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Biomedical subjects

J C Krieg

Publications and source records attributed to J C Krieg.

At least 73 records · Page 4Linked to original sources
PubMed1992

Brofaromine in panic disorder: a pilot study with a new reversible inhibitor of monoamine oxidase-A.

The therapeutic efficacy of brofaromine--a new reversible and short acting MAO-A inhibitor--was evaluated in 14 inpatients with a panic disorder. In an open trial, the patients were treated with placebo during the first week and with 150 mg brofaromine per day during the following four weeks. In all patients a distinct improvement in both anxiety and depressive symptoms was observed under the active drug. Treatment outcome was the same in patients with and without a concomitant major depressive episode. No side-effects of any note were reported. Our findings suggest that the MAO-A inhibitor brofaromine is an effective drug in the treatment of anxiety disorders.

Adult↗
PubMed1991

Pain sensitivity in anorexia nervosa and bulimia nervosa.

Pain threshold was measured with short heat stimuli using a contact thermode in 19 patients with anorexia nervosa, 20 patients with bulimia nervosa, and 21 control subjects. Both patient groups had significantly elevated pain thresholds compared with the control subjects. In the total sample, no substantial covariation could be demonstrated among pain threshold and clinical, physiological, metabolic, or psychological data. However, in separate regression analyses pain threshold correlated significantly (negatively) with local skin temperature in the anorectic patients and almost significantly (positively) with body weight in the bulimic patients. This finding suggests that the reduced pain sensitivity in the two kinds of eating disorders might have different causes.

Adult↗
PubMed1991

Nocturnal sleep in Huntington's disease.

Nocturnal sleep was studied in 16 inpatients with Huntington's disease. In comparison with healthy controls, patients exhibited a disturbed sleep pattern with increased sleep onset latency, reduced sleep efficiency, frequent nocturnal awakenings, more time spent awake and less slow wave sleep. These abnormalities correlated in part with duration of illness, severity of clinical symptoms, and degree of atrophy of the caudate nucleus. Patients showed an increased density of sleep spindles.

Adult↗
PubMed1991

Brain morphology and sleep EEG in patients with Huntington's disease.

In 12 patients with Huntington's disease, the relationship between brain morphology, nocturnal sleep EEG, and clinical variables was studied. Global cerebral atrophy did not significantly correlate with sleep parameters, whereas atrophy of the caudate nuclei was associated with reduced slow wave sleep and increased time spent awake. Several clinical parameters (e.g., anergia and thought disturbance scores of the Brief Psychiatric Rating Scale, illness duration and global clinical assessment) showed significant correlations with global cerebral atrophy. Similar studies in other neuropsychiatric disorders demonstrate associations between sleep alterations and brain morphological changes of different localizations, thus pointing to a complex relationship between both. It can be hypothesized that the caudate nuclei may be involved in sleep regulation; indirect evidence from studies with positron emission tomography (PET) point in the same direction.

Adult↗
PubMed1991

Nocturnal sleep EEG in patients with HIV infection.

Nocturnal sleep was studied in 14 human immunodeficiency virus (HIV)-positive patients without opportunistic infections of the central nervous system. Seven patients had no bodily complaints at the time of the investigation. Patients exhibited an impaired nocturnal sleep with longer sleep onset latency, reduced total sleep time, reduced sleep efficiency, and more time spent awake and in stage 1. Stage 2 sleep was significantly decreased; in 2 cases, sleep spindle density was extremely low. REM latency was reduced and correlated negatively with depressive symptomatology, while the percentages of REM and slow wave sleep were normal. No significant differences in sleep parameters were present among patients in different stages of the illness, or between patients with and without bodily complaints. Ventricular size and sulcal width on computed tomography scans correlated with sleep variables indicating reduced sleep quality, and with REM density. Decreased tryptophan plasma levels were associated with shorter and less efficient sleep, and with reduced stage 2 sleep. The findings demonstrate that sleep EEG investigations can be valuable for detecting and monitoring central nervous system affection in HIV-positive individuals.

AIDS Dementia Complex↗
PubMed1991

Assessment of somatosensory indicators of polyneuropathy in patients with eating disorders.

The somatosensory functions of small-diameter nerve fibres were tested on the lower and upper extremities in nine patients with anorexia nervosa, ten patients with bulimia nervosa and ten control subjects, by analysing warmth, cold, and pain thresholds. To test large-diameter nerve fibres, the vibration threshold was also measured. Both patient groups had markedly elevated pain thresholds compared with the control subjects. In contrast, warmth and cold thresholds were only suggestively elevated while vibration thresholds were not at all increased in the patients. A distal-proximal pattern of somatosensory deficits, suggestive of peripheral polyneuropathy, was not observed. Hence, a peripheral polyneuropathy affecting small or large afferent fibres as a consequence of an eating disorder seems to be a rare event.

Adult↗
PubMed1991

Effect of dexfenfluramine on sleep in healthy subjects.

The acute effects of dexfenfluramine on nocturnal sleep were studied in ten healthy male subjects by means of sleep EEG recordings and ratings of subjective sleep quality. Four different dosages (3 mg, 7 mg, 15 mg, and 30 mg) were tested, administered over a period of 3 days each. Under 15 mg and 30 mg dexfenfluramine, only slight effects on sleep were observed: 15 mg led to decreased sleep efficiency in the first night of medication, and to reduced percentage of slow wave sleep in the first and third night. A significant lengthening of REM latency was present in the third night under 30 mg dexfenfluramine, without changes in other REM sleep parameters. Daily doses of 3 mg and 7 mg dexfenfluramine did not influence sleep, except for a significant REM latency reduction observed in the first night under 3 mg. Apart from a transient slight impairment under 30 mg, ratings of subjective sleep quality did not mirror any impact of dexfenfluramine. The data suggest that therapeutic dosages of dexfenfluramine only slightly influence nocturnal sleep, which contrasts with the known impact of other anti-obesity agents like the amphetamines. Unlike classical antidepressants, dexfenfluramine does not reduce REM sleep; in light of a hypothetical link between REM sleep reduction and antidepressant action of a drug, dexfenfluramine is not expected to have a pronounced antidepressant effect.

Adolescent↗
PubMed1991

Glucose metabolism in the caudate nuclei of patients with eating disorders, measured by PET.

Regional cerebral glucose metabolism was measured with 18F-2-fluoro-2-deoxyglucose and positron emission tomography in nine patients with bulimia nervosa and in seven patients with anorexia nervosa. Relative caudate glucose metabolism (caudate glucose metabolism divided by global cerebral glucose metabolism) was significantly higher in anorexia nervosa than in bulimia nervosa, suggesting that caudate hyperactivity is characteristic of the anorexic state. Whether increased caudate function is a consequence of anorexic behaviour or whether it is directly involved in the pathogenesis of anorexia nervosa is an issue still to be clarified.

Adult↗
PubMed1991

Disturbed cholecystokinin secretion in patients with eating disorders.

It has been shown that the gastrointestinal hormone cholecystokinin (CCK) induces satiety and reduces food intake in laboratory animals and humans. In the light of this evidence we studied CCK release in patients suffering from eating disorders. The secretion of CCK into the general circulation was measured in 10 anorectic, in 7 bulimic patients, and in 8 healthy controls before and after a high-caloric liquid testmeal. Baseline CCK values were similar in controls (0.6 +/- 0.2 pmol/l) and bulimics (0.6 +/- 0.1 pmol/l) and were significantly increased in the anorectic group (1.8 +/- 0.4 pmol/l) (p less than or equal to 0.005). After eating peak plasma levels increased to 6.1 +/- 0.9 pmol/l in the anorectic, to 3.8 +/- 0.5 pmol/l in the bulimic and to 2.7 +/- 0.6 pmol/l in the control group. All postprandial CCK values were significantly higher in the anorectic group. The secretion of CCK-8-S, an important peptide in the CCK family, was significantly elevated, too. This disturbed CCK secretion in patients suffering from anorexia nervosa, even if it is a secondary, diet-induced defect, may perpetuate this disorder.

Adolescent↗
PubMed1991

Circadian pattern of large neutral amino acids, glucose, insulin, and food intake in anorexia nervosa and bulimia nervosa.

Insulin, glucose, and large neutral amino acids (LNAA) were studied in 10 patients with anorexia nervosa, 13 patients with bulimia nervosa, and 15 healthy controls. Blood samples were collected at hourly intervals during the day and at two-hour intervals during the night over a 24-hour period. Ad libitum caloric and relative carbohydrate intake was significantly reduced in the anorectic and bulimic patients. Elevated concentrations of beta-hydroxybutyric acid (BHBA) were seen in the bulimic group, and low triiodothyronine (T3) concentrations in the anorectic group. Mean plasma glucose and insulin concentrations were significantly lowered in both groups. The tryptophan (Trp) to LNAA ratio was reduced in anorectic, but not in bulimic patients. These findings suggest that Trp influx into the brain is reduced in anorectic patients, possibly impairing central serotonergic function.

Amino Acids↗
PubMed1991

Dieting and pain sensitivity: a validation of clinical findings.

To validate findings of a reduced pain sensitivity in anorexia and bulimia nervosa, the effects of dieting on somatosensation (especially pain sensitivity) were investigated in healthy young women. One group of subjects (n = 11) received a calorically reduced balanced diet for 21 days, while the other group (n = 14) continued to eat normally. The fasting state induced in the dieting subjects was comparable to that of eating disorder patients, since the dieters showed a reduction of the body mass index, a decrease in triiodothyronine and an increase in beta-hydroxybutyric acid plasma levels. However, neither the thresholds of pain, warmth, cold and vibration sensitivity nor the peripheral skin temperature changed systematically under the diet. Therefore, the reduced pain sensitivity in eating disorder patients is apparently not a mere effect of fasting, but a true pathological feature.

3-Hydroxybutyric Acid↗
PubMed1991

Alterations of nocturnal sleep in patients with HIV infection.

Nocturnal sleep of 14 patients with HIV infection was characterized by longer sleep onset latency, shorter total sleep time, reduced sleep efficiency, more time spent awake and in Stage 1. There was significantly less sleep Stage 2 than in healthy controls. REM latency was slightly reduced and correlated negatively with depressive symptomatology, while percentages of REM and slow wave sleep were normal. Patients without complaints at the time of the investigation exhibited similar sleep abnormalities. The results stress the usefulness of polysomnography as a sensitive methodology for detection and monitoring of CNS affection in HIV positive patients.

AIDS Dementia Complex↗
PubMed1991

Anxiety disorders: similarities and differences of comorbidity in treated and untreated groups.

The similarities and differences of comorbidity in treated and untreated samples with anxiety disorders were examined using data from the Munich Follow-up Study: 133 subjects with anxiety and depressive disorders and 101 former in-patients at the Max Planck Institute for Psychiatry. Diagnoses were based on the DIS, not using the optional DSM-III exclusion rules. In these epidemiological and clinical samples, 69% and 95% respectively had at least two diagnoses. The epidemiological sample was clearly differentiated from the clinical sample by age of onset. The development of both depressive episodes and substance disorders in the two samples was mostly secondary to the development of anxiety problems. The outcome for subjects with both anxiety and depressive disorders tended to be worse than that for those with anxiety alone, regardless of whether a depressive episode was present at the time of the follow-up investigation. The usefulness is underlined of the comorbidity concept based on operationalised diagnosis without the exclusion rules offered by DSM-III and DSM-III-R.

Adult↗
PubMed1990

A polysomnographic study in young psychiatric inpatients: major depression, anorexia nervosa, bulimia nervosa.

The baseline EEG sleep patterns of 10 young depressed patients, 20 patients with anorexia nervosa, 10 patients with bulimia nervosa, and 10 healthy subjects were found to be indistinguishable, except for an increased REM density in the depressed patients. In eating disorder patients, a concomitant major depressive episode had no influence on EEG sleep. The results of the cholinergic REM sleep induction test revealed a significantly faster induction of REM sleep in the depressed patients when compared with the eating disorder patients and the control subjects. This indicates a subthreshold hypersensitivity of the REM sleep triggering cholinergic transmitter system in depressives, but not in eating disorder patients.

Adolescent↗