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Biomedical subjects

R B Sloane

Publications and source records attributed to R B Sloane.

18 recordsLinked to original sources
PubMed1992

Personality in recovered depressed elderly.

Personality traits in euthymic elderly subjects with and without past histories of major depressive episodes were assessed using the Structured Clinical Interview for DSM-III-R and the Social Adjustment Scale-SR. Recovered depressed subjects were characterized by significantly more personality traits from DSM-III-R Clusters B and C than controls, and they exhibited differences in social adjustment, as well. Subjects who have recovered from depressive episodes may show significant differences in personality and social adjustment that might represent residua of past depression, a trait characteristic, or a risk factor for recurrence.

Aged↗
PubMed1991

Do blood pressure and age predict response to tacrine (THA) in Alzheimer's disease? A preliminary report.

Recent studies in major depression suggest that a pretreatment systolic orthostatic blood pressure (PSOP) fall of greater than or equal to 10 mm Hg in response to changing from a supine to a standing position may predict response to antidepressant treatment in older depressed patients. Because orthostatic blood pressure response is regulated, in part, by central cholinergic and noradrenergic systems, and both are implicated in Alzheimer's disease, PSOP was assessed as a predictor of initial response in Alzheimer's disease outpatients in a treatment protocol with tacrine, a cholinesterase inhibitor. We found that the magnitude of PSOP fall and increasing age each contributed to the prediction of response to tacrine. These results may suggest a relatively greater involvement of other neurotransmitter systems in younger, nonresponding Alzheimer's disease patients, and the results differ from those of a previous study.

Adult↗
PubMed1990

Relationship of hydroxynortriptyline to nortriptyline concentration and creatinine clearance in depressed elderly outpatients.

Plasma concentration of E-10-hydroxynortriptyline is increased in the elderly and may be related to both renal clearance of hydroxynortriptyline and rate of liver hydroxylation of nortriptyline. In 25 ambulatory, depressed elderly outpatients treated with therapeutic doses of nortriptyline, relationships among plasma levels of nortriptyline and E-10-hydroxynortriptyline, and an estimate of creatinine clearance were examined. Plasma levels of E-10-hydroxynortriptyline (corrected for varying dosage) were significantly correlated with age and inversely correlated (r = -0.50) with creatinine clearance but not with notriptyline or Z-10-hydroxynortriptyline concentration. E-10-hydroxynortriptyline concentration was about 5 1/2 times that of Z-10-hydroxynortriptyline. By best subsets multiple regression analyses, the ratio of E-10-hydroxynortriptyline to nortriptyline level was best predicted by plasma nortriptyline concentration, creatinine clearance, and age, all of which accounted for 63% of the variance. These results corroborate and extend previous findings in elderly inpatients in whom creatinine clearance was measured directly. In addition, age had an effect on E-10-hydroxynortriptyline independently of creatinine clearance. Since E-10-hydroxynortriptyline concentration has been related to both therapeutic efficacy and toxicity during nortriptyline treatment, it may be important to assess nortriptyline hydroxymetabolites in elderly patients and in those with renal insufficiency.

Aged↗
PubMed1989

Visual evoked potentials in dementia: a meta-analysis and empirical study of Alzheimer's disease patients.

A meta-analytic review of flash and pattern reversal visual evoked potential research indicates that elderly demented patients have longer P100 latencies than age-matched control subjects. In the present empirical research, patients with research diagnoses of probable Alzheimer's disease were compared with sex- and age-matched control subjects using P100 latencies of visual evoked potentials (VEP) elicited by flash and pattern reversal. As compared to control subjects, Alzheimer's disease patients showed significantly longer P100 latencies of the VEP elicited by pattern reversal; the flash P100 only marginally distinguished them. These findings are discussed within the context of VEP recording practices, patient selection, sex and age matching of control subjects, and the visual system.

Aged↗
PubMed1988

Platelet tritiated imipramine binding and MAO activity in Alzheimer's disease patients with agitation and delusions.

Decreased platelet 3H-imipramine binding density and decreased monoamine oxidase (MAO) activity have been considered as biological characteristics of several neuropsychiatric disorders, and may be related to central serotonin defects. Since serotonin system defects occur in Alzheimer's disease (AD), and decreased brain 3H-imipramine binding density, and increased brain and platelet MAO activity are reported also, we studied platelet 3H-imipramine binding density (Bmax) and platelet MAO activity in AD outpatients without antecedent psychiatric disorder. AD subjects with significant symptomatic behavioral disorder, predominantly agitation and delusions, and AD subjects without symptomatic behaviors were compared with controls. Age, sex, mini-mental state examination score, and illness duration did not distinguish the two AD groups. The agitated/delusional group showed significantly lower Bmax values than uncomplicated AD subjects or controls. MAO activity was significantly increased among female AD subjects without symptomatic behaviors compared to those who were agitated or to controls. These results indicate that 3H-imipramine binding and MAO activity may distinguish AD subjects with agitation or delusions from those without symptomatic behaviors, and suggest the existence of a biologically based Alzheimer's behavioral subtype.

Aged↗
PubMed1988

Electrocardiographic changes with nortriptyline and 10-hydroxynortriptyline in elderly depressed outpatients.

Pharmacokinetic factors may contribute to altered nortriptyline effects in the elderly. Plasma concentrations of nortriptyline's principal metabolite, E-10-hydroxynortriptyline, tend to be greater than nortriptyline, increase with age, and may contribute to cardiotoxicity. Electrocardiogram changes were evaluated in 21 ambulatory, elderly, depressed outpatients who were treated with therapeutic doses of nortriptyline. Resting electrocardiograms were obtained before and after 6 weeks of treatment. Plasma samples were assayed simultaneously for nortriptyline, E-, and Z-10-hydroxynortriptyline. Three subjects developed a first degree atrioventricular block and one developed a right bundle branch block during treatment. Mean daily nortriptyline dose and steady state plasma level in these subjects did not differ from those who did not develop conduction defects, but E-10-hydroxynortriptyline levels were significantly higher. Overall, there were significant correlations between changes in the PR interval and QRS duration with plasma concentrations of nortriptyline, E-10-hydroxynortriptyline, Z-10-hydroxynortriptyline, and the sum of nortriptyline and its 10-hydroxynortriptyline metabolites. Multiple regression analyses suggested that increases in PR interval were associated with increasing nortriptyline concentration, while increases in QRS duration and Q-Tc intervals were associated with increasing Z-10-hydroxynortriptyline concentration. E- and Z-10-hydroxynortriptyline may contribute substantially to the cardiac conduction effects of nortriptyline treatment and may be of particular importance in the elderly.

Aged↗
PubMed1979

Hemispheric dysfunction in schizophrenia: assessment by visual perception tasks.

Before and after a double-blind trial of haloperidol vs. mesoridazine, 24 hospitalized schizophrenics performed visual perception tasks designed to assess function of the cerebral hemispheres. Tasks involved identifying as "same" or "different" two images (either letters, digits, or unfamiliar shapes) projected tachistoscopically to the right or left visual field or to both together. Multivariate analysis of variance related response latency and accuracy to task type, hemisphere stimulated, and pre- vs. posttreatment testing. Both before and after treatment, subjects responded most slowly and least accurately to letter-matching. Bilateral presentation of stimuli resulted in faster and more accurate responses, except on shape-matching. Neuroleptic treatment improved speed and accuracy overall, though not under certain task conditions. Results accorded more with an impairment in verbal processing and interhemispheric coordination than with a specific left-hemispheric deficit in schizophrenia.

Acute Disease↗
PubMed1976

Truax factors, speech characteristics, and therapeutic outcome.

Initial interview ratings of therapist accurate empathy, unconditional positive regard, and self-congruence were correlated with nonlexical speech characteristics and outcome of individual psychotherapy. Speech characteristics of both patients (greater total speech time, shorter pause time following therapists' comments, and faster reaction times) and therapists (fewer speech units) were significantly related to improved outcome. While Rogers-Truax factors were unrelated to outcome, they were related to speech characteristics of both patient and therapist. Furthermore, patients whose therapists showed high levels of the Truax factors tended to increase their average speech durations and total speech time during the course of the initial interview.

Adult↗
PubMed1976

Auditory attention in process and reactive schizophrenia.

The present data indicate that, based on level of premorbid adjustment (process-reactive), schizophrenic subjects differ in auditory attention processes. Generally speaking, poor premorbid adjustment is associated with more attention dysfunction. Results also indicate that attentional deficits improve for all schizophrenic subjects after a 28-day period of neuroleptic therapy.

Adult↗
PubMed1975

Differences between behavior therapists and psychotherapists.

Patient-therapist interaction patterns of three experienced behavior therapists and three matched analytically oriented therapists were compared. Each therapist saw ten patients in short-term individual therapy. The more active behavior therapists dominated the conversation in terms of speech time, more frequently offered explicit advice and instructions, gave more direct information, presented their own value judgments, and exerted greater control over the content of the interaction than did psychotherapists. Although both groups provided a warm and accepting atmosphere, behavior therapists showed higher levels of accurate empathy, interpersonal contact, and therapist self-congruence. Patients viewed behavior therapists as more authoritarian and believed that psychotherapists encourage greater independence. It was concluded that the two therapy approaches to patients were consistent with theoretical models of each.

Behavior Therapy↗
PubMed1975

Short-term analytically oriented psychotherapy versus behavior therapy.

Ninety-four outpatients with anxiety neurosis or personality disorder were randomly assigned for four months to a waiting list, behavior therapy, or psychoanalytically oriented therapy. The target symptoms of all three groups improved significantly, but the two treated groups improved equally well and significantly more than those on the waiting list. There were no significant differences among the groups in work or social adjustment; however, the patients who received behavior therapy had a significant overall improvement at four months. One year and two years after the initial assessment, all groups were found to be equally and significantly improved.

Adult↗
PubMedDate not supplied

Decreased platelet 3H-imipramine binding in primary major depression compared with depression secondary to medical illness in elderly outpatients.

Platelet 3H-imipramine binding and monoamine oxidase (MAO) activity were investigated in elderly outpatients with primary major depression, and in a group with depression secondary to medical illness (organic mood disorder, depressed by DSM-III-R criteria) in a multidisciplinary geriatric clinic. The density of the binding of 3H-imipramine (Bmax) was decreased significantly in subjects with major depression compared to subjects with secondary depression, and to controls. There was no difference in Bmax values between subjects with secondary depression and controls. MAO activity was increased in the group with secondary depression, but not in the group with primary major depression. These results provide preliminary evidence for the relative specificity of platelet 3H-imipramine binding as a marker for primary major depressive disorder compared to secondary depression in medically ill elderly people, supports the concept of biological heterogeneity in secondary depression, and extends the findings of decreased Bmax values in two previous studies in non-medically ill depressed elderly patients.

Aged↗
PubMedDate not supplied

A pilot study of low-dose L-deprenyl in Alzheimer's disease.

The use of low-dose L-deprenyl, a selective MAO-B inhibitor, in Alzheimer's disease patients has been associated previously with improvements in agitation and episodic learning and memory. Behavioral, cognitive, and regional electroencephalogram (EEG) measures were obtained in a 4-week open pilot study of 14 patients with probable Alzheimer's disease by NINCDS criteria who were administered 10 mg L-deprenyl per day. L-Deprenyl administration was associated with significant improvements on the agitation and depression factors of the Brief Psychiatric Rating Scale, the Cornell Scale for Depression in Dementia, and spouses' blind ratings. Recall improved on the Buschke Selective Reminding Task, but intrusions also tended to increase; verbal fluency decreased. Absolute EEG delta measures were selectively suppressed in the right frontal region. The pattern of changes suggests that L-deprenyl may be associated with improvement in behavioral and cognitive performance, in part through a mild behavioral disinhibiting effect.

Activities of Daily Living↗