Errol Baker - Academia.edu (original) (raw)

Papers by Errol Baker

Archives of Neurology, Nov 1, 1998

To test whether lesion site patterns in patients with chronic, severe aphasia who have no meaning... more To test whether lesion site patterns in patients with chronic, severe aphasia who have no meaningful spontaneous speech are predictive of outcome following treatment with a nonverbal, icon-based computer-assisted visual communication (C-ViC) program. Retrospective study in which computed tomographic scans performed 3 months after onset of stroke and aphasia test scores obtained before C-ViC therapy were reviewed for patients after receiving C-ViC treatment. A neurology department and speech pathology service of a Department of Veterans Affairs medical center and a university aphasia research center. Seventeen patients with stroke and severe aphasia who began treatment with C-ViC from 3 months to 10 years after onset of stroke. Level of ability to use C-ViC on a personal computer to communicate. All patients with bilateral lesions failed to learn C-ViC. For patients with unilateral left hemisphere lesion sites, statistical analyses accurately discriminated between those who could initiate communication with C-ViC from those who were only able to answer directed questions. The critical lesion areas involved temporal lobe structures (Wernicke cortical area and the subcortical temporal isthmus), supraventricular frontal lobe structures (supplementary motor area or cingulate gyrus 24), and the subcortical medial subcallosal fasciculus, deep to the Broca area. Specific lesion sites were also identified for appropriate candidacy for C-ViC. Lesion site patterns on computed tomographic scans are helpful to define candidacy for C-ViC training, and to predict outcome level. A practical method is presented for clinical application of these lesion site results in combination with aphasia test scores.

Background: Asymptomatic bacteriuria and candidiuria (ABC) are common and usually require no anti... more Background: Asymptomatic bacteriuria and candidiuria (ABC) are common and usually require no antimicrobial therapy. Similarly, culture-negatve pyuria (CNP) is nonspecific and also rarely indicates underlying urinary tract infection (UTI). Antimicrobial prescribing practices often do not conform to established evidence-based guidelines and lead to excessive antimicrobial use, risking increased antimicrobial resistance and adverse events. Objective: We conducted a retrospective review of electronic medical records to characterize antimicrobial prescribing practices for ABC and CNP. Methods: Medical records of inpatients at the acute care teaching hospital of the Boston Veteran’s Affairs Health Care System were reviewed. Patients with abnormal urinalyses and urine cultures with any growth were randomly identified from the laboratory database. Abnormal urinalyses included those with pyuria, leukocyte esterase or nitrite positivity. Patient demographics and clinical characteristics inclu...

Background: Clostridium difficile infections (CDIs) related discharge diagnoses have doubled from... more Background: Clostridium difficile infections (CDIs) related discharge diagnoses have doubled from approximately 139,000 to 336,600 during this decade. Recent studies suggest that obesity may increase the risk of CDI acquisition due to dysbiosis of commensal gut flora seen in obese patients. No prior studies have examined whether obesity impacts the rate of CDI recurrence. Methods: We conducted a retrospective review of patients with laboratory confirmed CDI at the VA Boston Healthcare System between March 1, 2010 and February 28, 2013. Identified cases were patients who were treated for the first episode of CDI. A chart review was conducted to gather baseline characteristics such as body mass index (BMI), comorbidities (Charlson Index), age, use of proton pump inhibitors or H2-blockers, and initial treatment antibiotics. Patients with Charlson Index score of >3 were considered high risk. Each of the cases were followed forward for 6 months after initial diagnosis to identify recu...

Journal of studies on alcohol, 1997

Determinants of initial alcohol use may differ from predictors of accelerated or problematic cons... more Determinants of initial alcohol use may differ from predictors of accelerated or problematic consumption. Social influences may be strong predictors of initial drinking; however, later stages of problem drinking may be linked developmentally to intrapersonal deficits. This study prospectively examined the influence of chronic and changing risk and protective status in predicting adolescent alcohol involvement and transitions in alcohol use. Data were obtained from a three-wave cohort (N = 823) of 8th-10th grade nonintervention students participating in a school-based drug abuse prevention trial. Cognitive, attitudinal and social influence measures were dichotomized using empirical cut-offs to designate risk or protective status. Using a conceptually based assignment scheme, additive risk indices were created assessing chronic (averaging across time) and changing features of competence, psychological and interpersonal functioning, cognitive-affective and social influences. Three chro...

Public health reports (Washington, D.C. : 1974)

Despite the high rates of smoking-related cancers among black Americans, little is known about th... more Despite the high rates of smoking-related cancers among black Americans, little is known about the type of smoking prevention program that might be effective with black youth. The current study pilot-tested a promising smoking prevention approach to determine its feasibility, acceptability, and effectiveness. A total of 608 students in nine predominantly black urban junior high schools were stratified by community and randomly assigned to treatment and control conditions. Students in the treatment condition participated in a 12-session smoking prevention program which taught resistance skills and general life skills. Process data indicated that this prevention approach was feasible and acceptable to students, teachers, and administrators. Outcome data indicated that this program reduced the proportion of children who smoked in the past month by 56 percent, and it increased knowledge of the adverse consequences of smoking and normative expectations concerning adult and peer smoking. ...

Current neurology and neuroscience reports, 2009

Repetitive transcranial magnetic stimulation (rTMS) has been used to improve language behavior, i... more Repetitive transcranial magnetic stimulation (rTMS) has been used to improve language behavior, including naming, in stroke patients with chronic, nonfluent aphasia. Part 1 of this article reviews functional imaging studies related to language recovery in aphasia. Part 2 reviews the rationale for using rTMS to treat nonfluent aphasia (based on functional imaging) and presents our current rTMS protocol. We present language results from our rTMS studies as well as imaging results from overt naming functional MRI scans obtained before and after a series of rTMS treatments. Part 3 presents results from a pilot study in which rTMS treatments were followed immediately by constraint-induced language therapy. Part 4 reviews our diffusion tensor imaging study examining the possible connectivity of the arcuate fasciculus to different parts of Broca's area (pars triangularis, pars opercularis) and to the ventral premotor cortex. The potential role of mirror neurons in the right pars opercu...

NeuroImage, Jan 15, 2010

The arcuate fasciculus (AF) is a white matter pathway traditionally considered to connect left Br... more The arcuate fasciculus (AF) is a white matter pathway traditionally considered to connect left Broca's area with posterior language zones. We utilized diffusion tensor imaging (DTI) in eight healthy subjects (5 M) to track pathways in the horizontal mid-portion of the AF (hAF) to subregions of Broca's area - pars triangularis (PTr) and pars opercularis (POp); and to ventral premotor cortex (vPMC) in the right and left hemispheres (RH, LH). These pathways have previously been studied in the LH, but not in the RH. Only 1/8 subjects showed fiber tracts between PTr and hAF in the RH (also, only 1/8 in the LH). In contrast to PTr, 5/8 subjects showed fiber tracts between POp and hAF in the RH (8/8 in the LH). Fiber tracts for vPMC were similar to those of POp, where 7/8 subjects showed fiber tracts between vPMC and hAF in the RH (8/8 in the LH). Our designated hAF could have included some of the superior longitudinal fasciculus (SLF) III, because it is difficult to separate the t...

This study examined activation levels in the left (L) supplementary motor area (SMA) and the righ... more This study examined activation levels in the left (L) supplementary motor area (SMA) and the right (R) SMA (separately), and activation in nine R perisylvian language homologues during overt, propositional speech in chronic nonfluent aphasia patients. Previous functional imaging studies with a variety of chronic aphasia patients have reported activation in these regions during different language tasks, however, overt propositional speech has not been examined. In the present research, four nonfluent aphasia patients were studied during overt elicited propositional speech at 4-9 years post-single L hemisphere stroke, which spared the SMA. The dynamic susceptibility contrast (DSC) method of functional MRI was used to calculate relative cerebral blood volume (relCBV) for cortical regions of interest (ROIs) during the first-pass bolus of gadolinium during two conditions: (1) pattern (silent viewing of checkerboard patterns) and (2) story (overt, elicited propositional speech describing sequential pictures, which formed a story). During the story condition, controls had significantly higher relCBV in L SMA than in R SMA; aphasics, however, had significantly higher relCBV in R SMA than in L SMA. During the pattern condition, no significant differences were observed between the L SMA and the R SMA for either controls or aphasics. In addition, aphasics had significantly higher relCBV in the R sensorimotor mouth during story than pattern. This R sensorimotor mouth relCBV was also significantly higher in aphasics than controls during story, and the two groups did not differ during pattern. The overall mean relCBV for the nine R perisylvian ROIs was significantly higher for aphasics than controls during both story and pattern. These results suggest that poor modulation, including possible over-activation of R sensorimotor mouth and other R perisylvian language homologues may underlie in part, the hesitant, poorly articulated, agrammatic speech associated with nonfluent aphasia.

Neurobehavior of Language and Cognition, 2002

... Margaret A, Naeser, Errol H. Baker, Carole L. Palumbo, Marjorie Nicholas, Michael P. Alexande... more ... Margaret A, Naeser, Errol H. Baker, Carole L. Palumbo, Marjorie Nicholas, Michael P. Alexander, Ranji Samaraweera, Malee N. Prete ... utilize a nonverbal substituted language based on pictures and icons (Visual Communication, ViC) were reported (Baker, Berry, Gardner, Zurif ...

Restorative neurology and neuroscience, 2014

The purpose of this study was to investigate: 1) the feasibilty of administering a modified CILT ... more The purpose of this study was to investigate: 1) the feasibilty of administering a modified CILT (mCILT) treatment session immediately after TMS; and 2) if this combined therapy could improve naming and elicited propositional speech in chronic, nonfluent aphasia. Two chronic stroke patients with nonfluent aphasia (mild-moderate and severe) each received twenty minutes of rTMS to suppress the right pars triangularis, followed immediately by three hours of mCILT (5 days/week, 2 weeks). (Each patient had received TMS alone, 2-6 years prior.) Language evaluations were performed pre- TMS+mCILT, and post- at 1-2 months, and 6 or 16 months. Both patients showed significant improvements in naming pictures, and elicited propositional speech at 1-2 months post- TMS+mCILT. The improved naming was still present at 6 months post- TMS+mCILT for P2; but not at 16 months post- TMS+mCILT for P1. It is feasible to administer mCILT for three hours immediately after a TMS session. It is unknown if the ...

Seminars in Speech and Language, 1994

Psychological Reports, 1983

Psychological Reports, 1992

... Carolina at Chapel Hill GILBERT J. BOTVIN, ELIZABETH M. BOTVIN, ELI BAKER Institute for Preve... more ... Carolina at Chapel Hill GILBERT J. BOTVIN, ELIZABETH M. BOTVIN, ELI BAKER Institute for Prevention Research Department of Public Health Cornell Universiiy Medical College Summary.-Normative expectations for cigarette ...

New England Journal of Medicine, 1994

Low serum thyrotropin concentrations are a sensitive indicator of hyperthyroidism but can also oc... more Low serum thyrotropin concentrations are a sensitive indicator of hyperthyroidism but can also occur in persons who have no clinical manifestations of the disorder. We studied whether low serum thyrotropin concentrations in clinically euthyroid older persons are a risk factor for subsequent atrial fibrillation. We studied 2007 persons (814 men and 1193 women) 60 years of age or older who did not have atrial fibrillation in order to determine the frequency of this arrhythmia during a 10-year follow-up period. The subjects were classified according to their serum thyrotropin concentrations: those with low values (&amp;amp;amp;lt; or = 0.1 mU per liter; 61 subjects); those with slightly low values (&amp;amp;amp;gt; 0.1 to 0.4 mU per liter; 187 subjects); those with normal values (&amp;amp;amp;gt; 0.4 to 5.0 mU per liter; 1576 subjects); and those with high values (&amp;amp;amp;gt; 5.0 mU per liter; 183 subjects). During the 10-year follow-up period, atrial fibrillation occurred in 13 persons with low initial values for serum thyrotropin, 23 with slightly low values, 133 with normal values, and 23 with high values. The cumulative incidence of atrial fibrillation at 10 years was 28 percent among the subjects with low serum thyrotropin values (&amp;amp;amp;lt; or = 0.1 mU per liter), as compared with 11 percent among those with normal values; the age-adjusted incidence of atrial fibrillation was 28 per 1000 person-years among those with low values and 10 per 1000 person-years among those with normal values (P = 0.005). After adjustment for other known risk factors, the relative risk of atrial fibrillation in elderly subjects with low serum thyrotropin concentrations, as compared with those with normal concentrations, was 3.1 (95 percent confidence interval, 1.7 to 5.5; P &amp;amp;amp;lt; 0.001). The 10-year incidence of atrial fibrillation in the groups with slightly low and high serum thyrotropin values was not significantly different from that in the group with normal values. Among people 60 years of age or older, a low serum thyrotropin concentration is associated with a threefold higher risk that atrial fibrillation will develop in the subsequent decade.

NeuroImage, 2005

The purpose of this study was to develop a functional MRI method to examine overt speech in strok... more The purpose of this study was to develop a functional MRI method to examine overt speech in stroke patients with aphasia. An fMRI block design for overt picture naming was utilized which took advantage of the hemodynamic response delay where increased blood flow remains for 4 -8 s after the task [Friston, K.J., Jezzard, P., Turner, R., 1994. Analysis of functional MRI time-series. Hum. Brain Mapp. 1, 153 -171]. This allowed task-related information to be obtained after the task, minimizing motion artifact from overt speech [Eden, G.F., Joseph, J., Brown, H.E., Brown, C.P., Zeffiro, T.A., 1999. Utilizing hemodynamic delay and dispersion to detect fMRI signal change without auditory interference: the behavior interleaved gradients technique. Magn. Reson. Med. 41, 13 -20; Birn, RM., Bandettini, P.A., Cox, R.W., Shaker, R., 1999. Event-related fMRI of tasks involving brief motion. Hum. Brain Mapp. 7, 106 -114; Birn, R.M., Cox, R.W., Bandettini, P.A., 2004. Experimental designs and processing strategies for fMRI studies involving overt verbal responses. NeuroImage 23, 1046 -1058]. Five chronic aphasia patients participated (4 mild -moderate and 1 severe nonfluent/ global). The four mild -moderate patients who correctly named 88 -100% of the pictures during fMRI, had a greater number of suprathreshold voxels in L supplementary motor area (SMA) than R SMA (P < 0.07). Three of these four mild -moderate patients showed activation in R BA 45 and/or 44; along with L temporal and/or parietal regions. The severe patient, who named no pictures, activated almost twice as many voxels in R SMA than L SMA. He also showed activation in R BA 44, but had remarkably extensive L and R temporal activation. His poor naming and widespread temporal activation may reflect poor modulation of the bi-hemispheric neural network for naming. Results indicate that this fMRI block design utilizing hemodynamic response delay can be used to study overt naming in aphasia patients, including those with mildmoderate or severe aphasia. This method permitted verification that the patients were cooperating with the task during fMRI. It has application for future fMRI studies of overt speech in aphasia. Published by Elsevier Inc.

Neurocase, 2005

We report improved ability to name pictures at 2 and 8 months after repetitive transcranial magne... more We report improved ability to name pictures at 2 and 8 months after repetitive transcranial magnetic stimulation (rTMS) treatments to the pars triangularis portion of right Broca's homologue in a 57 year-old woman with severe nonfluent/global aphasia (6.5 years post left basal ganglia bleed, subcortical lesion). TMS was applied at 1 Hz, 20 minutes a day, 10 days, over a two-week period. She received no speech therapy during the study. One year after her TMS treatments, she entered speech therapy with continued improvement. TMS may have modulated activity in the remaining left and right hemisphere neural network for naming.

Journal of Developmental & Behavioral Pediatrics, 1989

Seventh grade students (N = 1539) from three regions of New York State were surveyed to determine... more Seventh grade students (N = 1539) from three regions of New York State were surveyed to determine the prevalence of smokeless tobacco use and its relationship to seven background variables, 13 substance use variables, and 19 psychosocial variables. Significant correlations with smokeless tobacco use were found within each of these variable domains. Concurrent predictors for each domain were determined using logistic regression analysis. The resulting three models were combined in a stepwise fashion in an effort to determine the most complete prediction model. The final model indicated that individuals at the highest risk for using smokeless tobacco were rural males who had smoked more than four cigarettes in their lifetime, were more heavily involved with alcohol, had a lower degree of assertiveness and social anxiety, and had reported eating as a coping response. Implications for prevention are discussed.

Journal of Consulting and Clinical Psychology, 1989

We tested a multidimensional formulation of assertiveness and substance (tobacco, alcohol, and ma... more We tested a multidimensional formulation of assertiveness and substance (tobacco, alcohol, and marijuana) use in 3 metropolitan-area school samples of adolescents aged 12-14 years. Three studies (N = 675, N = 1,430, and N = 5,545) included inner-city and suburban settings and included White, Black, and Hispanic students. Factor analysis of versions of the Gambrill-Richey Assertion Inventory indicated five independent dimensions of assertive behavioe Multiple regression analyses indicated that a dimension of Substance-specific Assertiveness was inversely associated with substance use, whereas dimensions of Social Assertiveness and Dating Assertiveness were positively associated with substance use. A dimension of General Assertiveness was unrelated to substance use. Interaction effects indicated that relations were stronger for girls for Substance and Social Assertiveness and for boys for Dating Assertiveness. Implications of the findings for models of assertive behavior and for design of primary prevention programs are discussed.

Journal of Behavioral Medicine, 1989

The present study was designed to test the feasibility, acceptability, and effectiveness of a 15-... more The present study was designed to test the feasibility, acceptability, and effectiveness of a 15-session smoking prevention intervention with a predominantly hispanic (74 %) sample of seventh-grade students (N = 471) in eizht urban schools in the New York area. The s m o k i n~ mevention curricuhm teaches social resistance skills within the context of h broader intervention promoting general personal and social competence and was implemented in this study by regular classroom teachers. Results of logistic regression analyses provided preliminary evidence of the efficacy of this type of smoking prevention strategy with urban minority youth when implemented with a reasonable degree of fidelity. The significance of these findings is that they provide support for the generalizability of an approach previously found to be effective with white middle-class populations to a predominantly hispanic inner-city population.