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Biomedical subjects

M W Dysken

Publications and source records attributed to M W Dysken.

At least 19 recordsLinked to original sources
PubMed1992

Neuropsychological performance in obsessive-compulsive disorder.

Neuropsychological functioning was examined in a group of 18 nondepressed patients with obsessive-compulsive disorder (OCD) and 18 age-, education-, and gender-matched normal controls. A recent nonverbal memory deficit was identified in the patients with OCD. From performance on timed and untimed measures of the same constructs, it appears that OCD patients score more poorly than controls when speed is a factor. Although performance on a timed tactual-spatial motor test was also impaired, it is unclear whether this deficit is attributable to the nonverbal memory and/or speed deficits. Deficits in verbal abilities, including recent verbal memory, were not identified. Results were equivocal for executive function and visual-spatial abilities. The previously established association of recent nonverbal memory abilities with functioning of the right mesial temporal area is discussed in the context of current hypotheses about the neuroanatomic substrate of OCD.

Adult↗
PubMed1992

Distribution of peripheral lymphocytes in Alzheimer patients and controls.

Deficient immunoregulation has been postulated to play a role in the pathogenesis of Alzheimer's dementia. Recently, lymphopenia was reported to be more prevalent in Alzheimer patients than in control subjects. In addition, a decreasing number of total lymphocytes was found to be significantly correlated with increasing severity of dementia. In an attempt to replicate these findings, we studied 55 Alzheimer patients and 41 healthy controls of comparable age and gender, but found no significant difference in the distribution of total lymphocytes between these groups. Furthermore, total lymphocytes were not significantly correlated with dementia severity. Our findings, therefore, do not lend further support to an immune hypothesis for Alzheimer's dementia.

Adult↗
PubMed1992

The Symptom Checklist-90: Obsessive-Compulsive Subscale: A reliability and validity study.

Twenty-three nondepressed patients with DSM-III obsessive-compulsive disorder completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Symptom Checklist-90 (SCL-90), and the National Institute of Mental Health Global Obsessive-Compulsive Scale (NIMH-GOCS) once a week for a total of three times during a 2-week medication-free period and 10 times during a 10-week double-blind drug treatment period. The pretreatment test-retest reliabilities were determined for the Y-BOCS, NIMH-GOCS, and the SCL-90-Obsessive-Compulsive Subscale (SCL-90-OCS). Comparisons of the three instruments revealed that the Y-BOCS and the NIMH-GOCS were significantly more reliable than the SCL-90-OCS. Posttreatment correlations were obtained between change scores on the Y-BOCS and NIMH-GOCS and the SCL-90-OCS. Correlations were high and statistically significant for both the Y-BOCS and the NIMH-GOCS, but the correlations of the SCL-90-OCS with the Y-BOCS, NIMH-GOCS, Physician's Global Rating, and the Patient's Global Rating were poor. The findings suggest that the SCL-90-OCS may not be a sensitive instrument in assessing change in obsessive-compulsive symptoms.

Adult↗
PubMed1992

Milacemide: a placebo-controlled study in senile dementia of the Alzheimer type.

OBJECTIVE: Milacemide, a MAO-B inhibitor that is also a prodrug for glycine, was tested as a treatment for senile dementia of the Alzheimer type (SDAT) because of its potential for enhancing cognition in animal models of impaired learning and memory. DESIGN: Double-blind, placebo-controlled, randomized clinical trial. SETTING: Sixteen study sites, both university-affiliated and private. PATIENTS: A total of 228 outpatients (116 men and 112 women) with SDAT, ranging in age from 49-93 years. INTERVENTION: 1200 mg/day milacemide treatment for 1 month (113 patients received milacemide, and 115 patients received placebo). MAIN OUTCOME MEASURES: Alzheimer's Disease Assessment Scale and the Mini-Mental State Examination. RESULTS: Milacemide-treated SDAT patients did not show significant improvement in any of the outcome measures used. Significant elevations in liver enzymes in four subjects were of sufficient magnitude to necessitate withdrawal from the study. CONCLUSIONS: Milacemide does not appear to be an effective treatment in enhancing cognition in SDAT patients.

Acetamides↗
PubMed1992

Haloperidol decanoate pharmacokinetics in red blood cells and plasma.

Red blood cell (RBC) and plasma concentrations of haloperidol (H) and reduced haloperidol (RH) were determined in nine patients (five men, four women) who had been receiving monthly injections of haloperidol decanoate (HD) for at least 3 months. A very sensitive high performance liquid chromatography method was used to measure H and RH, which could be detected at levels as low as 0.1 ng/ml. Blood samples for H and RH were drawn at the end of weeks 1, 2, 3, and 4 of a 4-week cycle. Monthly HD dosages ranged from 50 mg to 200 mg. At each time point RBC H did not differ significantly from plasma H. RBC RH and plasma RH did not change significantly over time and were consistently lower than RBC H and plasma H. However, RBC RH levels were higher than plasma RH levels. Also, the ratios of RBC RH/H were higher than were the ratios of plasma RH/H, which reflect an accumulation of RH intracellularly. HD dosage was highly correlated with both RBC H and plasma H, but RBC RH and plasma RH were not significantly related to dosage at any time point. Significant correlations were observed between HD dosage and prolactin concentration at week 1 and between prolactin concentration and RBC H and plasma H at weeks 1 and 4. Blood concentrations of H and RH and the corresponding standardized areas under the curve were not significantly related to smoking.

Adult↗
PubMed1992

Haloperidol and reduced haloperidol in saliva and blood.

A total of 18 outpatients (17 male, 1 female) ranging in age from 36-66 years old were on a constant dosage of haloperidol in equally divided doses at 9:00 a.m. and 9:00 p.m. for at least 1 month. DSM-III-R diagnoses included schizophrenia (N = 9), schizoaffective disorder (N = 3), bipolar disorder (N = 4), organic mental disorder (N = 1), and delusional disorder (N = 1). Blood samples for steady-state concentrations of plasma and red blood cell haloperidol (H) and reduced haloperidol (RH) were drawn at 9:00 a.m. (12 hr trough). The haloperidol dosage was held at 9:00 a.m. until samples of whole saliva and parotid saliva could be collected for flow rates and concentrations of H and RH. Haloperidol dosages ranged from 1 mg/day to 60 mg/day (mean 11 +/- 15). Correlation coefficients were calculated for saliva concentrations versus blood levels and for saliva secretion rates versus blood levels. The correlations between whole saliva measures and blood concentrations were all higher than the correlations between parotid saliva measures and blood concentrations. In one case the higher correlation reached statistical significance. There was only one case in which substitution of saliva secretion rate improved the correlation between measures with saliva concentration. Our findings suggest that saliva measures of H and RH are useful alternatives to plasma concentrations in monitoring maintenance haloperidol treatment.

Adult↗
PubMed1991

Platelet 3H-imipramine binding sites in obsessive-compulsive behavior.

Several studies indicate a serotonergic dysfunction in patients with obsessive-compulsive disorder (OCD). We examined serotonergic function in OCD by determining platelet 3H-impiramine binding sites in patients with OCD during a drug-free baseline period as well as normal control volunteers. The maximum number of binding sites (Bmax) and apparent dissociation constant (Kd) was determined using 3H-imipramine (IMI) as the binding ligand. We observed that the mean 3H-IMI binding Bmax (fmol/mg protein) determined in 24 patients with OCD was not significantly different from that in 23 normal control subjects. There were no significant differences in the Kd between patients with OCD and normal control subjects. Our results are thus similar to those reported by Insel et al (1985) and Black et al (1990), who observed no significant differences in platelet 3H-IMI binding between OCD patients and controls; but different from those reported by Weizmann et al (1986), who observed decreased 3H-IMI Bmax in OCD patients. The discrepancy in the results is not clear, but may be related to several factors. Our results thus indicate that any abnormality in serotonergic function present in patients with OCD is not related to imipramine binding sites in the platelets. However, the possibility that there may be an abnormal platelet serotonin uptake or other serotonergic function in OCD cannot be ruled out.

Adult↗
PubMed1991

A review of disorders of water homeostasis in psychiatric patients.

Disorders of water homeostasis are common in psychiatric patients and include compulsive water drinking, the syndrome of inappropriate antidiuretic hormone secretion (SIADH), and the syndrome of self-induced water intoxication (SIWI). Although water intoxication was recognized nearly 70 years ago, the physiological basis of these disorders of water metabolism still remains elusive. This review will provide a historical overview, critique current studies on compulsive water drinking and SIWI, discuss possible etiologies, and present current approaches to treatment of these disorders. Because of the complexity of the subject, a review of normal water homeostasis and the SIADH will be included.

Drinking↗
PubMed1991

Seasonal distribution of births in Alzheimer's disease.

We obtained season-of-birth data in 727 autopsy-confirmed cases of Alzheimer's Disease (AD) and compared these data with expected general population birth rates. There were no significant differences between quarterly birth rates in the AD group and expected quarterly birth rates. Edward's test for cyclical trends did not establish a peak period of birth in the AD sample. No significant differences between observed and expected quarterly birth rates were found when data were analyzed with regard to either family history of dementia or to gender. Edward's test for peak quarter was significant for AD females, however, with the peak period occurring early in the first quarter. These negative findings between observed and expected quarterly birth rates, based on the large number of autopsy-confirmed AD cases in this study, suggest that a season-of-birth effect in AD is highly unlikely.

Aged↗
PubMed1990

Rapid dynamic CT scanning in primary degenerative dementia and age-matched controls.

Dynamic computed tomography (CT) scanning of the brain was performed in 26 patients with primary degenerative dementia (PDD) and in 15 age-matched controls without evidence of a dementing illness. Changes in CT density values over time were obtained for 16 regions of interest (ROIs) that were carefully chosen to avoid overlap with adjacent cerebrospinal fluid (CSF), sulsi, or bone. CT density washout curves were compared between patients and controls to detect regions where blood brain barrier (BBB) permeability might be increased. Although the patients' washout curves declined more gradually than control curves in 11 of the 14 ROIs with a functioning BBB, in no case did the difference reach statistical significance. Intrarater correlation coefficients indicated good overall reliability in the selection of ROIs.

Aged↗
PubMed1990

Gender differences in TRH-stimulated TSH and prolactin in primary degenerative dementia and elderly controls.

We performed thyrotropin-releasing hormone (TRH) stimulation testing in 18 nondepressed patients with primary degenerative dementia (10 M, 8F; average age +/- SD = 68 +/- 7) and 12 elderly controls (7M, 5F; average age +/- SD = 61 +/- 6). Six patients were retested approximately 2 years later. Initial Mini-Mental State Examination scores for patients ranged from 2 to 28 (average +/- SD = 18 +/- 6) and the scores for the control subjects were all equal to 30. Protirelin (500 micrograms) was injected iv and blood was sampled at 0, 15, 30, 45, 60, and 90 min for thyrotropin-stimulating hormone (TSH) and prolactin (PRL). There were no significant differences between patients and controls in baseline T4, T3 uptake, TSH, or PRL. No significant differences were found between patients and controls for either TRH-stimulated TSH or PRL at all time points. Duration of illness, severity of dementia, and severity of depressive symptoms did not correlate significantly with stimulation test results. There were, however, significantly greater responses in stimulated TSH and PRL for women compared with men in both patients and controls. Upon repeat testing (n = 6), TRH-stimulated TSH and PRL were not significantly different from the initial results.

Aged↗
PubMed1990

The Yale-Brown Obsessive-Compulsive Scale: a reliability and validity study.

Twenty-eight nondepressed patients with DSM-III obsessive-compulsive disorder completed both the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Leyton Obsessional Inventory (LOI) once a week for a total of three times change. In general, the correlations between the Y-BOCS change scores and the Global Ratings were significantly greater than between the LOI and the Global scores, the Y-BOCS was found to be more reliable than the LOI. Correlations were also obtained for the baseline period between the Y-BOCS and Leyton scores. At the end of a 14-week trial of clomipramine, the Y-BOCS and the LOI were again administered along with a Physician and Patient Global Rating of change. In general, the correlations between the Y-BOCS change scores and the Global Ratings were significantly greater than between the LOI and the Global Ratings. This last finding suggests that the Y-BOCS is a better measure of clinical change than is the LOI.

Adult↗
PubMed1979

Clinical usefulness of sodium amobarbital interviewing.

We report a double-blind, randomized, placebo-controlled study utilizing a within-subjects design on 20 hospitalized, psychiatric patients who participated in sodium amobarbital interviews to determine if the drug has a specific effect in eliciting clinically useful information. The patients selected had difficulty communicating with their primary therapists during the postadmission, diagnostic interviews. Two raters completed a Hamilton Depression Scale, a New Haven Schizophrenia Index, and a Brief Psychiatric Rating Scale after each interview. Although both the amobarbital and saline interviews were moderately useful in obtaining new information, we found no significant difference in the primary therapists' assessments of clinical usefulness. In addition, the drug interview did not uncover material that would aid in the differential diagnosis between depression and schizophrenia. There was, however, a significant negative correlation between the assessment of general usefulness and the time interval between admission and interviewing. We report our only exception, a case of catatonic schizophrenia, in which the patient responded specifically to the drug.

Adult↗