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.

Cortical atrophy and white matter density in the brains of schizophrenics and clinical response to neuroleptics.

The relationship between clinical response to neuroleptics and brain morphology as revealed by CT scans was evaluated in a sample of 39 patients with schizophrenia and schizoaffective psychosis. Four measures of brain morphology previously shown to differ between schizophrenics and patients with headaches - white matter density, asymmetry in brain white matter density, sulcal width and global cortical atrophy - did not correlate with clinical improvement after 3 weeks treatment with constant doses of neuroleptics. These brain morphology measures also did not correlate with baseline psychopathology scores. The same results were found with scales or subscales reflecting primarily positive symptoms of schizophrenia as well as those reflecting primarily social withdrawal.

Neuropsychological performance in dementia of the Alzheimer type and multi-infarct dementia.

Neuropsychological performance was examined in patients with dementia of the Alzheimer type (DAT) and in age- and education-matched patients with multi-infarct dementia (MID). Significant differences were observed for FSIQ, VIQ, and Picture Completion. This contrasts to no difference in verbal memory, visual-spatial skills, and sustained attention/concentration. This report illustrates that neuropsychological testing of elderly patients is unable to aid in the differential diagnosis between clinically similar forms of dementia, and should be employed to establish the level of cognitive function to make inferences regarding the patient's functional independence.

Sensitivity of age-decline resistant ("hold") WAIS subtests to Alzheimer's disease.

WAIS age-decline-resistant ("hold") and age-decline-sensitive ("don't hold") subtests were both effective in discriminating 25 patients with Alzheimer-type dementia (DAT) from 25 normal elderly subjects who were matched on age, education, and sex. We found that global ratings of severity of dementia correlated significantly with the WAIS Information and Digit Symbol subtests, but not with memory test scores. These data indicate that (1) the practice of estimating premorbid ability based on current "hold" test performance should be abandoned, and (2) the utility of memory tests is greatest for initial diagnosis of DAT, while WAIS cognitive variables may be more useful in evaluating DAT severity.

Neuropsychological patterns of presenile and senile dementia of the Alzheimer type.

Thirty-seven patients with a presumptive diagnosis of dementia of the Alzheimer type were divided into presenile and senile groups according to the age at which they first received a clinical diagnosis. Although there were no differences in mental status, dementia rating, or chronicity of disease, multivariate analyses of WAIS subtests revealed the presenile subjects to be relatively impaired on Performance subtests. Univariate tests of Verbal, Performance, and Full Scale IQ measures were significantly lower in the presenile group. There was no group effect detected for Digits forward, adjusted for age differences based upon performance of 40 age-matched controls, while the presenile group performed significantly more poorly on backward span. Further, significant differences were detected for an embedded figure task, as well as graphomotor speed. These data suggest that patients who develop a degenerative dementia during the presenile period are more impaired than their senile counterparts on age-adjusted measures of sustained concentration and mental tracking.

Period analysis of the EEG in early putative Alzheimer's disease.

The EEG of patients with presumptive diagnoses of mild-to-moderate dementia of the Alzheimer type (DAT) and still residing in the community was examined using period analytic techniques. DAT patients were found to have significantly slower major and intermediate period EEG activity as compared to controls. Furthermore, one DAT patient, whose clinical EEG was read as normal, had period analytic EEG descriptors that were greater than one standard deviation below the mean of the control group. Results suggest that EEG activity, as quantified by period analysis, can be detected very early in the course of DAT.

Abnormalities of brain structure and density in schizophrenia.

Quantitative and qualitative measures of brain morphology were derived through CT scans using computer-assisted methodology in patients with schizophrenia or schizo-affective psychosis and headache controls. Schizophrenics had significantly higher density of white matter, together with greater right vs. left asymmetry in density of white matter than controls. Schizophrenics tended to have larger widths of cortical sulci than headache patients. In our sample of schizophrenics, however, no significant differences were found on measures of lateral ventricle (LV) width, LV area, VBR, or other measures of ventricular size compared to headache controls. There were no differences between CT scan measures taken in patients with schizophrenia vs. schizo-affective psychosis.

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.

Changes in brain ventricular size with repeated CAT scans in suspected Alzheimer's disease.

The interpretation of brain ventricular size in CAT scans of patients with dementia is made difficult by the marked variability in ventricular size that occurs with normal aging. Five patients with probable Alzheimer's disease had serial CAT scans. Published normative data were interpolated to estimate the normal rate of change in ventricular size. Over a period of 15 to 35 months, four of the five patients had increases in ventricular size that were remarkably greater than the norms. The data suggest that the rate of change in ventricular size may be of considerable interest in longitudinal analyses and as a neurodiagnostic parameter.

Russell's revised Wechsler Memory Scale in the evaluation of dementia.

Matched 31 elderly normals and 25 patients with suspected Alzheimer's disease for age and education and administered the Revised Wechsler Memory Scale (WMS-R). The patient group performed significantly less well than the control group on all WMS-R subtests. A bimodal distribution of Percent Retained scores was noted in the patient group, but not in the control group. Results are discussed with respect to the clinical utility of the WMS-R as a memory screening procedure.

Asymmetries in the densities of white and gray matter in the brains of schizophrenic patients.

Although the densities of gray and white matter of 25 schizophrenic or schizoaffective patients did not differ from those of controls, the schizophrenic patients had higher densities of gray and white matter in the right hemisphere than in the left.

Directional effects of skin temperature self-regulation on regional cerebral blood flow in normal subjects and migraine patients.

Vascular headache of the migraine type is associated with vasomotor changes in cerebral arteries. The authors studied whether skin temperature training (biofeedback) reduces the frequency, severity, and duration of these headaches by measuring the regional cerebral blood flow in 11 migraine patients and 9 normal volunteers using the noninvasive 133Xe inhalation technique. Half of each group was randomly assigned to a hand-warming or a hand-cooling group. Cerebral blood flow increased in several regions of the left hemisphere to a statistically significant degree only for the migraineurs who were in the hand-warming group. The pattern of vasomotor regulation apparently differs between migraine subjects and normal subjects. The migraineurs' headache symptoms were affected by both warming and cooling, but warming produced more salutary effects.

Biological symptoms of depression.

Frequency of occurrence of various biological symptoms in relation to intensity of depression and neuroticism was studied in 37 depressed patients. The best indicator of depression severity and neuroticism were, respectively, early waking and excessive dreaming, when the symptoms were studied individually. A group of biological symptoms predicting the severity of depression was found via stepwise multiple regression analysis of variance. No such grouping was found for neuroticism. However, only neuroticism was found for neuroticism. However, only neuroticism was found to be a useful predictor of the biological symptoms when taken as a whole.