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Biomedical subjects

S G Diamond

Publications and source records attributed to S G Diamond.

At least 19 recordsLinked to original sources
PubMed2001

Ocular counterrolling differs in dynamic and static stimulation.

In the past, the majority of ocular counterrolling (OCR) studies were performed with subjects tilted and held statically. Studies in our laboratory have focused on dynamic rotation below the threshold of the semicircular canals. The present study compares OCR in both static and dynamic modes. Ten normal subjects, mean age 50.9 years (SD 16.2 years), underwent rotation about their naso-occipital axis to 90 degrees to the right and left, at a constant velocity of 3 degrees/s and an acceleration of 0.2 degree/s2. Subsequently, they were tilted at the same acceleration and velocity to 30 degrees, 60 degrees, 90 degrees, 60 degrees, 30 degrees and 0 degree to both sides and held in each position for 1 min. The results showed that OCR varied substantially in the two protocols. The most dramatic difference was disconjugacy in the static mode, with the two eyes differing by as much as 4 degrees, in contrast to the generally conjugate OCR in the dynamic mode. Amplitudes also tended to differ, some subjects having greater and others lesser OCR in one mode vis-à-vis the other. Possible explanations for these differences may be found in the work of Hudspeth and colleagues, who found that mechanical deflection of the bullfrog saccula resulted in gradated responses in the underlying hair cells. Further, hair cells in the process of active bending led to different responses than those in a fixed position. Possibly in humans, too, the otoconia do not maintain a fixed relation to the underlying hair cells. Additionally, this study confirms our earlier finding of independent control in the two eyes.

Acceleration↗
PubMed2000

Parabolic flight reveals independent binocular control of otolith-induced eye torsion.

To examine otolith-governed ocular torsion in hyper- and hypogravity, eight subjects, including two astronauts, underwent parabolic flight while seated upright with head fixed. A mask fitted with two video cameras provided synchronized images of both eyes at a rate of 25/sec during 15 parabolas, the individual parabolas separated by a few minutes of level 1 G flight. Three main findings emerged: 1) After the first parabola, most subjects showed differential torsional offset of the two eyes in the 1 G portions between parabolas, compared to the conjugate baseline position of the eyes prior to the first parabola. 2) Changes in binocular torsion in the 0 G and 1.8 G portions of parabolic flight revealed in most subjects systematic reversal of direction. The reversal was consistent within, but not across subjects. 3) Disconjugacy defined as the moment-to-moment difference in the movements of the two eyes, and evaluated without the contribution of the differential offset, found two subjects with relatively high disconjugacy scores, and the remaining six with low scores. On the basis of prior studies (9, 20), we would predict the first two would be subject to SMS, the remainder not. The two astronauts, who did not have SMS on their space missions, fell into the low scoring group. We propose that the disconjugacies may be due to intrinsic asymmetries in the otolith receptors on the two sides of the head, which appear to be independently linked to the extraocular muscles of the two eyes, a phenomenon masked in normal 1 G states by adaptation. The apparently independent control of the two sides cannot be detected by the simpler and more common monocular studies.

Acceleration↗
PubMed1994

Four-year follow-up of adrenal-to-brain transplants in Parkinson's disease.

OBJECTIVE: Evaluate long-term efficacy of autologous adrenal-to-caudate transplants in idiopathic Parkinson's disease refractory to medical treatment. DESIGN: Subjects underwent evaluations several times preoperatively on the University of California-Los Angeles Parkinson's Disease Disability Scale and the Hoehn and Yahr stage of disease. Postoperatively, they were also repeatedly rated on the Unified Parkinson's Disease Rating Scale. SETTING: Clinical visits and surgery took place at the University of California-Los Angeles Center for the Health Sciences. PATIENTS: Three men and one woman, ages 44 to 55 years, were followed up for several years preoperatively. At surgery, disease durations ranged from 7 to 16 years. Originally, all patients had a good response to levodopa, but for several years preoperatively, they had had fluctuating responses and a short duration of drug action. INTERVENTION: Right adrenalectomy was performed through a midline abdominal incision. Open craniotomy exposed the head of the right caudate into which pieces of adrenal medulla, 1 to 2 mm in size, were implanted. MAIN OUTCOME MEASURES: Scores on the three major scales (see "Design") were augmented with the number of hours "off" per day and severity of abnormal involuntary movements. Disease progression of each patient was compared with his own preoperative course and with those of a cohort of patients with Parkinson's disease followed up for 14 years who had received medical treatment without transplant surgery. RESULTS: After 4 years, transplants continued to be beneficial to three patients and had been of brief transient benefit to the fourth. The course of disease was more benign postoperatively than preoperatively and was more slowly progressive than that in the cohort. CONCLUSION: Improvement was not sufficient to justify adrenal transplants as routine therapy but does point the way to the use of other dopamine tissue transplantation.

Adrenal Cortex↗
PubMed1994

Transplantation of fetal mesencephalic tissue in Parkinson's patients.

Patients with idiopathic Parkinson's disease who had become refractory to medical treatment underwent unilateral stereotactic transplantation of mesencephalic tissue obtained from 7- to 9-week-old postconception fetuses. Small pieces of tissue, less than 1 mm, were deposited in 9 sites in the putamen and 3 in the caudate. Patients were 4 men and 3 women and aged from 42 to 59 years (mean 50). Symptom durations were from 9 to 21 years (mean 14). The examinations were done at 3- to 4-month intervals pre- and postoperatively. Patients were examined for a minimum of 1 year postoperatively. The examinations consisted of neurological and general physical examinations, UCLA Parkinson's Disability Scale, Hoehn and Yahr rating and United Parkinson's Disease Rating Scale (PDRS), all in both 'on' and 'off' states. Video recordings and timed tests of a number of motor tests were performed. Patients also completed 7 consecutive days of hourly self-assessments prior to each visit. Fluorodopa PET scans were obtained pre- and 6 and 15 months postoperatively. The operations took place from mid-July 1992 to January 1993. Postoperative states have been free of complications. All have been on immunosuppressants. Levodopa was transiently decreased in the postoperative period, but raised to approximately the preoperative level thereafter. In late March 1993, 3 patients appeared to show modest improvement in the UCLA and UPDRS scales and in the patients' self-assessments.

Adult↗
PubMed1993

A predictive test for space motion sickness.

Eye torsion was examined in 13 astronaut subjects, tested during repeated episodes of 0 G and 1.8 G in parabolic flight aboard NASA's KC-135. Four findings are included. 1) A strong relationship between previous history of SMS and ocular torsional disconjugacy in novel gravitational states. 2) Responses were unchanged in 4 subjects retested a year later. 3) Ocular torsional disconjugacy scores increased as exposure to 0 and 1.8 G increased. This was particularly evident in subjects who had had SMS. 4) Torsional studies during 10 to 20 parabolas are required to accurately predict SMS. The hypothesis of otolith asymmetry, compensated in 1 G but becoming unmasked in novel gravitational states, is proposed to explain the torsional disconjugacy and ensuing SMS.

Eye Diseases↗
PubMed1992

Ocular torsion as a test of the asymmetry hypothesis of space motion sickness.

Disconjugate eye torsion induced by 0 G and 1.8 G during parabolic flight was studied in nine former astronauts in 1990 and eight in 1991, four of whom were included in the previous experiment. The astronauts could be divided into two statistically significant groups on the basis of low and high scores of disconjugacy. When their histories of space motion sickness (SMS) were later revealed, all of the low scorers had not been sick on previous space flights; all the high scorers had had SMS. These data give support to the hypothesis that SMS in one-half or two-thirds of astronauts is due to an otolith, probably utricular, asymmetry in those persons.

Eye Diseases↗
PubMed1992

Further evidence to support disconjugate eye torsion as a predictor of space motion sickness.

Disconjugate eye torsion in hypo- and hypergravity of parabolic flight was examined in four former astronauts and four previously tested ex-astronauts to replicate an earlier study and to further test the asymmetry hypothesis of otolith function. Results in the new subjects supported the asymmetry hypothesis and confirmed previous findings that those with low scores of torsional disconjugacy on the KC-135 did not suffer space motion sickness in their prior Shuttle missions while those with high scores did. Tilting subjects with high disconjugacy scores slightly to one side and the other failed to find a position that decreased disconjugacy in hypergravity, leading to the conclusion that a simple planar asymmetry about the y-axis was probably not the cause of the observed torsional differences in the two eyes. Disconjugacy increased at 0 G with increasing parabolas, much more so in subjects who had suffered SMS. Because of this, 10 to 20 parabolas were deemed to be a more certain discriminator than a fewer number.

Aerospace Medicine↗
PubMed1991

Prediction of space motion sickness susceptibility by disconjugate eye torsion in parabolic flight.

The hypothesis of asymmetric otolith function asserts that physiological or anatomical differences in the two sides of the bilateral gravity-sensing otolith apparatus of the inner ear may be well compensated on Earth, but when exposed to novel gravitational states, the prior compensatory stratagems may be ineffective, leading to unstable vestibular responses and causing the phenomenon of space motion sickness. To investigate this hypothesis, spontaneous eye torsion, a reflex governed by the otolith organs, was examined in the upright position during the hypo- and hypergravity of parabolic flight aboard NASA's KC-135 aircraft in nine former astronauts whose history of space motion sickness was revealed after data analysis had been completed. Results showed that astronauts who had been sick in space had significantly higher scores of disconjugate eye torsion in parabolic flight, and that their responses were consistently different in 1.8 G relative to 0 G compared to astronauts who had not been sick in space. In 1 G, there were no differences in disconjugate eye torsion between the subjects. The results support the asymmetry hypothesis and offer a possible predictive test of space motion sickness.

Disease Susceptibility↗
PubMed1990

An examination of male-female differences in progression and mortality of Parkinson's disease.

We conducted disability and mortality studies to determine if the male preponderance usually found in Parkinson's disease (PD) was reflected in different courses of the diseases in the 2 sexes. We analyzed longitudinal disability score in 47 men and 23 women with PD followed for 6 years at UCLA. We found no significant differences between the sexes in mean disability scores in any of the 6 years. Mean dopa dosage was significantly higher in men, possibly reflecting their generally larger body mass. Choreoathetosis, dementia, or other side effects did not differ between the 2 groups. We obtained observed to expected mortality ratios in 239 men and 132 women followed for 3,831 person-years from records of 4 medical centers. Using the sex-specific US Life Tables to calculate expected mortality, we found the observed to expected ratio for the men was 1.7457 and for the women 2.4740, a significantly greater excess in female mortality. Analyses of mortality using tables which are not sex-specific will fail to uncover the decreased longevity in women with PD. We conclude that, despite the male preponderance in PD, men and women acquire it at the same age, have the same progression and duration of disease, and die at the same age; whereas, in the general population, women have a longer life expectancy than men. It is not known what factors protect women from incurring PD and what lowers their life expectancy to that of men when they do have the disease.

Disability Evaluation↗
PubMed1990

Instability of ocular torsion in zero gravity: possible implications for space motion sickness.

Inherent asymmetries of the gravity-sensitive otolith organs of the inner ear may be well-compensated in ordinary 1 G, but rendered unstable in novel gravitational states. Several aspects of ocular counterrolling and spontaneous eye torsion, reflexes governed by the otoliths, were examined during the hypo- and hypergravity in parabolic flight on the NASA KC-135 aircraft. Among the subjects were two astronauts, one who had suffered space motion sickness during his mission and one who had not. Using an observed separation of scores of torsional instability at 0 G as the criterion, we divided our 10 subjects into the 5 highest and 5 lowest scorers, reminiscent of the approximately 50% who do and the 50% who do not experience space motion sickness (SMS). The astronaut who had had SMS was in the high group; and the one who had not was in the low group. At 1.8 G, the groups defined at 0 G were significantly different in the instability measure. They were also significantly different at both 0 G and 1.8 G in another measure, that of torsional variability. There were no differences between the groups in amplitude of eye torsion in 0 G or 1.8 G. None of the tests were significantly different in 1 G. The results suggest that these tests of eye torsion on the KC-135 might differentiate those who would experience SMS from those who would not. Proof of this speculation awaits replication of the study using only astronaut subjects.

Gravitation↗
PubMed1989

Effect of age at onset on progression and mortality in Parkinson's disease.

We examined longitudinal disability scores in 54 patients with Parkinson's disease followed for 6 years at UCLA. We sorted data into 3 groups based on age at onset of symptoms: group A, onset under 50 years; group B, 50 to 59 years; group C, 60 years or older. There were no significant differences between groups initially. All 3 groups improved dramatically when levodopa was given, but group A showed significantly less disability in years 4, 5, and 6 than did group C. The groups did not differ with respect to side effects. To determine if age at onset affected mortality, we sorted records from 4 geographically diverse centers into the same 3 groups. Results on 359 patients followed for 3,314 person-years, covering a period of 17 years after onset of symptoms, showed that group A had the most favorable observed-to-expected mortality ratio, 1.82, compared with 2.17 and 2.20 for groups B and C respectively, but the difference was not statistically significant. Results from the disability analyses indicate that patients with onset of Parkinson's disease under 50 years of age may have a more favorable prognosis than those whose symptoms begin in later years.

Aging↗