Effect of two beta-blockers on stress during mental arithmetic

Deciphering the sinus tachycardias

Sinus tachycardia is the most common rhythm disturbance encountered in clinical practice. Primary sinus tachycardia without an underlying secondary cause, despite often being associated with troublesome symptoms, is often neglected leading to multiple consultations and frustration on part of both the practitioner and the patient. The fact that primary sinus tachycardias are a heterogeneous group of disorders is seldom appreciated; hence, a firm diagnosis is rarely reached and management is haphazard. Furthermore, there may be prognostic implications for prolonged or recurrent sinus tachycardia, making it imperative that this group of arrhythmias receive adequate and appropriate attention. Normal sinus tachycardia (i.e., secondary), inappropriate sinus tachycardia, postural orthostatic tachycardia syndrome (POTS) and sinus node reentry tachycardia make up this group of arrhythmias. Their definitions, clinical features, diagnostic criteria, pathophysiologic mechanisms, and optimum management are discussed in this review.

Recent advances in animal models of chronic antidepressant effects: the novelty-induced hypophagia test

Animal models exhibiting sensitivity to chronic, but not acute, antidepressant treatment are greatly needed for studying the neural mechanisms of the antidepressant response. Although several models of acute antidepressant effects provide excellent tools for antidepressant discovery, they do not permit investigation into their therapeutic effects, which require several weeks of treatment to emerge. The inhibition of feeding produced by novelty, termed 'hyponeophagia', provides an anxiety-related measure that is sensitive to the effects of chronic, but not acute or subchronic, antidepressant treatment. This review evaluates the value of hyponeophagia-based tests as tools for investigating the neurobiology of the therapeutic response to antidepressant treatment. Criteria for the development and validation of animal models used to study neurobiological mechanisms of the antidepressant response are presented. Methodological considerations affecting the reliability, specificity, and ease of use of hyponeophagia-based models are also discussed. Lastly, we present a newly revised hyponeophagia paradigm, called the novelty-induced hypophagia (NIH) test, which attempts to maximize the predictive validity and practicality of the test. The NIH paradigm provides a promising new model for investigations into the neurobiology underlying the antidepressant response.

Sinus tachyarrhythmias and the specific bradycardic agents: a marriage made in heaven?

A relatively novel group of drugs that inhibit the funny current in the sinus node pacemaker cells, the so-called specific bradycardic agents, are likely to play a significant role in the management of a wide range of cardiovascular disorders, including the sinus tachyarrhythmias. This comprehensive review initially provides an insight into these agents, their historical background, and their mechanism of action. It then discusses the differential diagnosis of the sinus tachyarrhythmias (normal sinus tachycardia, inappropriate sinus tachycardia, postural orthostatic tachycardia syndrome, and sinus node reentry tachycardia), elaborates on their pathophysiologic basis, and provides up-to-date evidence-based information on their optimum management. The specific bradycardic agents, by the very nature of their mode of action, may prove ideal therapies for the management of the sinus tachyarrhythmias, and this is explored at every stage.

Influence of 5-HT1A receptor antagonism on plus-maze behaviour in mice. I. Pindolol enantiomers and pindobind 5-HT1A

Studies on the behavioural effects of 5-hydroxytryptamine receptor subtype 1A (5-HT1A) antagonists may provide important clues to the precise role of 5-HT1A receptor mechanisms in anxiety. In the first of a series of experiments designed to address this issue, the effects of mixed 5-HT1A and beta-adrenergic receptor antagonists pindolol enantiomers and pindobind 5-HT1A and of metoprolol and ICI 118,551 (selective beta1- and beta2-adrenoceptor antagonists, respectively) were assessed in the mouse elevated plus-maze using ethological techniques. Results showed that, at lower doses, (-)pindolol (0.1-1.6 mg/kg) and pindobind 5-HT1A (0.1-0.5 mg/kg) produced changes in both conventional and ethological measures (increased percentage of open arm time and reduced risk assessment) indicative of anxiety reduction. However, these anxiolyticlike actions were less evident at higher doses. In contrast, (+)pindolol (0.1-6.4 mg/kg), metoprolol (2.0-18.0 mg/kg) and ICI 118,551 (1.0-9.0 mg/kg) were behaviourally inert under present test conditions. These data suggest that antagonist actions at 5-HT1A receptors (but not beta-adrenoceptors) are involved in the anxiolyticlike effects of (-)pindolol and pindobind 5-HT1A in the murine elevated plus-maze test.

Beta-adrenoceptors in the tree shrew brain. I. Distribution and characterization of [125I]iodocyanopindolol binding sites

1. The number and distribution pattern of beta-adrenergic receptors in the brain have been reported to be species specific. The aim of the present study was to describe binding of the beta-adrenoceptor ligand [125I]iodocyanopindolol in the brain of the tree shrew (Tupaia belangeri), a species which provides an appropriate model for studies of psychosocial stress and its consequences on central nervous processes. 2. 125I-Iodocyanopindolol (125ICYP) labeling revealed a high degree of nonspecific binding, which was due mainly to interactions of this ligand with serotonin binding sites. For a quantitative evaluation of beta 1- and beta 2-adrenoceptors, serotonin binding sites had to be blocked by 100 microM 5HT. 3. Binding of the radioligand to beta 1- and beta 2-adrenoceptors was characterized using the beta 1-specific antagonist CGP20712A and the beta 2-specific antagonist ICI118.551. beta 1-adrenoceptor binding is present in the whole brain, revealing low receptor numbers in most brain regions (up to 1.5 to 2.7 fmol/mg). A slight enrichment was observed in cortical areas (lateral orbital cortex: 4.0 +/- 0.7 fmol/mg) and in the cerebellar molecular layer (8.7 +/- 1.0 fmol/mg). 4. Competition experiments demonstrated high- and low-affinity binding sites with considerable variations in Ki values for CGP20712A, showing that various affinity states of beta 1-adrenoceptors are present in the brain (Ki: 0.61 nM to 67.1 microM). In the hippocampus, only low-affinity beta 1-adrenoceptors were detected (Ki: 1.3 +/- 0.2 microM). Since it is known that 125ICYP labels not only membrane bound but also internalized beta-adrenoceptors, it can be assumed that the large population of the low-affinity sites represents internalized receptors which may be abundant due to a high sequestration rate. 5. High numbers of beta 2-adrenoceptors are present in only a few brain structures of tree shrews (external layer of the olfactory bulb, 15.8 +/- 2.0 fmol/mg; claustrum, 19.3 +/- 1.5 fmol/mg; anteroventral thalamic nucleus, 19.4 +/- 1.5 fmol/mg; cerebellar molecular layer, 55.0 +/- 4.3 fmol/mg). Also for this class of beta-adrenoceptors, high- and low-affinity binding sites for the beta 2-selective antagonist ICI118.551 were observed, indicating that 125ICYP labels membrane bound and internalized beta 2-adrenoceptors. Only in the cerebellar molecular layer was a high percentage of high-affinity beta 2-adrenoceptors detected (Ki for ICI118.551 was 1.8 +/- 0.3 nM for 90% of the receptors). 6. In conclusion, beta 1- and beta 2-adrenoceptor binding can be localized and quantified by in vitro receptor autoradiography in the brains of tree shrews when serotonergic binding sites are blocked. Modulatory effects of long-term psychosocial conflict on the central nervous beta-adrenoceptor system in male tree shrews are described in the following paper.

Activation of carotid baroreceptors inhibits spinal reflexes in man

The present study was designed to investigate the effect of baroreceptors on a spinal reflex. The Achilles tendon reflex (T reflex), a monosynaptic spinal reflex, was chosen as an indicator of descending influences of central activation. The baroreceptors are stretch receptors which respond to extensions of the arterial wall. Carotid sinus baroreceptors can be manipulated non-invasively by means of a cuff around the neck. In this study, the phase-related external suction (PRES) neck cuff technique was used. PRES applies short changes in cuff pressure as a function of heart cycle phase, controlling for non-specific effects found in other baroreceptor manipulation methods. The T reflex was reduced when elicited during the highest levels of baroreceptor activation. Reflex amplitude was largest when elicited during the lowest levels of baroreceptor activation. These results are consistent with previous findings that baroreceptor activation reduces CNS excitability.

PRES: the controlled noninvasive stimulation of the carotid baroreceptors in humans

To study physiological and psychological effects of baroreceptor activity, the cervical neck cuff technique has been frequently used to stimulate the carotid baroreceptors mechanically. Using this technique, no satisfying control conditions to date have been available. Because the carotid stretch receptors are sensitive not only to the pressure level, but also to the rate of change, it is possible to manipulate the receptor firing through changes in carotid pulse amplitude. The device described here relies on the application of short changes in cuff pressure tied to different phases within the cardiac cycle (phase related external suction (PRES)). A brief external suction during systole has potent stimulatory effects on baroreceptors whereas the application of the very same pressure pulse during diastole inhibits the firing burst associated with the pulse wave. To allow an ongoing period of stimulation, a sequence of alternating negative/positive pressure pulses is applied. In the stimulation condition, the R-wave of the electrocardiogram triggers a negative pulse which is followed by a positive one during diastole. In the control condition this relationship is reversed. Two experiments are reported confirming different baroreceptor effects of the two conditions. PRES allows for blind or double-blind experiments to investigate effects of baroreceptor activity on physiology and behavior.