Saliva level of free 3-methoxy-4-hydroxyphenylglycol in psychiatric outpatients with anxiety

Saliva levels of 3-methoxy-4-hydroxyphenylglycol and clinical efficacy of mirtazapine or selective serotonin reuptake inhibitors in patients with major depression

OBJECTIVE

This study compared saliva levels of 3-methoxy-4-hydroxyphenylglycol (sMHPG) in patients with major depressive disorder (MDD) to levels in healthy controls and explored whether sMHPG levels in patients with MDD were a predictive marker for antidepressant efficacy.

METHODS

sMHPG levels were compared in 53 patients with MDD and 275 age-matched healthy controls. Patients' depressive symptoms were assessed by the 17-item Hamilton Rating Scale for Depression at baseline and 4 weeks after treatment with selective serotonin reuptake inhibitors (SSRIs, n = 23) or mirtazapine (n = 30), followed by saliva sampling. The mirtazapine group included nine patients who had been treated with an SSRI for more than 4 weeks without any improvement. sMHPG levels were measured by gas chromatography-mass spectrometry.

RESULTS

sMHPG levels in MDD patients were significantly higher than in controls. The responder rate to drug treatment at 4 weeks was 62% for mirtazapine (13/21), 57% for SSRIs (13/23), and 89% (8/9) for SSRI plus mirtazapine. sMHPG at baseline in 13 responders treated with SSRIs, but not mirtazapine, was significantly higher than that in non-responder group and showed consequent reduction 4 weeks after treatment. The area under the receiver operating characteristic (ROC) curves of sMHPG for discrimination of SSRI responders and non-responders was 0.86 ± 0.10 (95% confidence interval: 0.64-1.0, p = 0.005). In contrast, the ROC curve of sMHPG levels for discrimination of mirtazapine responders and non-responders was not significant. Adjunctive treatment with mirtazapine to SSRI non-responders was effective, regardless of baseline sMHPG levels.

CONCLUSION

sMHPG in patients with MDD was higher than in healthy controls. High baseline sMHPG levels in patients with MDD maybe a predictive marker for SSRI response.

Relationship between saliva level of 3-methoxy-4-hydroxyphenylglycol and mental health in the elderly general population

AIMS

A large number of studies on the monoamine systems in Alzheimer's disease (AD) have found abnormalities of the noradrenergic system in the brain, but there has been no report concerning the relationship between noradrenergic activity and cognitive function in elderly living in a community. The aim of the present study was to explore the relationship between saliva level of 3-methoxy-4-hydroxyphenylglycol (sMHPG) and mental health in this population.

METHODS

The study was to examine the relationship between sMHPG and performance on the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and Beck Depression Inventory (BDI) in 213 elderly people living in the local community.

RESULTS

sMHPG in female subjects was positively correlated with age (r = 0.24, P = 0.003) and negatively correlated with scores on the MMSE (r = -0.26, P = 0.0016) and FAB (r = -0.19, P = 0.024), even after controlling for the effect of age (MMSE r = -0.20, P = 0.013). Notably, sMHPG was correlated with the pentagon drawing score (P = 0.0008) of MMSE. sMHPG was significantly correlated with BDI score in male subjects, but negatively correlated in female subjects. A gender difference was found in the relationship between the sMHPG and BDI score.

CONCLUSION

The measurement of sMHPG may be a useful marker of mental health in elderly community-dwelling subjects.

Involvement of the noradrenergic system in performance on a continuous task requiring effortful attention

To determine the effects of noradrenergic neuronal activity on performance in continuous tasks requiring effortful attention, the performance of 23 male students in the Uchida-Kraepelin test (UKT) was examined. The UKT requires continuous arithmetic addition of single-digit figures for 25 min. The relationship of performance with saliva levels of 3-methoxy-4-hydroxyphenylglycol (sMHPG) was analyzed. Saliva samples were taken before, during and after test performance, and sMHPG levels determined by gas chromatography-mass spectrometry. There was no significant change in mean sMHPG as a result of test performance. However, when initial effort was calculated, defined as number of items completed during the 1st min subtracted from the average completed per minute in the 1st and the 2nd halves (blocks) of the test, significant correlations with sMHPG (p = 0.0002 for the 1st block and p < 0.0001 for the 2nd block) were found. Thus the data indicate that noradrenergic neuronal activity affects the performance on continuous tasks requiring effortful attention.

Clinical response to antidepressant treatment and 3-methoxy-4-hydroxyphenylglycol levels: mini review

Plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) may provide valuable information regarding central noradrenergic activity. In this article, we mainly reviewed about the associations between plasma MHPG levels and responses to antidepressant treatment. There exists heterogeneity of depression with regards to plasma levels of MHPG; in other words, depressed patients might be dichotomized into one group characterized by anxiety and/or perceptions of powerlessness with high plasma MHPG levels and another group characterized by psychomotor retardation with low plasma MHPG levels. In addition, it is possible that patients with lower pretreatment MHPG levels might respond to drugs that affect both noradrenergic neurons and serotonergic neurons or predominantly noradrenergic neurons. On the other hand, patients with higher pretreatment MHPG levels might respond to drugs that affect predominantly serotonergic neurons or GABAergic neurons. It is possible to predict the responses to antidepressant drugs by means of plasma MHPG levels in depressed patients.

Saliva as a diagnostic fluid

In the last 10 years, the use of saliva as a diagnostic fluid has become somewhat of a translational research success story. Technologies are now available enabling saliva to be used to diagnose disease and predict disease progression. This review describes some important recent advances in salivary diagnostics and barriers to application and advancement. This review will also stimulate future research activity.

Association of plasma free-3-methoxy-4-hydroxyphenyl (ethylene)glycol, natural killer cell activity and delirium in postoperative patients

We measured and compared levels of plasma free 3-methoxy-4-hydroxyphenyl (ethylene)glycol (pMHPG), a major metabolite of noradrenaline, and natural killer (NK) cell activity in 26 patients prior to their undergoing an operation for cardiovascular diseases; 11 of whom expressed delirium and 15 who did not. In conclusion, we found that pMHPG levels before an operation were higher in patients with postoperative delirium than in the patients without, while NK cell activity showed no difference between the two groups. It is possible that hyperactivity of noradrenargic neurons is connected with the development of postoperative delirium. Furthermore, we considered that measurement of pMHPG level before operation might be a useful tool to predict the occurrence of postoperative delirium.

Comparative study of short-term anxiolytic potency of alprazolam and tandospirone in psychiatric outpatients with anxiety disorders

Anxiolytic potency of 1 week of treatment with alprazolam or tandospirone in psychiatric outpatients with anxiety disorders was evaluated by changes in the scores on the Hamilton Anxiety Scale and the State and Trait Anxiety Inventory and in the saliva level of free-3-methoxy-4-hydroxyphenylglycol (free-MHPG). Saliva level of free-MHPG was significantly reduced by 1 week of treatment with alprazolam but not with tandospirone. Reductions in the HAS score after 1 week of drug treatment were greater in patients treated with alprazolam than in those treated with tandospirone. These results indicate that the short-term anxiolytic potency of alprazolam is greater than that of tandospirone and that the saliva level of MHPG would be a useful marker for the evaluation of the therapeutic potency of anxiolytic agents. Copyright 2001 John Wiley & Sons, Ltd.

Saliva level of free 3-methoxy-4-hydroxyphenylglycol (MHPG) as a biological index of anxiety disorders

To access the saliva level of free 3-methoxy-4-hydroxyphenylglycol (MHPG) as a biological index of anxiety disorders, gender- or age-dependent changes in saliva MHPG level in patients with anxiety disorders were investigated. Saliva MHPG levels in 196 normal volunteers (59 male, 137 female) and 42 outpatients with anxiety disorders (20 male, 22 female) at the initial consultation to the hospital were measured by gas chromatography-mass spectrometry. Saliva MHPG levels in patients were higher than those in normal subjects. The increase in saliva MHPG levels in male patients was greater than that in female patients. Age-associated increase in the saliva MHPG level was greater in patients than in normal subjects. Especially, a significant interaction of age vs. patient effect was found in female subjects (P=0.0005), but not in male subjects (P=0. 174). These data indicate that the measurement of saliva MHPG would be valuable for detecting pathological anxiety in male patients regardless of age and in older female patients, but not in younger female patients.