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Biomedical subjects

W W Beatty

Publications and source records attributed to W W Beatty.

At least 37 records · Page 2Linked to original sources

Coping with general and disease-related stressors by patients with multiple sclerosis: relationships to psychological distress.

This study examined the relationships between coping styles and psychological distress in a non-institutionalized sample of individuals with multiple sclerosis (MS). The MS sample completed a measure of psychological distress and identified coping strategies utilized for stressors that were disease-related and general in nature. They also self-reported their perceived efficacy of the coping strategies utilized for both stressors. Individuals with MS exhibited greater levels of depression and their indices of psychological distress than demographically matched controls but the patterns of coping strategies endorsed and the ratings of coping effectiveness were similar for the two groups. When coping with disease-related stressors, individuals with MS utilized coping strategies that were more emotion-focused and dependent but no less effective than when the same patients coped with general stressors. Within the MS group, high levels of psychological distress were positively correlated with the use of emotion-focused coping strategies, but were unrelated to the use of problem-focused strategies. Most individuals with MS individuals with MS appear to be able to modify their coping strategies to adopt to varying sorts of stressors.

Adaptation, Psychological↗

Expression of game-related and generic knowledge by dementia patients who retain skill at playing dominoes.

Patients with dementia who remain skilled at musical performance or playing bridge fail explicit memory tests for information related to their skills, suggesting that implicit memory mediates their preserved skills. To reexamine this issue, 23 dementia patients and 15 elderly controls of comparable domino-playing skill were compared on tests of naming, verbal fluency, and domino knowledge. On an explicit test of domino knowledge, the patients scored well below the elderly controls, performing no better than students who were unfamiliar with the game. But when game-like situations were created with real dominoes, both the skilled controls and the patients with dementia chose optimal moves and verbally explained their choices equally well. On naming and fluency tests, the skilled patients showed no advantage over patients of comparable dementia severity who had no retained skill. In dementia, some complex knowledge seems intact but is accessible only in particular contexts.

Aged↗

Free radical production during ethanol intoxication, dependence, and withdrawal.

Indices of free radical production and cell damage were examined in male Sprague-Dawley rats chronically exposed to either ethanol (ETOH) or water vapor. In experiment 1, rats experienced either 1 or 11 cycles of ETOH exposure and withdrawal. Brain tissue was harvested 12 hr after ETOH exposure, and 1 hr after being injected with sodium salicylate as a scavenger. Brain tissue was analyzed for the formation of salicylate hydroxylation products as a measure of .OH production during withdrawal. Significant group differences for .OH production were demonstrated for 2,3- and 2,5-dihydroxybenzoic acid in the single cycle ETOH exposed rats compared with their water cohorts. A significant between group difference for 2,5-dihydroxybenzoic acid, only, was demonstrated for the multiple cycles of ETOH exposure. Spontaneous seizures were shown to correlate with increased production of .OH in ETOH exposed rats. In experiment 2, brain tissue was harvested from different groups of rats after removal from the chambers, at 0, 2, 12, 24, 36, and 48 hr after a single exposure cycle. Tissue was analyzed for (1) salicylate hydroxylation (as above), (2) glutamine synthetase activity, (3) whole brain glutamate concentration, and (4) oxidized protein. A multiple regression analysis was conducted on the five dependent variables and found they could be predicted by specific behavioral and neurological ratings. These data suggest that cell damage during withdrawal may have multiple time-dependent components.

Alcohol Withdrawal Delirium↗

Autobiographical memory in multiple sclerosis.

Studies have consistently found that patients with multiple sclerosis (MS) are impaired on tests of anterograde memory, but the status of remote memory in MS remains unclear. To better understand remote memory in MS we administered the Autobiographical Memory Interview (AMI) to 44 MS patients and 19 normal controls matched for age, education, and gender. Additionally, a shortened version of the Famous Faces Test, a test of recall of past U.S. presidents, and a 14-word learning list were administered. Patients performed significantly lower than controls on the learning list and Famous Faces Test, but not on recall of past presidents. On the AMI, patients were significantly impaired on recall of semantic but not of episodic memories. These results indicate that MS patients exhibit retrograde amnesia that cannot be attributed to anterograde memory deficits or lack of exposure to task-relevant information.

Adult↗

Problem solving by patients with multiple sclerosis: comparison of performance on the Wisconsin and California Card Sorting Tests.

Problem solving by patients with clinically definite multiple sclerosis (MS) was examined using the Wisconsin and California Card Sorting Tests (WCST and CCST). On the WCST, the MS patients achieved fewer categories and made more perseverative responses and errors than controls, confirming results of several previous studies. On the CCST, the MS patients generated and identified fewer concepts, but they performed normally when sorting was cued by the experimenter and they made no more perseverations than controls. Although findings from the WCST indicate that the problem solving deficits by MS patients closely resemble those exhibited by patients with various conditions that produce frontal lobe dysfunction, results from the CCST indicate that the problem solving difficulties exhibited by patients with MS are distinct and probably represent a primary deficit in concept formation.

Adult↗

Further validation of constructs from the selective reminding test.

The Selective Reminding Test (SRT) partitions recall into three classes. Short-Term Recall (STR), Random Long-Term Recall (RLTR), and Consistent Long-Term Recall (CLTR). Examination of conditional probabilities of delayed recall or recognition of individual words as a function of their memory status at the end of a standard 12-word, 12-trial test showed that Buschke's (1973) operational definitions of STR, RLTR, and CLTR have excellent predictive validity.

Adult↗

Memory disturbance in multiple sclerosis: reconsideration of patterns of performance on the selective reminding test.

Comparison of the average performance by 99 patients with multiple sclerosis (MS) and 32 healthy controls on the Selective Reminding Test (SRT) suggested that the patients' memory deficits arose primarily from difficulties in retrieving information from long-term storage. However, six different cluster analysis methods indicated three distinct patterns of SRT performance by patients, emphasizing the heterogeneity of memory function in MS. Approximately 25% of the patients performed normally while about 22% exhibited a severe amnesia-like disturbance. The remaining patients (53%) showed mild to moderate memory impairments, but only two patients met strict operational criteria for "pure retrieval failure".

Adult↗

Visuospatial perception, construction and memory in alcoholism.

OBJECTIVE: To analyze visuospatial cognition in recently detoxified alcoholics from the perspectives of three ways of conceptualizing spatial information processing: egocentric versus allocentric orientation, featural versus configural analysis, and categorical versus coordinate spatial judgements. METHOD: Twenty-eight chronic alcoholics (19 men, 9 women) were compared to 20 (10 men, 10 women) controls of comparable age and education on a battery of tests of visuospatial scanning, construction, mental imagery, and anterograde and remote spatial memory. Tests were administered 21-40 days after alcoholics entered treatment. RESULTS: Alcoholics displayed impairment in visuospatial scanning, construction, utilizing and manipulating information from visual images and on three tests of anterograde spatial memory, but remote spatial memory was not significantly affected. Their deficits were evident on some measures of allocentric orientation, featural and configural analysis, but consistent deficits on egocentric orientation or categorical or coordinate spatial judgments were not seen. CONCLUSIONS: Deficits in spatial cognition exhibited by alcoholics do not seem to arise from dysfunction in any localized brain region. Small but potentially important impairments in fundamental aspects of spatial information processing such as scanning and use of visual imagery were found. The empirical basis and clinical significance of these deficits requires further study.

Adult↗

Cognitive therapy for multiple sclerosis: a preliminary study.

BACKGROUND: Drug treatments for multiple sclerosis are expensive, may cause side effects, and do not have demonstrated efficacy for cognitive deficits associated with this disease. OBJECTIVE: To test the effectiveness of a multimodal cognitive therapy on cognitive and physical measures known to be affected in multiple sclerosis. DESIGN: Quasi-experimental wait-list control. SETTING: Alternative medicine clinic. PATIENTS: 27 persons with clinically definite multiple sclerosis. INTERVENTION: Multimodal cognitive therapy. MAIN OUTCOME MEASURES: Neuropsychological measures of verbal learning and memory, abstraction, vocabulary, and information processing speed; Beck Depression Inventory; tactile sensitivity of the hands; grip strength; and visual acuity. MAIN RESULTS: 12 of 14 patients in the therapy group and 10 of 13 patients in the control group completed 24 weeks of treatment and all assessments. Patients who received therapy showed significantly greater improvement in verbal learning, verbal abstraction, depression, and some measures of grip strength and tactile sensitivity than did patients in the untreated control group. The groups did not differ in the magnitude of change on vocabulary, information processing speed, or visual acuity. CONCLUSION: Cognitive therapy appears to be a promising treatment for ameliorating some symptoms of multiple sclerosis. A larger study with a randomized design and additional outcome measures is warranted.

Adult↗

Neuropsychological performance of recently abstinent alcoholics and cocaine abusers.

To examine possible influences of premorbid and comorbid factors on the neuropsychological test performance of recently abstinent (3-5 weeks) drug abusers, we studied 24 alcoholics, 23 cocaine abusers, and 22 healthy controls of comparable age and education. Both alcoholics and cocaine abusers performed significantly more poorly than controls on most measures of learning and memory, problem solving and abstraction and perceptual-motor speed, but the groups did not differ on the measure of sustained attention. Correlational analyses revealed no significant relationships between measures of childhood and residual hyperactivity and neuropsychological performance; scores on the Beck Depression Inventory were related only to performance on the Wisconsin Card Sorting Test. The findings indicate that abuse of cocaine or alcohol is associated with deficits on neuropsychological tests which cannot be attributed to specific premorbid or comorbid factors such as depression or childhood or residual attention deficit disorder.

Adult↗

Patterns of cognitive impairment among alcoholics: are there subtypes?

The mild generalized dysfunction hypothesis of alcohol abuse's deleterious effects on cognitive processes has gained support from a number of studies in which detoxified alcoholics have a lower mean performance level than peer controls on a variety of neuropsychological tests. This approach might obscure consistent but different patterns of preserved and impaired cognitive performance among subgroups of alcoholics, suggestive of alternative hypotheses. To test this possibility, neuropsychological test data from two large, independent samples of alcoholics (sample 1, n = 143; sample 2, n = 130) and controls (sample 1, n = 97; sample 2, n = 83) were subjected to separate centroid hierarchical cluster analyses. For both samples, the majority of alcoholics (94% and 94%) exhibited a pattern of impaired verbal and nonverbal performance and deficits in memory and perceptual motor skill, with normal motor skill. The alcoholics who did not fit this pattern showed more severe or wide-ranging impairments. These findings indicate that empirical support for the mild generalized dysfunction hypothesis of alcoholics' cognitive deficits is not an artifact of averaging.

Adult↗

Memory deficits in a demented patient with probable corticobasal degeneration.

Anterograde and retrograde amnesia in a patient with probable corticobasal degeneration (pCBD) and dementia were studied in a university medical center setting. The patient with pCBD and four comparison patients of comparable global mental status (Mini-Mental State Exam) who met NINCDS-ADRDA criteria for Alzheimer's disease (AD) were included. Standard neuropsychological tests of naming, intelligence, achievement, verbal fluency, anterograde and remote verbal and visuospatial memory, and motor skill learning were given. The pCBD patient exhibited a progressive asymmetric akinetic-rigid syndrome, which was unresponsive to Sinemet. His initially mild, intellectual deficits consisted of apraxia, slowed speech, and word-finding and memory difficulties. Over a 2-year period, a dementia syndrome developed, which involved more-serious deficits in praxis and naming, as well as impairments in spelling, calculation, verbal fluency, IQ, anterograde verbal and visuospatial memory, and motor skill learning. When tested by recall methods, the pCBD patient exhibited marked deficits on several tests of remote memory; however, on recognition testing, he performed normally on the Famous Faces Test and on a test of geographical knowledge, which measures remote visuospatial memory. By contrast, the four AD patients, who showed equivalent naming difficulties, less-severe fluency deficits, and normal motor skill learning, showed severe impairments in recalling and recognizing the names of famous people from photographs. A magnetic resonance imaging (MRI) scan of the pCBD patient showed marked frontal and parietal lobe atrophy and central atrophy, with ventriculomegaly that was greater on the left side of the brain. The temporal lobes were relatively spared, and the amygdalae, hippocampi, and temporal horns were of normal size.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Identifying multiple sclerosis patients with mild or global cognitive impairment using the Screening Examination for Cognitive Impairment (SEFCI).

Cognitive impairment affects 40 to 70% of patients with multiple sclerosis (MS), but its occurrence cannot be predicted from knowledge of the individual patient's age, level of physical disability, duration of disease, disease type, or performance on standard mental status examinations. To evaluate the usefulness of a brief screening battery, the Screening Examination for Cognitive Impairment (SEFCI), 103 community-dwelling MS patients and 32 healthy normal controls received the SEFCI and a 2-hour battery of other neuropsychological tests chosen for their sensitivity to the cognitive impairments most often observed in MS. Performance on the SEFCI correctly identified 86% of the patients with impairment on any of the 11 measures from the longer battery, 100% of the patients with impairments in at least three cognitive domains, and 90% of the patients without cognitive impairment. Because the SEFCI is sensitive, specific, and easily administered and scored, it should aid the physician in deciding whether to refer an MS patient for a complete evaluation.

Adult↗

Preserved cognitive skills in dementia of the Alzheimer type.

OBJECTIVE: To describe preserved cognitive skills in patients with dementia. DESIGN: Case series. SETTING: Community clinic. PATIENTS: Five patients who met National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for probable Alzheimer's disease and were claimed to retain a cognitive skill. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Standard neuropsychological tests and individualized measures of patient's skilled behaviors. For patients who remained skilled at games, performance was compared with that of normal controls in direct competition. For the patient-trombonist, raters compared premorbid and postmorbid recordings of his play. RESULTS: One patient continued to play the trombone in a Dixieland band, although he could not name well-known numbers that he played. Another continued to solve adult jigsaw puzzles. A third patient retained skill at canasta, the fourth at dominoes. The fifth patient remained a skillful contract bridge player, although he could not name the suits or articulate simple bidding rules. Four patients had impaired performance on standard anterograde and remote memory and naming tests but performed normally on pursuit rotor and letter fluency tests. Mini-Mental State Examination scores for these patients ranged from 10 to 22. One patient refused neuropsychological testing but displayed his skill. CONCLUSIONS: Together with previous studies of preserved piano playing or painting skills, our findings indicate that a broad range of complex cognitive abilities may be preserved in patients with dementia of the Alzheimer type who cannot perform simpler actions.

Aged↗

Picture and motor sequencing in multiple sclerosis.

Previous studies consistently report that patients with multiple sclerosis (MS) perform poorly on the Picture Arrangement subtest of the Wechsler Intelligence test. Although this finding implies that MS causes difficulties in cognitive sequencing, the Picture Arrangement test taps many cognitive abilities in addition to sequencing, and the reported deficits by MS patients could reflect difficulties in other skills such as information processing speed or visual acuity and scanning. To circumvent some of these interpretive problems, we used an untimed test of sequencing that required arranging relatively large drawings of familiar scenarios. The MS patients were impaired on this picture sequencing test, but they performed normally on the Luria three-step test of motor sequencing. Correlational analyses showed that picture and motor sequencing were highly correlated, and that performance on both sequencing tests was related to performance on a global mental status exam, the Wisconsin Card Sorting Test and Benton's Facial Recognition Test, but not to upper limb speed and dexterity. These findings demonstrate a relatively specific deficit in cognitive sequencing by MS patients, that can be partially dissociated from impairment in performing simple motor acts.

Adult↗

Memory and "frontal lobe" dysfunction in multiple sclerosis.

The characteristics of memory disturbance in multiple sclerosis (MS) are briefly reviewed and the interactions of conceptual and memory dysfunction in MS are considered. Although conceptual functions such as abstraction and problem solving traditionally have been considered to be frontal lobe functions, there is now convincing evidence from studies of patients with focal brain lesions that these capacities are not localized to the frontal lobes. Thus, the concept of frontal lobe dysfunction in MS is without empirical support. Nevertheless, studies examining the relationship between memory and conceptual impairment in MS have value for both basic and clinical neuroscience.

Frontal Lobe↗

Memory and frontal lobe dysfunction in schizophrenia and schizoaffective disorder.

Verbal memory and performance on a number of tests known to be sensitive to lesions that disrupt frontal lobe functioning were studied in patients with schizophrenia or schizoaffective illness. Both patient groups were severely and equally impaired on verbal and design fluency and on the Wisconsin Card Sorting Test, measures that are sensitive to dysfunction of frontal-striatal circuitry. Both patient groups exhibited impaired recall but nearly normal recognition memory, a pattern that is typically observed in frontal and subcortical diseases. Accelerated forgetting was evident on delayed recall tests; the magnitude of this impairment was greater for schizophrenic than for schizoaffective patients. These results suggest that frontal and/or subcortical dysfunction is common to schizophrenia and schizoaffective disorder. A subgroup including the majority of schizophrenic patients, however, exhibit a mild amnesia-like disorder which may result from pathological changes in the structure and function of the temporal lobes or the medial diencephalon.

Adult↗