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PubMed2001

Functional anatomical correlates of controlled and automatic processing.

Behavioral studies have shown that consistent practice of a cognitive task can increase the speed of performance and reduce variability of responses and error rate, reflecting a shift from controlled to automatic processing. This study examines how the shift from controlled to automatic processing changes brain activity. A verbal Sternberg task was used with continuously changing targets (novel task, NT) and with constant, practiced targets (practiced task, PT). NT and PT were presented in a blocked design and contrasted to a choice reaction time (RT) control task (CT) to isolate working memory (WM)-related activity. The three-dimensional (3-D) PRESTO functional magnetic resonance imaging (fMRI) sequence was used to measure hemodynamic responses. Behavioral data revealed that task processing became automated after practice, as responses were faster, less variable, and more accurate. This was accompanied specifically by a decrease in activation in regions related to WM (bilateral but predominantly left dorsolateral prefrontal cortex (DLPFC), right superior frontal cortex (SFC), and right frontopolar area) and the supplementary motor area. Results showed no evidence for a shift of foci of activity within or across regions of the brain. The findings have theoretical implications for understanding the functional anatomical substrates of automatic and controlled processing, indicating that these types of information processing have the same functional anatomical substrate, but differ in efficiency. In addition, there are practical implications for interpreting activity as a measure for task performance, such as in patient studies. Whereas reduced activity can reflect poor performance if a task is not sensitive to practice effects, it can reflect good performance if a task is sensitive to practice effects.

Adult↗

PubMed1980

The effect of various background protocols on the measurement of left ventricular ejection fraction in equilibrium radionuclide angiography.

Four methods of calculating left ventricular ejection fraction from equilibrium radionuclide angiography have been assessed for inter-observer variability and compared to single-plane contrast cineangiography. The superiority of data-processing methods which use a left ventricular region of interest which follows the changing size of the left ventricle into systole is demonstrated. A simple method of correcting for background is suggested as an alternative for those centres not possessing the necessary software for methods involving a changing region of interest.

Angiocardiography↗

PubMedDate not supplied

[Neuro-cognitive condition of 8 year old children with congenital hypothyroidism treated early].

INTRODUCTION: Congenital hypothyroidism is the most important cause of preventable mental retardation. Since the use of programmes for early detection, mental retardation due to cretinism has been abolished and current investigations seek to detect subtle damage due to foetal hypothyroidism and strategies to minimize such deficits. OBJECTIVE: This study presents the results of neurocognitive assessment of a group of 19 children aged 8 in the Cuban Programme for the early detection of Congenital Hypothyroidism. PATIENTS AND METHODS: The programme is based on the use of umbilical cord serum levels of thyrotropin (TSH), using the Elisa ultramicro method (SUMA) and substitutive treatment with sodium levothyroxine and a programme of neuropsychiatric stimulation until 5 years old. RESULTS: The results showed that the intelligence quotients of children with hypothyroidism were not statistically different from paired controls, and thus demonstrate the efficacy of the programme. On evaluation using computerized techniques for the detection of subtle disorders of the maintenance of attention, deficiencies were found. Analysis of the conventional EEG showed that in 13 cases recordings were normal, 4 had generalized cortical damage, 1 had cortico-subcortical damage and the remainder had signs of focal irritation. On the quantitative EEG, correlation between the attention variables and absolute values (MV2/Hz) were calculated for each derivation and associations found mainly in the right parietal and left frontal regions. CONCLUSION: The effect of stimulating development in these patients is discussed.

Age Factors↗

PubMed1991

[Vasomotor activity in the large arterial vessels and arterial hypertension].

Hypertension has long been considered to be a disease of the arterioles but it also concerns the great arteries. The hypothesis for this study was that the antihypertensive agents used in the large multicenter trials only partially correct the hemodynamic abnormalities of hypertension. The regression of the structural arterial changes responsible for the decreased arterial compliance, the regression of left ventricular hypertrophy without alteration of systolic function, the decrease in the variability of the blood pressure and the maintenance of regional blood flow should also be considered as therapeutic objectives for vasodilator antihypertensive therapy.

Arteries↗

PubMed1994

Effect of parathyroid hormone on myocardial bloodflow and infarct size following coronary artery occlusion in the dog.

OBJECTIVE: To investigate the cardioprotective effect of both the amino terminal of bovine parathyroid hormone (bPTH-[1-34]) and human parathyroid hormone (hPTH-[1-84]) following coronary artery occlusion. DESIGN: Animals were randomly assigned to one of three treatment groups following circumflex coronary artery occlusion. ANIMALS: Experiments were performed using 19 mongrel dogs of either sex. As four animals died during experimentation, data are shown for 15 dogs (n = 5 for each treatment group). INTERVENTIONS: Animals received saline, bPTH-(1-34) or hPTH-(1-84) following occlusion of the circumflex coronary artery. Peptides were given at 0.008 nmol/kg/min. All treatments were infused directly into the coronary circulation. Infusion rate was 1 mL/min for 10 mins at 30 min intervals until the end of the experiment (480 mins after onset of occlusion). Hemodynamic variables were monitored throughout the experiment. Radioactive microspheres were injected 10 mins before, and 30, 240 and 480 mins following, occlusion of the coronary vessel to determine regional myocardial blood-flows. At the end of the experiment, area at risk and infarct size were measured by simultaneous infusion of Evans blue dye and triphenyl tetrazolium chloride stain. MAIN RESULTS: Neither bPTH-(1-34) nor hPTH-(1-84) significantly reduced area of risk or infarct size as a percentage of area at risk compared with controls. These results were corroborated by regional blood-flows measured using radioactive microspheres. There was no significant difference in hemodynamic variables among the groups except that left atrial pressure was consistently lower following treatment with hPTH-(1-84). CONCLUSIONS: No evidence was found that either bPTH-(1-34) or hPTH-(1-84) salvaged ischemic myocardium in a canine model of myocardial infarction. Treatment with hPTH-(1-84) was associated with a reduction in left atrial pressure. This latter phenomenon may constitute a beneficial effect of this peptide on diastolic myocardial function.

Animals↗

PubMed1995

Long-term prognostic significance of M mode echocardiography in young men after myocardial infarction.

OBJECTIVE: To evaluate the power of measurements of left ventricular size and function for predicting long term (82 month) mortality by performing echocardiography in 97 men who had survived an acute myocardial infarction. SETTING: University hospital specialising in cardiology. PARTICIPANTS: 97 consecutive male patients who had survived a myocardial infarction. MAIN OUTCOME MEASURES: The additive prognostic value of functional measurements to that provided by primary risk factors (smoking habits and lipoprotein levels), radiological heart size, exercise capacity, and number of major coronary arteries with haemodynamically significant stenoses was evaluated. An echo index was calculated from three echocardiographic variables (yielding one score point each if: left ventricular diameter at the end of diastole (LVDD) > or = 5.7 cm, left ventricular fractional shortening < or = 24%, and E point-separation (EPSS) > or = 10 mm). MAIN OUTCOME: 17 cardiac deaths occurred during follow up. RESULTS: Univariate analysis showed that treatment with loop diuretics for heart failure (P < 0.01), LVDD (P < 0.01), left ventricular diameter at the end of systole (LVDS) (P < 0.001), left atrial diameter (P < 0.001), fractional shortening (P < 0.05), and echo index (P < 0.001) were all associated with cardiac death. Angiographically determined regional wall motion disturbances (P < 0.005) and angiographic ejection fraction (P < 0.001) were also associated with cardiac death, as was the number of major coronary arteries with significant stenosis (P < 0.05). When all significant echocardiographic variables from univariate analysis were entered into Cox proportional hazards survival analysis, LVDS and left atrial diameter contributed independently to the prediction of cardiac death. If angiographic data were also entered into the model, the echo index made an independent contribution to the prediction of cardiac death. CONCLUSIONS: Among young male patients with a previous myocardial infarction, a simple M mode echocardiographic examination can identify high and low risk patients and improve the prediction of cardiac death made from clinical information, exercise test, chest x ray and angiographically determined ejection fraction.

Adult↗

PubMed1990

Effect of a new alpha 2-adrenoceptor antagonist on poststenotic coronary resistance and myocardial function.

The effect of the alpha 2-adrenoceptor antagonist 4-fluoro-2-(imidazoline-2-ylamino)-isoindoline maleate (BDF 8933) on poststenotic end-diastolic distal coronary resistance and poststenotic myocardial function (sonomicrometry) was investigated under control conditions and during cardiac sympathetic nerve stimulation (CSNS = electrical stimulation of the left ventrolateral cervical cardiac nerve). In 7 vagotomized, open-chest dogs end-diastolic distal coronary resistance was determined. This variable was essentially unchanged after administration of the agent. In additional 6 dogs regional myocardial function was measured as systolic wall thickening (SWT). CSNS increased SWT of the posterior circumflex-perfused myocardium from 12.7 +/- 4.6% to 21.9 +/- 8.4% (p less than 0.05) under control conditions. With a severe stenosis on the left circumflex coronary artery, SWT was reduced to 5.4 +/- 4.0% and further decreased to 2.1 +/- 5.1% (p less than 0.05) during CSNS. After i.v. injection of 150 micrograms/kg BDF 8933, poststenotic myocardial function at rest was 4.2 +/- 4.2%, and 5.6 +/- 3.6% during CSNS. Regarding to the systemic effects BDF 8933 significantly increased peak left ventricular pressure in all 13 dogs. Thus, the new alpha 2-adrenoceptor antagonist BDF 8933 at the chosen dosage prevents sympathetically induced myocardial ischemia, but increases left ventricular afterload resistance.

Adrenergic alpha-Antagonists↗

PubMed1978

The effect of ergotamine on tissue blood flow and the arteriovenous shunting of radioactive microspheres in the head.

1 The radioactive microsphere method was used to study the effects of ergotamine (5, 10 and 20 mug/kg, i.v.) on systemic and regional haemodynamic variables in chloralose-urethane anaesthetized cats. The influence of the drug was also studied on the number of 15 mum microspheres escaping entrapment in the head to emerge in the left external jugular vein.2 Ergotamine decreased the heart rate and cardiac output. Since arterial blood pressure remained unchanged, calculated total peripheral resistance increased.3 The regional distribution of cardiac output obtained with 15 mum microspheres agreed well with previous studies in cats where 25 mum spheres were used. The most pronounced difference was that in the present investigation more microspheres, apparently escaping through arteriovenous anastomoses (AVAs), were detected in the lungs than when larger spheres had been used.4 Coronary blood flow decreased, while uterine blood flow was increased by the drug. The microsphere content of the lungs, which receive the spheres not only via bronchial arteries but also via AVAs, was greatly reduced by all doses of ergotamine. Ergotamine did not influence tissue blood flow to other major organs such as the brain, kidneys, skin, liver, skeletal muscle or the gastrointestinal tract.5 In the 16 experiments, 0.46 +/- 0.05 (s.e. mean)% of the total microspheres injected (equivalent to 11.7 +/- 1.4% of microspheres detected in the left-side of the head) appeared within 2 min of microsphere injection into the left external jugular vein. The highest dose of ergotamine significantly reduced the shunting of the microspheres in the head.6 Since 15 mum microspheres are only likely to reach the lungs by passing into the venous circulation through large glomus-type AVAs, we conclude that ergotamine reduces the fraction of microspheres appearing in the lungs by causing strong vasoconstriction in the AVAs in the head.7 In conformity with the closure of head AVAs is the finding that ergotamine reduced the jugular venous Po(2) and O(2) saturation thereby increasing the A-V O(2) saturation difference.8 It is quite possible that decreased A-V shunting may be the prominent mechanism of the antimigraine action of the drug, since sudden opening of AVA's has been implicated in the pathophysiology of migraine-syndrome.

Animals↗

PubMed1985

Late effects of intracoronary streptokinase on regional wall motion, ventricular aneurysm and left ventricular thrombus in myocardial infarction: results from the Western Washington Randomized Trial.

To determine whether intracoronary streptokinase improves late regional wall motion or reduces left ventricular aneurysm or thrombus formation in patients with acute myocardial infarction, two-dimensional echocardiography was performed at 8 +/- 3 weeks after infarction in 83 patients randomized to streptokinase (n = 45) or standard therapy (n = 38) in the Western Washington Intracoronary Streptokinase Trial. Among the patients treated with streptokinase, the average time to treatment was 4.7 +/- 2.5 hours after the onset of chest pain, and 67% had successful reperfusion. Regional wall motion was assessed in nine left ventricular segments on a scale of 1 to 4 (normal, hypokinetic, akinetic and dyskinetic). Left ventricular thrombus formation was interpreted as positive, equivocal or negative. All patients received anticoagulant therapy in the hospital and 52 received such therapy after hospital discharge. The mean (+/- SD) global (1.5 +/- 0.4 in both groups) and regional wall motion scores in the streptokinase-treated and control groups were not significantly different. The prevalence of aneurysm was 16% in both groups. Left ventricular thrombus was identified in only five patients (positive identification in four, and equivocal in one), all in the streptokinase-treated group (p = NS). There were also no differences between streptokinase and control treatment in any of the echocardiographic variables in subgroups of patients with anterior infarction, inferior infarction, no prior infarction or reperfusion with streptokinase. It is concluded that intracoronary streptokinase given relatively late in the course of acute myocardial infarction does not result in improved global or regional wall motion or a reduction in left ventricular thrombus or aneurysm formation in survivors studied 2 months after myocardial infarction.

Aged↗

PubMedDate not supplied

Major and trace element concentration differences between the right and left hemispheres of the "normal' human brain.

The brain can be divided into many anatomical regions, and the minor and trace element distribution across these regions has been shown to be heterogeneous. The various functions of the brain such as memory and language have been associated with different brain regions, and attempts to correlate brain function with elemental composition have been made. Establishing "normal" concentration values is a complex task due to the variability of factors such as age, sex, dietary intake, environmental exposure, and smoking habits. In establishing the elemental concentration of a particular brain region, a mean value from the right and left hemispheres of different brains is often used. This is usually due to the lack of availability for analysis of the same brain regions from both hemispheres of one individual. However, it is known that the right and left hemispheres have different functions. Thus, it may be expected that they may have different trace element concentrations as well. In this study 13 brain regions were sampled from both hemispheres of six elderly individuals, and their major element composition was determined by Rutherford backscattering (RBS) analysis, whereas the minor and trace element concentrations were obtained by particle induced X-ray emission (PIXE) analysis.

Aged↗

PubMed2004

New echocardiographic technologies in the study of acute myocardial infarction.

Echocardiography has a key role in the diagnostic and prognostic evaluation of patients in the different phases of acute myocardial infarction. Despite this important role of the conventional echocardiographic technologies, novel echocardiographic applications are under development or already used in the clinical practice. It is very difficult to distinguish which of these techniques will play a consistent role and will cover important diagnostic, prognostic and therapeutic use. The wise cardiologist will be the one who will choose the appropriate technology for the right subset of patients. In this review paper we try to assign to each novel echocardiographic technique its actual clinical weight in every pathophysiological condition: myocardial contrast echocardiography, contrast opacification of the left ventricle, coronary flow reserve study, integrated backscatter, tissue Doppler and strain rate imaging. For the best treatment choice, each patient has to be perfectly diagnosed and characterized in order to have a tailored therapy. A correct diagnosis of the extension of myocardial necrosis cannot ignore the transmural wavefront development, the amount of viable myocardium or the presence of microvascular damage. Also the simple echocardiographic wall motion akinesia can be caused by a variable extension of non-contracting, scarred myocardium. The different anatomic and functional intramyocardial patterns represent the basis for different functional outcome of regional and hence global left ventricular function. The greatest understanding of the pathology always leads to the best treatment.

Coronary Circulation↗

PubMed1989

Multigated radionuclide ventriculography during in-hospital phase of acute myocardial infarction.

Global and regional left ventricular performance was assessed by multigated radionuclide technique in thirty patients sustaining acute myocardial infarction on two occasions during in-hospital phase. Thirteen (76.5%) of the seventeen patients with anterior infarction had depressed initial left ventricular ejection fraction compared with seven (53.8%) of the thirteen patients with inferior infarction. From initial to discharge study, change in ejection fraction was statistically insignificant in either group of infarctions. All except three (10%) patients had regional wall motion abnormality on initial evaluation with little subsequent alteration. Our data demonstrates that ejection fraction changes variably during the course of illness, and location of infarction has profound effect upon degree of left ventricular dysfunction. Assessment by non-invasive radionuclide technique may have prognostic implications.

Adult↗

PubMed2005

Adverse 30-day outcomes after cardiac surgery: predictive role of intraoperative myocardial acidosis.

BACKGROUND: Regional myocardial acidosis in patients undergoing cardiac surgery has been shown to be reflective of regional myocardial ischemia. This study elucidates the relationship between intraoperative regional myocardial acidosis and 30-day postoperative outcomes after cardiac surgery. METHODS: Intramyocardial tissue pH in the anterior and posterior left ventricular walls was measured in 397 adult patients undergoing valve replacement or coronary revascularization surgery between 1987 and 2001. Dedicated nurses and research assistants prospectively collected preoperative, intraoperative, and outcomes data. Regional myocardial acidosis was defined in terms of pH thresholds identified by recursive partitioning. Adverse 30-day outcome, defined as death or any one of six complications, was the dependent variable in a multivariate logistic regression analysis. A morbidity score was developed on the basis of the sensitivity of each of the six complications in predicting death, and was the dependent variable in a multivariate linear regression analysis. RESULTS: During the period of aortic clamping, a mean intramyocardial tissue pH less than 6.85 was identified to be significant by recursive partitioning, and was encountered in either the anterior or posterior left ventricular wall in 85.4% of patients. After adjusting for preoperative and intraoperative variables, this pH threshold was found to be significantly associated with increased adverse outcomes within 30 days after surgery (p = 0.045). It was also significantly associated with increase in the morbidity score (p = 0.05). CONCLUSIONS: Regional myocardial acidosis of a magnitude frequently encountered during aortic clamping is an independent determinant of adverse 30-day outcomes after cardiac surgery. Its reversal by pH-guided myocardial management has the potential of improving postoperative patient outcomes.

Acidosis↗

PubMed2004

Re-innervation after heart transplantation: a multidisciplinary study.

BACKGROUND: Several authors have demonstrated the existence and implications of re-innervation in the transplanted heart. Our aim was to study this phenomenon using 3 different techniques and to analyze the correlation among them. METHODS: The study population consisted of 55 patients who had undergone heart transplantation 0.5 to 160 months earlier. We used a control group of 10 healthy individuals for comparison. To detect re-innervation, we used 1) planar and single photon emission computed tomography (SPECT) scintigraphic imaging of cardiac sympathetic activity with 123I-metaiodobenzylguanidine (MIBG), 2) analysis of heart-rate variability based on 24-hour Holter recordings; and 3) immunohistochemical study of endomyocardial biopsy specimens with anti-S100 antibody. RESULTS: The SPECT images showed evidence of sympathetic re-innervation in 17 patients (31%), predominantly in the anterior and in the septal regions of the left ventricle. Sympathetic activity increased during the post-transplant time course (r = 0.32; p = 0.017), although it did not reach normal values. We found a correlation between the low-frequency component of heart-rate variability (a marker of sympathetic activity) and the degree of MIBG uptake according to scintigraphy (r = 0.32; p = 0.015). Immunostaining study demonstrated the existence of nerve fibers in 36 patients (65%) who had greater values of heart-rate variability parameters reflecting parasympathetic activity. CONCLUSIONS: The 3 techniques evidenced re-innervation after heart transplantation. A correlation exists between sympathetic activity detected using MIBG scintigraphy and analysis of heart-rate variability. Patients in whom endomyocardial biopsy specimen reveals the presence of nerve fibers show more parasympathetic activity in the heart-rate variability analysis.

3-Iodobenzylguanidine↗

PubMed1991

Echocardiographic evaluation of fibrous replacement in the myocardium of patients with Duchenne muscular dystrophy.

OBJECTIVES: To study myocardial echo amplitude in Duchenne muscular dystrophy and to examine the implications of increased echo amplitude. DESIGN: Regional echo amplitude, wall motion, and uptake of thallium-201 were examined in the left ventricular wall and the relation between these variables was investigated. SETTING: Hara National Sanatorium, Japan. PATIENTS: Seven healthy controls aged 10-28 years and 14 patients with Duchenne muscular dystrophy aged 12 to 30 years. INTERVENTIONS: Echocardiography with a sector scanner (Hitachi EUB-150, Japan) and a 3.5 MHz transducer (Hitachi EUP-S21, Japan); thallium-201 myocardial single photon emission computed tomography at rest with a rotating gamma camera system (Hitachi RC-135DT, Japan). MAIN OUTCOME MEASURES: Echo amplitude of the myocardium, thickness and wall motion of the posterior wall and ventricular septum, and myocardial uptake of thallium-201. RESULTS: Areas of increased echo amplitude were detected along the outer half of or throughout the posterior wall of left ventricle in nine of the 14 patients. Their posterior walls showed significantly decreased maximal systolic and diastolic endocardial velocities (mean (SE) 31.4 (16.0) and 55.6 (53.5) mm/s) compared with normal subjects (57.7(19.4) and 113.0 (27.5) mm/s), and decreased uptake of thallium-201. Their ventricular septa, however, showed normal echo amplitude and wall motion and normal uptake of thallium-201. CONCLUSION: Areas of increased echo amplitude were detected in the posterior walls of left ventricles of patients with Duchenne muscular dystrophy. These areas were suspected to be the sites of myocardial fibrosis.

Adolescent↗

PubMed2000

Masticatory strains on osseous and ligamentous components of the temporomandibular joint in miniature pigs.

AIMS: An animal study of functional biomechanics was undertaken to understand normal loading of the temporomandibular joint (TMJ) and to provide insight into the pathogenesis of TMJ disorders. METHODS: Bone strain and ligamentous deformation were measured during mastication in 26 10-month-old minipigs. Half the subjects had undergone a surgical disruption of the left lateral capsular and disc attachments to the condyle 5 to 6 weeks previously. Rosette strain gauges were bonded to the left lateral surfaces of the squamosal bone near the TMJ, the condylar neck, and the mandibular corpus below the molar region. Differential variable reluctance transducers (DVRTs) were placed bilaterally in the lateral capsular tissue of the joints. Bone strains, ligamentous deformations, and the electromyographic activities of the masseters and lateral pterygoids were recorded during natural mastication. RESULTS: In all animals on both working and balancing sides, mastication caused bone strains that were dominated by tension in the squamosal bone site and by compression in the other sites. Measurements from the DVRT revealed elongation of the lateral capsular tissue in the last phase of the power stroke and shortening in the initial phase of opening, which was almost simultaneous with the development of bone strain. Strain in the capsule ranged from 3 to 25%, with the strain of the balancing side exceeding that of the working side. The surgical disruption did not alter chewing side preference or bone strain, but a tendency toward more extensive ligamentous deformation on the intact side was observed. Furthermore, the ratio of masseter to lateral pterygoid activity was smaller on the disrupted side and larger on the intact side, in comparison to control pigs. CONCLUSION: Both osseous and ligamentous components of the TMJ are strained during mastication, and the latter are more deformed on the balancing side. Disruption of the lateral attachment had little effect on strain in the osseous components but appeared to increase strain in the capsule and to modify the balance of masticatory muscle activity.

Analysis of Variance↗

PubMed1989

Tissue plasminogen activator: Toronto (TPAT) placebo-controlled randomized trial in acute myocardial infarction.

The efficacy and safety of recombinant tissue plasminogen activator (rt-PA) administered on a dosing per weight basis was evaluated in a randomized, placebo-controlled, double-blind trial in 115 patients with acute myocardial infarction. The principal outcomes were global and regional left ventricular function in the distribution of the qualifying myocardial infarction, determined 9 days after the onset of symptoms. Global and regional ejection fraction values were significantly better for patients treated with rt-PA than for placebo-treated patients (the differences were 5.8 +/- 2.7% units [p = 0.017] and 7.1 +/- 3.1% units [p = 0.012], respectively). This benefit was also evident from visual assessment of left ventricular segmental wall motion. After adjustment for differences in important prognostic variables at baseline, the estimates of treatment effect were 4.0 +/- 2.4% units (p = 0.048) for global and 4.3 +/- 2.6% units (p = 0.047) for regional ejection fraction. Early patency of the infarct-related vessel was demonstrable in 7 (29%) of 24 placebo-treated patients and 18 (78%) of 23 rt-PA-treated patients, whereas 15 (56%) of 27 patients in the placebo group and 23 (72%) of 32 in the rt-PA group had a patent infarct-related vessel at hospital day 9. There was no significant difference in irreversible or reversible defect size as assessed by thallium scintigraphy on day 7.(ABSTRACT TRUNCATED AT 250 WORDS)

Double-Blind Method↗

PubMed1985

Behavioral correlates of computed tomographic (CT) scan changes in older psychiatric patients.

Fifty psychiatric inpatients aged 50 and over, with no hard neurologic findings, and with a variety of DSM-III diagnoses (adjustment disorder, affective illness, and dementia), were rated for behavioral and psychiatric symptoms using the Geriatric Rating Scale and the Nurse's Assessment of Global Symptomatology-Elderly. These clinical ratings were correlated with computed tomographic (CT) scan assessments of various superficial cerebral regions as well as with linear measures of ventricular size. Behavioral deficits in activities of daily living (ADL) plus an interactional variable, inability to respond to requests, were correlated with superior temporal and inferior parietal CT abnormalities, particularly on the left side. Suspiciousness and peculiar thinking, mood lability and irritability, as well as impaired memory with confusion, perplexity, and disorientation were also associated with atrophy in these same regions. Prefrontal area defects correlated with mood lability and deficits in visual-interactional responsiveness. Statistically controlling for effects of age and alcohol abuse did not alter the basic nature of these results. Regional cerebral specialization in relation to these results are discussed using concepts developed by Luria.

Activities of Daily Living↗