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Biomedical subjects

M Alpert

Publications and source records attributed to M Alpert.

At least 19 recordsLinked to original sources
PubMed1991

The effects of electromyographic feedback training on suppression of the oral-lingual movements associated with tardive dyskinesia.

The efficacy of electromyographic feedback training in reducing the magnitude and frequency of the oral-lingual movements associated with tardive dyskinesia (TD) was investigated in a groups design. Twenty adult male inpatients diagnosed as having TD using the Abnormal Involuntary Movements Scale (AIMS) were randomly assigned to one of two treatment conditions. Following identification, all participants were initially reduced to the lowest effective dosage of neuroleptics, and then discontinued from anticholinergics. Following one month on this regimen, they were given a course of feedback training consisting of ten 14-minute sessions. Group one participants were provided with a tone contingent upon oral-lingual movements above a yoked threshold. Group two participants were given noncontingent feedback tones generated randomly. Weekly AIMS were administered as well as an initial baseline during each session to determine current level of oral-lingual activity. An analysis of session effects indicated significantly more suppression of oral-lingual activity in the contingent group versus the noncontingent feedback group. Jaw and forehead activity also measured showed reductions of similar magnitudes for both groups.

Aged↗
PubMed1991

Parathyroid function in normocalcemic renal transplant recipients: evaluation by calcium infusion.

The extent to which secondary hyperparathyroidism may involute remains poorly defined. Renal transplantation offers a clinical situation in which metabolic stimuli for hyperparathyroidism are removed. To examine whether hyperparathyroidism resolves after transplantation, we evaluated 11 renal transplant recipients who had been normocalcemic 6 or more months after transplantation using a sensitive 2-site immunoradiometric assay for intact serum PTH. Nine of the 11 had PTH concentrations within the normal range. Of these 9, 6 were found to have abnormal parathyroid function when challenged with an iv calcium infusion. The other 2 patients demonstrated significantly elevated basal PTH concentrations and elevated ionized calcium despite normal total serum calcium and albumin concentrations. In both, the PTH response to infused calcium was markedly abnormal, confirming hyperparathyroidism. The estimated renal threshold phosphate concentration was low in 4 of 9 patients with normal basal PTH concentrations and in both with elevated basal PTH. Bone mineral density, measured at the radius by single photon absorptiometry and at the spine by dual energy x-ray absorptiometry, was normal in 8 of the 9 transplant recipients who had normal basal PTH concentrations.

Adult↗
PubMed1990

Lateralization for the expression and perception of facial emotion as a function of age.

In order to test the hypothesis of right hemisphere changes with age, this study examined lateralization for facial emotion in young, middle-aged, and older women (N = 90). For expression, subjects were photographed while posing positive and negative emotions. Composite photographs were created and rated for intensity. For perception, subjects were required to make intensity judgements about emotional chimeric faces. Overall, subjects demonstrated significant left-sided facial asymmetry for expression and significant left hemispace biases for perception. The findings for facial expression were not influenced by emotional valence or resting face asymmetries. There were no changes in lateralization as a function of age for either expression or perception. Taken together, these findings lend support to the notion that the right hemisphere mediates emotional processing across the adult life span.

Adult↗
PubMed1990

Perceiver and poser asymmetries in processing facial emotion.

This study examined both perceiver and poser asymmetries in processing facial emotion. Posers were left brain-damaged (LBD), right brain-damaged (RBD), and normal control (NC) right-handed males videotaped while expressing happiness and anger. Perceivers rated the facial expressions for asymmetry in original and reversed orientations. Overall, expressions viewed in the reversed orientation were rated as more left-sided than in the original orientation. In the reversed orientation, the more extensive left hemiface of the NCs and LBDs fell in the perceiver's left hemispace. This finding is consistent with previous research demonstrating a left hemispace bias for free-field viewing of emotional faces. Expressions were produced significantly more intensely on the left than the right hemiface by NCs and LBDs; expressions of RBDs were not significantly lateralized.

Adult↗
PubMed1990

Panic disorder in cardiology patients.

This paper reviews current evidence from several cardiology populations that suggests panic disorder is prevalent and underdiagnosed. Cardiology patients with atypical angina and no heart disease have a high likelihood of having panic disorder as suggested by studies of two separate cardiology populations. That they resemble psychiatric populations with panic is suggested by their positive response to alprazolam. Although evidence is less clear concerning the relationship between MVP and panic, it appears that patients referred to ECHO and found to have MVP are also likely to have panic. Three other populations deserving further study are patients with 1) pacemaker syndrome, 2) coronary artery disease with atypical angina and 3) certain arrhythmias.

Adult↗
PubMed1990

A double-blind, placebo-controlled study of adjunctive nadolol in the management of violent psychiatric patients.

We report a controlled 3-week study (n = 30) of adjunctive use of nadolol, 80 to 120 mg per day, vs. placebo for the management of violent psychiatric patients. There were no remarkable adverse cardiac effects at this dose. The active treatment group showed lower total Brief Psychiatric Rating Scale (BPRS) scores after the first week of treatment (analysis of covariance [ANCOVA], p less than .08) and similar trends for the activation factor and the hostility scale. There were parallel findings for measures of extrapyramidal symptoms (EPS) (Simpson-Angus Neurological Rating Scale), which were reliable after the second week (ANCOVA, p less than .02). A significant association between changes in EPS and BPRS scores was found by regression analysis, after the effects of baseline measures were removed. Given that nadolol does not penetrate the central nervous system well, the antiaggressive effects may be associated with sympathetic nervous system feedback mechanisms.

Adult↗
PubMed1989

A preliminary comparison of flat affect schizophrenics and brain-damaged patients on measures of affective processing.

Flat affect is a major component of schizophrenia and is often also seen in neurological disorders. A preliminary set of comparisons were conducted to delineate neuropsychological mechanisms underlying flat affect in schizophrenia, and new measures are described for the assessment of affective deficits in clinical populations. Subjects were schizophrenic with flat affect (SZs), right brain-damaged (RBD), Parkinson's Disease (PDs), and normal control (NC) right-handed adults. Subjects were administered affective measures of expression and perception in both facial and vocal channels. For both perceptual and expressive tasks the SZs performed significantly less accurately than the NCs and the PDs but did not differ from the RBDs. This was the case for both face and voice. This finding lends support to the speculation that right hemisphere mechanisms, especially cortical ones, may be compromised among schizophrenics with flat affect.

Adult↗
PubMed1989

The 20 questions task with families of schizophrenics: divergent findings.

The study attempted to replicate and extend the results of an earlier study by Wild and Shapiro (16), establishing the utility of Mosher and Hornsby's (8) 20 Questions Task as a means of differentiating families with schizophrenic patients from those of psychiatrically hospitalized but nonschizophrenic individuals. In the current study, Wild and Shapiro's original design was expanded and revised by (a) diagnosing patients using Research Diagnostic Criteria rather than hospital diagnoses and (b) including families with schizophrenic daughters and/or one-parent families, in addition to intact families with schizophrenic sons. Families were comparable on age, intelligence, and socioeconomic variables. The results failed to replicate those reported by Wild and Shapiro, and indicated that the 20 Questions Task was sensitive to differences in family constellation and offspring gender as well as offspring diagnosis. The findings suggest that forms of familial communication deviance detected with the 20 Questions Task may not be unique to families of schizophrenics, thus highlighting the need to expand research on family communication deviance in families with schizophrenic offspring to families with varied family constellations and characteristics.

Attention↗
PubMed1989

Atypical angina in patients with coronary artery disease suggests panic disorder.

The occurrence of psychiatric disorders in patients with "medical" problems is not only possible but may be even facilitated by these problems. This article examines the relationship between the type of chest pain and the diagnosis of panic disorder among coronary artery disease (CAD) patients. Forty-nine such cardiology patients were interviewed using a structured instrument. Forty percent of patients with atypical angina met DSM-III-R criteria for current panic disorder while no panic disorder was identified in the typical angina group. This finding should have great implications for the care of CAD patients. At least many of the atypical angina patients could benefit from standard effective treatment for panic disorder. This would likely improve their functioning and decrease the financial burden on them and the health care system.

Adult↗
PubMed1988

Facial asymmetry while posing positive and negative emotions: support for the right hemisphere hypothesis.

The purpose of this report was to examine facial asymmetry during the expression of positive and negative emotions. In addition, methodological factors in the study of facial asymmetry were considered. Subjects were 16 neurologically-healthy right-handed adult males, videotaped while posing eight facial expressions (positive and negative) under two conditions (verbal command and visual imitation). Separate asymmetry ratings of the two sides of the face were made by judges viewing normal or mirror-reversed versions of the videotape. There were no effects of valence, condition, or videotape orientation on the asymmetry ratings, and, in general, expressions were produced significantly more intensely on the left than the right side of the face. This finding is consistent with the hypothesis that the right cerebral hemisphere is dominant for the expression of facial emotion of both valences.

Dominance, Cerebral↗
PubMed1988

The spectrum of closed-head injuries in facial trauma victims: incidence and impact.

Little is known of the incidence of closed-head injury (CHI) associated with facial trauma. To study this problem, we conducted a retrospective review of 200 consecutive admissions to the University of Michigan Medical Center Emergency Department from 1980 to 1985 for treatment of acute facial fractures. All patients were admitted within 48 hours of injury (93% within 24 hours). Medical records were reviewed for age, sex, description, and circumstances of facial injury; assessment of loss of consciousness and anterograde amnesia; and associated intracranial or extracranial injuries. Seventy-three percent of the patients were men (mean age, 27.8 years). Etiologies, in descending order, were road traffic accidents (52%), assaults (22%), sports (14%), falls (7%), other injuries (3%), and gunshot wounds (2%). The incidence rate of CHI in our study was 55%. More than 90% of the head injuries were associated with the loss of consciousness of less than one hour. Risk factor analysis failed to demonstrate that an increased risk of CHI is associated with age, sex, or number of facial fractures. However, there was a one and one-halffold increased risk associated with patients involved in automobile accidents.

Accidents, Traffic↗
PubMed1988

Posed facial emotional expression in brain-damaged patients.

Posed emotional facial expression was examined in brain-damaged adults with right (RBD) or left (LBD) hemisphere cerebrovascular lesions and in matched normal controls (NC). Subjects were videotaped while posing eight facial expressions (positive and negative) under two elicitation conditions (verbal command and visual imitation). Expressions were rated by four naïve judges for intensity, category accuracy, and valence accuracy. RBDs were significantly more impaired than LBDs or NCs on category and valence accuracy, while LBDs posed expressions with significantly more intensity than RBDs or NCs. These findings held for positive emotions only. The results for category accuracy replicate an earlier report (Borod et al., 1986) which utilized a different rating procedure. Finally, expressions posed to visual imitation were rated as more intense and more accurate than those posed to verbal command.

Brain Damage, Chronic↗
PubMed1987

The Family Rorschach with families of schizophrenics: replication and extension.

Using a modified version of procedures outlined by Shapiro and Wild (9), this study evaluates the use of a Family Rorschach technique as a means of distinguishing families of schizophrenic patients from those of psychiatrically hospitalized, nonschizophrenic individuals. The patients were diagnosed using Research Diagnostic Criteria, and families were matched for age, intelligence, and socioeconomic characteristics. Results showed that the families with schizophrenic offspring scored significantly lower (that is, they had more communication and attentional difficulties) than those with nonschizophrenic offspring; offspring gender and family constellation had little effect on scores. Subsequent analyses indicated that lower scores were not simply a reflection of the psychoticism of the patient. These findings suggest that families of schizophrenics have interpersonal communication difficulties that compromise their ability to maintain a shared focus of attention. The findings are consistent with the suggestion that deviant patterns of family communication in interaction with genetic vulnerability in an offspring may result in the development of a schizophrenic disorder.

Adult↗
PubMed1986

The effect of stress on the linguistic generalization of bilingual individuals.

Spanish-English coordinate bilinguals were subjects in a GSR linguistic conditioning experiment using strong and mild buzzer conditions and spoken stimuli. Each subject was randomly assigned to one of two lists of words and one of two levels of buzzer sounds. A Spanish word from the Spanish list and an English word from the English list functioned as a conditioned word (CS). The lists were Spanish and English words related semantically and phonemically and unrelated to the CS. Generalization was studied under conscious and unconscious conditions. We found that both buzzer conditions resulted in significantly greater GSR responses to semantic and phonemic words than to words unrelated to the CS. Generalization to semantic words was not significantly greater than to phonemic words. There was a tendency toward greater phonemic than semantic generalization in the strong buzzer condition. The opposite was observed regarding the mild buzzer. The results were the same in both lists and languages. Under a conscious and unstressful condition, generalization to semantic words was found to be more prominent than to phonemic words. This suggests that under normal condition semantic generalization is mediated by conscious cognition. We concluded that strong emotion produces an increase in phonemic, as compared to semantic, generalization in both languages. Hence, primitivization of the subjects' cognitive and linguistic functioning is assumed to have occurred. These results are important in understanding the deleterious effect that stressful situations may have on linguistic functioning and cognition in bilinguals.

Adolescent↗
PubMed1986

Influence of atrioventricular synchrony on hemodynamics in patients with normal and low ejection fractions following open heart surgery.

The authors wished to test the hypothesis that atrioventricular synchrony has a relatively greater effect on hemodynamic parameters in postoperative patients with low ejection fractions compared to those with normal ejection fractions. Temporary pacing wires were placed on the right atrium and right ventricle of patients undergoing open heart surgery. Duplicate thermodilution cardiac outputs were determined during atrial pacing and ventricular pacing at 100 beats/min. Mean left atrial and systemic blood pressures were monitored. Thirteen patients with ejection fractions of 45 per cent or less (range 24 to 45%, mean 37.3%) were included in the low ejection fraction group, and 27 patients with ejection fractions of 59 per cent or greater (range 59 to 80%, mean 66.8%) were considered in the normal ejection fraction group. All hemodynamic parameters improved significantly when changing from ventricular pacing to atrial pacing in both the normal ejection fraction group and low ejection fraction group (P less than 0.05). The magnitude of change between the groups showed no significant difference for all parameters except left atrial pressure, which decreased by a greater percentage in the low ejection fraction group with atrial pacing (P less than 0.001). The atrial contribution to hemodynamic enhancement is important in patients with normal and low ejection fraction following open heart surgery. Patients with low ejection fractions do not sustain a relatively greater reduction in cardiac output, stroke volume index, or systemic blood pressure with loss of atrioventricular synchrony when compared to patients with normal ejection fractions.

Cardiac Output↗