Primitive reflexes in cerebrovascular disease: a community study of older people with stroke and carotid stenosis.
OBJECTIVE
To determine the prevalence of primitive reflexes (frontal release signs) in elderly community residents with cerebrovascular disease and to examine their relationship with neuropsychological and mood-related variables.


METHODS
Three groups of 25 people over 65 with anterior circulation stroke, transient ischaemic attack (TIA) and a control group were assessed using measures of generalized cognitive impairment, frontal lobe dysfunction, frontal release signs and mood-related variables. Predictors of cerebrovascular disease were examined further in stroke and TIA groups.


RESULTS
Both stroke and TIA groups showed a higher mean score on the Frontal Release Signs Scale and a higher prevalence of most reflexes than the control group. Verbal fluency and DSM-IV depressive disorder were independent predictors of frontal release signs.


CONCLUSIONS
TIAs may predispose to subtle neurological impairment, which may be mediated by frontal lobe damage. Their role in the pathogenesis of depression in later life requires further exploration.
Rao
R
R
Department of Old Age Psychiatry, Maudsley Hospital and Institute of Psychiatry, London, UK. rrao@globalnet.co.uk
Jackson
S
S
Howard
R
R
D000339:Affect / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000503:physiopathology; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000503:physiopathology; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000503:physiopathology; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D015577:Geriatric Assessment; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D009483:Neuropsychological Tests; D011594:Psychometrics; D012021:Reflex, Abnormal / Q000502:physiology*; D012307:Risk Factors; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention