Huntington disease (HD) is a neurodegenerative condition with prominent motor (including oculomotor), cognitive, and psychiatric effects. While neuropsychological deficits are present in HD, motor impairments may impact performance on... more
Huntington disease (HD) is a neurodegenerative condition with prominent motor (including oculomotor), cognitive, and psychiatric effects. While neuropsychological deficits are present in HD, motor impairments may impact performance on neuropsychological measures, especially those requiring a speeded response, as has been demonstrated in multiple sclerosis and schizophrenia. The current study is the first to explore associations between oculomotor functions and neuropsychological performance in HD. Participants with impaired oculomotor functioning performed worse than those with normal oculomotor functioning on cognitive tasks requiring oculomotor involvement, particularly on psychomotor speed tasks, controlling for covariates. Consideration of oculomotor dysfunction on neuropsychological performance is critical, particularly for populations with motor deficits.
Research Interests: Psychology, Cognitive Science, Neuropsychology, Experimental Psychology, Cognition, and 15 moreMedicine, Executive Function, Cognitive Sciences, Processing Speed, Humans, Female, Male, Middle Aged, Adult, Huntington disease, Rc, Neurosciences, Cognition disorders, Psychomotor Performance, and Psychomotor Learning
ABSTRACT The advent of predictive HD gene testing has raised many unique issues, including the confidentiality of genetic information and the potential for social stigmatization and discrimination. There are also philosophical challenges... more
ABSTRACT The advent of predictive HD gene testing has raised many unique issues, including the confidentiality of genetic information and the potential for social stigmatization and discrimination. There are also philosophical challenges regarding identity, responsibility, and what it means to live with genetic information that predicts future health status. Some choose not to have predictive testing due to these issues. We examined, as part of RESPOND-HD, the experiences of Australian individuals with a family history of HD and/or who tested for the HD gene in order to evaluate the related social, ethical, and legal issues. Fifty-four participants so far have completed the RESPOND-HD survey at our Site 144. Information was gathered concerning each participant's background, history, experiences and decision making about genetic testing, family history relating to HD, knowledge of advantages and disadvantages of genetic testing and opinions on testing, and experiences of adverse and unfair treatment. Knowledge about existing laws and policies surrounding genetic discrimination and its use was also gathered. The subscales included questions relating to behavioral, decision-making, and coping style, life experiences, and spiritual, physical, and emotional wellbeing. There was a wide age range of respondents (M = 46 years, SD = 12), with 35% male and 65% female participants. All had genetic testing (59% gene-positive, 41% gene-negative). Ninety-eight percent of participants stated that knowing test results was positive and 72% reported ‘great benefit’ in knowing test results. Many respondents experienced adverse events and felt that they had been treated unfairly. Thirty percent reported specific incidents of genetic discrimination, with complaints in the insurance arena the most common (18%). Problems with employment, superannuation, and blood donation were also reported. Additionally, there is inadequate knowledge about the existing related laws and policies. Overall, this study revealed significant risk of discrimination to the Australian HD community. Detailed results are being analyzed for presentation.
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The primary impairment in early Alzheimer's disease (AD) is encoding/consolidation, resulting from medial temporal lobe (MTL) pathology. AD patients perform poorly on cued-recall paired associate learning (PAL) tasks, which assess the... more
The primary impairment in early Alzheimer's disease (AD) is encoding/consolidation, resulting from medial temporal lobe (MTL) pathology. AD patients perform poorly on cued-recall paired associate learning (PAL) tasks, which assess the ability of the MTLs to encode relational memory. Since encoding and retrieval processes are confounded within performance indexes on cued-recall PAL, its specificity for AD is limited. Recognition paradigms tend to show good specificity for AD, and are well tolerated, but are typically less sensitive than recall tasks. Associate-recognition is a novel PAL task requiring a combination of recall and recognition processes. We administered a verbal associate-recognition test and cued-recall analogue to 22 early AD patients and 55 elderly controls to compare their ability to discriminate these groups. Both paradigms used eight arbitrarily related word pairs (e.g., pool-teeth) with varying degrees of imageability. Associate-recognition was equally effect...
Research Interests: Neuropsychology, Semantics, Imagination, Face recognition (Psychology), Learning, and 13 moreMemory, Humans, Cues, Female, Male, Aged, Reference Values, Alzheimer Disease, Neuropsychological Tests, associative, Psychology and Cognitive Sciences, paired associate learning, and Medical and Health Sciences
Research Interests: Magnetic Resonance Imaging, Survival Analysis, Medicine, Humans, Major Depressive Disorder, and 15 moreElderly People, Female, Male, Magnetic Resonance, Depressive Disorder, Recurrence, Aged, Middle Aged, Major Depression, Public health systems and services research, BMJ, Prognosis, American Psychiatric Association, Cognitive Decline, and Brain Diseases
In 1992 a postal questionnaire identified 107 psychiatrists in Australia who, for a significant proportion of their time, were providing psychiatric services to elderly people. Only 18% were female. There were 34 psychiatrists working... more
In 1992 a postal questionnaire identified 107 psychiatrists in Australia who, for a significant proportion of their time, were providing psychiatric services to elderly people. Only 18% were female. There were 34 psychiatrists working full-time in psychiatry of old age in the public health system. Twenty-three multidisciplinary catchment area psychiatric services for elderly people were identified, but staff to population ratios varied considerably. The ratio of psychiatrists to elderly was 1:30,000 — similar to the ratio in a large part of Britain seven years previously. Psychogeriatricians are involved in a broad range of teaching and research activities. The mean number of non-medical staff in a catchment area psychogeriatric service should be increased.
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World psychiatric association section of old age psychiatry consensus statement on ethics and capacity in older people
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Research Interests: Perception, Cognition, Attention, Cognitive, Humans, and 15 moreCues, Orientation, Female, Male, Posture, Middle Aged, Adult, Analysis of Variance, Cost Benefit Analysis, Huntington disease, Fingers, Functional Laterality, Psychomotor Performance, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Mental Representation, Humans, Movement, Female, Male, and 15 moreReaction Time, Motor Cortex, Motor Evoked Potentials, Middle Aged, Visual Cues, Supplementary Motor Area, Adult, Basal ganglia, Huntington disease, Neurosciences, Movement Disorder, Psychomotor Performance, Neuropsychological Tests, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests: Genetics, Cognition, Evolution, Cognitive, Humans, and 15 moreFemale, Male, Genetic determinism, Gene, Cognitive Performance, Middle Aged, Gen, Adult, Disease Progression, Huntington disease, COgnitive and Behavioral Neurology Neuropsychology, Carrier, Motor Skills, Case Control Studies, and Medical and Health Sciences
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Research Interests: Psychometrics, Schizophrenia, Comorbidity, Activities of Daily Living, Test Validation, and 14 moreHumans, Female, Male, Aptitude, Psychometric Properties, Social Adjustment, Aged, Middle Aged, Observer Variation, Adult, Test Reliability, Substance-Related Disorders, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Family Therapy, Psychotherapy, Depression, Comorbidity, Humans, and 15 moreChronic Disease, Cognitive Therapy, Depressive Disorder, Differential Diagnosis, Social Environment, Health Status, Clinical Sciences, Geriatric Psychiatry, Aged, Gerontological Nursing, Patient Care Team, Cross Sectional Studies, Alzheimer Disease, Cognition disorders, and Hypochondriasis
Research Interests: Cognitive Science, Personality, Attention, Motor Control, Speech Disorders, and 15 moreMovement disorders, Humans, Movement, Male, Phenotype, Clinical Sciences, Longitudinal Studies, Family Health, Adult, Disease Progression, Huntington disease, Environment, Cognition disorders, Case Control Studies, and Psychomotor Performance
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Research Interests: Services and Human Rights
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We studied aspects of clock cognition that might underlie the sensitivity of the CDT in screening for dementia of the Alzheimer type (DAT). Two groups, 15 patients with mild-moderate DAT and 15 controls, were assessed with the CDT and... more
We studied aspects of clock cognition that might underlie the sensitivity of the CDT in screening for dementia of the Alzheimer type (DAT). Two groups, 15 patients with mild-moderate DAT and 15 controls, were assessed with the CDT and specially designed tests of clock-related cognition. Patients were impaired on the CDT, but they did not differ from controls in copying a clock face or selecting the correct representation of a given time. Patients were worse than controls at distinguishing between clock and nonclock objects, detecting anomalies in clocks, and in setting time irrespective of response format. These findings suggest that semantic-conceptual aspects of clock-related cognition are important in discriminating between patients with DAT and controls.
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In the past Alzheimer disease (AD) has been presented to elderly people and their families as a very frightening condition, based on media representation of the worst possible case scenarios. The current status of pharmacological and... more
In the past Alzheimer disease (AD) has been presented to elderly people and their families as a very frightening condition, based on media representation of the worst possible case scenarios. The current status of pharmacological and psychosocial Intervention in Alzheimer disease is reviewed from the recent literature. In the last decade, the picture of AD has turned to one of hope and optimism as a result of advances in developing pharmacological and psychological management.
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The progress of pharmacological management of schizophrenia is briefly reviewed, highlighting some of the major limitations especially in regard to side-effects which have been identified. The importance of the quality of life issues in... more
The progress of pharmacological management of schizophrenia is briefly reviewed, highlighting some of the major limitations especially in regard to side-effects which have been identified. The importance of the quality of life issues in chronic patients undergoing pharmacological treatment is stressed. A possible new approach is the use of beta-adrenergic blocking drugs which may have symptomatic effects as well as quality of life effects.
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The relationship between platelet density and platelet age appears to vary between species with relatively few labeling studies in humans reported. In this study, irreversible monoamine oxidase (MAO) inhibitors were used to biochemically... more
The relationship between platelet density and platelet age appears to vary between species with relatively few labeling studies in humans reported. In this study, irreversible monoamine oxidase (MAO) inhibitors were used to biochemically label the circulating platelet population in 15 humans. Platelet samples were then isolated during the 15 days after drug ingestion. The platelets were separated by density on continuous linear Percoll gradients and the density distributions were divided into five fractions containing approximately equal numbers of platelets. Baseline MAO activity was strongly correlated with platelet density. Twenty-four hours after a single dose of tranylcypromine, platelet MAO activities in the density subpopulations were reduced to 14% to 17% of the baseline values. During the first five days after inhibition, the rates of recovery of MAO activity (percentage per day) were inversely proportional to platelet density. The recovery rates in the two most dense fract...
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This experiment sought to quantify the extent to which patients with Huntington disease (HD) have difficulties in orienting attention, via a vibrotactile version of a Posner-type cost-benefit paradigm. Participants were required to push a... more
This experiment sought to quantify the extent to which patients with Huntington disease (HD) have difficulties in orienting attention, via a vibrotactile version of a Posner-type cost-benefit paradigm. Participants were required to push a button in response to a vibration delivered to the index finger of either hand. Prior to each stimulus vibration, a precue (valid, neutral, or invalid) was delivered to the finger. Benefits and costs were calculated from valid and invalid precues. Although patients with HD were overall slower than the controls, their performance was no different; both patients and controls demonstrated increased benefits from valid compared with invalid and neutral cues. Of interest was the finding that patients, unlike controls, performed significantly slower with the cue presented to the left compared with the right side. The crossed arm configuration proved to be too difficult for the patients with HD, and thus an analysis on these data was not permitted. Patien...