Biomedical subjects

B J Diamond

Publications and source records attributed to B J Diamond.

15 recordsLinked to original sources

PubMed2001

Functional magnetic resonance imaging of working memory impairment after traumatic brain injury.

OBJECTIVES: To examine patterns of brain activation while performing a working memory task in persons with moderate to severe traumatic brain injury (TBI) and healthy controls. It is well established that working memory is an area of cognition that is especially vulnerable to disruption after TBI. Although much has been learned about the system of cerebral representation of working memory in healthy people, little is known about how this system is disrupted by TBI. METHODS: Functional magnetic resonance imaging (fMRI) was used to assess brain activation during a working memory task (a modified version of the paced auditory serial addition test) in nine patients with TBI and seven healthy controls. RESULTS: Patients with TBI were able to perform the task, but made significantly more errors than healthy controls. Cerebral activation in both groups was found in similar regions of the frontal, parietal, and temporal lobes, and resembled patterns of activation found in previous neuroimaging studies of working memory in healthy persons. However, compared with the healthy controls, the TBI group displayed a pattern of cerebral activation that was more regionally dispersed and more lateralised to the right hemisphere. Differences in lateralisation were particularly evident in the frontal lobes. CONCLUSIONS: Impairment of working memory in TBI seems to be associated with alterations in functional cerebral activity.

Adult↗

PubMed2001

A comparison of memory performance in relapsing-remitting, primary progressive and secondary progressive, multiple sclerosis.

OBJECTIVE: The current investigation was designed to examine the influence of disease course on the specific patterns of acquisition and retrieval impairments in multiple sclerosis (MS). BACKGROUND: Recent investigations of learning and memory in MS have shown that many subjects have impaired verbal and visual new learning abilities, but normal long-term recall and recognition. However, heterogeneity in the learning and memory abilities of subjects has been documented. Some evidence in the literature suggests that this heterogeneity may be in part attributable to clinical variables, such as disease course. METHODS: Verbal and visual learning and memory tests, modified to equate MS groups with healthy controls on initial acquisition of information, were administered to 64 individuals with clinically definite MS (relapse-remitting = 21; primary progressive = 18; secondary progressive = 25), and to 20 healthy control participants. Recall and recognition performance then was evaluated at 30 minutes, at 90 minutes, and at 1 week for the verbal learning task, and at 30 minutes and at 90 minutes for the visual learning task. RESULTS: Results indicate that the two progressive forms of MS result in significantly greater deficits in regard to the acquisition of new verbal information, with the secondary progressive group showing a significantly higher failure rate in regard to meeting the learning criterion. Performance for recognition measures was not significantly different among groups, whereas recall performance of the primary progressive group was significantly below that of the control group and of the secondary progressive group. When testing new learning with visuospatial information, individuals with relapse-remitting MS and secondary progressive MS required more trials than control participants to learn the same amount of visual information. Visual recall and recognition performance did not differ between groups. No group differences in rates of forgetting for visuospatial material was observed after equating for acquisition. CONCLUSIONS: Results of the current study indicate that the primary problem in MS with regard to memory functioning is in the acquisition of new information. Our findings support previous research showing verbal memory deficits with a progressive disease course and visuospatial memory deficits in relapse-remitting MS. However, the detailed analysis of new learning and memory performed in the current study indicated that the primary progressive group may be showing difficulty in their ability to use newly learned information. The pattern of new learning deficits observed between MS disease subtypes in the current study was determined to be unrelated to the duration of MS and to the physical severity of the disease. The degree of physical disability observed in patients with MS does not appear to be related to the degree of cognitive decline because of the distinct patterns and severity of memory dysfunction noted within each disease type, independent of physical disability.

Adult↗

PubMed2000

Ginkgo biloba extract: mechanisms and clinical indications.

OBJECTIVE: Ginkgo biloba may have a role in treating impairments in memory, cognitive speed, activities of daily living (ADL), edema, inflammation, and free-radical toxicity associated with traumatic brain injury (TBI), Alzheimer's dementia, stroke, vasoocclusive disorders, and aging. The purpose of this review is to provide a synthesis of the mechanisms of action, clinical indications, and safety of Ginkgo biloba extract. DATA SOURCES: Empirical studies, reviews, chapters, and conference proceedings were identified in the following databases: Medline, the Research Council for Complementary Medicine based on the British Library database, and Psychlnfo. Ginkgo biloba, EGb 761, Tanakan, Tebonin, Rokan, and LI 1370 were the principal index terms. STUDY SELECTION AND DATA EXTRACTION: Controlled clinical studies with both positive and negative findings are included, in addition to animals studies illustrating mechanisms of activity. DATA SYNTHESIS: Ginkgo has shown activity centrally and peripherally, affecting electrochemical, physiologic, neurologic, and vascular systems in animals and humans with few adverse side effects or drug interactions. Ginkgo shows promise in patients with dementia, normal aging, and cerebrovascular-related disorders. Clinical indications include memory, information processing, and ADL. CONCLUSIONS: Ginkgo shows promise in treating some of the neurologic sequelae associated with Alzheimer's disease, TBI, stroke, normal aging, edema, tinnitus, and macular degeneration. Mechanisms of action may include antioxidant, neurotransmitter/receptor modulatory, and antiplatelet activating factor properties. While safe, caution is advised when recommending ginkgo to patients taking anticoagulants. Future studies should examine dose effects, component activity, mechanisms, and clinical applications.

Animals↗

PubMed2000

Speed of information processing in traumatic brain injury: modality-specific factors.

OBJECTIVE: To assess speed of information processing by two serial addition tests (one visual, one auditory) in individuals with moderate-to-severe traumatic brain injuries (TBIs) and in a healthy, normal control group (NC). The tasks were designed to equate and control for accuracy of performance across the TBI and NC groups, thus allowing for quantification of information processing speed. DESIGN: Performance across groups and tasks were compared using 2 x 2 repeated measure analyses of variance (ANOVAs). In addition, each individual's processing speed was used to adjust rate of stimulus presentation on a subsequent "rehabilitation" trial to determine further whether this adjustment equated accuracy of performance. SETTING: Rehabilitation hospital. PATIENTS: 22 outpatients with moderate-to-severe TBI (6 women, 16 men; mean age = 34.6 years; duration of loss of consciousness = 22.6 days) and 20 age- and education-matched healthy controls. RESULTS: Processing speed was slower in TBI subjects, relative to controls and was significantly related to measures of executive functioning for those with TBI. Relative to controls, speed of processing in the TBI group was disproportionately slower when information was presented in the auditory, relative to the visual, modality. CONCLUSIONS: Speed of information processing is a major impairment in those with TBI when unconfounded by performance accuracy. The modality-specific impairment observed in the TBI group may, in part, be due to a greater within-modality interference effect created by the auditory version of the task. By manipulating information at a pace customized for an individual through compensatory strategies and environmental modifications, information-processing performance of TBI participants can be enhanced significantly.

Adult↗

PubMed1999

Speed of information processing as a key deficit in multiple sclerosis: implications for rehabilitation.

Speed of information processing was assessed in patients with multiple sclerosis and healthy controls using both an auditory and visual task designed to control for accuracy of performance across groups. After controlling for accuracy of performance, patients with multiple sclerosis were found to have significantly slower speed of information processing relative healthy controls, irrespective of the modality of stimulus presentation (auditory or visual). When given an adequate amount of time to process information, however, the patients performed similarly to controls. These results suggest that persons with multiple sclerosis experience deficits specifically in processing speed but not performance accuracy. Results are discussed in terms of rehabilitative guidelines for the cognitive improvement of persons with multiple sclerosis.

Adult↗

PubMed1998

Acquisition and storage deficits in multiple sclerosis.

This study examined whether verbal and visual memory impairments in multiple sclerosis (MS) are attributable to deficits in acquisition, storage, or retrieval. Volunteers with MS (n = 40) and healthy controls (n = 20) rehearsed a word list and a checkerboard pattern using a selective reminding procedure until two consecutive error-free trials were attained. Recall and recognition were assessed after 30 min and 90 min (and 1 week for verbal material) delays. The MS group required significantly more trials to attain criterion on both learning tests. Once equated for acquisition, both groups performed similarly on verbal recall and recognition. However the MS group performed significantly worse on measures of visual recall and recognition. The results suggest that the verbal memory impairment in MS is due to deficient acquisition, while the visual memory impairment in MS is attributable to deficits in acquisition and storage.

Adult↗

PubMed1997

The question of disproportionate impairments in visual and auditory information processing in multiple sclerosis.

The present study was conducted to investigate the hypothesis that subjects with MS have a disproportionate impairment in the phonological loop of working memory and whether such impairment is domain-specific. This was assessed by comparing performance in subjects with MS across both the visual (using the Paced Visual Serial Addition Test: PVSAT) and auditory (using the Paced Auditory Serial Addition Test: PASAT) domains. In addition, we assessed the role of processing speed in mediating performance deficits. The results showed that: (1) Although all subjects performed better on the PVSAT versus the PASAT, no disproportionate modality-specific differences were observed in the MS group relative to controls; and (2) the rate of decline across trials in the MS and healthy control groups did not differ on either the PVSAT or PASAT. Implications of the results are discussed within the context of a working memory model.

Adult↗

PubMed1997

Memory and executive functions in amnesic and non-amnesic patients with aneurysms of the anterior communicating artery.

Ruptured and repaired anterior communicating artery (ACoA) aneurysm can result in devastating impairments involving memory, executive function, confabulation and personality change. Importantly, traditional cerebral areas implicated in amnesia are not damaged, yet amnesia can still be manifested. While ACoA patients show normal visual-constructional skills (i.e. copy scores) on the Rey-Osterrieth complex figure test, recall is often impaired. What is unclear is whether impaired recall is attributable to problems in encoding, accelerated rates of forgetting, retrieval or some combination. To disentangle these issues, we examined 10 patients with ruptured aneurysms of the ACoA, using the Rey-organizational and extended memory procedure which uses an organizational procedure for enhancing immediate recall and provides added sensitivity by combining recall with non-recall measures (e.g. recognition, spatial discrimination and spatial assembly). The major findings were: (i) immediate recall in amnesics was improved by providing an organizational strategy; (ii) following the organization trials, amnesics and non-amnesics retained information to a comparable extent over a 30-min delay; (iii) two subgroups of amnesics emerged, those subjects impaired in acquisition and a second group with impaired retrieval; (iv) all subjects showed preserved memory on non-recall measures. These findings have important implications with respect to using organizational strategies in cognitive treatments and in using non-recall measures in improving the validity and reliability of patient assessment.

Adult↗

PubMed1997

Verbal learning in amnesic anterior communicating artery aneurysm patients and in patients with multiple sclerosis.

The California Verbal Learning Test (CVLT) was used to examine the qualitative, and quantitative aspects of memory in patients with amnesic anterior communicating artery aneurysm (ACoA) and in patients with multiple sclerosis (MS). The results show that both groups were impaired relative to control participants with respect to acquisition of verbal material. The participants with A CoA exhibited a profound loss of information and emitted a significantly greater number of intrusions and false positives than either control participants or participants with MS. The advantages of using both quantitative and qualitative measures of memory in differentiating various clinical populations are discussed.

Journal Article↗

PubMed1996

Autonomic and recognition indices of memory in amnesic and healthy control subjects.

Autonomic and recognition indices were examined in six amnesic subjects of mixed aetiology and six control subjects matched with respect to age, education and intelligence. The key objectives of this study were: (a) assess amnesics level of recognition and autonomic discrimination for recently shown words compared with controls; (b) determine if amnesics' level of autonomic discrimination was preserved when compared with the control subjects, level of recognition; and (c) assess confidence in hits and false alarms. The results showed that: (1) despite showing impaired recognition, amnesics displayed significantly better autonomic discrimination; (2) the level of autonomic discrimination displayed by amnesics did not significantly differ from the control subjects' level of recognition; (3) the level of confidence expressed in false alarms and hits did not significantly differ between amnesics and controls, which is in sharp contrast to the significantly greater levels of confidence expressed by healthy subjects in hits versus false alarms. If future work shows that amnesics display preserved autonomic discrimination for novel information, then it may suggest that, at least, some amnesics can store information to an extent that is comparable to that of healthy controls.

Adult↗

PubMed1996

Selective impairment of auditory processing in chronic fatigue syndrome: a comparison with multiple sclerosis and healthy controls.

The most consistent deficit observed in individuals with Chronic Fatigue Syndrome has been in efficiency of information processing. To examine the possibility of a modality-specific impairment, the present study examined subjects with Chronic Fatigue Syndrome, multiple sclerosis, and healthy controls on an auditory-versus visual-paced serial-addition test. 20 subjects with Chronic Fatigue Syndrome, 20 subjects with clinically definite Multiple Sclerosis, and 20 sedentary healthy controls were compared. One-half of the subjects in each group were administered the Paced Auditory Serial Addition Test and the other half were administered the Paced Visual Serial Addition Test. The group with Chronic Fatigue Syndrome was differentially impaired on the auditory relative to the visual processing task. The group with Multiple Sclerosis was equally impaired on both versions of the task. The results are discussed within the framework of Baddeley's model of working memory.

Adult↗

PubMed1995

Aneurysm of the anterior communicating artery: a review of neuroanatomical and neuropsychological sequelae.

For over 100 years, the study of amnesia in humans has been limited primarily to subjects with either diencephalic or mesial temporal lobe lesions. However, over the last 30 years, it has been reported that individuals who survived aneurysms of the anterior communicating artery (ACoA) often displayed an amnestic syndrome, despite the fact that diencephalic and mesial temporal structures were intact. This article presents a comprehensive review of the ACoA literature concerning the neurobehavioral and neuroanatomical substrates of what has been termed the "ACoA syndrome". Various theoretical models regarding the neural substrates of amnesia are discussed. Possible directions for future research are outlined.

Amnesia↗

PubMed1995

Cardiovascular regulation in multiple sclerosis.

Traditional assessments of autonomic nervous system function have depended on invasive and complex procedures. Vagal power, which is the respiratory component of heart rate variability (HRV) is an alternative and non-invasive measure for indexing autonomic nervous control of the heart. In the current study, 18 multiple sclerosis (MS) and 20 healthy subjects matched with respect to age, education and intelligence served as subjects. The MS group showed significantly lower vagal power during natural and paced breathing than healthy subjects. Importantly, heart rate did not differ between the two groups. If MS patients exhibit abnormalities in mechanisms mediating cardiac parasympathetic control, the impact on quality of life and vulnerability to adverse cardiac events need to be further evaluated. The results of this study may have implications with respect to the feasibility of using HRV as both a diagnostic and prognostic tool for evaluating parasympathetic nervous system dysfunction and in providing valuable information for developing more effective treatment and rehabilitation strategies.

Adult↗

PubMed1994

Evidence of covert recognition in a prosopagnosic patient.

This is a case-study of a patient (ET) who suffers from prosopagnosia, in the context of impairment to cognitive functions, following traumatic brain injury. Despite severe perceptual difficulties in tests involving non-face stimuli and matching unfamiliar faces, ET showed evidence of "covert" recognition of familiar faces in a number of tasks. Although densely prosopagnosic, she performed at normal levels in word and object recognition tasks, and is unimpaired in her ability to recognise names of celebrities. She performed at the same level as controls in her ability to make a forced-choice of the correct name for a famous face, even though it evoked no feeling of familiarity for her. She performed at chance in a forced-choice face familiarity decision task, but showed evidence of covert recognition in a "true" versus "untrue" face-name learning task. ET showed overt recognition of some famous faces using a procedure based on Sergent and Poncet's (1990) semantic activation task. The pattern of impairment of ET's face processing abilities is interpreted in terms of an interactive activation model of face processing.

Adult↗

PubMedDate not supplied

Reciprocal inhibition in the forearm during voluntary contraction and thinking about movement.

The regulatory mechanism for the interaction of agonist and antagonist muscles is not still clear. In these studies we investigated reciprocal inhibition during voluntary contraction and thinking about movement by using transcranial magnetic stimulation (TMS) and the H reflex technique. Magnetic stimuli, with intensities 10% above threshold, were delivered at the scalp under 3 experimental conditions; at rest, during voluntary isometric weak contraction and during thinking about movement. Surface EMG responses were taken from extensor carpi radialis (ECR) and flexor carpi radialis (FCR) muscles in 14 normal subjects. Inhibitions of antagonist muscles induced by thinking about agonist movement occurred in 8 ECR and 10 FCR muscles, but most of them were not statistically significant. H reflexes were obtained from the FCR muscles in 10 normal subjects under the same conditions. Voluntary wrist extension and thinking about wrist extension produced inhibition of the H reflex in the FCR muscles. Reciprocal inhibition of antagonist muscles may occur at the cortical and spinal cord levels. The excitability of motoneurons has effects on the H reflex amplitude. Motor evoked potential (MEP) response to TMS might be affected by the combination of input from the motor cortex and the spinal cord. TMS may evoke simultaneous facilitatory and inhibitory volleys to antagonist muscles. This may explain why the inhibitions in the TMS study were weaker than those in the H reflex study.

Adult↗