Michael Silverman | Mount Sinai School of Medicine (original) (raw)

Books by Michael Silverman

Papers by Michael Silverman

Archives of women's mental health, Jun 16, 2015

A major barrier to the diagnosis of postpartum depression (PPD) includes symptom detection. The l... more A major barrier to the diagnosis of postpartum depression (PPD) includes symptom detection. The lack of awareness and understanding of PPD among new mothers, the variability in clinical presentation, and the various diagnostic strategies can increase this further. The purpose of this study was to test the feasibility of adding clinical decision support (CDS) to the electronic health record (EHR) as a means of implementing a universal standardized PPD screening program within a large, at high risk, population. All women returning to the Mount Sinai Hospital OB/GYN Ambulatory Practice for postpartum care between 2010 and 2013 were presented with the Edinburgh Postnatal Depression Scale (EPDS) in response to a CDS "hard stop" built into the EHR. Of the 2102 women who presented for postpartum care, 2092 women (99.5 %) were screened for PPD in response to a CDS hard stop module. Screens were missing on ten records (0.5 %) secondary to refusal, language barrier, or lack of clari...

Scientific Reports, 2020

The mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and... more The mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Coronavirus Disease 2019 (COVID-19) pandemic on postpartum women are of increasing concern among mental health practitioners. To date, only a handful of studies have explored the emotional impact of the pandemic surrounding pregnancy and none have investigated the consequence of pandemic-related social restrictions on the postpartum mood of those living among different socioeconomic status (SES). All postpartum patients appearing to the Mount Sinai Health System for their postpartum appointment between January 2, 2020 and June 30, 2020, corresponding to before and during pandemic imposed social restrictions, were screened for mood symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Each patient’s socioeconomic status (high/low) was determined by their location of clinical service. A total of 516 postpartum patients were screened. While no differences in EPDS scores...

NeuroImage, 2007

Neural substrates of behavioral inhibitory control have been probed in a variety of animal model,... more Neural substrates of behavioral inhibitory control have been probed in a variety of animal model, physiologic, behavioral, and imaging studies, many emphasizing the role of prefrontal circuits. Likewise, the neurocircuitry of emotion has been investigated from a variety of perspectives. Recently, neural mechanisms mediating the interaction of emotion and behavioral regulation have become the focus of intense study. To further define neurocircuitry specifically underlying the interaction between emotional processing and response inhibition, we developed an emotional linguistic go/no-go fMRI paradigm with a factorial block design which joins explicit inhibitory task demand (i.e., go or no-go) with task-unrelated incidental emotional stimulus valence manipulation, to probe the modulation of the former by the latter. In this study of normal subjects focusing on negative emotional processing, we hypothesized activity changes in specific frontal neocortical and limbic regions reflecting modulation of response inhibition by negative stimulus processing. We observed common fronto-limbic activations (including orbitofrontal cortical and amygdalar components) associated with the interaction of emotional stimulus processing and response suppression. Further, we found a distributed cortico-limbic network to be a candidate neural substrate for the interaction of negative valencespecific processing and inhibitory task demand. These findings have implications for elucidating neural mechanisms of emotional modulation of behavioral control, with relevance to a variety of neuropsychiatric disease states marked by behavioral dysregulation within the context of negative emotional processing.

Psychoneuroendocrinology, 2009

The development and exacerbation of many psychiatric and neurologic conditions are associated wit... more The development and exacerbation of many psychiatric and neurologic conditions are associated with dysregulation of the hypothalamic pituitary adrenal (HPA) axis as measured by aberrant levels of cortisol secretion. Here we report on the relationship between the amplitude of diurnal cortisol secretion, measured across 3 typical days in 18 healthy individuals, and blood oxygen level dependant (BOLD) response in limbic fear/stress circuits, elicited by in-scanner presentation of emotionally negative stimuli, specifically, images of the World Trade Center (WTC) attack. Results indicate that subjects who secrete a greater amplitude of cortisol diurnally demonstrate less brain activation in limbic regions, including the amygdala and hippocampus/ parahippocampus, and hypothalamus during exposure to traumatic WTC-related images. Such initial findings can begin to link our understanding, in humans, of the relationship between the diurnal amplitude of a hormone integral to the stress response, and those neuroanatomical regions that are implicated as both modulating and being modulated by that response.

CNS Spectrums, 2007

ABSTRACTIntroduction:With ∼4 million births each year in the United States, an estimated 760,000 ... more ABSTRACTIntroduction:With ∼4 million births each year in the United States, an estimated 760,000 women annually suffer from a clinically significant postpartum depressive illness. Yet even though the relationship between psychiatric disorders and the postpartum period has been documented since the time of Hippocrates, fewer than half of all these cases are recognized.Objective:Because postpartum depression (PPD), the most common complication of childbearing, remains poorly characterized, and its etiology remains unclear, we attempted to address a critical gap in the mechanistic understanding of PPD by probing its systems-level neuropathophysiology, in the context of a specific neurobiological model of fronto-limbic-striatal function.Methods:Using emotionally valenced word probes, with linguistic semantic specificity within an integrated functional magnetic resonance imaging (fMRI) protocol, we investigated emotional processing, behavioral regulation, and their interaction (functions...

The open neuroimaging journal, 2009

Low socioeconomic status (SES) is associated with increased morbidity and premature mortality. Be... more Low socioeconomic status (SES) is associated with increased morbidity and premature mortality. Because tonic adversity relates to a diminished ability to experience pleasure, we hypothesized that subjects living in poverty would show diminished neural responsivity to positive stimuli in regions associated with positive experience and reward. Visual images were presented to twenty-two subjects in the context of a EPI-BOLD fMRI paradigm. Significant differences in neural responses between SES groups to poverty vs. neutral images were assessed, examining group, condition, and interaction effects. The data suggest that persons living in low-SES have neural experiences consistent with diminished interest in things generally enjoyed and point toward a possible explanation for the relationship between socioeconomic inequalities and mood disorders, such as depression, by SES.

Optometry - Journal of the American Optometric Association, 2004

Background: This study examines the following questions: In moderately disabled readers, will tem... more Background: This study examines the following questions: In moderately disabled readers, will temporal vision-processing therapy procedures that benefit reading comprehension, visual attention, and oculomotor skills ameliorate M-cell processing deficits as measured with coherent motion threshold testing? And will the results show a corresponding improvement in oral reading and verbal skills? Method: A sample of 16 moderately disabled readers, evaluated in a study completed 6 months earlier, were retested with another form of the Gates-MacGinitie Reading Test. Each participant was additionally tested for coherent motion, oral reading, and word attack skills. During the succeeding 6 months, fifteen 45-minute therapy sessions were administered once a week (as the school schedule permitted). After completing 15 therapy sessions, the initial testing procedures were repeated. Results: All four variables-namely, Gates-MacGinitie Reading Test, Coherent Motion Threshold Test, Gray Oral Reading Test, and Woodcock-Johnson Word Attack Test-revealed significant improvements after temporal vision therapy. Half of the 16 participants improved 2 or more years in reading comprehension, compared to no significant mean difference following the bmonth "control period" before the onset of therapy. Conclusions: This research supports the value of rendering temporal vision therapy to children identified as moderately reading disabled (RD). The diagnostic procedures and the dynamic therapeutic techniques discussed In this article have not been previously used for the specific purpose of ameliorating an M-cell deficit. Improved temporal visual-processing skills and enhanced visual motion discrimination appear to have a salutary effect on magnocellular processing and reading comprehension in RD children with M-cell deficits.

Journal of Vision, 2004

Abstract While limbic responses to anxiety have been extensively studied, sensory region involvem... more Abstract While limbic responses to anxiety have been extensively studied, sensory region involvement is less understood. We utilized fMRI combined with a modified instructed fear/anticipatory anxiety paradigm to test our hypothesis that secondary visual areas ...

Journal of Learning Disabilities, 2003

Consciousness and Cognition, 2006

In a series of three experiments, we explored the nature of implicit representations in change bl... more In a series of three experiments, we explored the nature of implicit representations in change blindness (CB). Using 3 • 3 letter arrays, we asked subjects (Ss) to locate changes in paired arrays separated by 80 ms ISIs, in which one, two or three letters of a row in the second array changed. In one testing version, a tone followed the second array, signaling a row for partial report (PR). In the other version, no PR was required. After Ss reported whether a change had been detected and the PR had been completed (if required), they were asked to identify a degraded letter trigram that was either novel, or from a previously shown row (repetition priming). Our findings indicate that when CB occurs, both the pre-change and post-change stimulus information primes despite its unavailability to consciousness. Surprisingly, findings also indicate that when change detection occurs only the post-change information primes.

Archives of Women's Mental Health, 2010

American Journal of Obstetrics and Gynecology, 2009

For nulliparas, the CS rate was 21.3% for IL, and 10.1% for SL. For parous patients, CS rate was ... more For nulliparas, the CS rate was 21.3% for IL, and 10.1% for SL. For parous patients, CS rate was 5.7% for IL, 2.1% for SL. Four variables were almost exclusively associated with induction and cesarean delivery: IUGR, Oligohydramnios, PPROM, and Preeclampsia. Removing these diagnoses and other unmatched patients, left 11,780 parturients. After propensity score matching all p-values for the 27 covariates between IL and SL groups were Ͼ0.05, indicating that good balance was achieved. CD rate among induced patients was 1.88(1.62, 2.17) times SL. After stratifying patients by propensity score, IL patients were still 1.81(1.20, 2.73) times more likely than SL for CD. CONCLUSION: IL, when indicated, may be a valid tool in perinatal management. However, these data show that IL significantly increases the risk of CD when propensity modeling creates optimally balanced study groups. The risk of CD with IL should be part of the management decision.

Consciousness and Cognition, 2002

Attention is necessary for the conscious perception of any object. Objects not attended to are no... more Attention is necessary for the conscious perception of any object. Objects not attended to are not seen. What is it that captures attention when we are engaged in some attention-absorbing task? Earlier research has shown that there are only a very few stimuli which have this power and therefore are reliably detected under these conditions (for example, Mack & Rock, 1998; Moray, 1959). The two most reliable are the observerÕs own name and a happy face icon which seem to capture attention by virtue of their meaning. Three experiments are described which explore whether these stimuli are detected under conditions, heretofore unexamined, which either cause inattentional blindness or are associated with a perceptual failure associated with the limits of attention. The evidence obtained indicates that these stimuli have a unique capacity to capture and extend the limits of attention under conditions in which this has been deemed highly unlikely.

Depression and anxiety, Feb 1, 2017

Postpartum depression (PPD) can result in negative personal and child developmental outcomes. Onl... more Postpartum depression (PPD) can result in negative personal and child developmental outcomes. Only a few large population-based studies of PPD have used clinical diagnoses of depression and no study has examined how a maternal depression history interacts with known risk factors. The objective of this study was to examine the impact of a depression history on PPD and pre- and perinatal risk factors. A nationwide prospective cohort study of all women with live singleton births in Sweden from 1997 through 2008 was conducted. Relative risk (RR) of clinical depression within the first year postpartum and two-sided 95% confidence intervals were estimated. The RR of PPD in women with a history of depression was estimated at 21.03 (confidence interval: 19.72-22.42), compared to those without. Among all women, PPD risk increased with advanced age (1.25 (1.13-1.37)) and gestational diabetes (1.70 (1.36-2.13)). Among women with a history of depression, pregestational diabetes (1.49 (1.01-2.21...

Abstract This study quantified the influence of visual attention therapy on the reading comprehen... more Abstract This study quantified the influence of visual attention therapy on the reading comprehension of Grade 6 children with moderate reading disabilities (RD) in the absence of specific reading remediation. Thirty students with below-average reading scores were identified using standardized reading comprehension tests. Fifteen children were placed randomly in the experimental group and 15 in the control group. The Attention Battery of the Cognitive Assessment System was administered to all participants.

BACKGROUND: This study examines the following questions: In moderately disabled readers, will tem... more BACKGROUND: This study examines the following questions: In moderately disabled readers, will temporal vision-processing therapy procedures that benefit reading comprehension, visual attention, and oculomotor skills ameliorate M-cell processing deficits as measured with coherent motion threshold testing? And will the results show a corresponding improvement in oral reading and verbal skills?

The Journal of neuropsychiatry and clinical neurosciences

Journal of Anxiety Disorders, 2011

Most functional neuroimaging studies of panic disorder (PD) have focused on the resting state, an... more Most functional neuroimaging studies of panic disorder (PD) have focused on the resting state, and have explored PD in relation to healthy controls rather than in relation to other anxiety disorders. Here, PD patients, posttraumatic stress disorder (PTSD) patients, and healthy control subjects were studied with functional magnetic resonance imaging utilizing an instructed fear conditioning paradigm incorporating both Threat and Safe conditions. Relative to PTSD and control subjects, PD patients demonstrated significantly less activation to the Threat condition and increased activity to the Safe condition in the subgenual cingulate, ventral striatum and extended amygdala, as well as in midbrain periaquaeductal grey, suggesting abnormal reactivity in this key region for fear expression. PTSD subjects failed to show the temporal pattern of activity decrease found in control subjects.

Archives of women's mental health, Jun 16, 2015

A major barrier to the diagnosis of postpartum depression (PPD) includes symptom detection. The l... more A major barrier to the diagnosis of postpartum depression (PPD) includes symptom detection. The lack of awareness and understanding of PPD among new mothers, the variability in clinical presentation, and the various diagnostic strategies can increase this further. The purpose of this study was to test the feasibility of adding clinical decision support (CDS) to the electronic health record (EHR) as a means of implementing a universal standardized PPD screening program within a large, at high risk, population. All women returning to the Mount Sinai Hospital OB/GYN Ambulatory Practice for postpartum care between 2010 and 2013 were presented with the Edinburgh Postnatal Depression Scale (EPDS) in response to a CDS "hard stop" built into the EHR. Of the 2102 women who presented for postpartum care, 2092 women (99.5 %) were screened for PPD in response to a CDS hard stop module. Screens were missing on ten records (0.5 %) secondary to refusal, language barrier, or lack of clari...

Scientific Reports, 2020

The mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and... more The mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Coronavirus Disease 2019 (COVID-19) pandemic on postpartum women are of increasing concern among mental health practitioners. To date, only a handful of studies have explored the emotional impact of the pandemic surrounding pregnancy and none have investigated the consequence of pandemic-related social restrictions on the postpartum mood of those living among different socioeconomic status (SES). All postpartum patients appearing to the Mount Sinai Health System for their postpartum appointment between January 2, 2020 and June 30, 2020, corresponding to before and during pandemic imposed social restrictions, were screened for mood symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Each patient’s socioeconomic status (high/low) was determined by their location of clinical service. A total of 516 postpartum patients were screened. While no differences in EPDS scores...

NeuroImage, 2007

Neural substrates of behavioral inhibitory control have been probed in a variety of animal model,... more Neural substrates of behavioral inhibitory control have been probed in a variety of animal model, physiologic, behavioral, and imaging studies, many emphasizing the role of prefrontal circuits. Likewise, the neurocircuitry of emotion has been investigated from a variety of perspectives. Recently, neural mechanisms mediating the interaction of emotion and behavioral regulation have become the focus of intense study. To further define neurocircuitry specifically underlying the interaction between emotional processing and response inhibition, we developed an emotional linguistic go/no-go fMRI paradigm with a factorial block design which joins explicit inhibitory task demand (i.e., go or no-go) with task-unrelated incidental emotional stimulus valence manipulation, to probe the modulation of the former by the latter. In this study of normal subjects focusing on negative emotional processing, we hypothesized activity changes in specific frontal neocortical and limbic regions reflecting modulation of response inhibition by negative stimulus processing. We observed common fronto-limbic activations (including orbitofrontal cortical and amygdalar components) associated with the interaction of emotional stimulus processing and response suppression. Further, we found a distributed cortico-limbic network to be a candidate neural substrate for the interaction of negative valencespecific processing and inhibitory task demand. These findings have implications for elucidating neural mechanisms of emotional modulation of behavioral control, with relevance to a variety of neuropsychiatric disease states marked by behavioral dysregulation within the context of negative emotional processing.

Psychoneuroendocrinology, 2009

The development and exacerbation of many psychiatric and neurologic conditions are associated wit... more The development and exacerbation of many psychiatric and neurologic conditions are associated with dysregulation of the hypothalamic pituitary adrenal (HPA) axis as measured by aberrant levels of cortisol secretion. Here we report on the relationship between the amplitude of diurnal cortisol secretion, measured across 3 typical days in 18 healthy individuals, and blood oxygen level dependant (BOLD) response in limbic fear/stress circuits, elicited by in-scanner presentation of emotionally negative stimuli, specifically, images of the World Trade Center (WTC) attack. Results indicate that subjects who secrete a greater amplitude of cortisol diurnally demonstrate less brain activation in limbic regions, including the amygdala and hippocampus/ parahippocampus, and hypothalamus during exposure to traumatic WTC-related images. Such initial findings can begin to link our understanding, in humans, of the relationship between the diurnal amplitude of a hormone integral to the stress response, and those neuroanatomical regions that are implicated as both modulating and being modulated by that response.

CNS Spectrums, 2007

ABSTRACTIntroduction:With ∼4 million births each year in the United States, an estimated 760,000 ... more ABSTRACTIntroduction:With ∼4 million births each year in the United States, an estimated 760,000 women annually suffer from a clinically significant postpartum depressive illness. Yet even though the relationship between psychiatric disorders and the postpartum period has been documented since the time of Hippocrates, fewer than half of all these cases are recognized.Objective:Because postpartum depression (PPD), the most common complication of childbearing, remains poorly characterized, and its etiology remains unclear, we attempted to address a critical gap in the mechanistic understanding of PPD by probing its systems-level neuropathophysiology, in the context of a specific neurobiological model of fronto-limbic-striatal function.Methods:Using emotionally valenced word probes, with linguistic semantic specificity within an integrated functional magnetic resonance imaging (fMRI) protocol, we investigated emotional processing, behavioral regulation, and their interaction (functions...

The open neuroimaging journal, 2009

Low socioeconomic status (SES) is associated with increased morbidity and premature mortality. Be... more Low socioeconomic status (SES) is associated with increased morbidity and premature mortality. Because tonic adversity relates to a diminished ability to experience pleasure, we hypothesized that subjects living in poverty would show diminished neural responsivity to positive stimuli in regions associated with positive experience and reward. Visual images were presented to twenty-two subjects in the context of a EPI-BOLD fMRI paradigm. Significant differences in neural responses between SES groups to poverty vs. neutral images were assessed, examining group, condition, and interaction effects. The data suggest that persons living in low-SES have neural experiences consistent with diminished interest in things generally enjoyed and point toward a possible explanation for the relationship between socioeconomic inequalities and mood disorders, such as depression, by SES.

Optometry - Journal of the American Optometric Association, 2004

Background: This study examines the following questions: In moderately disabled readers, will tem... more Background: This study examines the following questions: In moderately disabled readers, will temporal vision-processing therapy procedures that benefit reading comprehension, visual attention, and oculomotor skills ameliorate M-cell processing deficits as measured with coherent motion threshold testing? And will the results show a corresponding improvement in oral reading and verbal skills? Method: A sample of 16 moderately disabled readers, evaluated in a study completed 6 months earlier, were retested with another form of the Gates-MacGinitie Reading Test. Each participant was additionally tested for coherent motion, oral reading, and word attack skills. During the succeeding 6 months, fifteen 45-minute therapy sessions were administered once a week (as the school schedule permitted). After completing 15 therapy sessions, the initial testing procedures were repeated. Results: All four variables-namely, Gates-MacGinitie Reading Test, Coherent Motion Threshold Test, Gray Oral Reading Test, and Woodcock-Johnson Word Attack Test-revealed significant improvements after temporal vision therapy. Half of the 16 participants improved 2 or more years in reading comprehension, compared to no significant mean difference following the bmonth "control period" before the onset of therapy. Conclusions: This research supports the value of rendering temporal vision therapy to children identified as moderately reading disabled (RD). The diagnostic procedures and the dynamic therapeutic techniques discussed In this article have not been previously used for the specific purpose of ameliorating an M-cell deficit. Improved temporal visual-processing skills and enhanced visual motion discrimination appear to have a salutary effect on magnocellular processing and reading comprehension in RD children with M-cell deficits.

Journal of Vision, 2004

Abstract While limbic responses to anxiety have been extensively studied, sensory region involvem... more Abstract While limbic responses to anxiety have been extensively studied, sensory region involvement is less understood. We utilized fMRI combined with a modified instructed fear/anticipatory anxiety paradigm to test our hypothesis that secondary visual areas ...

Journal of Learning Disabilities, 2003

Consciousness and Cognition, 2006

In a series of three experiments, we explored the nature of implicit representations in change bl... more In a series of three experiments, we explored the nature of implicit representations in change blindness (CB). Using 3 • 3 letter arrays, we asked subjects (Ss) to locate changes in paired arrays separated by 80 ms ISIs, in which one, two or three letters of a row in the second array changed. In one testing version, a tone followed the second array, signaling a row for partial report (PR). In the other version, no PR was required. After Ss reported whether a change had been detected and the PR had been completed (if required), they were asked to identify a degraded letter trigram that was either novel, or from a previously shown row (repetition priming). Our findings indicate that when CB occurs, both the pre-change and post-change stimulus information primes despite its unavailability to consciousness. Surprisingly, findings also indicate that when change detection occurs only the post-change information primes.

Archives of Women's Mental Health, 2010

American Journal of Obstetrics and Gynecology, 2009

For nulliparas, the CS rate was 21.3% for IL, and 10.1% for SL. For parous patients, CS rate was ... more For nulliparas, the CS rate was 21.3% for IL, and 10.1% for SL. For parous patients, CS rate was 5.7% for IL, 2.1% for SL. Four variables were almost exclusively associated with induction and cesarean delivery: IUGR, Oligohydramnios, PPROM, and Preeclampsia. Removing these diagnoses and other unmatched patients, left 11,780 parturients. After propensity score matching all p-values for the 27 covariates between IL and SL groups were Ͼ0.05, indicating that good balance was achieved. CD rate among induced patients was 1.88(1.62, 2.17) times SL. After stratifying patients by propensity score, IL patients were still 1.81(1.20, 2.73) times more likely than SL for CD. CONCLUSION: IL, when indicated, may be a valid tool in perinatal management. However, these data show that IL significantly increases the risk of CD when propensity modeling creates optimally balanced study groups. The risk of CD with IL should be part of the management decision.

Consciousness and Cognition, 2002

Attention is necessary for the conscious perception of any object. Objects not attended to are no... more Attention is necessary for the conscious perception of any object. Objects not attended to are not seen. What is it that captures attention when we are engaged in some attention-absorbing task? Earlier research has shown that there are only a very few stimuli which have this power and therefore are reliably detected under these conditions (for example, Mack & Rock, 1998; Moray, 1959). The two most reliable are the observerÕs own name and a happy face icon which seem to capture attention by virtue of their meaning. Three experiments are described which explore whether these stimuli are detected under conditions, heretofore unexamined, which either cause inattentional blindness or are associated with a perceptual failure associated with the limits of attention. The evidence obtained indicates that these stimuli have a unique capacity to capture and extend the limits of attention under conditions in which this has been deemed highly unlikely.

Depression and anxiety, Feb 1, 2017

Postpartum depression (PPD) can result in negative personal and child developmental outcomes. Onl... more Postpartum depression (PPD) can result in negative personal and child developmental outcomes. Only a few large population-based studies of PPD have used clinical diagnoses of depression and no study has examined how a maternal depression history interacts with known risk factors. The objective of this study was to examine the impact of a depression history on PPD and pre- and perinatal risk factors. A nationwide prospective cohort study of all women with live singleton births in Sweden from 1997 through 2008 was conducted. Relative risk (RR) of clinical depression within the first year postpartum and two-sided 95% confidence intervals were estimated. The RR of PPD in women with a history of depression was estimated at 21.03 (confidence interval: 19.72-22.42), compared to those without. Among all women, PPD risk increased with advanced age (1.25 (1.13-1.37)) and gestational diabetes (1.70 (1.36-2.13)). Among women with a history of depression, pregestational diabetes (1.49 (1.01-2.21...

Abstract This study quantified the influence of visual attention therapy on the reading comprehen... more Abstract This study quantified the influence of visual attention therapy on the reading comprehension of Grade 6 children with moderate reading disabilities (RD) in the absence of specific reading remediation. Thirty students with below-average reading scores were identified using standardized reading comprehension tests. Fifteen children were placed randomly in the experimental group and 15 in the control group. The Attention Battery of the Cognitive Assessment System was administered to all participants.

BACKGROUND: This study examines the following questions: In moderately disabled readers, will tem... more BACKGROUND: This study examines the following questions: In moderately disabled readers, will temporal vision-processing therapy procedures that benefit reading comprehension, visual attention, and oculomotor skills ameliorate M-cell processing deficits as measured with coherent motion threshold testing? And will the results show a corresponding improvement in oral reading and verbal skills?

The Journal of neuropsychiatry and clinical neurosciences

Journal of Anxiety Disorders, 2011

Most functional neuroimaging studies of panic disorder (PD) have focused on the resting state, an... more Most functional neuroimaging studies of panic disorder (PD) have focused on the resting state, and have explored PD in relation to healthy controls rather than in relation to other anxiety disorders. Here, PD patients, posttraumatic stress disorder (PTSD) patients, and healthy control subjects were studied with functional magnetic resonance imaging utilizing an instructed fear conditioning paradigm incorporating both Threat and Safe conditions. Relative to PTSD and control subjects, PD patients demonstrated significantly less activation to the Threat condition and increased activity to the Safe condition in the subgenual cingulate, ventral striatum and extended amygdala, as well as in midbrain periaquaeductal grey, suggesting abnormal reactivity in this key region for fear expression. PTSD subjects failed to show the temporal pattern of activity decrease found in control subjects.

Aktuelle Neurologie, 2007

The human stress response consists of a complex, coordinated sequence of neural and physiological... more The human stress response consists of a complex, coordinated sequence of neural and physiological changes partly subserved by the hypothalamic-pituitary-adrenocortical (HPA) axis. Key limbic and frontal structures, involved in fear conditioning and its modulation, have been demonstrated to play a role in modulating the activity of the HPA axis, including amygdaloid and hippocampal formations, and ventromedial prefrontal cortex (vmPFC) regions, which exhibit excitatory (amygdala) and inhibitory (hippocampus; vmPFC) effects on the HPA axis. While HPA function and associated endocrine changes have been widely investigated, to date, little research has been conducted utilizing functional neuroimaging in the study of the HPA axis and associated frontolimbic function in response to traumatic material. 20 subjects present in New York on the day of the September 11th, 2001 World Trade Center attacks participated in an emotional visual scene paradigm consisting of the presentation of images of varying emotional qualities, including images of the World Trade Center attacks, while BOLD response was measured utilizing fMRI. Salivary cortisol samples were collected, immediately prior to and following the scanning session, with changes in cortisol values analyzed as a covariate of interest during key condition contrasts of World Trade Center attack images, New York city images, and low-level visual controls. Results suggest that those subjects with a relative cortisol rise in response to the paradigm demonstrated greater amygdalar and bilateral dorsal hippocampi activity, in the context of decreased vmPFC activity in key condition contrasts involving traumatic imagery. These findings help to bridge models of fear circuitry with models of stress response as indexed by relative cortisol levels.