Folia psychiatrica et neurologica japonica最新文献

In order to examine the serotonin metabolism in children with attention deficit disorder (ADD), plasma tryptophan, which is the precursor of serotonin, was measured in 10 children with ADD and 12 normal children. The mean plasma total tryptophan level in the children with ADD was not significantly different from that of the normal children. The mean plasma free tryptophan level in the children with ADD was significantly higher than that in the normal children. There tended to be a positive correlation between the plasma free tryptophan level and the Werry-Weiss-Peters Activity Scale in children with ADD. In other words, the more severe the hyperactivity of ADD, the higher the plasma free tryptophan level. The mean ratio of plasma free to total tryptophan levels in the children with ADD was significantly higher than that in the normal children, which means that the children with ADD showed a high amount of free tryptophan in the total tryptophan level. These results suggest that there might be some disturbance in the tryptophan-serotonin metabolism in the brain of a child with ADD.

Two cases of circumscribed hypochondriasis were reported. Although the syndrome did not seem so rare, these cases were worthy of reporting in the following sense. In spite of the general opinion that the syndrome appeared in the middle age, the onset in our patients was in the young adult age, namely one at 25 and the other at 35, respectively. While the course of the syndrome is said to be chronic, our patients indicated a fairly favorable prognosis. The psychodynamics of the syndrome in our cases was discussed chiefly from the psychoanalytic point of view, and finally the similarity among the related syndromes was considered.

Expectancy-related and nonexpectancy-related cerebral potentials associated with stimuli and omitted stimuli were recorded in 7 normal subjects. The stimuli were constantly delivered to the right median nerve and the interstimulus interval was set at 7 seconds. When the subject counted to estimate the interstimulus interval correctly, a slow negative deflection appeared about one second prior to both the stimuli and the omitted stimuli. In the case of the omitted stimulus, this expectancy-related negative potential (ENP) returned to the base line after several hundred msec. When the stimuli were delivered, the amplitude of the P300 was much higher when the subject was paying attention to the stimuli than when he was not. The scalp distribution of the ENP was rather anterior to the P300. No ENP appeared when the subject was not paying attention to the stimuli or the omitted stimuli, or when the stimuli were delivered at a random rate.

A clinical and electroencephalographic study was undertaken on 215 children with complex partial seizures as selected on the basis of the International Classification of Epileptic Seizures (1981). Complex partial seizures were noted in 7.8% of the epileptic children. The ictal symptoms of complex partial seizures closely resembled those of psychomotor triad described by Lennox. Interictal EEG revealed seizure discharges from the temporal or frontal focus in 57.2%. There existed a group with automatism as a main symptom having both diffuse slow spike-waves and focal temporal spikes. This type should be interpreted to be one of secondary generalized epilepsies and be a variant of the Lennox syndrome.

The development of background activities of cortical EEG in El mouse, the seizure susceptible mutant strain of ddN mouse, were investigated. Furthermore, it was compared to that of the ddN control mouse. The average peak frequency of EEG background activity was much slower than that of the ddN mouse. After seizures in the El mouse were completed, the average energy distribution rates of the main frequency band, theta band, have decreased because of an increase in the delta band compared to those in seizure-free periods (the 5th to 8th week).

Few studies on schizophrenia with respect to the circadian alteration of the sleep-wake rhythm have been reported. We made a comparative study of the sleep-wake rhythm between chronic inpatient schizophrenics with a relatively bed-prone daily life and normal subjects under the conditions of absolute bed-rest to elucidate the chronobiological features of schizophrenia. The sleep-wake rhythm of the schizophrenics differed from that of the normals in two points: A significant difference was observed in the decrease of Stage 4 during their nocturnal sleep compared with the normal subjects, becoming conspicuous with the increasing lapse of time during sleep. The distribution and amount of their REM sleep in the morning were markedly low and the latency of their REM sleep was also prolonged. These facts suggested that the smooth slide of the sleep-wake rhythm was somewhat disturbed in the schizophrenics and that they were, therefore, in a state of hyperarousal despite their bed-prone life.

Possible factors affecting the seizure frequency during pregnancy and puerperium were prospectively studied on 125 cases, paying particular attention to the drug compliance and the antiepileptic drug disposition. Of the subjects, 27% were under the poor compliance category. As the reasons for the poor compliance, anxiety about the side effects of antiepileptic drugs including teratogenecity and the harmful effects on their newborns by breast feeding were found in about half of them. In the cases with regular drug taking, 80% showed no change in the seizure frequency whereas only 16% exhibited an increase and 4% a decrease. The apparent serum clearance of phenytoin, primidone, phenobarbitone derived from primidone and valproic acid increased during pregnancy and puerperium. In some cases, the lowering of the serum level of drugs was associated with the aggravation of seizures.

A prospective study of EEG changes following metrizamide myelography was made on 34 patients aged 17-79 years. EEGs were recorded just before and 22-26 hours after myelography. Usually 8-10 ml of metrizamide was injected by either lumbar or lateral cervical puncture. The concentration of metrizamide was relatively high. EEGs were abnormal in 15 out of the 20 patients whose baseline EEGs were normal. EEGs deteriorated in 10 of the 14 patients whose control tracings were abnormal. High voltage delta activity and/or a great deal of theta activity were common abnormalities. Three patients showed triphasic waves. No relationships were found between the EEG changes and clinical variables. But central nervous system involvements by metrizamide tended to be accompanied by a severe EEG slowing.

The discussion here is about the direct relationship of epileptic seizures to episodic psychotic states. The episodic psychotic states were divided into three groups: interictal, ictal and postictal. In each group, one representative case was described and the neurophysiological pathogenesis discussed according to a recent research, mainly depth-electrode findings. It is believed that: interictal psychotic state--limbic paroxysmal discharges play an important role in its pathogenesis, according to the theory of Geschwindt and others; ictal psychotic state--repetitive auras develop to the psychotic state, and aura continua itself can be described as a psychotic state; and postictal psychotic state--the increased limbic discharges might be responsible for the psychotic state. The common neurophysiological cause in all the three groups is due to the increased epileptic discharges in the limbic system. It is concluded that the episodic psychotic states in temporal lobe epilepsies are possibly of an epileptic nature in themselves.

The platelet monoamine oxidase (MAO) activities in alcoholism and schizophrenia were investigated by means of simultaneous determination, using beta-phenyl-ethylamine, tryptamine and serotonin as substrates. No significant difference was found between the MAO levels in the alcoholic and schizophrenic groups, when tryptamine was used as a substrate, but both groups showed lower values than the controls. On the other hand, beta-phenylethylamine, a specific substrate for MAO B used as a substrate, showed no significant difference between the alcoholic and control groups in the activities. These two groups showed higher values in MAO activity than the schizophrenic group, whereas when MAO activity was estimated using serotonin, platelet enzyme was found to be inhibited significantly in alcoholism, and the level of activities in the schizophrenics was similar to that of the controls. Moreover, the beta-phenylethylamine inhibition curve obtained serotonin as the substrate in the pooled platelets of 50 normal human subjects, and the MAO activity could not be inhibited by higher concentrations than the Km value of serotonin. These findings suggested that there might be two interacting catabolic sites having different substrate affinities in blood platelet MAO. Thus, it could be speculated that serotonergic catabolic sites of MAO in the platelets are disturbed in the alcoholics, while beta-phenylethylaminergic catabolic sites of platelet MAO are inherently vulnerable in schizophrenia.