Anne G. Scott

Strength of theory and theory of strength

Abstract Strength of treatment or intervention has been neglected as an important determinant of the outcomes of evaluations. We need to develop ways of quantifying interventions so that strength may be related to outcome and so that results of different interventions may be more usefully compared. Better, more systematic theory is required in order to derive measures of strength. Only if theory is incorporated at the very beginning into planning of interventions and their evaluation can we expect to benefit from the many advantages that good estimates of the strength of interventions would bring.

Electroencephalographic cordance patterns distinguish exceptional clinical responders with fibromyalgia to individualized homeopathic medicines.

OBJECTIVES To characterize initial central nervous system responses to olfactory administration of homeopathic remedies as biomarkers for subsequently exceptional, simillimum-like clinical outcomes at a systemic level (i.e., both locally and globally). DESIGN Double-blinded, randomized, placebo-controlled clinical trial. SETTING A private homeopathic clinic in Phoenix, AZ, and a university laboratory in Tucson, AZ. PATIENTS Sixty-two (62) persons with physician-confirmed fibromyalgia (FM) (mean age, 49 years; 94% women) enrolled; 53 completed the 3-month assessment visit. Exceptional responders (n = 6, 23% of active treatment group; none on placebo) were those with improvements in the top one-third for both tender point pain and global health ratings after 3 months. INTERVENTION Patients took daily oral doses of treatment solution in LM (1/50,000 dilution) potency (active group received individualized remedy; placebo group received plain solvent). Dependent measures: Baseline and 3-month difference scores for initial prefrontal electroencephalographic alpha frequency cordance (EEG-C, a correlate of functional brain activity) during 16 pairs of randomized, double-blinded bottle sniffs (treatment minus control solutions). RESULTS Exceptional responders versus other patients exhibited significantly more negative initial EEG-C difference scores at prefrontal sites. Right prefrontal cordance findings correlated with subsequently reduced pain (r = 0.85, p = 0.03), better global health (r =-0.73, p = 0.10), and trait absorption (genetically determined ability to focus attention selectively and fully) (r = 0.91, p = 0.012). CONCLUSIONS These observations suggest prefrontal EEG-C as an early biomarker of individualized homeopathic medicine effects in patients with FM who later exhibit exceptional outcomes. Prefrontal cortex controls executive function, including ability to redirect attention. Interactions between executive function, absorption, and the simillimum remedy could facilitate exceptional responses.

EEG ALPHA SENSITIZATION IN INDIVIDUALIZED HOMEOPATHIC TREATMENT OF FIBROMYALGIA

Fibromyalgia (FM) patients show evidence of sensitizability in pain pathways and electroencephalographic (EEG) alterations. One proposed mechanism for the claimed effects of homeopathy, a form of complementary medicine used for FM, is time-dependent sensitization (TDS, progressive amplification) of host responses. This study examined possible sensitization-related changes in EEG relative alpha magnitude during a clinical trial of homeopathy in FM. A 4-month randomized, placebo-controlled double-blind trial of daily orally administered individualized homeopathy in physician-confirmed FM, with an additional 2-month optional crossover phase, included three laboratory sessions, at baseline, 3 and 6 months (N = 48, age 49.2 ± 9.8 years, 94% women). Nineteen leads of EEG relative alpha magnitude at rest and during olfactory administration of treatment and control solutions were evaluated in each session. After 3 months, the active treatment group significantly increased, while the placebo group decreased, in global alpha-1 and alpha-2 during bottle sniffs over sessions. At 6 months, the subset of active patients who stayed on active continued to increase, while the active-switch subgroup reversed direction in alpha magnitude. Groups did not differ in resting alpha. Consistent with the TDS hypothesis, sniff alpha-1 and alpha-2 increases at 6 months versus baseline correlated with total amount of time on active remedy over all subjects (r = 0.45, p = .003), not with dose changes or clinical outcomes in the active group. The findings suggest initiation of TDS in relative EEG alpha magnitude by daily oral administration of active homeopathic medicines versus placebo, with laboratory elicitation by temporolimbic olfactory stimulation or sniffing.

Effects of [D-Ala2] Met-enkephalinamide, a Met-enkephalin analog, on delayed response by squirrel monkeys

Squirrel monkeys were tested on an indirect spatial delayed response task after subcutaneous injections of either physiological saline, 100, or 500 microgram/kg [D-Ala2] methionine enkephalinamide (DAME). During Experiment 1 monkeys completed two-choice delayed response problems with 0-, 6-, 12- and 18- sec delays; DAME significantly enhanced performance at 18-sec delays but not for the shorter delay. During Experiment 2, monkeys performed a nine-choice spatial delayed response task with 0-, 4- and 8-sec delays. In Experiment 2, low but not high doses of DAME impaired performance. Memory functions represented by a bias-free performance measure paralleled percentage correct in both experiments. Therefore, DAME effect, in enhancing and in impairing performance, were not attributable to changes in the relative number of systematic spatial errors (positional win-shift; lose-stay, position perseveration, and position preference).

Building And Using A Data Base To Identify Parameters To Further Improve Diagnostic Performance On The Toshiba Computed Radiography System Model 201

The digital imaging group at the University of Arizona Health Sciences Center Radiology Department is vigorously pursuing the development of a total digital radiology department (TDRD). One avenue of research being conducted is to define the needed resolutions and capabilities of TDRD systems. Parts of that effort are described in these proceedings and elsewhere. One of these investigations is to assess the general application of computed r adiography (CR) in clinical imaging. Specifically we are comparing images produced by the Toshiba computed radiography system (Model 201) to those produced by conventional imaging techniques. This paper describes one aspect of that work.