Biomedical subjects

C F Reynolds

Publications and source records attributed to C F Reynolds.

At least 307 records · Page 17Linked to original sources

PubMed1986

Body temperature and sleep architecture in response to a mild cold stress in women.

Six women participated in a seven consecutive night polygraphic sleep study during which both 24-hour rectal, body temperature and wrist activity were continuously sampled and stored at one-minute intervals. The study was designed to investigate the effects of a mild nocturnal cold stress on thermoregulation and sleep. On nights 4 and 5, subjects slept naked, without any bedcovers (mild cold stress) in a warm (26.7-28.3 degrees C) room. The daily mean rectal temperature and the daily nadir (low point) of the circadian temperature rhythm (CTR) showed a significant decrease between the baseline and cold stress conditions. The lowered nadir resulted in a significant amplitude increase in the daily CTR between the baseline and cold stress conditions. There were no significant changes in activity levels across experimental conditions. The ability to maintain a sleep state was significantly impaired during the cold stress. Stage 4 slow wave sleep increased, while Stage 3 decreased in response to the cold stress condition, and there was an associated lengthening of the first NREM period. These data suggest that challenges to the thermoregulatory system can be used as a vehicle to systematically alter sleep architecture in humans.

Adaptation, Physiological↗

PubMed1986

Vasopressin peptide (DDAVP) may narrow the focus of attention in normal elderly.

Administration of DDAVP (1 desamino-8-D-arginine vasopressin), a form of vasopressin with little pressor action, has been shown to improve cognitive performance in the elderly. It remains unclear whether memory processes are specifically influenced or more general processes are altered. Fifteen elderly subjects performed a central mental arithmetic task and a peripheral choice reaction time task in DDAVP and control conditions. DDAVP slowed reaction times to peripheral lights but did not alter arithmetic performance. The results suggest that DDAVP increases the proportion of attention allocated to primary task performance by decreasing attention to secondary tasks. This shift does not appear to be mediated by any action of DDAVP on peripheral cardiovascular function.

Aged↗

PubMed1986

Aspects of short REM latency in affective states: a revisit.

Electroencephalographic (EEG) sleep changes in affective disorders have been characterized by sleep continuity, slow wave sleep, and rapid eye movement (REM) abnormalities. The most commonly cited feature, however, has been shortened REM latency. Because the diagnostic and prognostic significance of shortened REM latency has been debated, this issue was reexamined in a group of 186 psychotic and nonpsychotic depressed inpatients and outpatients. The analyses suggest an increased frequency of sleep onset REM periods in psychotic depression and in elderly depressed patients (psychotic or nonpsychotic).

Adolescent↗

PubMed1986

Sleep deprivation in healthy elderly men and women: effects on mood and on sleep during recovery.

Elderly women had better recovery sleep than elderly men following 36-h sleep deprivation, as evidenced by higher sleep maintenance/efficiency and more slow wave sleep (particularly in the amount of stage 4 sleep). During recovery sleep, both groups showed REM latency reduction (two men and three women had seven sleep-onset REM periods out of a total of 40 recovery nights), decrease in percentage of early REM sleep and increase in whole-night REM sleep time. Total Mood Disturbance scores on the Profile of Mood States increased in both men and women following sleep deprivation (reflecting a decrease in vigor and increase in fatigue and tension). While the increase tended to be greater in women, in both groups self-ratings of mood returned to baseline after 1 night of recovery sleep. These observations underscore the importance of gender in determining late-life sleep structure and suggest that the ability of older women to achieve slow wave sleep and to have long uninterrupted sleep in greater than that of men.

Aged↗

PubMed1986

Two-year follow-up of elderly patients with mixed depression and dementia. Clinical and electroencephalographic sleep findings.

In a two-year follow-up of 16 patients with mixed symptoms of depression and dementia, eight showed clinical improvement and eight showed deterioration. Improvement at two-year follow-up was associated with several baseline measures: a Folstein Mini-Mental State score of 21 or greater, a Hamilton Depression score of 21 or greater, and a sleep efficiency of less than 75%. These findings suggest that in the elderly with mixed symptoms of depression and dementia, a more favorable outcome is associated with initially greater depressive symptomatology, higher cognitive function, and moderate sleep continuity disturbance ("early morning awakening").

Aged↗

PubMed1986

Central dopaminergic and noradrenergic receptor blockade in a patient with neuroleptic malignant syndrome.

During treatment with clomipramine and haloperidol, a 54-year-old depressed woman exhibited a typical neuroleptic malignant syndrome (NMS). Among results of biologic tests performed at least 2 weeks after discontinuation of all psychotropic treatment, the absence of normal growth hormone response after both apomorphine and clonidine challenge tests and increased levels of cerebrospinal fluid homovanillic acid and urinary 3-methoxy-4-hydroxyphenylglycol suggest that NMS may be related to central dopaminergic and possible alpha-noradrenergic receptor blockade.

Clomipramine↗

PubMed1986

Sleep-disordered breathing in normal and pathologic aging.

In a study of sleep-disordered breathing among 139 elderly individuals, sleep apnea (defined as 5 or more apneas per hour) occurred in 34 (41.7%) Alzheimer's subjects compared with 56 (5.4%) healthy controls, 35 (11.4%) depressive subjects, and 24 (16.7%) patients with mixed symptoms of both cognitive impairment and depression (p less than .001). Alzheimer's patients had a significantly higher proportion of NREM-related than REM-related apnea. Moreover, a significant (p less than .01) positive correlation between the apnea index and severity of dementia, as measured by the Blessed Dementia Rating Scale, was found in apnea-positive Alzheimer's patients, as well as in the entire sample of Alzheimer's patients (p less than .05). No such correlation was found in the mixed-symptoms group. Possible clinical and neuropathologic implications are discussed.

Aged↗

PubMed1985

Internight variability of REM latency in major depression: implications for the use of REM latency as a biological correlate.

The internight variability in REM latency in 92 drug-free inpatients with major depressive illness was recorded for 4 consecutive nights and subsequently assessed. Individual coefficients of variation in REM latency [CV = (standard deviation of mean REM latency for 4 recording nights/4-night mean REM latency) X 100] ranged from 5.1 to 121.7, with a mean of 37.0 (SD = 27.3) and a median of 27.4. CV was positively correlated with both age (p less than 0.05) and age at onset of depressive illness (p less than 0.01). Male patients showed more variability in REM latency than female patients (p less than 0.05); likewise, the subgroups of patients who either were incapacitated or had bipolar II illness showed greater variability in REM latency in comparison with the remainder of the sample (p less than 0.05). When the entire patient sample was stratified by CV into three equal subgroups, the subgroup of patients defined by the highest CV presented the longest sleep latency (p less than 0.05) and the shortest REM latency (p less than 0.0001). No other clinical or polysomnographic correlates of REM latency variability were noted nor was REM latency variability related to severity of illness, other subtypes of illness, or clinical response to antidepressant therapy. In selecting REM latency data for assessment of diagnostic sensitivity, the use of the shortest REM latency from at least 3 consecutive nights yielded a higher sensitivity (74%-81%) than did the use of any one individually specified night (50%-56%) or different internight means (49%-52%). The same conclusion applied when patient age was taken into account. These results have implications for standardizing the use of REM latency as a biological correlate in major depression.

Adult↗

PubMed1985

EEG sleep in elderly depressed, demented, and healthy subjects.

In a prospective study of EEG sleep patterns in 25 elderly depressives, 25 elderly demented patients, and 25 healthy, elderly control subjects, the sleep of depressives was characterized by reduced REM sleep latency, increased REM percent and first REM period density, and altered temporal distribution of REM sleep, as well as by diminished sleep maintenance (correlated significantly with Hamilton ratings of depression: multiple R = -0.42, p less than 0.05). In contrast, the sleep of demented patients showed reduced REM sleep percent, but normal REM temporal distribution, increased loss of spindles and K-complexes (the latter correlating significantly with severity of cognitive impairment as measured by the Folstein score: multiple R = -0.59, p less than 0.01), and less severe sleep maintenance difficulty than for depressives. An examination of REM latency demonstrated a skewed distribution in depression (i.e., 42% of nights with sleep-onset REM periods), but a normal distribution in the controls and demented subjects. A REM latency cut-off score of 30 min correctly classified 68% of all patients (kappa = 0.36; p less than 0.005), compared with 78% correctly identified in our retrospective study (Reynolds et al. 1983).

Aged↗

PubMed1985

"Paradoxical" shortening of REM latency on first recording night in major depressive disorder: clinical and polysomnographic correlates.

Among 92 inpatients with major depressive disorders, variability in REM latency (RL) during the first two recording nights was assessed by means of an "adaptation coefficient" (AC = night 1 RL--night 2 RL X 100 divided by mean RL for nights 1 and 2). Although mean RL was very similar for both nights (48.1 and 50.7 min), individual ACs showed a gaussian distribution [range: -176.5-171.4; mean: -1.2 (67.3); median: -4.4]. Forty-two patients (45.7%) exhibited shortening of RL on night 2 compared with night 1 (positive AC, corresponding to an "expected" evolution), 48 patients (52.2%) displayed the opposite pattern (negative AC, corresponding to a "paradoxical" evolution), and two patients had identical values on both nights. Extent of increase in RL from first to second night (i.e., extent of "paradoxical" evolution) correlated significantly with increasing duration of current episode, earlier age of onset, and poorer clinical response to tricyclic antidepressants. A cutoff AC of -7 correctly classified 62% of patients according to treatment response. The research diagnostic criteria-based retarded subtype of depression was associated with a more negative AC (i.e., a more "paradoxical" evolution), and the situational subtype was associated with a more positive AC (i.e., a more "expected" evolution) than the remainder of the sample. The subgroup with the most negative ACs (i.e., largest increases in RL from first to second night) also had longer sleep latencies, whereas the subgroup with the most positive ACs (i.e., largest decreases in RL) had higher REM activity and REM density as compared with the remainder of the sample. These results suggest that RL in major depression is not a static parameter and that the study of its within-subject variability can be helpful for diagnostic confirmation and prediction of treatment response.

Adaptation, Physiological↗

PubMed1985

Depression in borderline patients: a prospective EEG sleep study.

The relationship between borderline personality disorder and primary major depression was studied prospectively using Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L) interviews and electroencephalographic (EEG) sleep studies. Ten consecutively admitted borderline patients (a prospective sample), defined by Gunderson's Diagnostic Interview for Borderlines (DIB), underwent EEG sleep studies on two consecutive nights and were compared to previously reported samples of nonborderline depressed patients (defined by Research Diagnostic Criteria; RDC), normal controls, and DIB-defined borderline patients who had been referred "to rule out major depression" (a retrospective sample). EEG sleep data were analyzed visually and by automated techniques. Rapid eye movement (REM) latency values were similar in depressed and both borderline groups but significantly different from controls. Eighty-five percent of REM latency values in RDC major depressives were less than or equal to 65 minutes, compared to similar rates of 75% in the prospective sample of borderline patients and 65% in the retrospective sample, versus 35% for controls (chi 2 = 10.7, p less than 0.005). The REM latency in borderline patients did not vary with the severity of depression as measured by the Hamilton Rating Scale for Depression. In the prospective borderline sample, the major SADS-L diagnoses were chronic intermittent depression (five), current major depression (four) (two unipolar, two bipolar II), and labile personality (one). A convergence of nosologic and EEG sleep data is suggested, and supports the concept of a close relationship between criteria-defined borderline personality disorder and affective illness.

Adolescent↗

PubMed1985

Sleep of healthy seniors: a revisit.

In an EEG sleep study of 40 healthy seniors (19 men and 21 women) aged 58-82 years, men could not maintain sleep as well as women and experienced less stage 3 sleep. The increased wakefulness after sleep onset among the men was particularly marked during the last 2 h of recording. REM density (during the first and second REM periods) showed an interaction of sex and age effects: thus, women in their 60s had higher REM density than men, whereas men in their 70s had higher REM density than women. In both men and women, however, regardless of age, the temporal distribution of REM sleep and REM density during the night was flat. Finally, only a mild degree of sleep-disordered breathing was noted, with positive age effects on apnea/hypopnea index and maximal duration of apnea. These findings are reviewed in relation to the sleep and aging literature.

Aged↗

PubMed1985

Slow wave sleep in elderly depressed, demented, and healthy subjects.

The application of automated analysis in the measurement of sleep electroencephalogram delta activity allows a more precise temporal description of slow wave sleep changes in normal and pathological aging than do standard, all-night, slow wave sleep measures. Thus, with a baseline crossing technique, elderly depressives were shown to have a higher delta count per minute during the second NREM sleep period than did controls or demented subjects. This difference reflected greater activity per minute in the 2-3 Hz frequency band (75-200 microV).

Aged↗

PubMed1985

Extrapyramidal signs following zimelidine overdose.

A 35-year-old woman with depression attempted suicide by taking an overdose of zimelidine (5 g), which was confirmed by zimelidine and norzimelidine plasma levels. Physical examination and repeat EKGs performed 2, 6, 9, and 12 hours later showed no alteration in her level of consciousness and only a slight increase in QT duration. However, the patient exhibited a distinct extrapyramidal syndrome, a finding consistent with animal data suggesting that zimelidine may possess some dopamine-receptor blockade properties.

Adult↗

PubMed1985

Sleeping pills for the elderly: are they ever justified?

Sleep disturbances in the elderly are common but not trivial. They are almost always multiply determined by age-dependent changes in sleep (amount, composition, and circadian distribution), concurrent medical/neuropsychiatric disorders and their treatments, and psychosocial/environmental changes. Against this complex background, the widespread use of sleeping pills to treat insomnia in the elderly is inadequate and--because of delay in diagnosis, adverse effects on respiration during sleep, and impairment of daytime alertness--potentially dangerous. A more thoughtful, less reflexive, approach to the prescription of sleeping pills in the elderly is suggested.

Age Factors↗

PubMed1985

Sleep apnea in Alzheimer's dementia: correlation with mental deterioration.

In a prospective study of sleep-disordered breathing among healthy elderly controls (N = 23), major depressives (N = 17), and demented patients with probable Alzheimer's disease (N = 21), sleep apnea (defined as an apnea index of 5 or more) was found in 42.9% of demented patients, 17.6% of depressives, and 4.3% of controls (chi 2 = 9.90, p less than .01). A significant association between sleep apnea and dementia of the Alzheimer type was found in women but not in men. Moreover, severity of dementia was significantly correlated with apnea index. Possible neuropathologic and clinical implications of these findings are discussed.

Aged↗

PubMed1984

Elevated red blood cell/plasma choline ratio in dementia of the Alzheimer type: clinical and polysomnographic correlates.

In a prospective study we have observed a shift in distribution of red blood cell (RBC)/plasma choline ratios among patients with probable dementia of the Alzheimer type (DAT), compared with healthy controls and depressed patients. Fifteen of 22 DAT patients (68%) showed RBC/plasma choline ratios greater than 1.9, in contrast to 9 of 26 healthy controls (35%) and 7 of 20 depressives (35%). These significant differences confirm and expand earlier observations. The subgroup of DAT patients with elevated RBC/plasma choline ratios is older and more cognitively impaired, shows later onset of dementia, and has less rapid eye movement (REM) sleep than the DAT subgroup with normal RBC/plasma choline ratios. Within the entire group of DAT patients, moreover, the RBC/plasma choline ratio shows a significant inverse correlation with REM sleep latency. These findings are discussed in relation to abnormalities in other nonneural Alzheimer tissues and within the context of cholinergic involvement in both DAT and the timing of REM sleep.

Aged↗

PubMed1984

The effect of vasopressin on memory in the healthy elderly.

The effect that vasopressin has upon memory in young and old males was tested in a double-blind crossover study. There were two 1-week medication periods; during one, subjects received 60 micrograms of vasopressin daily; during the other, placebo. Reaction time tasks were used to measure their speed of retrieval from: short-term memory (STM), long-term memory (LTM), and semantic memory (SM). While vasopressin did not affect SM retrieval time or simple vocal reaction time, it did reduce memory comparison time and perceptual-motor time in STM and retrieval time in LTM. The degree of facilitation was similar in young and old.

Adult↗