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Biomedical subjects

M Falcini

Publications and source records attributed to M Falcini.

6 recordsLinked to original sources

Encephalopathy associated with Hashimoto's thyroiditis: an additional case.

A 35-year-old female with a history of Hashimoto's thyroiditis (HT) presented with episodic dysphasia and a burst of axial jerks with abdominal muscle contraction and asymmetric blepharospasm as manifestations of encephalopathy associated with HT. Brain magnetic resonance imaging (MRI) showed scattered supratentorial white matter hyperintense T2 foci. Brain single photon emission computerized tomography (SPECT) demonstrated a cortical hypoperfusion in the upper frontal and parietal areas. Corticosteroid therapy induced a rapid improvement of the clinical picture.

Journal Article↗

Alzheimer's disease: patterns of cognitive impairment at different levels of disease severity.

The aim of this study was to establish the presence and the consistency of different cognitive profiles in AD patients taking into consideration the severity of mental impairment. Therefore we stratified 679 neuropsychological observations on 119 probable AD patients followed longitudinally on the basis of overall degree of cognitive impairment. To compare performance on tests with different score ranges we transformed raw test scores into coefficients; to summarize our results in terms of language versus visuo-spatial performance we computed indices of prevalent impairment of performance (IPIP) by subtracting the coefficients for constructional praxis from coefficients for language-related tests. Finally, we converted these indices into z-scores for each level of mental decline to identify patients with generalized, language (L) or visuo-spatial (V) prevalent impairment. The latter, 30% of the sample, can be detected at all stages of dementia. There was a higher percentage of males among language impaired patients (P<0.05). Approximately half of patients with L/V prevalent impairment continued to show such a focality when followed longitudinally. The groups did not differ in the annual rate of cognitive decline.

Age of Onset↗

Natural history of Alzheimer's disease: prognostic value of plateaux.

The aim of this 7-year inception cohort study was to determine the prognostic value of plateaux in cognitive decline in the course of Alzheimer's disease (AD) as well as their impact on the rate of progression of cognitive impairment. From a consecutive sample of 106 outpatients participating in a longitudinal study on AD, we selected 31 with a mild degree of mental deficit at presentation and a disease duration of at least 3 years when included into the study. All underwent extensive clinico-neuropsychological testing about every 6 months and there were no drop-outs. Mean period of follow-up lasted 6.8 (SD 2.9) years. Nineteen patients displayed a plateau, where a plateau refers to a patient's remaining on a mild level of cognitive decline for more than two years. Survival curves (Kaplan-Meier method) showed that patients with plateaux reached several end-points--very severe functional or cognitive impairment, urinary incontinence, death--significantly later than patients without (p < 0.04). Patients with plateaux showed a smaller cognitive loss (p < 0.01) in terms of the mean annual rate of progression of mental decline. In conclusion plateaux in an early stage of Alzheimer's Disease served to identify patients with a more favourable course.

Aged↗

Magnetic resonance measures in Alzheimer disease: their utility in early diagnosis and evaluating disease progression.

We sought to identify the most reliable magnetic resonance (MR) measures for the diagnosis and staging of Alzheimer disease (AD) in a clinical setting and to estimate, for different degrees of dementia, the rate of change of cerebral atrophy in certain regions of interest (ROIs). Forty-two probable AD patients and eight normal controls underwent MR brain scans, neurological examinations, and neuropsychological testing. We computed each subject's corpus callosum width, ventricular size, right and left temporal lobe areas, interuncal distance, and assessed the degree of cortical atrophy. We also estimated the rate of change for Information-Memory-Concentration Test scores and for temporal lobe areas and corpus callosum width. Measures of temporal lobe area and subjective evaluation of temporal lobe atrophy both served to distinguish controls from mild AD cases (p < 0.05), whereas only the latter differentiated moderate from severe patients (p < 0.05). The rate of change for temporal lobe areas remained constant over different AD stages, whereas those for corpus callosum width and for cognitive impairment were greater for severe cases (p < 0.05). Our findings imply that measurements of temporal lobe area and ratings of temporoparietal atrophy can be useful in the diagnosis and staging of AD and suggest that atrophy progressed at different rates in selected ROIs for various stages of AD severity.

Aged↗