bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Computed Cranial Tomography (CT) in Epilepsy
Authors: Guberman A.
Published: July 2016

To evaluate the usefulness of CT in detecting unexpected brain lesions in epileptics, scan results were analyzed in a consecutive series of 196 adult epileptics in whom there was no known etiology for their seizures nor any abnormality on neurological examination. Nineteen additional epileptics, selected on the basis of an unexpected positive CT were also included for analysis.

In the consecutive series, the overall incidence of abnormal scans was 16% with the highest yield (44%) found in patients with partial elementary seizures. Partial seizures secondarily generalized were correlated with a significantly higher CT positivity than purely partial seizures. Patients with seizures for less than six months more frequently showed CT abnormalities than patients with a longer history.

In 25 of 51 cases with abnormal scans a specific lesion amenable to therapy was detected, including 16 neoplasms and 5 arteriovenous malformations. Other lesions included generalized or focal atrophy, infarcts, calcified lesions of tuberous sclerosis, unexplained calcifications and focal low-density or enhancing lesions.
Anticoagulation in Cerebral Embolism
Authors: Bass Edward
Published: July 2016

A case of presumed anticoagulant induced hemorrhage into infarction is presented along with a retrospective study of 110 cases of cerebral embolus.

An accurate recommendation for the timing of anticoagulation following cerebral embolism hinges on balancing the risk of hemorrhage into infarction against the benefits of early treatment attributed to preventing recurrent embolism. It is felt that the present literature, concepts of pathogenesis and experimental data provide insufficient information to make absolute clinical decisions. The available evidence implies that the risk of further embolic events is three to four times that of hemorrhage into infarction, yet additional randomized prospective studies and better experimental models are needed to establish a valid treatment plan. It may be possible to distinguish separate mechanisms underlying early diffuse hemorrhage into infarction from sudden delayed massive hematoma formation.
Acute Spinal Cord Injury in the Rat: Comparison of Three Experimental Techniques
Authors: Khan Moe , Griebel Robert
Published: July 2016

Three techniques to produce experimental spinal cord injuries in the rat are compared; 1) the weight dropping method, 2) the aneurysm clip compression method and 3) the extradural balloon compression method. In principle, different forces were used in technique one, while a constant force for different durations is maintained in techniques two and three. The relationship between these different types of injuries and subsequent clinical recovery was assessed quantitatively by the inclined plane method of Rivlin and Tator. The weight dropping technique was found unreliable for experimental spinal cord injury in the rat while the aneurysm clip compression technique resulted in consistent cord injuries with respect to subsequent clinical recovery. The extradural balloon compression method invariably resulted in complete recovery after three and five minutes but no recovery after seven minutes of 0.1 cc air inflated balloon compression of the cord indicating a steep dose — response curve. However, using a 0.2 cc air inflated balloon, no recovery was noted after one minute compression. The major factor in the pathogenesis of spinal cord injury produced by the weight dropping technique is believed to be mechanical, while both mechanical and vascular factors seem to operate in the clip and balloon compression techniques.
Computed Tomography in the Evaluation of Plexopathies and Proximal Neuropathies
Authors: Stewart John D. , Schmidt Brian , Wee Roberto
Published: July 2016

We describe nine patients with plexopathies or proximal mononeuropathies due to mass lesions. In four, computed tomography (CT) was the only radiological technique to show the cause of the neuropathy. In five patients, CT either unequivocally confirmed the presence of an abnormality or was superior to other imaging techniques in showing its full anatomical extent. CT scanning is a valuable aid in the assessment of lesions of the peripheral nervous system, particularly plexopathies and mononeuropathies caused by retroperitoneal, pelvic or superior pulmonary sulcus tumors.
Background Vascular Headache: Relief with Indomethacin
Authors: Boghen Dan , Desaulniers Nicole
Published: July 2016

A patient with long standing sustained unilateral headache (“background vascular”) and occasional multiple jabs received prompt and lasting relief from indomethacin. The effectiveness of the drug was tested in a placebo controlled double-blind trial. Indomethacin may be of value in some types of sustained headache.
Reversal of Acute Experimental Cerebral Vasospasm by Calcium Antagonism with Verapamil
Authors: Leblanc Richard , Feindel William , Yamamoto Lucas , Milton John G. , Frojmovic Mony M.
Published: July 2016

Acute vasospasm of the transclivally exposed basilar artery of anesthetised cats was produced by the subarachnoid injection of platelet-rich plasma (PRP) treated with enough adenosine diphosphate (ADP) to induce platelet aggregation and secretion. Vasorelaxation was produced by the topical application of the calcium antagonist verapamil. Changes in the internal diameter of the basilar artery were determined by measuring the blood column diameter from photomicrographs taken sequentially, at 5 minute intervals, through the operating microscope. Changes in blood vessel diameter are expressed as a plus or minus percentage of the pretreatment diameter. Arterial blood pressure and blood gas values were kept in the physiological range for the cat.

The subarachnoid injection of PRP-ADP produced severe constriction of the basilar artery (mean constriction at 5 minutes after injection: -40.7% ± 2.8 SEM). Platelet-free plasma, ADP alone and Elliott’s A solution had no spasmogenic effect when injected into the subarachnoid space. The topical application of the calcium channel blocker verapamil (0.1 mg per kg) 30 minutes after the injection of PRP-ADP, with the basilar artery still in spasm (mean constriction: -23% ± 3.5 SEM), produced prompt and dramatic vasodilation (mean dilation at 5 minutes after application: + 52.7% ±18.1 SEM). This spasmolytic effect persisted in a decremental fashion for the 60 minute period of observation, by which time the previously constricted vessel had returned to its normal size. These observations indicate that the platelet fraction of whole blood may be involved in the genesis of acute vasospasm following subarachnoid hemmorhage and that this phenomenon can be readily reversed by calcium antagonism.
Friedreich’s Ataxia with Dysautonomia and Labile Hypertension
Authors: Margalith D. , Dunn H.G. , Carter J.E. , Wright J.M.
Published: July 2016

An Amerindian girl with Friedreich’s ataxia presented at the age of 14 years with intermittent bifrontal headaches and abdominal aching, often associated with nausea and recurrent vomiting and an evanescent pink, blotchy rash on the upper trunk. In these attacks she also had hypertension up to 210/160 mm Hg. Renal function studies, including intravenous pyelogram and angiography, were normal. Plasma renin activity (2.5 ng/ml/hr) was also normal. Total body CT scan was negative for phaeochromocytoma, and repeated estimations of 24-hour excretion of urinary VMA were normal or borderline high. Levels of total catecholamines in 24-hour urine were normal twice, but two random specimens during the paroxysmal episodes contained abnormally high levels of norepinephrine and dopamine. Plasma catecholamine concentrations were increased but not as high as with phaeochromocytoma. Blood pressure monitoring demonstrated marked fluctuations with position and temperature. A clonidine suppression test showed a substantial fall of plasma catecholamine levels, consistent with dysautonomia and not with phaeochromocytoma. It is concluded that the patient has dysautonomia of central origin, probably as a manifestation of Friedreich’s ataxia. These findings are discussed in relation to the recent demonstration of increased levels of plasma catecholamines in that disease.
Calcium Antagonists, Cerebral Ischemia and Vasospasm
Authors: Weir Bryce
Published: July 2016

The past fifteen years has seen the classification of diverse substances into a group known as calcium antagonists (CAs). They have a common ability to reduce the transmembrane transport of extracellular calcium ions (CAe2+). This flow of calcium into vascular smooth muscle is ultimately associated with the development of tension and vasoconstriction. Some CAs appear to have a predilection for cerebral as opposed to systemic arteries and so may function as specific cerebral arterial vasodilators. It has been proposed that they might be useful in certain types of cerebral ischemia such as that due to arterial occlusion or prolonged vasoconstriction. Animal experiments and initial clinical trials give grounds for cautious optimism that CAs may become as useful in neurology as they have recently become in cardiology.
Lateral Asymmetries and Thalamic Components in Far-Field Somatosensory Evoked Potentials
Authors: Taylor M.J. , Black S.E.
Published: July 2016

To investigate the neural generators of the subcortical somatosensory evoked potential (SEP) waves we studied the far-field SEPs in 20 normal adults. We stimulated the median nerve at the wrist and used a 40k gain, 25 msec sweep and a 150-3000 Hz bandpass. We recorded SEPs simultaneously over C3′ and C4′ using a non-cephalic clavicle reference. The following series of six positive waves were found reliably in all subjects: P9, PI 1, P13, P14, P16 and P17.

The P16 and P17 probably arise from the thalamus and/or thalamocortical projections. Recent evidence suggests that the thalamus is not a closed field and thus one should be able to find corresponding waveforms in far-field recordings. We believe that this is a function of the bandpass used and with the above paradigm these components can be reliably recorded.

We found significant ipsilateral and contralateral amplitude asymmetries beginning with the negative deflection after P14 and including P16 and P17. The amplitude was greater over the contralateral hemisphere. This suggested that both P13 and P14 are generated prior to decussation of the afferent fibres in the medial lemniscus. Bilateral recording allowed detection of this asymmetry which has not been previously reported as a means of determining the electrophysiological correlates of lateralization.
Ocular and Cerebral Ischemic Mechanisms in Disease of the Internal Carotid Artery
Authors: Ross R.T. , Morrow Ian M.
Published: July 2016

Stenosis of the internal carotid artery reduces the flow velocity in the ophthalmic artery. Lowered velocity permits increased red cell aggregation and decreased red cell deformability which increases viscosity.

Contrary to the theory of remotely originating emboli, this is an alternate hypothesis regarding transient attacks of ocular and cerebral ischemia.

The ophthalmic artery circulation time was measured in two groups of patients. The circulation time was defined as the interval between the appearance of contrast media in the siphon of the internal carotid artery and in the ocular choroid. The measurement was made on 151 angiograms of 108 subjects. These vessels were normal. An additional 76 patients had 108 angiograms which showed various amounts of internal carotid artery stenosis. These 76 patients had transient ischemic attacks; retinal, cerebral, or both.

There is a significant difference in the ophthalmic artery circulation time in the two groups. The slowing in the ophthalmic artery is related to the degree of internal carotid artery narrowing.

The circulation time in a cerebral branch of the internal carotid was not measured. It is presumed that stenosis of the internal carotid artery would have the same effect on a cerebral artery as on the ophthalmic artery.
Characteristics of EMG Responses to Imposed Limb Displacement in Patients with Vascular Hemiplegia
Authors: Verrier M.C. , Tatton W.G. , Blair R.D.G.
Published: July 2016

The segmented EMG activity in flexor carpi radialis to imposed wrist movements was studied in 18 hemiplegic subjects with vascular lesions of the sensorimotor cortex or internal capsule and compared to that in age-matched normal subjects. The segmented EMG activity in the stretched muscle was normalized against the maximum M response elicited by electrical stimulation of its peripheral nerve in hemiplegic and normal subjects. This M response was used to estimate the maximal activity of the motoneuron pool. Twelve of the hemiplegic patients showed a stereotyped abnormal segmentation pattern of the EMG activity characterized by: an increased M1 segment of prolonged duration with both an increased sensitivity to low initial velocities of displacement and an increased slope of the input-output relationship for the range of velocities tested; absent or diminished activity during the interval of the normal M2-3 segment; and a late component not evident in normal subjects. The increased magnitude of the EMG activity during the MI interval, markedly exceeded the normal range of control values. A method to demonstrate the response distribution of the interrelationship of the magnitude of the M1 segment using two variables (background EMG activity and initial velocity) for individual responses rather than average responses is presented. The results of the study indicate that: the increased excitability, reflected in the enhanced EMG over the M1 segment does not result from increased levels of resting alpha motoneuron activity and may result from disruption of polysynaptic internuncial influences on alpha motoneurons; the absent or diminished activity over the interval of the normal M2-3 segment may partially result from the interruption of a transcortical reflex by the vascular lesions.
Recurrent Aseptic Meningitis Secondary to Intracranial Epidermoids
Authors: Becker Werner J. , Watters Gordon V. , Chadarevian Jean-Pierre de , Vanasse Michel
Published: July 2016

Two patients with recurrent aseptic meningitis are reported. Intracranial epidermoid tumors were eventually found in both patients. CSF changes in our first case with an epidermoid tumor were similar to those reported in Mollaret’s meningitis, with an initial polymorphonuclear pleocytosis early in each attack, followed by a lymphocytic predominance several days later. Large cells which proved to be macrophages were also seen in the CSF of this patient. Both patients had meningitis attacks for several years before the underlying epidermoid tumor was found. Mollaret’s meningitis remains a diagnosis of exclusion. These patients should remain tumor suspects for many years and deserve careful and repeated investigation.
Relapsing Polychondritis with Multifocal Neurological Abnormalities
Authors: Willis J. , Atack E.A. , Kraag G.
Published: July 2016

A sixty-five year old woman developed relapsing polychondritis with three of the diagnostic criteria established by McAdam et al. (1976), namely bilateral auricular chondritis, ocular inflammation and both cochlear and vestibular dysfunction. Many authors have mentioned other neurological symptoms including unilateral facial weakness. This patient is the first case described with bilateral facial weakness and cerebral manifestations.

Relapsing polychondritis, an uncommon, recurrent, inflammatory disorder affecting the cartilaginous tissues of the body (Jaksch-Wartenhorst, 1923; Herman, 1981), is regularly associated with audiovestibular dysfunction (Bollet et al., 1969; Cody et al., 1971; McAdam et al., 1976; Ridgway et al., 1979). McAdam et al. (1976) and Ridgway et al. (1979) have mentioned other neurological symptoms including unilateral facial weakness. We recently observed a patient with polychondritis and multifocal neurological abnormalities. We believe this is the first case described with bilateral facial nerve palsy and with cerebral manifestations.
Partially Reversible Cerebral Atrophy and Functional Improvement in Recently Abstinent Alcoholics
Authors: Carlen P.L. , Wilkinson D.A. , Wortzman G. , Holgate R.
Published: July 2016

52 recently abstinent chronic alcoholics were given repeated psychological tests and 20 of these had repeated CT scans. The first scan was done within 5 weeks of the last drink. The degree of measurably reversible cerebral atrophy on CT scan correlated negatively with the interval between the last drink and the first CT scan. Significantly more reversibility of cerebral atrophy was noted in those subjects claiming interscan abstinence. There were positive correlations between functional improvement scores on neurological exam and reversible cerebral atrophy measurements. Significant improvement on psychological test performance was restricted to patients tested initially within 3 weeks of the last drink. Both the CT results and the psychological test results suggest that reversible changes occur soon after the cessation of drinking.
Free Valproic Acid: Steady-State Pharmacokinetics in Patients with Intractable Epilepsy
Authors: Otten N. , Hall K. , Irvine-Meek J. , Leroux M. , Budnik D. , Seshia S.
Published: July 2016

Free and total valproic acid (VPA) pharmacokinetic evaluation was carried out at steady state in six young epileptics who were also receiving other anticonvulsants. Subjects received their usual morning dose of VPA after an overnight fast. Blood samples for free and total VPA were taken prior to the dose and frequently thereafter for 12 hours. The calculated pharmacokinetic parameters for total VPA and free VPA were: half-lives of 7.5 ± 1.6 hours and 5.0 ± 1.5 hours, volumes of distribution of 0.189 ± 0.038 l/kg and 1.51 ± 0.98 l/kg, and clearances of 0.30 ± 0.06 and 3.6 ± 2.0 ml/min/kg., respectively. There was a strong correlation between percent free VPA and total VPA (r = 0.81) but marked inter- and intra-subject variations were seen. Studies attempting to correlate VPA levels to clinical response must take such data into account.
The Neurobiological Substrates of Depression in Parkinson’s Disease: A Hypothesis
Authors: Fibiger H.C.
Published: July 2016

Evidence from a variety of sources indicates that the mesolimbic-mesocortical dopamine projections may play an important role in some types of reward or reinforcement processes in animals. There is circumstantial evidence that this is also true in humans. Since a reduced ability to experience pleasure or reward (i.e. anhedonia) is a cardinal feature of clinical depression, and since the mesolimbic and mesocortical dopamine projections have been shown to degenerate in Parkinson’s disease, it is suggested that damage to these reward-related systems may contribute directly to the high incidence of depression that has been reported in this disease.
Function of the Basal Ganglia as Revealed by Cognitive and Motor Disorders in Parkinson’s Disease
Authors: Marsden C.D.
Published: July 2016

Early Parkinson’s disease is taken to be the best human model of disordered basal ganglia function. An experimental study in Parkinsonians with swings in motor response to drug treatment suggests that general cognition is not controlled by dopamine mediated striatal activity. The variety of motor disorders in Parkinson’s disease cannot be explained by simple concepts. Although Parkinsonians cannot execute fast ballistic movements, an experimental study shows that they can adopt a predictive motor control strategy. It is argued that simple motor programs are not grossly disturbed in Parkinson’s disease. It is concluded that Parkinsonians cannot automatically execute learned motor plans.
Parkinsonism Induced By 1-Methyl-4-Phenyl-1, 2, 3, 6-Tetrahydropyridine (MPTP): Implications for Treatment and the Pathogenesis of Parkinson’s Disease
Authors: William Langston J. , Ballard Phillip
Published: July 2016

Our experience in treating 7 patients with moderate to severe parkinsonism induced by l-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) is reviewed. Virtually all of the problems typically encountered with dopamine precursor and agonist therapy in treating Parkinson’s disease have been observed during a one and one half year follow-up period, including “end-of-dose” deterioration (or “wearing off’), “peak-dose” dyskinesias, “on-off” phenomena, and psychiatric complications. These have occurred much earlier than is typically seen when treating the idiopathic disease. This rapid evolution of therapeutic side-effects favors the view that at least some of the complications of dopamine precursor therapy may be related to severity of disease rather than the length of levodopa therapy. Finally, we suggest that the occurrence of this full array of therapeutic complications in patients with MPTP-induced parkinsonism furthers the analogy between this syndrome and Parkinson’s disease.
Treatment of Parkinson’s disease with agents other than Levodopa and Dopamine Agonists: controversies and new approaches
Authors: Lang Anthony E.
Published: July 2016

Parkinson’s disease is associated with a variety of neurotransmitter disturbances which may be further altered by its treatment with dopamine agonists. Based on this information a wide range of pharmacological approaches have been used in search of newer treatment alternatives and in hopes of reducing complications of long-term levodopa use. This paper reviews the various therapies which have had some success in the management of Parkinson’s disease, other than levodopa and dopamine agonists. Special emphasis is placed on the many unresolved questions and controversies that exist in this area of neuropharmacology.
Intraoperative Localization of Intracranial Lesions with Real Time Ultrasound
Authors: Boyd Michael C. , Steinbok Paul , Cooperberg Peter L.
Published: July 2016

High resolution ultrasound has been used intraoperatively on forty-five patients with various intracranial lesions. The technique is quickly and easily carried out under sterile conditions in the operating room. Successful localization of both primary and metastatic tumors of various sizes, depths and consistencies have been made prior to extirpation or biopsy. Several of the biopsies were done through small burr holes. Arteriovenous malformations, abscesses, bone fragments from trauma, gliotic epileptic foci and ventricles for shunt placement have been readily found. No significant complications have been encountered. A new technique for localizing superficial lesions is described. An overall reduction in operating time and unnecessary trauma to the patient has resulted from more accurate intraoperative localization of intracranial lesions with real time ultrasound.
IgDK Multiple Myeloma Presenting as Unilateral Proptosis
Authors: Chu Joseph Y. , Lewis Anthony J. , Cowan Donald H.
Published: July 2016

A 72-year-old woman presented with painful proptosis of the right eye and a large destructive tumour of the middle cranial fossa. A diagnosis of IgDK multiple myeloma was made, based on histopathologic and immunologic studies of the biopsy. Biochemistry and bone marrow examination further confirmed the myeloma as IgDK type. The clinical, radiological, and pathological findings are presented. The patient was treated with radiotherapy with satisfactory results.
Binswanger’s Disease: Progressive Subcortical Encephalopathy or Multi-Infarct Dementia?
Authors: Huang Kewei , Wu Lijuan , Luo Yi
Published: July 2016

Since Binswanger’s description of subcortical arteriosclerotic encephalopathy in 1894, numerous cases have been reported. Several authors doubt the validity of this malady, although the majority consider it to be a disease entity. We report seven cases with this type of pallor of myelin, only two of which are accompanied by a history of dementia. Among the seven cases, two had arteriosclerosis of penetrating arteries and arterioles in cerebral white matter. Electron microscopy showed splitting of myelin sheaths, probably the result of edema. In reviewing the blood supply of the cerebral white matter, we conclude that no pathological alterations of medullary branches of the cerebral arteries, the same vessels supplying the white matter, can give rise to such diffuse pallor of white matter and spare the arcuate fibres. This pallor can only be due to cerebral edema, most likely of hypoxic-ischemic, hypotensive, or acidotic origin. We also contend that arteriosclerosis can only cause dementia through multiple infarcts or lacunae, if it indeed leads to dementia.
Sensorimotor Perineuritis – An Autoimmune Disease?
Authors: Bourque Christopher N. , Anderson Brian A. , del Campo C. Martin , Sima Anders A. F.
Published: July 2016

The literature contains a single description of sensory perineuritis (Asbury et al 1972). These patients demonstrated a painful, distal, sensory neuropathy, and examination of peripheral nerve biopsies revealed focal thickening and inflammatory infiltrates of the perineurium. We report a patient with sensorimotor peripheral nerve dysfunction, accompanied by progressive slowing of nerve conduction velocity. Examination of a sural nerve biopsy demonstrated focal thickening of the perineurium, inflammatory infiltrates, and necrosis of perineurial cells. Immunohistology revealed a patchy precipitation of IgG and IgM on perineurial cells. Ultrastructurally, mononuclear cells were found adjacent to perineurial cells undergoing necrosis. The patient showed gradual improvement partially coinciding with a course of steroid therapy. We suggest that this neuropathy is caused by damage to the perineurial barrier possibly by an immune-mediated destruction of perineurial cells and subsequent compression of the endoneurial content by perineurial scarring.
Some Professional and Political Events in Canadian Neurosurgery
Authors: Morley T.P.
Published: July 2016

The Hannah Institute for the History of Medicine and Science, with the Royal College’s Section on the History of Medicine, asked me for a contribution to the Annual Meeting (1984) in Montreal dealing with the history of Canadian neurosurgery. I soon discovered that the material available to me, from my own files and from colleagues who sent me information, was too extensive for a paper of the required length. I have therefore excluded from this article the balanced review of the scientific and clinical contributions of Canadians in neurosurgery that I had hoped to prepare. What remains is a collection of events and developments that have involved or interested me during my career.
Treatment of Subacute Polyneuritis with Corticosteroids
Authors: Newman M. J. , Nelson N.
Published: July 2016

A study of the course of 17 patients with subacute polyneuritis was undertaken. Ten were given corticosteroids. Assessment of time of turnaround, that is the beginning of clinical improvement, showed that some patients responded promptly to steroids whereas a few did not. A comparison of turnaround times between the treated and untreated cases shows a statistically significant effect of steroids in hastening the onset of recovery. This is not due to bias in selection of those for steroid treatment.
Critères investigation et de traitement de l'atheromatose carotidienne
Authors: Duplantis Fernand , Rousseau Suzanne , Roy Louis E. , Boileau Jean , Lemieux Lionel H.
Published: July 2016

This retrospective study concerning 102 patients was undertaken to study the therapeutic decisions in these patients when they presented with symptoms of cerebral vascular insufficiency, mostly from the territory of the carotid artery, either transient or accompanied by a deficit. The current literature on the subject is also mentioned. The clinical outcome with regard to the quality of life, seems to have been better in patients who were subjected to carotid endar terectomies than in those who received medical treatment.
Measurement of Ataxia and Related Neurological Signs in the Laboratory Rat
Authors: Jolicoeur F.B. , Rondeau D.B. , Hamel E. , Butterworth R. F. , Barbeau A.
Published: July 2016

The purpose of the present study was to design a standard battery of tests capable of quantitatively characterizing ataxia and concomitant neurological signs in the rat. In addition to a systematic analysis of the walking gait of animals, tests for activity, catalepsy, rigidity, and various reflexive responses were included in the battery. The standardization and validation of the test system was performed by determining and comparing profiles of neurobehavioral effects produced by 3-acetyl pyridine, acrylamide, pyrithiamine, and thiamine deficiency, four experimental treatments reported to induce ataxia in animals. Results indicate that profiles of neurobehavioral disturbances accompanying ataxia in animals varied distinctively with each experimental treatment.
Brain Neurotransmitter Receptors in Friedreich's Ataxia
Authors: Reisine I. D. , Azari J. , Johnson P.C. , Barbeau A. , Huxtable R. , Yamamura H.I.
Published: July 2016

The binding of ‘H-quinu-clidinyl henzilate. a muscarinic cholinergic antagonist, ofxH-dihydroalprenolol, a beta adrenergic antagonist, and of﹜H-flunitrazepam, a ligand which labels benzodiazepine receptors, was examined in several regions of control and Fried-retch's ataxia (FA) brains.yH-Quinuclidi-nyl henzilate binding appeared to increase in the inferior olivory nucleus, anterior and posterior cerebellar vermi but was unaltered m the dentate nucleus and cerebellar hemisphere of FA brain. The binding of1H-dihydroalprenolol seemed to increase in the inferior olivary nucleus yet was not different from controls in the dentate nucleus, cerebellar hemisphere, anterior and posterior cerebellar vermi of FA brains. * H-Flunitrazepam binding was slightly lowered in the inferior olivary and dentate nuclei but was unchanged in the other FA brain regions examined. The present study suggests possible trends in neurotransmitter receptor alterations in post-mortem brain tissue of FA patients.
Evidence for an Altered Physical State of Membrane Proteins in Erythrocytes in Friedreich's Ataxia
Authors: Butterfield D. A. , Leung P. K. , Markesbery W. R. , Barbeau A.
Published: July 2016

Electron spin resonance, scanning electron microscopic, and SDS-polyacrylamide gel electrophoretic studies of erythrocytes in Friedreich's ataxia have been performed. No alteration in the physical state of membrane lipids, in morphology, or in the staining profile of erythrocytes in Friedreich's ataxia could be demonstrated. An altered conformation and I or organization of proteins in ery-throcyte membranes in this disorder was suggested by spin labeling studies

(P < 0.025), favoring the possibility of a generalized membrane abnormality in Friedreich's ataxia. These findings are discussed in relation to other inherited neurological diseases where similar studies have been performed.
Adaptive Sliding Mode Control for Depth Trajectory Tracking of Remotely Operated Vehicle with Thruster Nonlinearity
Authors: Chu Zhenzhong , Zhu Daqi , Yang Simon X. , Jan Gene Eu
Published: July 2016

This paper focuses on depth trajectory tracking control for a Remotely Operated Vehicle (ROV) with dead-zone nonlinearity and saturation nonlinearity of thruster; an adaptive sliding mode control method based on neural network is proposed. Through the analysis of dead-zone nonlinearity and saturation nonlinearity of thruster, the depth trajectory tracking control system model of a ROV which uses thruster control signals as system input has been established. According to the principle of sliding mode control, an adaptive sliding mode depth trajectory tracking controller is built by using three-layer feed-forward neural network for online identification of unknown items. The selection method and update laws of the control parameters are also given. The uniform ultimate boundedness of trajectory tracking error is analysed by Lyapunov theorem. Finally, the effectiveness of the proposed method is illustrated by simulations.
Strapdown Inertial Navigation Algorithms Based on Lie Group
Authors: Mao Jun , Lian Junxiang , Hu Xiaoping
Published: July 2016

This paper presents a framework for a strapdown Inertial Navigation System (INS) algorithm design by using Lie group and Lie algebra. The general way to solve Lie group differential equations is introduced. Investigations reveal that this general Lie group method provides a simpler unified way to solve differential equations involving direction cosine matrix, quaternion and dual quaternion, which are widely used in INS algorithm design. Furthermore, we also present a new INS algorithm based on the Special Euclidean group se(3) under the guidelines of Lie group method. Analyses show that se(3) algorithm has the same accuracy as a dual quaternion algorithm, this is also justified by numerical simulations. Though the se(3) algorithm has no improvements in accuracy, the general Lie group method used in the design process shows its brevity and uniformity.
p < .05 — But Is It Clinically Significant? Practical Examples for Clinicians
Authors: Matthey Stephen
Published: July 2016

Many researchers report the p value of an analysis to communicate whether findings are significant. This may be misinterpreted to imply that if p < .05 the finding is also of clinical significance. Researchers should also report the magnitude of the association, an easily calculated statistic, to allow a better understanding of results when p < .05. Methods for doing this for t, χ2, and F values are given. The clinical significance of an intervention is also commonly determined by whether p < .05. A better understanding, however, is gained by then calculating the effect size (d). This measure enables effects and strengths of association to be compared among studies. Methods for doing this, for the same statistics, are given.
Empirically Validated Interventions in Education: A Comment on King
Authors: Hudson Alan
Published: July 2016

A strong case can be made that, in all areas of intervention into the lives of others, the interventions used ought be empirically validated. In response to the paper by King (1997), this paper argues that there is a need to improve the empirical basis of interventions in education, particularly in the areas of curriculum design, classroom management, and academic remediation. Further, it is argued that an initial step in facilitating that improvement is by ensuring that trainee teachers receive an extensive exposure to the scientific literature on educational practices.
Return of the Suppressed: Mental Control and Bulimia Nervosa
Authors: Ward Tony , Bulik Cynthia M. , Johnston Lucy
Published: July 2016

The clinical literature has long acknowledged the paradoxical findings that deliberate attempts to suppress particular thoughts actually increase their occurrence. The unwanted, intrusive thoughts that are a major feature of obsessive disorders, depression, sleep disorders, and a range of other disturbances are of particular clinical concern. The exploration of psychological factors associated with cognitive control is, therefore, clinically relevant. The present paper considers the role of mental control and thought suppression in bulimia nervosa in explaining the occurrence of unwanted thoughts and feelings, specifically in relation to weight, shape, and food. Our fundamental argument is that suppression of thoughts of food, weight, and body shape can lead to the increased frequency of these thoughts. The increase in unwanted thoughts is likely to result in a loss of control over eating, and lead to the escalation and perpetuation of bulimia. Dietary restriction is likely to be associated with successful suppression, and binge-eating with failed suppression. Indeed, the initial success of suppression paradoxically causes its inevitable failure. We conclude that the suppression of thoughts of food and weight or shape in bulimia nervosa is maladaptive and counterproductive. In addition, the therapeutic implications of thought suppression are considered.
Persisting Auditory Hallucinations: Prospects for Non-medication Interventions in a Hospital Population
Authors: Farhall John , Voudouris Nicholas
Published: July 2016

The potential efficacy of recently developed cognitive and behavioural treatments (CBT) for residual hallucinations raises practical questions about the extent of applicability of such treatments and the possible need for programmatic responses by mental health services. This pilot study, conducted in a 355-bed acute and rehabilitation psychiatric hospital, explored the prevalence of persisting auditory hallucinations, patients' coping strategies, and indicators for cognitive and behavioural treatments. A census identified 123 patients with persisting hallucinations. Information about practical impediments to CBT was obtained from structured interviews with staff. Detailed interviews with a subsample of 35 hallucinators identified natural coping strategies and indicators for treatment. High rates of natural coping strategies were reported by this very disabled sample. Fifty-three per cent of hallucinators were considered “potential” candidates, and 20% “good” candidates for CBT for voices.
New Developments in Social Skills Training
Authors: Mueser Kim T. , Wallace Charles J. , Liberman Robert P.
Published: July 2016

Social skills training (SST) has emerged as one of the most widely practiced methods of psychiatric rehabilitation. The purposes of this article are to review the research about its effects, propose guidelines for its practice, and discuss several related methodological and clinical issues such as promoting generalisation, predicting the degree of benefit, and integrating training with other rehabilitation services. The research suggests that SST, when conducted using appropriate curricula and teaching techniques, helps individuals with schizophrenia acquire relevant interpersonal and instrumental skills. Generalisation of these skills can be promoted by simultaneously linking training to the opportunities, prompts, and consequences needed to perform the skills in the extra-training environments. Long-term SST appears to be necessary in order to produce significant improvements in community functioning. The article concludes with suggestions for future clinical research.
Behaviour Therapy and Schizophrenia in Context: Challenges and Opportunities Provided within the Changing Mental Health System
Authors: Halford W. Kim
Published: July 2016

Research reported in the last two issues of Behaviour Change, and elsewhere, shows that cognitive behaviour therapy significantly improves a number of the problems suffered by people with schizophrenia. However, behaviour therapy alone does not constitute adequate care of schizophrenia, and inadequate mental health services undermine the effective implementation of behaviour therapy, in Australia, mental health services for people with severe psychiatric disorders such as schizophrenia are grossly inadequate, but are planned to change substantially in the late 1990s. Changes include a significant shift in resources toward community-based care, expansion of the range of treatment and rehabilitation services available, and increased integration of service provision across government and nongovernment sectors. These planned changes present a challenge to those interested in behaviour therapy to go beyond narrowly focused interventions to develop effective systems of rehabilitation.
Early Psychosis Prevention and Intervention: Evolution of a Comprehensive Community-Based Specialised Service
Authors: Edwards Jane , Francey Shona M. , McGorry Patrick D. , Jackson Henry J.
Published: July 2016

This article describes the Early Psychosis Prevention and Intervention Centre (EPPIC) — an innovative and comprehensive service that attempts to address the needs of older adolescents and young adults experiencing their first episode of psychosis. Some of the key theoretical concepts and philosophical tenets which underpin the service delivery model are adumbrated. Furthermore, the historical antecedents of the current service, and the “successive approximations” approach taken in developing the same, are delineated. Given the evolutionary nature of the program, the perceived future needs and developments are stipulated.
The Scientist-Practitioner Model Revisited: Strategies for Implementation
Authors: Nelson-Gray Rosemery O.
Published: July 2016

The scientist-practitioner model remains valuable in improving the treatment of individual clients and in enhancing clinical science. One deterrent to its implementation, however, is the unsuitability of traditional research methods to clinical settings. Alternative research tools are presented, namely, practical ways to collect dependent measures, specification of treatment and measures of treatment integrity, and single-subject research designs.
Family Processes in Child and Adolescent Anxiety and Depression
Authors: Dadds Mark R. , Barrett Paula M.
Published: July 2016

Anxiety and depression tend to run in families. This paper reviews some of the family processes that are implicated in the development, maintenance, and treatment of these problems in children and adolescents. Empirical studies and our theoretical review show that social learning processes within the context of intimate relationships are important in the development of anxiety and depression. Family processes have been shown to be important in the treatment of anxiety disorders but parallel evidence is lacking with regard to depression in adolescents. Two models are shown to have demonstrated explanatory power and empirical support: social learning theory and attachment theory. Examples are given of how these models can be contrasted and integrated at both clinical and theoretical levels.
Prescribing Medication Versus Promoting Behavioural Change: A Trial of the Use of Lifestyle Management to Replace Drug Treatment of Hypertension in General Practice
Authors: Reid Christopher M. , Murphy Barbara , Murphy Michael , Maher Thomas , Ruth Denise , Jennings Garry
Published: July 2016

Antihypertensive drug therapy may reverse the cardiac and vascular structural changes associated with sustained hypertension. This may enable appropriate blood pressure levels to be maintained with milder forms of therapy (such as lifestyle interventions) which will minimise any potential adverse effects of pharmacological therapy. The HEART project was conducted in the general practice setting and aimed to determine whether lifestyle strategies, such as increased physical activity and dietary modification, could be substituted for drug therapy in patients who had been well controlled on antihypertensive medication. In addition to objective measures of blood pressure and risk factor outcomes, attitudes and perceptions of general practitioners (GPs) and patients involved in the trial were assessed through focus group discussion and personal interviews. Of the 44 patients recruited to the trial, 41 (93%) participated in structured interviews of 20–40 minutes duration conducted in person or by telephone. Of 78 GPs working in the western suburbs of Melbourne who were approached about the trial, 50% were willing to participate. Of these, 13 (34%) recruited study patients. Of these 13, 10 (77%) participated in a 2-hour focus group discussion which was audiotaped for later transcription and analysis. Despite being enthusiastic about lifestyle interventions in principle, nearly all of these GPs felt resistant to the concept of withdrawing medication in well-controlled subjects. They were generally surprised to see that many patients (15 of 20 patients: 75%) were able to maintain appropriate blood pressure levels following drug therapy withdrawal and adoption of minimal lifestyle changes. GPs felt that the patients' eagerness to come off medication was the major incentive for patients to participate in the trial. This was corroborated by many patients indicating a desire not to be taking any medication. The majority of patients reported making minor changes in lifestyle behaviours leading to most being able to remain off therapy or to have drug dosage requirements reduced. The major barriers to maintaining lifestyle change were family and work stresses and the perception of the intervention not being treated as a therapy thus not at the same level of importance as a treatment method as drug therapy. It appears that a select group of hypertensive patients, highly motivated by the prospect of drug therapy withdrawal, were interested in and willing to trial a lifestyle behaviour change approach for their blood pressure management. The majority reported that they had been able to adopt small but meaningful changes in exercise and dietary habits through the provision of stand-alone self-help materials and support from their GP. Of these patients, 75% remained normotensive without drug therapy after a 9-month follow-up period.
Cognitive Behaviour Therapy, Psychology, and the Universities
Authors: Franklin John A.
Published: July 2016

Growth in the popularity of cognitive-behaviour therapy (CBT) raises the issue of ensuring standards of training and practice. Because of the close association of psychology with CBT, this responsibility falls disproportionately upon psychology departments. This paper examines ways of establishing standards and argues that professional associations should lobby universities for adequate coverage of CBT in professional training programs. Means of staffing and delivering specialist courses in CBT as a means of upgrading and certifying professional standards are discussed.
Emotion Theory and Cognitive-Behaviour Therapy
Authors: Strongman K.T.
Published: July 2016

This paper falls into three distinct sections. In the first, the attempt is made to discuss those aspects of emotion theory, particularly with respect to the links between emotion and cognition, that have been considered by cognitive-behaviour therapists. In the second, the aim is to describe recent emotion theory which has, in part, been directed towards cognitive-behaviour therapists and others who are concerned with emotional dysfunction, but which has not yet been taken up. In the final section, the goal is more speculative, arrived at through a description of some of the less obvious excursions made by emotion theorists. Although they mostly do not have emotional dysfunction in mind when addressing their theories, their views are, in the belief of the present author, particularly pertinent to the future directions of cognitive-behaviour therapy.
The Power of Extrapolating Basic Laboratory Principles: The Behavioural-Cognitive Approach of Implosive Therapy
Authors: Levis Donald J.
Published: July 2016

The purpose of this article is to emphasise the importance of basic research in the advancement of theory and clinical technique. To illustrate the power of such a strategy the theory and imagery technique of Implosive (Flooding) Therapy will be briefly described along with a recent modification that has resulted in the development of a new technique which is capable of reactivating all past traumatic memories responsible for the development and maintenance of psychopathology. This new approach has resulted in a number of important discoveries that challenge many currently held beliefs.
Patients Presenting With Anxiety and Mood Disturbance: The Importance of Correct Diagnosis
Authors: Craig Ashley
Published: July 2016

Difficulties can arise in correctly diagnosing clients who present with mood and anxiety disturbances. Unless a detailed history is taken and a comprehensive interview performed, errors of diagnosis are likely to occur which may result in aversive consequences. To illustrate this likelihood, two cases of persons exhibiting anxiety and mood disturbance are briefly reported. The first case involved a prior diagnosis of psychogenic disorder (Mood Disorder). However, further investigation of the client's symptoms revealed that the anxiety and depression were secondary and caused by an underlying organic disorder. The second case involved a prior diagnosis of a physically based disorder presenting with anxiety and depression (Multiple Sclerosis). However, further investigation of the client's symptoms revealed that the somatic symptoms were secondary and the mood and anxiety disturbance were primary symptoms. A model is presented as a guide to better understand the diagnostic process, comments upon the need for a detailed history and interview are offered, and problems arising from incorrect diagnoses are discussed.