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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fabry disease is an X-linked lysosomal storage disorder which can result in renal, cardiac, and cerebrovascular disease. Patients are at increased risk of stroke and neuroimaging studies note cerebrovascular pathology. This study provides a cognitive profile of a cohort of individuals with Fabry disease and investigates the impact of pain, age, renal, cardiac, and cerebrovascular functioning on cognition and psychological functioning. Seventeen Fabry patients (12 males) with ages ranging 25 to 60 years (M = 46.6+11.8), and 15 age-matched healthy controls (M = 46.2+12.7) were administered a comprehensive neuropsychological battery. Fabry males demonstrated slower speed of information processing, reduced performance on measures of executive functions (verbal generation, reasoning, problem solving, perseveration), were more likely to show clinically significant reductions, and were more likely to report symptoms of anxiety and depression. Conversely, Fabry females performed at a similar level to controls. Correlational analyses indicated a link between cognitive and clinical measures of disease severity.
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PMID:Cognitive and psychological functioning in Fabry disease. 2531 43

In four patients with thalamic infarcts causing severe neuropsychological deficits, regional cerebral blood flow (rCBF) was measured by single-photon emission computed tomography using (99m)Tc-d,l,-hexamethylpropyleneamine oxime as tracer. In one of these patients, cerebral glucose metabolism was measured by positron emission tomography using (18)F-fluorodeoxyglucose as tracer. Three patients had left paramedian thalamic infarcts, in one case combined with an infarction of the right cerebellar hemisphere, and one had bilateral paramedian and left anterior thalamic infarcts. Neuropsychological assessment revealed profound impairment of memory, verbal fluency, and abstract reasoning, as well as perseveration and varying degrees of dyscalculia and constructional apraxia in all patients. There were distinct personality changes and deficient judgment and insight. All four patients had reduced cortical rCBF in the left frontoparietal regions. In three cases, flow was also reduced in the left temporal lobe; they all presented with a fluent aphasia, which only partly remitted over time. Prosody and mimics were impaired only in the patient with bilateral thalamic infarction. In one of the patients with unilateral thalamic infarct extending into the mesencephalon, glucose metabolism was reduced in the ipsilateral frontal, temporal, and occipital regions. Thalamic infarcts can alter the activity in widespread functional systems of the brain and thus lead to extensive neuropsychological deficits.
J Stroke Cerebrovasc Dis 1993
PMID:Thalamic infarcts: Effects on cerebral blood flow, metabolism, and neuropsychological function. 2648 52

Poststroke movement disorders may manifest as parkinsonism, dystonia, chorea, ballism, athetosis, tremor, myoclonus, stereotypies, and akathisia. In this article, we describe a patient with clonic perseveration 2 days after an acute ischemic stroke. We discuss the phenomenology and provide insights on possible pathophysiological mechanisms involved.
J Stroke Cerebrovasc Dis 2016 Aug
PMID:Clonic Perseveration after Acute Ischemic Stroke: An Insight into the Pathophysiological Mechanisms. 2720 88

Spatial neglect is a characterized by a failure to attend or make movements towards left-sided stimuli. Common paper-and-pencil tasks to diagnose spatial neglect are sensitive to perseverative errors, including additional marks over already cancelled targets and "scribbling" out a target. Here, we examine whether functionally distinct perseverative behaviors are related to spatial neglect. Line cancellation tasks of 45 healthy controls and 220 right-hemisphere stroke survivors were examined for recurrent marks (RM) and continuous marks (CM) perseverations. We found that RM perseveration correlated with neglect severity, while CM perseveration did not. Examination of lesion profiles for the two groups indicated distinct anatomical correlates, with RM lesions overlapping regions implicated in spatial neglect including the rolandic operculum, superior temporal gyrus, and inferior parietal lobule.
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PMID:Which perseverative behaviors are symptoms of spatial neglect? 2816 11

Unilateral spatial neglect is a disabling neurologic deficit, most frequent and severe after right-hemispheric lesions. In most patients neglect involves the left side of space, contralateral to a right-hemispheric lesion. About 50% of stroke patients exhibit neglect in the acute phase. Patients fail to orient, respond to, and report sensory events occurring in the contralateral sides of space and of the body, to explore these portions of space through movements by action effectors (eye, limbs), and to move the contralateral limbs. Neglect is a multicomponent higher-level disorder of spatial awareness, cognition, and attention. Spatial neglect may occur independently of elementary sensory and motor neurologic deficits, but it can mimic and make them more severe. Diagnostic tests include: motor exploratory target cancellation; setting the midpoint of a horizontal line (bisection), that requires the estimation of lateral extent; drawing by copy and from memory; reading, assessing neglect dyslexia; and exploring the side of the body contralateral to the lesion. Activities of daily living scales are also used. Patients are typically not aware of neglect, although they may exhibit varying degrees of awareness toward different components of the deficit. The neural correlates include lesions to the inferior parietal lobule of the posterior parietal cortex, which was long considered the unique neuropathologic correlate of neglect, to the premotor and to the dorsolateral prefrontal cortices, to the posterior superior temporal gyrus, at the temporoparietal junction, to subcortical gray nuclei (thalamus, basal ganglia), and to parietofrontal white-matter fiber tracts, such as the superior longitudinal fascicle. Damage to the inferior parietal lobule of the posterior parietal cortex is specifically associated with the mainly egocentric, perceptual, and exploratory extrapersonal, and with the personal, bodily components of neglect. Productive manifestations, such as perseveration, are not a correlate of posterior parietal cortex damage.
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PMID:Unilateral spatial neglect after posterior parietal damage. 2951 63


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