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Biomedical subjects

W van den Burg

Publications and source records attributed to W van den Burg.

At least 19 recordsLinked to original sources

Performance of 225 Dutch school children on Rey's Auditory Verbal Learning Test (AVLT): parallel test-retest reliabilities with an interval of 3 months and normative data.

Performance on Dutch adaptations of Rey's AVLT was examined in a sample of 225 6- to 12-year-old Dutch school children, selected to be representative of the general population. With an interval of 3 months, they were tested twice, using two out of three test forms which proved to be parallel. No test-retest practice effects were apparent. Age had a considerable impact on test performance. Measured imperfectly, socioeconomic background and intellectual level had some additional influence, as did the examiner who administered the tests. Boys made more errors than girls. Normative data corresponded well with those collected in a smaller Australian sample, suggesting usefulness outside The Netherlands. With a parallel test-retest reliability of.70, which was reduced to.59 when the influence of age was taken into account, the most reliable AVLT measure was the total number of words correctly recalled over the five learning trials. On the basis of reliability data, implications for the clinical use of the AVLT are discussed.

Journal Article↗

The relationship between tiredness prior to sleep deprivation and the antidepressant response to sleep deprivation in depression.

Recently it was hypothesized that the antidepressant response to total sleep deprivation (SD) results from a disinhibition process induced by the increase of tiredness in the course of SD. In the present study, the role of tiredness in the antidepressant response to SD is further investigated. Seventy-two depressed patients scored subjective tiredness and depressed mood three times daily (in the morning, afternoon, and evening) on the days preceding and following SD. It was found that averaged tiredness on the day prior to SD was related to the SD response, when the severity of depression prior to SD had been held statistically constant. Also, when both severity of depression and diurnal variation of mood prior to SD were partialed out, tiredness showed a positive correlation with the SD response: patients who reported a relatively low degree of tiredness on the day preceding SD improved by SD. This result suggests that tiredness has an influence on SD effects, and that this influence is independent from that of the severity of depression. The findings are in accordance with current ideas on the role of tiredness as a mediating factor in the induction of the therapeutic effects of SD.

Adult↗

In vivo phosphorus magnetic resonance spectroscopy in multiple sclerosis.

Localized phosphorus magnetic resonance spectroscopy at 1.5 T was performed in 39 patients with multiple sclerosis and in 15 healthy controls. The multiple sclerosis spectra showed increased creatine phosphate levels. This increase was correlated with the severity of the handicap and was greater in patients with a progressive course of the disease than in patients with relapsing-remitting disease. No clear abnormalities were observed in the spectra of patients with multiple sclerosis regarding the phosphomonoesters, phosphodiesters, inorganic phosphate, and beta-adenosine triphosphate or with respect to pH values. There was an increased creatine phosphate level in the spectra in relation to a low metabolic state of the brain.

Adenosine Triphosphate↗

Sleep deprivation in bright and dim light: antidepressant effects on major depressive disorder.

Twenty-three patients with a major depressive disorder were deprived of a night's sleep twice weekly, one week staying up in the dimly lit living room of the ward (less than 60 lux), and one week in a brightly lit room (greater than 2000 lux). Immediate, but transient beneficial effects of sleep deprivation were observed primarily in eight patients (the 'responders'). The immediate effects did not differ greatly for the two conditions, indicating that exposure to light at night is an implausible explanation for the antidepressant effects of total sleep deprivation. There was some evidence that the bright light condition led to a more prolonged improvement of the responders.

Combined Modality Therapy↗

Cognitive impairment in patients with multiple sclerosis and mild physical disability.

Forty mildly disabled and clinically stable patients with multiple sclerosis (MS), representative of the corresponding population in Northern Holland, with disability Status Scale scores evenly distributed within the 1 to 4 range, were compared with 40 age-, sex-, and education-matched normal controls on a battery of neuropsychological tests. Apart from impairments in perceptual-motor functioning, generally mild deficiencies in intelligence and, specifically, in memory were displayed in the MS group. Attentional processes appeared uncompromised. Increasing fatigue during testing could not account for poor performance. The memory deficits could be attributed to poor initial learning, although there was also evidence suggesting that accelerated forgetting of what had been learned may appear with the progression of MS. Seven patients (17.5%), as compared with none of the controls, were classified by blind clinical judgement of test performance as definitely impaired.

Adult↗

Meige syndrome: double-blind crossover study of sodium valproate.

A double-blind crossover study of sodium valproate and placebo was conducted in five patients with Meige syndrome. CSF neurotransmitter studies were performed at the end of each treatment period. GABA levels were not influenced by the administration of sodium valproate. An increase in HVA levels was observed in every patient, which may reflect an increase in central dopaminergic activity. This finding may explain the trend towards clinical deterioration which was observed during treatment with sodium valproate. Sodium valproate appears to be ineffective in Meige syndrome.

Basal Ganglia Diseases↗

Carotid endarterectomy: does it improve cognitive or motor functioning?

In a group of 20 patients who were to undergo endarterectomy for atherosclerotic occlusive disease of the internal carotid artery, the stenosis did not appear to have resulted in cognitive or motor deficits. Consistent with this finding, surgery could not be shown to have a beneficial effect on cognitive or motor functioning. Control data were supplied by 20 patients who underwent peripheral vascular surgery and 20 healthy subjects. The test-retest interval was 10 weeks.

Arteriosclerosis↗

Residual complaints of patients two years after severe head injury.

In a follow up study of 57 patients who had sustained a severe closed head injury, 84% still reported some residual deficit in their psychological functioning after two years, with forgetfulness being the most common complaint. Expressing the severity of the injury in terms of both the duration of post-traumatic amnesia (PTA) and the extent to which previous work could be resumed (RTW), principal components analyses showed that the occurrence of "impairment complaints"--viz forgetfulness, slowness, poor concentration and inability to divide attention over two simultaneous activities--was positively related to severity. The other complaints, which in the main could be labelled as "intolerances" were not. The same pattern was found when the analyses were based on deficits of the patients as they were reported by relatives. Severity was not appreciably related to the total number of complaints. The correlation between PTA and RTW was 0.52, indicating that with longer PTA duration, work is likely to be resumed at a lower level, or not at all. Though Russell's cut-off of one week PTA to differentiate between severe and very severe concussion appeared useful, in the present study a further cut-off point at the unlucky number of 13 days was considered.

Adolescent↗

Role of stenosis of spinal canal in L4-L5 nerve root compression assessed by flexion-extension myelography.

Myelographic flexion-extension studies were performed in four groups of 10 patients each, with (A) normal myelogram; (B) bilateral nerve root compression at L4-L5; (C) unilateral nerve root compression at L4-L5 and (D) nerve root compression at L5-S1. The aim of the investigation was to assess the role of spinal stenosis in contributing to nerve root compression. The results indicate that a form of stenosis of the spinal canal plays an important role in bilateral nerve root compression at L4-L5, and to a lesser extent in unilateral nerve root compression at L4-L5. It does not appear to play a role in L5-S1 nerve root compression (stenosis of the lateral recess left aside). It is advocated that in myelographic L4-L5 nerve root compression additional flexion-extension studies should be performed in order to evaluate the possible role of stenosis of the spinal canal contributing to this compression. Even in nerve root compression by disc extrusion, concomitant spinal stenosis may necessitate additional decompressive laminectomy.

Humans↗

Spasmodic torticollis: treatment with Tizanidine.

A randomized double-blind cross-over study was performed to compare the efficacy of Tizanidine to that of placebo in the treatment of spasmodic torticollis. No evidence was found that Tizanidine was effective in 10 patients with spasmodic torticollis who received Tizanidine during 6 weeks, up to a dose of 12 mg a day.

Adolescent↗

Acid metabolites and precursor amino acids of 5-hydroxytryptamine and dopamine in affective and other psychiatric disorders.

Levels of various compounds related to monoamines were assessed in 96 patients with a variety of depressive and nondepressive syndromes. The diagnostic categories were composed retrospectively after examination of International Classification of Diseases (ICD) classifications and all available data in medical reports. All patients underwent the 8-hour probenecid test. Administration of probenecid was partly intravenous (1 g) and partly oral (4 g). In all patients, the cerebrospinal fluid (CSF) levels of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), and probenecid were estimated, while in about half of the patients tryptophan and tyrosine were determined in CSF and serum. When the group is taken as a whole, significant positive correlations are found between the CSF levels of 5-HIAA, HVA and probenecid, between the CSF levels of tryptophan and tyrosine, and between tyrosine levels in serum and CSF. A negative correlation is found between CSF probenecid and serum tryptophan. The group of patients was divided in several ways into various subgroups. Analysis of covariance of clinical and biochemical data indicates no significant biochemical differences between any of the subgroups. This retrospective study lacks supportive evidence that any of the clinical syndromes, including the depressive syndromes, is characterized by specific deficiencies of monoamine neurotransmission.

Adjustment Disorders↗

[Measurements of aphasic disorders. A brief description of the SAN-battery].

A Dutch test series for the measurement of aphasic disturbances is introduced. Factor analyses demonstrate three factors that can be interpreted clearly as spontaneous speech, production and comprehension of speech. This structure is very stable during a follow-up of one year. The tests and the production, comprehension and severity scores derived from them have high indices of reliability. Norms based on 147 cerebrovascular aphasics and 179 normal controls have been calculated.

Aphasia↗

Nature and severity of hydrocephalus and its relation to later intellectual function.

In 102 cases of infantile hydrocephalus, treated within 365 days of birth, the possibilities of predicting later intelligence were investigated, largely by means of multiple regression methods. No significant effect of aetiology, date of shunting or severity (measured in various ways) could be demonstrated. Within the spina bifida group however the 3 cases of encephalocele had considerably lower IQ's. There was no effect of lesion level in the rest of this group. Educational level of the parents had a significant, but not very marked impact on the IQ's of their children. Most outstanding was the difference between non-communicating and communicating hydrocephalus: nearly 50% of the non-communicating cases were mentally retarded, while this percentage was 22 for the communicating ones.

Adolescent↗

Comparative evaluation of metrizamide and meglumine ioxithalamate in angiography of the vessels of the head and neck.

Metrizamide, a non-ionic contrast medium of low osmolality was compared with meglumine ioxithalamate, the ionic angiographic contrast medium currently in use in our department in a double-blind study. Criteria upon which the comparison was based were: 1) the pain reaction of the patient upon intra-arterial contrast injection, 2) bradycardial reactions upon common carotid injection and 3) the quality of the contrast image. Metrizamide induced significantly less painful sensations than meglumine ioxithalamate in those vessels in which injections of contrast medium are frequently painful (external carotid artery, vertebral artery). No significant difference in the degree of bradycardia was caused by the two contrast media. The degree of bradycardia was also found to be poorly reproducible upon successive injections of the same contrast medium in the same patient, thus raising questions as to the suitability of this method for determining the toxicity of the contrast medium. The quality of the angiograms obtained did not differ significantly with the two media. Spasm, when it occurred during selective external carotid injections, was found to be independent of the contrast agent used, being correlated instead with the depth of distal advance of the catheter tip into the external carotid. Of the 51 patients included in the study, two patients suffered transient neurological deficit after angiography with metrizamide, and one patient suffered a permanent hemiplegia after angiography with meglumine ioxithalamate.

Aorta, Thoracic↗

TRH by slow, continuous infusion: an antidepressant?

A slow, continuous infusion of 1000 mug TRH (thyrotropin releasing hormone) over a period of 4 h had a very faint and diffuse short-lasting beneficial effect on a group of 10 depressive patients. This was assessed in a double blind cross-over trial with placebo. The effect was of no therapeutic value. No difference was found between the depressive patients and a control group of normal subjects in TSH response, T3 resin uptake, T4 or free thyroxine index values as a consequence of the TRH infusion.

Adjustment Disorders↗

Total sleep deprivation on endogenous depression.

Ten endogenous depressive patients were deprived of sleep for two whole nights according to the following schedule: sleep/sleep deprivation/sleep/sleep deprivation/sleep. No drugs were administered. Experimental conditions were as neutral as possible. Blind and nonblind ratings were taken. The patients were generally rated as improved after sleep deprivation, but a substantial effect, though temporary with rapid relapse, occurred in only two cases. After subsequent sleep, relapse followed as a rule. The net antidepressive effect of the total procedure was slightly more than nil.

Adult↗