Jan Harald Aarseth

Depression and anxiety amongst multiple sclerosis patients

The aim of this study was to investigate the prevalence of symptoms of depression and anxiety amongst multiple sclerosis (MS) patients, and the associations with demographic and clinical characteristics. The current treatment for depression and anxiety was also evaluated amongst the MS patients.

IL‐6: an early marker for outcome in acute ischemic stroke

Objectives –  Inflammation plays an important role in the pathophysiology of stroke. We correlated interleukin (IL)‐6, IL‐10, C‐reactive protein (CRP) and T‐lymphocyte subtype levels in acute ischemic stroke patients with stroke volume and clinical outcome.

Fatigue at Long-Term Follow-Up in Young Adults with Cerebral Infarction

Background: To study the impact of fatigue in young ischaemic stroke patients. Methods: The Fatigue Severity Scale score was obtained in 192 patients (mean time 6.0 years after the stroke) and 212 controls. Results: Fatigue was associated with cerebral infarction in a multivariate analysis of patients and controls (p = 0.002). Fatigue was independently associated with unfavourable functional outcome (p = 0.001), depression (p < 0.001), and basilar artery infarction through interaction with the modified Rankin Scale score (p = 0.047) in patients. Conclusion: Fatigue is frequent in young adults with cerebral infarction. Stroke-related factors independently associated with fatigue include functional outcome. Stroke location may influence fatigue.

Long‐term outcome of cerebral infarction in young adults

Objectives – We analysed the long‐term outcome of 232 young adults aged 15–49 years with first‐ever cerebral infarction in 1988–1997 in western Norway.

Hu and Voltage-Gated Calcium Channel (VGCC) Antibodies Related to the Prognosis of Small-Cell Lung Cancer

PURPOSE Hu antibodies previously have been associated with longer survival of patients with small-cell lung cancer (SCLC). Voltage-gated calcium channel (VGCC) antibodies play a pathogenic role in Lambert Eaton myasthenic syndrome, which is also associated with SCLC. These antibodies may reduce tumor growth in patients with the neurologic disease, but it is not clear whether they provide prognostic information in those without neurologic symptoms. PATIENTS AND METHODS Two hundred patients with SCLC (age 39 to 79 years; mean, 62.3 years; 129 males and 71 females) receiving chemotherapy were studied for the presence of Hu and VGCC antibodies. Sera were examined for Hu antibodies by an in vitro transcription-translation-based immunoprecipitation technique and by immunohistochemistry/dot blot. VGCC (P/Q subtype) antibodies were detected by radioimmunoassay. Survival analysis was used to analyze the data. Results Hu antibodies were detected in 51 of 200 patients (25.5%) by in vitro transcription-translation-based immunoprecipitation and in 37 of 200 patients (18.5%) by immunohistochemistry or dot blot, whereas VGCC antibodies were detected in only 10 of 200 patients (5%). The presence of Hu antibodies did not correlate with VGCC antibodies, and there was no association between Hu or VGCC antibodies and the extent of disease or survival. CONCLUSION Hu and VGCC antibodies are found in a proportion of SCLC patients, irrespective of neurologic symptoms, but their presence does not correlate with the prognosis of the SCLC.

Survival and cause of death in multiple sclerosis: results from a 50-year follow-up in Western Norway

Background Survival time among patients with multiple sclerosis (MS) has varied considerably according to previous reports. Objectives Survival and cause of death were analyzed among all patients with MS (878) with onset of MS in Hordaland County, Western Norway during 1953–2003, of whom 198 were dead at follow-up on January 1, 2005. Methods Standardized mortality ratios (SMRs) and relative mortality ratios (RMRs) were calculated based on observed mortality in MS and expected mortality. Results Median survival from onset was 41 years versus 49 years in the corresponding population, and mortality (SMR) was 2.7-fold increased in MS. The median survival was 43 years among women and 36 years among men, but women had higher relative mortality, when compared with the corresponding population, than men (RMR = 1.40). The median survival time was 45 years among young-onset patients (21–30 years) and 23 years among older-onset patients (51–60 years), but young-onset patients had higher relative mortality than older-onset patients, as shown by a significant reduction by 10-year interval of age at onset (RMR = 0.65). Median survival from onset was longer (43 years) among relapsing–remitting MS than primary progressive MS ([PPMS]; 49 years), and the relative mortality was higher in the PPMS group, (RMR = 1.55). According to death certificates, 57% died from MS. Conclusion Female patients and patients with young onset had longer median time to death but higher relative risk of dying compared with the corresponding population. PPMS had both shorter median time to death from onset and a higher relative risk of dying.

EEG background activity described by a large computerized database

OBJECTIVE To show how our newly developed software for classification and storage of visually routinely assessed EEGs are used to evaluate the general background activity (GBA) and the alpha rhythm (AR) in a large number of prospective EEGs. METHODS EEGs from 4651 consecutive patients were visually assessed using a computerized description system connected to an EEG database. The AR and the GBA apart from the AR were described separately for frequency and amplitude. RESULTS AR frequencies declined from the age of 45 years and slowed with increasing age independently of non-AR pathology and gender. Females had higher AR frequencies than males. EEGs with non-GBA pathology had lower GBA frequencies and higher GBA amplitudes. Higher GBA amplitudes were associated with lower GBA frequencies in normal EEGs for all age groups. EEG interpretations by 4 independent electroencephalographers showed the same trends, but differed in exact assessment of frequencies and amplitudes. CONCLUSIONS EEG interpretations stored in a categorized database with easy access to data have successfully been used to evaluate interobserver variation and other quality control measurements. Statistical analysis of the data has at the same time produced new information regarding the development of AR and GBA throughout life.

Incidence and Short-Term Outcome of Cerebral Infarction in Young Adults in Western Norway

Background and Purpose— We sought to determine the incidence and short-term outcome of people aged 15 to 49 years with first-ever cerebral infarction in 1988–1997 in Hordaland County, Norway. Methods— Cases were found from computer search of hospital registries and detailed review of patient records. Stroke subtype was classified according to the major intracranial artery affected. Short-term outcome was evaluated by the modified Rankin Scale (mRS). Results— A total of 96 women and 136 men met the inclusion criteria. The average annual incidence was 11.4/100 000. Women outnumbered men among those aged <30 years (P =0.059); men predominated among those aged ≥30 years (P =0.004). A total of 148 patients had anterior circulation infarction (64%), and 84 had posterior circulation infarction (36%) (P <0.001). Patients with posterior circulation infarction had better mRS score at discharge (P =0.005). Eighty percent had favorable outcome (mRS score ≤2). The 30-day case fatality rate was 3.4%. The recurrence rate in hospital was 2.2%. Conclusions— The incidence was in the lower range compared with other reports from western Europe. Although men predominated, there was a strong trend toward more women among patients aged <30 years. Short-term outcome was generally good. Patients with posterior circulation infarction had significantly better short-term outcome.

Multiple sclerosis in Nord-Trøndelag County, Norway: a prevalence and incidence study

Objective – To calculate the prevalence and incidence of multiple sclerosis (MS) in Nord‐Trøndelag County, Norway.

Etiology of and risk factors for cerebral infarction in young adults in western Norway: a population-based case-control study

We sought to study the etiology of and risk factors for cerebral infarction in young adults in Hordaland County, Norway. All patients aged 15–49 years living in Hordaland County with a first‐ever cerebral infarction during 1988–97 were included. Etiology was analyzed in subgroups defined by sex, age (<40 years versus 40 years), circulation territory (anterior versus posterior circulation) and short‐term functional outcome [modified Rankin score (mRS)  2 versus mRS > 2]. A questionnaire was used to evaluate possible risk factors amongst the patients compared with an age‐ and sex‐matched control group. The distribution of etiology was significantly different in all subgroups. Atherosclerosis was frequent amongst men (22.8% vs. 4.2%) and patients  40 years (20.8% vs. 2.7%). All patients with microangiopathy had favorable short‐term outcome. Significant risk factors were smoking more than 15 cigarettes per day (P < 0.001), hypertension (P = 0.001), and myocardial infarction (P = 0.035). Modifiable risk factors were frequent.