Beta-endorphin and cholecystokinin 8 concentrations in peripheral blood mononuclear cells of autistic children.

beta-Endorphin (beta-EP) and cholecystokinin 8 (CCK-8) concentrations in peripheral blood mononuclear cells were measured in 12 drug-free autistic (AU) children, in 10 drug-free children with pervasive developmental disorders (PDD) and in 11 healthy controls. The aim of the study was to see whether or not there was an alteration of beta-EP and CCK-8 concentrations in this peripheral compartment, in which it has been suggested that secretion and regulation of the two peptides mimic those of neurons in the central nervous system. Mean beta-EP values were significantly higher in AU than in PDD and control children, while there were no differences in CCK-8 values of the three groups.

Growth hormone response to growth hormone releasing hormone and to clonidine stimulation in peripubertal patients with major depressive disorder.

The responses of growth hormone (GH) to administration of growth hormone-releasing hormone (GHRH-1 micrograms/kg b.w.) and of clonidine (clon-2.5 micrograms/kg b.w.) and basal levels of somatomedin C (SmC) were measured in nine peripubertal patients with Major Depressive Disorder (MDD) and in 9 age- and gender-matched controls. Basal GH and SmC levels, and GH response to GHRH did not differ in patients and controls, whereas responses to clonidine were significantly higher in some and lower in other patients than in controls.

Cortisol responses of depressed children and adolescents to clonidine administration.

The responses of cortisol to acute administration of saline and of clonidine (2.5 micrograms/kg B.W.) were examined in 10 children and adolescents with major depressive disorder and in 10 age- and sex-matched controls. Clonidine administration did not inhibit cortisol secretion in controls or in patients, contrary to what has been observed in depressed adults. In controls, but not in patients, clonidine administration induced a transitory increase of the steroid.

Developmental course of brain-stem auditory evoked potentials in the first days of full term infants.

Modifications of brain-stem acoustic evoked potentials (BAEPs) in the first 5 days of life of normal full-term infants are reported. BAEPs were recorded using rarefaction clicks at 70, 60, 40, 20 dB HL. Multiple linear regression analysis was performed to evaluate chronological and gestational age differences for all positive and negative peaks, interpeak latencies, amplitudes and amplitude ratios. The percentage of newborn infants with auditory threshold of 20 dB HL increased with the number of days. At all intensities the latency of PIII and PV decreased significantly between the 2nd and 3rd day, while the latency of PI decreased significantly between the 3rd and the 4th day; PIII and PV latencies decreased also between the 4th and the 5th day. The longer the period of gestation the longer was the PI latency recorded between the 2nd and 5th day after birth. The anatomical and physiological changes developing shortly after birth are probably responsible for the above findings. These changes most probably appear firstly in the cochlear and trapezoid nuclei and later on in the organ of Corti.

Effects of carbamazepine and valproate on immunological assessment in young epileptic patients.

Serum immunoglobulin levels and peripheral blood lymphocyte subsets were determined in 25 epileptic children treated with anticonvulsant drugs [carbamazepine (CBZ) or sodium valproate (VPA)], 17 untreated patients and 18 healthy subjects. The treated and untreated patients did not differ significantly from the controls with respect to the mean IgA, IgG, IgM values or lymphocyte subsets. The patients on carbamazepine had lower serum concentrations of IgG (though not significantly lower) than the untreated patients and children on valproate. OKT8 subset, in absolute terms and as a percentage of total lymphocytes, was significantly higher in generalized than in partial epilepsy, but this was probably due to the antiepileptic treatment. We found a sex difference in serum immunoglobulins (Ig M, IgG) in the epileptic group. Our data do not seem to argue for major changes in immune status related to clinical type of epilepsy or to VPA or CBZ treatment.

The acute and chronic administrations of piracetam affect the movement-related brain macropotentials.

Neurophysiological and neurochemical studies have demonstrated that piracetam improves learning and memory both in animals and humans. In recent years it has been shown that when a subject is engaged in a motor perceptual task, some psychomotor functions are correlated with a consistent pattern of brain electrical activity. Given the relationship between the movement-related brain macropotentials (MRBMs) and the cognitive processes associated with them, we considered the MRBMs particularly suitable for the neurophysiological assessment of the efficacy of piracetam in man. The aim of this study was to test the acute and chronic effect of piracetam administration on the MRBMs in normal children during the performance of a motor perceptual task. The design was a triple-blind study, during which the subjects took either placebo or piracetam in random sequence, with a washout period of 3 weeks. The dose was 170 mg/kg for the acute treatment and 140 mg/kg/day for chronic treatment. No side-effects were reported by the children during or after acute or chronic treatment with piracetam. There was no statistically significant difference between placebo or piracetam treatment with regard to 'performance', which was already optimal at baseline, and to electromyographic activity. On the contrary, the MRBMs were significantly modified by treatment. In particular the Bereitschaftspotential was present as a positive shift during acute treatment with piracetam and increased after chronic treatment. Skilled performance positivity (SPP) amplitudes were significantly increased and SPP latency reduced by chronic treatment with piracetam. piracetam appears to act on the catecholaminergic and cholinergic systems via an increase of the inhibitory hyperpolarizing processes.

Neuroendocrine investigation in children and adolescents with dysthymic disorders: the DST, TRH and clonidine tests.

A neuroendocrine study was conducted in eight children and adolescents with dysthymic disorders (three females and five males) and in eight age- and sex-matched psychologically normal controls. The dexamethasone suppression test (DST), TSH and GH responses to TRH stimulation and GH response to clonidine stimulation were studied in parallel in each patient. Depressive symptomatology was monitored with the Poznanski Rating Scale. The DST, TRH and clonidine tests revealed normal responses in each patient. TRH induced abnormal GH rises in five of the eight patients. There were no correlations between neuroendocrine parameters and degree of depression, age, sex or weight of the patients, age of onset, duration and family history of the disease.

EEG and clinical findings during pemoline treatment in children and adults with attention deficit disorder. An 8-week open trial.

A clinical study has been conducted on a selected group of 9 children and 12 adults with attention deficit disorder, evaluating the response to the therapy with magnesium pemoline by means of EEG power spectra. Pemoline was given orally in increasing doses ranging from 20 to 80 mg/day. EEG was recorded during baseline and at three fixed intervals during the treatment. Clinical response was assessed by objective and subjective ratings. In the adult sample, the drug produced two opposite patterns of EEG response which allowed us to discriminate by the 1st day of treatment responders who reported a paradoxical calming and non-responders who reported a worsening in anxiety. Inconsistent EEG power changes produced by the drug in children did not allow the discrimination of responders and non-responders. Children did not show paradoxical signs of sedation. EEG and clinical data suggest that adults and children show different drug response and that the paradoxical sedation is present only in adults.

Movement-related brain macropotentials during skilled performances. A developmental study.

A developmental study of movement-related brain macropotentials (MRBMs) during a self-paced bimanual skilled performance task (Papakostopoulos 1980) was carried out. MRBMs were obtained from Fpz, Cz and right and left pre-central and electromyograms were recorded from the left and right flexor muscles of the forearms in 30 normal children ranging from 8 to 13 years of age. A consistent Bereitschaftspotential appeared in children of 10 years; in the younger children it was absent or it was positive at precentral and central locations. The motor cortex potential and P200 were present in all children. The skilled performance positivity (SPP), absent at 8 and 9 years, appeared at 11 years of age and was present in older children. The latency of P200 and SPP decreased with age. ANOVA tests showed a statistically significant age effect on performance, EMG rise time and MRBMs; MRBMs were not statistically influenced by time in the experiment: MCP and P200 increased in amplitude with improvement of performance. The results indicate different rates of maturation of the neuronal systems underlying the genesis of the various movement-related brain macropotentials.

Effects of long-lasting sulpiride therapy on growth hormone secretion in mentally disturbed children.

The effects of chronic sulpiride therapy on growth hormone (GH) secretion were studied in 11 mentally disturbed children, aged 5 to 13 years, five with personality disorders, three with childhood psychoses, one with hysteria, one with anxiety reactions, and one with neurosis. The basal GH secretion and response to insulin-induced hypoglycemia were studied before the beginning of therapy and after ten days and three months of treatment with sulpiride (8 mg/kg body weight). No modifications in basal levels of GH or in the response to the stimulus were observed after ten days of therapy. After three months of treatment a blunted GH response to the stimulation was observed in three subjects, one of whom showed increased basal levels of GH.

Psychopharmacological perspectives in childhood psychoses.

1. Neuroleptic drugs are still widely employed in childhood psychoses, but new experiences on a large number of cases in this field, have shown the usefullness of antidepressive drugs, either alone or associated with neuroleptics, also when depressive symptoms are not clearly evident. 2. This peculiar aspect, still noticed in pathological situations of less gravity, calls again attention to childhood depression and to the difficulty of identifying it. 3. The problem is developed and discussed as follows: a. The psychopathological features regarded from the psychodynamic point of view; b. The neurofunctional background in various ages; c. The pharmacodynamic characteristics of the drugs; d. The good results with lithium treatment in several cases allow the authors to outline some clinical pictures as well as biochemical markers as to recognize endogenous depression in childhood.

Cognitive processes and cognitive progresses as didactic tools in psychiatry.

The authors expose the characteristics of two methods about the teaching and the learning of Psychiatry. Hermeneutic method is based on the model: "this want to say that". It gives rise to rapid and diffused learning which are rarely personalized and it attributes activity to the teacher and passivity to the pupil. "Conjectural" method is based on the model: "this is one of the aspects of a polymer of significances that we may point out as probable conjecture and not as truth". It produces learning less rapid, less diffused but more personal. It attributes activity and passivity as to the teacher as to the pupil. The first method tends to provoke pathological dependence as proselitism and/or contest so the pupil difficulty may assume the heritage of the teacher by having idealized or killed him. The second method tends to form self-governing pupils able to break away from the teacher after having learned from him new knowledges which they use in a personal way.

Immunogenetics of Lennox-Gastaut syndrome: search for LD determinants as genetic markers of the syndrome.

In a previous work we demonstrated a strong association between HLA-B7 and the susceptibility to the Lennox-Gastaut syndrome. In this work we report some preliminary results obtained performing one-way mixed lymphocyte cultures in vitro between 15 unrelated children showing the typical EEG and clinical patterns of the syndrome. The same children were also tested against unrelated control cells from healthy donors. The low stimulation displayed by Lennox-Gastaut patients between them as compared with the higher stimulation found in patients/controls and controls/controls comparisons suggests the existence of an LD allele which may be associated with the disease.

Immunogenetics of the Lennox-Gastaut syndrome: frequency of HL-A antigens and haplotypes in patients and first-degree relatives.

Twenty-two patients with the Lennox-Gastaut syndrome and their families were examined for HL-A antigens by the microlymphocytotoxicity test. The antigen HL-A7 belonging to the HL-A locus showed a significantly increased frequency (p less than 0.0005) both in parents and in patients. The same antigen showed a significantly altered segregation in patients but a normal one in healthy siblings. Another antigen of the second HL-A locus, HL-A12, did not display a normal segregation in our patients, in whom it was nearly not represented.