Thomas Schenkenberg

Neuropsychological correlates of chronic alcoholism and aging.

Independent investigations of alcoholism and aging have demonstrated significant parallels between the two phenomena suggesting the possibility of “premature aging” as a result of alcoholism. To test this hypothesis a cross-sectional design was utilized with three groups of 20 male subjects: young normal (mean age 31 years), young alcoholics (mean age 33 years), and elderly normal (mean age 71 years). Eleven objective measures, selected from a battery of sensory and perceptual motor tests routinely used to evaluate cerebral dysfunction in hospitalized patients, were compared for the three groups. The results indicated a definite general decline in neuropsychological functioning with aging and suggested a similar trend with alcoholism. The tendency seen with alcoholism was least apparent with regard to fundamental sensory-motor functions and the perceptual functions of vision and audition and most apparent with regard to short term memory and abstract reasoning, i.e., higher mental processes. The results provided support for the hypothesis that chronic alcoholism causes premature aging of neuropsychological functions and possibly the brain.

Life Span Changes in the Electrical Activity of the Human Brain as Reflected in the Cerebral Evoked Response

Processes associated with life span cerebral changes, such as growth, development, aging and eventual degeneration have long been known to be reflected in the brain’s electrical activity. In fact, in reporting his discovery of brain waves in the early 1930’s, Berger described age differences in the electroencephalogram (EEG), noting dramatic changes in brain rhythms from infancy to adulthood (Berger, 1932). Early EEG investigators pursued this observation, notably Lindsley (1938), Smith (1938) and Bernhard and Skogland (1939), describing in detail age changes in brain wave frequency and amplitude. Alpha frequency was found to increase steadily with age along a roughly exponential curve reaching the asymptote at 12–15 years. Amplitude, on the other hand, rapidly increased between the ages of 3 months to 3 years, then significantly decreased at the 4th year, probably because of final closing of the fontanels (Lindsley, 1938). Thereafter, there was a gradual decrement in amplitude until stabilization occurred in late childhood. Also studied were the distribution and emergence of such rhythms as alpha, delta and theta at different ages (Henry, 1949, Walter, 1950, and Corbin and Bickford, 1955).

Does Dopamine Replacement Medication Affect Postural Sequence Learning in Parkinson’s Disease?

The aim of this study was to examine (1) the temporal structures of variation in rowers’ (natural) ergometer strokes to make inferences about the underlying motor organization, and (2) the relation between these temporal structures and skill level. Four high-skilled and five lower-skilled rowers completed 550 strokes on a rowing ergometer. Detrended Fluctuation Analysis was used to quantify the temporal structure of the intervals between force peaks. Results showed that the temporal structure differed from random, and revealed prominent patterns of pink noise for each rower. Furthermore, the high-skilled rowers demonstrated more pink noise than the lower-skilled rowers. The presence of pink noise suggeststhat rowing performance emerges from the coordination among interacting component processes across multiple time scales. The difference in noise pattern between high-skilled and lower-skilled athletes indicates that the complexity of athletes’ motor organization is a potential key characteristic of elite performance.Deficits in sequence-specific learning (SSL) may be a product of Parkinsons disease (PD) but this deficit could also be related to dopamine replacement. The purpose of this study was to determine whether dopamine replacement affected acquisition and retention of a standing Continuous Tracking Task in individuals with PD. SSL (difference between random/repeated Root Mean Square Error across trials) was calculated over 2 days of practice and 1 day of retention for 4 groups; 10 healthy young (HY), 10 healthy elders, 10 individuals with PD on, 9 individuals with PD off their usual dosage of dopamine replacement. Improvements in acquisition were observed for all groups; however, only the HY demonstrated retention. Therefore, age appeared to have the largest effect on SSL with no significant effect of medication. Additional research is needed to understand the influence of factors such as practice amount, task difficulty, and dopamine replacement status on SSL deficits during postural tasks.

Neurology Academic Advisory Committee A strategy for faculty retention and advancement

Major effort and expense are devoted to faculty recruitment. Subsequent direction, support, and guidance of faculty members for retention and academic advancement are often inconsistent and ineffective. Individual mentorship is widely endorsed as an important element in advancement but often does not occur or is uneven in its pragmatic benefit. We formed a Departmental Academic Advisory Committee to provide individualized advice and guidance about career development and institutional promotion, retention, and tenure procedures. To assess the effectiveness of this process, a survey was sent to faculty members. A 100% response rate was achieved. The results of the survey demonstrated high levels of acceptance by faculty members and described benefits experienced by faculty, including better understanding of promotion and tenure policies and specific actions taken to achieve professional goals. An academic advisory committee can be a valuable adjunct to individual mentorship and to meetings with department chairs to enhance faculty satisfaction and advancement of neurology faculty members.

A survey of stress among amyotrophic lateral sclerosis care providers

Abstract Amyotrophic lateral sclerosis (ALS) is a uniformly fatal disease. In the US, care is concentrated in specialized clinics. ALS health care providers likely experience stress, but levels and associated factors and methods to manage them are not known. A questionnaire was designed to assess levels of emotional stress among ALS clinic providers (neurologists and clinic managers) at time of diagnosis, during care of the patient, and at time of the patients death. Also included were questions about diagnostic practice patterns. Sixty-eight Muscular Dystrophy Association and ALS Association certified clinics were surveyed with a 47% response rate. Stress levels ranged from very severe to none at the various clinical stages but did not differ significantly between neurologists and managers. Stress tended to be lower in more experienced providers, although not uniformly so for all situations and time-points. Stress reduction techniques were rated as more effective for managers than for neurologists. Providers reported high levels of job satisfaction but a significant number gave consideration to leaving their positions due to stress and operational issues. In conclusion, stress is experienced by ALS clinic providers and managed by a variety of methods but with limited success.

Assessing the neurology clerkship: The value of student feedback

A Neurology Clerkship Core Curriculum was recently approved by the American Academy of Neurology, the American Neurological Association, and the Association of University Professors of Neurology.1 This curriculum has been considered a landmark effort because it represents a broad consensus of “virtually every leading neurologist teaching medical students” in the United States.2 The objective of this curriculum is to address the educational needs of future physicians, regardless of whether they pursue neurology as a specialty. The proposed curriculum is assumed to include a required, 4-week clerkship placed in the 3rd year of the medical school experience. Although the curriculum has been defined, “almost nothing about evaluation of achieving the goals of the clerkship” is available.2 We decided to elicit feedback from students to determine whether the goals of our clerkship were being achieved. We also reasoned that our predominantly 4th year clerkship would provide a more experienced perspective on the question of 3rd year vs 4th year placement of the clerkship. Our 4-week clerkship is offered at multiple sites. The numbers of students in each placement during the 4 years of this study (1999 to 2003) were University Hospital (111), Veterans Administration …

Age differences in MMPI scale scores from 1,189 psychiatric patients†

Investigated age-related differences in MMPI scale scores from 1,189 individuals (ages 20 to 64 years) who were applying for psychiatric treatment. All major scales except L, K, D, and SI showed statistically significant age group differences. In general, older patients had higher scores on HS and HY, while younger patients had higher scores on F, PD, PA, PT, SC, MA. These results underscore the importance of the age of the patient in the clinical interpretation of an individual protocol.