Minimal Brain Dysfunction Syndrome Research Articles

NOOTROPICS: A LONG WAY IN HALF A CENTURY

Introduction. Currently, there are drugs that can improve cognitive processes. They are nootropics. The term "nootropics" was introduced in 1972, when piracetam's memory-enhancing properties were discovered, and this group of drugs has served the human benefit for half a century. The purpose of the work is to analyze known facts and new trends in the development of nootropics as a pharmacological group. Materials and methods. Internet resources (PubMed, Google Scholar, CrossRef) are used to search for information. Original research articles, meta-analyses and systematic reviews are included in the study. Attention was focused on providing an up-to-date overview of known means. Main part. For classification, the distribution of nootropics according to the mechanism of action is proposed. Nootropics have both a receptor mechanism of action and improve the supply of glucose and oxygen to the brain, the synthesis of proteins, nucleic acids and phospholipids, eliminate oxygen free radicals, have an antiplatelet effect, and optimize cerebral blood circulation. They are used for the treatment of psycho-organic syndrome. Nootropics are effective in providing benign senile disease, in children with minimal brain dysfunction syndrome, in case of encephalopathy and myalgic encephalomyelitis. Nootropics are indicated for patients with Alzheimer's disease, schizophrenia, hyperkinetic disorder. They are well tolerated. Their effectiveness depends on the dose, and after the disappearance of the disorder, the treatment should be continued for at least 2-3 weeks. Nootropics attract the attention of practically healthy individuals, in particular, students, but their use by healthy people is against concern due to the absence of clinical evidence of effectiveness, safety and social consequences. Some of the most famous nootropic drugs are piracetam, pyritinol, nicergoline, and vinpocetine, which have certain shades of pharmacodynamics, dosage, and side effects. Conclusions. Therefore, all nootropics improve cognitive function, especially in cases of the damage or degeneration, are well tolerated and should be prescribed by a specialist in each specific case. New research is needed to confirm or simplify the beneficial effects of nootropics in healthy individuals.

PO-0801 Clinical And Pathogenetic Aspects Of The Delayed Psychoverbal Development In Children Of An Early Age

26 children at the age of 1.5 to 4 with delayed psychoverbal development (DPVD) without movement disorders were examined. All children were born full-term, had cerebral ischaemia of the 1st and 2nd degrees, were observed by a neurologist during the 1st year of life and were further observed according to their place of residence. The complex of examination included: video-EEG monitoring of the daytime sleep, brain MRI, transcranial dopplerography (TCDG) and consultation of a psychologist, logopedist, endocrinologist and geneticist. The data of psychological testing revealed mental retardation of a different level and character: immaturity of emotional regulation, skills of communicative behaviour and cooperative activity as well as partial delay of cognitive development against the background of general speech underdevelopment, delay of sensorimotor development (12), intellectual deficiency of cerebral-organic genesis with neurodynamic disorders (10) and traits of autistic behaviour (4). As a result of logopedist’s examination it was revealed that more than 1/3 of children had alalia, 2 children had dysarthria and 15 children had dyslalia. According to the data of video-EEG 13 children had decrease of functional lability of cortical processes, 6 children had paroxysmal activity, 2 children had epiactivity in the form of ‘peak-slow wave’ complexes, 5 children had delay in the basic rhythm formation that conformed to the presence of organicity as per the data of brain MRI in the form of periventricular gliosis and allowed to consider DPVD of cerebral-organic type. As a result of complex examination the following clinical entities were revealed: subclinical hypothyroidism (2), syndrome of cognitive epileptiform disintegration (2), autism (3), organic lesion of central nervous system (5), encephalasthenia (7) and syndrome of minimal brain dysfunction (9). The analysis of results revealed different variants of DPVD: dysontogenetic variant due to immaturity, encephalopathic variant against the background of minor organic lesion of CNS, secondary DPVD against the background of hypothyroidism that determined the initial approach and amount of therapy as well as further prognosis for the disease.

Neonatal 6-hydroxydopamine-induced dopamine depletions: Motor activity and performance in maze learning

Three experiments were performed to study the effect of dopamine (DA) depletions, induced by neonatal intracerebroventricular (ICV) treatment with 6-hydroxydopamine (6-OHDA), upon measures of spontaneous motor activity. Instrumental learning for food reward in an Olton radial arm maze and escape learning from a large, circular water maze were studied also. Motor activity was measured by direct observation of rats in a modified radial arm maze and by use of automated test cages equipped with photocell devices. 6-OHDA-treated rats demonstrated considerable and long-lasting locomotor (ambulation) activity and total activity increases. 6-OHDA-treated rats showed notably less rearing activity than the vehicle-treated rats during the initial 20 min of each 60-min test period. However, over the second half of these 60-min test periods, the 6-OHDA-treated rats demonstrated significantly more rearing activity than the vehicle-treated rats. In the acquisition of the running response, to obtain the 8 food pellets placed in each of the 8 arms of the radial arm maze, 6-OHDA rats showed a retarded acquisition, as measured by the latency and number of arms visited to acquire all eight pellets. 6-OHDA-treated rats failed completely to acquire the Morris-type swim maze task by which they were required to locate a platform just under the water surface in a circular water tank. The neurochemical assays indicated severe DA depletion in several forebrain regions. The present findings add to existing indications of the potential of this DA depletion condition as an animal model of the minimal brain dysfunction syndrome.

The role of the central monoaminergic system and rapid eye movement sleep in development

Transmission of information in the brain is of a chemical nature. Neurotransmitters are present at very early stages of brain development, having trophic effects on maturation of target neurons as well as mediating the behavioral repertoire of the immature brain. Many centrally acting psychoactive drugs which are commonly used (also during pregnancy) for treatment of depression, asthma, hypertension, epilepsy, parkinsonism, hyperkinetism and other neurological and psychiatric disorders act directly on brain neurotransmitters (in particular monoamines) and behavioral states. Disturbances observed later in life in animals and man, as a result of early interference with brain neurotransmitters, using these drugs, are not gross physical malformations but are in fact subtle behavioral and neurological symptoms such as hyperactivity, emotional lability, attentional distractability and sleep disturbances, similar to symptoms observed in the minimal brain dysfunction syndrome.

Relationship of neuropsychological performance to primary alcoholism and self-reported symptoms of childhood minimal brain dysfunction.

The relationship between neuropsychological performance and a childhood history of the hyperkinetic and minimal brain dysfunction syndrome (Hk-MBD) was studied in 60 men alcoholic patients at an alcoholism treatment center. Primary (N = 28) an secondary (N = 32) alcoholics and a matched group of 60 nonalcoholic controls were administered a checklist on the presence of childhood symptoms associated with Hk-MBD. The primary alcoholics reported a significantly higher number of Hk-MBD symptoms than the secondary alcoholics and controls; they also performed significantly more poorly than the other groups on several neuropsychological tests. The secondary alcoholics did not differ significantly from the controls in the number of Hk-MBD symptoms reported or in neuropsychological functioning. Neuropsychological performance did not differ significantly between those with high and low numbers of Hk-MBD symptoms, but in almost all comparisons the direction of differences favored those with low numbers of Hk-MBD symptoms. In general, the results suggest that primary alcoholics might account for most neuropsychological deficits reported in alcoholics and that at least some of these deficits may be present premorbidly.

The health consequences of caffeine.

Acutely administered caffeine modestly increases blood pressure, plasma catecholamine levels, plasma renin activity, serum free fatty acid levels, urine production, and gastric acid secretion. It alters the electroencephalographic spectrum, mood, and sleep patterns of normal volunteers. Chronic caffeine consumption has no effect on blood pressure, plasma catecholamine levels, plasma renin activity, serum cholesterol concentration, blood glucose levels, or urine production. Caffeine does not appear to be useful for increasing the motility of hypomotile sperm in artificial insemination or in the therapy of minimal brain dysfunction, cancer, or Parkinson's syndrome, but it may be effective as a topical treatment of atopic dermatitis and as systemic therapy for neonatal apnea. Caffeine does not seem to be associated with myocardial infarction; lower urinary tract, renal, or pancreatic cancer; teratogenicity; or fibrocystic breast disease. The role of caffeine in the production of cardiac arrhythmias or gastric or duodenal ulcers remains uncertain.

Attention Deficit Disorder, Residual Type- A Case Study

The syndrome of Minimal Brain Dysfunction (MBD) in children has been well described by a number of authors. Such children were first described in 1941 by Werner and Strauss(1) who made a distinction between brain injury and -simple- mental retardation. In the past such terms as Hyperactive Child Syndrome, Minimal Brain Damage, and Hyperkinetic Behavior Syndrome have been used to describe this syndrome.

Perceptual, motor and attentional deficits in seven-year-old children. Neurological screening aspects.

In an extensive neuropsychiatric study of seven-year-old children, operational criteria for diagnosing minimal brain dysfunction (MBD) syndrome were used. Detailed behavioural assessment and meticulous neurological examination provided the basis for the MBD diagnosis. The time-consuming specialist examination by the child neurologist was considered too sophisticated for use in everyday clinical practice. Therefore, the results obtained at a short neurodevelopmental screening assessment performed by a child psychiatrist were analysed with the aim of finding a limited set of neurological examination items with high discriminating capacity detecting for MBD syndromes. A set of six such items (diadochokinesis, hopping on one leg, standing on one leg, cutting out a paper circle, associated movements when walking on lateral sides of feet and the labyrinth test of the WISC) produced a minimal rate of misclassified cases. It is argued that this discriminant set may be useful in everyday child psychiatric and pediatric assessment of children who raise suspicion of suffering from MBD.

Childhood psychosis and urinary excretion of peptides and protein-associated peptide complexes.

Twenty-four infantile autistic children were compared with 12 children with other kinds of childhood psychoses, 5 children with so-called minimal brain dysfunction syndrome, 5 children with attention deficit disorder, 14 children with mental retardation, and 19 normal children with regard to chromatographic profiles of urinary products that give ultraviolet absorbency at 280 nm. Six main types of chromatographic patterns emerged. Fifty-four percent of the autistic children and 17% of the children with other psychoses showed a distinct pattern that was not seen in any other cases. Only 8% of the autistic children showed the "normal" pattern seen in 95% of the normal and 93% of the mentally retarded children without psychosis. The ultraviolet absorbency peaks of the chromatograms possibly correspond to peptides and protein-associated peptide complexes. It is argued that these products are probably at least partly of CNS origin.

An Occupational Therapy Pediatric Research Project in Community Integration

This study examines two groups of children diagnosed as having minimal brain dysfunction syndrome; one group was integrated into a YMCA Urban Day Camp, with normal children, while the second group was treated in the same setting but followed a program led by occupational therapists and had no contact with the normal children. The study was based on a pilot project conducted in 1975. Pre- and post-measures of visual-motor skills, of self-concept and of parent reactions are analyzed. Principally, however, observational data of the social interactions engaged in within each group is analyzed, comparing the first and the final weeks of the camp. Methods used and results are described. A discussion of the results is presented as are recommendations for the use of mainstreaming in the practice of occupational therapy.

Attention Deficit Disorder

Attention deficit disorder is the current nosological attempt of the American Psychiatric Association to label the behaviors which have variously been described under the hyperkinetic syndrome, hyperkinesis, minimal brain dysfunction, and so forth. A series of difficulties with the other labels brought about this change, specifically, the demonstration in a sample of over 30,000 7 year old children that there was, in fact, no clustering of symptoms that related neurological, behavioral, and academic variables. In addition, no common etiological, biological, or unique treatment characteristics consistent with the purported minimal brain dysfunction syndrome could be validated (Nichols and Chen, 1980).

Minimal brain dysfunction and hyperkinesis: a clinical viewpoint.

During the last 20 years much attention has been given in the medical and psychological literature to the syndrome of minimal brain dysfunction (MBD) or hyperkinesis (hyperactivity), the terms generally being used interchangeably. Experts have emphasized the high frequency and clinical importance of this condition and have warned clinicians about the necessity of early detection and proper treatment. The conscientious clinician cannot fail to be impressed by the magnitude of this literature and its sense of urgency. However, when the clinician inspects these reports closely, the concept is found to be so poorly described that deciding whether a particular case fits the definition adequately is difficult. The expert consultant, who is presented with a child with clear evidence of academic or behavioral problems, may label such a case as MBD with little hesitation, but the primary care clinician is often perplexed. The purposes of this communication are to review critically

Minimal Brain Dysfunction Syndrome

Minimal brain dysfunction encompasses a variety of different behavioral, learning, and motor problems. The etiologic factors vary, ranging from brain damage and fetal malformations to more subtle maturational delays and biochemical alterations. Environmental factors may be significant. The life history of a person with minimal brain dysfunction is characterized by disordered activity and behavioral patterns in early childhood, learning disabilities during the school years, and continued problems with adjustment in adulthood. Medications, particularly stimulants, may improve behavior and attentiveness, but as yet, there is no indication that they improve the long-range prognosis. Children with minimal brain dysfunction syndrome require comprehensive care which must include appropriate school programming, encouragement of activities to preserve self-esteem, vocational planning, and anticipatory guidance.

Neuropsychological and Treatment Aspects of Learning and Behavior Disorders in Children

The present article discusses the aspects of brain-behavior disorders in children from the standpoint of terms such as minimal brain dysfunction, learning disabilities, hyperactivity, and Hyperkinetic Syndrome. The concept of “brain damage” versus “brain dysfunction” in relationship to behavior disorders is discussed. A partial selection of neurobiological aspects of brain disturbances and behavior disorders in children is presented in terms of physical anomalies and physiologic growth and maturation. Approaches to the use of clinical child neuropsychological assessment, diagnostic problems, and some issues facing the clinician, school psychologist, and remediator, are presented and considered in relation to current intervention strategies for children presenting with severe behavioral and learning disorders in the classroom and at home. Management, treatment efficacy, educational policy and brain science implications are discussed in relation to the above.

Neuropathology of "spinning syndrome" induced by prenatal intoxication with a PCB in mice.

A striking motor dysfunction, "spinning syndrome," developed with a high frequency in weaning mice whose dams received oral 3,4,3',4'-tetrachlorobiphenyl (4-CB) during gestation (day 10 through day 16). The syndrome is permanent and is characterized by swift circling movements sustained in one direction at a minimal rate of 40 turns/min (usually 50 to 150 turns/min), restlessness, and hyperkinesia. Twenty-four spinners and 4-CB nonspinners and age-matched controls were subjected to histopathologic, histofluorescent, histochemical, and electron microscopic studies. The most reliable histopathologic marker for prenatal 4-CB injury to the CNS is the presence of cylindrical CNS peninsulas (CCPs) in the spinal and cranial nerve roots. The CCPs consist of either CNS-type myelinated fibers, unmyelinated fibers, or astroglial bundles in varying proportions, and are enclosed by a basement membrane. The CCPs are also observed in 4-CB nonspinners but in none of 12 controls studied. A selective defect in synaptogenesis induced prenatally by 4-CB is proposed as the primary event pursuant to the development of the CCPs, while interference with synaptogenesis may have occurred selectively in the striatonigral dopaminergic system. This is suggested by electron microscopy on the nucleus accumbens and also by the responses to administration of dopaminergic agonists and antagonist. The 4-CB induced clinico-pathologic anomaly may serve as a singular model for understanding human neurologic disorders, in particular, Werdnig-Hoffmann disease and minimal brain dysfunction syndrome.

Wormian Bones

The present investigation was undertaken to determine the incidence and significance of Wormian bones (WBs) in a random group of infants and children seen at the Jewish Hospital Medical Center of Brooklyn. Ninety-one (17%) of 515 infants and children were found to have WBs; 82 of these children (90%) had a gross disorder of the CNS and five (6%) had the so-called minimal brain dysfunction syndrome. In the remaining four patients, the data and follow-up are incomplete. Three of these did have developmental anomalies of other organ systems. Thus, the presence of WBs is almost invariably associated with abnormal development of the CNS and may serve as a useful marker for the early identification and treatment of the affected infant or child.

Testing the attentional deficit notion.

The current evidence for an attentional deficit explanation of learning disability must be evaluated cautiously. The attentional deficit notion really represents a number of different hypotheses, which means that it is permitted a great many degrees of freedom in accounting for data. Also, many of the findings cited as supporting the attentional-deficit notion are equally consistent with the two basic alternative explanations for learning disability: the diminished capacity and the specific deficit hypotheses. Finally, the existing studies rarely provide the information needed to differentiate the processing deficit responsible for learning disabilities from concomitant deficits that may occur as a part of the minimal brain dysfunction syndrome or reflect motivational and emotional difficulties. Until researchers address these issues, an attentional deficit explanation for learning disability will remain conjectural.

Pneumoencephalographic and clinical findings of the XYY syndrome.

In order to approach the hitherto unknown brain involvement in the XYY syndrome five adult patients with this syndrome were studied clinically and pneumoencephalographically. Clinical manifestations included delayed difficulties of speech and learning, clumsiness, mild intention tremor, muscular hypotonia, convulsions, hyperactivity, distractibility, impulsiveness, weak mental control, psychosexual disturbances and a slight defect of intelligence. All five had committed crimes. Pneumoencephalograms showed general ventricular enlargement of mild or moderate degree. The enlargement of lateral ventricles was unilateral or asymmetrically bilateral. The suprapineal recess of the third ventricle was uniformly enlarged. Small cerebellum and enlarged fourth ventricle were the abnormal findings in the posterior fossa. No cortical abnormalities were found. The clinical and pneumoencephalographic findings suggest a slight non-progressive developmental disorder of the brain resembling the so-called minimal brain dysfunction syndrome. The XYY syndrome appears to be one cause of the male preponderance in minimal brain dysfunction syndrome and criminal psychopathy.

Methylphenidate in 6-hydroxydopamine-treated developing rat pups. Effects on activity and maze performance.

In order to better devine the relationship between brain catecholaminergic mechanisms and the clinical syndrome of minimal brain dysfunction, we have developed an experimental model that has many of the features of the disorder seen in children. This model is effected by the preferential depletion of brain dopamine in 5-day-old rat pups following the intracisternal administration of 6-hydroxydopamine, and in the present investigation, we have examined the effects of methylphenidate hydrochloride (0.25 to 2.0 mg/kg) on activity levels and cognitive performance in normal and 6-hydroxydopamine treated animals. Methylphenidate therapy resulted in a significant increase in activity levels of normal rat pups 12 and 19 days of age; in contrast, methylphenidate administered to 6-hydroxydopamine-treated animals did not increase activity at 12 days of age and significantly reduced activity at 19 and 26 days. Methylphenidate had no effect on T-maze performance in normals, but significantly improved performance in 6-hydroxydopamine-treated animals. Our results suggest that the "paradoxical" response to methylphenidate found in 6-hydroxydopamine-treated rat pups may be the result of central denervation supersensitivity.

Transitory or Pseudo-Organicity and Borderline Personality in a 7-Year-Old Child

In some children, signs suggestive of organicity consistent with the minimal brain dysfunction syndrome may mask a borderline condition. If the treatment in these cases is based solely on the so-called “organicity,” which the child may or may not have, the child is in danger of acquiring, so to speak, an added iatrogenic vulnerability. By virtue of the label Minimal Brain Dysfunction, and the treatment that ensues, significant personality difficulties may be either missed or inadequately treated. Minimal brain dysfunction is defined here operationally in terms of a cluster of deviant behavior items (Eisenberg, 1957; Pincus and Glaser, 1966; Wender, 1972). These may include short attention span, distractibility, hyperkinesis, impulsiveness, labile emotions, poor motor coordination, deficits in the perception of space, form, movement and time, disordered or delayed language or symbol development, diminished ability to experience pleasure, and a diminished responsiveness to both positive and negative reinforcement. A particular behavior item may be present in varying degree at any given time and place, and is in no way pathognomonic. Multiple, heterogenous etiological factors, including biogenetic, congenital, traumatic, infective, and psychosocial elements, may underlie each item. Such children often appear to be stimulus-hungry and have strong object-seeking tendencies. Unfortunately, they are also often misunderstood, and are rejected by their parents, their peers, and their teachers, which reinforces their already low self-esteem. The natural history of the syndrome, not surprisingly, is as varied as its forms; some have a good prognosis, while others develop