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Biomedical subjects

C F Reynolds

Publications and source records attributed to C F Reynolds.

At least 289 records · Page 16Linked to original sources
PubMed1987

Sleep deprivation effects in older endogenous depressed patients.

In a drug-free group of 15 older endogenous depressed inpatients, all-night sleep deprivation (SD) was associated with a significant decrease in Hamilton depression scores and in Profile of Mood States self-ratings of depression. Six of 15 patients (40%) were responders to SD, as evidenced by greater than or equal to 30% improvement in Hamilton ratings. While symptomatic improvement was short-lived (8 of 15 patients worsened after 1 night of recovery sleep), five patients showed further improvement after 1 night of recovery sleep. The final two patients had an increase in Hamilton ratings after sleep deprivation, with a return to baseline values after 1 night of recovery sleep. Responders (but not nonresponders) showed significant improvement in sleep latency, sleep efficiency, and slow wave sleep during recovery sleep (as did controls). The SD Hamilton depression rating (at 9 a.m. after all-night sleep deprivation) showed a significant inverse correlation with the increase in slow wave sleep (SWS) minutes and in SWS % from baseline to first recovery night. Responders also had significantly larger increases in SWS minutes than did nonresponders (53.8 vs. 7 minutes). Similarly, the % change in Hamilton depression ratings was predicted by baseline Stage 4 sleep. These findings suggest that there is a mutual interaction between the process of sleep regulation and the symptoms of depression. They also confirm a prediction from the two-process model of sleep regulation--namely, that improved sleep initiation and maintenance and increased SWS, attained by SD, are associated with clinical improvement.

Affect↗
PubMed1987

Open-trial response to antidepressant treatment in elderly patients with mixed depression and cognitive impairment.

We report open-trial antidepressant response in 16 inpatients with mixed symptoms of depression and cognitive impairment, compared to 16 elderly depressives without cognitive impairment. Criteria for adequate treatment specified a steady-state plasma nortriptyline level of 50-150 ng/ml for 4 consecutive weeks or a minimum of six treatments with electroconvulsive therapy. Ten of 16 mixed-symptom patients showed a drop in Hamilton depression ratings greater than or equal to 50% during treatment. Similarly, Blessed dementia ratings declined significantly; the % change in Blessed dementia ratings was significantly correlated with improvement in Hamilton depression ratings. By contrast, Folstein mini-mental state scores did not change significantly during treatment. Six of 16 (37.5%) patients showed resolution of cognitive impairment with adequate treatment of depression. Mixed-symptom patients diagnosed as suffering from major depression (with cognitive impairment) showed more robust pre-post treatment differences, particularly in Hamilton, Folstein, and Blessed dementia scores, than did mixed patients diagnosed as having primary degenerative dementia (with depression). In cognitively intact elderly depressives, the mean % change in Hamilton ratings was 72% (4.3), not significantly different from mean % change in mixed-symptom patients (57.4 +/- 29.9). The proportion of intact depressives showing a reduction greater than or equal to 50% in Hamilton depression ratings was significantly greater (93.8%) than in the mixed group (62.5%). In both groups, 81.3% of patients (13 of 16 in each cell) had a final Hamilton rating less than or equal to 10. These data suggest that elderly patients with mixed depression and cognitive impairment respond to treatment similar to that used in cognitively intact elderly depressives. A controlled study of antidepressant treatment in mixed-symptom patients is warranted.

Aged↗
PubMed1987

Platelet membrane fluidity identifies a clinical subtype of Alzheimer's disease.

1. The fluorescence anisotropy of 1,6-diphenyl-1,3,5-hexatriene (DPH) in labeled platelet membranes, an index of membrane fluidity, identifies a prominent subgroup (approx. 50%) of patients with Alzheimer's disease who manifest distinct clinical features. 2. We review an integrated series of studies that explore both the clinical significance of this finding and the biological basis for the platelet membrane alteration.

Aged↗
PubMed1987

[Sleep and depression: toward a standardization of the use of the latency of paradoxical sleep as a biological marker of major depression].

Among the various disturbances in sleep architecture among major depressive patients, the shortening of REM latency seems the most specific feature. Therefore, several groups have tested the usefulness of this parameter as a "biological marker" of major depression. The divergent results of those studies probably result from the marked differences in the methodology used. In this context, we compared the diagnostic sensitivity of various methodologies for selection of REM latency data among 92 major depressive inpatients recorded for 4 consecutive nights. The selection of individual night values or of mean values yielded very similar diagnostic sensitivity. However, the selection of the shortest REM latency from consecutive nights was associated with a higher diagnostic sensitivity, especially if at least 3 nights were included. After controlling for age, 87% of patients were identified by this methodology (sum of REM latency and age less than 90). Therefore we propose to standardize the methodology for use of REM latency: recording of 3 consecutive nights and selection of the shortest REM latency. If the sum of this value and of patient'age equals 90 or less, the diagnosis of major depression is supported.

Adolescent↗
PubMed1987

Sleep research in affective illness: state of the art circa 1987.

Future sleep research in affective illness will probably continue the current evolution beyond cross-sectional to longitudinal studies, and beyond a largely descriptive emphasis to the testing of specific hypotheses and predictions derived from models of the pathophysiology of depression. These models are and will be variously neurochemical, chronobiological, genetic, and developmental in nature. Adequate testing of these models and predictions from them will require the use of pharmacologic and naturalistic probes and the use of sophisticated CNS imaging techniques. These probes will help further characterize the physiology of depression under conditions of disequilibrium or perturbation, such as following sleep deprivation, REM deprivation, phase advancement of the major sleep period, or the administration of antidepressant drugs with specific monoaminergic activity. Concurrently, if one is to understand further whether the sleep abnormalities of depression are part of a larger circadian rhythm disturbance, investigations will necessarily include 24-h measures of sleep-wake activity, psychomotor activity, and probably core body temperature rhythm under constant routine conditions. A complementary point of view would suggest that more intensive investigative efforts be focused on the first 100 min of sleep at night, since it is the first NREM-REM cycle that seems to show the greatest and most specific deviation in depressed patients from normal controls. Efforts to characterize further this part of the 24-h cycle, with respect to age- and gender-related variance as well as responses to physiologic, hormonal, pharmacologic, and naturalistic probes, are strongly warranted.

Aging↗
PubMed1987

Reliability of NPT scoring and visual estimates of erectile fullness.

We report the reliability of nocturnal penile tumescence (NPT) scoring and visual estimates of erectile fullness performed by a group of eight registered polysomnographic technologists (RPSGTs). We achieved overall good to excellent interrater reliability (as measured by coefficients of variation, CVs) for seven widely used electrographic measures of NPT activity: number of episodes, categorization of episodes (full or partial), total tumescence changes, tip change, base change, duration of episode, and duration of 80% maximum tumescence. In two different visual estimate trials using photographs, separated by 2 weeks, female technologists (n = 4) made mean visual estimates of erectile fullness that were significantly higher than those of male technologists (n = 4). In addition, the CVs among the female technologists on visual estimates was consistently lower than those of the males. Higher correlations, however, were found between male technologists' estimates of fullness versus buckling force than for female technologists' estimates. Thus, the gender of a technologist may affect visual estimates of erectile fullness during NPT assessment.

Adult↗
PubMed1987

Do nocturnal penile tumescence recordings alter electroencephalographic sleep?

While concurrent monitoring of sleep is considered to be a necessary component of evaluating nocturnal penile tumescence (NPT), in order to ensure that NPT data are not invalidated by fragmented sleep or diminished REM sleep, it is not known whether NPT recording itself disrupts sleep beyond the expected first night effect. In this study of 42 outpatient men with major depression and 36 normal control subjects, we found no effect of NPT recording on measures of sleep continuity, proportion of NREM to REM sleep, or REM sleep in either depressed or healthy control subjects.

Depressive Disorder↗
PubMed1987

Nocturnal penile tumescence in depressed men.

Nocturnal penile tumescence recordings were performed in 10 men with major depression and 10 age-matched healthy control subjects to evaluate the possibility that clinical disturbances in sexual interest and activity often reported by depressed persons are associated with objective changes in sexual neurophysiology. Depressed men had significantly reduced minutes of tumescence time, a finding that was not attributable to alterations in sleep efficiency or REM sleep time. Three depressed men had baseline tumescence profiles suggestive of "organogenic" impotence, which improved after recovery. The authors discuss the implications of such findings for clinical practice and future research.

Adult↗
PubMed1987

Platelet membrane fluidity in Alzheimer's disease and major depression.

Double-blind fluorescence studies of platelet membrane fluidity were conducted at 37 degrees C for 51 patients with Alzheimer-type dementia, 24 nondemented depressed patients, and 50 neurologically healthy subjects. The fluidity of the hydrocarbon region of platelet membranes from the demented group, as reflected by the steady-state anisotropy of the fluorescent probe 1,6-diphenyl-1,3,5-hexatriene (DPH), was significantly greater than that for the depressed and normal control subjects. Within the demented group, platelet membrane fluidity was significantly correlated with severity of dementia but not with duration of illness or age at onset. Demented patients with "increased" platelet membrane fluidity had an earlier onset, were more severely demented, and deteriorated more rapidly.

Aged↗
PubMed1987

The superior sleep of healthy elderly nuns.

The nocturnal sleep structure of ten healthy elderly nuns was compared to that of ten healthy age-matched female controls. The nuns fell asleep more quickly and had less early morning awakening, as well as greater REM sleep time. These differences may reflect the more highly entrained life style of the nuns, including modest habitual sleep restriction (and thus accumulated sleep debt) of about one hour each night. The current findings, reviewed in relation to the sleep and aging literature, tend to support the concept that some of the effects of aging on sleep can be offset by attention to good "sleep hygiene," including careful entrainment of sleep schedule and modest habitual sleep restriction. However, age-related decrements in slow-wave sleep and sleep maintenance were not significantly better in the nuns.

Aged↗
PubMed1987

Sleep and affective disorders. A minireview.

The most predictable electroencephalographic sleep changes of major depression are a shortened first NREM sleep period, a prolonged first REM period (with increased density of rapid eye movements), sleep continuity disturbance, and diminished slow wave sleep (with shifting of delta activity from the first to the second NREM sleep period). The more rapid appearance of the first REM sleep period occurs in relation to sleep onset but not apparently in relation to clock time. The changes occurring in the first NREM-REM cycle of the night appear to be relatively specific to major (particularly endogenous) depression. Depressed men appear to have diminished nocturnal penile tumescence compared with healthy controls, but depressed patients generally do not have a higher incidence of sleep apnea or nocturnal myoclonus. The sleep physiologic changes of depression appear to persist into clinical remission, suggesting that they are trait-like. Published studies appear to support the conclusion that there is a close link between the regulation of sleep and the regulation of mood in affective illness.

Aged↗
PubMed1987

Electroencephalographic sleep of healthy children. Part II: Findings using automated delta and REM sleep measurement methods.

Using earlier developed computer-based measurement methods, delta and REM activity were examined during sleep as a function of age, gender, and time of night in 85 healthy, 6- to 16-year-old children. Chronological age was found to account most strongly for differences in automated delta and REM count measures in this age range. Increasing age was shown to be associated with a significant decline in both automated measures, but the effect was much greater for the delta count measure. The age-related decline in delta wave activity was reflected primarily in a linear decline in 2.0-3.0 Hz delta activity, that is, in the faster end of the delta frequency band. Examination of these measurements in successive NREM and REM sleep periods confirmed that, in children as in adults, delta activity decreases and REM activity increases across the night. Findings are discussed relative to those obtained in the same children using standard measurement methods.

Adolescent↗
PubMed1986

Comparison of automated REM and slow-wave sleep analysis in young and middle-aged depressed subjects.

A comparison of electroencephalographic sleep measures between young and middle-aged groups of depressed inpatients was conducted with specific interest in the application of automated measures of REM and delta wave sleep. Aside from the expected differences in sleep continuity, increased Stage 1 percent, decreased Stage 2 percent, and decreased REM latency in the middle-aged depressives as compared to the younger depressives, distinct findings from automated analyses were noted in the distribution of REM and delta sleep throughout the night. Although the younger depressed patients showed increased numbers of delta waves, the middle-aged depressives showed greater average REM count. Such changes were more pronounced in the first third of the night. Finally, in the middle-aged depressives, little statistical relationship between manual measures of slow-wave sleep and automated measures of delta sleep was found.

Adult↗
PubMed1986

Computerized EEG spectral analysis in elderly normal, demented and depressed subjects.

Computerized spectral analysis of the EEG was performed in 35 patients with Alzheimer's disease and compared to patients with major depression (23) and healthy elderly controls (61). Compared to controls, demented patients had a significant increase in the theta and alpha 1 bandwidths as well as an increased theta-beta difference. The parasagittal mean frequency, beta 1 and beta 2 activity were significantly decreased. Depressed patients differed from demented patients, particularly at the lower end of the spectrum, having significantly less delta and theta activity. Like the demented group, depressed patients also had a decreased parasagittal mean frequency, beta 1 and beta 2 when compared to controls. In demented patients, there was a high correlation between several spectral parameters (parasagittal mean frequency, delta and theta activity, and the theta-beta difference) and the Folstein score, EEG measures used for discriminant analysis were more accurate in identifying demented patients who had lower Folstein scores.

Aged↗