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PubMed2004

Patient perception of comorbid conditions after acoustic neuroma management: survey results from the acoustic neuroma association.

OBJECTIVES/HYPOTHESIS: Based on survey results of the Acoustic Neuroma Association, the patient ratings of the most difficult aspects of acoustic neuroma management were reported and a review of the literature was made regarding comorbid conditions associated with acoustic neuroma treatment and their impact on patient quality of life. STUDY DESIGN: Cohort study of 1940 patients who were members of the Acoustic Neuroma Association. METHODS: A detailed questionnaire was mailed to 2372 members of the Acoustic Neuroma Association to identify preoperative and postoperative symptoms, complications, and long-term effects on physical and psychosocial function. For 1940 respondents (81.8%) who reported the "most difficult aspect of the AN [acoustic neuroma] experience," the responses were analyzed by tumor size, surgical approach, and patient age and sex. Statistical analysis was performed using SPSS software. RESULTS: Respondents reported that the most difficult aspect of the acoustic neuroma experience was hearing loss (25.8%), followed by facial weakness (17.9%), eye problems (10.8%), and headache (10.5%). In order of frequency, men reported hearing loss, balance problems, perioperative surgical experience, and eye and facial weakness, and women reported hearing loss, facial weakness, eye problems, and headache. Facial weakness was a morbidity more often reported for men and women who had large tumors, who were young, or who had undergone the retrosigmoid approach. Balance dysfunction was significant in patients older than 75 years of age. In patients with small tumors, headaches and balance problems were frequently reported. CONCLUSION: In the large cohort study of patients with acoustic neuroma, perceptions regarding the impact of treatment illustrated why it is incumbent on physicians to understand the sentiments of patients with acoustic neuroma when counseling them and recommending optimal management strategies.

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PubMed2002

Semantic dysfunction in women with schizotypal personality disorder.

OBJECTIVE: This study examined whether early or late processes in semantic networks were abnormal in women with a diagnosis of schizotypal personality disorder. The N400 component of the EEG event-related potentials was used as a probe of semantic processes. METHOD: Word pairs were presented with short and long stimulus-onset asynchronies to investigate, respectively, early and late semantic processes in 16 women with schizotypal personality disorder and 15 normal female comparison subjects. Event-related potentials were recorded in response to the last words in a pair. RESULTS: With the short stimulus-onset asynchrony, the N400 amplitude was less negative in the schizotypal personality disorder group than in the normal comparison group. No group differences were found with the long stimulus-onset asynchrony. CONCLUSIONS: The finding of a less negative than normal N400 amplitude with the short stimulus-onset asynchrony in women with schizotypal personality disorder supports the hypothesis that persons with this disorder evince an overactivation of semantic networks. The absence of group differences with the long stimulus-onset asynchrony, which is primarily sensitive to processes involved in context integration, suggests that in this group of schizotypal personality disorder subjects, additional demands on working memory may be necessary to bring out the semantic dysfunction.

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PubMed1986

Fipexide, an effective cognition activator in the elderly: a placebo-controlled, double-blind clinical trial.

Forty geriatric in-patients with severe cognition disorders were randomly allocated to treatment with either 600 mg fipexide daily or placebo over a period of 3 weeks. Before and after treatment, the symptoms of cognitive performance (disorders of memory and attention, asthenia, apathy and disorders of coenaesthesia) were monitored and scored. Similarly, the Thurstone test (symbol matching test) was performed and time to completion, number of errors and exactitude index were recorded. Haemodynamics, haematology and haematochemistry investigations were made before and after treatment, and accessory symptoms of potential side-reactions were monitored by positive questioning. Treatment with fipexide was associated with a significant improvement in each and all monitored symptoms and signs to an average extent of 60%, whereas placebo was not. Similarly, the patients given fipexide experienced a significant improvement in the Thurstone test, in terms of time to completion (-22%), number of errors (-46%) and exactitude index (+60%); again, placebo was not associated with any significant improvement (variations, respectively, of -5%, -14%, and +24%). Overall, 85% of the patients given fipexide experienced clinical improvement to a greater or lesser degree, a significantly greater proportion than that associated with placebo (25%; p less than 0.001). Tolerance, both subjective and objective, was good in both treatment groups.

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