Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We evaluated the long-lasting effects of systemic high-dose recombinant interferon alpha-2a (rIFNA) in relapsing-remitting (RR) MS after discontinuing treatment in a single-blind randomized placebo-controlled trial with 20 RR clinically definite MS patients using either nine million IU intramuscular rIFNA (n = 12) or placebo (n = 8) every other day for 6 months. Follow-up continued for a further 6 months without IFN treatment. In rIFNA-treated patients, main outcome measures, significantly different from placebo during treatment, returned, after discontinuing treatment, to values similar to placebo or baseline. Active MRI lesions per patient increased from 0.08 +/- 0.08 to 1.2 +/- 0.4 (p < 0.02), number of patients with clinical MRI signs of disease activity from 2 of 12 to 8 to 12 (P < 0.04), lymphocyte IFN gamma production from 3.0 +/- 0.7 to 12.4 +/- 2.2 IU/mL (p < 0.01), lymphocyte tumor necrosis factor alpha production from 5.8 +/- 0.9 to 18.9 +/- 6.3 pg/mL (p < 0.05). All side effects of rIFNA treatment disappeared after discontinuing the drug. The reduction of clinical MRI signs of disease activity and the immunologic effects were temporary and restricted to the period of rIFNA administration. The depression of many immunologic and clinical MRI responses during drug administration and their simultaneous return to baseline after discontinuing the drug strongly argue all observed changes were related to drug administration.
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PMID:Interferon alpha-2a treatment of relapsing-remitting multiple sclerosis: disease activity resumes after stopping treatment. 871 65

Animal studies have demonstrated that renal MR contrast enhancement depends on the timing of image acquisition. Limited human studies have demonstrated effects of dipyridamole (DP) on total renal perfusion. This study assessed the effect of DP on total and regional renal perfusion using gated perfusion MRI for patients undergoing DP stress. Five subjects with no evidence of renal ischemia were examined at rest and after DP stress. Rest MRI images in the left kidney were acquired using electrocardiogram (ECG)-gated MR: turbo fast low-angle shot (FLASH); echo time (TE) = 12, repetition time (TR) = 6, flip angle = 12, inversion time (TI) = 100) 10 to 45 seconds after injection of gadopentetate dimeglumine. Stress was induced in the MRI scanner (DP, .56 mg/kg over 4 minutes) followed by stress MRI after a second bolus of gadopentetate dimeglumine in the same position and identical time intervals. MR signal in the whole left kidney and renal medulla and cortex pre- and post-DP demonstrated a 70% depression of total renal perfusion with relative preservation of cortical perfusion at the expense of medullary perfusion. Post-DP MR images demonstrated a decrease in cortical perfusion with an additional 29% depression of medullary perfusion (P < .001) with respect to cortical perfusion. Turbo FLASH MRI can provide adequate time and spatial resolution to demonstrate changes in renal perfusion. Depression of renal medullary perfusion after DP appears to be caused by the intrarenal effect of DP and may have clinical impact.
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PMID:MR perfusion imaging of the kidney pre- and post-dipyridamole stress. 872 11

Neuroimaging in anorexia nervosa has revealed morphological and functional alterations, most of which are currently interpreted as consequences of the anorectic state that are reversible, at least partially, after weight gain. Enlargement of CSF spaces, mainly of cortical sulci, is evident on CT and MRI. This reversible shrinkage of brain tissue ("pseudoatrophy") also affects the pituitary gland. A functional imaging study with positron emission tomography (PET) revealed caudate hyperactivity during the anorectic state, and several mild right-left asymmetries possibly related to alterations of mental state (vigilance, depression, etc.) have also been reported in bulimia nervosa. New aspects may be added, when techniques to image functional brain activation during specific tasks and regional receptor binding capacities are used to study anorexia nervosa.
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PMID:Neuroimaging in anorexia nervosa. 952 6

We described a 67-year-old right handed man with a left internal carotid artery occlusion, who developed monocular photopsia that supervened neovascular glaucoma. He had an antecedent transient motor aphasia. His photopsia, exaggerated by light, persisted intermittently. Orbital bruit was obtained on the left, more clearly during the photopsia. Brain MRI, cerebral angiography, and duplex sonography of carotid and ophthalmic arteries indicated left internal carotid artery (ICA) occlusion with collateral circulation through the ophthalmic artery. Visual evoked potentials (VEPs) revealed a prechiasmal disturbance of the optic pathway of the left side. The patient had carotid endarterectomy of the left ICA, and his visual disturbance has gradually improved. Ocular symptoms due to ICA ischemia are commonly transient visual loss with dark background known as amaurosis fugax. Neovascular glaucoma is sometimes complicated with carotid artery occlusion. However, photopsia associated with carotid artery occlusion is rare. Photopsia mimics scintillating scotomata, but the latter precedes migraine and is biocular and homonymous, ascribable to spreading depression from the occipital lobe. Retinal or prechiasmal optic pathway might be influenced by poor circulation of the ophthalmic artery. In addition, disturbance of light adaptation due to retinal hypoperfusion may be possible reason. Neovascular glaucoma is intractable, once developed. Therefore, atypical scintillating visual disturbance must be recognized as a sign of carotid artery insufficiency and supervened glaucoma to prevent it.
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PMID:[Monocular photopsia preceding with neovascular glaucoma due to internal carotid artery occlusion; a case report]. 874 54

There are several new magnetic resonance (MR) technologies, which will provide data about the pathogenesis, circulatory state and cellular effects of ischemic stroke. Among them, diffusion MRI is the most promising one. This technology clearly reveals, within minutes of stroke onset, ischemic lesions which ultimately progress to infarct. The early ischemic lesions demonstrated by diffusion MRI represent regions with slower water diffusions perhaps due to intracellular water accumulation or shrinkage of the extracellular spaces resulting from ionic pump failure, spreading depression, or other mechanisms. The diffusion MRI can show not only irreversible but also reversible ischemic lesions, and therefore has a potential to discriminate salvageable tissues from irreversibly damaged tissues before a therapeutic intervention with thrombolytic and/or cytoprotective agents. The diffusion MRI can highlight only a fresh lesion, because water diffusion is decreased during several days after stroke onset. Diffusion MRI is extremely prone to motion artifacts, a major concern against clinical application. This problem can be solved by combination with an ultrafast technique, echo planar (EP) imaging. The EP diffusion MRI will become a rapid, reliable, objective and essential emergency diagnostic test in a clinical setting that will guide the development and application of acute therapeutic intervention.
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PMID:[Diffusion MRI for evaluating cerebrovascular disease]. 875 68

Brain imaging has become an integral part of the evaluation of neurological and psychiatric disorders. Functional imaging techniques, SPECT and PET, together with structural modalities, CT and MRI, are widely employed. Functional imaging studies are routinely used in the diagnostic workup of patients with well-characterized neurological disorders, such as epilepsy and brain tumors, and have a growing role in research on psychiatric disorders without known mechanisms such as depression and schizophrenia. Furthermore, many well-defined neurological disorders manifest prominent psychiatric symptomatology which may pose difficulties in differential diagnosis. This review addresses the current knowledge of SPECT findings in patients who present with psychiatric phenomena, associated with disorders at the interface of neurology and psychiatry.
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PMID:Brain SPECT imaging of neuropsychiatric disorders. 877 8

In clinical practice, Alzheimer's disease (AD), multi-infarct Dementia (MID) and depression are often difficult to differentiate and may coexist. This study reports the findings of CT and MRI focused on hippocampal atrophy (HA). Quantitative volumetric MRI measurements of the hippocampus showed a reduced volume in AD patients compared to normal controls with no overlap. CT studies reported a significant widening of the hippocampal fissure in AD patients. Because volumetric measurements are not available for routine examinations, so far we are required to use the finding of hippocampal lucency in CT and dilatation of the directly visible hippocampal fissure in coronal MRI scans as criteria for HA. These findings were visually classified on a 4-point scale by 2 neuroradiologists, who had no knowledge of the clinical diagnosis. The examinations of 80 patients (42 with AD, 22 with major depression, 3 with MID, 6 classified as age-associated memory impairment (AAMI) and 8 'normals' with only subjective memory impairment) showed that the HA strongly supports the diagnosis of AD, by correctly identifying 95% of the AD patients and 47.8% of the patients without AD. These results suggest that CT and MRI examinations of the hippocampus are capable of demonstrating HA in clinical practice, which is strongly correlated with the diagnosis of AD.
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PMID:Atrophy of hippocampus in patients with Alzheimer's disease and other diseases with memory impairment. 883 80

To investigate influence of social activity on normal brain aging, we studied the social activity score, cognitive functions, self-rating depression scale, cerebral blood flow (CBF), MRI and motor function in the normal elderly people living in different social environments. There was no difference in risk factors for stroke, MRI findings and CBF between the two groups. However, the subjects living in a home for elderly showed significantly lower social activities than those living with families. Cognitive functions and motor function were lower, and SDS was higher in subjects living in retirement house than those living with families. The social environment including social activities closely related to life style may significantly influence brain aging with regard to silent brain infarctions or risk factors for stroke.
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PMID:[Influence of social environments on brain aging]. 886 22

We here describe two patients with empty sella syndrome who had variable and abnormal ACTH and cortisol secretory profiles. The patients are a 58-year old male and a 41-year old female, both of whom were neurotic. In both cases, low-dose dexamethasone suppression tests (1 mg, p.o., overnight) caused variable responses, such as a paradoxical increase, insufficient decrease or normal decrease in ACTH and cortisol depending on the period when they were performed. The circadian rhythm of ACTH and cortisol also showed variable patterns. Abdominal CT showed slight enlargement of both adrenal glands. Adrenal scintigraphy after dexamethasone suppression (3 mg, p.o., 7 days) revealed uptake into both adrenal glands. MRI of the brain indicated empty sella, but failed to show evidence of pituitary adenoma. It remains to be elucidated whether these secretory profiles of ACTH and cortisol in the two cases are only to be regarded as secondary changes associated with neurosis, as reported in depression or alcoholism, or the two cases share some pathogenetic mechanism with cyclic Cushing disease.
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PMID:Two cases of empty sella syndrome with variable dexamethasone-suppressibility of ACTH and cortisol. 893 May 30

The long-term neuropsychological and psychiatric sequelae of herpes simplex virus encephalitis (HSVE) and their relationship to the volume of temporal lesions and to amygdala and hippocampus damage remain undefined. We have conducted a prospective study of long-term sequelae in 11 patients with clinically presumed HSVE and detection of HSV DNA in the cerebrospinal fluid by polymerase chain reaction. Six months after encephalitis, patients underwent neuropsychological and language assessment. At the same stage, single photon emission computed tomography (SPECT) evaluated the occurrence of hypoperfusion with an index of asymmetry. MRI was used for the measurement of amygdala, hippocampus and cerebral lesions by two blind neurologists. The volume of the amygdala and hippocampus was compared with those of five controls, matched for age and level of education. Long-term memory disorders were seen in 6 patients, associated with the larger lesions and damage of at least two structures. Long-term behavioural changes with emotionalism, irritability, anxiety or depression were prominent in 7. Left prefrontal hypoperfusion appeared in 8 patients, associated with psychiatric disorders in 7 and left amygdala damage in 6. The reduction of amygdala and hippocampus volume was correlated with the overall volume of lesions. Different patterns of mesial temporal lobe damage occurred, involving either amygdala alone, or amygdala and hippocampus, but never hippocampus alone. MRI volumetric measurements in HSVE could be a good indicator of long-term prognosis. Persistant behavioural changes could be related to an amygdala and frontal dysfunction.
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PMID:Cognitive and psychiatric impairment in herpes simplex virus encephalitis suggest involvement of the amygdalo-frontal pathways. 893 55


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