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Biomedical subjects

A Pfefferbaum

Publications and source records attributed to A Pfefferbaum.

At least 73 records · Page 4Linked to original sources

Clinical application of the P3 component of event-related potentials. II. Dementia, depression and schizophrenia.

Patients with dementia, schizophrenia and depression were tested with analogous auditory and visual event-related potential (ERP) paradigms designed to elicit a large P3. The patient groups were compared to age normative predictions derived from a large control sample for a number of ERP and behavioral variables. The results were similar for the auditory and visual paradigms. P3 latency was prolonged two or more S.D.s beyond that predicted by age for less than one-half of the demented patients. This latency prolongation was significant for the group as a whole but would result in too many false negatives if used diagnostically for individuals. Furthermore, increased P3 latency was not specific, as the schizophrenic patients also had later P3s. The amplitude of P3 was reduced in the demented patients, but it was also smaller in other patient groups. The only variable which distinguished the demented patients from both controls and from the other patients was the single trial P3 latency/RT correlation. The demented patients, as a group, had significantly lower P3 latency/RT correlations, but this effect also was not sensitive enough to be diagnostic for individuals. The data from these two paradigms suggest that the P3 amplitude and latency abnormalities observed reflect a common, rather than a diagnostically specific deficit. This study is in contrast to some others which report much more sensitivity and specificity in the use of P3 latency in the diagnosis of dementia. Differences in task demands, patient samples and ERP analysis techniques might explain some of the discrepancy.

Auditory Perception

ERPs and Psychopathology. I. Behavioral process issues.

The clinical study of ERPs has an inherent defect--a self-selection of clinical populations that hampers equating of clinically defined groups on factors extraneous to the independent variables. Such ex post facto studies increase the likelihood of confounding variables in the interpretation of findings. Hence, the development of lawful relationships between clinical variables and ERPs is impeded and the fulfillment of description, explanation, prediction, and control in brain science is thwarted. Proper methodologies and theory development can increase the likelihood of establishing these lawful relationships. One methodology of potential value in the clinical application of ERPs, particularly in studies of aging, is that of divided attention. Two promising theoretical developments in the understanding of brain functioning and aging are the distraction-arousal hypothesis and the controlled-automatic attention model. The evaluation of ERPs in the study of brain-behavior relations in clinical populations might be facilitated by the differentiation of concurrent, predictive, content, and construct validities.

Adolescent

Age-related loss of trabecular bone in premenopausal women: a biopsy study.

We measured the trabecular bone volume (TBV) of 62 iliac crest biopsies taken from women admitted to lymphoma protocols at Stanford University between 1970-1981. All subjects were active, cycling premenopausal women, with bone marrows that were negative for tumor. Disease status was stage III or less in 90% of the subjects. Trabecular bone volume was negatively correlated with age, and the annual predicted loss of bone was 0.14-0.18% TBV, or 0.7% of the original bone volume. In addition, there was a substantial range of normal TBV at any given age, evident even during adolescence. This study demonstrates that TBV is lost from iliac crest throughout adult life. The large spread in TBV indicates further that factors operating during adolescence or even earlier may have an important impact on skeletal mass.

Adolescent

Manipulation of P3 latency: speed vs. accuracy instructions.

Twelve young female subjects were presented with a series of horizontal line-pairs of same or different length in a two-alternative, forced-choice RT task, with 60 of each type pair in each block of trials. In one block (Easy) lines differed by 30%, in another block (Difficult) lines differed by 7%. Subjects were first given 60 practice trials with the Easy discrimination and with the instruction that speed and accuracy should be emphasized equally. For the next block of trials, accuracy was emphasized with a monetary bonus for accurate performance. Finally, in the last block of trials, speed was emphasized with a monetary bonus for speedy performance. Additionally, a penalty was incurred for RTs that exceeded a criterion level based on each individual subject's performance. The order of Easy and Difficult discrimination blocks was maintained within a subject but balanced across subjects. From the latency-adjusted P3s recorded from Pz, we obtained P3 latencies, amplitudes and single-trial P3 latency/RT correlations. RT to correct and incorrect trials and error data were also collected. P3 was considerably larger during the Speed than Accuracy conditions. The single-trial P3 latency/RT correlation was higher in Speed than in Accuracy runs. RT was 235 msec faster and P3 was 40 msec earlier during the Speed than during the Accuracy runs. On the other hand, discrimination difficulty delayed P3 and RT about equally, 28 and 43 msec respectively. This pattern suggests that speed instructions and discrimination difficulty affect stimulus processing time and response production time differently.

Adult

Effects of perceptual and cognitive difficulty on P3 and RT in young and old adults.

Ten healthy old and 10 healthy young subjects each received a series of trials in a memory retrieval task similar to that devised by Sternberg (1967). On each trial the subject saw a memory set of 2 or 4 digits (set size) followed by a probe. The task was to indicate whether the probe was a positive or negative instance (response type) of the memory set for that trial. On half the trials, the probe digits were degraded by a mask of random dots (stimulus quality). For both young and old subjects, RT was later to probes following the larger set size, later to degraded probes, and later to negative probes. For the young subjects only, P3 latency was delayed by the same variables affecting RT although to a lesser degree. P3 latency in the elderly responded quite differently: it was unaffected by set size or response type. However, P3 was somewhat delayed by the degraded probes suggesting that the failure to reflect set size or ceiling effect in the elderly. The correlation between single-trial P3 latency and RT in the elderly is lower than in the young. The data are discussed in terms of age-related differences in the meaning of P3 latency.

Adult

CT measures of cerebrospinal fluid volume in alcoholics and normal volunteers.

Cranial computed tomography (CT) scans were obtained in 46 male chronic alcoholics and 31 normal male volunteers. Automated methods were used to estimate the cerebrospinal fluid (CSF) volume in various intracranial zones. Measures of the ventricular fluid volume, the volume of fluid in cortical areas on CT sections at the level of the ventricles, and the sulcal fluid volumes on two convexity sections were computed. The alcoholic group, excluding subjects with chronic liver disease, had significantly more fluid than the control group on all sulcal measures. The group difference on the ventricular measure fell short of significance. Within the alcoholic group, no significant correlation was found between the number of years of alcoholism and any fluid measure when normal age effects were taken into account. A striking degree of variability in the sulcal volumes was observed within the alcoholic group, with many subjects showing normal values while a large group showed markedly elevated values. Further studies will be necessary to determine the significance of these variations.

Adult

Expectancy for events in old age: stimulus sequence effects on P300 and reaction time.

Event-related brain potentials were collected from 10 young (M = 22 years) and 10 elderly (M = 77 years) women. Stimuli were random sequences of 1000- and 1500-Hz tone pips in a two alternative, forced choice, reaction time task. Trials were sorted and averaged according to the sequence of the preceding four tones: continuations of repetitions (AAAAA) and alternations (ABABA) and discontinuations of repetitions (BBBBA) and alternations (BABAA). For both groups the P300 component of the event-related brain elicited larger P300s than did discontinuations of alternations, an effect especially large for the elderly women. Mean reaction time did not differ between the two groups, although P300 latencies were significantly longer for the elderly group. Results are discussed in terms of age-related differences in response strategies and sensitivity of P300 latency to response strategy.

Acoustic Stimulation

Auditory event-related potentials in schizophrenia and depression.

Event-related potentials in two auditory target detection paradigms and two auditory paradigms without overt tasks were studied in 22 schizophrenic, 21 depressed, and 28 matched control subjects meeting Research Diagnostic Criteria. In the target detection paradigms, schizophrenics showed a pattern of reduced N120 amplitude and shorter P200 latency to frequently occurring tones, and reduced P300 and Slow Wave amplitude to infrequent target and nontarget tones. This pattern is consistent with impaired selective attention for stimuli. For depressed patients these variables were generally intermediate between those of schizophrenics and controls. In the other paradigms N120 latency was greater for schizophrenics, and P200 amplitude was less for depressed patients.

Adult

Lithium's effect of parathyroid hormone.

Lithium has been reported to raise serum calcium and lower serum phosphate concentrations and to increase urinary calcium excretion. Because these changes may be effects of parathyroid hormone (PTH), PTH was measured in 19 patients receiving lithium. PTH was significantly higher in these patients than in 150 normal subjects. For all patients serum calcium concentrations correlated significantly with serum lithium concentrations. These results indicate that lithium may cause biochemical hyperparathyroidism. Secondary hyperparathyroidism in certain patients with lithium nephrotoxicity is also possible.

Adult

Racial intolerance in a correctional institution: an ecological view.

To determine the significance of social factors in racial intolerance, the authors studied the relationship between relational behavior and ethnicity, group status and role, peer acceptance, and group cohesion in an adolescent correctional institution. Results portray three distinct patterns of adaptation. Hispanics (Chicanos) formed a highly cohesive group that required considerable conformity to group norms; policy was implemented by a leadership capable of relating well to all ethnic groups. Whites formed a disorganized and fragmented group, led by individuals who engaged in racially antagonistic behavior. The highly cohesive black group and their leadership were simultaneously in the forefront of both racial cooperation and racial conflict.

Ethnicity

Group therapy in the management of manic-depressive illness.

Because patients with bipolar affective illness have generally been viewed as poor candidates for psychotherapy, many clinicians have relied on lithium prophylaxis as the major treatment modality. However, even with lithium prophylaxis many patients still relapse, often in settings providing little support for maintenance treatment. This report presents the results of a long-term therapy group composed exclusively of bipolar manic-depressive patients, many of whom had histories of poor adherence ot lithium maintenance. The group met weekly and was conducted with an interpersonal, interactional "here and now" format. Patients attended an average of 47 sessions. Members were initially somewhat aloof and remote and minimized their problems. Over the course of their participation, members became more open and began to discuss their concerns about their illness and lithium maintenance treatment; during this time they functioned much as members in any long-term psychotherapy group. In the two-year period prior to entering the group, patients averaged 16.8 weeks of hospitalization; in the subsequent two-year period they averaged 3.6 weeks of hospitalization. Groups of this kind may offer a simple, cost-effective adjunct to lithium maintenance treatment and may provide the advantages and opportunities of psychotherapy to a group of patients generally seen as resistant to such approaches.

Adolescent

Cholinomimetics and memory. The effect of choline chloride.

Young normal subjects received 16 g of choline chloride in a double-blind A-B-A design. Short- and long-term memory function was evaluated. Comparison of group means indicated that choline chloride did not significantly affect short-term memory or long-term memory. However, individual subjects may have had some aspects of long-term memory affected by choline chloride treatments. The results suggest that the effect of lower doses of choline on long-term memory should be evaluated.

Adolescent

beta-Endorphin and schizophrenia.

To study the effects of beta-endorphin in chronic schizophrenia, nine male patients participated in a double-blind crossover comparison of a single intravenous 20-mg injection of beta-endorphin and saline. Bolus injection of beta-endorphin from an albumin-coated syringe produced markedly higher plasma concentrations than did slow intravenous infusion from a non-albumin-coated syringe. Beta-endorphin intravenously injected in nine patients produced a statistically significant increase in serum prolactin levels. In one patient, both 10 mg of morphine sulfate and 20 mg of beta-endorphin produced similar increases in the alpha power of the EEG. In eight patients, beta-endorphin administration was associated with a statistically significant but not clinically obvious improvement in schizophrenic symptoms.

Adult

Age differences in P3-reaction time associations.

Eight healthy old and 12 healthy young women had event-related potentials (ERPs) recorded during the performance of a memory retrieval task. For each subject the single trial data recorded at Pz were analyzed using Woody's adaptive filter technique. The old subjects differed from the young in several respects: P3 amplitude at Pz was smaller, P3 latency and reaction time (RT) were greater, the relationship between P3 latency and RT was considerably altered. The adaptive filter increased the amplitude of P3 but the age-related amplitude difference persisted, suggesting that this difference is not due to increased latency variability with age. The old subjects had lower single trial P3-RT correlations and longer elapsed time from P3 peak to the response than did the young subjects. Both groups had greater RTs for outset items ('negative' responses) than for inset items ('positive' responses). For the young subjects P3 latency was also greater for the outset compared to the inset items but the difference was not found for the old subjects. Thus, the relationship between P3 latency and RT is altered in the aged--P3 and RT are less tightly coupled than in the young.

Adult