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Biomedical subjects

J Sramek

Publications and source records attributed to J Sramek.

At least 19 recordsLinked to original sources

Delayed onset of progressive dystonia following subacute 3-nitropropionic acid treatment in Cebus apella monkeys.

Delayed abnormal movements can be observed in patients with acute neurologic insult after a prolonged period of apparent neurologic stability. To reproduce such a secondary neurologic manifestation in primates, the present experiment investigated whether systemic administration of subacute 3-nitropropionic acid (3NP), a mitochondrial toxin, could induce abnormal movements that were delayed and progressive over time. Four Cebus apella monkeys received systemic 3NP injections until acute neurologic signs manifested. The monkeys were regularly video-recorded and rated for abnormal movements for up to 15 weeks after the cessation of 3NP treatment. Five to 6 weeks after the 3NP treatment, monkeys displayed a significant increase in dyskinesias compared with pretreatment conditions. Over time the chorea attenuated, whereas the dystonic movements increased in intensity and severity which was characterized by a delayed decrease of peak tangential velocity. The intensity of abnormal movements and extent of affected body regions observed in each monkey were consistent with the size of basal ganglia hypersignal as documented by T2 sequence on magnetic resonance imaging. Thus, more severe motor impairments were associated with large magnetic resonance image abnormalities. This novel primate model may be particularly useful for studying the structural changes underlying delayed and progressive manifestations of abnormal movements with the ultimate goal of facilitating the evaluation of novel therapeutic strategies.

Animals↗

Effects of treatment with simvastatin and pravastatin on cognitive function in patients with hypercholesterolaemia.

The effects of equi-efficacious doses of the cholesterol-lowering drugs simvastatin (20 mg day-1) and pravastatin (40 mg day-1) on tests of cognitive function were investigated in a double-blind, placebo-controlled, 2-period (4 weeks per period), incomplete block, crossover study of 36 patients (24 per treatment) with hypercholesterolaemia. After 4 weeks neither of the active treatments differed significantly from placebo on any cognitive measure.

Adult↗

Prevalence of tardive dyskinesia among three ethnic groups of chronic psychiatric patients.

The relationship between prevalence of tardive dyskinesia and ethnicity (black, white, or Hispanic) was examined in a group of 491 chronic psychiatric patients at a large state psychiatric hospital in California. Overall, the prevalence of tardive dyskinesia was 17.7 percent. No significant differences in the prevalence of tardive dyskinesia or in neuroleptic dosage levels were found among the three groups. A relationship was found between lower prevalence of tardive dyskinesia and higher current neuroleptic dosage, suggesting that higher dosage masks symptoms of tardive dyskinesia.

Adult↗

Negative symptoms: psychopathological models.

The psychopathological manifestations of schizophrenia have been broadly divided into positive and negative symptom groups. Even though there is no definitive consensus, psychomotor agitation, motor excitement, hallucinations, delusions and thought disorder constitute positive and psychomotor retardation, amotivation, apathy and decreased emotional expression are grouped into negative symptoms. The negative symptoms have been reported to appear late in the course of the illness and resistant to treatment with neuroleptics. While these claims have not been substantiated, the current interest on negative symptoms is related to the fact that many nonfunctioning institutionalized as well as ambulatory schizophrenics manifest negative symptoms. As chronic psychiatric beds have become scarce, many patients with negative symptoms who were harbored in the chronic mental hospitals have been released to the community care and some of these patients live on the streets. Thus their visibility has challenged psychiatry to focus its efforts on the etiology and treatment of negative symptoms.

Deinstitutionalization↗

Subjective neuroleptic response and treatment outcome under open and double-blind conditions--a preliminary report.

1. A patient's early subjective response to a neuroleptic was recorded in 17 schizophrenic patients following a fixed dose of neuroleptic under both open and double-blind placebo-controlled conditions. 2. High correlations were found between a patient's subjective response at 2.5, 24 and 48 hours after the initial dose, suggesting that the timing of the initial subjective response rating is not critical. 3. The relationship between the psychiatric improvement and subjective response was not significant under double-blind conditions (r = 0.004), while the relationship under the open condition showed a trend towards significance comparable to earlier reports (r = 0.32). 4. The findings question the usefulness of applying early subjective response to a neuroleptic to predict clinical improvement.

Adult↗

Abnormal EEG responses to photic stimulation in schizophrenic patients.

Numerous studies have differentiated schizophrenic patients and normal controls in electroencephalography (EEG) spectral patterns recorded at rest. We replicated the resting EEG spectral differences between these groups and observed significant differences in periodic photic stimuli on the EEG spectra. Drug-free schizophrenic male patients (n = 8, mean age = 23.9) and normal male controls (n = 11, mean age = 24.3) were studied. Eighty seconds of EEG were collected from each subject for each of four experimental conditions: one resting and three photic-driving conditions (2.38, 4.54, and 8.33 Hz). Eye movement and other movement artifacts were minimized by use of an automatic amplitude threshold filter. Although large eye movements could be excluded as confounding factors, the filter could not for certain exclude small eye movements. Subjects were instructed to keep their eyes closed throughout. A significant difference was found between the groups both at rest and following photic stimulation in EEG activity. This result was characterized by increased delta activity and decreased alpha activity in schizophrenic patients at rest. The EEG activity following the photic driving also differentiated the groups. Schizophrenic patients had decreased sensitivity to the photic stimulation in the alpha range for spectra derived from both fundamental and harmonic analysis.

Adult↗

EEG alpha photic driving abnormalities in chronic schizophrenia.

Periodic photic stimuli across the entire electroencephalographic (EEG) frequency range were used in an attempt to assess EEG functional differences between chronic schizophrenic patients and control subjects. The EEG responses to these photic stimuli were significantly attenuated in the schizophrenic patients, specifically at the frequencies within the EEG alpha range. The schizophrenic patients also showed an alpha range attenuation in the "no stimulus" EEG alpha measure, such that there was a significant correlation across subjects between the "stimulus" and "no stimulus" EEG alpha range abnormalities. These abnormalities are discussed with reference to possible dysfunctional thalamic mechanisms involved in the pacing of EEG alpha activity and the gating of information through the cerebral cortex.

Adult↗

MMPI subtypes for chronic phencyclidine (PCP) abusers.

The present study applied empirical clustering procedures to the MMPI protocols of 196 chronic phencyclidine (PCP) abusers. Subjects were randomly divided into two groups, and two methods of cluster analysis, the average linkage method and Ward's hierarchical procedure, were performed. Both cluster methods produced highly comparable results within each group, and the MMPI profiles found in each group were quite similar. Cluster analytic studies of other substance abuse populations are needed in order to replicate the MMPI profile types found in the present study. These investigations would lead to an empirical typology across various substance abuse populations that would depict developmental stages.

Adult↗

Neuroleptic-induced hypothermia associated with amelioration of psychosis in schizophrenia.

Body temperature is a regulatory function of the hypothalamus. Recently, DeMet et al. (Society for Neuroscience Abstracts Vol 12, 1986) reported that apomorphine stimulation of dopamine autoreceptors caused a significant decrease in metabolic rate in the posterior heat-conserving area of the hypothalamus. The logical hypothesis to follow is that apomorphine administration should induce a decrement in body temperature; this in fact was demonstrated by Cutler et al. (Commun Psychopharmacol 3:375-382, 1979) in humans. It is well known that neuroleptics also disrupt thermoregulation (Clark: Neurosci Biobehav Rev 3:179-231, 1979) and affect dopamine autoreceptors. Therefore, eight chronic treatment-resistant schizophrenics underwent a 6-week single-blind trial of haloperidol and then a subsequent 6-week double-blind trial of clozapine. Both haloperidol and clozapine significantly lowered oral body temperatures relative to baseline washout temperatures. More interestingly, clozapine relative to haloperidol was found to induce a greater decrement in body temperature and was associated with greater clinical improvement. Possible confounding variables are discussed, as is the possible neurochemical basis for the amelioration of psychosis associated with hypothermia.

Adult↗

A carbamazepine trial in chronic, treatment-refractory schizophrenia.

Carbamazepine was given to 12 chronic, treatment-refractory schizophrenic patients for 5 weeks. No overall change was found, but four patients significantly improved while eight worsened. Given the paucity of successful treatments for refractory schizophrenia, further study of carbamazepine appears warranted.

Adult↗