Endoscopic Versus Microscopic Transcanal Resection of Glomus Tympanicum: A Retrospective Comparative Study.

OBJECTIVE: Comparison of outcomes of microscopic and endoscopic resection of glomus tympanicum (GT) tumors. STUDY DESIGN: Retrospective case review. SETTING: Single tertiary referral center. PATIENTS: All adult patients undergoing transcanal GT resection without mastoidectomy from 2007 to 2021. INTERVENTIONS: Surgical resection-endoscopic versus microscopic approach. MAIN OUTCOME MEASURES: Primary outcomes were tumor recurrence at 1 year and presence of residual tumor at conclusion of surgery. Secondary outcome measures included operative time, postoperative air-bone gap, postoperative symptom resolution, and surgical complications. RESULTS: Thirty-eight patients underwent resection of GT (74% female; mean age, 59 years). Twenty-nine cases were performed microscopically, and nine cases were performed endoscopically. Both endoscopic and microscopic approaches yielded high rates of complete tumor resection (27/29 microscopic cases, 7/9 endoscopic cases). There was no significant difference in mean operative time (2.3 hours for microscopic; 2.6 hours for endoscopic). On average, air-bone gaps (ABGs) decreased by 6.3 dB after endoscopic resection compared with 1.0 dB after microscopic resection ( p = 0.064). No patients were found to have tumor recurrence during an average follow-up interval of 21 months. CONCLUSIONS: These results suggest comparable outcomes with both endoscopic and microscopic approaches for GT resection, and decisions regarding preferred approach should be dictated by surgeon preference.

Relative predictive value of sociodemographic factors for chronic diseases among All of Us participants: a descriptive analysis.

BACKGROUND: Although sociodemographic characteristics are associated with health disparities, the relative predictive value of different social and demographic factors remains largely unknown. This study aimed to describe the sociodemographic characteristics of All of Us participants and evaluate the predictive value of each factor for chronic diseases associated with high morbidity and mortality. METHODS: We performed a cross-sectional analysis using de-identified survey data from the All of Us Research Program, which has collected social, demographic, and health information from adults living in the United States since May 2018. Sociodemographic data included self-reported age, sex, gender, sexual orientation, race/ethnicity, income, education, health insurance, primary care provider (PCP) status, and health literacy scores. We analyzed the self-reported prevalence of hypertension, coronary artery disease, any cancer, skin cancer, lung disease, diabetes, obesity, and chronic kidney disease. Finally, we assessed the relative importance of each sociodemographic factor for predicting each chronic disease using the adequacy index for each predictor from logistic regression. RESULTS: Among the 372,050 participants in this analysis, the median age was 53 years, 59.8% reported female sex, and the most common racial/ethnic categories were White (54.0%), Black (19.9%), and Hispanic/Latino (16.7%). Participants who identified as Asian, Middle Eastern/North African, and White were the most likely to report annual incomes greater than $200,000, advanced degrees, and employer or union insurance, while participants who identified as Black, Hispanic, and Native Hawaiian/Pacific Islander were the most likely to report annual incomes less than $10,000, less than a high school education, and Medicaid insurance. We found that age was most predictive of hypertension, coronary artery disease, any cancer, skin cancer, diabetes, obesity, and chronic kidney disease. Insurance type was most predictive of lung disease. Notably, no two health conditions had the same order of importance for sociodemographic factors. CONCLUSIONS: Age was the best predictor for the assessed chronic diseases, but the relative predictive value of income, education, health insurance, PCP status, race/ethnicity, and sexual orientation was highly variable across health conditions. Identifying the sociodemographic groups with the largest disparities in a specific disease can guide future interventions to promote health equity.

Surgical Management and Outcomes of Pediatric Congenital Head and Neck Teratomas: A Scoping Review.

Objective: To perform a scoping review to characterize postoperative outcomes of pediatric patients (ages 0-18) with a history of congenital head and neck teratomas. Data Sources: PubMed, EMBASE, Web of Science, Cochrane, Clinicaltrails.gov. Review Methods: A search of multiple databases was performed. Studies were included if they detailed the surgical management and outcomes of pediatric patients with a history of congenital head and neck teratomas. Results: One hundred and eight studies totaling 137 patients were identified. The median gestational age at birth was 37 weeks. Respiratory distress, prompting emergent endotracheal intubation or tracheostomy, was present in most patients (58%). The ex utero intrapartum treatment (EXIT) procedure was utilized for 21 (15%) patients. The teratomas were resected after a median duration of 4 days from birth. The most common postsurgical complications were vocal cord paralysis (3%), hemorrhage (2%), and tracheomalacia (2%). Death occurred perioperatively in 2 patients (2%). Twenty-six patients (19%) required additional surgery, and 5 patients (4%) needed adjuvant chemotherapy. Patients were monitored for a median duration of 24 months with a recurrence rate of 6%. Four recurrent cases (50%) had intracranial extension, and 88% of the recurrent cases were mature teratomas at initial histopathological diagnosis. Conclusion: Most patients with congenital head and neck teratomas require emergent airway management perinatally. Excisional and surgical complications are rare, and most patients are cured of their disease with a single operation. Recurrent teratomas tend to have an intracranial extension and are likely to be of mature pathology at the time of initial diagnosis.

Cholinergic modulation of sensory perception and plasticity.

Sensory systems are highly plastic, but the mechanisms of sensory plasticity remain unclear. People with vision or hearing loss demonstrate significant neural network reorganization that promotes adaptive changes in other sensory modalities as well as in their ability to combine information across the different senses (i.e., multisensory integration. Furthermore, sensory network remodeling is necessary for sensory restoration after a period of sensory deprivation. Acetylcholine is a powerful regulator of sensory plasticity, and studies suggest that cholinergic medications may improve visual and auditory abilities by facilitating sensory network plasticity. There are currently no approved therapeutics for sensory loss that target neuroplasticity. This review explores the systems-level effects of cholinergic signaling on human visual and auditory perception, with a focus on functional performance, sensory disorders, and neural activity. Understanding the role of acetylcholine in sensory plasticity will be essential for developing targeted treatments for sensory restoration.

Leaching of select per-/poly-fluoroalkyl substances, pharmaceuticals, and hormones through soils amended with composted biosolids.

The use of organic amendments to enhance soil health is increasingly being identified as a strategy to improve residential landscapes while also reducing the need for external inputs (e.g., fertilizers, irrigation). Composted biosolids are a re-purposed waste product that can be used in organic amendments to improve the overall sustainability of a municipality by enhancing residential soil carbon content while simultaneously reducing waste materials. However, the biosolids-based feedstock of these compost products has the potential to be a source of organic contaminants. We conducted a laboratory-based soil column experiment to evaluate the potential for different commercially available compost products to act as a source of emerging organic contaminants in residential landscapes. We compared two biosolids-based compost products, a manure-based compost product, and a control (no compost) treatment by irrigating soil columns for 30 days and collecting daily leachate samples to quantify leaching rates of six hormones, eight pharmaceuticals, and seven per- and polyfluoroalkyl substances (PFAS). Detection of hormones and pharmaceuticals was rare, suggesting that compost amendments are likely not a major source of these contaminants to groundwater resources. In contrast, we detected three of the seven PFAS compounds in leachate samples throughout the study. Perfluorohexanoic acid (PFHxA) was more likely to leach from biosolids-based compost treatments than other treatments (p < 0.05) and perfluorobutane sulfonate (PFBS) was only detected in biosolids-based treatments (although PFBS concentrations did not significantly differ among treatments). In contrast, perfluorooctanoic acid (PFOA) was commonly detected across all treatments (including controls), suggesting potential PFOA experimental contamination. Overall, these results demonstrate that commercially available composted biosolids amendments are likely not a major source of hormone and pharmaceutical contamination. The detection of PFHxA at significantly higher concentrations in biosolids treatments suggests that biosolids-based composts may act as sources of PFHxA to the environment. However, concentrations of multiple PFAS compounds found in leachate in this study were lower than concentrations found in known PFAS hotspots. Therefore, there is potential for environmental contamination from PFAS leaching from composted biosolids, but leachate concentrations are low which should be considered in risk-benefit analyses when considering whether or not to use composted biosolids as an organic amendment to enhance residential soil health.

Glutamate Receptors Mediate Changes to Dendritic Mitochondria in Neurons Grown on Stiff Substrates.

The stiffness of brain tissue changes during development and disease. These changes can affect neuronal morphology, specifically dendritic arborization. We previously reported that N-methyl-D-aspartate (NMDA) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors regulate dendrite number and branching in a manner that is dependent on substrate stiffness. Since mitochondria affect the shape of dendrites, in this study, we determined whether the stiffness of substrates on which rat hippocampal neurons are grown affects mitochondrial characteristics and if glutamate receptors mediate the effects of substrate stiffness. Dendritic mitochondria are small, short, simple, and scarce in neurons cultured on substrates of 0.5 kPa stiffness. In contrast, dendritic mitochondria are large, long, complex, and low in number in neurons grown on substrates of 4 kPa stiffness. Dendritic mitochondria of neurons cultured on glass are high in number and small with complex shapes. Treatment of neurons grown on the stiffer gels or glass with the NMDA and AMPA receptor antagonists, 2-amino-5-phosphonopentanoic acid and 6-cyano-7-nitroquinoxaline-2,3-dione, respectively, results in mitochondrial characteristics of neurons grown on the softer substrate. These results suggest that glutamate receptors play important roles in regulating both mitochondrial morphology and dendritic arborization in response to substrate stiffness.

An optimized procedure for robust volitional cocaine intake in mice.

Substance use disorder (SUD) is a behavioral disorder characterized by volitional drug consumption. Mouse models of SUD allow for the use of molecular, genetic, and circuit-level tools, providing enormous potential for defining the underlying mechanisms of this disorder. However, the relevance of results depends on the validity of the mouse models used. Self-administration models have long been the preferred preclinical model for SUD as they allow for volitional drug consumption, thus providing strong face validity. While previous work has defined the parameters that influence intravenous cocaine self-administration in other species-such as rats and primates-many of these parameters have not been explicitly assessed in mice. In a series of experiments, we showed that commonly used mouse models of self-administration, where behavior is maintained on a fixed-ratio schedule of reinforcement, show similar levels of responding in the presence and absence of drug delivery-demonstrating that it is impossible to determine when drug consumption is and is not volitional. To address these issues, we have developed a novel mouse self-administration procedure where animals do not need to be pretrained on sucrose and behavior is maintained on a variable-ratio schedule of reinforcement. This procedure increases rates of reinforcement behavior, increases levels of drug intake, and results in clearer delineation between drug-reinforced and saline conditions. Together, these data highlight a major issue with fixed-ratio models in mice that complicates subsequent analysis and provide a simple approach to minimize these confounds with variable-ratio schedules of reinforcement. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Subcortical T1-Rho MRI Abnormalities in Juvenile-Onset Huntington's Disease.

Huntington's disease (HD) is a fatal neurodegenerative disease caused by the expansion of cytosine-adenine-guanine (CAG) repeats in the huntingtin gene. An increased CAG repeat length is associated with an earlier disease onset. About 5% of HD cases occur under the age of 21 years, which are classified as juvenile-onset Huntington's disease (JOHD). Our study aims to measure subcortical metabolic abnormalities in JOHD participants. T1-Rho (T1ρ) MRI was used to compare brain regions of 13 JOHD participants and 39 controls. Region-of-interest analyses were used to assess differences in quantitative T1ρ relaxation times. We found that the mean relaxation times in the caudate (p < 0.001), putamen (p < 0.001), globus pallidus (p < 0.001), and thalamus (p < 0.001) were increased in JOHD participants compared to controls. Furthermore, increased T1ρ relaxation times in these areas were significantly associated with lower volumes amongst participants in the JOHD group. These findings suggest metabolic abnormalities in brain regions previously shown to degenerate in JOHD. We also analyzed the relationships between mean regional T1ρ relaxation times and Universal Huntington's Disease Rating Scale (UHDRS) scores. UHDRS was used to evaluate participants' motor function, cognitive function, behavior, and functional capacity. Mean T1ρ relaxation times in the caudate (p = 0.003), putamen (p = 0.005), globus pallidus (p = 0.009), and thalamus (p = 0.015) were directly proportional to the UHDRS score. This suggests that the T1ρ relaxation time may also predict HD-related motor deficits. Our findings suggest that subcortical metabolic abnormalities drive the unique hypokinetic symptoms in JOHD.

d-Serine administration affects nitric oxide synthase 1 adaptor protein and DISC1 expression in sex-specific manner.

Antipsychotic medications are inefficient at treating symptoms of schizophrenia (SCZ), and N-methyl d-aspartate receptor (NMDAR) agonists are potential therapeutic alternatives. As such, these agonists may act on different pathways and proteins altered in the brains of patients with SCZ than do antipsychotic medications. Here, we investigate the effects of administration of the antipsychotic haloperidol and NMDAR agonist d-serine on function and expression of three proteins that play significant roles in SCZ: nitric oxide synthase 1 adaptor protein (NOS1AP), dopamine D2 (D2) receptor, and disrupted in schizophrenia 1 (DISC1). We administered haloperidol or d-serine to male and female Sprague Dawley rats via intraperitoneal injection for 12 days and subsequently examined cortical expression of NOS1AP, D2 receptor, and DISC1. We found sex-specific effects of haloperidol and d-serine treatment on the expression of these proteins. Haloperidol significantly reduced expression of D2 receptor in male, but not female, rats. Conversely, d-serine reduced expression of NOS1AP in male rats and did not affect D2 receptor expression. d-serine treatment also reduced expression of DISC1 in male rats and increased DISC1 expression in female rats. As NOS1AP is overexpressed in the cortex of patients with SCZ and negatively regulates NMDAR signaling, we subsequently examined whether treatment with antipsychotics or NMDAR agonists can reverse the detrimental effects of NOS1AP overexpression in vitro as previously reported by our group. NOS1AP overexpression promotes reduced dendrite branching in vitro, and as such, we treated cortical neurons overexpressing NOS1AP with different antipsychotics (haloperidol, clozapine, fluphenazine) or d-serine for 24 h and determined the effects of these drugs on NOS1AP expression and dendrite branching. While antipsychotics did not affect NOS1AP protein expression or dendrite branching in vitro, d-serine reduced NOS1AP expression and rescued NOS1AP-mediated reductions in dendrite branching. Taken together, our data suggest that d-serine influences the function and expression of NOS1AP, D2 receptor, and DISC1 in a sex-specific manner and reverses the effects of NOS1AP overexpression on dendrite morphology.

Lack of utility of postoperative chest radiograph in pediatric tracheotomy.

OBJECTIVE: To assess the incidence of pulmonary complications after nonemergent pediatric tracheotomy and to determine whether obtaining a routine postoperative chest radiograph is warranted. STUDY DESIGN: Retrospective review of the records of 107 consecutive patients (age 1 month to 18 years) who underwent tracheotomy from October 1994 to June 2000. Main outcome measures included frequency of pulmonary complications and use of information obtained from postoperative chest radiograph for intervention. SETTING: Tertiary care university children's hospital. RESULTS: No pneumothoraces or significant pulmonary complications were detected in the immediate postoperative period. No management changes were undertaken as a result of information obtained from any chest radiograph in this period. CONCLUSIONS: The incidence of significant pulmonary complications after pediatric tracheotomy is low. Little information is obtained from chest radiograph after tracheotomy, and this information does not change management. SIGNIFICANCE: Routine postoperative chest radiograph after pediatric tracheotomy is not indicated in all patients.

Results with abdominal vascular trauma in the modern era.

This is a report of a 10-year experience (1989-1998) with 300 consecutive patients found to have an injury to a named abdominal vessel at the time of an exploratory laparotomy for trauma. An abdominal gunshot wound was the mechanism of injury in 78 per cent of patients, and injury to more than one named abdominal vessel was present in 42 per cent. The abdominal aorta, inferior vena cava, and external iliac artery and vein were the most commonly injured vessels. When management for the five most commonly injured arteries was grouped, exsanguination before attempts at repair occurred in 11 to 15 per cent of patients and the mean survival in the remainder was 46 per cent. When management for the five most commonly injured veins was grouped, exsanguination before attempts at repair occurred in 5 per cent of patients and the mean survival in the remainder was 64 per cent. A number of administrative and medical changes in the management of patients with abdominal trauma occurred from 1992 through 1994. Despite significantly increased Injury Severity Scores for patients treated from 1993 through 1998 as compared with those treated from 1989 through 1992 survival rates for patients with injuries to the abdominal aorta and inferior vena cava were unchanged. Survival rates for injuries to the external iliac artery and vein increased significantly. The local changes in management should be considered for prospective studies in other urban trauma centers.

Apoptosis in the developing human cricoid cartilage: a pilot study.

Apoptosis is widely recognized as a major phenomenon in normal development. Deficiencies in this process may lead to developmental abnormalities such as congenital subglottic stenosis. We studied apoptosis using in situ end labeling of the 3'-OH ends of fragmented DNA in 5 progressively older, normal, human cricoid cartilage specimens. Results show that apoptosis is a very active process in fetal and neonatal tissue. The process gradually slows with advancing age. In the 4- and 13-year-old specimens, minimal to no apoptosis was seen. We conclude that apoptosis plays a critical role in the intraluminal and extraluminal expansion of the cricoid cartilage.

Rigid tracheobronchoscopy-induced bacteremia in the pediatric population.

OBJECTIVE: To assess the incidence of bacteremia following rigid tracheobronchoscopy in children to determine whether use of prophylactic antibiotics is warranted in pediatric patients at risk for perioperative endocarditis. DESIGN: Prospective nonrandomized clinical study. SETTING: Specialty care referral center. PATIENTS: Patients younger than 18 years undergoing diagnostic rigid tracheobronchoscopy for airway assessment. Twenty-five patients (14 boys and 11 girls) were enrolled. The mean age was 5.2 years (range, 10 months to 13 years). INTERVENTIONS: Blood samples for culture were obtained intraoperatively at 2 time intervals. The first culture was obtained after the induction of mask anesthesia prior to airway instrumentation; the second, within 5 minutes following the completion of tracheobronchoscopy. Blood cultures were performed under sterile technique and were placed into 20 mL of brain heart infusion broth. All cultures were incubated at 35 degrees C and observed for growth over a 14-day period. RESULTS: There were no documented cases of bacterial growth in blood cultures. All blood cultures, obtained before and after tracheobronchoscopy, were negative for bacterial growth after incubation for 14 days. Two culture bottles yielded contaminant organisms. CONCLUSIONS: Rigid tracheobronchoscopy in the pediatric population is a low-risk procedure for the development of bacteremia. This may bear on present guidelines regarding perioperative antibiotic prophylaxis for endocarditis in the high-risk population.

Treatment of aural foreign bodies in children.

OBJECTIVE: To determine the proper treatment of children and adolescents with foreign bodies of the external auditory canal (EAC). DESIGN: Retrospective case series. SETTING: Specialty care referral hospital. PATIENTS: All patients younger than 18 years of age who presented in the emergency ward or office setting with a foreign body of the EAC during a 5-year period. RESULTS: One hundred ninety-one patients with aural foreign bodies were identified. Age at presentation ranged from 10 months to 17 years with 141 patients (74%) younger than 8 years old. Twenty-seven different objects were encountered with pebbles, beads, insects, and plastic toys the most common. Fifty-seven (30%) of the patients required surgical removal of the aural foreign body under general anesthesia. CONCLUSION: Adequate immobilization and proper instrumentation allow the uncomplicated removal of many EAC foreign bodies in the pediatric population. The use of general anesthesia is preferred in very young children and in children of any age with aural foreign bodies whose contour, composition, or location predispose to traumatic removal in the ambulatory setting. Criteria for otolaryngologic referral and consideration of operative microscopic removal are outlined.

Management of casualties from the bombing at the centennial olympics.

BACKGROUND: The explosion of a bomb 75 to 100 yards away from attendees at a concert who were in the process of being evacuated from Centennial Olympic Park at approximately 1:25 AM on July 27, 1996, resulted in a multiple-casualty event involving primarily four hospitals in proximity to the blast. The purpose of this study was to review triage and care of the victims, emphasizing those with significant injuries. METHODS: Retrospective review of triage and care of injured patients. RESULTS: Ninety-six of the 111 victims of the blast were triaged in the first half hour to four hospitals within 3 miles of the bombing. Only four minor operations were performed in 61 patients evaluated at community hospitals. Ten of 35 patients evaluated at the regional trauma center underwent emergency or urgent operations, and all who were seriously injured did well. CONCLUSIONS: Although overtriage to the regional trauma center occurred, outcome was excellent in all seriously injured victims treated there.

Iliac vessel injury: operative physiology related to outcome.

BACKGROUND: Fifty-three patients treated at a level I trauma center with iliac vessel injury were studied to determine if body temperature and acid-base status in the operating room predicts outcome. METHODS: Records were reviewed for demographics, mechanism of injury, body temperature, acid-base status, operative management, and outcome. Statistical methods included Student's t test, odds ratio determination, and chi-square analysis to determine statistical significance. RESULTS: Fifty-three patients (47 male, 6 female) sustained 92 iliac vascular injuries (36 arterial, 56 venous). Mortality was 34%, with 72% of deaths due to shock within 24 hours. Physiologic parameters differed significantly between survivors and nonsurvivors. Odds ratio identified six conditions; the number present predicted outcome. CONCLUSIONS: (1) There are significant differences between initial and final operating room temperature and acid-base status in survivors versus nonsurvivors with iliac vessel injury. Conditions for odds ratio can be calculated and correlated with outcome. (2) A patient with two or more conditions should be considered for an abbreviated laparotomy to allow for reversal of "physiologic failure."

The role of surgeon-performed ultrasound in patients with possible cardiac wounds.

OBJECTIVE: The authors evaluate surgeon-performed ultrasound in determining the need for operation in patients with possible cardiac wounds. BACKGROUND DATA: Ultrasound quickly is becoming part of the surgeon's diagnostic armamentarium; however, its role for the patient with penetrating injury is less well-defined. Although accurate for the detection of hemopericardium, the lack of immediate availability of the cardiologist to perform the test may delay the diagnosis, adversely affecting patient outcome. To be an effective diagnostic test in trauma centers, ultrasound must be immediately available in the resuscitation area and performed and interpreted by surgeons. METHODS: Surgeons performed pericardial ultrasound examinations on patients with penetrating truncal wounds but no immediate indication for operation. The subcostal view detected hemopericardium, and patients with positive examinations underwent immediate operation by the same surgeon. Vital signs, base deficit, time from examination to operation, operative findings, treatment, and outcome were recorded. RESULTS: During 13 months, 247 patients had surgeon-performed ultrasound. There were 236 true-negative and 10 true-positive results, and no false-negative or false-positive results; however, the pericardial region could not be visualized in one patient. Sensitivity, specificity, and accuracy were 100%; mean examination time was 0.8 minute (246 patients). Of the ten true-positive examinations, three were hypotensive. The mean time (8 patients) from ultrasound to operation was 12.1 minutes; all survived. Operative findings (site of cardiac wounds) were: left ventricle (4), right ventricle (3), right atrium (2), right atrium/superior vena cava (1), and right atrium/inferior vena cava (1). CONCLUSIONS: Surgeon-performed ultrasound is a rapid and accurate technique for diagnosing hemopericardium. Delay times from admission to operating room are minimized when the surgeon performs the ultrasound examination.

The adaptation of Rhizobium leguminosarum bv. phaseoli to oxidative stress and its overlap with other environmental stress responses.

This paper reports the adaptation of Rhizobium leguminosarum bv. phaseoli to oxidative stress and the investigation of its overlap with other environmental stress responses. Treatment of R. leguminosarum bv. phaseoli cells with low concentrations of either menadione (MD, a superoxide generating agent) or 1-chloro-2,4-dinitrobenzene (CDNB, which depletes GSH levels) induced an adaptive response which resulted in cells becoming resistant to subsequent treatment with high concentrations of these oxidative stress compounds. There was overlap between the adaptive response to MD-generated superoxide stress and the response previously demonstrated in this organism to H2O2 (A. J. Crockford, G. A. Davis & H. D. Williams, 1995, Microbiology 141, 843-851); pretreatment with H2O2 was protective against cell killing by MD and vice versa. In contrast, similar experiments indicated only a limited overlap between the responses to H2O2 and CDNB-mediated GSH depletion. It was also found that H2O2, but not MD or CDNB, adaptation protected cells against subsequent osmotic challenge and heat shock. Carbon-starved cells were more resistant to H2O2 and MD killing than exponentially growing cultures, but were more sensitive to CDNB-mediated GSH depletion. Therefore, this work shows that there is a substantial, but incomplete overlap between the responses of R. leguminosarum to different forms of oxidative and other environmental stresses.

MMPI correlates of poststroke neurobehavioral deficits.

MMPI profiles of 130 male veterans with cerebrovascular accidents were examined in relation to type and degree of neuropsychological deficit, hemispheric location of lesion, and time poststroke. Three neurobehavioral factors (Verbal, Visuospatial, Sensorimotor) were extracted from the Halstead-Reitan Battery and Wechsler Memory Scale. Canonical analyses revealed verbal impairment to be associated with greater openness in reporting emotional difficulties (Scale F) and limited social facility (Scale Hy). Sensorimotor deficits were associated with anxiety and distress (Pt) in patients with left hemisphere (LHD) but not right hemisphere damage (RHD). Although RHD and LHD patients had similar composite MMPI profiles, neuropsychological deficits in RHD were unrelated to MMPI scores. Time poststroke was independent of MMPI findings in both LHD and RHD samples.

Emotional correlates of fluency test and maze performance.

This study tested the hypothesis that depression, anxiety, and bizarre thought content, as measured by MMPI-2 scales, would show a negative relationship with performance on widely used measures of executive functioning. Subjects were 70 male psychiatric patients who were ostensibly free of any neurologic disease or history of substance abuse. Correlational analyses were performed between age and education-corrected scores on the Controlled Oral Word Association Test (FAS), Design Fluency, and WISC-R Mazes, and scores on MMPI-2 scales D, PT, Anxiety, Fears, Obsessional Thinking, Depression, and Bizarre Mentation. The findings suggest that fluency and maze performance is (1) largely independent of measures of depression (D, DEP) and bizarre mentation (BIZ); (2) mildly associated with a measure of generalized anxiety (ANX); and (3) strongly related to an MMPI-2 measure of fearfulness (FRS).