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Biomedical subjects

P Videbech

Publications and source records attributed to P Videbech.

At least 19 recordsLinked to original sources
PubMed2003

The Danish PET/depression project: cognitive function and regional cerebral blood flow.

OBJECTIVE: To clarify the relationship between cognitive functions and regional cerebral blood flow (rCBF) in a large group of depressed patients compared with healthy controls. METHOD: A set of principal components was extracted from scores of a battery of neuropsychological tests of 40 patients suffering from major depression and 49 healthy controls. The components were correlated by multiple linear regression analyses to selected regions of interest in the brain obtained from positron emission tomography images. RESULTS: In contrast to findings in the healthy controls, cognitive functions in the depressed patients correlated significantly with rCBF in specified regions of interest in only a few instances. CONCLUSION: Our study indicates that disturbed cognitive functions in depression do not relate to specific areas of the brain in the same way as normal cognitive functioning, suggesting that the abnormalities of brain function in major depression may be qualitative, rather than quantitative, in nature.

Adolescent↗
PubMed2002

The Danish PET/depression project: clinical symptoms and cerebral blood flow. A regions-of-interest analysis.

OBJECTIVE: We wanted to explore associations between clinical symptoms of depression and the blood flow to specific regions of the brain. Furthermore, we wanted to compare the regions-of-interest (ROI) method with the functions-of-interest (FOI) approach. METHOD: The resting blood flow to 42 ROI in the brain was obtained with positron emission tomography (PET) imaging in 42 representative in-patients with major depression and 47 matched healthy controls. RESULTS: The patients had increased blood flow to hippocampus, cerebellum, anterior cingulate gyrus, and the basal ganglia. A strong negative correlation was found between the degree of psychomotor retardation of the patients and the blood flow to the dorsolateral and supraorbital prefrontal cortices. The total Hamilton score was correlated with the blood flow to the hippocampus. CONCLUSION: Our findings support the notion that depressed patients have disturbances in the loops connecting the frontal lobes, limbic system, basal ganglia, and cerebellum.

Adult↗
PubMed2001

[Depression, stress and brain function].

Many patients with major depression have elevated serum cortisol, which cannot be suppressed with dexamethasone. This points to a disturbance in the hypothalamus-pituitary-adrenal (HPA) axis, which might have pathogenetic importance. Recent investigations with MRI have shown an increased frequency of generalised, as well as localised atrophy in the brains of depressed patients. The reduced volume of the hippocampus is particularly interesting, because of the participation of this structure in the regulation of the individual's stress response. Furthermore, the hippocampus is of major importance for cognitive processes. There is evidence that the increased cortisol concentration is neurotoxic and may cause atrophy, as is known from Cushing's disease. This is supported by studies of the accumulated duration of depressive episodes, and also by the fact that drugs that dampen the HPA axis have proved to have antidepressant properties in clinical controlled, double-blind studies. This points to new principles in the treatment of major depression and underlines the importance of early intervention in order to prevent cerebral atrophy, which is probably reversible at the beginning of the disease process.

Antidepressive Agents↗
PubMed2001

The Danish PET/depression project: PET findings in patients with major depression.

BACKGROUND: It is hypothesized from previous positron emission tomography (PET) studies of patients with major depression that dysfunction of regions of the limbic system and the frontal lobes in close connection with the basal ganglia is involved in the pathophysiology of major depression. METHODS: By means of PET and 15O labelled radioactive water we determined an index of the neuronal activity by mapping the cerebral blood flow distribution of 42 unselected in-patients suffering from moderate to severe depression and 47 healthy controls controlling for age and gender. The PET maps were co-registered to magnetic resonance images of the anatomy of the brain. RESULTS: The functions-of-interest analysis revealed significant gender differences in cerebral blood flow and changes in the relative distribution of the blood with increasing age. The patients had increased activity of the hippocampus and the cerebellum compared to the healthy controls when corrected for these confounders and the influence of antidepressant medication. Furthermore, data in the Danish Psychiatric Central Register showed that the patients studied were representative of the population of depressed patients admitted to the hospital during the study period. CONCLUSION: Our main finding is increased blood flow to the hippocampus, even when controlling for a number of confounders. This is in accordance with a rapidly expanding literature suggesting an important role for this structure in major depression.

Adolescent↗
PubMed2001

Structural brain abnormalities in unselected in-patients with major depression.

OBJECTIVE: Several studies have indicated an increased frequency of cerebral atrophy and white matter lesions in patients with major depression, especially in older age groups. METHOD: Forty-four representative in-patients with major depression in which neurological disorders were clinically excluded, and 49 age- and gender-matched controls were MR scanned. RESULTS: Unexpectedly, two of the patients had severe brain pathology which could account for their psychiatric symptoms. Analysis of the remaining patients (mean age 42 years) did not reveal an increased frequency of cerebral atrophy. The number of white matter lesions increased with age to an odds ratio greater than 3 for patients aged 50, but this was not statistically significant. CONCLUSION: Brain atrophy and white matter lesions did not occur with significantly increased frequency in these relatively young unselected depressives, but the finding of severe brain pathology stresses the importance of brain imaging in late-onset psychiatric disorders.

Adult↗
PubMed2000

PET measurements of brain glucose metabolism and blood flow in major depressive disorder: a critical review.

OBJECTIVE: To show that PET investigations of brain function in patients with major depression can contribute with valuable pathophysiological knowledge about brain function of these states. METHODS: PET studies of cerebral blood flow or glucose metabolism in patients with unipolar or bipolar depression were reviewed. RESULTS: The studies have great discrepancies related to sample size, subject selection, imaging protocol and image analysis. In spite of this shortcoming, there is evidence that patients with major depression have reduced blood flow and metabolism in the prefrontal cortex, particularly when they exhibit psychomotor retardation. Abnormalities are also found in the anterior cingulate gyrus and the basal ganglia. A few studies point to the possibility that response to antidepressant treatment can be predicted from PET scans. CONCLUSION: This evidence is consistent with the hypothesis that depressive symptoms are caused by dysfunction of regions of the limbic system and the frontal lobes in close connection with the basal ganglia.

Basal Ganglia↗
PubMed2000

Postpartum depression: identification of women at risk.

OBJECTIVE: To identify and test the predictive power of demographic, obstetric, and psychosocial risk factors of postpartum depression. DESIGN: Community-based, prospective follow up study based on questionnaires on past history of psychiatric disease, psychological distress and social support during pregnancy and depression at four months after delivery. Obstetric files were collected at time of birth. SETTING: Antenatal care clinic and delivery ward, Aarhus University Hospital, Denmark. POPULATION: 6,790 women giving birth between 1 January 1994 and 31 December 1995, who attended the antenatal clinic during pregnancy; 5,252 (78%) completed all questionnaires. The validation population comprised 528 women enrolled immediately prior to and after the study period. MAIN OUTCOME MEASURE: Postpartum depression four months after giving birth assessed by the Edinburgh Postnatal Depression Scale. RESULTS: 5.5% of the women suffered from postpartum depression, corresponding to a score of 13 or higher on the Edinburgh Postnatal Depression Scale. Risk factors identified by multivariate logistic regression analysis included psychological distress in late pregnancy (OR 6.3 [95% CI 4.4-9.1]), perceived social isolation during pregnancy (OR 3.6 [95% CI 1.9-7.0]); high parity (OR 3.8 [95% CI 1.8-8.0]); and a positive history of prepregnant psychiatric disease (OR 2.1 [95% CI 1.4-3.2]). No association was found between pregnancy or delivery complications, and postpartum depression. The maximum predictive power of the identified risk factors was 0.3. According to these results, one out of three women who suffers from psychological distress in late pregnancy with perceived social isolation will develop postpartum depression. CONCLUSION: Antenatal focus on psychosocial wellbeing may help to identify women at risk of postpartum depression.

Adolescent↗
PubMed1997

MRI findings in patients with affective disorder: a meta-analysis.

A review of the literature on primarily magnetic resonance imaging (MRI) scans of patients with affective disorders is presented. Several studies have indicated an increased ventricle/brain ratio and other signs of cerebral atrophy, as well as an increased frequency of lesions (so-called signal hyperintensities) in the brains of unipolar and bipolar patients. This notion is strongly supported by two meta-analyses performed in the present study. The lesions are often localized in the frontal lobes and the basal ganglia, indicating a defective basal ganglia/frontal circuit, and are correlated with the degree of cognitive impairment seen in these conditions. No studies have indicated that psychoactive drugs or electroconvulsive therapy (ECT) might cause the lesions, but on the other hand they can probably increase the risk of delirium complicating the treatment.

Adult↗
PubMed1995

Neuropsychological deficit in newly diagnosed patients with schizophrenia or schizophreniform disorder.

Forty-six patients with schizophrenia or schizophreniform disorder admitted to hospital for the first time were compared with 21 healthy volunteers on neuropsychological tests reflecting prefrontal and left respectively right hemisphere function. The patients with schizophrenia or schizophreniform disorder had a poorer performance on neuropsychological tests (such as Wisconsin Card Sorting) compared with healthy volunteers. Both left and right hemisphere seemed to be involved. Especially poor performance was found on somewhat complicated tests requiring ability of analysis, abstraction and memory, thus indicating dysfunction of prefrontal and temporohippocampal regions. Signs of sulcal enlargement and size of lateral ventricles on computed tomographic scan correlated with poor test performance on some tests both in patients and in healthy volunteers. No correlations were found between performance on neuropsychological test and negative symptoms.

Adolescent↗
PubMed1995

First admission with puerperal psychosis: 7-14 years of follow-up.

The aim of this study was to investigate women who had first-episode psychosis within 1 year after parturition. The Danish Psychiatric Central Register and the Danish Medical Birth Register were linked to identify all women admitted for the first time to a psychiatric department in Arhus County with a psychotic episode. Fifty cases were found, giving a frequency of first-episode psychosis within 1 year after delivery of 1 per 1000. First-episode psychotic disease within the first month postpartum occurred in 1 case per 2000 deliveries. The age distribution corresponded to that of the background population, but the cases were primiparous more often than expected. The socioeconomic status was equal to that of a matched control group of obstetric patients. Birth complications did not occur more frequently than expected, but the probands had a higher risk of preterm delivery than the controls. The clinical picture of the index episode was that of manic-depressive psychosis in nearly half of the cases, but no cases of schizophrenia were found. Sixty percent of the patients had a picture of severe depression, and 20% suffered from manic disorder. The follow-up, 7 to 14 years later, was carried out by interviewing the general practitioners. Forty percent of the women had not preserved full working capacity due to mental disorder. Moreover, the follow-up pointed to schizophreniform symptoms at the index episode as a predictor of incapacity to work. Recurrences were very common (60%), especially of the nonpuerperal type, and half of the recurrences belonged to the manic-depressive disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Regional cerebral blood flow distribution in newly diagnosed schizophrenia and schizophreniform disorder.

Regional cerebral blood flow distribution (rCBF) in 24 first admissions with schizophrenia or schizophreniform disorder and in 17 healthy volunteers was examined. Single photon emission computed tomography with a brain-retained tracer, technetium-99m-d,l-hexamethyl-propylene amine oxime, was used to study subjects under resting conditions and during performance of the Wisconsin Card Sorting Test. The study is a replication of a previous investigation in an independent series of patients and healthy volunteers. The patients had significantly lower relative blood flow in prefrontal regions during activation than did the healthy volunteers. An earlier series of 19 patients and 7 healthy volunteers was studied using exactly the same procedure. Analyses of the combined samples from the two studies (43 patients and 24 healthy volunteers) showed the patients to have significantly lower relative flow in prefrontal regions both at rest and during activation and higher flow in the left striatum during activation. The same finding emerged when analyses were confined to drug-naive patients and patients educationally matched to the healthy volunteers. The study suggests a defective frontostriatal interrelationship in schizophrenia and schizophreniform disorder.

Adolescent↗
PubMed1991

Altered modulation of prefrontal and subcortical brain activity in newly diagnosed schizophrenia and schizophreniform disorder. A regional cerebral blood flow study.

To measure prefrontal and subcortical activity during a cognitive task, we examined 19 newly diagnosed schizophrenics and patients with schizophreniform psychosis. Seven healthy volunteers served as controls. The patients were drug naive or had received neuroleptics for a few days only. Cerebral blood flow distribution was depicted by single photon emission computed tomography at rest and during activation with the Wisconsin Card Sorting Test. A significant relative activation deficit in the left inferior-prefrontal region was revealed during the Wisconsin Card Sorting Test in the patient group. Furthermore, the patients had impaired striatal suppression on the left side during the cognitive task. The test performance was significantly impaired in the patients. The inability to reduce striatal activity may be due to a lack of corticostriatal feedback during prefrontal activation.

Adult↗
PubMed1989

[Breech presentation deliveries].

A total of 5,519 consecutive single deliveries at term were analysed for maternal and foetal factors associated with breech presentation (UK). The protocol in this department for breech deliveries which permits vaginal delivery of foetuses estimated to be between 2,400 and 3,800 g in cases where the pelvis was considered to be clinically normal, was also evaluated. Breech presentation was found in 173 cases. In 102 of these circumstances were present which permitted trial of vaginal delivery. Seventy-seven were delivered vaginally. An increased frequency of low Apgar scores (less than 8) after one minute was demonstrated among infants delivered vaginally in the breech presentation on comparison with infants delivered by Caesarean section, whereas low scoring after five minutes occurred with the same frequency. One infant died during delivery. Follow-up of infants delivered in breech presentation (mean period of observation two years) showed developmental disturbances in three of the vaginally delivered infants and in five of those delivered abdominally. Two of the infants delivered abdominally had severe cerebral paresis and psychomotor retardation without evidence of intrauterine or severe neonatal asphyxia. On comparison with the population delivered in cephalic presentation (HST), significantly increased frequencies of primiparity and light-for-dates infants were found in the breech presentations. Low Apgar score after one minute was significantly more frequent in breech presentations while low Apgar scoring after five minutes occurred with the same frequency. The perinatal mortality rates in breech and cephalic presentations were 17.3 and 4.7 per 1,000 respectively. Following correction for lethal malformations, the rates were 5.8 and 3.8 per 1,000, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Apgar Score↗
PubMed1987

Screening for Down's syndrome using an iso-risk curve based on maternal age and serum alpha-fetoprotein level.

On the basis of the significantly different distributions of maternal serum alpha-fetoprotein (AFP) levels in 86 pregnancies associated with fetal Down's syndrome and in 2018 unaffected pregnancies, an iso-risk curve for Down's syndrome was constructed. An iso-risk curve shows, for women of all ages, which combinations of maternal age and level of maternal serum AFP result in the same risk of carrying a fetus with Down's syndrome. A 1:400 risk of Down's syndrome, corresponding to the risk of a 35-year-old woman, was chosen as the lowest risk indicating referral for amniocentesis. If all women, irrespective of their age, are offered amniocentesis, when their risk of carrying a Down's syndrome fetus is 1:400 or higher, 53% of the affected fetuses can be detected as compared with 28% of the affected fetuses diagnosed at present in women above 35 years of age.

Adult↗
PubMed1987

Short stature in Scandinavian women. An obstetrical risk factor.

We have carried out a case-controlled study on relations between short stature (i.e. less than 156 cm tall) and problems with childbirth in Danish women. Data obtained from 182 pregnant, short women (short mothers) were compared with those obtained from a control group of 2116 pregnant women who were between 166 and 175 cm tall (control mothers). The prevalence rate for acute cesarean section was three-fold greater in short mothers than in controls, and the prevalence rate for elective cesarean section was twice as high in short mothers as in controls. Moreover, the prevalence rates of intra-uterine asphyxia, intra-uterine growth retardation and low Apgar scores were higher in babies of short mothers than in those of control mothers, despite the increased level of obstetric intervention in the former group. Since the findings show that short stature in pregnant women is an obstetrical risk factor, we recommend that it should be given attention in order to detect early signs of intra-uterine asphyxia and to apply the best form of active management of labor if necessary.

Body Height↗
PubMed1987

Mortality, life expectancy and causes of death of mildly mentally retarded in Denmark.

Based upon the nationwide Danish registration, all cases with ICD 8 diagnoses 310 and 311 were drawn; 71% lived outside institutions. 7,134 persons were studied for the period 1 January 1976-3 March 1984 and examined in the central register for death, emigration, etc. 5.86%, 446 died during the observation period from 1 January 1976 to 31 March 1984. Mortality tables show estimated survival probability at the end of the 5-year intervals and the life expectancy at the start of the age intervals. Only small differences were found when comparing differences of mortality for sex and residence (institutions or outside institutions). By a linkage study with the Danish Central Register for causes of death in the National Health Service of Denmark, the causes of death were obtained. For males of the age 15-64 an excess mortality of malignant neoplasms, of diseases of the respiratory system, of congenital malformations, and of accidents were found. For females the pattern was less significant.

Abnormalities, Multiple↗