Robert Reed

Deficient learning and memory in early and middle phases of multiple sclerosis.

Forty-three patients with multiple sclerosis showed disturbances in short-term memory, learning, and delayed recall which were associated with years of active disease (average was 4.5 years), age, presence of flareup, but not steroid/ACTH treatment. Unrecognised memory loss might be prevalent early in the natural history of multiple sclerosis and deserves neuropsychological assessment.

Neuropsychology of Alcohol and Drug Abuse

Human interest in substances that have the capacity to alter his intrapsychic state must be as ancient as humanity itself. Certainly, the desirable effects and many of the toxic properties of ethanol, cannabis, opium, and some of the naturally occurring central stimulants have been known from antiquity. In the late 19th century, progress in organic chemistry led to the ready availability of purified, naturally occurring psychoactive substances and their synthetic analogues. Although the chemistry and pharmacology of at least some representatives of most of the drug classes with which we shall be concerned in this chapter were already appreciated in the first half of the 20th century, it was not until the coming of the psychosocial revolution of the 1960s that any but a few scientists and small groups of addicts were aware of most of them (with the exception of alcohol). The sixties brought with them an interest in altering the psychological internal milieu. This philosophical disposition toward inner exploration was powerfully reinforced by an increasing popular understanding of some of the neurochemical bases of brain function, and by clinical psychiatry’s demonstration that powerful drugs could be used to alter mood, thinking, and behavior.

Is Phencyclidine (PCP) Abuse Associated with Organic Mental Impairment

The performance of sober (average length of abstinence = 27 months) phencyclidine (PCP) abusers on neuropsychological measures of organicity was compared to that of polydrug users who were not experienced with PCP, and to controls who were not alcohol or drug abusers. Six of 12 PCP users, five of 12 polydrug users, and none of the controls showed neuropsychological impairments. The deficits in PCP users occurred despite negative medical-neurological history, and even though the PCP group abused other drugs previously associated with neuropsychological impairment less than the polydrug group. Deficiencies in abstracting and in perceptual-motor integrative abilities were noted. The results suggest the possibility that PCP abuse might be associated with neuropsychological disturbance which persists for considerable time after PCP use ceases.

Single photon emission computed tomography with iodoamphetamine-123 and neuropsychological studies in long-term abstinent alcoholics

Ten long-term abstinent alcoholics (mean abstinence = 7.7 years) were compared with 13 recently detoxified substance-dependent inpatients (mean abstinence = 25 days) and 8 nonalcoholic control subjects on global end regional measures of cortical cerebral blood flow (CBF), and on neuropsychological measures. CBF was assessed using 123iodoamphetamine (IMP) single photon emission computed tomography (SPECT) under conditions of behavioral challenge (Ravens Progressive Matrices). CBF and neuropsychological test performance were worse in the recently detoxified inpatients. Of greater interest, there was a dissociation in the long-term abstinent group, which, while neuropsychologically indistinguishable from controls, showed significantly decreased mean cortical IMP uptake. We conclude that there may be persistent physiologic abnormalities in long-term abstinent alcoholics who have achieved full behavioral recovery. Smoking on the day of SPECT scanning was also identified to be a significant confound to understanding CBF changes in alcoholism.

Natural history of alcohol and drug-related brain disorder: Implications for neuropsychological research

Abstract Clinical investigations are conducted within limits imposed by the natural history of the phenomena under study. A model for the natural history of alcohol and drug-related brain disorder is presented along with the theoretical arguments and research data which support such a model. The model is then discussed in terms of how it might affect the design and implementation of future studies of the neuropsychological consequences of substance abuse.

Neuropsychological function in young alcoholics and polydrug abusers

Abstract The neuropsychological abilities of younger (mean age, 30) alcoholics and polydrug abusers were compared. On the basis of a clinicians rating of Halstead-Reitan results, 10 of 20 polydrug users (50%) and 4 of 20 alcoholics (20%) were found to show impairment. The polydrug users also scored significantly worse on Halsteads Impairment Index, Category Test, and Trail-Making Test, part B. Because the two groups were closely matched in age, education, Verbal IQ, and the medical history, the possibility is raised that, whereas 10 years of heavy drinking is not sufficient to yield neuropsychological impairment in younger persons, heavy multiple drug abuse might have more serious implications for cerebral functioning.

REVIEW OF THE OPERATIVE TECHNIQUE ADOPTED IN DETERMINING THE LOCATION OF INTESTINAL OBSTRUCTION, WITH THE SUGGESTION OF A SIMPLE AND SAFE METHOD.

In the surgery of intestinal obstruction, the steps of chief importance in the operative technique are the removal of the cause of the obstruction when located, and the repair, if necessary, of the wounded bowel. Final success, however, depends upon the general condition in which the patient is left at the end of the operation, as much as upon the condition of the liberated intestine. All the preliminary steps, therefore, should be so ordered as to avoid unnecessary sacrifice of time or the infliction of injury by mischievous bowel manipulation. In addition to the remote danger of intestinal paresis and peritonitis, there is another more imminent. Shock is the prominent element of danger in the operative interference for relief of this condition. It is already present, usually in a marked degree, as a result of the injury the intestine has sustained, as well as from the depressing effects of the