Biomedical subjects

P Rosado

Publications and source records attributed to P Rosado.

4 recordsLinked to original sources

PubMed2006

Apparent diffusion coefficient mapping of the hippocampus and the amygdala in pharmaco-resistant temporal lobe epilepsy.

BACKGROUND AND PURPOSE: The purpose of this study is to determine whether interictal apparent diffusion coefficients (ADC) provide a robust means for detecting amygdalo-hippocampal abnormalities in adult patients with localization-related chronic temporal lobe epilepsy (TLE) undergoing presurgical evaluation. METHODS: Fifty-five patients and 20 age-matched controls were studied with hippocampal and amygdala ADC maps (HADC and AMYADC), volumes (HCVOL, AMYVOL), T2 relaxometry (HCT2, AMYT2), and hippocampal N-acetylaspartate to choline and creatine/phosphocreatine ratios (HCSI). Mean values and 99% confidence ellipses were computed for the groups. Individual ADC mapping was compared with electroencephalography (EEG) data and further correlated with the quantitative MR measures and with the age at onset and duration of TLE. Moreover, we evaluated the association and the predictive value of HADC and AMYADC with respect to the surgical outcome in a subgroup of patients (n = 21) operated on the side of maximal EEG lateralization and with MR imaging criteria for hippocampal sclerosis, 71% of which became seizure-free. RESULTS: In controls, there was no relation between ADC values and age, sex, or right-left asymmetries. In TLE groups with right (n = 29) or left epileptogenic foci (n = 26), group comparisons showed that ADC mapping detected changes ipsilateral to the focus in the hippocampus (P < .01) and the amygdala (P < .05), accordingly with the volumes, T2 maps, and HCSI. Significant Pearson correlations (2-tailed) were obtained between ADC maps and the volume of the hippocampus (r = -0.64) and of the amygdala (r = -0.55; both P < .01), T2 (r = 0.70, r = 0.29; both P < .01), but not with HCSI. Individual ADC analysis showed ipsilateral pathology in 82% of cases (hippocampus) and 35% (amygdala) and included a moderate association between ipsilateral HADC and AMYADC (r = 0.54; P < .01). Bilateral abnormalities were found in 7% (hippocampus) and 5% (amygdala) of cases. Except for HCSI and the amygdala data, there were significant correlations between the asymmetry indices and the duration of epilepsy (HADC: r = 0.42; HCT2: r = 0.50; HCVOL: r = 0.35; all P < .01). Age at onset was associated only with ipsilateral HADC (r = 0.35; P < .01) and HCVOL and HCT2 (both P < .05). The association with postsurgical successes was characteristic of HADC (Fisher exact test, 2-tailed: P =.031; Spearman correlation: r(s) = -0.75; P = .0002), but not AMYADC. The predictive value regarding a favorable outcome was 0.87 (odds ratio 26; 95% confidence interval 2.33-38.86). As determined by regression models, both larger ipsilateral HADCs and asymmetry indices predicted surgical success. CONCLUSION: Interictal ADC mapping lateralizes efficiently the lesion side in accordance with the EEG data and might be used to study the differential regional aspects of mesio-temporal sclerosis. HADC--not AMYADC--maps discriminate favorably postoperative outcome and can be added to the multidisciplinary evaluation workout of pharmacoresistant TLE patients.

Adolescent↗

PubMed1997

Multiple sclerosis and intrathecal IgA synthesis.

A clinically definite diagnosis of multiple sclerosis was done in a 61 year-old woman who displayed severe cerebellar and pyramidal tract involvement. Symptoms developed 5 years before with unsteadiness of gait and difficulties in walking. Diagnosis was supported by evoked potentials studies and magnetic resonance imaging. However, the cerebrospinal fluid (CSF) analysis was very unusual. CSF albumin and IgG concentrations were normal, as well as the IgG index. In contrast, the IgA level and the IgA index were markedly increased and the local synthesis of IgA was estimated at 31.36 mg/l. Reduction by dithiotreitol did not change the IgA level. On affinity immunoblots, oligoclonal IgA bands were not detected but oligoclonal IgG bands were present. The strong local production of IgA in this patient seems to be therefore polyclonal.

Dithioerythritol↗

PubMed1995

[Neuropathy in Waldenstrom's macroglobulinemia].

The association of a neuropathy and a paraproteinaemia such as Waldenström's macroglobulinaemia is frequent and not fortuitous. This paper reports a slowly progressive, predominantly sensory neuropathy, occurring in a 69-year-old man, as the first sign of a Waldenström's macroglobulinaemia. A saphenous [correction of sural] nerve biopsy revealed a mixed process of primary demyelination and axonal degeneration. Accumulations of immunoglobulin M were observed in the myelin sheets and the perineurium by immunocytochemistry. Infiltrations of inflammatory blood cells and accumulations of amyloid material were absent in the peripheral nerve. The axonal loss was most prominent in central areas of the nerve fascicles. This find supports the hypothesis of an ischemic mechanism for the axonal degeneration plus secondary demyelination, associated to a direct immunological attack against myelin. The various types of peripheral nerve involvement in Waldenström's macroglobulinaemia, as well as the admitted mechanisms of nerve lesion and the therapeutic approaches to this still unclear neuropathy are briefly reviewed.

Aged↗

PubMed1990

The sleep of dysthymic patients: a comparison with normal controls.

All-night electroencephalographic (EEG) sleep recordings were compared in dysthymic patients and normal controls. Patients were selected according to DSM-III and underwent 2 weeks of treatment with placebo before the sleep evaluation, which also included self-assessments of sleep quality. As compared with normals, dysthymic patients demonstrated fragmented and superficial sleep with no changes in rapid eye movement (REM) sleep. In addition to sleep continuity disturbances, dysthymics had a higher percentage of stage 1 and a reduction of slow wave sleep (SWS), mainly due to a diminished percentage of stage 4. Other differences were related to a higher incidence of some EEG events, and it is suggested that the analysis of sleep microstructure is a useful approach to study sleep physiology in psychiatric patients. The classification of minor forms of depression is a controversial issue and therefore the nosological implications of our findings are discussed.

Adult↗