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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Psychopharmacology 126 (1996), S. 1-16 
    ISSN: 1432-2072
    Keywords: Sleep ; Hypnotic drugs ; Polysomnography ; Insomnia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This review aims at providing a critical assessment of the effects of the most widely used benzodiazepine (flurazepam, flunitrazepam, temazepam, triazolam) and non-benzodiazepine (zopiclone and zolpidem) hypnotic drugs, based on the recording of polysomnographic variables. In the light of newly acquired neurophysiological data on the microstructure of sleep, this paper reconsiders the problem of insomnia and the current ideas on polysomnography and hypnotic drugs.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2072
    Keywords: Sleep ; Cyclic alternating pattern ; Brotizolam ; Triazolam ; Insomnia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The standardized scoring criteria of sleep can serve as a rough tool for monitoring the effects of psychoactive compounds, both in normal sleepers and in insomniac patients. More sensitive information on the impact of perturbing factors and drugs during sleep is supplied by the cyclic alternating pattern (CAP) parameters. In particular, CAP rate, which measures the amount of arousal instability during NREM sleep, has been proved of high reliability in a variety of clinical and pharmacological settings. The present study aimed at evaluating the activity of brotizolam (Br) 0.25 mg and triazolam (Tr) 0.25 mg on both conventional and CAP parameters in a model of situational insomnia of intermediate severity. Six middle-aged healthy subjects (three males and three females, aged 40–55 years) with no complaints about sleep, underwent a polysomnographic investigation according to a double-blind crossover design: placebo without noise (night 1), placebo with noise (night 2), brotizolam or triazolam without noise (nights 3 and 5), brotizolam or triazolam with noise (nights 4 and 6). The unperturbed nights consisted of standard recording conditions in a sound-protected sleep laboratory, whereas situational insomnia was accomplished by means of continuous white noise at 55 dBA delivered throughout the night. Subjects received medication orally at bedtime. An interval of at least 48 h was secured between consecutive recordings in the same individual. Compared to baseline conditions, situational insomnia was characterized by a shorter amount of total sleep (−40 min) and by an extension of intrasleep awakenings (+62 min). Compared to triazolam, during the perturbed nights brotizolam guaranteed a longer duration of sleep time (Br: 462 min versus Tr: 443 min), a reduced length of intrasleep awakenings (Br: 14 min versus Tr: 34 min) and a lower percentage of stage 1 (Br: 3.6% versus Tr: 5.8%). However, on the basis of the statistical information supplied by the conventional sleep parameters, the drug nights could not be clearly discriminated from the placebo nights. By contrast, both brotizolam and triazolam significantly reduced (P〈0.0001) the pathological amounts of CAP Rate (Br: −17%; Tr: −15%) during acoustic perturbation, while they preserved the physiological values of CAP parameters under basal conditions. In essence, CAP parameters reveal the protective activity of hypnotic compounds in situational insomnia even in the absence of macrostructural alterations.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Neurological sciences 1 (1979), S. 149-153 
    ISSN: 1590-3478
    Keywords: Lithium carbonate Cluster headache ; Melphalan ; Serotonin ; Enkephalins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario 6 pazienti affetti da cefalea a grappolo cronica sono stati sottoposti a trattamento con carbonato di litio, allo scopo di stabilire la posologia minima individuale efficace e di valutare la possibilità di interruzione della terapia dopo somministrazione prolungata. Il litio è stato somministrato a dosaggi gradualmente crescenti, fino ad ottenere un miglioramento percentuale superiore al 90% Questo risultato terapeutico è stato raggiunto in 1 caso con soli 300 mg-die, in 3 casi con 600 mg, in 2 casi con 900 mg. Alla sospensione della terapia attuata in 5 pazienti, 3 hanno ripresentato subito attacchi quotidiani di cefalea, 1 dopo quattro mesi di benessere, 1 mantiene ancora inalterato l'indice di miglioramento a distanza di sei mesi. Le brusche diminuzioni dell'efficacia terapeutica del litio in un paziente, in stretta coincidenza con la somministrazione di un farmaco antiblastico (Melphalan), sono lo spunto per una discussione sui possibili meccanismi d'azione del litio nella cefalea a grappolo.
    Notes: Abstract 6 patients with chronic cluster headache were treated with lithium carbonate in order to establish the individual lowest effective dose and to assess the possibility of suspending treatment after prolonged administration. Lithium was given at rising doses until more than 90% improvement was obtained. This was achieved in 1 case with only 300 mg daily, in 3 cases with 600 mg and in 2 with 900 mg daily. Of the 5 patients in whom drug administration was suspended 3 had an immediate return of daily attacks of headache, 1 after a 4-month free interval and 1 has maintained the improvement after 6 months without the drug. The sharp decline of the effectiveness of lithium on administration of an antimitotic (Melphalan) provides the starting-point for a discussion on the possible mechanisms of action of lithium in cluster headache.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1590-3478
    Keywords: Coma and sleep patterns ; Creutzfeldt-Jakob disease ; cyclic EEG changes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Il contributo diagnostico dell'elettroencefalografia nella malattia di Creutzfeldt-Jakob è fornito non solo dalla presenza di un pattern caratteristico con anomalie pseudoperiodiche, ma anche dalla comparsa di modificazioni cicliche del tracciato. La comparsa delle modificazioni cicliche in 9 pazienti affetti da malattia di Creutzfeldt-Jakob è precoce nel corso della fase di stato della malattia e si manifesta in coincidenza di un abbassamento del livello di vigilanza. La percentuale di questo tracciato alternante ciclico aumenta con il progredire della malattia fino a raggiungere il 100% alla instaurazione del coma. Nel tracciato alternante ciclico le frequenze cardiaca e respiratoria sono sempre più elevate durante la fase A rispetto alla B. Le crisi ipertoniche e la maggior parte delle miocloniche sono presenti solo durante la fase A, ma le mioclonie parziali e le fascicolazioni sono egualmente presenti nelle due fasi. Il comportamento delle alternanze cicliche nella malattia di Creutzfeldt-Jakob mostra che i sistemi di vigilanza vi sono applicati in modo severo e progressivo. Uno studio longitudinale di questi aspetti poligrafici si dimostra molto utile per sorvegliare l'evoluzione clinica della malattia di Creutzfelt-Jakob.
    Notes: Abstract The diagnostic value of the EEG in Creutzfeldt-Jakob disease is based not only on the presence of a typical pattern of periodic discharges but also on the appearance of cyclic changes in the EEG. The pattern of the cyclic EEG changes was analysed in 9 patients with Creutzfeldt-Jakob disease. The changes appear when the level of wakefulness is reduced. The alternating pattern rate increases as the disease progresses and accounts for as much as 100 per cent of the tracing when the patient is in coma. During the cyclic changes the cardiorespiratory rate is always higher in phase A than in phase B. Hypertonic fits and most myoclonic jerks are present only in the A-phase, whereas partial myoclonus and fasciculations are present in both phases. The cyclic change pattern in Creutzfeldt-Jakob disease reveals a progressive, serious involvement of the waking system.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1590-3478
    Keywords: Creutzfeldt-Jakob disease ; status spongiosus ; transmissible subacute encephalopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario 10 su 11 pazienti di malattia di Creutzfeldt-Jakob sono stati visti dal febbraio 1975 al novembre 1979. Mentre i reperti clinici ed elettroencefalografici sono stati omogenei, i dati neuropatologici sono stati diversi da caso a caso: l'astrogliosi è sempre stata fenomeno diffuso ed ubiquitario mentre le altre classiche lesioni (perdita neuronale e spongiosi) sono state notevolmente variabili sia per gravità che per caratteri e localizzazione.
    Notes: Abstract 10 of the 11 Creutzfeldt-Jakob disease patients were seen between February 1975 and November 1979. Whilst the clinical and EEG findings were uniform, the neuropathological changes were not: astrogliosis was always diffuse and widespread but the other typical changes (neuronal loss and spongiosis) varied greatly both in degree and location.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Neurological sciences 4 (1983), S. 87-90 
    ISSN: 1590-3478
    Keywords: Asterixis ; postural tone ; thalamic tumor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Gli Autori riportano l'osservazione clinicostrumentale di asterixis unilaterale in unpaziente affetto da tumore talamico, documentato con esame tomodensitometrico. Vengono discussi il decorso clinico dell'asterixis e il suo rapporto con il deficit motorio a carico degli arti interessati e sono riportate le ipotesi correnti sui meccanismi fisiopatologici coinvolti.
    Notes: Abstract Unilateral asterixis in a patient with a contralateral thalamic tumor, confirmed by computerized tomography, is described. The timecourse of asterixis and its relationship with motor deficit in the same limbs are discussed in the light of current views on the pathophysiological mechanisms involved.
    Type of Medium: Electronic Resource
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