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The relationship between poststroke depression and cognitive impairment in the patients of subacute stroke
296
Abstracts / Journal of the Neurological Sciences 283 (2009) 240–320
Correlation of plasma homocysteine levels with common neurological diseases in the elderly
Al. Siannia, K. Kosmaa, K. Liatsosc, E. Laskosa, A. Ganotopouloub a Dromokaitio Psychiatric Hospital of Athens, Attiki, Greece b Health Center of Skiathos, General Prefectural Hospital of Volos, Magnissia, Greece c Mitera Maternity Hospital of Athens, Attiki, Greece Introduction: Elevated levels of homocysteine have been associated with a variety of atherosclerotic diseases and with an increased risk for Alzheimer's dementia. Methods: In total, 97 subjects were included. All were over 55 years-old and inpatients of the Psychiatric Hospital of Athens. Patients with a diagnosis of congenital hyperhomocysteinemia were excluded. Subjects were divided in three groups. Group A consisted of 35 patients, 16 men and 19 women with a diagnosis of Alzheimer's dementia at least one year before entering the study. Group B was comprised of 32 patients, 18 men and 14 women. Patients of this group had a positive history of stroke, or a diagnosis of vascular or mixed dementia. At last 30 subjects, 14 men and 16 women, non demented and free of atherosclerotic disease psychiatric patients constituted Group C. Results: 5 patients (14.3%) of Group A presented with high homocysteine levels > 15 μmol/l. The rest had normal homocysteine values. The percentage was higher for Group B in which 7 patients (21%) had elevated homocysteine levels and finally and lower for group C in which only 3 patients 8.5% presented hyperhomocysteinemia The differences between the three subpopulations did not reach a statistical significance(x2 = 1.64). Conclusions: No significant relationship was detected between high homocysteine levels and the presence of Alzheimer's dementia. On the other hand, elevated homocysteine levels were detected more often when vascular dementia or a positive history of stroke was presented.
Group A Homocysteine levels 5-15mmol/lt >5mmol/lt Group B Homocysteine levels 5-15mmol/lt >5mmol/lt Group C Homocysteine levels 5-15mmol/lt >5mmol/lt
Patients N = 35 30 5
Women N = 19 17 2
Men N = 16 13 3
Patients N = 32 25 7
Women N = 14 12 2
Men N = 18 13 5
Patients N = 30 27 3
Women N = 16 15 1
Men N = 14 12 2
doi:10.1016/j.jns.2009.02.213
Homocysteine and cognitive tests as predictors of cognitive decline: A cohort study A. Garciaa, A. Hemraja, S. Klara, T. Chestneya, L. Khojaa, A. Dayb Department of Medicine, Queen's University, Kingston, Ontario, Canada Clinical Research Centre, KGH, Queen's University, Kingston, Ontario, Canada Background and aim: Homocysteine (tHcy) is considered a vascular dementia risk factor. We have assessed the relative impact of tHcy and psychometric tests scores in the development of dementia in a cohort of older adults. Methods: Cohort (n = 281) of cognitively normal older adults (ages 65 to 89) at baseline. Follow-up was 8 years (median of 6.5 years) and 44 (15.7%) were lost to follow-up (or had < 4 years of follow-up). Tests at baseline and at follow-up included: Mini-Mental State Exam (MMSE), Mattis Dementia Rating Scale (DRS), California Verbal Learning Test (CVLT), Stroop test, and serum tHcy. Analysis of data included CVLT factor analysis, Cox proportional hazards and Receiver Operating Characteristics (ROC). Results: At baseline, mean (± SD) tHy was 10.0 ± 4.0 with 12% having high tHcy (≥ 13 mM). Baseline tHcy was positively correlated with age and female sex and negatively correlated with baseline Stroop and CVLT factor 1. There were no significant differences at baseline between subjects followed
and the ones lost to follow-up but for the DRS score. Cumulative incidence of dementia at 8 years was 21%. Participants diagnosed with dementia were: older, more likely to be female, had higher tHcy levels, and had lower baseline test scores. Cox proportional hazard models showed that all psychometric test scores significantly predicted dementia after adjustment for age and sex. tHcy as continuous variable was not independently associated with dementia diagnosis (p = 0.42), but was mildly suggestive when dichotomized as high/normal (p = 0.048). Only CVLT factor 1 and DRS showed significant hazard ratio (p < 0.001) in backwards selection. ROC analysis showed that all variables had an area under the curve significantly greater than 0.5 (all p < 0.005 but for tHcy p < 0.012). Conclusions: These results suggest that tHcy predicts dementia only marginally when levels are high and that psychometric tests scores at baseline are better predictors of dementia. doi:10.1016/j.jns.2009.02.214
Post-stroke depression after mild stroke D.C. Kuljic Obradovic, S. Medic, N. Ivanovic Basurovic Sveti Sava Hospital, Belgrade, Serbia Background and aims: Post-stroke depression is one of the most frequent complications of stroke. The prevalence rates range from 30% to 50%. Whether post-stroke depression is an emotional response to the independence or an organic consequence of the brain injury still remains to be resolve. The aim of the study was to investigate the prevalence of depression in mild stroke patients and relationship between the occurrence of depression and sex, age, type of stroke, size of the cerebral lesion and involvement of specific areas of the brain. Methods: We included patients with single, demarcated, unilateral stroke defined by brain CT and/or MRI examination. The neurological examination was performed and diagnosis made using the criteria established by National Institute of Neurological Disorders and Stroke NIH-NINDS. The patients were studied using a standard protocol including Mini-Mental State Examination (MMSE) and Hamilton Rating Scale for Depression (HRSD). The patients with previous psychiatric illness, severe stroke (HIH-NINDS > 20) and cognitive impairments (MMSE < 24) were excluded. Results: 56 patients were studied, 31 female, 25 male, mean age 66.5. Thirty percent of the stroke patients fit the criteria for minor (14) or major (3) depression. No significant differences in sex, age, type of stroke (hemorrhagic/ischemic), territory of the stroke (cortical vs. subcortical, anterior vs. posterior vs. nonclassifiable) were found between depressed and non-depressed patients. There was a higher frequency of left hemisphere lesions (50% vs. 23.5%) and brain lesions larger than 2 cm (50% vs. 23.5%) in patients who have developed depression. Conclusions: Among the patients with mild stroke, the frequency of the depression was 30%, and was higher in patients with large brain lesions (p < 0.05), located in the left hemisphere (p < 0.05). We found no significant differences in depression scores depending on sex, age, type of stroke and vascular territory of the stroke. doi:10.1016/j.jns.2009.02.215
The relationship between poststroke depression and cognitive impairment in the patients of subacute stroke
S.D. Yoo, Y.S. Jeong, D.H. Kim Department of Physical Medicine and Rehabilitation, Kyung Hee University, East-West Neo Medical Center, Seoul, South Korea Background and aims: The aim of this study was to understand the correlation between PSD and the cognitive function in the patients of subacute stroke. Methods: We studied stroke patients who did not have aphasia, hearing disturbance, and history of depression. The severity of PSD were evaluated by Beck depression inventory(BDI), Korean form of Geriatric depression scale
Abstracts / Journal of the Neurological Sciences 283 (2009) 240–320
(KGDS), and Hamilton rating scale for depression (HRS-D) and the evaluation of cognitive impairments was based on Computerized Neuro-psychological Test (CNT), Mini-Mental Status Examination (MMSE), and Neurobehavioral Cognitive Status Examination (NCSE). Results: 53 patients with cerebral infarction (n = 28) and cerebral hemorrhage (n = 25) participated in this study. These patients had a mean age of 64.3 ± 10.2. Stroke location was the right hemisphere in 24 subjects, the left hemisphere in 23, and bilateral hemisphere in 6. PSD was diagnosed in 33 of 53 patients by BDI, in 28 of 43 by KGDS and in 22 of 45 by HRS-D. The domains of CNT to be significantly correlated with BDI, KGDS, and HRS-D were verbal and visual learning test. But, MMSE and NCSE had no relation with BDI, KGDS, and HRS-D. Conclusions: We suggest that the evaluation of CNT in post-stroke depression patients could be useful diagnostic method from the viewpoint of early management of PSD and the diagnosis for poststroke depression should be conducted by self rating (BDI) and objective assessments (HRS-D). doi:10.1016/j.jns.2009.02.216
Vascular depression and vascular cognitive impairment share some common pathological aspects
297
Methods: Sixty two patients with chronic stroke were followed up for 2 months. Cognitive functions were assessed with Mini Mental State Examination (MMSE), independence of ADL with Modified Barthel Index (MBI) and depressive symptoms with the Beck Depression Inventory (BDI) before and after rehabilitation treatments. Patients with depressive symptom received antidepressant drugs. Patients were divided into two groups: one for improved depressive symptoms and the other for no improvement after treatment. We compare the scores of the MMSE and MBI before treatment with those after treatment in each group and compared the changes of those during treatment between two groups. Results: The prevalence of depressive symptoms was 77% (48/62). Improvement in BDI scores after treatment was seen in 67% (32/48) and in improvement group increases of MMSE scores (from 42.6 to 56.9, p < 0.05) and MBI scores (from 42.6 to 56.9, p < 0.05) were seen. In no improvement group MBI scores increased from 49.8 to 68.9 (p < 0.05), but no significant change was seen in MMSE scores. In comparison of changes of scores during treatment between two groups significant improvement was seen only in the item of speech in MMSE and no statistical difference in the changes of MBI was seen. Conclusions: The prevalence of depressive symptoms was high and treatment of depressive symptoms was thought to improve cognitive function in chronic stroke patients. doi:10.1016/j.jns.2009.02.218
Citalopram can be useful in the treatment of vascular depression K. Sasa, L. Sztrihaa, L. Vecseia, J.Gy. Pappb Department of Neurology, University of Szeged, Szeged, Hungary Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary The prefrontal cortex plays a special role in a host of human functions such as execution, emotion, motivation, behavior, attention, and verbal memory. The control of these functions takes place in neuronal circuits involving the prefrontal cortex and sub-cortical structures like the striatum, pallidum, substantia nigra, subthalamic nucleus and thalamus. Three of the five frontosubcortical circuits (dorsolateral, lateral orbito-frontal and anterior cingulate) play a part in mediating emotions and behavior (cognition). Chronic stress followed by hyperactivity of the glucocorticoid axis and chronic glutamaterg over excitation of the hippocampus (from prefrontal cortex) are thought to be the main processes in the pathomechanism of “idiosyncratic” depression. The prefrontal cortex gets noradrenergic and serotonergic innervation from the locus coeruleus and raphe nucleus, respectively, and these pathways form synaptic connections with neurons in the prefrontal cortex. These synapses may be the target of antidepressant drugs. Vascular depression is related to various types of cerebrovascular pathology. Subcortical ischemic depression is related to silent lacunar infarcts or leucoaraiosis in the deep white matter of the brain. These subtle lesions can interrupt the above-mentioned fronto-subcortical circuits and ascending pathways and lead to a subcortical-type cognitive deficit, and/or depression and/or movement/gait or vegetative (incontinence) disturbances. In our study, we investigated the effects of i.v. citalopram and fluoxetin on the CBF by the hydrogen clearance technique in normal, healthy rabbits and under ischemic conditions of the brain caused by unilateral carotid occlusion. Each dose of citalopram (0.1, 0.3 and 1 mg/kg) exerted pronounced and dose-dependent CBF-increasing effects in the animal subjects with unilateral carotid occlusion (maximal mean CBF changes: 10, 16 and 27 ml/min/100 g tissue). These results suggest that the drug might be beneficial in the treatment of vascular depression. doi:10.1016/j.jns.2009.02.217
Investigation on the effect of lemon peel essential oil in blood level lipids number of differential leukocytes of Wistar rats P. Yaghmaei, K. Parivar, M. Haft Savar Biology Department, Science and Research Branch of Islamic Azad University, Tehran, Iran Cardiovascular and infected diseases are important problems in most countries of the world. Cardiovascular diseases are the result of vessel occlusion as causing atherosclerosis. Quantitative disturbance and the increase of cholesterol and other plasma lipids have an important role in pathogenesis of this disease. Also, the most important cause of cancer and its progress is insufficiency of immune system and specially activation of leukocytes. An increase of the number of leukocytes and augmentation of immune system can cause prevention and challenge with this disease. The aim was to study the effect of oral drop lemon peel essential oil on the level of blood lipids and differential leukocyte counts. For this purpose, a group of mature male rats strain were used (including 5 subgroups,1 control group,1 sham group and 3 experimental groups) the experimental groups were fed with cholesterol for five weeks given oral drop lemon peel essential oil with 25 µl/ kg, 50 µl/kg and 100 µl/kg doses, sham groups received saline solution (1 ml/ day). At the end of this period, by blood sampling from the heart, plasma lipids were measured in control, sham and experimental groups, in order to evaluate differential leukocyte counts blood smear method. The results showed that a low dose of lemon peel essential oil did not have a significant effect on the level of plasma lipids but moderate and especially high doses showed significant effects on cholesterol, LDL and triglyceride levels compared with control group. None of these doses had significant effects on the plasma HDL. It is concluded that by decreasing plasma lipids, lemon peel may prevent atherosclerosis and decrease the incidence of cardiovascular disease. This research showed that three doses of lemon peel have a significant effect on the increase of the number and percent of blood leukocytes and a more significant effect resulted from the high dose. doi:10.1016/j.jns.2009.02.219
The influence of depressive symptoms on the recovery of cognitive function in chronic stroke patients B.S. Kwon, J.W. Park, H.J. Lee, T.S. Yoon Dept. of Physical Medicine & Rehabilitation, Dongguk University International Hospital, Goyang-si, South Korea Background and aims: This study was designed to investigate prevalence of depressive symptoms and effect of treatment of depressive symptoms on cognitive function and activities of daily living (ADL) in chronic stroke patients.
Changes of cognitive functions after stroke I. Gašparića, Z. Andrićb, N. Gotovacc Department of Neurology, General Hospital Požega, Požega, Croatia b Department of infectology, General Hospital Požega, Croatia, Požega, Croatia c Department of radiology, General Hospital Požega, Croatia, Požega, Croatia
a
A series of neural disorders can be observed after stroke, and most common is the decrease of cognitive functions. Such changes can be
Abstracts / Journal of the Neurological Sciences 283 (2009) 240–320
Correlation of plasma homocysteine levels with common neurological diseases in the elderly
Al. Siannia, K. Kosmaa, K. Liatsosc, E. Laskosa, A. Ganotopouloub a Dromokaitio Psychiatric Hospital of Athens, Attiki, Greece b Health Center of Skiathos, General Prefectural Hospital of Volos, Magnissia, Greece c Mitera Maternity Hospital of Athens, Attiki, Greece Introduction: Elevated levels of homocysteine have been associated with a variety of atherosclerotic diseases and with an increased risk for Alzheimer's dementia. Methods: In total, 97 subjects were included. All were over 55 years-old and inpatients of the Psychiatric Hospital of Athens. Patients with a diagnosis of congenital hyperhomocysteinemia were excluded. Subjects were divided in three groups. Group A consisted of 35 patients, 16 men and 19 women with a diagnosis of Alzheimer's dementia at least one year before entering the study. Group B was comprised of 32 patients, 18 men and 14 women. Patients of this group had a positive history of stroke, or a diagnosis of vascular or mixed dementia. At last 30 subjects, 14 men and 16 women, non demented and free of atherosclerotic disease psychiatric patients constituted Group C. Results: 5 patients (14.3%) of Group A presented with high homocysteine levels > 15 μmol/l. The rest had normal homocysteine values. The percentage was higher for Group B in which 7 patients (21%) had elevated homocysteine levels and finally and lower for group C in which only 3 patients 8.5% presented hyperhomocysteinemia The differences between the three subpopulations did not reach a statistical significance(x2 = 1.64). Conclusions: No significant relationship was detected between high homocysteine levels and the presence of Alzheimer's dementia. On the other hand, elevated homocysteine levels were detected more often when vascular dementia or a positive history of stroke was presented.
Group A Homocysteine levels 5-15mmol/lt >5mmol/lt Group B Homocysteine levels 5-15mmol/lt >5mmol/lt Group C Homocysteine levels 5-15mmol/lt >5mmol/lt
Patients N = 35 30 5
Women N = 19 17 2
Men N = 16 13 3
Patients N = 32 25 7
Women N = 14 12 2
Men N = 18 13 5
Patients N = 30 27 3
Women N = 16 15 1
Men N = 14 12 2
doi:10.1016/j.jns.2009.02.213
Homocysteine and cognitive tests as predictors of cognitive decline: A cohort study A. Garciaa, A. Hemraja, S. Klara, T. Chestneya, L. Khojaa, A. Dayb Department of Medicine, Queen's University, Kingston, Ontario, Canada Clinical Research Centre, KGH, Queen's University, Kingston, Ontario, Canada Background and aim: Homocysteine (tHcy) is considered a vascular dementia risk factor. We have assessed the relative impact of tHcy and psychometric tests scores in the development of dementia in a cohort of older adults. Methods: Cohort (n = 281) of cognitively normal older adults (ages 65 to 89) at baseline. Follow-up was 8 years (median of 6.5 years) and 44 (15.7%) were lost to follow-up (or had < 4 years of follow-up). Tests at baseline and at follow-up included: Mini-Mental State Exam (MMSE), Mattis Dementia Rating Scale (DRS), California Verbal Learning Test (CVLT), Stroop test, and serum tHcy. Analysis of data included CVLT factor analysis, Cox proportional hazards and Receiver Operating Characteristics (ROC). Results: At baseline, mean (± SD) tHy was 10.0 ± 4.0 with 12% having high tHcy (≥ 13 mM). Baseline tHcy was positively correlated with age and female sex and negatively correlated with baseline Stroop and CVLT factor 1. There were no significant differences at baseline between subjects followed
and the ones lost to follow-up but for the DRS score. Cumulative incidence of dementia at 8 years was 21%. Participants diagnosed with dementia were: older, more likely to be female, had higher tHcy levels, and had lower baseline test scores. Cox proportional hazard models showed that all psychometric test scores significantly predicted dementia after adjustment for age and sex. tHcy as continuous variable was not independently associated with dementia diagnosis (p = 0.42), but was mildly suggestive when dichotomized as high/normal (p = 0.048). Only CVLT factor 1 and DRS showed significant hazard ratio (p < 0.001) in backwards selection. ROC analysis showed that all variables had an area under the curve significantly greater than 0.5 (all p < 0.005 but for tHcy p < 0.012). Conclusions: These results suggest that tHcy predicts dementia only marginally when levels are high and that psychometric tests scores at baseline are better predictors of dementia. doi:10.1016/j.jns.2009.02.214
Post-stroke depression after mild stroke D.C. Kuljic Obradovic, S. Medic, N. Ivanovic Basurovic Sveti Sava Hospital, Belgrade, Serbia Background and aims: Post-stroke depression is one of the most frequent complications of stroke. The prevalence rates range from 30% to 50%. Whether post-stroke depression is an emotional response to the independence or an organic consequence of the brain injury still remains to be resolve. The aim of the study was to investigate the prevalence of depression in mild stroke patients and relationship between the occurrence of depression and sex, age, type of stroke, size of the cerebral lesion and involvement of specific areas of the brain. Methods: We included patients with single, demarcated, unilateral stroke defined by brain CT and/or MRI examination. The neurological examination was performed and diagnosis made using the criteria established by National Institute of Neurological Disorders and Stroke NIH-NINDS. The patients were studied using a standard protocol including Mini-Mental State Examination (MMSE) and Hamilton Rating Scale for Depression (HRSD). The patients with previous psychiatric illness, severe stroke (HIH-NINDS > 20) and cognitive impairments (MMSE < 24) were excluded. Results: 56 patients were studied, 31 female, 25 male, mean age 66.5. Thirty percent of the stroke patients fit the criteria for minor (14) or major (3) depression. No significant differences in sex, age, type of stroke (hemorrhagic/ischemic), territory of the stroke (cortical vs. subcortical, anterior vs. posterior vs. nonclassifiable) were found between depressed and non-depressed patients. There was a higher frequency of left hemisphere lesions (50% vs. 23.5%) and brain lesions larger than 2 cm (50% vs. 23.5%) in patients who have developed depression. Conclusions: Among the patients with mild stroke, the frequency of the depression was 30%, and was higher in patients with large brain lesions (p < 0.05), located in the left hemisphere (p < 0.05). We found no significant differences in depression scores depending on sex, age, type of stroke and vascular territory of the stroke. doi:10.1016/j.jns.2009.02.215
The relationship between poststroke depression and cognitive impairment in the patients of subacute stroke
S.D. Yoo, Y.S. Jeong, D.H. Kim Department of Physical Medicine and Rehabilitation, Kyung Hee University, East-West Neo Medical Center, Seoul, South Korea Background and aims: The aim of this study was to understand the correlation between PSD and the cognitive function in the patients of subacute stroke. Methods: We studied stroke patients who did not have aphasia, hearing disturbance, and history of depression. The severity of PSD were evaluated by Beck depression inventory(BDI), Korean form of Geriatric depression scale
Abstracts / Journal of the Neurological Sciences 283 (2009) 240–320
(KGDS), and Hamilton rating scale for depression (HRS-D) and the evaluation of cognitive impairments was based on Computerized Neuro-psychological Test (CNT), Mini-Mental Status Examination (MMSE), and Neurobehavioral Cognitive Status Examination (NCSE). Results: 53 patients with cerebral infarction (n = 28) and cerebral hemorrhage (n = 25) participated in this study. These patients had a mean age of 64.3 ± 10.2. Stroke location was the right hemisphere in 24 subjects, the left hemisphere in 23, and bilateral hemisphere in 6. PSD was diagnosed in 33 of 53 patients by BDI, in 28 of 43 by KGDS and in 22 of 45 by HRS-D. The domains of CNT to be significantly correlated with BDI, KGDS, and HRS-D were verbal and visual learning test. But, MMSE and NCSE had no relation with BDI, KGDS, and HRS-D. Conclusions: We suggest that the evaluation of CNT in post-stroke depression patients could be useful diagnostic method from the viewpoint of early management of PSD and the diagnosis for poststroke depression should be conducted by self rating (BDI) and objective assessments (HRS-D). doi:10.1016/j.jns.2009.02.216
Vascular depression and vascular cognitive impairment share some common pathological aspects
297
Methods: Sixty two patients with chronic stroke were followed up for 2 months. Cognitive functions were assessed with Mini Mental State Examination (MMSE), independence of ADL with Modified Barthel Index (MBI) and depressive symptoms with the Beck Depression Inventory (BDI) before and after rehabilitation treatments. Patients with depressive symptom received antidepressant drugs. Patients were divided into two groups: one for improved depressive symptoms and the other for no improvement after treatment. We compare the scores of the MMSE and MBI before treatment with those after treatment in each group and compared the changes of those during treatment between two groups. Results: The prevalence of depressive symptoms was 77% (48/62). Improvement in BDI scores after treatment was seen in 67% (32/48) and in improvement group increases of MMSE scores (from 42.6 to 56.9, p < 0.05) and MBI scores (from 42.6 to 56.9, p < 0.05) were seen. In no improvement group MBI scores increased from 49.8 to 68.9 (p < 0.05), but no significant change was seen in MMSE scores. In comparison of changes of scores during treatment between two groups significant improvement was seen only in the item of speech in MMSE and no statistical difference in the changes of MBI was seen. Conclusions: The prevalence of depressive symptoms was high and treatment of depressive symptoms was thought to improve cognitive function in chronic stroke patients. doi:10.1016/j.jns.2009.02.218
Citalopram can be useful in the treatment of vascular depression K. Sasa, L. Sztrihaa, L. Vecseia, J.Gy. Pappb Department of Neurology, University of Szeged, Szeged, Hungary Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary The prefrontal cortex plays a special role in a host of human functions such as execution, emotion, motivation, behavior, attention, and verbal memory. The control of these functions takes place in neuronal circuits involving the prefrontal cortex and sub-cortical structures like the striatum, pallidum, substantia nigra, subthalamic nucleus and thalamus. Three of the five frontosubcortical circuits (dorsolateral, lateral orbito-frontal and anterior cingulate) play a part in mediating emotions and behavior (cognition). Chronic stress followed by hyperactivity of the glucocorticoid axis and chronic glutamaterg over excitation of the hippocampus (from prefrontal cortex) are thought to be the main processes in the pathomechanism of “idiosyncratic” depression. The prefrontal cortex gets noradrenergic and serotonergic innervation from the locus coeruleus and raphe nucleus, respectively, and these pathways form synaptic connections with neurons in the prefrontal cortex. These synapses may be the target of antidepressant drugs. Vascular depression is related to various types of cerebrovascular pathology. Subcortical ischemic depression is related to silent lacunar infarcts or leucoaraiosis in the deep white matter of the brain. These subtle lesions can interrupt the above-mentioned fronto-subcortical circuits and ascending pathways and lead to a subcortical-type cognitive deficit, and/or depression and/or movement/gait or vegetative (incontinence) disturbances. In our study, we investigated the effects of i.v. citalopram and fluoxetin on the CBF by the hydrogen clearance technique in normal, healthy rabbits and under ischemic conditions of the brain caused by unilateral carotid occlusion. Each dose of citalopram (0.1, 0.3 and 1 mg/kg) exerted pronounced and dose-dependent CBF-increasing effects in the animal subjects with unilateral carotid occlusion (maximal mean CBF changes: 10, 16 and 27 ml/min/100 g tissue). These results suggest that the drug might be beneficial in the treatment of vascular depression. doi:10.1016/j.jns.2009.02.217
Investigation on the effect of lemon peel essential oil in blood level lipids number of differential leukocytes of Wistar rats P. Yaghmaei, K. Parivar, M. Haft Savar Biology Department, Science and Research Branch of Islamic Azad University, Tehran, Iran Cardiovascular and infected diseases are important problems in most countries of the world. Cardiovascular diseases are the result of vessel occlusion as causing atherosclerosis. Quantitative disturbance and the increase of cholesterol and other plasma lipids have an important role in pathogenesis of this disease. Also, the most important cause of cancer and its progress is insufficiency of immune system and specially activation of leukocytes. An increase of the number of leukocytes and augmentation of immune system can cause prevention and challenge with this disease. The aim was to study the effect of oral drop lemon peel essential oil on the level of blood lipids and differential leukocyte counts. For this purpose, a group of mature male rats strain were used (including 5 subgroups,1 control group,1 sham group and 3 experimental groups) the experimental groups were fed with cholesterol for five weeks given oral drop lemon peel essential oil with 25 µl/ kg, 50 µl/kg and 100 µl/kg doses, sham groups received saline solution (1 ml/ day). At the end of this period, by blood sampling from the heart, plasma lipids were measured in control, sham and experimental groups, in order to evaluate differential leukocyte counts blood smear method. The results showed that a low dose of lemon peel essential oil did not have a significant effect on the level of plasma lipids but moderate and especially high doses showed significant effects on cholesterol, LDL and triglyceride levels compared with control group. None of these doses had significant effects on the plasma HDL. It is concluded that by decreasing plasma lipids, lemon peel may prevent atherosclerosis and decrease the incidence of cardiovascular disease. This research showed that three doses of lemon peel have a significant effect on the increase of the number and percent of blood leukocytes and a more significant effect resulted from the high dose. doi:10.1016/j.jns.2009.02.219
The influence of depressive symptoms on the recovery of cognitive function in chronic stroke patients B.S. Kwon, J.W. Park, H.J. Lee, T.S. Yoon Dept. of Physical Medicine & Rehabilitation, Dongguk University International Hospital, Goyang-si, South Korea Background and aims: This study was designed to investigate prevalence of depressive symptoms and effect of treatment of depressive symptoms on cognitive function and activities of daily living (ADL) in chronic stroke patients.
Changes of cognitive functions after stroke I. Gašparića, Z. Andrićb, N. Gotovacc Department of Neurology, General Hospital Požega, Požega, Croatia b Department of infectology, General Hospital Požega, Croatia, Požega, Croatia c Department of radiology, General Hospital Požega, Croatia, Požega, Croatia
a
A series of neural disorders can be observed after stroke, and most common is the decrease of cognitive functions. Such changes can be