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PubMed1998

Age-related changes in the prevalence of smell/taste problems among the United States adult population. Results of the 1994 disability supplement to the National Health Interview Survey (NHIS).

Information about the prevalence of disorders of the chemical senses has been limited. In the late 1970s, the consensus among experts convened by the National Institutes of Health (NIH) was that more than 2 million adults in the United States had a disorder of smell or taste. A large, nonrandom survey conducted by the National Geographic Society in 1987 found that 1% of their 1.2 million respondents could not smell 3 or more of 6 odorants using a 'scratch and sniff' test. Age was an important factor, with a decline beginning in the second decade of life. No comparable data have been available for taste, although it has been suggested that the sense of taste remains more robust with age. The National Institute on Deafness and Other Communication Disorders (NIDCD), NIH, began collaborating with the National Center for Health Statistics (NCHS) in 1993 to acquire information on the prevalence of smell/taste problems using the Disability Supplement to the National Health Interview Survey (NHIS). This survey was administered to approximately 42,000 randomly-selected households (representing about 80,000 adults over 18 years of age) in 1994. Adjusted national estimates derived from this survey showed a prevalence of 2.7 million (1.4%) U.S. adults with an olfactory problem. Also, 1.1 million (0.6%) adults reported a gustatory problem. When smell or taste problems were combined, 3.2 million (1.65%) adults indicated a chronic chemosensory problem. The prevalence rates increased exponentially with age. Almost 40% with a chemosensory problem (1.5 million) were 65 years of age or greater. In a multivariate analysis, the individual's overall health status, other sensory impairments, functional limitations (including difficulty standing or bending), depression, phobia, and several other health-related characteristics were associated with an increase in the rate of chemosensory disorders.

Adolescent↗
PubMed1992

Speech perception and production skills of students with impaired hearing from oral and total communication education settings.

This study examined the degree to which students with profoundly impaired hearing who had been educated in oral and total communication (TC) environments developed auditory and speech skills. The sample consisted of 227 16- and 17-year-old students with profoundly impaired hearing: 127 from TC programs (63 with normal-hearing parents and 64 with deaf parents) and 100 from oral programs. Subject groups were matched in terms of age, unaided residual hearing, and IQ. On average, students from oral programs acquired more intelligible speech and made significantly better use of their limited residual hearing than did the TC students. This finding held for all TC students--those with deaf parents as well as those with normal-hearing parents. Although results of this study indicate that auditory and speech production skills are comparatively well developed in students who have consistently used spoken language throughout the day as the primary means of communicating, other factors associated with this oral sample, such as early amplification, consistent hearing aid use, early education, and parental support, may also be necessary for the development of good spoken language skills.

Adolescent↗
PubMed2001

[Deglutition disorders--simple to diagnose and difficult to treat?].

The swallowing sequence can be disturbed by different structural and neurological disorders especially in its oral and pharyngeal phases. Beside the suffering from the loss of a basic physical function dysphagia causes life-threatening complications as malnutrition, pneumonia or the blockage of the airways. In general radiographic and endoscopic evaluations provide sufficient information about the specific pathology of a case of dysphagia so that an individual treatment plan with surgery, behavioral therapy and prosthetic aids can be formulated. The aim of treatment is to regain a save and as complete as possible an oral nutrition. Dysphagia is often not detected when patients have impaired cognitive abilities or communication disorders.

Deglutition Disorders↗
PubMed1977

Parental focus of attention in a videotape feedback task as a function of hypothesized risk for offspring schizophrenia.

The families of 29 disturbed but nonpsychotic adolescents were observed in a structured task in which they discussed their reactions to viewing themselves interacting on videotape. Measures derived from the Singer-Wynne concenpt of transactional style deviance were applied to the parental behaviors and related to prior assessments of parental communication disorder based on individual parental TAT protocols. The results confirm the Singer-Wynne hypothesis of the cross-situational stability of transactional style deviance. The most striking finding, however, is that an index of positive focusing behavior differentiates more strongly parents of adolescents hypothesized to be at varying leves of risk for schizophrenia than does the measure of transactional style deviance.

Adolescent↗
PubMed2004

Dopamine transporter loss visualized with FP-CIT SPECT in the differential diagnosis of dementia with Lewy bodies.

BACKGROUND: Dementia with Lewy bodies (DLB) is a common form of late-life dementia that can be difficult to differentiate from other disorders, especially Alzheimer disease (AD), during life. At autopsy the striatal dopaminergic transporter is reduced. OBJECTIVES: To examine the extent and pattern of dopamine transporter loss using iodine I 123-radiolabeled 2beta-carbomethoxy-3beta-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (FP-CIT) with single-photon emission computed tomography (SPECT) in DLBs compared with other dementias and to assess its potential to enhance a differential diagnosis. DESIGN: Cohort study comparing FP-CIT with criterion standard of consensus clinical diagnosis. SETTING: General hospital. PARTICIPANTS: One hundred sixty-four older subjects (33 healthy older control subjects, 34 with NINCDS/ADRDA [National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association]-confirmed AD, 23 with consensus guideline-confirmed DLB, 38 with United Kingdom's Parkinson Disease Society Brain Bank-confirmed Parkinson disease [PD], and 36 with PD and dementia). INTERVENTIONS: Injection of (123)I-2beta-carbomethoxy-3beta-(4-iodophenyl)-N-(3-fluoropropyl) nortropane with SPECT scan performed at 4 hours. MAIN OUTCOME MEASURES: Visual ratings of scans and region of interest analysis. RESULTS: Significant reductions (P<.001) in FP-CIT binding occurred in the caudate and anterior and posterior putamens in subjects with DLB compared with subjects with AD and controls. Transporter loss in DLBs was of similar magnitude to that seen in PD, but with a flatter rostrocaudal (caudate-putamen) gradient (P =.001), while the greatest loss in all 3 areas was seen in those who had PD and dementia. Both region of interest analysis and visual ratings provided good separation between DLBs and AD (region of interest: sensitivity, 78%; specificity, 94%; positive predictive value, 90%) but not among subjects with DLB, PD, and PD with dementia. CONCLUSIONS: Dopamine transporter loss can be detected in vivo using FP-CIT SPECT in DLB. Further studies, especially of subjects with DLB without PD, are required to fully establish use in clinical practice.

Aged↗
PubMed1994

Prevalence and incidence of major depression in Alzheimer's disease.

OBJECTIVE: This study examined the prevalence and incidence of major depressive disorder in Alzheimer's disease. METHOD: The authors retrospectively reviewed two large Alzheimer's disease databases, one at the University of Texas Southwestern Medical Center in Dallas and the other at the Consortium to Establish a Registry for Alzheimer's Disease (CERAD). The Dallas series contained 264 cases of Alzheimer's disease, of which 153 patients were followed up for an average of 3 years from initial evaluation. The CERAD database contained 1,095 cases and excluded patients with histories of depression at initial evaluation; 325 of these patients were followed up for at least 2 years. Alzheimer's disease was diagnosed according to the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association; major depression was diagnosed according to the DSM-III-R criteria. Most of the patients in these series were dwelling in the community and had had Alzheimer's disease symptoms for approximately 4 years at the time of evaluation. RESULTS: In the Dallas series there was a 1.5% prevalence and a 0% incidence of major depression. In the CERAD series there was a 1.3% 2-year incidence of major depression. CONCLUSIONS: The low prevalence and incidence of DSM-III-R major depression in these patients suggest that for the period of time the patients were followed up, Alzheimer's disease did not predispose to major depression. However, major depression may herald the subsequent onset of dementia. Depression in dementia should perhaps be diagnosed by different criteria.

Aged↗
PubMed2001

Disordered recognition of facial identity and emotions in three Asperger type autists.

In this report we aim to explore severe deficits in facial affect recognition in three boys all of whom meet the criteria of Asperger's syndrome (AS), as well as overt prosopagnosia in one (B) and covert prosopagnosia in the remaining two (C and D). Subject B, with a familially-based talent of being highly gifted in physics and mathematics, showed no interest in people, a quasi complete lack of comprehension of emotions, and very poor emotional reactivity. The marked neuropsychological deficits were a moderate prosopagnosia and severely disordered recognition of facial emotions, gender and age. Expressive facial emotion, whole body psychomotor expression and speech prosody were quasi absent as well. In all three boys these facial processing deficits were more or less isolated, and general visuospatial functions, attention, formal language and scholastic performances were normal or even highly developed with the exception of deficient gestalt perception in B. We consider the deficient facial emotion perception as an important pathogenetic symptom for the autistic behaviour in the three boys. Prosopagnosia, the absent facial and bodily expression, and speech prosody were important but varying co-morbid disorders. The total clinical picture of non-verbal disordered communication is a complex of predominantly bilateral and/or right hemisphere cortical deficits. Moreover, in B, insensitivity to pain, smells, noises and internal bodily feelings suggested a more general emotional anaesthesia and/or a deficient means of expression. It is possible that a limbic component might be involved, thus making affective appreciation also deficient.

Adult↗
PubMed1988

Communication disturbances in parents of schizophrenics.

The article describes the method and results of and experimental study of communication disturbances in parents of schizophrenics. A non-structured interview was carried out with parents of mentally retarded patients as a control group. Communication disturbances were analysed by means of a manual with operational descriptions of communication disorders. The results showed more disturbances in parents of schizophrenic parents. Within the group of parents of schizophrenics, those with schizophrenia in remission after an active phase of the illness showed more disturbances than parents of chronic schizophrenics. These data, obtained at one point in time after the illness has developed, are consistent with, but cannot confirm the hypothesis that interactional factors may contribute to the pathogenesis of an acute, florid form of schizophrenia.

Acute Disease↗
PubMed2005

Planum parietale of chimpanzees and orangutans: a comparative resonance of human-like planum temporale asymmetry.

We have previously demonstrated that leftward asymmetry of the planum temporale (PT), a brain language area, was not unique to humans since a similar condition is present in great apes. Here we report on a related area in great apes, the planum parietale (PP). PP in humans has a rightward asymmetry with no correlation to the L>R PT, which indicates functional independence. The roles of the PT in human language are well known while PP is implicated in dyslexia and communication disorders. Since posterior bifurcation of the sylvian fissure (SF) is unique to humans and great apes, we used it to determine characteristics of its posterior ascending ramus, an indicator of the PP, in chimpanzee and orangutan brains. Results showed a human-like pattern of R>L PP (P = 0.04) in chimpanzees with a nonsignificant negative correlation of L>R PT vs. R>L PP (CC = -0.3; P = 0.39). In orangutans, SF anatomy is more variable, although PP was nonsignificantly R>L in three of four brains (P = 0.17). We have now demonstrated human-like hemispheric asymmetry of a second language-related brain area in great apes. Our findings persuasively support an argument for addition of a new component to the comparative neuroanatomic complex that defines brain language or polymodal communication areas. PP strengthens the evolutionary links that living great apes may offer to better understand the origins of these progressive parts of the brain. Evidence mounts for the stable expression of a neural foundation for language in species that we recently shared a common ancestor with.

Animals↗
PubMed1990

Addition of an error correction facility to a functioning data management system.

The National Institute of Neurological and Communicative Disorders and Stroke conducted the Stroke Data Bank, a prospectively collected database, in collaboration with investigators from four clinical centers. A distributed data entry system was originally designed to permit data entry and editing using microcomputers. As data collection progressed, it became evident that the editing system was inadequate. A central data editing component was added to the system, with responsibility for error correction remaining at the clinical centers. This report summarizes the design of the error correction facility and demonstrates the feasibility of its late implementation.

Computer Communication Networks↗
PubMed1998

Epileptic aphasia: a consequence of regional hypometabolic encephalopathy?

A series of 25 children, 13 females and 12 males, who had an acquired communication disorder together with epilepsy, but did not fulfil the strict criteria of the Landau-Kleffner syndrome, was studied. All children had a clinical neurological evaluation, speech and language assessment, an awake and sleep EEG, cranial MRI, SPET scan, and audiometry. Clinical seizures were most often polymorphic in type (17 of 25). Atypical absences were the commonest individual seizure type occurring in 15 cases. All patients had an unequivocal epileptiform EEG. Normal sleep phenomena were only observed in 10 cases, enhancement of epileptiform activity in sleep was seen in 16. Cranial MRI was abnormal in six and normal in 19 cases. The SPET scans were abnormal in 22 of 25 children. The language deficits were classified neurologically as receptive aphasia, 24 of 25; expressive aphasia, 20 of 25; nominal aphasia, eight of 25; articulatory dyspraxia, 10 of 25; and auditory agnosia, nine of 25. It is hypothesized that the loss of communication skills is due to an encephalopathy secondary to the persistent epileptic discharge and manifests as a hypometabolic area on the SPET scan.

Adolescent↗
PubMed2005

Madness explained: why we must reject the Kraepelinian paradigm and replace it with a 'complaint-orientated' approach to understanding mental illness.

This article is a synopsis of the argument outlined in my book Madness explained: Psychosis and human nature, in which I describe a new paradigm (which might be called a 'complaint-orientated' approach) for understanding the psychotic disorders, the most disabling forms of psychiatric illness. Despite extensive efforts to study the genetics, pathophysiology and neuropsychology of the psychoses, replicable findings have been rare. I argue that this is because the phenomena concerned have been poorly defined. Since the end of the 19th century, research into the psychoses has been dominated by the system of classification first proposed by the German psychiatrist Emil Kraepelin, which assumes that the severe mental illnesses fall into discrete types such as 'schizophrenia' and 'manic depression', and that there is a clear dividing line between madness and normal functioning. However, Kraepelinian diagnoses fail all empirical tests of their validity. For example, they do not identify patients with common symptoms, with common aetiologies, who respond to specific treatments. I suggest that we therefore need to abandon psychiatric diagnoses altogether and must instead attempt to explain the specific complaints ('symptoms') that patients bring to our attention. These include hallucinations, delusional beliefs, thought and communication disorders, which are much more widely experienced than was previously thought (for example, about 10% of the population have experienced hallucinations). I show that recent psychological research has revealed much about the mechanisms underlying each of these complaints. For example, auditory hallucinations occur when the individual mistakes inner speech for an external stimulus, and delusions appear to be the product of abnormal inferential processes. The new approach has implications for aetiology. For example, researchers working within the Kraepelinian paradigm have often assumed that the psychoses are endogenous. However, there is compelling evidence that the risk of experiencing psychotic complaints is influenced by adverse environmental factors such as insecure attachment relations and exposure to sexual and other kinds of trauma. These associations are relatively easy to understand once the psychological mechanisms leading to specific complaints are known. When all of the psychotic complaints have been explained, there will be no 'schizophrenia' or 'manic depression' left behind awaiting explanation. The approach that I advocate is not only more scientific than the Kraepelinian approach, but also more humane. In contrast to the Kraepelinian approach, which has encouraged disrespect for patients' experiences, it encourages us to treat patients as rational agents and to take what they say seriously.

Cognition↗
PubMed1992

Speech monitoring skills in Alzheimer's disease, Parkinson's disease, and normal aging.

We examined the abilities of 15 patients with dementia of the Alzheimer type (DAT), 22 patients with Parkinson's Disease (PD), and 141 healthy subjects (ranging in age from 30 to 79 years) to detect and correct their own speech errors. Each subject was shown the Cookie Theft picture of the BDAE (Goodglass & Kaplan, 1972. The assessment of aphasia and related disorders. Philadelphia: Lea & Febiger.) and instructed to tell the examiner the "...story of what's happening in the picture." Self-monitoring performance was assessed by tabulating the number of uncorrected errors as well as repaired errors. We divided repairs into two types based on the psycholinguistics literature (van Wijk & Kempen, 1987. Cognitive Psychology, 19, 403-440). Speech corrections were judged to be lemma repairs when the reparandum was a single word, and reformulation repairs when a new syntactic constituent was added to the reparandum. Patients with DAT corrected only 24% of their total errors and patients with PD only 25%. Healthy subjects, by contrast, corrected from 72 to 92% of their total errors. Patients with DAT tended to rely on reformulation repairs while patients with PD used both repair types about equally often. While healthy elderly Ss (in the 70s group) utilized lemma repairs more often than the reformulation strategy, all other healthy Ss used both strategies about equally often. Across all groups naming performance correlated negatively with numbers of undetected errors. Results point to a previously unrecognized communication disorder associated with PD and DAT and manifested by an impairment in the ability to correct output errors. This impairment may be related to attentional and frontal dysfunction in the two patient groups.

Adult↗
PubMed2004

Perceptual consequences of disrupted auditory nerve activity.

Perceptual consequences of disrupted auditory nerve activity were systematically studied in 21 subjects who had been clinically diagnosed with auditory neuropathy (AN), a recently defined disorder characterized by normal outer hair cell function but disrupted auditory nerve function. Neurological and electrophysical evidence suggests that disrupted auditory nerve activity is due to desynchronized or reduced neural activity or both. Psychophysical measures showed that the disrupted neural activity has minimal effects on intensity-related perception, such as loudness discrimination, pitch discrimination at high frequencies, and sound localization using interaural level differences. In contrast, the disrupted neural activity significantly impairs timing related perception, such as pitch discrimination at low frequencies, temporal integration, gap detection, temporal modulation detection, backward and forward masking, signal detection in noise, binaural beats, and sound localization using interaural time differences. These perceptual consequences are the opposite of what is typically observed in cochlear-impaired subjects who have impaired intensity perception but relatively normal temporal processing after taking their impaired intensity perception into account. These differences in perceptual consequences between auditory neuropathy and cochlear damage suggest the use of different neural codes in auditory perception: a suboptimal spike count code for intensity processing, a synchronized spike code for temporal processing, and a duplex code for frequency processing. We also proposed two underlying physiological models based on desynchronized and reduced discharge in the auditory nerve to successfully account for the observed neurological and behavioral data. These methods and measures cannot differentiate between these two AN models, but future studies using electric stimulation of the auditory nerve via a cochlear implant might. These results not only show the unique contribution of neural synchrony to sensory perception but also provide guidance for translational research in terms of better diagnosis and management of human communication disorders.

Acoustic Stimulation↗
PubMedDate not supplied

[Communication and auditory behavior obtained by auditory evoked potentials in mammals, birds, amphibians, and reptiles].

METHODS ANIMALS: amphibians, Frog catesbiana (frog bull, 30 animals); reptiles, Sceloporus torcuatus (common small lizard, 22 animals); birds: Columba livia (common dove, 20 animals), and mammals, Cavia porcellus, (guinea pig, 20 animals). With regard to lodging, all animals were maintained at the Institute of Human Communication Disorders, were fed with special food for each species, and had water available ad libitum. Regarding procedure, for carrying out analysis of auditory evoked potentials of brain stem SPL amphibians, birds, and mammals were anesthetized with ketamine 20, 25, and 50 mg/kg, by injection. Reptiles were anesthetized by freezing (6 degrees C). Study subjects had needle electrodes placed in an imaginary line on the half sagittal line between both ears and eyes, behind right ear, and behind left ear. Stimulation was carried out inside a no noise site by means of a horn in free field. The sign was filtered at between 100 and 3,000 Hz and analyzed in a computer for provoked potentials (Racia APE 78). RESULTS: In data shown by amphibians, wave-evoked responses showed greater latency than those of the other species. In reptiles, latency was observed as reduced in comparison with amphibians. In the case of birds, lesser latency values were observed, while in the case of guinea pigs latencies were greater than those of doves but they were stimulated by 10 dB, which demonstrated best auditory threshold in the four studied species. Last, it was corroborated that as the auditory threshold of each species it descends conforms to it advances in the phylogenetic scale. CONCLUSIONS: Beginning with these registrations, we care able to say that response for evoked brain stem potential showed to be more complex and lesser values of absolute latency as we advance along the phylogenetic scale; thus, the opposing auditory threshold is better agreement with regard to the phylogenetic scale among studied species. These data indicated to us that seeking of auditory information is more complex in more evolved species.

Amphibians↗
PubMed1987

Migraine and other diseases in women of reproductive age. The influence of smoking on observed associations.

From among the pregnant women in the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke, we identified 508 who had migraine, and 3192 who had no history of migraine, of taking headache medication during the previous 12 months, and of headaches during the pregnancy. Migraineurs smoked more heavily and had a longer smoking history than their headache-free peers. Among migraineurs, smokers were not more likely to consume analgesics than nonsmokers. Regardless of smoking classification, more migraineurs consumed tranquilizers, amphetamines, and sleeping pills than headache-free women. Among smokers only, migraine was associated with heart disease, thrombosis/phlebitis, asthma, peptic ulcer, and pneumonia. In nonsmokers, migraine was associated with drug sensitivity and other allergies.

Adolescent↗
PubMed1988

Thiamine and Alzheimer's disease. A pilot study.

As a test of the significance of previously described biochemical abnormalities in thiamine-dependent enzymes in brains and other tissues in patients with Alzheimer's disease, a double-blind, placebo-controlled, crossover, outpatient pilot study compared the effects of 3 g/d of oral thiamine hydrochloride for three months with those of a niacinamide placebo. Eleven moderately impaired patients with "probable Alzheimer's disease" by the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria completed the study. All patients were well nourished and had no stigmata of dietary thiamine deficiency. Their initial mean +/- SEM Mini-Mental State Examination score was 14.2 +/- 1.4, and the mean age was 72 years. Global cognitive rating by the Mini-Mental State Examination was higher during three months with 3 g/d of oral thiamine hydrochloride than with niacinamide placebo. Behavioral ratings, however, did not differ significantly, nor did clinical state when it was judged subjectively.

Alzheimer Disease↗
PubMed1991

Regional cerebral blood flow in developmental stutterers.

Stuttering is a poorly understood communication disorder with a 1% global prevalence. Recently, there has been a resurgence of interest in a neurogenic origin for the disorder, although no research has established clear neurological differences between "developmental" (stuttering onset in childhood) stutterers and nonstutterers. We have used xenon 133 single-photon emission computed tomography to study regional cerebral blood flow (rCBF) in 20 stutterers. Analysis revealed global, absolute flow reductions. Relative flow asymmetries (left less than right) were identified in three hemispheric regions: anterior cingulate and superior and middle temporal gyri. Milder changes were found in the left inferior frontal gyrus. Stutterers had rCBF values below median for either anterior cingulate or middle temporal gyri. With one exception, severe stutterers had rCBF values below median for the anterior cingulate gyrus. All stutterers with rCBF values above median in the cingulate gyrus had rCBF values below median in the middle temporal gyrus, and severity of their disorder was either mild or moderate. Our findings suggest that stuttering is a neurogenic disorder involving recognized cortical regions of speech-motor control.

Adult↗