ABSTRACT
We present clinical, electroencephalographic and low-resolution electromagnetic tomography data that support combined treatment with insulin and a monoamine oxidase inhibitor in a patient with type 1 diabetes. We suggest that brain imaging data can identify a subgroup of patients who are likely to benefit from an insulin regimen and monoamine oxidase inhibition to improve glycaemic control, cardiovascular function, normalize the circadian rhythm and restore perception of glycaemic awareness.
Subject(s)
Blood Glucose/drug effects , Brain Waves/drug effects , Brain/drug effects , Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/administration & dosage , Insulins/administration & dosage , Monoamine Oxidase Inhibitors/therapeutic use , Tranylcypromine/therapeutic use , Biomarkers/blood , Blood Glucose/metabolism , Brain/physiopathology , Brain Mapping/methods , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 1/physiopathology , Drug Therapy, Combination , Electroencephalography , Humans , Hypoglycemic Agents/adverse effects , Insulin Glargine/administration & dosage , Insulin Lispro/administration & dosage , Insulin Resistance , Insulins/adverse effects , Male , Predictive Value of Tests , Treatment Outcome , Young AdultSubject(s)
Depressive Disorder/complications , Depressive Disorder/drug therapy , Diabetes Mellitus, Type 1/complications , Monoamine Oxidase Inhibitors/therapeutic use , Selegiline/therapeutic use , Tranylcypromine/therapeutic use , Adult , Depressive Disorder/psychology , Diabetes Mellitus, Type 1/diagnostic imaging , Diabetes Mellitus, Type 1/psychology , Female , Humans , Magnetic Resonance Imaging , Selective Serotonin Reuptake Inhibitors/adverse effectsABSTRACT
Two adolescent females with absence epilepsy were classified, one as attention deficit and the other as bipolar disorder. Physical and cognitive exams identified hypotension, bradycardia, and cognitive dysfunction. Their initial electroencephalograms (EEGs) were considered slightly slow, but within normal limits. Quantitative EEG (QEEG) data included relative theta excess and low alpha mean frequencies. A combined treatment of antiepileptic drugs with a catecholamine agonist/reuptake inhibitor was sequentially used. Both patients' physical and cognitive functions improved and they have remained seizure free. The clinical outcomes were correlated with statistically significant changes in QEEG measures toward normal Z-scores in both anterior and posterior regions. In addition, low resolution electromagnetic tomography (LORETA) Z-scored source correlation analyses of the initial and treated QEEG data showed normalized patterns, supporting a neuroanatomic resolution. This study presents preliminary evidence for a neurophysiologic approach to patients with absence epilepsy and comorbid disorders and may provide a method for further research.
