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Biomedical subjects

M M Robertson

Publications and source records attributed to M M Robertson.

At least 19 recordsLinked to original sources
PubMed1992

Elevated frontal cerebral blood flow in Gilles de la Tourette syndrome: a 99Tcm-HMPAO SPECT study.

Case reports, numerous brain imaging studies, and certain disease states suggest that the orbital frontal cortex and the striatum are dysfunctional in obsessive-compulsive disorder (OCD). Interest has also grown recently concerning the genetic, neuroanatomic, and clinical links between OCD, chronic motor tics, and Gilles de la Tourette Syndrome (GTS). To test the hypothesis of possible orbito-frontal/basal ganglia dysfunction in GTS, similar to OCD, we studied 20 unmedicated GTS subjects, 10 of whom also had comorbid OCD (GTS/OCD), and 8 control subjects. The subjects were examined with high-resolution single photon emission computed tomography (SPECT) and the labeled regional cerebral blood flow (rCBF) ligand technetium-99m-d,l-hexamethyl-propylene amine oxime (99Tcm-HMPAO). As a group, GTS subjects showed significantly elevated right frontal/visual cortex activity (mean = 0.879, SD = 0.107) compared with control subjects (mean = 0.798, SD = 0.049). A subanalysis comparing simple GTS versus GTS with comorbid OCD failed to reveal significant differences in regional flow.

Adult↗
PubMed1992

Pharmacologic controversy of CNS stimulants in Gilles de la Tourette's syndrome.

The controversy of the use of stimulants in Gilles de la Tourette's syndrome (GTS) can only be understood by examining the relationship between GTS and attention deficit-hyperactivity disorder (ADHD), because the relationship between the two disorders is complex, and stimulants are used in the one (ADHD) and may be contraindicated in the other (GTS). This relationship therefore has to be viewed from several perspectives, including clinical, genetic, neurobiochemical, neurophysiological, and treatment strategies, to highlight the complexities involved, and reasons for controversy. The present review will examine these relationships, and thus the evidence for and against the treatment of GTS with stimulants.

Adolescent↗
PubMed1992

Autosomal dominant gene transmission in a large kindred with Gilles de la Tourette syndrome.

A multiplex kindred ascertained through a single proband with GTS has been systematically investigated with standardised diagnostic instruments for other cases of GTS and related disorders. Complex segregation analysis supported the hypothesis that a single major gene inherited in autosomal dominant fashion but with incomplete penetrance contributed most of the variance in the liability to develop GTS and related disorders. This result is consistent with previous segregation analyses which have employed different methods of ascertainment, and tends to confirm that a proportion of GTS is due to a dominant gene and is suitable for investigation with genetic markers for linkage analysis.

Causality↗
PubMed1991

Gilles de la Tourette syndrome in the Middle East. Report of a cohort and a multiply affected large pedigree.

In a cohort of five patients from the Middle East with the Gilles de la Tourette syndrome, family history of a tic disorder or the Gilles de la Tourette syndrome was positive in three cases. In one of these there was a multiply affected pedigree spanning six generations. The phenomenology of the syndrome is the same as that described in Western reports. The familial pattern of inheritance and cross-cultural similarity emphasise the biological factors in the aetiology of the syndrome.

Adult↗
PubMed1991

The Gilles de la Tourette syndrome and obsessional disorder.

Georges Gilles de la Tourette first drew attention to the psychopathology of the Gilles de la Tourette Syndrome (GTS) in 1889 when he commented on the anxieties and phobias of his patients. In this paper he acknowledged the contribution of Guinon, who in 1886 had noted that "tiquers" nearly always had associated psychiatric disorders characterised by multiple phobias, arithmomania and agoraphobia. Since that time many types of psychopathology have been documented in association with GTS, including depression, anxiety, phobic disorder, hostility and aggression. However, the exact association between these disorders and GTS remains unclear. What is becoming increasingly evident is that there is a clear and strong association between obsessional thoughts and behaviours and GTS, and this is seen both in patients with GTS and in their family members. There have now been at least twenty investigations which have reported on this association, which is evident in clinic patients, epidemiological studies and family/pedigree populations. There have also been convincing arguments for the association being genetic.

Adolescent↗
PubMed1990

Management of Gilles de la Tourette syndrome using sulpiride.

One hundred and fourteen patients with Gilles de la Tourette syndrome have been reviewed. Sixty-three were managed using sulpiride, and worthwhile beneficial effects occurred in 59%. Our experience with sulpiride compared to other drug treatments is discussed. The main adverse side effects of sulpiride treatment were sustained drowsiness and, possibly, depression. Tardive dyskinesia was not reported in our cohort.

Adolescent↗
PubMed1990

Familial Tourette's syndrome in a large British pedigree. Associated psychopathology, severity, and potential for linkage analysis.

A British pedigree multiply affected by the Gilles de la Tourette syndrome and spanning six generations is described. Of 122 members identified, 85 were individually interviewed, and 50 were diagnosed as 'cases'. 'Cases' consisted of 29 with definite or probable Gilles de la Tourette syndrome, 17 with definite or probable chronic multiple tics, and four with definite or probable obsessive-compulsive behaviour. Only eight of the 50 'cases' had consulted a doctor for their symptoms. 'Cases' and 'non-cases' could be distinguished on the basis of echo-phenomena, obsessive-compulsive features, self-injurious behaviour, and the trait score of the Leyton Obsessional Inventory, but did not differ significantly on any other psychopathological variables. The pattern of inheritance of the Gilles de la Tourette syndrome in this pedigree is consistent with autosomal dominant transmission.

Adult↗
PubMed1989

Self-injurious behaviour and the Gilles de la Tourette syndrome: a clinical study and review of the literature.

Thirty (33%) of 90 patients with the Gilles de la Tourette syndrome exhibited self-injurious behaviour. Fourteen were head bangers, of whom two had cavum septum pellucidum. Clinical correlates of self-injury were the severity of Gilles de la Tourette syndrome symptoms and psychopathology, with special reference to obsessionality and hostility. We discuss an additional patient who died from a subdural haematoma as a result of head banging, and three who had permanent vision impairment from self inflicted eye injuries.

Adolescent↗
PubMed1989

The Gilles de la Tourette syndrome: the current status.

The Gilles de la Tourette Syndrome is a movement disorder characterised by both motor and vocal (phonic) tics. It was once thought to be rare, and the literature until the 1970s consisted predominantly of case reports, both highlighting the fascinating clinical manifestations and speculating as to their aetiology. Many areas of GTS are under investigation, including the neurology, psychopathology, neurophysiology, biochemistry, and genetics. This review briefly considers early descriptions of GTS as well as current research, highlighting the areas of agreement and controversy.

Female↗
PubMed1985

The treatment of depression in patients with epilepsy. A double-blind trial.

Forty-two patients with depression and epilepsy were entered into an antidepressant trial of amitriptyline, nomifensine and placebo. The dose of the active drug was 25 mg tid, which was doubled in non-responders on the active drug after 6 weeks. At that point a further 6 week follow-up was carried out. Serum antidepressant and anticonvulsant levels were assessed. The results indicated that at 6 weeks all patients showed a decline in their depression scores but at 12 weeks nomifensine was superior to amitriptyline. The possible reasons for this and the clinical implications of this are discussed.

Adolescent↗
PubMed1978

Osteitis deformans in the South African negro. A report of 3 cases.

Osteitis deformans is a relatively common disease in Caucasians, but rare in the indigenous people in Africa. Three cases of Paget's disease occuring in South African Negroes are reported here. Gene marker studies confirmed the absence of Caucasoid genes in these patients.

Black People↗