Neuropsychological test scores and clinical response to neuroleptic drugs in schizophrenic patients.

Schizophrenic patients who showed greater neuropsychological deficits on the Luria-Nebraska Pathognomonic subscale (PATH) and Trail-Making Test showed less improvement during treatment with neuroleptic drugs than patients with lower scores on these neuropsychological tests. Other neuropsychological test scores we used were not consistently related to the patients' degree of clinical improvement during neuroleptic treatment. Only a few patients evidenced severe scores on either the PATH or TM tests, suggesting that more subtle neuropsychological deficits may identify a subgroup of schizophrenics who will show a relatively poor response to treatment with standard neuroleptic drugs.

Lateral ventricular enlargement and clinical response in schizophrenia.

The relationship between enlargement of the lateral ventricles in the brains of schizophrenic patients and clinical response to neuroleptic treatment, as assessed by the ventricle-brain ratio (VBR) and psychopathology scores, was studied in a sample of 39 patients with schizophrenia or schizoaffective psychosis during a drug-free washout and after 3 1/2 weeks of treatment with either haloperidol or thioridazine. There was a weak, but statistically significant positive relationship between VBR and improvement on BPRS Psychosis factor scores after 3 1/2 weeks of treatment, and a negative correlation between VBR and baseline (washout) scores on the BPRS Anergia factor. Patients with enlarged VBRs, as defined by two criteria, also tended to show a better response to neuroleptics than patients below these criterion values.

Comparative efficacy of red cell and plasma haloperidol as predictors of clinical response in schizophrenia.

The relative utility of steady-state (SS), plasma (Pl), and red blood cell (RBC) haloperidol levels for predicting clinical response was evaluated in a fixed-dose study in schizophrenic inpatients. There were significant curvilinear relationships between the decrease in BPRS Psychosis Factor Scores by day 24 of haloperidol treatment and both Pl (R2 = 0.34) and RBC (R2 = 0.38) haloperidol levels. Although SS RBC haloperidol levels consistently showed a slightly stronger relationship to clinical response than Pl levels in several comparisons, the differences in R2s between Pl and RBC haloperidol were not statistically significant. Ninety percent confidence intervals for the blood level ranges associated with optimal clinical response in our sample of patients were: 6.5-16.5 ng/ml Pl haloperidol and 2.2-6.8 ng/ml RBC haloperidol.

Nuclear magnetic resonance in schizophrenia: a preliminary study.

Nuclear magnetic resonance (NMR) scans were performed in nine patients with schizophrenia and five control subjects. NMR scans allowed multiple-plane views of the brains of schizophrenic patients and demonstrated much greater detail of morphological structure than computed tomographic (CT) scans. This small sample of subjects, however, showed no significant differences in several quantitative measurements between schizophrenic patients and control subjects. Problems in the interpretation of image intensity measures of NMR scans are discussed.

RBC and plasma levels of haloperidol and clinical response in schizophrenia.

The authors conducted a fixed-dose study of haloperidol blood levels and clinical response in schizophrenic in patients and found that those with steady-state RBC haloperidol levels in the range of 2.4--5.4 ng/ml showed greater improvement than those with lower or higher levels. They found a similar , although nonsignificant, curvilinear relationship between plasma haloperidol levels and clinical response. These findings suggest that the relationship between haloperidol blood levels and clinical response fits a therapeutic window for the treatment of schizophrenia.

Cholinesterase enzymes in the blood of patients with Alzheimer's disease.

Plasma pseudocholinesterase activity was about 100% higher in patients with Alzheimer's type dementia than in similar age controls. Red cell acetylcholinesterase activity tended to be lower in patients than controls. Administration of lecithin substantially increased plasma choline levels but did not alter activity of either of the cholinesterase enzymes.

Lecithin and memory training in suspected Alzheimer's disease.

Ten patients diagnosed clinically as having Alzheimer's disease (age range 54 to 73 years) were given 35 g/day of a 53% lecithin mixture for two weeks, in a double-blind crossover design. Patients received memory training during the lecithin condition and "placebo training" during the placebo drug condition. Repeated assessment with Buschke's Selective Reminding Procedure provided no evidence of a therapeutic lecithin effect either during the two week clinical trial or during longer follow-up trials. Noninvasive measurement of regional cerebral blood flow (nr CBF) by the 133Xe-inhalation method, and repeated EEG's also failed to demonstrate a therapeutic effect. These latter indices reflected a decline in cerebral function over the course of the study, a finding which paralleled clinical impressions in four of the patients. Follow-up trials of memory training under placebo and lecithin conditions provided some suggestion that memory training may lead to some immediate improvement in list-learning ability, but the improvement was not well maintained overtime.