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Biomedical subjects

M H Teicher

Publications and source records attributed to M H Teicher.

At least 37 records · Page 2Linked to original sources
PubMed1997

Circadian rest-activity disturbances in children with seasonal affective disorder.

OBJECTIVE: Seasonal affective disorder (SAD) affects from 1.7% to 5.5% of children. Previous studies found that nonseasonally depressed children had a blunted circadian rhythm, while adults with SAD had a delayed and poorly entrained rhythm. The purpose of this study was to determine whether pediatric SAD more closely resembles nonseasonal pediatric depression or adult SAD. METHOD: Twelve normal, healthy volunteers (11.6 +/- 3.7 years; 6 female, 6 male) and 14 unmedicated children with SAD (11.0 +/- 3.3 years; 9 female, 5 male) meeting Rosenthal/NIMH criteria for SAD and Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic version criteria for major depression had their levels of activity recorded for 72 hours (weekdays) using belt-worn actigraphs. RESULTS: The SAD group had blunted circadian amplitudes that were 10% lower than normal (p = .004). They were more poorly modeled by the standard cosinor equation (p = .001), and a circadian rhythm accounted for 39% less of the variability in their activity profile (p = .007). The amplitude of the 12-hour harmonic rhythm was markedly increased. There were no differences between SAD and control children in the timing of the circadian rhythm and degree of entrainment. CONCLUSIONS: Children with SAD displayed dysregulated circadian activity rhythms comparable with those reported in nonseasonally depressed children, yet different from those observed in adults.

Activity Cycles↗
PubMed1997

A controlled trial of light therapy for the treatment of pediatric seasonal affective disorder.

OBJECTIVE: To evaluate the efficacy of light therapy for the treatment of pediatric seasonal affective disorder (SAD). METHOD: 28 children (aged 7 to 17 years) at two geographically distinct sites were enrolled in a double-blind, placebo-controlled, crossover trial of bright-light treatment. Subjects initially entered a week-long baseline period during which they wore dark glasses for an hour a day. They were then randomly assigned to receive either active treatment (1 hour of bright-light therapy plus 2 hours of dawn simulation) or placebo (1 hour of clear goggles plus 5 minutes of low-intensity dawn simulation) for 1 week. The treatment phase was followed by a second dark-glasses phase lasting 1 to 2 weeks. After this phase, the children received the alternate treatment. Response was measured using the parent and child versions of the Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders version (SIGH-SAD). RESULTS: Data were analyzed as change from baseline. SIGH-SAD-P total depression scores were significantly decreased from baseline during light therapy compared with placebo (one-way analysis of variance, rho = .009), and no differences were found between the placebo and control phases. Subscores of atypical and typical depression were also significantly decreased during the active treatment (rho = .004 and .028, respectively). A similar trend was noted with the SIGH-SAD-C, but this did not reach significance. At the end of the study, 78% of the parents questioned and 80% of the children questioned rated light therapy as the phase during which the child "felt best." CONCLUSION: Light therapy appears to be an effective treatment for pediatric SAD.

Adolescent↗
PubMed1997

Increased nocturnal activity and impaired sleep maintenance in abused children.

OBJECTIVE: Previous studies have suggested that sleep disturbance may be the "hallmark of posttraumatic stress disorder," although several investigations have failed to find evidence for sleep disruption. The purpose of this study was to determine whether intense averse stimulation during early development, in the form of physical and/or sexual abuse, led to disruption of sleep and nocturnal activity. METHOD: Nineteen prepubertal children with documented abuse were compared with 15 nonabused normal controls and 10 depressed children. All subjects received a complete semistructured diagnostic interview. Ambulatory activity monitoring was used to evaluate sleep-related activity for three consecutive nights. Data were analyzed for nocturnal activity and algorithmic estimation of sleep initiation and continuity. RESULTS: Abused subjects were twice as active at night as normal and depressed children, and abused subjects emitted a greater percentage of their total daily activity during the night. Actigraph-derived sleep measures suggested that abused children had prolonged sleep latency and decreased sleep efficiency. Physically abused children had more impaired sleep efficiency than sexually abused children. CONCLUSION: Abused children have higher levels of nocturnal activity than normal controls or depressed children and appear to have more difficulty falling and staying asleep. Physical abuse appears to be the salient factor rather than posttraumatic stress disorder.

Analysis of Variance↗
PubMed1996

Cortisol regulation in posttraumatic stress disorder and major depression: a chronobiological analysis.

The aim of the present study was to evaluate the pattern of basal cortisol release in PTSD and major depression using a chronobiological analysis. Plasma for cortisol determination was obtained from 15 combat veterans with PTSD, 14 subjects with major depression, and 15 normal men every 30 min during a 24-hour period of bed rest. Raw cortisol data were modeled using standard and multioscillator cosinor models to determine the best fitting functions for circadian, hemicircadian, and ultradian components of cortisol release. PTSD subjects had substantially lower cortisol levels, and displayed a pattern of cortisol release that was better modeled by circadian rhythm. PTSD subjects also showed a greater circadian signal-to-noise ratio than the other groups. In contrast, depressed patients displayed a less-rhythmic, more chaotic pattern of cortisol release. The pattern of cortisol secretion and regulation observed in the PTSD group under baseline conditions may reflect an exaggerated sensitization, whereas the chronobiological alterations in depression may reflect dysregulation, of the hypothalamic-pituitary-adrenal (HPA) axis.

Adult↗
PubMed1996

Development of an affordable hi-resolution activity monitor system for laboratory animals.

We describe a hardware and software system for recording and analyzing the spatial and temporal pattern of locomotor activity of laboratory animals. The system offers maximal spatial resolution 500-fold greater than existing light beam monitors. An infrared motion analysis systems (MacReflex, Qualysis) simultaneously tracks the location of up to 20 subjects (identified by reflective markers) to within 0.04 mm at a rate of up to 50 Hz. Macintosh software provides measures of distance traveled, amount of area traversed, number of position changes (microevents), average time between movements, number of left and right turns, number of forward movements and reversals, as well as temporal and spatial scaling exponents. This system was validated by comparing these parameters to direct observer scoring of video tapes and other commercially available activity monitors. Our findings show that applying reflective markers to the subjects does not significantly alter activity levels. The effect of pharmacological manipulation with d-amphetamine is provided to show the value of the different activity parameters. The main advantages of this system are very high spatial resolution, capacity to monitoring up to 20 animals simultaneously at reasonable cost, and lack of sensitivity of the system to ambient lighting. The main limitation is the need to apply reflective markers.

Animals↗
PubMed1996

Objective measurement of hyperactivity and attentional problems in ADHD.

OBJECTIVE: To precisely describe movement abnormalities in seated children with attention-deficit hyperactivity disorder (ADHD) while they were engaged in a continuous performance task (CPT). METHOD: Diagnoses were made by using structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version) and DSM-IV criteria. Movement patterns of 18 boys with ADHD (9.3 +/- 2.4 years) and 11 normal controls (8.6 +/- 1.8 years) were recorded using an infrared motion analysis system that tracked the position of four markers 50 times per second to a resolution of 0.04 mm. RESULTS: Boys with ADHD moved their head 2.3 times more often than normal children (p < .002), moved 3.4 times as far (p < .01), covered a 3.8-fold greater area (p < .001), and had a more linear and less complex movement pattern (p < .00004). They responded more slowly and with greater variability on the CPT. Complexity of head movement and variability in response latency significantly correlated with teacher ratings. A predefined composite of movement and attention discriminated 16 of 18 patients from 11 of 11 controls. CONCLUSIONS: The relative inability of boys with ADHD to sit still can be objectively verified, and "fidgeting" appears to consist of more frequent, larger amplitude, whole body movements.

Attention Deficit Disorder with Hyperactivity↗
PubMed1996

Motor activity and severity of depression in hospitalized prepubertal children.

OBJECTIVE: To determine whether there is an association between activity levels and the severity and nature of depressive symptoms. METHOD: Locomotor activity was quantified in 27 consecutively selected hospitalized prepubertal children. Activity was measured in 5-minute epochs over a period of 72 hours using belt-worn monitors. Depressive symptoms were rated using the Children's Depression Rating Scale-Revised, the Children's Depression Inventory, and an observer rating scale for nursing staff. RESULTS: Measures of reduced daytime activity correlated with scores on the Children's Depression Rating Scale and the observer rating scale, but not the Children's Depression Inventory. Stepwise regression indicated that the strongest association occurred between a composite measure of severity, age, and percentage of low-level diurnal activity periods (r = .724, p < .0005). Activity measures correlated with clinical ratings of sadness, low self-esteem, anhedonia, and physical complaints, and to a lesser degree with ratings of hypoactivity, fatigue, and slow speech. CONCLUSIONS: Reduced levels of activity correlated significantly with clinical ratings of depressive severity across diagnostic groups. The development of objective measures of depressive severity may have prognostic and therapeutic implications.

Child↗
PubMed1996

Relationship between early abuse, posttraumatic stress disorder, and activity levels in prepubertal children.

OBJECTIVE: To examine the relationship between early physical and sexual abuse, posttraumatic stress disorder (PTSD), major depression, and activity levels in prepubertal children. METHOD: Nineteen unmedicated children with documented abuse (9.4 +/- 2.3 years; 6 girls, 13 boys) were compared with 15 healthy controls (8.3 +/- 1.9 years; 6 girls, 9 boys). Diagnoses were derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version). Motionlogger actigraphs collected activity data for 72 continuous hours in 1-minute epochs. RESULTS: Overall, abused children were 10% more active than normal children (p < .05) and displayed a paucity of periods of low-level daytime activity (p < .01). Abused children with PTSD were largely responsible for the increase in activity. Abused children with PTSD had a robust and normal circadian activity rhythm. Abused children in whom PTSD failed to develop had an attenuated circadian amplitude compared with subjects with PTSD (101% versus 93%, p < .01) and were phase-delayed by 61 minutes versus controls (p = .01). Early onset of abuse was significantly associated with greater likelihood of the development of PTSD and hyperactivity. Later age of abuse was associated with circadian dysregulation. CONCLUSIONS: These preliminary observations indicate that abused children with PTSD have activity profiles similar to those of children with attention-deficit hyperactivity disorder, while abused children without PTSD have activity profiles more similar to those of depressed children.

Attention Deficit Disorder with Hyperactivity↗
PubMed1996

Effects of passive body heating on the sleep of older female insomniacs.

The purpose of this study was to evaluate passive body heating (PBH) as a treatment for insomnia in older adults. Polysomnographic recordings of older adults routinely show an increase in sleep fragmentation and a substantial decrease in slow-wave sleep (SWS) consistent with complaints of "lighter" more disturbed sleep. An increase in body temperature in young adults early in the evening by way of PBH has been shown to produce an increase in SWS in the early part of the sleep period. In a crossover design, nine female insomniacs (aged 60-72 yr) participated in two consecutive nights of PBH, involving hot (40-40.5 degrees C) and luke-warm (37.5-38.5 degrees C) baths 1.5 hours before bedtime. Significant improvement in sleep continuity and a trend toward an increase in SWS occurred after hot baths. Results of subjective measures showed that subjects experienced significantly "deeper" and more restful sleep after hot baths. In addition, hot baths resulted in a significant delay of temperature nadir in comparison to baseline nights.

Adult↗
PubMed1995

Evidence for dopamine receptor pruning between adolescence and adulthood in striatum but not nucleus accumbens.

Postnatal development of dopamine D1 and D2 receptor families in striatum and nucleus accumbens of rats was studied at 25, 35, 40, 60, 80, 100 and 120 days using autoradiography. These ages were selected to test the hypothesis that dopamine receptors were overproduced prior to puberty (day 40), and pruned back to adult levels thereafter. This hypothesis was confirmed in striatum but not nucleus accumbens. D1 receptor Bmax ([3H]SCH-23390) peaked at 40 days, with levels 67 +/- 21% greater than at 25 days. However, Bmax levels were at least 35% lower at 60-120 days than at 40 days. Similarly, D2 receptor numbers ([3H]YM-09151-2) increased 144 +/- 26% between 25 and 40 days, but were reduced by 34-38% between 60-120 days. In contrast, D1 and D2 receptor Bmax increase approximately 150% between 25 and 40 days in nucleus accumbens, levels fell slightly at 60 or 80 days, but were no different at 100 and 120 days then they were at 40 days. These findings suggest that these two major dopamine target regions follow different developmental strategies, and this has implications for etiological theories of schizophrenia that focus on anomalous receptor pruning.

Aging↗
PubMed1995

Development of an animal model of fluoxetine akathisia.

1. Akathisia describes the pattern of intense inner restlessness often associated with neuroleptic and antidepressant treatment. 2. The authors postulated that drug-induced akathisia would be characterized by more position changes and less time spent immobile, in the absence of significant increase in ambulation. In contrast, a psychomotor stimulant would produce both activation and ambulation. 3. Procedures and instruments were developed to test this hypothesis. Adult rats were habituated for 72 hours to the testing environment, and their precise pattern of movements was tracked and recorded (10 reading per second; resolution 0.04 mm) by an infrared motion analysis system. Activity was recorded for a 90 min period after a single injection of sub-stereotypic doses of d-amphetamine (0, 0.3, 1.0 mg/kg) or racemic fluoxetine (0, 3.0, 10.0, 20.0, or 30.0 mg/kg, s.c.). 4. Amphetamine produced both activation and ambulation. Activation was indicated by a decrease in time spent immobile, and an increase in the temporal scaling exponent, which reflects the degree the animal is "acting' in its environment, and the number of position changes. Enhanced locomotion was inferred from marked increases in both the total distance traversed and the ratio of forward movements-to-reversals and a decrease in the spatial scaling exponent, indicative of a less complex and more linear movement pattern. 5. Fluoxetine caused animals to spend more time active, but exerted little effect on locomotion. Activation was indicated by a decrease in time spent immobile and an increase in the temporal scaling exponent and number of position changes. Fluoxetine failed to significantly effect either the ratio of forward movements-to-reversals or the spatial scaling exponent. 6. These findings provide an operational definition and methodology that can be used to differentiate between psychostimulant effects and akathisic effects. This approach may have utility for screening drugs for akathisic potential, for exploring underlying mechanisms, and for developing novel treatments.

Akathisia, Drug-Induced↗
PubMed1995

The phototherapy light visor: more to it than meets the eye.

OBJECTIVE: The purpose of the study was to ascertain whether phototherapy light visors provide an effective treatment for seasonal affective disorder. Previous studies have demonstrated a moderate response rate but have failed to find any difference in efficacy between light intensities. METHOD: Subjects were randomly assigned to receive, over a 2-week treatment period, 30 minutes of morning phototherapy with a light visor that emitted either a dim (30-lux) red light or a bright (600-lux) white light. Raters were blind to treatment, and patients were unaware of the alternatives. Response was assessed by using the structured 21-item Hamilton Depression Rating Scale, with an eight-item addendum for atypical depressive symptoms. Fifty-seven patients were enrolled across two sites. RESULTS: Patients assigned to the different visors had similar baseline depression scores and similar expectations of outcome. Hamilton depression scale scores declined by 34.6% for subjects given bright white light and by 40.9% for subjects given dim red light. Scores for atypical depressive symptoms fell by 44.1% for patients assigned the bright white light visors and by 49.0% for patients assigned the dim red light visors. Altogether, 39.3% of the patients who received red light and 41.4% of the patients who received bright white light showed a full clinical response. CONCLUSIONS: There were no significant differences in therapeutic response between patients who were treated with red or white light. The results of this study suggest that the phototherapy light visor may function as an elaborate placebo. Alternative explanations, however, are considered.

Adult↗
PubMed1995

Evoked potential evidence for right brain activity during the recall of traumatic memories.

Auditory probe evoked potential attenuation was measured as an index of hemispheric activity in 10 subjects with a history of childhood trauma and 10 matched subjects without such history while they recalled a neutral memory and then a traumatic memory. There were prominent group differences in degree of cerebral laterality between memory tasks (P = 0.02). The trauma group had a significant left dominant asymmetry during the neutral memory (P = 0.02), which markedly shifted to the right during the unpleasant memory (P = 0.007 for degree of shift). Normal control subjects did not display a significant asymmetry during either task, nor did they show a significant shift between tasks.

Adult↗
PubMed1994

A controlled trial of cyanocobalamin (vitamin B12) in the treatment of winter seasonal affective disorder.

To test the hypothesis that cyanocobalamin (vitamin B12) is an effective treatment for winter seasonal affective disorder (SAD). 2 weeks of double-blind placebo washout, followed by random assignment to parallel treatments for 2 weeks with cyanocobalamin vs. placebo. Observations were made during weekly outpatient visits. All subjects met criteria for SAD. 27 patients were studied. After the washout period, 14 were randomly assigned to 1.5 mg cyanocobalamin (3 x/day) and 13 remained on placebo on the same schedule. 29 item SIGH-SAD scores were used to determine antidepressant efficacy. No significant differences were found in the responses between the two groups. Cyanocobalamin does not appear to be an effective short-term treatment for depression in SAD patients. The usefulness as a treatment for SAD of the methylated form of Vitamin B12, which has been used extensively in related studies, remains to be explored.

Adult↗
PubMed1994

Modifying quiet room design enhances calming of children and adolescents.

OBJECTIVE: To determine whether altering design of a quiet room (QR) produced more rapid calming of agitated or aggressive hospitalized children. METHOD: One of five similar QRs was modified by painting the white walls tea rose, carpeting the vinyl floor, and painting a picturesque mural on one wall. The effects of these modifications were assessed in 19 patients (mean age = 9.6 years), using a within-subjects, repeated-measures design. Overt Aggression ratings were made at the time of placement, and at 5-minute intervals thereafter, until the child was dismissed. Children were blind to the fact that a study was being conducted; raters and staff were not. RESULTS: Total aggression ratings were 45% lower in the modified QR than in the standard QR (p < .03), and initial aggression scores fell by 50% during 5 minutes of placement in the modified QR, but only after 20 minutes of placement in the standard QR (p < .0001). Motor excitement and verbal aggression were the two component factors most strongly influenced by QR design. CONCLUSION: This preliminary report suggests that it may be possible to modify QRs to facilitate calming of aggressive, agitated children and provides preliminary support for redesign of QRs.

Acting Out↗