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Biomedical subjects

H H Stonnington

Publications and source records attributed to H H Stonnington.

At least 19 recordsLinked to original sources
PubMed1991

Post-acute management of head injuries.

Many advances have been made in the last 15 years in the treatment of traumatic brain injuries. This paper reviews the advances not only in the acute management stage but also in the crucial rehabilitation phases, both acute and post-acute. Rehabilitation of the brain-injured patient has been shown to result from therapies rather than spontaneous improvement and take years to accomplish, emphasizing the need for a coordinated continuum of rehabilitation programs. There is now evidence that coma and vegetative states are sometimes reversible with a combination of treatments, among them neuropharmacology.

Adult↗
PubMed1990

Incidence of lumbar disc surgery. A population-based study in Olmsted County, Minnesota, 1950-1979.

Age- and sex-specific incidence rates of operation for suspected lumbar disc prolapse were determined for residents of Olmsted County, Minnesota, for the 30-year period 1950 through 1979. The incidence rate (adjusted to the age and sex distribution of the United States white population in 1980) was 52.3 per 100,000 person-years for all such operations and 46.3 per 100,000 person-years for initial operations. These rates remained fairly constant over the study period. A distinction was made between surgically proven and unproven cases of lumbar disc prolapse. Patients with a surgically proven lumbar disc prolapse had about 10 times the risk of another operation for disc prolapse within 10 years after the first operation compared with the general population.

Adolescent↗
PubMed1990

Return to work for persons with traumatic brain injury: a supported employment approach.

Supported employment was used to place 41 persons into competitive employment during 30 months. All individuals had experienced severe head injuries; almost 70% of injuries were due to motor vehicle accidents. A mean of seven years had passed since injury for all referred clients, who had been unconscious a mean of 53 days. Only 36% of referred clients had achieved any competitive postinjury employment, compared with 91% of the same group who were competitively employed before injury. A job retention rate of 71% was reported, with most jobs in warehouse, clerical, and service-related occupations. A mean of 291 hours of job coaching was required to place and maintain all clients in supported employment.

Adolescent↗
PubMed1988

Effects of scopolamine treatment on long-term behavioral deficits following concussive brain injury to the rat.

Scopolamine (0.1, 1.0, or 10.0 mg/kg) or saline was systemically (i.p.) administered to rats 15 min prior to concussive fluid percussion brain injury. Animals pretreated with the 1.0 mg/kg dose exhibited significantly (P less than 0.05) less motor deficits and less body weight loss and recovered to baseline performance sooner than saline-treated rats. Mortality and associated convulsions were significantly lower in rats pretreated with the 1.0 mg/kg dose of scopolamine. A 1.0 mg/kg dose of scopolamine administered (i.p.) 30 s after injury also significantly reduced behavioral deficits. No differences were observed between saline- and scopolamine-treated animals in either the incidence or duration of transient apnea following injury. A 1.0 mg/kg dose of scopolamine administered (i.p.) 15 min prior to epidural clip compression of the spinal cord had no effect on the severity of motor function deficits assessed by an inclined plane test. The data from these experiments suggest muscarinic cholinergic involvement in at least some of the long-term behavioral deficits following mild and moderate levels of brain injury. These results suggest that muscarinic cholinergic antagonists may prove beneficial in the treatment of human head injury.

Animals↗
PubMed1988

Effects of anticholinergic treatment on transient behavioral suppression and physiological responses following concussive brain injury to the rat.

Increasing doses (0.1, 1.0, 10.0 mg/kg) of scopolamine were systemically (i.p.) administered to rats subjected to moderate fluid percussion brain injury. Scopolamine treatment (1.0 mg/kg, i.p.) 15 min prior to trauma significantly reduced mortality and the duration of transient behavioral suppression assessed by a variety of measures. No differences were observed between saline- and scopolamine-treated animals in either the incidence or duration of transient apnea associated with injury. Preinjury treatment with methylscopolamine (1.04 mg/kg) or mecamylamine (1.0 mg/kg) had no effect on transient behavioral suppression. Except for increased heart rate, preinjury treatment with scopolamine (1.0 mg/kg) did not significantly alter systemic physiological responses to injury. Rats treated with scopolamine (1.0 mg/kg, i.p.) 30 s after injury tended to have shorter durations of reflex and response suppression. These experiments suggest that antimuscarinics can attenuate components of transient behavioral suppression associated with concussive brain injury. These findings are consistent with previous experimental and clinical observations and lend further support to the hypothesis that activation of a muscarinic system within the CNS mediates components of reversible traumatic unconsciousness following cerebral concussion.

Animals↗
PubMed1988

Changes in regional brain acetylcholine content in rats following unilateral and bilateral brainstem lesions.

Previous research (Adametz, 1959) has shown that two-step bilateral lesions of the reticular formation in cats produce minimal behavioral disruption compared to one-step bilateral lesions, which produce profound behavioral suppression. We systematically examined alterations in forebrain acetylcholine (ACh) content and neurologic tolerance to one-step and two-step bilateral and unilateral lesions of the pontomesencephalic reticular formation (PMRF) in rats. One-step and two-step bilateral lesions separated by 1 or 5 days produced irreversible bilateral motor dysfunction. Survival after lesioning was 10%, 20%, and 0%, respectively. Unilateral lesion or two-step bilateral lesions separated by 15 or 30 days produced transient (less than 3 days) contralateral motor dysfunction. Survival after lesioning was 90%, 90%, and 100%, respectively. Within 24 h after one-step bilateral lesions, ACh content was significantly decreased bilaterally in thalamus, frontal cortex, amygdala, hippocampus, and basal forebrain. Within 5 days after unilateral lesioning, ACh content was significantly decreased ipsilaterally in the thalamus, amygdala, and hippocampus and had returned to control values by day 10 in the thalamus and hippocampus. The increased neurologic tolerance and recovery of ACh content in two-step bilateral PMRF lesions demonstrate important functional and neurochemical plasticity to brain injury. Although not directly addressing mechanisms of neural plasticity, this research examined possible associations between neurologic tolerance to PMRF lesions and neurochemical markers of forebrain ACh activity.

Acetylcholine↗
PubMed1987

Transient suppression of event-related evoked potentials produced by mild head injury in the cat.

Studies in humans have shown that sensory stimuli, presented in the context of certain tasks, can elicit a late positive component (LPC), namely P300, in the scalp-recorded evoked potential believed to reflect neural activity related to attentional processes. A similar LPC has been reported in cats and monkeys. In this study, the LPC of the auditory evoked potential (AEP) in the cat was used to detect impairment in attention to a relevant stimulus after low levels of cerebral concussion produced by a fluid percussion device. A hollow screw (for fluid percussion) and stainless steel screws (for AEP recording) were surgically placed in the skull. After recovery from surgery, animals were trained in the paradigm to obtain an LPC. Pupillary dilation was conditioned to tones. A random sequence of two discriminable tones was presented. The lower tone had a probability of 0.1 and was followed by a tail shock (tone-shock). After 400 to 1000 tone-shock presentations, animals attended to the lower tone stimulus as inferred by selective pupillary dilation. In the AEP an early positive component at 50 to 120 msec related to an alerting response was enhanced, and an LPC at 250 to 450 msec appeared in response to the paired tone-shock. Animals were then subjected to cerebral concussion. Complete recovery of normal reflexes, motor coordination, and orienting response was seen within 2 hours after injury. The LPC was suppressed for a period of at least 3 days, suggesting that low magnitudes of brain injury can disrupt higher-order neural activities. This disruption can persist despite recovery of other neurological functions.

Animals↗
PubMed1986

Metabolic and neurophysiologic sequelae of brain injury: a cholinergic hypothesis.

This paper reviews a number of lines of evidence developed in our laboratories indicating that at least some components of neurologic disturbances following concussion may be attributable to increased functional activity of cholinergic systems located within specific brain regions. These lines of evidence include EEG studies indicating that disruption of the reticular activating system is not necessary for production of a reversible, flaccid, comatose state following low levels of concussion, systematic transection studies indicating that regions bounded by collicular and midpontine transections may contribute to at least motor components of the behavioral suppression associated with concussion, local rates of glucose utilization following fluid percussion injury increase in restricted areas bounded by collicular and midpontine transections; microinjection of carbachol (but not tetracaine) into these hypermetabolic regions produced behavioral suppression and electroencephalographic changes resembling those following concussion, systemic administration or microinjections of atropine, but not mecamylamine, antagonized the behavioral effects of carbachol, and data indicating that pharmacologic blockage of muscarinic cholinergic systems can attenuate neurologic deficits. Taken in conjunction with data from earlier clinical and laboratory studies, our research also indicates that anticholinergic therapy may potentially benefit head-injured patients.

Animals↗
PubMed1980

Rehabilitation in cerebrovascular diseases.

After a stroke, the plasticity of the central nervous system usually enables some return of function, so that patients can be rehabilitated rather than simply learning to compensate for lost function. Methods for evaluating potential for rehabilitation, for the setting of realistic goals, and for functional restoration are discussed.

Activities of Daily Living↗
PubMed1977

Transcutaneous electrical stimulation: a double-blind trial of its efficacy for pain.

A double-blind trial was done using a stimulator and a placebo device on patients who had chronic pain to determine the effectiveness of transcutaneous electrical stimulation in controlling pain. Ninety-three patients were studied, and 83 of these completed the Minnesota Multiphasic Personality Inventory (MMPI). Thirty-three patients had low-back pain and 24 had neuropathies. The stimulator was more effective than the placebo during treatment when used over the center of pain (P less than .005) or over an unrelated nerve trunk (P less than .01) and after treatment over the center of pain (P less than .05). The stimulator was significantly more effective than the placebo in neuropathies when stimulating over the related nerve trunk (P less than .005), where the stimulator response was nearly three times better than that of the placebo. The duration of subsequent relief was not significantly different after treatment with the stimulator or with the placebo device. Follow-up showed significant declines in the use and effect of the stimulator with the greatest decline noted by the depressed group.

Adult↗
PubMed1977

Tension myalgia.

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Humans↗