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Biomedical subjects

Saxby Pridmore

Publications and source records attributed to Saxby Pridmore.

At least 19 recordsLinked to original sources
PubMed2006

Changes to somatosensory detection and pain thresholds following high frequency repetitive TMS of the motor cortex in individuals suffering from chronic pain.

Research has shown that transcranial magnetic stimulation (TMS) results in a transient reduction in the experience of chronic pain. The present research aimed to investigate whether a single session of high frequency TMS is able to change the sensory thresholds of individuals suffering from chronic pain. Detection and pain thresholds for cold and heat sensations were measured before and after 20Hz repetitive TMS (rTMS) administered over the motor cortex. A significant decrease in temperature for cold detection and pain thresholds and a significant increase in temperature for heat pain thresholds were evident following a single session of rTMS. In contrast, no change in detection and pain thresholds was obtained following sham rTMS. The finding that rTMS can have a direct effect on sensory thresholds in individuals suffering from chronic pain has implications for the therapeutic use of rTMS in the relief of chronic pain.

Adult↗
PubMed2006

Repetitive transcranial magnetic stimulation and chronic tinnitus.

CONCLUSION: There is a good theoretical basis and early research evidence suggesting that transcranial magnetic stimulation (TMS) may have treatment potential in tinnitus. Further studies with larger sample sizes and additional assessment of neurobiological effects are necessary. OBJECTIVES: Tinnitus is a common and often severely disabling disorder for which there is no satisfactory treatment. TMS is a new, non-invasive method of modifying the excitability of the cerebral cortex, which has proven effective in auditory hallucinations and other disorders. Some early studies have been published in which TMS has been used in the treatment of tinnitus. The objective of this paper is to examine the literature and consider the potential for TMS as a therapy in tinnitus. METHODS: A thorough search of the tinnitus and TMS literature was conducted, and all available relevant material was examined. RESULTS: Tinnitus is common, with a prevalence of 8.2% in subjects aged 50 years and over, and may be associated with great distress (tinnitus sufferers). There are no effective treatments. Tinnitus is frequently associated with deafness, and may be the result of a pathological plasticity process. Neuroimaging studies demonstrate increased activity within the central auditory system. TMS is a non-invasive method of modulating excitability in cerebral cortex. It uses electromagnetic principles and has been successfully employed in the treatment of other conditions associated with increased activity of the cerebral cortex. Meanwhile, a growing number of studies suggest that repetitive TMS may be effective in the treatment of chronic tinnitus.

Auditory Cortex↗
PubMed2006

Daily and spaced treatment with transcranial magnetic stimulation in major depression: a pilot study.

OBJECTIVE: Transcranial magnetic stimulation is an emerging treatment of treatment-resistant depression. Current protocols rely on daily treatments. This study was designed to determine whether the time period over which treatment is delivered is an important factor in efficacy. METHOD: Sixteen adult patients with treatment-resistant major depression were randomly assigned to one of the two treatment groups, both of which received 2 weeks of treatment. One group received daily treatment (10 treatments, on business days). The other group received three treatments in week one, and two treatments in week two (five treatments, on spaced business days). Mood was rated using the Hamilton Depression Rating Scale (HDRS) and a self-rated visual analogue scale. Response was defined as a 50% reduction in HDRS rating, and remission was defined as achieving an HDRS score of 8 or less. The groups were compared throughout the 2-week study period. RESULTS: At entry, there were no demographic differences between the groups. Multivariate tests showed a significant main effect for time (Pillai trace=0.76, F(4,56)=8.56, p<0.001, power=0.99) reflecting the improvement in both measures of depression during treatment. There was no significant difference between the groups overall (Pillai trace=0.25, F(2,13)=2.12, p=0.16, power=0.36). Additionally, there was no significant interaction between time and treatment group (Pillai trace=0.18, F(4,56)=1.35, p=0.26, power=0.39) indicating that the significant improvement in depression over time was similar for both treatment groups. There were no significant differences in response and remission rates between the groups. CONCLUSION: The time period of treatment appeared to be an important outcome factor. This suggests that less than daily transcranial magnetic stimulation treatment may be a useful clinical alternative.

Adult↗
PubMed2006

Suicide for scrutinizers.

OBJECTIVES: The aim is to present information which may be useful to those who scrutinize mental health professionals and systems in the aftermath of completed suicide. CONCLUSION: Suicide has been known in all cultures, throughout history, and may be committed in the absence of mental disorder. Risk factors for suicide are known but they are of limited clinical utility. Prediction and prevention of suicide are beyond current abilities. Criticism of mental health professionals and systems in the aftermath of suicide may be destructive and work to the disadvantage of patients.

Acute Disease↗
PubMed2006

Transcranial magnetic stimulation: potential treatment for tinnitus?

Tinnitus is a common and often severely disabling disorder for which there is no satisfactory treatment. Transcranial magnetic stimulation (TMS) is a new, non-invasive method of modifying the excitability of the cerebral cortex, which has proven effective in auditory hallucinations and other disorders. Some early studies have been published in which TMS has been trialed in the treatment of tinnitus. The aim of the present paper was to examine the literature and consider the potential for TMS as a therapy in tinnitus. A thorough search of the tinnitus and TMS literature was conducted, and all available relevant material was examined. Discussions were held with leaders in both fields. Tinnitus is common and there are no effective treatments. It is frequently associated with deafness, and may be the result of a pathological plastic process, secondary to loss of innervation of the outer hair cells of the cochlea. Neuroimaging studies demonstrate increase blood flow to the primary and secondary auditory cortices, particularly on the left side. Transcranial magnetic stimulation is a non-invasive method of perturbing and inducing change in the cerebral cortex. It uses electromagnetic principles and has been successfully employed in the treatment of other conditions associated with increased activity of the cerebral cortex. A small number of studies have suggested that TMS may be effective in the treatment of tinnitus. There is a good theoretical basis and early research evidence suggesting that TMS may have treatment potential in tinnitus. Further, larger studies are necessary.

Auditory Cortex↗
PubMed2005

Neuroimaging in psychopathy.

OBJECTIVE: The biological basis of psychopathy remains to be fully elucidated. Evidence suggests a genetic contribution and dysfunction of the serotonin system. The objective of this article is to review the contribution of the neuroimaging of the last decade to our understanding of psychopathy. METHOD: A literature search was conducted using PubMed and the words psychopath, antisocial personality disorder, dissocial personality disorder, violence, image and imaging. In addition, the reference lists of the identified papers, and recent textbooks, were perused for additional sources. RESULTS: Five structural and 15 functional neuroimaging studies were selected and examined. Structural studies have reported decreased prefrontal grey matter, decreased posterior hippocampal volume and increased callosal white matter, but to this point, these have not been replicated. Functional studies suggest reduced perfusion and metabolism in the frontal and temporal lobes. Abnormalities of function have been reported, predominantly in frontal and temporal lobe structures during classical conditioning and response inhibition tasks, and in the processing of emotional words and pictures. CONCLUSION: Functional neuroimaging strongly suggests dysfunction of particular frontal and temporal lobe structures in psychopathy. However, there are difficulties in selecting homogeneous index cases and appropriate control groups. Further studies are necessary. Responses depend on genetic endowment, early life experience, the sociocultural context and the significance of any stimulus to the individual.

Brain↗
PubMed2005

Transcranial magnetic stimulation and chronic pain: current status.

OBJECTIVE: To examine evidence suggesting a potential role for transcranial magnetic stimulation (TMS) in the treatment of chronic pain. CONCLUSION: Chronic pain is characterized by brain changes that can reasonably be presumed to be associated with hyperalgesia, as occurs with neuropathic changes in the periphery. TMS has the ability to induce plastic changes in the cortex at the site of stimulation and at connected sites, including the spinal cord. It also has the ability to influence the experience of experimental/acute pain. In studies of TMS in chronic pain, there is some evidence that temporary relief can be achieved in a proportion of sufferers. Chronic pain is common. Current treatments are often ineffective and complicated by side-effects. Work to this point is encouraging, but systematic assessment of stimulation parameters is necessary if TMS is to achieve a role in the treatment of chronic pain. Maintenance TMS is currently provided in relapsing major depression and may be a useful model in chronic pain management.

Cerebral Cortex↗
PubMed2004

Changes to cold detection and pain thresholds following low and high frequency transcranial magnetic stimulation of the motor cortex.

There is some evidence that repetitive transcranial magnetic stimulation (rTMS) can alleviate the experience of chronic pain. The mechanisms by which rTMS may induce pain relief, however, are unknown. The present study examined whether a session of rTMS would produce sensory threshold changes in healthy individuals. Detection and pain thresholds for cold sensations were compared following low frequency (1 Hz) (Experiment 1) and high frequency (20 Hz) (Experiment 2) repetitive TMS. While cold detection threshold was significantly lowered by both rTMS rates, only high frequency rTMS produced a significant change in cold pain threshold. In contrast, sham rTMS did not alter thresholds for cold stimuli. These findings provide evidence that sensory thresholds can be influenced by repetitive transcranial magnetic stimulation.

Adult↗
PubMed2004

Why do doctors dislike treating people with somatoform disorder?

OBJECTIVE: To consider the question of why doctors dislike treating people with somatoform disorder, with a view to assisting debate and improving services. METHODS: The literature was examined, and compared with clinical experience. RESULTS: Psychological, sociological and evolutionary theory make relevant contributions. Important factors include that these conditions are problematic and positive outcomes may not be possible given current knowledge and clinical skills and techniques. Patients may not accept that their problem is a form of psychiatric or brain disorder. Most importantly, the doctor may not accept that somatoform disorders are beyond the control of patients, setting the scene for irritation and unsatisfactory interactions. CONCLUSIONS: There are many factors that underlie the dislike of some doctors for treating people with somatoform disorder. There is a pressing need for educational efforts to help students and doctors accept that the symptoms of somatoform disorder are beyond the control of those who suffer them.

Attitude of Health Personnel↗
PubMed2004

Medication options in the treatment of treatment-resistant depression.

AIM: Less than half of those suffering major depressive episodes achieve remission with the first antidepressant provided and one-third of all patients suffering depression have a chronic condition. Clinical experience indicates that a substantial proportion of patients suffer treatment-resistant depression (TRD). Our aim is to explore the literature reporting the drug treatment of TRD, and to present such information as would be of interest to clinical psychiatrists. METHOD: Literature searches were conducted using PubMed and entering the words antidepressant, augmentation, combined antidepressants, treatment resistant depression and the names of individual antidepressant medications. RESULTS: Most authors recommended that TRD should be first approached by reassessing the diagnosis, adding psychotherapy and attending to psychosocial factors. Details of the following pharmacological options were identified: (i) augmentation of the currently employed antidepressant with a medication which is not an antidepressant; (ii) change of antidepressant; and (iii) addition of a second antidepressant to the current antidepressant, or commencement of a combination of two antidepressants. CONCLUSIONS: When monotherapy provided at the maximum manufacturer-recommended doses for 3-4 weeks has failed to provide remission in depression, the diagnosis should be confirmed, psychotherapy added and psychosocial factors should receive attention. In the sustained absence of remission, a better outcome may be obtained by augmenting the antidepressant, changing from a single-action to a double- or multiple-action drug, or by combining antidepressants.

Antidepressive Agents↗
PubMed2004

Psychiatry and Islam.

OBJECTIVE: To explore psychiatry in Islam, with a view to informing Western psychiatrists working with Islamic patients, and Islamic medical students studying in Western countries. METHODS: The first necessary step was to acquire some understanding of Islam, Sharia and Sharia law, as the basis on which the available psychiatric literature was considered. Standard textbooks on Islam and English-language papers in the psychiatric literature were examined. Discussions with knowledgeable Muslim people were conducted. RESULTS: Islam shares roots with the other Abrahamic, monotheistic religions: Judaism and Christianity. A central issues is unity: the unity of God, unity with God and unity within the Islamic community. Islam is more than a religion, because it informs all aspects of behaviour and has been described as 'a comprehensive way of life'. Individualism is less important than the welfare of the community. The Sharia is a list of rules and regulations derived from authentic sources. Psychiatric services in Islam, according to Western standards, are somewhat limited. This issue is being addressed through epidemiological studies, provision of new services and policy development. Although mental health legislation is not universal, forensic psychiatry has a role, in many ways similar to that in the West. CONCLUSION: Islam is based on unity and core values of compassion, justice and benevolence. Islamic psychiatry has a proud early history, and advances are occurring. There is an opportunity for the profession of psychiatry to bridge religious, ethnic and cultural boundaries.

Australia↗
PubMed2004

M'Naghten rules.

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Borderline Personality Disorder↗