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Biomedical subjects

A Winokur

Publications and source records attributed to A Winokur.

At least 73 records · Page 4Linked to original sources
PubMed1985

Autoradiographic localization of thyrotropin-releasing hormone (TRH) receptors in human spinal cord.

Thyrotropin-releasing hormone (TRH) exerts many effects upon spinal cord function in animals, and may also play a role in human spinal cord function. We have used the technique of quantitative autoradiography to anatomically localize specific receptors for TRH within human spinal cord. Highest concentrations of TRH receptors were localized within lamina II, the substantia gelatinosa. A moderate density of TRH receptors was found in lamina IX, the motor neurons of the anterior horn. Low levels of TRH receptors were noted throughout the remainder of the gray matter of the human spinal cord, and no TRH receptors were localized within white matter. This anatomic distribution of TRH receptors within the human spinal cord is consistent with the localization of endogenous TRH and the effects of exogenously applied TRH in animal studies. These results suggest that any effects of TRH on human spinal cord function may be mediated by TRH receptors.

Aged↗
PubMed1985

Autoradiographic localization of thyrotropin-releasing hormone receptors in the rat central nervous system.

We employed quantitative autoradiography to examine the distribution of thyrotropin-releasing hormone (TRH) receptors in the rat CNS. The binding of [3H]3-methyl-histidine-TRH [( 3H]MeTRH) to TRH receptors in frozen rat brain sections was saturable, of a high affinity (Kd = 5 nM), and specific for TRH analogs. Autoradiograms of [3H]MeTRH binding showed highest concentrations of TRH receptors in the rhinencephalon, including accessory olfactory bulb, nuclei of the amygdala, and the ventral dentate gyrus and subiculum of the hippocampus. Moderate TRH receptor concentrations were found within the thalamus and hypothalamus, in most regions of the rhombencephalon, such as the cranial nerve nuclei, and in the substantia gelatinosa of the spinal cord. Neocortex and basal ganglia contained low densities of TRH receptors. This distribution correlates well with the sensitivity of brain regions to the known effects of TRH, and suggests that TRH receptors may mediate the actions of TRH in the rat CNS.

Amygdala↗
PubMed1985

Six-week trial with diazepam: some clinical observations.

Side effects, improvement, and predictors of response were examined in 295 patients treated for greater than or equal to 1 week with diazepam; 234 of these patients completed 6 weeks of treatment. The greatest improvement occurred during the first week of treatment. Sedation was the predominant side effect. Predictors of improvement included low educational level, lack of previous treatment, presence of precipitating stress, low occupational and/or family adjustment, low levels of trait anxiety, and high levels of state anxiety.

Adult↗
PubMed1984

Withdrawal responses to abrupt discontinuation of desmethyldiazepam.

The authors present the results of a controlled observation of withdrawal reactions accompanying cessation of desmethyldiazepam (clorazepate) therapy. The two subjects studied had had generalized anxiety disorder for several years; both were free from manifestations of other forms of psychopathology or addictive behavior patterns. Both patients maintained stable patterns of clorazepate use at modest doses for extended periods of time. The findings suggest that the long plasma half-life of clorazepate does not offer unique protection from withdrawal reactions associated with long-term therapy. Manifestations of these withdrawal reactions are indistinguishable from reactions associated with other benzodiazepine compounds.

Acute Disease↗
PubMed1984

Symptoms of emotional distress in a family planning service: stability over a four-week period.

The 25-item Hopkins Symptom Checklist ( HSCL -25) was used on two occasions four weeks apart to identify self-reported symptoms of anxiety and depression in patients attending a family planning service. Only 28 per cent of patients classified as anxious to start with remained so four weeks later, but 62 per cent of those with high depression scores and 74 per cent of those with high depression and high anxiety scores maintained significant levels of depression. The implications of these findings for routine screening are discussed.

Adult↗
PubMed1984

Administration of thyrotropin-releasing hormone at weekly intervals results in a diminished thyrotropin response.

A diminished thyrotropin (TSH) response to the administration of thyrotropin-releasing hormone (TRH) has been widely reported in depressed patients. Repeated TRH administration at short intervals has been shown to produce a diminished TRH response in healthy subjects. In the present study, TRH (400 micrograms) was administered to ten healthy male subjects at weekly intervals for 4 weeks. The TSH response to TRH diminished steadily from 8.2 +/- 1.3 microU/ml on Trial 1 to 6.3 +/- 0.7 microU/ml on Trial 4 (p less than 0.05). No change in the prolactin response to TRH administration was observed over the four trials. Reduction in the TSH response to TRH was not correlated with basal concentrations of thyroxine, triiodothyronine, or cortisol.

Adult↗
PubMed1984

Hormonal response to thyrotropin-releasing hormone following rest-activity reversal in normal men.

The prolactin (PRL) and thyrotropin (TSH) response to an intravenous dose (400 micrograms) of thyrotropin-releasing hormone (TRH) was studied in eight healthy young men in the morning (0800 hr), in the evening (2000 hr), and after an acute 12-hr shift of the rest-activity cycle. The PRL and TSH response to TRH was significantly greater in the evening than the morning. The increased PRL and TSH responses observed in the evening were significantly reduced following rest-activity reversal. Our findings underscore the importance of temporal factors in determining response to TRH. These factors may be relevant in clarifying the mechanisms underlying abnormal hormonal responses to TRH in patients with affective disorders.

Adult↗
PubMed1983

Long-term diazepam therapy and clinical outcome.

This double-blind study involved the continuous (six to 22 weeks) treatment of 180 chronically anxious outpatients with diazepam, 15 to 40 mg/day. Our findings indicate that a significant number of patients benefit from prolonged diazepam treatment and that tolerance to the anxiolytic effect of diazepam does not develop during a 22-week study period. The duration of continual treatment with sedative-benzodiazepines was clearly the most important determinant of withdrawal reactions. Patients treated continuously for less than eight months with sedative-benzodiazepines had an incidence of withdrawal of 5%, whereas 43% of patients treated for eight months or more demonstrated clear withdrawal reactions. While these withdrawal reactions produced considerable distress, they were neither life threatening nor incapacitating and did not include convulsions or psychotic reactions. In all cases, withdrawal reactions could be readily managed by gradually tapering the dose of the benzodiazepine.

Adult↗
PubMed1983

A neuroendocrine test battery in bipolar patients and healthy subjects.

Abnormalities of hormonal responses to a number of neuroendocrine challenges have been reported in depressed patients. Most studies have examined responses in a single neuroendocrine axis. We used a series of four neuroendocrine challenges (thyrotropin-releasing hormone test, gonadotropin-releasing hormone test, insulin tolerance test, and dexamethasone suppression test) to examine eight hormonal responses in 22 healthy subjects and 22 patients with bipolar disorder. Variability of hormonal responses in bipolar patients was examined by evaluating the number of abnormal hormonal responses as compared with responses from healthy volunteers. Abnormalities were observed after all four neuroendocrine tests. Nine control subjects (40.9%) and 17 bipolar patients (77.3%) had at least one abnormal response. More strikingly, 12 bipolar patients (54.5%), but no controls, had two or more abnormal responses. These findings suggest that manic-depressive patients show increased variability in hormonal response from multiple neuroendocrine axes.

Adult↗
PubMed1983

Multiple hormonal responses to protirelin (TRH) in depressed patients.

The effects of protirelin (thyrotropin-releasing hormone [TRH]) administration on the release of five pituitary hormones (thyrotropin [TSH], prolactin [Prol], growth hormone, luteinizing hormone, and follicle-stimulating hormone [FSH]) were examined in 45 patients with major depressive disorder and 32 healthy volunteers. Although mean pituitary responses to protirelin in depressed patients and controls appeared to be comparable, depressed patients had higher SDs in all cases. Twelve patients (26.7%) but no controls had two or more abnormal hormonal responses to protirelin administration. The use of several nonparametric analyses revealed significant differences in patterns of hormonal response between depressed patients and controls for TSH, Prol, and FSH. These findings support the hypothesis that increased variability of neuroendocrine responsiveness represents a fundamental aspect of physiologic function in patients with endogenous depression.

Adult↗
PubMed1983

The dexamethasone suppression test as a predictor of antidepressant response.

There is some evidence to suggest that dexamethasone suppression test (DST) results obtained prior to treatment for depression might aid in selecting the proper type of antidepressant medication. Forty endogenously depressed outpatients were evaluated with the DST and 12 (30%) were identified as nonsuppressors. All patients were then treated with desipramine (150-350 mg/day). Plasma concentrations of desipramine were monitored to assure that therapeutic levels were achieved. At 5 weeks of treatment, patients were characterized as treatment responders or nonresponders on the basis of change in Hamilton Depression Scale scores.

Adolescent↗
PubMed1983

Response to dexamethasone in psychotic depression.

The utility of the dexamethasone suppression test (DST) in the diagnosis of psychotic depression was examined by comparing the responses of 11 psychotic and 18 nonpsychotic depressed inpatients. Nine of 11 psychotic patients (81.8%) and 10 of 18 nonpsychotic patients (55.6%) showed nonsuppression (nonsignificant). Using the 0800h cortisol level alone, we found that significantly more psychotic patients (7 of 11; 63.6%) than nonpsychotic patients (3 of 18; 16.7%) showed nonsuppression. Nonsuppression at 0800h postdexamethasone may be a useful biologic marker for patients with psychotic depression. Implications of these data for the nosologic status of psychotic depression are discussed.

Adult↗
PubMed1983

Neuroendocrine regulation in depressed postmenopausal women and healthy subjects.

Results from prior studies utilizing gonadotropin-releasing hormone (GnRH) in affective illness have been contradictory. There have been no systematic investigations of multiple pituitary hormonal responses to GnRH infusion in either depressed or healthy postmenopausal women. Potential abnormalities in the hypothalamic-pituitary-gonadal (HPG) axis may be limited to postmenopausal women who lack the estradiol feedback influence at the pituitary level. We therefore studied 18 depressed and nine healthy postmenopausal women with the GnRH infusion test and measured LH, FSH, prolactin, growth hormone, and thyrotropin responses. Our findings confirmed earlier reports of a lower basal LH concentration in postmenopausal depressed subjects. GnRH stimulated release of LH, FSH, and prolactin in both patients and controls; however, there were no differences in the mean peak hormone values between groups.

Depressive Disorder↗