Dystonia and reflex sympathetic dystrophy induced by ergotamine

A 59-year-old man developed dystonia and reflex sympathetic dystrophy after receiving high doses of ergotamine for migraine treatment. Ischemia is suggested as the precipitating factor.     

MR characteristics of iophendylate (Pantopaque)

Although iophendylate (Pantopaque) has been largely replaced by water soluble agents for myelography, retained intracranial or intraspinal Pantopaque remains a common occurrence. Pantopaque has signal characteristics similar to fat with both short T1 and T2 relaxation times. In vitro measurements revealed T1 = 170 ms and T2 = 27 ms. Spine radiography is recommended in patients with a history of previous myelography and magnetic resonance abnormalities similar to fat.     

Contributions of occipital and temporal brain regions to visual and acoustic imagery--a spect study

Regional cerebral blood flow (rCBF) was assessed by means of HMPAO-SPECT in two experimental groups. In a control condition both groups listened to abstract words, in the experimental condition they heard five names of objects. One group was advised to form visual images of the objects, the other group was advised to form acoustic images of the sounds made by these objects. Post-experimental questionnaires revealed that most of the subjects in the acoustic imagery condition had had visual images in addition to the acoustic ones. Both imagery conditions lead to approximately equal increases of rCBF in the left inferior occipital region and in the left thalamus. Flow increases in both hippocampal regions and the right inferior and superior temporal regions were larger in the acoustic than in the visual imagery condition. It is concluded that only the activation of left inferior occipital and left thalamic regions can be interpreted as being related to modality-specific visual aspects of imagery.     

Learning and retention of computer-related vocabulary in memory-impaired patients: method of vanishing cues

Several investigators have suggested that microcomputers might serve as useful external aids for memory-impaired patients. However, knowledge of basic computer vocabulary may be necessary for patients to use and benefit from a microcomputer. The present paper describes a procedure, the method of vanishing cues, which facilitated the acquisition of computer-related vocabulary in four memory-impaired patients. The method involves the systematic reduction of letter fragments of to-be-learned words across trials. Although learning was slow and strongly dependent on first-letter cues, all patients acquired a substantial amount of the vocabulary and eventually were able to produce the target words in the absence of fragment cues. Further, they retained the vocabulary over a 6-week interval and showed some transfer of the knowledge they had acquired. These findings suggest that memory-impaired patients may eventually be able to use a microcomputer as a prosthetic device.     

PET network abnormalities and cognitive decline in patients with mild cognitive impairment.

Temporoparietal and posterior cingulate metabolism deficits characterize patients with Alzheimer's disease (AD). A H(2)(15)O resting PET scan covariance pattern, derived by using multivariate techniques, was previously shown to discriminate 17 mild AD patients from 16 healthy controls. This AD covariance pattern revealed hypoperfusion in bilateral inferior parietal lobule and cingulate; and left middle frontal, inferior frontal, precentral, and supramarginal gyri. The AD pattern also revealed hyperperfusion in bilateral insula, lingual gyri, and cuneus; left fusiform and superior occipital gyri; and right parahippocampal gyrus and pulvinar. In an independent sample of 23 outpatients with mild cognitive impairment (MCI) followed at 6-month intervals, the AD pattern score was evaluated as a predictor of cognitive decline. In this MCI sample, an H2(15)O resting PET scan was carried out at baseline. Mean duration of follow-up was 48.8 (SD 15.5) months, during which time six of 23 MCI patients converted to AD. In generalized estimating equations (GEE) analyses, controlling for age, sex, education, and baseline neuropsychological scores, increased AD pattern score was associated with greater decline in each neuropsychological test score over time (Mini Mental State Exam, Selective Reminding Test delayed recall, Animal Naming, WAIS-R digit symbol; Ps<0.01-0.001). In summary, a resting PET covariance pattern previously reported to discriminate AD patients from control subjects was applied prospectively to an independent sample of MCI patients and found to predict cognitive decline. Independent replication in larger samples is needed before clinical application can be considered.