Abnormalities of the left temporal lobe in schizophrenia.
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Functional Laterality↗
Biomedical subjects
W T Roth
Publications and source records attributed to W T Roth.
Imipramine and alprazolam effects on stress test reactivity in panic disorder.
The reactivity of 40 panic disorder patients on mental arithmetic, cold pressor, and 5% CO2 inhalation stressors was tested before and after 8 weeks of treatment with imipramine, alprazolam, or placebo. Mean levels of subjective and physiological stress measures were compared during a baseline before any stressors were given, and at anticipation, stressor, and recovery periods for each stressor. After treatment, imipramine patients differed from the other two treatment groups on the prestressor baseline in showing higher systolic blood pressure (mean difference about 10 mmHg), higher diastolic blood pressure (10 mm Hg), higher heart rate (15 bpm), less respiratory sinus arrhythmia, shorter pulse transit time, and lower T-wave amplitude. Respiratory measures, electrodermal measures, body movement, and self-reported anxiety and excitement did not distinguish the groups. Reactivity to the stress tests was unaffected by the medications, but tonic differences present in the baseline persisted.
Adult↗
Stress test reactivity in panic disorder.
The psychological and physiological reactivity of 52 patients with panic disorder to mental arithmetic, cold pressor, and 5% carbon dioxide inhalation tests was compared with that of 26 age- and sex-matched normal subjects. In general, patients with panic disorder were neither more physiologically reactive to these stressors than normal subjects nor slower to recover from them, but they were tonically more anxious and much more likely to ask to stop carbon dioxide inhalation or to report panic attacks during this test. Patients who reported panic attacks (46%) had manifested greater anticipatory anxiety before the gas was delivered, accompanied with increased beta-adrenergic cardiac tone. Thus, anticipatory anxiety can be an important factor in panic provocation. Physiological measures varied greatly in their sensitivity to phasic or tonic anxiety. Carbon dioxide stimulated large increases in respiratory minute volume, but these increases were no greater for patients than for normal subjects.
Adult↗
Guidelines for reducing the risk of disease transmission in the psychophysiology laboratory. SPR Ad Hoc Committee on the Prevention of Disease Transmission.
The acquired immunodeficiency syndrome (AIDS) pandemic has highlighted the need for safeguards against the inadvertent transmission of infectious disease in the psychophysiology laboratory. These Guidelines identify factors contributing to the risk of bloodborne disease transmission to subjects or technicians, and recommend procedures to minimize such risk, given current knowledge and techniques. The lowest risk is associated with the application of devices, such as surface electrodes, to nonabraded, intact skin. Such devices should be clean, but do not require disinfection. The potential risk of infection is higher when surface electrodes are applied to non-intact skin. Abrasion, or other breaks in the skin, can allow seepage of blood products carrying such pathogens as hepatitis B virus and the human immunodeficiency virus that causes AIDS. Thus electrodes require high-level disinfection before reuse on non-intact skin. In addition, technicians should wear gloves during skin preparation and should abrade the skin no more than necessary, using only sterile, preferably non-sharp materials. The highest risk is that associated with items that enter sterile tissue, such as subdermal electrodes and the needles and lancets sometimes used in skin preparation. Such items must be sterile at the time of use and must be handled with extreme caution.
Humans↗
Auditory event-related potentials and electrodermal activity in medicated and unmedicated schizophrenics.
Event-related potentials (ERPs) and electrodermal activity were studied in 14 medicated schizophrenics, 17 unmedicated schizophrenics, and 23 age- and education-matched controls. Subjects were run in three auditory stimulus paradigms differing from the usual ERP paradigms in having interstimulus intervals greater than 12 sec to permit measurement of the longer latency skin conductance response (SCR). In every paradigm medicated but not unmedicated schizophrenics had smaller N120 amplitudes and fewer SCRs than controls. In addition, medicated schizophrenics showed reduced P200 amplitude and latency, longer P320 latency, and reduced skin conductance levels in certain paradigms. These effects cannot easily be attributed to different mental states of medicated and unmedicated patients, since their Brief Psychiatric Rating Scale scores were almost the same. It is more probable that antipsychotic and antiparkinsonian drugs reduced electrodermal activity through anticholinergic mechanisms and that the antipsychotic drugs attenuated N120 through other biological mechanisms.
Adult↗
Effect of two beta-blockers on stress during mental arithmetic.
Heart rate, blood pressure, and subjective stress ratings were recorded from 36 healthy normotensive students at three points in time: during a drug-free baseline, during a baseline 2 h after ingesting single oral doses of atenolol (75 mg), metoprolol (150 mg), or lactate placebo, and during a subsequently administered mental arithmetic test. Both beta-blockers equally reduced baseline heart rate and heart rate response to arithmetic, but subjective stress rating increases to arithmetic were greater for atenolol than for placebo and metoprolol. These results are contrary to peripheral theories of anxiety regulation. While the hydrophilic atenolol barely penetrates the blood-brain barrier, the lipophilic metoprolol can exert direct CNS effects in addition to its peripheral actions. Central stress-dampening effects of lipophilic beta-blockers may override peripheral baroreceptor-mediated stress-promoting effects.
Adult↗
How "blind" are double-blind studies?
Psychopharmacological studies usually attempt to eliminate "nonspecific" influences on outcome by double-blind designs. In a randomized, double-blind comparison of alprazolam, imipramine, and placebo, the great majority of panic disorder patients (N = 59) and their physicians were able to rate accurately whether active drug or placebo had been given. Moreover, physicians could distinguish between the two types of active drugs. Inasmuch as correct rating was possible halfway through treatment, concerns about the internal validity of the double-blind strategy arise.
Adult↗
Filter frequency in P3 experiments.
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Arousal↗
Skin conductance habituation in panic disorder patients.
Skin conductance habituation was compared between 38 patients meeting DSM-III criteria for Panic Disorder and 29 normal controls. Approximately half of each group was randomly assigned to be given 100 dB SPL tones and the other half 75 dB tones. All indices pointed to slowed habituation in patients compared with normals: number of trials to response habituation, total number of responses, and slope of decline of skin conductance level. Patient-normal differences were not significantly larger for 100 dB than for 75 dB. In addition, patients compared with normals had more nonspecific fluctuations, higher skin conductance levels, and a shorter response latency to the first stimulus. Stepwise discriminant analyses classified patients and normals better in the 100 dB than in the 75 dB condition, and showed that the various skin conductancy variables were largely redundant at the higher intensity.
Acoustic Stimulation↗
Motor activity and tonic heart rate in panic disorder.
Motor activity and tonic heart rate were monitored in 62 drug-free panic disorder patients and 40 normal control subjects. Mean daily activity, mean waking heart rate controlled for activity, and mean sleeping heart rate were determined. Panic disorder patients without phobic avoidance showed higher activity than control subjects or patients with limited or extensive avoidance. Similarly, an "inverted U", relationship between trait anxiety and activity was observed. On the other hand, neither mean waking nor sleeping heart rate showed significant differences between patients and controls, suggesting that the differences previously reported in laboratory studies result from anticipatory anxiety.
Adult↗
Dietary and hormonal evaluation of men at different risks for prostate cancer: plasma and fecal hormone-nutrient interrelationships.
Relationships between dietary nutrients and plasma and fecal estrone, estradiol-17 beta, testosterone, and plasma prolactin concentrations were studied in young Seventh-day Adventist men: 18 nonvegetarians (NVs), 20 lactoovovegetarians (LOVs), and 15 vegans (V). Blood samples and 3-d dietary records were obtained. Contemporaneously collected diet composites and stool samples were analyzed for fiber. Vs and LOVs consumed significantly more fiber than did the omnivores, whereas NVs and LOVs consumed more saturated fatty acids than did Vs. Although plasma steroid-hormone status did not differ, Vs had significantly higher fecal estrogen concentrations than did NVs or LOVs. Plasma prolactin concentrations were significantly higher in NVs and LOVs than in Vs. Significant relationships were observed for the combined groups between dietary and fecal fiber components and fecal, but not plasma, steroid hormones. For the combined groups, prolactin concentrations were positively correlated with saturated fatty acid intake. Further research on the effects of dietary nutrients on endocrine homeostasis in other age groups is warranted.
Adult↗
Cardiovascular and symptomatic reduction effects of alprazolam and imipramine in patients with panic disorder: results of a double-blind, placebo-controlled trial.
Seventy-nine patients with panic disorder were randomized to an 8-week double-blind treatment with alprazolam, imipramine, or placebo. Patients kept daily records of panic attacks, activity, anxiety, sleep, and medication use. Weekly measures of anxiety, depression, somatic symptoms, fears, avoidance, disability, and improvement were obtained. All patients underwent a symptom-limited exercise treadmill and other cardiovascular measures. By physician and patient global assessment, patients receiving alprazolam or imipramine were significantly better than patients on placebo. The alprazolam effects were apparent by week 1; the imipramine effects by week 4. All groups showed significant reductions in anxiety, depression, somatic measures, and panic attack frequency. At 8 weeks, patients in the alprazolam group reported significantly less fear than patients in the other two groups. Subjects in the imipramine group showed a significant increase in heart rate and blood pressure.
Adult↗
Effects of stimulus repetition, duration, and rise time on startle blink and automatically elicited P300.
Intense auditory stimuli of sudden onset evoke not only startle blinks but also an event-related potential component resembling classic P300, even when subjects have no assigned task. To more closely examine the relationship of this P300 to startle, event-related potentials and eyeblink were recorded from 16 young adults in three paradigms designed to produce wide variation in startle amplitude: an Habituation series of 30-ms, 105dBA white noise bursts, a Duration paradigm which presented 105dB noise bursts for 3, 10, 30, or 90 ms, and a Rise Time paradigm which varied the rise/fall times (3, 15, 30, and 45 ms) of 110dBA, 1000-Hz tone bursts. Subjects received two runs of each paradigm. Only on the final Duration and Rise Time runs were stimuli explicitly task relevant; on those runs subjects rated verbally, midway in each 8.4-s interstimulus interval, the disturbingness of the prior sound. Although even the briefest noise bursts evoked parietal P300 as well as startle blink, P300 did not behave like startle. P300 habituated more slowly than did blink amplitude, was more responsive to sustained noise than were blink, N110, and P190, and most importantly, did not show the sensitivity to stimulus rise time manifested by these measures. These findings suggest that the amplitude of automatically elicited P300 is not governed by the same mechanisms as startle amplitude, but behaves more like a defense response.
Adolescent↗
Guttman scaling in agoraphobia: cross-cultural replication and prediction of treatment response patterns.
The Fear and Avoidance Scales (FAS) is an 11-item questionnaire consisting of two subscales that measure features of agoraphobia and claustrophobia and that were demonstrated to be valid Guttman scales in a British clinical population. The purposes of the study reported here were to replicate the scale characteristics in the United States and to determine if improvement during treatment would follow the sequence predicted by the hierarchy implied in the scales. The FAS was given to 25 female agoraphobics before and after behavioural treatment. A principal components analysis replicated the agoraphobia and claustrophobia factors established in the British sample. Scalogram analyses showed that the Claustrophobia subscale of the FAS was a valid Guttman scale in the US sample whereas the Agoraphobia subscale yielded a high coefficient of reproducibility but a low coefficient of scalability. Treatment reduced the patients' fears and avoidances in the predicted sequence since for both scales the hierarchy of items remained unchanged following treatment.
Adult↗
Surreptitious drug use by patients in a panic disorder study.
In a double-blind, placebo-controlled trial comparing alprazolam and imipramine for panic disorder, serum analysis revealed that a substantial proportion of the patients took explicitly prohibited anxiolytic medication. Excluding these patients changed the results.
Adult↗
P3 in schizophrenia is affected by stimulus modality, response requirements, medication status, and negative symptoms.
Eighteen schizophrenics who were not taking medication, 13 schizophrenics who were taking medication, and 37 age-matched controls were tested with event-related potential paradigms designed to elicit P3 response automatically or effortfully (ie, with a choice reaction time task). Electroencephalograms were recorded from the 19 standard 10-20 electrode sites. Compared with controls, both groups of schizophrenics had reduced P3 amplitudes for both effortful and automatic paradigms. P3 latencies were delayed relative to controls for the medication-taking schizophrenics in the effortful paradigms. Negative symptoms derived from the Brief Psychiatric Rating Scale within 1 week of event-related potential testing correlated negatively with both auditory and visual P3 amplitude in the subjects who were not taking medication. There was no evidence that P3 is smaller over left temporal electrode sites in schizophrenics, as has been reported by others. P3 amplitude reduction in schizophrenia is a robust psychobiological phenomenon that is present regardless of medication status or task demands.
Adult↗
Use of medication and in vivo exposure in volunteers for panic disorder research.
A survey of 794 subjects volunteering for studies of panic disorder with or without phobic avoidance revealed that fewer than 15% had received imipramine and fewer than 15% had undergone in vivo exposure, although the majority had engaged in some form of counseling and had used benzodiazepines. Subjects with spontaneous panic attacks reported more avoidance than subjects with situational attacks. One-half of the subjects were unemployed. The authors recommend wider use of the available effective treatments for panic disorder and phobic avoidance.
Adult↗
Plasma lipid levels in patients with panic disorder or agoraphobia.
Plasma lipids were measured in 102 subjects with panic disorder or agoraphobia. In women, but not men, a significantly higher than expected number of subjects had cholesterol values that exceeded the 75th percentile of national reference values for their sex and age.
Adult↗