Cortisol response to morphine and the DST.
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Adult↗
Biomedical subjects
C M Banki
Publications and source records attributed to C M Banki.
TRH-induced hormonal responses: the effect of pizotifene and naloxone.
We examined the effects of the serotonin antagonist pizotifene (4 mg daily for 3 days orally), and the opiate antagonist naloxone-HCI (0.8 mg intravenously) on the TRH-induced thyrotropin (TSH), growth hormone (GH), and prolactin (PRL) response in female psychiatric inpatients with adjustment disorder or alcohol abuse. All the patients were free from interfering endocrine and metabolic illness and had not received major psychotropic medication before the investigation. Pizotifene caused a small but significant decrease of the TRH-induced TSH response in 8 patients, two of them changed their responses from normal (i.e. above 5 mU/l) to blunted. Neither GH nor PRL changed significantly after pizotifene. Naloxone-HCI, 30 min before the TRH challenge, did not produce any significant change in the TSH, GH or PRL responses, nor did it cause any significant change in the plasma level of these hormones by itself. The hormonal responses to TRH remained unaltered in ten other patients who had repeated tests without any drug treatment between the two occasions. The results suggest that serotonin deficiency may play a role in the blunted TSH response to TRH, while opiate mechanisms do not appear to have a primary influence on these endocrine effects of TRH.
Adjustment Disorders↗
Biochemical markers for suicidal behavior.
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Dexamethasone↗
Biochemical markers in suicidal patients. Investigations with cerebrospinal fluid amine metabolites and neuroendocrine tests.
141 female psychiatric patients, suffering from major depression, schizophrenia, alcohol dependence or adjustment disorder, were investigated for their 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA) and cortisol level in the cerebrospinal fluid (CSF). Dexamethasone suppression tests were also performed in 111 cases, and TRH/TSH tests in 40 subjects. Fifty-two patients were hospitalized following a recent suicide attempt, 18 of which were made using a violent method. The other 34 attempters took tranquilizer or sedative overdoses. CSF 5-HIAA was significantly lower in violent attempters in all 4 diagnostic categories. CSF HVA was higher in those taking drug overdoses, but only in depression (and less markedly in schizophrenia). CSF cortisol did not differ among either diagnostic or suicidal subgroups. Dexamethasone suppression was more frequently abnormal in suicidal patients than in nonattempters, and this difference was more important where the overall nonsuppression rate was lower. Maximal TSH response to TRH showed an inverse correlation with CSF 5-HIAA, and it was lowest in the nonattempter group. The difference between violent suicide attempters and nonattempters in their TSH response was significant. Since these biochemical changes were more or less independent of clinical diagnoses, it seems relevant to explore further the biological background of human aggression and suicide as a separate research direction.
Adult↗
Thyroid stimulation test in healthy subjects and psychiatric patients.
Fifteen healthy women and 64 female psychiatric inpatients (major depression: 17, schizophrenia: 24, alcohol dependence: 9, and adjustment disorder: 14 cases) without identifiable thyroid dysfunction were investigated with the TRH test under comparable circumstances. Although all patient groups showed some tendency toward lower baseline TSH and smaller TRH-induced TSH responses, only patients with major depression demonstrated marked, statistically significant differences from controls in both variables. Women with alcohol dependence (in the early withdrawal period) showed significantly decreased TSH responses to TRH but only a weak tendency to lower basal TSH levels. Intergroup differences in the TSH response remained significant after correction for basal TSH by analysis of covariance. Neither variables correlated significantly with age, weight or body height, but baseline TSH correlated with body surface. The TRH test, using only 0.2 mg TRH for stimulation, seemed to be useful for identifying major depression and showed that early withdrawal from alcohol may be a factor to be considered in similar studies.
Adjustment Disorders↗
Neuroendocrine differences among subtypes of schizophrenic disorder? An investigation with the dexamethasone suppression test.
The plasma cortisol suppression following 1 mg dexamethasone was studied in 45 recently hospitalized female patients who met DSM-III criteria for a schizophrenic (or 'schizophreniform') disorder. 19 patients showed nonsuppression (42%): 4 out of 6 within the disorganized (hebephrenic) subtype, 9 out of 10 within the catatonic subtype, 6 out of 11 within the acute ('schizophreniform') subtype and non of the 18 within the paranoid subtype. The distribution is heterogeneous, suggesting that schizophrenic disorders may contain different conditions in terms of limbic pathology. Catatonic patients revealed a very high frequency of nonsuppression, which may indicate that this subtype shares some features of the affective disorders.
Adult↗
Dexamethasone suppression test and thyroid stimulation test in depression.
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Adult↗
Some clinical and biochemical predictors of outcome in depression.
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Adult↗
Amine metabolites and neuroendocrine responses related to depression and suicide.
5-Hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were measured in the lumbar cerebrospinal fluid of 57 drug-free female patients with DSM-III diagnoses of major unipolar or bipolar depression (n = 14), schizophrenic disorder (n = 18), alcohol dependence (n = 13) and a group of other disorders (n = 12). Following lumbar punctures all patients received a dexamethasone suppression test. Fourteen patients had attempted suicide immediately before admission, 4 of them by violent methods. Severity of depression, independent of the diagnosis, was assessed in every patient on the 24-item Hamilton scale. No significant differences in means and variances of amine metabolite or postdexamethasone plasma cortisol concentrations were found among the diagnostic subgroups. Suicidal patients, and in particular those who used violent methods, tended to have lower 5-HIAA, but not HVA, in their CSF; they also more often had non-suppression of cortisol after dexamethasone. Since correlation matrices in the diagnostic subgroups were homogeneous, we calculated partial correlations for the total group: here suicide attempts but not depression, seemed to be significantly correlated with CSF 5-HIAA. Thyrotropin stimulation tests were administered to 6 patients: maximal TSH responses showed a borderline significant correlation with CSF 5-HIAA, and a significant correlation with severity of depression. Neither suicide nor postdexamethasone cortisol levels showed any relation to maximal TSH changes.
Alcoholism↗
Amine metabolites, neuroendocrine findings, and personality dimensions as correlates of suicidal behavior.
Levels of 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were measured in the cerebrospinal fluid (CSF) of 62 female inpatients with major depression (n = 19), schizophrenic disorder (n = 18), alcohol dependence (n = 13), and other disorders (n = 12). Nineteen patients had attempted suicide immediately before admission, and six had used violent methods. Fifty-three patients received a dexamethasone suppression test (DST) following lumbar puncture and all completed the Marke-Nyman Temperament Scale (Hungarian version) within 10 days. CSF 5-HIAA was significantly lower in patients who had made violent suicide attempts, but did not differ between suicide attempters who had taken drug overdoses and nonattempters. CSF HVA showed no significant differences. Dexamethasone nonsuppression occurred more frequently among attempters, but this difference did not reach statistical significance. Among the three personality dimensions of the Marke-Nyman Scale, validity was lower and stability higher in suicidal patients; both findings were more pronounced in the violent subgroup. CSF 5-HIAA and Marke-Nyman validity were inversely correlated to each other in all three subgroups, and violent attempters could be separated from the other two groups by their simultaneously low CSF 5-HIAA values and Marke-Nyman validity scores.
Adult↗
The effect of dexamethasone on cerebrospinal fluid monoamine metabolites and cortisol in psychiatric patients.
The effect of 1 mg dexamethasone on CSF levels of 5-hydroxyindoleacetic acid (5 HIAA), homovanillic acid (HVA) and cortisol (CS) was investigated in 100 psychiatric inpatients: 45 subjects had their lumbar punctures 1-4 days following dexamethasone administration, and the results were compared with those from 55 other patients investigated before drug ingestion. All patients were women, and none had received psychotropic medication for at least two weeks before the study. Seven subjects consented to two LPs both before and after dexamethasone. As expected, cortisol in the CSF significantly decreased after dexamethasone: the decrease was greatest 10 hours following the drug. HVA showed a weak and transient elevation after 10 hours only. CSF 5 HIAA was found to be significantly increased in postdexamethasone samples and high levels were still found even after 82 hours. Diagnostic differences (major or minor depression, schizophrenia, alcohol abuse or dependence) did not account for the observed differences. Repeated CSF examinations in seven subjects corroborated these findings: all cortisol values were decreased and all 5 HIAA values were increased after dexamethasone while HVA values showed random changes. The data may suggest that serotonergic mechanisms may be involved in dexamethasone action in the CNS. In addition, dexamethasone administration can alter CSF 5 HIAA level, a possible factor which should be taken into consideration in CSF studies.
Adult↗
Relationship between cerebrospinal fluid amine metabolites, neuroendocrine findings and personality dimensions (Marke-Nyman scale factors) in psychiatric patients.
5-Hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were measured in the spinal fluid of 45 women hospitalized in a psychiatric department for major depression (14 cases), schizophrenia (18 cases) and alcohol dependence (13 cases). Dexamethasone suppression tests were performed following CSF examinations in all patients, and TRH stimulation tests were also made in six subjects. All biological examinations were carried out in a drug-free state. The Marke-Nyman Temperament scale was administered to all patients as soon as severe psychotic disturbances subsided and sufficient cooperation was achieved, but no later than 10 days following biological examinations. The MNT was repeated after recovery to check reliability of the test results during an episode of a psychiatric disorder. CSF amine metabolite concentrations did not differ significantly in the three patient groups; postdexamethasone average cortisol levels were above the critical level (5 micrograms/dl) in each group, the highest values being found in major depression. One of the three MNT factors was inhomogeneous among diagnostic groups (validity: low in depression and alcoholism), but the other two also differed from a healthy control population. Correlation structure between biological and psychological variables was homogeneous throughout the diagnoses and a significant inverse correlation was found only between CSF 5-HIAA and the validity factor of MNT. Maximal TSH response to TRH stimulation correlated with both solidity and stability in the MNT scale. Since MNT results proved to be stable even during an illness episode, a possible link is suggested between personality traits and central serotonin metabolism.
Alcoholism↗
Cerebrospinal fluid biochemical examinations: do they reflect clinical or biological differences?
5-Hydroxyindoleacetic acid (5HIAA), homovanillic acid (HVA), cortisol (CS), tryptophan (TRY), and calcium (Ca) concentrations were measured in the spinal fluid of 85 female psychiatric inpatients in a drug-free state; 32 women suffered from major depression, another 32 had schizophrenic (or schizophreniform) disorder, and 21 had alcohol dependence as defined by DSM-III criteria. A dexamethasone suppression test (DST) was carried out following lumbar punctures in all patients. Biochemical results were analyzed by two-way analysis of variance to test the effect of diagnosis and dexamethasone nonsuppression. CS concentration proved to be significantly higher in dexamethasone nonsuppressors, independent of the diagnosis. HVA was lower in nonsuppressors, particularly in alcohol-dependent patients; 5HIAA showed a tendency to be higher in nonsuppressor depressed patients. TRY was again higher in nonsuppressors, significant only in schizophrenic patients. Ca concentration was higher in depression and lower in alcohol dependence, and within the depression group it was higher in normal DST patients. The results indicate that the primarily biological dysfunction, i.e., the limbic-hypothalamic disinhibition reflected in the DST, may be more closely related to spinal fluid biochemistry than clinical syndromes.
Adult↗
Factors influencing monoamine metabolites and tryptophan in patients with alcohol dependence.
Cerebrospinal fluid 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA) and tryptophan (TRY) were measured in 36 female patients with alcohol dependence defined by strict operational criteria. Results were compared with a control group of 32 women hospitalized in a neurological unit for peripheral diseases. Several disorders presumably interfering with monoamine metabolism were excluded and diet, psychomotor activity, diurnal variation, nutritional state and similar nonspecific variables controlled in both groups. Only 5-HIAA was found to be decreased in development patients as compared to controls. Since 5-HIAA--but neither HVA nor TRY--correlated with body height in both groups, we eliminated its effect by analysis of covariance: as a result 5-HIAA difference became statistically significant but the other two biochemical measures remained unchanged. A multivariate regression analysis with five independent clinical variables (body height, age, weight, years of alcohol abuse and days of abstinence) yielded significant determination coefficient R2 only for 5-HIAA. Regarding its components only body height and days of abstinence proved to be significantly correlated with 5-HIAA. Severity of withdrawal symptoms assessed on a rating scale in 14 patients with 4 days or less of abstinence correlated marginally with HVA but not with 5-HIAA. This latter metabolite decreased only in patients with 5 days or more of abstinence; the difference between 5-HIAA levels of short-term and long-term abstinence subgroups was statistically highly significant.
Alcoholism↗
Correlation of individual symptoms and other clinical variables with cerebrospinal fluid amine metabolites and tryptophan in depression.
Cerebrospinal fluid 5-hydroxyindoleacetic acid (5HIAA), homovanillic acid (HVA), and tryptophan in both CSF and plasma were measured in a carefully selected group of 33 depressed women. Strict and explicit inclusion and exclusion criteria were used, and CSF was taken under controlled circumstances. Seventeen operationally defined and uniformly rate psychiatric symptoms as well as global depression severity and 12 clinical background variables were correlated with the four biochemical parameters, using multivariate regression analysis based on Spearman's rank correlation coefficient according to the nature of the data. Global depression severity did not correlated with any of the biochemical variables; there were, however, significant correlations between CSF 5HIAA and anxiety, insomnia, and suicide on the one hand, and between CSF HVA and motor symptoms and paranoidity on the other hand. Background variables showed only a few--and much weaker--correlations. It was concluded that central monoamine metabolism does affect some particular psychiatric symptoms but is not parallel with the complex clinical construct of the depressive disease. Further studies using isolated psychopathological symptoms instead of nosological categories are suggested in clinical neurochemistry.
Depressive Disorder↗
Cerebrospinal fluid amine metabolites, tryptophan and clinical parameters in depression. Part 1. Background variables.
5-Hydroxyindoleacetic acid, homovanillic acid, and tryptophan were measured in the lumbar cerebrospinal fluid of 33 female patients with severe hospitalized depression. Total plasma tryptophan was also determined in blood samples taken simultaneously at the time of lumbar puncture. Twelve clinical parameters were recorded using operational definitions for variables not measurable in physical units, and were compared in patient subgroups containing individuals with the highest and the lowest metabolite levels. Only age proved to be significantly higher in patients with low CSF 5-HIAA, and body height showed the same tendency. The lack of other significant differences indicates that there are no close relations between these clinical parameters and the biochemical variables except the two mentioned above.
Age Factors↗
Cerebrospinal fluid amine metabolites, tryptophan and clinical parameters in depression. Part 2. Psychopathological symptoms.
The group of 33 severely depressed female patients was divided into 3 equally large subgroups, separately according to their CSF 5-HIAA, HVA, tryptophan and total plasma tryptophan, and the severity of 17 operationally defined psychopathological symptoms was compared between the subgroups containing the highest and lowest biochemical values. Nonparametric statistical testing yielded significant results on several symptoms, when the subgroups were formed from CSF 5-HIAA and HVA. There was only one significant symptom difference between subgroups separated by CSF tryptophan and a few other differences by plasma tryptophan level. The results indicate that lumbar CSF metabolites correlate more with certain individual symptoms than with the global severity of depression.
Anxiety↗
Cerebrospinal fluid 5-hydroxyindoleacetic acid as an index of central serotonergic processes.
Faulty transmission in the central serotonin and catecholamine systems may be involved in some psychiatric and neurological conditions. Central monoamine metabolism can be studied by measuring amine metabolites in the lumbar cerebrospinal fluid (CSF), but results to date have been inconsistent. Since most studies have analyzed lumbar CSF, one reason for the inconsistencies may be that lumbar fluid does not reflect brain amine metabolism. We measured 5-hydroxyindoleacetic acid (5HIAA) and homovanillic acid (HVA) in serial CSF samples obtained in connection with pneumoencephalographic (PEG) examinations: through seven samples of equal volume, a gradual increase was found for both metabolites in 14 neurological patients, and the first and last fractions were statistically significantly correlated. In addition, a small series of cisternal CSF samples from psychiatric (depressed and alcoholic) and neurological patients were analyzed for 5HIAA. Frequency distribution in cisternal CSF was similar to that of lumbar values, although the levels were about twice as high, close to those found in the last PEG fractions. There were no significant differences between patient groups either in cisternal or lumbar CSF 5HIAA. These findings suggest that while there is an ascending gradient, lumbar CSF samples do reflect amine metabolite concentrations of the more central fluid. No disease-specific differences in cisternal CSF were found which were absent in the lumbar fluid.
Adult↗