摘要:

Recently, analysis of partial variance (APV) was proposed as a technique to control for day-to-day variance in mitogen-induced lymphoproliferative responses whereby data obtained from controls, run in the laboratory on the same day, are used as covariates in regression analysis. In order to check the utility of the APV method in the interpretation of functional immune tests, we have reanalyzed lymphoproliferative responses in experimental subjects with depression (n = 38) stimulated by phytohemagglutinin (PHA), pokeweed mitogen (PWM) and concanavalin A (Con A) in relation to responses obtained in laboratory controls. There were no significant relationships between the depressed patients’ and laboratory controls’ lymphoproliferative responses to PHA, PWM or Con A. Controlling for day-to-day variation by means of regression analysis did not significantly alter the significant relationships between the patients’ lymphoproliferative responses and clinical variables, such as depressive classification and severity of illness. It is argued that the APV method may not be used to adjust for an inappropriately high day-to-day variability in immune a

ISSN:0302-282X    

DOI:10.1159/000119371

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We evaluated whether pituitary-adrenal response to surgical stress is modified in chronic schizophrenic patients. Twenty-two schizophrenic patients on chronic antipsychotic therapy of phenothiazine derivatives over 10 years underwent orthopedic surgery of the extremities under general anesthesia by isoflurane and nitrous oxide. In chronic schizophrenic patients, responses of plasma epinephrine, norepinephrine, ACTH and cortisol levels during surgical stress were significantly lower than those of control patients. The attenuated response to surgical stress in these patients may be associated with their autonomic dysfunction and decreased pituitary-adrenal activity due to chronic administration of antipsychotic agents.

ISSN:0302-282X    

DOI:10.1159/000119372

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective and subjective sleep and awakening quality as well as daytime vigilance of insomniac patients with generalized anxiety disorder (GAD) were investigated, as compared with normal controls. Forty-four outpatients (25 females, 19 males), aged 24–65 (mean 43) years, diagnosed with non-organic insomnia (ICD-10: F 51.0), related to mild GAD (F 41.1), with a Hamilton anxiety (HAMA) score of 22 ± 6 and a Zung self-rating anxiety (SAS) score of 37 ± 6 were included. After 1 adaptation night, sleep induction, maintainance and architecture were measured objectively by polysomnography, subjective sleep and awakening quality were assessed by self-rating scales and visual analog scales, objective awakening quality was measured by a psychometric test battery, and diurnal tiredness was measured by a 3-min vigilance-controlled EEG (V-EEG) and a 4-min resting EEG mapping. In polysomnography patients demonstrated – as compared with normals – significantly increased wake time during the total sleep period and more early-morning awakening, decreased total sleep and sleep efficiency. Subjective sleep quality was deteriorated as well, as were well-being, drive, mood, and wakefulness in the morning. In noopsychic performance, GAD patients did rather well in attention, concentration, attention variability, and numerical memory, while fine-motor activity and reaction time were deteriorated. In psychophysiology, critical flicker frequency was decreased in the morning, while muscle strength, blood pressure and pulse rate showed no differences. EEG mapping during the late morning hours (10.00–12.00 h) demonstrated hypervigilance in the V-EEG, while in the resting recording an increased sleep pressure was detected. The latter was correlated significantly to the SAS score, but less so to the observer-rated Hamilton anxiety score. Our findings suggest that CNS hypervigilance and hyperarousal, as actual symptoms of GAD, lead to nocturnal insomnia, which in turn may cause – as a consequence of sleep pressure not slept off -diurna

ISSN:0302-282X    

DOI:10.1159/000119373

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Previous human pharmacological and toxicological studies demonstrated advantages of the combination drug Somnium® [SOM, lorazepam (LOR) 1 mg plus diphenhydramine 25 mg] over 1 mg LOR alone, as it showed synergistic effects in hypnotic properties and antagonistic effects in regard to toxicity. In the present double-blind, parallel-group study, hypnotic and anxiolytic effects of SOM were studied in 44 patients with non-organic insomnia related to mild generalized anxiety disorder (GAD), as compared with LOR alone. After a placebo run-in phase of 1 week, they received active treatment (1 tablet SOM or LOR 1 mg) for 4 weeks and thereafter placebo again for 1 week. Clinical evaluations included the physician’s general assessment of efficacy, tolerance and adverse effects, the Hamilton anxiety rating scale (HAMA), the Zung self-rating anxiety scale (SAS) and depression scale, the withdrawal symptom scale (WSS), hematology and blood chemistry. Sleep laboratory evaluations included objective and subjective sleep and awakening quality, measured by polysomnography, self-rating of sleep and awakening quality (SSA) and a psychometric test battery in the morning, as well as measurement of daytime brain function, objectivated by EEG mapping. Physicians’ global evaluation of insomnia demonstrated no changes in the pre-drug placebo period, moderate improvement under both drugs, with a marginal advantage of SOM over LOR in the first 2 weeks, and a return to pre-drug values in the post-drug placebo period. Anxiety improved in observer ratings (HAMA) under both drugs, in self-rating (SAS) under the combination drug only, with the scores returning to pre-drug placebo values after post-drug placebo substitution. There were no significant findings in the self-rating depression scale and the WSS, with the exception of an improvement in the WSS score 4 weeks after SOM, as compared with pre-drug placebo. There were no rebound phenomena. Both drugs were well tolerated – in regard to both adverse effects and laboratory findings. Confirmatory statistics on the polysomnographically recorded target variable latency to sleep onset stage 2 demonstrated a significant shortening of sleep latency after SOM and a significant superiority of the combination drug SOM over LOR after acute dosing, as compared with pre-drug placebo. Descriptive statistics demonstrated further a significant improvement of sleep efficiency and total sleep time after SOM and of wakefulness time and number of awakenings during the total sleep period after both drugs, but no interdrug differences. Sleep architecture remained unchanged. Subjective sleep quality improved with both drugs, morning drowsiness and the total SSA score only with SOM, while LOR was superior to SOM regarding morning somatic complaints. There were neither changes nor interdrug differences in the morning noopsyche. In psychophysiology, critical flicker frequency decreased more under SOM than LOR. After 4 weeks therapy, no significant findings in polysomnography and subjective sleep and awakening were seen, except for an increase in movement time under LOR (tolerance development). In objective awakening quality, psychometry revealed an improvement of reaction time under SOM and a decrease of attention variability and an increase in fine-motor activity under LOR, with an interdrug comparison showing a significant superiority of SOM over LOR in regard to reaction time, reaction time variability and reaction time performance. After placebo substitution, rebound phenomena were seen in polysomnography and subjective sleep and awakening in the 1st night of the SOM group only, which were gone in the 7th placebo night, however. Noopsychic performance remained improved in both groups, with a superiority of SOM to LOR in regard to reaction time and reaction time variability. With a decrease of total power, of absolute delta/theta and alpha power, an increase of absolute beta power, further with an increase of relative delta/theta and beta and decrease of alpha power, as well as a slowing of the DT centroid (C) and acceleration of the alpha, beta and total C, EEG mapping demonstrated changes typical for anxiolytic drugs, which were significantly more pronounced after the combination drug than after LOR only. It is of interest that the drug-induced changes were exactly opposite to the differences measured between GAD patients and normal controls, which suggests a normalization of brain function by the anxiolytics at the receptor

ISSN:0302-282X    

DOI:10.1159/000119374

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Quantitative electroencephalography (qEEG) and the Folstein Mini Mental State examination (MMSE) were obtained from 31 patients affected by probable dementia of Alzheimer’s type (DAT). qEEG data were examined both by spectral analysis (Fast Fourier Transformation) and by single frequency band topographical centroid, and compared with those of 24 healthy subjects of the same age group. DAT patients were found to have higher absolute power in the slow (delta and theta) frequency bands. Quantitative topographical assessment showed significantly more anteriorly located centers of gravity for the alpha and beta activity. Only alpha anteriorization was correlated with the degree of cognitive impairment as measured by the global deterioration scale and MMSE. It is concluded that quantitative topographical assessment was successful for the statistical handling of the EEG power maps, and to identify a potential parameter for the functional staging of the diseas

ISSN:0302-282X    

DOI:10.1159/000119375

出版商:S. Karger AG    

年代:1997

数据来源: Karger