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Biomedical subjects

S Weintraub

Publications and source records attributed to S Weintraub.

At least 37 records · Page 2Linked to original sources
PubMed1996

Right sided hemispatial neglect and bilateral cerebral lesions.

This study compared the frequency with which unilateral and bilateral cerebral disease gives rise to right sided visual hemispatial inattention. A retrospective survey identified brain injured patients for whom target omissions on visual target cancellation tasks significantly exceeded control values. Subjects consisted of 40 right handed patients referred for clinical evaluation or research study of hemispatial inattention. Right sided visual hemispatial inattention occurred with greater frequency and severity in patients with bilateral lesions than in patients with unilateral left sided or right sided lesions. All eight patients with bilateral lesions manifested right sided hemispatial inattention and failed to detect more targets overall than patients in the other two groups. Of the 13 patients with left sided lesion, seven ignored more targets on the right and six ignored more targets on the left. All but one of the 19 patients with right sided lesions ignored more targets on the left. The association of severe right sided visual hemispatial inattention with bilateral cerebral disease extends previous findings and showed that, in this sample, the most common setting for right sided hemispatial neglect occurred in patients with bilateral cerebral lesions.

Aged↗
PubMed1994

A potential noninvasive neurobiological test for Alzheimer's disease.

Currently Alzheimer's disease, which affects more than 20 million people worldwide, can only be definitely diagnosed by histological examination of brain tissue obtained at autopsy or biopsy. There is a great need for an early, noninvasive, sensitive, and easily administered diagnostic test of Alzheimer's disease. Here it is reported that patients diagnosed with probable Alzheimer's disease by standard clinical criteria exhibited a marked hypersensitivity in their pupil dilation response to a cholinergic antagonist, tropicamide, placed in their eyes. It was possible to distinguish 18 of 19 individuals (95%) either clinically diagnosed with Alzheimer's disease or classified as suspect Alzheimer's individuals by neuropsychological screening from 30 of 32 normal elderly controls (94%).

Aged↗
PubMed1994

The impact of aging on curiosity as measured by exploratory eye movements.

OBJECTIVE: To investigate changes in novelty-seeking behavior (curiosity) associated with normal aging. BACKGROUND: Recently, we demonstrated that patients with a diagnosis of probable Alzheimer's disease display diminished novelty-seeking behavior as measured by exploratory eye movements. Nondemented, elderly individuals are often depicted in clinical descriptions as exhibiting diminished curiosity and increased disengagement from their surroundings. However, this behavior has not been systematically investigated as a function of normal aging. SETTING: University hospital center studying aging and dementia. SUBJECTS: Fourteen active, healthy elderly subjects (mean age, 72 years) and 16 middle-aged subjects (mean age, 42 years) matched for education and estimated IQ. MEASURES: Exploratory eye movements were recorded in response to visual stimuli that varied in novelty, complexity, and incongruity. RESULTS: Both older and middle-aged subjects (1) spent significantly more time exploring the more irregular or incongruous of two simultaneously presented stimuli, (2) spent increasingly less time looking at a repeating visual stimulus paired with a stimulus that changed with each trial, and (3) exhibited the same degree of overall exploration of a visual scene and devoted an approximately equal amount of attention to an unexpected element within it. As a group, older subjects spent slightly less time than middle-aged subjects examining incongruous stimuli. However, 71% (10/14) of older subjects performed within 1 SD of the mean of middle-aged subjects and 21% (3/14) performed as well as the top 50% (8/16) of middle-aged controls. CONCLUSIONS: The drive for curiosity, as measured by exploratory eye movements, can be well preserved in older individuals. Further research is needed to determine if the integrity of this drive can serve as a marker of "successful aging" and to identify which physiological and psychological factors influence its preservation through the life cycle.

Adult↗
PubMed1994

Impairment of spatially directed attention in patients with probable Alzheimer's disease as measured by eye movements.

OBJECTIVE: To investigate changes in spatially directed attention in patients with a diagnosis of probable Alzheimer's disease (AD). BACKGROUND: Impaired attention in patients with probable AD has not been the subject of extensive research. Yet recent reports suggest that attentional deficits may be an important early feature of the disease in a subset of patients. SETTING: University hospital center studying dementia and aging. SUBJECTS: Ten mild to moderately impaired patients diagnosed as having probable AD, by National Institute of Neurologic and Communicative Diseases and Stroke criteria, and 11 healthy age- and education-matched controls. MEASURES: Eye movements were recorded as subjects participated in two experiments designed to measure spatially directed attention. Subjects were instructed to (1) attend to and fixate a target appearing randomly to the right or left of a central marker and (2) direct attention to and fixate a target appearing randomly in one of four peripheral locations. RESULTS: Patients with probable AD exhibited fewer accurate trials and longer saccade latencies in both tasks. As a group, patients performed worse in the second task that placed increased demands on attention. However, the performance of patients in this second experiment varied. Four patients performed significantly worse than all other patients, while three patients performed as well as controls. Errors in the second task were reviewed to identify specific types of attentional deficits. Six empirically derived error patterns were classified into one of two major categories: perseveration and impersistence. Seven of 10 patients made greater than 50% errors of perseveration, and three of 10 made greater than 50% errors of impersistence. CONCLUSIONS: Impairment of attention may be an early feature of AD and a prominent clinical characteristic of some patients. The differences observed in error types made by patients may reflect the varied distribution of neuropathologic changes affecting structures that mediate aspects of attention. The architecture of eye movements can be used as a physiologic measure that should provide useful information for the diagnosis and clinicopathologic subtyping of patients with AD.

Aged↗
PubMed1994

Right hemisphere learning disability associated with left hemisphere dysfunction: anomalous dominance and development.

Two patients are described with the social emotional processing disorder, a developmental syndrome usually ascribed to right hemisphere dysfunction. In these two patients however, neurological examinations, EEG, and neuroimaging studies were all consistent with left hemisphere dysfunction. Both patients were left handed and had findings suggestive of anomalous dominance for language. It is proposed that early left hemisphere injury may have resulted in functional reorganisation that allowed sparing of language and motor skills but interfered with the development of functions that the right hemisphere normally subserves.

Adult↗
PubMed1993

Neuropsychological patterns and language deficits in 20 consecutive cases of autopsy-confirmed Alzheimer's disease.

A retrospective chart review of clinical symptoms was done for 20 consecutive patients in whom postmortem examination had revealed senile plaques and neurofibrillary tangles in a distribution consistent with Alzheimer's disease. All patients had met clinical diagnostic criteria for probable Alzheimer's disease. On initial examination, 1 to 14 years beyond putative onset of the dementia, all patients displayed at least some memory impairment. In 16 patients, disturbances of attention or recent memory were among the most salient features. In two patients, language disturbances, and in two others, visuospatial deficits, were more prominent than difficulties with memory and attention. On initial examination, 17 of the 20 patients displayed word-finding difficulties, characteristically in the context of a fluent, anomic aphasia. All of the 12 reexamined patients demonstrated progressive, although variable, deterioration. In general, the initial salient deficit remained salient during much of the disease course. Language comprehension was spared in the earlier stages but eventually deteriorated. Severe deficits emerged in all major cognitive domains as the disease reached the terminal stages. Nonfluent aphasias (eg, Broca's aphasia) were not observed even in the advanced stages of the disease.

Aged↗
PubMed1993

Childhood behavior problems and bipolar disorder--relationship or coincidence?

A group of offspring at risk for Bipolar Disorder is compared to a Normal Control group whose parents had no psychiatric disorder and a group of offspring at risk for other, non-bipolar psychiatric disorder. Variables examined include childhood attention and behavior problems and psychopathology in young adulthood. Rates of childhood behavior and attention problems, and psychopathology and social/occupational impairment in young adulthood, were higher in the Bipolar Risk group than the Normal Control group, but no higher than in the non-bipolar (Combined Risk) group. Although childhood behavior and attention problems were significantly associated with other psychopathology in all three offspring groups, a unique relationship between childhood problems and young adult mood disorder was found only in the Bipolar Risk group.

Adolescent↗
PubMed1993

Studies of catecholamine metabolism in schizophrenia/psychosis--I.

Acutely psychotic schizophrenic patients not taking antipsychotic medications and control subjects were studied before and during treatment with debrisoquin (DBQ), an inhibitor of monoamine oxidase, which does not penetrate into brain. Homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) were measured in plasma, urine, and cerebrospinal fluid (CSF). Significant differences between patients and control subjects were more easily discerned during treatment with DBQ. In patients, HVA was increased in plasma but not in urine or CSF, although MHPG was increased in all three fluids. There were many significant correlations between plasma MHPG and HVA levels and clinical ratings of psychoticism. Plasma MHPG correlated positively with both the severity of positive and negative symptoms and plasma HVA correlated only with positive symptom severity. These data suggest that both dopamine and norepinephrine (NE) metabolism are disturbed in acutely psychotic schizophrenic patients; disturbed NE metabolism may relate to negative symptoms as well.

Adult↗
PubMed1993

Hospital response to psychosocial needs of AIDS inpatients.

Compassionate care for HIV-infected persons requires response to psychosocial needs. With no new external funding, Women's College Hospital, a 270-bed urban teaching hospital, provided effective psychosocial services for HIV-infected inpatients by developing a comprehensive policy, educating staff, organizing existing services into a psychosocial support team to provide crisis intervention, and developing liaisons with community AIDS organizations. A retrospective chart review of epidemiologic and psychosocial patient data was carried out for 59 HIV inpatients (58 men, 1 woman) admitted 1987-89. Of the cohort, 91% indicated homosexual contact as the only risk factor. A psychosocial support team contacted 90% of these inpatients. One third (36%) of the patients designated as next of kin individuals who were not legally or biologically related. Approximately 25%-30% made active arrangements for impending death, e.g. wills and funeral plans. Thirteen patients, 22%, died in hospital, and three, 5%, on first admission. Experience showed that psychosocial interventions that focus on human dignity and quality of life, normally seen as elements of palliative care, are critically important from the earliest stages of HIV disease and should not be reserved only for those who are terminally ill.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Dissociated perceptual-sensory and exploratory-motor neglect.

A patient with a right sided parietal lobe infarction manifested left sided sensory extinction in the visual, auditory, and tactile modalities but had only mild exploratory-motor neglect. In contrast, another patient with a right frontal haemorrhage demonstrated only left sided exploratory-motor hemispatial neglect. Tasks that combined perceptual and exploratory features elicited varying degrees of neglect in each patient. These two cases with dissociated neglect behaviour lend further evidence for behavioural specialisation within components of a cortical network for directed attention: sensory-representational aspects mediated primarily by the parietal component, motor-exploratory primarily by the frontal component. These cases also highlight the need to include and distinguish among several different measures of neglect in the clinical investigation of patients with hemispatial inattention.

Aged↗
PubMed1992

Diminished curiosity in patients with probable Alzheimer's disease as measured by exploratory eye movements.

Clinical accounts of Alzheimer's disease (AD) suggest that some patients exhibit markedly diminished curiosity and initiative early in the course of their illness. Such behavioral changes are extremely difficult to measure experimentally. We studied one aspect of curiosity by measuring exploratory eye movements in response to provocative visual stimuli in 12 patients with probable AD and 10 matched controls. Subjects viewed slides, each of which contained an incongruous or irregular figure paired with a congruous or regular one. Unlike controls, who spent significantly more time viewing the incongruous stimuli, AD patients distributed their viewing time equally and spent significantly less time than controls looking at the novel stimuli. Additionally, when presented with picture slides containing an unexpected element, AD patients exhibited diminished visual exploration overall and decreased attention to the incongruous part. Further analyses suggest that the results cannot be adequately explained by a general decline in cognition or by problems with ocular motility or directing visual attention. We conclude that AD patients exhibit diminished curiosity which can be measured by the study of exploratory eye movements.

Aged↗
PubMed1992

North American free trade and the European situation compared.

The author analyzes and compares the trade situation in the European Community (EC) with the North American Free Trade Agreement (NAFTA). He finds that "while both the EC and NAFTA are designed to provide trade preferences to the member countries, the two groupings differ markedly in other respects. The Treaty of Rome, establishing what is now the EC, consciously used economic means to foster political cohesion in Western Europe; whereas, the NAFTA negotiations seek free trade rather than more comprehensive economic integration precisely to minimize political content. The EC contains many social provisions absent from the NAFTA discussions, the most important of which is the right of migration from one EC country to another." The effects of NAFTA on the economy of Mexico and on Mexican migration to the United States are also assessed.

Americas↗
PubMed1991

Right hemisphere advantage for evaluating emotional facial expressions.

The ability to evaluate the intensity of emotional facial expressions was investigated in patients undergoing the intracarotid sodium amytal procedure. It was found that when the hemisphere non-dominant for language (usually right) was anesthetized, the patients' ratings of the intensity of emotional expressions in photographs were lower than baseline ratings of these expressions. Such an effect was not seen with anesthetization of the hemisphere dominant for language (usually left). Ratings of shades of gray (which served as control stimuli) showed no such effect. The findings are interpreted in terms of a right hemisphere superiority in the perception and evaluation of emotional expression.

Adolescent↗
PubMed1990

Serum stimulation of fibronectin gene expression appears to result from rapid serum-induced binding of nuclear proteins to a cAMP response element.

Fibronectin (FN) mRNA levels increased when quiescent cells (serum starved) were stimulated to undergo the G0/G1 transition by the addition of 20% given fetal calf serum to the media. The 5'-flanking region of the FN gene (position +69 to -510 base pairs (bp] was fused to the coding region of the chloramphenicol acetyltransferase (CAT), and the fusion gene was used in transfection assays. Expression of FNCAT increased on serum treatment indicating that the region of the FN gene between positions +69 and -510 bp mediated serum responsiveness. Deletion of FN gene 5'-flanking sequences from position -510 to -122 bp eliminated serum responsiveness suggesting that an element between these positions was mediating the effect. Sequences between positions -122 and -510 bp of the FN gene were able to confer serum responsiveness on a herpes virus thymidine kinase promoter-CAT fusion gene (TKCAT) when the FN gene sequences were cloned upstream of TKCAT. The ability to confer serum responsiveness on TKCAT was retained with a smaller 100-bp sequence (position -122 to -222 bp). Both a cAMP response element (position -170 bp) and a nuclear factor-1 binding site (position -155 bp) have been identified within this sequence (Dean, D. C., Blakeley, M. S., Newby, R. F., Ghazal, P., Hennighausen, L., and Bourgeois, S. (1989) Mol. Cell. Biol. 9, 1498-1506). The cAMP response element was serum-responsive when cloned upstream of TKCAT or a minimal FN promoter (deleted to position -56 bp) while the nuclear factor-1 binding site was unresponsive. Therefore, the cAMP regulatory element (CRE) is the serum-responsive element between position -122 and -222 bp. Serum-induced binding of proteins to the CRE was detected in gel retardation assays with extracts from cell lines where FN expression was serum-responsive. However, no serum-induced binding was detected with extracts from the JEG-3 cell line where FN expression was not serum-responsive. Serum-induced binding occurred rapidly, within 15 min, and did not require protein synthesis. The decay of serum-induced binding was relatively slow as increased binding was still detectable 24 h after removal of serum. The CRE also mediates transcriptional stimulation by cAMP, but unlike serum stimulation increased CRE binding activity was not detectable in extracts from cAMP-treated cells (Dean, D. C., Blakeley, M. S., Newby, R. F., Ghazal, P., Hennighausen, L., and Bourgeois, S. (1989) Mol. Cell. Biol. 9, 1498-1506).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1990

Primary progressive aphasia. Longitudinal course, neuropsychological profile, and language features.

Four patients with the clinical syndrome of primary progressive aphasia and a nonfluent aphasia profile were followed up over a period of 3 to 5 years. Extensive neuropsychological data for three patients revealed a progressive, quantitative decline of language with relative stability of memory, visuospatial skills, and reasoning. Comportment and most activities of daily living were preserved even when speech was unintelligible. Although several aphasia types may be associated with primary progressive aphasia, a nonfluent aphasia profile and phonemic paraphasic errors are most useful in differentiating it from the much more common clinical syndrome, "probable Alzheimer's disease." The clinicopathological correlates of probable Alzheimer's disease differ from those associated with primary progressive aphasia. Therefore, the clinical distinction between the two syndromes may be important for predicting the underlying pathophysiologic changes during the life of the patient.

Adult↗
PubMed1990

Dissociated neglect behavior following sequential strokes in the right hemisphere.

A 42-year-old woman suffered two focal right hemisphere strokes, sequentially damaging different components of a proposed cerebral network for the spatial distribution of attention. Her first stroke was centered in the right frontal lobe and resulted in left hemi-spatial neglect but only for tasks that emphasize exploratory-motor components of directed attention. A second stroke occurred 20 days later in the parietal lobe and led to the emergence of perceptual-sensory aspects of neglect. This case strongly supports the existence of a distributed anatomic-functional network subserving directed attention.

Adult↗