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PubMed1990

Neuropsychology and psychopathology: a progress report.

This paper summarizes and discusses the contributions of neuropsychological assessment to various forms of psychopathology. Emphasis is placed upon studies done with the Halstead-Reitan battery and the Wechsler Adult Intelligence Scale, but studies done with other neuropsychological test procedures are also reviewed. The conclusions reached are that neuropsychological tests are sensitive to functional regional brain disorganization in psychopathology, and that they are useful in the diagnostic process for a number of disorders including schizophrenia, psychopathy, mood disorders, and other psychiatric conditions.

Affective Disorders, Psychotic↗
PubMed1996

Ketorolac does not decrease postoperative pain in elderly men after transvesical prostatectomy.

PURPOSE: To assess the postoperative analgesic efficacy and morphine-sparing effect of ketorolac in elderly patients. METHODS: Sixty ASA-physical status I to III men, aged 60-88 yr, undergoing transvesical prostatectomy were studied according to a randomized, placebo controlled, double-blind study protocol. A standard general anaesthetic was administered. Thirty minutes before concluding the surgical procedure either ketorolac 60 mg or an equal volume of saline was administered, im. Postoperative pain was assessed hourly for six hours using a 100 mm visual analog score (VAS) and a patient-controlled analgesia (PCA) device. RESULTS: Hourly PCA-demands, actual morphine delivered, and patient generated VAS pain scores were unaffected by the treatment modality. On conclusion of the study the total PCA morphine delivered was 11.9 mg +/- 1.38 and 10.8 mg +/- 1.52 for the saline and ketorolac groups, respectively. CONCLUSION: The intraoperative administration of ketorolac, 60 mg, im, was not associated with postoperative morphinesparing or improved analgesia in this elderly population.

Aged↗
PubMed2004

Effect of oral vitamin D2 yearly bolus on hip fracture risk in elderly women: a community primary prevention study.

BACKGROUND AND AIMS: Vitamin D deficiency is a well-known risk for hip fracture, and vitamin D insufficiency is so frequent in the elderly that population-wide preventive intervention would be useful. The objective of the study was to evaluate the efficacy of vitamin D bolus on hip fracture incidence in elderly women. METHODS: All women aged > 65 years registered at Health District 20 of the Regione Veneto, Italy, were eligible for this quasi-experimental, prospective community intervention study. A vial containing 400,000 IU vitamin D2 (Ostelin 800, Teofarma, Italy) was offered for oral administration to all women in the winters of 2000-2001 and 2001-2002. The only exclusion criteria for treatment were age and gender, and the control group included women who did not participate in the Health District initiative. Analysis of hip fracture incidence was carried out for 4 years, from 1999 to 2002. Patients with incident hip fracture were identified as soon as they were admitted to one of the 3 hospitals of the health district and interviewed regarding their participation in the vitamin D preventive intervention program. In 120 of the women (age range 68-90 years), serum concentrations of 25-OH vitamin D were measured from October to June, both before and 1 and 4 months after vitamin D administration. RESULTS: 23,325 and 24,747 women received the vitamin D bolus during winters 2000-2001 and 2001-2002 respectively, i.e. 45-47% of eligible women. The proportion of women who accepted the bolus declined with advancing age, from 50-55% in women aged 60-70 years to 22-26% in those aged > 90 years. The two-year intervention on the community decreased the incidence of fracture by 10% (p = 0.050) in comparison with the previous two years. The age-adjusted risk reduction (RR) of hip fracture during 2001 and 2002 in women who had received vitamin D, with respect to women who had not, decreased by 17% (p = 0.056) and 25% (p = 0.005) respectively. The RR was considerably greater and statistically significant over both 2001 and 2002 in the cohort aged > 75 years. 25-OH vitamin D concentrations, in the subset of women in whom it was measured, rose significantly (p < 0.0001) by 9 ng/ml over 4 months after administration. CONCLUSION: Despite several obvious limitations due to its nature, this study sufficiently documents that yearly vitamin D bolus supplements, given as primary prevention to elderly Caucasian women, may decrease the incidence of hip fracture. For its probable safety and excellent feasibility and cost-effectiveness, this primary intervention has a great potential for generalisability.

Administration, Oral↗
PubMed2004

[Visualisation of phantom- and backpain using imaging techniques. Implication for treatment].

If patients with chronic low back pain are stimulated in the painful region, an expanded representation of the back in the primary somatosensory cortex becomes visible that increases with chronicity. This "pain memory" might play an important role in the chronicity process. In patients with phantom limb pain, e.g. subsequent to the amputation of an arm or leg, a shift in the representation of neighboring areas into the deafferented area in primary somatosensory cortex has been observed. This reorganization of functional brain maps is not present in congenital amputees or amputees without phantom limb pain. The magnitude of such pain is positively correlated with this reorganization. We present a model of phantom limb pain that assigns an important role to pre-existing chronic pain. The modulation of plasticity and phantom limb pain by anesthesiological manipulation, the use of NMDA receptor antagonists and opioids is presented. Behaviorally relevant stimulation, e.g. by the use of a myoelectric prosthesis or sensory discrimination training can also influence the cortical somatosensory pain memory. More recent studies focus also on brain areas such as the cingulate gyrus believed to be involved in the affective processing of pain.

Back Pain↗
PubMed2005

Control of the phytopathogen Botrytis cinerea using adipic acid monoethyl ester.

The in vitro and in vivo antifungal activity of adipic acid monoethyl ester (AAME) on the necrotrophic pathogen Botrytis cinerea has been studied. This chemical effectively controlled this important phytopathogen, inhibited spore germination and mycelium development at non-phytotoxic concentrations. The effectiveness of AAME treatment is concentration-dependent and influenced by pH. Spore germination in the presence of AAME is stopped at a very early stage, preventing germ tube development. In addition, cytological changes such as retraction of the conidial cytoplasm in the fungus are observed. AAME was also found to act on membrane integrity, affecting permeability without exhibiting lytic activity, as described previously for other antifungal compounds. Polyamine content in the mycelium of B. cinerea was also affected in response to AAME treatment, resulting in putrescine reduction and spermine accumulation similar to a number of antifungal agents. Microscopic observation of treated conidia after inoculation on tomato leaves suggested that inhibited spores are not able to attach to and penetrate the leaf. Finally, AAME completely suppressed the grey mould disease of tomato fruits under controlled inoculation conditions, providing evidence for its efficacy in a biological context and for the potential use of this chemical as an alternative fungicide treatment.

Adipates↗
PubMed2004

Cue-induced activation of the striatum and medial prefrontal cortex is associated with subsequent relapse in abstinent alcoholics.

RATIONALE: Animal experiments have provided evidence that the striatum and medial prefrontal cortex play a predominant role in the acquisition and maintenance of drug-seeking behavior. OBJECTIVES: Alcohol-associated stimuli that were regularly paired with alcohol intake may become conditioned cues and elicit a motivational response that triggers relapse in alcohol-dependent patients. METHODS: We used functional magnetic resonance imaging and visual alcohol-associated and control cues to assess brain activation in ten abstinent alcoholics and control subjects. Patients were followed for 3 months, and alcohol intake was recorded. RESULTS: Alcohol-related versus neutral visual stimuli activated the putamen, anterior cingulate and adjacent medial prefrontal cortex in alcoholics compared with healthy controls. Cue-induced activation of these brain areas was pronounced in the five alcoholics who subsequently relapsed during the observation period. A multiple regression analysis showed that, in alcoholics, the amount of subsequent alcohol intake was associated with the intensity of cue-induced brain activation but not the severity of alcohol craving, amount of previous alcohol intake or duration of abstinence before scanning. CONCLUSIONS: This pilot study showed that cue-induced activation of the anterior cingulate, medial prefrontal cortex and striatum may play a role in the attribution of incentive salience to alcohol-associated stimuli, thus increasing the motivational value and attentional processing of alcohol cues. Functional brain imaging may help to identify a group of alcoholics with an otherwise undetected high risk of relapse.

Adult↗
PubMed2003

Determination of total homocysteine in human serum by capillary gas chromatography with sulfur-specific detection by double focusing ICP-MS.

A selective and sensitive method for determination of total homocysteine (Hcy) in human serum, by gas chromatography coupled to ICP-MS(HR), has been developed. After reduction of the sample with sodium borohydride the liberated Hcy and other aminothiols, such as cysteine (Cys) and methionine (Met), were converted to their N-trifluoroacetyl (TFA)- O-isopropyl derivatives and these were injected into a gas chromatograph equipped with an HP-5 capillary column. Detection was carried out by means of a double-focusing inductively coupled plasma mass spectrometer (DF-ICP-MS) monitoring (32)S at m/Delta m (resolving power)=3000. The transfer line used to transport the analytes from the GC column to the ICP-MS had previously been developed in our laboratory. The different parameters affecting the derivatisation process were optimised, as were the instrumental operating conditions. This optimised GC-ICP-MS(HR) method was successfully applied to the determination of total homocysteine in human serum-values obtained were in agreement with data reported in the literature. Quantitative recoveries and good precision were obtained for spiked human serum, demonstrating the suitability of the method for quantitative determination of total homocysteine in serum.

Acylation↗
PubMed2003

Brain areas activated in fMRI during self-regulation of slow cortical potentials (SCPs).

In humans, surface-negative slow cortical potentials (SCPs) originating in the apical dendritic layers of the neocortex reflect synchronized depolarization of large groups of neuronal assemblies. They are recorded during states of behavioural or cognitive preparation and during motivational states of apprehension and fear. Surface positive SCPs are thought to indicate reduction of cortical excitation of the underlying neural networks and appear during behavioural inhibition and motivational inertia (e.g. satiety). SCPs at the cortical surface constitute summated population activity of local field potentials (LFPs). SCPs and LFPs may share identical neural substrates. In this study the relationship between negative and positive SCPs and changes in the BOLD signal of the fMRI were examined in ten subjects who were trained to successfully self-regulate their SCPs. FMRI revealed that the generation of negativity (increased cortical excitation) was accompanied by widespread activation in central, pre-frontal, and parietal brain regions as well as the basal ganglia. Positivity (decreased cortical excitation) was associated with widespread deactivations in several cortical sites as well as some activation, primarily in frontal and parietal structures as well as insula and putamen. Regression analyses revealed that cortical positivity was predicted with high accuracy by pallidum and putamen activation and supplementary motor area (SMA) and motor cortex deactivation, while differentiation between cortical negativity and positivity was revealed primarily in parahippocampal regions. These data suggest that negative and positive electrocortical potential shifts in the EEG are related to distinct differences in cerebral activation detected by fMRI and support animal studies showing parallel activations in fMRI and neuroelectric recordings.

Adult↗
PubMed2003

Remote activation of referred phantom sensation and cortical reorganization in human upper extremity amputees.

Phantom limb sensation, whether painful or not, frequently occurs after peripheral nerve lesions. It can be elicited by stimulating body parts adjacent to the amputation site (referred to as phantom sensation) and it is often similar in quality to the stimulation at the remote site. The present study induced referred phantom sensations in two upper limb amputees. Neuroelectric source imaging (ESI) as well as functional magnetic resonance imaging (fMRI) was used to assess reorganization in primary somatosensory cortex (SI). Whereas recent studies found mislocalization of sensation related to stimulation mainly in regions adjacent and ipsilateral to the amputation site, we report here the elicitation of phantom sensation in the arm by stimulation in the lower body part both ipsi- and contralateral to the amputation in two arm amputees. The fMRI evaluation of one patient showed no shift in the location of the foot whereas ESI revealed major reorganization of the mouth region in primary somatosensory cortex in both patients. These data suggest that cortical structures other than SI might be contributing to the phenomenon of referred sensation. Candidate structures are the thalamus, secondary somatosensory cortex, posterior parietal cortex and prefrontal cortex.

Adult↗
PubMed2003

A multimodal brain-based feedback and communication system.

The Thought Translation Device (TTD) is a brain-computer interface based on the self-regulation of slow cortical potentials (SCPs) and enables completely paralyzed patients to communicate using their brain potentials. Here, an extended version of the TTD is presented that has an auditory and a combined visual and auditory feedback modality added to the standard visual feedback. This feature is necessary for locked-in patients who are no longer able to focus their gaze. In order to test performance of physiological regulation with auditory feedback 54 healthy participants were randomly assigned to visual, auditory or combined visual-auditory feedback of slow cortical potentials. The training consisted of three sessions with 500 trials per session with random assignment of required cortical positivity or negativity in half of the trials. The data show that physiological regulation of SCPs can be learned with auditory and combined auditory and visual feedback although the performance of auditory feedback alone was significantly worse than with visual feedback alone.

Acoustic Stimulation↗
PubMed2005

Central and peripheral psychophysiological responses to trauma-related cues in subclinical posttraumatic stress disorder: a pilot study.

This study examined verbal-subjective, peripheral and central physiological responses of motor vehicle accident (MVA) survivors with subclinical posttraumatic stress disorder (PTSD), without PTSD symptoms as well as healthy controls. Seven persons of each group were exposed to positive, neutral, accident-related and negative, non-accident-related slides. The verbal-subjective ratings of the slides did not differ between the groups. In contrast to the verbal ratings of the trauma-related materials, the behavioral and physiological responses showed a remarkable dissociation from these reports. The startle responses were enhanced to accident-related slides only in the PTSD group and MVA survivors with PTSD had a significantly lower response to the neutral slides than MVA survivors without PTSD. P200 was lower to positive, neutral and negative slides in the PTSD group compared to both other groups. The late positive complex showed no group-related effects. The data suggest that traumatized persons with PTSD show exaggerated emotional responses to trauma-related stimuli and reduced cognitive responses to several types of stimuli that may interfere with the extinction of the emotional trauma memory.

Accidents, Traffic↗
PubMed2005

Localization of the human female breast in primary somatosensory cortex.

RATIONALE: Despite an extensive body of research on the topography of the primary somatosensory cortex (S1) little is known about the representation of the trunk. AIM: The aim of this study was to determine the representation of the breast in S1 in human females. RESULTS: The representation of the human breast in primary somatosensory cortex was determined in ten healthy female subjects. Non-painful electrical stimulation of the mammilla (Th4 dermatome), groin (L1 dermatome) and the first digit of both sides of the body activated cutaneous receptors and thus elicited somatosensory evoked potentials. The representation of these body parts in primary somatosensory cortex (S1) was determined using neuroelectric source imaging. Equivalent current dipole localizations were overlaid with individual structural magnetic resonance images to account for individual cortical differences. The breast representation was localized between the representation of the groin and the first digit. In the medial-lateral direction the representation of the breast was approximately 15 mm lateral of the longitudinal fissure in the contralateral hemisphere. Source localizations were stable across subjects. However, one subject showed ipsilateral representation of the breast, which might be related to bilateral receptive fields of the ventral body midline representation. This study confirms the Penfield and Rasmussen (1950) invasive data by use of noninvasive source imaging.

Adolescent↗
PubMed2006

The influence of current mood on affective startle modulation.

The affect-modulated startle response is a reliable indicator of the affective processing of stimuli. It may be influenced by trait and state affective variables as well as psychopathological status. The aim of the present study was to determine the influence of the current mood state on startle modulation. Forty-five healthy volunteers viewed affective stimuli while eye blink responses and subjective emotional ratings were assessed. In addition, the current state of mood was assessed, pre and post the experimental procedure. Subjects were divided into those that were in a more positive and those that were in a more negative mood based on a median split. Compared to subjects in a positive mood those in a more negative mood showed significantly reduced startle amplitudes after viewing the negative and neutral stimuli. The results of the present study show that changes in startle responses are not only related to the current state of psychopathology but also to the general affective state of the participants during the assessments.

Adult↗
PubMed2000

Pavlovian aversive and appetitive odor conditioning in humans: subjective, peripheral, and electrocortical changes.

Differential Pavlovian conditioning of aversive and appetitive odors was examined in 30 male healthy subjects. The appetitive conditioning group (n=15) received a pleasant odor (vanilla), the aversive conditioning group (n=15) an unpleasant odor (fermented yeast) as unconditioned stimulus. Slides of two different neutral faces that were easy to discriminate served as conditioned stimuli (CS). An EEG was recorded from nine electrodes. Electromyographic activity was measured bilaterally from the m. corrugator supercilii and m. zygomaticus. The startle response was obtained from the m. orbicularis oculi. Finally, heart rate and skin conductance response were assessed. The subjective data and the skin conductance response revealed successful differential aversive conditioning. By contrast, the pleasant odor failed to produce appetitive odor conditioning. The conditioned and unconditioned response of the corrugator muscles confirm previous reports on the m. corrugator being strongly involved in the expression of negative affect. Contrary to previous findings, magnitude of the startle reflex was not found to be modulated depending on the valence of the CS. Central psychophysiological parameters showed little change during differential conditioning. The presence of subjective-evaluative conditioning and contingency awareness without significant changes in cortical and cardiovascular correlates might be due to extremely localized cortical processing of conditioned olfactory cues or primarily subcortical processing. The latter interpretation is strengthened by the presence of differential conditioning in non-voluntary responses such as the corrugator muscles.

Adolescent↗
PubMed1997

Input-increase and input-decrease types of cortical reorganization after upper extremity amputation in humans.

A plastic remodeling of regions in somatosensory cortex has previously been observed to occur in separate experimental paradigms in response to loss of somatosensory input and to increase in input. In this study, both types of cortical reorganization have been observed to occur concurrently in the same adult human nervous system as a result of a single intervention. Following upper extremity amputation, magnetic source imaging revealed that tactile stimulation of the lip evoked responses not only in the area of the somatosensory cortex corresponding to the face, but also within the cortical region that would normally correspond to the now absent hand. This "invasion" of the cortical amputation zone was accompanied by a significant increase in the size of the representation of the digits of the intact hand, presumably as a result of an increased importance of sensory stimulation consequent to increased dependence on that hand imposed by the loss of the contralateral extremity.

Adolescent↗
PubMed1998

Cortical reorganization and phantom phenomena in congenital and traumatic upper-extremity amputees.

The relationship between phantom limb phenomena and cortical reorganization was examined in five subjects with congenital absence of an upper limb and nine traumatic amputees. Neuromagnetic source imaging revealed minimal reorganization of primary somatosensory cortex in the congenital amputees (M=0.69 cm, SD 0.24) and the traumatic amputees without phantom limb pain (M=0.27 cm, SD 0.25); the amputees with phantom limb pain showed massive cortical reorganization (M=2.22 cm, SD 0.78). Phantom limb pain and nonpainful phantom limb phenomena were absent in the congenital amputees. Whereas phantom limb pain was positively related to cortical reorganization (r=0.87), nonpainful phantom phenomena were not significantly correlated with cortical reorganization (r=0.34). Sensory discrimination was normal and mislocalization (referral of stimulation-induced sensation to a phantom limb) was absent in the congenital amputees. The role of peripheral and central factors in the understanding of phantom limb pain and phantom limb phenomena is discussed in view of these findings.

Adult↗