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Biomedical subjects

L Laplante

Publications and source records attributed to L Laplante.

At least 19 recordsLinked to original sources

Attention disturbance in clinical depression. Deficient distractor inhibition or processing resource deficit?

Cognitive impairments in depression have recently been proposed as secondary to more basic attentional disturbances. Studies have shown that performance on the Stroop Color-Word Test is impaired in depressives, but it is not clear whether this impairment reflects a primary distractor inhibition disturbance or a more global cognitive dysfunction, such as a reduction of processing resources. In the present study, unmedicated clinical depressives were evaluated using a computerized Stroop Color-Word Test and the Visuo-Spatial Interference Test, a selective attention task that makes fewer demands on resources. Compared with normal subjects, depressives presented increased choice reaction times (CRT) and interference in both tests. Correlations were found between CRT and interferences only in depressives, favoring the processing resource hypothesis. Further exploratory analysis comparing the more rapid depressives and the slower normal subjects on CRT revealed that although these subgroups had comparable CRT, rapid depressives still exhibited increased interference on the Visuo-Spatial Interference Test. Thus, in non- or mildly retarded patients, a specific distractor inhibition deficit was observed in absence of resource deficit.

Adult↗

The severity of visual hemineglect follows a bimodal frequency distribution.

The purpose of this study was to determine whether the severity of visual hemineglect follows a unimodal or bimodal frequency distribution. Seventy-seven consecutive patients with a unilateral cerebral infarct (36 left- and 41 right-hemisphere lesions) were evaluated. The severity of neglect was measured as the number of omissions on a line cancellation task. The frequency distribution of the number of lines omitted was bimodal following right lesions. One group of patients showed no or only mild neglect, whereas other patients showed severe neglect. Very few patients showed neglect of intermediate severity. The frequency distribution following left lesions was unimodal. Most patients exhibited no or only mild neglect. These results suggest that, following right lesions, the dichotomy regarding the severity of neglect is real and cannot be explained by observers' tendency to categorize.

Aged↗

Inhibition through negative priming with Stroop stimuli in schizophrenia.

Stroop stimuli were used to measure the negative priming effect in eight positive and 10 negative schizophrenics, 21 depressive and 35 healthy control subjects in order to test hypotheses of insufficient versus persistent cognitive inhibition in schizophrenia. Data show that schizophrenics do not increase their response times to suppressor Stroop items compared to identical but neutral Stroop stimuli because the insufficiency of their inhibitory processes weakens the distractor-suppression effect. However, pre-exposure of the lexical distractor can compensate for insufficient inhibitory mechanisms in positive but not negative schizophrenics, suggesting more severe deterioration in the latter. Depressed subjects showed a slower development of cognitive inhibition. The results suggest important differences in the temporal evolution of inhibitory processes, and are discussed in terms of Hemsley's (1977) and Frith's (1979) theories.

Adult↗

[Frontal lobe hypoactivity in schizophrenia: change in perspective].

Many attempts to isolate a dysfunctional site in the brain of schizophrenic patients have converged in a neuropathological conception of the disease based on frontal lobe hypoactivity. Recent data from studies using cytoarchitectony, computerized tomographic scans, cerebral regional blood flow, smooth pursuit eye movements and neuropsychological assessments are discussed. Current data on the hypofrontality hypothesis in schizophrenia seem to suggest an associationist rather than a localisationist perspective of the disorder.

Cerebrovascular Circulation↗

[Selective attention in major depression: clinical retardation and cognitive inhibition].

Relationships between clinical retardation (measured by the Hamilton Depression Inventory) and selective attention (measured with a computerized version of the Stroop word colour test) were studied in a population of 21 depressed patients. Stroop interference was higher in depressed patients than in normals. Desynchronized presentations of the distractor and the target and intervals between responses and succeeding stimuli permitted depressed subjects to respectively apply and lift inhibition of the distractor so that their interference was reduced to control levels. Finally, successive inhibition scores were correlated with the retardation score in depressed subjects. The results are consistent with the hypothesis of a retardation in the application and the lifting of cognitive inhibition in depression.

Adult↗

Treatment of mild-to-moderate hypertension: comparison between a calcium-channel blocker and a potassium-sparing diuretic.

In a multicenter study, 61 patients, 18-70 years of age, with mild-to-moderate hypertension [diastolic blood pressure (DBP) 95/114] completed a 28-week treatment. After initial placebo washout, patients were randomly allocated either to diltiazem or hydrochlorothiazide/triamterene. At the end of 12 weeks, the patients continued on the same medication if their goal blood pressure achieved (DBP less than 90; or 10 mm Hg below baseline). If not, the alternate agent was added (either diltiazem + hydrochlorothiazide/triamterene or hydrochlorothiazide/triamterene + diltiazem). At the end of 28 weeks, the intent-to-treat analysis showed that 90% on diltiazem alone, 73.7% on hydrochlorothiazide/triamterene alone, 71.4% on (diltiazem + hydrochlorothiazide/triamterene), and 57.1% on (hydrochlorothiazide/triamterene + diltiazem) achieved goal BP. End point mean values of BP and heart rate after adjusting for sex, baseline values, age, and weight showed no significant difference between groups. Forty-six percent on hydrochlorothiazide/triamterene alone and 24% on diltiazem alone reported one or more adverse events, possibly related to study medication. Patients with diltiazem as the first choice had better BP control than those on hydrochlorothiazide/triamterene alone (81.5% vs. 69.7%). Furthermore, among non-goal achievers at week 12, there was a greater response in the group when hydrochlorothiazide/triamterene was added to diltiazem than when diltiazem was added to hydrochlorothiazide/triamterene. This study suggests that in mild-to-moderate hypertension, diltiazem is better than hydrochlorothiazide/triamterene as first line therapy.

Adolescent↗

The selective attention deficit in schizophrenia. Limited resources or cognitive fatigue?

The Stroop Word-Color Test was used to study selective attention deficits in schizophrenic and nonschizophrenic psychiatric patients, compared with nonpsychiatric control subjects. Parts of the Weschler Memory Test and a shortened version of the Stroop Test were administered to test the hypotheses that the attentional deficit could be explained by problems of memory or cognitive fatigue. All patients showed deficits on all of the Stroop scales, but closer analysis of the results permitted discrimination of schizophrenic from nonschizophrenic patients. Schizophrenic patients showed as much difficulty as nonschizophrenic subjects on a limited-duration selective-attention task, but deteriorated significantly more when selective attention had to be maintained. The results could not be attributed to memory problems in the schizophrenic group. The results support the existence of two separable selective attention deficits in schizophrenic patients: a difficulty in selectively attending to the salient aspect of a complex stimulus, a difficulty shared with nonschizophrenic subjects, and a difficulty in maintaining selective attention over time that seems to be more marked in schizophrenic subjects.

Adult↗

Nephrogenic adenoma of the bladder after kidney transplantation: spontaneous improvement with azathioprine removal; surgical trauma and cytomegalovirus infection as possible etiologic factors.

We report 2 cases of nephrogenic adenoma several years after successful cadaver kidney transplantation. In 1 case the lesion had cytomegalovirus inclusions, and we observed a marked and sustained reduction in the extension of the lesion with cessation of azathioprine. Surgical trauma and cytomegalovirus infections are discussed as etiologic factors. Conservative treatment seemed appropriate.

Adenoma↗