Degree Of Cerebral Atrophy Research Articles

Magnetic resonance imaging and clinical correlates of intellectual impairment in myotonic dystrophy.

Although intellectual impairment is common in patients with myotonic dystrophy, this aspect of the disease has received relatively little research attention. We examined 41 patients with myotonic dystrophy using objective neuropsychological procedures and magnetic resonance imaging. Ten patients (24%) had severe and generalized intellectual dysfunction, while lesser or no cognitive impairment characterized the remaining patients. Degree of intellectual impairment was not related to neuromuscular status or sex. Patients with severe intellectual disturbance had significantly earlier onset of both myotonia and weakness and were more likely to inherit the disease from their mother. Magnetic resonance imaging findings indicated that while degree of cerebral atrophy was not related to severity of intellectual impairment, skull thickness, focal white matter lesions, and anterior temporal lobe abnormalities were significantly more common in patients with severely disturbed intellect. This study reports a number of previously unreported cerebral magnetic resonance imaging findings associated with intellectual impairment in myotonic dystrophy, but the etiology of these changes awaits neuropathologic examination.

Cerebral atrophy in younger persons: A comparative study between clinical examinations and computed tomography

Eighty-nine patients, all below the age of 50 and under suspicion of dementia underwent computed tomography. The degree of cerebral atrophy was visually estimated and also calculated using different ventricular diameters and the mean width of four cortical sulci. The degree of dementia was evaluated by a neurological specialist. No correlation between internal atrophy and the degree of dementia was found. In spite of a significant correlation between external atrophy and the degree of dementia, there was such overlap and underestimation that the value of computed tomography in quantifying atrophy in younger persons is very limited. In none of the patients did computed tomography disclose any organic cause of dementia.

Dexamethasone suppression test in dementia

AbstractThe performance of the Dexamethasone Suppression Test (DST) was investigated in 60 demented patients including 14 patients admitted to a psychogeriatric assessment ward, 29 electively admitted patients and 17 long‐stay patients in comparison with 37 normal control subjects. It was shown that acutely admitted patients had the highest rate of DST non‐suppression (86%), whilst electively admitted patients had the lowest rate (55%) in comparison with normal controls (11%). In the electively admitted group abnormal DST results and Cortisol Suppression Index and DST non‐suppressors showed depressive signs more frequently than suppressors. There was no association between DST results and age, weight, cognitive, behavioural, cortical dysfunction and degree of cerebral atrophy as determined by CT scan results.

Imaging the centenarian brain. A computed tomographic study.

Ten healthy and mentally alert centenarians underwent cranial computed tomography (CT) using a fourth-generation CT scanner. The subjects ranged in age from 100 to 102 years, and included six women and four men. Two of them used alcohol on a daily basis and five had systolic blood pressures of at least 160 mmHg. The CT scans demonstrated considerable variation in the degree of cerebral atrophy, which had no relation to either sex, alcohol use, or hypertension. Three of the centenarians had evidence of mild periventricular white matter lucency. Although progressive cerebral atrophy is an integral aspect of the normal aging process in the very elderly, its exact relationship to cognitive function remains unclear.

The value of CT in diagnosis and prognosis of different inborn neurodegenerative disorders in childhood.

Inborn errors of metabolism in 40 children have been investigated by computed tomography to obtain data on the degree of cerebral involvement in neurodegenerative and storage disorders: 20 children had various mucopolysaccharidoses, 8 sphingolipidoses , 3 mucolipidoses, 2 oligosaccharidoses , 3 ceroidlipofuscinoses and 4 had various leucodystrophies . Diagnosis in all patients except Alexander's disease was established by biochemical or histological means. The main findings on CT were cerebral atrophy with enlargement of the ventricles and the subarachnoid spaces and hypodensity of the white matter. The degree of cerebral atrophy seemed to develop according to the age of the patients, as could be seen from the patients with mucopolysaccharidosis III, metachromatic leucodystrophy and GM1-gangliosidosis. Hypodensity of the white matter was found in mucopolysaccharidosis I-H, II-B, VI, in mucolipidosis II and in patients with leucodystrophies . On the other hand, there was great variability in these CT findings even in siblings, as seen in four patients with mucopolysaccharidosis VI. Among the series there were several patients who did not show any abnormalities in CT, so that a negative CT did not exclude these disorders, even the leucodystrophies . CT features such as cerebral atrophy or hypodensity were helpful in the evaluation of these disorders, though a diagnosis could not be made by CT alone.

Computerized Axial Tomography in the Detection of Brain Damage: 2. Epilepsy. Migraine, and General Medical Disorders

The cranial computerized axial tomography (CAT) findings in groups of patients with epilepsy, migraine, hypertension, and other general medical disorders have been reviewed to assess the frequency and patterns of focal and diffuse brain damage. In addition to demonstrating focal lesions in a proportion of patients with seizures and in patients presenting with a stroke, the CAT scan showed a premature degree of cerebral atrophy in an appreciable proportion of patients with long-standing epilepsy, hypertension and diabetes, and in some patients with migraine, valvular and ischaemic, heart disease, chronic obstructive airways disease, and chronic renal failure. The value of CAT as a means of screening for brain damage in groups of individuals at risk is discussed.

Predictors of mortality in presenile and senile dementia.

Forty-seven hospitalized patients with a diagnosis of presenile or senile dementia and without focal neurological disease of major systemic illness were given complete neurological, neuroradiological, and neuropsychological examinations. Mortality at one year after hospitalization was determined, 12 patients being lost to follow-up. Of the remaining 35 patients, 19 were alive and 1l had died. These groups did not differ in age, education, length of dementia history, sex, race, or degree of cerebral atrophy (by computerized tomography). Significant differences were found in degree of electroencephalographic abnormality and in 8 of 14 cognitive measures, the the largest single difference being on a test of expressive language. Discriminant function analysis made with the cognitive measures as dependent variables yielded a correct prediction (classification analysis) of mortality in all but 1 case (97% accuracy). These results suggest that (1) degree of functional brain impairment rather than degree of cerebral atrophy may be the more important influence on mortality in dementia patients without focal lesions, (2) short-term survival may be accurately predicted in such patients by tests of cognitive functioning, and (3) expressive language deficit in such patients may indicate a particularly poor prognosis for survival.

The sylvian cistern on computed tomography scanning.

The sylvian cistern is an important landmark in neuroradiology. It can be directly evaluated with computed tomographic (CT) scanning, especially in patients with some degree of cerebral atrophy or when enlarged by masses or fluid accumulations.

Correlation between diffuse EEG abnormalities and cerebral atrophy in senile dementia.

Thirty-five elderly patients were investigated because of clinical signs of dementia. The presence or diffuse cerebral atrophy, and its severity, were determined by the use of computed tomography (CT scan). All of the patients were also examined by electroencephalography (EEG), and the presence of diffuse abnormalities, especially diffuse slowing, was noted. Specifically, patients with normal or near-normal EEGs were compared with those with severe diffuse slowing. No correlation between the presence or severity of diffuse EEG abnormalities and the degree of cerebral atrophy as measured by CT scan was found. Though the EEG is clearly identifying physiological dysfunction of nerve cells in demented patients it does not appear to be reliable tool for the prediction of diffuse cerebral atrophy in this population.