Kei Matsumoto

Correlation of third ventricular enlargement and EEG slow wave activity in schizophrenic patients

Twenty-eight schizophrenic patients and 22 normal control subjects underwent magnetic resonance imaging (MRI) and topographic electroencephalography (EEG) in a study attempting to correlate morphological and electrophysiological findings. Schizophrenic patients had larger anterior horns of the lateral ventricles and third ventricles than normal control subjects. Schizophrenic patients showed more delta wave activity in the right parietooccipital region than normal control subjects. Alpha 2 wave activity was reduced in the entire region in schizophrenic patients. In schizophrenic patients, a significant positive correlation was seen between the area of the third ventricle and delta wave activity in the right occipital region. These results suggest that schizophrenic patients may have a dysfunction of diencephalic structures associated with morphological abnormality.

Postural myoclonus associated with long-term administration of neuroleptics in schizophrenic patients

Postural myoclonus associated with long-term administration of neuroleptics was demonstrated in schizophrenic patients. Sixty patients who had been taking neuroleptics for more than 3 months were investigated for myoclonus and the relationships between postural myoclonus and age, duration of illness, duration of medication, current daily dose, cumulative dose, occurrence of abnormal finger movement, parkinsonism, and tardive dyskinesia were evaluated. Twenty-three patients (38%) showed postural myoclonus when holding the hands forward with the elbow joints flexed at about 90%. Male patients showed a higher incidence of myoclonus than female patients. Patients with myoclonus had been given significantly higher doses of neuroleptics than those without myoclonus. There was a significant correlation between the occurrence of myoclonus and abnormal finger movement. Electromyographic recordings in 7 patients with prominent myoclonus revealed that arrhythmic jerks occurred in the extensor carpi radialis and posterior deltoid muscles and that the jerks on the left and right side were not synchronized. Clonazepam reduced the frequency of the myoclonic activity.

Blood flow velocity waveform in the common carotid artery and its analysis in elderly subjects

We investigated common carotid artery blood flow in 99 elderly nursing home residents using an ultrasonic quantitative blood flow measurement system. Systolic velocity and end-diastolic velocity were obtained from the waveform and classified, using the end-diastolic/systolic volume as Type A which is normal flow (>20% bilaterally), Type B which is unilateral decreased flow (<20% unilaterally), Type C which is bilateral decreased flow (<20% bilaterally), Type D which is Type C plus a saw tooth pattern and Type E which is no diastolic pattern, i.e. a value of 0 unilaterally or bilaterally. Five per cent of subjects showed Type A of blood flow velocity waveform (normal flow pattern) and about 40% showed Type E (no diastolic pattern). The subjects were divided into three groups according to blood flow velocity waveform. Groups 1, 2 and 3 showed Types A or B, C or D, and E, respectively. The total blood flow volume and mean blood flow velocity of Group 1 were significantly higher than those of Groups 2 and 3 in both the supine and sitting positions. Although both total blood flow volume and mean blood flow velocity of Group 1 decreased significantly in postural change, those of Groups 2 and 3 did not change. These results suggest that total blood flow volume and mean blood flow velocity decrease in proportion to changes in the blood flow velocity waveform.

Depression and Quality of Life in the Elderly in a Special Nursing Home

Abstract: Using a Japanese version of the Self‐Rating Depression Scale by Zung (SDS) and the Quality of Life (QOL) rating scale designed by Iida et al. (QOL scale), we compared the QOL and depressive state of special nursing home residents and the elderly in the general community. The QOL scale has four categories: physical functioning, emotional adjustment, interpersonal relationships and attitudes toward life. High scores in either examination indicate a greater impairment. The SDS scores of the residents in the special nursing home were significantly lower than those of the elderly in the community, but the scores in 3 categories and the total score, except for those of physical functioning of the QOL, were significantly higher in the nursing home residents. In the nondepressed elderly rated by the SDS, the physical functioning score of the elderly in the community significantly exceeded that of the special nursing home residents. In the depressed elderly, all the scores including the total score were significantly higher than those in the special nursing home residents. Our results suggest that while the QOL of the depressed elderly in a special nursing home was poorer than that of the elderly in the community, their depression could be treated. However, the QOL cannot be improved by treatment alone.

Water intoxication in a schizophrenic patient with rhabdomyolysis

Abstract: We report a case of water intoxication in a 54‐year‐old female schizophrenic patient with rhabdomyolysis. She had been admitted to a mental hospital, and treated with spiperone 6 mg daily. On August 3, 1992, the coma following a convulsion occurred. Laboratory data initially showed marked hyponatremia and hypochloremia with decreased serum potassium, and a gradual increase in serum creatine phosphokinase (CPK). The elevation in serum CPK with marked hyponatremia observed in the present patient was probably caused by excessive drinking of water. In this patient, the CPK elevation revealed the rhabdomyolysis.

Influences of prolonged bed rest and cognitive impairment on nursing home residents.

Abstract: Seventy nursing home residents with and 87 without cerebrovascular diseases (CVD) were examined by the modified Stockton Geriatric Rating Scale (modified SGRS) which measures four aspects of impairments; physical disability, socially irritating behavior, communication failure and apathy. They were divided into 3 subgroups according to walking ability; prolonged bed rest, walking with aids and walking by themselves in both groups. Physical disability of mental decline was significantly aggravated more than that of normal intelligence in all the subgroups. Although communication failure and apathy of mental decline had deteriorated more than those of normal intelligence in prolonged bed rest in residents without CVD, apathy of the former had deteriorated more than that of the latter in walking by themselves in residents with CVD.

Jerk‐Locked Averaging and Somatosensory Evoked Potential in Tricyclic‐Induced Myoclonus: A Case Report

Abstract: The authors describe a case of tricyclic‐induced myoclonus in a 41‐year‐old depressed woman showing spike activity on electroencephalogram. The results of jerk‐locked averaging and somatosensory evoked potential (SEP) are presented. No jerk‐related cortical spikes and enlarged evoked potentials were observed. These findings suggest that tricyclic‐induced myoclonus may not be associated with excitability in the transcortical pathways detectable by SEP.

THREE CASES OF CHRONIC SUBDURAL HEMATOMA WITH DEPRESSIVE STATE

Abstract: The authors described 3 cases of chronic subdural hematoma (CSDH) with a depressive state. There were no abnormal findings from general and neurological examinations. Computed tomographic (CT) brain scans revealed sickle‐shaped low density areas in the bilateral frontal lobes. Two of the 3 cases had not had episodes of head contusion, and it was not until the CT brain scanning that they were found to have CSDH. Evacuation of the hematomas was not considered suitable and the depressive state of these 2 cases was improved by antidepressants. The remaining case seemed to have become depressive because of failure in business. After the head contusion, his depressive state gradually became more severe. A neurosurgical operation was carried out to evacuate the hematoma. CSDH seemed to aggravate his depressive state. These 3 cases show that CSDH located in the bilateral frontal lobes may cause and/or influence affective disorder.

Accelerated Plethysmogram in Nursing Home Residents

Abstract: To investigate the peripheral blood circulation, 24 young volunteers, 28 nursing home residents with cerebrovascular diseases (CVD) and 42 residents without them were studied for accelerated plethysmogram (APG). Both residents were rated by the modified Stockton geriatric rating scale (modified SGRS) which have four aspects of impairments; physical disability, socially irritating behavior, communication failure and apathy. As to the waveform patterns of APG, the majority of the young volunteers and both the residents showed patterns B and G, respectively. Coefficient of APG (Co‐APG) of the former was significantly larger than that of the latter. In the residents without CVD, Co‐APG was significantly negatively correlated with physical disability and apathy of the modified SGRS. But, Co‐APG did not correlate with the modified SGRS in the residents with CVD.

Three‐Year Follow‐Up Studies on Heart Rate Variability in Nursing Home Residents

Abstract: The coefficient of variation of the R‐R interval (CV value) of nursing home residents was investigated twice during a three‐year period. The initial CV value of the deceased during the period was significantly lower than that of the survivors. Among the survivors, residents without chronic cerebrovascular disease mainly showed a decrease in their CV values during the period.