摘要:

SummaryNumerous observations have suggested that there is a disturbance in laterality in schizophrenia. For example, some reports indicate that left-handed schizophrenic patients show more evidence of neurological dysfunction and more severe symptoms than right-handed schizophrenic patients. We have found that formal thought disorder is more severe and more common in left-handed than in right-handed schizophrenic subjects. Because subtle cognitive and language disorders have also been associated with formal thought disorder in schizophrenia, we hypothesized a particular relationship between left-hand preference and cognitive dysfunction in a schizophrenic sample. We investigated the nature of context-assisted memory performance and thought disorder in 21 left-handed and 21 right-handed schizophrenic patients individually matched on word-recall ability, age, sex, and education. Left-handed schizophrenic patients were less able to take advantage of increasing context to assist in word recall. The locus of this performance difference was found in the primacy portion of the serial position curve. Left-handed subjects also had more evidence of formal thought disorder, specifically the poverty of content dimension. These results could not be accounted for on the basis of chronicity or neuroleptic usage. In related research we have found evidence for a relationship between context memory and magnetic resonance imaging frontal volume (especially the dorsolateral division) in schizophrenia. We propose that left-handed schizophrenic patients may suffer from a more pronounced form of selective memory disturbance, possibly related to left-hemisphere disturbance, and may also exhibit more frontal atrophy than closely matched right-handed schizophrenic controls.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryIn the past few years some progress has been made in quantification of heartbeat perception. The role of visceral self-perception in various diseases is being increasingly discussed. In some studies patients suffering from cardiocentered panic syndrome were found to better perceive their heartbeats than healthy control subjects, while the reverse was found in other studies. In the present study nine patients with panic syndrome, as defined in the DSM-III-R, were compared with 20 healthy controls. In contrast to former studies, cardiocentered perceptual accuracy was assessed with three different methods. In addition, general, psychological, and psychophysiological variables, including blood pressure, heart rate, and spontaneous EEG, were measured. While the panic group was 10 years older than the control group, no differences were found in other demographic variables, heartbeat perception, or psychophysiological variables. Although the lack of difference in heartbeat perception could be a genuine finding, low correlations among the three heartbeat perception tests raise questions about their reliability. The differences between panic patients and controls in some psychological dimensions, including external control orientations, agoraphobia, and health-centered worries, suggest evaluative rather than perceptual differences between the two groups.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe purpose of this review is to examine the potential role of the macrophage in certain neuropsychiatric disorders, including dementia, delirium, schizophrenia, and depression. The authors review the English-language literature on this subject published during the last 20 years. There is support for the hypothesis that macrophages and their products play an integral role in the neurodevelopment and pathophysiology of various neuropsychiatric conditions. The macrophage responds to neuropeptide signal molecules that affect its behavior. At the same time it produces a multitude of cytokines that not only alter its own behavior and that of other immunocytes but also affect central nervous system activity. The study of the interrelationship between neurologic and immune systems may help to illuminate the pathophysiologies of some neuropsychiatric syndromes and to offer new directions for potential anti-inflammatory treatments. Among the most important immunocytes to study in neuropsychoimmunology is the monocyte/macrophage, which crosses the blood-brain barrier and gives rise to brain microglia.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryAlthough lithium is a mainstay in the treatment of mood disorders, its use is often accompanied by neuropsychological side effects that may contribute to a high rate of medication noncompliance. These deficits, including subjectively slowed information-processing speed, a sense of lethargy, and memory disturbance, are similar to those seen in patients with hypothyroidism, whether overt or subclinical. This comparison is relevant because lithium is a potent antithyroid drug, and it has been hypothesized that at least some of the neuropsychological deficits caused by lithium are attributable to its antithyroid properties. As a preliminary test of this hypothesis, the neuropsychological functioning of 16 psychiatric outpatients taking lithium, eight of whom were determined to be subclinically hypothyroid and eight of whom were euthyroid, was assessed. Subclinically hypothyroid patients were found to perform significantly worse on measures of verbal learning and memory than their euthyroid counterparts. Performance on these measures was more highly correlated with thyrotropin levels than with serum lithium levels. These preliminary results are consistent with the hypothesis that some deficits are caused by lithium and may have implications for the treatment of lithium's neuropsychological side effects.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryCognitive estimation was evaluated in patients with mild to moderate Alzheimer's disease (AD). In Experiment I, 25 AD patients and 16 normal controls generated estimates of real-world events. AD patients provided more extreme judgments than controls. Experiment II explored whether impaired word-finding contributed to the AD deficit by having subjects choose the “best” answer to estimation questions. New samples of 14 AD patients and 12 normal controls were compared. AD patients selected the target responses less often than controls. These findings indicate that cognitive estimation is impaired in Alzheimer's disease. The potential contribution of semantic memory to cognitive estimation is discussed.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThis study examined the relationships among cerebrospinal fluid (CSF) HIV-1 culture, quinolinic acid (QUIN) levels, and neurobehavioral functioning as measured by reaction time (RT) in HIV-1-infected (HIV+) individuals. Twenty HIV+subjects completed lumbar puncture, neurological screening, magnetic resonance imaging scan, RT procedures, an estimated IQ measure, and self-reported mood state measures. Routine CSF laboratory studies, including white blood cell count (WBC), red blood cell count, protein, glucose, and percentage IgG were conducted. CSF was cultured for HIV-1 and assayed for QUIN. Subjects with positive HIV-1 CSF culture (CSF+) had significantly higher QUIN levels than subjects with negative HIV-1 CSF culture (CSF−), although this difference was attenuated when WBC was controlled. Controlling for age and education, M ANCOVA showed that CSF+subjects had significantly slower RTs than CSF−subjects. Controlling for WBC did not change RT findings. Logistic regression indicated that both RT and QUIN contributed to the prediction of culture group. Group differences could not be explained by demographic factors, history, neurologic status, or medical status. Findings suggest a link among ability to culture HIV-1 from CSF, elevated QUIN, and slowed RT. This link, in turn, suggests a potential HIV- 1-specific biological marker associated with neurobehavioral change in HIV-1 disease. Findings may be related to subclinical brain inflammation.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe oral paradigm for the Trail Making Test (TMT)—which, unlike the traditional written administration, has no visual or graphomotor component—was investigated in 85 stroke patients with recent (<3 weeks) anterior (n.= 56) or posterior (n.= 29) infarction, as classified by visual inspection of computed tomography scans. Age, education, chronicity, and overall cognitive functioning were equivalent between groups. Patients with anterior lesions performed more slowly on the written TMT-B (the second part of the test) when compared with patients with posterior lesions. Oral TMT-B scores were converted to written TMT-B scores and subsequently to T scores. The resulting scores for the posterior group fell within normal limits, while the scores for the anterior group were significantly lower. There was no effect for the laterality of lesion. Oral TMT was significantly correlated with established executive control measures and was unrelated to expressive language functioning. The results supported the validity of the oral TMT-B as a clinical measure of executive functioning.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe Mini-Mental State Examination (MMSE) and the Neurobehavioral Cognitive Status Examination (NCSE) were compared in terms of their validity as cognitive screening instruments. Subjects, all inpatients in a geriatric medicine and rehabilitation facility, included 59 with diagnosed brain dysfunction and 46 with no such diagnosis. Significant group differences were found for the MMSE and all NCSE subscales. The NCSE was more sensitive than the MMSE only when traditional cutoff criteria for impairment were employed, consisting of a raw score of ≤23 on the MMSE and one or more scales impaired on the NCSE. When the MMSE's criterion score was increased, the more lengthy NCSE was no more sensitive to brain dysfunction. The highest diagnostic accuracies were 70% for the MMSE, at a cutoff score of 26, and 69% for the NCSE, at a cutoff of two impaired scales. Findings suggest that neither of the tests functions acceptably as a standalone screening instrument among geriatric medical inpatients.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryNeuropsychological impairment has been found in patients with eosinophilia myalgia syndrome (EMS), but there has been no research comparing EMS patients with a group drawn from a similar population. This study, undertaken from a biopsychosocial standpoint, compared the neuropsychological functioning of a group diagnosed with EMS with a matched comparison group of insomnia sufferers. The EMS group, consisting of 24 subjects who had already undergone neuropsychological testing, were asked to complete additional health history questionnaires as well as mood and personality inventories. A matched group of 19 insomnia sufferers completed the same questionnaires and were administered the neuropsychological test battery. Significant differences in the domains of visuospatial memory and construction were found. When levels of depression and physical well-being were statistically controlled, the difference in neuropsychological functioning between groups was found not to be significant. However, when groups were again examined by using neuropsychological impairment indexes, a greater number of EMS group members were classified as deficient in neuropsychological functioning. The EMS group was found to be more depressed and to have higher Minnesota Multiphasic Personality Inventory-2 (MMPI-2) T scale elevations; a greater number of physical, cognitive and emotional complaints; and a greater deterioration in reported health status since 1988 (when EMS appeared) than the comparison group. Physical distress, years of education, and the MMPI- 2 Hy T scale were most likely to predict the individual's assessment of well-being. Impairment indexes were weakly associated with depression.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryAssessments of higher visual functioning and regional cerebral blood flow (rCBF) using positron emission tomography were obtained in three visual apperceptive agnosics. Their clinical impairment included difficulty appreciating the perceptual features of line drawings, letters, and other visual material, despite relatively intact elementary visual functioning and access to visual information in semantic memory. rCBF was significantly reduced in temporooccipital cortices. Our findings suggest that apperceptive agnosia is associated with massive ventral visual system dysfunction that interferes with visual perceptual processing needed for object recognition.

ISSN:0894-878X    

出版商:OVID    

年代:1996

数据来源: OVID