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Biomedical subjects

J M Gaillard

Publications and source records attributed to J M Gaillard.

At least 163 records · Page 9Linked to original sources

[Sleep disorders in psychiatric diseases. Clinical and polygraphic data].

This article considers first the relationships between sleep disturbances and psychiatry in general. It shows the interest of sleep recordings in psychiatric diseases as a complementary examination, in order to clarify a diagnosis or the selection of a treatment. Sleep disturbances in the main psychiatric disorders are described: brain organic diseases, thymic disorders, schizophrenia. Modifications of sleep are also found in many other psychiatric disturbances such as anxiety or neuroses. Polysomnography is an excellent functional examination of the brain and has an increasing importance in psychiatry.

Female↗

Comparison of two muscle relaxant drugs on human sleep: diazepam and parachlorophenylgaba.

The effects of two muscle relaxant drugs of different chemical structures, parachlorophenylgaba and diazepam, were investigated in the sleep of normal young adults. Parachlorophenylgaba did not show any significant and dose-related effect. In contrast, diazepam induced clear modifications, including a decrease of stage 4 and of REM-sleep, an increase of spindles and a decrease of K potentials in stage 2, a decrease of rapid eye movements in REM-sleep, and finally a decrease of body movements. In addition, the recovery of REM-sleep upon withdrawal of the drug was much faster than the recovery of stage 4. These results add a new contribution to known differences in the pharmacological profiles of these two compounds ; for diazepam, the possible role of GABA mediated monoaminergic mechanisms is discussed.

Aminobutyrates↗

[Flunitrazepam and memory (author's transl)].

This work is based on the observation of memory troubles before sleep in patients with sleep problems treated with flunitrazepam. Eight subjects are tested in two sessions, flunitrazepam and placebo, in double blind, with memory tests given the evening after medication and controlled the next morning. One additional test is controlling vigilance. The results show that memory is significantly disturbed by flunitrazepam, both for direct and delayed memory, the next day. On the contrary, recognition is not altered, neither vigilance.

Adult↗

Sleep, depression and the effects of antidepressant drugs.

We have investigated the modifications of paradoxical sleep (PS) induced by antidepressant drugs acting on two different neurotransmitters, noradrenaline (NA) and serotonin (5-HT). Desipramine (DMI) decreased PS in the rat and this effect was reduced by pretreatment with alpha-methyl-paratyrosine (aMPT), but unmodified by parachlorophenylalanine (pCPA). Indalpine (IND), which inhibits specifically the reuptake of 5-HT, also decreased PS; this effect was enhanced by pretreatment with aMPT and decreased by pretreatment with pCPA. Taken together, these results suggest that DMI and IND decrease PS by enhancing the extracellular concentration of NA and 5-HT respectively. In addition, they evoke the possibility of interaction between 5-HT and NA systems, with an inhibitory effect of 5-HT on NA systems.

Animals↗

[Efficacy of antidepressants selected as a function of erythrocyte membrane transport and plasma levels of L-tyrosine and L-tryptophan].

The present study concerned 69 depressed patients (26 men, 43 women). The antidepressant drug was prescribed in accordance with perturbations of tyrosine and tryptophan membrane transports (MT) across the red cell, measured in vitro after a wash-out period of ten days. After two to four months of treatment, the clinical results were divided into two groups: normal mood (AMDP - Depression Scale less than 6) and no recovery (AMDP - Depression Scale greater than 6). The initial criteria (e.g. MT) was completed by using plasma tyrosine, tryptophan and the product MT by plasma level. Indeed, the success of this treatment was corresponding to precise abnormalities of variable: (i) tyrosine and tryptophan values for imipramine, (ii) tyrosine values, plasma tryptophan and tryptophan product for desipramine, (iii) tryptophan variables and plasma tyrosine for fluvoxamine (and indalpine). The analysis of clinical failures permitted to complete our previous choice of antidepressant drug.

Adult↗

[Joint evolution of erythrocyte membrane transport of tyrosine and tryptophan as a function of the clinical course of depression].

The clinical state and the erythrocyte membrane transports of tyrosine and tryptophan were studied longitudinally during one year (minimum period of 3 months) in 44 depressive patients, 21 men and 23 women of 30 to 77 years of age. According to the DSM III, 18 patients had bipolar disorders (8 with short cycles), 14 had recurrent major depressions and 12 dysthymic disorders. Abnormal values for the membrane transports are found in the majority of patients; the pattern of these abnormalities differs among the nosological groups but decreased ratio of the tyrosine to tryptophan is the predominant finding. The membrane transports normalize as the clinical status improves. In bipolar disorders, the changes observed at the time of switching into mania differ among short and long cyclers. Short cyclers who become manic generally present a short period of normal mood and show values of membrane transports higher than when depressed or euthymic and higher than those of normal controls. Long cyclers directly switch into mania, and when manic have the same ratio of tyrosine to tryptophan than when depressed. Based on these biochemical observations, long cyclers resemble patients with recurrent major depression and short cyclers resemble dysthymic disorder patients, a group for which it has been suggested that one fifth become bipolar within years of evolution.

Adult↗

[Relationship between blood catecholaminergic variables in depressive patients and normal subjects].

Some biochemical assays are available to test the central NA activity in depressed patients. In several laboratories, two metabolites of NA, namely DHPG and MHPG, in either free, conjugated or total form, have been assayed indifferently for this purpose. The present report shows positive correlations between the level of the two glycols, as well as between their different forms in the plasma. In contrast, the level of erythrocyte COMT activity was not correlated with plasma MHPG, and did not show any change during the treatment with respect to the control pretreatment period in depressed patients. The values of MHPG showed a bimodal distribution in the patients before treatment; the plasma level of this metabolite decreased significantly in the first month of treatment, but did not change subsequently. The COMT activity values, as well as MHPG, were significantly correlated between the different time points, that is the control period and after 1 to 3 months of treatment.

Adult↗

[Erythrocyte membrane transport and plasma levels of tyrosine and tryptophan in depression].

L-Tyrosine and L-Tryptophan were studied in 80 depressed patients, hospitalised in Genova and Marseille. After a washout period of ten days, the erythrocyte membrane transports (MT) of L-Tyrosine and L-Tryptophan were measured, as well as their plasma levels; plasma phenylalanine was moreover measured. 33 normal subjects served as control group. In the whole population of patients, the mean of MT's was different compared to controls (MT tyrosine low and MT tryptophan high) and the plasma tyrosine was low. The perturbations of these variables were different according to diagnostic groups (DSM III): MT tyrosine, plasma tyrosine and tryptophan low in bipolar disorders depressed; MT tyrosine low, MT tryptophan high, plasma tryptophan low in major depressions; MT tryptophan high in dysthymic disorders. Phenylalanine was in the normal range compared to controls. The perturbations of MT's involved the part incubated at 37 degrees C for tyrosine, e.g. the facilitated diffusion, and the part incubated at 0 degrees C for tryptophan, e.g. probably the passive and facilitated diffusion. These results were in agreement with the monoaminergic hypothesis of affective disorders and might provide a useful peripheral model.

Adult↗

[Erythrocyte membrane transport of L-tyrosine and L-tryptophan in 66 patients with depressive syndromes. Preliminary results].

The transport of Tyrosine and Tryptophan by the membrane of red blood cells has been studied in a group of 66 depressed patients (DSM-III: 27 major depressions, single episode or recurrent; 17 bipolar disorders, depressed; 22 dysthymic disorders). Anomalies were observed: tyrosine transport was decreased in the bipolar disorders and in the major depressions; tryptophan transport was increased in the major depressions and in the dysthymic disorders. These results suggest that membrane transports are disturbed in depressed syndromes, and may be related to dysfunction in the monoaminergic balance.

Adult↗

[Choice of antidepressive agents as a function of membrane transport (erythrocytes) of monoamine precursors (L-tyrosine and L-tryptophan)].

In a group of 66 depressed patients, the choice of the antidepressant drug was based upon the result of tyrosine and tryptophan uptake by the membrane of red blood cells. After one month of treatment, 56 subjects were improved, that is 85% of the cases. This result is discussed in comparison with the percentage of improvement described in the literature.

Antidepressive Agents↗

[Sleep in Pick disease].

19 polygraphic sleep recordings from 12 patients with Pick's Disease, including four histologically proved cases, were compared to those of an age-matched control group. Symptoms had been present for a mean 8 years, the patients being aged 59 to 78 (mean 70.5 years). All sleep stages could be identified. Total sleep time was reduced and the number of awakenings was sharply increased. High proportion of stage 1 contrasted with the reduction in the other sleep stages with disappearance of stage 4 in advanced cases. REM Sleep was identified in all recordings, although reduced as a function of the length of the illness; its production as a function of total sleep time was not different from that of the control. REM Sleep appeared often fragmented and with a remarkably short latency, reminiscent of that observed in severely depressed patients.

Aged↗

[Sleep and psychotropic drugs].

After reviewing a number of recent concepts of the anatomy of the cerebral noradrenergic systems, the authors examines the effects of several representative drugs of each of the three major classes of psychotropic drugs (neuroleptics, antidepressants, tranquilizers) on sleep. The effects of the neuroleptics on the paradoxical phase of sleep can be explained by the particular features of the organization of the cerebral noradrenergic systems. The antidepressants reduce the paradoxical phase by a number of mechanisms related to their principal pharmacological properties of inhibition of monoamine uptake and the anticholinergic effect. The benzodiazepine tranquillizers have a complex action on sleep, probably acting via several mechanisms. Newly developed benzodiazepine receptor antagonists enable us to distinguish some of these effects. The sensitivity of sleep to a large number of drugs is a useful tool for the functional investigation of the central nervous system.

Antidepressive Agents↗

The effect of presynaptic alpha blocker yohimbine on rat paradoxical sleep.

In rats, the presynaptic alpha-receptor blocking drug yohimbine given at low doses increases paradoxical sleep (PS) while much higher doses are necessary to depress it. These results are in line with the postulated preferential affinity of this drug for presynaptic noradrenergic (NA) receptors, resulting in an increased activity in NA synapses. The depression of PS under high doses of yohimbine may be related to a post-synaptic blockade of NA receptors, thus cancelling the presynaptic effect. This type of study illustrates the necessity of investigating the temporal evolution of PS instead of simply counting its total amount in a given period of time.

Animals↗

[Initial contact in clinical interview with patients suffering from chronic insomnia].

One of the most controversial issue concerning chronic insomnia is its association with psychopathology. Many patients tend to present their sleep disturbances as isolated, whereas others admit that they have difficulties in other sectors of their life too. If psychopathology exists in chronic insomnia, it should manifest itself in the form of defensive mechanisms which can be clinically observed. In order to have information concerning this problem, the initial interview of patients with chronic insomnia has been analysed in every details, in order to detect behavioural features and characteristics of verbal expression, indicating that defense mechanisms are working. A group of 100 patients from the specialized consultation for sleep disorders has been studied They were referred by their physicians. The patients with a somatic disease or a psychiatric condition corresponding to a diagnostic on axis I of DSM III-R were not included. The patients with a form of insomnia corresponding to psychophysiological insomnia, idiopathic insomnia or sleep state misperception of the international classification were included in this sample. For all patients except 2 of them, the initial interview was audiovisually recorded. This interview aimed at establishing the clinical features of the disturbance, the psychiatric and somatic condition as well as the history of the trouble and the treatment taken at the time or attempted in the past. After an initial open query: "what seems to be the problem?", a semi-structured interview was conducted to obtain information about nocturnal sleep, daytime condition, dream and parasomnia, the history of the disturbance and the treatment. Anxiety and depression, as well as other psychiatric conditions were systematically investigated. Under these conditions, the patients showed from the very beginning of the interview, noticeable characteristics in their behaviour and verbal expression. Therefore, it is essentially the first 10 minutes of the interview that have been analysed. One exception was regressive weepiness, which usually appeared later in the interview. The audio-visual recording was analysed two times, two months apart, and a number of individual traits have been scored for presence or absence. Only the most obvious traits have been scored. In the behavioural presentation of the patient, detachment, eye avoidance and distant attitude were most commonly observed. Many patients also showed some signs of tension and anxiety. The other traits were smile, immobility of the body posture, incessant movements and tics, bored attitude, mannerism, difficulties to concentrate, retardation or weepiness. The formal characteristics on verbal expression can indicate logorrhea, or in contrast very parcimonious expression, precipitated elocution which makes the patient difficult to understand, or montonous voice. From the point of view of verbal content, the speech is often vague, hesitant, dispersed or superficial, the patient going rapidly from one line to the next one. Some patients have problems to focus on what they want to explain.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗