What is Vasculitis?
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Giant Cell Arteritis↗
Biomedical subjects
Stephen E Nadeau
Publications and source records attributed to Stephen E Nadeau.
Immobilization dystonia.
The mechanisms underlying dystonia after injury are unclear. Pain has been implicated as an important factor. We report four patients who exhibited segmental dystonia following removal of a cast, only two of whom experienced pain during casting. Recent work implicates the cerebral cortex as an important site of neural plasticity underlying the development of dystonia. Cortical changes may be induced by peripheral stimuli that are repetitive, spatially and temporally proximate, stereotyped, and attended. Immobilization by casting may meet these requirements if there is sufficiently persistent sensation of the immobilized limb to assure that it is regularly attended. The fact that all of our patients were immobilized but only two experienced pain during casting suggests that pain is not necessary and immobilization alone may be sufficient for the development of segmental dystonia after peripheral injury, consistent with the implications of animal studies.
Adult↗
Category-specific naming deficits for objects and actions: semantic attribute and grammatical role hypotheses.
Research on category-specific naming deficits and on noun and verb naming has raised questions about how organization of knowledge in the brain impacts word retrieval. The semantic attribute hypothesis posits that lexical access is mediated by brain systems that process the most definitive attributes of specific concepts. For example, it has been suggested that the most definitive attribute of living things is their visual form, whereas the most definitive attribute of non-living things is their function. The competing grammatical role hypothesis posits that access to a word depends on the grammatical role it plays in a sentence. Since nouns and verbs have different roles, it is assumed that the brain uses different systems to process them. These two hypotheses were tested in experimental subjects who had undergone left anterior temporal lobectomy (LATL) or right anterior temporal lobectomy (RATL) by assessing confrontation naming of living things, tools/implements, non-human actions, and human actions. The names of living things and implements are nouns and the names of actions are verbs. Within each grammatical class, items were characterized either predominantly by visual attributes (living things and non-human actions) or by attributes related to human activity (implements and human actions). Our results support the semantic attribute hypothesis. Patients with LATL were worse at naming tools/implements and human actions than RATL patients. Dysfunction in or removal of the left anterior temporal lobe disrupts fronto-temporal connections from the uncinate fasciculus. These connections may mediate activation of action-related information (i.e. movement plan and/or motor use) that facilitates the retrieval of names for tools/implements and human actions.
Adult↗
Neurologic manifestations of systemic vasculitis.
The clinical features, diagnosis, and treatment of polyarteritis nodosa, Kawasaki disease, hypersensitivity angiitides (including drug-related vasculitis, serum sickness, Henoch-Schönlein purpura, hypocomplementemic vasculitis and cryoglobulinemia), Wegner's granulomatosis, temporal arteritis and Takayasu's arteritis are reviewed from a neurological perspective.
Arteritis↗
Neurologic manifestations of connective tissue disease.
The clinical features, diagnosis, and treatment of systemic lupus erythematosus, scleroderma, rheumatoid arthritis, Sjögren's syndrome, mixed connective tissue disease, Behcet's disease, Cogan's syndrome, and relapsing polychondritis are reviewed from a neurological perspective with an emphasis on pathogenic mechanisms and their relationship to treatment.
Arthritis, Rheumatoid↗
A paradigm shift in neurorehabilitation.
The practice of neurorehabilitation in the clinic has undergone a paradigm shift as a result of influences from basic and clinical research. I have identified six areas of knowledge that by advancing so rapidly have brought about this paradigm shift: first, the increased understanding of how the CNS is reorganised after training or injury; second, the knowledge of how declarative and procedural memory operates and how this can influence rehabilitation therapy; third, a greater appreciation of the chemical factors that promote learning and neural remodelling; fourth, the fact that computational neuroscience can teach us how complex behaviour can emerge from the interaction of thousands of neurons; fifth, the influence of evidence-based medicine on neurorehabilitation; and sixth, the importance of reliable outcome measures for both injury and treatment. These are young scientific disciplines that offer great opportunities for further research. The complexity of neurorehabilitation will also require greater attention to a substantially neglected problem, the incorporation of techniques that have been proven effective in clinical trials into routine and effective clinical practice.
Animals↗
Cerebral blood flow changes in depressed patients after treatment with repetitive transcranial magnetic stimulation: evidence of individual variability.
OBJECTIVE: To elucidate the neural mechanisms of depression. BACKGROUND: Despite extensive study, the neurophysiology of the brain's state(s) corresponding to depression remains uncertain. METHODS: HMPAO single photon emission computed tomographic (SPECT) scans were obtained from eight adults diagnosed with major depression resistant to medication (average age 51 years; 4 men) before and immediately after 10 days of 20 Hz repetitive transcranial magnetic stimulation (rTMS) (2000 stimuli/daily 30' treatment). To maximize the likelihood that SPECT scans reflected the state of depression, rather than uncontrolled responses of patients to poorly constrained environments, HMPAO was administered while subjects performed a simple task involving continuous monitoring of the direction of a large arrow on a computer screen and continuously tapping with the left or right index finger according to the direction of the arrow. Mean baseline Beck Depression Inventory (BDI) score was 27.4 (SD = 8.3) and mean posttreatment BDI score was 17.5 (SD = 8.5). RESULTS: Treatment responders (defined by reduction in BDI score of > or = 30%) had significantly less pretreatment blood flow in the left amygdala compared with nonresponders. Responders demonstrated two patterns of change in regional blood flow with treatment: a reduction in orbitofrontal blood flow and/or a reduction in anterior cingulate blood flow. Nonresponders did not demonstrate any regional changes in blood flow with treatment. CONCLUSIONS: These results suggest that there may be either more than one state of depression, or that depression may be associated with more than one pattern of psychologic activity, which in turn defines the depressive experience for individual patients.
Adult↗