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Biomedical subjects

P Linkowski

Publications and source records attributed to P Linkowski.

At least 91 records · Page 5Linked to original sources
PubMed1985

The 24-hour profile of adrenocorticotropin and cortisol in major depressive illness.

The 24-h profile of plasma ACTH and cortisol levels was determined in 18 men suffering from major depressive illness (8 with unipolar depression and 10 with bipolar depression) as well as in 7 age-matched normal men. Blood was sampled every 15 min. The circadian variation and episodic fluctuations were analyzed for each individual profile. Both unipolar and bipolar depressed patients had higher 24-h mean cortisol levels (P less than 0.01) than normal men, but no significant difference in 24-h mean ACTH level was found. The nadir of cortisol secretion occurred almost 3 h earlier in older normal subjects and patients with unipolar depression, regardless of age, than in younger normal subjects. This shift paralleled a similar advance of the ACTH nadir. Early timing of the quiescent period of ACTH-cortisol secretion was also found in several patients with bipolar depression, but did not reach significance at the group level. The hypercortisolism in the depressed patients was associated with an increase in the magnitude, but not the number, of cortisol secretory episodes. About 90% of the cortisol pulses could be related to a concomitant ACTH pulse in normal subjects as well as in both groups of depressed patients. However, concomitant ACTH and cortisol pulses were less correlated in magnitude in depressed patients than in normal subjects. These results indicate that major depressive illness is associated with disturbances of pituitary-adrenal function. The early timing of the nadir of ACTH-cortisol secretion suggests that disorders of circadian time keeping may characterize major endogenous depression.

Adrenocorticotropic Hormone↗
PubMed1984

Reduced cholecystokinin immunoreactivity in the cerebrospinal fluid of patients with psychiatric disorders.

The close relationship of cholecystokinin peptides with some of the dopamine pathways and the limbic system suggests a putative role for these peptides in the pathophysiology of neuropsychiatric disorders such as Parkinson's disease, manic-depression and schizophrenia. By use of radioimmunoassay, we report a significant decrease in cholecystokinin-immunoreactivity in the cerebrospinal fluid of patients with bipolar manic-depression and untreated schizophrenia in comparison to control subjects.

Adult↗
PubMed1984

Haloperidol plasma levels and clinical response in paranoid schizophrenics.

The relationship between haloperidol plasma levels, plasma prolactin, and therapeutic efficacy was evaluated in 20 paranoïd schizophrenics in a fixed-dose study for 6 weeks. We found a significant intrapatient cross-correlation of therapeutic efficacy, as measured by decrease in MSS and BPRS rating scales and time-dependent haloperidol and prolactin changes, which were tested at weekly intervals. However, no significant curvilinear relationship was present between steady-state haloperidol plasma levels and MSS and BPRS improvement scores. Our data do not furnish clear-cut evidence in favor of the existence of a therapeutic window for haloperidol plasma levels in paranoïd schizophrenia.

Adult↗
PubMed1984

Cerebrospinal fluid neurophysins in affective illness and in schizophrenia.

We studied the concentration of neurophysin I (hNPI) and II (hNPII), the hypothalamo-pituitary carriers of vasopressin and oxytocin, in CSF of depressed and schizophrenic patients and age matched controls. Mean hNPI values were lower and mean hNPII values greater in schizophrenics than in controls. Lower hNPI values were observed in unipolar patients than in controls. In bipolar patients however, higher hNPI values were present. Significantly higher hNPII values were observed in bipolar patients than in controls; no difference was present between unipolars and controls. A positive correlation was observed with age in controls and bipolars for hNPII. These data emphasize the interest of studying the neurohypophysal function in affective illness and in schizophrenia.

Adult↗
PubMed1984

Sleep and neuroendocrine disturbances in catatonia. A case report.

Sleep EEG investigations were performed in a 31-year-old catatonic male patient before and after electroconvulsive therapy and 3 months after recovery. The dexamethasone suppression test was also performed longitudinally together with measurements of CSF 5-HIAA, HVA and 24-h urinary MHPG. A normal male control aged 32 was also investigated. Sleep analysis showed reduced REM latency and increased REM activity and density during the catatonic phase before treatment when compared to the age-matched control. REM latency remained shortened after recovery following ECT treatment and 3 months after recovery. Dexamethasone suppression test, abnormal before treatment normalized with clinical improvement during ECT. Urinary MHPG values were low in the catatonic state and did not change after ECT treatment. CSF HVA and 5-HIAA were also low in the pretreatment period and increased during the 3 months follow-up period. There results indicate that some cases of catatonic behavior may be linked to affective disorders.

Adult↗
PubMed1984

Electroencephalogram and neuroendocrine parameters in pubertal and adolescent depressed children. A case report study.

EEG sleep recordings and two provocative neuroendocrinological tests (the DST and the GH stimulation test after desipramine) were investigated in two depressed pubertal monozygotic twin boys with Major Depressive Disorder and compared with results from one normal pubertal control boy and an adolescent girl suffering from major depression. REM latency was reduced in the adolescent depressed girl but not in the pubertal depressed twin children when compared to the normal control. Sleep continuity and sleep architecture were, however, disturbed in pubertal and adolescent depression as a function of severity of the depressive state. The results of the DST showed abnormal cortisol values in the most severely depressed twin and in the depressed adolescent. GH secretion after DMI showed a clear GH response in the less depressed twin and in the normal subject while in the depressed adolescent, the GH response was blunted. The findings suggest that REM latency disturbances in our depressed patients do not appear before adolescence, while neuroendocrine dysfunction can already be present in pubertal depression.

Adolescent↗
PubMed1984

Violent suicidal behavior and the thyrotropin-releasing hormone-thyroid-stimulating hormone test: a clinical outcome study.

A relation between abnormal response of thyroid-stimulating hormone (TSH) to thyrotropin-releasing hormone (TRH) and a personal history of violent suicidal behavior was observed in a sample of 60 depressive women. Patients with a blunted TSH response to TRH were also at greater risk for subsequent suicide. There was no relationship between TSH response to TRH and age, severity of depression and polarity of the illness.

Adult↗
PubMed1984

Dexamethasone suppression test and REM sleep in patients with major depressive disorder.

Dexamethasone suppression Test (DST) and sleep electroencephalogram (EEG) recordings were carried out during three consecutive nights in 39 depressed patients who met Research Diagnostic Criteria (RDC) for major depressive disorder and in nine normal controls. Cortisol response to DST was abnormal in 26 patients and normal in all controls. REM latency and REM density were compared in patients with abnormal DST (n = 26) to values obtained in patients with normal DST (n = 13) and in normal controls (n = 9). Rapid Eye Movement (REM) latencies were significantly lower in depressed patients showing cortisol non-suppression after dexamethasone than in patients with a normal DST or in controls. REM densities were significantly higher in depressed patients than in normal controls (P less than 0.025), but there was no significant difference between DST suppressors and non-suppressors. The DST provided high specificity (100%) and a sensitivity of 67%, while REM latency showed a lower specificity (78%), but a higher sensitivity (85%).

Adolescent↗
PubMed1983

Hemodialysis in schizophrenics. A double-blind study.

The therapeutic effects of hemodialysis were evaluated in 19 schizophrenics with random assignment to active (n = 10) or sham (n = 9) dialysis. Evaluations were done before and after one month of treatment by an investigator blind to the type of dialysis using four rating scales. Five of the ten patients undergoing active dialysis and three of the nine patients undergoing sham dialysis showed clinical improvement on the psychiatric rating scales. There were no significant differences between the two groups in the magnitude of this improvement. For three patients treated by active dialysis after sham dialysis, there were no significant differences. Three other patients whose conditions dramatically improved by active dialysis did not confirm such a beneficial effect with a second period of active dialysis. Transient improvement of some schizophrenic patients cannot thus be explained by blood clearance through dialysis.

Adult↗
PubMed1983

State-dependent tardive dyskinesia in manic-depressive illness.

We report the occurrence of a drug-resistant tardive dyskinesia coexistent with Parkinsonism-like symptoms in a manic-depressive patient. The tardive dyskinesia completely disappeared during the manic phases and recurred after remission over the course of different mood-cycles.

Antipsychotic Agents↗
PubMed1983

Prolactin and growth hormone response to levodopa in affective illness.

Prolactin (PRL) and growth hormone (GH) response to L-Dopa have been studied in 51 affectively ill women (26 unipolar and 25 bipolar) before and after amitriptyline treatment and in 14 normal female controls. There was no difference in GH response to L-dopa in all groups studied except for bipolar postmenopausal women, who showed a blunted GH response to L-Dopa compared to bipolar premenopausal women. After amitriptyline treatment, no difference in GH response was found in all groups studied. Basal PRL levels were significantly lower in unipolar premenopausal and bipolar premenopausal patients in comparison to their controls. PRL response to L-Dopa was significantly less inhibited in postmenopausal controls than in premenopausal controls and in bipolar premenopausal patients compared to premenopausal controls. These data provide further evidence of hypothalamo-pituitary dysfunction in subgroups of affective disorders and emphasize the importance of considering the menopausal status in neuroendocrine studies of psychiatric disorders.

Amitriptyline↗
PubMed1983

Regional cerebral blood flow and lateralized hemispheric dysfunction in depression.

Cerebral blood flow is known as an indicator of cerebral metabolism. Using the 133Xenon inhalation method, we studied the regional cerebral blood flow (r-CBF) in patients with different subtypes of depression and in remission. A left frontal hypervascularization and a right posterior hypovascularization were found in major depressives, compared to normal subjects, minor depressives, and normothymic bipolar patients. These results tend to confirm the existence of cerebral dysfunction in both hemispheres in major depression, as reported by other authors using different techniques.

Adult↗
PubMed1983

Thyrotrophin response to thyreostimulin in affectively ill women relationship to suicidal behaviour.

Past history of suicidal behaviour was investigated in 51 depressed women (27 unipolar and 24 bipolar) in whom the TSH response to TRH was studied. Patients with a history of violent suicidal attempts were shown to have a reduced TSH response to TRH, compared to depressed patients with a history of non-violent suicidal attempts and depressed patients with no history of suicidal behaviour. A five-year follow-up study on these patients revealed that four patients who died from suicide had an absence of TSH response to TRH.

Adult↗
PubMed1983

Immediate and delayed alterations of adrenocorticotropin and cortisol nyctohemeral profiles after corticotropin-releasing factor in normal man.

Intravenous injections of 50 micrograms corticotropin-releasing factor (CRF) to four normal men at 0900 and 2300 h were followed by significant plasma ACTH and cortisol elevations, without changes in GH and PRL concentrations. The responses were more easily assessed late in the evening than in the morning, when they were superimposed upon the spontaneous hormonal variations. The initial hormonal response was always followed by a period of decreased hormonal values compared to control patterns. The normal pituitary-adrenal response to CRF was blunted or abolished by prior administration of dexamethasone. These data suggest that exogenous administration or CRF-induced endogenous production of glucocorticoids modulates the sensitivity of corticotropic cells to the action of CRF. Since normal ACTH and cortisol secretory episodes are likely to obscure the effects of CRF, stimulation tests for clinical purposes should be performed during the quiescent period, i.e. late in the evening.

Adrenocorticotropic Hormone↗
PubMed1983

General anesthesia after neuroleptic malignant syndrome.

The neuroleptic malignant syndrome (NMS) is an uncommon and potentially lethal complication of therapy with neuroleptics characterized by pallor, hyperthermia, and extrapyramidal signs (Delay and Deniker, 1968). Malignant hyperthermia (MH) is a rare but often fatal complication of general anesthesia characterized by hyperpyrexia and muscle rigidity, but not related to neuroleptic therapy. For both syndromes, NMS and MH, a common pathophysiology has been considered (Meltzer, 1973; Itoh, 1977; Caroff, 1980). These two syndromes may also be clinically indistinguishable from "acute lethal catatonia" characterized by fever, muscular hypertonicity, and stupor, first described by Stauder in 1934. We now report a case in whom NMS appeared following neuroleptic treatment for a psychotic depressive syndrome. After remission from the NMS, the patient underwent general anesthesia nine times for electroconvulsive therapy (ECT) without ill effect. This case supports the theory of distinct pathogenic mechanisms for both NMS and MH.

Anesthesia, General↗
PubMed1983

Value of lithium plasma concentration in severe lithium intoxication.

Lithium intoxication is a frequent condition with sometimes severe symptoms. Despite repeated plasma measurements, it is not always possible to prevent serious side effects because they can occur at therapeutic plasma levels. Several aspects of the lithium metabolism are reviewed and illustrated by two case reports.

Adult↗