Studies on Tryptophan Metabolites in Patients of Major Monopolar Depression

Plasma levels of tryptophan metabolites were compared between healthy volunteers and patients of major monopolar depression at various ages and genders. An ultrahigh-speed liquid chromatography/mass spectrometry has been used for analysis. There are significant gender and age differences in TRP metabolites of healthy volunteers. At the upper stream of metabolism, metabolites of young women and old men are higher, but at the lower stream of metabolism, their levels are higher in young men and old women. Such differences disappear in plasma of patients of major monopolar depression except for kynurenine (KYN). Daily variation of blood serotonin (5-HT) levels showed that 5-HT levels were low in the morning and increased toward evening, but blood levels of 5-HT were higher in healthy people than depressive people in the morning and decreased to ward evening. Significant age and gender differences of plasma levels of tryptophan metabolites in healthy volunteers disappear in patients of major monopolar depression. Blood levels of 5-HT were higher in healthy people than depressive patients

Report on Two Cases of Adequate Medical Support System Using the Japanese Version of Kid-KINDL Questionnaire for Children with ADHD

We are investigating whether medical support improves not only the core symptoms of children with attention deficit/hyperactivity disorder (ADHD), but also their quality of life (QOL) using the Japanese version of the Kid-KINDLR (for ages 7-13 years) questionnaire (Kid-KINDLR). Herein, we report two cases of adequate medical support using Kid-KINDLR for children with ADHD. Case 1 is a 9-year-old boy. The Kid-KINDLR questionnaire revealed that this patient had conflict with his father; however, the father was unaware of such situation and had no understanding of the conflict. In addition to medical treatment, we advised his father to ascertain a good relationship with his son in order to better understand him. Case 2 is an 8-year-old boy who showed a decreasing self-esteem score after administration of medicine, despite improvements in his ADHD symptoms. We considered that the medicine had improved both his self-discernment and his relationships with others, indicating that the medical support was more effective in case 2 than in case 1. The Kid-KINDLR Questionnaire, and in particular the self-esteem scores, enabled us to understand the QOL changes in the reported cases. We speculated that children with ADHD have a greater obstacle of self-discernment than children showing normal development. However, such children may learn to recognize the concept of self-esteem, and we conclude that it is necessary to support these patients with specialized care to improve their ability to compare themselves with others

Effects of Paroxetine and Milnacipran on Pain Disorder

The outcomes of treatment for pain disorder are generally disappointing: symptoms are poorly controlled, they are seldom managed by experts, and they are often long standing. The aim of the present study was to compare the therapeutic effectiveness of paroxetine and milnacipran for outpatients with pain disorder. The study was performed on 43 consecutive outpatients with pain disorder diagnosed according to DSM-IV-TR criteria. Patients were treated with either antidepressant for 8 weeks. Pain was self-assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ), the total Pain Rating Index (t-PRI), Present Pain Intensity (PPI), and visual analogue scale (VAS). In addition, pain was evaluated objectively using Pain Vision (a machine devised by NIPRO for semiquantitative measurements). Possible depressive symptoms were rated on the Hamilton Depression Scale (HAM-D) and the Zung Self-rating Depression Scale (SDS). Although VAS scores decreased significantly over the course of the 8-week trial in both the paroxetine- and milnacipran-treated groups (from 6.6 ± 2.3 to 4.8 ± 3.0 [P = 0.01] and from 7.5 ± 2.4 to 5.4 ± 3.3 [P = 0.03], respectively), the t-PRI decreased only in the paroxetine group (from 13.9 ± 10.1 to 7.6 ± 7.5; P = 0.01). The Pain Vision indicated a tendency for decreased pain in both groups, with no significant differences between them. There were no significant changes in the SDS in either group, but the HAM-D decreased significantly in the milnacipran-treated group (from 7.8 ± 4.0 to 6.7 ± 3.9; P = 0.04). The results of the present study suggest that both paroxetine (a selective serotonin re-uptake inhibitor) and milnacipran (a selective serotonin-noradrenaline re-uptake inhibitor) may decrease pain in individuals with pain disorder

An fMRI Study of an Abnormal Neurovascular Response in the Right Premotor Cortex during Inner Speech and the Relationship to Auditory Hallucinations in Patients with Schizophrenia

There is evidence for sensory and cognitive impairments at multiple levels in schizophrenia, which may be related to the clinical symptoms of the condition. Inner speech involves both auditory and language systems and dysfunction of inner speech and may be associated with auditory hallucinations in schizophrenia. We used functional magnetic resonance imaging to examine this association by measuring brain activation in 23 patients with schizophrenia and 23 healthy control individuals. The participants performed an auditory verbal working memory task that required inner speech in the form of subvocal rehearsal. The control participants showed prominent activation in the inferior frontal cortex (IFC), premotor cortex (PMC), superior temporal cortex (STC), and lateral parietal cortex (LPC) bilaterally, throughout the task. In contrast, patients with schizophrenia showed significant activation in STC bilaterally during encoding phase and in the IFC, PMC, STC, and LPC bilaterally during the recognition phase. A comparison between groups showed that controls had greater activation during rehearsal in the IFC, LPC, and PMC bilaterally than patients with schizophrenia. In the region-of-interest analysis, we observed a significant negative correlation between right PMC activation and Auditory Hallucination Rating Scale scores as well as the hallucination item in the Positive and Negative Syndrome Scale. These observations indicate that inner speech is impaired in schizophrenia and that the severity of auditory hallucinations is associated with abnormal activation in the right PMC during inner speech

Short-term variation of chemical property of water and microplankton community in the coastal area near Syowa Station, Antarctica, in midsummer of 1984, I. Chemical property including chlorophyll a

Variation of chemical porperties and chlorophyll α standing stock in the water column below fast ice were monitored in the coastal area north of Syowa Station, Antarctica, for 2 weeks in midsummer of 1984. Because the ice was continuously melting, the surface water was diluted to a greater extent and isolated from underlying waters by a well-defined pycnocline. Nitrate and nitrite were rapidly and completely depleted from the surface water. Silicate was also removed rapidly but remained at a certain level in the latter half of the investigation period. Phosphate and ammonium were apparently replenished probably by excretion of larger animals such as seals. Despite of not a small amount of the nutrients, chlorophyll α decreased in the surface water. Excess dilution with ice melted water is likely to be detrimental to most phytoplankters. During these variations in the surface layer, the chlorophyll maximum was formed in the subsurface layer and clearly observed to become definite at shallower depths. The present findings demonstrate that the variations of phytoplankton stocks as well as environmental conditions within a limited period can be very intensive in midsummer

Efficacy and Safety of Transcranial Magnetic Stimulation in Patients with Depression

Transcranial magnetic stimulation （TMS） could be a helpful addition to pharmacotherapy in treating depression; however, more evidence of its efficacy and safety is needed. This single-arm, open clinical study tested the efficacy and safety of TMS in 46 patients diagnosed with major depression or bipolar disorder. TMS was performed 30 times in total, with treatment frequencies of 3-5 times weekly. Patients were examined at the 10th and 20th treatments, after completion of TMS treatment, and at 2 and 4 weeks after completion of treatment. Primary efficacy endpoints were changes in Hamilton Depression Scale （HAMD-17） and Patient Health Questionnaire （PHQ-9） scores from baseline. Mean scores and changes in HAMD-17 and PHQ-9 were significantly decreased from baseline. The response rate at completion of treatment was 68.57％. Systolic blood pressure was significantly decreased at 4 weeks after completion of treatment. Adverse events were observed in 10 patients （21.74％）, including headache, discomfort, and fatigue. The present study found that patients with major depression or bipolar disorder who received TMS showed significant improvement in HAMD-17, PHQ-9, and Clinical Global Impression Scale scores