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Biomedical subjects

E Taub

Publications and source records attributed to E Taub.

At least 73 records · Page 4Linked to original sources
PubMed1997

Moyamoya disease in Europe, past and present status.

A questionnaire was distributed in early 1996 to 160 leading European neurological, neuro-pediatric and neurosurgical centers to assess the present status of Moyamoya disease in Europe. The response rate was 43%. Information was obtained on a total of 168 patients, of whom 110 had presented before 1992, and 58 from 1993 onward. 82% of the patients were Caucasian. In all other respects, the clinical findings were similar to those observed in Japan. The present study yields an incidence of 0.3 patients per center per year, which is approximately one-tenth of the incidence in Japan. Alongside these results, the history of the recognition and treatment of this disease in Europe is briefly discussed.

Adult↗
PubMed1997

The relationship of phantom limb pain to other phantom limb phenomena in upper extremity amputees.

In thirty-two unilateral upper extremity amputees with and without phantom limb pain, various phantom limb phenomena were investigated. In general, the incidence of non-painful phantom limb sensations was higher in patients with phantom limb pain than in pain-free amputees. Kinesthetic and kinetic phantom limb sensations were reported more frequently than exteroceptive cutaneous sensations. There was a significant positive correlation between phantom limb pain and stump pain. Patients more frequently assigned sensory than affective pain qualities to their phantom limb pain, whereas no differences between pain qualities were observed for stump pain. No support was found for a relationship between the presence of telescoping (i.e., shrinkage of the phantom limb) and phantom limb pain. These findings point to central as well as to peripheral factors contributing to phantom limb pain.

Adult↗
PubMed1997

Globus pallidus stimulation activates the cortical motor system during alleviation of parkinsonian symptoms.

Studies of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonism in monkeys suggest that excessive inhibitory outflow from the internal segment of the globus pallidus (GPi) suppresses the motor thalamus, which reduces activation of the cerebral cortex motor system, resulting in the slowness and poverty of movement of Parkinson's disease (PD). This hypothesis is supported by reports of high rates of spontaneous neuronal discharges and hypermetabolism in GPi (ref. 4-7) and impaired activation of the supplementary motor area (SMA) and dorsolateral prefrontal regions in PD patients. Furthermore, lesion or chronic high-frequency electrical (likely inactivating) stimulation of GPi (ref. 10-14) is associated with marked improvements in akinesia and rigidity, and the impaired activation of SMA is reversed when the akinesia is treated with dopamine agonists. To test whether improvement in motor function with pallidal surgery can be attributed to increased activity in premotor cortical regions, we assessed the changes in regional cerebral blood flow (rCBF) and parkinsonian symptoms during disruption of GPi activity with high-frequency stimulation delivered through implanted brain electrodes. Positron emission tomography (PET) revealed an increase in rCBF in ipsilateral premotor cortical areas during GPi stimulation, which improved rigidity and bradykinesia. These results suggest that disrupting the excessive inhibitory output of the basal ganglia reverses parkinsonism, via a thalamic relay, by activation of brain areas involved in the initiation of movement.

Aged↗
PubMed1997

Chronic electrical stimulation of the gasserian ganglion for the relief of pain in a series of 34 patients.

The use of an implanted system for chronic electrical stimulation of the gasserian ganglion for relief of facial pain was described in 1980 by Meyerson and Håkansson. Between 1982 and 1995, the senior author (R.R.T.) performed gasserian ganglion stimulation in 34 patients for the relief of chronic medically intractable facial pain. The etiology of pain was peripheral damage to the trigeminal nerve in 22 patients (65%), central (stroke) damage in seven (21%), postherpetic neuralgia in four (12%), and unclassifiable cause in one (3%). All patients received a trial of transcutaneous stimulation (Stage 1). Successful trials in 19 patients (56%) were followed by implantation of a permanent system (Stage II). Trial and postimplantation stimulation were deemed successful when there was a reduction of pain by at least 50% whenever the stimulator was on. Success rates varied from five (71%) of seven patients for central pain to five (23%) of 22 for peripheral pain and none (0%) of four for postherpetic neuralgia. The median follow-up duration in successful cases was 22.5 months. Infections occurred in seven patients, all of whom had undergone Stage II treatment. Infections were more frequent when the stimulating electrode from Stage I was left in place for Stage II (six [43%] of 14) than when completely new hardware was used and prophylactic antibiotic drugs were administered (one [20%] of five). Other complications included iatrogenic injury to the trigeminal nerve or ganglion in three cases (9%), transient diplopia in two (6%), increased pain in two (6%), and various technical problems in 10 (29%). It is concluded that pain of central origin (stroke) is the type most likely to be relieved by this procedure. This finding is new, as the few other clinical series reported to date contain no patients with this type of pain. The risk of infection seems to be lower when completely new hardware is used for Stage II and prophylactic antibiotic drugs are administered.

Antibiotic Prophylaxis↗
PubMed1996

Impact of irritable bowel syndrome on quality of life.

The aims of this study were to determine the impact of irritable bowel syndrome on quality of life using a well-standardized measure, the SF-36, and to determine whether apparent impairments may be due to neuroticism. Undergraduate students with irritable bowel syndrome who had consulted a physician (41 females, 42 males), students with irritable bowel who had not consulted a physician (91 females, 74 males), and asymptomatic controls (52 females, 70 males) completed questionnaires on quality of life, neuroticism, and psychological distress. Patients showed greater impairment in quality of life than nonconsulters, who in turn showed greater impairment than controls. Neuroticism and psychological distress were correlated with all quality-of-life measures. However, when neuroticism and psychological distress were statistically partialed out, irritable bowel syndrome still had a significant negative impact. The SF-36 may be a useful outcome measure in treatment studies, but investigators will need to correct for confounding influences of neuroticism.

Adult↗
PubMed1996

Reorganizational and perceptional changes after amputation.

The demonstration of cortical representational shifts in adult animals subsequent to deafferentation from amputation or dorsal rhizotomy has spurred attempts to elucidate the perceptual correlates of reorganization. Because the hand is flanked by the face and the trunk on the cortical homunculus it has been suggested that cortical remapping in arm amputees leads to a mislocalization of sensations from these sites to the phantom arm in a systematic manner with modality specific one-to-one topographical correspondence. Therefore, we assessed shifts of representational zones by magnetic source imaging in eight arm-amputees and examined them for referred sensation by somaesthetic stimuli of different modalities at standardized sites. It was found that referred phantom sensations can be evoked from sites on the face and the trunk ipsilateral but also contralateral to the amputation and that the extent of physiological reorganization as revealed by magnetic source imaging strongly correlates with the number of sites, be it ipsi- or contralateral, from where painful stimuli evoke referred sensation. Thus, it seems that the extent of reorganization after amputation is closely related to nociceptive inputs. The mislocalization evoked from both sides of the body, suggesting involvement of bilateral pathways, demonstrates that the perceptual changes go beyond what can be explained by shifts in neighbouring cortical representational zones.

Adult↗
PubMed1995

Cortical reorganization in human amputees and mislocalization of painful stimuli to the phantom limb.

In human arm amputees, a significant relationship was found between the amount of reorganization in the primary somato-sensory cortex, and the amount of body surface from which painful stimuli evoked sensations that were perceived to be emanating from the now missing extremity, i.e. the phantom limb. This mislocalization could be evoked almost equally from stimulation of either side of the body. Based on these findings obtained by magnetic source imaging and psychophysical testing in eight amputees, it is concluded that the extent of the generally known cortical reorganization contralateral to the amputation is an indicator of more widespread plastic changes in the brain involving bilateral pathways.

Adult↗
PubMed1995

Increased cortical representation of the fingers of the left hand in string players.

Magnetic source imaging revealed that the cortical representation of the digits of the left hand of string players was larger than that in controls. The effect was smallest for the left thumb, and no such differences were observed for the representations of the right hand digits. The amount of cortical reorganization in the representation of the fingering digits was correlated with the age at which the person had begun to play. These results suggest that the representation of different parts of the body in the primary somatosensory cortex of humans depends on use and changes to conform to the current needs and experiences of the individual.

Adult↗
PubMed1995

Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputation.

Although phantom-limb pain is a frequent consequence of the amputation of an extremity, little is known about its origin. On the basis of the demonstration of substantial plasticity of the somatosensory cortex after amputation or somatosensory deafferentation in adult monkeys, it has been suggested that cortical reorganization could account for some non-painful phantom-limb phenomena in amputees and that cortical reorganization has an adaptive (that is, pain-preventing) function. Theoretical and empirical work on chronic back pain has revealed a positive relationship between the amount of cortical alteration and the magnitude of pain, so we predicted that cortical reorganization and phantom-limb pain should be positively related. Using non-invasive neuromagnetic imaging techniques to determine cortical reorganization in humans, we report a very strong direct relationship (r = 0.93) between the amount of cortical reorganization and the magnitude of phantom limb pain (but not non-painful phantom phenomena) experienced after arm amputation. These data indicate that phantom-limb pain is related to, and may be a consequence of, plastic changes in primary somatosensory cortex.

Adult↗
PubMed1995

Spontaneous swallowing rate and emotional state. Possible mechanism for stress-related gastrointestinal disorders.

Excessive spontaneous swallowing has been associated with a variety of common gastrointestinal symptoms including abdominal pain, heartburn, and bloating and may contribute to disorders such as hiatus hernia, duodenal ulcer, and irritable bowel syndrome. The present study investigated the hypothesis that changes in emotional state alter spontaneous swallowing rate. Subjects were 38 generally healthy undergraduates assigned to either a pleasant low arousal, neutral, or aversive high arousal condition. Each experimental session was divided into 30-min baseline and arousal manipulation periods. Spontaneous swallowing rate increased significantly with emotional arousal: for low, neutral, and high arousal groups, means were 7.9 +/- 1.9 (SE), 15.8 +/- 2.4, and 23.7 +/- 3.6 swallows/30 min, respectively. Other physiological and self-report measures, used to check the effectiveness of the arousal manipulation, varied appropriately with experimental procedures. These results indicate that changes in emotional state alter spontaneous swallowing rate in generally healthy individuals. Further research with patients is needed to establish whether stress-induced increases in swallowing rate produce or exacerbate clinically significant gastrointestinal symptomatology.

Adolescent↗
PubMed1995

Irritable bowel syndrome defined by factor analysis. Gender and race comparisons.

To examine the applicability across subgroups of the Manning criteria commonly used to diagnose the irritable bowel syndrome, a 22-item symptom questionnaire was administered to male and female African-American and Caucasian adults (N = 1344). Principal components factor analysis with varimax rotation was used to identify symptom clusters. Consistent with the findings of a previous factor analytic study, three of the six Manning symptoms (loose stools and more frequent bowel movement with onset of pain, pain relieved by defecation) formed a cluster corresponding to the irritable bowel syndrome in all subgroups. It is concluded that: (1) The three core Manning symptoms have equal applicability to both genders and to African-Americans as well as to Caucasians. They useful symptom criteria for the diagnosis of IBS when used in conjunction with medical evaluation. (2) Three of the six Manning symptoms rarely correlate with the others; if confirmed in patient samples, this would indicate that these three symptoms are not useful for making a diagnosis of the irritable bowel syndrome.

Adult↗
PubMed1995

Dorsal root ganglionectomy for intractable monoradicular sciatica. A series of 61 patients.

Dorsal root ganglionectomy was introduced in 1975 as a procedure with theoretical advantages over dorsal rhizotomy for the treatment of intractable radicular pain. Results of the few clinical reports have been generally favorable. The authors report the largest and most comprehensively studied series to date. 61 patients (33 men, 28 women) underwent dorsal root ganglionectomy for intractable sciatica, most often monoradicular. Patients were selected for surgery only if the clinical history, physical examination, radiologic studies, and diagnostic radicular block all predicted a favorable outcome. Sciatica was markedly reduced or eliminated in 36 patients (59%). Dysesthesia following ganglionectomy was observed frequently, but not invariably (approximately 60% of cases). Dysesthesia was generally of mild or moderate severity, self-limited, and responsive to treatment.

Adult↗
PubMed1995

Resolution of chronic cluster headache after resection of a tentorial meningioma: case report.

Cluster headache is almost always idiopathic, but, in rare cases, associated intracranial lesions have been found. We describe a patient who had chronic cluster headache for more than 20 years. The headache immediately resolved upon resection of a tentorial meningioma. Prior reports of cluster headache as a manifestation of structural disease are briefly reviewed. In the patient described, the pain was referred from the right tentorium cerebelli to the right side of the face, in accordance with reported studies on the subjective localization of pain referred from posterior fossa structures. The accompanying abnormalities of autonomic function may have been mediated by central autonomic reflexes that are also involved in the pathogenesis of idiopathic cluster headache.

Autonomic Nervous System Diseases↗
PubMed1994

Extensive reorganization of the somatosensory cortex in adult humans after nervous system injury.

Magnetic source imaging revealed that the topographic representation in the somatosensory cortex of the face area in upper extremity amputees was shifted an average of 1.5 cm toward the area that would normally receive input from the now absent nerves supplying the hand and fingers. Observed alterations provide evidence for extensive plastic reorganization in the adult human cortex following nervous system injury, but they are not a sufficient cause of the phantom phenomenon termed 'facial remapping'.

Adult↗
PubMed1994

Thoracic complications of ventriculoperitoneal shunts: case report and review of the literature.

Thoracic complications of ventriculoperitoneal shunts are rare, but potentially serious. The authors report a case of a drainage of cerebrospinal fluid into the tracheobronchial tree through a peritoneal shunt catheter that migrated into the chest. After injection of contrast material into the shunt, a plain radiograph of the chest revealed a bronchogram. The symptoms resolved after a revision of the shunt. Published case reports of this and other thoracic complications of ventriculoperitoneal shunts are comprehensively reviewed. A classification of such complications into three types is proposed as follows: intrathoracic trauma during placement of a shunt, migration of the peritoneal catheter into the chest (by either a supradiaphragmatic or a transdiaphragmatic route), and pleural effusion accompanying cerebrospinal fluid ascites. The possible mechanisms and contributing factors are discussed.

Adult↗
PubMed1994

An operant approach to rehabilitation medicine: overcoming learned nonuse by shaping.

A new approach to the rehabilitation of movement, based primarily on the principles of operant conditioning, was derived from research with deafferented monkeys. The analysis suggests that a certain proportion of excess motor disability after certain types of injury involves a learned suppression of movement and may be termed learned nonuse. Learned nonuse can be overcome by changing the contingencies of reinforcement so that they strongly favor use of an affected upper extremity in the chronic postinjury situation. The techniques employed here involved 2 weeks of restricting movement of the opposite (unaffected) extremity and training of the affected limb. Initial work with humans has been with chronic stroke patients for whom the approach has yielded large improvements in motor ability and functional independence. We report here preliminary data suggesting that shaping with verbal feedback further enhances the motor recovery.

Animals↗
PubMed1993

Parents of children newly diagnosed with cancer: anxiety, coping, and marital distress.

Evaluated anxiety, approach-avoidance coping style, and marital distress in 134 parents of children with cancer shortly after diagnosis. Of the 67 marital pairs studied, approximately 25% of the mothers and 28% of the fathers reported significant marital distress. Regression analyses revealed that marital distress was predicted by a combination of general emotional distress, the discrepancy between the couple's state anxiety levels, and the couple's use of sensitizing coping strategies. Greater differences in anxiety levels between the parents and greater stimulus approach coping activity in the marriage were associated with greater reported marital distress.

Adaptation, Psychological↗