Biomedical subjects

R A Bornstein

Publications and source records attributed to R A Bornstein.

At least 55 records · Page 3Linked to original sources

PubMed1991

Rate of CD4 decline and neuropsychological performance in HIV infection.

This study examined the relationship between performance on a battery of neuropsychologic tasks and rate of CD4 lymphocyte decline in 47 gay or bisexual men infected with the human immunodeficiency virus type 1. Subjects were volunteers for a longitudinal study of the human immunodeficiency virus infection and were not selected because of neuropsychiatric symptoms. Subjects were at all stages of illness, although most were asymptomatic. Faster rates of decline in percent CD4 lymphocyte were related to poorer performance on measures of memory and reaction time. This relationship was independent of stage of illness and CD4 level at the time of neuropsychologic examination, and was not due to medication effects. The rate of percent CD4 lymphocyte cell loss is associated with and may represent a risk factor for the development of the human immunodeficiency virus-related neurobehavioral deficit.

Adult↗

PubMed1991

Neuropsychological performance in adults with Tourette's syndrome.

Neuropsychological performance was examined in a sample of 36 adults who met DSM-III-R criteria for Tourette's syndrome (TS), confirmed by a psychiatrist or a neurologist. All subjects were administered an extensive battery of psychological and neuropsychological tests as well as symptom rating scales. The mean performance on most tests was within normal limits, and the patients and controls did not differ on a summary measure of neuropsychological performance. However, apparently 20% of the TS subjects had mild abnormalities on a summary measure of neuropsychological performance. These data are consistent with recent reports of generally normal performance in children with TS. Poor performance on several tasks was related to later age at symptom onset. The results were discussed with regard to the nature of the sample and directions for future research.

Adult↗

PubMed1991

Tourette syndrome and neuropsychological performance.

This study examined performance on a battery of neuropsychological tests in a sample of 28 patients with Tourette's syndrome (TS). Test scores were converted to age-corrected T-scores to control for the effect of age on test performance. The frequency of abnormal test performances was variable, but more frequent on motor and sensory tasks. Symptom severity as measured by the Tourette Syndrome Global Scale was inversely related to neuropsychological performance. In general, neuropsychological performance was mildly below average. The pattern of performance was similar to previous studies of TS patients.

Adolescent↗

PubMed1991

Neuropsychological performance in medicated and unmedicated patients with Tourette's disorder.

OBJECTIVE: To date, there have been no formal investigations of neuropsychological performance in patients with Tourette's disorder who are taking psychotropic medications. The authors conducted this study to provide such information. METHOD: They examined the neuropsychological performance of 96 patients 6-18 years old who met DSM-III-R criteria for Tourette's disorder; 51 of these patients were taking neuroleptic medications and 45 were not. The groups were well matched with regard to age, sex, education, and duration of symptoms. Each group was given a complete neuropsychological test battery as well as instruments rating symptoms of Tourette's disorder, obsessive-compulsive characteristics, and other behavioral disturbances. RESULTS: The patients taking medications did not differ from those not taking medications on any of the neuropsychological, intellectual, or educational measures. In addition, the groups did not differ with regard to level of Tourette's disorder symptoms. CONCLUSIONS: The results of this investigation suggest that patients with Tourette's disorder who do not experience intolerable side effects from neuroleptic medications are able to perform on educational, intellectual, and neuropsychological tests at a level comparable to that of unmedicated patients. These results have positive implications for patients with Tourette's disorder who respond to neuroleptic medications.

Adolescent↗

PubMed1991

Depression and memory in major depressive disorder.

The relationship between memory function and depression was examined in 23 patients who met DSM-III criteria for major depression. All patients were unmedicated at the time of examination, which included the Wechsler Memory Scale, Minnesota Multiphasic Personality Inventory-Depression Scale (MMPI-D), and Hamilton Depression Rating Scale (HDRS). Consistent with previous studies, there was no relationship between the MMPI-D and any of the Wechsler Memory Scale measures. In contrast, poor memory was related to elevated scores on the HDRS. These data indicate that depression does influence memory performance. The most important implication of this study is the need for the use of appropriate measurement instruments in studies of neuropsychological correlates of neuropsychiatric disorders.

Adolescent↗

PubMed1991

Neuropsychological correlates of obsessive characteristics in Tourette syndrome.

The relationship between obsessive-compulsive (OC) characteristics and performance on a test sensitive to frontal lobe function (Wisconsin Card Sorting Test) was examined in a sample of 100 patients between the ages of 6 and 18 years. All patients met DSM-III-R criteria for Tourette syndrome (TS), confirmed by a neurologist or psychiatrist. Performance on the Wisconsin Card Sorting Test was correlated with ratings of OC characteristics, but not with other TS symptoms. This relationship was maintained even when Full-Scale IQ and the total number of Tourette symptoms were controlled. The effect could not be attributed to medication. These findings were interpreted in the context of models of basal ganglia-cortical associations. It was speculated that different symptoms associated with TS may have different neuroanatomic substrates.

Adolescent↗

PubMed1991

Neuropsychological performance and urinary phenylethylamine in Tourette's syndrome.

Patients with Tourette's syndrome (TS) were grouped on the basis of levels of urinary phenylethylamine (PEA). These groups of TS patients were compared on an extensive battery of neuropsychological measures converted to age-corrected T scores based on published normative data. Patients with PEA levels below that of normal controls performed significantly worse than TS patients with normal PEA levels. The data were interpreted to suggest that abnormalities in PEA may contribute to neuropsychological deficits. Furthermore, these data may provide further support for an etiological subgroup of TS patients characterized by an abnormality in PEA metabolism. These data are discussed in regard to directions for further investigation.

Adolescent↗

PubMed1991

Serial-position effects in paragraph recall following mild closed-head injury.

Serial-position effects were examined on a contextual memory task (paragraph recall) for patients with minor to mild closed-head injury and normal controls. Analysis indicated that at immediate recall, both normals and closed-head-injury patients have primacy and recency effects. With regard to total recall, however, the closed-head-injury patients remembered significantly fewer items than normal controls. The poorer performance of the minor to mild closed-head-injury group was not related to the duration from injury to neuropsychological evaluation and appears to be a lasting feature of memory performance following such injury. The pattern of serial-position effects was different between the groups. Normal controls showed slight recency and primacy effects and relatively better recall for the middle portions of the story, while patients with minor to mild closed-head injuries have prominent recency and primacy effects. Potential explanations for this pattern of performance are discussed.

Adult↗

PubMed1991

The relationship between intelligence and memory following minor or mild closed head injury: greater impairment in memory than intelligence.

This study investigated the performance of patients with minor or mild closed head injury and age/education-matched normal controls on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) and the Wechsler Memory Scale-Revised (WMS-R). The results demonstrated that the control group had significantly higher scores than the patients with closed head injury on all WAIS-R and WMS-R index scores. Further analysis revealed that the patients with closed head injury showed a greater impairment in delayed memory when directly compared to intellectual performance that was not seen in the control group. These results are discussed in relation to findings in patients with more severe closed head injury, the construction of the WAIS-R and the WMS-R, and the performance patterns of the two groups.

Adult↗

PubMed1990

Cognitive impairment and cerebral structure by MRI in bipolar disorder.

The distinction between bipolar disorder and schizophrenia customarily follows examination of the clinical symptomatology and course of illness. The presence of cognitive impairment has been held to be uncommon in bipolar disorder and more likely in schizophrenia. This study explored neuropsychological function in 30 ambulatory outpatients with a DSM-III-R diagnosis of bipolar affective disorder (all of whom had been psychotic during manic episodes), comparing their performance with that of controls. These bipolar patients proved to have significant levels of diffusely represented cognitive impairment when compared with controls. Further, the degree of impairment was significantly correlated with reduction in midsagittal areas of brain structures measured on magnetic resonance imaging scans. The implications of these findings in relation to bipolar disorder are discussed.

Adult↗

PubMed1990

Leukoaraiosis in asymptomatic adult offspring of individuals with Alzheimer's disease.

The presence of white matter changes on magnetic resonance imaging (MRI), which has been referred to by Hachinski (1987) as leukoaraiosis, is frequently noted in elderly individuals in conditions ranging from health to frank dementia. This study involved the use of MRI to document cerebral structure if 41 healthy 50-60-year-old individuals, 28 of whom were offspring of Alzheimer's disease victims. On visual inspection of spin-echo images, 13 of the 28 offspring showed white matter lesions whereas all of the controls were free of leukoaraiosis. This statistically significant difference suggests that the presence of leukoaraiosis might be of importance in understanding changes in the white matter among populations at increased risk for Alzheimer's disease.

Alzheimer Disease↗

PubMed1990

Urinary excretion of metabolites of norepinephrine in Tourette's syndrome.

Urinary excretion of the norepinephrine metabolites 3-methoxy-4-hydroxyphenylethylene glycol (MHPG) and normetanephrine (NMR) was measured in Tourette's Syndrome (TS) patients and in control subjects matched for age and education. The 24-h excretion (expressed per gram of creatinine) of total MHPG and of free and total (free + conjugated) NME was significantly lower in TS patients than in the normal subjects.

Child↗

PubMed1990

Plasma amino acids in attention deficit disorder.

This study examines plasma amino acids in a group of 28 patients meeting DSM-III criteria for attention deficit disorder (ADD) and 20 control subjects. Compared with controls, the ADD subjects had significantly lower levels of phenylalanine, tyrosine, tryptophan, histidine, and isoleucine. These data suggest a general deficit in amino acid transport, absorption, or both.

Amino Acids↗

PubMed1990

Urinary amines in Tourette's syndrome patients with and without phenylethylamine abnormality.

Previous data indicated a subgroup of Tourette's syndrome patients with a beta-phenylethylamine (PEA) level that was lower than all subjects in a control group matched for age and education. The current study compared the subgroups of Tourette's syndrome patients (n = 28) from the previous study with 20 control subjects in regard to other amines and metabolites. Patients with low levels of PEA were also found to have lower levels of 3-methoxy-4-hydroxy-phenylglycol, normetanephrine, serotonin, m-tyramine, and p-tyramine. There was also some evidence of dopaminergic abnormalities in the low-PEA subgroup. These data provide suggest a role of PEA in the pathophysiology of some patients with Tourette's syndrome. This effect may be mediated through other neurotransmitter systems.

Adolescent↗

PubMed1990

Neuropsychological deficit in schizophrenic subtypes: paranoid, nonparanoid, and schizoaffective subgroups.

Schizophrenic patients were carefully diagnosed and screened for a history of neurological disorders. Diagnosis and subtyping was based on DSM-III-R criteria, using the Structured Clinical Interview for DSM-III-R, which was administered by trained interviewers and confirmed by a research psychiatrist. The schizophrenic patients were compared with an age-matched control group on an extensive battery of neuropsychological measures. The undifferentiated/disorganized schizophrenic patients were consistently the most impaired on a broad range of tasks. When the effect of symptom severity and drug level were statistically controlled (analysis of covariance), however, the magnitude and number of differences were substantially reduced. The perseverative error score from the Wisconsin Card Sort Test showed the greatest difference between the groups. However, the strongest and most consistent effects were observed in relation to symptom ratings. These data indicate the importance of controlling for medication and symptom severity, and suggest that current diagnostic classifications may not be the most useful factors for studies of the cognitive correlates of schizophrenia.

Adult↗

PubMed1990

Neuropsychological performance in children with Tourette's syndrome.

Neuropsychological performance was examined in a sample of 100 children between the ages of 6 and 18 years who met DSM-III-R criteria for Tourette's syndrome. Neuropsychological test scores were converted to age-corrected t scores based on published normative data. Ratings of Tourette's symptoms were also obtained. The mean IQ of the sample was approximately 100. Most of the subjects performed within normal limits, although approximately 20% obtained scores suggesting impairment on a summary neuropsychological performance measure. There were no differences attributable to medication effects. Later age at onset and the severity of complex tics were related to performance below normal levels on a number of neuropsychological measures. There was no specific evidence of frontal lobe dysfunction. The pattern of neuropsychological performance was virtually identical to a previously reported independent sample of patients. These data suggest a relatively characteristic pattern of neuropsychological performance abnormalities in a subgroup of patients with Tourette's syndrome. In general, most patients appear to perform within normal limits. Directions for future investigation are considered.

Adolescent↗

PubMed1990

Prevalence of the Fuld profile in temporal lobe epilepsy.

A pattern of performance on the WAIS-R presumably related to temporal lobe abnormalities associated with Alzheimer's Disease was examined in patients with focal temporal lobe EEG abnormalities to determine if the profile was related to other forms of temporal lobe disease. Among 120 patients with unilateral or bilateral temporal lobe EEG abnormalities, only 4(3%) demonstrated the profile. The presence of the profile was unrelated to laterality of EEG abnormality. These findings were discussed in regard to previous studies and the utility of the so-called Fuld profile.

Adult↗

PubMed1990

A survey of Tourette syndrome patients and their families: the 1987 Ohio Tourette Survey.

A large sample of patients (N = 763) with Tourette syndrome (TS) responded to a questionnaire dealing primarily with symptoms, treatment history, and associated disorders. The shrinking duration between symptom onset and diagnostic confirmation confirms that diagnostic awareness of TS is increasing. A significant proportion of the sample identified several common factors that occurred in the year before symptom onset. A significantly lower proportion of subjects whose initial symptoms included facial tics reported a positive response to haloperidol. Obsessive characteristics were associated with age and were more common in females. Patients with attention deficit disorder (ADD) had earlier age at onset of TS symptoms and were diagnosed earlier than patients without ADD. In general the data provide some support for a stress-diathesis model and also support previous suggestions about the genetics of Tourette syndrome and related conditions.

Adolescent↗