Search PubMed⌕ Search

Biomedical subjects

J Balldin

Publications and source records attributed to J Balldin.

53 records · Page 3Linked to original sources

Neuroendocrine evidence for increased responsiveness of dopamine receptors in humans following electroconvulsive therapy.

The previous finding that electroconvulsive therapy (ECT) enhances effects of dopamine (DA) agonists was further investigated in the present clinical experiment using neuroendocrine techniques. Apomorphine chloride (AP) (0.18-0.24 mg IV) induced stimulation of growth hormone (GH) and suppression of prolactin (PRL), as shown 2-3 days before and after ECT in mentally depressed patients (N = 12) and therapy-resistant parkinsonian patients with on-off phenomena (N = 9). AP-stimulated GH secretion was not significantly affected by ECT, whereas AP-induced suppression of PRL, expressed as percentage of baseline PRL levels, was significantly enhanced after ECT. Changes in clinical and hormonal parameters were not significantly correlated. Control patients not receiving ECT showed no significant changes in AP-induced GH secretion or PRL suppression in repeated investigations. The results support the view that ECT increases responsiveness of DA receptors and indicates that AP-induced suppression of PRL is a useful model to reflect these changes in humans.

Adult↗

Factors influencing prolactin release induced by electroconvulsive therapy.

Electroconvulsions have been reported to induce rapid elevations of serum prolactin (PRL) levels. To further evaluate factors involved in the hormonal release an extended study was performed. Blood samples for determination of PRL were withdrawn from depressed patients 5 min before and 15 min after administration of electroconvulsions. Significant elevations of PRL levels were found in 35 of 37 patients. Increase in PRl levels was significantly correlated to duration of seizures but not to duration of the electric stimulation. The hormonal response to electroconvulsions was diminished with age. Patients on lithium medication had significantly more pronounced rises of PRL levels than patients treated with other psychotropic drugs and otherwise untreated patients. The results indicate that the elevation in PRL levels is a biochemical marker of the seizure activity during electroconvulsive therapy.

Adolescent↗

Studies on duration of a late recovery period after chronic abuse of ethanol. A cross-sectional study of biochemical and psychiatric indicators.

A cross-sectional study on patients with different abstinence time was performed to describe long-time biochemical and psychiatric changes due to withdrawal from heavy alcohol abuse. Physical, neurological, psychiatric and biochemical parameters were measured in 70 patients with a withdrawal period ranging from 2-90 days. The various parameters changed over time in different manners. Fatigability, reduced sleep, reduced sexual interest, apparent sadness, hostility and global ratings of abstinence improved significantly with the duration of the recovery period. Symptoms related to brain hyperexcitability such as fatigability, inner tension, insomnia and pains persisted for approximately 5 weeks. Of the biochemical parameters, the transaminases were normal in patients with more than 10 days of abstinence, while the levels of gamma-glutamyltransferase and HDL-cholesterol remained high for longer periods. The essential fatty acid status, measured by the fatty acid composition of serum lecithin, appeared to be normal only in patients with long recovery time. MAO in platelets was significantly lower than in the controls. The highest values were seen in the early recovery phase, which may indicate a temporary increase. Since polyunsaturated fatty acids are important constituents of synaptic membranes and since platelet MAO may reflect brain MAO, we consider these co-existing findings important in the interpretation of the psychiatric symptoms. The study demonstrated the existence of a subacute withdrawal syndrome lasting for 4-6 weeks.

Adult↗

Predictors for improvement after electroconvulsive therapy in parkinsonian patients with on-off symptoms.

The antiparkinsonian effect of electroconvulsive therapy (ECT) was investigated in nine parkinsonian patients with "on-off" phenomena. The patients were maintained on previously adjusted doses of antiparkinsonian drugs during and after ECT. Parkinsonian as well as mental symptoms were rated before and after treatment. Basal serum levels of prolactin (PRL) and growth hormone (GH) as well as apomorphine induced changes (0.24 mg i.v.) in these levels were investigated three days before start of treatment. Marked improvement of parkinsonian symptoms was seen in five patients. Two further patients showed slight improvements. The improvement persisted for 2-41 weeks. Improvement after ECT was found to correlate with age at the time of treatment and with duration of L-dopa therapy as well as the estimated life-dose of L-dopa. No correlation was found between depression before treatment, basal serum levels of GH and PRL or apomorphine induced changes in these hormone levels. The investigation indicates that ECT is a valuable adjuvant in the treatment of a selected group of parkinsonian patients with "on-off" phenomena. Furthermore, the results support our earlier proposal that ECT increases the responsiveness in postsynaptic dopamine sensitive structures.

Aged↗

Prolactin response to electroconvulsive therapy.

Prolactin response to electroconvulsive therapy (E.C.T.)was investigated in nine patients with endogenous depression. Four patients undergoing minor gynaecological surgery who had had the same type of intravenous anaesthesia as the E.C.T. group were studied as controls. 15 minutes after E.C.T. there was a 10 to 50 fold increase in serum-prolactin in eight of the patients. The effects of anaesthesia and surgery on serum-prolactin in the controls were negligible.

Adult↗

Mental well-being in alcohol withdrawal: relationship to alpha2-adrenoceptor function.

The possible relationship between postsynaptic alpha2-adrenoceptor function, as assessed by the growth hormone (GH) response to clonidine (CLON) and aspects of mental well-being by self-report of mood using the Swedish Mood Adjective Check List, was investigated in alcohol-dependent patients in the early withdrawal period. Patients had blunted GH responses to CLON and worse mental well-being than control subjects immediately after the end of alcohol intake. No relation was found between mental well-being and postsynaptic alpha2-adrenoceptor function. After 1 week, the GH responses to CLON remained blunted, whereas the state of mental well-being had improved to levels similar to those of control subjects. The results further support a downregulated alpha2-adrenoceptor function during 1 week of alcohol withdrawal. Furthermore, even if subsensitive postsynaptic alpha2-adrenoceptor function was not generally related to state of mood, patients with the lowest postsynaptic alpha2-adrenoceptor function reported the highest levels in the dimensions pleasantness/unpleasantness and activation/deactivation when sober.

Adrenergic Agonists↗

Psychopathology in alcohol withdrawal: relationship to alpha2-adrenoceptor function.

The possible relationship between postsynaptic alpha2-adrenoceptor function, as assessed by growth hormone (GH) response to clonidine (CLON; 1.5 or 2.0 microg/kg i.v.), and psychopathology was investigated in 30 patients with alcohol-dependence in the early withdrawal period. Excluding patients with high baseline GH, 23 of the 26 patients had blunted GH responses to CLON and 57% moderate or severe depression at day 1 after the end of alcohol intake. After 1 week, the GH responses to CLON remained blunted in 20 of 21 retested patients, whereas the depression and anxiety remitted in all but two patients. The results do not support any relationship between postsynaptic alpha2-adrenoceptor function and symptoms of psychopathology in alcohol withdrawal.

Adrenergic Agonists↗

Transient increase in platelet monoamine oxidase b activity during early abstinence in alcoholics: implications for research.

Some earlier studies have suggested that platelet monoamine oxidase (MAO)-B activity should be determined at time points other than early in the abstinence phase. However, the optimal times for blood sampling have not been precisely defined. We therefore assessed platelet MAO-B activity repeatedly in 13 male alcohol-dependent patients over the 2 months after the end of a period of heavy alcohol intake. Twelve healthy men were used as controls. In the alcohol-dependent patients, platelet MAO-B activity was transiently increased from 2 to 6 weeks after the end of alcohol intake and the values during this time period were not different from those of controls. Platelet MAO-B activity was, however, significantly lower in the alcohol-dependent patients at 1 week and at 2 months after the end of alcohol intake, in comparison to controls. It is concluded that the transient increase in platelet MAO-B activity after the end of alcohol intake in alcohol-dependent patients may conceal a difference from a control group. Therefore, it is suggested that when platelet MAO-B activity is determined, the preferential time point for obtaining those values in alcohol-dependent patients is after 2 months of abstinence.

Adult↗

Alcoholics with the dopamine receptor DRD2 A1 allele have lower platelet monoamine oxidase-B activity than those with the A2 allele: a preliminary study.

Low platelet monoamine oxidase B (MAO-B) activity and the presence of the Taq1 A1 allele of the dopamine D2 receptor (DRD2) gene have independently been proposed as 'biological/genetic' markers for alcoholism. In the present study, the relationship between these two markers was investigated in a group of socially stable Caucasian middle-aged men with a mean (+/-SD) daily ethanol consumption of 85 +/- 57 g. The platelet MAO-B activity was significantly lower in individuals with the DRD2 A1 allele (n = 8), compared to those without it (n = 29). This relationship remained unchanged when including only subjects who fulfilled DSM-IV criteria for alcohol dependence (n = 27). The finding suggests that alcoholics who are carriers of the DRD2 A1 allele may have lower platelet MAO-B activity.

Adult↗

High AST/ALT ratio may indicate advanced alcoholic liver disease rather than heavy drinking.

AIMS: To assess the place of AST/ALT ratio (the ratio of serum aspartate aminotransferase to serum alanine aminotransferase) as a diagnostic marker in medical populations. METHODS: Laboratory tests were viewed retrospectively in three groups of patients: 313 patients with alcohol dependence, consecutively admitted to an alcohol and drug treatment unit for treatment of withdrawal (W) symptoms, 78 patients with alcohol abuse or dependence consecutively admitted to surgical or medical wards with various primary somatic (S) diagnoses (e.g. respiratory, gastrointestinal and metabolic), and 48 consecutive patients with alcohol abuse or dependence admitted to surgical or medical wards for treatment of alcohol-related liver cirrhosis and its complications (C). Comparison between groups was made of the pattern of patients' AST/ALT ratios using, for Groups S and C, laboratory data from patients' first admission for their condition. RESULTS: There was a significant rise in the AST/ALT ratio from the W to the S patients, and from the S to the C patients. In the W group, the ratio was < or = 1.0 in 64% of the patients, and only exceptionally > or = 2. In the C group, 69% had a ratio > or = 2, and 8% a ratio < or = 1.0. The mean ratio was midway in the S group. In the C group, there was a progressive decline in aspartate (AST/ALT) ratios after admission. CONCLUSIONS: Most patients with high alcohol consumption but without severe liver disease do not have an AST/ALT ratio above 1. High AST/ALT ratio suggests advanced alcoholic liver disease.

Adult↗

Relationship between mental impairment and HPA axis activity in dementia disorders.

In 40 patients with Alzheimer's disease (AD, < 65 years), 56 patients with senile dementia of the Alzheimer type (SDAT, > or = 65 years) and 45 patients with vascular dementia (VAD), basal cortisol levels were estimated and the dexamethasone test (DST) was performed. The degree of dementia was assessed according to DSM-III-R and the GBS scale was used for quantitative measures of functional impairment. There were no significant differences in basal cortisol levels. Especially in the VAD group, scores on functional impairment correlated significantly with post-DST cortisol levels. The results indicate hypothalamic overactivity in demented patients which can be correlated to the degree of dementia. In VAD, and to a certain extent also in SDAT, there appears to be a disconnection between cortical areas, including the hippocampus and the hypothalamus.

Aged↗