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[Relationship between dexamethasone suppression test and contingent negative variation in major depressive patients].

We tried to relate two different indexes sensitive to the perturbations induced by major depression: the Dexamethasone Suppression Test or DST (Caroll, 1982) and the Contingent Negative Variation (CNV). The question was whether abnormalities in cortisol levels, following dexamethasone would enlight the modifications observed in CNV parameters and other electrophysiological indexes (EEG spectrum, reaction time). In 61 major depressive patients, 29 being DST-non-suppressors, we calculated differences in electrophysiological variables according to DST suppression or not, but we were not able to evidence significant differences between the groups. However, there were correlations between log-transformed levels of cortisol and on the one hand, CNV slope (r = -0.34, P less than 0.03) and on the other hand, reaction time (r = 0.45, P less than 0.01). Correlations between electrophysiological variables appeared in the sole suppressors group (e.g. CNV amplitude and alpha rythm reactivity; post-imperative variation and percent beta of the EEG spectrum). These results underline the complementary aspect of the two methods.

Adult

Comparison of adinazolam, amitriptyline, and diazepam in endogenous depressive inpatients exhibiting DST nonsuppression or abnormal contingent negative variation.

Adinazolam, a triazolobenzodiazepine that has an action similar to antidepressants in several pharmacological tests, was compared with amitriptyline and diazepam in endogenous depressive inpatients exhibiting dexamethasone suppression test non-suppression and/or abnormal contingent negative variation. Three parallel groups of 22 patients received in double-blind conditions either adinazolam (60-90 mg/day), amitriptyline (150-225 mg/day), or diazepam (30-45 mg/day) over a 4-week period, with weekly assessments by the Hamilton Rating Scale for Depression. Results showed significant superiority of amitriptyline over diazepam on total Hamilton depression scores. On the endogenomorphy subscale, amitriptyline induced significantly better improvement than both diazepam and adinazolam, whereas both amitriptyline and adinazolam exhibited significantly better antidepressant efficacy on the core symptoms of depression. Moreover, the dropout rate for inefficacy after 2 weeks of treatment was higher in the diazepam group. Taken together, these findings suggest that adinazolam has an antidepressant efficacy intermediate between amitriptyline and diazepam. Adinazolam was, however, much better tolerated than amitriptyline, and produced significantly fewer anticholinergic side effects.

Adult

Contingent negative variation and reaction time in patients with presenile idiopathic cognitive decline and presenile Alzheimer-type dementia. Preliminary report on long-term nicergoline treatment.

Up to date 6 patients with initial presenile idiopathic cognitive decline (PICD) and 5 suffering from a presenile Alzheimer-type dementia (PAD) with a mean age of 59.5 were admitted to the trial. The 6 PICD patients were assigned to a double-blind nicergoline/placebo 6-month course with an oral dose of 30 mg twice a day. PAD patients were treated in an open design (nicergoline oral dose 30 mg twice a day) for at least 6 months. Until now only 4 PICD and 3 PAD patients have been treated regularly for 6 months. Two of 4 PICD patients showed a progressive enhancement of contingent negative variation (CNV), shorter reaction time (RT) and an improvement of clinical status. The other 2 PICD patients, on the contrary, showed a progressive mild worsening of CNV-RT and clinical patterns. The double-blind trial is not yet completed. CNV activity, RTs and clinical patterns progressively improved also in 2 PAD patients while in the 3rd they remained nearly unchanged or minimally worse during the 6-month treatment. The positive nicergoline effect on CNV-RT and clinical status noted in our patients appeared similar to that observed by other authors with DHEMT in patients with senile dementia of Alzheimer type. No adverse drug-related reactions were seen.

Alzheimer Disease

The contingent negative variation and the excitability of the spinal monosynaptic reflex.

A method is described which permits simultaneous measurement of changes in slow electroencephalographic potentials (Contingent Negative Variation-CNV) and the excitability of the spinal monosynaptic arc (H reflex) during the foreperiod of a simple reaction time experiment. Data from 11 normal subjects show that during the development of the CNV there is an augmentation of the amplitude of the H-reflex. It is suggested that the two phenomena are controlled by a common subcortical structure.

Acoustic Stimulation