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Biomedical subjects

L Staner

Publications and source records attributed to L Staner.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

The first-night effect may last more than one night.

The first-night effect in sleep polysomnographic studies is usually considered to last for one night. However, a few observations have indicated that variables associated to rapid eye movement sleep take longer to stabilize. Notwithstanding, current opinion holds that second nights of recording can be used without restriction for research and clinical purposes. The goal of this study was to describe the dynamics of habituation to polysomnography in optimal conditions. Twenty-six young, carefully screened, healthy subjects were recorded in their home for four consecutive full polysomnographies. Repeated measures ANOVA were applied. Between the two first nights, while there were no differences in sleep duration in non-rapid eye movement sleep, marked modifications in corresponding spectral power were observed. The dynamics of adaptation of rapid eye movement sleep appeared to be a process extending up to the fourth night. Similar dynamics in NREMS and REMS homeostasis have been observed in sleep deprivation studies, and it appears that the same mechanisms may be responsible for the FNE. The longer habituation process of REMS in particular has important implications for sleep research in psychiatry.

Adolescent↗
PubMedDate not supplied

Disturbances in hypothalamo pituitary adrenal and thyroid axis identify different sleep EEG patterns in major depressed patients.

This study was aimed at investigating the relationships between sleep EEG abnormalities and hypothalamo pituitary adrenal (HPA) and hypothalamo pituitary thyroid (HPT) disturbances in major depressive disorder. Post dexamethasone (DXM) cortisol levels and the dual TSH response to 08:00 h and 23:00 h TRH administration were determined after a 2 weeks wash-out period in a group of 113 DSM-IV major depressed patients (72 females aged 44.3+/-13.0 and 41 males aged 45.7+/-11) who were consecutively admitted to undergo sleep EEG recordings. Post-DXM cortisolemia, 08:00 and 23:00 post-TRH TSH values, time spent in rapid eye movement sleep (REMS), in slow wave sleep (SWS), and in stage 2 as well as time awake after sleep onset were introduced in a principal component (PC) analysis. The four 3 PC scores explaining up to 74% of the data set were further calculated for each patients and used in a cluster analysis. A three-cluster solution was retained. Controlling for the effects of age and gender, patients belonging to these three clusters could clearly be differentiated on the basis of their neuroendocrine responses and on their sleep EEG profiles. Compared to the two other clusters, cluster I (n=26) patients showed the most severe sleep continuity disturbances. Post-DXM cortisol escape and sleep architecture disturbances (consisting of a shortening of REMS latency and a decreased SWS) identified patients belonging to cluster II (n=39). Patients in cluster III (n=48) had the lowest TSH response to TRH and the less marked sleep EEG alteration. Clinical or demographic variables were unable to differentiate the three clusters. Our results suggest that different biological dysfunctions could each underlie particular neuroendocrine and sleep EEG disturbances in major depression.

Administration, Topical↗
PubMedDate not supplied

Critical analysis of the theories advanced to explain short REM sleep latencies and other sleep anomalies in several psychiatric conditions.

One of the most consistent and most studied sleep modifications in several psychiatric conditions is the shortening of the rapid eye movement (REM) sleep latency. While its clinical usefulness is still to be proven and its meaning relatively obscure, the appearance of a short REM latency continues to be a daily fact in sleep laboratories. Many theories compete to explain what is observed, the most important being the circadian rhythm hypotheses, the homeostatic model and the reciprocal interaction model. These three are summarised and their pros and cons are exposed in a systematic manner. Points of conflict, possible convergences and limitations are discussed in the light of recent developments on the general theories of sleep regulation.

Body Temperature↗
PubMedDate not supplied

[Mania, parkinson disease and risperidone. Case report].

Risperidone is an atypical antipsychotic with a low prevalence of extrapyramidal side-effects. The use of this antipsychotic in Parkinson's disease is still controversial. We describe a 59 year-old bipolar patient with Parkinson's disease non-responding to conventional antimanic drugs successfully treated with risperidone.

Antipsychotic Agents↗
PubMedDate not supplied

[The practice of electroconvulsive therapy: current contribution. II.--administration and evaluation of treatment].

In this second of a two-part review about electroconvulsive therapy (ECT) practice, the author highlights recent advances in ECT course management with a special emphasis on pre-ECT evaluation, treatment procedures, evaluation of outcome and post-ECT course. Pre-ECT assessment should include an evaluation of medical risk factors and concomitant use of psychotropic or medical agents have to be reconsidered. Practical and technical aspects of stimulus administration and their relationships with post-ECT cognitive disabilities are then presented. Monitoring of treatment response and cognitive changes during ECT course is also discussed as well as post-ECT pharmacotherapy maintenance or continuation ECT.

Anesthesia, General↗
PubMedDate not supplied

[Biological psychiatry and current classifications of depressive disorders].

By means of a review of genetic, biological and neurophysiological studies, we attempted to validate the DSM III-R depressive disorder categories. Genetic studies support the distinction between bipolar and recurrent major (unipolar) depression although genetic heterogeneity and variable phenotypic expressivity have been suggested in bipolar depression. Biological and neuroendocrine abnormalities in depression seem to relate more to a particular symptomatological profile than to a specific depressive subtype including the bipolar-unipolar dichotomy. For example, catecholamines and serotonin metabolism seem to reflect respectively psychomotor status and aggressiveness in depression. Using genetic and biological criteria, major depression with psychotic features is the best validated category of the four main DSM-R major depressive subclasses or specifications (psychotic, chronic, melancholic, seasonal). Psychotic depression seems to constitute the most coherent subgroup and biological abnormalities such as dexamethasone non suppression and shortened REM latency are very often observed. An important confounding variable in these biological validation studies is the severity of the depressive state. Psychotic depression is considered to be a more severe depressive subtype and also shows marked biological disturbances. Conversely, in seasonal depression, a less severe depressive subtype, CSF monoamine metabolism abnormalities, dexamethasone non suppression and shortened REM latency could not clearly be demonstrated. Genetic studies show that early onset dysthymia and cyclothymia could be part of the affective spectrum and some maintain that these two clinical entities are attenued forms of bipolar or recurrent major depression.

Biological Psychiatry↗
PubMedDate not supplied

[Reevaluation of melancholic depression].

15 operational definitions for melancholic depression and their validation studies are reviewed. None of these definitions have yet been conclusively validated. Using a different approach, we attempt to validate melancholic symptoms rather than operational definitions for melancholia. The aim is to define, by means of a review of genetic, biological and therapeutical studies, a "biological symptomatic profile" that responds to somatic therapies. Psychomotor and appetite disturbances, early awakening, anhedonia and psychotic symptoms seem more likely to reflect this biological dysfunction in melancholia. Confounding variables such as symptom stability, severity of depression and possible subtypes of melancholia are also discussed.

Adolescent↗
PubMedDate not supplied

[Quantitative psychopathology of depression: application of the Newcastle Scale].

Hypothalamo-pituitary axis disturbances, such as plasma cortisol escape after dexamethasone (DXM) administration or blunted TSH response to TRH, and sleep architecture abnormalities such as shortened REM latency are frequently encountered in depressive disorders. These anomalies only occur in a subgroup of depressed patients and could thus identify a biological or endogenous component to depressive illness. Several definitions of this endogenous depression have been proposed. In this regard, using biological criteria, the Newcastle scale remains the strongest validated clinical definition. In this study, 93 patients (58 women and 35 men) aged 15-79 years (mean: 42) who complained about a depressed mood were admitted for biological investigations (DXM and TRH tests, sleep EEG recording) after a drug wash-out period of at least 10 days. Patients were assessed with the Newcastle scale and diagnosed with RDC using the SADS. After the effects of age, gender and severity of illness were controlled for, multiple regression analyses showed that depressive pychomotor activity and weight loss were the 2 items of the Newcastle scale most contributing to explain the variances of the neuroendocrine tests results. Moreover, when the sample was dichotomized according to the presence of these 2 items, the 2 groups had significantly different post DXM cortisol values, TSH levels after TRH and REM latency values. The 2 groups (biological and non-biological) were then characterized using 16 depressive symptoms more frequently cited in 15 operational definitions of endogenous depression. A logistic regression analysis showed that weight loss, anhedonia, early awakening, and morning worsening of mood were the 4 symptoms that best distinguished biological from non-biological patients group. These symptoms could reflect biological abnormalities in depression and form the core of the endogenous depression.

Adolescent↗
PubMedDate not supplied

[Cerebral blood flow and post-TIA depression].

OBJECT: This study tries to evaluate the hypothesis of an association between severity of post-stroke depression and reduced cerebral blood flow (SPECT Xenon-133). METHOD: 37 patients in the fourth week of post-stroke evolution with RDS criteria of major depression (N = 20) and non-depressed patients (N = 17) were compared in regard to following parameters: values of cerebral blood flow (SPECT Xenon-133), localization of brain lesion (CT Scanner) and quantitative measurement of mood (HDRS, MARDS, BDI), functional ability (Barthel, Karnofsky), cognitive function (MMSE, WPT) and neurological function (Orgogozo's Scale). RESULTS: Post-stroke major depression is more frequent (NS) in left and anterior lesions. We also demonstrated a significant association between total brain hypoperfusion and 1) severity of post-stroke depression, 2) severity of neurologic and functional impairments. CONCLUSION: these results suggest a relationship between mood and cerebral perfusion following stroke.

Adult↗
PubMedDate not supplied

[Tridimensional Personality Questionnaire (TPQ): validation in a French-speaking control population].

Among the dimensional scales that measure personality, Cloninger's TPQ (Tridimensional Personality Questionnaire) holds a place apart in the literature, because the hypotheses it relies on are partially biological. The questionnaire (100 forced binary items) includes three axes: "Novelty Seeking", "Harm Avoidance" and "Reward Dependence", each theoretically bound to a preferential neuromediator, respectively dopamine, serotonin and norepinephrine. Each axis includes four minor subscales. The study presented here is the analysis of 104 control volunteers from both genders (59 males). This database is the first to be published with a French-speaking population. The comparison with Cloninger's normative database shows many similarities: the mean values for the 3 axes are relatively close. The population studied here is younger and this factor could play a role in the somewhat higher mean novelty seeking scores found here. The three axes show a normal distribution. Skewness and kurtosis are between -1 and +1 for all the subscales, except here for NS2. Factorial structure is quite similar to Cloninger's results. The three first axes correspond to the variables isolated in the first studies and the fourth one includes the same subscales as in the large American database. Inverse correlation between age and novelty seeking, positive correlation between female gender and harm avoidance and reward dependence were also found. However, no correlation was found between novelty seeking and male gender. A correlation was found between level of instruction and NS1 only, not with the whole NS axis. Eighty-seven % of volunteers presented with at least one standard deviation on at least one axis and 68% on at least two. This does not seem to have been described previously. It can be a sign of the difficulty of human beings to show a balanced personality. In conclusion, the database presented here shows many similarities with Cloninger's normative database. This underscores its value for comparisons in clinical trials in the future.

Adult↗