- Email: [email protected]
Role of corticotropin-releasing-factor in anxiety
1568
DIaL. PSYCHIATRY
Psychoneuroendocrinology
1991;42: 15-2975
Orals 60. Psychoneuroendocrinology
160-1 I Hlgh-dose naloxone (1.0 mglkg) psychological and
endocrine effects on the dexamethasone supresslon test In male normal subjects
A.F. Martln-Del-eampo, J. Cortes-Sotres, Karen Herrera-Ferra. Departamento de Psico-Neuroendocrfnolog(a. Instituto Mexicano De Psiquiatria, Mexico The participation of the endogenous oploid system (EOS) In Hypotha• lamic-Pituitary-Adrenal axis (HPA-a) negative feedback mechanisms was Investigated. We studied 10 male healthy subjects on two separate days, In a double-blind, crossover. and placebo-controlled design. All subjects were pretreated with 1.0 mg dexamethasone (Dex) orally the night (23:00 hrs) before both test days. The naloxone (Nal) (1.0 mglkg) or Sal solution (Sal) tV. bolus administration was at 09:00 hrs. Before and following each Infusion, mood was measured by a Visual Analogue Scales (VAS) and by the Allectlve Quality Scale (AQS) at 3O-min intervals, and blood samples taken at 15-mln Intervals. The cortisol plasma levels before Dex were within normal values in all SUbjects. meanwhile the 9-hrs post·Dex cortisol levels showed a significant (>95%, p < 0.01) decrease as expected. There were no Increase in the cortisol plasma levels following Nal nor alter Sal Infu• sions. However. there was a LH naloxone-Induced significant increase (p < 0.01). There were also a mild and selective (cognitive), but significant naloxone-induced dysphoric ellects (p < 0.05). These results suggest that the EOS In not directly Involved in the HPA-a negative feedback mechanisms and that there might be a possible glucocorticoid-opioid interaction in terms of mood modulation.
160-21 HypothalamIc dysfunction In anorexIa nervosa: Study of B-endorphlns plasma levels and cortisol response after CRF stimulation D. Bailly, M.P. Bouvard, J. Bouchez, M. Dugas. Department of Child and Adolescent Psychiatry. CITD. Ulle, France. Department of Child and Adolescent Psyc:hiatry. Robert Debrd Hospital, Paris, France The Involvement of opiate system In the pathophysiology of anorexia nervosa is besed on dillerents arguments such as ellects of opioid agonists on feeding In animals, or clinical similarities between anorexia nervosa and oplold withdrawal (socIal withdrawal, hyperactivity, analgesia). Moreover, oploid antagonist such as naltrexone does normalize LH-RH cyclic release In anorectic patients (Bailly, 1993). Previous studies do not found consistent data about levels of endorphins In plasma or In CSF. We have performed a study In 35 anorectic adolescent lemales at admission and alter short term-recovery (mean age: 15.6 years). All patients were assessed on clinical and blological parameters. In a first time basal plasma leVels of Jj-endorphlns and ACTH were analysed. Blood samples were drewn at 81n the momlng. We used RIA methods (INCSTAR
160-31 Is weight responsible for the
hypothalamlc-pituitary-adrenal axis dlsregUlation In anorexia nervosa?
J.P. Kahn. M.J. Gross, J.P. Nicolas, C. Burtel Department of Psychiatry CHU de NANCY, H6pital Jeanne d'Arc 54201 TOUL-Francs and INSERAI U 308, 38. rue Uonnois 54000 NANCY, Francs Underweight status and central mechanisms have both been considered to contribute to the hypothalamlc-pituitary-adrenal (HPA) axis disregulation, observed In Anorexia Nervosa. The aim of this study was to evaluate 1he specific role of body weight on the HPA functioning In Anorexia NeNosa. Therefore, we compared patients meeting DSM-III R criteria for Anorexia Nervosa (AN: n = 9) with age-matched female normal Volunteers (NV: n • t1) and underweight volunteers (UV: n = 10). The dlumal cycle CIt conisoI and the response to a betamethasone suppression test (BST) were studied HPA axis function was assessed by a radioimmunoassay of salivary COltisol. Anorectic patients exhibIted higher basal cortisol values, as CXlmpar8d 10 both UV and NV SUbjects. In contrast, no difference in basaJ salivary c::ortisoI could be observed between underweIght and normal weight volunteers. Alter betamethasone, UVand NV SUbjects had decreased salivary c::ortisoI levels. In these two groups, retum to basal values was observed aI'ler 39 hours. In anorectic patients, salivary cortisol levels remained higher alter BST and an earty escape could be observed. These results IUggest that, In Anorexia Nervosa, weight alone cannot account for the aI:lnonnaI hypothalamic-pituitary-adrenal function.
160-41 SelectIve hormone replacement In hypothyroidism: Maintenance mood R. Bunevlcius,', A.J. Prange 2. 'Instituts of Endocrinology, Kaunas, Uthuania, 2 The Unlversify of North carolina at Chapel Hi". USA
The efficacy of thyroid hormone replacement with L-thyroxine (Td and With. mixture of T4 and L-trilodothyronine (T.-T3) was investigated In I1ypothyn;Nd patients. Methods: Twenty-one patients (eight with late stage autoimmune 1tly• roiditis; 13 with surgical thyroid ablation and radioiodine therapy for thyrtllCS cancer) completed a 10 week study. In a cross-over, double-blind design patients received T4 or a dose of T4-T3 of equal metabolic potency. AI. patients received each regimen. randomly assigned, for five weeks. Results: Thyroid stimulating hormone (TSH) levels were nearly identical II the end of the two treatment conditions, indicating that piluitaly &uppression and thus the metabolic activity of tha two treatments was, in fact, about 8qUaI. Global scores on the Profile of Mood States (POMS) (P .0.016) and POUS depression-dejection and fatigue-inertia lactors were significantly lower II the end of the T4-T3 condition (p 0.004 and P 0.006, respectively). Conclusion: Replacement with T4 alone may not be suffICient for mairlle• nance of mood. T3 appears to be a useful addition to the usual T 4 regimen.
=
=
160-51 Role of corticotropin-releasIng-factor In anxiety D. Servant. Anxiefy Unit, University Hospital, Lills, France Recently the neuropeplide Corticotroping Releasing Factor (eRF) has been hypothesized to play a role In the pathophysiology of anxiety. Precrlllical study Indicate that CRF produces a number of behavioral effects COITlmonIy seen In anxiety. Most of the evidence supporting CRF hyperactivity In patients with anxiety disorders is Indirect. Methods: In order to check this hypothesis. we have studied pIasrna cortisol and ACTH responses to the stimulation by ovine CRF (o-<:RF) In patients with Panic Disorder (PO) and Obsessive Compulsive Disorder (OCD).
Results: In patients with PO or OCD, the CRF stimulation test resufls In a blunted ACTH response, suggesting a hyperactive HPA axis. HPA dysfunction found in some patients with Panic Disorder but not in all cases. More direct studies are needed in patients with anxiety disorders to 8lcpI(:n the hypothesis of HPA axis hyperactivity resulting from an lncreasa 01 CRF secretion.
DIaL. PSYCHIATRY
Psychoneuroendocrinology
1991;42: 15-2975
Orals 60. Psychoneuroendocrinology
160-1 I Hlgh-dose naloxone (1.0 mglkg) psychological and
endocrine effects on the dexamethasone supresslon test In male normal subjects
A.F. Martln-Del-eampo, J. Cortes-Sotres, Karen Herrera-Ferra. Departamento de Psico-Neuroendocrfnolog(a. Instituto Mexicano De Psiquiatria, Mexico The participation of the endogenous oploid system (EOS) In Hypotha• lamic-Pituitary-Adrenal axis (HPA-a) negative feedback mechanisms was Investigated. We studied 10 male healthy subjects on two separate days, In a double-blind, crossover. and placebo-controlled design. All subjects were pretreated with 1.0 mg dexamethasone (Dex) orally the night (23:00 hrs) before both test days. The naloxone (Nal) (1.0 mglkg) or Sal solution (Sal) tV. bolus administration was at 09:00 hrs. Before and following each Infusion, mood was measured by a Visual Analogue Scales (VAS) and by the Allectlve Quality Scale (AQS) at 3O-min intervals, and blood samples taken at 15-mln Intervals. The cortisol plasma levels before Dex were within normal values in all SUbjects. meanwhile the 9-hrs post·Dex cortisol levels showed a significant (>95%, p < 0.01) decrease as expected. There were no Increase in the cortisol plasma levels following Nal nor alter Sal Infu• sions. However. there was a LH naloxone-Induced significant increase (p < 0.01). There were also a mild and selective (cognitive), but significant naloxone-induced dysphoric ellects (p < 0.05). These results suggest that the EOS In not directly Involved in the HPA-a negative feedback mechanisms and that there might be a possible glucocorticoid-opioid interaction in terms of mood modulation.
160-21 HypothalamIc dysfunction In anorexIa nervosa: Study of B-endorphlns plasma levels and cortisol response after CRF stimulation D. Bailly, M.P. Bouvard, J. Bouchez, M. Dugas. Department of Child and Adolescent Psychiatry. CITD. Ulle, France. Department of Child and Adolescent Psyc:hiatry. Robert Debrd Hospital, Paris, France The Involvement of opiate system In the pathophysiology of anorexia nervosa is besed on dillerents arguments such as ellects of opioid agonists on feeding In animals, or clinical similarities between anorexia nervosa and oplold withdrawal (socIal withdrawal, hyperactivity, analgesia). Moreover, oploid antagonist such as naltrexone does normalize LH-RH cyclic release In anorectic patients (Bailly, 1993). Previous studies do not found consistent data about levels of endorphins In plasma or In CSF. We have performed a study In 35 anorectic adolescent lemales at admission and alter short term-recovery (mean age: 15.6 years). All patients were assessed on clinical and blological parameters. In a first time basal plasma leVels of Jj-endorphlns and ACTH were analysed. Blood samples were drewn at 81n the momlng. We used RIA methods (INCSTAR
160-31 Is weight responsible for the
hypothalamlc-pituitary-adrenal axis dlsregUlation In anorexia nervosa?
J.P. Kahn. M.J. Gross, J.P. Nicolas, C. Burtel Department of Psychiatry CHU de NANCY, H6pital Jeanne d'Arc 54201 TOUL-Francs and INSERAI U 308, 38. rue Uonnois 54000 NANCY, Francs Underweight status and central mechanisms have both been considered to contribute to the hypothalamlc-pituitary-adrenal (HPA) axis disregulation, observed In Anorexia Nervosa. The aim of this study was to evaluate 1he specific role of body weight on the HPA functioning In Anorexia NeNosa. Therefore, we compared patients meeting DSM-III R criteria for Anorexia Nervosa (AN: n = 9) with age-matched female normal Volunteers (NV: n • t1) and underweight volunteers (UV: n = 10). The dlumal cycle CIt conisoI and the response to a betamethasone suppression test (BST) were studied HPA axis function was assessed by a radioimmunoassay of salivary COltisol. Anorectic patients exhibIted higher basal cortisol values, as CXlmpar8d 10 both UV and NV SUbjects. In contrast, no difference in basaJ salivary c::ortisoI could be observed between underweIght and normal weight volunteers. Alter betamethasone, UVand NV SUbjects had decreased salivary c::ortisoI levels. In these two groups, retum to basal values was observed aI'ler 39 hours. In anorectic patients, salivary cortisol levels remained higher alter BST and an earty escape could be observed. These results IUggest that, In Anorexia Nervosa, weight alone cannot account for the aI:lnonnaI hypothalamic-pituitary-adrenal function.
160-41 SelectIve hormone replacement In hypothyroidism: Maintenance mood R. Bunevlcius,', A.J. Prange 2. 'Instituts of Endocrinology, Kaunas, Uthuania, 2 The Unlversify of North carolina at Chapel Hi". USA
The efficacy of thyroid hormone replacement with L-thyroxine (Td and With. mixture of T4 and L-trilodothyronine (T.-T3) was investigated In I1ypothyn;Nd patients. Methods: Twenty-one patients (eight with late stage autoimmune 1tly• roiditis; 13 with surgical thyroid ablation and radioiodine therapy for thyrtllCS cancer) completed a 10 week study. In a cross-over, double-blind design patients received T4 or a dose of T4-T3 of equal metabolic potency. AI. patients received each regimen. randomly assigned, for five weeks. Results: Thyroid stimulating hormone (TSH) levels were nearly identical II the end of the two treatment conditions, indicating that piluitaly &uppression and thus the metabolic activity of tha two treatments was, in fact, about 8qUaI. Global scores on the Profile of Mood States (POMS) (P .0.016) and POUS depression-dejection and fatigue-inertia lactors were significantly lower II the end of the T4-T3 condition (p 0.004 and P 0.006, respectively). Conclusion: Replacement with T4 alone may not be suffICient for mairlle• nance of mood. T3 appears to be a useful addition to the usual T 4 regimen.
=
=
160-51 Role of corticotropin-releasIng-factor In anxiety D. Servant. Anxiefy Unit, University Hospital, Lills, France Recently the neuropeplide Corticotroping Releasing Factor (eRF) has been hypothesized to play a role In the pathophysiology of anxiety. Precrlllical study Indicate that CRF produces a number of behavioral effects COITlmonIy seen In anxiety. Most of the evidence supporting CRF hyperactivity In patients with anxiety disorders is Indirect. Methods: In order to check this hypothesis. we have studied pIasrna cortisol and ACTH responses to the stimulation by ovine CRF (o-<:RF) In patients with Panic Disorder (PO) and Obsessive Compulsive Disorder (OCD).
Results: In patients with PO or OCD, the CRF stimulation test resufls In a blunted ACTH response, suggesting a hyperactive HPA axis. HPA dysfunction found in some patients with Panic Disorder but not in all cases. More direct studies are needed in patients with anxiety disorders to 8lcpI(:n the hypothesis of HPA axis hyperactivity resulting from an lncreasa 01 CRF secretion.