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J M Silverman

Publications and source records attributed to J M Silverman.

79 records · Page 5Linked to original sources

Reliability of the family history method in genetic studies of Alzheimer's disease and related dementias.

The investigation of genetic and other causes of Alzheimer's disease requires reliable and valid methods of gathering historical data on elderly relatives. To assess the reliability of the family history method in the study of late-onset dementing illness, the authors studied families with Alzheimer's disease probands and control families. The results indicated that family history data obtained from multiple informants with standardized instruments are consistent across informants. The rate of Alzheimer's disease in the families studied was similar to rates found in previous studies.

Aged↗

Dynamic study of the upper airway with ultrafast spoiled GRASS MR imaging.

Dynamic magnetic resonance (MR) imaging of the upper airway was not possible previously because of poor temporal resolution. Recently, a rapid technique has been developed that provides the means to obtain multiple images at different section locations with sufficient image quality and temporal resolution to allow a comprehensive, dynamic study of the upper airway. The authors describe an ultrafast spoiled GRASS (gradient-recalled acquisition in the steady state) pulse sequence for dynamic studies of the upper airway. The authors believe that this procedure has potential for identifying and characterizing upper airway abnormalities such as nonfixed occlusions and/or narrowings that may exist in patients with obstructive sleep apnea.

Humans↗

A multicenter clinical trial of Gadolite Oral Suspension as a contrast agent for MRI.

The purpose of this study was to assess the effectiveness and safety of Gadolite Oral Suspension as a gastrointestinal (GI) contrast agent for MRI in a phase II and two phase III multicenter clinical trials. Gadolite was administered to 306 patients with known or suspected abdominal and/or pelvic disease. MRI with T1- and T2-weighted sequences was performed before and after ingestion. Efficacy was evaluated by having two masked readers rate the certainty of their MR diagnosis (0 = uncertain, 1 = probable, 2 = definite) on randomly presented pre- and post-Gadolite Oral Suspension enhanced images. Principal investigators also evaluated the images and established the final diagnosis. Vital signs, clinical chemistries, and adverse events were documented. Blood and urine samples were analyzed for gadolinium content to determine whether Gadolite Oral Suspension was absorbed systemically. Certainty in MR diagnosis increased significantly (P < .001) for both blinded readers between pre- and post-Gadolite images (.49-1.18 for reader 1: .46-1.53 for reader 2). Sensitivity, specificity, and accuracy also increased for both masked readers. No gadolinium was detected in blood or urine samples. There were no serious adverse events and no apparent drug-related trends in mean vital signs or laboratory values. Gadolite is a highly effective, safe, and well tolerated contrast agent for clinical use with MRI.

Administration, Oral↗

Genetic studies of typical Alzheimer's disease.

Typical, late-onset Alzheimer's disease is familial but shows no clear Mendelian pattern of inheritance. Strategies that could help to reveal its genetics are: 1) identification of genetically homogeneous phenotypes, 2) identification of early or alternate manifestations of AD gene expression in relatives, and 3) use of small multiplex families with cases of typical AD for linkage studies.

Alzheimer Disease↗

Diagnostic issues in chronic schizophrenia: kraepelinian schizophrenia, undifferentiated schizophrenia, and state-independent negative symptoms.

Data are presented concerning three recent clinical distinctions in schizophrenia: kraepelinian versus non-kraepelinian patients; mixed versus simple undifferentiated subtypes; and state-dependent versus state-independent negative symptoms. Schizophrenic patients who have been ill and dependent on others for the past 5 years ('kraepelinians') were compared to other chronic schizophrenics. The kraepelinian patients met the criteria for schizophrenia by more diagnostic systems than other patients, were less responsive to haloperidol, had more severe negative symptoms and formal thought disorder, and had similarly severe positive symptoms. They also had cerebral ventricles that demonstrated more left-to-right asymmetry and a greater family history of schizophrenia spectrum disorders. Mixed undifferentiated schizophrenic patients, who met criteria for more than one schizophrenic subtype, were compared to simple undifferentiated schizophrenic patients, who met criteria for no subtype. The mixed group was characterized by more severe positive and negative symptoms and formal thought disorder, worse social functioning, and a worse response to haloperidol. In a subgroup of patients who were studied once while in a state of exacerbation and once while in a state of relative remission, the negative symptoms of inattention and affective flattening were state-dependent, while anhedonia-asociality was state-independent.

Adult↗

Refining phenotype characterization in genetic linkage studies of schizophrenia.

A definitive replicable genetic linkage for a major locus underlying the susceptibility to schizophrenia has not been identified to date. Although there are several possible explanations for the failure to find linkage in schizophrenia, one major problem is that the range of phenotypic expressions of the genes for schizophrenia has not been clarified. A more refined understanding of the various phenotypic expressions of a gene related to schizophrenia would enhance the power of studies designed to detect a genetic linkage with a major chromosomal locus and would benefit other strategies for understanding the etiology of schizophrenia. The genes for schizophrenia may be frequently expressed in relatives of schizophrenic patients, although with less severe symptoms than those of chronic schizophrenia. Two series of findings support this notion. Nonschizophrenic relatives of schizophrenic patients demonstrate an increased incidence of nonpsychotic schizophrenia-like symptoms and traits, and they manifest deficit performances on several different laboratory tests of neurocognitive functioning. A more refined phenotypic expression of a schizophrenia-related gene may thus be indicated by personality traits and subclinical neurocognitive deficits. These personality traits and neurocognitive deficits are considered here as possible aids in the identification of affected cases in genetic linkage studies of schizophrenia. Terminology for different indicators of neurocognitive deficits is introduced, and the relative utility of personality traits and indicators of neurocognitive deficit for genetic linkage studies is discussed. As specific examples, schizophrenia-related personality traits that are unrelated to affective symptoms and performance deficits on tasks of eye tracking and continuous attention are considered for strategies for broadening phenotype characterization without reducing the specificity of affected case identification.

Eye Movements↗