Parálisis hipocalémica tirotóxica. A propósito de un caso / Thyrotoxic hypokalemic paralysis. Apropos of case

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Epilepsia infantil por descargas rolándicas: diagnóstico mediante magnetoencefalografía / Rolandic discharges in childhood epilepsy: magnetoencephalographic diagnosis

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[Atrophy of the amygdala complex and neuropsychiatric expression of Alzheimer s disease]. / Atrofia del complejo amigdalino y expresión neuropsiquiátrica de la enfermedad de Alzheimer.

INTRODUCTION: In Alzheimer s disease, together with cognitive changes (loss of memory, lack of orientation in time and space, difficulty in carrying things out, etc.) non cognitive disorders also occur, seriously disturbing the patient s behavioral and emotional balance. Depression, delirious ideas, hallucinations and behavior changes (habits regarding sex, feeding and movement) are amongst the commonest features of this disease from its earliest stages. Several studies have described how initially the histopathological changes selectively involve different structures of the medial temporal lobe ( entorinal cortex, hippocampal formation, amygdala) and gradually includes neocortical association areas. Thus, the amygdala complex, a structure related to processes of memory and emotional control, is severely affected in this disease from the initial stages. PATIENTS AND METHODS: Therefore, to find any possible relationship between involvement of the amygdala and the psychiatric expression of Alzheimer s type dementia, we did a radiological study, using magnetic resonance, together with a neuropsychological study of a group of 24 persons with Alzheimer s disease who had mild moderate deterioration. Analysis of the amygdala area and the scores on the subtest Alzheimer s Disease Assessment Scale Non cognitive (ADAS NC) were the variables chosen for measurement of the anatomical and psychiatric aspects of the subjects under investigation. RESULTS AND CONCLUSIONS: The results of our study show a close relation between involvement of the amygdala (atrophy) and the presence of neuropsychiatric changes in persons with Alzheimer s disease.

Atrofia del complejo amigdalino y expresión neuropsiquiátricade la enfermedad de Alzheimer / Atrophy pf the amygdala complex and neuropsychiatric expression of Alzheimer´s disease

Introducción. En la enfermedad de Alzheimer, junto con las alteraciones cognitivas (pérdida de memoria, desorientación temporo-espacial, disejecución, etc.), aparecen una serie de manifestaciones `no cognitivas' que afectan gravemente al ajuste conductual y emocional del paciente. Depresión, ideas delirantes, alucinaciones o cambios conductuales (hábitos sexuales, alimenticios, motrices) son algunas de las manifestaciones más frecuentes en esta enfermedad ya desde sus primeros estadios. Diversos estudios han descrito cómo, inicialmente, las alteraciones histopatológicas involucran de forma selectiva a diversas estructuras del lóbulo temporal medial (corteza entorrinal, formación del hipocampo, amígdala) y su acción se amplía paulatinamente hasta áreas asociativas neocorticales. Así, el complejo amigdalino, una estructura relacionada con los procesos mnésicos y de control emocional, se encuentra gravemente afectado en esta enfermedad desde sus fases iniciales. Pacientes y métodos. A fin de contrastar las posibles relaciones entre la afectación de la amígdala y la expresión psiquiátrica de la enfermedad de Alzheimer, se realizó un estudio radiológico, mediante resonancia magnética, y neuropsicológico en un grupo de 24 sujetos con demencia de tipo Alzheimer y deterioro leve-moderado. El análisis del área de la amígdala y las puntuaciones en el subtest Alzheimer's Disease Assessment Scale-Non Cognitive fueron las variables que se seleccionaron para medir los aspectos anatómicos y psiquiátricos en los sujetos a estudio. Resultados y conclusiones. Los resultados procedentes de nuestro trabajo evidencian la existencia de una fuerte relación entre la afectación de la amígdala (atrofia) y la presencia de alteraciones neuropsiquiátricas en sujetos con enfermedad de Alzheimer (AU)

Deficit in sensory motor processing in depression and Alzheimer's disease: a study with EMG and event related potentials.

Event related potentials have been examined in depression and Alzheimer disease like clinical utility. To evaluate the influence of visual and auditory stimuli on the P300 latency we studied 12 patients with major depression, 12 patients with Alzheimer disease and 12 normal subjects. The experimental tasks applied was, first a series of 300 auditory stimuli, 255 (85%), with tones of 1,000 Hz, and considered as the frequent stimulus, whereas 45 (15%) were tones of 2,000 Hz and referred as the rare stimulus. A second series of 300 visual stimuli, 255 (85%) that were black circles on a white background, and considered the frequent stimulus (9 cm diameter, 200 ms duration), whereas 45 (15%) were black squares on a white background and referred as the rare stimulus (9 cm diameter, 200 ms duration) in the centre of a computer screen. The results show an increase of P300 latency in depressive and Alzheimer patients during auditory and visual tasks. Differences were found in reaction time to visual or auditory stimuli in Alzheimer disease. These results are consistent with an impairment in brain function in depressive patients that is associated with cortical hypoactivity and deficits in perceptive, auditory or visual, functions, whereas deterioration in Alzheimer's disease is sensorymotor, according to the slowness latency in the reaction time.

Callosal atrophy and associated electromyographic responses in Alzheimer's disease and aging.

Alzheimer's disease is a degenerative disorder characterised by cerebral atrophy with cortical and subcortical changes. Our objective is to investigate the patterns of atrophic changes in the corpus callosum in patients with Alzheimer's disease and healthy elderly subjects and to clarify the relations of callosal impairment and the presence of associated electromyographic responses. We compare cross-sectional area of the corpus callosum by age, group and associated electromyographic responses, using quantitative magnetic resonance imaging from 47 subjects (twenty four healthy subjects and twenty three Alzheimer's disease patients). The control population was selected by criteria of optimal health; medical, neurological or psychiatric illnesses were excluded. We find that the first anterior and medial-anterior corpus callosum areas show an atrophy in Alzheimer group patients. These sectors show a clear relationship with the presence of associated movements.

[Psychometric validation of the telephone memory test]. / Validación psicométrica del Autotest Telefónico de Memoria.

INTRODUCTION: Several pathologies (i.e. Alzheimer's disease) that courses with memory alterations, appears in a context of impaired cognitive status and mobility. In recent years, several investigations were carried out in order to design short batteries that detect those subjects under risk of dementia. Some of this batteries were also design to be administrated over the telephone, trying to overcome the accessibility limitations of this patients. METHODOLOGY: In this paper we present a battery (called Autotest de Memoria) essentially composed by episodic and semantic memory tests, administered both over the telephone and face to face. This battery was employed in the cognitive assessment of healthy controls and subjects diagnosed as probable Alzheimer's disease patients. RESULTS: Results show the capability of this battery in order to discriminate patients and healthy controls, a great sensibility and specificity, and a nearly absolute parallelism of telephone and face to face administrations. CONCLUSION: These data led us to claim the usefulness and practicality of our so called <>.

Inhibitory deficits in probable Alzheimer's disease. A study of movement related potentials and EMG response.

We have recently reported contralateral associated EMG responses to voluntary hand movement in Alzheimer's disease. Several aspects of this process were not fully explained in our last paper. In the present one we present data on the register of movement-related potentials (Negative Shift, NS) and Lateralized Readiness Potential (LRP), which have shown a very fine capacity to reveal processes that occur in the motor cortex while movement execution is being prepared. The associated EMG responses (so called by us) have almost all the characteristics of the partial errors revealed by cognitive psychology. First, it is a covert response, so it can only be detected by EMG recording; second, the appearance of this partial error changes the reaction time in the same way as described by Coles: mainly, by increasing reaction time as compared with clear responses. Nevertheless, contrary to partial errors, the associated EMG response does not constantly appear before the correct response. Associated EMG responses always appear after correct responses, with a constant delay of 54 +/- 28 ms. Our results show also an incorrect response preparation related to associated EMG response. We interpreted this specific feature in relation to inhibitory deficits in motor cortex and associated callosal pathways that avoid a correct response performance in Alzheimer patients.

[Electromyographic response associated with capsular stroke]. / Respuesta electromiográfica asociada en ictus capsular.

INTRODUCTION: Lesions of the pyramidal system are characterized by their effects on qualitative aspects of movement. One of the features of pyramidal defects is the presence of associated movements or synkinesis. CLINICAL CASE: We present a case with residual associated electromyographic (EMG) response in a patient who had had a capsular stroke 11 months previously. The patient presented with acute onset of a syndrome of purely motor right hemiparesis (PMH) which improved satisfactorily with complete functional recovery three months later. Eleven months after the acute episode, there was good functional recovery and neurophysiological examination showed the presence of EMG responses associated with the unaffected limb (left hand) when voluntary movements were made with the right hand. CONCLUSION: The appearance of qualitative alterations of movement associated with pyramidal syndromes and particularly the presence of associated EMG responses in the case of capsular infarct described, may reflect the different processes of reinnervation and functional reorganization which occur following the lesion and which are involved in recovery of motor function.