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Papers by kim bishop

Abstracts of the 46th Annual Meeting of the Society for Neuropediatrics, 2021

Epilepsy & Behavior, 2021

Objective: Individuals with Dravet syndrome (DS) experience frequent pharmacoresistant seizures b... more Objective: Individuals with Dravet syndrome (DS) experience frequent pharmacoresistant seizures beginning in infancy. Most exhibit poor neurodevelopmental outcomes including motor function difficulties, behavior problems, and cognitive impairment. Cognitive deficits in children with DS have been associated with seizure frequency and antiseizure medication (ASM) use. Recent research in children and young adults with DS has begun to examine the role of executive functions (EFs), as these include higher-order cognitive functions and may mediate the relationship between risk factors and cognitive impairment. Current conceptualizations, however, of EFs involve the broader self-regulation of cognitive, behavioral, and emotional domains. We explored relationships between reduction in convulsive seizure frequency and everyday EFs in a subset of children and young adults with DS treated with adjunctive fenfluramine for 1 year. Methods: This is a post-hoc analysis of data from children and young adults with Dravet syndrome aged 5-18 years who participated in a phase 3 randomized, placebo-controlled clinical trial (core study) followed by completion of at least 1 year of fenfluramine treatment in an open-label extension (OLE) study. Eligible children and young adults started the OLE study at 0.2 mg/kg/day fenfluramine and were titrated to optimal seizure control and tolerability (maximum daily dose: 26 mg/day). Parents/caregivers documented convulsive seizure frequency per 28 days (i.e., monthly convulsive seizure frequency [MCSF]) by electronic diary. A parent/caregiver for each child also completed the Behavior Rating Inventory of Executive Function (BRIEF Ò) parent form, a questionnaire capturing parents'/caregivers' perceptions of everyday EF that was included as a safety measure to assess treatment-related adverse effects on EF during the trial. Ratings on BRIEF Ò were mapped to the current edition, the BRIEF Ò 2 parent form, and were used to calculate T-scores for the Behavior Regulation Index (BRI), Emotion Regulation Index (ERI), Cognitive Regulation Index (CRI), and Global Executive Composite (GEC). Change in BRIEF Ò 2 T-scores from baseline in the core study to Year 1 of the OLE study was calculated. Spearman's rho correlation coefficients assessed associations between change in BRIEF Ò 2 indexes/composite T-scores and percentage change in MCSF. Children and young adults were divided into 2 groups based on percentage of MCSF reduction achieved from pre-randomization baseline in the core study to Year 1 of the OLE study: <50% and !50% MCSF reduction. Changes in the distribution of BRIEF Ò 2 indexes/composite T-scores were compared between MCSF reduction groups using Mann-Whitney U tests. The proportions of children and young adults in these groups who showed clinically meaningful improvement in everyday EF, defined as

Documenta Ophthalmologica Proceedings Series, 1987

The total long-term fluctuation of the visual field was measured in 22 patients with open-angle g... more The total long-term fluctuation of the visual field was measured in 22 patients with open-angle glaucoma who appeared to be clinically stable and well controlled on medical therapy. All patients had at least three visual fields performed on the Octopus 201 perimeter with at least 12 months follow-up since their first visual field. The three most recently performed visual fields were analyzed.

American Journal of Ophthalmology, 1988

American Journal of Ophthalmology, 1989

We performed bilateral argon laser trabeculoplasty on 34 patients with medically uncontrolled ope... more We performed bilateral argon laser trabeculoplasty on 34 patients with medically uncontrolled open-angle glaucoma. Preoperative intraocular pressure was greater than 21 mm Hg, with a less than 3-mm Hg difference between the two eyes. Laser treatment (360 degrees) was performed on both eyes within a three-month interval. Mean (+/- S. D.) baseline intraocular pressure was similar in the first- (26.9 +/- 3.7 mm Hg) and second- (26.5 +/- 3.3 mm Hg) treated eyes. One hour after treatment, four first- and four second-treated eyes had a greater than 30% increase in intraocular pressure. The one-hour change in pressure was highly correlated between the two eyes (r = .794, P less than .0001). Intraocular pressure was reduced (P less than .0001) one, two, and three years after treatment in both the first and second-treated eyes. The percentages of first- and second-treated eyes with a pressure of less than or equal to 21 mm Hg were similar at one, two, and three years. Pressure response between the two eyes was correlated (P less than .0001) at year 1 (r = .815), 2 (r = .757), and 3 (r = .886) after laser therapy.

Ophthalmology, 1986

The effect of argon laser trabeculoplasty (AL T) on lowering intraocular pressure (lOP) was studi... more The effect of argon laser trabeculoplasty (AL T) on lowering intraocular pressure (lOP) was studied retrospectively in 68 black patients and 42 white patients with uncontrolled primary open-angle glaucoma on maximally tolerated medical therapy. Patients with the diagnosis of pigmentary or pseudoexfoliation glaucoma and those having previous intraocular or laser surgery were excluded. While the mean age of the black patients (66.9 years) was lower than the white patients (72.2 years), the prelaser lOP was similar between the two groups: 26.2 mmHg for the black patients and 25.5 mmHg for the white patients. The mean lOP one year (18.4 mmHg for black patients and 18.4 mmHg for white patients) and two years (19.5 mmHg and 20.3 mmHg, respectively) after AL T was the same between the two groups of patients. A similar percentage of black (85%) and white (83%) patients showed more than a 15% decrease in lOP from their prelaser values one year after treatment. The lOP lowering effect of ALT decreased during the second post-operative year; but the diminished response was identical in patients of both races, with 71% of patients of both groups still showing greater than 15% reduction from their pre-laser lOP. We conclude that AL T is equally effective in lowering lOP for black and white patients with medically uncontrolled primary open-angle glaucoma.

Ophthalmology, 1987

Nineteen patients undergoing argon laser trabeculoplasty for open-angle glaucoma were studied pro... more Nineteen patients undergoing argon laser trabeculoplasty for open-angle glaucoma were studied prospectively. All patients had glaucomatous visual field defects with inadequate medical control of intraocular pressure (IOP) before laser treatment. All patients had two automated visual fields immediately before laser treatment. They also had follow-up automated perimetry at 1, 4, 8, and 12 months posttreatment. The serial visual fields were compared using a one-way analysis of variance and trend analysis. After the laser trabeculoplasty, six patients showed visual field improvement, eight showed no change, and five showed progressive visual field deterioration. Patients with little fluctuation of IOP measurements after laser treatment had a better prognosis for visual field retention. The mean IOP level, however, was a poor predictor of visual field progression. Patients with more extensive visual field damage before laser treatment did not do worse than patients with less extensive visual field loss.

Archives of Ophthalmology, 1988

The visual fields of 30 patients (subjects) with glaucoma were sent to six experienced clinicians... more The visual fields of 30 patients (subjects) with glaucoma were sent to six experienced clinicians (observers). Each subject had at least four visual field examinations on the OCTOPUS 201 automated perimeter spanning at least one year. Each observer was asked to review the visual field data of each subject and determine whether the visual fields were stable, improved, or worse over time. The visual field data were then analyzed using six different statistical models. In only 15 of the 30 subjects did at least five of the six human observers agree on the behavior of the visual field. Agreement among the statistical models was better, with at least five of the six models agreeing on 22 of the 30 subjects. It was concluded that there is, at present, no validated technique for detecting progressive visual field loss in glaucoma using automated perimetry when relatively few visual fields are available for analysis.

Psychopharmacology, 1995

Recent studies have suggested that the benzodiazepine (BZ) lorazepam (LZ) differs from other BZs ... more Recent studies have suggested that the benzodiazepine (BZ) lorazepam (LZ) differs from other BZs in its impairing effects on implicit memory tasks. The present study was designed to assess whether this atypical effect withstood the experimental rigour of Schacter's retrieval intentionality criterion and further, whether it could be reversed by the BZ antagonist, flumazenil (FL). The separate and combined effects of LZ, FL and placebo (PL) were assessed on indices of memory, sedation, and attention in 48 healthy volunteers. LZ disrupted performance on both explicit and implicit memory tasks, induced motor sedation and impaired focussed attention. FL attenuated LZinduced attentional deficits but did not affect motor sedation. FL also attenuated LZ-induced impairment on the implicit retrieval task. On the explicit retrieval task FL attenuated LZ-induced impairment for words which had been deeply processed at study but not words which had been shallowly processed. A subsequent recognition test showed LZ impaired recognition memory only when accompanied by recollective experience and flumazenil again attenuated this effect. FL itself lowered performance on several measures, reflecting intrinsic activity of this "antagonist". Assessment of the relationship between the mnestic and other effects of the drugs suggested that attentional effects contribute to, but do not explain, effects on implicit memory tasks. These results imply that the apparent atypical effects of LZ on implicit memory tasks are mediated by the same BZ receptor complex as mediates LZ's other effects.

Experimental and Clinical Psychopharmacology, 1996

ABSTRACT

Ophthalmology, 1989

Postoperative intraocular pressure (lOP) was measured in patients with open-angle glaucoma underg... more Postoperative intraocular pressure (lOP) was measured in patients with open-angle glaucoma undergoing extracapsular cataract extraction with a posterior chamber lens implant (ECCE-PC IOL). Patients considered to be under adequate medical glaucoma control had cataract surgery alone or combined with a posterior lip sclerectomy. Patients with medically uncontrolled glaucoma had cataract surgery combined with either a posterior lip sclerectomy or a trabeculectomy. Cataract surgery alone (n = 26) was associated with a significantly (P < 0.001) increased lOP on postoperative day 1: preoperative lOP, 18.9 ± 3.6 mmHg; postoperative lOP, 34.2 ± 12 mmHg. An lOP rise of 10 mmHg or more occurred in 69% of the eyes, whereas 77% of the eyes had an absolute lOP over 25 mmHg. Eyes undergoing combined surgery (n = 42) had a preoperative lOP of 21.3 ± 4.8 mmHg. On postoperative day 1, the mean lOP was 14.9 ± 12.0 mmHg. An lOP rise of 10 mmHg or more was observed in 14%, and an lOP over 25 mmHg in 21 % of combined surgery eyes. Cataract surgery in eyes with open-angle glaucoma requires careful monitoring and therapy for early postoperative increases in lOP. Combined surgery reduces the frequency and magnitude of, but does not eliminate, this complication. Ophthalmology 96:579-584, 1989 Significant postoperative increases in intraocular pressure (lOP) have been reported in normal eyes after cataract surgery. This complication occurs after intracapsular cataract extraction (ICCE) with or without the use of zonulysis with the enzyme alpha-chymotrypsin_ 1-3 More re

Psychopharmacology, 1998

Scopolamine and lorazepam both produce anterograde impairments of explicit memory but only loraze... more Scopolamine and lorazepam both produce anterograde impairments of explicit memory but only lorazepam impairs implicit memory as assessed by perceptual priming tasks. The main aim of the two experiments reported in this article was to determine the effects of these drugs on conceptual priming. Experiment 1 compared the effects of lorazepam (1,2 mg PO) with scopolamine (0.3,0.6 mg SC) and placebo in a study with 60 healthy volunteers. Experiment 2 compared the separate and combined effects of lorazepam (2 mg PO) and flumazenil (2 mg IV) with placebo in a study with 48 healthy volunteers. We found that conceptual priming in category generation tasks was intact following lorazepam in both studies. This preservation of conceptual priming contrasted with lorazepam-induced impairments on explicit memory tasks. In conjunction with previous findings, these results are interpreted as providing further support for the notion that conceptual and perceptual priming are subserved by distinct memory systems, one based on the operations of semantic memory, the other possibly based on a perceptual representation system. That lorazepam impairs perceptual but not conceptual priming suggests that the neurochemical substrates of the two kinds of priming are distinct.