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Biomedical subjects

S Starkstein

Publications and source records attributed to S Starkstein.

14 recordsLinked to original sources
PubMed1990

D2 receptors in Huntington's disease: positron emission tomography findings and clinical correlates.

The relationship of dopamine receptor binding in the caudate nucleus and the putamen to neurological and neuropsychological functioning was examined in 21 patients with Huntington's disease (HD) and eight individuals at risk of developing Huntington's disease. A significant reduction in relative binding of [11C]3-N-methylspiperone to the dopamine receptor was found in both the caudate and putamen of HD patients. Binding in the caudate was correlated only with tests of rapid coding and set alternation, while binding in the putamen was correlated only with duration of illness. The findings indicate that the well-described atrophic changes in the striatum of Huntington's disease patients are accompanied by receptor alterations. They also support previous animal and human studies indicating that the caudate nucleus plays a larger role in cognition than in motor functions.

Adult↗
PubMed1989

Anterior callosal haemorrhage. A partial interhemispheric disconnection syndrome.

The interhemispheric disconnection syndrome secondary to a callosal haemorrhage is exceedingly uncommon. In the present study, 3 patients with haemorrhages restricted to the corpus callosum are presented. All 3 developed a partial anterior interhemispheric disconnection syndrome: unilateral tactile anomia, unilateral agraphia, unilateral apraxia, difficulty in copying drawings, dyscalculia as well as abnormalities of somaesthetic transfer and the 'alien hand' sign. The study of these cases allowed a close examination of the association between deficits in the transfer of specific neuropsychological information and the precise topography of callosal damage. Variability in the lateralization of cognitive functions, and possible mechanisms underlying the production of callosal haemorrhages after the rupture of saccular aneurysms are also discussed.

Adult↗
PubMed1988

Asymbolia for pain: a sensory-limbic disconnection syndrome.

We describe the behavioral and neuroanatomical features of asymbolia for pain occurring in 6 patients following unilateral hemispheric damage secondary to ischemic lesions in 5 and traumatic hematoma in 1. In the absence of primary sensory deficits, these 6 patients showed a lack of withdrawal and absent or inadequate emotional responses to painful stimuli applied over the entire body, as well as to threatening gestures. Five patients also failed to react to verbal menaces. Patients appeared unconcerned about the defect and seemed unable to learn appropriate escape or protective responses. Common associated abnormalities were rapidly resolving hemiparesis, cortical-type sensory loss, unilateral neglect, and body-schema disorders. Neuroradiological examination disclosed left hemispheric lesions in 4 patients and right hemispheric involvement in 2. Although lesion extension differed, the insular cortex was invariably damaged in all 6 patients. These findings suggest that insular damage may play a critical role in the development of the syndrome by interrupting connections between sensory cortices and the limbic system.

Adult↗
PubMed1988

Unusual manifestations of basilar artery ectasia.

Three patients with unusual presentations of basilar artery ectasia are described: subarachnoid hemorrhage was manifest in one and autonomic dysfunction developed in the other two. Aneurysmal rupture was the cause in the first patient, while compression of the brainstem and/or of the baroreceptor afferences of the IXth and Xth cranial nerves is postulated to be responsible for the symptoms found in the other two. Basilar artery aneurysms should be considered in cases with subarachnoid hemorrhage or autonomic dysfunction, particularly when diagnostic procedures fail to disclose other possible etiologies.

Autonomic Nervous System Diseases↗
PubMed1988

Ischemic infarction in 25 children with tuberculous meningitis.

Twenty-five cases (38%) of ischemic infarction occurred among 65 cases of tuberculous meningitis in patients less than 14 years of age. The male:female ratio was 1.3:1. The most frequent clinical findings were meningeal signs, fever, alteration of consciousness, cranial nerve involvement, seizures, and focal neurologic deficit. Twenty-three patients had anterior circulation infarcts, and two more had infarcts in the vertebrobasilar territories. Distribution of infarcts in the anterior circulation was shown by computed tomography in the territories of the following arteries: lenticulostriate, 10 cases unilateral and 6 bilateral; middle cerebral, 3 cases; internal carotid, 1 case; multiple areas, 3 cases. Of the 25 ischemic infarction cases, 23 (92%) had hydrocephalus, 19 (76%) basal exudates, and 2 (8%) tuberculomas. Outcome was poor since no patient with infarction recovered completely. Six died and bilateral subcortical infarcts led to a considerably higher mortality than unilateral ones, whether cortical or subcortical.

Brain Ischemia↗
PubMed1987

Behavioral effects of damage to the right insula and surrounding regions.

A severe multimodal neglect syndrome, mutism, oral apraxia and ideomotor apraxia for the right hand suddenly developed in a right-handed male following a right hemisphere (central) stroke. Neuropathologic examination showed an ischemic infarction involving the whole right insula, adjacent white matter, and the inner cortical surface of the right fronto-temporo-parietal operculum. The left hemisphere was spared. It is suggested that damage to the right insula (a polymodal convergence area), and the adjacent white matter may lead to severe neglect. Our case also demonstrates a clear dissociation between dominance for handedness and dominance for kinesthetic motor engrams.

Behavior↗
PubMed1987

Neuropsychological disturbances in hemiparkinson's disease.

Nine parkinsonian patients with main unilateral symptoms on the right side (RHP) and nine with symptoms on the left side (LHP) were assessed through a comprehensive neuropsychological battery. RHP performed at a lower level than LHP on the WAIS verbal subtests. Although both groups scored poorly on a test of frontal lobe functions, RHP performed significantly lower than LHP. On a line bisection task, LHP showed a mild left hemispatial neglect. In conclusion, mild but significant intergroup differences were observed, tending to correlate with predominantly hemispheric functional deficits.

Female↗
PubMedDate not supplied

Cardiovascular reflexes and pudendal evoked responses in chronic haemodialysis patients.

The bulbocavernous reflex (BCR), cortical pudendal evoked responses (CPERs), non-invasive cardiovascular tests and nerve conduction studies were performed in 16 patients on chronic haemodialysis and in a group of normal subjects. BCR and CPERs were more severely affected in patients with impotence. There was a significant correlation between the Valsalva ratio and P1 latency of the CPERs. The BCR and CPERs are alternative techniques for the assessment of impotence in uremic patients.

Adult↗
PubMedDate not supplied

Acute atypical psychosis following a right hemisphere stroke.

An acute atypical psychotic episode characterized by hallucinations and delusions suddenly developed in a 63-year-old right-handed male following an extensive right hemisphere infarction in the carotid artery distribution. While hallucinations were visual, tactile and auditory, delusions were associated with specific neurologic defects (anosognostic phenomenon, reduplication for place, body-parts and objects and confabulation). Distractibility, inappropriate sexual behavior, agitation or seizures were lacking. This case supports the presumption that the right hemisphere damage plays a major role in the genesis of organic psychotic episodes.

Brain↗