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p2 component as predictor of clinical response to serotonin agonists in patients with affective disorders
Abstracts
/International
Journal
ment was accompanied by a disappearance of this difference. Moreover, the CNV amplitude was normalized, compared with the day before treatment when the patient presented a high level of anhedonia. Thus, this paradigm seems to provide a sensitive measure of the cognitive expression of anhedonia. These preliminary results, which will be completed by the healthy anhedonic subjects data, tend to show that, from a cognitive level, anhedonia is related to an attentional loss, expressed in effortful situations.
439 TESTING AUTONOMIC FUNCTIONS UNDER THE CONDITION OF TREATMENT WITH PSYCHOTROPIC DRUGS M Muck-Weymann* , T Rechlin, P Joraschky Dept. of Psychosomatic Medicine, Dresden University of Technology, FetscherstraBe 74, D-01307 Dresden, Germany Cutaneous microcirculation, skin conductance and heart rate variation were investigated in patients treated with amitriptyline (n = 25), fluoxetine (n = 251, or hypericum extract (n = 25). As a standardized test a short sympathetic activation-induced by a voluntary deep inspiration - was evaluated. In normal controls this manoeuvre leads to a short vasoconstrictor episode (VCE) and to a short episode of increased perspiration (PE). Additionally we investigated heart rate variability (HRV) parameters during rest and during hyperventilation. In patients treated with amitriptyline we found reduced HRV parameters, a significant prolonged redilation phase of VCE, and in 70% of the patients a complete loss of PE. In fluoxetine treated patients we found no changes in HRV parameters, or in VCEs, while the duration of PE was somewhat shortened (not significant). In patients treated with hypericum extract no changes could be observed in HRV and in VCE. However, in about 70% of patients the amplitude of PE was reduced. Our tindings demonstrate autonomic disfunctions under treatment with psychotropic drugs. Autonomic functions were influenced most in patients treated with amitriptyline, and less under treatment with fluoxetine or with hypericum extract. Evaluation of different receptor profiles of drugs may lead to a better understanding of the impact of psychotropic drugs on autonomic fun&ions. The described autonomic tests may be also a helpful tool in clinical practice, identifying individual risks in psychiatric patients for getting (potentially) mortal dangerous autonomic dysfunctions under drug treatment (e.g. sudden heart death).
440 LOUDNESS DEPENDENCE OF AUDITORY EVOKED Nl/P2 COMPONENT AS PREDICTOR OF CLINICAL RESPONSE TO SEROTONIN AGONISTS IN PATIENTS WITH AFFECTIVE DISORDERS
of Psychophysiology
30 (1998)
169
95-271
J. Gallinat*, P. Mavrogiorgou, G. Juckel, T. Frodl-Bauch, A. Munke, R. Bottlender, H.-J. Moeller, U. Hegerl Psychiatrische Klinik der LMU Miinchen, 80336 Germany OBJECTIVE: Both preclinical and clinical studies indicate that the dependence of the auditory evoked potentials (AEP) on stimulus loudness is negatively related to central serotonergic neurotransmission and may be useful as predictor of clinical response to serotonin agonists. The hypothesis is tested that a strong loudness dependence of the AEP, which reflects low serotonergic function, is related to a favorable clinical response to serotonin agonists in patients with affective disorders. METHOD: SSRI responders (50% decrease in Hamilton Depression Score after 4 weeks) and responders to preventive lithium treatment (no recurrence with hospitalisation during lithium medication in the last 4 years) were compared to the corresponding nonresponders. AEP to stimuli with different intensities were recorded (32 channels). Using dipole source analysis, the loudness dependence of the tangential Nl/P2-dipole activity was calculated. RESULTS: Responders to preventive lithium treatment as well as depressed patients responding to SSRI were characterised by a significantly stronger loudness dependence. CONCLUSION: The loudness dependence of the AEP can give clinically relevant information concerning the response probability to serotonin agonists in the individual patient. The underlying mechanisms will be discussed in detail.
441 PSYCHOPHYSIOLOGICAL SCHIZOPHRENIC DELUSION Vladimir Ivanov* Medical University-Sofia, 26, Sofia 1606, Bulgaria
BASES
OF
I Psychiatric Clinic, Blvd “Praga”
In order to explain the psychic processes through material dependences, the author employed 7 original methods of his own and has modified some other methods. The most important of the author’s own methods is formation of a conditionconditioned connection through conceptual generalization of a group of verbal signals. This method is regarded as a physiological model of the most frequent logical operation-the inductive conclusion or as a method of “artificial” formation of concepts. The results of our investigations show, that the pathophysiological basis of the schizophrenic delusion is the reduction of the functional ability of the cerebral cortex, which manifests itself in an incorrect formation of new temporary connections. The originating hypnotic phases determine a peculiar phasic reactivity: the superior, more essential connections are inhibited and inferior, less essential connections come into area of optimum excitability. As a result of quick exhaustion and the
/International
Journal
ment was accompanied by a disappearance of this difference. Moreover, the CNV amplitude was normalized, compared with the day before treatment when the patient presented a high level of anhedonia. Thus, this paradigm seems to provide a sensitive measure of the cognitive expression of anhedonia. These preliminary results, which will be completed by the healthy anhedonic subjects data, tend to show that, from a cognitive level, anhedonia is related to an attentional loss, expressed in effortful situations.
439 TESTING AUTONOMIC FUNCTIONS UNDER THE CONDITION OF TREATMENT WITH PSYCHOTROPIC DRUGS M Muck-Weymann* , T Rechlin, P Joraschky Dept. of Psychosomatic Medicine, Dresden University of Technology, FetscherstraBe 74, D-01307 Dresden, Germany Cutaneous microcirculation, skin conductance and heart rate variation were investigated in patients treated with amitriptyline (n = 25), fluoxetine (n = 251, or hypericum extract (n = 25). As a standardized test a short sympathetic activation-induced by a voluntary deep inspiration - was evaluated. In normal controls this manoeuvre leads to a short vasoconstrictor episode (VCE) and to a short episode of increased perspiration (PE). Additionally we investigated heart rate variability (HRV) parameters during rest and during hyperventilation. In patients treated with amitriptyline we found reduced HRV parameters, a significant prolonged redilation phase of VCE, and in 70% of the patients a complete loss of PE. In fluoxetine treated patients we found no changes in HRV parameters, or in VCEs, while the duration of PE was somewhat shortened (not significant). In patients treated with hypericum extract no changes could be observed in HRV and in VCE. However, in about 70% of patients the amplitude of PE was reduced. Our tindings demonstrate autonomic disfunctions under treatment with psychotropic drugs. Autonomic functions were influenced most in patients treated with amitriptyline, and less under treatment with fluoxetine or with hypericum extract. Evaluation of different receptor profiles of drugs may lead to a better understanding of the impact of psychotropic drugs on autonomic fun&ions. The described autonomic tests may be also a helpful tool in clinical practice, identifying individual risks in psychiatric patients for getting (potentially) mortal dangerous autonomic dysfunctions under drug treatment (e.g. sudden heart death).
440 LOUDNESS DEPENDENCE OF AUDITORY EVOKED Nl/P2 COMPONENT AS PREDICTOR OF CLINICAL RESPONSE TO SEROTONIN AGONISTS IN PATIENTS WITH AFFECTIVE DISORDERS
of Psychophysiology
30 (1998)
169
95-271
J. Gallinat*, P. Mavrogiorgou, G. Juckel, T. Frodl-Bauch, A. Munke, R. Bottlender, H.-J. Moeller, U. Hegerl Psychiatrische Klinik der LMU Miinchen, 80336 Germany OBJECTIVE: Both preclinical and clinical studies indicate that the dependence of the auditory evoked potentials (AEP) on stimulus loudness is negatively related to central serotonergic neurotransmission and may be useful as predictor of clinical response to serotonin agonists. The hypothesis is tested that a strong loudness dependence of the AEP, which reflects low serotonergic function, is related to a favorable clinical response to serotonin agonists in patients with affective disorders. METHOD: SSRI responders (50% decrease in Hamilton Depression Score after 4 weeks) and responders to preventive lithium treatment (no recurrence with hospitalisation during lithium medication in the last 4 years) were compared to the corresponding nonresponders. AEP to stimuli with different intensities were recorded (32 channels). Using dipole source analysis, the loudness dependence of the tangential Nl/P2-dipole activity was calculated. RESULTS: Responders to preventive lithium treatment as well as depressed patients responding to SSRI were characterised by a significantly stronger loudness dependence. CONCLUSION: The loudness dependence of the AEP can give clinically relevant information concerning the response probability to serotonin agonists in the individual patient. The underlying mechanisms will be discussed in detail.
441 PSYCHOPHYSIOLOGICAL SCHIZOPHRENIC DELUSION Vladimir Ivanov* Medical University-Sofia, 26, Sofia 1606, Bulgaria
BASES
OF
I Psychiatric Clinic, Blvd “Praga”
In order to explain the psychic processes through material dependences, the author employed 7 original methods of his own and has modified some other methods. The most important of the author’s own methods is formation of a conditionconditioned connection through conceptual generalization of a group of verbal signals. This method is regarded as a physiological model of the most frequent logical operation-the inductive conclusion or as a method of “artificial” formation of concepts. The results of our investigations show, that the pathophysiological basis of the schizophrenic delusion is the reduction of the functional ability of the cerebral cortex, which manifests itself in an incorrect formation of new temporary connections. The originating hypnotic phases determine a peculiar phasic reactivity: the superior, more essential connections are inhibited and inferior, less essential connections come into area of optimum excitability. As a result of quick exhaustion and the