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Neurophysiological correlates of senile dementia: I. Motor and sensory nerve conduction velocity

Published online by Cambridge University Press:  09 July 2009

Raymond Levy
Affiliation:
Academic Department of Psychiatry, Middlesex Hospital Medical School;
Anthony Isaacs
Affiliation:
Cane Hill Hospital and the Bethlem Royal and Maudsley Hospitals;
Gail Hawks
Affiliation:
The Spastics Society

Summary

This paper describes an investigation into the relationship between senile dementia and slowing of peripheral nerve conduction velocity. Twenty-eight demented patients and 19 controls were studied. Each patient was rated clinically and given a battery of simple psychological tests in addition to the physiological recordings. The results were as follows: (1) Motor nerve conduction was slower in the demented group than in the control group but this difference was not significant. (2) When subjects were divided according to their dementia score, those with scores above 7 were found to have motor nerve conductions which were significantly slower than those with scores of 7 or less. (3) There was a significant correlation between the severity of the dementia as measured by the rating scale and the psychological tests and the degree of slowing of motor nerve conduction. (4) In those patients who were retested after one year, increase in dementia was significantly correlated with a further slowing of conduction in motor nerves. (5) The possible role of vitamin deficiency was investigated in a small sub-group of demented patients. Deficiencies of thiamine, nicotinic acid, and vitamin B12 were not thought to be important but some patients had low folate levels. The significance of these results is discussed.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1970

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References

REFERENCES

Batata, M., Spray, G. H., Bolton, F. G., Higgins, G., and Wollner, L. (1967). Blood and bone marrow changes in elderly patients with special reference to folic acid, vitamin B12, iron and ascorbic acid. British Medical Journal, 2, 667669.CrossRefGoogle ScholarPubMed
Bender, L. (1946). Instructions for the Use of the Visual-Motor Gestalt Test. American Orthopsychiatric Association: New York.Google Scholar
Benton, A. L. (1955). The Revised Visual Retention Test. Clinical and Experimental Applications. Iowa State University: Iowa.Google Scholar
Blessed, G., Tomlinson, B. E., and Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114, 797812.CrossRefGoogle ScholarPubMed
British Medical Journal (1968). Folie acid and the nervous system, 4, 722723.CrossRefGoogle Scholar
Chanarin, I. (1969). The Megaloblastic Anaemias. Blackwell Scientific Publications: Oxford.Google Scholar
Corsellis, J. A. N. (1962). Mental Illness and the Ageing Brain: the distribution of pathological change in a mental hospital population. Oxford University Press: London.Google Scholar
Gilliatt, R. W., and Thomas, P. K. (1960). Changes in nerve conduction with ulnar lesions at the elbow. Journal of Neurology, Neurosurgerv and Psychiatry, 23, 312320.Google ScholarPubMed
Gilliatt, R. W., Melville, I. D., Velate, A. S., and Willison, R. G. (1965). A study of normal nerve action potentials using an averaging technique (barrier grid storage tube). Journal of Neurology, Neurosurgery and Psychiatry, 28, 191200.Google ScholarPubMed
Gilliatt, R. W. (1966). Applied electrophysiology in nerve and muscle disease. Proceedings of the Royal Society of Medicine, 59, 989993.CrossRefGoogle ScholarPubMed
Girdwood, R. H. (1967). Folic acid. The Practitioner, 199, 368376.Google ScholarPubMed
Girdwood, R. H., Thomson, A. D., and Williamson, J. (1967). Folate status in the elderly. British Medical Journal, 2, 670672.CrossRefGoogle ScholarPubMed
Grant, H. C., Hoffbrand, A. V., and Wells, D. G. (1965). Folate deficiency and neurological disease. Lancet, 2, 763767.CrossRefGoogle ScholarPubMed
Grünthal, E. (1927). Klinisch-anatomisch vergleichende Untersuchungen über den Greisenblödsinn. Zeitschrift für die gesamte Neurologie und Psychiatrie, 111, 763818.CrossRefGoogle Scholar
Henricksen, J. D. (1956). Conduction velocity of motor nerves in normal subjects and patients with neuromuscular disorders. Thesis. Mayo Foundation.Google Scholar
Hunter, R., Jones, M., Jones, T. G., and Matthews, D. M. (1967). Serum B12 and folate concentrations in mental patients. British Journal of Psychiatry, 113, 12911296.CrossRefGoogle Scholar
Hurdle, A. D. F., and Williams, T. C. P. (1966). Folic-acid deficiency in elderly patients admitted to hospital. British Medical Journal, 2, 202205.CrossRefGoogle ScholarPubMed
Johnson, E. W., and Olsen, K. J. (1960). Clinical value of motor nerve conduction velocity determination. Journal of the American Medical Association, 172, 20302035.CrossRefGoogle ScholarPubMed
Kauchtschischwili, G. M., Ramelli, E., and Zerbi, F. (1962). La vitesse de conduction du nerf cubital chez personnes très âgées. Electroencephalography and Clinical Neurophysiology, Suppl. 22, 2123.Google Scholar
Kershaw, P. W. (1967). Blood thiamine and nicotinic acid levels in alcoholism and confusional states. British Journal of Psychiatry, 113, 387393.CrossRefGoogle ScholarPubMed
Kral, V. A. (1962). Senescent forgetfulness: benign and malignant. Canadian Medical Association Journal, 86, 257260.Google ScholarPubMed
Levy, R., and Poole, E. W. (1966). Peripheral motor nerve conduction in elderly demented and non-demented psychiatric patients. Journal of Neurology, Neurosurgery and Psychiatry, 29, 362366.Google ScholarPubMed
Norris, A. H., Shock, N. W., and Wagman, I. H. (1953). Age changes in the maximum conduction velocity of motor fibres of human ulnar nerves. Journal of Applied Physiology, 5, 589593.CrossRefGoogle ScholarPubMed
Reynolds, E. H. (1968). Mental effects of anti-convulsants and folic acid metabolism. Brain, 91, 197214.CrossRefGoogle Scholar
Rothschild, D. (1937). Pathologic changes in senile psychoses and their psychobiologic significance. American Journal of Psychiatry, 93, 757784.CrossRefGoogle Scholar
Shapiro, M. B., Post, F., Löfving, B., and Inglis, J. (1956). ‘Memory function’ in psychiatric patients over 60. Some methodological and diagnostic implications. Journal of Mental Science, 102, 233246.CrossRefGoogle Scholar
Shapiro, M. B., Field, J., and Post, F. (1957). An enquiry into the determinants of a differentiation between elderly ‘Organic’ and ‘non-organic’ patients on the Bender Gestalt Test. Journal of Mental Science, 103, 364374.CrossRefGoogle ScholarPubMed
Simpson, J. A. (1956). Electrical signs in the diagnosis of carpal tunnel and related syndromes. Journal of Neurology, Neurosurgery and Psychiatry, 19, 275280.Google ScholarPubMed
Shulman, R. (1967). A survey of B12 deficiency in an elderly psychiatric population. British Journal of Psychiatry, 113, 241251.CrossRefGoogle Scholar
Strachan, R. W., and Henderson, J. G. (1965). Psychiatric syndromes due to avitaminosis B12 with normal blood and marrow. Quarterly Journal of Medicine, 34, 303317.Google Scholar
Thomas, P. K., Sears, T. A., and Gilliatt, R. W. (1959). The range of conduction velocity in normal motor nerve fibres to the small muscles of the hand and foot. Journal of Neurology, Neurosurgery and Psychiatry, 22, 175181.Google Scholar
Wagman, I. H., and Lesse, H. (1952). Maximum conduction velocities of motor fibres of ulnar nerve in human subjects of various ages and sizes. Journal of Neurophysiology, 15, 235244.CrossRefGoogle ScholarPubMed
Wechsler, D. (1945). A standardised memory scale for clinical use. Journal of Psychology, 19, 8795.CrossRefGoogle Scholar