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Biomedical subjects

M Ackenheil

Publications and source records attributed to M Ackenheil.

At least 91 records · Page 5Linked to original sources
PubMed1986

A double-blind study with ceruletide in chronic schizophrenic patients: biochemical and clinical results.

We evaluated ceruletide, a cholecystokininlike peptide, in a double-blind, placebo-controlled study of 20 male chronic schizophrenic patients. After baseline investigations, 10 patients received 0.3 microgram/kg body weight ceruletide, and 10 patients received placebo (normal saline) intramuscularly once weekly for 3 consecutive weeks. Psychopathology was rated on the Brief Psychiatric Rating Scale and the Nurses' Observation Scale for Inpatient Evaluation. Blood was drawn on the same days for estimation of norepinephrine, epinephrine, beta-endorphin, cortisol, and prolactin. There were no significant changes in biochemical parameters. With regard to psychopathology, no significant differences in behavioral ratings were found between the ceruletide- and placebo-treated groups. Furthermore, there was no changes in either positive or negative symptoms of schizophrenia secondary to ceruletide. Contrary to uncontrolled studies, we failed to show antipsychotic properties of ceruletide.

Adult↗
PubMed1986

[Psychopathologic changes in chronic schizophrenic patients following withdrawal of neuroleptics: relation to therapeutic, neuroendocrine and computer tomography variables].

The following data were obtained from 36 male chronic schizophrenics (ICD 295.6) of 47 +/- 11 years of age, treated with neuroleptics for the last 16 +/- 6 years: Age, age at first manifestation of disease, duration and dosage scheme of neuroleptic therapy and number of electroconvulsive shock treatments. Blood samples were drawn both under neuroleptic treatment and after a 12-day withdrawal of neuroleptics, for determining cortisol, prolactin, beta-endorphin and noradrenaline. Psychopathology was assessed by standard criteria via BPRS. In 27 patients CT determination was carried out to determine the breadth of the third ventricle and the ventricular brain ratio. Withdrawal of neuroleptics resulted in a marked improvement, whereas 11 patients showed pronounced deterioration of their psychotic symptoms. In respect of the entire group there was a significant improvement of anergy, while disturbances of thinking were significantly enhanced. Serum levels of beta-endorphin and cortisol increased after neuroleptic withdrawal, whereas the levels of prolactin and of noradrenaline dropped. A considerable proportion of the patients showed a distinct extension of the ventricular system, but the CT variables correlated only slight with psychopathological parameters or their changes after neuroleptic withdrawal. The other variables, too, were without clinically relevant prognostic importance compared with the psychopathological changes after neuroleptic withdrawal. These variables were e.g. demography, psychopathology, therapy and neuroendocrinology.

Adult↗
PubMed1986

Preliminary experiences and results with the Munich version of the Andreasen Scale. Assessment of productive and negative symptoms in chronic schizophrenic patients.

The Andreasen Scale (SANS), an instrument for evaluating negative symptoms in schizophrenic patients, was translated at the Psychiatric Hospital of Munich and tested on 35 chronic schizophrenic inpatients at the Regensburg State Mental Hospital. In addition, psychopathology was evaluated with the BPRS, sociodemographic data were collected, and cognitive performance was evaluated by the MMS. Also, VBR was determined on the basis of CAT scans. Our results suggest that the SANS is a reliable instrument for measuring negative symptoms; however, the symptom complexes are affected by age, duration of illness and hospitalization, thus making a clear distinction between negative symptoms per se and the effects of hospitalization questionable.

Adult↗
PubMed1986

Clinical and biochemical effects of nicergoline in chronic schizophrenic patients.

To investigate the potential effect of Nicergoline, an alpha-adrenolytic drug, on negative symptoms in patients suffering from chronic schizophrenia, we administered this compound to 20 male chronic schizophrenics. Patients were previously maintained on long-term neuroleptic (NL) medication. Neuroleptic treatment was discontinued for 12 days, patients were then treated with 30 mg Nicergoline per day. Under NL (A), after 12 days NL-withdrawal (B), after 15 (C) and 30 (D) days Nicergoline treatment clinical ratings (BPRS and AMDP) and stimulation with clonidine (0.002 micrograms/kg body weight) were carried out. Norepinephrine (NE), epinephrine (E), and human growth hormone (HGH) were measured before and after application. Seventeen patients finished the study, 3 dropped out. Some ratings on the AMDP and BPRS scales showed an improvement. However, this improvement was only weak and accompanied by a worsening in other subscores. The withdrawal-induced decrease in NE serum levels continued after 15 days NIC, followed by an increase after 30 days. HGH response to clonidine stimulation was only attenuated after 30 days NIC. Epinephrine, blood pressure and heart rate showed no significant changes throughout the entire study. Our data suggest that NIC in the dosage applied shows no clear and pronounced alpha-2-adrenolytic effects and no specific clinical benefits for chronic schizophrenics. Further investigations are required to evaluate its effect on alpha-1-adrenoceptors.

Adult↗
PubMed1985

Physical activity decreases the number of beta-adrenergic receptors on human lymphocytes.

On intact human lymphocytes a specific binding site (BS) for 125I-Cyanopindolol (125I-CYP), a derivative of the beta-blocking drug pindolol, was characterized. Inhibition of binding for catecholamines in the following order of potency: l-isoprenaline greater than l-adrenaline greater than l-noradrenaline proves the BS as a beta 2-receptor subtype. In 77 healthy persons (36 females, 41 males) the number of BS amounted to 2,639 +/- 125 BS/cell without any significant correlation to age (17-86 years) or sex. The dissociation constant (KD) indicating the affinity of iodocyanopindolol to the BS on intact lymphocytes was KD = 1.9 +/- 1.1 X 10(-10) M. A change of the number of beta-adrenergic receptors on intact human lymphocytes has been measured previously in asthmatics and in the myocardium of patients with congestive heart failure. We investigated a possible change in the beta-receptors on lymphocytes by physical and mental activity ("stress") in physicians going about their daily routine work. Persons left alone in a hospital room reading or sleeping were defined as "inactive controls". The number of BS on intact lymphocytes was significantly higher in inactive persons at 8 a.m. (2,230 +/- 482 BS) compared to active persons (1,743 +/- 285 BS; P less than 0.05) and at 1 p.m. (2,394 +/- 253 BS vs 1,733 +/- 556; P less than 0.05) but not different at 6 p.m. (1,634 +/- 578 BS vs 1,768 +/- 588 BS; P less than 0.1). The KD remained unchanged under all conditions. The serum noradrenaline and adrenaline levels were also measured during the day.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Tardive dyskinesia: relation to computer-tomographic, endocrine, and psychopathological variables.

Severity of tardive dyskinesia (TD) and psychopathology of 36 chronic schizophrenic patients under long-term treatment with neuroleptics (NL) was rated during NL therapy and again 12 days after NL withdrawal. Both times serum levels of prolactin, norepinephrine, beta-endorphin, and cortisol were determined. In 27 of these patients ventricular-brain ratio, width of third ventricle, maximal width of anterior horns, distance between choroid plexus, and width of four largest sulci were also measured. Fifteen patients had no signs of TD; 14 had moderate, and 7 severe TD. TD was not related to age, age at onset of illness, duration of illness, dosage and type of neuroleptics, number of ECTs, or any endocrine variable. Psychopathology was barely related to TD, but after NL withdrawal, patients with TD tended to show more deterioration, particularly with regard to thought disorder and activation. With regard to computer-tomographic (CT) variables, patients without TD showed significantly less sulcal enlargement than those with TD. These results indicate that individual predisposition, which may have led to the development of TD, also seems to involve a higher risk of relapse after NL withdrawal.

Adult↗
PubMed1985

Binding of 3H-spiperone to human lymphocytes: a biological marker in schizophrenia?

The specific binding of the dopamine antagonist 3H-spiperone to lymphocytes from a healthy control group (n = 40), a group of acute, unmedicated schizophrenic patients (n = 27), and a psychiatric control group (n = 16) was investigated. There were no differences in binding parameters between the healthy controls (Bmax 2.6 +/- 0.7 fmoles/10(6) cells; Kd 0.17 +/- 0.07 nM) and the psychiatric control group. Binding capacity of 3H-spiperone was significantly increased in lymphocytes from the schizophrenic patients (Bmax 14.4 +/- 9.3 fmoles/10(6) cells). Moreover, a slight decrease in affinity was observed (Kd 0.44 +/- 0.21 nM). Because the increase in binding appeared only in schizophrenic patients, this peripheral model could prove valuable as a diagnostic criterion.

Acute Disease↗
PubMed1985

Neuroleptic withdrawal in chronic schizophrenia: CT and endocrine variables relating to psychopathology.

The psychopathology of 36 chronic, schizophrenic patients who had been on maintenance neuroleptics was rated during neuroleptic therapy and after 12 days of neuroleptic withdrawal. At both times, hormonal serum levels were also determined. Moreover, in 27 of these patients, ventricle-brain ratio, maximal width of the third ventricle, and sulcal widening were measured on computed tomography (CT). Neuroleptic withdrawal resulted in individually different psychopathological changes: 7 patients improved, 11 worsened. Within the whole group, thought disorder deteriorated, and anergia improved. Levels of cortisol and beta-endorphin increased; those of prolactin and norepinephrine decreased. The majority of patients showed ventricular enlargement, which was marginally related to reduced thought disorder. CT and endocrine variables were slightly related to psychopathology or psychopathological effects of neuroleptic withdrawal.

Adult↗
PubMed1984

Altered hormonal activity in severely ill patients after injury or sepsis.

We studied the hormonal millieu and possibility of altered thyroid function in 25 patients in a surgical intensive care unit (ICU) who had severe life-threatening illnesses. Sixteen patients had septic complications and nine patients had multiple-system injuries. On admission to the ICU, serial measurements were begun of thyroxine (T4), triiodothyronine (T3), T4-binding globulin, thyrotropin (thyroid-stimulating hormone [TSH]), corticotropin (adrenocorticotropic hormone [ACTH]), cortisol, prolactin, human growth hormone, catecholamine, insulin and glucose, lactate, retinol-binding protein, prealbumin, and transferrin levels. All patients initially had low normal levels of T4 (4.5 +/- 2 micrograms/dL) and T3 (55 +/- 26 ng/dL), with normal TSH levels (2.3 +/- 2.3 microU/mL) (the "low T3 syndrome"). The 11 surviving patients had their levels increase to normal before leaving the ICU (T4, 7.0 +/- 2.1 micrograms/dL; T3, 110 +/- 48 ng/dL; and TSH, no change). The 14 patients who died showed further decreases before death (T4, 2.6 +/- 2.1 micrograms/dL; T3, 30.6 +/- 23.5 ng/dL; and TSH, 0.9 +/- 0.7 microU/mL). The corticotropin, cortisol, prolactin, and growth hormone levels were normal throughout the study. Catecholamine levels were high initially and decreased in surviving patients. Epinephrine levels increased greatly in nonsurvivors before death, and the norepinephrine-epinephrine ratio decreased from 5.7:1 to 2:1. After protirelin (thyroid-releasing hormone [TRH]) stimulation, the TSH level increased either minimally or not at all in six patients who eventually died. This indicates hypothalamic-pituitary dysregulation or suppression, and altered release and/or peripheral metabolism of T4. Whether this represents a deficiency of thyroid hormone for cell and organ function remains to be established.

Adolescent↗
PubMed1984

Neuroendocrine effects of apomorphine in chronic schizophrenic patients under long-term neuroleptic therapy and after drug withdrawal: relations to psychopathology and tardive dyskinesia.

The sensitivity of the dopaminergic hypothalamic pituitary system, as indicated by growth hormone (GH) release after apomorphine (0.5 mg SC), was studied in 11 chronic schizophrenic in-patients under long-term neuroleptic (NL) therapy and after 12 and 30 days' drug withdrawal. GH peak levels after a 12-day drug-free period were significantly elevated (13.1 +/- 12 ng/ml) as compared to NL therapy (4.6 +/- 6.1 ng/ml). Controls showed a significant higher mean peak GH response (13.6 +/- 10 ng/ml) compared to chronic schizophrenic patients under long-term NL therapy. The GH response of patients with symptoms of tardive dyskinesia (TD) did not differ significantly from that of patients without signs of TD. The prolactin (PRL) serum levels under long-term NL treatment were within the normal range in male schizophrenics but decreased significantly after 12 days' drug withdrawal. The data presented indicate a reduced sensitivity of the hypothalamic-pituitary dopamine receptors under long-term NL therapy. The significant increase in GH response on day 12 probably corresponds to a readjustment from a mostly blunted GH response under NL therapy back to stimulated levels of normal controls. No supersensitivity of the pituitary dopamine receptors could be detected.

Adult↗
PubMed1984

The dependence of the clonidine growth hormone test on alcohol drinking habits and the menstrual cycle.

The dependence of the growth hormone (GH) response to clonidine (CLON) on alcohol drinking habits and on the menstrual cycle was investigated. GH response to CLON (0.15 mg i.v.) was blunted in 6 of 9 male, regularly beer-drinking non-depressed probands. After 14-17 and 30-37 days of abstinency, the probands showed a slight but not significant increase of the CLON stimulated GH maxima, and with great variability. During their menses, female probands had a significantly lower GH response to CLON than during ovulation. For these reasons, both alcohol drinking habits and, in females, the day of the menstrual cycle should be considered when the CLON-GH test is carried out in clinical studies.

Adult↗
PubMed1984

Catecholamines and their receptors in blood: evidence for alterations in schizophrenia.

The simultaneous determination of serum catecholamine (CA) and their receptors in blood cells offers the possibility of evaluating disturbances of the dopamine (DA) and noradrenaline (NA) neuronal systems in man. High-affinity binding sites for 3H-yohimbine in platelets, 3H-DHA in granulocytes, and 3H-spiperone in lymphocytes from healthy control persons, unmedicated (n = 28), and medicated (n = 8) schizophrenics, and from an unmedicated psychiatric control group (n = 14) were investigated. Furthermore, the actual concentration of the circulating CA was determined with HPLC-ECD. In unmedicated schizophrenics, as compared with controls, specific binding of 3H-spiperone to lymphocytes was markedly elevated in capacity and less in affinity. For beta 2 receptors a significant decrease was found in capacity with no change in affinity. The changes in alpha 2 receptors, viz. a slight decrease in capacity, were less distinct. The concentrations of circulating CA ranged from normal values to a more than threefold increase in NA and DA, whereas adrenaline (A) concentrations were nearly unchanged. No overall change in these data was found in the medicated schizophrenic patients. 3H-Spiperone binding was characteristically increased only in schizophrenics, but did not rise above control data in the nonschizophrenic psychiatric control group. Preliminary family studies suggest that this model could be valuable as a vulnerability marker.

Adult↗
PubMed1982

Situational reactivity of autonomic functions in schizophrenic patients.

In a study designed to evaluate the state of arousal and the autonomic reactivity to experimental conditions in schizophrenic patients, 12 acute, unmedicated schizophrenic patients with paranoid hallucinatory symptomatology and 63 healthy normal control subjects were administered four standardized tasks: cold pressor test, noise, mental arithmetic, and active relaxation. Biochemical (norepinephrine and cortisol) and physiological (electromyogram, electroencephalogram, skin and conductance response, skin conductance level, finger pulse amplitude, finger temperature, heart rate, respiratory volume, pulse wave velocity, and electrogastrogram) parameters were measured simultaneously. Schizophrenic patients showed elevated levels of cortisol and norepinephrine, as well as heightened responsivity on measures of electromyographic activity, skin conductance level, and heart rate, throughout the trial, and reduced responsivity to conditions of stress. It is concluded that schizophrenic patients show higher nonspecific activation and reduced ability to react to external stimulation, perhaps induced by lack of inhibition of the reticular formation by the limbic system.

Acute Disease↗
PubMed1982

Experimental stress situations and the state of autonomic arousal in schizophrenic and depressive patients.

The influence of short-time emotional and cognitive stimuli on autonomic functions and plasma catecholamines was investigated in 12 paranoid schizophrenics, 12 endogenous depressive patients, and 63 normal controls. The schizophrenics showed higher norepinephrine levels, depressives higher epinephrine levels; in both groups of patients most of the physiological parameters were elevated throughout the trial, showing, on the other hand, reduced responsiveness to external stimulation.

Adult↗