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Biomedical subjects

P Dal-Bianco

Publications and source records attributed to P Dal-Bianco.

At least 19 recordsLinked to original sources
PubMed2003

Magnetoencephalographic--features related to mild cognitive impairment.

We recorded changes of brain activity from 10 MCI patients and 10 controls related to shallow (nonsemantic) and deep (semantic) word encoding using a whole-head MEG. During the following recognition tasks, all participants had to recognize the previously encoded words, which were presented again together with new words. In both groups recognition performance significantly varied as a function of depth of processing. No significant differences were found between the groups. Reaction times related to correctly classified new words (correct rejections) and incorrectly classified repetitions (misses) of MCI patients showed a strong tendency toward prolongation compared to controls, although no statistically significant differences occurred. Strikingly, in patients the neurophysiological data associated with nonsemantic and semantic word encoding differed significantly between 250 and 450 ms after stimulus onset mainly over left frontal and left temporal sensors. They showed higher electrophysiological activation during shallow encoding as compared to deep encoding. No such significant differences were found in controls. The present results might reflect a dysfunction with respect to shallow encoding of visually presented verbal information. It is interpreted that additional neural activation is needed to compensate for neurodegeneration. This finding is suggested to be an additional tool for MCI diagnosis.

Aged↗
PubMed2002

[Differential diagnosis of dementia].

Owing to the progress of individual life expectancy, the number of demented people will clearly increase in the next decades. Cognitive impairment refers not only to dementia, but also to mild cognitive impairment (MCI), associated with reduced complex daily activity and decreased quality of live. It may, in many cases (10-15% per year) progress to permanent dementia. The most frequent aetiologies of dementia syndromes are the Alzheimer's Disease (AD), vascular Dementia (VD), the combination of both and Lewy-Body-Disease. Primarily neuro-psychiatric and internal medical reasons for cognitive decline have also to be taken into account for rational treatment.

Aged↗
PubMed1999

Efficacy and safety of rivastigmine in patients with Alzheimer's disease: international randomised controlled trial.

OBJECTIVES: To assess the effects of rivastigmine on the core domains of Alzheimer's disease. DESIGN: Prospective, randomised, multicentre, double blind, placebo controlled, parallel group trial. Patients received either placebo, 1-4 mg/day (lower dose) rivastigmine, or 6-12 mg/day (higher dose) rivastigmine. Doses were increased in one of two fixed dose ranges (1-4 mg/day or 6-12 mg/day) over the first 12 weeks with a subsequent assessment period of 14 weeks. SETTING: 45 centres in Europe and North America. PARTICIPANTS: 725 patients with mild to moderately severe probable Alzheimer's disease diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, and the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association. OUTCOME MEASURES: Cognitive subscale of the Alzheimer's disease assessment scale, rating on the clinician interview based impression of change incorporating caregiver information scale, and the progressive deterioration scale. RESULTS: At the end of the study cognitive function had deteriorated among those in the placebo group. Scores on the Alzheimer's disease assessment scale improved in patients in the higher dose group when compared with patients taking placebo (P<0.05). Significantly more patients in the higher dose group had improved by 4 points or more than had improved in the placebo group (24% (57/242) v 16% (39/238)). Global function as rated by the clinician interview scale had significantly improved among those in the higher dose group compared with those taking placebo (P<0.001), and significantly more patients in the higher dose group showed improvement than did in the placebo group (37% (80/219) v 20% (46/230)). Mean scores on the progressive deterioration scale improved from baseline in patients in the higher dose group but fell in the placebo group. Adverse events were predominantly gastrointestinal, of mild to moderate severity, transient, and occurred mainly during escalation of the dose. 23% (55/242) of those in the higher dose group, 7% (18/242) of those in the lower dose group, and 7% (16/239) of those in the placebo group discontinued treatment because of adverse events. CONCLUSIONS: Rivastigmine is well tolerated and effective. It improves cognition, participation in activities of daily living, and global evaluation ratings in patients with mild to moderately severe Alzheimer's disease. This is the first treatment to show compelling evidence of efficacy in a predominantly European population.

Activities of Daily Living↗
PubMed1999

[Psychosocial risk factors for Alzheimer's disease].

Psychosocial stress has been shown to contribute to neurodegenerative changes and has been discussed as a pathogenic element in Alzheimer's disease (AD). However, studies investigating this aspect are rare. We performed a case-control study on 50 clinically diagnosed probable AD patients and 90 controls consisting of surgical patients. Interviews were performed by trained personnel, using a questionnaire, a semi-structured interview, and a psychosocial risk list protocol. Findings are presented as marginal and partial odds ratio from linear logistic regressions. Adapting to an active but unproductive working style as well as living with a dominant spouse is associated with significant risk for AD. Protective factors are high self-esteem and working in one's desired job. Our results indicate psychosocial factors as a possible agent in the latent development of AD and may shift the focus from more traditional risk factors to hitherto almost neglected psychosocial factors in a disease of still unknown etiology.

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PubMed1997

Olfactory functions in Parkinson's disease and Alzheimer's disease.

The aim of this investigation was to compare olfactory functions of patients suffering from Parkinson's disease (PD) and Alzheimer's disease (AD). Olfactory threshold, odor identification ability and odor memory performance were assessed in 21 non-demented PD patients and in 22 AD patients. Both patient groups were impaired in relation to an age-matched control group for the measure of odor identification. AD patients showed a higher olfactory threshold and poorer odor memory performance.

Aged↗
PubMed1992

[Etiology of Alzheimer's disease].

The major factor that causes problems in studies on the aetiology of Alzheimer's disease (AD) is the clinical heterogeneity of the condition. Familial early-onset AD and familial late-onset AD are differentiated from sporadic AD. Aetiologically a genetic defect on chromosome 21 is the most important factor, at least in some cases of AD. In familial AD and autosomal dominant inheritance with complete penetrance in old age is thought to be possible. In sporadic AD the role of genetic and exogenous factors (infectious agents, aluminium) is unknown. The current status of knowledge about the aetiology of Alzheimer's disease is reviewed with reference to the literature.

Aged↗
PubMed1991

Galanthamine treatment in Alzheimer's disease.

18 patients who had fulfilled the NINCDS-ADRDA criteria for "possible AD" took part in a clinical study to evaluate the effect of the cholinesterase inhibitor Galanthamine, 30 mg/day. Neuropsychological und social parameters were rated. This open clinical pilot-study showed no statistic significant change in neuropsychological test-results. However after 1 year treatment 6 patients are still taking the drug. According to their care-persons there was a positive changes in competence of everyday-routine and/or in the emotional situation.

Aged↗
PubMed1991

Pattern electroretinogram and luminance electroretinogram in Alzheimer's disease.

Visual symptoms are often among the first complaints of patients suffering from Alzheimer's disease and several studies showed a delay in flash visual evoked potentials. Hinton et al. (1986) described optic nerve degenerations in patients with Alzheimer's disease and Sadun published a dropout of retinal ganglion cells that range from 30% to 60%. The reduction of neurotransmitters, especially of acetylcholine, found in the brain might also occur in the retina. Therefore we examined the retinal functions of patients suffering from Alzheimer's disease. In eight patients the pattern-electroretinograms and the scotopic and photopic luminance-electroretinograms were recorded and compared to an age-matched control group. We could not find any abnormalities in the pattern- and the luminance electroretinograms of patients with Alzheimer's disease. Although cholinergic cells have been found in the retina, our results did not reveal an involvement of retinal functions in Morbus Alzheimer.

Aged↗
PubMed1991

Early diagnosis of Alzheimer dementia?

The main problems in early diagnosis of Alzheimer dementia (AD) are: 1. The differentiation between normal aging and AD i.e. difficulties in the assessment of cognitive disturbances in the healthy elderly and in early demented subjects. 2. Interference with other dementia syndromes. 3. Lack of information in the population and among physicians about the different causes and courses of dementia syndromes. The first two aspects are discussed in this paper.

Aging↗
PubMed1991

Subarachnoid hemorrhage of unknown etiology: early prognostic factors for long-term functional capacity.

Forty-one patients suffering subarachnoid hemorrhage (SAH) of unknown etiology were re-investigated at an average of 91 months after the bleed to determine functional capacity. Nineteen patients were performing at their previous level of work, five were employed part-time, and four could not work due to the SAH. Five patients showed a moderate disability in activities of daily living but were not dependent on help, one patient was severely disabled, and two had died. There was one rebleed. Early prognosis of an unfavorable outcome was possible on the basis of three clinical variables on admission: a history of hypertension, a Hunt and Hess grade of greater than II, and the presence of focal neurological deficits. In addition, the presence of an organic mental syndrome at discharge was identified as a predictive factor for reduced functional capacity later on. Other clinical variables in the acute stage, including sex, age, history of headache, interval between SAH and admission, impaired consciousness, and cognitive deficits, were not related to a limited functional level. Residual neurological deficits and the Glasgow Outcome Scale score on discharge were also not predictive of restrictions in global functions evaluated by means of the Karnofsky Performance Scale status at follow-up review.

Activities of Daily Living↗
PubMed1991

Clinical comparison of dementia in Parkinson's and Alzheimer's disease.

Neuropsychological, neuropathological and neurochemical findings show different types of dementias. Few of them have been able to confirm a division into "subcortical" and "cortical" dementia, so this concept has to be questioned. The present clinical study compared type and severity of dementia in 12 Parkinson-patients (PD) and 12 Alzheimer-patients (AD). The age-adjusted normal value differed a significantly from both patient groups. No significant difference in pattern of neuropsychological deficits between PD- and AD-patients was apparent. However, after similar duration of illness, dementia was more severe in AD- than in PD-patients.

Aged↗
PubMed1985

[Effect of body size, arm length, sex and temperature on somatosensory evoked potential latency].

Beside the technical factors different biological factors contribute to the variability of the somatosensoric evoked potentials. In 30 volunteers the dependence of the latency of the spinal components N9, N13 (recorded at C7), of the cortical component N20 and of the interpeak interval N13-N20 from the body size and length of the arm was investigated. A significant dependence at the 1% level (p less than 0.001) was found for the latencies of N9, N13 and N20, whereas the interpeak interval N13-N20 was significant at the 5% level (p less than 0.05). Similarly in 20 further volunteers a significant dependence of the components N1, P1, N2, P2 and N3 from the body size at the 1% (p less than 0.001) after distal stimulation of the tibial nerve was observed. Using a covariance analysis it could be shown, that even after a body size correction, in females shorter latencies occur than in males. Furtheron we studied the effect of the temperature on the SSEP-latencies, by heating the upper and lower extremity stepwise from 31 degrees C to 37 degrees C using an infrared (DISA-Regler-System) lamp. As no significant dependence could be observed, we believe that the effect of temperature on latencies is so small, that in usual conditions no correction is needed. On the contrary a correction with body size or arm length is necessary, to avoid wrong positive or negative results.

Adult↗
PubMed1985

[Incidence of identification and configuration variants of the NSEP signal in relation to the recording site and measuring moment].

The component evaluation of the spinal and cortical recorded SEP-signals of thirty healthy volunteers after stimulation of the median nerve at the wrist gave information about variation of waveforms and frequency of peak identification with respect to the position of the active electrode and the repetition of the SEP recording. Basically one can distinguish three main groups of NSEP waveforms (Fig. 1). Firstly the "classical form" (i.e. N11 in the ascending part, N13 at the highest peak of the NSEP main component and N14 in the descending part of the curve). Secondly the "plateau-form" and thirdly the "polypeak form" (i.e. many peaks of the same amplitude). The latter two configurations were seen in more than a third of the evaluated NSEP maincomponents. Neither the position of the active electrode (C2 and C7) nor repetition of the SEP recording were found to have significant influence on the waveform. The position of the active electrode influenced the number of identificable peaks: the early components (N9 and N11) were more often recognisable when the recording was made over the lower neckregion (C7), N14 when the recording was made over the upper neckregion (C2). N13 was always identificable in both electrode positions. The repetition of the SEP recordings immediately after the first run is helpful if there was difficulty in identifying the peaks. The normal values of the SEP latency of the spinal and cortical recorded signals were evaluated taking above mentioned criteria into account.

Adult↗
PubMed1983

[Somatosensory evoked potentials: normal values and methodological problems in various recording technics].

In order to optimize the method of examination, somatosensory evoked potentials (SSEP) were studied in 27 healthy subjects, as recorded during stimulation of the median nerve at the wrist. The study shows that recordings with surface electrodes produced better results than with needle electrodes, owing to lesser disturbance from muscle artifacts. The SSEPs of each subject were recorded taking a fixed position of the active electrode placed over the contralateral sensory "hand field", and a reference electrode positioned for the first recording mid-frontally and for the second recording at the contralateral ear or vice versa. The first 3 positive and the first 3 negative peaks were studied. Exact identification of each peak was more often possible when recordings were made with the reference electrode placed mid-frontally than placed at the contralateral er. Normal values were evaluated for the latency P15, P25, P45, N30, N35 and N55, for the amplitudes P15-N20, N20-P25, P25-N35, N35-P45 and P45-N55 and for the latency intervals P15-N20, N20-N35, N35-N55, P15-P25 and P25-P45, with the reference electrode in different positions. In addition, the side difference for each subject was determined. Statistical analysis (T-test for independent variables) revealed a significant difference, depending on the position of the reference electrode: with the reference electrode placed at the contralateral ear, the latency P15 was shorter, the amplitude P15-N20 was increased and the amplitude N20-P25 was decreased as compared with a reference electrode placed mid-frontally.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Effect of dantrolene sodium in myotonic dystrophy.

The effect of dantrolene sodium, using a dosage of 120 mg/day, was investigated in 3 patients suffering from myotonic dystrophy. These patients showed a marked reversible deterioration of the clinical symptoms, caused by a reduction of the isometric strength. Dantrolene sodium showed no influence on myotonic discharges and on the latency of the electrical and mechanical muscle response of the adductor pollicis muscle after electrical stimulation of the ulnar nerve. On the other hand a shortening of the relaxation time (in 2 patients) could be observed. The effect of dantrolene sodium on the contractile mechanism without having any influence on the electrical activity is confirmed. Although the relaxation time is shortened, a clinical deterioration is observed, caused by a reduction of the strength. This phenomenon can be explained by a reduction of the calcium release from the sarcoplasmic reticulum after drug application.

Adult↗