Effect of Sorbitol on Psychomotor Function

McClain, Craig J.; Kromhout, James P.; Zieve, Leslie; Duane, William

doi:10.1001/archinte.1981.00340070081017

Cited by 13 publications

(6 citation statements)

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“…In our experience, mean test scores following acquisition generally range between 35 and 55 correct in 90 sec. With paperand-pencil versions of the test, higher (Bond & Lader, 1973;Schaeffer, Andrysiak, & Ungerleider, 1981), lower (McClain, Kromhout, Zieve, & Duane, 1981), and comparable (Eckhardt, Parker, Noble, Pautler, & Gottschalk, 1979;Kornetsky, 1951) scores have been reported under nondrug conditions. Of special relevance to this comparison are studies with the paper-and-pencil version of the DSST that showed not only scores comparable to those found using the present method, but similar acquisition curves for repeated administration as well (Wittenborn, Flaherty, McGough, Bossange, & Nash, 1976;Wittenborn, Flaherty, McGough, & Nash, 1979).…”

Section: Discussionmentioning

confidence: 97%

An automated version of the digit symbol substitution test (DSST)

McLeod

Griffiths

Bigelow

et al. 1982

Behavior Research Methods & Instrumentation

355

218

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An automated version of the Digit Symbol Substitution Test is described that employs a relatively inexpensive, commercially available microcomputer to present and score the task. Advantages of the automated DSST include: (1) objective scoring of both speed and accuracy of test performance, (2) printed copies of test scores, (3) convenient administration under standardized test conditions, and (4) the capacity for repeated assessment of an individual's performance over time. Task performance data for individual subjects following doses of pentobarbital are presented; these data illustrate both the stability of task performance under constant conditions and the within-subjects sensitivity of task performance to experimental manipulations.The Digit Symbol Substitution Test (DSST), a component of the Wechsler Adult Intelligence Scale (Wechsler, 1958), is frequently used to measure associative ability. The DSST is also a popular instrument for the assessment of performance following administration of pharmacological agents. Indeed, it appears to be one of the more sensitive tasks used for this purpose (Hindmarch, 1980; McNair, 1973;Wittenborn, 1979).The DSST typically is administered as a paper-andpencil task. A subject is given a digit-symbol code in which each of nine digits is paired with a different symbol. On the same page (located below the code), a series of digits, selected from those in the code, is presented in an irregular order. The subject is instructed to draw the symbol that is appropriate for each digit in the space below each digit and to draw as many correct symbols as possible within a 90-sec test period.The present paper describes an automated version of the DSST that can be implemented easily on a commercially available personal microcomputer. This computerized version of the task offers advantages over the traditional pencil-and-paper version in terms of conve- nience, objective scoring, repeated measurement, and experimental control. METHODWith the automated DSST, the digit-symbol code is constantly displayed at the top of the video screen and the test digits are presented, one at a time, in the center of the screen. The subject's task is to enter, on the microcomputer keyboard, the geometric pattern of keypresses, shown in the digit-symbol code, which corresponds to the test digit. The microcomputer controls each 90-sec test session, scores the test, and stores the results; there is no need for a test administrator to be present during the test session.To implement the DSST program that controls the procedures described below, we use a TRS-80® Model I or Model III microcomputer (Radio Shack) with Level II BASIC and numeric key pad, a cassette tape recorder to load and save the program, and a peripheral interface package manufactured by the LVB Corporation (Lehigh Valley, Pennsylvania). The interface package includes a 1080-54 programmable timer card, 1080-01 bus extension, and a 1081-72 daisy chain cable. A Quick Printer II® (Radio Shack) is a useful system addition for providing printed rec...

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Section: Discussionmentioning

confidence: 97%

An automated version of the digit symbol substitution test (DSST)

McLeod

Griffiths

Bigelow

et al. 1982

Behavior Research Methods & Instrumentation

355

218

View full text Add to dashboard Cite

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“…As the main processor ofingested compounds, the liver might be expected to encounter sorbitol. However, orally ingested sorbitol is poorly absorbed in man and animals, and products ofits metabolism by intestinal microorganisms, rather than sorbitol itself, are absorbed (13,14). Nevertheless, sorbitol entering the liver could be oxidized by hepatic sorbitol dehydrogenase in the same way that ethanol is oxidized by alcohol dehydrogenase.…”

mentioning

confidence: 99%

Enzyme relationships in a sorbitol pathway that bypasses glycolysis and pentose phosphates in glucose metabolism.

Jeffery¹,

Jörnvall²

1983

Proc. Natl. Acad. Sci. U.S.A.

116

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A pathway from glucose via sorbitol bypasses the control points of hexokinase and phosphofructokinase in glucose metabolism. It also may produce glycerol, linking the bypass to lipid synthesis. Utilization of this bypass is favored by a plentiful supply of glucose-hence, conditions under which glycolysis also is active. The bypass further involves oxidation of NADPH, so the pentose phosphate pathway and the bypass are mutually facilitative. Possible consequences in different organs under normal and pathological, especially diabetic, conditions are detailed. Enzymes with related structures (for example, sorbitol dehydrogenase and alcohol dehydrogenase, and possibly, aldehyde reductase and aldose reductase, respectively) are linked functionally by this scheme. Some enzymes of the bypass also feature in glycolysis (aldolase and alcohol dehydrogenase), and these enzymes, with the reductases involved, are proteins known to occur in different classes or multiple isozyme forms. Two of the enzymes (aldolase and alcohol dehydrogenase) both involve classes with and without a catalytic metal (zinc). The existence of parallel pathways and the occurrence of similar enzymic steps in one pathway may help to explain the abundance and multiplicity of enzymes such as reductases, aldolases, and alcohol dehydrogenases.Although alcohol dehydrogenase is widespread in nature, is common in liver, and has been structurally characterized from several sources (1), its exact role in mammalian organs generally has remained unclear. In addition to ethanol oxidation, functions in bile acid formation, fatty acid degradation, vitamin A metabolism, a hydroxysteroid reaction, and other areas of metabolism have been considered (2). Different and multiple functions of alcohol dehydrogenase would be consistent with the considerable species variations and extensive evolutionary changes found.Recently, another common liver enzyme, sorbitol dehydrogenase, was shown to be structurally, mechanistically, and ancestrally related to alcohol dehydrogenase (3). The substrates of sorbitol dehydrogenase, fructose and sorbitol, are considered important in special organs, such as male sexual organs (4), or special disease states, such as hyperglycemic cataract formation (5) and possibly diabetic neuropathy (6) and glomerulosclerosis (7), but a more general metabolic significance that is compatible with the structural similarity of these enzymes has not been clear.The structural link between alcohol and polyol dehydrogenases showed a type ofparallel or convergent evolution ofa second, different enzyme in each case with related specificity (3). Enhancement of alcohol metabolism by fructose gave one association between the substrates for sorbitol and alcohol dehydrogenases. This effect may stem from avoidance of the ratelimiting NADH dissociation off alcohol dehydrogenase by an in situ coenzyme reoxidation with glyceraldehyde formed from fructose (8). Increased operation ofthe glycerol phosphate shuttle could also mediate the effect (9).The structural relat...

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“…21,22 McClain et at report an improvement in psychomotor tests in patients with alcoholic cirrhosis following administration ofsorbitol. 6 In theory it is clear that sorbitol might be expected to .be as effective as lactulose in the treatment of PSE. However, in order to assess whether this is the case, a large double-blind clinical trial is required to compare equal doses (dry weight) of sorbitol and lactulose in the treatment of PSE.…”

Section: Introductionmentioning

confidence: 99%

“…An in vitro experiment demonstrated that faecal bacteria metabolised sorbitol, resulting in faecal acidification and reduction in faecal ammonia concentration 5 . This was followed by studies utilising the “Hydrogen Breath Test” which prove conclusively that sorbitol is metabolised in the gut 6 , 7 , 8 …”

Section: Introductionmentioning

confidence: 99%