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Biomedical subjects

H L Fehm

Publications and source records attributed to H L Fehm.

At least 109 records · Page 6Linked to original sources
PubMed1996

A nose-brain pathway for psychotropic peptides: evidence from a brain evoked potential study with cholecystokinin.

The access of substances to the brain is of particular relevance for the etiology and treatment of psychiatric and neurologic diseases. This study provides functional evidence for a direct access of peptides to the human brain after intranasal administration. Effects were compared of intranasal (IN, 10 micrograms) and intravenous (i.v., 0.25 and 2.5 micrograms) administered cholecystokinin-8 (CCK) on the auditory event related potential (AERP) in 20 healthy subjects. Also, plasma concentration of cortisol and ACTH were monitored. The study was designed as a placebo-controlled, double-blind within-subject cross-over comparison. AERPs were recorded while the subject performed on an attention task (oddball task). Plasma CCK concentrations after IN administration of CCK were comparable to those after i.v. administration of 0.25 microgram CCK, but were substantially lower than those after 2.5 micrograms CCK. The P3 complex of the AERP was markedly increased following the IN administration of CCK (p < .01) compared to placebo and to the i.v. administration of 0.25 microgram. This pattern was more obvious in women than men. Increases in plasma ACTH concentrations after CCK reached significance selectively following the IN mode of administration (p < .01).

Administration, Intranasal↗
PubMed1996

Changes in cortisol and growth hormone secretion during nocturnal sleep in the course of aging.

BACKGROUND: One current hypothesis of biological aging proposes that aging results from the deterioration of neuroendocrine functions. Sleep dependent growth hormone (GH) secretion is diminished in elderly people. However, the time course of this decrease from puberty to senescence is still unknown. Cortisol secretion is also related to sleep processes with the 24 hr nadir occurring, like the sleep dependent GH secretory surge, during the first half of nocturnal sleep. Whether age also affects the sleep-associated nadir of cortisol secretion has yet to be clarified. This study investigated changes in GH and cortisol secretion during sleep in 30 male volunteers age 20 to 92 yr. METHODS: After an adaptation night, each subject spent another night in the sleep laboratory for polygraphic sleep recording and determination of GH and cortisol levels every 15 min. RESULTS: GH peak values exponentially decreased with age (r = -.80, p < .001), while the cortisol nadir increased linearly as a function of age (r = .79, p < .001). Age-related changes in sleep-dependent secretion of GH and cortisol correlated significantly (r = .47, r = -.55, respectively; p < .05) with an age-dependent decrease in slow wave sleep. CONCLUSION: Alterations of GH peak amplitude and basal cortisol secretion are not restricted to senescence. These changes develop gradually during adult life with different time courses. Both changes in GH and cortisol secretion may act together to reduce anabolic functions of sleep in the aged.

Adult↗
PubMed1996

Slow potential shifts at sleep--wake transitions and shifts between NREM and REM sleep.

Scalp-recorded direct current (DC) potentials and their topographical distribution (F3, F4, C3, C4 and Pz) were investigated at the transition from wakefulness to sleep, and during NREM-REM sleep and REM-NREM sleep transitions in 11 healthy men during normal sleep. Changes in endexpiratory CO2 partial pressure (ETCO2), scalp temperature and polysomnographic data were simultaneously measured. The transition to sleep was associated with a negative potential shift reaching significance bilaterally at frontal and central sites 5 to 10 minutes after sleep onset (p < 0.05). Largest shifts were found at frontal locations 10 to 15 minutes after sleep onset averaging (mean +/- SEM) -512 +/- 103 mu V. Negative DC potential shifts also occurred at the transitions from NREM to REM sleep and from REM to NREM sleep, but were, however, less pronounced. The negative DC shift at NREM-REM sleep transitions preceded the REM sleep onset (assessed conventionally by polysomnographic criteria) by about 1.5 minutes. Changes in temperature, ETCO2 and eye movements were ruled out as factors significantly contributing to the generation of these shifts. Assuming a neuronal origin of the DC potential, the negative shifts at the wake--sleep transition and between NREM and REM sleep suggest a temporary phase of increased cortical excitability.

Adult↗
PubMed1996

Ceruletide improves event-related potential indicators of cognitive processing in young but not in elderly humans.

The effect of intravenously administered ceruletide, a cholecystokinin (CCK) analogue, on neurophysiologic signs of stimulus processing was tested in 16 young (19-28 years) and 16 aged (70-86 years) healthy subjects. Placebo or 2.5 micrograms ceruletide was infused within 30 minutes according to a double-blind within-subject crossover design. Thereafter, auditory event-related brain potential (AERP) responses to stimuli of an "oddball" task (including the random presentation of frequent standard tones and rare target tones) were recorded. Amplitudes of the P2, P3, and SW components of the AERP were reduced in aged subjects (p < 0.05, p < 0.001, and p < 0.01, respectively), and latencies (from stimulus onset) of the N2 and P3 components were prolonged (p < 0.05 and p < 0.01, respectively). Together, these changes indicate impaired cognitive processing capabilities in aged compared with young subjects. Ceruletide enhanced P3 and also the subsequent slow-wave (SW) component that occurs 500 to 700 ms poststimulus in young subjects (p < 0.05 and p < 0.001, respectively). The peptide did not at all affect AERPs in the elderly subjects. Results demonstrate the capability of ceruletide after systemic administration to enhance central nervous system indicators of cognitive processing such as P3 and SW in young subjects. However, despite the clear effect of the CCK analogue in young subjects, it remained ineffective in the group of aged subjects and, thus, failed to compensate for the decline in AERP signs of working memory functioning in the elderly subjects.

Adult↗
PubMed1996

The angiotensin converting enzyme inhibitors fosinopril and enalapril differ in their central nervous effects in humans.

BACKGROUND: Although the antihypertensive actions of different angiotensin converting enzyme (ACE) inhibitors are comparable, they may affect central nervous activity, mood and well-being differently. Thus, central nervous actions of ACE inhibitors may represent an essential factor determining compliance with antihypertensive therapy. OBJECTIVE: To compare central nervous effects of the biochemically different ACE inhibitors fosinopril and enalapril in healthy men. METHODS: In a double-blind cross-over study, auditory event-related brain potentials and heart rate variability were assessed 6 h after oral intake of placebo, enalapril (10 mg) and fosinopril (20 mg) with the doses being equipotent with regard to systemic ACE inhibition. Plasma concentrations of noradrenaline, adrenaline, vasopressin and cortisol were determined 3 and 6 h after drug intake. Central nervous effects mediated via direct systemic hypotensive actions were avoided (although not completely ruled out) by including only subjects (n = 14) who displayed no substantial drop in blood pressure following intake of the ACE inhibitors. RESULTS: Enalapril, but not fosinopril, enhanced the N1 component and the N1-P2 amplitude of the event-related brain potential (P < 0.05). In addition, enalapril enhanced plasma noradrenaline concentrations (P < 0.05). A similar effect of fosinopril failed to reach significance. There was no clear-cut effect of ACE inhibition on heart rate variability, and also plasma concentrations of adrenaline, vasopressin and cortisol remained unaffected. CONCLUSION: The results suggest an enhancing effect of enalapril on mechanisms regulating stimulus-induced cortical arousal and central nervous sympathetic outflow. The effects diverging between enalapril and fosinopril indicate that access to human brain functions differs among the various types of ACE inhibitors.

Adult↗
PubMed1996

Enhanced psychophysiological signs of attention after angiotensin-converting enzyme inhibition by captopril.

Complementary to its essential role in the central nervous control of cardiovascular activity, the neuropeptide angiotensin II may regulate attentional processes. The present study evaluated central nervous, cardiovascular, and sympathetic indicators of attention after inhibition of angiotensin II synthesis by captopril (50 mg vs. placebo) in 14 men. Event-related potentials (ERPs) and stimulus-related electroencephalographic (EEG) activity were recorded while the subject performed an auditory oddball task. Captopril increased both the N1-P2 component of the ERP (p < .05) and--following the first tone of the task--the EEG desynchronization in the lower alpha frequency band (p < .05). Although blood pressure remained unchanged, heart rate was lowered (p < .05) and plasma norepinephrine concentrations increased (p < .01) after captopril. The effects suggest that inhibition of angiotensin II synthesis enhances an attentional state typically present during sensory intake.

Acoustic Stimulation↗
PubMed1996

Greater efficacy of episodic than continuous growth hormone-releasing hormone (GHRH) administration in promoting slow-wave sleep (SWS).

It has been suggested that growth hormone (GH)-releasing hormone (GHRH) stimulates the surge in GH and enhances slow-wave sleep (SWS), two phenomena that characterize the beginning of nocturnal sleep. However, in human studies the effects of systemic GHRH administration on sleep were not consistent. This may reflect the differential influence of administration procedures being episodic in one of the above studies, but either a continuous infusion or a single bolus in the others. The present study in healthy volunteers compared changes in nocturnal sleep following 200 micrograms GHRH administered iv either episodically (4 boluses of 50 micrograms each at 2200, 2300, 2400, and 0100 h) or as a continuous infusion (57 micrograms/h between 2130 and 0100 h). Time spent in stage 4 of SWS on nights of episodic GHRH administration significantly exceeded that on nights of continuous GHRH administration (P < 0.01). Compared with a placebo condition, episodic administration of GHRH enhanced SWS (P < 0.01) and rapid eye movement (REM) sleep (P < 0.05) and diminished time spent in wakefulness and sleep stage 1 (P < 0.05). Effects of continuous GHRH infusion on sleep generally remained insignificant compared with placebo. Plasma GH concentrations were enhanced during both conditions of GHRH administration (P < 0.01), with the increase following episodic administration slightly exceeding that during continuous infusion (P < 0.05). The results support a greater physiological efficacy of episodic GHRH stimulation in promoting sleep.

Adult↗
PubMed1996

Entrainment of ultradian oscillations in the secretion of insulin and glucagon to the nonrapid eye movement/rapid eye movement sleep rhythm in humans.

The cause of ultradian oscillations in the secretion of glucagon and insulin with a period length between 70-140 min has been atttributed to feedback mechanisms of glucose and insulin. Influences of the central nervous system on these ultradian glucagon and insulin oscillations remained to be elucidated. In the present study on one occasion, concentrations of glucose, glucagon, insulin, and GH were determined at 15-min intervals from 2100-0700 h in 16 healthy subjects while they were infused with saline solution. On another occasion, concentrations of these hormones during nocturnal sleep were determined in 10 of these subjects while they were constantly infused with glucose (4.5 mg/kg x min). The order of the treatments (placebo vs. glucose) was balanced across subjects, and experiments were performed in a double blind manner. Significant glucagon and insulin peaks were determined by the peak detection algorithm Cluster. Sleep was recorded somnopolygraphically. During the infusion of saline solution, glucagon concentrations showed spontaneous oscillations, with a mean periodicity of 107.9 +/- 13.2 min. During the constant infusion of glucose, oscillations of similar periodicity (110.1 +/- 10.3 min) were observed for insulin. The phases of glucagon and insulin secretory activity on the respective nights were entrained to the nonrapid eye movement (non-REM)/REM sleep cycle. Significant increases in the concentrations of glucagon (chi 5.23; P < 0.02) and insulin (chi= 7.32; P < 0.01) generally fell into epochs of non-REM sleep, with a preference for the beginning of the epochs, whereas decreasing concentrations of these hormones coincided significantly with epochs of REM sleep (P < 0.05). The time spent in the different sleep stages was not altered during glucose infusion. In conclusion, ultradian oscillations of insulin and glucagon concentrations are modulated by central nervous system mechanisms entraining secretory pulses of the alpha- and beta-cells of the endocrine pancreas to the non-REM sleep epochs of the non-REM/REM sleep cycle.

Activity Cycles↗
PubMed1996

Accelerated ST-segment reduction after thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) compared to urokinase.

Effects of therapy with urokinase (UK) and with recombinant tissue plasminogen activator (rtPA) were compared in patients with acute myocardial infarction (AMI). To achieve homogenous therapeutic conditions the comparison was restricted to patients having their first AMI and to cases of clinically successful thrombolytic therapy (defined by non-invasive criteria, such as a 50% decrease in elevated ST-segment in the worst load of a 12 lead ECG within 300 min after onset of thrombolytic therapy, complete pain resolution during thrombolytic therapy, and later confirmed by angiography 10 days after AMI). Effects of UK and rtPA on continuous multilead ST-segment analysis and cardiac proteins (creatine kinase and its isoenzyme CK-MB, aspartate transaminase and hydroxybutyrate dehydrogenase) were analyzed during 24 hours following onset of therapy. Continuous ST analysis showed a faster resolution of the elevated ST-segments after thrombolytic therapy with rtPA than with UK(p < 0.01). Accelerated idioventricular rhythms (p < 0.05) occurred sooner following rtPA than UK treatment. The wash-out of creatine kinase was increased (p < 0.01) after rtPA. Although both drugs induced comparable, angiographically controlled reperfusion, the results suggest that the process of reperfusion was accelerated during thrombolysis with rtPA compared to UK. Thrombolytic therapy of AMI with rtPA may hence improve myocardial salvage.

Adult↗
PubMed1995

Cytokine production and lymphocyte subpopulations in aged humans. An assessment during nocturnal sleep.

The view of a general impairment of immune functions associated with aging has been challenged by recent studies including a more detailed evaluation of various cytokines and lymphocyte subsets. In the present human study, effects of age on the production of cytokines by T cells and monocytes were assessed, together with age-dependent changes in subset populations of mononuclear cells (MNC). Blood was collected every 30 min during nocturnal sleep in 16 aged (mean: 79.6 +/- 7.5 years) and in 16 young controls (mean: 24.6 +/- 3.1 years). Nocturnal sleep was chosen as a well-defined period within the 24-h cycle with minimal exogenous influences. The in vitro production of interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) was measured after mitogen stimulation with lipopolisaccharide from E. coli (LPS). Production of interleukin-2 (IL-2) and interferon-gamma (IFN-gamma) was measured after stimulation with phytohemagglutinin (PHA). Regarding MNC subsets, monocytes, lymphocytes, CD3+, CD4+, CD8+, HLA-DR, CD16+, CD25+, and CD19+ were determined. Advanced age was associated with a decreased number of T cells (CD3+) and decreases in the major T cell subsets (CD4+, CD8+, P < 0.001). Production of IL-2 was not affected. However, production of IFN-gamma tended to be enhanced, and numbers of activated T cells (HLA-DR/CD3+), natural killer cells (CD16+), and T cells expressing IL-2 receptors (CD25+/CD3+) were markedly increased in the aged. While monocyte counts were unchanged in the elderly production of IL-1 beta and TNF-alpha mainly derived from these cells, was enhanced (p < 0.05). Results indicate a state of enhanced responsiveness of the T cell compartment and of monocytes in aged which may compensate for the substantial decrease in T cells.

Adult↗
PubMed1995

Improved event-related potential signs of selective attention after the administration of the cholecystokinin analog ceruletide in healthy persons.

Cholecystokinin (CCK) is co-localized with dopamine (DA) in neurons of the mesolimbic-frontocortical dopamine (DA) system, considered essential for the pathology of psychotic behavior and associated attention deficits. The present experiments in 13 healthy men aimed at examining the effects of the CCK analog ceruletide on attention as reflected by event-related brain potentials (ERPs). Subjects were tested according to a double-blind cross-over design on three occasions, following intravenous infusion of placebo, 0.5 microgram ceruletide, and 2.5 micrograms ceruletide. ERPs were recorded during the subject's performance on an auditory selective attention task including the concurrent presentation of frequent standard tones and infrequent deviant tones which the subject had to listen to, or to ignore. The processing negativity (PN) over frontocentral cortical areas, reflecting selective attention, was higher after ceruletide than placebo, this increase being most pronounced after the 2.5 micrograms dose (placebo -1.29 +/- 0.38 microV versus ceruletide -3.02 +/- 0.65 microV, p < .05). ERP signs of a general increase in cortical arousal after ceruletide did not reach significance. Likewise, mismatch negativity, an indicator of preattentive processing of stimulus deviance, was not significantly affected by the peptide. The results indicate that ceruletide affects human brain function primarily by improving selective attention.

Adult↗
PubMed1995

Binding of human, porcine and bovine insulin to insulin receptors from human brain, muscle and adipocytes and to expressed recombinant alternatively spliced insulin receptor isoforms.

Previous studies have suggested that human and porcine insulin exert identical effects on blood glucose and counter-regulatory hormones but elicit different neurophysiological reactions. A major goal of the present study was to investigate whether this could be caused by different relative affinities of the insulins from different species to insulin receptors from the brain compared to other tissues. Insulin receptors isolated from human brain, muscle or adipocytes as well as from cultured cells over-expressing either of the human insulin receptor isoforms (exon 11- or exon 11 +) were immobilized to microwells coated with monoclonal anti-insulin receptor antibody. Subsequently the binding of human, porcine and bovine insulin was measured. While the receptors derived from the different tissues had different affinities for insulin, there were no tissue-specific differences in the relative binding of the insulins of the three species. The insulins of the three species were also not different with regard to their binding to the receptor isoforms. Finally, in human brain homogenates no differences in the degradation rates for human, porcine and bovine insulin were detected. Thus, our data do not support the hypothesis that different neurophysiological reactions during hypoglycaemia due to human or porcine insulin are caused by differences of the binding of the insulins to human brain insulin receptors or their degradation in the human brain.

Adipocytes↗
PubMed1995

Delta-sleep-inducing peptide does not affect CRH and meal-induced ACTH and cortisol secretion.

Besides sleep-promoting properties, delta-sleep-inducing peptide (DSIP) has been reported to act as a corticotropin-releasing inhibiting factor in vitro and in vivo. We examined, first, the influence of DSIP on ACTH and cortisol release following stimulation with human corticotropin-releasing hormone (h-CRH; 1.0 microgram/kg body weight, and 0.5 microgram/kg body weight, respectively) in healthy young men (n = 5 in each condition). DSIP (total doses of 3 and 4 mg, respectively, vs. placebo) was infused intravenously between 30 min prior to and 90 min after CRH injections. Responses of ACTH and cortisol were almost identical during and after infusion of DSIP and placebo. In a second experiment, the influence of DSIP (4 mg, also administered as intravenous infusion) on meal-related ACTH and cortisol secretion was studied in another 10 men. Meal-related midday surge of ACTH and cortisol was also not affected by DSIP. Our data do not support an inhibitory role of DSIP on ACTH and cortisol secretion in man.

Adolescent↗
PubMed1995

Hormonal secretion during nighttime sleep indicating stress of daytime exercise.

We tested the hypothesis that long-duration exercise (LDE) of moderate intensity, but not LDE of low intensity, during the daytime changes the typical temporal patterns of hormone release during subsequent nocturnal sleep. Ten trained healthy men participated in a balanced crossover study including three conditions: 1) no exercise, 2) LDE of low intensity (biking 40 km; 1800-2030), and 3) LDE of moderate intensity (biking 120-150 km; 1600-2030). During the subsequent night (2300-0700), somnopolygraphic sleep recordings were obtained, and concentrations of cortisol, growth hormone (GH), and testosterone were measured every 15 min. During the no exercise nights, the typical secretory patterns were present with peak concentrations of GH but nadir concentrations of cortisol during the first half of sleep but increased cortisol levels and minimum GH levels during the second part of sleep. Testosterone concentrations increased during the second half of sleep. LDE of moderate intensity reduced rapid-eye-movement sleep [13.9 vs. 16.9% (no exercise); P < 0.01]. Levels of testosterone decreased with increasing intensity of daytime exercise (P < 0.05). Moderate-, but not low-intensity, LDE decreased GH levels in the first half (P < 0.05) and increased GH levels in the second half (P < 0.005) of sleep. Also, LDE of moderate intensity but not LDE of low intensity increased cortisol levels during the first half (P < 0.005) and decreased cortisol secretion during the second half (P < 0.05) of sleep. Results suggest that nocturnal profiles of GH and cortisol concentrations may serve to indicate the disturbance of normal anabolic functions of sleep due to daytime exercise.

Adult↗
PubMed1995

Nocturnal wakefulness inhibits growth hormone (GH)-releasing hormone-induced GH secretion.

Recent studies have suggested that spontaneous release of GH as well as GH secretion stimulated by exogenous GHRH are influenced by central nervous mechanisms that regulate sleep and wakefulness. Here, the effect of nocturnal wakefulness on GH secretion stimulated by i.v. administration of GHRH was examined in two experiments in healthy men. On all nights, GHRH (1 microgram/kg BW) was injected after the subjects had slept for about 2.5 h to minimize interference of endogenous release of GH during early sleep with the response to exogenous GHRH. Both experiments included a control condition to assess GH secretory responses to GHRH during undisturbed sleep and an experimental condition to assess the effect of wakefulness. In the control conditions, subjects slept throughout the night, and GHRH was administered 170 min after sleep onset. In the experimental condition of Exp I (n = 10), subjects were awakened 150 min after sleep onset and stayed awake. GHRH was given 20 min after awakening. In the experimental condition of Exp II (n = 8), subjects were awakened 30 min after GHRH treatment, which was administered 170 min after sleep onset. GHRH administrations during sleep fell into epochs of stage 2 sleep or rapid eye movement sleep. GH secretion and sleep characteristics before GHRH administrations were comparable for experimental and control conditions of both experiments. GH secretory responses were inhibited when the subject was awake at the time of GHRH administration compared to GH responses during undisturbed sleep. Awakening the subject 30 min after GHRH administration abruptly interrupted the initiated GH secretory response. The results demonstrate a profound inhibitory effect of nocturnal awakenings on GHRH-induced GH secretion. They indicate that the GH secretory response to GHRH is strongly determined by central nervous system sleep-wake activity.

Adult↗
PubMed1995

Effects of age and gender on pituitary-adrenocortical responsiveness in humans.

This study compared plasma concentrations of adrenocorticotropin (ACTH) and cortisol in young men (N = 10, mean age 24.4 years), young women (N = 10, mean age 25.4 years), old men (N = 8, mean age 81.6 years) and old women (N = 8, mean age 83.5 years) under basal resting conditions and after stimulation with either human corticotropin-releasing hormone (hCRH, 100 micrograms iv) or a combined injection of hCRH (100 micrograms) and arginine vasopressin (VP, 0.5 IU iv). Basal secretion of cortisol did not differ among groups, but basal concentrations of ACTH were diminished in young women (p < 0.01), indicating an enhanced adrenal sensitivity to ACTH in these subjects. Pituitary responses to hCRH did not differ between young men and women. However, responses to hCRH/VP were stronger in the young females (p < 0.01), suggesting an enhanced pituitary responsiveness to the augmenting effect of VP on ACTH release in this group. Pituitary-adrenal secretory responses were greater in old than in young men after sole injection of hCRH (p < 0.05) and even more so after combined injection of hCRH/VP (p < 0.01). In old women, pituitary-adrenal secretory responses were also greater than in young women (p < 0.05). But, in particular for responses to hCRH/VP, these effects were less distinct than within the men. Results indicate an enhancing effect of age on pituitary responsiveness to the hypothalamic secretagogues hCRH and VP, modulated by the subject's gender.

Adrenocorticotropic Hormone↗
PubMed1994

[Diagnosis of an Ullrich-Turner syndrome in pension evaluation].

A 56-year-old woman of short stature (148 cm) was medically examined after applying for a disability pension on account of chronic back-pain. She gave a history of primary amenorrhoea (not examined further), slowly increasing deafness, type IIb diabetes mellitus, hyperlipoproteinaemia, hypothyroidism and osteoporosis. Physical examination showed hypoplasia of both breasts, shield chest and slight webbing of the neck. Ultrasonography of the thyroid revealed late stage of Hashimoto thyroiditis. Vaginal ultrasonography confirmed absence of uterus and adnexae. All these findings were compatible with the diagnosis of Turner's syndrome, which was confirmed by chromosomal examination of 50 analysable metaphases showing chromosomal mosaic 45,X/46,X, i(Xq), as well as two cells with 47 chromosomes, two with isochromosomes for the long arm of the X-chromosome. Treatment consisted of administration of L-thyroxin (75 micrograms/d) and oestrogen. There was no follow-up.

Female↗