Biomedical subjects
Publications and source records attributed to M Piccirilli.
A patient with a pure acquired dysgraphia is reported. The pattern of the patient's performance is discussed in relation to current functional models of writing. The case may be interpreted by assuming a selective impairment to the graphemic buffer.
Great interest has been recently raised by the discovery of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), a meperidine analogue capable of producing an irreversible Parkinson's disease. On the basis of papers published during the last years, we examined the structural features and the specific mechanism of action of this substance at the level of dopaminergic neurons. Furthermore, the clinical features of the experimental Parkinson model, obtained by means of MPTP inoculation in various animals and their similarities to the analogous human disease are described. We can conclude that the MPTP discovery enhances the hypothesis that Parkinson's disease can be also attributed to toxic factors.
The functions of multiple brain dopamine receptors are discussed in relation to the physiological role of dopamine in CNS.
Two cases of subcortical arteriosclerotic encephalopathy (Binswanger's disease) are reported. The two patients lacked a clinical history of hypertension, relevant pathogenetic factor in the development of the small and medium size cerebral arteries atherosclerosis, which is the main pathologic finding of the disease. The two subjects clinically showed a marked intellectual deterioration, together with mood depression and focal neurological signs, that were an expression of the multifocal neurologic involvement. In both cases CT scans evidentiated a mainly periventricular leucoencephalopathy associated, in the first patient, with small multiple ischemic lesions and, in the second, with a unique hypodense area in the centrum semiovale. A review of the literature on the subjects is proposed, together with an attempt of pathogenetic interpretation of our two cases.
Sixty right-handed subjects, divided into four groups of 15 according to sex and familial sinistrality (FS), performed a test of language lateralization. A verbal-manual dual-task paradigm was employed. Results suggest that the pattern of cerebral organization may differ among right-handers in relation to both sex and FS. However, it is not merely the separate influence of these two factors, but rather their interaction which determines the pattern. It is stressed that identification of individual predictors of language laterality may provide some information on prognosis and management of aphasic patients.
Selective deficit of verbal output not associated to other anomalies of language, represents a syndrome in which articulatory as well as linguistic aspects can be independently affected. The critical lesion for pure articulatory deficit appears to involve left prerolandic cortico-subcortical structures. Nevertheless, in relation to individual differences in cerebral organization, damage in these structures can be responsible for a simultaneous deficit of articulatory and linguistic mechanisms.
We report the results of a double-blind placebo controlled study of bornaprine, an anticholinergic drug, in the treatment of Parkinson's disease. We studied 17 patients presenting persistent tremor in spite of a stable long-term L-Dopa therapy. The bornaprine, in doses of 8 mg/die, compared with placebo significantly improves tremor. Only mild side effects occurred. We think the bornaprine may be of value in the treatment of parkinsonian tremor.
Three patients with calcification of the posterior longitudinal ligament with myelopathy are reported and discussed. This condition which is frequent in Japan is rarely described in the western population. Such calcification is not only a radiographic finding but is a progressing phenomenon which may extend to compressive lesions of the spinal cord. All patients with calcification of the posterior longitudinal ligament should be fully studied neurologically and followed up.
There are at least four phenomenologically different types of movement disorders that fall under the rubric of tardive dyskinesia: a) classical TD which is choreatic in speed of movement and stereotypic in pattern, b) tardive akathisia, c) withdrawal emergent syndrome, which presents as true chorea and d) tardive dystonia which presents with dystonic movement and postures. This paper reviews the main treatments of tardive dyskinesia. The drugs utilized have been considered according to their mechanism of action.
A 68 years old man affected by parkinson's disease for four years suddenly developed symptoms of a motor neuron disease. He also had a defect of his visual-spatial ability with an intra cerebral calcifications in right parieto-temporo-occipital region. The AA. discuss the nosological aspects of this case and do not accept the possibility of a chance occurrence of the two systemic degenerative diseases and favour a unification of nuerological abiotrophic diseases.
A literature review shows that patients affected by Parkinson's disease present an intellectual impairment more frequently than the comparably aged population. Such impairment has been related to several factors (age, arteriosclerosis, motor difficulties, depression, dopaminergic therapy, cortical and/or subcortical lesions). Parkinsonian dementia may be caused by the extent of the degenerative process. Our own results show that parkinsonian patients with dementia are different from nondemented ones with the following features: a) a more marked bradykinesia b) a more severe extrapyramidal picture c) a progressive unresponsiveness to levodopa in a shorter time. It seems possible that there is a Parkinson syndrome characterized, clinically, by an intellectual impairment with a poor prognosis quoad valetudinem, and, anatomically, with multiple cortical and subcortical lesions. Such syndrome may be a "transition" form between Parkinson disease and senile-presenile dementia.
Left-handedness, being exception to the rule of right-handedness, has provoked several questions about its origins and the significance of its relationships with some individual traits, like cognitive style, personality, creativity, motor abilities. Investigations on left-handedness in recent years suggest that hand preference is linked to the peculiar functional organization of the two hemispheres of the brain.
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