Low lead levels and neuropsychological assessment: let us not be mislead.
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Biomedical subjects
N Hebben
Publications and source records attributed to N Hebben.
Neuropsychological aspects of lack of insight in bipolar disorder: a preliminary report.
In 16 inpatients with acute mania, neuropsychological evaluation revealed a trend toward correlation between less insight (lower scores on the Insight and Treatment Attitudes Questionnaire, ITAQ) and improved delayed visual recall. This result may either reflect the absence of a relationship between neuropsychological abnormalities and lack of insight in bipolar disorder, or it may represent an indirect expression of frontal lobe dysfunction. Also, an association was found between increased number of previous hospitalizations and greater insight. Since the neuropsychological result noted above was limited to patients with more than six previous hospitalizations, an interaction may exist between number of previous hospitalizations and neuropsychological abnormalities in the development of insight.
Adult↗
Brain perfusion is abnormal in cocaine-dependent polydrug users: a study using technetium-99m-HMPAO and ASPECT.
Cocaine abuse is widespread and has been associated with serious neurovascular complications. We studied a group of cocaine-dependent polydrug users with 99mTc-HMPAO and high-resolution SPECT and compared their perfusion pattern to cerebral perfusion in a group of older control subjects. Sixteen of 18 cocaine-dependent polydrug users had abnormal perfusion characterized primarily as small focal defects involving inferoparietal, temporal, and anterofrontal cortex and basal ganglia. Psychometric testing was abnormal in all 18 cocaine-dependent subjects. No relation was found between the severity of SPECT abnormalities and mode of administration or frequency or length of cocaine use. All 15 older normal subjects had normal cerebral perfusion. While the focal perfusion abnormalities to the cortex and basal ganglia could be explained by the profound vasoconstrictor effects of cocaine, the combinational use of multiple substances including cannabis and alcohol may play a contributory role. This study documents the high incidence of functional brain abnormalities in cocaine-dependent chronic polydrug users without corresponding abnormalities on imaging studies of cerebral anatomy and morphology.
Adult↗
Relationships between brain CT scan findings and cortisol in psychotic and nonpsychotic depressed patients.
In this report, data are presented on pre- and postdexamethasone cortisol levels, neuropsychological testing, and computed tomography (CT) scan findings in 30 depressed patients (15 psychotic and 15 nonpsychotic). Particularly significant findings were observed when data from the unipolar subgroup (n = 22) were analyzed separately. Unipolar psychotic depressed patients had significantly larger (p less than 0.05) anterior pole and cella media ventricle-to-brain ratios (VBRs) and significantly greater (p less than 0.05) left and right inferior parietal brain "atrophy" than nonpsychotic depressed patients. Higher rates of Dexamethasone Suppression Test (DST) nonsuppression were observed in psychotic depressed patients and in patients with larger cella VBRs. Inferior parietal brain atrophy and large VBRs were also associated with greater cognitive impairment on psychometric testing. Implications of these findings are discussed.
Adult↗
The role of the frontal and temporal lobes in the phonetic organization of speech stimuli: a multidimensional scaling analysis.
Auditory perception of 10 two-letter consonant-vowel syllables and visual short-term memory for sequences of the same syllables were examined in 28 patients with lesions in the frontal or temporal lobe of either hemisphere and in 12 normal control subjects. Multidimensional scaling analyses showed that manner of articulation and voicing were salient organizational categories for all groups on the auditory task whereas manner of articulation and place of articulation were the salient organizational clusters for all groups on the visual task. The pattern of confusion errors made by all groups on both tasks were consistent with some, but not all, of the phonetic distinctive features expected based on formal linguistic description of human phonology. No group showed a consistent lack of sensitivity across all phonetic features, arguing against the idea that use of a phonetic code is dependent upon any specific focal structure in the cerebral hemispheres.
Adolescent↗
Diminished ability to interpret and report internal states after bilateral medial temporal resection: case H.M.
These experiments centered around H.M., a 54-year-old man who became amnesic 27 years ago after a bilateral resection in the medial temporal lobe region for epilepsy. In order to document the clinical reports that he rarely comments on such internal states as pain, hunger, and thirst, his thermal pain perception was examined in relation to his other somatosensory capacities, and his reports of hunger and thirst were assessed before and after meals. In order to investigate the effect of limited memory ability on the reporting of internal states, H.M.'s performance was compared with that of 5 other subjects with global amnesia. The results provided evidence that H.M.'s information about internal states is less available or less accessible than normal and that his impairment is not attributable to his well-documented memory deficit. Instead, it is believed that the bilateral resection of the amygdala accounts for H.M.'s poor appreciation of his internal states.
Adult↗
Visual recognition through kinaesthetic mediation.
A case is reported in which mercury intoxication produced visual symptoms with an unusual compensation. The similarity of this patient to Schn., a much reported neuropsychiatric case, was striking and prompted correlation of the two cases. Experimental psychological studies performed on the present case provide a basis for an understanding of both cases.
Adult↗
The relationship among handedness, sighting dominance, and acuity dominance in elementary school children.
The present study was an attempt to clarify the relationship between handedness, sighting dominance, and eye-acuity in children. Ninety-four males and ninety-seven females between the ages of five and eleven were assessed on standardized measures of handedness, sighting dominance, and visual acuity. Right-handers were more likely to show right-sighting dominance, whereas left-handers had an equal chance of being right-sighted or left-sighted. Acuity dominance was not consistently associated with handedness or sighting dominance. No effects for sex or age were found. It is suggested that further clarification of the function of various lateralized sensorimotor measures is needed before an understanding of how these measures may be related to cortical dominance is possible.
Child↗
Relationship of normal serum vitamin B12 and folate levels to cognitive test performance in subtypes of geriatric major depression.
This retrospective study evaluated the relationships between normal serum vitamin B12 and folate levels and neuropsychologic measures in a sample of 60 geriatric inpatients with psychotic depression, nonpsychotic depression, bipolar disorder, and dementia--all consecutively referred for cognitive testing. The psychotic depression subgroup demonstrated numerous significant positive correlations between B12 and cognitive subtests not seen in other diagnostic subgroups, especially those of IQ, and verbal and visual memory. Metabolic factors including vitamin B12 may play specific roles in the cognitive dysfunctions of different geropsychiatric disorders.
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