Presenile dementia in Israel

A nationwide epidemiologic study of presenile dementia of the Alzheimer type (PDAT) with onset through age 60 years was carried out in Israel. The Israeli National Neurologic Disease Register and clinical records of all patients discharged from hospitals between 1974 and 1983 with a neurologic or psychiatric diagnosis suggestive of dementia were reviewed. A total of 71 Jewish patients with onset of PDAT between 1974 and 1978 was ascertained. The age at onset in these patients ranged from 43 to 60 years. The median survival was 8.1 years, with slightly longer survival if onset occurred before age 55 years, even after correction for expected mortality according to age and sex. The average annual incidence rate per 100,000 population at risk was 2.4 in the population aged 40 through 60 years. Although the incidence rates were slightly greater for women, the difference between the rates by sex was not statistically significant. The age- and sex-adjusted incidence of PDAT per 100,000 population was significantly higher in those born in Europe or America (2.9) than in those born in Africa or Asia (1.4). No significant difference in survival was found between these two groups. The curve of the incidence rates by age for PDAT in Israel is continuous with that for senile dementia of the Alzheimer type collected by similar methods elsewhere, which suggests that one disease process may account for both conditions.     

Planum temporale and Heschl gyrus volume reduction in schizophrenia: a magnetic resonance imaging study of first-episode patients

BACKGROUND: Magnetic resonance imaging studies in schizophrenia have revealed abnormalities in temporal lobe structures, including the superior temporal gyrus. More specifically, abnormalities have been reported in the posterior superior temporal gyrus, which includes the Heschl gyrus and planum temporale, the latter being an important substrate for language. However, the specificity of the Heschl gyrus and planum temporale structural abnormalities to schizophrenia vs affective psychosis, and the possible confounding roles of chronic morbidity and neuroleptic treatment, remain unclear. METHODS: Magnetic resonance images were acquired using a 1.5-T magnet from 20 first-episode (at first hospitalization) patients with schizophrenia (mean age, 27.3 years), 24 first-episode patients with manic psychosis (mean age, 23.6 years), and 22 controls (mean age, 24.5 years). There was no significant difference in age for the 3 groups. All brain images were uniformly aligned and then reformatted and resampled to yield isotropic voxels. RESULTS: Gray matter volume of the left planum temporale differed among the 3 groups. The patients with schizophrenia had significantly smaller left planum temporale volume than controls (20.0%) and patients with mania (20.0%). Heschl gyrus gray matter volume (left and right) was also reduced in patients with schizophrenia compared with controls (13.1%) and patients with bipolar mania (16.8%). CONCLUSIONS: Compared with controls and patients with bipolar manic psychosis, patients with first-episode schizophrenia showed left planum temporale gray matter volume reduction and bilateral Heschl gyrus gray matter volume reduction. These findings are similar to those reported in patients with chronic schizophrenia and suggest that such abnormalities are present at first episode and are specific to schizophrenia.     

3D MRI of the membranous labyrinth. An age related comparison of MR findings in patients with labyrinthine fibrosis and in persons without inner ear symptoms

PURPOSE: We compared MRI of the membranous labyrinth in patients with chronic non-neoplastic inner ear disease and MR signs of labyrinthine fibrosis and controls depending on their age, in order to establish whether there were any MR differences regarding patient age groups, control age groups and between the patients and controls themselves. MATERIALS AND METHODS: Clinical ENT examinations as well as a T2* weighted 3D CISS (Constructive Interference in Steady State) sequence with a slice thickness of 0.7 mm were performed. Our collective was subdivided as follows: 0-19 years (10 controls, 3 patients with chronic non-neoplastic inner ear disease), 20-49 years (55 controls, 8 patients), 50 years and older (40 controls, 22 patients). Detectability of labyrinthine structures (e.g. cochlea, vestibule, semicircular canals) and filling defects were evaluated. RESULTS: In the 3 age-groups of the control collective no significant differences were observed in the membranous labyrinth. However differences concerning labyrinthine detectability emerged between controls and patients in both the 20-49 years and 50 years and older age groups. In the patient collective the 3 age groups showed no significant discrepancy in the mean number of lesions. CONCLUSION: Filling defects of the membranous labyrinth on 3D CISS MR images are pathological even in older persons. We would therefore recommend high resolution T2* weighted MRI in the case of suspected labyrinthine fibrosis.     

Neurological soft signs in juvenile patients with Asperger syndrome, early-onset psychosis, and healthy controls

Aim: The study of neurological soft signs (NSS) in patients with Asperger syndrome may help us to elucidate the neurological basis of this disorder and to clarify its relationship with other neurodevelopmental disorders. The goal of this study was to compare the prevalence of NSS in a sample of patients with Asperger syndrome, early-onset psychosis and healthy controls. Method: NSS were assessed by means of the Neurological Evaluation Scale in a sample of 29 patients with Asperger syndrome (mean age = 12.86 ± 2.58 years), 30 patients with first-episode early-onset psychoses (mean age 14.17 ± 1.02 years) and 30 healthy controls (mean age 12.33 ± 2.69 years). Results: Significant group differences were found between Asperger syndrome patients and healthy controls both in all the Neurological Evaluation Scale subscales and in the Neurological Evaluation Scale total score. There were no significant differences between both groups of patients in any of the Neurological Evaluation Scale scores. Conclusions: NSS are more prevalent in Asperger syndrome than in healthy controls. The NSS profile was not disorder-specific in our samples of patients with Asperger syndrome and early-onset psychoses.     

Vitamin D in schizophrenia, major depression and alcoholism

Summary. 25-Hydroxyvitamin D₃, 1,25-dihydroxyvitamin D₃, calcium, phosphate and parathyreoidal hormone levels were assessed in 34 patients with schizophrenia (DSM-III-R, 44% female, mean age 38.9 ± 2.1 years), 30 patients with alcohol addiction (16% female, mean age 48.7 ± 2.2 years), 25 patients with major depression (56% female, mean age 57.6± years) and 31 healthy controls. Only 25-hydroxyvitamin D₃ and 1,25-dihydroxvitamin D₃ levels were significantly lower in all groups of psychiatric patients than in normal controls, but not phosphate, calcium and parathyreoidal hormone levels. Significant differences in the vitamin D levels could not be found between the three psychiatric groups. These findings do not support the idea that vitamin D is specifically involved in the pathophysiology of depression. The difference in patients as compared to the healthy controls might be related to a different social background resulting in differing habits e.g. of nutrition. Received November 23, 1999; accepted February 21, 2000     

Prior history of head trauma in Parkinson's disease

The purpose of this study was to evaluate the relationship between head trauma and Parkinson's disease (PD). A questionnaire was completed by 97 PD patients (mean age 68.6 years, duration of disease 6.4 years) and 64 spouses acting as controls (mean age 63 years). Thirty-one PD patients reported head trauma before onset of PD (mean 32.3 years earlier), whereas 11 controls reported head injury before completing the survey (mean 26 years earlier) (p less than 0.05). Twenty PD patients and five controls reported head injury associated with alteration or loss of consciousness (p less than 0.05). Injury occurred a mean of 37.7 years before onset of PD and 37.2 years before survey completion in the two groups, respectively. In both of these comparisons we adjusted the frequencies to eliminate sex differences between groups. Comparison of new frequencies showed differences that were not significant. However, a trend toward significance was observed when examining head trauma with alteration of consciousness. Other investigators have reported similar results indicating that previous head trauma may be a risk factor in the etiology of PD. However, recall bias might have an effect on the outcome of these studies and this is discussed. The relationship between head trauma and PD is still tenuous.     

Comparison of magnetic resonance imaging in Alzheimer's disease, vascular dementia and normal aging.

MRI scans of 27 patients with probable Alzheimer's disease (mean age 68.2 years), 31 patients with vascular dementia (mean age 69.9 years) and 18 normal controls (mean age 66.3 years) were compared to evaluate possible distinguishing parenchymal abnormalities among these groups. Atrophy was quantitated by subjective rating, linear and volumetric measurements. A number of findings were significantly more common in vascular dementia than in the other subsets. These included (1) basal ganglionic/thalamic hyperintense foci, (2) thromboembolic infarctions, (3) confluent white matter and (4) irregular periventricular hyperintensities. Signal abnormalities on intermediate T2-weighted scans in the uncal-hippocampal or insular cortex were frequently and almost exclusively noted in Alzheimer's disease. Moderate and severe cortical and ventricular atrophy and a third ventricular to intracranial width ratio larger than 7% were good discriminators between demented groups and normally aging controls. Selective atrophy measurements, however, failed to separate dementia syndromes. These results suggest that MRI has the potential to increase the accuracy of the clinical diagnosis of Alzheimer's disease and vascular dementia.     

The range and nature of sleep dysfunction in untreated Parkinson's disease (PD). A comparative controlled clinical study using the Parkinson's disease sleep scale and selective polysomnography

In this study we have explored the nature and range of sleep dysfunction that occurs in untreated Parkinson's disease (PD) comparing data obtained from the use of the Parkinson's disease sleep scale (PDSS) in an untreated PD patient group compared to advanced PD and healthy controls. 25 untreated (drug-naive, DNPD) PD patients (mean age 66.9 years, range 53-80, 18 males) completed the validated Parkinson's disease sleep scale (PDSS), mean duration of PD was 2.1 years (1-10, up to 4 years in all except one patient with tremulous PD reporting tremor duration of 10 years) and mean Hoehn and Yahr score 1.9 (1-3). Data were compared to 34 advanced PD (mean age 70.2 years, range 51-88, 23 male), mean duration of PD 11 years (range 4-22), mean Hoehn and Yahr score 3.4 (3-5) and PDSS data obtained from 131 healthy controls (mean age 66.6 years, range 50-93, 56 males). Total PDSS scores and PDSS sub-items, except PDSS item 2, were highly significantly different (p<0.001) between DNPD, advanced PD and controls. Controls reported higher mean PDSS scores than both groups of patients, and advanced cases reported lower (mean+/-S.D.) PDSS scores (86.95+/-20.78) than drug-naive (105.72+/-21.5) (p<0.001). Logistic regression analysis showed that items PDSS8 (nocturia), PDSS11 (cramps), PDSS12 (dystonia), PDSS13 (tremor), and PDSS15 (daytime somnolence) were significantly impaired in DNPD compared to controls while PDSS7 (nighttime hallucinations) additionally separated advanced PD from DNPD. In a subgroup of 11 advanced PD cases (mean age 62 years, range=49-84 years, mean Hoehn and Yahr score 2.5, range=1-3) with high Epworth Sleepiness Scale (ESS) scores (mean 14.5), low item 15 PDSS score (mean 4.7) and complaints of severe daytime sleepiness, underwent detailed overnight polysomnography (PSG) studies, all showing abnormal sleep patterns. We conclude that nocturia, nighttime cramps, dystonia, tremor and daytime somnolence seem to be the important nocturnal disabilities in DNPD and some of these symptoms may be reminiscent of "off" period related symptoms even though patients are untreated. Furthermore, polysomnography in "sleepy" PD patients may help diagnose unrecognised conditions such as periodic limb movement of sleep (PLMS), obstructive sleep apnoea (OSA) and REM Sleep Behaviour Disorder.     

White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer's disease, vascular dementia, and normal aging

OBJECTIVES: Alzheimer's disease and vascular dementia are associated with an increase in changes in white matter on MRI. The aims were to investigate whether white matter changes also occur in dementia with Lewy bodies and to examine the relation between white matter lesions and the cognitive and non-cognitive features of dementia with Lewy bodies, Alzheimer's disease, and vascular dementia. METHODS: Proton density and T2 weighted images were obtained on a 1.0 Tesla MRI scanner in patients with dementia with Lewy bodies (consensus criteria; n=27, mean age=75.9 years), Alzheimer's disease (NINCDS/ADRDA; n=28, mean age=77.4 years), vascular dementia (NINDS/AIREN; n=25, mean age=76.8 years), and normal controls (n=26, mean age=76.2 years). Cognitive function, depressive symptoms, and psychotic features were assessed using a standardised protocol. Periventricular hyperintensities (PVHs), white matter hyperintensities (WMHs) and basal ganglia hyperintensities (BGHs) were visually rated blind to diagnosis using a semiquantitative scale. RESULTS: Periventricular hyperintensities were positively correlated with age and were more severe in all dementia groups than controls. Total deep hyperintensities scores (WMHs plus BGHs) were significantly higher in all dementia groups than controls and higher in patients with vascular dementia than those with dementia with Lewy bodies or Alzheimer's disease. In all patients with dementia, frontal WMHs were associated with higher depression scores and occipital WMHs were associated with an absence of visual hallucinations and delusions. CONCLUSION: In common with Alzheimer's disease and vascular dementia, PVHs and WMHs were significantly more extensive in dementia with Lewy bodies than in controls. This overlap between different dementias may reflect shared pathological mechanisms. The link between frontal WMHs and depression and the absence of occipital WMHs and psychotic symptoms has important implications for understanding the neurobiological basis of these symptoms.     

Baroreflex function in patients with Binswanger's encephalopathy]

To analyze the baroreflex function in Binswanger's encephalopathy, we performed head-up tilting (HUT) in three steps (20 degrees, 40 degrees, and 60 degrees for 5 min.) and evaluated changes in blood pressure, heart rate, plasma noradrenaline (NA) and plasma arginine vasopressin (AVP) in 15 patients with Binswanger's encephalopathy (mean age; 70.1 +/- 5.6 years), 10 patients with lacunar infarction (mean age; 72.3 +/- 6.3 years) and eight normal controls (mean age; 69.0 +/- 4.3 years). In the patients with Binswanger's encephalopathy, the resting blood pressure was higher than that in the other two groups and the blood pressure decreased by more than 20 mmHg in five cases and by 15 mmHg in one case after HUT. In all groups, the heart rates and NA increased significantly after HUT, but the AVP levels were not significantly increased after HUT in the patients with Binswanger's encephalopathy. In conclusion, central baroreceptor pathways involved in the function of AVP release, brainstem-hypothalamic pathways are impaired in Binswanger's encephalopathy.     

Nighttime sleep problems and daytime sleepiness in Parkinson's disease

Our objective is to evaluate nighttime sleep problems (NSP) and daytime sleepiness (DS) in patients with Parkinson's disease (PD) compared to controls, and to assess relations with demographic, disease‐related, and clinical characteristics in patients. NSP and DS were evaluated with the SCOPA‐SLEEP questionnaire in PD patients and controls. In patients, other disease‐related and clinical characteristics were also evaluated. Four hundred twenty PD patients [mean (SD) age 61.1 (11.5) years] and 150 controls [mean (SD) age 60.9 (9.9) years] participated in the study. Compared to controls, a significantly greater proportion of patients had excessive DS (EDS) (43 vs. 10%), excessive NSP (ENSP) (27 vs. 9%), or used sleep medication (17 vs. 12%). Difficulties with falling asleep were similar in both groups. In both patients and controls, women experienced more NSP than men. In patients, depressive symptoms accounted for 21% of NSP variance and was the major contributor to the total explained variance (30%). Furthermore, NSP were related to dopamine‐agonist and levodopa dose, whereas DS was related to age, dopamine‐agonist dose, and disease severity. NSP and DS occur frequently in PD, with EDS being reported more commonly than ENSP. No strong relations were found between DS and demographic or clinical variables. The strong relation between NSP and depressive symptoms in PD calls for future studies to explore the nature of this relation. © 2007 Movement Disorder Society     

Plasma β-Amyloids and Tau Proteins in Patients with Vascular Cognitive Impairment

Increases in plasma of β-amyloids (Aβ) and tau proteins have been noted in patients with Alzheimer’s dementia (AD). Our study investigated the associations of plasma Aβ and tau proteins with dementia in stroke patients. This cross-sectional study recruited 24 controls (mean age: 67.4?±?7.5 years, 33.3% male), 27 stroke patients without dementia (mean age: 70.7?±?6.9 years, 60.7% male), 34 stroke patients with dementia (mean age: 78.3?±?5.3 years, 45.5% male, Clinical Dementia Ranking (CDR): 1.46?±?0.63), and 21 AD patients (mean age: 77.1?±?9.1 years, 42.9% male, CDR: 1.43?±?0.60) from a medical center. Dementia was defined as a CDR scale score of ≥?1. The plasma levels of Aβ-40, Aβ-42, and tau were analyzed using immunomagnetic reduction. One-way analysis of variance was used to compare the differences in measured protein levels between the groups. The results indicated that plasma levels of tau and Aβ-42, but not Aβ-40, in stroke patients were significantly higher than in the controls. After adjustment for age, sex, diabetes mellitus, hypertension, and hyperlipidemia, only plasma level of Aβ-42 remained significantly higher in stroke patients with dementia than in those without dementia (OR 1.85, 1.25–2.75, p?=?0.002). In summary, our results suggest that plasma Aβ-42 is a potential biomarker for dementia in stroke patients.     

Influence of age on the association between primary hemifacial spasm and arterial hypertension

OBJECTIVE: To investigate the association between primary hemifacial spasm and arterial hypertension. SUBJECTS: 114 patients with primary hemifacial spasm and 228 neurological controls, matched for age, sex, and referral centre, were recruited during an 18 month period from consecutive outpatients attending two neurological institutions. DESIGN: The association between exposure variables and case/control status was examined in conditional logistic regression models, adjusting simultaneously for disease duration and education level. RESULTS: Hypertension was more common among the patients with primary hemifacial spasm than among the controls. The association was independent of age, disease duration, years of schooling, and other diseases (adjusted odds ratio (OR) 2.76 (95% confidence interval (CI), 1.43 to 5.33); p = 0.002). Hypertension was associated with hemifacial spasm in both the left sided group (adjusted OR, 2.76 (1.18 to 6.44); p = 0.02) and the right sided group (adjusted OR, 3.02 (1.13 to 8.1); p = 0.03). The association of hypertension with hemifacial spasm was apparently greater in the age group < 60 years (adjusted OR, 4.2 (1.4 to 12); p = 0.008) than in the age group >/= 60 years (adjusted OR, 2.5 (CI 1.3 to 4.6); p = 0.005), but the difference in the OR estimates between the two age groups was not significant. Among hypertensive patients, mean age at the diagnosis of hypertension was significantly lower than mean age at the onset of hemifacial spasm in the age group >/= 60 years, but not significantly different in the age group < 60 years. CONCLUSIONS: The findings support the hypothesised association of primary hemifacial spasm with hypertension and raise the possibility that a different mechanism underlies the association in different age groups.     

Physical and hormonal profile of male sexual development in epilepsy

PURPOSE: This study was designed to investigate the effect of epilepsy and antiepileptic drugs (AEDs) on both the physical and hormonal aspects of the sexual development of male patients with epilepsy. METHODS: One hundred thirty male subjects with epilepsy, their age ranging between 8 and 18 years (mean, 14 +/- 2.9 years), entered the study; all were taking AEDs. Anthropometric measurements [height, weight, and body mass index (BMI)], testicular volume, penile length, and pubarche were assessed in the studied groups, as well as measurement of the levels of testosterone (T), free testosterone (FT), estradiol (E2), lutenizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin (PRL), and the results were compared with those of a control group. RESULTS: In this study, male patients older than 16 years were significantly shorter than their matched controls. The mean values of testicular volume and penile length were significantly lower in the patients in the different age subgroups, and the pubic hair staging (pubarche) was delayed in the patients older than 16 years. The mean values of total testosterone, estradiol, LH, and FSH serum levels were significantly higher, whereas the mean values of free testosterone, total-T/E2, total. T/LH, and FT/E2 ratios were lower in the patient subgroups compared with their age-matched controls. There were no significant changes in the mean basal PRL serum levels in the patients compared with the controls. The present study demonstrated a reduction in the testicular volume and penile length, significantly lower mean values of free testosterone and total-T/E2, and a higher mean value of E2 in the patients receiving polytherapy in the age subgroup older than 16 years compared with those on monotherapy; however, there was no demonstrable effect of seizure control or the duration of illness in any of the studied parameters. CONCLUSIONS: There is a delay in the sexual development of male patients with epilepsy in the different age subgroups, with endocrine changes in the form of increase in the total testosterone, but the free testosterone is lower, and an increase in estradiol, with lower T/LH levels. Patients receiving polytherapy, especially those older than 16 years, were more likely to have delayed gonadarch and disturbances in their hormonal profile.     

Bone mineral density in angelman syndrome

Our aim was to evaluate bone mineral densitometry in patients with Angelman syndrome with or without antiepileptic therapy. Eighteen patients (9 females, 9 males), aged 4.0-24.3 years (mean age, 10.1 years), and two control groups consisting of 18 epileptic and 24 healthy patients, underwent dual-energy X-ray absorptiometry at the lumbar spine (L(1)-L(4)), and z score was evaluated for each patient; the t score was considered for patients aged > or = 18 years. Abnormal bone mineral density was present in 8/18 (44.5%) of patients with Angelman syndrome, in 7/18 (38.9%) of the epileptic group, and in none of the healthy controls. Furthermore, a significant difference regarding mean age of patients (6 versus 15 years, P = 0.008, by Fisher exact test), and mean length of drug treatment (3.5 versus 11.1 years, P = 0.005 by Fisher exact test), appeared in the group with Angelman syndrome. Most of these patients (94.4%) were receiving antiepileptic drugs, mainly valproic acid, for many years. In conclusion, our study revealed osteopenia in almost half the children and young patients with Angelman syndrome. Dual-energy X-ray absorptiometry should be performed in all patients with Angelman syndrome, particularly if they are treated with antiepileptic drugs.     

Functional abnormalities in the primary orofacial sensorimotor cortex during speech in Parkinson's disease.

Parkinson's disease (PD) affects speech, including respiration, phonation, and articulation. We measured the blood oxygen level-dependent (BOLD) response to overt sentence reading in: (1) 9 treated female patients with mild to moderate PD (age; mean 66.0 +/- 11.6 years, mean levodopa equivalent 583.3 +/- 397.9 mg) and (2) 8 age-matched healthy female controls (age; mean 62.2 years +/- 12.3). Speech was recorded in the scanner to assess which brain regions underlie variations in the initiation and paralinguistic aspects (e.g., pitch, loudness, and rate) of speech production in the two groups. There were no differences in paralinguistic aspects of speech except for speech loudness; it was lower in PD patients compared with that in controls, when age was used as a covariate. In both groups, we observed increases in the BOLD response (reading-baseline) in brain regions involved in speech production and perception. In PD patients, as compared with controls, we found significantly higher BOLD signal in the right primary orofacial sensorimotor cortex and more robust correlations between the measured speech parameters and the BOLD response to reading, particularly, in the left primary orofacial sensorimotor cortex. These results might reflect compensatory mechanisms and/or treatment effects that take place in mild to moderately ill PD patients with quality of speech yet comparable with that of age-matched controls.     

Global fibrinolytic capacity in children on dialysis

Disturbances of coagulation and fibrinolysis have been reported in patients with chronic uremia. Studies of different coagulation and fibrinolysis parameters in regularly dialyzed patients have yielded conflicting results. Global fibrinolytic capacity (GFC) examines the function of the entire fibrinolytic system. This assay is a sensitive and reliable method for evaluating the fibrinolytic function of plasma in vitro. In this study, GFC was used as a screening test to investigate the effects of two different dialysis modalities on the fibrinolytic system on children on long-term dialysis. MATERIALS AND METHODS: The study included 12 children (age range, 11-20 years; mean age, 15.9+/-3.3 years) who were undergoing regular hemodialysis (HD) and 12 children (age range, 10-15 years; mean age, 13.1+/-1.7 years) who were undergoing continuous ambulatory peritoneal dialysis (CAPD). Thirteen healthy age- and sex-matched subjects served as controls. Each sample was investigated for complete blood count and serum levels of C-reactive protein, serum electrolytes, total cholesterol, triglyceride, fibrinogen, total protein and albumin. A GFC assay was also done in each case. RESULTS: The mean GFC in the CAPD group was lower than that in the HD and control groups (p<0.05). There was no significant difference between the mean GFC values of HD patients and controls. The mean serum albumin level was lower in CAPD patients than in HD patients (p<0.05), and there was also a positive correlation between serum albumin level and GFC in patient groups(r=0.52, p<0.05). Global fibrinolytic capacity was positively correlated with hemoglobin level and negatively correlated with weekly erythropoietin dose per kg body weight (r=0.56 and r=-0.49, respectively; p<0.05). CONCLUSION: The results suggest that CAPD patients have decreased fibrinolytic capacity compared to HD patients. Hypoalbuminemia and erythropoietin treatment may contribute to suppression of fibrinolytic function CAPD patients.     

Dissociative symptoms in schizophrenia: a comparative analysis of patients with borderline personality disorder and healthy controls

The aim of this study was to investigate the occurrence of dissociative symptoms in patients with a schizophrenic disorder. The pattern of dissociative experiences was examined in a group of patients with a diagnosis of the schizophrenia spectrum disorder (n = 26; mean age 27.9 years), and a group of patients with a diagnosis of borderline personality disorder (n = 26; mean age 24.0 years) was compared with normal controls of the general population (n = 1,056; mean age 18.7 years). The degree of self-reported dissociative symptoms was measured using the German version of the Dissociative Experiences Scales. The dissociation scores were significantly higher among patients with a diagnosis of borderline personality disorder compared to the group of schizophrenic patients and to the control group. There was no difference in the degree of reported dissociative experiences between the group of schizophrenic patients and the normal volunteers. An analysis of the subdimensions (dissociative amnesia, absorption/imaginative involvement, depersonalization/derealization) of the scale revealed the same strong distinctions between the investigated groups. There was no evidence that dissociative symptoms reflect a specific vulnerability in young schizophrenic patients.     

Subgenual prefrontal cortex of child and adolescent bipolar patients: a morphometric magnetic resonance imaging study

The subgenual prefrontal cortex (SGPFC) plays an important role in emotional processing. We carried out a magnetic resonance imaging (MRI) study comparing the volume of the SGPFC in child and adolescent bipolar patients and healthy controls. The sample consisted of 15 children and adolescents who met DSM-IV criteria for bipolar disorder (mean age +/- S.D.=15.5 +/- 3.5 years) and 21 healthy adolescents (mean age +/- S.D.=16.9 +/- 3.8 years). MR images were obtained with a 1.5 T GE Signa Imaging System with Signa 5.4.3 software. SGPFC volumes were measured with the semi-automated software MedX (Sensor Systems, Sterling, VA, USA). ANCOVA was performed to compare SGPFC volumes between groups, using age, gender and intra-cranial volume (ICV) as covariates. The volumes (mean +/- S.D.) of the right and left SGPFC for bipolar patients were 291.27 +/- 88.70 mm(3) and 284.86 +/- 83.98 mm(3), respectively. For healthy controls, the right and left SGPFC volumes were 284.95 +/- 73.33 mm(3) and 307.55 +/- 73.67 mm(3), respectively. There were no statistically significant differences between groups regarding right or left SGPFC volumes. We found no evidence of volumetric abnormalities in the SGPFC of bipolar children and adolescents.     

Assessment of erectile dysfunction in patients with Parkinson's disease

Thirty men having Parkinsons disease (PD) and 30 controls were studied prospectively by the use of the International Index of Erectile Function (IIEF) to assess erectile dysfunction (ED). Of the patients with PD (mean age of 59 years), 46.66% referred to the practice of sexual activity. All of the parkinsonians were using antiparkinsonian medication. In the control group (mean age of 63 years), 76.66% referred to the practice of sexual activity, 46.60% to arterial hypertension and 6.66% to diabetes mellitus. The median score for the PD group according to the IIEF was 34, and that for the controls 50. The main differences between the two groups were in the erectile function, orgasmic function and satisfaction with the sexual relationship. The IIEF is a multidimensional scale widely accepted to assess the ED. The data obtained suggest that ED is more frequent among parkinsonians and points out to the role of DP in the genesis of ED.