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Biomedical subjects

M Trimble

Publications and source records attributed to M Trimble.

At least 37 records · Page 2Linked to original sources
PubMed1996

Depression in multiple system atrophy and in idiopathic Parkinson's disease: a pilot comparative study.

Multiple system atrophy (MSA) is a disease causing parkinsonism in which response to levodopa is classically absent, poor, or transient. Idiopathic Parkinson's disease (IPD) itself, which responds favorably to levodopa, has been associated with the development of disease-related depression. Over and above the clinical and pathological characteristics of IPD, MSA causes additional, more widespread, clinical and pathological deficits. We have compared motor disability and mood in 12 patients with MSA and 12 with IPD. There was more severe motor disability, but no clinical evidence of depression among the MSA patients studied, and their Beck Depression Inventory scores did not differ significantly from the group with IPD. We conclude that depression does not appear to be more common in MSA than in IPD.

Activities of Daily Living↗
PubMed1996

Vigabatrin and behaviour disorders: a retrospective survey.

Vigabatrin is an anticonvulsant drug with a relatively favourable side-effect profile. However, in clinical trials behaviour disorders have been reported, including agitation, depression and psychoses. In this study, 136 cases of behavioural problems that had been reported to the manufacturers, or the authors, were followed up. Satisfactory clinical information could be obtained on 81 patients. Of these, 50 cases met the criteria for either a psychosis (n = 28) or depression (n = 22). These were compared with a group of Queen Square patients, with epilepsy and psychosis, who had never taken vigabatrin (n = 21) and another group, who received vigabatrin without experiencing any behavioural problems (n = 28). The main results from this study suggest that: (1) Psychosis as a treatment emergent effect of vigabatrin is seen in patients with more severe epilepsy, compared with those patients who never develop psychopathology, and those developing an affective disorder. The psychosis is related to a right-sided EEG focus, and suppression of seizures (64% became seizure free). (2) Depression as a treatment emergent effect of vigabatrin is associated with a past history of depressive illness. There was little or no change in seizure frequency is this group. Some suggestions for managing patients who may develop these behaviour disorders are given.

Anticonvulsants↗
PubMed1996

Acute psychological disorders in patients with epilepsy: a nation-wide study.

Acute psychological disorders (APDs) are more common in epilepsy than in the general population, with estimates varying from 2 to 16% depending on the population of patients sampled. APD has traditionally been classified by seizure activity (ictal), the early post-ictal period (post-ictal) and unrelated to seizure activity (inter-ictal). APD may also occur as a consequence of the use of antiepileptic drugs (AEDs). An ongoing prospective active surveillance system was utilised which surveys all neurologists and associated specialists in the United Kingdom run by the British Neurological Surveillance Unit (BNSU). Incident cases were ascertained, using the BNSU, for a period of 1 year and were defined as patients with epilepsy who developed an acute psychological disorder, whatever the cause, such as a psychosis or depression. Sixty-four cases were ascertained. The ages were between 17 and 69 (mean 36); there were 38 males and 26 females. The majority of patients had location-related epilepsy (52, 81%), either cryptogenic (29, 45%) or secondary to a symptomatic lesion (23, 36%), of which the most common were mesial temporal sclerosis (6, 9%) and trauma (4, 6%). Thirty-one (48%) patients were considered to have APD due to ictal or post-ictal activity. Thirty-three (52%) were inter-ictal. Carbamazepine was the most common AED prescribed (42, 66%), and of the new AEDs lamotrigine was prescribed in 17 patients (27%) and vigabatrin in 16 (25%). The APD in 19 (30%) patients was reported by the referring physician as being secondary to an AED. In 12 patients this was attributed to vigabatrin. However, the relative frequency of APD due to AEDs, or to the different new AEDs, could not accurately be calculated as this was not a true incidence study. In the 19 drug-related APD patients, there was no change in seizure frequency in 8 (42%) and in 7 (37%) the seizure frequency had decreased (in 3 (16%), ceasing altogether prior to the APD). In 4 of the 19 patients (21%) the seizure frequency increased. The overall outcome was good with 17/19 (89%) of the AED attributed cases resolving.

Adolescent↗
PubMed1996

The effects of vigabatrin on attention, concentration and mood: an investigation in healthy volunteers.

Ten healthy volunteers (six males; four females) completed this double-blind, crossover design study of vigabatrin vs placebo. Subjects were tested on four occasions; at the baselines of the placebo and the vigabatrin phase, and two weeks thereafter. At time of testing, the dose of vigabatrin was 2 g daily. Changes in cognition were assessed using the Sternberg, the PASAT, the Stroop, and Critical Fusion Flicker tests. Mood was assessed with the Mood Adjective Check List, the Beck Depression Inventory, and the Irritability, Depression and Anxiety scales. We found one drug, and one placebo, related significant difference on a measure of cognition.

Adult↗
PubMed1995

Expression of VAMP-2-like protein in kidney collecting duct intracellular vesicles. Colocalization with Aquaporin-2 water channels.

Body water balance is controlled by vasopressin, which regulates Aquaporin-2 (AQP2) water channels in kidney collecting duct cells by vesicular trafficking between intracellular vesicles and the plasma membrane. To examine the molecular apparatus involved in vesicle trafficking and vasopressin regulation of AQP2 in collecting duct cells, we tested if targeting proteins expressed in the synaptic vesicles, namely vesicle-associated membrane proteins 1 and 2 (VAMP1 and 2), are expressed in kidney collecting duct. Immunoblotting revealed specific labeling of VAMP2 (18-kD band) but not VAMP1 in membrane fractions prepared from kidney inner medulla. Controls using preadsorbed antibody or preimmune serum were negative. Bands of identical molecular size were detected in immunoblots of brain membrane vesicles and purified synaptic vesicles. VAMP2 in kidney membranes was cleaved by tetanus toxin, revealing a tetanus toxin-sensitive VAMP homologue. Similarly, tetanus toxin cleaved VAMP2 in synaptic vesicles. In kidney inner medulla, VAMP2 was predominantly expressed in the membrane fraction enriched for intracellular vesicles, with little or no VAMP2 in the plasma membrane enriched fraction. This was confirmed by immunocytochemistry using semithin cryosections, which showed mainly vesicular labeling in collecting duct principal cells, with no labeling of intercalated cells. VAMP2 immunolabeling colocalized with AQP2 labeling in intracellular vesicles, as determined by immunoelectron microscopy after double immunolabeling of isolated vesicles. Quantitative analysis of 1,310 vesicles revealed a highly significant association of both AQP2 and VAMP2 in the same vesicles (P < 0.0001). Furthermore, the presence of AQP2 in vesicles immunoisolated with anti-VAMP2 antibodies was confirmed by immunoblotting. In conclusion, VAMP2, a component of the neuronal SNARE complex, is expressed in vesicles carrying AQP2, suggesting a role in vasopressin-regulated vesicle trafficking of AQP2 water channels.

Animals↗
PubMed1992

Comparison of the effects of frontal and temporal lobe partial seizures on prolactin levels.

The acute effects of partial (focal) epileptic seizures on serum prolactin levels were studied in two groups of patients: (1) 10 with temporal lobe seizures and (2) 11 with seizures that arose from the frontal lobes, recorded on cable video-electroencephalographic telemetry. Six of the eight complex partial seizures of temporal lobe origin were associated with a marked rise in prolactin levels at 10 minutes after onset (rise in levels, from a mean of 279 to 534 mU/L), compared with a rise in only one of the eight frontal lobe complex partial seizures. None of the five simple partial seizures (two of temporal and three of frontal lobe origin) was associated with a marked rise in prolactin levels. This difference in prolactin response following complex partial seizures of frontal and temporal lobe origin may help in the clinical differentiation of these seizures. A failure of prolactin levels to rise does not, however, exclude a diagnosis of complex partial seizures; thus, this measurement will not help in the clinical differentiation of frontal lobe complex partial seizures from psychogenic attacks.

Adolescent↗
PubMed1991

Secondary erythrocytosis due to a cerebellar hemangioblastoma: demonstration of erythropoietin mRNA in the tumor.

Cerebellar hemangioblastoma is a rare cause of secondary erythrocytosis. Although the erythrocytosis is a result of erythropoietin (Ep) stimulation, direct evidence of Ep synthesis by the tumor has been lacking. In an erythrocytotic patient with a cerebellar hemangioblastoma we found elevated levels of Ep in the tumor cyst fluid and for the first time demonstrated Ep mRNA in the tumor by Northern blotting. This finding confirms cerebellar hemangioblastoma as a site of ectopic Ep production.

Adult↗
PubMed1991

Serotonin reuptake inhibitors, epilepsy and myoclonus.

Specific inhibitors of 5-HT reuptake are reported to have lower proconvulsive activity than other antidepressants. A patient with post-traumatic epilepsy who had remained fit-free for many years until she was given the 5-HT reuptake inhibitor fluvoxamine is reported. Changes in serotonergic function may play a more widespread role in the pathophysiology of seizure disorders than hitherto thought.

Brain↗
PubMed1990

The antiphospholipid syndrome: prevalence among patients with stroke and transient ischemic attacks.

PURPOSE: The prevalence of the antiphospholipid syndrome was determined prospectively in patients presenting with stroke and transient ischemic attacks. An attempt was made to define a subset of stroke patients at risk for this syndrome on the basis of their clinical features. PATIENTS AND METHODS: Fifty-one consecutive patients with stroke and transient ischemic attacks were assessed. Tests used for the laboratory diagnosis of the antiphospholipid syndrome included four phospholipid-dependent coagulation tests for detection of the lupus anticoagulant, and two enzyme-linked immunosorbent assays for antibodies to phospholipid. RESULTS: Three of 51 patients (6%, 95% confidence intervals 0% to 12.0%) had a lupus anticoagulant and the clinical features of the antiphospholipid syndrome. Seven patients had clinical features suggestive of the syndrome but negative laboratory tests. Those patients who were clinically unlikely to have this syndrome also had negative laboratory tests. CONCLUSION: In a series of 51 unselected patients presenting with stroke and transient ischemic attacks, three had the antiphospholipid syndrome. The clinical features of this syndrome are helpful in identifying this group of patients. The role of the lupus anticoagulant in the pathogenesis of stroke remains to be defined.

Adolescent↗
PubMed1990

The treatment of Gilles de la Tourette syndrome by limbic leucotomy.

A patient with Gilles de la Tourette syndrome and severe self-injurious compulsions who had failed to respond to drug treatment and behavioural therapy obtained a complete and sustained resolution of his destructive behaviour and improvement in his tics following bilateral limbic leucotomy.

Adult↗
PubMed1989

Psychopathology and movement disorders: a new perspective on the Gilles de la Tourette syndrome.

Attention is drawn to associations between movement disorders and psychopathology. The historical background of this is briefly reviewed, and then some recent research findings with regards to the Gilles de la Tourette syndrome are presented. In particular, associations between aggressive and obsessive compulsive disorder and Gilles de la Tourette movements are reported. Further there are associations between a family history of tics and obsessive compulsive disorder in the subsequent generation. It is concluded that the Gilles de la Tourette syndrome should not be viewed as a tic disorder, but a far more complex condition in which the tics form but one aspect.

Humans↗
PubMed1987

Abnormalities of copper in Gilles de la Tourette syndrome.

The Gilles de la Tourette syndrome is a disorder whose etiology and pathogenesis are little understood. The number of biochemical abnormalities described in this disorder is minimal. Ten of a total of 80 patients were found to have an abnormally low serum copper. A report is presented on two patients who consented to further detailed investigation and in whom copper radioisotope studies were carried out. Both exhibited abnormalities of copper handling, in that we observed an abnormally fast disappearance of copper from the plasma and an abnormally slow uptake by the liver. The rates of intestinal absorption and urinary excretion were normal. We did not identify an abnormal site of sequestration of the metal in the body.

Adult↗