CSF neurochemistry of women with anorexia nervosa and normal women

CSF tyrosine, tryptophan, 5-hydroxyindoleacetic acid, 3-methoxy-4-hydroxyphenylglycol (MHPG), homovanillic acid (HVA), gamma-aminobutyric acid, choline, and calcium were compared in 33 anorexic and 14 normal women. The only significant difference between groups was a lower tyrosine level in the anorexic patients; their MHPG level was nonsignificantly higher. No significant group differences in body weight or depressive subgroup were found. HVA levels were positively related to body weight, and choline was negatively correlated with anorexia severity. The role of tyrosine requires further research, but these findings do suggest that HVA and choline increase with some recovery measures and MHPG is increased with this illness.

Determinants of the increasing cesarean birth rate. Ontario data 1979 to 1982

We analyzed the records of 454,668 births in Ontario in the years 1979 to 1982 and found that the cesarean birth rate increased from 16.5 per hundred deliveries in 1979 to 18.7 in 1982. Cesarean births were classified according to four indications: previous cesarean birth, breech presentation, dystocia, and fetal distress. The increase in the cesarean rate for each indication from 1979 to 1982 was calculated and expressed as a percentage of the total rate increase. Previous cesarean births accounted for 68 per cent of the increase, breech presentation for 14 per cent, dystocia for 4 per cent, and fetal distress for 14 per cent. The impact of previous cesarean births was indicated by an increase in the number of women presenting with this indication--from 5.8 to 7.8 per cent of all deliveries. Although the incidence of breech presentation remained stable, the cesarean birth rate increased from 54.8 to 65 per cent for this indication. There were no marked changes in either the incidence of or cesarean rates for dystocia. The incidence of fetal distress doubled (2.4 to 4.7 per cent of deliveries), but the rate of cesarean births in these cases fell from 50.5 to 32.7 per cent. These findings suggest that physicians may have begun to respond to rising professional and public concern over the increasing cesarean birth rate, but major advances in controlling this rate can be achieved only by addressing the question of vaginal deliveries for some patients who have previously had cesarean section.

Central tryptamine turnover in depression, schizophrenia, and anorexia: measurement of indoleacetic acid in cerebrospinal fluid

There has been a continuing interest in the possible role of the trace amine tryptamine in the etiology of neuropsychiatric disorders. We have therefore examined cerebrospinal fluid (CSF) levels of indole-3-acetic acid (IAA), the major metabolite of tryptamine, in a large group of normals and in several patient populations. No differences in CSF IAA levels (ng/ml, mean +/- SEM) were observed between normals (4.39 +/- 0.37, n = 36), anorectics (4.40 +/- 0.42, n = 35), schizophrenics (4.06 +/- 0.05, n = 17), manics (4.32 +/- 0.63, n = 10), or depressives (5.23 +/- 0.49, n = 39). A significant elevation (p = 0.05) was found in the subgroup of retarded depressives (RDC) where levels of 5.90 +/- 0.80 (n = 19) were observed. An age effect (r = 0.39, p = 0.02, n = 36) was observed in normals; however IAA was not reduced to either height or weight. IAA tended to be higher (but not significantly) in females in all groups studied; this difference also was not significant when all diagnostic groups (except anorectics) were combined (female: 4.95 +/- 0.44, n = 45; male: 4.46 +/- 0.30, n = 66). In general, the results indicate that tryptamine turnover is not altered in the disorders studied. The functional significance of the slight elevation seen in retarded depressives is not clear.

Radial arm maze performance in rats following neonatal dopamine depletion

Neonatal dopamine (DA) depletion produces learning impairments both during development and throughout adulthood in the rat. The present experiment further investigated the memory capabilities of the dopamine-depleted rat by assessing performance in the radial arm maze. Results showed that, following neonatal injection of 6-hydroxydopamine and desmethylimipramine, lesioned rats per-performed more accurately than controls. In this paradigm, DA-depleted rats tended to enter each arm to obtain a food pellet and not enter unbaited, incorrect arms. The difference in performance of control and treated rats could not be accounted for by differences in locomotor activity, body weights, or motivational factors. A computer analysis of the data revealed that DA-depleted animals adopted a strategy of choosing adjacent arms consecutively, which probably accounted for their superior performance. Results are discussed in terms using algorithms versus extra-maze cues to complete the maze following early brain injury.

Sympathetic control of sexual reflexes: peripheral 6-hydroxydopamine administration facilitates the onset of penile reflexes in male rats

The latency to display penile reflexes was significantly reduced in male rats tested one day following treatment with 6-hydroxydopamine (6-OHDA; 75 mg/kg, administered via acute tail vein injection). Eight days following treatment the latency to the first reflex in 6-OHDA treated males did not differ significantly from saline treated control subjects. There were no significant differences in the mean number of erections or flips displayed by 6-OHDA subjects when compared to saline treated control subjects. On tests one day after 6-OHDA administration, treated subjects displayed significantly fewer cups than control subjects on the corresponding tests. Chemical sympathectomy was verified by extreme reduction of peripheral norepinephrine levels. Results of this study are consistant with those reported for spinally transected rats tested under similar conditions (that is, one day following spinal transection), and suggest sympathetic inhibition of the onset of penile reflexes.

Neurochemical correlates of attention deficit disorder

Evidence from both epidemiologic and pharmacologic investigations into the biology of attention deficit disorder suggests that abnormalities in neurotransmitter function exist in children with attention deficit disorder. This article reviews this evidence and discusses the limitations imposed upon such clinical investigations.

Platelet imipramine binding in autistic subjects

Previous reports of elevated platelet serotonin (5-HT) concentrations in autistic subjects suggest that platelet 5-HT uptake might be altered in autism. Parameters of 3H-imipramine (IMI) binding were measured in 11 drug-free autistic subjects and 10 normal volunteers. Similar means (+/- SD) for Bmax (autistics, 1350 +/- fmole/mg protein; normals, 1590 +/- 206 fmole/mg protein) and Kd (autistics, 0.98 +/- 0.10 nM; normals, 0.94 +/- 0.13 nM) were found in the two groups. The normal number (Bmax) and affinity (Kd) of the IMI binding site in autistic subjects suggest that the regulation of 5-HT uptake is not different in autism.

Dopaminergic but not noradrenergic mediation of hyperactivity and performance deficits in the developing rat pup

The relative contribution of dopamine (DA) and norepinephrine (NE) in behavioral arousal was examined in developing rat pups using intracisternal 6-hydroxydopamine (6-OHDA) either alone or following pretreatment with desmethylimipramine (DMI). Such treatments were designed to examine the effects of preferential reduction of DA (DA depletion), NE (NE depletion), or both catecholamines (CA depletion) in the development of motor activity and escape performance. General motor activity increased with age and, over all ages, DA-depleted pups tended to exhibit greater activity. This was most apparent at 15 days of age, where DA-depleted pups were significantly more active than controls, NE-depleted, or CA-depleted pups. DA-depleted pups failed to exhibit the steep decline in activity over time (habituation of activity) demonstrated by the control and NE-depleted pups, while pups depleted of both CA fell into an intermediate position in habituation. Escape latency in a T-maze at 20 days and shuttle box at 26 days of age indicated comparable performance to controls for NE-depleted pups, while those animals in DA-depleted and CA-depleted groups appeared unable to perform the task. Brain CA concentrations (determined by a radioenzymatic assay) indicated preferential reduction of DA in the DA-depleted group to concentrations 25% of controls, reduction of NE to 62% of controls in the NE-depleted group, and reductions of DA to 42% and NE to 60% in the CA-depleted group. These results suggest that preferential reduction of brain DA in the developing rat pup increases motor activity and impairs habituation of activity during the stage of behavioral arousal in week 3 of postnatal life.(ABSTRACT TRUNCATED AT 250 WORDS)

Differential effects of selective dopamine, norepinephrine or catecholamine depletion on activity and learning in the developing rat

The present experiment investigated the behavioral changes which occurred following neonatal depletion of central catecholamine systems in the rat. The behavioral effects which resulted from selective dopamine (DA) depletion were compared with those resulting from selective norepinephrine (NE) depletion as well as depletion of both catecholamines (CA). Neonatal 6-hydroxydopamine (6-OHDA) was administered intracisternally at 5 days of age following pretreatment with desmethylimipramine in order to selectively deplete DA. NE levels were reduced by intraperitoneal injections of 6-OHDA at 1 and 2 days of age. Depletion of both catecholamines was effected by combining the procedures used for selective depletion of both DA and NE. Activity was time sampled during an hour at 3 preweanling ages. Avoidance and escape learning were measured in a T maze when pups were 20 days of age and in a Shuttlebox apparatus on day 28. Results revealed that DA and CA depleted animals were hyperactive in comparison to controls and displayed severe learning impairments in both T maze and Shuttlebox performance. In contrast, NE depleted animals showed activity levels which were similar to controls but were significantly impaired on both learning paradigms. These results suggest that selective lesions of DA and NE in infancy lead to a constellation of behaviors which are distinctly unique. The implications of these findings is discussed in terms of clinical research into the Attentional Deficit Disorder of childhood.

Concentration of intrathecal 3H-labeled metrizamide in normal dog brain: age-related differences

Responses to intrathecal metrizamide in dogs were found to be age-related: Adult dogs had seizures; 7-week-old dogs appeared stuporous; 6-day-old dogs were clinically unaffected. The brain metrizamide concentrations 4, 6, and 20 hr after intrathecal injection correlated directly with the occurrence and severity of neurotoxic symptoms. Age-related differences in brain metrizamide concentration may be explained by two factors. The first is the failure of current clinical guidelines to adjust the recommended dosage of metrizamide to reflect differences among age groups in brain weight rather than body weight. This error resulted in lower doses/gram of brain weight being given to the puppies. However, the large differences in brain metrizamide concentrations among the three groups of dogs could not be explained solely by differences in the dose. A second factor, physiologic age-related differences in brain penetration, is believed to be operative. The precise nature of these differences is unclear.

Effects of apomorphine on appetitive conditioning in 6-hydroxydopamine treated rat pups

Rat pups were treated on postnatal day 5 either with the combination of desmethylimipramine (DMI) and 6-hydroxydopamine (6-OHDA) to produce depletion of brain dopamine, or with control injections of saline. Two days later they were presented a novel anise odor paired with intraoral baby formula, and on the next day were tested for preference for the novel odor. Before conditioning and testing, animals were treated with either apomorphine (0.05 mg/kg) or isotonic saline. Performance of the conditioned appetitive response was impaired in dopamine depleted animals. In DMI/6-OHDA treated pups, apomorphine administration prior to conditioning produced an improvement in performance, but drug treatment prior to testing had no effect. In normal pups, apomorphine administration either before conditioning or testing produced impaired performance at testing.

Factors influencing melatonin, 5-hydroxytryptophol, 5-hydroxyindoleacetic acid, 5-hydroxytryptamine and tryptophan in rat pineal glands

Using a simple high performance liquid chromatographic method, we measured melatonin, N-acetyl-5-hydroxytryptamine (NAc-5HT), 5-hydroxytryptophol (5HTOL), 5-hydroxyindoleacetic acid (5HIAA), 5-hydroxytryptamine (5HT) and tryptophan in single rat pineal glands. 5-Methoxytryptophol and 5-methoxyindoleacetic acid were not detected at levels which have been reported previously. 5HTOL, 5HIAA and 5HT showed the opposite diurnal rhythm to NAc-5HT and melatonin. Light during the dark period lowered melatonin while increasing 5HTOL, 5HIAA and 5HT. As the peak 5HTOL levels were higher than the peak melatonin levels, the functional significance of 5HTOL deserves consideration. Tryptophan administration increased melatonin and 5HTOL as well as the other indoles.

Discriminative stimulus properties of MDA analogs

Rats trained to discriminate (+/-) 2,5-dimethoxy-4-methylphenylisopropylamine (DOM) (1.0 mg/kg) from saline, using a standard two-lever operant task, were challenged with various doses of 3,4-methylenedioxyphenylisopropylamine (MDA) and several related agents. The (+/-)-DOM stimulus generalized to (+/-)-MDA, suggesting that both agents apparently produce similar stimulus cues. Related agents, known to produce effects in man similar to those produced by (+/-)-MDA, also resulted in generalization when administered to the DOM-trained animals, e.g., R(-)-MDA and a methoxylated derivative of (+/-)-MDA, (+/-)-2-OMe-4,5-MDA. DOM stimulus generalization was not observed for S(+)-MDA, the N-monomethyl and alpha-demethyl derivatives of MDA, nor for a metabolite of MDA (i.e., 3-methoxy-4-hydroxyphenylisopropylamine). The results suggest that R(-)- and (+/-)-MDA, as well as (+/-)-2-OMe-4,5-MDA, but not the other derivatives of MDA, are capable of producing behavioral (stimulus) effects common to those produced by the training dose of (+/-)-DOM.

Clinical neurochemistry of autism and associated disorders

Advances in information concerning brain function in animals and advances in analytical neurochemical methods for determining extremely low levels of compounds in physiological fluids have opened great opportunities for clinical neurochemical studies of autism. Nevertheless, the behavioral deficits in autistic individuals are major obstacles to clarification of the relations between symptoms and biochemical dysfunction in the brain. The fundamental preclinical and clinical studies of serotonin, dopamine, and norepinephrine metabolism related to infantile autism are reviewed, and new studies are suggested as examples of the productive strategies that will illuminate features of the autistic syndrome in the next decade.

Massive diphenhydramine overdose resulting in death

Overdosage of diphenhydramine may result in the development of anticholinergic symptoms, seizures, and coma. A fatal outcome following a diphenhydramine overdose does not commonly occur. This report describes the largest documented overdosage of diphenhydramine (7.5 g) which resulted in the death of a 14-year-old girl. The patient initially developed seizures following by cardiac conduction and hemodynamic compromise resulting in death despite life support measures.

Determination of indoles in human and rat pineal

Tryptophan, serotonin, N-acetylserotonin, melatonin, 5-hydroxyindoleacetic acid and 5-hydroxytryptophol have been determined in rat and human pineal glands. The compounds were measured by directly injecting centrifuged tissue homogenates into a liquid chromatographic-fluorometric system. Normal ranges are reported for these compounds and upper limits established for several other indoles.