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Biomedical subjects

M Raskind

Publications and source records attributed to M Raskind.

At least 37 records · Page 2Linked to original sources
PubMed1990

A case-control study of Alzheimer's disease.

A case-control study of Alzheimer's disease (AD) was conducted to evaluate the roles of family history of dementing disease and AD, and medical conditions, particularly those related to the viral and immune hypotheses in AD. One hundred and eighty-three clinically diagnosed patients were identified between 1980 and 1985 through the Geriatric and Family Services clinic at the University of Washington hospital, and 18 patients were identified during the same time period through the Veteran's Administration Medical Center in Seattle, Washington. Telephone interviews were conducted with spouses (87.7%) and children (12.3%) of the patients. Each patient was matched to a friend or nonblood relative of the patient by age, sex, and the relationship between the patient and his or her respondent, for a total of 130 matched pairs. The odds ratio for AD was elevated if a first-degree relative was reported to have a history of dementia (odds ratio, 2.21; 95% confidence interval, 1.17 to 4.18). This risk was especially elevated if a sibling was affected (odds ratio, 4.04; 95% confidence interval, 1.37 to 11.90); the highest risk to the proband was observed if a sibling had presumed AD (odds ratio, 5.92; 95% confidence interval, 1.59 to 21.96). The risk increased with increasing numbers of first-degree family members affected for both a history of dementia and presumed AD. We found little difference between patients and control subjects with respect to the age of the mother or father at the time of the subject's birth. No statistically significant differences were observed between the two groups with regard to conditions that might support the immune and viral hypothesis in AD, smoking, or alcohol problems.

Adult↗
PubMed1990

The association between head trauma and Alzheimer's disease.

The relation between head trauma and Alzheimer's disease was one of four major risk factors explored in a case-control study of 130 matched pairs; cases were clinically diagnosed between January 1980 and June 1985 at two geriatric psychiatric clinics in Seattle, Washington, and controls were friends or nonblood relatives of the cases. Subjects were matched by age, sex, and relationship between the case and his or her surrogate respondent. Head injuries which resulted in a loss of consciousness or which caused the subject to seek medical care were documented by means of interviews with surrogate respondents. A history of head injury was recorded for 24% of the cases and 8.5% of the controls, yielding an odds ratio of 3.5 (95% confidence interval 1.5-8.3) in conditional logistic regression analysis adjusted for age at onset of disease symptoms and family history of Alzheimer's disease. The estimated risk of Alzheimer's disease increased as the time between the last head trauma event and the onset of disease symptoms diminished (p = 0.002). This trend remained statistically significant (p = 0.006) when head injuries which occurred within 5 years of onset of the disease were excluded from the analysis. There was some difference between cases and controls for the average duration of unconsciousness in events accompanied by such a loss, but this was not statistically significant. The two groups were also similar in the circumstances surrounding the injuries and in the frequency of alcohol problems. This is the third case-control study to find a statistically significant association between head trauma and Alzheimer's disease.

Aged↗
PubMed1990

Soluble derivatives of the beta amyloid protein precursor in cerebrospinal fluid: alterations in normal aging and in Alzheimer's disease.

We isolated and sequenced a soluble approximately 25 kDa amino-terminal derivative of the beta amyloid protein precursor (beta APP) that is readily detected in human cerebrospinal fluid (CSF). In CSF samples from 24 Alzheimer's disease (AD) patients and 12 controls, we then quantitated this approximately 25 kDa form as well as the approximately 125 and approximately 105 kDa derivatives that we previously identified. Our analysis shows (1) that, in AD, there is a significant decrease in the relative amount of the approximately 105 kDa form and a corresponding significant increase in the relative amount of the approximately 25 kDa form; (2) that these changes correlate with the mental status of the AD patients; and (3) that the same changes occur to a lesser extent in elderly as compared with young control patients. These observations indicate that processing of the beta APP changes in normal individuals as they age and to a greater extent in those who develop AD. The changes in beta APP derivatives that we have observed in CSF could have major implications because they may reflect fundamental mechanisms responsible for amyloid deposition and can be measured in living patients.

Adult↗
PubMed1989

Double-blind trial of imipramine in Alzheimer's disease patients with and without depression.

The authors divided 61 subjects with primary degenerative dementia of the Alzheimer's type into a group who also met DSM-III criteria for depression (N = 28) and a group who did not (N = 33). Both groups were randomly assigned to an 8-week double-blind trial of imipramine or placebo. Scores on the Hamilton Rating Scale for Depression, administered at baseline and weeks 2, 4, 6, and 8, indicated significant improvement in both groups. Two measures of cognitive function yielded differing results. The results suggest that moderate depression is a treatable condition in patients with Alzheimer's disease.

Aged↗
PubMed1983

Vasopressin affects adenylate cyclase activity in rat brain: a possible neuromodulator.

The effect of vasopressin on adenylate cyclase activity was measured in the homogenates of selected rat brain regions. Adenylate cyclase activity in homogenate of the caudate nucleus did not change significantly with various concentrations of vasopressin. Furthermore, vasopressin did not reliably alter adenylate cyclase activity in various brain regions. Vasopressin in low concentrations significantly enhanced the activation of caudate adenylate cyclase activity by dopamine. This effect of vasopressin was dose dependent. Maximal enhancement by vasopressin occurred at 100 microM vasopressin. These results indicate that vasopressin may not have a direct effect on brain adenylate cyclase activity but appears to modulate the action of dopamine on brain adenylate cyclase.

Adenylyl Cyclases↗
PubMed1983

Alzheimer's disease: choline acetyltransferase activity in brain tissue from clinical and pathological subgroups.

Choline acetyltransferase activity was measured postmortem in five brain regions to determine if such activity provided biochemical support for clinical and pathological subgrouping of Alzheimer's disease. Seven patients with Alzheimer's disease were divided into groups based on age at onset, severity of neuropathological changes, history of myoclonus, family history of dementia, cerebellar amyloid plaques, and congophilic angiopathy. Thirty-two age-matched normal control subjects and 17 neurological control patients with Huntington's disease were also studied. Patients with early-onset and late-onset Alzheimer's disease did not differ in the clinical duration of their disease. Choline acetyltransferase activity was significantly lower in patients with early-onset Alzheimer's disease than in age-matched control subjects in frontal cortex, temporal cortex, hippocampus, and cerebellum. In contrast, choline acetyltransferase activity in patients with late-onset Alzheimer's disease was significantly lower than in age-matched control subjects only in hippocampus. There was a tendency for choline acetyltransferase activity to be lower in cortex from patients with early-onset Alzheimer's disease compared with cortex from the late-onset group, and this difference was significant in temporal cortex. Choline acetyltransferase activity was also measured in the substantia innominata from 9 patients with Alzheimer's disease and 5 age-matched control subjects. Subjects with early-onset Alzheimer's disease had significantly lower choline acetyltransferase activity in substantia innominata than did control subjects. Patients with Alzheimer's disease and a history of myoclonus had significantly lower choline acetyltransferase activity than did affected patients without myoclonus. Multivariate regression analysis showed myoclonus to be the single best predictor of low brain choline acetyltransferase activity. These results provide further evidence for clinical, pathological, and biochemical heterogeneity in Alzheimer's disease.

Adult↗
PubMed1982

Sleep, EEG and mental function changes in senile dementia of the Alzheimer's type.

Sleep, EEG and mental function variables were studied in 44 subjects diagnosed as having probable senile dementia of the Alzheimer's type (SDAT) and 22 controls matched for age and minimal depression. Results indicate that sleep, EEG and mental function variables all undergo significant change even in the early, mild stage of SDAT, with further change in the moderate and severe stages of dementia. Mental function variables also underwent significant decline across levels of dementia. Sleep and mental function variables had strong power in correctly classifying subjects into control vs. mild dementia groups (90 and 100%, respectively). Dominant occipital rhythm frequency, a clinical EEG measure, also discriminate as well (75%). The results indicate that sleep and EEG variables discriminate well for early, mild SDAT in minimally depressed aged individuals.

Aged↗
PubMed1982

Psychiatric diagnoses among geriatric patients seen in an outreach program.

Over 2300 patients referred to a geriatric outreach program were evaluated for the relationships between diagnosis and (1) referral reason, (2) referral source, and (3) age. Referral reason was only a clue to the eventual diagnosis. Patients referred for depression received a diagnosis of depression in only 46 per cent of such referrals, and patients referred for forgetfulness or confusion received a diagnosis of dementia in only 37 per cent of these referrals. Families were most likely to refer demented patients, and health agencies to refer depressed patients. Apartment managers and housing authority representatives were least likely to refer depressed patients and most likely to refer paranoid patients. The rate for diagnosis of dementia increased with age, whereas the rates for diagnoses of depression and alcohol/drug abuse decreased with age.

Aged↗
PubMed1982

Dexamethasone suppression test and cortisol circadian rhythm in primary degenerative dementia.

Before the dexamethasone suppression test (DST) can be accepted as a valid diagnostic tool for differentiating depression from dementia, it must be demonstrated that dementing illnesses per se are not associated with a positive DST. The authors studied cortisol circadian rhythm and the overnight DST in 15 nondepressed patients with advanced primary degenerative dementia and 15 normal control subjects. Seven dementia patients and no control patients were DST positive. The DST-positive dementia patients had a blunted predexamethasone circadian cortisol rhythm. These results cast doubt on the utility of the DST in diagnosing depression that complicates advanced primary degenerative dementia.

Aged↗
PubMed1982

Cardiovascular and antidepressant effects of imipramine in the treatment of secondary depression in patients with ischemic heart disease.

The authors report on 12 men with ischemic heart disease who developed secondary depression following myocardial infarction or coronary artery bypass-graft surgery and were treated with imipramine hydrochloride for 4 weeks. Imipramine had an antiarrhythmic effect, manifested by reduction in premature ventricular contractions during treatment. This drug did not produce clinically significant disturbances in cardiac conduction, but orthostatic hypotension led to early termination of the drug treatment in 1 subject. Imipramine treatment was associated with significant improvement in both observer-rated and patient-rated depression scales.

Adult↗
PubMed1982

Efficacy of antipsychotic medications in behaviorally disturbed dementia patients.

This study compared the therapeutic efficacy of thioridazine, loxapine, and a placebo in the treatment of behavioral disturbances in nursing home patients with dementia. Antipsychotic medications were effective for the specific behavioral problems of anxiety, excitement, emotional lability, and uncooperativeness. Subjects with the most severe symptoms at baseline assessment derived the greatest benefit from treatment. Sedation, extrapyramidal symptoms, and decreased blood pressure were common side effects among patients treated with the antipsychotic drugs. The authors conclude that antipsychotic medication has a definite but limited therapeutic role in the treatment of behavioral disturbances in nursing home patients with dementia.

Aged↗
PubMed1982

The effects of age on the plasma catecholamine response to mental stress in man.

To determine if sympathetic nervous system activity is heightened during psychological stress in older adults, plasma norepinephrine (NE), epinephrine (EPI), heart rate, and blood pressure were measured in 10 healthy old (mean age, 68.5 yr) men and 10 healthy young (mean age, 26.6 yr) men during a 12-min mental stress test. Basal NE was higher in old than in young men (400 +/- 33 vs. 286 +/- 32 pg/ml: p less than 0.01). Consistent significant increases in plasma NE occurred only in the elderly and mean increases (delta) in NE during testing were significantly greater (P less than 0.01) in the old than in the young men. Compared to basal levels, plasma EPI increased by 2 min in both young (delta EPI, 50 +/- 20 pg/ml; P less than 0.02) and old subjects (delta EPI, 41 +/- 11; P less than 0.01) and remained significantly increased throughout the test. There was no difference in either basal or delta EPI between young and old men. Heart rate and blood pressure were significantly increased throughout testing for both age groups. Although the delta blood pressure during testing tended to be greater in the old men, this difference was not statistically significant. Conversely, the delta heart rate was greater in the young subjects (P less than 0.005). Since EPI increases were similar in old and young men, mental stress-related adrenomedullary activation does not appear to change with age. However, the increased plasma NE response in the elderly suggests that they have heightened activity of postganglionic sympathetic neurons during psychological stress.

Adult↗
PubMed1981

The dexamethasone suppression test in an elderly population.

Impaired suppression of plasma cortisol levels following a single midnight dose of dexamethasone has been well documented in a large subgroup of depressed patients. To interpret meaningfully this 24-hr dexamethasone suppression test in geriatric patients, the effect of age per se was examined by comparing the pattern and duration of suppression in ten healthy elderly and ten healthy young subjects. Advanced age did not appear to affect the overnight dexamethasone suppression in healthy humans and should not invalidate the use of dexamethasone suppression test as a laboratory tool in the diagnosis and investigation of depression.

Adult↗
PubMed1980

Treatment of depression in the medically ill elderly with methylphenidate.

Three depressed geriatric patients had a marked therapeutic response to the psychostimulant drug methylphenidate. These patients either had been unable to tolerate tricyclic antidepressants or had a medical illness that contraindicated tricyclic therapy. The lack of adverse effects in our elderly patients and methylphenidate's effectiveness as an antidepressant were consistent with the findings of other investigators. These results suggest that psychostimulants deserve further evaluation as antidepressant agents in the geriatric population.

Adjustment Disorders↗