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Biomedical subjects

S Caroff

Publications and source records attributed to S Caroff.

At least 19 recordsLinked to original sources
PubMed1987

Regional brain function in schizophrenia. I. A positron emission tomography study.

Local cerebral glucose metabolism was determined with 18-F-fluorodeoxyglucose using positron emission tomography in a sample of 12 unmedicated schizophrenics and 12 matched normal controls. The data were analyzed for absolute metabolic rates and region/whole-brain ratios using the cortical-subcortical, antero-posterior, and laterality dimensions. Lobar areas within cortical regions were also compared. Across groups, subcortical metabolism was higher than cortical metabolism. Patients had lower metabolism, cortically and subcortically, and a steeper subcortical to cortical gradient. Patients with higher scores on the Brief Psychiatric Rating Scale had higher absolute metabolism and higher left relative to right hemispheric metabolism than did patients with lesser severity. The results did not show "hypofrontality" in schizophrenia. These findings provide some support for cerebral dysfunction in schizophrenia and indicate the need for further examination of the cortical-subcortical dimension.

Brain↗
PubMed1987

Regional brain function in schizophrenia. II. Repeated evaluation with positron emission tomography.

Cerebral glucose metabolism was measured twice in a sample of 15 schizophrenics and eight controls, using positron emission tomography (PET) with 18-F-fluorodeoxyglucose. Studies were separated by three to 33 weeks. Patients were unmedicated during the first study, and the majority were receiving neuroleptics during the second study. There were no changes from study 1 to study 2 in average whole-brain metabolic rates, regional cortical activity, or the gradient of subcortical to cortical activity. The steeper subcortical to cortical gradient in schizophrenics, present in the first study, persisted in the second. Changes in this gradient were uncorrelated with changes in clinical status. Laterality (right-left) was stable across studies, and changes toward higher right relative to left hemispheric metabolism were correlated with clinical improvement. The results support the hypothesis of abnormal hemispheric activity in schizophrenia and implicate the subcortical-cortical gradient as another dimension that merits further exploration.

Adult↗
PubMed1987

Neuroendocrine responses to cold stress in normal subjects and depressives.

In order to assess the effects of cold stress on neuroendocrine function in persons with affective disorders, 11 normal subjects and eight depressed patients were subjected to a well-defined thermal stress in a cold chamber at 10 degrees C. Metabolic rate, skin and rectal temperature, and TSH, T4, T3, growth hormone, prolactin, and cortisol were measured simultaneously for 45 minutes prior to cold exposure and for 60 minutes in the cold. All subjects experienced robust changes in skin temperature and metabolic rate during cold exposure, while maintaining core temperature throughout. There were no changes in any of the neuroendocrine parameters during exposure to cold stress in either the controls or the depressives, although depressives had somewhat higher T4 and lower T3, TSH, and GH throughout the study. These findings indicate that hormones of these neuroendocrine axes are unresponsive to acute, moderate cold stress in normal man and that depressives show no greater reactivity than normals.

Acclimatization↗
PubMed1986

Patterns of melatonin rhythms in depression.

The nocturnal rise of melatonin in serum of humans is the result of endogenously released norepinephrine (NE) acting upon beta-adrenergic receptors of the pineal gland. As there is much interest in the possibility of there being changes in the function of beta-receptors in depressed patients, the nocturnal rise of melatonin was measured in depressives and healthy control subjects. In one study, multiple serum samples were taken between 4.30 p.m. to 7.30 a.m. in seven male depressed patients with melancholia and five healthy male control subjects. The melancholic patients had a significantly reduced nocturnal elevation of melatonin. In a separate study, serum samples were taken at 8 a.m. and 11 p.m. in melancholic depressives, non-melancholic depressives and healthy control subjects. The melancholic patients had a significantly lower concentration of melatonin at 11 p.m., but not at 9 a.m., than that measured in either the control subjects or the non-melancholic depressed patients. These results are similar to those found recently by several other groups of investigators. Further research is indicated to elucidate mechanism(s) responsible for this phenomenon.

Adult↗
PubMed1985

Brain function in psychiatric disorders. III. Regional cerebral blood flow in unmedicated schizophrenics.

Regional cerebral blood flow (rCBF) was measured during resting baseline and the performance of a verbal and a spatial task in 19 unmedicated schizophrenics and 19 matched controls. Abnormalities in rCBF were evident in schizophrenics both for resting and activated measures. Resting flows were higher in the left hemisphere for schizophrenics, supporting the hypothesis of left hemispheric overactivation. This effect was stronger in the more severely disturbed patients. The pattern of rCBF changes during activation with the verbal and spatial tasks was also different in schizophrenics. Laterality of flow changes further supported the hypothesis of left hemispheric overactivation. Furthermore, whereas normals had greater increase in flow for the spatial than the verbal task, schizophrenics showed the reverse pattern. This effect also was more pronounced in the severely disturbed patients. Comparison with an earlier sample of medicated schizophrenics suggested that neuroleptics restore symmetry of resting flows before they produce symptomatic relief. Medication did not affect the abnormalities in pattern of rCBF changes during activation with cognitive tasks.

Adolescent↗
PubMed1985

Differences in nocturnal melatonin secretion between melancholic depressed patients and control subjects.

The authors took multiple serum samples for measurement of melatonin between 4:30 p.m. and 7:30 a.m. in seven male depressed patients with melancholia and five healthy male control subjects and found that melancholic patients had a significantly lower rise of melatonin. They also compared a second, separate group of 14 women and five men suffering from melancholic depression with seven healthy male control subjects and nine depressed women without melancholia. The melancholic patients had a significantly lower concentration of serum melatonin at 11:00 p.m. than either the control subjects or the nonmelancholic depressed patients. These findings support the possibility that the functioning of the pineal gland is altered in these patients.

Adult↗
PubMed1984

Brain function in psychiatric disorders. II. Regional cerebral blood flow in medicated unipolar depressives.

Regional cerebral blood flow was measured during resting baseline and the performance of a verbal and a spatial task in 14 medicated depressives and 25 matched controls. Overall resting flows did not differ, nor were there hemispheric or anteroposterior differences between patients and controls for resting flows. Differences between patients and controls were evident during cognitive activity, and the effects were different for male and female patients. Depressed female patients had higher than normal flows in all conditions, whereas depressed male patients had lower than normal resting flows, which increased to normal during cognitive activity. Their anterior flows increased for the verbal task but not for the spatial task.

Adult↗
PubMed1984

Neuroleptic malignant syndrome. Patient with unique clinical and physiologic features.

Lethargy, marked muscle weakness and rigidity, a maximal temperature of 40 degrees C, and a maximal creatine kinase value of 17,240 IU/liter developed in a 36-year-old woman following treatment with several neuroleptics. Initial treatment with dantrolene was unsuccessful. The patient's condition improved gradually over a 10-day period with no specific therapy. Muscle biopsy revealed a contracture pattern diagnostic of malignant hyperthermia susceptibility, as well as abnormal sensitivity to fluphenazine. This report may be the first description of a patient with neuroleptic malignant syndrome in whom muscle biopsy response similar to that seen in malignant hyperthermia occurred and documents that dantrolene is not uniformly successful therapy for this syndrome.

Adult↗
PubMed1983

A neuroendocrine test battery in bipolar patients and healthy subjects.

Abnormalities of hormonal responses to a number of neuroendocrine challenges have been reported in depressed patients. Most studies have examined responses in a single neuroendocrine axis. We used a series of four neuroendocrine challenges (thyrotropin-releasing hormone test, gonadotropin-releasing hormone test, insulin tolerance test, and dexamethasone suppression test) to examine eight hormonal responses in 22 healthy subjects and 22 patients with bipolar disorder. Variability of hormonal responses in bipolar patients was examined by evaluating the number of abnormal hormonal responses as compared with responses from healthy volunteers. Abnormalities were observed after all four neuroendocrine tests. Nine control subjects (40.9%) and 17 bipolar patients (77.3%) had at least one abnormal response. More strikingly, 12 bipolar patients (54.5%), but no controls, had two or more abnormal responses. These findings suggest that manic-depressive patients show increased variability in hormonal response from multiple neuroendocrine axes.

Adult↗
PubMed1983

Brain function in psychiatric disorders. I. Regional cerebral blood flow in medicated schizophrenics.

We measured regional cerebral blood flow during resting baseline and the performance of verbal and spatial tasks in 15 medicated schizophrenics and 25 matched controls. Patients did not differ from controls in resting flows but showed different blood-flow changes during task performance. Controls replicated earlier findings in normal subjects: flow increased during task performance, and the hemispheric increase was greater in the left for the verbal and in the right for the spatial task. In contrast, patients showed no flow asymmetry for the verbal task and greater left hemispheric increase for the spatial task. The latter finding is consistent with the hypothesis that schizophrenia is associated with left hemispheric overactivation for spatial tasks. In addition, schizophrenic women had unusual flow changes in that their highest flow increase was for the verbal task.

Adult↗
PubMed1983

Response to dexamethasone in psychotic depression.

The utility of the dexamethasone suppression test (DST) in the diagnosis of psychotic depression was examined by comparing the responses of 11 psychotic and 18 nonpsychotic depressed inpatients. Nine of 11 psychotic patients (81.8%) and 10 of 18 nonpsychotic patients (55.6%) showed nonsuppression (nonsignificant). Using the 0800h cortisol level alone, we found that significantly more psychotic patients (7 of 11; 63.6%) than nonpsychotic patients (3 of 18; 16.7%) showed nonsuppression. Nonsuppression at 0800h postdexamethasone may be a useful biologic marker for patients with psychotic depression. Implications of these data for the nosologic status of psychotic depression are discussed.

Adult↗
PubMed1983

Relationship between tricyclic antidepressant plasma levels and clinical response in patients treated with desipramine or doxepin.

A study examining the relationship between plasma levels of tricyclic antidepressants (TCA), clinical response, and side effects was performed in patients with major affective disorder. Patients received either desmethylimipramine (DMI) (150-200 mg/day) or doxepin (200 mg/day) for 4 weeks. No significant correlations were found between plasma levels and either clinical response or side effects when males and females were analyzed together. A significant correlation between plasma levels and response was found in females taking desmethylimipramine. Support for the finding that females may show a stronger relationship than males between clinical response and plasma TCA levels is provided from analysis of previous studies in the literature.

Adult↗
PubMed1982

Growth hormone, prolactin and thyrotropin responses to gonadotropin-releasing hormone in depressed patients and healthy volunteers.

Growth hormone (GH), prolactin (PRL) and thyrotropin (TSH) release following gonadotropin-releasing hormone (GnRH) administration were examined in 56 patients with major affective disorder (37 unipolar, 19 bipolar) and 38 normal healthy subjects. There were no differences in GH, PRL or TSH responses after GnRH infusion between the patients and the normal subjects, in contrast to previously reported abnormalities in depressed patients. Serum GH concentration increased after GnRH in both normal and depressed men; serum TSH increased after GnRH in both normal women and bipolar women, but not in unipolar depressed women. Further studies comparing GnRH to saline infusion will be necessary to determine if the GH and TSH responses seen in this study are due to GnRH or result from the stress of the experimental procedures.

Adult↗
PubMed1982

Double-blind comparison of doxepin and desipramine in patients with primary affective disorder.

A double-blind comparison of doxepin versus desipramine was performed in carefully defined patients with research diagnosis of Primary Affective Disorder. While both drugs showed equal efficacy after 4 weeks, doxepin demonstrated a more rapid onset of action and surprisingly few side effects. Desipramine did not prove to be "activating" and did not worsen agitated depression. Although doxepin showed few autonomic side effects, it was nevertheless sedating, indicating that tricyclics with more anticholinergic effects are not necessarily more sedating drugs.

Adult↗