Reliability of automated EEG sleep measures: A paradigm for across-center assay replications

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27533/1/0000577.pd

ECT, sleep, and biogenic amines in affective illness

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26148/1/0000225.pd

Cholinergic mechanisms in schizophrenia: Relationship to sleep-EEG abnormalities and positive/ negative symptoms

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30875/1/0000539.pd

Imipramine effects on sleep in depressed adolescents: A preliminary report

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28419/1/0000198.pd

Effect of neuroleptic treatment on polysomnographic measures in schizophrenia

To study the effects of neuroleptic therapy on sleep EEG variables in schizophrenia, as well as the clinical correlates of these variables, we performed polysomnographic (PSG) studies on 14 schizophrenic inpatients before and during neuroleptic therapy. Sleep continuity measures improved after 3 weeks of neuroleptic therapy, showing decreased sleep latency and improved sleep efficiency. REM latency increased with treatment, although half the patients continued to exhibit REM latencies less than 60 min. Other sleep stages and measures of REM sleep (density, activity, number of periods) did not appear to change with neuroleptic treatment. At baseline, REM latency had strong negative correlations with BPRS and SANS scores, but with 3 weeks of such treatment, this association disappeared. Further work is needed to distinguish direct medication effects from the effects of the changing clinical state on PSG measures.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29068/1/0000102.pd

Association between abnormal REM sleep and negative symptoms in schizophrenia

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28038/1/0000477.pd

Cholinergic mechanisms and REM sleep abnormalities in schizophrenia

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30304/1/0000706.pd

Sleep onset REM periods in schizophrenic patients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29224/1/0000279.pd

Muscarinic cholinergic hyperactivity in schizophrenia : relationship to positive and negative symptoms

Based on the implication of increased muscarinic ACh activity in the production of negative symptoms, the association of decreasing cholinergic activity with positive symptoms, and the covariance of positive and negative symptoms in the psychotic phase of schizophrenia, a model of (DA) dopaminergic/(ACh) cholinergic interactions in schizophrenia was recently formulated. It suggests that DA/ACh balance is of central importance in schizophrenic pathophysiology and that muscarinic ACh activity increases in an attempt to maintain this balance in the face of increasing DA activity that occurs in the psychotic phase of the illness. The model further suggests that the muscarinic system exerts a damping influence on the emergence of positive symptoms associated with DA hyperactivity, but that this compensatory increase in muscarinic activity is accompanied by an intensification of negative symptoms. In the present study, we tested two important postulates of this model. We tested the prediction that muscarinic activity is increased in schizophrenia by comparing the effect of biperiden, an antimuscarinic M-1 agent, on REM latency in 12 drug-free schizophrenic inpatients and matched normal controls. We found that biperiden caused a smaller increase in REM latency in schizophrenic patients, suggesting that muscarinic activity is increased in schizophrenia. We tested the prediction that an anticholinergic agent would increase positive symptoms and decrease negative symptoms by studying the effect of 8 mg of biperiden/day for 2 days on positive and negative symptoms (assessed by the BPRS) in 30 medication-free schizophrenic inpatients. Biperiden produced a significant increase in positive symptoms (t = 6.36, DF = 29, P t = -2.05, DF = 29, P < 0.05). These findings suggest that central muscarinic activity is increased in the psychotic phase of schizophrenia and is relevant to the expression of positive and negative symptoms.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29522/1/0000609.pd

Schizophrenia, narcolepsy, and HLA-DR15, DQ6

A strong association between HLA-DR2, DQ1 and narcolepsy-cataplexy has been known since 1986. In 1990 a subdivision (HLA-DR15, DQ6) was shown to be equally associated. Narcolepsy symptoms include rapid eye movement (REM)-sleep intrusion hallucinations during the day. Some narcoleptics may be so hallucinated that they become delusional and receive a diagnosis of schizophrenia. Fifty-six inpatient schizophrenics and 56 normal controls were compared to see if there was an excess of the narcolepsy-associated antigens (NAA) among schizophrenics. Patients had frequency of the NAA 3.89 times higher than controls. After a subset was studied by night (n = 9) and day (n = 7) polysomnography, two patients were found to be true narcoleptics. Their psychosis improved with treatment for narcolepsy. When NAA(+) and NAA(-) schizophrenics were compared, the NAA(+) subgroup had significantly higher Brief Psychiatric Rating Scale (BPRS) scores and more hospitalizations. There were no effects attributable only to gender or race. We conclude that narcolepsy can simulate schizophrenia in some cases, and that even in nonnarcoleptic patients, the HLA-DR15, DQ6 antigens mark a group of severe schizophrenics that merits further study.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30431/1/0000052.pd