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Biomedical subjects

M S Goldman

Publications and source records attributed to M S Goldman.

At least 37 records · Page 2Linked to original sources
PubMed1992

Symptomatic and functional outcome of stereotactic ventralis lateralis thalamotomy for intention tremor.

In the past, intention tremor has responded well to selected neuroablative procedures; however, objective symptomatic and functional outcomes of ventralis lateralis (VL) thalamotomy specifically for intention tremor in the post-computerized tomography era has rarely been reported. This series explored the symptomatic and functional impact of VL thalamotomy on 14 patients presenting at the Mayo Clinic with severe, refractory intention tremor due to multiple sclerosis (five patients), trauma (four patients), or stroke (five patients). General neurological examinations, psychometric evaluations, speech pathology assessments, and neuroradiological scans were performed. Pre- and postoperative disability were graded according to a modified form of an established rating scale for tremor. All patients received VL radiofrequency thalamotomies utilizing neurophysiological recording and stimulation control. Contralateral targeted upper-extremity tremor remained symptomatically absent or markedly reduced in 81.8% of cases (mean follow-up period 23.4 months). The median disability score was reduced by 12 points (0.02 less than p less than 0.05). Persistent surgical morbidity was limited to two patients with mild, nondisabling dysarthrias. One elderly patient died of pulmonary complications 2 weeks postoperatively. There were no reported surgically induced exacerbations in multiple sclerosis; however, some of these patients exhibited difficulties with electrophysiological localization. These results compare favorably with those reported in the literature and confirm that stereotactic VL thalamotomy for debilitating intention tremor carries a low surgical risk and can be an effective treatment option for properly selected patients.

Adolescent↗
PubMed1992

Effects of intermittent reperfusion during temporal focal ischemia.

There is controversy regarding the role of intermittent reperfusion employed as a cerebroprotective measure when temporary arterial occlusion is necessary during repair of difficult aneurysms. The intraluminal suture middle cerebral artery (MCA) occlusion technique was used in 23 Wistar rats under barbiturate anesthesia to induce 60, 90, or 120 minutes of uninterrupted MCA occlusion. The total infarcted areas obtained were compared to those occurring in 27 animals subjected to identical cumulative ischemic periods but with 5 minutes of reperfusion after every 10-minute ischemic period. The mean total infarcted areas in the groups with 60-minute (1.8 +/- 0.89 sq mm), 90-minute (1.08 +/- 1.02 sq mm), and 120-minute (8.72 +/- 5.89 sq mm) intermittent reperfusion were significantly smaller than those occurring in the 60-minute (12.02 +/- 3.10 sq mm), 90-minute (11.54 +/- 2.68 sq mm), or 120-minute (30.43 +/- 6.51 sq mm) control groups, respectively (p < 0.05). Furthermore, there was no difference in the occurrence of blood-brain barrier breakdown, intraparenchymal hemorrhage, hemispheric edema, or seizures between control and intermittent reperfusion groups. The results support the hypothesis that intermittent reperfusion is beneficial if vessel occlusion is required during aneurysm repair.

Animals↗
PubMed1991

Alcoholism and memory: broadening the scope of alcohol-expectancy research.

Current biopsychosocial research on the etiology of alcoholism has begun to focus on memory processes as a possible common pathway for drinking decisions. The alcohol-expectancy construct is rooted both in cognitive psychology and alcohol research and can serve as a vehicle for this study. Reexamination of one recent review of issues in alcohol-expectancy research provides an opportunity to broaden the scope of this research with theoretical and methodological alternatives to those suggested in that review. Most importantly, this article shows that expectancy findings, discussed by Leigh (1989a) as reflecting "psychometric" limitations, are instead quite consistent with recent network models of memory structure. Such models can provide an informative guide to future research activities. It is also recommended that alcohol-expectancy research remain open to inputs from expectancy theories already developed in several psychological domains, as well as to theories of social cognition and attitude structure in addition to those advanced by Leigh.

Alcohol Drinking↗
PubMed1990

Experience-dependent neuropsychological recovery and the treatment of chronic alcoholism.

This paper reviews the relationship between cognitive status and treatment outcome in chronic alcoholics, the natural history of recovery, and the role of cognitively oriented remediation programs in facilitating recovery. Seven studies of experience-dependent recovery are described in which behavioral improvement was noted. Various recommendations for treatment over the course of recovery are made, guided by anticipated changes in capacity to process complex information over time.

Alcoholics Anonymous↗
PubMed1990

Emergence of alcohol expectancies in childhood: a possible critical period.

Previous investigations with adolescents (aged 12-19) have shown alcohol-related expectancies to develop in childhood prior to significant drinking experience and to covary directly with drinking behavior. To chart the development of alcohol expectancies in children as young as age 6, a procedure was developed to be as independent as possible of age-related variation in reading and language development. This instrument was administered to 114 elementary school children of both genders, distributed across grades 1 to 5. Psychometric analysis provided evidence of the test's reliability and validity. Evaluation of the developmental pattern produced two primary findings: (1) there was an overall trend of increasingly positive expectancies with age; and (2) strikingly, the bulk of the increase was observed in the third and fourth grades. Children's expectancies may be less differentiated than adolescent or adult expectancies. These findings suggest that the precursors for later alcohol use and abuse are formed in childhood and that prevention efforts may need to begin as early as third grade.

Age Factors↗
PubMed1989

Using alcohol expectancies to predict adolescent drinking behavior after one year.

An accumulating literature has shown the influence of childhood experiences associated with alcohol use on later drinking practices. Recent studies have suggested that alcohol-related expectancy may serve as an intervening variable to connect these early experiences with the later, proximal decision to drink when opportunities for actual alcohol consumption arise. Those studies, however, have collected expectancy and drinking data concurrently, whereas the present study for the first time reports on the power of expectancies measured in early adolescents (seventh and eighth grades) to predict self-reported drinking onset and drinking behavior measured a full year later. Results show that five of seven expectancy scores readily discriminated between nonproblem drinkers and those subsequently beginning problem drinking and accounted for a large portion of the variance in a continuous quantity/frequency index and a problem drinking index. The strength of these timelagged relations strengthens the case for inferring that expectancies have causal power on drinking behavior and suggests prevention strategies.

Adolescent↗
PubMed1988

Experience-dependent cognitive recovery in alcoholics: a task component strategy.

Visuospatial problem-solving deficits following chronic alcohol abuse may not readily recover spontaneously after drinking cessation but may reverse with appropriate environmental stimulation. To determine if such recovery in alcoholics under age 40 may be accelerated by training with components of an initially impaired task (Trails B), this study employed four groups of alcoholics (N = 53) and a group of matched controls (N = 13). Two alcoholic groups received two consecutive cognitive remediation sessions during the latter 2 weeks of a 1-month treatment program, and two groups of alcoholics received no remediation. Results confirmed that recovery of visuospatial problem-solving skills is facilitated by training with task components (experience-dependent recovery) while spontaneous recovery during the first month of abstinence is minimal for this task. These findings demonstrate the efficacy of cognitive remediation in reversing some alcohol-induced cognitive impairment and have important implications for improving alcohol treatment outcome and adaptive functioning.

Adult↗
PubMed1988

Experience-dependent recovery of block design performance in male alcoholics: strategy training versus unstructured practice.

Neuropsychological functioning in alcoholics has been known to improve with length of abstinence. However, recovery in some areas is limited in the absence of specific cognitive stimulation. In order to better identify the factor(s) responsible for experience-dependent recovery in alcoholics, the current investigation compared a strategy training approach to the unstructured practice approach used in previous studies. Results showed that both treatments improved Block Design performance in abstinent male alcoholics to levels comparable to nonalcoholic controls, while unremediated alcoholics remained significantly impaired. Unstructured practice was sufficient to improve Block Design performance, with no additional advantage evident in alcoholics receiving strategy training. Hence, forced use of cognitive skills appears to be the important factor in experience-dependent recovery.

Alcoholism↗
PubMed1987

The Alcohol Expectancy Questionnaire: an instrument for the assessment of adolescent and adult alcohol expectancies.

Alcohol-related expectancies can influence the behavioral effects of alcohol and decisions regarding alcohol use. A standard measure of expectancies is needed for research and clinical work in the alcohol arena; the development and current status of the Alcohol Expectancy Questionnaire (AEQ) is summarized. The adolescent and adult forms of this instrument are designed to measure the degree to which individuals expect alcohol to produce a variety of general and specific effects. Research with the AEQ indicates a consistent relationship between alcohol expectancies and alcohol consumption, alcohol abuse and behavior while drinking. Data bearing on the psychometric properties and clinical and research utility of the AEQ are discussed.

Adolescent↗
PubMed1985

The differential development of adolescent alcohol expectancies may predict adult alcoholism.

To investigate changes in adolescent's alcohol expectancies as a function of increasing age and drinking experience, we compared the degree to which 12-14, 15-16, and 17-19 year old adolescents from normal seventh to twelfth grade classrooms (N = 1580) affirmed items comprising seven alcohol-expectancy scales. Results showed that adolescents increasingly believe alcohol improves social behavior, increases arousal, and decreases tension as they age. In contrast, the belief that alcohol improves cognitive and motor functioning increased and then decreased in a general adolescent sample, but remained high in problem drinking adolescents. The subsequent discovery of this same factor in 305 hospitalized alcoholics suggests that strong affirmation of this expectancy in late adolescence may have prognostic, and perhaps etiologic significance for the development of alcoholism.

Adolescent↗
PubMed1985

Experience-dependent recovery of cognitive functioning in young alcoholics.

Spontaneous recovery of some cognitive functioning in alcoholics after drinking has ceased has been convincingly demonstrated, but there have been no demonstrations of recovery that occurs primarily due to exposure of the alcoholic to specific environmental events. In the present study two groups of alcoholics began a 3-week series of tests sensitive to alcoholic cognitive dysfunction at different time lags after drinking ceased (1 week vs. at least 3 weeks). Each group received five administrations each of three tests. On two of the measures, comparisons between the initial testings administered at least three weeks apart revealed the expected pattern of improvement concommitant with the passage of time. On the Halstead-Reitan Trailmaking Test (Part B), initial test scores were equivalent, showing no time-dependent recovery. Instead, performance improved solely as a function of repeated task administration, thus demonstrating "experience-dependent" recovery. Initial levels of impairment and the extent of recovery were established using two non-alcoholic control groups. Since evidence has accrued that alcoholics' treatment outcome may relate to neuropsychological status, experience-dependent rehabilitation of cognitive functioning may improve success rates in alcoholism treatment.

Adult↗
PubMed1984

Repair of shattered solitary testicle.

A solitary shattered testicle with complete eventration of the seminiferous tubules was repaired with resultant satisfactory function. Principles of management in testicular trauma are reviewed briefly.

Adolescent↗
PubMed1984

Effects of naloxone on ethanol dependence in rats.

Adult male Long-Evans rats were maintained on an ethanol-containing liquid diet. During development of ethanol dependence, the rats were given daily i.p. injections of either naloxone (2 mg/kg) or saline daily. At the beginning of ethanol withdrawal, the rats were injected with either naloxone (10 mg/kg) or saline i.p. Rats injected with naloxone during the development of ethanol dependence consumed significantly more of the ethanol diet and therefore more ethanol than rats injected with saline. Rats treated with naloxone throughout both the development of ethanol dependence and during ethanol-withdrawal showed delayed or reduced withdrawal symptomatology compared to rats injected with only saline, naloxone only during the development of dependence and naloxone only during ethanol withdrawal. These results indicate that naloxone can alter the effects of chronic ethanol exposure and further suggest that ethanol may exert some of its actions via the brain opioid system.

Alcohol Drinking↗
PubMed1983

Discrimination of systolic blood pressure.

The ability of humans to discriminate systolic blood pressure (BP) was investigated in two experiments. In Experiment 1, 14 normal subjects were asked to make estimates of their systolic BP while performing both BP-elevating and BP-lowering tasks. They were given intermittent feedback throughout all 10 45-min sessions. Results indicated significant correlations and small absolute differences between estimated and measured BP for all subjects in almost all sessions. Experiment 2, undertaken 6 months after Experiment 1, assessed whether estimation accuracy by subjects who had available both external and interoceptive cues surpassed that of subjects which access to external cues only. Three subjects from the original group who showed consistently high motivation, and who improved in accuracy across the 10 sessions in the previous experiment, made estimates of BP while performing novel tasks with no feedback. Correlations between estimated and measured BP remained high for 2 of the 3. These results were compared with the accuracy of control subjects (3 for each experimental subject) who were asked to estimate experimental subjects' BP using only the cognitive information available to the experimental subjects. Control subjects also had high correlations between their estimates and the experimental subjects' measured BP but at lower levels than two experimental subjects. These findings are discussed in relation to subjects' possible use of interoceptive information.

Adolescent↗