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S Asenbaum

Publications and source records attributed to S Asenbaum.

68 records · Page 4Linked to original sources

Dopamine D2 receptor blockade and antimigraine action of flunarizine.

We studied in vivo the influence of flunarizine on dopamine D2 receptors and investigated whether dopamine D2 receptor blockade is involved in its antimigraine action. Eleven migraine patients, treated with flunarizine, 10 mg per day, underwent single photon emission computer tomography (SPECT) using [123I] labeled iodobenzamide, a ligand with high affinity and high specificity for D2 receptors. There was a reduction of the dopamine D2 receptor binding potential in all patients compared to age-matched controls. The efficacy of flunarizine in migraine prophylaxis failed to correlate with the degree of the dopamine D2 receptor blockade. The antimigraine action of flunarizine may not involve antidopaminergic mechanisms.

Adult↗

SPECT imaging of dopamine and serotonin transporters with [123I]beta-CIT. Binding kinetics in the human brain.

Single photon emission computerized tomography (SPECT) studies in non-human primates have previously shown that the cocaine derivative [123I]-2-beta-carbomethoxy-3-beta-(4-iodophenyl)-tropane ([123I]beta-CIT) labels dopamine transporters in the striatum and serotonin transporters in the hypothalamus-midbrain area. Here, we report on the regional kinetic uptake of [123I]beta-CIT in the brain of 4 normal volunteers and 2 patients with Parkinson's disease. In healthy subjects striatal activity increased slowly to reach peak values at about 20 hours post injection. In the hypothalamus-midbrain area peak activities were observed at about 4 hours with a slow decrease thereafter. Low activity was observed in cortical and cerebellar areas. The striatal to cerebellar ratio was about 4 after 5 hours and 9 after 20 hours. In 2 patients with idiopathic Parkinson's disease striatal activity was markedly decreased while the activity in hypothalamus-midbrain areas was only mildly diminished. Uptake into cortical and cerebellar areas appeared to be unchanged in Parkinson's disease. Consequently, in Parkinson's disease the striatal to cerebellar ratio was decreased to values around 2.5 after 20 hours. These preliminary methodological studies suggest that [123I]beta-CIT is a useful SPECT ligand for studying dopamine and possibly also serotonin transporters in the living human brain.

Adult↗

[The importance of magnetic field strength in the MR diagnosis of multiple sclerosis: a comparison of 0.5 and 1.5 T].

The value of magnetic resonance (MR) to establish the diagnosis of multiple sclerosis (MS) is well known. This study was undertaken to compare MR imaging of the brain of MS patients at high (1.5T) and mid (0.5T) field strength. 25 patients with MS underwent two consecutive MR studies within one hour, each consisting of axial proton density and T2-weighted spin-echo images. Lesions in the supratentorial white matter and corpus callosum and those in the brain stem and cerebellum were separately counted. At 1.5T significantly more lesions were seen than at 0.5T (p < 0.05). Although T2-weighted images at 1.5T added significant information compared to images obtained at 0.5T, in none of our 25 patients the diagnosis was missed at 0.5T. However, at 1.5T dissemination in space was better demonstrated, suggesting MR scanning with high field-units to be favourable in patients with clinically suspected MS.

Adult↗

Central nervous system function after cardiopulmonary bypass.

In a prospective study, an elderly group of patients (n = 63, 47 male, 16 female, age 40-65 years) was examined before and after open-heart surgery under cardiopulmonary bypass: postoperatively, 19 patients (30%) showed no clinical neuropsychiatric symptoms, whereas in 35 patients (56%) mild or transient neurological signs and in nine (14%) severe neurological complications were found. The postoperative EEG changes were characterized by a slight delta-theta increase, an alpha decrease and a significant slowing of the dominant frequency from 9.7 to 9.3 Hz. In brainstem auditory evoked potentials no changes were found, and in somatosensory evoked potentials (median nerve) the latency of the early cortical component, N20, increased. Cardiovascular reflexes showed increased changes, similar to those found in autonomic neuropathies. In the neuropsychological test battery, the Visual retention test (Benton) and the Rorschach test showed slight postoperative improvement, whereas other psychometric variables (flicker fusion frequency, reaction time) did not change. Despite an improved operative technique some minor clinical and neurophysiological disturbances of the central nervous system remain. However, specific pre- or peri-operative risk factors for these postoperative disturbances or complications could not be identified.

Adult↗

Dopamine D2 receptor imaging and measurement with SPECT.

Only recently it has become possible to label and visualize dopamine D2 receptors in the living human brain using an [123I]labeled ligand and the SPECT technique. Iodobenzamide (S(-)IBZM) is a substance with high affinity and high specificity for D2 receptors and was used in controls and in patients with different extrapyramidal disorders. After the i.v. administration of 5mCi (185 MBq) of [123I] labeled S(-)IBZM data collection was performed with a rotating double head scintillation camera between 60 and 110 minutes. In a semiquantitative approach a ratio was calculated between mean counts/pixel in the striatum and a region in the lateral frontal cortex, which gives an index of receptor density. In a group of 21 controls this ratio is 1.73 +/- 0.09. A highly significant age-related decline is found in controls and in 57 patients with PD. PD patients without L-DOPA or dopamine agonist treatment do not differ from controls (1.72 +/- 0.09; n = 18), whereas patients under dopaminergic therapy show a significantly lower binding ratio (1.65 +/- 0.13; n = 39; p = 0.017) suggesting receptor downregulation. Comparing the striatum ipsi- and contralateral to clinical symptoms in 18 hemiparkinsonian patients shows slightly but significantly higher values on the contralateral side, indicating receptor supersensitivity (1.71 +/- 0.11 vs. 1.66 +/- 0.09; p = 0.0014). No correlation between D2 receptor binding and clinical stage, duration of disease or duration of dopaminergic therapy exists. Markedly reduced ratios are measured in 7 patients with progressive supranuclear palsy and multiple system atrophies and in 18 patients with Huntington's disease (1.40 +/- 0.09 and 1.37 +/- 0.12 respectively; p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Frontal DC potentials in auditory selective attention.

Selective dichotic listening during periods of 35 sec was associated with negative shifts of the cortical DC potential. Amplitudes of negative DC potentials had maxima in frontal, in particular, in anterior frontal records. The temporal pattern of negative DC potentials was different between the fronto-lateral records of the two hemispheres: in records from the right side, DC potentials declined during the 35 sec observation period, whereas they remained sustained in those of the left side. Different instructions ("attend left ear," "attend right," "attend both") and different levels of pitch separation between deviants and standards had no effects on frontal negative DC potential shifts, which are discussed in terms of higher order control of selective dichotic listening.

Adult↗

[Neurologic and psychiatric complications after heart surgery].

In 63 patients undergoing heart operations with extracorporeal circulation (47 males, 16 females, mean age 54 years; coronary artery bypass in 38 cases, valvular surgery in the rest) postoperative neurological and psychiatric complications were evaluated. 18 patients (29%) had no complications, whereas 35 patients (56%) showed minor or transient neurological symptoms, and 9 patients (14%) exhibited severe symptoms. Nine of the patients had slight psychiatric disturbances (affective disturbances, disorientation). No correlation was found between risk factors (age, nicotine abuse, hypertension, hypercholesteremia, neurologic and cardiac history), intraoperative parameters (duration of extracorporeal bypass, aortic clamp time, deviation of mean arterial pressure), postoperative parameters (internal complications) and the complication rate. Therefore no predisposing factors could be identified.

Adult↗

Dopamine receptor classification, neuroanatomical distribution and in vivo imaging.

The classification of dopamine receptors and their neuroanatomical distribution is reviewed, including the newly discovered D3, D4 and D5 subtypes. In vivo imaging techniques and methods for quantification are briefly described and PET and SPECT studies of D2 receptors in schizophrenia, under neuroleptic treatment, in aging, Parkinson's disease, Huntington's disease, tardive dyskinesia and multisystem atrophies are reviewed and compared with our own results. A short description is given of imaging studies of D1 receptors.

Brain↗

The influence of temperature on somatosensory-evoked potentials during cardiopulmonary bypass.

Somatosensory-evoked potentials (SEPs) after median nerve stimulation were recorded in 10 neurologically normal patients during cardiopulmonary bypass and hypothermia. In all patients the changes of the latencies (spinal N13, cortical N20 and N35) and the central conduction time during cooling, and the decrease in latencies during rewarming was described by a gamma function. The analytic discussion of pooled data of all patients led to another SEP-latency-temperature relationship than the observation of each single patient. In 6 of 10 patients there was found a maximum of latency increase before the minimal temperature was reached. The cooling and the rewarming curve had to be considered separately. Latency changes of SEPs during hypothermia are discussed as a very complex phenomenon influenced by many technical and patient factors. This reduces the value of SEPs as an index of central nervous system integrity during open heart surgery and hypothermia.

Adult↗

[Evoked potentials in the follow-up and prognosis of patients with craniocerebral trauma].

The aims of this study were to find a reliable way of establishing the prognosis for the final outcome in the first week after head injury, to show the correlation between abnormalities in evoked potentials (EP) and clinical coma score, and finally, to document EP results in patients with the clinical diagnosis of brain death. We examined 46 patients, 23 in different states of coma and 23 with bulbar syndrome (complete absence of cortical and brain stem function). In the group of comatose patients brain stem auditory EP (BAEP) and somatosensory EP (SEP) were recorded in the first 48 h, 3-5 days, 1 week and 4 weeks after the head injury. The depth of coma was scaled with a scoring system devised by the authors and with the Innsbruck coma scale. Outcome was evaluated with the Glasgow outcome scale after 3, 6, and 9 months. BAEP were recorded bilaterally after stimulation with clicks; SEP were recorded from the neck (C2) and the contralateral cortex (C3', C4') after electrical stimulation of the median nerve. Evoked potentials were scored according to a four-point scale from grade 1 (normal) to grade 4 (only component I present in BAEP or absence of cortical responses on both sides in SEP). We found a significant correlation between the mean SEP score of the first week and the Glasgow outcome of the 3rd month, but no significant correlation between the BAEP score of the first week and the Glasgow outcome. There was a significant correlation between SEP (BAEP) scores and the corresponding clinical score.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Topographic brain mapping of EEG before and after open-heart surgery.

The brain function of 60 patients undergoing open-heart surgery (36 patients receiving coronary artery bypass, 21 patients valve replacements, 3 both) was investigated before and 10 days after the operation utilizing topographic brain mapping of the electroencephalogram (EEG). The postoperative EEG changes were characterized by a slight delta-theta increase, an alpha decrease [especially in the fast alpha (10.5-13 Hz) band] and a beta increase in the relative power. The total power and the absolute power of the delta-theta, alpha and beta showed a decrease, the dominant frequency a significant slowing from 9.7 to 9.3 Hz. The centroid of alpha and beta activity decreased as well. These results are similar to findings obtained in patients with organic brain syndrome. The EEG changes were prominent over the left hemisphere, which may be of particular clinical relevance.

Adult↗

SPECT and MR imaging in herpes simplex encephalitis.

Two cases of necrotizing herpes simplex encephalitis (HSE) were investigated with 99mTc-hexamethylpropyleneamineoxime (HMPAO) SPECT and MR. The clinical course was compared with the neuroimaging results. In the acute stage, the increased HMPAO uptake matched the MR hyperintense signal in the limbic temporal lobe and in the basal ganglia. Protracted inflammation was accompanied by persistently high HMPAO uptake. The sequelae of HSE were characterized by decreased HMPAO uptake and postnecrotic widening of the temporal horns. The "limbic" pattern recognized in both SPECT and MR reflects the basic pathophysiology and neuropathology of HSE. Both methods may be useful in the diagnosis and follow-up of HSE.

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