dosages and more prolonged administration.
Adult↗
Death and functional outcome after spontaneous intracerebral hemorrhage. A prospective study of 166 cases using multivariate analysis.
Using death and functional status as end points, we prospectively analyzed the outcome 6 months after spontaneous intracerebral hemorrhage in 166 patients admitted to an acute-care stroke unit on the first day of their stroke. Seventy-one patients (43%) died, 69 (42%) had a satisfactory outcome, and 26 (16%) had a poor functional outcome. Early (30-day) survival was correlated with morphologic parameters on the initial computed tomogram (hemorrhage size, midline shift, and intraventricular spread of the hemorrhage), while later (6-month) survival was correlated with age. Using logistic regression, we found five independent predictors of satisfactory outcome at 6 months: age, hemorrhage size, intraventricular spread of the hemorrhage, limb paresis, and communication disorders. Of these, age was the most important predictor by far.
Adult↗
Validity of the Mini-Mental State examination as a screening instrument for cognitive impairment and dementia in French elderly community residents.
A survey was made of 2,792 subjects aged 65 and older living in the community of Gironde (South-Western France). The predictive value of the Mini-Mental state examination (MMS) as a screening instrument for the detection of cognitive impairment was tested against DSM-III criteria for dementing syndromes. Of the 2,792 subjects who consented to participate in the study, 101 met the DSM-III criteria for dementia, giving a 3.62% prevalence rate. With an MMS threshold of 24, the sensitivity was 100%, the specificity was 78%, and the positive predictive value was equal to 15%. Using the same MMS threshold, 572 subjects (85%) were false-positive for the diagnosis of dementia. A multiple logistic regression analysis revealed that age, sex, depressive symptomatology and educational level were independently correlated with false-positive cases of the MMS. Several issues are raised for using the MMS as the only screening instrument for cognitive impairment in elderly community residents.
Aged↗
Reliability of clinical criteria for the diagnosis of dementia. A longitudinal multicenter study.
The reliability of the clinical diagnosis of dementia was estimated by comparing the diagnosis made at 1-year intervals on 55 consecutive subjects with suspected cognitive impairment seen at three different centers by neurologists and gerontologists. The diagnosis was based on history and clinical examination, the criteria of the Diagnostic and Statistical Manual of Mental Disorders (revised ed 3), the Modified Ischemic Score, and a computed tomographic scan. Fifty-two of 55 subjects were given the same diagnosis a year later indicating a reliability of 95%. The study shows that a diagnosis of dementia established by simple clinical criteria comparable to the NINCDS/ADRDA criteria affords sufficient reliability to allow the comparability of groups at different centers for purposes of research, including research on the evaluation of the efficacy of pharmacologic treatment.
Aged↗
Identification and characterization of anti-conjugated azelaic acid antibodies in multiple sclerosis.
Human sera from patients with multiple sclerosis (MS) were tested using an enzyme-linked immunosorbent assay (ELISA) method on well plates coated with various dicarboxylic acid (C4 to C10) protein conjugates. Specific immunological binding was found with an azelaic acid (AzeA, C9) conjugate. The antibody titer was higher in the sera from the patients in acute relapse than with the progressive form, and higher than that from sera of patients with other neurological diseases and healthy subjects. Modifications of coating concentrations and of antibody dilutions, and experiments with preadsorption enabled determination of binding specificity. Competition experiments with related conjugates demonstrated that the AzeA residue was 167 times better recognized by antibodies from MS patients in acute relapse than those from controls. The suberic and sebasic acid conjugates which only differ from the AzeA conjugate by one methylene group were less well-recognized by MS sera (11 and 47 times, respectively) than the conjugate AzeA-BSA.
Antibodies↗
Predictors of non-bedridden survival in dementia.
The present study examined non-bedridden survival in 105 patients diagnosed as demented (Alzheimer's disease, multi-infarct dementia, mixed dementia) in a neurological ward. Follow-up observations were made. During the first year, the cumulative mortality rate was 69% compared to a rate of 44% in the second year. The initial disability stage, as assessed by the Dementia Disability Scale, was found to be the only significant predictor of non-bedridden survival. The type of dementia, age, type of diagnosis, and post-hospitalization placement in an institution have not been found to be significant predictors of this evolution.
Adult↗
[Cerebral embolism of cardiac origin].
Embolisms of cardiac origin represent approximately 15 p. cent of the causes of cerebral vascular accidents. This article considers the difficult diagnostic and therapeutic problems raised by cerebral embolisms. First: arguments permitting to suspect this mechanism in the absence of an obvious cardiac cause or in the presence of a high incidence heart disease but low embolic potential. The main etiologies are then reviewed emphasizing the evolution of their respective frequencies, then a program of additional investigative examinations is suggested. Finally the indication of anticoagulants is discussed according to neurological and cardiologic criteria.
Heart Diseases↗
[Anti-acetylcholine and anti-receptor antibodies in myasthenia].
The presence of anti-acetylcholine antibodies has been demonstrated in 24 patients with myasthenia gravis. Their titer was moderately but significantly higher than in controls. There was no significant correlation between the titer of these anti-acetylcholine antibodies and the clinical severity of the disease or the titer of anti-receptor antibodies in the same patients. Several populations of antibodies are present in myasthenia gravis according to an idiotype-anti-idiotype process, reflecting the complexity of immune reactions.
Acetylcholine↗
Natural seric anti-fatty acid antibodies in multiple sclerosis.
Naturally occurring anti-oleic acid conjugate antibodies were detected in human sera using an adapted direct immunoenzymatic assay. They were present to a higher level in the sera of patients with multiple sclerosis in acute relapse compared to patients with other neurological diseases or healthy subjects and even patients with multiple sclerosis in progressive form.
Adult↗
Anti-acetylcholine antibodies and the pathogenesis of myasthenia gravis.
Using an ELISA system, antibodies recognizing conjugated acetylcholine (ACh) were detected in sera of patients suffering from myasthenia gravis. The mean antibody level was three times higher in sera from myasthenic than from control patients. No correlation was found between anti-ACh antibody levels and anti-ACh receptor (AChR) titer. Also, the anti-ACh antibody titers were independent of sex and age of patients. Competition experiments demonstrated that the most immunoreactive compounds were choline-glutaryl-bovine serum albumin (BSA) and choline-succinyl-BSA. Antibodies present in the sera of myasthenic patients recognized an antigenic determinant mimicking conjugated ACh. The antibody affinity and specificity were sufficiently high for the detection of ACh in locust brain.
Acetylcholine↗
Critical review of clinical trials in senile dementia--I.
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Central Nervous System Stimulants↗
Critical review of clinical trials in senile dementia--II.
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Clinical Trials as Topic↗
[Indications for the long-term electrocardiogram and echocardiogram after a cerebral ischemia complication].
Ninety patients admitted to a neurology unit for cerebral ischaemic accident without evidence of embolism from the heart were examined by ambulatory electrocardiographic monitoring (AEM) and by echocardiography assessable in 76 cases. On the basis of a standard cardiac evaluation (SCE) including physical examination, chest radiography and electrocardiography, the patients were divided into 3 groups: 42 with normal SCE (group I), 19 with isolated arterial hypertension (group II) and 36 with patent cardiac disease (group III). Significant abnormalities were detected by AEM in 10.5% of group I patients, 18.5% of group II patients and 33% of group III patients. A structural cardiopathy was discovered at echocardiography in 33%, 62% and 91% respectively of patients in these 3 groups. The greatest number of mitral valve prolapses (7/9 cases) was found in group I. The main echocardiographic abnormality detected in group II was dilatation of the left cardiac cavities: atrium more than 38 mm in 8 cases, ventricle more than 50 mm in 3 cases. Comparisons between the two explorations showed that arrhythmias were often associated with dilatation of the left cardiac cavities (39%) and much less frequently with mitral valve prolapse (11%) and myocardial hypertrophy (16%). Our results suggest that when examinations cannot be routinely performed in hospital patients with a cerebral ischaemic accident echocardiography should be reserved to patients with heart disease or hypertension, and AEM to those with heart disease or hypertension and with dilatation of the left cardiac cavities.
Adult↗
Detection of anti-acetylcholine antibodies in myasthenic patients.
Antibodies, directed against an acetylcholine (ACh) conjugate, were found in the sera of myasthenic patients by using a modified enzyme-linked immunosorbent assay method. Binding of sera from control patients to the conjugate was extremely low. From competition experiments, done with compounds close to ACh, a good antibody specificity for the ACh conjugate was demonstrated in the sera of myasthenic patients. Laboratory tests will be done to help a more precise diagnostic of the disease to be given. These results may also be of value in further understanding of the process of the disease itself.
Acetylcholine↗
Reversible cerebral arteriopathy associated with the administration of ergot derivatives.
Three cases of intracranial arteriopathy associated with the administration of ergot derivatives are reported. In the first case, excessive doses of dihydroergotamine and of ergotamine tartrate seemed to be the cause, but simultaneous treatment with an antibiotic and the existence of a cytomegalovirus infection could have favoured the arteriopathic process. The second patient also received excessive doses of these two drugs, but in addition she was taking oestrogen and progesteron containing contraceptives. In the third case, an intravenous injection of methylergometrine in a dose of 0.2 mg seemed to have initiated the arteriopathy. Arteriograms were comparable in all three cases, with segmental stenosis of several cerebral arteries, whereas internal carotid and vertebral arteries remained normal. In the first case a control cerebral arteriography was normal one month later. These findings suggest that widespread cerebral arteriopathy can appear in subjects who chronically abuse ergotamine tartrate.
Adult↗
[Partial epilepsies of adolescence with computer tomography abnormalities, localized astrocytic reaction and spontaneously remitting course].
Four teenagers with partial epileptic seizures presented focal cortical enhanced CT scan images. Angiographies were normal. Stereotactic biopsies revealed astrocytic proliferation. CT scan abnormalities diminished or vanished in some months. On long-term follow-up seizures were either less frequent or disappeared. None of the possible aetiologic hypotheses (astrocytoma, encephalitis, sarcoidosis, multiple sclerosis, vascular malformation) was fully satisfying. Nevertheless, a regressive evolution observed in these four patients demonstrates that acquired epileptogenic lesions during adolescence are not always of poor prognosis.
Adolescent↗