Biomedical subjects

G B McAnulty

Publications and source records attributed to G B McAnulty.

12 recordsLinked to original sources

PubMed1996

Effectiveness of individualized neurodevelopmental care in the newborn intensive care unit (NICU).

The individual infant's neurodevelopmental process provides an integrative framework for the delivery of medical care needed to assure the infant's survival and quality of outcome. The infant's neurobehavioral functioning and expression provides an opportunity for caregivers to estimate the individual infant's current strengths, vulnerabilities and threshold to disorganization, as well as to identify the infant's strategies in collaborating in his or her best progression. This perspective supports caregivers in seeing themselves in a relationship with the infant, and in considering opportunities to enhance the infant's strengths and reduce apparent stressors in collaboration with the infant and the family. The results of several randomized studies supporting the effectiveness of such a neurodevelopment approach to NICU care will be presented, and suggest implications for staff education and nursery-wide implementation.

Brain↗

PubMed1995

Spectral coherence in normal adults: unrestricted principal components analysis; relation of factors to age, gender, and neuropsychologic data.

This paper demonstrates, by means of Principal Components Analysis (PCA), an objective approach to the reduction of large data sets produced by multichannel spectral coherence analyses. Coherence data, gathered from 371 normal healthy adults using Hjorth/Laplacian referencing during waking eyes-open and eyes-closed states, were analyzed by "unrestricted" PCA where neither spatial nor temporal variance was folded into among subject variance. There was substantial data reduction with our 4416 initial coherence variables for each state reduced to just 150 factors containing approximately 80% of the variance reflecting a 30 fold concentration of information content. Varimax rotation of the first 40 factors, encompassing 50% of the total variance for both states, revealed loading patterns primarily bilateral with no hemispheric bias, relationships primarily between distant single electrode pairs, (although a single electrode to multiple electrode pattern was also observed), and involvement of all spectral bands. Elemental left to right and anterior to posterior coherence patterns, often used on an a priori basis for coherence studies, were not evident among the rotated factor loading patterns. On the basis of high loadings upon extra bipolar artifact channels, 32 factors accounting for approximately 40% of the variance were identified as reflecting artifactual coherence relationships. By multiple regression the 48 non-artifactual factor scores successfully predicted subject age. In general, coherence diminished with age, which may partly explain age-related EEG desynchronization in healthy adults. Coherence factors also predicted 6 of 10 neuropsychologic variables. Gender was successfully predicted by discriminant analysis. No global interpretations about coherence and gender or neuropsychologic function were possible, i.e., almost equal numbers of factors increased as decreased in males as females. PCA derived coherence factor scores are useful for subsequent statistical analyses, but their factor loading plots of cortical coupling may require more experience to fully interpret.

Adult↗

PubMed1995

Effectiveness of individualized developmental care for low-risk preterm infants: behavioral and electrophysiologic evidence.

OBJECTIVE: We assessed the effectiveness of individualized developmental support in the special care nursery for low-risk preterm infants. SETTING: A university-affiliated teaching hospital. PARTICIPANTS: Twelve healthy full-term infants, and 24 low-risk preterm infants randomly assigned to a control or an experimental group. DESIGN: The preterm control group received standard care and the preterm experimental group received individualized developmental care at the same special care nursery. OUTCOME MEASURES: Medical, behavioral (Assessment of Preterm Infants' Behavior and Prechtl's Neurological Examination of the Full-Term Newborn Infant), and electrophysiologic outcome (using quantitative electroencephalography with topographic mapping) of all three groups was assessed 2 weeks after the expected due date. RESULTS: No between- or among-group medical differences were seen for this low-risk, healthy sample. The preterm experimental group showed behavioral and electrophysiologic performances comparable to those of the full-term group, whereas the preterm control group performed significantly less well. Behavioral measures suggested significantly poorer attentional functioning for the preterm control group. Electrophysiologic results implicated the frontal lobe. CONCLUSIONS: Individualized developmental intervention supports neurobehavioral functioning as measured at 2 weeks post-term. It appears to prevent frontal lobe and attentional difficulties in the newborn period, the possible causes of behavioral and scholastic disabilities often seen in low-risk preterm infants at later ages.

Child Development↗

PubMed1994

Individualized developmental care for the very low-birth-weight preterm infant. Medical and neurofunctional effects.

OBJECTIVE: To investigate the effectiveness of individualized developmental care in reducing medical and neurodevelopmental sequelae for very low-birth-weight infants. DESIGN: Randomized controlled trial. SETTING: Newborn intensive care unit. PATIENTS: Thirty-eight singleton preterm infants, free of known congenital abnormalities, weighing less than 1250 g, born before 30 weeks' gestation, mechanically ventilated within 3 hours of delivery and for more than 24 hours in the first 48 hours, randomly assigned to a control or an experimental group. INTERVENTION: Caregiving by nurses specifically trained in individualized developmental care; observation and documentation of the infants' behavior within 12 hours of admission, and subsequently every 10th day; developmental care recommendations and ongoing clinical support for the nurses and parents based on regular observation of the infant by developmental specialists; and the availability of special caregiving accessories. MAIN OUTCOME MEASURES: Medical outcome, including average daily weight gain; number of days the infant required mechanical ventilation, oxygen, gavage tube feeding, and hospitalization; severity of retinopathy of prematurity, bronchopulmonary dysplasia, pneumothorax, and intraventricular hemorrhage; pediatric complications; age at discharge; and hospital charges. Neurodevelopmental outcome, including Assessment of Preterm Infants' Behavior scale and quantified electroencephalography (2 weeks after due date); and Bayley Scales of Infant Development and Kangaroo Box Paradigm (9 months after due date). RESULTS: The infants in the experimental group had a significantly shorter duration of mechanical ventilation and supplemental oxygen support; earlier oral feeding; reduced incidence of intraventricular hemorrhage, pneumothorax, and severe bronchopulmonary dysplasia; improved daily weight gain; shorter hospital stays; younger ages at hospital discharge; and reduced hospital charges compared with the infants in the control group. At 2 weeks after their due dates, these infants also showed improved autonomic regulation, motor system functioning, self-regulatory abilities, and visual evoked potential measures; and at 9 months, they had improved Bayley Mental and Psychomotor Developmental Index scores, as well as Kangaroo Box Paradigm scores. CONCLUSION: Very low-birth-weight preterm infants may benefit from individualized developmental care in the neonatal intensive care unit in terms of medical and neurodevelopmental outcome.

Child Development↗

PubMed1993

Brain electrical correlates of psychological measures: strategies and problems.

We explore relationships between brain electrical activity and cognitive performance where qEEG data are correlated with psychological variables gathered at a different time. For a population of 202 healthy adults using univariate and multivariate correlation techniques in a split half replication design, we confirm prior findings that subjects with better psychological scores show shorter evoked potential (EP) latency, suggesting that speed of processing is an important factor in cognitive performance. By canonical correlation we demonstrate a consistent, replicable relationship between electrophysiological and behavioral data. We suggest that reliance upon univariate correlation may have fueled early controversies about relationships between electrophysiology and IQ. In addition we correlate psychological factors with the entire qEEG data set (both EP and spectral analyzed EEG) and demonstrate the use a multidimensional image graphics techniques to assist in visual assessment of the resulting correlation matrices.

Adult↗

PubMed1990

Electrophysiologic comparisons between two groups of patients with Alzheimer's disease.

Two groups of patients with Alzheimer's disease were compared using brain electrical activity mapping. The patients were selected on the basis of their cognitive history. The initial symptom of disease of the patients in group 1 was a significant and profound memory deficit, whereas the patients in group 2 initially presented with a gradually progressive spatial impairment. Fourteen topographic features distinguished the groups. Eleven of the 14 features pertained to electrical activity differences in parietal regions, and 9 were bilateral. These features were highly correlated with cognitive measures that are also useful in distinguishing the groups.

Aged↗

PubMed1990

Quantified neurophysiology with mapping: statistical inference, exploratory and confirmatory data analysis.

Topographic mapping of brain electrical activity has become a commonly used method in the clinical as well as research laboratory. To enhance analytic power and accuracy, mapping applications often involve statistical paradigms for the detection of abnormality or difference. Because mapping studies involve many measurements and variables, the appearance of a large data dimensionality may be created. If abnormality is sought by statistical mapping procedures and if the many variables are uncorrelated, certain positive findings could be attributable to chance. To protect against this undesirable possibility we advocate the replication of initial findings on independent data sets. Statistical difference attributable to chance will not replicate, whereas real difference will reproduce. Clinical studies must, therefore, provide for repeat measurements and research studies must involve analysis of second populations. Furthermore, Principal Components Analysis can be employed to demonstrate that variables derived from mapping studies are highly intercorrelated and data dimensionality substantially less than the total number of variables initially created. This reduces the likelihood of capitalization on chance. The need to constrain alpha levels is not necessary when dimensionality is low and/or a second data set is available. When only one data set is available in research applications, techniques such as the Bonferroni correction, the "leave-one-out" method, and Descriptive Data Analysis (DDA) are available. These techniques are discussed, clinical and research examples are given, and differences between Exploratory (EDA) and Confirmatory Data Analysis (EDA) are reviewed.

Brain↗

PubMed1990

Behavioral and electrophysiological evidence for gestational age effects in healthy preterm and fullterm infants studied two weeks after expected due date.

We investigated the effects of gestational age at birth on behavioral and electrophysiological measures of 135 medically healthy infants, studied at 42 weeks postconception, and stratified into 3 groups--early-born preterms, 26-32 weeks (n = 55); middle-group preterms, 33-37 weeks (n = 43); and fullterms, 38-41 weeks (n = 37). Subjects were studied behaviorally with the Assessment of Preterm Infants' Behavior (APIB) and electrophysiologically with brain electrical activity mapping (BEAM). Fullterms showed significantly better behavioral function than both preterm groups. Less difference was found between the preterm groups. EEG spectral and photic evoked response were of significantly less amplitude for the preterms than the fullterms. Path analysis showed gestational age effects on behavioral (3 of 6) and electrophysiological (13 of 17) variables due to postnatal complications. We conclude that some differences attributable to gestational age at birth are explained by the cumulative effect of minor but unavoidable complications associated with premature birth. We speculate that remaining effects may result from developmentally inappropriate sensorimotor stimulation consequent to the premature experience of an extrauterine environment.

Arousal↗

PubMed1988

Neurophysiological studies in dyslexia.

Using sophisticated computer graphics technologies and sensitive methods, our original dyslexia study of dyslexic boys delineated specific areas of the brain which in combination could constitute a "physiological signature" of dyslexia. In addition to identifying aberrant brain function in the traditional language-associated left posterior region, we also observed medial frontal lobe differences from normals, a finding confirmed by others in recent research. Our subsequent study sought to refine further current definitional subgroupings within the broad entity known as dyslexia-pure. Indeed language-based subgroups appear to have identifiable and differing topographic signatures. Furthermore, based on correlations between neuropsychological test scores and neurophysiological measurements, we suggest that subgroup electrophysiological differences may reflect compensatory as well as pathological brain activity. We believe that the currently expanding understanding of the neurophysiology of dyslexia will lead eventually to improved diagnosis and remediation of this learning disability. The detailed mapping of brain electrical activity shows promise of providing the neuropsychologist and learning disability specialist with another "perspective" on reading disability. This technique may prove valuable in the diagnosis of dyslexia at an early age and in the tailoring of the learning experience to a child's specific deficits and capabilities.

Brain↗

PubMed1985

Structure and function: brain electrical activity mapping and computed tomography in schizophrenia.

A computerized topographic technique that maps brain electrical activity is applied to the investigation of neurophysiological abnormalities in medicated and drug-free schizophrenic patients. This topographic approach uses EEG and evoked potentials to provide functional measures of electrophysiological abnormalities. Neurophysiological differences between schizophrenic patients and controls are delineated which add further evidence that frontal lobe dysfunction may be relevant to our understanding of schizophrenia. An initial investigation employs computed tomography to examine the relationship of structural anatomical pathology in schizophrenia with the functional abnormalities that may be defined using brain electrical activity mapping. When schizophrenic patients with and without frontal cortical atrophy were compared, electrophysiological differences were delineated that overlay frontal cortical regions. This preliminary work suggests that in schizophrenia, abnormal electrophysiological function is associated with definable gross morphological abnormalities of the brain.

Adult↗

PubMedDate not supplied

The pattern of age-related differences in electrophysiological activity of healthy males and females.

Age-related differences in quantified electrophysiological measures were examined in 202 subjects (109 females; 93 males) ages 30-80 all of whom were judged to be optimally healthy on a wide variety of criteria. The study utilized both absolute and relative measures from EEG spectral analysis as well as additional measures from long latency-evoked potentials. The same findings were noted for the 109 newly studied females as were reported for 63 previously studied male subjects. Results indicate that there is a broad trend for decreased EEG slow and increased fast activity with age, however, some of the measures change linearly and others are best represented by nonlinear functions. There is no decade where activities remain stable. Overall the pattern of change for males and females is similar, however, gender differences in both the EEG and EP data were present. The females had higher magnitudes for almost all absolute spectral and fast relative spectral measures. However, females demonstrated lower absolute alpha amplitude, lower relative slow activity, and lower late-latency EP data. Moreover, the absolute slow activity measure showed a gender X age interaction, indicating that the females had a different change in pattern of activity with increasing age than the males. Thus, gender-related findings were complex and could not be expressed as simple differences in overall amplitude. Age-related change is not a simple linear process but differs for differing EEG spectral bands, relative, and absolute spectral measures and for males and females. The overall findings contradict the common wisdom that EEG and alpha slow with age and that age related EEG change is on a continuum with findings in Alzheimer's disease where increased slowing predominates.

Adult↗

PubMedDate not supplied

Temporoparietal electrophysiological differences characterize patients with Alzheimer's disease: a split-half replication study.

One hundred and eighty nine subjects were examined by quantified EEG (qEEG) during the resting awake state. Sixty subjects had probable Alzheimer's disease (AD) and were mild to moderately impaired. There were 129 healthy controls. Differences between patients and controls by topographic mapping demonstrated a pattern of group difference maximal posteriorly, primarily in posterior temporal and/or parietal regions. Frontal regions were much less frequently involved. Long-latency evoked potential derived difference showed similar spatial patterns of difference. By EEG spectral analysis, theta was increased and beta decreased for the AD patients. In addition, the qEEG measures were significantly correlated with neuropsychological test scores related to abilities that are impaired in the early stages of disease, such as delayed recall and verbal fluency. To assess replicability the population was split in half. Regions of interest derived from the first half provided numerical measures for discriminant function analysis. A discriminant function, derived from the first half, correctly identified 86% of all second-half subjects (91% controls, 77% AD).

Aged↗