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Biomedical subjects

R C Gur

Publications and source records attributed to R C Gur.

At least 109 records · Page 6Linked to original sources

Gender differences in the clinical expression of schizophrenia.

Gender differences have been reported for a variety of clinical measures in patients with schizophrenia. Clinical characterization may be helpful in identifying symptom clusters which can then be linked to underlying brain function. In this study 74 men and 33 women meeting DSM-IIIR criteria for schizophrenia were studied off medication and rated on measures of symptom type and severity, as well as premorbid and current function. Men were more severely impaired in ratings of negative symptoms, while positive symptoms were not significantly different. There were also differences in premorbid and current functioning, with women manifesting better social functioning than men.

Activities of Daily Living↗

Decreases in frontal and parietal lobe regional cerebral blood flow related to habituation.

We previously reported decreased mean CBF between consecutive resting conditions, ascribed to habituation. Here we address the regional specificity of habituation over three consecutive flow studies. Regional CBF (rCBF) was measured in 55 adults (12 right-handed men, 12 right-handed women, 14 left-handed men, 17 left-handed women), with the 133Xe inhalation technique, during three conditions: resting, verbal tasks (analogies), and spatial tasks (line orientation). Changes in rCBF attributable to the cognitive tasks were eliminated by correcting these values to a resting equivalent. There was a progressive decrease in mean rCBF over time, reflecting habituation. This effect differed by region, with specificity at frontal (prefrontal, inferior frontal, midfrontal, superior frontal) and inferior parietal regions. In the inferior parietal region, habituation was more marked in the left than the right hemisphere. Right-handers showed greater habituation than did left-handers. There was no sex difference in global habituation, but males showed greater left whereas females showed greater right hemispheric habituation. The results suggest that habituation to the experimental setting has measurable effects on rCBF, which are differently lateralized for men and women. These effects are superimposed on task activation and are most pronounced in regions that have been implicated in attentional processes. Thus, regional decrement in brain activity related to habituation seems to complement attentional effects, suggesting a neural network for habituation reciprocating that for attention.

Adult↗

Phenomenology and functioning in first-episode schizophrenia.

One current view of schizophrenia is that its clinical and functional features show a deteriorating course, particularly for negative symptoms. However, this is difficult to study in chronic patients who have been exposed to pharmacologic treatment and institutionalization. Examining first-episode (FE) patients can help clarify which symptoms are present initially and how the symptom pattern is linked to functioning. We evaluated a sample of 37 FE patients with schizophrenia and compared them to 70 other schizophrenia (OS) patients on standard clinical scales, measures of premorbid functioning, and quality of life. FE patients showed a symptom profile similar to OS patients; in particular, there was no evidence that negative symptoms are less severe in the FE group. Analysis of the clinical data led us to the conclusion that the symptom profile of schizophrenia exists at the outset, that negative symptoms are associated with poor premorbid and current functioning, but that the role of positive symptoms is more complex and may vary in subtypes.

Adult↗

Memory in a case of bilateral thalamic infarction.

The role of individual structures within the diencephalon for memory functioning is unknown. We present anatomic localization of lesions and a longitudinal neuropsychological profile of a young man who had a bilateral diencephalic stroke in the interpeduncular profundus arterial territory. MRI localized the lesions to the mamillothalamic tracts and inferior thalamic peduncle. The amnesia was characterized by severe impairment in explicit recall of new facts and events, while word-completion priming and remote memory were intact. We suggest that the memory deficit results from a disconnection of the diencephalon from the medial temporal region.

Adult↗

Midlatency auditory evoked responses in schizophrenia.

The auditory evoked component P50 has been reported as having an abnormal recovery cycle in patients with schizophrenia. Recent studies examining the effects of stimulus rate on the midlatency response (MLR) component P1, found P1 recovery cycles in normals similar to P50. This study examined the P1 recovery cycle in patients using a rate protocol and MLR recording procedures. MLRs were recorded from 13 controls and 13 patients with schizophrenia in response to binaurally presented clicks presented at three stimulus rates: 0.9/sec, 5.1/sec, and 9.9/sec. The P1 (50-70 msec latency) in patients did not decrease as much in amplitude as in controls at the 9.9/sec stimulus rate. This lack of recovery was correlated with clinical ratings of symptomatology. Since evidence from both the human and the cat model suggests that the P1 is generated in thalamus, these findings are consistent with reports of thalamic dysfunction in schizophrenia.

Adolescent↗

Gender differences in age effect on brain atrophy measured by magnetic resonance imaging.

A prospective sample of 69 healthy adults, age range 18-80 years, was studied with magnetic resonance imaging scans (T2 weighted, 5 mm thick) of the entire cranium. Volumes were obtained by a segmentation algorithm that uses proton density and T2 pixel values to correct field inhomogeneities ("shading"). Average (+/- SD) brain volume, excluding cerebellum, was 1090.91 ml (+/- 114.30; range, 822.19-1363.66), and cerebrospinal fluid (CSF) volume was 127.91 ml (+/- 57.62; range, 34.00-297.02). Brain volume was higher (by 5 ml) in the right hemisphere (P less than 0.0001). Men (n = 34) had 91 ml higher brain and 20 ml higher CSF volume than women (n = 35). Age was negatively correlated with brain volume [r(67) = -0.32, P less than 0.01] and positively correlated with CSF volume (r = 0.74, P less than 0.0001). The slope of the regression line with age for CSF was steeper for men than women (P = 0.03). This difference in slopes was significant for sulcal (P less than 0.0001), but not ventricular, CSF. The greatest amount of atrophy in elderly men was in the left hemisphere, whereas in women age effects were symmetric. The findings may point to neuroanatomic substrates of hemispheric specialization and gender differences in age-related changes in brain function. They suggest that women are less vulnerable to age-related changes in mental abilities, whereas men are particularly susceptible to aging effects on left hemispheric functions.

Adult↗

Neuropsychological function in schizophrenia. Selective impairment in memory and learning.

Unmedicated schizophrenic patients (according to DSM-III-R criteria) (n = 36) and age-matched normal controls (n = 36), balanced for parental socioeconomic status, were administered a battery of standardized neuropsychological tests. Patients showed generalized impairment relative to controls and a selective deficit in memory and learning compared with other functions. Selective impairment was not found on tests related to frontal system function (abstraction, verbal fluency, and motor). The observed pattern is consistent with greater involvement of the temporal-hippocampal system, against the background of diffuse dysfunction. Although impairment in memory and learning has been reported, the selectivity and relative severity compared with other behavioral functions have not been recognized. The specificity of this profile merits further examination. These findings lend support to the hypothesized importance of the temporal-hippocampal region in understanding the pathophysiology of schizophrenia.

Adult↗

Volunteers for biomedical research. Recruitment and screening of normal controls.

We examined the process of accruing healthy control subjects for biomedical research on brain function. Of 1670 responders to newspaper advertising, 23.1% were uninterested when learning more about the studies, and 50.9% of those remaining were found by structured telephone screening to meet exclusionary criteria for having a history of psychiatric, neurologic, or medical disease that might affect brain function. Of 312 volunteers passing the telephone screening who came to an in-person evaluation by a physician and agreed to participate, 49.7% were found to meet exclusionary criteria, and only 157 were admitted to the study. This underscores the importance of attending to the issue of screening and assessment of "normal volunteers." Alternative strategies should be considered for enriching the pool.

Adult↗

Acute effect of anterior temporal lobectomy on musical processing.

Patients with intractable epilepsy treated by anterior temporal lobectomy (Right, RT, n = 12; Left, LT, n = 9) and healthy controls (n = 12) with no musical training were prospectively evaluated with a standardized battery, including the Musical Aptitude Profile and the Seashore Tonal Memory Test. Before surgery, patients performed below controls (P less than 0.001), but there were no differences between RT and LT patients. After resection (2 weeks), RT patients showed a differential decline on tasks measuring perception of meter (P = 0.005) and tempo (P = 0.008) but not tonal processes. LT, and controls studied at the same time interval, showed no decline. The results support the role of the right hemisphere in specific aspects of musical processing.

Adult↗

Analysis of brain and cerebrospinal fluid volumes with MR imaging. Part I. Methods, reliability, and validation.

A computerized system was developed to process standard spin-echo magnetic resonance (MR) imaging data for estimation of brain parenchyma and cerebrospinal fluid (CSF) volumes. In phantom experiments, the estimated volumes corresponded closely to the true volumes (r = .998), with a mean error less than 1.0 cm3 (for phantom volumes ranging from 5 to 35 cm3), with excellent intra- and interobserver reliability. In a clinical validation study with actual brain images of 10 human subjects, the average coefficient of variation between observers for the measurement of absolute brain and CSF volumes was 1.2% and 6.4%, respectively. The intraclass correlations for three expert operators is greater than .99 in the measurement of brain and ventricular volumes and greater than .94 for total CSF volume. Therefore, the authors believe that their technique to analyze MR images of the brain performed with acceptable levels of accuracy and reliability and that it can be used to measure brain and CSF volumes for clinical research. This technique could be helpful in the correlation of neuroanatomic measurements to behavioral and physiologic parameters in neuropsychiatric disorders.

Algorithms↗

Relations among clinical scales in schizophrenia.

OBJECTIVE: Clinical scales have become established as tools to quantify phenomenological features of schizophrenia. The goal of this study was to examine relations among the following: the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the deficit-nondeficit classification. METHOD: Forty-seven patients with schizophrenia were recruited according to specific inclusion and exclusion criteria. The standardized assessment procedures were administered by a trained psychiatric research team. RESULTS: Examination of the BPRS showed that the patients had highest scores on the thought disorder factor and the symptoms specific to schizophrenia. Classification of patients as having the positive, negative, or mixed type of schizophrenia resulted in a finding of seven with the positive, seven with the negative, and 33 with the mixed type. The division of patients into those with the deficit syndrome (N = 29) and those without (N = 18) was related to symptom specificity and to positive and negative symptoms. Deficit syndrome patients had more symptoms specific to schizophrenia, fewer nonspecific symptoms, and, as expected, greater severity of negative symptoms. Cluster analysis revealed three clusters of patients: those with low negative symptom scores and high scores on specific symptoms (the majority were without the deficit syndrome); those with high scores on negative, positive, and specific symptoms (the majority had the deficit syndrome); and those with lower scores on specific symptoms and high scores on negative and positive symptoms (the majority had the deficit syndrome). CONCLUSIONS: The scales showed some overlap but also seemed to measure complementary aspects of the phenomenology of schizophrenia. Subtypes of patients identified by the combined use of these scales may differ in underlying pathology.

Cluster Analysis↗

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↗

Gender differences in regional cerebral blood flow.

Gender differences have been noted in neurobehavioral studies. The 133xenon inhalation method for measuring regional cerebral blood flow (rCBF) can contribute to the understanding of the neural basis of gender differences in brain function. Few studies have examined gender differences in rCBF. In studies of normal subjects, women have higher rates of CBF than men, and this is related to age. Usually by the sixth decade men and women have similar flow rates. Fewer studies on rCBF in schizophrenia have examined sex differences. The pattern of higher flows for females maintains, but its correlates with gender differences in clinical as well as other parameters of brain function remain to be examined.

Adult↗

Neurobehavioral studies in schizophrenia: implications for regional brain dysfunction.

The application of neurobehavioral methods to the study of brain function in schizophrenia can provide useful information on the neurobiology of schizophrenia. Standard neuropsychological batteries were designed to assess behavioral correlates of regional brain function. Methodological considerations in the application of these tests to schizophrenia are discussed. Although there is considerable evidence for both frontal and temporal lobe dysfunction in schizophrenia, the field is likely to advance further through the systematic study of brain function. A combination of neurobehavioral and physiological data obtained simultaneously is a promising avenue to pursue, and the behavioral imaging method is presented as an example of one approach to data integration.

Algorithms↗

Acute naming deficits following dominant temporal lobectomy: prediction by age at 1st risk for seizures.

Age at 1st risk for seizures may predict anomia following dominant anterior temporal lobectomy. We assessed confrontation naming before and 2 to 3 weeks after surgery in 45 right-handed patients grouped by side of focus and presence or absence of early (less than or equal to 5 years) risk factors. After left lobectomy, 6 of 10 (60%) patients with no early risks demonstrated significant decline (greater than or equal to 25%) in naming, but none of the patients with early risks showed this decline. After right lobectomy, there was no change. Cerebral representation of naming may be atypical in patients with early risks.

Aging↗

Topographic mapping of cerebral blood flow and behavior.

This paper describes the methods for presenting (i) scores obtained by a subject in neuropsychologic tests as a map of the brain by assigning the various scores to those regions or areas of the brain where the specific function is supposed to be localized and (ii) similar maps of the regional cerebral blood flow measured by the extra-cranial detectors. The maps so produced can be displayed as top or side view topographic images. These imaging methods enable the user to comprehend large arrays of numbers in a readily interpretable manner, and will be useful in identifying the brain activity patterns associated with various neurological and psychiatric disorders. The methods described here also present an opportunity to integrate the behavioral information with anatomical and physiological data obtained using various neuro-imaging techniques.

Algorithms↗

The effects of right and left hemiparkinsonism on prosody.

Recent studies show right hemisphere dominance in the mediation of emotional prosody and left hemisphere contribution to linguistic prosody in patients with cortical injury. The present study investigated emotional and linguistic functions of prosody as well as facial and musical processing in 21 patients with lateralized subcortical disease. Fourteen right hemiparkinsonians (RPD) and 7 left hemiparkinsonians (LPD) were compared to 17 normal controls (NC). Patients were impaired on receptive and expressive tests of emotional and linguistic prosody. Patients were also selectively impaired on emotional processing of facial stimuli and in the musical processing of pitch and tonal memory, though not timber. These findings suggest that monotone speech reported in PD is of multimodal origins and may involve dysfunction in neural centers involved in emotional and linguistic processing. There were no differences between RPD and LPD groups in the pattern of deficits, suggesting bilateral involvement in emotional processing at the subcortical level.

Cerebral Cortex↗