- Email: [email protected]
Electrophysiological assessment in morbid obesity after biliopancreatic diversion (BPD)
56P
Society Proceeding.~
little diagnostic value in these patients. The clinical usefulness of these tests (Fowler et al.1 is stil1 debated and we discuss our results with the data previously reported. data: a prelimi74. Multisystem integration of neurophysiological nary application. - A. Suppiej ‘, P. De Cosmo b, P. Cogato b and F. Zacchello ’ (” Department of Pediatrics, University of Padua, Padua, and b Noise Software Engineering, Padua) Data exchange among different instruments for neurophysiological diagnosis can allow: (1) the integration of various instruments within a laboratory, (2) storage retrieval and viewing of data from old and new generation instruments, (3) communication with other laboratories for exchange of data and experience. We report our experience in the integration of evoked potential (EP) data coming from our old (Multibasis, Ote Biomedica) and new (Neuroscan) equipment. We make a program that can read EP data coming from the two instruments, display the traces, in the same way, on any personal computer and supplement them with information on the source of the data and methodology for their production. This method can be easily expanded to other instruments. Our program uses different software loaders for different data format and displays many different EP traces in the same way on the same screen, in order to avoid conversion of one data format to another. The information on methodology and equipment combined with traces indicates that similar traces coming from different instruments are not comparable. We think that the standard is in the representation of data and in the function applied to them, not in a particular data-format conversion. Preliminary applications of the described system are a data base collection and data transfer to other Italian and European centres via diskettes and “internet.” 75. Alzheimer type dementia (DAT): cerehral perfusion ?mTcHMPAO-CERASPECT) and cognitive deficit. - F. Nobili, F. Priano, A. Arrigo, P. Cogomo, P. Di Paolo, M. Gambaro and G. Rodriguez (Dept. of Motor Science (Neurophysiopathology), University and Center for Cerebral Neurophysiology (CNR), Genoa) In 10 DAT patients (mean age 70.3 years), Y9mTcHM-PAO-CERASPECT (high-resolution device), verbal fluency, short-term memory, PM47 and constructional praxia tests were performed. Four regions of interest (ROI), 2 frontal and 2 temporo-parietal, were drawn according to the EEG 10-20 International System on a 2 cm transaxial slice, on the orbito-meatal line over the thalamus. Antero-posterior perfusional ratios between the ROI of either side (A/P right; A/P left) and the right to left asymmetries between ROIs were correlated to the Global Deterioration Scale (GDS) and to the test scores. The left (hut not the right) A/P ratio correlated with the GDS (P < 0.011, the PM47 (P < O.Ol), constructional praxia (P < 0.01) and verba1 fluency (P < 0.01). Temporo-parietal asymmetry inversely correlated (f’ < 0.01) with verbal fluency. Mental deficit, as expressed either by a global deterioration scale or by specific tests for cognitive areas, seems particularly related with left temporo-parietal hypoperfusion. 76. Alzheimer type dementia (DAT): cerebral perfusion (99 mTcHMPAO-CERASPECT) and quantifïed EEG (qEEG). - A. Arrigo, F. Nobili, P. Cogomo, M. Gamharo, S. Garbarino and G. Rodriguez (Dept. of Motor Science (Neurophysiopathology), University and Center for Cerebral Neurophysiology (CNR), Genoa) Ten DAT patients underwent y9mTcHM-PAO-CERASPECI (highresolution device with annular crystal) and qEEG. Four regions ofinterest (ROI), 2 frontal and 2 temporo-parietal, were drawn according to the EEG 10-20 International System on a 2 cm transaxial slice on the orbito-meatal line over the thalamus. On power spectra of parietal and posterior tempora1 leads of either side the ratio between the 1-7 Hz and the 7.5-20 Hz percent powers (qEEG index) were computed and then averaged. The severity of disease was graded by the GDS. Antero-pos-
terior perfusional ratios between the ROI of either side (A/P right; A/P left) were correlated with the GDS and the qEEG index. The left qEEG index directly correlated with the left A/P ratio (P < 0.01) and with the GDS (P < 0.05); thc left A/P ratio correlated with the GDS (P < 0.01). NO correlation was found on the right side. Both CERASPECT and electrophysiology show a functional derangement correlated with the severity of disease in the left posterior regions. assessment in morbid obesity after biliopan77. Electrophysiological creatie diversion (BPD). - C. Caponnetto, M. Abbruzzese, E. Giannetta ‘, S. Cuneo ‘, G. Marinari ‘, C. Trompetto, A. Primavera and G. Abbruzzese (Departments of Neurology and ’ Surgery, University of Genoa, Genoa) BPD is used in the surgical treatment of morbid obesity. After BPD about 2% of patients may develop early neurologie disorders because of malabsorption. To detect possible subclinical functional abnormalities, we investigated 17 obese patients after BPD (interval: 2-70 months) by recording median and posterior tibial n. SEPs, biceps, thenar and tibialis anterior MEPs to magnetic stimulation, peroneal and ulnar n. motor neurography, median and sural n. sensory neurography. Neurological examination was normal in al1 patients. CMCT was increased in 3 cases, neurographic studies were abnormal in 3 cases. One patient showed both centra1 and peripheral abnormalities. NO changes of centra1 sensory conduction were observed. Five patients were evaluated before and after BPD: in 1 case a significant increase of CMCT was observed. Subclinical abnormalities (centra1 or peripheral) may occur in about 30% of patients after BPD. Electrophysiological assessment of patients undergoing BPD allows the detection of early neurological signs and the establishment of adequate treatments. 78. Lowering of body temperature of thermosensitive multiple sclerosis patients: a clinical and neurophysiological study. - F. Bandini, C. Trompetto, C. Minatel and E. Capello (Department of Neurology, University of Genoa, Genoa) The clinical symptoms of multiple sclerosis (MS) often deteriorate during fever, induced hyperthermia and even on very hot days. On the contrary it is known that a moderate hypothermia can produce a transient improvement of the clinical signs. We used a cooling system (Mark VII Microclimate System), which consists of a jacket and a skull can fed by a hydraulic cooling system, in 6 thermosensitive MS patients. The patients were subjected to 2 daily coolings of 45 min duration for a period of a month, in order to investigate the acute and cumulative effects of body temperature lowering on neurological performances. A clinical (Expanded Kurtzke Scale and physiatric evaluation) and electrophysiological (MEPs, SEPs from the upper and lower limbs and VEPs) study was performed before the first cooling, after 45 min of cooling and on the thirtieth cooling day, thus obtaining information on acute and chronic efficacy. Clinical improvement was observed both after acute and, more unexpectedly, after chronic cooling. Neurophysiological findings showed that the only significant differente was between SEPs from the lower limbs immediately after cooling and their baseline values. For al1 the other EPs no statistically significant differente was seen, either in acute or chronic recording. 79. Correlations among EEG target variables in experimental pharmaco-EEG models. - E. Marchioni and A. Tartam (Neurologie Institute “C. Mondino,” University of Pavia, Pavia) The choice of target variables from spectrally analyzed EEGs, both in clinical and experimental conditions, is stil1 being discussed. The use of many parameters has been criticized because of the inflation of statistical tests. On the other hand the use of multivariate methods is often impossible. In the present study we correlate absolute power spectrum, relative power and dominant frequenties of 5 selected bands (range 0.2-40.0 Hz)
Society Proceeding.~
little diagnostic value in these patients. The clinical usefulness of these tests (Fowler et al.1 is stil1 debated and we discuss our results with the data previously reported. data: a prelimi74. Multisystem integration of neurophysiological nary application. - A. Suppiej ‘, P. De Cosmo b, P. Cogato b and F. Zacchello ’ (” Department of Pediatrics, University of Padua, Padua, and b Noise Software Engineering, Padua) Data exchange among different instruments for neurophysiological diagnosis can allow: (1) the integration of various instruments within a laboratory, (2) storage retrieval and viewing of data from old and new generation instruments, (3) communication with other laboratories for exchange of data and experience. We report our experience in the integration of evoked potential (EP) data coming from our old (Multibasis, Ote Biomedica) and new (Neuroscan) equipment. We make a program that can read EP data coming from the two instruments, display the traces, in the same way, on any personal computer and supplement them with information on the source of the data and methodology for their production. This method can be easily expanded to other instruments. Our program uses different software loaders for different data format and displays many different EP traces in the same way on the same screen, in order to avoid conversion of one data format to another. The information on methodology and equipment combined with traces indicates that similar traces coming from different instruments are not comparable. We think that the standard is in the representation of data and in the function applied to them, not in a particular data-format conversion. Preliminary applications of the described system are a data base collection and data transfer to other Italian and European centres via diskettes and “internet.” 75. Alzheimer type dementia (DAT): cerehral perfusion ?mTcHMPAO-CERASPECT) and cognitive deficit. - F. Nobili, F. Priano, A. Arrigo, P. Cogomo, P. Di Paolo, M. Gambaro and G. Rodriguez (Dept. of Motor Science (Neurophysiopathology), University and Center for Cerebral Neurophysiology (CNR), Genoa) In 10 DAT patients (mean age 70.3 years), Y9mTcHM-PAO-CERASPECT (high-resolution device), verbal fluency, short-term memory, PM47 and constructional praxia tests were performed. Four regions of interest (ROI), 2 frontal and 2 temporo-parietal, were drawn according to the EEG 10-20 International System on a 2 cm transaxial slice, on the orbito-meatal line over the thalamus. Antero-posterior perfusional ratios between the ROI of either side (A/P right; A/P left) and the right to left asymmetries between ROIs were correlated to the Global Deterioration Scale (GDS) and to the test scores. The left (hut not the right) A/P ratio correlated with the GDS (P < 0.011, the PM47 (P < O.Ol), constructional praxia (P < 0.01) and verba1 fluency (P < 0.01). Temporo-parietal asymmetry inversely correlated (f’ < 0.01) with verbal fluency. Mental deficit, as expressed either by a global deterioration scale or by specific tests for cognitive areas, seems particularly related with left temporo-parietal hypoperfusion. 76. Alzheimer type dementia (DAT): cerebral perfusion (99 mTcHMPAO-CERASPECT) and quantifïed EEG (qEEG). - A. Arrigo, F. Nobili, P. Cogomo, M. Gamharo, S. Garbarino and G. Rodriguez (Dept. of Motor Science (Neurophysiopathology), University and Center for Cerebral Neurophysiology (CNR), Genoa) Ten DAT patients underwent y9mTcHM-PAO-CERASPECI (highresolution device with annular crystal) and qEEG. Four regions ofinterest (ROI), 2 frontal and 2 temporo-parietal, were drawn according to the EEG 10-20 International System on a 2 cm transaxial slice on the orbito-meatal line over the thalamus. On power spectra of parietal and posterior tempora1 leads of either side the ratio between the 1-7 Hz and the 7.5-20 Hz percent powers (qEEG index) were computed and then averaged. The severity of disease was graded by the GDS. Antero-pos-
terior perfusional ratios between the ROI of either side (A/P right; A/P left) were correlated with the GDS and the qEEG index. The left qEEG index directly correlated with the left A/P ratio (P < 0.01) and with the GDS (P < 0.05); thc left A/P ratio correlated with the GDS (P < 0.01). NO correlation was found on the right side. Both CERASPECT and electrophysiology show a functional derangement correlated with the severity of disease in the left posterior regions. assessment in morbid obesity after biliopan77. Electrophysiological creatie diversion (BPD). - C. Caponnetto, M. Abbruzzese, E. Giannetta ‘, S. Cuneo ‘, G. Marinari ‘, C. Trompetto, A. Primavera and G. Abbruzzese (Departments of Neurology and ’ Surgery, University of Genoa, Genoa) BPD is used in the surgical treatment of morbid obesity. After BPD about 2% of patients may develop early neurologie disorders because of malabsorption. To detect possible subclinical functional abnormalities, we investigated 17 obese patients after BPD (interval: 2-70 months) by recording median and posterior tibial n. SEPs, biceps, thenar and tibialis anterior MEPs to magnetic stimulation, peroneal and ulnar n. motor neurography, median and sural n. sensory neurography. Neurological examination was normal in al1 patients. CMCT was increased in 3 cases, neurographic studies were abnormal in 3 cases. One patient showed both centra1 and peripheral abnormalities. NO changes of centra1 sensory conduction were observed. Five patients were evaluated before and after BPD: in 1 case a significant increase of CMCT was observed. Subclinical abnormalities (centra1 or peripheral) may occur in about 30% of patients after BPD. Electrophysiological assessment of patients undergoing BPD allows the detection of early neurological signs and the establishment of adequate treatments. 78. Lowering of body temperature of thermosensitive multiple sclerosis patients: a clinical and neurophysiological study. - F. Bandini, C. Trompetto, C. Minatel and E. Capello (Department of Neurology, University of Genoa, Genoa) The clinical symptoms of multiple sclerosis (MS) often deteriorate during fever, induced hyperthermia and even on very hot days. On the contrary it is known that a moderate hypothermia can produce a transient improvement of the clinical signs. We used a cooling system (Mark VII Microclimate System), which consists of a jacket and a skull can fed by a hydraulic cooling system, in 6 thermosensitive MS patients. The patients were subjected to 2 daily coolings of 45 min duration for a period of a month, in order to investigate the acute and cumulative effects of body temperature lowering on neurological performances. A clinical (Expanded Kurtzke Scale and physiatric evaluation) and electrophysiological (MEPs, SEPs from the upper and lower limbs and VEPs) study was performed before the first cooling, after 45 min of cooling and on the thirtieth cooling day, thus obtaining information on acute and chronic efficacy. Clinical improvement was observed both after acute and, more unexpectedly, after chronic cooling. Neurophysiological findings showed that the only significant differente was between SEPs from the lower limbs immediately after cooling and their baseline values. For al1 the other EPs no statistically significant differente was seen, either in acute or chronic recording. 79. Correlations among EEG target variables in experimental pharmaco-EEG models. - E. Marchioni and A. Tartam (Neurologie Institute “C. Mondino,” University of Pavia, Pavia) The choice of target variables from spectrally analyzed EEGs, both in clinical and experimental conditions, is stil1 being discussed. The use of many parameters has been criticized because of the inflation of statistical tests. On the other hand the use of multivariate methods is often impossible. In the present study we correlate absolute power spectrum, relative power and dominant frequenties of 5 selected bands (range 0.2-40.0 Hz)