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Biomedical subjects

S Arndt

Publications and source records attributed to S Arndt.

At least 19 recordsLinked to original sources

Withdrawal-emergent dyskinesia in patients with schizophrenia during antipsychotic discontinuation.

We examined whether patients exhibiting withdrawal-emergent dyskinesia (WE-D) represent a group vulnerable to subsequent development of tardive dyskinesia (TD). WE-D was defined as moderate abnormal movements during antipsychotic withdrawal in persons without persistent TD. We assessed patients with schizophrenia-spectrum illness participating in withdrawal from antipsychotic medication. Patients with WE-D were compared to those without dyskinesia and to those with persistent TD. Clinical measures included duration of illness and antipsychotic exposure, negative symptoms, and neurologic soft signs. We hypothesized that WE-D patients would not differ from persistent-TD patients across the above variables, but would differ from non-TD patients. Patients without TD significantly differed from persistent TD in duration of illness, medication exposure and neurologic soft signs. WE-D did not differ from TD across these measures. No-TD patients also showed less duration of medication exposure and neurologic soft signs than those with WE-D.

Adolescent

Premorbid adjustment as a predictor of phenomenological and neurobiological indices in schizophrenia.

Previous studies have demonstrated relationships between poor premorbid adjustment and a variety of phenomenological and neurobiological indices in schizophrenic patients. Using the Modified Premorbid Adjustment Scale we re-examined these relationships in a large sample (n = 131) of schizophrenic patients. Subjects were evaluated with the Comprehensive Assessment of Symptoms and History (CASH) and magnetic resonance imaging. Multiple correlation indicated that poor premorbid adjustment was significantly associated with prominence of negative symptoms, early age of onset, educational problems, chronicity, and neurological soft signs, but not with any MRI measures. These results confirm poor premorbid adjustment as an important predictor of a malignant form of schizophrenia as evidenced by an earlier age of onset, poorer educational performance, prominent negative symptoms, presence of soft signs, and chronicity of course.

Brain

Short-term and long-term verbal memory: a positron emission tomography study.

Short-term and long-term retention of experimentally presented words were compared in a sample of 33 healthy normal volunteers by the [15O]H2O method with positron emission tomography (PET). The design included three conditions. For the long-term condition, subjects thoroughly studied 18 words 1 week before the PET study. For the short-term condition, subjects were shown another set of 18 words 60 sec before imaging, with instructions to remember them. For the baseline condition, subtracted from the two memory conditions, subjects read a third set of words that they had not previously seen in the experiment. Similar regions were activated in both short-term and long-term conditions: large right frontal areas, biparietal areas, and the left cerebellum. In addition, the short-term condition also activated a relatively large region in the left prefrontal region. These complex distributed circuits appear to represent the neural substrates for aspects of memory such as encoding, retrieval, and storage. They indicate that circuitry involved in episodic memory has much larger cortical and cerebellar components than has been emphasized in earlier lesion studies.

Adult

Symptoms of schizophrenia. Methods, meanings, and mechanisms.

BACKGROUND: The "group of schizophrenias," normally referred to with a single nominative, is phenomenologically heterogeneous. Its symptoms represent multiple psychological domains, including perception, inferential thinking, language, attention, social interaction, emotion expression, and volition. Studies of psychopathology have simplified this complex array in several ways, one of which is a subdivision into positive and negative symptoms. METHODS: This study examined the positive vs negative distinction in a sample of 243 patients with schizophrenia or schizophreniform disorder who were evaluated with the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. A two-stage factor analysis was applied, beginning with a principal components analysis applying varimax rotation, followed by an extension analysis. The purpose of these analyses was to evaluate the correlational relationships of the various symptoms of schizophrenia. RESULTS: The results confirmed previous reports by our group and others suggesting that the symptoms of schizophrenia fall into three natural dimensions, as assessed by the correlational interrelationships: positive symptoms subdivide into psychotic and disorganized dimensions, while a third negative dimension also emerges. CONCLUSION: Because these dimensions have impressive consistency across studies, future work must examine their relationship to clinically relevant concepts such as prognosis or etiology and examine four different aspects: longitudinal course, neural mechanisms, relationship to treatment, and interrelationships in other pathological conditions.

Age of Onset

A longitudinal study of symptom dimensions in schizophrenia. Prediction and patterns of change.

BACKGROUND: Factor analytic studies have suggested that the symptoms of schizophrenia may be divided into three uncorrelated dimensions. This study examines the longitudinal course of the symptoms of schizophrenia using this three-dimensional perspective. METHODS: The sample was composed primarily of neuroleptic-naive patients suffering from schizophrenia. Subjects were studied in a prospective longitudinal design, with comprehensive structured assessments at index, discharge, and 6-month intervals after discharge over a 2-year period. RESULTS: Negative symptoms were already relatively prominent at the time of index evaluation; they tended to remain stable throughout the follow-up period. The two dimensions of positive symptoms, psychoticism and disorganization, although prominent at index evaluation, declined over the course of the follow-up period and tended to be less stable. A longitudinal factor analysis was conducted to determine whether the changes in symptoms followed any consistent pattern. We observed that all three groups of symptoms tended to change in unison and independently from one another. CONCLUSIONS: These results suggest that these three dimensions of psychopathology show different patterns of exacerbation and remission during the course of schizophrenia. This independent pattern of evolution suggests that these three dimensions should be studied further with respect to response to treatment, cognitive mechanisms, psychosocial correlates, and neural substrates.

Adult

Multi-center N400 ERP consistency using a primed and unprimed word paradigm.

A word priming paradigm involving primed, unprimed, and non-word experimental conditions was used to elicit event-related potentials (ERPs) in normal, young adult males in identically equipped electrophysiology laboratories located in 6 different cities in the USA. Analyses of the average amplitude of a specified latency window containing the N400, the N400 peak amplitude, or the latency of the N400 peak amplitude found no differences among laboratory locations. The shape of the N400 ERP wave form was also found to be highly correlated across laboratory sites for each experimental condition. Comparison of the data with analogous word priming paradigms revealed similar patterns for the N400 components and response times in both the primed and unprimed experimental conditions. These findings suggest that the data from all 6 laboratory locations are consistent with each other and are congruous with those found in other N400 studies and will permit pooling of subject data for future research.

Adolescent

Infestation of rodents with larval Ixodes ricinus (Acari: Ixodidae) is an important factor in the transmission cycle of Borrelia burgdorferi s.l. in German woodlands.

The ecology of Borrelia burgdorferi Johnson et al. s.l. was investigated from 1987 to 1993 in a preserved woodland in western Germany near Bonn. In selected biotopes, host-seeking Ixodes ricinus L. were regularly collected by blanket dragging in 1987, 1988, and 1989 and screened for infection with B. burgdorferi. Rodents were trapped monthly between April and October in 1988, 1990, 1991, and in the winter of 1992-1993, examined for antibodies to B. burgdorferi s.l., and inspected for feeding ticks. Ticks collected from rodents were screened for spirochete infection. High numbers of host-seeking nymphs were consistently collected within a biotope characterized by humid and acid soils. The mean number of ticks was significantly lower in biotopes with permeable soils. All small mammals captured belonged to the species Apodemus flavicollis Melchior, A. sylvaticus L., and Clethrionomys glareolus Schreber. Of 11,680 ticks obtained from rodents, 11,674 were I. ricinus, with 97.9% of the ticks being larvae, 2.0% nymphs, and 0.1% females. Mean numbers of feeding ticks ranged from 3.4 to 117 larvae per rodent and from 0.0 to 0.64 nymph per rodent, respectively. High levels of larval infestation on rodents were recorded in the same biotope where high numbers of host-seeking nymphs were present. Members of the genus Apodemus were more heavily infested with I. ricinus larvae than C. glareolus. The mean infection prevalence in host-seeking ticks was found to be 1% for larvae, 5% for nymphs, and 10-20% for adults. The infection prevalence in host-seeking nymphs ranged from 1.1 to 15.4% according to the particular biotope. The values for specific infectivity for the Apodemus populations were positively correlated with the mean larval infestation, but not with nymphal infestation. The respective estimates for C. glareolus were much higher than those for Apodemus spp. in biotopes with low tick densities. However, specific infectivity of C. glareolus was substantially reduced at sites with high tick abundances. In biotopes with high numbers of infected I. ricinus, significantly more rodents were found to have antibodies to B. burgdorferi than in biotopes with low abundances of ticks. The data show that C. glareolus plays a different role as reservoir host species compared with the 2 Apodemus species. This and previous studies suggest that the degree of infestation with larval I. ricinus differentially modulates infectivity of host species for ticks. We conclude that immune processes in natural reservoir hosts induced by B. burgdorferi or I. ricinus bites (or both) are important regulatory factors in the transmission cycle(s) of B. burgdorferi.

Animals

Correlational studies of the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms: an overview and update.

The interrelationships between the various symptoms of schizophrenia may be explored by examining their intercorrelations. Five different factor analytic studies, which examine these interrelationships, are summarized. Three major factors emerge consistently: psychotic, disorganized, and negative. These three factors appear to represent three dimensions of the psychopathology of schizophrenia.

Factor Analysis, Statistical

Remembering the past: two facets of episodic memory explored with positron emission tomography.

OBJECTIVE: This study used positron emission tomography to examine two kinds of personal memory that are used in psychiatric evaluation: focused episodic memory (recall of past experience, employed in "taking a history") and random episodic memory (uncensored thinking about experience, examined during analytic therapy using free association). For comparison, a third memory task was used to tap impersonal memory that represents general information about the world ("semantic memory"). METHOD: Thirteen subjects were studied using the [15O]H2O method to obtain quantitative measurements of cerebral blood flow. The three conditions were subtracted and their relative relationships examined. RESULTS: The random episodic condition produced activations in widely distributed association cortex (right and left frontal, parietal, angular/supramarginal, and posterior inferior temporal regions). Focused episodic memory engaged a network that included the medial inferior frontal regions, precuneus/retrosplenial cingulate, anterior cingulate, thalamus, and cerebellum. The use of medial frontal regions and the precuneus/retrosplenial cingulate was common to both focused and random episodic memory. The major difference between semantic and episodic memory was activation of Broca's area and the left frontal operculum by semantic memory. CONCLUSIONS: These results indicate that free-ranging mental activity (random episodic memory) produces large activations in association cortex and may reflect both active retrieval of past experiences and planning of future experiences. Focused episodic memory shares some components of this circuit (inferior frontal and precuneus), which may reflect the time-linked components of both aspects of episodic memory, and which permit human beings to experience personal identity, consciousness, and self-awareness.

Adult

Neurological soft signs in neuroleptic-naive and neuroleptic-treated schizophrenic patients and in normal comparison subjects.

OBJECTIVE: The goal of this study was to assess neurological soft signs and developmental reflexes in schizophrenic patients who had never received neuroleptic medication and those who were receiving neuroleptic medication. METHOD: Neurological soft signs and developmental reflexes were examined in 26 schizophrenic patients who had never received a neuroleptic, 126 schizophrenic patients who were currently receiving neuroleptics, and 117 normal subjects. RESULTS: Soft signs were present in 23% of the neuroleptic-naive and 46% of the medicated schizophrenic patients. Developmental reflexes were present in 19% of the neuroleptic-naive and 12% of the medicated patients. Both soft signs and developmental reflexes were absent in the normal subjects. There were significant differences between patients and normal subjects in neurological soft signs and developmental reflexes. The possibly confounding variables of age, age at onset, duration of illness, number of hospitalizations, Abnormal Involuntary Movement Scale (AIMS) scores, and Simpson-Angus Scale extrapyramidal symptom scores were assessed by using logistic regression in the patients who were receiving neuroleptics. AIMS scores and Simpson-Angus Scale scores correlated with soft signs in these patients. CONCLUSIONS: The presence of neurological soft signs in schizophrenic patients who had never received neuroleptics indicates that these signs are present independent of medication effects, but it is possible that neuroleptics contribute to the prevalence of these abnormalities, as demonstrated by the patients who were receiving neuroleptics.

Adult

An MRI study of brain size in autism.

OBJECTIVE: This study was undertaken to obtain detailed measurements of the volume of the brain, using magnetic resonance imaging (MRI), in a carefully selected group of autistic subjects and comparison subjects. METHOD: Twenty-two male autistic subjects and 20 male volunteer comparison subjects were examined with detailed (1.5-mm slices) MRI throughout the entire brain. Total brain, total brain tissue, and total lateral ventricle volumes were measured by using manual tracing and automated techniques. RESULTS: After height and performance IQ were controlled, autistic subjects had significantly greater total brain, total tissue, and total lateral ventricle volumes than comparison subjects. CONCLUSIONS: These findings suggest that male autistic subjects have enlarged brains and that enlargement is a result of both greater brain tissue volume and greater lateral ventricle volume.

Adolescent

A comparison of approaches to the statistical analysis of [15O]H2O PET cognitive activation studies.

This study compares two of the most widely used statistical techniques for analyzing data obtained from [15O]H2O PET studies of brain function. The Friston method (SPM94) and the Worsley (Montreal) method were applied to a single data set of 33 subjects who were studied in a paradigm designed to evaluate memory for word lists. Neither of these methods emerged as either strikingly different or strikingly preferable, although the occasional differences may be important in some experiments. In general, the two methods were found to produce similar results in identifying brain regions active during long-term memory: frontal, parietal, cingulate, and cerebellar. Underlying assumptions of the two methods, as well as their strengths and weaknesses, are discussed.

Arousal

Regional brain abnormalities in schizophrenia measured with magnetic resonance imaging.

OBJECTIVE: To determine general and regional indices of structural brain abnormality in schizophrenia. DESIGN: Case-control comparison study. SUBJECTS: Fifty-two patients diagnosed as having schizophrenia according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, were compared with 90 healthy volunteers recruited from the community. MEASUREMENTS: Structural brain images were acquired using magnetic resonance; measurements were obtained using three-dimensional visualization of volume-rendered brains and an automated atlas-based dissection of specific regions. General measures included the volume of total brain tissue, total cerebrospinal fluid (CSF), and CSF within the ventricular system. Regional measures included the volume of tissue and CSF in the frontal, temporal, parietal, and occipital lobes and the cerebellum. RESULTS: Compared with the controls, the patients had a smaller average volume of total brain tissue and a greater average volume of total and ventricular CSF. A specific relative decrease in brain tissue was found only in the frontal lobes, although the volume of CSF was greater in patients than in controls in all brain regions. CONCLUSION: In addition to the generalized brain abnormalities observed in schizophrenia, a regional abnormality may be present in frontal regions. Since the frontal lobes integrate multimodality information and perform a variety of "higher" cognitive and emotional functions that are impaired in schizophrenia, the frontal abnormality noted is consistent with the clinical presentation of the illness. Impaired frontal function and a disruption in its complex circuitry (including thalamocortical projections) may explain why patients with schizophrenia often have significant deficits in formulating concepts and organizing their thinking and behavior.

Adult

Thalamic abnormalities in schizophrenia visualized through magnetic resonance image averaging.

Schizophrenia is a complex illness characterized by multiple types of symptoms involving many aspects of cognition and emotion. Most efforts to identify its underlying neural substrates have focused on a strategy that relates a single symptom to a single brain region. An alternative hypothesis, that the variety of symptoms could be explained by a lesion in midline neural circuits mediating attention and information processing, is explored. Magnetic resonance images from patients and controls were transformed with a "bounding box" to produce an "average schizophrenic brain" and an "average normal brain." After image subtraction of the two averages, the areas of difference were displayed as an effect size map. Specific regional abnormalities were observed in the thalamus and adjacent white matter. An abnormality in the thalamus and related circuitry explains the diverse symptoms of schizophrenia parsimoniously because they could all result from a defect in filtering or gating sensory input, which is one of the primary functions of the thalamus in the human brain.

Brain

Techniques for measuring sulcal/gyral patterns in the brain as visualized through magnetic resonance scanning: BRAINPLOT and BRAINMAP.

A method for measuring sulcal and gyral patterns, using data derived from magnetic resonance (MR) scanning, is described. This method can be applied through two newly developed computer programs, BRAINPLOT and BRAINMAP. These programs provide quantitative measures of brain surface pattern. The method has been validated with postmortem brains, phantoms, and human MR data. The method is robust to detecting differences in brain surface anatomy between atrophic and nonatrophic brains. It appears to offer an efficient, fully automated, and accurate method for analyzing the large amounts of information generated through in vivo neuroimaging techniques.

Autopsy

Stability of cognitive functioning early in the course of schizophrenia.

This study evaluated the longitudinal course of neuropsychological deficits in a group of patients with new or recent onset schizophrenia. Thirty-five inpatients with DSM-III-R diagnoses of schizophrenia were administered a comprehensive battery of neuropsychological tests during their index hospitalization, and either 1 or 2 years after intake. Cognitive function remained stable in most domains, including motor speed, verbal and nonverbal memory, and verbal learning. Significant improvement in neuropsychological performance was observed on a task of complex attention (Trails B) and a set response shifting task (Stroop). These improvements were correlated with changes in clinical symptoms, but not with changes in medication dose. These findings suggest that most of the neuropsychological functioning in schizophrenia is stable over the first few years of the illness. Moreover, those neuropsychological deficits that remain unchanging appear to be independent of significant change in clinical symptoms, suggesting they may be a trait of the illness. However, a small subset of functions such as complex attention and response inhibition appear to fluctuate with time, and in particular, with clinical symptomatology, and may be considered 'state' dependent.

Adult

Effect of antipsychotic withdrawal on negative symptoms in schizophrenia.

Although it is generally accepted that antipsychotic treatment improves the negative symptoms of schizophrenia in the context of improvement of positive symptoms, exactly how and to what extent they effect "primary" negative symptoms remains controversial. Antipsychotic treatment may reduce only those negative symptoms secondary to positive or depressive symptoms, and may have minimal, if any effect, on negative symptoms that represent a primary psychopathological trait manifestation of schizophrenia. In an effort to further examine this issue, we prospectively assessed negative, positive, depressive, and extrapyramidal symptoms following the discontinuation of antipsychotic medication. Fifty-nine DSM III-R schizophrenic patients underwent a three-week drug wash as part of our neuroimaging protocols. We assessed psychopathological status and adverse effects utilizing various rating instruments (i.e., Scale for Assessment of Positive Symptoms [SAPS], Scale for Assessment of Negative Symptoms [SANS], Hamilton Rating Scale for Depression, and Simpson-Angus Extrapyramidal) at baseline and weekly during this three-week period. Negative symptoms, as measured by the SANS, worsened significantly during the three-week drug wash. Positive symptoms showed a less consistent change with symptoms of disorganization worsening and with psychotic symptoms remaining the same. The changes in negative symptoms during the drug-free period were correlated with the changes in psychosis and disorganization, but not with changes in depression or extrapyramidal side effects. We were not able to substantiate if the worsening in negative symptoms was a direct result of the worsening of positive symptoms or if they were changing simultaneously, but independent of each other.

Adult