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Rafeeque Bhadelia

Publications and source records attributed to Rafeeque Bhadelia.

7 recordsLinked to original sources

Orbitofrontal correlates of aggression and impulsivity in psychiatric patients.

The association between orbital frontal cortex (OFC) volume and aggression and impulsivity was investigated among a heterogeneous group of non-psychotic psychiatric clients. Fifteen non-psychotic subjects from two different psychiatric clinics (New England Medical Center and Lemuel Shattuck Hospital) with a variety of diagnoses were sequentially referred for magnetic resonance imaging (MRI) for clinical purposes. This convenience sample, clinically stable at the time of evaluation, received a standardized psychiatric diagnostic interview, aggression and impulsivity psychometrics (Barratt Impulsivity, Lifetime History of Aggression, and Buss-Perry Aggression scales), and an MRI protocol with image analysis. OFC gray matter volume, total as well as left and right, was significantly and positively associated with motor impulsivity. OFC asymmetry was associated with aggression, though total, left, and right OFC volume measurements were not. For subjects without affective disorder, there was a strong and positive association of the OFC to motor and no-planning subscales of the Barratt Impulsivity Scale. For subjects with affective disorder, there was a strong association of OFC asymmetry to both of the aggression psychometrics. Consistent with expectation, results are suggestive of OFC involvement in the neural circuitry of impulsivity and aggression. The findings suggest a dissociation of the role of the OFC in relation to aggression and impulsivity, such that the OFC may play a part in the regulation of aggressive behavior and a generative role in impulsive behavior.

Adult↗

The Nutrition, Aging, and Memory in Elders (NAME) study: design and methods for a study of micronutrients and cognitive function in a homebound elderly population.

BACKGROUND: Micronutrient status can affect cognitive function in the elderly; however, there is much to learn about the precise effects. Understanding mediating factors by which micronutrient status affects cognitive function would contribute to elders' quality of life and their ability to remain in the home. OBJECTIVES: The Nutrition, Aging, and Memory in Elders (NAME) Study is designed to advance the current level of knowledge by investigating potential mediating factors by which micronutrient status contributes to cognitive impairment and central nervous system abnormalities in the elderly. NAME targets homebound elders because they are understudied and particularly at risk for poor nutritional status. METHODS: Subjects are community-based elders aged 60 and older, recruited through area Aging Services Access Points. The NAME core data include demographics; neuropsychological testing and activities of daily living measures; food frequency, health and behavioral questionnaires; anthropometrics; gene status; plasma micronutrients, homocysteine, and other blood determinants. A neurological examination, psychiatric examination, and brain MRI and volumetric measurements are obtained from a sub-sample. RESULTS: Preliminary data from first 300 subjects are reported. These data show that the NAME protocol is feasible and that the enrolled subjects are racially diverse, at-risk, and had similar basic demographics to the population from which they were drawn. CONCLUSION: The goal of the NAME study is to evaluate novel relationships between nutritional factors and cognitive impairment. These data may provide important information on potential new therapeutic strategies and supplementation standards for the elderly to maintain cognitive function and potentially reduce the public health costs of dementia.

Activities of Daily Living↗

Rapid development of optic glioma in a patient with hybrid phakomatosis: neurofibromatosis type 1 and tuberous sclerosis.

Increased propensity for tumor formation in neurofibromatosis and tuberous sclerosis exists because of defective tumor-suppressor genes. Although different tumor-suppressor genes may be involved in neurofibromatosis and tuberous sclerosis, at the cellular level these genes share rather common enzymatic pathways. We believe these genetic malfunctions have resulted in a cumulative or additive effect for rapid growth of optic glioma in the following unusual case that has hybrid phakomatosis.

Female↗

Case report: hypoglycemia and diffusion-weighted imaging.

The effect of severe hypoglycemia on the brain is well known, ranging from alterations of mental status to profound coma and death. We describe a case of global diffusion abnormalities eventually resulting in death. This otherwise healthy patient presented with seizures and a serum glucose level less than 20 mg/dL. Testing suggested that the hypoglycemia was likely caused by exogenous insulin or perhaps insulin receptor antibodies. Magnetic resonance imaging on the day after admission showed regions of restricted diffusion in the temporal and occipital lobes as well as in the basal ganglia. Despite the large body of literature concerning the pathophysiology of hypoglycemia and its clinical implications, little is known regarding its radiologic correlations.

Brain↗

Rhabdomyoma of the head and neck demonstrated by prenatal magnetic resonance imaging.

A case of fetal rhabdomyoma (myxoid type) of the head and neck demonstrated on prenatal magnetic resonance imaging (MRI) is presented. This benign tumor of skeletal muscle is uncommon and should not be confused with its malignant counterpart-rhabdomyosarcoma. With the increasing use of ultrafast MRI, the radiologist is more likely to encounter head and neck masses in the fetus.

Adult↗

Homocysteine and B vitamins relate to brain volume and white-matter changes in geriatric patients with psychiatric disorders.

OBJECTIVE: There is a growing literature on the relationship between low serum B-vitamins, elevated homocysteine, and cognitive impairment; however, few studies have examined radiological markers of associated neuropathology in geropsychiatry inpatients. The authors examined the relationship of homocysteine, folate, and vitamin B12 with magnetic resonance imaging (MRI) markers of neuropathology. METHODS: In this archival study, authors reviewed the MRIs and medical records of 34 inpatients in a geriatric psychiatry unit. Patients were selected if folate, B12, and/or homocysteine levels had been assessed and if the appropriate clinical MRIs were performed (19 men; mean age, 75 years). Patients with schizophrenia or current substance dependence were excluded. The relationships between MRI volume measures, white-matter hyperintensity (WMH) grade, and serum concentrations of folate, B12, and homocysteine were analyzed, using age-adjusted Pearson correlations. RESULTS: Homocysteine was related to WMH grade, but not brain-volume measures. Folate was associated with hippocampus and amygdala, and negatively associated with WMH. B12 level was not statistically associated with any brain measure. CONCLUSIONS: Elevated homocysteine and low folate were associated with radiological markers of neuropathology. Since no patient had clinically deficient folate, it may be important to rethink what defines functionally significant micronutrient deficiency and explore what this means in different age- and health-status groups. Larger samples will be needed to assess interactions between homocysteine, micronutrients, and other neuropathology risk factors.

Adult↗