无先兆偏头痛患者血浆及血小板5-HT、5-HIAA含量的变化

目的　了解 5 -羟色胺 (5 - HT)、5 -羟吲哚乙酸 (5 - HIAA)在无先兆偏头痛发病中的作用。方法　用荧光分光光度法检测 2 0例无先兆偏头痛患者 (病例组 )和 2 3名正常人 (对照组 )血浆及血小板 5 - HT、5 - HI-AA的含量。结果　病例组发作期血浆 5 - HT含量低于对照组 (P<0 .0 5 ) ,而 5 - HIAA高于对照组 (P<0 .0 5 ) ;间歇期血浆 5 - HT高于发作期 (P<0 .0 5 ) ,而 5 - HIAA含量低于发作期 (P<0 .0 5 )。发作期血小板 5 - HT含量显著高于间歇期和对照组 (P<0 .0 1) ,而 5 - HIAA含量显著低于间歇期和对照组 (P<0 .0 1)。病例组 (含发作期和间歇期 )血小板 5 - HT含量高于对照组 (P<0 .0 5 ) ,而 5 - HIAA含量显著低于对照组 (P<0 .0 5 )。结论　无先兆偏头痛患者不同时期其血浆和血小板 5 - HT、5 - HIAA含量发生不同变化     

精神分裂症患者的中枢多巴胺和5—羟色胺浓度及其性别差异

目的 了解精神分裂症中枢多巴胺（DA）与5－羟色胺（5－HT）相互作用的变化及其性别影响的程度。方法 应用高效液相色谱对符合CCMD－2精神分裂症诊断标准的30例男性病人、37例女性病人、21例男性对照组、9例女性对照组脑脊液中DA、5－HT及其代谢产物高香草酸（HVA）、5－羟吲哚乙酸（5－HIAA）进行测试,并应用5－HT／DA、5－HIAA／HVA作为它们的相互作用的指标。结果 5－HT／DA、5－HIAA／HVA在4组中有显著性差异（F＝3．567,P＝0．032;F＝12．464,P＝0．001）,进一步分析提示;女性分裂症5－HT／DA显著低于男性对照组,且男性、女性分裂症及男性对照组5－HIAA／HVA均显著低于女性对照组。在男性病例组的相关分析中,5－HT／DA与BPRS及其阳性症状呈显著负漠、非特异性症状呈显著负、正相关;5－HIAA／HVA与思维形式障碍呈显著正相关。结论 精神分裂症患者存在中枢DA和5－HT相互作用的失平衡,这种失平衡与某些重要精神症状有关,且受性别因素的影响。     

偏头痛患者血浆和脑脊液中甲硫氨酸脑啡肽及β-内啡肽的变化

为探讨偏头痛与甲硫氨酸脑啡肽（MEK）和β-内啡肽（β-EP）含量变化的关系,检测了30例偏头痛患者血浆及脑脊液MEK、β-EP在同一偏头痛患者不同时期的含量及21例健康正常人血浆MEK、β-EP的含量,做统计学处理。结果发现：偏头痛患者脑脊液中MEK、β-EP含量的变化与血浆的变化基本一致;偏头痛患者间歇期MEK浓度显著低于发作期（P＜0．001）及健康对照组（P＜0．001）;β-EP含量普遍降低,在无先兆性偏头痛（COM）组发作期明显低于间歇期（P＜0．05）;同时发现间歇期血浆β-EP含量在COM与健康组相似,在先兆性偏头痛（CLM）组则有较明显降低。结果表明：偏头痛患者存在鸦片类肽系统紊乱,MEK降低可导致偏头痛发作;β-EP含量减少可能是偏头痛发作的诱因之一,偏头痛发作与β-EP进一步降低有关。     

抑郁症患者血浆白细胞介素与单胺代谢产物的研究

目的：探讨抑郁症患抗抑郁症治疗前后的细胞免疫及单胺类神经递质代谢产物的改变。方法：采用酶联免疫吸附法和高效液相电化学检测法，对40例抑郁症患在治疗前和抗抑郁药治疗4周后的血浆细胞因子白介素2（IL－2）和白介素6（IL－6），以及单胺代谢产物5－羟吲哚乙酸（5－HIAA）、3-甲基－4－羟－苯乙二醇（MHPG）和高香草酸（HVA）的浓度进行测定，并以20名健康人作为对照组。结果：（1）抑郁症组治疗前血浆IL－2、IL－6浓度明显高于正常对照组（P＜0．01），经过4周抗抑郁剂治疗后，随着病情显好转IL－2、IL－6较治疗前显降低（P＜0．01）；（2）抑郁症组治疗前血浆T－HIAA、MHPG、HVA浓度显低于正常对照组（P＜0．05），治疗后5－HIAA、MHPG明显高于治疗前（P＜0．05）；（3）治疗前后血浆5－HIAA的差值与治疗前后IL－2、IL－6的差值均呈显的负相关（P＜0．05）。结论：（1）抑郁症患可能伴有免疫激活和炎症反应。（2）抑郁症患存在中枢5－HT和NE功能低下。（3）IL－2、IL－6可影响中枢的5－HT活动。     

焦虑和抑郁障碍共病血浆单胺类神经递质研究

目的：探讨血浆单胺类神经递质与焦虑和抑郁障碍共病的关系。方法：使用高效液相－电化学检测法检测25例焦虑和抑郁障碍共病、30例抑郁症、20例焦虑症患者和21例正常人的血浆去甲肾上腺素（NE）和5－羟色胺（5－HT）浓度。结果：3组患者的血浆NE浓度均显著高于正常对照组,但共病组与抑郁症组和焦虑症组无明显差异;抑郁症组的血浆5－HT浓度显著低于正常对照组,共病组和焦虑症组的血浆5－HT浓度与正常对照组无显著差异,3组患者之间血浆5－HT浓度也无显著差异。结论：血浆单胺类神经递质不能鉴别抑郁症和焦虑症,也不支持焦虑和抑郁障碍共病是第3种疾病的观点。     

偏头痛患者血清肿瘤坏死因子的检测及其意义

通过检测偏头痛患者血清中肿瘤坏死因子α（tumornecrosisfac－tor－α,TNF－α）的含量,探讨其与偏头痛发病的关系。方法　50例病程1年以上、无用激素及免疫抑制剂的偏头痛患者和20例神经衰弱患者及20名正常对照者抽血后,用放射免疫分析法测定血清中TNF－α的含量。结果　　偏头痛患者血清中TNF－α水平显著高于神经衰弱患者（P＜0．01）及正常对照组（P＜0．01）;偏头痛患者发作期血清TNF－α水平高于间歇期（P＜0．05）;有先兆偏头痛患者与无先兆患者血清TNF－α水平差别不显著（P＞0．05）;女性偏头痛患者血清TNF－α水平高于男性（P＜0．05）;不同年龄段患者血清TNF－α水平无差别（P＞0．05）。结论TNF－α与偏头痛发病有关系,可能是引起偏头痛发作的原因。     

帕金森病患者立体定向手术前后脑脊液单胺类递质含量的改变

目的　研究帕金森病 (PD)患者脑立体定向手术前后脑脊液 (CSF)中单胺类递质含量的变化。方法测定 2 6例原发性PD患者 (PD组 )脑立体定向术前、后CSF中多巴胺 (DA)、5 羟色胺 (5 HT)、去甲肾上腺素 (NE)及其代谢产物高香草酸 (HVA)、5 羟吲哚乙酸 (5 HIAA)、3 甲氧基 4羟基苯乙二醇 (MHPG)的含量 ,另外测定 2 5例外科疾病腰麻手术患者 (对照组 )CSF中HVA、5 HIAA、MHPG含量。结果　PD组CSF中HVA、5 HIAA、MHPG含量明显低于对照组 (P <0 0 0 1、P <0 0 5、P <0 0 0 1) ;手术后组的CSF中DA、HVA ,、5 HT、5 HIAA、NE、MHPG含量明显高于手术前组 (其中DA、HVA、5 HT、5 HIAA和NE均P <0 0 0 1;MHPGP <0 0 5 )。结论　PD患者CSF单胺类神经递质代谢产物含量明显降低 ,脑立体定向术可提高PD患者脑部单胺类神经递质及其代谢产物的含量 ,其发生机制可能与DA能神经元的保护作用有关     

偏头痛与血浆cGRP、ANF和AⅡ含量的研究

采用放射免疫分析技术对３１例偏头痛患者血浆钙基因相关肽（ｃＧＲＰ）、心房利钠多肽（ＡＮＦ）和血管紧张素Ⅱ（ＡⅡ）含量进行了研究。发现偏头痛发作期血浆ｃＧＲＰ和ＡⅡ含量显著高于间歇期（Ｐ均＜０．０１），也显著高于对照组（Ｐ均＜０．０１），血浆ＡＮＦ含量各组间无显著差异。偏头痛间歇期血浆ｃＧＲＰ、ＡＮＦ、ＡⅡ含量与对照组比较均无显著差异。偏头痛发作患者经英明格针剂注射后，血浆ｃＧＲＰ含量显著下降（Ｐ＜０．０１），而ＡＮＦ和ＡⅡ含量则无显著变化。因此，偏头痛发作与血浆ｃＧＲＰ含量增高具有重要关系。     

炎性细胞因子IL—6,TNF与偏头痛关系的研究

采用桥联酶标APAAP染色技术检测无先兆偏头痛（MWA）患者淋巴细胞亚群CD3 、CD4 、CD8 、CD15 、CD19 的变化，用敏感细胞株杀伤试验及依赖细胞株增殖试验（MTT比色法）分别检测血浆TNF及IL－6水平的变化。结果显示：偏头痛患者外周血白细胞及淋巴细胞数均在正常范围内，发作期白细胞数较缓解期明显升高（P＜0．05）；而淋巴细胞数各组间差异无显著意义。CD3 、CD4 、CD8 、CD4 ／CD8 比率MWA组与对照组间差异均无显著性意义，但CD15 以细胞数则显著低于对照组（P＜0．01）。MWA组血浆TNF、IL－6水平显著高于对照组（P＜0．01），且发作期高于缓解期（P＜0．05）。对4例患者进行连续检测结果显示，发作期、缓解期血浆TNF与IL-6水平之间呈正相关（r＝0．9232，P＜0．01）。以上结果提示MWA患者存在细胞免疫缺陷，炎性细胞因子IL－6、TNF在其发病中可能起一定作用。     

脑脊液5-羟色胺和多巴胺及其代谢产物在病毒性脑炎和精神分裂症鉴别诊断中的价值

目的探讨脑脊液5-羟色胺（5-HT）、多巴胺（DA）及其代谢产物水平在病毒性脑炎和精神分裂症鉴别诊断中的价值。方法对病毒性脑炎和脑膜脑炎患者（简称病脑组）67例、精神分裂症患者37例和病例对照患者21例采用高效液相色谱法（HPLC）检测其脑脊液中5-HT、DA、5-羟吲哚乙酸（5-HIAA）和高香草酸（HVA）水平，并进行比较。结果（1）病脑组5-HT、5-HIAA、5-HIAA／HVA和5-HT／DA均明显低于病例对照组（P〈0．05～0．01），而HVA则明显高于病例对照组（P〈0．01）；病脑组脑脊液中5-HIAA、5-HIAA／5．HT和5-H｜AA／HVA日月显低于精神分裂症组（均P〈0．01），而HVA／DA则高于精神分裂症组（P〈0．05）；精神分裂症组脑脊液中5-HIAA／5-HT高于病例对照组（P〈0．05），5-HT／DA低于病例对照组（P〈0．05）。（2）病脑组有精神症状者脑脊液中5-HIAA浓度低于无精神症状者（P〈0．05），5-HT、5．HIAA、5-HIAA／5．HT和5-HIAA／HVA均低于精神分裂症组（P〈0．05～0．01），而HVA／DA高于精神分裂症组（P〈0．05）。结论病毒性脑炎患者脑脊液中可能存在5-HT和DA系统失衡；脑脊液中5-HT、DA及其代谢产物的水平可能有助于病毒性脑炎和精神分裂症的鉴别诊断。     

Serotonin metabolism in migraine

To investigate systemic serotonin (5-HT) metabolism in migraine, we determined platelet and platelet-free plasma concentrations of 5-HT, its precursors tryptophan and 5-hydroxytryptophan, and its main metabolite 5-hydroxyindoleacetic acid (5-HIAA), as well as the activities of the platelet enzymes monoamine oxidase and phenolsulfotransferase in classic and common migraineurs. Between attacks, migraineurs had lower plasma 5-HT and higher 5-HIAA levels than did healthy controls and patients with tension headache. During migraine attacks, plasma 5-HT levels were substantially higher than during attack-free periods, while 5-HIAA concentrations and platelet enzyme activities were lower. Platelet 5-HT was reduced only during common, but not classic, migraine attacks. We hypothesize that systemic 5-HT metabolism is enhanced in migraineurs during headache-free periods and transiently decreases during attacks, presumably due to a fall in enzymatic degradation. Furthermore, platelet behavior differs during migraine attacks with and without aura, and release of platelet 5-HT cannot (exclusively) be held accountable for the rise of plasma 5-HT during migraine attacks.     

Endothelin 1 in migraine and tension-type headache

We determined the plasma levels of ET1, both interictally and ictally, in 50 migraine patients, 20 with aura (MPA) and 30 without aura (MPWA), comparing them with the levels of 40 age-matched tension-type headache patients (20 episodic and 20 chronic) (ETTHP and CTTHP) and the levels of a group of 20 healthy control subjects (CS). No statistically significant difference was evident between the mean ET1 plasma levels of MPA and those of MPWA, assessed in headache-free periods. The mean ET1 plasma levels of MPA and MPWA, assessed interictally, were significantly higher than those of CS. However, the values of plasma ET1 in ETTP and in CTTHP did not differ statistically from those of CS. MPA and MPWA ET1 plasma levels increased significantly within 2 h from the onset of attacks (p<0.0001) and remained significantly higher between 4 and 6 h from the onset. The ET1 plasma levels of ETTHP and CTTHP assessed during attacks did not differ statistically from those of the same patients assessed in the headache-free periods. The increase in ET1 levels in MPA and MPWA patients when assessed ictally, suggests that this peptide is involved in the haemodynamic changes and vascular tone modifications observed during migraine attacks, particularly in the first phase of the ictal period.     

Spinal cord monoaminergic system response to age and cold-acclimatization in Muscovy duckling

Summary. The effect of age and cold acclimatization on the regional distribution of monoamines in duckling spinal cord was studied. In thermoneutral controls (TN), the high dopamine (DA) to norepinephrine (NE) ratios (0.25 at 4 weeks of age and 0.15 at 6 weeks of age) suggest the presence of specific (non precursor) dopaminergic pools in cervical spinal cord. DA levels and the ratio of DA to NE were lowered by age and cold exposure in the cervical cord. In TN ducklings, serotonin (5-HT) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) showed a decline with age in the spinal cord, indicating that this system is affected with development, whereas cold exposure prevents this decrease. The contents of 5-HT (+58%), 5-HIAA (+93%) and the ratio of 5-HIAA to 5-HT (+50%) are higher in the cervical spinal cord of cold acclimated than in TN ducklings. These results indicate that central monoaminergic systems are markedly affected by age and cold exposure. Received November 11, 1999; accepted March 6, 2000     

Indoleamine and catecholamine concentrations in the mid-term human fetal brain

Because of the likelihood that androgen-induced sex specific brain differentiation is mediated by various neurotransmitters, their concentrations were measured in the mid-term human fetal hypothalamus, cortex and cerebrospinal fluid (CSF). Tissue was collected from 32 hysterotomy specimens aged from 10 to 23 weeks, immediately frozen in liquid nitrogen, and stored at -20 degrees C. 5-Hydroxytryptamine (5-HT), 5-hydroxy indole acetic acid (5-HIAA), norepinephrine (NE) and dopamine (DA) levels were measured by a fluorometric assay. Cord serum testosterone levels were measured by radioimmunoassay. In the male fetuses, hypothalamic concentrations of 5-HT, 5-HIAA and NE were all significantly increased in comparison to those in the cortex. Because the number of female fetuses was small, only the 5-HIAA levels were seen to be significantly higher in the hypothalamus than in the cortex. In the CSF from fetuses of both sexes, the DA levels were greatly raised. Concentrations of NE were significantly higher in male fetuses aged from 14-16 weeks, a time when plasma testosterone levels are also elevated. It is hypothesized that the raised plasma testosterone and hypothalamic NE concentrations are inter-related.     

Variations of monoamines and their metabolites in the human brain putamen

The levels of the monoamines dopamine (DA), serotonin (5-HT) and norepinephrine (NE) and the monoaminergic metabolites 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were measured with HPLC-ECD in 42 samples from human brain putamen. The influence of gender and of age was investigated and correlations between the monoamines were established. The DAergic system shows a significant difference between males and females, with females having lower DA and higher DOPAC levels and a higher DOPAC/DA ratio than males. No gender-related differences of 5-HT and its metabolites were observed, nor of NE. Three different age groups (group 1: 0–9.9 years; group 2: 10–59.9 years; group 3: 60 years and older) were defined according to previous studies on ontogenesis and senescence in human brain. An increase in 5-HT levels, decrease in 5-HIAA levels a d a decrease in the 5-HIAA/5-HT ratio were observed after the first decade of life. Changes in the DAergic system were seen in senescence, with decreasing DA levels and an increase in the HVA/DA ratio. DOPAC, HVA and the DOPAC/DA ratio are unaffected. NE is similar in all age groups. The analysis of the relation of the levels of the three monoamines proved a strong correlation between the DAergic and 5-HTergic systems. The nature of this relationship might have an impact on neuro-psychiatric disorders and brain function.     

偏头痛患者血浆内皮素水平的观察

用放免法测定５２例偏头痛病人血浆内皮素含量在不同时期的动态变化。结果发现偏头痛患者不同病程阶段血浆内皮素水平均明显高于对照组。头痛发作期与间歇期比较，内皮素含量有显著差异（Ｐ＜０．０５）。不同头痛程度之间内皮素水平比较无显著性意义。提示偏头痛患者血管内皮细胞系统可能存在异常。     

L-arginine/nitric oxide pathway activation in platelets of migraine patients with and without aura

Nitric oxide (NO) in platelets has been proposed as a promising tool for studying NO variations in migraine. In the present research the platelet response to collagen and the basal and collagen-induced production of NO and cGMP in platelet cytosol were assessed in migraine patients (25 with aura and 35 without aura) both interictally and ictally, and compared with the same parameters in 30 age-matched control subjects. A reduced responsiveness to collagen was found in migraine patients, particularly those with aura, and this was more marked during attacks (ANOVA interictal periods: p<0.01, attacks: p<0.02) The basal and collagen-stimulated production of NO and cGMP in the platelet cytosol was significantly higher in migraine patients with aura assessed in interictal periods than in control subjects, and this production was further increased during attacks (interictal period: NO ANOVA: p<0.001, ictal period: p<0.01; cGMP: interictal period p<0.01, ictal period: p<0.02). The increase in platelet NO and cGMP production was also evident, though to a lesser extent, in migraine patients without aura. The present research supports the hypothesis of an activation of the L-arginine/NO pathway in migraine patients, especially those with aura, and confirms the findings of a previous study of increased levels of L-arginine in platelets of migraine patients studied in headache free-periods, and decreased collagen aggregation in whole blood.     

Activity Wheel Running Reduces Escape Latency and Alters Brain Monoamine Levels After Footshock

We examined the effects of chronic activity wheel running on brain monoamines and latency to escape foot shock after prior exposure to uncontrollable, inescapable foot shock. Individually housed young (∼50 day) female Sprague-Dawley rats were randomly assigned to standard cages (sedentary) or cages with activity wheels. After 9–12 weeks, animals were matched in pairs on body mass. Activity wheel animals were also matched on running distance. An animal from each matched pair was randomly assigned to controllable or uncontrollable inescapable foot shock followed the next day by a foot shock escape test in a shuttle box. Brain concentrations of norepinephrine (NE), dopamine (DA), dihydroxyphenylacetic acid (DOPAC), 5-hydroxytryptamine (5-HT), and 5-hydroxyindole acetic acid (5-HIAA) were assayed in the locus coeruleus (LC), dorsal raphe (DR), central amygdala (AC), hippocampus (CA1), arcuate nucleus, paraventricular nucleus (PVN), and midbrain central gray. After prior exposure to uncontrollable foot shock, escape latency was reduced by 34% for wheel runners compared with sedentary controls. The shortened escape latency for wheel runners was associated with 61% higher NE concentrations in LC and 44% higher NE concentrations in DR compared with sedentary controls. Sedentary controls, compared with wheel runners, had 31% higher 5-HIAA concentrations in CA1 and 30% higher 5-HIAA concentrations in AC after uncontrollable foot shock and had 28% higher 5-HT and 33% higher 5-HIAA concentrations in AC averaged across both foot shock conditions. There were no group differences in monoamines in the central gray or in plasma prolactin or ACTH concentrations, despite 52% higher DA concentrations in the arcuate nucleus after uncontrollable foot shock and 50% higher DOPAC/DA and 17% higher 5-HIAA/5-HT concentrations in the PVN averaged across both foot shock conditions for sedentary compared with activity wheel animals. The present results extend understanding of the escape-deficit by indicating an attenuating role for circadian physical activity. The altered monoamine levels suggest brain regions for more direct probes of neural activity after wheel running and foot shock.     

抑郁症患者自杀与脑脊液单胺代谢产物的关系

目的：探讨抑郁症患者自杀与脑脊液单胺代谢产物之间的关系。方法：应用高效液相色谱法，测定24例抑郁症患者(自杀组10例，无自杀组14例)及25例对照组5-羟色胺(5-HT)代谢产物5-羟吲哚乙酸(5-HIAA)，去甲肾上腺素(NE)代谢产物3-甲基-4-羟苯乙二醇(MHPG)及多巴胺(DA)代谢产物高香草酸(HVA)的浓度。结果：抑郁症自杀组5-HIAA浓度显著低于对照组，男性自杀组5-HIAA浓度、HVA浓度和HVA／MHPG比值均显著低于男性对照组，女性则无显著差异：结论：抑郁症患者自杀可能与5-HT和DA功能低下以及DA和NE之间的关系改变有关。     

Cardiovascular and biochemical assessment in migraine patients submitted to tilt test

Ten migraine patients underwent a tilt test both during migraine attack and headache-free interval, and the following parameters were assessed: plasma levels of norepinephrine (NE), and serum dopamine beta hydroxylase (D beta H), systolic and diastolic blood pressure and heart rate (SBP, DBP, HR). SBP during the tilt test showed a fall greater than 30 mmHg in 2 cases in the headache-free interval and in 4 cases during migraine attack. In migraine patients in headache-free interval, tilt test increased NE and D beta H as it did in the control group, while in migraine attack tilt test increased NE and D beta H less than in the control group. This impairment of the sympathetic nervous system during the migraine attack is discussed.