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Biomedical subjects

Kari Hirvonen

Publications and source records attributed to Kari Hirvonen.

4 recordsLinked to original sources
PubMed2006

Efficacy and safety of pramipexole in idiopathic restless legs syndrome: a polysomnographic dose-finding study--the PRELUDE study.

BACKGROUND AND PURPOSE: To evaluate the effects of pramipexole (0.125-0.75 mg/d) on polysomnographic (PSG) measures and patient and clinician ratings of restless legs syndrome (RLS). PATIENTS AND METHODS: Patients (n=109) with moderate to severe RLS were randomized to placebo or fixed doses of pramipexole during a 3-week, double-blind, placebo-controlled, dose-finding study. RESULTS: In each pramipexole dose group, the periodic limb movements during time in bed index (PLMI) decreased significantly, compared with placebo (adjusted mean difference in log-transformed data: 0.125 mg, -1.54; 0.25 mg, -1.93; 0.50 mg, -1.89; and 0.75 mg, -1.52; P<0.0001). At all doses, International RLS Study Group Rating Scale (IRLS) scores were also significantly reduced, with the greatest adjusted mean reduction in the 0.50mg group (-17.01). At all but the lowest pramipexole dose, the percentage of responders (> or =50% reduction of IRLS score) was substantially higher than for placebo (61.9-77.3, vs 33.3%). In the pramipexole groups, 50.0-77.3% of patients rated their condition as 'much better' or 'very much better', compared with 38.1% of patients in the placebo group (P=0.0139 for the 0.50 mg dose). Clinical global impressions (CGI) scale ratings of 'much improved' or 'very much improved' were given to 61.9-86.4% of patients in the pramipexole groups, compared with 42.9% in the placebo group (P<0.05 for the 0.25, 0.50, and 0.75 mg groups). Pramipexole was well tolerated and did not produce somnolence at any dose. CONCLUSION: Pramipexole is effective and safe in the treatment of both objective and subjective facets of RLS.

Adult↗
PubMed2003

Automatic sleep-wake and nap analysis with a new wrist worn online activity monitoring device vivago WristCare.

STUDY OBJECTIVE: Vivago WristCare is a new activity monitoring device, which allows long-term online monitoring of the activity of the user. This study evaluates the ability of the device to discriminate sleep/wake patterns during nighttime and during napping. DESIGN: Participants spent one night in the sleep laboratory where signals from polysomnography, actigraphy and WristCare were acquired. In addition, actigraphy and WristCare were used for 3-6 days for nap-analysis. SETTING: NA. PATIENTS OR PARTICIPANTS: Participants were 32 adults aged 26-89 years. The participants were studied in three study groups: all subjects, senior subjects (age > 65 years) and middle-aged subjects (age < 65 years). INTERVENTIONS: NA. RESULTS: Sleep/wake patterns were extracted from polysomnography, actigraphy and WristCare for the night slept in sleep laboratory. The agreement percents between the scorings of polysomnography and actigraphy, and between polysomnography and WristCare were about 80 % for all study groups. As total sleep time was estimated and the algorithm was optimized for this measure, the performance of the WristCare and actigraphy were similar. Both actigraphy and WristCare overestimated appreciably total sleep time (TST). Also in nap-analysis, actigraphy and WristCare performed similarly as the number of naps and the length of the naps were compared. CONCLUSIONS: The performance of the WristCare can be assumed to be well comparable to actigraphy in sleep/wake studies. The study suggests that the device may be used in long-term monitoring of sleep/wake patterns with similar performance to actigraphy.

Adult↗
PubMed2003

Visual agnosia in a child with non-lesional occipito-temporal CSWS.

In this paper we describe a case of severe visual agnosia in a child with an electrophysiological pattern of continuous spike-wave discharges in slow sleep (CSWS) in the occipito-temporal regions. The neuropsychological spectrum related to this phenomenon is discussed. Published paediatric reports associate visual agnosia (i.e. an inability to recognize objects without impairment of visual acuity) mainly with symptomatic occipito-temporal aetiology (e.g. cortical dysplasia, vascular insults) and other neurological symptoms (e.g. autism). We describe a detailed 2 year electrophysiological and neuropsychological follow-up of an 8-year-old boy with sporadic seizures, occipito-temporal CSWS and visual agnosia. The growth and neurological development of the child had been considered as normal, neurological examination did not reveal any focal signs, visual acuity was intact and MRI was normal. First EEG and six consecutive 24 h video EEG recordings during the follow-up of 22 months showed continuous spike-and-wave activity covering over 85% of the non-REM sleep. According to structured neuropsychological tests (Wechsler Intelligence Scale for Children--Third Edition, A Developmental Neuropsychological Assessment (NEPSY), Test of Visual-Perceptual Skills, Corsi block, Hooper Visual Organization Test) the boy had normal verbal intelligence but major deficits in visual perception, especially in object recognition, impaired shape discrimination and detection, and poor copying skills. Attention and executive functions were intact. There were no difficulties in short- or long-term memory. Verbal cues and naming the objects improved visual memory. Tracing the objects with a finger or by moving the head improved object recognition. Currently the boy attends a special school with a rehabilitation plan including neuropsychological and occupational therapies. This case adds a new facet to the spectrum of neuropsychological deficits in children with CSWS. Sleep EEG should be included in the etiological studies of children with specific neuropsychological problems and detailed neuropsychological assessment is needed for diagnostic and rehabilitation purposes.

Agnosia↗