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Neuropsychological deficits in seven women with silicone implant disease
Abstracts from the 18th Annual Meeting
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concurrent validity of several measures which may be used to identify adult reading achievement. The implications of these results to the assessment of reading achievement, and the diagnosis of specific reading learning disability, are discussed.
Lewis, ,I. E., & Spicknali, K. E. Neuropsychological Deficits in Seven Women with Silicone Implant Disease. Despite being the center of a national public health controversy for over a decade, silicone implant disease and its CNS sequelae have seldom been the focus of neuropsychological examiners and the implant manufacturers, NP testing became a listed examination component for women suffering ANDS symptoms. Prior reported ANDS profiles included dementia-type cognitive deficits and MS-type motor and sensory impairments. Of further key importance in the public health controversy, the largest epidemiologic study by Hennekens was based on a "Women's Health Questionnaire" instrument that had no symptom questions whatsoever on possible CNS dysfunction and rather focused almost exclusively on the putative connective tissue correlates of suspected human (silicone) adjuvant disease. The present paper reports WAIS-R and complete Halstead-Reitan Battery findings on seven women with a mean age of 45.1 years, a mean educational level of 14.4 years and a mean silicone breast implant exposure of 13.6 years. History-taking and review of patients' medical records revealed no personal or family history of other potential or preexisting sources of CNS injury, damage, disease or defect. All seven women had neurological diagnosis of CNS pathology based on clinical examination. MRI and/or other lab findings (e.g., abnormal myelin basic protein). All seven women had NP test profiles with General-Neuropsychological Deficit Scale elevations in the mild, moderate, and severely impaired ranges and Halstead Impairment Index scores which remained clinically significant after Heaton norms correction for age, education, and gender influences. As postulated by ANDS medical researchers, all seven women had NP profiles with a combination of different dementia-type cognitive deficits in immediate memory, problem-solving and attention/concentration as well as MS-like bilateral motor, sensorimotor and sensory-perceptual impairments. While no broad generalization of findings is justified based on the small case study size (7), the present results are consistent with reports of prior human and animal studies and points to the crucial need for larger sample NI' study into this neglected area of women's health in NP research.
Martin, R., Hugg, J., Giiliam, F., Faught, E., & Kuzniecky, R. 1H-Magnetic Resonance Spectroscopic Imaging Detected Hippocampal Metabolic Abnormalities Correlate with Neuropsychological Performance: Preliminary Findings in Mesial Temporal Lobe Epilepsy Patients. Rationale: Metabolic mesial temporal abnormalities as detected by ~H-Magnetic Resonance spectroscopic imaging (MRSI) are commonly found in patients with mesial temporal lobe epilepsy (MTLE). The present study examined potential relationships between performance across measures of general verbal intellect, memory, attention, and executive functioning to extent of MRSI-detected metabolic lesions. The primary question was whether patients with more extensive MRSI-detected metabolic lesions would demonstrate worse neuropsychological performance. Methods: by aH-MRSI as acquired with a 4.1T imaging spectrometer in 29 adult left T L E patients. Single 10mm slice MRS images were obtained in the plane of the hippocampus. Cr/NAA metabolite ratio maps were produced. The area of each metabolic lesion (i.e., number of contiguous abnormal pixels within the hippocampus) provided a measure of lesion extent. The neuropsycho-
135
concurrent validity of several measures which may be used to identify adult reading achievement. The implications of these results to the assessment of reading achievement, and the diagnosis of specific reading learning disability, are discussed.
Lewis, ,I. E., & Spicknali, K. E. Neuropsychological Deficits in Seven Women with Silicone Implant Disease. Despite being the center of a national public health controversy for over a decade, silicone implant disease and its CNS sequelae have seldom been the focus of neuropsychological examiners and the implant manufacturers, NP testing became a listed examination component for women suffering ANDS symptoms. Prior reported ANDS profiles included dementia-type cognitive deficits and MS-type motor and sensory impairments. Of further key importance in the public health controversy, the largest epidemiologic study by Hennekens was based on a "Women's Health Questionnaire" instrument that had no symptom questions whatsoever on possible CNS dysfunction and rather focused almost exclusively on the putative connective tissue correlates of suspected human (silicone) adjuvant disease. The present paper reports WAIS-R and complete Halstead-Reitan Battery findings on seven women with a mean age of 45.1 years, a mean educational level of 14.4 years and a mean silicone breast implant exposure of 13.6 years. History-taking and review of patients' medical records revealed no personal or family history of other potential or preexisting sources of CNS injury, damage, disease or defect. All seven women had neurological diagnosis of CNS pathology based on clinical examination. MRI and/or other lab findings (e.g., abnormal myelin basic protein). All seven women had NP test profiles with General-Neuropsychological Deficit Scale elevations in the mild, moderate, and severely impaired ranges and Halstead Impairment Index scores which remained clinically significant after Heaton norms correction for age, education, and gender influences. As postulated by ANDS medical researchers, all seven women had NP profiles with a combination of different dementia-type cognitive deficits in immediate memory, problem-solving and attention/concentration as well as MS-like bilateral motor, sensorimotor and sensory-perceptual impairments. While no broad generalization of findings is justified based on the small case study size (7), the present results are consistent with reports of prior human and animal studies and points to the crucial need for larger sample NI' study into this neglected area of women's health in NP research.
Martin, R., Hugg, J., Giiliam, F., Faught, E., & Kuzniecky, R. 1H-Magnetic Resonance Spectroscopic Imaging Detected Hippocampal Metabolic Abnormalities Correlate with Neuropsychological Performance: Preliminary Findings in Mesial Temporal Lobe Epilepsy Patients. Rationale: Metabolic mesial temporal abnormalities as detected by ~H-Magnetic Resonance spectroscopic imaging (MRSI) are commonly found in patients with mesial temporal lobe epilepsy (MTLE). The present study examined potential relationships between performance across measures of general verbal intellect, memory, attention, and executive functioning to extent of MRSI-detected metabolic lesions. The primary question was whether patients with more extensive MRSI-detected metabolic lesions would demonstrate worse neuropsychological performance. Methods: by aH-MRSI as acquired with a 4.1T imaging spectrometer in 29 adult left T L E patients. Single 10mm slice MRS images were obtained in the plane of the hippocampus. Cr/NAA metabolite ratio maps were produced. The area of each metabolic lesion (i.e., number of contiguous abnormal pixels within the hippocampus) provided a measure of lesion extent. The neuropsycho-