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Biomedical subjects

R A Bornstein

Publications and source records attributed to R A Bornstein.

At least 19 recordsLinked to original sources
PubMed2000

Effects of immunosuppression and disease severity upon neuropsychological function in HIV infection.

Effects of immunosuppression and illness severity upon neuropsychological function were assessed in a group of homosexual men with AIDS across 6 months. Participants included 62 who were seronegative (HIV-), 74 asymptomatic seropositives (HIV+A), 31 symptomatic seropositives (HIV+S), 23 with AIDS defining illnesses (AIDS-DI), and 10 who were diagnosed with AIDS solely on the basis of CD4+ levels falling below 200 /mm3 (AIDS-CD4). Groups were equivalent in age, education, and IQ. None were drug users, and none experienced a change in disease status across the 6-month inter-test interval. There was little evidence of cognitive decline across time. Nonetheless, after collapsing across time intervals, the AIDS-DI group had worse new-learning than all other groups. Additionally, the AIDS-DI demonstrated a greater number of impaired performances than the other participant groups. The data suggest that cognitive impairment in AIDS is unlikely due to independent contributions of immunosuppression and illness. Rather neurobehavioral deficits are more likely attributable to a combination of the two.

AIDS Dementia Complex↗
PubMed2000

Estimated premorbid intelligence mediates neurobehavioral change in individuals infected with HIV across 12 months.

This study tested whether estimated premorbid intelligence moderates worsening neurobehavioral dysfunction in HIV infection. 155 homosexual men (54 controls, 49 HIV+ asymptomatic, 24 HIV+ symptomatic, 28 AIDS) with stable disease status were tested on measures of executive function at baseline and 12-month follow-up. Premorbid intelligence was estimated on the basis of a demographically-based regression equation (Hamsher, 1984), and participants were classified as average or above-average intelligence. Regardless of disease status, participants with above-average IQ showed no declines on measures of executive function across time. In contrast, among those with average IQ, symptomatic groups showed declines, whereas the asymptomatic group did not. The findings support the hypothesis that estimated premorbid intelligence mediates declines in neuropsychological function in patients with stable HIV status. These findings are consistent with theoretical models of cognitive reserve capacity.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Neuropsychological deficits in psychotic versus nonpsychotic unipolar depression.

A broad range of neuropsychological function was compared in samples of young adult unipolar depressed inpatients with and without psychotic features. Consistent with expectations, the psychotic depressive group demonstrated a broad range of deficit and had more impaired performances than the nonpsychotic group. Relevance of these data for hypotheses concerning psychotic depression as a unique diagnostic entity is discussed. In the context of previous research, the current findings suggest that accounting for individual differences in depression may clarify discrepancies between earlier studies of neuropsychological function in depression, and our understanding of the mechanisms by which depression influences cognition may be refined.

Adult↗
PubMed1999

Relative memory deficits in recurrent versus first-episode major depression on a word-list learning task.

Although memory deficits are associated with major depressive disorder, few studies have identified which patient characteristics predict impairment. Because recurrent depression appears related to more severe cerebral dysfunction, the present study tested whether recurrent depressed individuals have worse memory function than first-episode depressed individuals. Two groups of young-adult, nonpsychotic, depressed inpatients (20 single episode [SE] and 46 recurrent episode [RE]) were administered the California Verbal Learning Test within a broader battery of neuropsychological tests. The groups were equivalent in age, education, estimated IQ, severity of depression, and demographic composition. The RE group demonstrated memory deficits relative to both the SE group and published norms, but no other significant difference was found across the battery. Data indicate that abnormal memory performance is associated with recurrent depression, whereas memory deficits are not prominent in first-episode depressed individuals.

Acute Disease↗
PubMed1999

Practice effects on commonly used measures of executive function across twelve months.

Fifty men (age M = 32.50; education M = 14.98 years) were administered the Wisconsin Card Sorting Test (WCST), Ruff Figural Fluency Test (FFT), Verbal Concept Attainment Test (VCAT) Trail Making Test, Parts A and B (TMT), and F-A-S Verbal Fluency at baseline and 12 months later. WCST, FFT, and VCAT scores improved significantly over a 12-month interval. In contrast, TMT and F-A-S scores did not change. Level of intellectual ability failed to moderate the effect of previous testing upon performance. Suggestions concerning the use of these measures in longitudinal research designs and clinical follow-up examinations are offered, and reliable change indices concerning these measures are included.

Adult↗
PubMed1998

Neuropsychological correlates of negative, disorganized and psychotic symptoms in schizophrenia.

Recent studies suggest that three dimensions (negative, disorganized and psychotic) categorize schizophrenic symptoms. A developing literature indicates distinct cerebral correlates of each symptom cluster, but few investigations have determined their neuropsychological correlates. In the present study, the Schedules of Negative and Positive Symptoms measured symptom severity in 62 schizophrenics, and a subsequent principal components analysis revealed three symptom dimensions. Factor scores, age and parental socio-economic status were simultaneously entered into regression equations to explain variance across a broad neuropsychological test battery. Negative symptoms were associated with deficits involving intelligence, executive function, memory, sustained-attention and sensory-motor function, whereas disorganized symptoms correlated with decreased intelligence, attention-span and sensory-motor function. Psychotic symptoms were unrelated to deficits. These data are consistent with hypotheses that these three symptom dimensions have distinct neurobehavioral correlates.

Adolescent↗
PubMed1997

Impaired neuropsychological functioning in Tourette's syndrome subjects with co-occurring obsessive-compulsive and attention deficit symptoms.

This study examined neuropsychological performance by 92 children with Tourette's syndrome (TS) grouped by the presence or absence of obsessive-compulsive and/or attention deficit symptoms. The identified groups did not differ with respect to age, education, age at onset of TS symptoms, or medication use. After statistical control for complex motor symptoms, impaired performance on measures of achievement and executive functioning was correlated with obsessive and obsessive/attention symptoms, but not with attention symptoms alone. The presence of both obsessive and attention symptoms identified children with impairment across several tasks. Clinical and functional implications are discussed.

Adolescent↗
PubMed1997

Cognitive deficits distinguish patients with adolescent- and adult-onset schizophrenia.

Recent studies have shown that patients with schizophrenia who have an adolescent-symptom onset (before age 21) have a worse clinical course and greater frequency of cerebral abnormalities than those with an adult-onset (after age 25). However, little is known about the neuropsychological functioning of these groups. A comprehensive neuropsychological examination was administered to groups of patients with schizophrenia with either an adolescent- or adult symptom-onset and a healthy control group. The adolescent-onset group performed worse than the adult-onset and control groups, particularly on measures of memory and executive function. The adult-onset group also performed worse than the controls, but to a lesser extent than did the adolescent-onset group. Results are discussed with reference to hypotheses that adolescent-onset schizophrenia represents a distinct neurodevelopmental disease entity.

Adolescent↗
PubMed1996

Screening for cognitive dysfunction in multiple sclerosis.

BACKGROUND: With the use of comprehensive neuro-psychological assessments, a substantial proportion of patients with multiple sclerosis have been found to have substantial cognitive impairment. Although data generated from comprehensive examinations are useful in making recommendations for treatment interventions and compensatory strategies, the cost of such assessments prohibits their use with all patients. OBJECTIVE: To develop a screening battery to detect cognitive impairment in patients with multiple sclerosis that is sensitive, specific, brief, and cost-effective, and could identify patients who might benefit from a more comprehensive neuropsychological examination. DESIGN: On the basis of a comprehensive neuropsychological assessment battery, the presence of significant cognitive impairment was determined in patients with multiple sclerosis. The screening battery consisted of a subset of tests from the comprehensive battery. Performance on the screening battery was then used to predict presence of cognitive impairment on the comprehensive battery in validation and cross-validation samples. Severity of impairment on the screening battery was also regressed on ratings of functional impairment derived from the Expanded Disability Status Scale. RESULTS: In the validation sample, the screening battery had 100% sensitivity, 80% specificity, and 88.1% overall diagnostic accuracy. In the cross-validation sample, the screening battery had 100% sensitivity, 81.8% specificity, and an overall diagnostic accuracy rate of 90.7%. chi 2 tests showed that the accuracy of the screening battery was significantly better than chance in both samples. Performance on the screening battery also predicted the level of disability ratings on the Expanded Disability Status Scale and functional systems scales. CONCLUSIONS: The screening battery had a high degree of sensitivity, specificity, and diagnostic accuracy, while maintaining a brief administration time and high cost-effectiveness. The screening battery also predicted higher levels of disability and functional impairment as assessed by the Expanded Disability Status Scale, thereby enhancing its clinical utility. Despite its advantages, the findings do not suggest that the screening battery may be an effective substitute for a more detailed examination.

Adult↗
PubMed1996

Neuropsychological correlates of learning disability subtypes in children with Tourette's syndrome.

Neuropsychological deficits in Tourette's syndrome (TS) may be associated with learning disabilities. We examined the neuropsychological performance of 70 children with TS between the ages 6 and 18 years who were classified into four groups based on their pattern of performance on the Wide Range Achievement Test-Revised. The groups included three learning disability subtypes and a nonlearning disabled comparison group. The groups differed significantly on several measures in a comprehensive neuropsychological test battery. The pattern of differences was not entirely consistent with previous research, however, suggesting that neuropsychological correlates of learning disabilities may be influenced by the specific pathophysiology associated with TS. Thus, previous research on the neuropsychology of learning disability subtypes might not be generalizable to children with discrete neuropsychiatric disorders such as TS.

Achievement↗
PubMed1995

Obsessive-compulsive symptom clusters and urinary amine correlates in Tourette syndrome.

This study was conducted to identify clusters of obsessive-compulsive characteristics in Tourette syndrome subjects and to explore their neurochemical correlates. Patients completed a 40-item questionnaire assessing obsessive-compulsive symptoms. Each subject had a 24-hour urine specimen collected and analyzed for a variety of biogenic amines and their metabolites. Factor analysis identified eight symptom clusters, the majority of which appeared to reflect obsessive symptoms. Consistent relationships were observed between symptom clusters and levels of catecholamine and indolamine amines and metabolites. Overall, the primary metabolite of serotonin, 5-hydroxyindoleacetic acid, appeared to be the most highly correlated with the individual obsessive-compulsive symptoms.

Adolescent↗
PubMed1995

Neuropsychological function in patients with end-stage heart failure before and after cardiac transplantation.

This study was performed to examine cognitive function in patients with end-stage heart failure, to identify possible cardiovascular factors associated with cognitive function, and to evaluate changes in cognitive function in a subgroup of patients who received heart transplantation. An extensive battery of neuropsychological tests were given to 62 patients with end-stage cardiac failure as part of their evaluation for cardiac transplantation. Most patients were consecutive referrals, not selected because of cognitive complaints. A small subgroup of transplanted (n = 7) and non-transplanted (n = 4) patients received a repeat neuropsychological examination. At initial examination, approximately 50% of the patients met criteria for impairment in reference to normal control values. Higher stroke volume index and cardiac index and lower right atrial pressure were correlated with better cognitive function. In the subgroup of patients re-examined, the transplanted patients demonstrated significantly improved cognitive function, whereas the non-transplanted subjects were unchanged. These data indicate that in patients with end-stage heart failure there is a high prevalence of impaired cognitive function which is related to measures of cardiovascular efficiency. Preliminary evidence suggests that these impairments may be partially ameliorated by cardiac transplantation.

Adult↗
PubMed1994

Neuropsychological performance and CD4 levels in HIV-1 asymptomatic infection.

The performance of 68 HIV-1 seropositive asymptomatic (HIV+) subjects stratified on CD4 levels were compared with 82 HIV-1 seronegative (HIV-) subjects on a battery of neuropsychological, mood state, and perceived health status measures. The neuropsychological test battery included measures of attention, reaction time, memory, intellectual ability, psychomotor speed, frontal lobe or "executive" function, and decision time. None of the HIV+ subjects were taking antiviral agents. The groups did not differ for age, mood state, or WAIS-R Verbal and Performance IQ scores. Due to group differences for education and weekly ethanol consumption, both variables were used as covariates in multivariate analyses of variance. Relatively few differences were observed between subgroups of HIV+ patients or between these subgroups and control subjects. These data suggest that factors other than absolute levels of immunosuppression as expressed by CD4 levels alone, appear to be responsible for the deficits observed in HIV+ asymptomatic patients.

AIDS Dementia Complex↗
PubMed1994

Self-report of symptoms and neuropsychological performance in asymptomatic HIV-positive individuals.

This study examined the relationship between subjective complaints and neuropsychological performance in 133 HIV-positive asymptomatic and 80 HIV-negative gay or bisexual men. Presence and duration of self-reported symptoms were most strongly related to measures of information processing and reaction time. These relationships remained significant when the effect of depression was statistically controlled, and no significant relationships were found between CD4 level and either presence or duration of symptoms. These data suggest that 1) depression does not completely account for the relationship between subjective complaints and neuropsychological performance and 2) early subjective recognition of symptoms may represent a risk factor for subsequent development of neurobehavioral abnormalities.

Adult↗
PubMed1994

Duration of illness and neuropsychological performance in asymptomatic HIV infection.

The relationship between duration of illness and neuropsychological performance was examined in 25 asymptomatic HIV-infected men with an estimated date of seroconversion. Mean duration of illness was approximately 2 years. After controlling for CD4 level at the time of neuropsychological examination, duration of illness was correlated with measures of visual attention, mental flexibility, dexterity, auditory information processing, and response fluency, as well as an overall measure of neuropsychological performance. Although these patients performed within normal limits, these data suggest that duration of infection may be related to subtle alterations in neuropsychological performance. These results are discussed with regard to possible mechanisms that implicate gradual accumulation of neurotoxins.

AIDS Dementia Complex↗
PubMed1994

The course of tics in Tourette syndrome: a 5-year follow-up study.

The current study was undertaken to explore the course of tics in Gilles de la Tourette's syndrome (TS). As part of a prospective 5-year follow-up of non-clinically based TS subjects who had originally participated in a comprehensive research protocol, 23 subjects (ages 11 to 53 years) were reevaluated for tics and obsessive-compulsive (OC) characteristics. Three (13%) of the subjects had an improvement in total tic symptomatology, while 15 (65.2%) had no change and 5 (21.7%) worsened. Improvement or worsening was independent of baseline developmental age across child, adolescent, and adult subgroups. Complex motor tics at baseline predicted complex motor tics and simple phonic tics at follow-up. Baseline OC and complex motor tics independently predicted subsequent OC and complex motor symptoms. Data from the current study provide evidence of the stability of tic subtypes over time and developmental period.

Adolescent↗
PubMed1993

Trace amines and Tourette's syndrome.

There has been considerable interest in recent years in possible neurochemical abnormalities in Tourette's Syndrome (TS). In studies combining neuropsychological and neurochemical measurements, we have investigated the possible roles of trace amines in this disorder. Urinary levels of free beta-phenylethylamine (PEA) and plasma levels of its precursor amino acid phenylalanine were decreased in TS patients when compared to values in normal children. These urinary PEA levels in TS patients were inversely related to several scores from the Tourette's Syndrome Global Scale (TSGS). Further investigation of the group of subjects with low urinary PEA indicated that they also had low levels of MHPG, normetanephrine, 5-HT and m- and p-tyramine. Patients with low PEA were also compared on an extensive battery of neuropsychological measures and observed to perform significantly worse than TS patients with normal urinary PEA levels. Biochemical measurements also suggest a possible abnormality in tryptamine turnover in TS since urinary levels of indole-3-acetic acid (IAA; the acid metabolite of tryptamine) are significantly lower in TS patients than in normal controls.

Biogenic Amines↗