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Biomedical subjects

A L Stoll

Publications and source records attributed to A L Stoll.

52 records · Page 3Linked to original sources
PubMed1992

Comorbidity in mania at first hospitalization.

Comorbidity was studied in 41 manic and mixed-state bipolar patients at first hospitalization. The lifetime prevalence of comorbidity was high; 21 subjects (51.2%) had at least one other psychiatric diagnosis (N = 16, 39.0%) or medical disorder (N = 9, 22.0%). Nine subjects had multiple comorbid diagnoses. Women were 2.7 times more likely to have a comorbid diagnosis. The presence of comorbidity was not associated with differences in outcome measures.

Adult↗
PubMed1992

Increasing frequency of the diagnosis of obsessive-compulsive disorder.

OBJECTIVE: This study attempted to document a hypothesized increase in the frequency of the diagnosis of obsessive-compulsive disorder at a large psychiatric teaching hospital and to investigate correlates of this trend. METHOD: The annual rates of psychiatric discharge diagnoses at the hospital from 1969 to 1990 were reviewed, and the frequency of the diagnosis of obsessive-compulsive disorder was compared with that of paranoid disorders. Correlations were also done on these diagnostic rates and the rates of reports in the literature in the same years on each of these types of disorders and their treatment. RESULTS: The frequency of the diagnosis of obsessive-compulsive disorder, but not paranoid disorders, increased markedly during the 1980s. This increase was associated strongly and selectively with increases in publications about that disorder, particularly reports on drug and behavior therapy. CONCLUSIONS: There has been a large recent increase in the rate of diagnosis of obsessive-compulsive disorder, evidently associated with advances in the study and treatment of the disorder. The observations suggest the influence of a treatment-oriented diagnostic bias in which clinicians may more readily consider and diagnose a condition for which an innovative or effective treatment is available.

Behavior Therapy↗
PubMed1991

Erythrocyte choline concentration in bipolar disorder: a predictor of clinical course and medication response.

Erythrocyte choline concentrations were measured in hospitalized patients with bipolar disorder, manic phase, and control subjects. There was a significant elevation in mean erythrocyte choline in the patients with mania. This elevation in erythrocyte choline was due to a subgroup of patients with especially high values. Significant clinical differences were apparent between the patients with "high" and those with "low" erythrocyte choline concentrations. The subgroup of manic patients with elevated erythrocyte choline had a more severe illness at admission, a worse outcome at discharge, and required significantly more neuroleptic during hospitalization than their low choline counterparts; that is, they were less likely to respond well to lithium alone. Furthermore, the bipolar patients with low erythrocyte choline concentrations, as a whole, had more than four times as many previous manic episodes than depressive episodes, while the patients with high choline values had approximately the same number of past manias and depressions. These results are discussed in light of the evidence implicating cholinergic neurotransmission in the pathophysiology of affective disorders. In addition, the design of future clinical studies of erythrocyte choline and its possible clinical utility are discussed.

Adolescent↗
PubMed1991

Erythrocyte choline concentrations in psychiatric disorders.

Erythrocyte choline has been used as a potential indirect measure of cholinergic function in the central nervous system (CNS). We review the literature and present some new data on erythrocyte choline concentrations in patients with neuropsychiatric disorders. Our data and most of the reviewed studies report modest elevations in mean erythrocyte choline values in patients with affective illnesses, psychoses, dementia, and other neuropsychiatric disorders when compared to controls. Within each disorder, the increased mean erythrocyte choline concentrations are due to subgroups of patients with especially high values. These subgroups of patients with elevated erythrocyte choline levels appear to have clinical characteristics that distinguish them from patients with normal choline values. Finally, the dramatic rise in erythrocyte choline concentration produced by lithium therapy is reviewed, and the implication of this effect, in particular, the possibility that pretreatment or posttreatment erythrocyte choline concentrations may predict response to lithium, is discussed.

Adult↗
PubMed1984

Neonatal tail posture and its relationship to striatal dopamine asymmetry in the rat.

Previous research has demonstrated a link between rotational behavior and striatal dopamine asymmetry in the rat (rats rotate contralateral to the side of higher striatal dopamine concentration) and that the direction of a rat pup's tail posture will predict rotational bias. The present study hypothesized that neonatal tail posture would also predict adult striatal dopamine asymmetry. This hypothesis was confirmed for animals with a left but not right tail posture.

Animals↗
PubMed1984

Neurochemical asymmetries in the albino rat's cortex, striatum, and nucleus accumbens.

The concentrations of dopamine (DA), norepinephrine (NE), serotonin (5-HT), dihydroxyphenylacetic acid (DOPAC), and 5-hydroxyindoleacetic acid (5-HIAA) were measured in the right and left cortex, striatum, and nucleus accumbens of adult Purdue-Wistar rats. There was more DA in the right cortex and accumbens and a greater concentration of NE in the left striatum. There is more 5-HT in the left striatum and right accumbens, more 5-HIAA in the left cortex, as well as a greater 5-HT turnover in the left accumbens. These results are considered in the light of previous findings concerning the relationship of neurochemical asymmetries and behavioral lateralization.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1983

Changes in cortical and subcortical levels of monoamines and their metabolites following unilateral ventrolateral cortical lesions in the rat.

Suction lesions were made in the anterior, posterior or both halves of the right ventrolateral cortex in rats. Six days later, levels of the monoamine neurotransmitters, norepinephrine (NE), dopamine (DA) and serotonin (5-HT), and their metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and 5-hydroxyindoleacetic acid (5-HIAA), were measured in cortical and subcortical regions of lesioned rats and compared to values in sham-operated animals. NE and 5-HT were decreased in sections of ipsilateral (right) cortex including, and posterior to lesions, while 5-HIAA was increased throughout the ipsilateral cortex. Decreases in monoamines and increases in metabolites and metabolite:monoamine ratios (especially 5-HIAA:5-HT) were found in ipsilateral subcortical structures, including striatum, nucleus accumbens, hippocampus, hypothalamus, midbrain and brainstem, depending on the type of lesion. Subacutely, focal ventrolateral cortical lesions may profoundly alter the levels and utilization rates of monoamine neurotransmitters in widespread regions of the ipsilateral hemisphere.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1982

Mood, vegetative disturbance, and dexamethasone suppression test after stroke.

Assessments of mood disturbance and "vegetative" (appetite or sleep) disturbance as well as a single-dose dexamethasone suppression test (DST) were carried out in 25 randomly selected stroke patients and in 13 nonstroke control patients hospitalized in a rehabilitation center. Prevalence rates of moderate-to-serve depression of mood and vegetative disturbance were significantly higher in stroke patients than controls (48% and 52% versus 0% and 8%, respectively), as was the prevalence of abnormal DST results (52% versus 8%). Abnormal DST results were associated with the occurrence of moderate to severe mood, appetite, and sleep disturbances among all patients. in 2 stroke patients, repeated DST results paralleled the clinical course. The DST may be useful as an adjunct to the diagnosis and in monitoring the progress of the common and potentially reversible mood and vegetative disturbances occurring after stroke.

Aged↗
PubMedDate not supplied

Structural brain abnormalities in first-episode mania.

Using magnetic resonance imaging (MRI), we studied brain morphometric differences between patients with first-episode mania (n = 17) and normal control subjects (n = 16). Patients were admitted for their first psychiatric hospitalization and met DSM-III-R criteria for bipolar disorder, manic or mixed. Diagnoses were made using the Structured Clinical Interview for DSM-III-R. Patients and control subjects were matched for age, gender, height, past history of substance abuse, and handedness, although control subjects had attained higher levels of education. MRI inversion recovery coronal scans were used for measurements. Volumetric measurements were obtained for cerebral hemispheres, lateral and third ventricles, caudate, thalamus, and cingulate gyrus. Patients with first-episode mania demonstrated significantly larger third-ventricular volumes, possibly increased lateral ventricular volumes, and differences in gray/white matter distribution compared with normal control subjects. The possible pathophysiological meaning of these findings is discussed.

Adolescent↗
PubMedDate not supplied

Omega-3 fatty acids and bipolar disorder: a review.

The important role of the omega-3 fatty acids in the pathophysiology and treatment of bipolar disorder is now supported by a substantial body of indirect and direct evidence. This paper will describe the clinical and pharmacological features of bipolar disorder, review the available data regarding omega-3 fatty acids in bipolar disorder and provide recommendations for future research.

Animals↗
PubMedDate not supplied

Omega-3 fatty acids, homocysteine, and the increased risk of cardiovascular mortality in major depressive disorder.

Depression is associated with elevated rates of cardiovascular morbidity and mortality. This elevation seems to be due to a significantly increased risk of coronary artery disease and myocardial infarction and, once the ischemic heart disease is established, sudden cardiac death. Recent data suggest that the increased rates of cardiovascular disease in patients with depression may be the result of one or more still-unrecognized underlying physiological factors that predispose a patient to both depression and cardiovascular disease. Two possibly related factors that may have a causal relation with both depressive disorders and cardiovascular disease are an omega-3 fatty acid deficiency and elevated homocysteine levels. We present the available data connecting cardiovascular disease, depression, omega-3 fatty acids, and homocysteine. In addition, we suggest research strategies and some preliminary treatment recommendations that may reduce the increased risk of cardiovascular mortality in patients with major depressive disorder.

Animals↗
PubMedDate not supplied

Mood stabilizers: shared mechanisms of action at postsynaptic signal-transduction and kindling processes.

Several distinct classes of agents have demonstrated efficacy as mood stabilizers in patients with bipolar disorder. It may be reasonable to assume that these agents share one or more common mechanisms of action. This paper will explore the hypothesis that all effective mood stabilizers exert their actions through inhibition of postsynaptic signal-transduction and kindling processes. A literature search was performed for all currently used mood stabilizers to identify reports of mood-stabilizer action in postreceptor cell-signaling and kindling processes. Most effective mood stabilizers appear to inhibit intracellular calcium mobilization through several distinct mechanisms. In addition, several mood stabilizers appear to diminish generation of second-messenger molecules from the membrane phospholipids phosphatidylinositol and phosphatidylcholine, inhibit the activity of protein kinases, and directly inhibit activity of G-proteins. Finally, all established mood stabilizers also exhibit antikindling effects. All of these mechanisms of action could dampen excessive intracellular and intercellular signaling, which may be a core feature of the pathophysiology of bipolar disorder. The observation that all effective mood stabilizers inhibit both kindling and signal-transduction pathways suggests that these processes are intimately linked. We hypothesize that an effective mood stabilizer must possess some specific minimum inhibitory effects at postsynaptic signal-transduction and kindling processes. If this hypothesis is correct, then a rational search for safer and more effective mood-stabilizing agents can begin.

Animals↗