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Biomedical subjects

K D Wiedmann

Publications and source records attributed to K D Wiedmann.

5 recordsLinked to original sources

Cognitive function in adult epileptic patients established on anticonvulsant monotherapy.

A battery of psychometric tests was administered to 110 patients with epilepsy and to 24 non-epileptic controls. Eighty-four patients had been established on treatment with a single anticonvulsant drug (35 carbamazepine (CBZ), 30 sodium valproate (VPA), 19 phenytoin (PHT)) at unaltered dosage for the previous 3 months. The remaining 26 patients were untreated at the time of study. No individual test discriminated between the groups. Tests were converted to standard scores and summated to give overall psychomotor, memory and side-effect assessments. There were no important differences between the performances of untreated epileptic patients and non-epileptic controls. The CBZ-treated patients had poorer psychomotor scores than both control groups and the VPA-treated patients (all P less than 0.05). The PHT patients scored less well on the composite memory scale than did VPA patients and non-epileptic controls (both P less than 0.05). There were no significant differences in subjective side-effects among the groups. This study demonstrated that anticonvulsant monotherapy has little effect on overall cognitive function in patients tolerating treatment. Psychomotor performance appeared to be selectively influenced by CBZ and memory impaired by PHT. VPA may be the drug to chose when cognitive function is an important consideration. Different cognitive modalities can be affected by different first-line anticonvulsants and this should be taken into account when choosing the most appropriate drug for an individual patient.

Adolescent

Visual event perception in alcoholics.

A series of microcomputer-based procedures were devised to investigate the ability of alcoholics to detect and locate rapid visual changes, and to assess deficits of visual processing in this patient population. Forty alcoholics were tested 7-13 days after cessation of drinking (mean period of abstinence = 9.5 days), and 24 were retested 2-3 weeks later (mean abstinence = 27.8 days). In comparison to a matched control group the alcoholics were impaired on initial testing at locating visual events. Alcoholics also had significantly slower movement times in a visual-choice reaction time task, and were slower on visual search. At retest the alcoholics were impaired on one of the event perception tasks. Alcoholics were not impaired initially on a measure of visual memory span but were impaired at retest, possibly due to a learning deficit. It is concluded that alcoholics show a persisting deficit in the ability to notice and locate rapid visual changes, together with a transitory impairment on timed tasks requiring visually guided movement.

Adult

Early and late magnetic resonance imaging and neuropsychological outcome after head injury.

Twenty five adults with closed head injury who had early magnetic resonance imaging (MRI) and computed tomography (CT) were followed up 5 to 18 months after injury. Patients were given a repeat MRI and performed a series of neuropsychological tests. They were classified by the deepest abnormality detectable on scanning. Classifications derived from early and late MRI scanning were significantly correlated. However, measures of neuropsychological outcome showed a strong correlation only with late MRI, and little or no relationship with either early MRI or early CT. Deeper abnormalities detected by late MRI were associated with poorer neuropsychological test performance; late ventricular enlargement was particularly associated with poor outcome. It is concluded that the lesions visualised by MRI are important for neuropsychological outcome, and that functionally significant abnormalities may only be fully apparent on late scanning.

Adolescent

Intercorrelation of lesions detected by magnetic resonance imaging after closed head injury.

Forty-three patients with closed head injuries were followed up 5 to 12 months post-injury. Patients had magnetic resonance imaging (MRI) and performed a variety of neuropsychological tests. There were systematic relationships between lesions in different sites: depth of lesions in orbito-frontal regions, frontal regions, and temporal poles were particularly strongly intercorrelated. Depth of lesions in specific sites also correlated with an overall measure of brain damage: the number of areas with lesions present. After correcting for premorbid differences there were significant correlations between lesions in specific sites and scores on three out of five WAIS subtests. Scores on these three subtests also correlated significantly with overall brain damage. In general, hemispheric sites which were significantly related to neuropsychological measures also showed significant intercorrelations among themselves. The findings stress the importance of patterns of lesions in head injury, and emphasize the difficulty of showing differential localization of cerebral function in this population.

Adolescent