Biomedical subjects
T Botez
Publications and source records attributed to T Botez.
Thiamine and folate treatment of chronic epileptic patients: a controlled study with the Wechsler IQ scale.
Seventy-two epileptic patients receiving phenytoin (PHT) alone or in combination with phenobarbital for more than 4 years were divided into four groups, the first taking two placebo tablets per day; the second folate (5 mg/day) and placebo; the third placebo and thiamine (50 mg/day); and the fourth both vitamins. The clinical trial lasted 6 months. At baseline assessment, 31% of the patients had subnormal blood thiamine levels and 30% had low folate. The vitamin deficiencies were independent phenomena. It was found that thiamine improved neuropsychological functions in both verbal and non-verbal IQ testing. In particular, higher scores were recorded on the block design, digit symbol, similarities and digit span subtests. Folate treatment was ineffective. These results indicate that, in epileptics chronically treated with PHT, thiamine improves neuropsychological functions, such as visuo-spatial analysis, visuo-motor speed and verbal abstracting ability.
Methodologic considerations in neuropsychologic testing of ataxic patients.
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Treatment of heredo-degenerative ataxias with amantadine hydrochloride.
Amantadine hydrochloride (AH) was administered (200 mg/day) for more than three months to 17 patients with Friedreich's ataxia (FA) and to 12 patients with olivopontocerebellar atrophies (OPCA) in an open clinical trial. Reaction time (RT) and movement time (MT) with the right and left hand were measured before and after treatment. A striking improvement on both RT and MT was observed in the OPCA group (on seven out of eight measures), whereas in the FA patients improvement was seen only in two out of four MT measures with no improvement in RT. Both groups had low levels of homovanillic acid (HVA) in their cerebrospinal fluid before treatment, relative to their controls. However, improvement with AH was not related to HVA levels.
Single photon emission computed tomography (SPECT) in cerebellar disease: cerebello-cerebral diaschisis.
Single photon emission computed tomography assessments were conducted in normal controls (n = 25), patients with unilateral cerebellar infarctions (n = 4), patients with olivopontocerebellar atrophy (OPCA; n = 15) and patients with Friedreich's ataxia (FA; n = 6). In subjects with unilateral cerebellar infarctions, crossed cerebellar-cortical diaschisis was observed: reduced cerebellar hexamethylpropyleneamine oxime (HMPAO) uptake was invariably accompanied by a diminution of HMPAO in the contralateral basal ganglia and frontoparietal cortex. OPCA and FA patients had various degrees of decreased HMPAO uptake in both the cerebellum and cerebral hemispheres.
Role of the cerebellum in complex human behavior.
Thirty-three outpatient epileptics with normal CT scans (group 1) and 31 patients with cerebellar and brain stem (CBS) atrophy (group 2) were randomly included in this study. There were no significant statistical differences between the groups with regard to age, education, and number of grand mal and other seizures. Statistical analyses showed that group 2 had a longer history of epilepsy with a consequently longer duration of phenytoin (PHT) consumption. Neuropsychological assessment revealed lower performance by this group on the following measures: full I.Q. scale, verbal I.Q. scale, performance I.Q. scale, information, arithmetic, block design, object assembly, digit symbol, Stroop test forms I and II, the B-M dexterity test, and the simple visual and auditory reaction time. No significant differences were observed between the two groups for the remaining 5 subtests from the WAIS scale, for the immediate recall and the delayed recall subtests belonging to Wechsler memory scale as well as for visual and auditory movement time. Analysis of the composite scores of neuropsychological performance showed that the cerebellum interferes with the following complex behavioral functions: (i) visuo-spatial organization for a concrete task, a function related to the cerebello-parietal loops' (ii) planning and programming of daily activities, a function related to the cerebello-frontal loops; and (iii) the speed of information processing, a mainly subcortical function.
[Acute respiratory insufficiency in acute dyspneic pneumonias].
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Defective revisualization: dissociation between cognitive and imagistic thought case report and short review of the literature.
A 38-year-old shifted-sinistral patient displayed a definite deficit in visual imagery accompanied by defective dreaming capacity, loss of hypnagogic imagery, some defects in topographical memory, a mild unilateral right spatial neglect and mild difficulties in right-left orientation on the examiner's body. CT-scan and NMR studies showed evidence of an inborn hypoplasia of the right hemisphere and a stretched corpus callosum in its posterior and superior part. The vicarious compensatory action of the cognitive-verbal function of the defect of visual imagery was obvious. It is concluded that: there are various forms of visual imagery deficits: some are "pure" whereas in the great majority of reported cases the loss of visual imagery is associated to different forms of visual agnosia; the brain mechanisms underlying cognitive thought and imagistic thought could be obviously dissociated.
The Wechsler subtests in mild organic brain damage associated with folate deficiency.
Forty-nine patients with low serum and cerebrospinal fluid folate levels completed the Ottawa-Wechsler Scale after 7-11 months of folate supplementation (10 mg daily). Twelve patients exhibited major neurological symptoms, while 37 patients displayed depression and minor neurological signs. After folate therapy, Verbal, Performance and Full Wechsler scores were significantly improved (P less than 0.001). The order of improvement in scores on the Wechsler subtests (from the statistically most significant to the least as measured by the t-statistics) was: Block Design, Digit Symbol, Similarities, Picture Completion, Picture Arrangement, Arithmetic, Object Assembly, Digit Span, Information, and Comprehension.
[Neuromusicology, an integral part of clinical neuropsychology].
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Computerized tomographic scanning and the diagnosis of dementia.
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Polyunsaturated fatty acids and colchicine in multiple sclerosis.
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Folate-responsive neurological and mental disorders: report of 16 cases. Neuropsychological correlates of computerized transaxial tomography and radionuclide cisternography in folic acid deficiencies.
Two groups of patients with folic acid responsive neurological and psychiatric disorders are reported. The first group (7 patients) had well-established acquired folate deficiency due either to defective absorption (4 cases with atrophy of jejunal mucosa) or to a deficient diet (3 cases). One patient had a subacute combined degeneration of the spinal cord while others were depressed and had weight loss, permanent muscular and intellectual fatigue, restless legs syndrome, depressed ankle jerks, diminution of the sense of vibration in the knees and a stocking-type tactile hypoesthesia. The second group (9 patients) comprised idiopathic cases of folic acid deficiency. Their main subjective complaints were chronic fatigability and familial restless legs syndrome. The neurological findings were similar to those of the patients with acquired disorders. Neuropsychological testing procedures revealed an abnormal intellectual functioning in all 16 patients. Abnormal patterns of radionuclide cisternograms and computerized transaxial tomography (CTT) were found in 11 patients. After 6-12 months of folic acid therapy a striking improvement regarding their intellectual functioning was noticed: the IQ, Kohs Block Design and Category tests were significantly improved. The correlation of neuropsychological findings with CTT and radionuclide cisternograms led to the conclusion that chronic folate deficiency could induce cerebral atrophy.