Behavioural Neurology - Volume 10, issue 2-3

Authors: European Federation of Neurological Societies Task Force,

Article Type: Research Article

Abstract: The European Federation of Neurological Societies (EFNS) Scientific Panel on Neurorehabilitation established a Task Force on standards in neurological rehabilitation in June 1996. The remit for the Task Force was to: (1) produce a report on the state of neurological rehabilitation across Europe; and (2) recommend standards for the provision of neurological services for disabled people. The main conclusions of the Task Force were as follows: (1) A questionnaire circulated to each European member country has indicated a significant lack of adequate neurological rehabilitation facilities across Europe. Very few countries have any established network of neurological rehabilitation centres. Few …countries have adequately trained neurological rehabilitation physicians, therapists or nurses. Such poor facilities should be seen in the context of the large numbers and increasing prevalence of people with neurological disabilities. (2) The Task Force has summarized the significant benefits that can follow from the establishment of a dedicated and cost effective neurological rehabilitation service including functional improvement, reduction of unnecessary complications, better coordination and use of limited resources, improved opportunities for education, training and research and a clear point of contact for the disabled person. (3) The Task Force recommends minimum standards for the prevention of neurological disability including access to health education, genetic counselling and emergency resources. The Task Force also encourages governments to invest in improved legislation for accident prevention. (4) The Task Force has outlined some minimum standards for the staffing of a neurological rehabilitation service including improved training both for neurologists and rehabilitation physicians. Such training could include a cross-national training programme both for physicians and other health care staff. (5) The Task Force supports a two-tier system of neurological services. We believe that disabled individuals should have access to a regional specialist service as well as a local community service. The regional specialist service would cater for people with more complicated and severe disabilities, including spinal injury and severe brain injury. The regional centres would provide specialist expertise for wheelchairs and special seating, orthotics, continence and urological services, aids and equipment including communication aids and environmental controls, prosthetics and driving assessment. The Task Force additionally endorses the development of local and community based rehabilitation teams with clear links to the regional centre. (6) The Task Force recognizes the limited amount of rehabilitation research and encourages individuals, universities and governments to invest more in rehabilitation research. Such investment should produce benefits for disabled people and their carers and in the long term benefits for the national economy. (7) The Task Force realizes that neurological rehabilitation is poorly developed both in Europe and the world as a whole. We firmly endorse international co-operation in this field and are happy to co-operate with any international organization in order to develop such links for clinical, educational or research initiatives. (8) The Task Force encourages individual countries to produce a document summarizing their own situation with regard to these standards and to produce a timetable for action to improve their situation. The EFNS Task Force would be pleased to assist in the publication of such deliberations or to act as a focus for international education and research or for sharing of examples of good practice. Show more

DOI: 10.3233/BEN-1997-102-301

Citation: Behavioural Neurology, vol. 10, no. 2-3, pp. 1-7, 1997

Authors: Nikolaenko, N.N. | Egorov, A.Y. | Freiman, E.A.

Article Type: Research Article

Abstract: Drawings by psychiatric patients were studied in various states (i) in depression; (ii) after neuroleptic injection; and (iii) during left hemisphere suppression induced by unilateral electroconvulsive seizure (UES). In these states, right hemisphere activation predominates. The results of the study demonstrate that, under the predominance of right hemisphere activation over the left hemisphere, there is a tendency to reproduce the image of the object and to represent it in near space. Drawings by psychiatric patients were also investigated in (i) the manic state; (ii) after injection of psychotropic drugs which improved the mood; and (iii) during right hemisphere suppression following …right-sided UES. Under these conditions, left hemisphere activation predominates and the drawings loose the illusion of three-dimensional space. A tendency to reproduce the knowledge and the ideas of the object and to represent it in distant space was observed. Thus, both hemispheres may represent space and elaborate perceptive and conceptional models of the world in different ways. It is probable that different types of representation are based on global (right-hemispheric) in comparison with focal (left-hemispheric) attention to space. Show more

Keywords: Cerebral asymmetry, Depression, Mania, Psychotropic drugs, Unilateral electroconvulsive seizures

DOI: 10.3233/BEN-1997-102-302

Citation: Behavioural Neurology, vol. 10, no. 2-3, pp. 49-59, 1997

Authors: Towell, A.D. | Williams, D. | Boyd, S.G.

Article Type: Research Article

Abstract: We investigated the effects of non-invasive high frequency (625Hz) stimulation over the spine on mechanical pain tolerance and subjective mood. Sixty healthy subjects were divided equally into three groups receiving either high intensity (250 V), low intensity (3–4 V) or sham electrical stimulation directly over the spinal cord for 30 minutes. Following high intensity stimulation, subjects felt significantly more elated, leisurely and less tense and, contrary to reports on patients with clinical pain, had lower mechanical pain tolerances. There were no correlations between changes in mood and changes in mechanical pain tolerances. These findings contrasted with the lack of any …significant differences in mood or mechanical pain tolerances in a second study where 20 subjects received either high intensity or sham stimulation across the left shoulder joint. The results indicate that decreases in mechanical pain tolerance are independent of changes in mood following non-invasive high frequency, high intensity cutaneous stimulation but that both effects are dependent on that stimulation being applied over the spine. Show more

Keywords: Mechanical pain tolerance, Mood, Spinal stimulation

DOI: 10.3233/BEN-1997-102-303

Citation: Behavioural Neurology, vol. 10, no. 2-3, pp. 61-65, 1997

Authors: Mohr, Erich | Claus, Jules J. | Brouwers, Pim

Article Type: Research Article

Abstract: Visuospatial deficits in basal ganglia disease may be a non-specific function of the severity of dementia or they could reflect disease-specific impairments. To examine this question, Huntington (HD) patients, demented and non-demented Parkinson (PD) patients and healthy controls were examined with neuropsychological tests emphasising visuospatial abilities. Global intellectual function and general visuospatial cognition were less efficient in the two demented patient groups relative to both controls and non-demented PD patients and they did not differ significantly between non-demented Parkinsonians and controls nor between demented PD and HD patients. However, HD patients but not demented PD patients were impaired on a …test of person-centred spatial judgement compared to non-demented subjects while demented PD patients scored significantly lower than HD patients on a test of field independence. Factor analysis yielded a factor reflecting general visuospatial processing capacity which discriminated between demented and non-demented PD patients but not between demented PD and HD patients. A unique factor associated with the manipulation of person-centred space discriminated between demented PD and HD patients. These results suggest general visuospatial processing is impaired as a non-specific function of dementia presence in HD and PD. Abnormalities in circumscribed aspects of visuospatial function, on the other hand, may differentiate between HD and PD, suggesting differential involvement of the basal ganglia in the respective illnesses. Show more

Keywords: Basal ganglia disease, Dementias, Huntington's disease, Parkinson's disease, Visuospatial impairment

DOI: 10.3233/BEN-1997-102-304

Citation: Behavioural Neurology, vol. 10, no. 2-3, pp. 67-75, 1997

Authors: McDowell, Sally-Ann | Harris, John P.

Article Type: Research Article

Abstract: A questionnaire was completed by 53 putative sufferers from Parkinson's disease and 31 putative age-matched normal controls. The aim of the questionnaire was to elicit reports of any changes in visual perception. The incidence of self-reported Parkinsonian symptoms was very much higher in the patient group than in the controls. The patients reported significantly more problems with depth and motion perception than the controls. They also reported a significantly higher incidence of hallucinations, double vision and the need to turn the head to see objects in the periphery. However, the reported incidence of changes in brightness, colour, shape and size …perception was not significantly different in the two groups. The results are discussed with reference to laboratory studies of Parkinsonian vision and to the likely neurological basis of some of the changes. Show more

Keywords: Parkinson's disease, Questionnaires, Vision

DOI: 10.3233/BEN-1997-102-305

Citation: Behavioural Neurology, vol. 10, no. 2-3, pp. 77-81, 1997

Authors: Castro-Sierra, E. | Paredes-Díaz, E. | Lazareff, J.A.

Article Type: Research Article

Abstract: Two children (male, 10 years, and female, 13 years one month) with tumours of the inferior temporal (IT) cortex of the brain were studied post-surgically for their abilities to carry out a short-term memory test. This involved: differences in colour, number and shape of small plastic objects; differences in receptacles where these objects should be placed and in ways in which this placement should be done; a procedural task involving differences either in colour or in size of wooden rings employed in the task. Their performances in these tests, and those of patients with tumours of other encephalic areas, were …compared with the performances of normal controls. The subjects with IT tumours spent a significantly greater amount of time than normal subjects of their age in carrying out the procedural task involving differences in colour. One of the IT subjects also spent a significantly greater amount of time in the procedural task involving size differences. Other differences in the performances of patients with encephalic tumours and the performances of normal controls were not significant. Results are discussed in relation to findings of colour and size perception and memory localized to the inferior temporal and middle temporal cortices. Show more

Keywords: Colours, Inferior temporal cortex, Procedural learning, Short-term memory

DOI: 10.3233/BEN-1997-102-306

Citation: Behavioural Neurology, vol. 10, no. 2-3, pp. 83-92, 1997

Authors: de Saint Hilaire, Z. | Karege, F. | Gaillard, J.-M. | Blois, R.

Article Type: Research Article

Abstract: The purpose of this experiment was to determine the sensitivity of wakefulness and paradoxical sleep to the α2-agonist, c1onidine. The drug inhibited both wakefulness and paradoxical sleep but the smallest dose necessary to inhibit wakefulness was 64 times larger than the smallest dose inhibiting paradoxical sleep. The effect on paradoxical sleep was inhibitory for all the clonidine doses but wakefulness was enhanced transiently after the four largest doses used. The time between injection and maximum wakefulness enhancement was highly correlated with the dose of c1onidine. The brain level measured after these four different doses at the moment of maximum wakefulness …enhancement was the same, suggesting that this effect occurred only when a critical concentration of the drug was attained in the brain and not when the concentration was higher or lower. These data suggest that different α2-adrenoceptors are involved in these two states of vigilance or, alternatively, that their sensitivity is modulated physiologically. In addition, a sensitivity imbalance between different α2-adrenoceptors may exist in wakefulness but not in paradoxical sleep. Show more

Keywords: Alpha2-adrenoceptors, Clonidine, Paradoxical sleep, Rat, Wakefulness

DOI: 10.3233/BEN-1997-102-307

Citation: Behavioural Neurology, vol. 10, no. 2-3, pp. 93-100, 1997

Authors: Lopez-Rodriguez, Faustino | Gunay, Ibrahim | Glaser, Nancy

Article Type: Research Article

Abstract: This report presents a syndrome resembling obsessive convulsive disorder (OCD) secondary to a stroke in the left basal ganglia. The patient's syndrome is virtually identical to those that have been described in bilateral damage of the basal ganglia. However, the stroke described in this case report is located unilaterally in the left basal ganglia. In addition, experience in treating a patient with OCD induced by structural damage of basal ganglia is presented.

Keywords: Obsessive compulsive disorder, Stroke

DOI: 10.3233/BEN-1997-102-308

Citation: Behavioural Neurology, vol. 10, no. 2-3, pp. 101-103, 1997

Article Type: Other

DOI: 10.3233/BEN-1997-102-309

Citation: Behavioural Neurology, vol. 10, no. 2-3, pp. 105-106, 1997