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A total of 18 outpatients (17 male, 1 female) ranging in age from 36-66 years old were on a constant dosage of haloperidol in equally divided doses at 9:00 a.m. and 9:00 p.m. for at least 1 month. DSM-III-R diagnoses included schizophrenia (N = 9), schizoaffective disorder (N = 3), bipolar disorder (N = 4), organic mental disorder (N = 1), and delusional disorder (N = 1). Blood samples for steady-state concentrations of plasma and red blood cell haloperidol (H) and reduced haloperidol (RH) were drawn at 9:00 a.m. (12 hr trough). The haloperidol dosage was held at 9:00 a.m. until samples of whole saliva and parotid saliva could be collected for flow rates and concentrations of H and RH. Haloperidol dosages ranged from 1 mg/day to 60 mg/day (mean 11 +/- 15). Correlation coefficients were calculated for saliva concentrations versus blood levels and for saliva secretion rates versus blood levels. The correlations between whole saliva measures and blood concentrations were all higher than the correlations between parotid saliva measures and blood concentrations. In one case the higher correlation reached statistical significance. There was only one case in which substitution of saliva secretion rate improved the correlation between measures with saliva concentration. Our findings suggest that saliva measures of H and RH are useful alternatives to plasma concentrations in monitoring maintenance haloperidol treatment.

Twenty patients with primary degenerative dementia participated in a 6-week, doseranging, double-blind, placebo-controlled study of Cl-911, a cognition activator that enhances performance in animal models of impaired cognition. Cl-911 was well tolerated in these patients, but it did not result in significant improvement on objective measures of cognition, social functioning, or self-care.

Smooth pursuit eye movements (SPEM) to a sinusoidally modulated target moving horizontally across a cathode ray tube screen were examined for 17 patients with dementia of the Alzheimer type (DAT) and for 14 age-matched control subjects. There were 3 target-motion conditions at frequencies representing varying ranges of target velocity. DAT patients differed from controls on all measures of smooth pursuit quality: their gain was reduced at high target velocities and lower target accelerations, they made more frequent directionally appropriate saccades and had more saccadic intrusions, they led the target with their eyes (phase lead) in all 3 conditions, and lag-adjusted cross-correlation coefficients, computed between digitized eye-movement and target signals, were lower among patients. The cross-correlation measure was most sensitive to between-group variability. These results suggest that the impaired SPEM observed in DAT patients reflect degeneration of cortical oculomotor centers, either through inappropriate saccadic intrusions in smooth pursuit as a result of physiologic disinhibition or through effects on attentional processes or both.

An extensive set of neuropsychological measures was administered to 60 Parkinson's disease patients and age-, sex-, and education-matched controls in order to investigate the nature and prevalence of the cognitive deficit in the disease. Parkinsonian patients performed significantly poorer on all measures with the exception of tests for apraxia and object recognition, and on a test of vocabulary knowledge. Discriminant analysis of the test data revealed that over 93% of patients are impaired relative to matched controls, but that assigning a prevalence rate for dementia in the disease may be difficult due to the continuous distribution of cognitive deficits.

When an infrequent or unexpected stimulus is presented to the adult, a characteristic enhancement of the late positive component (LPC) of the averaged evoked cortical potential is observed. To test whether this effect obtains near birth, we presented low and high probability visual stimuli to 29 3-month-old infants in two studies. In Study 1, electrical potentials were recorded from occipital and parietal scalp sites (Oz and Opz), and in Study 2 also from a frontal lead (Fz). A clear LPC effect was observed over the posterior regions between 300-600 msec following the onset of the infrequent stimulus. This is the first demonstration of an LPC effect in infants, reflecting cognitive processing involving memory. A linear discriminant analysis was used to analyze the nature of the LPC effect on single trials. A local probability index (LPI) was calculated to examine the effects of prior presentations of familiar events on the infants' responses to specific occurrences of unfamiliar events. The LPC occurred more frequently for those unfamiliar trials preceded by a sequence of three or more familiar stimuli than by only one or two. Thus, single trial analysis of infant evoked potentials provides an opportunity to assess trial-to-trial variation in the brain's responses to rapidly changing events.

Oxiracetam is a recently synthesized nootropic that was tested as a potential treatment for cognitive decline in patients with multi-infarct dementia (MID) and primary degenerative dementia (PDD). Subjects were 34 MID patients and 39 PDD patients who met entrance criteria for the study. A repeated measures ANOVA showed significant improvement in both patients with MID and patients with PDD for word fluency. The total score on the Relatives' Assessment of Global Symptomatology-Elderly showed significant improvement for patients with PDD. The average score on the Instrumental Activities of Daily Living Scale, however, showed a significant decline for patients with PDD.

To assess the impact of psychiatric consultation, the authors reviewed the charts of patients referred from a neurology clinic to an outpatient consultation/liaison psychiatry clinic. The patients were found to have both significant neurologic and psychiatric disorders. Only 46 percent returned to see their neurologists within six months of the referral. This finding highlights a major problem in outpatient consultation.

Ocular motor performance was significantly impaired in familial ataxia patients as compared with normal controls. Ataxic patients showed prolonged saccadic latencies, longer saccadic refixation times, reduced visual tracking performance, and increased saccadic hypermetria. Cutoff values were derived and applied to 15 subjects at risk for developing familial ataxia. Three of 15 showed abnormal values in three or more of four categories of ocular motor performance. Within 3 years, all three subjects were diagnosed on clinical grounds as having familial ataxia. We conclude that ocular motor performance is impaired in familial ataxia and may prove useful for earlier diagnosis.

Vitamin E concentrations were determined in plasma and platelet samples from 23 diabetic and 30 control human subjects. The mean concentrations of alpha and total tocopherols in the plasma and platelets of the diabetics were higher than that of the controls. The mean gamma tocopherol concentrations in both plasma and platelets were similar in diabetics and controls. The platelet vitamin E concentrations decreased significantly with age in only the controls and not in the diabetics. Thus diabetics have higher concentrations of tocopherols in blood platelets and plasma. The total plasma tocopherol concentrations correlated significantly with total plasma cholesterol, triglyceride, and total lipid concentrations in both diabetic and control groups. However, no significant correlations were observed between platelet tocopherol levels and plasma lipids in either group. In five subjects plasma and platelet vitamin E concentrations remained unchanged during standard glucose tolerance tests.