Behavioral neuropsychiatry最新文献

This was a study to determine whether centration, as a perceptual process, could be a criterion for differentiating between neurologically impaired and emotionally disturbed children. Centration was defined by Piaget as a prolonged involuntary attachment of a sensory modality to one part of a field, causing perceptual errors of exaggerations and distortions. It is hypothesized that centration would affect motor behavior, producing effects on drawing tasks characterized by separation of designs or their parts, coincident with distortions of the figures drawn. The neurologically impaired children were identified as having primary difficulties with perception whereas the emotionally disturbed children would have primary difficulties with intellection. The centration-distortion error would characterize the drawing of the neurologically impaired but not those of the emotionally disturbed children. A sample of 44 children was selected, each with EEG records, psychological tests and psychiatric interviews used as differential criteria for the groups. Eleven children were diagnosed as having minimal brain damage, 33 as emotionally disturbed. Three psychologists scored the Bender Gestalt tests, blind, for indicators of brain injury and emotional disturbance as defined by Koppitz' criteria, and for the centration-distortion error. The hypothesis was upheld at the .001 level of confidence, validating an earlier pilot study.

The authors, drawing from their very large experience, describe technics of administering anesthesia and muscle-relaxing agents for convulsive therapy. After a brief historical review, they mention in detail the materials used and the set up for this modified electroconvulsive treatment. They describe the signs of amnesia and those of muscular relaxation in order to administer a modified electroconvulsive treatment properly. A comparison of this modification with various other methods used in different centers is made. A section of the paper is devoted to the less common use of Indoklon. Contraindications for the various therapeutic methods are mentioned and a critical evaluation is provided. The authors draw conclusions from their clinical experience and give the results of their observations. The management of various side-effects and possible complications is discussed. The article should be considered as a guide in the use of modified convulsive therapy.

The reduction of high serum LH levels toward or to normal in diabetic women in the menopausal range recorded during the first year of treatment with a synthetic progestin, 17-alpha-ethynyl-19-nortestosterone acetate, 3-cyclopentylenol ether (quingestanol acetate), was maintained during the second and third years of daily ingestion of this steroid. Normal LH and normal or high FSH levels prior to therapy were not affected. Other endocrine indices, including serum PBI and T4, plasma 11(OH) corticosteroids, serum growth hormone titers, insulin responses to oral glucose, and urinary excretion of 17-ketosteroids, Porter-Silber chromogens, and 11-desoxycortisol metabolites, estrogens, and creatinine remained relatively unchanged during quingestanol therapy. At the 36th month of treatment, a small increase in fasting blood glucose levels with greater hypoglycemia after oral carbohydrate was noted, but this probably reflected the natural history of treated diabetes mellitus. The decrease in urinary steroid responses to partial blockade of adrenal 11-beta hydroxylase by metyrapone observed in the 12th month of quingestanol therapy was not evident at the end of 24 and 36 months of treatment. Quingestanol therapy was associated with maintenance of the increase in serum sodium from low-normal to mid-normal concentrations noted during the first year of treatment. Serum chloride increases were less frequent. Other serum electrolytes, solutes, proteins and other nitrogenous constituents, lipids, and enzymes and formed blood elements generally fluctuated within the pre-therapy ranges. Body weight, blood pressure, pulse rate, electrocardiograms, and perception of vibrations were about the same prior to and at the completion of the three-year course of therapy. The steroid was well tolerated.

The pharmacologic management of childhood hyperkinesis with psychostimulants has repeatedly proved its efficacy. In the case of hyperkinesis with an organic background (with eviden electrocencephalographic signs), the association with different anticonvulsants is usually beneficial although at times it gives rise to exceptionally undesirable side-effects, or to a paradoxically depressant action of the psychic activity. A clinical trial was carried out in 30 children aged from 5 10 years, with 2-dimethylaminoethanol in association with a magnesium salt of dipropylacetic acid (DAP).

This article is the result of an effort to help the neurologist deal with the hysterical patient on both a diagnostic and therapeutic level. The conclusion reached is that use of major tranquilizers may be needed to keep hysterical symptomatology under control while diagnostic investigation is proceeding and, if the diagnostic studies are negative, may be used to help ameliorate symptoms in patients unwilling to see a psychiatrist.

Mean plasma free-norepinephrine concentration rose significantly (p less than 0.001) during induction of anesthesia with intravenous ketamine (2.0 mg/kg) in 12 patients. In contrast, no change occurred during induction with thiamylal (5.0 mg/kg) in a control group of 8 patients. No significant rise in plasma free-epinephrine concentration occurred in either ketamine or thiamylal groups. These data support the suggestion that increased venous return mediated by the sympathetic nervous system may be responsible for the increased cardiac output and hypertension known to occur during ketamine anesthesia.

Electroencephalographic techniques were used to study unusual sensory capabilities. One S, the "sender," of a pair of Ss was stimulated with 10 sec duration trains of flicker at 6 or 16 fps, randomly interspersed with periods of no flicker. EEGs were recorded from another S, the "receiver," to determine if EEG driving or alpha block would be evident on trials when the sender was stimulated, compared to when the sender was not stimulated. Differential alpha block on control and stimulus trials was observed reliably in one receiver, indicating some information transfer. The S's overt indications of which stimulus occurred were not different from what would be expected by chance. The physical parameters by which the EEG effect was mediated were not determined.