http://exhibits.library.stonybrook.edu/mfp/files/original/bf0b6905f6c2b44054f0b8c530666cd5.pdf b11f5eee6a69d331f4c3c98cd7961516 PDF Text Text Reprinted from the :1. M. :1. Archives of Neurology May 1960, Vol. 2, pp. 547—551 Copyright 1960, by Aerircm Medical Association F igure-Ground Discrimination After Induced Altered Brain Function ROBERT l.. KAHN, Ph.D.; MAX POLLACK, Ph.D., and Studies of complex visual perception with altered brain function in man have not always yielded clear or consistent results. The disagreements may be due to many factors, such as differences in population studied, types of procedures employed, and difficulties in evaluating the degree of alteration in brain function. Electroconvulsive therapy (ECT), however, provides a unique op portunity for studying the effects of cere— bral dysfunction in that more accurate control can be maintained over the degree of induced cerebral dysfunction and its measurement. While most investigations of brain—injured populations have focused on the role of the locus of the lesion on behavior, current studies of ECT have emphasized individual differences. Marked variability has been shown for perceptual}2 behavorial,7 and physiologic 5'8 responses to ECT. Various personality 6'11 and social factors 9'10 have also been related to differences in response to treatment. In the course of an investigation of the perceptual and behavorial changes with ECT, a convulsive—subconvulsive control study was undertaken. In this report, the performance on complex visual tasks is pre— sented. Specifically, the aim was to deter— mine whether perceptual change induced by ECT is related to the degree of altered brain function and clinical behavioral ‘ Accepted for publication Jan. 18, 1960. From The Department of Experimental Psy— chiatry, Hillside Hospital. Presented at the American Psychological Association, New York, August, 1957. Aided by Grants M-927 and MY-2092 of the National Institute of Mental Health, National Institutes of Health, US. Public Health Service. MAX FINK, M.D., Glen Oaks, New York change, and Whether the pretreatment perceptual pattern is related to physiologic changes with treatment. The method used in the study was the perception of embedded geometric figures—— a technique which has been employed in recent years in studies of perceptual change in head trauma and brain tumor pa- tients.1'“"'14 Method Population—Fifty-three consecutive patients referred for ECT were studied. These included 16 men and 37 women, the ages ranging from 22 to 66 years, with a median of 49 years. The patients were divided at random into two groups. A convulsive group, of 29 patients, received grand mal electrotherapy with thiopental (Pentothal) premedication three times a week, using either a Medcraft alternating-current instrument or a. Reiter C-47 electrostimulator. A minimum of 12 treatments was given. The total number of treat— 1. ments was determined by the supervising psychia— trist in charge of the treatment unit on the basis of clinical criteria. A subconvulsive group, of 24 patients, was treated in similar fashion except that only subconvulsive stimulation was given after the thiopental. Fourteen of the subjects in the 'subconvulsive group were subsequently given a regular course of convulsive therapy. 2. Perceptual Task—In the week prior to treat— ment and on the day following the 12th treatment each patient was tested with a modification of the Gottschaldt hidden—figure test developed by Bat— tersby et al.1 The subject is presented with a page containing two forms—a simple geometric figure, and below it a complex figure in which the simple figure is embedded (Figure). The patient is asked to trace a specific geometric figure from the background by outlining it with a colored pencil. The discriminations range in complexity from relatively simple to more complex. There are 25 such discriminations. A maximum of two minutes is allowed for each. Performance is scored in terms of total number of errors. To minimize a practice effect, two equivalent forms of the test were used. The forms were alternated with 77/547 �A.M.A. ARCHIVES OF NEUROLOGY Comparisons for Number of Errorr Before and During EC T TABLE 1.———Intragr0up Type of Treatment Subconvulsivo Convulsive Before No. 24 43 ECT During Differ— ECT once 1’ 7.7 11.8 ~2.3 +2.3 <0.02 10.0 9.5 * (0.02 Intragroup analyses in this and in subsequent tables are based on Wilcoxon’s method of paired replicates. * Results \VAVI ‘7"7V 'AL A AL‘ Figures in hidden-figures test. The preliminary sample used to acquaint the subjects with the task is shown in a; b and c are examples of test figures. In (1 the task is complicated by having the subject determine which of the two single figures can be found in the complex figure. successive patients in pretreatment testing. During treatment the patient was reexamined with the form different from that given initially. 3. Evaluation of Physiologic Change. Two measures of brain function——the electroencephalo— gram and the amobarbital test15—were given to each patient prio1 to and at weekly intervals during treatment. The electroencephalogram was evaluated as to the degree of induced slow-wave activity according to criteria previously published.5 The amobarbital test was noted as positive or negative for brain dysfunction according to standardized criteria}5 The results of these tests during the second, third, and fourth weeks of treatment furnished the criteria for physiologic change. A combined physiologic index was obtained by ascribing to each high—degree slow—wave EEG record and each positive amobarbital test a score of one. The range of physiologic altera— tion thus ranged from 0 to 6. 4. Behavior Ratings.—Each patient’s behavior was evaluated at weekly intervals. After the 12th treatment, a rating for the degree of behavioral change was made according to four classes: marked, moderate, minimal, or none. These ratings of change were not value judgments as to the quality of change but, rather, quantitative estimates of differences in behavior patterns under similar conditions of observation. Thus, such behavior patterns as euphoria, paranoia, and withdrawal might all be rated as equivalent for degree of quantitative change, although the implications of. each for the qualitative evaluation of improvement may be difi'erent. 78/548 The pretreatment and treatment scores and the mean change in the number of er— rors with treatment are shown for each group in Table 1. Intragroup analysis shows that the subconvulsive group made signifi— cantly fewer errors during treatment, whereas the convulsive patients made sig— nificantly more. Prior to treatment, subconvulsive patients made approximately the same number of errors as those in the convulsive group, a mean difference of 0.5 error. During treatment, however, the difference between these bet— at significant (4.1 errors) was groups ter than the 1'% level of confidence. When the data are analyzed with respect to physiologic change, significant increases in errors are found only for those patients with great— er degrees of physiologic change. This re— lationship is present in the analysis of the amobarbital test and the EEG as separate 2,—1ntragroup Comparisons for Number of Errors Before and After EC T in Relation to Degree of Physiologic Change TABLE 3 Mean Difference in No. of Errors During Treatment Physiological Index N Amobarbital Test None or one positive 13 —0.2 Two or three positive Electroencephalogram None or one high delta 28 +3.7 23 +1.7 Two or three high delta Combined Physiologic 0 t0 3 18 +3.3 21 +1.0 20 +3.9 4 to 6 1’ Not significant <0.01 Not significant <0.05 Not significant <0.01 V 01. 2, May, 1960 �FIGURE-GROUND DISCRIMINATION 3,—Intragronp Comparisons for Number of Errors Before and During ECT in Relation to Degree of Behavioral Change 4.—Relation of Pretreatment Errors to Eventnal Degree of Physiologic Change TABLE Degree of Behavioral Change Marked Moderate Minimal or none N Treatment 14 5 ——0.4 Physiologic Change 1’ 0 3 5 <0.01 Not significant Not significant indices, and when the two tests are bined (Table 2). to 2 and N 16 4 and 6 19 8 Mean N o. of Errors Pretreatment 7.9 11.2 13.3 logic change had frequent difficulty following instructions. They would trace the lines com— The relationship between the degree of behavioral change and the change in num— ber of errors during treatment is shown in Table 3. Those patients with minimal or moderate behavior changes did not show an appreciable difference in number of er— rors. Those with marked behavior changes, however, made significantly more errors during treatment. Analysis of the pretreatment error scores in relation to the degree of physiologic change is shown in Table 4. A significant relationship is shown between the pretreatment error scores and the degree of physio— logic change during treatment. Patients with minimal physiologic change during convulsive therapy had a mean pretreat— ment score of 7.9 errors, while those who developed marked physiologic effects had a mean pretreatment score of 13.2. The triserial correlation of pretreatment score and physiologic change is +0.34, significant at the 0.05 level of confidence. Qualitative Data—Alterations in size of figure or in minor aspects of form were common types of error during both testing periods. Certain qualitative patterns were frequently noted during treatment, which occurred only rarely in the pretreatment period. It was common for patients to make no attempt to trace the more complex figures. This failure was often associated with a generalized withdrawal reaction in which theipatient was unresponsive to any stimulus or procedure. Others became hos— tile and negativistic toward the testing. Patients with the greatest amount of physio— Kalm ,et al. During Treatment Mean Difference for Number of Errors During +3.6 +1.0 24 TABLE indiscriminately, without regard for the specific figure to be traced, repeat a previous figure despite changes in the test figure, draw lines where none actually existed, and attempt to trace the stimulus figure while ignoring the more complex test figure. Such patients were likely to respond quickly and impulsively, and showed little concern about making an error even when spontaneously commenting, “I know that’s not right.” Comment This study demonstrates a relationship between the degree of cerebral dysfunction and the degree of perceptual alteration as measured by errors on the embedded-figures test. Patients with subconvulsive stimulation made fewer errors on retesting. Patients receiving convulsive therapy, in whom only minimal physiologic changes were recorded, manifested slight increase or no change in errors. The convulsive patients, however, with the more marked physiologic altera— tions, showed a significant increase in ‘ errors. This interrelationship of brain func— tion and perception may be related both to the perceptual patterns with neurologic dis— orders and t0 the mode of action of con— vulsive therapy. It is evident that perceptual responses systematically vary with the degree of dif— fuse cerebral dysfunction. In relating these patterns to concepts of localized pathology, the role of generalized, nonspecific cerebral dysfunction must be considered. For ex— ample, unilateral spatial “inattention,” fre— quently attributed to parietal lobe lesions alone?!4 has been reported with a variety 79/ 549 �AM. A. ARCHIVES OF NEUROLOGY of lesions provided there was a somato— sensory defect and an associated generalized mental impairment."""16 Teuber and Wein— stein 1“ found that performance on an em— bedded—figures test was unrelated to locus of lesion in cases with penetrating brain wounds, but that aphasic patients made significantly more errors than a nonaphasic group. Pollack et al.,13 using a test identical with that in this study, reported no rela— tionship between errors and the location of lesion in tumor patients. They noted, instead, that the number of errors was related to the severity of general mental changes, manifested as disorientation for time and place. The present observation that perception of embedded figures is re— lated to the degree of diffuse brain dys— function is in accord with these studies of patients with head injuries and brain tu— mors. In previous investigations of the mode of action of convulsive therapy, we have shown that clinical behavioral change is related to the degree of altered brain func— tion.5'7'8 The present study reinforces this observation, the objective criterion of per— ceptual errors being used as an index of behavioral change. As a group, the patients who showed the greatest increase in errors with treatment were those who also showed the most pronounced change in clinical behavior, as assessed by conventional psychiatric evaluation. There appeared to be considerable comparability in the type, as well as the degree, of clinical behavioral change and the quali— tative aspects of performance on the em— bedded-figures test. Failure to attempt the task characteristically accompanied with— drawal or paranoid hostility. A lack of con— cern in correcting errors was associated with clinical euphoria or hypomania. From these behavioral observations, the increases in errors may be attributed to a change in attitude toward the task or examiner, as well as to a specific defect. The altered brain function modified the total pattern of interaction with the environment, of which 80/550 the performance on a complex perceptual task is just one aspect. Previous studies have shown that there is a relationship between the clinical response to convulsive therapy and aspects of personality, defined as the habitual or characteristic modes of response and adaptation.“v1°'11 In this study it has been shown that the pretreatment perceptual performance is related to the physiological response during treatment. This finding suggests that the indi— vidual differences in the development of physiologic change may also be related, in part, to personality factors. Summary and Conclusion Fifty—three consecutive patients referred for electrotherapy were studied before and after treatment on their ability to perceive embedded geometric figures. An experimental group of 29 patients received a course of grand mal therapy with thiopental (Pentothal) premedication. A control group of 24 patients received submnvulsive stimu— lation with thiopental premedication only. The experimental group made significant— ly more errors after treatment than did the controls. Within the experimental group there was considerable variability. Increase in errors was significantly related to the degree of altered brain function and to the degree of behavioral change. Qualitative aspects of perceptual behavior mirrored the pattern of behavioral change observed clinically. Pretreatment error scores were signifi— cantly related to the degree of altered brain function developed during treatment. The significance of this observation in terms of personality factors is indicated. Department of Experimental Psychiatry, Hillside Hospital. REFERENCES l. Battersby, W. S.; Krieger, H. P.; Pollack, M., and Bender, M. B.: Figure-Ground Discrimi— nation and the Abstract Attitude in Patients with Cerebral Neoplasms, A.M.A. Arch. Neurol. & Psychiat. 76 2369, 1956. Vol. 2, May, 1960 �FIGURE-GROUND DISCRIMINA TION Battersby, W. S.; Bender, M. B.; Pollack, M., and Kahn, R. L.: Unilateral Spatial Agnosia (Inattention) in Patients with Cerebral Lesions, Brain 79:68, 1956. 3. Critchley, MacD.: The Parietal Lobes, Baltimore, Williams & Wilkins Company, 1953. 4. Cobb, S.: Amnesia for the Left Limbs De— veloping into Anosognosia, Bull. Los Angeles Neurol. Soc. 12:48, 1947. 5. Fink, M., and Kahn, R. L.: Relation of Electroencephalographic Delta Activity to Behavioral Response in Electroshock: Quantitative Serial Studies, A.M.A. Arch. Neurol. & Psychiat. 2. 78:516, 1957. Fink, M.; Kahn, R. L., and Pollack, M.: Psychological Factors Affecting Individual Differ— ences in Behavioral Response to Convulsive Therapy, J. Nerv. & Ment. Dis. 1282243, 1959. 7. Fink, M.; Kahn, R. L., and Green, M. A.: Experimental Studies of the Electroshock Process, Dis. Nerv. System 19:1, 1958. 8. Kahn, R. L.; Fink, M., and Weinstein, E. A.: Relation of Amobarbital Test to Clinical Improve— ment in Electroshock, A.M.A. Arch. Neurol. & Psychiat. 76:23, 1956. 9. Kahn, R. L.; Pollack, M., and Fink, M.: Social Factors in the Selection of Therapy in a Voluntary Mental Hospital, J. Hillside Hosp. 6: 6. 216, 1957. Kalm cl 0]. Kahn, R. L.; Pollack, M., and Fink, M.: Sociopsychologic Aspects of Psychiatric Treatment in a Voluntary Mental Hospital, A.M.A. Arch. Gen. Psychiat. 1:565, 1959. 11. Kahn, R. L., and Fink, M.: Personality Factors in Behavioral Response to Electroshock Therapy, J. Neuropsychiat. 1:45, 1959. 12. Landis, C.; Dillon, D., and Leopold, 8.: Changes in Flicker-Fusion Threshold and in Choice Reaction Time Induced by Electroconvul— sive Therapy, J. Psychol. 41:61, 1956. 13. Pollack, M.; Battersby, W. S., and Bender, M. B.: Figure—Ground Discrimination in Patients with Cerebral Tumor, read at Eastern Psychological Association, 1957. 14. Teuber, H. L., and Weinstein, 5.: Ability to Discover Hidden Figures After Cerebral Lesions, A.M.A. Arch. Neurol. & Psychiat. 76: 10. 369, 1956. Weinstein, E. A.; Kahn, R. L.; Sugarman, L. A., and Linn, L.: Diagnostic Use of Amo— barbital Sodium (“Amytal Sodium”) in Brain Disease, Am. J. Psychiat. 112 2889. 1953. 16. Weinstein, E. A.; Kahn, R. L., and Slote, W. H.: Withdrawal, Inattention, and Pain Asymbolia, A.M.A. Arch. 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Iu‘rnctunp cuuparlaonn ,1331nataauaa Iran: Aaszsthéaa!_z:£& lung or on. ,- In: lI-bav It Izrnra nut-rt I Inc: Bittbrcnoo 1- 13 06.! ,‘Ci‘l’i :8 ‘30? loan or at. high «01‘. 23 01.7 pauzttv. 9!. or thrto turn. or401%. fit. high 3’ Us and 'IleI p Int tinnittaon‘ 001 lat lttuttloant , ' 10 .3.) 33 *1.o :3 ‘30, .05 lat attaittcunt . 001 �-W and having Safari o: strata cunpurtllnu tor_IIuh¢r In‘rnur1up angrvo O! lohnvacrnl filingt . litttd ”liturunconilnbfir a: 03.6 01.0 ~0.h Eh lb locnrato hiatus: or that R¢1u$ton I lat: x W t: at Pritv‘nfinunt tutor. p x... .fll lot aaanlftcaat Int atctitlnant xv'utunx 20;?!0 or rhrltolscidax 72353;; agggg‘ zggggggg , W! 9 $0 2 3 '3‘ ‘ I 1‘ 70’ I, 11.1 �«a. to ink: I6 nttcnpt tn tvtau fit. hora cunplcx figures. was. v.1poncc uga ottou unnaaiatud lith I gsnarnltacd r1tbdrauu1 rcdctlun in witch ‘ha paticnt was unruuponniva $0 an: attnula: u! pracodura. ethnra b.3335 hua‘tlo and uncuttviuilu touted it. tasting. ratauntu with th- groafiu-t tumult or phytiologtanl thing. it‘an had ditticllty I‘llivtas tantruc%a.ag. 13¢: it‘ld in... ‘IC 113.. stalwartntn.tolr I1th¢:§ rognra 1.: it. #9001113 tigurt‘ic it uttlsutd; rtpousod a pruvitun txatr‘ doapitc august. 1: ti. #0:: figurn; draw 11:». uhnro aunt uc$nully Oxiifiad; and afitnnutcd to trlcc tbs tttunluc tinny: Ital-'1cuorlig 1h: Into couplcx toot»:1:url. patleufin VOID and uhuvud it.) might 11kuly ltttlu fiuah it rcupaud quickly and tawlzclvuxr. o-annvu about making an arrow 0": «tan apantanoiutly dounont, '1 luau $hst'n unt rich€.' �W! .9, bdiuuon $|o d.:run ruln‘ionnhip fit: Ot'fii’ibrll‘fiyiflllfitlt and $ha aggro. u! parnuptual :Itcrn31ln taut. unbuddui PI‘tcutt eh. nunpurod on figiruu an h: crrurn ‘utth aubcolvnlsxvu uttlslntton-Iika shunt aurora an rotuattua. A ultghs dgcrauss or unwahanul tn Ottawa octurrnd in that. who riogtvzaz ahnitd cuntulitvo ally'haallnl thirty: pattlatt thing‘s. in. aunvulsivu pittcatl, houivor, ut‘t pkg-Intogtcul atudr‘luunlatrlitu - & 68. unit anvkud phamaglcgtcux altsruttnn, Ihnvtd a ctxuttlnnat tn¢r0330 1n number at strewn. 1‘4: lntorrnlntaoauhAp at bruit £una££un aha porcupiiuu or caboddcd tsguvuu is in actard wi‘t atudtnn of pu$tnutu with altarud tibia rua¢ttiu an. to htad wutaatoia u (10) uppaytng fwufitr tad taunt. taint: ul-ilur inuhuta 1n QISI& with pauotrattng brain unuadt, tutu alldud that ycrrurllnan Inn_uarnln&ua to lien. or lonlua but ihat uphuuic pntttnto and. nixaittcnntly'unru arvnra thtu & unaunphnnlc bruinwtnjirol group. Pollack g§_g§, (9). 1113‘ ruporfiod Qltc SI an taxation-t1, an taut atuty. tauntttul tit httuuul attain and ‘h. laaation a: 10010: &n tutor patsoutt. fits rnlutol author at that rwporfiad. tuntnnd, in: Irrort it!) to it: stvurtty o: amok unut¢1 changes an dzuaritatntiau. 1‘ should be yuanint o‘t «hat the total prc‘roatunnt than atom. tow I11 pntlcnt- r‘larraa lav upnvulntvo thnruyy fin sauna hy saunt1¢a1 10.5 n linou‘ nun». tat! ctrurn. at. and brain nxmk 21.5%: (9) an um: man tw pltluu“. an” ‘ use populations It. auuparublc 3: turn: .1 a£hnr pntnntfiura £11or1u1u.~ xvuund In $3. and lattata figurt ceuautiwa. a: as. two �‘16“ iii! oaunct in rugurfiud an rntlntttvc o: notnhrtl 43:9inotaou an an inalnfiad out$£y tbairna‘od (It. fit. t¢tn11my at hchavtur. hasn‘t ‘hll beta; :- 3.0Io in tin rolatloatth, your parttvuuaau tn aunt inthu any be due to it: internation a: Ina: tn:$«rn. mu 117thth um. an); an. my “on m nu.»watt nation cnrnbrcl din... uh» lit! fi'tf hit!!! an $ht- iatk than ocntrul llhltt‘l vifih tn§n¢t turtbrnl tunataun. In in. prbouafi otudy It. rtugc at altturoacou lull: $hn pattunfi: prior ‘0 ‘lflflildli nun cruator than thnfi uhintlud cvua‘ux‘h atrium: phyasalartall chlacu. “’11. patlaut in thy nahnoavnlatva group wish I high author at prutvtnilaut «trorn at: ants a yrlattcn attics In ritcnttn; watt a ruita£1on in crrtra, hit nbnulutc arrow near: :nr still bu hixhnr tits shut it n puiinnfi ronutvilu tournlntvn ‘hnaunr_uh¢ had Irv protv*ainnnt erurn 0“ I:s alum: auurtaacd dattxaulsy with trociunnt. than. obnnrvatioan tuccuufi thtt isttanulty 1| ptrtotvtnc cnhaadad (tutti. ta tainted to acrintu ’Oviiilltiw unpocti tn v.11 n: it first. ttwthnstailu Galitufialt with talc aanulptiou. flttita (1!, 13) but thiod tha‘ fit. Hurlid thtividi&1 dillnrwunua in tin porttptaoa-c: haddnu tautrla nuns; 0011.10 otudoatn If. rtlnfici to purnounIAtr tun$oro. its rvlatlllnhip or parucpintl altnruticn to bohavtornl 1.: clearly during u: u group an than haunt ,puiauntc at. thalud Qt. cystitis snaruutu in autumn during troufiuant viii than. vi. .130 lhlfltl tun swat yruaouncod ah$a¢u m t manna. �«11¢ mucmd mm puma: cult“: team”. may“. Wt... “mum. «aunt-ta a a: to “we“ m mum m“ m mutt" on a» mom: tutu an mm tun-Int. ham to may 1n or mu. pm» «at» «um tut m um‘ WW 1» in Infinity um "mum u t pm.“ at «ml mu, “ton. A or raw- to an um In! of mm in wanna: "mm at non-um claim ”its!“ c: mm“ 1:. mun“ :- «W. m «$81th with «d mu. than” m. tho ”that“! to arr an.» «aim an n m mi: num. a. a 0: 0: m uuutm 1: tutu mum. am... a can N on mum.“ u Mutt“ an omit: flflmm tut with or a m ammt. u it. ”won “and“: u W mmum to 0 in in rim . am nun“ :0:m 3m1¢1u1031 mum. in “an.“ manual» m In at no“ c: a «an “null". that». WI1: mm an 3m um I m mm“ cm“ «mitnm a Manna.” flu at flu t ”can.” «alum for at Ma pron-«mat mum M3. mulch. mm man»- that m in a» mum! wanna».- mover. at of a dam. mun-«u: “an a 4mm“ ma M at much "nut ”nanny. u m an (a, 5). to ”an": �all; taxman. manna ”than ”1‘qu hr in mm. m an: What “tummy an um; A: 4“ ms: an“: man «ma mm. that... 0: gm, a 0: I! united min-um ”an“ mu mi 1. m mm: i It“ mum: Man...n-mu‘m with ”nun-a My nun” ”ulna «hum. m In: a: It pmmutm my. I. a. madman “110'“; What M ' ' in»: an an “Mina: m “I! «am... ram as manual no» mu m tfllflfl'flth in» tun-nu "nanny. mm an imminent” mum u ‘ ' ' 3. mumuotnwmmunmumnmnu “but!“ “use. p um um: mo autumn: of bran alum m «gm tutu“ amino! mm u In run-«hunt W Mm at ”nanny («my tmhmt. I'M 1.th mint“. “flute!!!“ at “It! in .1 psi-«pm W10: mu“: “than chum: «1mm». no puns-u or human: 5. m M am �mm: M. 1|"le 11133th a: hut (ulna. m 1.: In.“ ma: man flu u mutt as also.“ m1. "by 9.: Wk mug-ma um m an.“ u 3. n g m an: m tn um» Hm. «I: u “I“ an at“ m was “we. W m �«1 3a References I. Inttarahy, w.s.. traccnr. x.r., reliant, n. and nundlr. 3.3.: figuruogrcmnd ¢£unr£uannt1nu and the abatrtut uttitncn 1n putatuta with narchrax neayltnna. 5,555, ‘4 xi, '_'_, gaig.~;k;w., 19; 369, 195$. 2. rink. I. and Kuhn, Into: leln‘ttn Qt ita ficltl anivtty ‘a behavioral raapouao an electrouhaaks quantitnfiivn ' sorts: utiliaa, ewe .'o 1!? a 516. 1951. J. rink. h. m. I.t. tucturc vayuhnlnnzaal l.u rlmllsh, l.. Ittecttng individual attrcrlacus In hohtvanrtl filviiii Kata. and a. «man mm. mg... m: m. 1939. m. rm, M... and arm. ma... Mora-um mm. ' 0! the alaotveuhaek prune... Egg, leggg 51p., l2! 1. 1958. 5. mm. 2.3... rm, 1:. mt manna, 1m... lemma .3 Innhtrbttaa tout to altfiifill inprrvoann‘ in cleatrclhatk, 1.mt.,‘1§I 83. 1956. 6. Kuhn, 3.3.. Pollnel, fl. and tint, n.a auutul flatari 1n ‘ho taxonfiauu at thtvlwy ta 3 valuntear ninth: hanpttal. ,. 7. .fi _. , uI. go :16”. 1997. Iain, I.L., Pulltnk, and risk, 3.: atatapuylhaluuto firtntlnut an I reinstary ninth! haspt‘tl. 5.x.n. trot. flan. Payer. (In preto). I. tenets, 6.. 3111‘», a. and beeper; 8.! damage: 3: little:lliinn thrtlhfild and in until. vtnnfitlu $1.! Indtotd 1956. by 61. that-pr. a: magenta ‘3 paguhtttrso “wanna“ W... �...L 1.1.23.1...LL hunt. I... ground tuna”. 10. rum, Id. I). 8.3.: W and 'nnna W M. ‘ 5.: woman. attu- {W “any hunt, mm 1;.»- m. 1m. to hunch, 3a.. uh. IJ...‘ Guam. ammo m a a man“ in“ than. 1953. 1!. mm. Wumm M, 1‘va mu“ mm: 11. ma. m4 itltrfintnlttui in pttllut: itth carthvll at Panama“). Amati“. m. m 1957. ‘ mm. 3.4.1. “It. in: m: 889. on «an (Inn: want) ’ . «mm». 8.5.: .1 unhaido‘ tiguruu, g, rugg.. in £23 «u a! 1, 1936. swam mm»: um Wu 3.9M. um. 1M. pot-«yam. a a: W" LA... um .1 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Published Works Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Figure-ground discrimination after induced altered brain function. Arch Neurol. (Chic.) 1960 May; 2:547-51 Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context mfp-02-01-003-47-013 Date A point or period of time associated with an event in the lifecycle of the resource 1960 Creator An entity primarily responsible for making the resource Kahn, Robert L.; Pollack, Max; <a title="Fink, Max, 1923-" href="http://id.loc.gov/authorities/names/n79039548" target="_blank">Fink, Max, 1923-</a> Subject The topic of the resource Published Works -- Articles and Reviews Relation A related resource The Max Fink Collection Description An account of the resource Reprint and [preprint]. Reprinted from the A.M.A. Archives of Neurology May 1960, Vol. 2, pp. 547—551 Rights Information about rights held in and over the resource <a title="IN COPYRIGHT - EDUCATIONAL USE PERMITTED" href="http://rightsstatements.org/vocab/InC-EDU/1.0/" target="_blank">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a> Source A related resource from which the described resource is derived Special Collections and University Archives, University Libraries. Stony Brook University Libraries (State University of New York). Language A language of the resource en-US Format The file format, physical medium, or dimensions of the resource application/pdf Publisher An entity responsible for making the resource available Contributor An entity responsible for making contributions to the resource Published