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Biomedical subjects

A S David

Publications and source records attributed to A S David.

At least 73 records · Page 4Linked to original sources

Depersonalization in cyberspace.

We explored the possibility of carrying out clinical research on the Internet. To do so, we compared psychometric and demographic variables between two groups of sufferers of depersonalization disorder, one recruited via the Internet, the other from outpatients attending the Depersonalization Research Unit. No differences were found in demographics or features of depersonalization. Those seen in the clinic were, however, significantly more depressed. We then explored the answers to several questions posted on a depersonalization bulletin board by a second group of Internet users. Useful information on symptoms, precipitants, and treatment was gained. It is concluded that the Internet could become a valuable tool in clinical psychiatric research.

Adult↗

Common and distinct neural substrates for pragmatic, semantic, and syntactic processing of spoken sentences: an fMRI study.

Extracting meaning from speech requires the use of pragmatic, semantic, and syntactic information. A central question is: Does the processing of these different types of linguistic information have common or distinct neuroanatomical substrates? We addressed this issue using functional magnetic resonance imaging (fMRI) to measure neural activity when subjects listened to spoken normal sentences contrasted with sentences that had either (A) pragmatical, (B) semantic (selection restriction), or (C) syntactic (subcategorical) violations sentences. All three contrasts revealed robust activation of the left-inferior-temporal/fusiform gyrus. Activity in this area was also observed in a combined analysis of all three experiments, suggesting that it was modulated by all three types of linguistic violation. Planned statistical comparisons between the three experiments revealed (1) a greater difference between conditions in activation of the left-superior-temporal gyrus for the pragmatic experiment than the semantic/syntactic experiments; (2) a greater difference between conditions in activation of the right-superior and middle-temporal gyrus in the semantic experiment than in the syntactic experiment; and (3) no regions activated to a greater degree in the syntactic experiment than in the semantic experiment. These data show that, while left- and right-superior-temporal regions may be differentially involved in processing pragmatic and lexico-semantic information within sentences, the left-inferior-temporal/fusiform gyrus is involved in processing all three types of linguistic information. We suggest that this region may play a key role in using pragmatic, semantic (selection restriction), and subcategorical information to construct a higher representation of meaning of sentences.

Brain↗

Meta-analysis of regional brain volumes in schizophrenia.

OBJECTIVE: The authors' goal was to determine whether patients with schizophrenia differ from comparison subjects in regional brain volumes and whether these differences are similar in male and female subjects. METHOD: They conducted a systematic search for structural magnetic resonance imaging (MRI) studies of patients with schizophrenia that reported volume measurements of selected cortical, subcortical, and ventricular regions in relation to comparison groups. They carried out a meta-analysis of the volumes of these regions in the patients with schizophrenia and the comparison subjects using a random effects model; they also used random effects regression analysis to examine the influence of gender on effect sizes. RESULTS: Fifty-eight studies were identified as suitable for analysis; these studies included 1,588 independent patients with schizophrenia. Assuming a volume of 100% in the comparison group, they found that the mean cerebral volume of the subjects with schizophrenia was smaller (98%), but the mean total ventricular volume of the subjects with schizophrenia was greater (126%). Relative to the cerebral volume differences, the regional volumes of the subjects with schizophrenia were 94% in the left and right amygdala, 94% in the left and 95% in the right hippocampus/amygdala, and 93% in the left and 95% in the right parahippocampus. Relative to the global ventricular system differences, the largest differences in ventricular subdivisions were in the right and left body of the lateral ventricle, where the volumes of schizophrenic subjects were 116% and 116%, respectively. For most regions, effect size was not significantly related to gender. CONCLUSIONS: Regional structural differences in patients with schizophrenia include bilaterally reduced volume of medial temporal lobe structures. There is a need for greater integration of results from structural MRI studies to avoid redundant research activity.

Adult↗

Non-psychotic psychiatric disorder and subsequent risk of schizophrenia. Cohort study.

BACKGROUND: Those with schizophrenia often give a history of premorbid non-psychotic psychiatric disorder. AIMS: To investigate the association between non-psychotic psychiatric disorders and the later development of schizophrenia. METHOD: Men aged 18 or 19 years, conscripted to the Swedish army in 1970 (n=50 054) were linked to the Swedish National Psychiatric Case Register. RESULTS: There was an increased risk of schizophrenia in those with ICD-8 diagnoses of neurosis (OR=4.6,95% Cl 3.2-6.9), personality disorder (OR=8.2, 95% Cl 5.4-12.3), alcohol abuse (OR=5.5, 95% Cl 1.7-17.5) or substance abuse (OR=14.0, 95% Cl 7.8-25.0) at age 18. Of those who developed schizophrenia, 38% (95% Cl 32-45) received a diagnosis of non-psychotic psychiatric disorder at age 18. Only those with personality disorder had a significantly increased risk of schizophrenia (OR=2.4, 95% Cl 1.1-5.2) with onset after age 23. CONCLUSIONS: Personality factors could represent an underlying vulnerability to schizophrenia. Other diagnoses occurring before schizophrenia may reflect a prodromal phase of the illness.

Adolescent↗

A differential neural response to threatening and non-threatening negative facial expressions in paranoid and non-paranoid schizophrenics.

Several studies have demonstrated impaired facial expression recognition in schizophrenia. Few have examined the neural basis for this; none have compared the neural correlates of facial expression perception in different schizophrenic patient subgroups. We compared neural responses to facial expressions in 10 right-handed schizophrenic patients (five paranoid and five non-paranoid) and five normal volunteers using functional Magnetic Resonance Imaging (fMRI). In three 5-min experiments, subjects viewed alternating 30-s blocks of black-and-white facial expressions of either fear, anger or disgust contrasted with expressions of mild happiness. After scanning, subjects categorised each expression. All patients were less accurate in identifying expressions, and showed less activation to these stimuli than normals. Non-paranoids performed poorly in the identification task and failed to activate neural regions that are normally linked with perception of these stimuli. They categorised disgust as either anger or fear more frequently than paranoids, and demonstrated in response to disgust expressions activation in the amygdala, a region associated with perception of fearful faces. Paranoids were more accurate in recognising expressions, and demonstrated greater activation than non-paranoids to most stimuli. We provide the first evidence for a distinction between two schizophrenic patient subgroups on the basis of recognition of and neural response to different negative facial expressions.

Adult↗

Response amplification in sensory-specific cortices during crossmodal binding.

Integrating information across the senses can enhance our ability to detect and classify stimuli in the environment. For example, auditory speech perception is substantially improved when the speaker's face is visible. In an fMRI study designed to investigate the neural mechanisms underlying these crossmodal behavioural gains, bimodal (audio-visual) speech was contrasted against both unimodal (auditory and visual) components. Significant response enhancements in auditory (BA 41/42) and visual (V5) cortices were detected during bimodal stimulation. This effect was found to be specific to semantically congruent crossmodal inputs. These data suggest that the perceptual improvements effected by synthesizing matched multisensory inputs are realised by reciprocal amplification of the signal intensity in participating unimodal cortices.

Adult↗

The functional anatomy of the McCollough contingent colour after-effect.

We report two functional magnetic resonance imaging (fMRI) experiments which reveal a cortical network activated when perceiving coloured grids, and experiencing the McCollough effect (ME). Our results show that perception of red-black and green-black grids activate the right fusiform gyrus (area V4) plus the left and right lingual gyri, right striate cortex (V1) and left insula. The ME activated the left anterior fusiform gyrus as well as the ventrolateral prefrontal cortex, and in common with colour perception, the left insula. These data confirm the critical role of the fusiform gyrus in actual and illusory colour perception as well as revealing localized frontal cortical activation associated with the ME, which would suggest that a 'top-down' mechanism is implicated in this illusion.

Adult↗

The planum temporale: a systematic, quantitative review of its structural, functional and clinical significance.

The planum temporale (PT) is a triangular area situated on the superior temporal gyrus (STG), which has enjoyed a resurgence of interest across several disciplines, including neurology, psychiatry and psychology. Traditionally, the planum is thought to be larger on the left side of the brain in the majority of normal subjects [N. Geschwind, W. Levitsky, Human brain: left-right asymmetries in temporal speech regions, Science 161 (1968) 186-87.]. It coincides with part of Wernicke's area and it is believed to consist cytoarchitectonically of secondary auditory cortex. Consequently, it has long been thought to be intimately involved in language function. The PT is, therefore, of relevance to disorders where language function is impaired, such as schizophrenia and dyslexia. The gross anatomical boundaries remain in dispute, and only recently has its cytoarchitecture begun to be studied again after 60 years silence, and finally its functional significance is only now being explored. In the first part of this review the structural aspects and anatomical boundaries of the PT in the normal brain from post mortem and magnetic resonance imaging (MRI) and methods of measurement are discussed. In the second part, studies of the functional significance of the PT in the normal brain are reviewed critically. Finally a meta-analysis of MRI measurements of the distribution of planum anatomy in normal subjects is presented. Comparison is made with clinical populations, including schizophrenia and dyslexia, and the influence of handedness and gender on such measurements is quantified. Although there are many ways of defining and measuring the PT with a wide variety of results, overall there is a significant leftward asymmetry in normals, which is reduced in left handers and females. The leftward asymmetry is much reduced in patients with schizophrenia due to a relatively larger right PT than normal controls. The review is intended to guide future researchers in this area.

Cadaver↗

Is semantic fluency differentially impaired in schizophrenic patients with delusions?

The study of cognitive deficits in schizophrenia has recently focused upon semantics: the study of meaning. Delusions are a plausible manifestation of abnormal semantics because by definition they involve changes in personal meaning and belief. A symptom-based approach was used to investigate semantic and phonological fluency in a group of schizophrenic patients subdivided into those with delusions and those with no current delusions. The results demonstrated that deluded patients only were differentially impaired on a test of semantic fluency in comparison to phonological fluency. All subjects showed the same decline in performance over the time course of both tests indicating that retrieval speed in schizophrenia is no different from that of normal controls. Further analysis of word associations in two semantic categories (animals and body parts), revealed that deluded subjects have a more idiosyncratic organisation for animals. The findings of reduced semantic fluency production and poor logical word associations may represent a disorganised storage of semantic information in deluded patients, which in turn affects efficient access.

Adult↗

Auditory hallucinations: phenomenology, neuropsychology and neuroimaging update.

Auditory verbal hallucinations (AVHs) are a cardinal feature of psychosis. Recent research is reviewed which has attempted to advance our knowledge of the mechanisms underlying this symptom. Phenomenological surveys have confirmed the importance of the content of such hallucinations and their meaning to the voice-hearer. Psychological and neuroimaging studies of inner speech and source monitoring have provided a neuropsychological framework for AVHs as well as some novel therapeutic strategies. There have also been successful attempts to 'capture' neural activity coincident with the experience of hallucinations using PET, SPECT and functional magnetic resonance imaging (MRI). This body of knowledge in combination with work on in-vivo receptor binding (dopamine and GABA) provides the beginnings of a cognitive and neurophysiological understanding of this complex and intriguing phenomenon.

Auditory Cortex↗

"To see oursels as others see us". Aubrey Lewis's insight.

BACKGROUND: This paper takes as its starting point the paper by Aubrey Lewis entitled "The psychopathology of insight" published in 1934, unreferenced. AIMS: To attempt to explore the historical antecedents and consequences of this work. METHOD: Speculative review. RESULTS: Lewis's approach to phenomenology, contemporaneous movements in psychology and Lewis's own life and times--notably the eugenics legislation in Nazi Germany--probably shaped his conclusions. Modern concepts of insight, which emphasise neuropsychology as well as social psychology, were anticipated in Lewis's writings. CONCLUSIONS: The concept of insight has stimulated research into difficult theoretical and practical areas such as self-awareness and treatment compliance, respectively. Concern over a patient's capacity for insight has the potential to humanise psychiatry.

Cognition Disorders↗

An investigation into the perception of dominance from schematic faces: a study using the World-Wide Web.

The World-Wide Web (WWW) is considered to be a viable tool for scientific research, and several investigators have already made use of it in their studies. Although the WWW allows researchers to access a vast subject pool, questions of reliability and validity need to be addressed before it is incorporated into mainstream research. By replicating, on the Internet, an existing study (Keating, Mazur, & Segall, 1977) on the perception of schematic faces, we were able to conclude that experimental work carried out in this manner is not necessarily biased by the medium. One difference from previous work was the effect of a smiling versus a nonsmiling face on the perception of dominance, given an identical brow position for the two faces. This was replicated on a different occasion with different subjects, which may represent a shift in attitudes to this facial configuration since the original study was conducted. Young North American males were overrepresented in our sample, but comparison with other surveys indicates that the population sampled by the Internet is becoming more representative.

Facial Expression↗

Investigation of facial recognition memory and happy and sad facial expression perception: an fMRI study.

We investigated facial recognition memory (for previously unfamiliar faces) and facial expression perception with functional magnetic resonance imaging (fMRI). Eight healthy, right-handed volunteers participated. For the facial recognition task, subjects made a decision as to the familiarity of each of 50 faces (25 previously viewed; 25 novel). We detected signal increase in the right middle temporal gyrus and left prefrontal cortex during presentation of familiar faces, and in several brain regions, including bilateral posterior cingulate gyri, bilateral insulae and right middle occipital cortex during presentation of unfamiliar faces. Standard facial expressions of emotion were used as stimuli in two further tasks of facial expression perception. In the first task, subjects were presented with alternating happy and neutral faces; in the second task, subjects were presented with alternating sad and neutral faces. During presentation of happy facial expressions, we detected a signal increase predominantly in the left anterior cingulate gyrus, bilateral posterior cingulate gyri, medial frontal cortex and right supramarginal gyrus, brain regions previously implicated in visuospatial and emotion processing tasks. No brain regions showed increased signal intensity during presentation of sad facial expressions. These results provide evidence for a distinction between the neural correlates of facial recognition memory and perception of facial expression but, whilst highlighting the role of limbic structures in perception of happy facial expressions, do not allow the mapping of a distinct neural substrate for perception of sad facial expressions.

Adult↗

The functional anatomy of imagining and perceiving colour.

We report two functional magnetic resonance imaging experiments which reveal similarities and differences between perceptual and imaginal networks within the single visual submodality of colour. The first experiment contrasted viewing of a coloured and grey-scale Mondrian display, while the second contrasted a relative colour judgement with a spatial task and required the generation of mental images. Our results show that colour perception activates the posterior fusiform gyrus bilaterally (area V4), plus right-sided anterior fusiform and lingual gyri, striate cortex (area V1), and the left and right insula. Colour imagery activated right anterior fusiform gyrus, left insula, right hippocampus and parahippocampal gyrus, but not V4 or V1. The findings reconcile neurological case studies suggesting a double dissociation between deficits in colour imagery and perception and point to anterior fusiform, parahippocampal gyri and hippocampus as the location for stored representations of coloured objects.

Brain Mapping↗

Abnormal visual scan paths: a psychophysiological marker of delusions in schizophrenia.

The role of the visual scan path as a psychophysiological marker of visual attention has been highlighted previously (Phillips and David, 1994). We investigated information processing in schizophrenic patients with severe delusions and again when the delusions were subsiding using visual scan path measurements. We aimed to demonstrate a specific deficit in processing human faces in deluded subjects by relating this to abnormal viewing strategies. Scan paths were measured in six deluded and five non-deluded schizophrenics (matched for medication and negative symptoms), and nine age-matched normal controls. Deluded subjects had abnormal scan paths in a recognition task, fixating non-feature areas significantly more than controls, but were equally accurate. Re-testing after improvement in delusional conviction revealed fewer group differences. The results suggest state-dependent abnormal information processing in schizophrenics when deluded, with reliance on less-salient visual information for decision-making.

Adult↗

Cognitive functioning and GABAA/benzodiazepine receptor binding in schizophrenia: a 123I-iomazenil SPET study.

BACKGROUND: The role of the inhibitory neurotransmitter gamma aminobutyric acid (GABA) in schizophrenia has previously been investigated using postmortem material. Recently, using single photon emission tomography (SPET) with the selective benzodiazepine antagonist 123I-Iomazenil as the radioligand, we have demonstrated an in vivo relationship between reduced GABAA/benzodiazepine receptor binding and the severity of positive symptomatology in schizophrenia. The present study aimed to build on this using the same in vivo scanning techniques, and relating findings to cognitive functioning. METHODS: Ten nonpsychiatric control subjects and 15 schizophrenic patients, matched for age and handedness, were scanned. A battery of neuropsychologic tests was also administered. RESULTS: Correlational analysis revealed a pattern of increased correlations between GABAA/benzodiazepine receptor binding and task performance, in the schizophrenic group compared to the control group. CONCLUSIONS: Findings are preliminary but suggest a relationship between reduced GABAA/benzodiazepine receptor binding and poorer cognitive functioning, involving memory and visual attention processes, in the schizophrenic group but not in the control group. A role for GABA in the pathophysiology of schizophrenia is suggested. Limitations of the present study and suggestions for future research are discussed.

Adult↗