Biomedical subjects

W Frawley

Publications and source records attributed to W Frawley.

5 recordsLinked to original sources

PubMed2002

Quantitative oculographic characterisation of internuclear ophthalmoparesis in multiple sclerosis: the versional dysconjugacy index Z score.

BACKGROUND: There is a poor correlation between multiple sclerosis disease activity, as measured by magnetic resonance imaging, and clinical disability. OBJECTIVE: To establish oculographic criteria for the diagnosis and severity of internuclear ophthalmoparesis (INO), so that future studies can link the severity of ocular dysconjugacy with neuroradiological abnormalities within the dorsomedial brain stem tegmentum. METHODS: The study involved 58 patients with multiple sclerosis and chronic INO and 40 normal subjects. Two dimensional infrared oculography was used to derive the versional dysconjugacy index (VDI)-the ratio of abducting to adducting eye movements for peak velocity and acceleration. Diagnostic criteria for the diagnosis and severity of INO were derived using a Z score and histogram analysis, which allowed comparisons of the VDI from multiple sclerosis patients and from a control population. RESULTS: For a given saccade, the VDI was typically higher for acceleration v velocity, whereas the Z scores for velocity measures were always higher than values derived from comparable acceleration VDI measures; this was related to the greater variability of acceleration measures. Thus velocity was a more reliable measure from which to determine Z scores and thereby the criteria for INO and its level of severity. The mean (SD) value of the VDI velocity derived from 40 control subjects was 0.922 (0.072). The highest VDI for velocity from a normal control subject was 1.09, which was 2.33 SD above the normal control mean VDI. We therefore chose 2 SD beyond this value (that is, a Z score of 4.33) as the minimum criterion for the oculographic confirmation of INO. Of patients thought to have unilateral INO on clinical grounds, 70% (16/23) were found to have bilateral INO on oculographic assessment. CONCLUSIONS: INO can be confirmed and characterised by level of severity using Z score analysis of quantitative oculography. Such assessments may be useful for linking the level of severity of a specific clinical disability with neuroradiological measures of brain tissue pathology in multiple sclerosis.

Case-Control Studies↗

PubMed2001

Idiosyncratic profiles of collinearity error using segments and dot pairs.

It is well known that judgments of oblique line segments are more variable and less accurate than are judgments of horizontal or vertical segments, i.e., the "oblique effect." A prior study from our laboratories confirmed these differentials for a task in which the collinearity of segments at various angular positions was judged. Further, that study found that each observer manifests a distinct, idiosyncratic profile of errors across the 360 degrees range. These error tendencies are conspicuous in models derived by harmonic analysis, and we describe significant excursions of a given model as "delta errors." The present experiments found complex profiles of delta error with various stimulus and test conditions. A given subject manifested similar models of delta error when judging collinearity of dot pairs versus line segments. In the prior work the segments to be judged were asymmetrically positioned upon the test sheet. However, the asymmetric positioning is not responsible for the errors, as the present work found errors excursions with a round display field. Similar profiles of delta error were found when subjects were allowed to mark an open space, versus being required to respond at a specific distance (indicated by a target circle). This addresses questions of whether the error should be measured as an angle. In the two final experiments, we present evidence that the source of delta error within the nervous system is at the point of binocular synthesis of the information from the two eyes, or beyond, and the effects are not due to errors of reaching. Potential neural substrates for these complex, idiosyncratic error tendencies are discussed.

Discrimination Learning↗

PubMed2001

Evaluating models of collinearity judgment for reliability and scale.

In prior work from this laboratory, we have examined how accurately subjects can judge collinearity, i.e. alignment, as a function of the angular position of stimulus elements. In those experiments, subjects were presented with a line segment (or a pair of dots) which varied across the 360 degrees range of angular positions, and were required to select and mark a point which was perceived as being collinear. We found that the models of error for each subject consisted of a complex set of peaks and valleys which are herein described as delta excursions. The error tendencies appeared to be idiosyncratic, in that each subject manifested a different profile of these excursions. Here we report the results of three experiments. In the first, we tested subjects across five sessions, and found that the five models of error were fairly comparable for a given subject. In the second and third experiments, we tested at close intervals of angular position, and found evidence for localized sources of error. We continue to find that the error model for each subject is idiosyncratic, and argue that the excursions may be due to defects in a system which combines responses from position-encoding fields that vary in size.

Analysis of Variance↗

PubMed2000

Effect of the spine practitioner on patient smoking status.

STUDY DESIGN: A prospective evaluation of the smoking habits of new spine patients was performed during a 4-year interval. OBJECTIVE: To assess what effect the spine health care provider has on a patient's ongoing nicotine addiction. SUMMARY OF BACKGROUND DATA: The negative effects of smoking and nicotine for the spine patient are well defined. METHODS: Spine patients (N = 10,901) were queried as to their smoking habits during their new patient consultation; 3041 current smokers were identified. Data were obtained during 20,835 follow-up visits. Some of the smokers (n = 1632) were seen in follow-up visits and evaluated for their cigarette usage. Two different approaches were applied to assist the patient to stop smoking: 1) chart identification, reinforcement at each visit, continued education, written handout, practitioner assigning high priority, and 2) occasional mentioning, lower priority. RESULTS: The number of smokers who quit smoking was 35.6% in the high priority group versus 19.5% in the lower priority group. There was also a difference in the number of patients who decreased their smoking (67% vs. 38%). The fear that confronting a patient who smoked would cause the patient to leave the practice was not realized. Other factors that predicted successful cessation were fewer packs per day, fewer years smoking, and older age. The effect of the practitioner was independent of these other variables as determined by a logistic regression analysis. CONCLUSION: Patients will respond better if the practitioner assigns a priority and works with the patient to educate them about ways to address this particular substance abuse. Just asking about the patient's smoking status had a dramatic effect on smoking status. All spine practitioners should do all in their power to help their patients overcome their nicotine addiction.

Humans↗

PubMed2000

Individual differences in collinearity judgment as a function of angular position.

Previous research indicates that perceived orientation and/or alignment of segments and points can vary as a function of the angular position of the stimulus elements. Several studies show that the variability of the responses is least and accuracy of judgment is greatest where segments and dots are aligned with a cardinal axis. Additionally, some report assimilation of judgments toward the nearest cardinal axis--that is, the segments (or dots) are seen as being closer to the horizontal or vertical than is true. The present research confirms that judgments of collinearity are least variable and most accurate when the segment being judged is aligned with a cardinal axis. However, we do not find any consistent tendency for cardinal axis assimilation. Plotting the collinearity error (delta) as a function of angular position (phi), we find a distinctive profile of oscillation for each subject. Furthermore, subjects who were evaluated in two sessions showed very similar profiles of delta oscillation from Day 1 to Day 2. Harmonic analysis indicated a wide-ranging pattern of significant components. The components at the 4th harmonic and below were more likely to be significant, but each subject showed differential loadings in terms of which of the components were significant, as well as in the sign and amplitude of significant components. These results may reflect idiosyncratic fixation tendencies, or individual differences in the design of neural mechanisms that encode the angular positions of stimuli.

Humans↗