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Biomedical subjects

G W Paulson

Publications and source records attributed to G W Paulson.

At least 19 recordsLinked to original sources
PubMed1992

Reflexes and neurologists.

Neurologists are particularly concerned with elicitation of reflexes, interpret them as indicative of levels of the nervous system and its development or dissolution. This article reviews selected aspects of reflex action. No longer simply reflexology, clinical neurology will still make new observations about reflexes and, more relevant, clinical neurologists will enjoy the process. The breadth of interests of George Bruyn is a permanent reminder to future neurologists of what complexities can be constructed on basic observations such as have been done on "our" reflexes.

Brain↗
PubMed1992

Addiction to nicotine is due to high intrinsic levels of dopamine.

Smokers are less likely to develop Parkinson's disease (PD) than is true of non-smokers, and PD is the only disease inversely related to smoking. PD is associated with a reduced level of dopamine. Although nicotine can affect the receptors, including dopamine receptors, it seems unlikely that use of nicotine is protective in PD. An alternative explanation is that just as PD is associated with a lower than normal level of dopamine, addiction to smoking is linked with a higher than normal level of dopamine. This high innate level of dopamine facilitates addiction to nicotine.

Dopamine↗
PubMed1991

Is there a premorbid personality typical for Parkinson's disease?

For decades clinicians have postulated a characteristic preexisting personality in patients who develop Parkinson's disease (PD). They are described as moralistic, law-abiding, conscientious, and averse to risk-taking. The limited personality surveys tend to be confirmatory, but most of the literature is anecdotal or replete with unprovable psychodynamic postulates. In addition to an apparent stability of marriages and lack of alcoholism, patients with PD are less likely than controls to be smokers. It has been suggested that nicotine and its byproducts are not actually protective against PD, and it could be postulated that higher-than-average intrinsic dopamine may facilitate addiction. Smoking for the patient who is later to develop PD may be particularly unrewarding. In addition, the postulated personality for PD may predispose to hard work, perspiration, and increased exposure to putative trace elements in the water supply.

Affect↗
PubMed1990

Magnetic resonance imaging in Parkinson's disease.

Magnetic resonance imaging was utilized to examine changes in the pars compacta associated with Parkinson's disease. We found a reduction in average width of the pars compacta in advanced- but not early-stage patients. Conversely, a significant difference in width (right minus left) was observed in early- but not late-stage patients. Width asymmetry may be a sensitive magnetic resonance imaging indicator for the early detection of Parkinson's disease when there is a predominance of unilateral clinical symptoms.

Adult↗
PubMed1990

The pattern of depressive symptoms varies with progression of Parkinson's disease.

Whether or not depressive symptoms increase in severity with progression of Parkinson's disease (PD) remains uncertain. Unlike previous studies, we examined whether the severity of specific features of depression (mood, self reproach, vegetative, and somatic symptoms) differ with respect to the progression of PD. Results indicated that symptoms related to both mood and self-reproach were present in the early stages of PD but did not increase in severity with advancing disease. Somatic features of depression were evident early and increased with disease progression, and vegetative symptoms were seen only in the later stages of PD. The different patterns of these depressive features with progression of PD may account in part for the variations seen in previous studies.

Adult↗
PubMed1989

Neuropsychological similarities in lateralized parkinsonism.

Parkinson's disease (PD) patients who have left or right predominance of motor symptoms may exhibit cognitive differences. Previous research found greater neuropsychological impairment in patients with both right and left motor predominance, and some found no differences. Variability in overall severity of disease among the patients studied makes evaluation of these reports difficult. We examined the possibility that neuropsychological differences may occur in different stages of disease by comparing patients with mild unilateral disease (Exp. 1) and advanced disease (Exp. 2). Results indicated that while overall cognitive impairment increased with advancing disease, the pattern of neuropsychological impairments were not different with respect to laterality of motor symptoms in either experiment.

Cognition↗
PubMed1989

Magnetic resonance imaging in dementia of Parkinson's disease.

The possibility that dementia in Parkinson's disease is associated with specific cerebral abnormalities identifiable by magnetic resonance imaging (MRI) was examined. Sixty eight patients with Parkinson's disease and 28 age and education matched normal controls were evaluated using neuropsychological procedures that included assessment of language, memory, cognition, visuospatial skills and mood. Twenty three patients (34%) were found to have developed significant impairment in at least three of the five areas, thus meeting criteria for a dementia syndrome. Eleven patients (16%) had no intellectual impairment and thirty four patients (50%) had a mild to moderate intellectual disturbance. Patients with (n = 10) and without dementia (n = 20), matched for severity of Parkinson's disease, and normal controls (n = 10) matched for age with the two patients groups, were evaluated by MRI. MRI scans were analysed for evidence of generalised cerebral atrophy, ventricular enlargement, visualisation of the substantia nigra and severity of focal brain lesions. Results indicated that the presence of dementia in patients with Parkinson's disease was not associated with any specific pattern of MRI abnormalities.

Adult↗
PubMed1989

Influence of dopamine and disease severity on primitive reflexes in Parkinson's disease.

Several primitive reflexes are common in patients with Parkinson's disease (PD), but can also be noted in patients who have diffuse cerebral degeneration. The glabellar response is present in virtually all patients with PD and this reflex has been of theoretical interest in PD. It has been suggested that the glabellar response is related to inhibition via dopamine pathways. We examined changes in several primitive reflexes as a function of the plasma dopamine level and the severity of PD. The probability of observing these reflexes did not vary with dopamine levels, but the corneomandibular and palmomental reflexes were significantly more likely to be present in patients with advanced disease. Our findings confirm that primitive reflexes are prominent in PD and suggest that they may be secondary to extrapyramidal disease.

Age Factors↗
PubMed1989

Neuropsychological impairments associated with severity of Parkinson's disease.

Intellectual impairment and disease severity tend to parallel one another in patients with Parkinson's disease (PD), but the pattern of development of the neuropsychological impairments contributing to the overall intellectual decline is unknown. This problem was addressed by comparing neuropsychological performance in the early and later stages of PD. Impairment of recent memory, impairment of cognition, and somatic features of depression were seen early and worsened with more advanced disease. Impairment of visuospatial skills, remote memory, language, and mood were observed only in the later stages of PD. These findings suggest that neuropsychological impairments do not develop in a uniform manner with progression of PD.

Aged↗
PubMed1989

Dose-dependent memory impairment in Parkinson's disease.

Variation in plasma dopamine level between the time of original learning and subsequent memory retrieval causes a state-dependent memory impairment in Parkinson's disease. The occurrence of this phenomenon is not related to either progression of disease or duration of therapy, but is more likely to occur with high-dosage levels of levodopa-carbidopa.

Carbidopa↗
PubMed1988

Magnetic resonance imaging and clinical correlations in multiple sclerosis.

We examined the relationship between magnetic resonance imaging (MRI) cerebral findings and clinical evaluations in 66 patients with clinically definite multiple sclerosis (MS). MRI observations included total number and location of lesions visualized, degree of periventricular involvement, degree of degeneration of the corpus callosum, and extent of generalized parenchymal atrophy. Overall physical disability was evaluated by the Kurtzke Expanded Disability Status Scale (EDSS) and individual symptoms were rated according to the Kurtzke Functional Systems (FS) scale. Our results suggest that MRI brain abnormalities are significantly related to the overall severity of disease, but MRI is not particularly useful to predict the presence or absence of individual symptoms. These findings do suggest that the MRI may provide useful information to monitor clinical progression of patients with MS, but the lesions visualized need not always be symptomatic nor are we sure that all symptomatic lesions, particularly in the spinal cord and optic nerves, will be visualized.

Adult↗
PubMed1988

Relationship of motor symptoms, intellectual impairment, and depression in Parkinson's disease.

The relationship between severity of disease, intellectual impairment, and depression was examined in 50 patients with Parkinson's disease. A significant correlation between severity of disease and intellectual impairment suggests that both may result from the same subcortical lesions. Depression was not significantly related either to severity of disease or to intellectual impairment. This suggests that the relationship between severity of disease and intellectual impairment was not an artifact of increasing depression. Severity of rigidity and of bradykinesia did predict severity of intellectual decline, but severity of tremor predicted better intellectual status. Patients with a predominance of tremor may have a more benign clinical course as well as better intellectual function than patients with a predominance of rigidity and bradykinesia.

Adult↗
PubMed1988

Efficacy of alprazolam for essential tremor.

The effect of alprazolam on essential tremor was examined by a double-blind, placebo-controlled parallel study of 24 patients. Results indicated that patients treated with alprazolam had significant improvement in tremor. Transient mild fatigue or sedation in 50% of patients was the primary side effect. Alprazolam may provide therapeutic benefit, especially in patients who require only intermittent therapy.

Adult↗
PubMed1987

Magnetic resonance imaging correlates of dementia in multiple sclerosis.

Thirty-two patients with clinically definite multiple sclerosis were evaluated with neuropsychological procedures and magnetic resonance imaging (MRI). Neuropsychological evaluation included assessment of language, memory, cognition, visuospatial skills, and depression. Significant impairment in any three areas, compatible with diagnosis of a dementia syndrome, was observed in 28% of these patients, and lesser or no cognitive impairment characterized the remaining patients. Magnetic resonance imaging was used to evaluate the number and distribution of lesions as well as the presence of cerebral atrophy and atrophy of specific anatomic structures such as the corpus callosum. Results suggest that neither the number of lesions, the distribution of lesions, nor the extent of generalized cerebral atrophy was significantly greater in demented compared with non-demented patients. The primary finding was that atrophy of the corpus callosum was significantly more extensive on MRI scans in demented patients. Although the callosum itself may not be implicated directly in the pathogenesis of dementia, the presence of callosal atrophy on MRI scans should alert the physician to the possible occurrence of dementia in patients with multiple sclerosis.

Adult↗
PubMed1987

Memory impairment associated with progression of Huntington's disease.

Huntington's Disease (HD) has been described as one example of a "subcortical" dementia, characterized by slowed cognitive processing and impairment of memory. We examined the relationship between slowed cognitive processing and memory impairment as a function of disease progression in patients with HD. Results from three experiments suggest that in the early stages of HD there is slowed cognition with intact memory acquisition and retrieval processes. In later stages, cognition is further slowed and specific impairments of memory become evident. Thus, memory impairment in HD would appear to change qualitatively with progression of the disease.

Adult↗
PubMed1987

Fluctuations in plasma dopamine level impair memory in Parkinson's disease.

We found a causal relationship between variation in plasma dopamine level and memory impairment in Parkinson's disease. If the level of dopamine was changed between the time of original learning and a later time of attempted memory retrieval, memory performance was impaired when compared with a maintenance of similar dopamine levels on both occasions. The absolute level of dopamine did not influence memory performance. Side-effects of levodopa-carbidopa therapy include variation in dopamine level, parkinsonian symptoms, and possibly "state-dependent" impairment of memory.

Carbidopa↗
PubMed1987

Depression in patients with dementia of Alzheimer type.

Depression in dementia of Alzheimer type (DAT) has classically been considered to diminish as the disorder progresses. Using the Zung Self-Rating Depression Scale and the Mini-Mental State Examination to gauge the severity of depression and dementia, respectively, the authors found that the magnitude of depression did not differ as a function of disease severity in patients with DAT. The use of appropriate antidepressant therapy is therefore encouraged at any stage of disease in these patients.

Aged↗