摘要:

SummaryThis study investigated psychosensory symptoms and their relationship to retrospective and prospective courses of illness, as well as therapeutic outcomes, in patients with bipolar disorder. Using the Silberman-Post Psychosensory Rating Scale (SP-PSRS), psychosensory symptoms were assessed in 51 patients who met Diagnostic and Statistical Manual, 3rd Edition-Revised (DSM-III-R) criteria for bipolar disorder and in 39 healthy, normal controls. Patients with bipolar disorder were enrolled in a 3-year, double-blind, randomized study comparing the prophylactic efficacy of lithium or carbamazepine in the first year, a crossover to the other drug in the second year, and the combination of both medications in the third year. Psychosensory scores from patients with bipolar disorder were compared with scores from healthy controls and with a variety of retrospective and prospective course of illness and treatment variables. Psychosensory symptoms occurred frequently in patients with bipolar I and II disorders, but were rare in healthy controls. When depressed, patients with bipolar II disorder (n= 23) reported more psychosensory symptoms when compared to patients with bipolar I disorder (n= 28), and those with a history of rapid cycling (n= 29) reported more psychosensory symptoms when compared to patients without a history of rapid cycling (n= 21). Psychosensory symptoms were not related to response to carbamazepine, lithium, or the combination of both drugs. Although the presence of psychosensory symptoms is associated with some bipolar subtypes (patients with bipolar II disorder and patients with a history of rapid cycling), they do not appear to predict treatment response. Further studies are needed to assess the pathophysiologic implications of the presence of psychosensory symptoms and their potential implications, if any, for directing therapeutics.

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThe pattern of neuropsychological dysfunction in patients with inactive systemic lupus erythematosus (SLE) was examined. Fifty-eight subjects with inactive SLE and 47 healthy controls were administered a standardized neuropsychological test battery. Summary scores reflecting 18 different cognitive processes were derived. Subjects were designated cognitively impaired if three or more summary scores differed significantly from premorbid estimates of cognitive functioning. Cognitive impairment was identified in 43% of subjects with inactive SLE and 19% of healthy controls. Subjects with inactive SLE, as a group, performed significantly worse than healthy controls on measures of auditory verbal memory, visual spatial memory, psychomotor speed, and motor functioning. A significantly greater proportion of subjects with inactive SLE than healthy controls was impaired only on a measure of visual spatial memory. Cognitive impairment in subjects with inactive SLE was associated with increasing age. There were no associations between cognitive impairment and current depressive symptoms or current corticosteroid use. These findings suggest that cognitive dysfunction occurs frequently in inactive SLE. The variability of performance of subjects with inactive SLE is consistent with the heterogeneity of CNS involvement in the disease.

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThis study assessed the influence of age (younger women and elderly women living in communities) on cerebral laterality using dichotic listening. Previous research has purported to show a relative right cerebral decline with age. To date, however, research on the right hemiaging hypothesis has provided mixed findings. It is possible that these mixed findings are caused by use of simple versus complex dichotic listening tasks. As a test of this hypothesis, older women were expected to have a heightened right ear advantage (REA) for phonemic speech sounds and greater difficulty switching intention to the left ear when instructed to focus to either the left or the right ear. No age difference was found using the traditional presentation of concurrent phonemes. However, the right hemiaging hypothesis was supported on the intentional task, in which older women were less able to switch intention to the left but not to the right ear. Implications for right hemiaging are discussed.

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThe authors investigated cognition in juvenile myoclonic epilepsy (JME), focusing on frontal functions as suggested by maximal spatial distribution of epileptiform activity seen over frontocentral regions. Fifteen patients with JME (mean age, 34.3 years; mean estimated IQ, 101) were administered a battery of tests sensitive to frontal dysfunction. The number of patients with impaired test performance and the frequency of impairment per test were calculated. Performance on selected tests was compared with that of 15 patients with temporal lobe epilepsy (TLE) who were matched for estimated IQ using pairedt-tests. Although the performance of the group with JME was not uniform—some patients showed marked impairment whereas others showed little or no deficit—a high frequency of impairment was found on tests of concept formation-abstract reasoning and mental flexibility, cognitive speed, and planning and organization. Significant differences were found between the group with JME and the group with TLE on tests requiring mental flexibility and concept formation-abstract reasoning. In conjunction with studies demonstrating intractable seizures in −20% of patients, the results from this study suggest that JME is not a uniformly benign condition. Frontal deficits may have maladaptive behavioral consequences suggestive of personality dysfunction, as described anecdotally by previous investigators.

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThe objective of this study was to determine whether inconsistent and erratic within-day and across-day performance is a symptom of mild to moderate traumatic brain injury (TBI), and to determine whether impaired consistency of performance can coexist, in the same patient, with intact or “normal” performance on single administrations of neuropsychological and other cognitive tests. The design was a matched-pair study in which a computerized cognitive test battery was administered 30 times over 4 days to all subjects. Performance patterns between TBI and control subjects were compared. Subjects also received traditional neuropsychological testing. The setting was a rehabilitation hospital outpatient department. The subjects were 12 adult volunteers, six with documented TBI and six with no history of TBI, neurologic illness, or injury. Control subjects showed consistent improvement of performance over days 1 to 4, whereas subjects with TBI showed erratic and inconsistent performance across days. In addition to inconsistent performance, some subjects with TBI showed worsening performance across days. The main outcome measures were performance on the Automated Neuropsychological Assessment Metrics (ANAM) battery and performance on traditional neuropsychological tests. Some patients with TBI in the study who have normal initial performance on traditional clinical neuropsychological tests and newly developed computerized cognitive tests show abnormalities of sustained performance. Such abnormalities are most apparent when performance is observed over multiple days, and are characterized by erratic and inconsistent across-day performance. Inconsistent performance was observed even in those subjects with TBI whose initial performance was equal to or better than that of the control subjects. Deficits in dynamic performance may explain why some patients with TBI who have excellent neuropsychological test performance nonetheless complain of functional decrement from premorbid ability.

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryAkinetic mutism may result from anterior cingulate lesions or a disconnection of the limbic connections projecting from the cingulate through sub-cortical circuits. Based on nonhuman primate tracer studies, ventral pallidal lesions should disrupt the anterior cingulate frontal-subcortical circuit. A patient developed a rigid akinetic mute state caused by bilateral lesions of the globus pallidus interna with ventral extension. The anatomic basis of the patient's clinical findings support a similarity in frontal-subcortical anatomy between humans and nonhuman primates. Isolated pallidal lesions are rare. Future studies should document whether ventral extension below the anterior commissure is associated with a loss of motivation.

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0894-878X    

出版商:OVID    

年代:1997

数据来源: OVID