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Biomedical subjects

A K Shapiro

Publications and source records attributed to A K Shapiro.

At least 19 recordsLinked to original sources
PubMed1989

Controlled study of haloperidol, pimozide and placebo for the treatment of Gilles de la Tourette's syndrome.

The results of this controlled study of the treatment of 57 patients with Gilles de la Tourette's syndrome suggested that both haloperidol and pimozide were more effective than placebo, but that haloperidol was slightly more effective than pimozide. Adverse effects occurred more frequently with haloperidol vs placebo than with pimozide vs placebo, but the frequency was not significantly different for haloperidol compared with pimozide. Clinically significant cardiac effects did not occur at a maximum dosage of 0.3 mg/kg or 20 mg/d for pimozide and 10 mg/d for haloperidol. However, the QTc interval was prolonged during pimozide treatment compared with that during haloperidol treatment, although the values for both medications were not in an abnormal range.

Adolescent↗
PubMed1986

Paroxysmal myoclonic dystonia with vocalisations: new entity or variant of preexisting syndromes?

From among 1377 patients with movement disorders, four patients had an unusual movement disorder characterised by paroxysmal bursts of involuntary, regular, repetitive, rhythmic, bilateral, coordinated, simultaneous, stereotypic myoclonus and vocalisations, often associated with tonic symptoms, interference with voluntary functioning, presence of hyperactivity, attention and learning disabilities, and resistance to treatment with haloperidol and other drugs. This symptom complex may represent a new disease entity, referred to here as paroxysmal myoclonic dystonia with vocalisations or a variant or combination of other movement disorders such as Gilles de la Tourette, myoclonic, or dystonic syndromes.

Adolescent↗
PubMed1986

Semiology, nosology and criteria for tic disorders.

Precise description of the signs, symptoms, classification and criteria for Tic Disorder and Gilles de la Tourette Syndrome (GTS) is important to reduce heterogeneity in studies and to develop hypotheses about the pathophysiology of these disorders. Previous diagnostic categories and criteria for Tic Disorders and GTS in DSM-III and ICD-9 were derived from our study of 114 consecutive patients, questionnaire responses by 31 patients and data on 76 patients from 8 published reports. During the past 20 years we have evaluated 1490 patients for movement disorders, of whom 1210 had GTS and 137 had another tic disorder. Analysis of these data and review of the literature serve as the basis for proposed revision of the signs, symptoms, nosology and criteria for Tic Disorders and GTS.

Compulsive Behavior↗
PubMed1985

Eye-blink rate in Tourette's syndrome.

Gilles de la Tourette's syndrome is a hyperkinetic movement disorder in which an etiological role for dopaminergic hyperactivity has been proposed. Blink rate, a putative correlate of central dopamine activity, is commonly held to be elevated in Tourette's syndrome, a finding that would be consistent with the "dopamine" hypothesis of this disorder. In 19 patients who had Tourette's syndrome, however, blink rates during placebo treatment were identical with those of 49 index controls during reading and quiet sitting. Blink rate did correlate, however, with both the number and severity of tics. Pimozide treatment did not reduce blinking in the patients. It should be noted that nine of the patients were adolescents for whom there were not adequate age-matched controls, a fact which could obscure a blink rate elevation in this group. Insofar as blink rate is a putative correlate of central dopamine activity, these results are not consistent with elevated brain dopamine activity in adult patients who have Tourette's syndrome.

Adolescent↗
PubMed1984

Enzyme activity in Tourette's syndrome.

Activity levels of platelet monoamine oxidase (MAO), plasma amine oxidase (PAO), erythrocyte catechol-o-methyltransferase, and dopamine-beta-hydroxylase were measured in 24 drug-free patients with Tourette's syndrome (TS) and in 24 normal control subjects matched for age and sex. Only MAO and PAO activity levels were significantly higher in patients than in controls. Activity of the four enzymes was uncorrelated with age, sex, age of onset of illness, severity of illness, family history of tics and Ts, and ethnic-religious background. The hypothesis that probands with heavily loaded pedigrees or with Ashkenazi ethnic-religious background would be more biochemically deviant was not supported.

Adult↗
PubMed1983

Treatment of Gilles de la Tourette's syndrome with clonidine and neuroleptics.

In an open clinical trial of clonidine hydrochloride and neuroleptics in patients with Gilles de la Tourette's syndrome, neuroleptics resulted in greater improvement across the range of symptoms in a larger proportion of patients than did clonidine. A small subgroup of patients may have benefited from treatment with clonidine. Carefully controlled, randomized, and double-blind studies are necessary to resolve the divergent views about the effectiveness of clonidine in the treatment of Gilles de la Tourette's syndrome.

Adult↗
PubMed1983

Treatment of Gilles de la Tourette syndrome with pimozide.

The results of this clinical study of 31 patients with Tourette syndrome suggest that pimozide is more effective and induces fewer side effects than haloperidol in some patients. The clinical advantages of pimozide may be associated with its more specific dopamine-blocking properties and the absence of significant norepinephrine effects. The authors recommend further controlled study of exclusive dopamine antagonists in the treatment of Tourette syndrome.

Adolescent↗
PubMed1982

An update on Tourette syndrome.

This summary of the present status of tic disorders in based on our experience with 650 patients and review of the literature. The three major tic disorders, Transient Tic of Childhood, Chronic Motor Tic, and Tourette syndrome, now thought to have similar organic etiology, form a continuum with heterogeneity of symptoms and severity. This paper summarizes current understanding of the demography, illness-related characteristics, psychopathology, neuropathology, genetics, neurochemistry, and treatment.

Adolescent↗
PubMed1981

Tic disorders.

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Humans↗