Stuttering acquired from subcortical pathologies and its alleviation from thalamic perturbation

Acquired stuttering subsequent to subcortical pathology of mesothalamus was observed in four neurosurgical subjects. The patients suffered from chronic pain, seizures, and somatosensory disorders. They also exhibited unpredictable and uncontrollable speech, spasmodic blocks which were devoid of accessory features, and adaptation effect. Therapeutic mesothalamic stimulation, used as a treatment of last resort to relieve the pain and associated symptoms, also had an ameliorating effect on the stuttering. Spontaneously occurring focal abnormal EEG discharges were anatomically delineated and used as a guide for therapeutic stimulation electrode placement. Attentuation of the abnormal discharges was followed by alleviation of symptoms. This investigation examines the clinical characteristics of stuttering in four neurosurgical patients and suggests an electropathologic basis for their mesothalamic-generated speech dysfluencies. The cooccurrence of pain, seizures, somatosensory disorders, and stuttering, and their concurrent amelioration, suggests that both chronic pain and stuttering may be implicated by similar or related reticular electropathologic generators, couched in overlapping reticular networks extending from the brain stem to the thalamus, and that the acquired stuttering may be recruited as one component of a larger syndrome complex.     

Clamped Corticosterone (B) Reveals the Effect of Endogenous B on Both Facilitated Responsivity to Acute Restraint and Metabolic Responses to Chronic Stress

To determine the effects of both corticosterone (B) and chronic stressors on acute ACTH responses to restraint, young male rats were exposed to streptozotocin-induced diabetes, cold (5-7 degreesC) or intracerebroventricular (icv) neuropeptide Y (NPY) for 5 d and then exposed to restraint within 2 h after lights on. Two groups of rats were studied: intact and adrenalectomized replaced with B pellets that maintained plasma B in the normal mean 24-h range of intact rats. In addition to ACTH and B responses to restraint on d 5, body weight, food intake, fat depots, glucose and other hormones were measured to determine the role of stress-induced elevations in B on energy balance. ACTH responses to restraint were normal in intact rats subjected to diabetes or cold. By contrast, there was no ACTH or B response to restraint in NPY-infused intact rats. All 3 groups of chronically stimulated adrenalectomized rats with clamped B had facilitated ACTH responses to restraint compared to their treatment controls. Overall food intake increased in all groups of stressed rats; however, augmented intake occurred only during the light in intact rats and equally in the light and dark in B-clamped rats. White adipose depot weights were decreased by both diabetes and cold and increased by NPY in intact rats; the decreases with cold and increases with NPY were both blunted and changes in fat stores were not significant in adrenalectomized, B-clamped rats. We conclude that: 1. diabetes- and cold-induced facilitation of restraint-induced afferent input to hypothalamic control of the hypothalamo-pituitary-adrenal (HPA) axis is opposed in intact rats by the elevated feedback signal of B secretion; 2. NPY does not induce facilitation of afferent stress pathways; 3. chronic stimulation of the HPA axis induces acute hyperresponsiveness of hypothalamic neurons to restraint provided that the afferent input of this acute stimulus is not prevented by B feedback; 4. stimulus-induced elevations in B secretion result in day-time feeding; 5. insensitivity of both caloric efficiency and white fat stores to chronic stress in adrenalectomized, B-clamped rats results from loss of normally variable B levels.     

Professional women in organizations: New paradigms for research and action

Writings about professional women in organizations often adopt an advocacy approach and look at problems of women in isolation from the rest of the organization. This article suggests a systems perspective for viewing these problems as concerns of an organizational subsystem that can have important ramifications for the other subsystems and for the organization as a whole. Reviewing research on some major issues encountered by professional women at the workplace, this article demonstrates the usefulness of complementary research to integrate these issues into an organizational framework.     

Interactions among chronic cold, corticosterone and puberty on energy intake and deposition

We have shown that chronic cold stress strongly interacts with corticosterone (B) to determine subsequent regulation of the hypothalamo-pituitary-adrenal (HPA) axis responses to novel stress. These studies, using the same 2 sets of rats, show that chronic cold also interacts with B and testosterone on signals of energy balance. The two groups of rats differed in weight by 20% and in age by 2 weeks (44-59 days of age). Adrenalectomized rats, replaced with varying doses of B, were exposed to cold or served as controls. Food intake and body weight during the experiments and hormones, metabolites and fat depots were measured on day 5. B, but not cold, affected food intake in the younger rats; by contrast, cold, but not B, affected food intake in the older rats. Testosterone was higher in older control rats and was markedly depressed by cold; younger rats had lower testosterone that was minimally affected by cold. Weight gain decreased in all rats at room temperature with increasing B, whereas they all lost weight in cold independently of B. Cold stimulated and B inhibited interscapular brown adipose tissue DNA content (reflecting sympathetic stimulation of thermogenesis). B stimulated insulin, whereas cold inhibited leptin and insulin; B also increased white adipose tissue weight gain in controls and inhibited its loss in cold. Leptin was unrelated to white adipose tissue depots in older control rats but was strongly related to these stores in younger rats and in all rats in cold. We conclude that: 1. By decreasing signals that act centrally to inhibit food intake (insulin, leptin and testosterone) cold allows B to stimulate food intake; 2. B inhibits weight gain although it causes accrual of fat; 3. Cold, probably through sympathetic stimulation of white adipose tissue, causes fat loss which is modulated by the inhibitory effect of B on sympathetic outflow; and, 4. The slope of the relationship between fat depot size and leptin becomes flatter in cold, possibly because of increased sympathetic outflow to these depots.     

Right-hemispheric language evidence from cortical stimulation

While the left-hemispheric dominance for language in most right-handers is unquestionable, clinical observations suggest that the right, nondominant hemisphere has a considerable capacity for language. Under certain neuroanatomical conditions, the right-hemispheric capacity becomes functional and, thus, measurable. This study focuses on evoked language responses during electrical stimulation of the right hemisphere in three left-dominant patients undergoing temporal lobe resections for medically intractable seizures.     

The Milgram Experiments, Learned Helplessness, and Character Traits

The Milgram and other situationist experiments support the real-life evidence that most of us are highly akratic and heteronomous, and that Aristototelian virtue is not global. Indeed, like global theoretical knowledge, global virtue is psychologically impossible because it requires too much of finite human beings with finite powers in a finite life; virtue can only be domain-specific. But unlike local, situation-specific virtues, domain-specific virtues entail some general understanding of what matters in life, and are connected conceptually and causally to our traits in other domains. The experiments also make us aware of how easily unobtrusive situational factors can tap our susceptibilities to obedience, conformity, irresponsibility, cruelty, or indifference to others’ welfare, thereby empowering us to change ourselves for the better. Thus, they advance the Socratic project of living the examined life. I note a remarkable parallel between the results of the baseline Milgram experiments and the results of the learned helplessness experiments by Martin Seligman et al. This provides fresh insight into the psychology and character of the obedient Milgram subjects, and I use this insight to argue that pusillanimity, as Aristotle conceives of it, is part of a complete explanation of the behavior of the obedient Milgram subjects.     

Effects of intralaminar thalamic stimulation on language functions

Fifteen neurosurgical subjects, who were undergoing thalamic chronic electrode implants as a treatment for dyskinesia and chronic pain, were evaluated on a series of neurolinguistic functions to determine if the stimulation of the centromedianum nucleus of the thalamus affected language and cognitive processing. Analysis of the data revealed that the stimulation of the left centromedianum nucleus had resulted in a notable facilitatory influence on the processing of language functions; this facilitatory effect was measured in terms of the number of errors produced and the patients' response latency time. The facilitatory effect was also noted to have extended to other language functions. The nature of the facilitation from the stimulation of the left centromedianum nucleus, an extension of the brainstem reticular formation, on language functions is discussed.     

Tonotypic cortical representation in man (case report)

Cortical stimulation—evoked perception of tones differing in pitch suggests that the perception of pitch may be discretely organized in the human auditory parakoniocortex. Findings, obtained from a neurosurgical patient undergoing temporal lobectomy, are discussed with reference to anatomical and functional considerations of the auditory parakoniocortex in humans. These tonotypic findings are potentially significant since, as previously reported (see references in Discussion section), auditory sensations have not been analyzed in relation to perceptual categories of pitch. Address correspondence to: Department of Speech Pathology and Audiology, Marquette University, Milwaukee, Wisconsin 53233.     

Body Mass Index Is an Important Predictor for Suicide: Results from a Systematic Review and Meta‐Analysis

Public health concerns for the independent management of obesity and suicidal behavior are rising. Emerging evidence suggests body weight plays an important role in quantifying the risk of suicide. In light of these findings, we aimed to clarify the association between body mass index (BMI) and suicidal behavior by systematically reviewing and evaluating the literature. Studies were identified by searching MEDLINE, EMBASE, PsycINFO, and CINAHL from inception to January 2015, supplemented by hand and grey literature searches. Study screening, data extraction, and risk of bias assessment were conducted in duplicate. We included 38 observational studies. Meta‐analyses supported an inverse association between BMI and completed suicide. Pooled summary estimates demonstrated that underweight was significantly associated with an increased risk of completed suicide (HR = 1.21, 95% CI 1.07 to 1.36, p = .002), and obesity (HR = 0.71, 95% CI 0.56 to 0.89, p = .003) and overweight (HR = 0.78, 95% CI 0.75 to 0.82, p < .0001) were significantly associated with a decreased risk of completed suicide relative to normal weight. A qualitative summary of the literature demonstrated conflicting evidence regarding the association between BMI and attempted suicide and revealed no association between BMI and suicidal ideation. BMI may be used to aid the assessment of suicide risk, especially that of completed suicide. However, unmeasured confounders and systematic biases of individual studies limit the quality of evidence.     

Adolescent Attitudes About Death in Relation to Suicidality

This study examined psychiatrically disturbed adolescents' history of exposure to suicide attempts, completions, and other deaths in relation to attitudes about life and death. A primary goal of the study was to study the mediating processes involved in the impact of loss on suicidality. Adolescents who experienced the suicide of a friend or immediate family member reported a weaker attraction to life and stronger attraction to death than adolescents lacking this experience. Exposure to attempted suicide resulted in attitudes indicating a stronger attraction to death and repulsion by life. We conclude that a comprehensive history of loss and assessment of current attitudes toward death are important aspects of evaluation and subsequent treatment of at-risk adolescents.