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Biomedical subjects

B G Winsberg

Publications and source records attributed to B G Winsberg.

At least 19 recordsLinked to original sources
PubMed1999

Association of the dopamine transporter gene (DAT1) with poor methylphenidate response.

OBJECTIVE: This study attempted to relate the alleles of the D2 (DRD2), D4 (DRD4), and dopamine transporter (DAT1) genes to the behavioral outcome of methylphenidate therapy. METHOD: African-American children with attention-deficit hyperactivity disorder were treated with methylphenidate in doses not in excess of 60 mg/day. The dosage was increased until behavioral change was achieved, using a decrement in scores of less than or equal to 1 on a commonly used rating scale or until the maximum tolerated dose was achieved. Blood samples were obtained at that point, and genotypes for polymorphism at the respective genes were identified. RESULTS: Genotypes were then tested by chi 2 to assess the significance of any association with drug response. Only the dopamine transporter gene was found to be significant. Homozygosity of the 10-repeat allele was found to characterize nonresponse to methylphenidate therapy (p = .008). CONCLUSIONS: While the results suggest that alleles of the dopamine transporter gene play a role in methylphenidate response, replication in additional studies is needed.

Alleles↗
PubMed1997

Electrophysiological indices of information processing in methylphenidate responders.

Event-related potential (ERP) studies report that the positive deflection following stimulus evaluation at 300 msec (P3) in hyperactive children is augmented by methylphenidate (MP). This study investigates P3 and preceding ERP components using an auditory oddball task in attention-deficit hyperactivity disorder (ADHD). Mismatch negativity, negativity at 100 and 200 msec, and positivity at 200 msec and 300 msec (P3) were obtained from 14 control and hyperkinetic children. ADHD children who responded to MP were tested on two separate days while receiving either MP or placebo. Controls were tested once. No differences were found between groups for ERP components preceding P3. P3 amplitude was significantly larger under MP than under placebo, but did not differ from controls. Under MP, differences in P3 amplitude unexpectedly occurred when no response was required. A P3 amplitude increase under MP and the unexpected P3 suggest that MP affects attention regulation.

Attention Deficit Disorder with Hyperactivity↗
PubMed1993

Mismatch negativity in hyperactive children: effects of methylphenidate.

This pilot study investigates electrophysiological correlates of methylphenidate (MP) treatment among hyperkinetic children who are clinical responders to therapy. Event-related potentials were obtained from a small sample (6 hyperactive and 5 controls) during an auditory "oddball" task. In the ignore condition, oddball tones elicited a frontocentral "mismatch" negativity (MMN) during the 100- to 200-msec latency range following stimulus presentation. In the attend condition, oddball target tones elicited a centroparietal P3 as well. MP significantly decreased hyperkinetic behaviors. Preliminary analyses of the electrophysiological data indicated a decreased amplitude of the P3 waveform among hyperkinetic children and a trend toward normalization on MP. Waveform abnormalities in the latency range of control MMN suggested either a decrease in MMN amplitude or an increase in MMN latency in hyperactive subjects along with a trend toward normalization by MP. The preliminary data are suggestive of information-processing abnormalities among hyperactive children that may be sensitive to MP therapy.

Attention Deficit Disorder with Hyperactivity↗
PubMed1992

Methylphenidate augmentation therapy in schizophrenia.

Eight schizophrenic inpatients participated in a 2-week double-blind crossover study to test the efficacy of methylphenidate treatment for patients on a stabilized neuroleptic dose. All were young men with a childhood history of hyperactivity. The instruments used, the Brief Psychiatric Rating Scale, Scale for Assessment of Positive Symptoms, Scale for Assessment of Negative Symptoms, and Nurses Observation Scale for Inpatient Evaluation, showed no significant differences between stimulant and placebo conditions. One patient suffered a repeated pressor effect and was removed from the protocol. However, staff and self-report found some improvement in 3 patients and a slight worsening in 1.

Adult↗
PubMed1991

Effects of respite on mothers of school-age and adult children with severe disabilities.

The immediate and short-term effects of a preplanned, 10-day overnight respite on 14 mothers of school-age and adult children with multiple disabilities were evaluated. Change in maternal mood, well-being, and activity patterns was measured before, during, and after respite. The data indicate that during respite, mothers experienced increased feelings of well-being and less depressed mood. Concomittant changes in activity patterns were also found. After respite, increased feelings of well-being continued, and there was a strong tendency for mothers to be less depressed. Results suggest that researchers should conduct controlled evaluation, using standardized measures, to assess the effectiveness of respite on enhancing the quality of life of mothers caring for children with disabilities at home.

Adaptation, Psychological↗
PubMed1989

Efficacy of benztropine therapy for drooling.

This study assessed the efficacy of synthetic anticholinergic benztropine and incidence of side-effects in 20 developmentally-disabled patients with severe drooling. The double-blind, placebo-controlled, crossover protocol included one-week baseline, two-week placebo and two-week benztropine conditions (mean dose 3.8 mg). A significant decrease in drooling during the benztropine condition relative to placebo was demonstrated and conservative response rates (calculated by deleting placebo responders), ranged up to 65 to 70 per cent. For patients completing the protocol the incidence of side-effects did not differ across conditions and minor problems such as a dry mouth were eliminated by small dose adjustments. More serious cholinergic side-effects, which resolved within 24 to 48 hours, necessitated discontinuation of the drug in three patients. This study demonstrates that synthetic anticholinergics can provide an important therapeutic alternative to surgical and behavioral therapies for drooling.

Adolescent↗
PubMed1987

Mianserin pharmacokinetics and behavior in hyperkinetic children.

The present study was conducted to derive pediatric mianserin pharmacokinetic parameters, which were compared to those from healthy young adults, and to obtain preliminary information regarding the utility of mianserin for the management of hyperkinesis in children. The sample consisted of six prepubescent children with hyperkinetic behavior disorders who had not responded, or had developed tolerance to, stimulant medication. Mianserin pharmacokinetics were derived from plasma samples obtained over a 36- to 50-hour period following a single oral dose which ranged from 0.28 to 0.72 mg/kg. Children evidenced a significantly faster elimination half-life and a significantly smaller apparent kinetic volume of distribution than did adults, whereas maximum plasma concentration, time to maximum concentration, and apparent oral plasma clearance were similar. Ratings of behavioral deviance were obtained from teachers and parents during placebo and mianserin titration to a maximum dose of 40 mg/day. Although half the children showed some decrease in hyperactivity ratings, the small sample size and high variability of response preclude conclusions regarding the efficacy of mianserin for childhood hyperkinesis. Possible side effects in our sample included akathisia, excitability, insomnia, and migraine-like headache, as well as cardiovascular effects of tachycardia and two instances of minor electrocardiographic change. Our pharmacokinetic findings will be of import should mianserin prove useful for such childhood disorders as depression and/or enuresis.(ABSTRACT TRUNCATED AT 250 WORDS)

Attention Deficit Disorder with Hyperactivity↗
PubMed1985

Psychostimulant plasma concentration and learning performance.

Six normal adults were administered an oral dose of 0.25 mg/kg of dextroamphetamine, and their learning performance on a paired-associate task and drug blood level were measured at hourly intervals for 5 hours postdrug intake. Dextroamphetamine plasma concentration peaked at 2 to 3 hours following the oral dose, and learning errors were lowest during the same period. A self-report measure of mood also yielded findings consistent with peak plasma concentration. Similar findings obtained with hyperactive children treated with methylphenidate (Ritalin) lead the authors to conclude that the paired-associate learning task may be useful as an indicator of psychostimulant plasma levels, as a predictor of clinical response after an acute dose, and as a highly controlled task for studying psychostimulant drug effects on learning.

Administration, Oral↗
PubMed1982

Methylphenidate oral dose plasma concentrations and behavioral response in children.

The relationship between methylphenidate (MP) oral dose and plasma concentration to social and cognitive behaviors was studied in 25 boys diagnosed as having "attention deficit disorder with hyperactivity". Children were administered successive 1-week treatment conditions under the following schedule of fixed oral doses given twice daily: placebo; 0.25 mg/kg; 0.50 mg/kg; 1.0 mg/kg; placebo. Teacher and parent ratings showed increased improvement in social behavior as a function of MP dose. No drug effects were obtained on cognitive performance. MP plasma concentrations were significantly associated with oral dose and with measures of social behavior. No relationship was found with cognitive behavior. Side effects at the largest dose were severe enough to require discontinuation of treatment for five children, but were relatively mild for the remaining children.

Administration, Oral↗
PubMed1980

Home vs hospital care of children with behavior disorders. A controlled investigation.

A controlled investigation was conducted to assess and compare the treatment outcomes of community and hospital care for children with behavior disorders. Findings showed that (1) community care was effective with regard to behavioral control, and (2) both treatments were comparable concerning educational achievement, parent role function, family adjustment, and parent satisfaction with treatment. It was noted that many severely disturbed children who are in dire socioeconomic predicaments can be maintained in the community with special care and intervention.

Adolescent↗
PubMed1980

Effects of methylphenidate on learning a 'beginning reading vocabulary' by normal adults.

The effects of methylphenidate on reading was studied by having nine adults learn a beginning vocabulary of 96 Chinese characters under placebo and 5 mg and 10 mg methylphenidate by two teaching methods which differed in the rate at which new items were introduced for practice. Using lists composed of 12 characters and their English equivalents, all items were presented prior to the start of practice trials (simultaneous method), or each item was introduced only as the subject practiced items previously presented (progressive method). Learning performance was analyzed in terms of total errors and errors made at two criterion stages in list acquisition. Overall performance was significantly facilitated by the low (5 mg) dose or methylphenidate, but only with the simultaneous method. Significant drug effects were also obtained at criterion stages which were associated with high error rates. It was concluded that drug effects are likely to be most pronounced in difficult learning situations and that dosage appears to be an important variable for consideration in further studies.

Adult↗