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1.
Epilepsy Res ; 44(2-3): 119-28, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11325568

RESUMO

PURPOSE: The EEG pattern of epilepsy with continuous spike-waves during slow wave sleep (CSWSS) is characterized by an almost continuous activation of spike-and-slow-wave complexes during nREM sleep with a marked reduction of EEG abnormalities during REM sleep and the awake state. Experimental studies indicate that normal sleep oscillations that during nREM sleep lead to the appearance of spindles and delta waves on scalp EEG might develop into paroxysmal synchronization. Spectral analysis enables the quantitative description of the dynamics of delta (Delta Activity, DA, 0.5-4.5 Hz) and sigma activity (SA, 12-16 Hz) and can be used to assess the relationship between SA, DA and epileptiform discharges (EDs) during sleep. METHODS: We analyzed the EDs distribution during sleep in five children affected by CSWSS. We used a model of the evolution of power of DA and SA to which the time series of EDs could be fitted. RESULTS: We found a high and positive correlation between EDs and SA. DA resulted negatively correlated with EDs. CONCLUSION: Our data suggest that neural mechanisms involved in the generation of sleep spindles facilitate EDs production in the CSWSS syndrome. Such a mechanism seems to be an age related phenomenon shared by other epileptic syndromes of childhood.


Assuntos
Ritmo Delta , Convulsões/fisiopatologia , Sono REM/fisiologia , Criança , Pré-Escolar , Ritmo Delta/métodos , Feminino , Humanos , Masculino
2.
Clin Neurophysiol ; 111(5): 916-23, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10802464

RESUMO

INTRODUCTION: In order to define accurately the relationship between EEG components (spindles, delta and theta frequencies) and the occurrence of interictal epileptiform discharges (IED) during sleep in partial epilepsy, a correlation study between spike overnight distribution and EEG spectral power time series was performed. METHODS: Eighteen patients (mean age: 24.7+/-5.5 years) affected by partial epilepsy underwent continuous EEG-polysomnography. The temporal series of Slow Wave Activity (SWA), Sigma Activity (SA) and Theta Band (TB), derived from spectral analysis, were obtained from a spike-free and pathologic alteration-free derivation, contralateral to the most active lead, where the IED count was performed. Relationships between SA, SWA and TB and time series of IED were tested by means of correlation techniques after data normalization. RESULTS: Our results revealed a significantly higher correlation between IED and SWA in 12 subjects; a significantly higher correlation between IED and SA in three subjects and a significant correlation with TB in three cases. CONCLUSIONS: Data suggest that in most adult patients with partial epilepsy IED production during sleep is facilitated by the action of synchronizing mechanisms which are active during NREM sleep and lead to the appearance of EEG delta waves. Nevertheless evidence is given of two smaller groups of patients. In one of them IED are more sensitive to the promoting action of the spindle generating mechanism, active during stage 2 of NREM sleep. In the other one the promoting action of TB, characterizing EEG during stage 1 and REM sleep, is evident.


Assuntos
Eletroencefalografia , Epilepsias Parciais/fisiopatologia , Sono/fisiologia , Adulto , Idade de Início , Ritmo Delta , Feminino , Lateralidade Funcional , Humanos , Masculino , Polissonografia , Fases do Sono/fisiologia , Ritmo Teta
3.
Clin Neurophysiol ; 110(5): 839-45, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10400197

RESUMO

OBJECTIVE: NREM sleep increases the Interictal Epileptic Discharges (IEDs) in the majority of children affected by partial epilepsy (both symptomatic or cryptogenetic). Experimental data revealed that the normal sleep oscillations, leading to the appearance of spindles and delta waves on the surface EEG during NREM sleep, might develop into paroxysmal synchronization. Spectral analysis enables the quantitative description of the dynamics of delta (slow wave activity, SWA, 0,5-4,5 Hz) and sigma activity (SA, 12.0-16.0 Hz) and can be used to assess the relationship between SA, SWA and IEDs during sleep. DESIGN AND METHODS: We have performed overnight continuous EEG-polysomnographic studies in 7 patients (mean age 7.2+/-1.3). The temporal series of SWA and SA were obtained from a spike-free derivation lead. The IEDs count was performed on the most active lead. Relationships between sigma and SWA and time series of IEDs were tested by means of correlation techniques after data normalization. RESULTS: Our results revealed a significant higher correlation between IEDs and SA with respect to SWA in all the subjects, in total sleep time. The same analysis limited to NREM sleep highlights the better correlation between SA and IEDs. CONCLUSIONS: Our data suggest that the neural mechanisms involved in the generation of sleep spindles facilitate the IEDs production in childhood partial epilepsies at least in those strongly activated by sleep.


Assuntos
Epilepsias Parciais/fisiopatologia , Encéfalo/fisiopatologia , Criança , Pré-Escolar , Eletroencefalografia , Feminino , Humanos , Masculino , Polissonografia , Sono/fisiologia
4.
Clin Neurophysiol ; 110(1): 39-46, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10348319

RESUMO

OBJECTIVE: The activation of interictal epileptic discharges (IEDs) by NREM sleep is a well-known phenomenon in benign epilepsy of childhood with rolandic spikes (BECRS). The activating properties of NREM sleep on IEDs have been attributed to increased synchronization within thalamocortical neurons. During NREM sleep two synchronizing mechanisms lead to the appearance of spindles and delta waves on the EEG. Spectral analysis technique is a suitable method that can be used to quantitatively describe the dynamics of delta (slow wave activity (SWA) 0.5-4.0 Hz) and sigma activity (12.0-16.0 Hz) during sleep. METHODS: In order to define more accurately the relationship between synchronizing mechanisms (spindles and delta activities) and IEDs during sleep in BECRS, we have performed overnight continuous EEG polysomnography studies in 9 patients (mean age 7.4 +/- 2.5 years). The temporal series of SWA and sigma values, derived from spectral analysis, have been obtained from a spike-free derivation lead. The IEDs count has been performed on the most active lead. Relationships between sigma and SWA and time series of IEDs were tested by means of correlation techniques after data normalization. RESULTS: Our results revealed a significant higher correlation between IEDs and sigma activity with respect to SWA in all the subjects, in total sleep time. The same analysis limited to NREM sleep highlights the better correlation between sigma and IEDs. CONCLUSIONS: Data suggest that during sleep of BECRS patients, IEDs are more sensitive to the promoting action of the spindle-generating mechanism than to the SWA-producing one.


Assuntos
Encéfalo/fisiopatologia , Epilepsia/fisiopatologia , Sono/fisiologia , Criança , Pré-Escolar , Eletroencefalografia , Feminino , Humanos , Masculino , Fatores de Tempo
5.
Dement Geriatr Cogn Disord ; 9(5): 274-83, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9701679

RESUMO

Forty-two patients with probable Alzheimer's disease (AD) and 18 elderly healthy controls underwent quantitative EEG (qEEG) and regional cerebral blood flow (rCBF; 133Xe clearance) examinations. Correlations were sought between relative qEEG band powers and percent rCBF values in a posterior temporoparietal region of interest in either hemisphere. Moreover, stepwise discriminant analysis was applied to study the accuracy of the two techniques in differentiating AD from healthy ageing. rCBF and qEEG were correlated with one another, especially in the right hemisphere (p values ranging from <0.001 to <0.01). Significant correlations were found between Mini Mental State Examination (MMSE) and relative power of both the 2- to 6-Hz and the 6.5- to 12-Hz bands on either side (p < 0.001), and between MMSE and left rCBF (p < 0.005), while the correlation with right rCBF was poorer (p < 0.02). The statistical procedure identified the right values of both examinations for the discriminant analysis. Sensitivity of qEEG and rCBF employed together was 88% and specificity 89%, with a total accuracy of 88.3%. The unrecognized patients (n = 5) were affected by mild AD (4 scoring 3 at the Global Deterioration Scale and 1 scoring 4). qEEG alone showed an accuracy of 77% in the whole group and of 69% in mild AD, and rCBF alone an accuracy of 75% in the whole group and of 71% in mild AD. It is concluded that qEEG and rCBF examinations employed together are accurate tools to differentiate AD from normal ageing, although a lower degree of accuracy is achieved in mildly demented patients.


Assuntos
Doença de Alzheimer/diagnóstico , Doença de Alzheimer/fisiopatologia , Circulação Cerebrovascular , Eletroencefalografia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Análise Discriminante , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radioisótopos de Xenônio
6.
J Neurol Sci ; 152(1): 63-71, 1997 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-9395127

RESUMO

Systemic Sclerosis (SSc) is a multisystem disease characterised by proliferation of vascular tissue, obliterative microvascular lesions and diffuse organ fibrosis. Despite widespread vascular disease, Central Nervous System complaints are only infrequently reported and it is uncertain whether they merely derive from systemic complications or whether they may be also caused by a primary vascular process within the brain. Regional cerebral blood flow (rCBF) was quantitatively measured by the 133Xenon clearance technique in twenty-seven consecutive SSc patients without relevant systemic complications and with different severity of vascular involvement, as staged by nailfold capillary videomicroscopy (NCV). Absolute, percent, and asymmetry rCBF values were compared (z-statistics) with age- and sex-matched healthy controls. Cerebral MRI and Mini-Mental State Examination (MMSE) were also performed. Doppler sonography of neck vessels and Transcranial Doppler sonography (TCD) were performed in patients presenting rCBF reduction. Cerebral hypoperfusion was found in the 52% of patients, i.e.: in 33% of patients with the 'early' NCV pattern, in 56% of patients with the 'active' pattern, and in 67% of patients with the 'late' NCV pattern. Thirty percent were the MRIs showing focal and/or diffuse signal abnormalities in the white matter of both hemispheres with the highest rate (44%) in the 'late' NCV pattern. MMSE disclosed mild dementia in one patient in the 'late' NCV group and some mistakes in 6 more patients, in the 'active' or 'late' NCV groups, whereas TCD failed to find significant stenosis of Willis' arteries. Cerebral hypoperfusion is shown for the first time in a substantial part of SSc patients without either neurological symptoms or relevant systemic complications. It is suggested that the rCBF reduction might be related to the systemic scleroderma microangiopathy although, probably due to the paucity of connective tissue in cerebral vessels, the vast majority of patients remains in a subclinical phase.


Assuntos
Circulação Cerebrovascular , Escleroderma Sistêmico/fisiopatologia , Adulto , Idoso , Angiografia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Microcirculação , Pessoa de Meia-Idade , Escleroderma Sistêmico/diagnóstico por imagem , Ultrassonografia Doppler Transcraniana , Radioisótopos de Xenônio
7.
Ital J Neurol Sci ; 18(4): 209-14, 1997 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9323514

RESUMO

A 15-year-old, right-handed boy underwent video-EEG study as a first step in presurgical evaluation for a severe drug-resistant right temporo-central epilepsy. He was monitored while performing neuropsychological tests over a 67-minute period during which 23 brief seizures were recorded. Despite his right-handedness, both inter-ictal and ictal verbal performances were impaired. Analysis of the relationships between the characteristics of the EEG and the neuropsychological results revealed that a worsening in cognitive performances correlated with an increase in inter-ictal abnormalities, particularly when subclinical paroxysms were present; that the cognitive tasks executed peri-ictally were correctly performed in almost 50% of the cases; and that the error rate was higher when a task was presented during or immediately after a seizure rather than before its onset. A Wada test, performed on the basis of the cognitive results, demonstrated right hemisphere dominance for language. Our observations underline the importance of neuropsychological testing in presurgical procedures, and suggest that it should be performed peri-ictally whenever possible.


Assuntos
Eletroencefalografia , Epilepsias Parciais/fisiopatologia , Epilepsia do Lobo Temporal/fisiopatologia , Adolescente , Humanos , Masculino , Testes Neuropsicológicos , Gravação em Vídeo
8.
Electroencephalogr Clin Neurophysiol ; 99(2): 123-8, 1996 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8761048

RESUMO

In 31 Alzheimer outpatients followed up for a mean time of 26.4 months the hypothesis that quantitative electroencephalography (qEEG) could predict the loss of activities of daily living (ADL), the onset of incontinence, and death was tested by the Weibull proportional hazard model of 'lifereg' procedure of the Statistical Analysis System package. A central-posterior temporal region was considered in either side (power-weighted, log transformed relative values). Right delta predicted both the loss of ADL and death, whereas right theta predicted the onset of incontinence. Left values gave borderline significant results toward all end-points, whereas power-weighted mean frequency always gave borderline results. The curves calculated for predicted times may be a valid support for the clinician in attempting prognostic judgments of disease evolution.


Assuntos
Doença de Alzheimer/fisiopatologia , Encéfalo/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico
9.
Eur J Pharmacol ; 300(1-2): 33-41, 1996 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-8741162

RESUMO

The cutaneous antihistaminic action (prick test; 1:100, 1:200 and 1:1000) and neuropsychological and electroencephalographic (EEG) concomitants of sedation following the histamine H1 receptor antagonist cetirizine (10- and 20-mg acute oral doses) and chlorpheniramine, 4 mg, were investigated in a cross-over, placebo-controlled study in healthy male volunteers (age 23-29 years). With an average Cmax of cetirizine of 697.0 ng/ml (10 mg) and 1000.2 ng/ml (20 mg), the diameter of histamine-induced skin weals was reduced by 24.0-74.9% depending on histamine concentration and with no dose dependence for cetirizine. Placebo and chlorpheniramine were ineffective. Behavioral or neuropsychological signs of sedation were never observed. An increase of the 6.5-14.5 Hz EEG power, with anterior scalp preponderance, was observed after chlorpheniramine or cetirizine 20 mg. This effect of cetirizine was accounted for by a substantial increase of power in the 6.5-8.0 Hz frequency subsegment and is regarded, for these experimental conditions, as an established early EEG indication of mild sedation (vigilance 'state A'). No EEG effects were observed after placebo or cetirizine at the 10 mg dose. The existence of some histaminergic (H1) specificity of the mechanisms modulating vigilance and of a threshold dose of cetirizine for sedative action is suggested.


Assuntos
Cetirizina/farmacologia , Dermatite de Contato/prevenção & controle , Eletroencefalografia/efeitos dos fármacos , Administração Oral , Adulto , Cetirizina/sangue , Cetirizina/farmacocinética , Clorfeniramina/farmacologia , Estado de Consciência/efeitos dos fármacos , Estudos Cross-Over , Relação Dose-Resposta a Droga , Antagonistas dos Receptores Histamínicos/farmacologia , Humanos , Masculino , Testes Cutâneos
10.
Lupus ; 5(2): 93-102, 1996 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8743121

RESUMO

OBJECTIVE: Comparative assessment of sensitivity and specificity of regional Cerebral Blood Flow (rCBF) by 133-Xenon inhalation and quantitative Electroencephalography (qEEG) in patients with Neuropsychiatric Systemic Lupus Erythematosus (NP-SLE). METHODS: Sixty-two combined rCBF and qEEG examinations were performed in fifty-two SLE patients. Group A: 27 SLE patients without NP-SLE; group B: 17 patients with florid (within 1 month) NP-SLE; group C: 12 patients previous NP-SLE examined in the remission phase (four patients of which already considered in group B). The study also included data deriving from two sets of examinations in ten patients who were observed twice, in different phases of the clinical course of NP-SLE. RESULTS: In comparison to healthy controls, rCBF lower (p < .001) in group B only, whereas qEEG showed similar increases of both delta and theta relative powers together with a reduction of alpha relative power in groups A-C. As compared to group A, sensitivity and specificity in detecting cerebral abnormalities in group B were 76% and 78% for rCBF, and 59% and 44% for qEEG, respectively. In the ten patients examined twice, rCBF was consistent with clinical course in 90% of cases and qEEG in 60%. CONCLUSION: Total accuracy in detecting cerebral functional abnormalities during florid NP-SLE is better by rCBF than by qEEG. rCBF and, in selected cases, qEEG examinations are reliable markers of NP-SLE.


Assuntos
Encéfalo/irrigação sanguínea , Circulação Cerebrovascular , Eletroencefalografia/métodos , Lúpus Eritematoso Sistêmico/fisiopatologia , Radioisótopos de Xenônio , Adolescente , Adulto , Idoso , Criança , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fluxo Sanguíneo Regional , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
11.
Ital J Neurol Sci ; 17(1): 55-7, 1996 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8742988

RESUMO

Spinal cord stimulation (SCS) has been shown to influence cerebral perfusion in both experimental models and humans. With the aim of further verifying such an effect, twelve patients had an epidural (cervical or dorsal) lead inserted percutaneously and underwent regional cerebral blood flow (rCBF) examinations (133-Xenon inhalation method) before and during SCS. Mean blood velocity (MBV) in the middle cerebral artery was also measured in seven cases by means of transcranial Doppler. In the patients with a cervical lead, a symmetrical increase in rCBF was found, mainly in the anterior regions (from +8% to +21%). MBV increased in four cervical lead implants (from +16% to +20%) and in one case with a dorsal lead (+15%). These results suggest that cerebral perfusion may increase in patients undergoing SCS through a cervical lead. Although the mechanism involved in the increase in rCBF remains to be clarified, frontal lobe functional activation by the ascending reticular pathways through the thalamo-cortical projections might be hypothesised.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Circulação Cerebrovascular/fisiologia , Hemodinâmica/fisiologia , Doenças da Medula Espinal/fisiopatologia , Adolescente , Adulto , Idoso , Mapeamento Encefálico , Estimulação Elétrica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Neurophysiol Clin ; 26(1): 51-9, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-8657098

RESUMO

Following a baseline night recording, 9 narcoleptic subjects and 9 sex and age-matched control subjects were maintained on 16 hours of diurnal sleep deprivation. Thereafter subjects were submitted to a 32 hour bed rest protocol in a sound-light attenuated room. The EEG was recorded and processed using a Fast Fourier Transform. Narcoleptic patients did not differ from control subjects in total sleep time over the whole time-span. An ultradian tendency to sleep seems to be predominant in narcoleptic patients and evidence of a strong basic rest activity cycle is shown. The coupling between the homeostatic process of sleep regulation and an ultradian drive to sleep would explain the peculiar 4 hour distribution pattern of SWA in narcoleptic patients.


Assuntos
Ciclos de Atividade/fisiologia , Narcolepsia/fisiopatologia , Fases do Sono/fisiologia , Adulto , Estudos de Casos e Controles , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
Electroencephalogr Clin Neurophysiol ; 95(6): 414-25, 1995 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8536570

RESUMO

Following a baseline night recording, 9 narcoleptic subjects and 9 sex- and age-matched control subjects were maintained on 16 h of diurnal sleep deprivation. Thereafter subjects were submitted to a 32 h bed rest protocol in a sound- and light-attenuated room. The EEG was recorded and processed by a Fast Fourier Transform. Narcoleptics did not differ from controls in total sleep time over the whole 32 h, but spent more time sleeping during the daytime (DT). In both groups slow wave activity (SWA) showed an exponential decaying trend during the first night (N1); a similar exponential trend during the second night (N2) was evident only in controls. In controls SWA showed a circadian-circasemidian distribution that was hardly detectable in nacroleptics. Narcoleptics showed an ultradian distribution of SWA with periodic emergence every 4 h during DT and N2. Our data confirm that a homeostatic mechanism is evident in narcolpetics when stimulated by diurnal sleep deprivation, while circadian and circasemidian mechanisms are less evident during DT and N2. These findings suggest a different coupling between homeostatic sleep regulating and circadian drives to sleep in narcoleptics. Ultradian drives to sleep seem to be predominant in these patients, thus probably acting as a means for the avoidance of stressful attempts to counteract a weaker waking state maintenance mechanism.


Assuntos
Encéfalo/fisiopatologia , Narcolepsia/fisiopatologia , Adulto , Análise de Variância , Ritmo Circadiano , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Sono/fisiologia
14.
Stroke ; 25(4): 831-6, 1994 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8160229

RESUMO

BACKGROUND AND PURPOSE: Although epidemiologic investigations are trying to clarify the role of plasma lipid concentrations (primarily cholesterol and its subfractions) as risk factors for both ischemic and hemorrhagic stroke, little information is available regarding the effect of sustained hypercholesterolemia on cerebral perfusion. METHODS: Regional cerebral blood flow (CBF) was measured by the 133Xe inhalation method in 25 heterozygous patients (four untreated) affected with familial hypercholesterolemia. In 15 patients regional CBF was repeated 20 minutes after intravenous administration of acetazolamide (10 mg/kg body wt) to evaluate cerebrovascular reactivity. Correlations among cerebral perfusion data, present or pretreatment plasma lipid concentrations, and certain other clinical features were assessed by ANOVA. RESULTS: Both basal regional CBF and cerebrovascular reactivity were normal in the vast majority of patients compared with age- and sex-matched normal control subjects. CBF was significantly dependent on pretreatment low-density lipoprotein cholesterol (LDL-C) concentration (P = .005) and the presence of symptomatic ischemic heart disease (P = .015). CBF was only slightly dependent on age (P = .05) and was not dependent on either lipoprotein(a) or present LDL-C concentration. CBF did not differ between treated and untreated patients, and the perfusional increase induced by acetazolamide was not related to any other variable. CONCLUSIONS: Cerebral perfusion and cerebrovascular reactivity were maintained within the normal range despite long-lasting, severe hypercholesterolemia, even if a somewhat lower CBF was found in those patients with the highest LDL-C pretreatment levels. These results are in accord with the epidemiologic data that implicate hypercholesterolemia as a minor risk factor, if a risk factor at all, for intracranial atherosclerosis and ischemic stroke.


Assuntos
Encéfalo/irrigação sanguínea , Hiperlipoproteinemia Tipo II/fisiopatologia , Acetazolamida/farmacologia , Adulto , Idoso , Encéfalo/diagnóstico por imagem , Circulação Cerebrovascular , LDL-Colesterol/sangue , Feminino , Humanos , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/diagnóstico por imagem , Lipoproteína(a)/sangue , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/sangue , Isquemia Miocárdica/fisiopatologia , Cintilografia , Fluxo Sanguíneo Regional , Vasoconstrição/efeitos dos fármacos
15.
Neuropharmacology ; 32(9): 919-28, 1993 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8232792

RESUMO

The effects on the background quantitative EEG (power spectral analysis) and concentration of valproate in plasma were studied after single-dose (14.3-33.3 mg/kg) oral administration in 12 epileptic patients with generalized nonconvulsive or partial seizures. An increase of the amplitude of the background EEG (diffuse and preponderant on anterior scalp areas) and a decrease of the 12.5-32.0 Hz relative power (limited to the posterior electrode deviations) were observed; the increase in the EEG total power was paralleled by a definite increment in incidence of epileptic phenomena in the EEG. Both effects proved unrelated to shifts in vigilance or changes in the concentration of ammonia or serum glucose in plasma and confirm previous observations from superimposable study designs. These findings are qualitatively opposite to those observed during long-term treatment at comparable doses and are suggested to reflect a direct CNS action of acute administration of valproate.


Assuntos
Amônia/farmacologia , Eletroencefalografia/efeitos dos fármacos , Epilepsia/fisiopatologia , Ácido Valproico/farmacologia , Adolescente , Adulto , Amônia/sangue , Nível de Alerta/efeitos dos fármacos , Glicemia/metabolismo , Pressão Sanguínea/efeitos dos fármacos , Epilepsia/induzido quimicamente , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Ácido Valproico/sangue
16.
Stroke ; 24(8): 1148-53, 1993 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8342188

RESUMO

BACKGROUND AND PURPOSE: Cerebral hypoperfusion has occasionally been reported during essential hypertension. We explored regional cerebral blood flow in a large series of neurologically asymptomatic hypertensive patients to determine relations among cerebral blood flow, concomitant main vascular risk factors, and the most common signs of end-organ damage. METHODS: Regional cerebral blood flow was measured by the 133Xe inhalation method in 101 hypertensive patients without clinically apparent central nervous system involvement, including 39 mild to moderate untreated and 62 mild to severe treated patients. RESULTS: Compared with age- and sex-matched normal control subjects, cerebral blood flow was significantly reduced in untreated hypertensive patients (P < .01) and to a lesser extent in treated patients (P = .047). Both regional and global cerebral blood flow reductions were observed in approximately one third of patients in both groups. Analysis of variance failed to show significant correlations between cerebral blood flow and total cholesterol concentration, mean arterial blood pressure, duration of disease, or the presence of retinopathy or left ventricular hypertrophy. In the treated group, the quality of control of hypertension significantly influenced both global cerebral blood flow (P = .007) and cerebrovascular resistance (P < .0001). CONCLUSIONS: Focal or diffuse cerebral hypoperfusion is present even in neurologically asymptomatic hypertensive patients, especially when untreated; good control of blood pressure may preserve cerebral perfusion and reduce cerebrovascular resistance. Regional cerebral blood flow examination represents a relatively simple and low-cost technique to explore the perfusional condition of the brain, one of the main target organs of hypertensive disease.


Assuntos
Circulação Cerebrovascular , Hipertensão/fisiopatologia , Adulto , Pressão Sanguínea , Doença Crônica , Feminino , Humanos , Hipertensão/diagnóstico por imagem , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Valores de Referência , Tomografia Computadorizada por Raios X , Xenônio
17.
Electroencephalogr Clin Neurophysiol ; 86(4): 275-82, 1993 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-7682931

RESUMO

Scopolamine in acute intramuscular doses of 0.25-0.75 mg reduced the P2-N3 flash-VEP amplitude and, in the quantitative EEG, the 8.5-12.0 Hz power and total power in 8 healthy young male volunteers. The effects on flash-VEP and EEG total power were dose dependent and were evident 30 min and 90 min respectively after drug administration, regardless of dose. The reduction in 8.5-12.0 Hz power was limited to the 0.50 and 0.75 mg doses. No systematic effects on the pattern-VEP were observed. Possible interferences with flash- or pattern-VEP amplitude of the scopolamine-induced EEG changes were identified and removed by regression analysis and computation of VEP residuals from the regression function. The P2-N3 flash-VEP residuals proved EEG independent and showed relationships with dose and time after drug administration that were superimposable on those of the original data, with comparable significance levels at the drug/placebo and pre/postdrug statistical comparisons. The results indicate that VEP estimates of drug effects which are independent from EEG changes can be identified in human studies and allow some inference on the cholinergic specificity of the systems affecting late flash-VEP components. The statistical approach used in this study is suitable for application in VEP studies when effects of interacting factors are to be expected.


Assuntos
Encéfalo/fisiologia , Eletroencefalografia , Potenciais Evocados Visuais/efeitos dos fármacos , Escopolamina/farmacologia , Adulto , Humanos , Masculino , Reconhecimento Visual de Modelos/efeitos dos fármacos
18.
Diabetes Care ; 16(2): 462-8, 1993 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8432218

RESUMO

OBJECTIVE: To investigate both rCBF and cerebrovascular reactivity, evaluated as pre- and post-ACZ rCBF differences in a group of IDDM patients with differences in duration of disease and severity of complications. RESEARCH DESIGN AND METHODS: rCBF was measured by the 133Xenon inhalation method in 20 IDDM patients and in 15 healthy control subjects before and after an intravenous injection of ACZ, a carbonic anhydrase inhibitor commonly used to assess cerebrovascular reactivity. RESULTS: Basal global CBF (the mean of 32 regional values) was within the normal range in all patients but 1, who showed slight hyperperfusion; moreover, in 3 patients with long-lasting disease, some hypoperfused regions were found. ANOVA showed an inverse correlation between basal global CBF (P < 0.01) and duration of diabetes, but no correlation with Hb, MABP, serum glucose concentration, or GHb. Compared with control subjects, the percentage of global CBF increment after ACZ administration was significantly impaired in 4 patients and gave a borderline response in 2 patients; 4 of these poor ACZ responders had retinopathy, and 1 had suffered from a TIA. Duration of diabetes, Hb, MABP, serum glucose concentration, and GHb did not correlate with the percentage of post-ACZ global CBF changes, and did not differ among the 6 poor ACZ responders and the other diabetic patients or control subjects. CONCLUSIONS: These results confirm that global CBF is within the normal range in most IDDM patients, although it is significantly influenced by the duration of diabetes; pathophysiological correlates of the altered cerebrovascular reactivity need to be further investigated. rCBF measurements, before and after ACZ administration, seem to represent a safe and reliable tool for assessing cerebrovascular function in IDDM.


Assuntos
Encéfalo/irrigação sanguínea , Circulação Cerebrovascular , Diabetes Mellitus Tipo 1/fisiopatologia , Acetazolamida , Adulto , Análise de Variância , Glicemia/metabolismo , Pressão Sanguínea , Encéfalo/diagnóstico por imagem , Circulação Cerebrovascular/efeitos dos fármacos , Feminino , Humanos , Masculino , Cintilografia , Valores de Referência , Fluxo Sanguíneo Regional/efeitos dos fármacos , Radioisótopos de Xenônio
19.
Stroke ; 24(1): 94-9, 1993 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8418558

RESUMO

BACKGROUND AND PURPOSE: The aim of this study was to investigate regional cerebral blood flow parameters during the postacute phase of unilateral ischemic stroke and to correlate them with clinical data. METHODS: Regional cerebral blood flow was measured in 187 patients in the stabilized phase of stroke by the xenon-133 inhalation method with 32 extracranial detectors. Thirty-eight patients were reexamined after a mean +/- SD time of 32 +/- 21.4 months. RESULTS: The overall detection of hypoperfusion was 92.0%, with asymmetries as the most sensitive index, especially for patients with a lesser degree of neurological disability. Neurological disability score was strongly associated with regional cerebral blood flow in the affected hemisphere (p < 0.0001) and with asymmetries (p < 0.0001). The presence of carotid obstruction further decreased the regional cerebral blood flow in the affected hemisphere and significantly increased asymmetry (p < 0.0001). Subjects who had no hypoperfusion at absolute values analysis were more frequently free of carotid disease and had less severe disability than those who had bilateral or unilateral regional absolute cerebral blood flow reduction. In 38 patients without new cerebrovascular events, a significant (p = 0.005) reduction of hemispheric regional cerebral blood flow asymmetries was found on a follow-up examination. CONCLUSIONS: These data confirm the value of regional cerebral blood flow asymmetries in stroke detection and point out that important clinical information is also contained in absolute values analysis.


Assuntos
Encéfalo/irrigação sanguínea , Circulação Cerebrovascular , Transtornos Cerebrovasculares/fisiopatologia , Adolescente , Adulto , Idoso , Isquemia Encefálica/fisiopatologia , Ecoencefalografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
20.
Int J Psychophysiol ; 13(3): 291-7, 1992 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-1459886

RESUMO

Digital recording of sleep EEG allows computer analysis and quantitative evaluations of sleep disorders and pharmacological effects. A system for polygraphic signal acquisition and storage, which performs a Fourier transform to compute series of spectra representing the evolution of EEG frequency composition through different sleep stages is described. The time course of spectral descriptors like relative band power is used to study the cyclic patterns of sleep and to compute the DSRI (Delta Sleep Regularity Index), a synthetic measure of sleep quality. The method is compared with conventional sleep scoring and examples of applications to normal, pathological and pharmacological conditions are shown. The topographical distribution of spectral parameters is analyzed by means of mapping techniques, allowing the detection of regional variations of EEG in specific pharmacological conditions.


Assuntos
Eletroencefalografia/métodos , Hipnóticos e Sedativos/farmacologia , Fases do Sono/fisiologia , Transtornos do Sono-Vigília/fisiopatologia , Mapeamento Encefálico , Eletroencefalografia/efeitos dos fármacos , Eletroencefalografia/instrumentação , Humanos , Processamento de Sinais Assistido por Computador , Fases do Sono/efeitos dos fármacos
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