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R B Zipursky

Publications and source records attributed to R B Zipursky.

65 records · Page 4Linked to original sources
PubMed1991

Structural and functional brain imaging in schizophrenia.

We present an evaluation of the contribution of structural and functional brain imaging to our understanding of schizophrenia. Methodological influences on the validity of the data generated by these new technologies include problems with measurement and clinical and anatomic heterogeneity. These considerations greatly affect the interpretation of the data generated by these technologies. Work in these fields to date, however, has produced strong evidence which suggests that schizophrenia is a disease which involves abnormalities in the structure and function of many brain areas. Structural brain imaging studies of schizophrenia using computed tomography (CT) and magnetic resonance imaging (MRI) are reviewed and their contribution to current theories of the pathogenesis of schizophrenia are discussed. Positron emission tomography (PET) studies of brain metabolic activity and dopamine receptor binding in schizophrenia are summarized and the critical questions raised by these studies are outlined. Future studies in these fields have the potential to yield critical insights into the pathophysiology of schizophrenia; new directions for studies of schizophrenia using these technologies are identified.

Brain↗
PubMed1990

In vivo quantification of the limbic system using MRI: effects of normal aging.

Limbic system structures are of central interest in many neuropsychiatric disorders. Magnetic resonance imaging (MRI) has a unique potential for imaging limbic system structures in vivo, but methodological constraints can limit the usefulness and interpretation of the collected image data. In this article, we present approaches for the acquisition and quantification of high resolution MR images of the limbic system. We used a long TR, cardiac gated, flow compensated, spin echo sequence to collect 22, 3-mm thick contiguous sections encompassing the limbic system. The sections were oriented relative to standard internal neuroanatomical landmarks. The sequence provided good gray matter/white matter/cerebrospinal fluid (CSF) and CSF/bone contrast; the latter is necessary for quantifying intracranial size and total CSF volume. Using operationalized criteria, we achieved high interrater reliability in volumetric measurement of temporal horn and hippocampus. This technique was then used to examine the effect of normal aging by comparing eight young (mean = 24 years) and seven old (mean = 73 years) healthy community members. We were able to demonstrate a significant age-related increase in temporal horn volume and a trend toward an age-related decrease in hippocampal volume.

Adult↗
PubMed1990

Volumetric assessment of cerebral asymmetry from CT scans.

The advent of computed tomography (CT) of the brain has facilitated the study of brain asymmetries in normal individuals and in patients with various diseases. A computerized volumetric approach to quantifying CT scan data is used to demonstrate that imperfect alignment of the subject's head in the CT scanner can be a major source of artifact in the assessment of cerebral asymmetry. An approach for estimating the extent of misalignment of the head in the scanner is described. This approach can be used to take variations in head alignment into account when studying cerebral asymmetries. When volumetric measures were used, left-handed subjects (n = 5) were found to have a significantly lower left/right ratio of total cerebral hemispheric tissue than right-handed subjects (n = 41). The amount of asymmetry in the lateral ventricles was found to depend on their total size. A method for controlling for the effect of size when measuring asymmetry of the lateral ventricles is described. In both right- and left-handed subjects, the left lateral ventricles were significantly larger than the right. A magnetic resonance (MR) scan was performed with standard alignment and with a deliberate 10 degrees misalignment, using a volunteer subject. These data are presented to demonstrate how artifactual cerebral asymmetries can be generated by head tilt and to test the quantification procedures developed.

Adult↗
PubMed1990

A quantitative analysis of CT and cognitive measures in normal aging and Alzheimer's disease.

Patients with presumptive Alzheimer's disease (AD) and healthy community volunteers received computed tomographic (CT) brain scans and cognitive tests. The CT scans were quantitatively analyzed with a semiautomated thresholding technique to derive volumetric measures of cerebrospinal fluid (CSF)-to-tissue ratios in six regions of interest (ROIs): lateral ventricles; vertex sulci, frontal sulci, Sylvian fissures, parieto-occipital sulci, and third ventricle. Regression analysis was performed on CT data from 85 older volunteers (ages 51-82) to generate age norms for each ROI. Within this group, tissue loss, as measured by the % CSF in each ROI, was highly correlated with age, although each ROI showed different rates of change over age. For all ROIs, the AD group had significantly more tissue loss than expected in normal aging. In addition, AD patients with a presenescent onset (before age 65) tended to have greater vertex sulcal and frontal sulcal tissue reduction than AD patients with a senescent onset (age 65 or after). When regional tissue reduction, corrected for age, was correlated with cognitive test scores, two sets of double dissociations emerged within the AD group: large CT z scores (i.e., decreased tissue and increased CSF) of frontal sulci, but not of the third ventricle, correlated with low Comprehension and Boston Naming Test scores, whereas large CT z scores of the third ventricle, but not of the frontal sulci, correlated with low scores on Digit Symbol and Picture Arrangement. These results suggest that heterogeneity of structural and functional integrity exists among patients with AD.

Adult↗
PubMed1990

Brain magnetic resonance imaging: approaches for investigating schizophrenia.

Magnetic resonance imaging (MRI) offers the potential for identifying, in vivo, specific brain abnormalities associated with schizophrenia. The detection of small morphological differences in areas such as the prefrontal cortex, limbic structures, and basal ganglia requires attention to a number of technical and methodological details. The effects of age, height, sex, head size, and overall tissue loss are of particular concern and are discussed. MRI acquisition and processing techniques for improving gray/white tissue contrast and image resolution are described, as are techniques for quantitative, volumetric measurement of localized regions of interest and specific brain structures as well as of the brain as a whole. Techniques for evaluating frontal lobes, temporal lobes, and basal ganglia integrity are reviewed, and recent observations on these brain regions in patients with schizophrenia are described.

Basal Ganglia↗
PubMed1989

MRI study of brain changes with short-term abstinence from alcohol.

Magnetic resonance brain scans were obtained from 10 chronic alcoholics within 2 weeks of alcohol withdrawal, and 19 to 28 days later. Age-matched control subjects were scanned at comparable intervals. At the initial scan, the alcoholics had larger lateral ventricles than the controls; at the second scan, their ventricles were significantly smaller than at the first scan. Among the controls, there was no mean change in the size of the lateral ventricles between the first and second scan. This study demonstrates reversibility in ventricular enlargement with short-term abstinence from alcohol. The role of rehydration in this process and the possibility of further changes with continued abstinence remain to be tested.

Alcoholism↗
PubMed1988

Computed tomographic evidence for generalized sulcal and ventricular enlargement in schizophrenia.

Quantification of ventricular and sulcal volumes from the computed tomographic (CT) scans of 45 schizophrenic patients and 57 normal controls was carried out using a semi-automated computerized approach. The sizes of all cerebrospinal fluid spaces measured were significantly related to age in the control population. An age regression model was used to compare patients and controls. Schizophrenics had slightly larger ventricles and considerably larger sulci than controls. Enlargement of the ventricles and sulci was not correlated with measures of negative symptoms or neuropsychological impairment. The CT scans of eight very ill chronically institutionalized schizophrenics were also analyzed. Their CT findings did not differ significantly from the larger group of schizophrenics studied. Our results show that the cerebral atrophy found in schizophrenia is diffuse in nature and does not relate clearly to measures of disease severity or chronicity.

Adult↗
PubMed1985

Alprazolam withdrawal delirium unresponsive to diazepam: case report.

A case is presented in which a 68-year-old man became delirious after being withdrawn from a low dosage of alprazolam. The delirium was not affected by administration of alprazolam. The authors suggest that alprazolam may have enhanced specificity for a subpopulation of benzodiazepine receptors.

Aged↗
PubMedDate not supplied

Neuroimaging studies of schizophrenia.

Neuroimaging studies of schizophrenia have identified abnormalities in neuroanatomy, regional brain metabolism and receptor physiology. Computerized tomographic (CT) studies have demonstrated gross ventricular and sulcal enlargement. These findings are probably nonprogressive, and it is not yet clear whether they are present only in a subgroup of patients; whether they represent a reduction in tissue from a previously normal condition or an abnormality in brain development; and what relationship they have to genetic risk for schizophrenia, clinical features, or longterm prognosis. Magnetic resonance imaging (MRI) studies, which offer higher resolution and greater flexibility in imaging plane, are currently focussing on specific neuroanatomic sites, such as the limbic system, basal ganglia and frontal cortex, implicated by neuropathological or clinical studies in the pathophysiology of schizophrenia. Positron emission tomographic (PET) scanning now enables investigators to study brain metabolism and receptor physiology. Evidence to date suggests that there may be significant abnormalities in the pattern of cerebral glucose utilization as well as in the density of dopamine receptors in patients with schizophrenia. Much future work is needed to determine the sensitivity and specificity of these observations as well as the extent to which they are affected by changes in clinical state, attention and medication exposure.

Brain↗