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R Tomer

Publications and source records attributed to R Tomer.

36 records · Page 2Linked to original sources

Neuroleptics reverse attention asymmetries in schizophrenic patients.

Discussions of hemispheric asymmetry in psychopathology are often confounded by the effects of medication. We examined the effect of neuroleptic drugs on attention asymmetries in acutely psychotic patients admitted for the first time to a psychiatric hospital before the initiation of drug treatment and again after a period of treatment with neuroleptics. Overall performance did not change significantly; however, attention asymmetry was clearly related to the medication status of the patient: unmedicated patients showed inattention to the right hemispace, which changed to more prominent left-sided inattention when medicated. A longer time on medication or a higher daily dose were associated with a shift of inattention from the right to left hemispace. This suggests that neuroleptics may normalize left hemisphere performance, at the expense of deteriorated right hemisphere performance.

Adult↗

Amygdala kindling modifies interhemispheric dopaminergic asymmetry.

Brain dopamine is known to retard the development of kindled seizures, but it is uncertain whether kindling affects dopamine function. In the present study, rats were screened for cerebral dominance by recording their preferred direction of rotation when injected with d-amphetamine. Bipolar stimulating electrodes were then implanted in the amygdaloid complex of either the dominant or nondominant hemisphere (i.e., respectively, contra- and ipsilateral to the preferred direction of rotation; the dominant hemisphere identified in this way has been shown to contain higher concentrations of dopamine than the nondominant hemisphere). Kindling stimulation (or sham-kindling, in control rats) was applied through the electrodes two or three times daily for 21 days, and the rats were reassessed for amphetamine- and apomorphine-induced rotation, during and after the course of treatment. Kindling of the originally dominant hemisphere caused a diminution of rotational asymmetry as measured in tests 2 to 3 h after stimulation sessions, and in some rats led to a reversal in the preferred direction of amphetamine-induced rotation. Kindling of the nondominant hemisphere tended to accentuate the original amphetamine-induced asymmetry. The direction of rotation induced by a direct postsynaptic DA-receptor agonist (apomorphine) was not significantly affected by kindling of either hemisphere. It appears that kindling stimulation brings about a relatively inferior level of DA function on the stimulated vs. the nonstimulated side of the brain, and that this process depends mainly on changes occurring at a presynaptic level.

Amygdala↗

Lateralized neuroleptic-induced side effects are associated with asymmetric visual evoked potentials.

Recent studies suggest that neuroleptic drugs may have an asymmetric effect on the two cerebral hemispheres. This effect is reflected by emergence of drug-induced lateralized extrapyramidal side effects and by dose-related alterations in electrophysiological asymmetries. The present study examined the hypothesis that asymmetry of visual evoked potentials (VEPs) is associated with lateralized appearance of neuroleptic-induced parkinsonism or tardive dyskinesia (TD). The asymmetry of the amplitudes of later VEP components was significantly higher in patients with lateralized side effects (n = 8) than in patients with symmetrical side effects (n = 6) or free of extrapyramidal side effects (n = 11). The possibility that VEP asymmetry reflects the differential degree to which the two hemispheres are affected by medication is discussed.

Adult↗

Transient contralateral rotation following unilateral substantia nigra lesion reflects susceptibility of the nigrostriatal system to exhaustion by amphetamine.

Following unilateral 6-OHDA induced SN lesion, a transient period of contralateral rotation has been reported to precede the predominant ipsilateral circling. In order to clarify the nature of this initial contralateral rotation we examined the effect of the duration of recovery period after the lesion, on amphetamine-induced rotational behavior. Three days post lesion, most rats circled predominantly contralaterally to the lesion. Such contralateral rotation may result from either degeneration-induced breakdown of the DA pool, or lesion-induced increase of DA turnover in the spared neurons. A substantial degree of contralateral preference was still evident when amphetamine was administered for the first time 24 days after lesioning, indicating involvement of spared cells in the contralateral rotation. However, regardless of the duration of recovery (and irrespective of either lesion volume, amphetamine dose, or post-lesion motor exercise), amphetamine-induced rotation tended to become gradually more ipsilateral as the observation session progressed, and all rats circled ipsilaterally to the lesion in response to further amphetamine injections. These findings suggest that amphetamine has an irreversible effect on the post-lesion DA pool contributing to contralateral rotation.

Amphetamine↗

Exposure to amphetamine after substantia nigra lesion interferes with the process of behavioral recovery.

Recovery from unilateral substantia nigra lesion may be indicated by re-emergence of circling in the pre-lesion preferred direction. Following 6-OHDA-induced lesion of the dominant SN, we examined: (a) The effect of the delay from lesioning on amphetamine-induced rotation asymmetry, and (b) The effect of early post-lesion exposure to amphetamine on later rotation asymmetry. d-Amphetamine was initially injected either 7, 14, 21, or 30 days after lesioning. Transient circling in pre-lesion preferred direction (contralateral to lesioned side) was more frequently encountered on days 7 and 30 after lesioning, as compared to days 14 and 21. The contralateral rotation observed on day 7 is attributed to degeneration-induced DA release, whereas contralateral rotation noted on day 30 is believed to reflect the operation of post-lesion compensatory processes within the spared DA neurons. In response to subsequent amphetamine administration 30 days after lesioning, rats with previous exposure to the drug circled ipsilaterally, whereas most rats given amphetamine for the first time in that session rotated contralaterally to the lesion. These findings suggest that post-lesion administration of amphetamine interferes with the process of recovery.

Animals↗

Does unilateral dopamine deficit contribute to depression?

A system of emotional control of behavior is believed to be lateralized to the right hemisphere. Given that dopaminergic pathways are involved in affective behavior, depression, which is recognized as an integral part of Parkinson's disease, may be associated with a dopamine imbalance. The present study examined this hypothesis in patients with unilateral symptomatology indicating either left hemisphere parkinsonism (LHP) or right hemisphere parkinsonism (RHP). Sixteen patients were tested on a battery of neuropsychological tests and several scales for evaluating mood. The two groups did not differ significantly on either cognitive or emotional measures. However, RHP patients rated themselves higher on the Present Scale of Cantril, and showed some neglect of the left visual field, as compared to LHP patients.

Affect↗

Cognitive impairment in patients with tardive dyskinesia.

Schizophrenic patients with (N = 17) and without (N = 14) tardive dyskinesia performed several neuropsychological tests. Most patients (88%) showed complete lack of concern or anosognosia with regard to their involuntary movement. A marginally significant difference was found in recall of pictures presented in the right hemispace. It is suggested that when patients with organic brain disorder and a low Mini-Mental State score are excluded, neuropsychological tests do not differentiate between tardive dyskinesia patients and nonhyperkinetic controls. The results are discussed in relation to hemispheric asymmetries in schizophrenia.

Aged↗

Left hemisphere hyperactivity in schizophrenia: abnormality inherent to psychosis or neuroleptic side-effects?

Studies measuring reflective lateral eye movements (LEM) in schizophrenic patients revealed predominance of rightward LEMS, which was interpreted as suggesting left hemisphere overactivation in schizophrenia. In the present study LEM behaviour of medicated schizophrenics was compared to that of non-medicated patients. Rightward LEMs were predominant in a group of patients treated with phenothiazines with piperazine side chains, whereas among schizophrenics treated with non-piperazine drugs leftward LEMs were more predominant. This finding suggests that previous reports on LEM directionality in schizophrenia may have been confounded by neuroleptic medication. The possible effect of piperazine derivatives on hemispheric balance is discussed.

Adult↗

A comparison of levodopa treatment and task demands on visual evoked potentials in hemi-parkinsonism.

In patients with hemi-Parkinsonism the amplitude of visual evoked potential (EP) components was relatively reduced over the hemisphere contralateral to Parkinsonian symptomatology. Chronic levodopa treatment tended to reverse this lateral asymmetry. Before levodopa treatment, participation in a simple attentional task brought about similar EP changes. After levodopa treatment, only patients with left symptomatology responded to the attention task with an enlargement of EP components, largely in the noninvolved hemisphere. These findings suggest that task demands cause changes in the sensory system which are similar to those contributing to "paradoxical kinesia."

Adult↗

Neuroleptic-induced lateral asymmetry of visual evoked potentials in schizophrenia.

Electrophysiological studies have shown asymmetric brain reactivity in schizophrenia, supporting the hypothesis of left hemisphere hyperarousal in this disease. It may be assumed, therefore, that neuroleptic treatment restores hemispheric balance in schizophrenic patients by selectively suppressing the hyperactive left hemisphere. This hypothesis was tested in the present study which compared bilaterally recorded visual evoked potentials (VEP) in 9 non-medicated patients and 29 schizophrenics treated with various neuroleptic drugs, as well as in 34 normal controls. In medicated patients later VEP components showed enhancement over the right hemisphere as a function of the overall dose (chlorpromazine equivalent) of neuroleptics. Reversed asymmetry was seen in drug-free patients. In view of this result, some amendments of the concept of left hemisphere hyperactivity in schizophrenia are proposed.

Adolescent↗

Smooth pursuit pattern in schizophrenic patients during cognitive task.

Asymmetries in saccadic pursuit were studied, using EOG, ion 20 schizophrenic patients, as well as in two groups of normal subjects, screened for their patterns of lateral eye movements (LEM). Tracking performance was also examined while subjects were concurrently engaged in performing a cognitive task. Saccadic pursuit among schizophrenic patients was replicated in the present study. No asymmetry was observed in the quality of leftward as compared to rightward tracking. However, solving syllogisms while tracking resulted in further deterioration in tracking performance of the patients, with significantly more saccades and arrests in tracking occurring when following the target to the left as compared to rightward following. Similar asymmetry was observed in one group of controls who are believed to rely more on their left hemisphere on the LEM test, whereas no asymmetry was observed in the performance of the second control group. These results are interpreted as supporting the hypothesis of left hemispheric hyperactivity in schizophrenia. Saccadic pursuit in one subgroup of the normal sample is considered as suggesting that these individuals belong to the high-risk group.

Adolescent↗

Hemisphere laterality and smooth pursuit in normal individuals.

34 right-handed women of college age who consistently responded with leftward ("left-movers") or rightward ("right-movers") reflective lateral eye movements were tested on spatial and non-spatial syllogisms while engaged in an eye-tracking task. Contrary to expectation, no interaction between tracking direction and syllogism type was observed. Left-movers performed better on all tasks. The results are discussed in relation to hemispheric asymmetry.

Adult↗

Reactive gaze laterality in schizophrenic patients.

Reflective lateral eye movements (LEMs) in response to questions of different categories are indicative of differential hemispheric reactivity. These LEMs were studied in schizophrenic patients and normal subjects, in response to 24 questions (12 visual-emotional and 12 verbal-neutral). Two categories of saccades were observed: short-latency LEMs (S-LEMs) and long-latency LEMs (L-LEMs). S-LEMs are believed to be associated with orienting response mechanism. L-LEMs are considered to be related to decision-making or formulating hemispheric-activity-dependent response strategy. In the present study, a general trend of leftward LEMs was found among normals regardless of the question's category, whereas schizophrenics tended to show predominantly rightward LEMs. This suggests that individual cognitive style, rather than task variables, affects LEM direction. The two types of LEM's and their different involvement in hemispheric activity are discussed.

Adult↗

Behavioral differences between white matter lacunar dementia and Alzheimer's disease: a comparison on the neuropsychiatric inventory.

BACKGROUND AND PURPOSE: Behavioral abnormalities account for much of the morbidity of vascular dementia (VaD) and Alzheimer's disease (AD). The goals of the study were to compare the behavioral changes in patients with VaD associated with ischemic white matter subcortical changes and lacunar infarctions (VaD-WSI) to those in patients with AD. METHODS: Thirty outpatients with VaD and multiple lacunar infarctions in the periventricular white matter and 30 AD patients, matched for age and severity of dementia, were enrolled in this prospective study. The behavioral abnormalities of these patients were assessed by interviewing their caregivers with the Neuropsychiatric Inventory. RESULTS: A similar spectrum of noncognitive behavioral changes was found in AD and WSI patients. In VaD-WSI, the severity of delusions, hallucinations, aggression, irritability, aberrant motor behavior, nighttime behavior and appetite changes was correlated with cognitive decline, whereas depression, apathy, anxiety and euphoria were unrelated to the severity of dementia. In AD, none of the behavioral changes correlated with the severity of dementia. CONCLUSION: Behavioral changes are frequent in VaD-WSI and are present regardless of the severity of the cognitive decline. It is therefore important to assess behavioral as well as cognitive changes at early stages of the illness, to ensure appropriate treatment.

Aged↗