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Biomedical subjects

E F Kaplan

Publications and source records attributed to E F Kaplan.

12 recordsLinked to original sources

Detection of mild cognitive deficits in Parkinson's disease patients with the WAIS-R NI.

The relative insensitivity of traditional IQ tests to mild cognitive deficits has led investigators to develop a version of the widely used Wechsler intelligence scales that allows quantitative analysis of underlying qualitative responses. This instrument, the Wechsler Adult Intelligence Scale-Revised as a Neuropsychological Instrument (WAIS-R NI) was administered to 16 Parkinson's disease (PD) patients and 30 normal controls (NC). The 2 groups did not differ significantly in mean age or education, or on their mean Mattis Dementia Rating Scale score. Relative to NC participants, PD patients showed decreased visual attention span, longer response latencies, slower visuomotor processing, and more stimulus-bound errors. Many of the WAIS-R NI measures were able to detect cognitive impairment in a greater percentage of patients than the traditional WAIS-R measures, making it easier to identify deficits that could affect quality of life early in the course of the disease.

Adult↗

The 'preclinical phase' of probable Alzheimer's disease. A 13-year prospective study of the Framingham cohort.

OBJECTIVE: To evaluate the interval between the onset of detectable cognitive impairment and clinical diagnosis in individuals with probable Alzheimer's disease (AD), and to identify the pattern of the earliest changes in cognition in probable AD. DESIGN: Longitudinal follow-up of a community-based cohort sample. In 1976 through 1978, a screening neuropsychological examination was administered to Framingham Study participants. These subjects were then followed up prospectively for development of probable AD for up to 13 years. SETTING: This study was conducted at a community-based center for epidemiologic research. PARTICIPANTS: The surveillance sample consisted of 1045 participants in the Framingham Study aged 65 to 88 years who were free of dementia at the time of the neuropsychological screening examination. MAIN OUTCOME MEASURES: Scores on a group of neuropsychological tests were entered into a series of age- and education-adjusted multiple regression procedures, with the presence or absence of probable AD as the outcome variable. RESULTS: Considered individually, most of the screening neuropsychological measures were significantly related to later AD diagnosis. When stepwise regression procedures were employed, only measures of verbal memory and immediate auditory attention span remained significantly related to AD diagnosis. Of note, subjects later diagnosed with probable AD performed at higher levels than normal subjects on the Digit Span test at initial screening. Regression results were essentially unchanged even when the AD sample was restricted to those individuals for whom the screening examination preceded the clinical onset of dementia by 7 years or more. CONCLUSIONS: These findings support previous contentions that a "preclinical phase" of detectable cognitive deficits can precede the clinical diagnosis of probable AD by many years, and they also support the hypothesis that problems with secondary verbal memory are among the first signs of AD.

Aged↗

Comparison of two short forms of the Wisconsin Card Sorting Test.

Two short forms of the Wisconsin Card Sorting Test (WCST) were evaluated. The WCST-64 consists of one deck of 64 cards; derived measures are number of categories obtained and number of perseverative responses. The WCST-3 includes measures of the number of cards required to complete three categories and the number of perseverative responses. WCST protocols from 37 schizophrenics, 20 temporal lobe epileptics, 11 patients with probable SDAT, and 54 normal controls, were scored using the three methods. Pearson correlations between WCST and WCST-64 scores ranged from.70 to.91. while correlations between WCST and WCST-3 were somewhat lower (.36 to.82). The WCST-64 was superior to the WCST-3 in agreement with the full WCST. The WCST-3 tended to underestimate the number of perseverative responses on the full WCST. Although the use of a short form reduces reliability, the WCST-64 appears to be an acceptable alternative when administration of the full WCST is not possible.

Journal Article↗

Language functioning after bilateral prefrontal leukotomy.

Three groups of patients with orbital frontal lesions secondary to leukotomy were compared to psychiatric and normal control groups on a series of tasks involving language. The results indicated that chronic orbital frontal lesions, at least in the patients in this study, do not affect language as defined by the tasks used in the study. The frontal lobes, when implicated in language, appear to require dorsal-lateral or medial cortical involvement.

Aphasia↗

The effects of prefrontal leucotomy on visuoperceptive and visuoconstructive tests.

Visuoperceptive and visuoconstructive tests were administered to three groups of schizophrenics who had undergone bilateral prefrontal leucotomy approximately 25 years earlier. A nonoperated schizophrenic patient group and a normal subject group served as controls for the effects of schizophrenic symptomatology and for age and education. The results demonstrated that orbital frontal white matter lesions do not disturb simple perceptions and constructions. The nonoperated schizophrenics had significant problems on many of the tests. Only one test, the WAIS Picture Arrangement, revealed deficits in all patient groups, including the good recovery leucotomized patients. This suggests impairment in the higher-order control and organization of perceptual material which may be secondary to orbital frontal white matter lesions or reflect aspects of the underlying schizophrenic disorder.

Frontal Lobe↗

The involvement of orbitofrontal cerebrum in cognitive tasks.

Although the frontal lobes are frequently associated with high-level cognitive functions, patients with significant frontal damage often maintain normal "intelligence". While recent research has clarified some aspects of this enigma, specific questions remain concerning the nature of the deficit in these patients and its relation to lesion localization within the frontal lobes. A group of psychiatric patients who had undergone prefrontal leucotomy 25 years earlier and whose frontal lesions were bilateral and maximal orbitofrontally were evaluated. Sixteen leucotomized schizophrenics, divided into three groups based upon recovery after psychosurgery, were compared to two control groups: (1) non-leucotomized chronic schizophrenics; (2) normal subjects. Four tests were administered: Wechsler Adult Intelligence Scale, Wisconsin Card Sorting test, Visual Metaphor test, and the Visual Verbal test of abstraction. The results suggest that orbitofrontal pathology does cause impaired performance on certain cognitive tests, which appeared independent of IQ measures.

Cognition↗

Evidence for the involvement of orbitofrontal cortex in memory functions: an interference effect.

Although it is frequently stated that the frontal lobes play a significant role in memory function, research proof has been ambiguous at best. This problem was addressed by administering a variety of memory tests to 16 schizophrenic patients who had undergone prefrontal leucotomy approximately 25 years earlier. The 16 were divided into three groups on the basis of recovery after surgery. Two comparison groups were established to control for psychiatric symptomatology, years of institutionalization, age, and years of education. The results demonstrate that large bilateral orbitofrontal lesions may not result in amnesia; in fact, the nonoperated schizophrenic control group performed the most poorly. Proactive interference was demonstrated, however, resulting in significant impairment for all patients with prefrontal lobe damage despite normal scores on commonly used memory tests. Ability to maintain consistent and directed attention and to overcome interference is proposed as a role of the frontal lobes in memory function.

Amnesia, Retrograde↗

The long-term effects of prefrontal leukotomy.

To explore the long-term effects of bilateral prefrontal destruction, 16 schizophrenics who had undergone prefrontal leukotomy approximately 25 years earlier were studied by neurologic examination, psychiatric outcome, EEG, computerized tomography (CT), and a battery of neuropsychological tests. Five nonleukotomized chronic schizophrenics and five age-matched normal subjects served as controls. We report details on the subjects, outline the test procedures, and offer an overview of the long-term residua. In general, the larger the frontal lesion demonstrated by CT, particularly if asymmetric, the better the psychiatric outcome and the better the performance on psychological testing, but there was no correlation between frontal lesion size and either neurological or EEG abnormality.

Brain Diseases↗

Long-term effects of prefrontal leucotomy--an overview of neuropsychologic residuals.

A battery of neuropsychologic tests was administered to 16 schizophrenics who had undergone prefrontal leucotomy approximately 25 years earlier. The 16 were divided into three groups based on their recovery after surgery. Five non-leucotomized chronic schizophrenics and five normal subjects served as controls. This paper presents a description of the subject population, a listing of the neuropsychologic battery administered, as well as main results from each major psychologic function tested. This information serves as an introduction and an overview for later detailed results.

Adult↗

Leucotomized and nonleucotomized schizophrenics: comparison on tests of attention.

Deficits in attention have been strongly linked with both schizophrenia and pathology in the prefrontal cortex. This observation was tested by administering a battery of commonly used tests of attention, sustained mental activity, and tracking to 16 patients who had undergone prefrontal leucotomy approximately 25 years earlier. Presurgical diagnosis in each patient was schizophrenia. The 16 were divided into three groups based on their recovery after surgery. A control group of nonleucotomized schizophrenics was established to control for psychiatric symptomatology. A second control group consisted of subjects without history of psychiatric or CNS disorder. In general, there was no statistically significant impairment of performance in attention tests between the patients with prefrontal psychosurgery and the normal control subjects. The nonoperated schizophrenic control group performed most poorly. Lesion chronicity, interaction of leucotomy and presurgical psychiatric state, and conditions of test administration are suggested as possible explanations for the unexpected results.

Attention↗