Search PubMed⌕ Search

Biomedical subjects

V Milstein

Publications and source records attributed to V Milstein.

At least 37 records · Page 2Linked to original sources
PubMed1987

Computerized EEG profiles of haloperidol, chlorpromazine, clozapine and placebo in treatment resistant schizophrenia.

In this paper we have described early applications of computerized EEG techniques in psychopharmacology. Perhaps our most remarkable finding was there were practically no differences between very chronic drug free schizophrenic patients and normals, which contradicts much of the EEG imaging literature. To us, the most likely explanation is that most of the anterior slowing observed in other studies was due to contamination from orbital artifacts, which we took exceptional pains to remove. Lingering effects of neuroleptic medications may also have contributed. Alternatively, EEG deviations in schizophrenia may recede when the illness reaches a very chronic stage, although this hypothesis is less tenable. There were significant differences between placebo and the three neuroleptics in terms of increased amplitudes in the delta and theta frequency bands in the anterior head regions, which is compatible with data from other studies. These changes were most pronounced with clozapine and least prominent with haloperidol, with chlorpromazine occupying an intermediate position. This order happens to parallel their relative antiserotonergic, antihistaminic and anticholinergic properties. The latter may have been partially obscured by the addition of benztropine. In a subgroup of patients who were recorded under each of the treatment conditions, there were more fast frequencies with clozapine than with the other neuroleptics agreeing with Roubicek and Major. This could be a function of clozapine's increased adrenergic activity as reported by Ackenheil. An unexpected finding was that patients who responded to clozapine had higher amplitudes in the alpha spectrum, most pronounced in the left anterior quadrant, than did the nonresponders. These differences between responders and nonresponders obtained whether patients were on placebo, haloperidol or clozapine. Curiously, Buchsbaum et al. found that anxious patients who responded to benzodiazepines also had higher alpha amplitudes in the same brain regions, which differentiated them from nonresponders. These findings clearly warrant future scientific investigation. In this regard, the generalizability of our data is limited by the extremely chronic, treatment-resistant population studied. However, promising directions for further research in EEG and psychopharmacology have been identified.

Adolescent↗
PubMed1986

Electroconvulsive treatment--indications, benefits, and limitations.

Multiple variables were examined in relation to outcome of ECT in a complete population of 261 patients treated over a four-year period. Sixty-three percent were rated as much improved. Response to ECT was not predicted by identifying data, DSM-III Axes I, II and III, Research Diagnostic Categories (RDC) or the majority of the "blind" clinical ratings and neuropsychological and EEG data. ECT response was significantly associated with DSM-III Axis IV and V, history of substance abuse and the Brief Psychiatric Rating Scale (BPRS) withdrawal-retardation factor. Ratings of psychopathology and measures of intelligence improved with ECT, more in the patients who responded favorably than in those who did not. Scores on the neuropsychological test battery were better after ECT but remained within the brain-damaged range. Schizophrenic patients received the greatest number of treatments and showed the least variability in seizure duration. Electrical energy required for seizure induction was highest in depressed patients. Bilateral electrode placement was preferred for the majority of patients.

Adolescent↗
PubMed1986

Psychosexual disturbances in multiple personality: characteristics, etiology, and treatment.

In a series of 20 patients with multiple personality, there was a 75% incidence of sexual abuse and a 55% incidence of physical abuse during childhood. Six of the 17 female patients (35%) had been raped in adolescence or adulthood. Patients were matched for age and sex with a nondissociative disorder control group. Although 55% of the multiple personality group had psychosexual disturbances, this was just barely significant when compared with the control group. Multiple personality appears to be an adaptive response to various traumata and enables the individual superficially to function sexually because sexual functioning is often dissociated and managed by an alternate personality.

Adolescent↗
PubMed1985

Manic symptoms: an indication for bilateral ECT.

As a follow-up to pilot observations that six manic patients who failed to respond to unilateral electroconvulsive therapy (ECT) recovered rapidly when switched to bilateral treatment, a retrospective study was conducted. Twenty-five patients who responded after switchover from unilateral to bilateral ECT, 25 age- and sex-matched controls, and 25 concurrent controls who responded to right unilateral ECT alone were evaluated. Demographic variables and DSM-III diagnosis did not discriminate between the groups, nor were they different in terms of electroencephalographic (EEG) findings, neuropsychological test results, numbers of ECT, and duration of seizure discharges. Standard assessments of psychopathology performed by independent psychiatrists showed no differences in ratings of psychosis or depressive phenomena. However, scales assessing manic symptoms showed highly significant differences with many more features of unrestrained behavior, elevated mood, hurried speech, and other typical features of mania in the patients who were switched from unilateral to bilateral ECT. Although there were no differences in prescribed drugs, the use of prn medications for sleep was greater in the experimental-switched patients than in controls. Patients who responded to unilateral ECT alone exhibited virtually no manic features, whereas those who demonstrated these characteristics failed to respond to unilateral ECT but benefited when switched to bilateral treatment.

Adult↗
PubMed1984

Pattern reversal evoked potentials in psychiatric patients.

Elicitation of pattern reversal evoked potentials (PREPs) was added to routine clinical EEG examinations in 100 consecutive adult psychiatric admissions. Latencies and correlations between the peaks and troughs of the triphasic complex were examined with particular reference to current hypotheses about neurophysiologic dysfunctions in schizophrenia and other psychiatric illnesses. PREP data also were examined in relation to age, sex, handedness, concurrent medications, and the clinical EEG findings. The results obtained indicated that age, sex, handedness, neuroleptic and anticholinergic medications and underlying EEG characteristics exert minimal influences upon the PREP. Schizophrenics showed lower hemispheric correlations and greater response stability than did patients with other diagnoses. No lateralized differences in relation to diagnosis were identified.

Adult↗
PubMed1984

Electroencephalographic findings in relation to diagnostic constructs in psychiatry.

A group of 759 patients with final DSM-I and -II diagnoses of schizophrenia was identified among a cohort of 1494 adults who were hospitalized between 1965 and 1972. Admission EEG recordings were done in each patient during waking, activation procedures, drowsiness, and sleep. All cases were reclassified according to the Feighner et al. criteria, and relationships between the EEG, reassigned diagnosis, and outcome were examined. One-third of the schizophrenics were rediagnosed as having affective, organic, or other disorders. EEG abnormalities predicted diagnostic change and relatively favorable prognosis. Mean alpha frequencies were slower in schizophrenics than in patients with other DSM I-II disorders, and less in patients with Feighner et al. diagnoses of schizophrenia than in some rediagnosed categories. In 1980-82, matched samples from the original cohort with affective, schizophrenic, and mixed Feighner et al. diagnoses were followed and evaluated blindly with the SADS-L. RDC follow-up diagnoses were significantly correlated with the index EEG findings in terms of higher alpha average frequencies proportional to the amount of affective psychopathology. A subgroup of high functioning individuals within the RDC schizophrenic category was identified with affective symptomatology early in the course of illness, normal EEGs, and high alpha average frequencies. Patients with a consistent diagnosis of schizophrenia according to the three nosologic systems were shown to function better in some areas if the index EEG was abnormal. Discriminant function analysis established that DSM-I and -II categories possessed the greatest long-term predictive accuracy which was enhanced by the EEG diagnosis and alpha average to a level of more than 50%. The Feighner et al. and RDC diagnostic systems were not as relevant for prediction of long-term follow-up status.

Alpha Rhythm↗
PubMed1982

EEG studies of two multiple personalities and a control.

There are few reports of EEG findings in patients with multiple personalities. In our study, EEGs were visually scanned and frequency analyzed in two patients with multiple personalities and one control. Auditory and visual evoked responses were also obtained from one of the patients and the control. The visually scanned EEGs and the evoked responses demonstrated few differences among the various personalities in each patient, whereas the frequency analysis showed the greatest number of significant differences among the "personalities" in the control. These data suggest that EEG differences among personalities in a person with multiple personalities involve intensity of concentration, mood changes, degree of muscle tension, and duration of recording, rather than some inherent difference between the brains of persons with multiple personalities and those of normal persons.

Adult↗
PubMed1982

Follow-up study of memory deficits after ECT.

Twenty-four patients received ECT induced by either alternating sine wave or brief pulsed-square wave stimulus and were evaluated at follow-up for clinical functioning and subjective memory loss. The hypothesis of less memory loss in the group receiving a weaker stimulus (pulsed-square wave) was not supported. The two treatment groups and a group of controls showed no significant differences on the memory test. On measures of clinical functioning the sine wave group scored better on every measure than the square wave group, although not significantly better.

Adult↗
PubMed1982

Changes in neuropsychological test performance after electroconvulsive therapy.

A group of 231 psychiatric patients were evaluated (with the Wechsler Adult Intelligence Scale and the Halstead-Reitan Neuropsychological Test Battery) before and after electroconvulsive therapy. Improvement during the course of therapy was shown in 96% of the measures and significant improvement (p less than 0.05) occurred in 37.5% of the measures, indicating generally improved functioning. The performance of these patients on the pre-ECT testing was generally in the range characteristic of patients with documented brain damage, but the score improved during the course of treatment to the borderline normal level.

Dominance, Cerebral↗