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Biomedical subjects

L L Thompson

Publications and source records attributed to L L Thompson.

At least 19 recordsLinked to original sources
PubMed2001

Intensive voice treatment (LSVT) for patients with Parkinson's disease: a 2 year follow up.

OBJECTIVES: To assess long term (24 months) effects of the Lee Silverman voice treatment (LSVT), a method designed to improve vocal function in patients with Parkinson's disease. METHODS: Thirty three patients with idiopathic Parkinson's disease were stratified and randomly assigned to two treatment groups. One group received the LSVT, which emphasises high phonatory-respiratory effort. The other group received respiratory therapy (RET), which emphasises high respiratory effort alone. Patients in both treatment groups sustained vowel phonation, read a passage, and produced a monologue under identical conditions before, immediately after, and 24 months after speech treatment. Change in vocal function was measured by means of acoustic analyses of voice loudness (measured as sound pressure level, or SPL) and inflection in voice fundamental frequency (measured in terms of semitone standard deviation, or STSD). RESULTS: The LSVT was significantly more effective than the RET in improving (increasing) SPL and STSD immediately post-treatment and maintaining those improvements at 2 year follow up. CONCLUSIONS: The findings provide evidence for the efficacy of the LSVT as well as the long term maintenance of these effects in the treatment of voice and speech disorders in patients with idiopathic Parkinson's disease.

Aged↗
PubMed1999

White matter dementia in CADASIL.

Cerebral white matter disorders may be associated with profound neurobehavioral dysfunction. We report a 62-year-old man who had a slowly progressive 25-year history of personality change, psychosis, mood disorder, and dementia. Neurologic examination disclosed abulia, impaired memory retrieval, and preserved language, with only minimal motor impairment. Neuropsychological testing found a sustained attention deficit, cognitive slowing, impaired learning with intact recognition, and perseveration. Magnetic resonance imaging of the brain revealed extensive leukoencephalopathy. Right frontal brain biopsy showed ill-defined white matter pallor with hyaline narrowing of white matter arterioles. Granular osmiophilic material adjacent to vascular smooth muscle cells on electron microscopy of a skin biopsy, and an arginine for cysteine replacement at position 169 in the 4 EGF motif of the notch 3 region on chromosome 19q12 established the diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). This case illustrates that CADASIL can manifest as an isolated neurobehavioral disorder over an extended time period. The dementia associated with CADASIL closely resembles that which may occur with other white matter disorders, and represents an example of white matter dementia.

Brain↗
PubMed1998

Vitamin C status of an outpatient population.

OBJECTIVE: To determined the prevalence of vitamin C deficiency (plasma vitamin C concentrations less than 11.4 mumol/L) and vitamin C depletion (plasma vitamin C concentrations from 11.4 to less than 28.4 mumol/L) in an outpatient population. SUBJECTS AND METHODS: A consecutive sample of patients presenting at a health maintenance organization laboratory for outpatient procedures was utilized. Plasma vitamin C concentrations were determined in 350 females and 144 males, aged 6 to 92 years (mean +/- SD: 46.7 +/- 18.7 years). RESULTS: The mean plasma vitamin C concentration for all subjects was 32.4 +/- 13.6 mumol/L. Mean plasma vitamin C did not vary by sex, race, or fasted state. Diabetics had a significantly lower mean plasma vitamin C concentration (25.6 +/- 10.8 mumol/L) compared to patients presenting for general check-up/gynecological exams (33.5 +/- 14.8 mumol/L) or pregnancy exams (32.4 +/- 9.7 mumol/L). Six percent of subjects had plasma vitamin C concentrations indicative of vitamin C deficiency (n = 31), and 30.4% of the sample were vitamin C depleted (n = 150). The prevalence of vitamin C deficiency or vitamin C depletion did not differ by race or visit category. CONCLUSIONS: Surprisingly high rates of vitamin C deficiency and vitamin C depletion were evident among generally healthy, middle class patients visiting a health care facility for routine health exams, gynecological exams, and pregnancy exams.

Adolescent↗
PubMed1997

Influences on adolescent substance dependence: conduct disorder, depression, attention deficit hyperactivity disorder, and gender.

OBJECTIVE: In adolescents, conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), and depression are frequently comorbid with substance dependence (SD). We hypothesized that the prevalence and severity of CD, major depressive disorder (MDD), and ADHD would differ by gender, and that these conditions would associate differentially with severity of SD in males and females. METHODS: We examined these issues, using standardized diagnostic interviews, in 285 male and 82 female adolescents referred for comorbid CD and SD. RESULTS: Males and females did not differ significantly in severity of substance involvement, MDD, or ADHD, but males had more severe CD. MDD severity was the only variable significantly associated with SD severity for females, while for males, severity of CD combined with MDD and ADHD was significantly associated with SD severity. CONCLUSIONS: Among referred adolescents, CD, MDD, and ADHD may all be important concomitants of SD in males, while in females, depression may be the primary variable related to SD.

Adolescent↗
PubMed1997

Neuropsychological diagnosis and outcome in mild traumatic brain injury.

Despite its frequency, many, aspects of mild traumatic brain injury (MTBI) remain controversial. This likely reflects the inherent complexities of MTBI and its sequelae as well as various methodological issues in the literature. To further complicate matters, our understanding of what constitutes "necessary" and "sufficient" force to sustain a brain injury, remains limited, particularly in cases of nonimpact brain injury. Little debate exists regarding acute MTBI effects and postconcussional symptoms, although the issue of residual neuropsychological impairment remains hotly contested in many cases. Base rates of neuropsychological "impairment" must be considered in the context of individuals who present for evaluation following possible TBI or MTBI. In this article we highlight some of the critical issues in the assessment and diagnosis of MTBI, including the pitfalls of false-positive and false-negative diagnostic and interpretive errors.

Journal Article↗
PubMed1996

Analysis of cognitive and psychological deficits in systemic lupus erythematosus patients without overt central nervous system disease.

OBJECTIVE: To examine cognitive and psychological functioning in relation to antiribosomal P protein autoantibodies in patients with systemic lupus erythematosus (SLE) who had no previous history of central nervous system disease (non-CNS SLE). METHODS: Comprehensive neuropsychological and psychological tests were administered to 51 non-CNS SLE patients, 29 rheumatoid arthritis (RA) patients, and 27 healthy controls. RESULTS: Twenty-nine percent of the non-CNS SLE patients, 31% of the RA patients, and 11% of the control subjects were classified as cognitively impaired. Similar reductions in intelligence, attention, and fluency were detected in the non-CNS SLE and RA patients compared with controls. The non-CNS SLE patients showed a distinct deficit in learning compared with the RA and control groups. Forty-two percent of the non-CNS SLE patients demonstrated psychological distress, compared with 7% of the RA patients and 6% of the controls. In the patient groups, neither cognitive dysfunction nor psychological distress was associated with disease activity or prednisone dosage. Elevated serum levels of autoantibodies to ribosomal P protein were not associated with either psychological or cognitive abnormalities. CONCLUSION: These results suggest that certain cognitive deficits in non-CNS SLE patients may not be specific to the immunopathology of SLE. In contrast, it is possible that deficits in learning, as well as psychological distress without major psychiatric pathology, may be subtle manifestations of CNS lupus.

Adult↗
PubMed1996

Contribution of ADHD symptoms to substance problems and delinquency in conduct-disordered adolescents.

We examined adolescents with conduct disorder (CD) and substance problems to determine if those with attention deficit hyperactivity disorder (ADHD) symptomatology had more severe delinquency and substance involvement. ADHD symptomatology was assessed in two ways: (1) by self-reports using the Diagnostic Interview Schedule for Children (DISC) and (2) by use of DISC plus reports of others (parents, program staff, and program teacher). We divided boys into three ADHD groups based on DISC: those who met criteria, those who reported at least eight current symptoms, and those who reported fewer than eight symptoms. We also divided the same boys into two groups: those with reports of ADHD by two or more sources and those without this multisource ADHD. Examining these definitions of ADHD revealed that boys with either self- or multisource ADHD had more CD symptoms, earlier age of CD onset, more substance dependence diagnoses, and more comorbid depression and anxiety.

Adolescent↗
PubMed1996

Discriminability of the Wisconsin Card Sorting Test using the standardization sample.

The four neurological patient groups and the normals from the Wisconsin Card Sorting Test (WCST) standardization sample were used to examine the discriminability of the WCST's indices. Results reveal consistent differentiation of normals from the patient groups on all WCST variables, with classification rates averaging 71% accuracy. However, patient groups with frontal, diffuse, and nonfrontal lesions were not consistently discriminable from each other. The results suggest that the WCST is most usefully conceptualized as a measure of executive abilities that involves the frontal lobes, but should not be considered solely as a marker of isolated frontal lobe pathology.

Adult↗
PubMed1996

An open trial of pemoline in drug-dependent delinquents with attention-deficit hyperactivity disorder.

OBJECTIVE: Adolescents with conduct disorder and substance use disorders have high rates of comorbid attention-deficit hyperactivity disorder (ADHD); ADHD may contribute to the severity and persistence of substance use disorders and antisocial behaviors. Treatment of ADHD may help patients utilize substance and other behaviorally focused treatment. Yet little is known about the response of ADHD symptoms to psychopharmacological intervention in substance-dependent delinquents. METHOD: Pilot data are presented for 13 male adolescents with conduct disorder, substance use disorders, and ADHD, in a residential substance use treatment program. Patients were treated with pemoline. Scores from the Conners Hyperactivity Index and continuous performance tasks were obtained at baseline and after about 1 month of treatment with pemoline. Physical activity measurements were also assessed at baseline and 1 month. Postmedication assessments were obtained after at least 1 week at maximal dosage (1.2 to 3.3 mg/kg). RESULTS: Mean Conners Hyperactivity Index scores declined 13.9% (p < or = .002) and mean motility declined 7% (p < or = .04) with pemoline treatment. Continuous performance task scores did not change. CONCLUSIONS: Preliminary data indicate that pemoline may be a useful treatment for ADHD in substance-dependent delinquents; the authors propose a controlled trial of pemoline in such youths.

Adolescent↗
PubMed1995

Ethics code and neuropsychological assessment practices.

The 1992 revision of the Ethics Code of the American Psychological Association is more detailed than its predecessor. Sections with direct relevance to neuropsychological assessment practice are discussed. Commentary and specific recommendations are provided regarding the issues of avoiding harm to patients, competence of the practitioner, test validity, test interpretation, maintenance of records, use and supervision of nondoctoral personnel, forensic activities, release of raw data, documentation of results, multiple relationships, and fees. Clinicians are urged to adhere to the Ethics Code rather than to a personnel standard of professional behavior.

Journal Article↗
PubMed1995

Comparison of two forms of intensive speech treatment for Parkinson disease.

This study investigated the effect of two forms of intensive speech treatment, (a) respiration (R) and (b) voice and respiration (Lee Silverman Voice Treatment [LSVT]), on the speech and voice deficits associated with idiopathic Parkinson disease. Forty-five subjects with Idiopathic Parkinson disease completed extensive pretreatment neurological, otolaryngological, neuropsychological, and speech assessments. All subjects completed 16 sessions of intensive speech treatment, 4 times a week for 1 month. Pre- and post-treatment measures included intensity and maximum duration during sustained vowel phonation. Intensity, habitual fundamental frequency, fundamental frequency variability, and utterance and pause duration were measured during reading of the "Rainbow Passage" and conversational monologue as well. Family and subject self-ratings were completed pre- and post-treatment for the perceptual variables loudness, monotonicity, hoarseness, overall intelligibility, and initiation of conversation. Significant pre- to post-treatment improvements were observed for more variables and were of greater magnitude for the subjects who received the voice and respiration treatment (LSVT). Only subjects who received the LSVT rated a significant decrease post-treatment on the impact of Parkinson disease on their communication. Correlations between descriptive prognostic variables (i.e., stage of disease, speech/voice severity rating, depression, and time since diagnosis) and magnitude of treatment-related change indicated these factors did not significantly predict treatment effectiveness. These findings suggest that intensive voice and respiration (LSVT) treatment, focusing on increased vocal fold adduction and respiration, is more effective than respiration (R) treatment alone for improving vocal intensity and decreasing the impact of Parkinson disease on communication.

Aged↗
PubMed1995

Introduction.

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Journal Article↗
PubMed1994

A charge-coupled-device camera image analysis system for quantifying DNA distributions in agarose gels after pulsed-field gel electrophoresis.

A charge-coupled-device camera system was coupled to a personal computer and, with uniformity in illumination and detection (within 4-8%) along each lane, was used for quantifying the distribution of DNA molecules that migrate from the PFGE well (plug) into the lane at distances varying from 1 to 50 mm (with 0.5 mm/pixel). By using a specially designed transmission filter for transmitting 470-725 nm fluorescence from ethidium bromide-stained DNA while eliminating most of the fluorescence (< 400 nm) from the agarose gel, and by using neutral density filters to prevent saturation of the camera, the fluorescence intensity is linearly related to the amount of DNA varying from approximately 0.03 micrograms in a 3-mm-diameter cylindrical plug 5 mm long (equal to background) to approximately 4 micrograms (where ethidium bromide staining saturates). The percentage DNA released from the plug and distribution in the lane (with 1-2 mm resolution) obtained by quantifying DNA fluorescence were not significantly different from the same data obtained by analysis of radioactivity of the same DNA labeled with [3H]dThd. However, scattering of fluorescence from one lane into an adjacent lane 3 mm away and as far as 10 mm from the plug into the lane presented a problem. This problem was overcome by using a form with slots to cover every other lane when the images were obtained and either (1) cutting the lane from the plug and moving it 15 mm away or (2) imaging the intact gel and applying a correction for approximately 7% of the fluorescence from the plug tailing out approximately 10 mm beyond the first 1 mm in the lane. In addition, the following were required: (1) carefully controlled staining and destaining procedures, and (2) a low background that is obtained as an average uniform background in each lane 5 mm beyond where DNA migration stops.

DNA↗
PubMed1994

The effects of incorporation of bromodeoxyuridine into mammalian DNA on the migration patterns of DNA fragments subjected to pulsed-field gel electrophoresis after X irradiation or cutting with a restriction enzyme.

Incorporation of bromodeoxyuridine (BrdU) into DNA in both Chinese hamster ovary (CHO) cells and human melanoma (U1) cells reduced the rate of DNA migration in transverse alternating-field electrophoresis (TAFE) agarose gel optimized for separating molecules larger than 2 Mb. This "BrdU migration effect" was independent of the method of damaging the DNA; i.e., the effect was observed after irradiation of the cells or treatment of the plugs containing DNA with the restriction enzyme, Mlu-1, and similar results were found for CHO and U1 cells. However, when the amount of cutting of DNA was estimated from the amount of DNA migrating from the plugs, a difference between U1 cells and CHO cells was observed in that incorporation of BrdU enhanced the cutting of DNA by either irradiation or Mlu-1 digestion for U1 cells but not for CHO cells. Therefore, the "BrdU migration effect" could not be attributed to an increase in large molecules because of reduced cutting of the BrdU-labeled DNA. The decrease in migration rate during pulsed-field gel electrophoresis when BrdU replaces thymidine in the DNA is hypothesized to result from the increase in negative charge on BrdU-labeled DNA. An increase in electron charge density is expected to increase the reorientation time of BrdU-labeled DNA fragments during each voltage pulse due to an increase in the elongation length of the DNA caused by an increase in electronegativity.

Animals↗
PubMed1993

Three-word recall as a measure of memory.

Clinical examination of memory functions often includes the administration of simple free recall tasks, such as the recall of several words following a few minutes. Little is known, however, about the normative parameters or psychometric properties of such procedures, and such techniques have rarely been compared with more comprehensive, well-standardized memory indices. To address these issues, two three-word recall tasks were administered to a large group of carefully selected healthy subjects over the age of 50 years. The Mini-Mental State Examination (MMSE) was obtained as an index of global cognitive status, and the California Verbal Learning Test (CVLT) was used to exclude subjects with abnormal memory abilities. Significant but modest relationships were found between two three-word recall tasks and CVLT results. Substantial variability was seen on three-word recall, with a significant proportion of normal subjects recalling zero or one word. Results suggest using caution in interpreting simple recall performance as an index of memory, as great variability in results is seen among healthy (particularly older) individuals.

Aged↗
PubMed1991

Use of pulsed-field gel electrophoresis to measure X-ray-induced double-strand breaks in DNA substituted with BrdU.

The substitution of BrdU for TdR in the DNA of Chinese hamster ovary cells caused radiosensitization for both cell killing and an increase in the rate of neutral elution of the DNA. However, no radiosensitization was observed for the amount of DNA that migrated from the plug of agarose gels subjected to pulsed-field gel electrophoresis. An unexpected observation, however, was that the migration rate of BrdU-substituted DNA was relatively independent of radiation dose and was much less than that of unsubstituted DNA which migrated at a faster rate as the radiation dose increased. This difference in migration between TdR- and BrdU-labeled DNA was observed only when electrophoresis conditions were optimized for separating DNA molecules from 1 to 7 Mb. Possibly, the increase in negative charge on BrdU-labeled DNA increases the reorientation time during each pulse, with a resulting decrease in rate of migration, or radiation effects on BrdU-labeled DNA may be responsible for the decrease in migration rate.

Animals↗