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W E Semple

Publications and source records attributed to W E Semple.

27 records · Page 2Linked to original sources

Cerebral glucose metabolic differences in patients with panic disorder.

Regional glucose metabolic rates were measured in patients with panic disorder during the performance of auditory discrimination. Those regions examined by Reiman and colleagues in their blood flow study of panic disorder [Nature 310:683 (1984)] were examined with a higher resolution positron emission tomography (PET) scanner and with the tracer [F-18]-2-fluoro-2-deoxyglucose (FDG). In contrast to the blood flow findings of Reiman et al., we did not find global gray metabolic differences between patients with panic disorder and normal controls. Consistent with the findings of Reiman et al. [Nature; Am J Psychiatry 143:469 (1986)], we found hippocampal region asymmetry. We also found metabolic decreases in the left inferior parietal lobule and in the anterior cingulate (trend), as well as an increase in the metabolic rate of the medial orbital frontal cortex (trend) of panic disorder patients. It is unclear whether the continuous performance task (CPT) enhanced or diminished findings that would have been noted in a study performed without task.

Acoustic Stimulation↗

Cerebral glucose metabolic rates in obsessive compulsive disorder.

Brain metabolism was measured with positron emission tomography and [18F] 2-fluoro-2-deoxyglucose in normal subjects and in patients with obsessive compulsive disorder (OCD) while they performed a continuous auditory discrimination task designed to evaluate the functional localization of sustained attention. Data on 8 nondepressed patients with OCD were compared with 30 normal volunteers. We observed significantly higher normalized regional metabolism both in the right orbital frontal cortex (p = 0.002, two-tailed t test) and in the left anterior orbital frontal cortex (p = 0.017, one-tailed t test) and in patients with OCD as compared to normal controls. We observed no normalized glucose metabolic differences in basal ganglia structures in patients with OCD as compared to our normal controls. There were no statistical differences in global glucose metabolic values between the OCD and the control group. Our findings are consistent with the findings of Baxter et al. (Arch Gen Psychiatry 44:211-218, 1987). Regions in the parietal cortex also appear to show differences in this preliminary study.

Adult↗

Evidence for common alterations in cerebral glucose metabolism in major affective disorders and schizophrenia.

Regional glucose metabolic rates were measured in affectively disordered patients during the performance of auditory discrimination. Those regions previously observed as abnormal in schizophrenia were examined to see if similar alterations might be associated with affective disorder. The abnormalities observed in the mid-prefrontal cortex, an area that appears to be an important biologic determinant of the sustained attention required of subjects in this task, are similar to those previously observed in schizophrenia. Moreover, the abnormalities do not appear to relate directly to symptomatology or the subject's performance. The authors discuss the possibility that this abnormality may reflect dysfunction in the integrating component of the attention network critical for the maintenance of goal-directed behavior and thus represent a psychosis vulnerability factor in some patients.

Acoustic Stimulation↗

The effect of neuroleptics on dysfunction in a prefrontal substrate of sustained attention in schizophrenia.

Regional brain metabolism was measured in patients with schizophrenia during the performance of auditory discrimination to evaluate the effect of neuroleptic medication on the middle prefrontal cortex, an area that appears to be an important biological determinant of the sustained attention required of subjects in this task. While unmedicated patients with schizophrenia have lower than "normal" metabolic rates in this cortical area that are unrelated to performance, patients receiving neuroleptics appear to have this metabolic deficit attenuated with higher metabolism in this area associated with greater accuracy of performance. This change occurs in the context of differential neuroleptic effects on the cortical regions of the frontal cortex, increased metabolism in the basal ganglia, thalamus and temporal lobes, and no apparent effect in the parietal and occipital cortices. The findings suggest that only part of the abnormality in the prefrontal cortex determination of sustained attention in schizophrenia is sensitive to neuroleptic treatment.

Adult↗

From syndrome to illness: delineating the pathophysiology of schizophrenia with PET.

The Section on Clinical Brain Imaging of the Laboratory of Cerebral Metabolism has been engaged in studying regional brain metabolism by positron emission tomography (PET) to establish the pathophysiology of schizophrenia. Recent studies have revealed that the fluorodeoxyglucose (FDG) PET methodology can be applied successfully to determine the anatomical substrata of directed attention. In normal controls, the metabolic rate in the middle prefrontal cortex, measured during the ongoing performance of auditory discrimination, is associated with their accuracy of performance. In unmedicated patients with schizophrenia, even those who performed as well as normals, the metabolic rate in the mid-prefrontal cortex was found to be significantly lower than normal. Further, this decreased metabolic rate was unrelated to performance. In medicated patients with schizophrenia, at least part of the metabolic deficit remains, but this deficit appears to be performance-related. These findings suggest several conclusions. The mid-prefrontal cortex and its dopamine neurotransmitter pathway input are important biological determinants of sustained attention. Two types of prefrontal metabolic deficits may contribute to dysfunctional goal-directed behavior and, more speculatively, vulnerability to psychosis in some patients with schizophrenia. One deficit is sensitive to neuroleptics, and thus presumably to a change in the balance of regional brain dopamine input. A second deficit is unaffected by neurolpetic treatment.

Brain↗

Dysfunction in a prefrontal substrate of sustained attention in schizophrenia.

Regional brain metabolism was measured in normal subjects and patients with schizophrenia while they performed an auditory discrimination task designed to emphasize sustained attention. A direct relationship was found in the normal subjects between metabolic rate in the middle prefrontal cortex and accuracy of performance. The metabolic rate in the middle prefrontal cortex of patients with schizophrenia, even those who performed as well as normals, was found to be significantly lower than normal and unrelated to performance. The findings point to a role of the mid-prefrontal region in sustained attention and to dysfunction of this region in schizophrenia.

Adult↗

Positron emission tomography.

PET is a unique tool for the direct in vivo evaluation of physiologic processes within discrete areas of the brain. Thus far, its application to the study of schizophrenia has served to confirm the subtleties of this illness. However, PET does promise to increase our knowledge of the neurochemical anatomy of the normal and abnormal mind with respect to goal-directed behavior.

Basal Ganglia↗