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Kukucka T, Ferencova N, Visnovcova Z, Ondrejka I, Hrtanek I, Kovacova V, Macejova A, Mlyncekova Z, Tonhajzerova I. Mechanisms Involved in the Link between Depression, Antidepressant Treatment, and Associated Weight Change. Int J Mol Sci 2024; 25:4511. [PMID: 38674096 PMCID: PMC11050075 DOI: 10.3390/ijms25084511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Major depressive disorder is a severe mood disorder associated with a marked decrease in quality of life and social functioning, accompanied by a risk of suicidal behavior. Therefore, seeking out and adhering to effective treatment is of great personal and society-wide importance. Weight changes associated with antidepressant therapy are often cited as the reason for treatment withdrawal and thus are an important topic of interest. There indeed exists a significant mechanistic overlap between depression, antidepressant treatment, and the regulation of appetite and body weight. The suggested pathomechanisms include the abnormal functioning of the homeostatic (mostly humoral) and hedonic (mostly dopaminergic) circuits of appetite regulation, as well as causing neuromorphological and neurophysiological changes underlying the development of depressive disorder. However, this issue is still extensively discussed. This review aims to summarize mechanisms linked to depression and antidepressant therapy in the context of weight change.
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Affiliation(s)
- Tomas Kukucka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (N.F.); (Z.V.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (N.F.); (Z.V.)
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Igor Hrtanek
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Veronika Kovacova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Andrea Macejova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Zuzana Mlyncekova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
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Tonhajzerova I, Ferencova N, Ondrejka I, Hrtanek I, Farsky I, Kukucka T, Visnovcova Z. Cardiac Autonomic Balance Is Altered during the Acute Stress Response in Adolescent Major Depression-Effect of Sex. Life (Basel) 2023; 13:2230. [PMID: 38004370 PMCID: PMC10672327 DOI: 10.3390/life13112230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
Autonomic nervous system (ANS) abnormalities are associated with major depressive disorder (MDD) already at adolescent age. The majority of studies so far evaluated parasympathetic and sympathetic branches of ANS individually, although composite indices including cardiac autonomic balance (CAB) and cardiac autonomic regulation (CAR) seem to measure ANS functioning more comprehensively and thus could provide better psychopathologies' predictors. We aimed to study CAB and CAR derived from high-frequency bands of heart rate variability and left ventricular ejection time during complex stress response (rest-Go/NoGo task-recovery) in MDD adolescents with respect to sex. We examined 85 MDD adolescents (52 girls, age: 15.7 ± 0.14 yrs.) and 80 age- and sex-matched controls. The MDD group showed significantly reduced CAB compared to controls at rest, in response to the Go/NoGo task, and in the recovery phase. Moreover, while depressed boys showed significantly lower CAB at rest and in response to the Go/NoGo task compared to control boys, depressed girls showed no significant differences in evaluated parameters compared to control girls. This study for the first time evaluated CAB and CAR indices in drug-naïve first-episode diagnosed MDD adolescents during complex stress responses, indicating an altered cardiac autonomic pattern (i.e., reciprocal sympathetic dominance associated with parasympathetic underactivity), which was predominant for depressed boys.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia;
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 036 01 Martin, Slovakia; (I.O.); (I.H.); (I.F.); (T.K.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 036 01 Martin, Slovakia; (I.O.); (I.H.); (I.F.); (T.K.)
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 036 01 Martin, Slovakia; (I.O.); (I.H.); (I.F.); (T.K.)
| | - Ivan Farsky
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 036 01 Martin, Slovakia; (I.O.); (I.H.); (I.F.); (T.K.)
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Tomas Kukucka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 036 01 Martin, Slovakia; (I.O.); (I.H.); (I.F.); (T.K.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia
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Mlyncekova Z, Hutka P, Visnovcova Z, Ferencova N, Kovacova V, Macejova A, Tonhajzerova I, Ondrejka I. Effects of Vortioxetine on Sleep Architecture of Adolescents with Major Depressive Disorder. Clocks Sleep 2023; 5:627-638. [PMID: 37987393 PMCID: PMC10660849 DOI: 10.3390/clockssleep5040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 11/22/2023] Open
Abstract
The relationship between depression and insomnia is bidirectional and both conditions need to be treated adequately, especially in a vulnerable neurodevelopmental stage of adolescence. This study aimed to evaluate the effects of antidepressant treatment using vortioxetine (VOR) on the sleep architecture of depressed adolescents by using video-polysomnography (v-PSG), which has not been researched before. The v-PSG was performed on 30 adolescent in-patients (mean age of 15.0 years ± 1.5 SD, 21 girls) treated with VOR (dosage of 10/15/20 mg/day) administered orally once a day, before and after VOR treatment. The evaluated parameters were conventional sleep parameters, sleep fragmentation parameters, and selected spectral power indices. Symptoms of depression and insomnia before and after the treatment period were evaluated using valid and reliable questionnaires (the Children´s Depression Inventory and the Athens Insomnia Scale). Depressed adolescents showed higher REM latency and decreased REM sleep percentage after treatment than before the treatment period (p = 0.005, p = 0.009, respectively). Our study revealed REM suppression (increased REM latency and reduced REM sleep percentage), indicating altered sleep architecture as a potential result of VOR treatment, which seems to be dose-dependent.
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Affiliation(s)
- Zuzana Mlyncekova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Peter Hutka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 03601 Martin, Slovakia; (Z.V.); (N.F.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 03601 Martin, Slovakia; (Z.V.); (N.F.)
| | - Veronika Kovacova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Andrea Macejova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 03601 Martin, Slovakia;
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
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Ferencova N, Visnovcova Z, Ondrejka I, Hrtanek I, Bujnakova I, Kovacova V, Macejova A, Tonhajzerova I. Peripheral Inflammatory Markers in Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder at Adolescent Age. Int J Mol Sci 2023; 24:11710. [PMID: 37511467 PMCID: PMC10380731 DOI: 10.3390/ijms241411710] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are associated with immune dysregulation. We aimed to estimate the pro- and anti-inflammatory activity/balance in ASD and ADHD patients at a little-studied adolescent age with respect to sex. We evaluated 20 ASD patients (5 girls, average age: 12.4 ± 1.9 y), 20 ADHD patients (5 girls, average age: 13.4 ± 1.8 y), and 20 age- and gender-matched controls (average age: 13.2 ± 1.9 y). The evaluated parameters included (1) white blood cells (WBCs), neutrophils, monocytes, lymphocytes, platelets, platelet distribution width (PDW), mean platelet volume, and derived ratios, as well as (2) cytokines-interferon-gamma, interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10, tumor necrosis factor-alpha (TNF-α), and derived profiles and ratios. ASD adolescents showed higher levels of WBC, monocytes, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10, macrophages (M)1 profile, and anti-inflammatory profile than the controls, with ASD males showing higher monocytes, IL-6 and IL-10, anti-inflammatory profile, and a lower T-helper (Th)1/Th2+T-regulatory cell ratio than control males. The ADHD adolescents showed higher levels of PDW, IL-1β and IL-6, TNF-α, M1 profile, proinflammatory profile, and pro-/anti-inflammatory ratio than the controls, with ADHD females showing a higher TNF-α and pro-/anti-inflammatory ratio than the control females and ADHD males showing higher levels of IL-1β and IL-6, TNF-α, and M1 profile than the control males. Immune dysregulation appeared to be different for both neurodevelopmental disorders in adolescence.
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Affiliation(s)
- Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Iveta Bujnakova
- Society to Help People with Autism (SPOSA-Turiec), 03601 Martin, Slovakia
| | - Veronika Kovacova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Andrea Macejova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03601 Martin, Slovakia
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
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Krivosova M, Adamcakova J, Kaadt E, Mumm BH, Dvorska D, Brany D, Dankova Z, Dohal M, Samec M, Ferencova N, Tonhajzerova I, Ondrejka I, Hrtanek I, Hutka P, Oppa M, Mokry J, Elfving B. The VEGF protein levels, miR-101-3p, and miR-122-5p are dysregulated in plasma from adolescents with major depression. J Affect Disord 2023; 334:60-68. [PMID: 37127118 DOI: 10.1016/j.jad.2023.04.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/24/2023] [Accepted: 04/24/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Michaela Krivosova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Jana Adamcakova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Erik Kaadt
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Birgitte Hviid Mumm
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Dana Dvorska
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Dusan Brany
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Zuzana Dankova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Matus Dohal
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic; Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Marek Samec
- Department of Pathological Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic.
| | - Peter Hutka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic.
| | - Miloslav Oppa
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic.
| | - Juraj Mokry
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Betina Elfving
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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Ferencova N, Visnovcova Z, Ondrejka I, Funakova D, Hrtanek I, Kelcikova S, Tonhajzerova I. Evaluation of Inflammatory Response System (IRS) and Compensatory Immune Response System (CIRS) in Adolescent Major Depression. J Inflamm Res 2022; 15:5959-5976. [PMID: 36303711 PMCID: PMC9596279 DOI: 10.2147/jir.s387588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose Nowadays, the role of two tightly interconnected systems, the inflammatory response system (IRS) and the compensatory immune response system (CIRS) in depression, is increasingly discussed. Various studies indicate pro-inflammatory activity in adolescent depression; however, there is an almost complete lack of findings about IRS and CIRS balance. Thus, we aimed to assess different IRS and CIRS indices, profiles, and IRS/CIRS ratios in drug-naïve MDD patients at adolescent age, with respect to sex. Patients and Methods One hundred MDD adolescents (40 boys, average age: 15.4±1.2 yrs.) and 60 controls (28 boys, average age: 15.3±1.5 yrs.) were examined. Evaluated parameters were 1. plasma levels of interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, interferon gamma, tumor necrosis factor alpha (TNF-α), soluble receptor of IL-6 (sIL-6R), soluble receptors of TNF-α (sTNF-R1, sTNF-R2); 2. profiles: IL-6 trans-signaling, M1 macrophage signaling, helper T lymphocytes (Th) 1 profile, regulatory T lymphocytes (Treg)+Th2, allIRS, and allCIRS; 3. IRS vs CIRS activity ratios: TNF-α/TNF-R1, TNF-α/TNF-R2, TNF-α/sTNF-Rs (ie sTNF-R1+sTNF-R2), Th1/Th2, Th1/Treg, Th1/Th2+Treg, M1/Th2, M1/Treg, M1/Treg+Th2, allIRS/allCIRS. Results MDD patients showed increased IL-4, IL-10, TNF-α, sIL-6R, Treg+Th2, allIRS, allCIRS, and TNF-α/sTNF-Rs, and decreased Th1/Th2+Treg. MDD females showed increased IL-10 and TNF-α compared to control females. MDD males showed increased IL-4, IL-10, sIL-6R, Treg+Th2, and TNF-α/TNF-R1 compared to control males. Increased sTNF-R1 was found in MDD males compared to MDD females. Positive correlations were found between CDI score and sIL-6R and IL-10 in the total group and between CDI score and IL-10 in adolescent males. Conclusion Our study for the first time extensively evaluated IRS and CIRS interactions revealing enhanced pro-inflammatory TNF-α signaling and IL-6 trans-signaling in association with increased IL-10- and IL-4-mediated anti-inflammatory activity in first-episode depression at the adolescent age. Moreover, results reflect the sex-specific simultaneous activation of IRS and CIRS pathways in adolescent depression.
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Affiliation(s)
- Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic
| | - Dana Funakova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic
| | - Simona Kelcikova
- Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic,Correspondence: Ingrid Tonhajzerova, Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, Martin, Slovak Republic, Tel +421432633425, Email
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Tonhajzerova I, Visnovcova Z, Ondrejka I, Funakova D, Hrtanek I, Ferencova N. Major depressive disorder at adolescent age is associated with impaired cardiovascular autonomic regulation and vasculature functioning. Int J Psychophysiol 2022; 181:14-22. [PMID: 36029918 DOI: 10.1016/j.ijpsycho.2022.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022]
Abstract
Cardiovascular adverse complications represent a risk factor for increased cardiovascular morbidity and mortality in patients with major depressive disorder (MDD). However, there is little knowledge of adolescent MDD. We aimed to study complex cardiovascular autonomic regulation and early atherosclerotic damage with a focus on an analysis of heart rate variability (HRV), blood pressure variability (BPV), systolic time intervals, and measures of early atherosclerotic changes in adolescent MDD. Ninety depressive adolescents (34 boys, age 15.8 ± 1.3 yrs.) and 90 age-/gender-matched controls were examined. Evaluated parameters: HRV - time and spectral parameters, BPV - mean, systolic, and diastolic blood pressure, spectral systolic parameters; haemodynamic indices - stroke volume, cardiac output, total peripheral resistance, systolic time intervals - left ventricular ejection time, pre-ejection period; atherosclerotic indices - ankle-brachial index (ABI), pulse wave velocity, brachial-ankle pulse wave velocity, cardio-ankle vascular index; growth factors - epidermal growth factor (EGF), vascular endothelial growth factor associated with monocyte chemoattractant protein-1. Our results showed that the MDD group had significantly reduced HRV and higher BPV measures, shortened systolic time intervals, lower ABI, and higher EGF compared to controls. Concluding, our study revealed that adolescent MDD is associated with cardiovascular dysregulation and early vasculature dysfunction as preclinical markers of higher risk for cardiovascular morbidity, thus adolescence seems to represent an important age period for early diagnosis and prevention of later MDD-linked cardiovascular diseases manifesting in adulthood.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Dana Funakova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic.
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic.
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Krivosova M, Gondas E, Murin R, Dohal M, Ondrejka I, Tonhajzerova I, Hutka P, Ferencova N, Visnovcova Z, Hrtanek I, Mokry J. The Plasma Levels of 3-Hydroxybutyrate, Dityrosine, and Other Markers of Oxidative Stress and Energy Metabolism in Major Depressive Disorder. Diagnostics (Basel) 2022; 12:diagnostics12040813. [PMID: 35453861 PMCID: PMC9025710 DOI: 10.3390/diagnostics12040813] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/20/2022] [Accepted: 03/24/2022] [Indexed: 02/01/2023] Open
Abstract
Major depressive disorder (MDD) is a serious mental disease with a pathophysiology that is not yet fully clarified. An increasing number of studies show an association of MDD with energy metabolism alteration and the presence of oxidative stress. We aimed to evaluate plasma levels of 3-hydroxybutyrate (3HB), NADH, myeloperoxidase, and dityrosine (di-Tyr) in adolescent and adult patients with MDD, compare them with healthy age-matched controls, and assess the effect of antidepressant treatment during hospitalisation on these levels. In our study, plasmatic levels of 3HB were elevated in both adolescents (by 55%; p = 0.0004) and adults (by 88%; p < 0.0001) with MDD compared to controls. Levels of dityrosine were increased in MDD adults (by 19%; p = 0.0092) but not adolescents. We have not found any significant effect of antidepressants on the selected parameters during the short observation period. Our study supports the findings suggesting altered energy metabolism in MDD and demonstrates its presence independently of the age of the patients.
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Affiliation(s)
- Michaela Krivosova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (M.K.); (N.F.); (Z.V.)
| | - Eduard Gondas
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (E.G.); (R.M.)
| | - Radovan Murin
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (E.G.); (R.M.)
| | - Matus Dohal
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia;
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (I.O.); (P.H.); (I.H.)
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia;
| | - Peter Hutka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (I.O.); (P.H.); (I.H.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (M.K.); (N.F.); (Z.V.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (M.K.); (N.F.); (Z.V.)
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (I.O.); (P.H.); (I.H.)
| | - Juraj Mokry
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia;
- Correspondence:
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Visnovcova Z, Ferencova N, Grendar M, Ondrejka I, Bona Olexova L, Bujnakova I, Tonhajzerova I. Electrodermal activity spectral and nonlinear analysis - potential biomarkers for sympathetic dysregulation in autism. Gen Physiol Biophys 2022; 41:123-131. [PMID: 35416175 DOI: 10.4149/gpb_2022011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disease characterized by emotional and social deficits, which can be associated with sympathetic dysregulation. Thus, we aimed to analyze the electrodermal activity (EDA) using time, and novel spectral and nonlinear indices in ASD. The cohort consisted of 45 ASD boys and 45 age-matched controls. EDA was continuously recorded at rest. The EDA indices were evaluated by time-, spectral-, and nonlinear-domain analysis. Our results revealed increased non-specific skin conductance responses, spectral parameters in high and very-high frequency bands, approximate and symbolic information entropy indicating sympathetic overactivity in ASD vs. controls (p < 0.05, for all). Surprisingly, the nonlinear index from detrended fluctuation analysis α1 was lower in ASD vs. controls (p = 0.024) providing thus distinct information about qualitative features of complex sympathetic regulation. Concluding, the complex time, spectral, and nonlinear EDA indices revealed discrete abnormalities in sympathetic cholinergic regulation as one of the potential pathomechanisms contributing to cardiovascular complications in ASD.
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Affiliation(s)
- Zuzana Visnovcova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
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10
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Mlyncekova Z, Vysehradsky R, Tonhajzerova I, Hutka P, Krivosova M, Hamrakova A, Hamrakova A, Ondrejka I, Sonka K. Vortioxetine Effects on Sleep Architecture in Treatment of Comorbid Depression in Adolescent Patient with Narcolepsy and Cataplexy: Case Report. Neuro Endocrinol Lett 2021; 42:503-507. [PMID: 34969190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
This report presents a rare case of adolescent patient treated by novel antidepressant vortioxetine for depressive disorder comorbid to narcolepsy type 1 (NT1) and newly diagnosed REM behavior disorder (RBD) and describes the overall clinical improvement of the conditions. Additionally, we discuss effect of vortioxetine on sleep architecture by evaluating objective polysomnographic studies before and on the treatment. We propose a possible efficacy of this multimodal serotoninergic agent in treatment of RBD associated with NT1.
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Affiliation(s)
- Zuzana Mlyncekova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, 03659 Martin, Slovak Republic
| | - Robert Vysehradsky
- Clinic of Pneumology and Phthisiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, 03659 Martin, Slovak Republic
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic
| | - Peter Hutka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, 03659 Martin, Slovak Republic
| | - Michaela Krivosova
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic
| | - Andrea Hamrakova
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic
| | - Andrea Hamrakova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovak Republic
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, 03659 Martin, Slovak Republic
| | - Karel Sonka
- Department of Neurology and Center for Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, 120 00 Prague 2, Czech Republic
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11
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Tonhajzerova I, Ondrejka I, Ferencova N, Bujnakova I, Grendar M, Olexova LB, Hrtanek I, Visnovcova Z. Alternations in the Cardiovascular Autonomic Regulation and Growth Factors in Autism. Physiol Res 2021; 70:551-561. [PMID: 34062079 DOI: 10.33549/physiolres.934662] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Autism spectrum disorder (ASD) represents a serious neurodevelopmental disorder associated with autonomic nervous system dysregulation. The aim was to study complex cardiovascular autonomic regulation using heart rate variability (HRV) and systolic blood pressure variability (SBPV) linear/non-linear analysis at rest and during orthostasis, and to assess plasma levels of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) in autistic children. Twenty-five ASD boys and 25 age and gender-matched children at the age 7-15 years were examined. After venous blood taking, continuous ECG and blood pressure biosignals were recorded at rest and during orthostasis. Evaluated parameters: RR intervals, high- and low-frequency band of HRV spectral analysis (HF-HRV, LF-HRV), symbolic dynamics parameters 0V%, 1V%, 2LV%, 2UV%, low- and high-frequency band of SBPV (LF-SBPV, HF-SBPV), systolic, diastolic, mean blood pressure, EGF, VEGF plasma levels. RR intervals were significantly shortened and the HF-HRV, LF-SBPV, HF-SBPV parameters were significantly lower at rest, the HF-HRV and LF-SBPV remained lower during orthostasis in autistic children compared to controls (p<0.05). EGF plasma levels were significantly lower in ASD compared to controls (p=0.046). No significant differences were found in remaining parameters. Our study revealed tachycardia, cardiovagal underactivity, and blunted sympathetic vasomotor regulation at rest and during orthostasis in autistic children. Additionally, complex heart rate dynamics are similar in autistic children than controls. Furthermore, EGF was reduced in autistic children without significant correlations with any autonomic parameters. We suggest that the abnormal complex cardiovascular reflex control could contribute to understanding the pathway linking autonomic features and autism.
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Affiliation(s)
- I Tonhajzerova
- Biomedical Center Martin JFM CU, Mala Hora, Martin, Slovak Republic
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12
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Tonhajzerova I, Ferencova N, Ondrejka I, Olexova LB, Funakova D, Hrtanek I, Visnovcova Z. Electrodermal activity – a promising biomarker for cardiovascular risk assessment in adolescent anorexia nervosa. Eur Psychiatry 2021. [PMCID: PMC9528396 DOI: 10.1192/j.eurpsy.2021.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Anorexia nervosa (AN) represents a severe mental disorder associated with cardiovascular complications leading to morbidity and mortality. Abnormal functioning of autonomic nervous system, particularly sympathetic nervous system, plays a crucial role in AN-linked psychopathology and cardiovascular diseases; however, the pathomechanisms are still unclear. Objectives Thus, we studied sympathetic arousal in response to mental stress using conventional parameters, and for the first time by spectral analysis of electrodermal activity with aim to detect non-invasive biomarkers for cardiovascular risk assessment already in adolescent AN patients. Methods Twenty-five AN girls were examined (14.8±0.4 yr.) and age/gender matched controls (15.1±0.3 years). Electrodermal activity (EDA) was continuously recorded at rest (5 min.) and in response to Go/NoGo test (5 min.). Evaluated parameters: skin conductance level (SCL) and spectral parameter of EDA in the sympathetic frequency band (EDASymp). EDA reactivity was calculated as percentual change (%) of SCL and EDASymp in response to stressor. Results The AN group had significantly reduced SCL and EDASymp compared to controls during baseline (p=0.041, p=0.0001, respectively) and in response to Go/NoGo test (p=0.043, p=0.017, respectively). The EDASymp index reactivity was significantly lower in AN group compared to control (p=0.034). Conclusions
Our study revealed resting sympathetic underactivity associated with lower reactivity to mental stressor indexed by EDA parameters in adolescent AN patients. This altered pattern of sympathetic arousal could play important role as a pathomechanism leading to cardiovascular complications in AN. It seems that EDA indices represent potential non-invasive biomarkers to detect AN-linked cardiovascular risk already at adolescent age. Conflict of interest This study was funded by the Slovak Scientific Grant Agency under grants VEGA 1/0044/18 and VEGA 1/0190/20 and Ministry of Health of the Slovak Republic under the project registration number 2018/20-UKMT-16.
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Krivosova M, Grendar M, Hrtanek I, Ondrejka I, Tonhajzerova I, Sekaninova N, Bona Olexova L, Mokra D, Mokry J. Potential major depressive disorder biomarkers in pediatric population - a pilot study. Physiol Res 2020; 69:S523-S532. [PMID: 33476174 DOI: 10.33549/physiolres.934590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mental disorders affect 10-20 % of the young population in the world. Major depressive disorder (MDD) is a common mental disease with a multifactorial and not clearly explained pathophysiology. Many cases remain undetected and untreated, which influences patients' physical and mental health and their quality of life also in adulthood. The aim of our pilot study was to assess the prediction value of selected potential biomarkers, including blood cell counts, blood cell ratios, and parameters like peroxiredoxin 1 (PRDX1), tenascin C (TNC) and type IV collagen (COL4) between depressive pediatric patients and healthy peers and to evaluate a short effect of antidepressant treatment. In this study, 27 young depressive patients and 26 non-depressed age-matched controls were included. Blood analyses and immunological assays using commercial kits were performed. Platelet count was the only blood parameter for which the case/control status was statistically significant (p=0.01) in a regression model controlling for the age and gender differences. The results from ELISA analyses showed that the case/control status is a significant predictor of the parameters PRDX1 (p=0.05) and COL4 (p=0.009) in respective regression model considering the age and gender differences between MDD patients and controls. A major finding of this study is that values of platelet count, monocyte to lymphocyte ratio, white blood cell, and monocyte counts were assessed by the Random Forest machine learning algorithm as relevant predictors for discrimination between MDD patients and healthy controls with a power of prediction AUC=0.749.
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Affiliation(s)
- M Krivosova
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
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14
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Hamrakova A, Ondrejka I, Sekaninova N, Bona Olexova L, Visnovcova Z, Cesnekova D, Hrtanek I, Oppa M, Hutka P, Tonhajzerova I. Central autonomic regulation assessed by pupillary light reflex is impaired in children with attention deficit hyperactivity disorder. Physiol Res 2020; 69:S513-S521. [PMID: 33476173 DOI: 10.33549/physiolres.934589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
It is assumed that the Attention Deficit Hyperactivity Disorder is associated with the central autonomic dysregulation, however, the studies are rare. Analysis of pupillary light reflex represents a non-invasive tool to provide information related to the central autonomic regulation; thus, we aimed to evaluate potential disturbances in the central autonomic integrity using pupillary light reflex examination in Attention Deficit Hyperactivity Disorder. We have examined 20 children with Attention Deficit Hyperactivity Disorder (10 boys, 13.0+/-2.3 years) and 20 age/gender-matched healthy subjects. Pupillary light reflex was examined at rest for both eyes using Pupillometer PLR-2000 (NeurOptics, USA). Evaluated parameters were: diameter of the pupil before the application of light stimulus and after illumination at the peak of the constriction, the percentual change of the pupil diameter during constriction, average constriction velocity, maximum constriction velocity and average dilation velocity. We found significantly lower percentual change of the pupil diameter during constriction for both eyes in Attention Deficit Hyperactivity Disorder group compared to controls (right eye: -25.81+/-1.23 % vs. -30.32+/-1.31 %, p<0.05, left eye: -25.44+/-1.65 % vs. -30.35+/-0.98 %, p<0.05). The average constriction velocity and maximum constriction velocity were significantly shortened in left eye in Attention Deficit Hyperactivity Disorder group compared to controls (p<0.05). Our findings revealed altered pupillary light reflex indicating abnormal centrally-mediated autonomic regulation characterized by parasympathetic underactivity associated with relative sympathetic predominance in children suffering from Attention Deficit Hyperactivity Disorder.
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Affiliation(s)
- A Hamrakova
- Department of Physiology and Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic. ,
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15
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Tonhajzerova I, Ondrejka I, Turianikova Z, Chladekova L, Javorka K, Farsky I, Kerna V, Javorka M. Heart rate variability in adolescent major depression. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)72070-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
IntroductionImpaired cardiac autonomic regulation is likely important contributor to a potential cardiac complications in major depression. The knowledge regarding the depression effect on cardiac regulation in adolescent age is limited. Aim was to study short-term heart rate variability (HRV) as an index of cardiac autonomic control in never-treated major depressive disorder (MDD) adolescent patients using linear and nonlinear methods related to depressive symptoms severity.MethodsWe have examined 20 MDD girls and 20 healthy age-matched girls at the age from 15 to 18 years. The ECG was recorded in three positions: supine - orthostasis - supine. The HRV was analyzed using linear (time and frequency analysis) and novel nonlinear (symbolic dynamics, time assymetry) methods. The severity of depressive symptoms was evaluated using the scales Montgomery-Asberg Depression Rating Scale (MADRS) and Children’s Depression Inventory (CDI).ResultsSeveral HRV linear and nonlinear parameters were significantly reduced in MDD group compared to controls in supine rest and during orthostasis. The HRV nonlinear analysis indices significantly correlated with depressive symptoms severity.ConclusionsLinear and nonlinear analyses revealed reduced magnitude and complexity of the HRV indicating impaired neurocardiac regulation in adolescent major depression. In addition, new approach of HRV analysis using nonlinear methods provided important information about depressive symptoms severity and cardiac autonomic regulation relations.
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16
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Kertys M, Krivosova M, Ondrejka I, Hrtanek I, Tonhajzerova I, Mokry J. Simultaneous determination of fluoxetine, venlafaxine, vortioxetine and their active metabolites in human plasma by LC-MS/MS using one-step sample preparation procedure. J Pharm Biomed Anal 2020; 181:113098. [PMID: 31978643 DOI: 10.1016/j.jpba.2020.113098] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 12/15/2022]
Abstract
The aim of antidepressant therapy is to induce remission and prevent relapses of major depressive disorder with minimum adverse effects during the treatment. Due to high variability in metabolism, therapeutic drug monitoring is recommended as a useful tool for individualisation of the therapy. For this purpose, we have developed simple and sensitive ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for quantification of fluoxetine (FLX), venlafaxine (VEN), vortioxetine (VTX) and their active metabolites norfluoxetine (NFLX) and O-desmethylvenlafaxine (ODV). After one-step extraction procedure using OSTRO plate, analytes were separated by gradient elution on Acquity UPLC BEH C18 (50 × 2.1 mm, 1.7 μm) column with runtime 4.2 min. The detection was done on a triple quadrupole tandem mass spectrometer by multiple reaction monitoring (MRM) mode with transitions at m/z 310.23 → 148.20 for FLX, m/z 296.23 → 134.20 for NFLX, m/z 278.31 → 121.13 for VEN, m/z 264.31 → 107.14 for ODV and m/z 299.19 → 150.05 for VTX using a positive electrospray ionisation interface. The method was successfully validated according to the European Medicine Agency guideline for the selectivity, linearity and lower limit of detection, precision and accuracy, matrix effect, extraction recovery, carryover, dilution integrity and stability over a concentration range of 1-300 ng/mL for FLX, NFLX, VEN, ODV and 0.2-100 ng/mL VTX. Extraction recovery for each analyte was > 80 %, and no significant matrix effects were observed. The developed method was employed for quantification of antidepressants in clinical samples from patients treated with either FLX, VEN, or VTX.
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Affiliation(s)
- Martin Kertys
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia; Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia.
| | - Michaela Krivosova
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Igor Hrtanek
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Ingrid Tonhajzerova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Juraj Mokry
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia; Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
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Sekaninova N, Ondrejka I, Bona Olexova L, Visnovcova Z, Mestanik M, Cesnekova D, Hamrakova A, Tonhajzerova I. Oculometric behavior assessed by pupil response is altered in adolescent depression. Physiol Res 2019; 68:S325-S338. [PMID: 31928050 DOI: 10.33549/physiolres.934359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Oculometric behaviour assessed by pupil response provides important information about central autonomic activity and emotional regulation. However, studies regarding pupil response to emotional stimuli in adolescent depression are rare. We aimed to study emotional-linked pupil response in adolescent depression. Twenty depressive adolescents (average age: 15.4+/-1.2 years) and 20 age/gender-matched healthy subjects were examined. Average pupil diameter assessed by eye-tracking and pupillary light reflex were evaluated during protocol - baseline, free-view task, recovery phase. Regarding right eye, significantly greater initial pupil diameter and pupil dilation to positive pictures free-viewing (p=0.013, p=0.031, respectively), significantly slower average and maximum constriction velocity in baseline and positive pictures free-viewing (p=0.036, p=0.050, p=0.021, p=0.015, respectively), significantly slower maximum constriction velocity in recovery phase (p=0.045), and significantly faster average dilation velocity in negative pictures free-viewing (p=0.042) were observed in depressive group. Regarding left eye, significantly lower constriction percentual change in negative pictures free-viewing (p=0.044) and significantly greater baseline pupil diameter and pupil diameter at the peak of constriction in positive vs. negative pictures free-viewing (p=0.002, p=0.015, respectively) were observed in depressive group. Our study revealed discrete central autonomic dysregulation - parasympathetic hypoactivity associated with relative sympathetic dominance influenced by impairments in emotional processing already in adolescent depression.
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Affiliation(s)
- N Sekaninova
- Department of Physiology and Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
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18
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Tonhajzerova I, Mestanikova A, Jurko A, Grendar M, Langer P, Ondrejka I, Jurko T, Hrtanek I, Cesnekova D, Mestanik M. Arterial stiffness and haemodynamic regulation in adolescent anorexia nervosa versus obesity. Appl Physiol Nutr Metab 2019; 45:81-90. [PMID: 31163115 DOI: 10.1139/apnm-2018-0867] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cardiovascular complications contribute to higher morbidity and mortality in patients with anorexia nervosa. We aimed to study biomarkers of cardiovascular risk in anorexic, normal-weight, and obese adolescents with focus on complex cardiovascular autonomic regulation and early arteriosclerotic damage. We examined 20 adolescent girls with anorexia nervosa, 20 obese girls, and 20 healthy normal-weight controls. Collected data: body composition analysis, 5 min recordings of R-R intervals and beat-to-beat blood pressure (BP), and arterial stiffness evaluated using cardio-ankle vascular index (CAVI). Evaluated parameters: beat-to-beat heart rate and BP variability, haemodynamic parameters (total peripheral resistance (TPR) cardiac output), CAVI, and anthropometric indices, including novel body roundness index (BRI). Adolescents with anorexia nervosa had increased CAVI associated with lower arterial constriction indexed by low-frequency band of BP variability compared with normal-weight peers (p = 0.03, p = 0.04, respectively) and obese adolescents (p < 0.01, p = 0.01, respectively). After normalization of CAVI and TPR by BRI, the relationship between CAVI and TPR was significant for all groups with the highest slope in the anorexia nervosa group (R2 = 0.724, p < 0.01). This is the first study revealing early arteriosclerotic damage in anorexic girls with increased CAVI. Complex analysis of cardiovascular autonomic regulation, and early arteriosclerotic, hemodynamic, and anthropometric changes in spectrum anorexia nervosa, normal weight, and obesity could help to understand the mechanisms of increased cardiovascular risk in malnutrition. Novelty Girls with anorexia nervosa showed signs of early arteriosclerotic damage indexed by CAVI. Insufficient sympathetic cardiovascular control was found already in adolescents with anorexia nervosa. The effect of body composition on CAVI was best predicted by novel body roundness index.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.,Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic
| | - Andrea Mestanikova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.,Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic
| | - Alexander Jurko
- Pediatric Cardiology, Kollarova 13, 036 01 Martin, Slovak Republic
| | - Marian Grendar
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic
| | - Peter Langer
- Research Center, St. Anne's University Hospital Brno, 656 91 Brno, Czech Republic; Institute of Scientific Instruments of the ASCR, v.v.i., Kralovopolska 147, 612 64 Brno, Czech Republic
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic
| | - Tomas Jurko
- Department of Neonatology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic
| | - Dana Cesnekova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Kollarova 2, 036 59 Martin, Slovak Republic
| | - Michal Mestanik
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.,Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 036 01 Martin, Slovak Republic
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Mestanikova A, Mestanik M, Ondrejka I, Hrtanek I, Cesnekova D, Jurko A, Visnovcova Z, Sekaninova N, Tonhajzerova I. Complex cardiac vagal regulation to mental and physiological stress in adolescent major depression. J Affect Disord 2019; 249:234-241. [PMID: 30780116 DOI: 10.1016/j.jad.2019.01.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/22/2018] [Accepted: 01/22/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cardiovagal control is known to be reduced in major depressive disorder (MDD), however, the neurocardiac reflex control to distinct types of stressors is still unclear. We aimed to study parasympathetically mediated cardiac reflex functioning in response to mental and physiological stressors using heart rate variability (HRV) linear and nonlinear analysis in adolescent MDD. METHODS We examined 60 adolescents (40 girls) with MDD (age 14.9 ± 0.3 years) and 60 age and gender-matched controls. ECG was continuously recorded during stress protocol: baseline, Go/NoGo test, recovery, supine position, and orthostasis. Evaluated HRV linear and nonlinear indices: RR interval, pNN50, rMSSD, HF-HRV, Poincaré plot (SD1), symbolic dynamics 2UV%. Cardiovagal reactivity expressed as percentual change (%) was calculated in response to both stressors. RESULTS In each phase of stress protocol, the MDD group had significantly reduced HRV parameters compared to controls, except for symbolic dynamics index 2UV% in supine position. The reactivity of HRV indices was significantly greater in response to orthostasis in MDD compared to controls. No significant differences were found in response to Go/NoGo test. LIMITATIONS The smoking status and the menstrual cycle phase potentially affecting the HRV parameters were not monitored. Future research is needed to expand a sample size with respect to sex and to study neurocardiac response to other different stressors in MDD. CONCLUSIONS This study revealed reduced resting cardiovagal regulation and greater vagal withdrawal indicating abnormal neurocardiac reflex functioning to physiological stressor (orthostasis) in adolescent MDD patients. Nonlinear HRV analysis was sensitive to detect cardiac-linked regulatory differences in adolescent depression.
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Affiliation(s)
- Andrea Mestanikova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Michal Mestanik
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Dana Cesnekova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Alexander Jurko
- Pediatric Cardiology, Kollarova 13, 036 01 Martin, Slovak Republic.
| | - Zuzana Visnovcova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Nikola Sekaninova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Ingrid Tonhajzerova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
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Smetanka A, Stara V, Farsky I, Tonhajzerova I, Ondrejka I. Pycnogenol supplementation as an adjunct treatment for antidepressant-induced sexual dysfunction. Physiol Int 2019; 106:59-69. [PMID: 30888217 DOI: 10.1556/2060.106.2019.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Major depressive disorder is a serious mental disorder in which treatment with antidepressant medication is associated with incidence of adverse events, such as constipation, diarrhea, dry mouth, headache, insomnia, and sexual dysfunction (SDys). Escitalopram (ESC), an effective and safe selective serotonin reuptake inhibitor with good tolerability, was used in this study. In this study, we investigated the prospective effect of Pycnogenol (PYC), an antioxidant, anti-inflammatory, and vasodilator agent, on ESC-induced SDys. METHODS This was a randomized, parallel, open-label study. Seventy-two outpatients of both genders with depression were randomized into two groups as follows: 37 patients from the ESC + PYC group took 50 mg of PYC per day for 4 months in ESC co-treatment, and 35 subjects from the ESC group took ESC only. Five patients dropped out and were excluded from the analysis. The participants were examined every month (visits 1-4). RESULTS ESC use led to improvement of depressive symptoms and severity scored by standardized psychiatric tests. PYC co-treatment resulted in attenuation of SDys beginning at 1 month of treatment and continuing for two consecutive months. Furthermore, an increase in heart rate in the PYC group was registered. CONCLUSIONS We propose that PYC-mediated SDys attenuation is based on its ability to improve endothelial functions by its antioxidant, anti-inflammatory, vasodilatory, and anticoagulant action. We assume that the action of PYC on heart rate is in accordance with the aforementioned vasodilatory action of PYC and consequent baroreflex-mediated heart rate response. PYC co-treatment reduced ESC-induced SDys and elevated heart rate.
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Affiliation(s)
- A Smetanka
- 1 Outpatient Psychiatric Clinic , Bojnice, Slovakia.,2 Faculty of Medicine, Comenius University in Bratislava , Bratislava, Slovakia
| | - V Stara
- 3 Biomedical Center Martin, Division of Neurosciences, Jessenius Faculty of Medicine in Martin, Department of Physiology JFM CU, Comenius University in Bratislava (JFM CU) , Martin, Slovakia
| | - I Farsky
- 4 Department of Nursing, Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - I Tonhajzerova
- 5 Department of Physiology, Jessenius Faculty of Medicine in Martin, Biomedical Center Martin JFM CU, Comenius University in Bratislava (JFM CU) , Martin, Slovakia
| | - I Ondrejka
- 6 Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin , Bratislava, Slovakia
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Mestanikova A, Sekaninova N, Ondrejka I, Cesnekova D, Bujnakova I, Mestanik M, Tonhajzerova I. PUPILLOMETRY IN ADOLESCENT DEPRESSION. Pathophysiology 2018. [DOI: 10.1016/j.pathophys.2018.07.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mestanikova A, Ondrejka I, Mestanik M, Cesnekova D, Visnovcova Z, Bujnakova I, Oppa M, Calkovska A, Tonhajzerova I. Pupillary light reflex is altered in adolescent depression. Physiol Res 2018; 66:S277-S284. [PMID: 28937242 DOI: 10.33549/physiolres.933683] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Major depressive disorder is associated with abnormal autonomic regulation which could be noninvasively studied using pupillometry. However, the studies in adolescent patients are rare. Therefore, we aimed to study the pupillary light reflex (PLR), which could provide novel important information about dynamic balance between sympathetic and parasympathetic nervous system in adolescent patients suffering from major depression. We have examined 25 depressive adolescent girls (age 15.2+/-0.3 year) prior to pharmacotherapy and 25 age/gender-matched healthy subjects. PLR parameters were measured separately for both eyes after 5 min of rest using Pupillometer PLR-2000 (NeurOptics, USA). The constriction percentual change for the left eye was significantly lower in depressive group compared to control group (-24.12+/-0.87 % vs. -28.04+/-0.96 %, p<0.01). Furthermore, average constriction velocity and maximum constriction velocity for the left eye were significantly lower in depressive group compared to control group (p<0.05, p<0.01, respectively). In contrast, no significant between-groups differences were found for the right eye. Concluding, this study revealed altered PLR for left eye indicating a deficient parasympathetic activity already in adolescent major depression. Additionally, the differences between left and right eye could be related to functional lateralization of autonomic control in the central nervous system.
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Affiliation(s)
- A Mestanikova
- Department of Physiology and Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia. or
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Bujnakova I, Ondrejka I, Mestanik M, Fleskova D, Sekaninova N, Farsky I, Tonhajzerova I. Potential Effect of Pharmacotherapy on Sympathetic Arousal in Autism. Acta Medica Martiniana 2018. [DOI: 10.1515/acm-2017-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Abstract
Background: Autism spectrum disorder (ASD) is a serious neurodevelopmental disorder associated with autonomic nervous system (ANS) abnormalities. Moreover, at least 50% of children with ASD suffer from other comorbid diseases such as anxiety, depression, and attention deficit hyperactivity disorder (ADHD) associated with receiving psychotropic medication. From this context we aimed to evaluate changes in sympathetic arousal using analysis of electrodermal activity (EDA) as an index of sympathetic cholinergic activity in treated and non-treated autistic children under resting conditions.
Methods: We examined 23 children with ASD and 14 healthy age- and gender-matched children at the age of 7–15 years. The ASD patients were divided into ASD non-treated group (n=12) and ASD treated group (n=11). The EDA was continuously monitored during resting phase in a supine position. The EDA amplitude (μS) was computed as an average of 5 min baseline period.
Results: We found significantly lower EDA in ASD non-treated subgroup compared to controls indicating subtle abnormalities in the regulation of the sympathetic nervous system. Although no significant differences were found between the ASD treated and non-treated subgroups the ASD treated group showed comparable sympathetic activity relative to controls indicating a potential ameliorated treatment effect on sympathetic arousal in ASD.
Conclusions: These findings could help to determine differences in sympathetic arousal in treated and non-treated children with ASD, which is important for assessment of autism-linked cardiovascular risk depending on pharmacotherapy.
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Affiliation(s)
- I Bujnakova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava , Martin , Slovakia
- Department of Physiology, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava , Martin , Slovakia
| | - I Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava, University Hospital Martin , Slovakia
| | - M Mestanik
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava , Martin , Slovakia
| | - D Fleskova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava, University Hospital Martin , Slovakia
| | - N Sekaninova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava , Martin , Slovakia
- Department of Physiology, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava , Martin , Slovakia
| | - I Farsky
- Department of Nursing, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava , Martin , Slovakia
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava, University Hospital Martin , Slovakia
| | - I Tonhajzerova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava , Martin , Slovakia
- Department of Physiology, Jessenius Faculty of Medicine in Martin , Comenius University in Bratislava , Martin , Slovakia
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Snircova E, Marcincakova Husarova V, Ondrejka I, Hrtanek I, Farsky I, Nosalova G. QTc prolongation after ADHD medication. Neuro Endocrinol Lett 2018; 38:549-554. [PMID: 29504733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 01/02/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Multicenter studies have shown that cardiovascular risks of ADHD medication are extremely low. However, QTc length has been shown to be increased in smaller samples of patients or case reports after stimulant and atomoxetine medication. Based on recent studies of genetic polymorphisms associated with drug-induced QTc prolongation and polymorphisms linkage to regional populations, we hypothesized that the drug-induced QTc prolongation could be a factor of particular polymorphisms linked to specific regional populations undistinguished in multicenter studies. METHODS We included 69 patients from a region of central Slovakia, 36 patients were taking atomoxetine and 33 patients methylphenidate. QTc, heart rate, potassium levels and BMI were examined before and after 8 weeks of treatment. Therapeutic effect was measured by ADHD-RS-IV. RESULTS We found QTc prolongation after 8 weeks of treatment both with atomoxetine and methylphenidate that was neither followed by the significant changes in BMI and potassium levels nor the significant increase of heart rate. CONCLUSION This is the first study revealing QTc prolongation in the group of ADHD children from the same region after 8-week treatment with atomoxetine and methylphenidate, indicating the potential discrete abnormalities in cardiac functioning associated with polymorphisms in genes of dopaminergic and noradrenergic system.
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Affiliation(s)
- Eva Snircova
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | | | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Igor Hrtanek
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Ivan Farsky
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Gabriela Nosalova
- Institute of Pharmacology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
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Kulhan T, Marcincakova Husarova V, Ondrejka I, Farsky I, Nosalova G. Anxiolytic effects of venlafaxine/olanzapine combination in treatment of anxious depression. Neuro Endocrinol Lett 2018; 38:579-585. [PMID: 29504736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 01/12/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Both venlafaxine and olanzapine have been previously found to have anxiolytic properties, however no study examined the effect of their combination on anxiety in anxious MDD. The aim of this study was to reveal if and when venlafaxine/olanzapine combination (VOC) can reduce the anxiety and depressive symptoms in patients with severe MDD at the level of patients with moderate-severe depression treated with venlafaxine monotherapy. METHODS Fifty seven patients were included into the study. Symptoms of depression were objectively assessed by Montgomery-Asberg Depression Rating Scale and subjectively scored by BECK Depression scale, symptoms of anxiety were objectively assessed by Hamilton Anxiety scale and subjectively evluated by ZUNG Self-Rating Anxiety scale before treatment and after each following week untill the fourth week of treatment. RESULTS VOC eliminated the pre-treatment score differences in all the scales within the first week of treatment. At the third week, VOC group had significantly lower level of anxiety symptoms and the effect maintained through the fourth week of medication. CONCLUSION Our results indicate that VOC could replace another anxiolytic medication in managing the symptoms of anxiety in patients with severe anxious MDD already within the first week of treatment.
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Affiliation(s)
- Tomas Kulhan
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | | | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Ivan Farsky
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Gabriela Nosalova
- Department of Pharmacology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
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Oppa M, Ondrejka I, Cesnekova D, Tonhajzerova I, Nosalova G. Efficacy of vortioxetine monotherapy compared with combined therapy vortioxetine and olanzapine in the treatment of major depression – first results. European Pharmaceutical Journal 2017. [DOI: 10.1515/afpuc-2017-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Vortioxetine is a novel antidepressant with two mechanisms of action – direct effect on several serotonin receptors and serotonin reuptake inhibition. Atypical antipsychotics, such as olanzapine, used in the augmentation of antidepressants causes not only a better response to treatment, but also increased number of remissions. The aim of our work was to evaluate the efficacy of vortioxetine monotherapy compared to the combined treatment vortioxetine and olanzapine in adult patients with depression during the acute phase of treatment lasting 6 weeks. Depressive symptomatology was assessed by the MADRS scale, anxiety symptoms were assessed by the HAM-A scale and global clinical impression were evaluated by the CGI-S scale. The number of patients in full-analysis set was 28. The results showed statistically significant improvement in CGI-S for both groups. Patients with vortioxetine monotherapy showed significant improvement in MADRS total score from the third week of treatment (p = 0.009) compared to patients with combined therapy that showed significant improvement since the end of first week of treatment (p = 0.036). Both groups showed significant improvement in HAM-A total score from the second week of treatment. Our results show the possibility of olanzapine in the augmentation strategy in treatment of major depressive disorder in adult patients.
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Affiliation(s)
| | - I. Ondrejka
- Comenius University in Bratislava , Jessenius Faculty of Medicine in Martin, Biomedical Center Martin , Martin , Slovak Republic
| | - D. Cesnekova
- Comenius University in Bratislava , Jessenius Faculty of Medicine in Martin, Biomedical Center Martin , Martin , Slovak Republic
| | - I. Tonhajzerova
- Comenius University in Bratislava , Jessenius Faculty of Medicine in Martin, Biomedical Center Martin , Martin , Slovak Republic
| | - G. Nosalova
- Comenius University in Bratislava , Jessenius Faculty of Medicine in Martin, Department of Pharmacology , Martin , Slovak Republic
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Cesneková D, Ondrejka I, Oppa M, Tonhajzerová I, Nosáľová G. Pharmacotherapy of adolescent depression - fluoxetine monotherapy or combined treatment? European Pharmaceutical Journal 2017. [DOI: 10.1515/afpuc-2017-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Depressive disorder is one of the most common and serious psychiatric diagnosis in paediatric population, often connected with suicidal risk. In recent years, fluoxetine monotherapy is the gold standard in acute phase of depression treatment in children and adolescents, but is not effective enough after an acute phase of treatment. More helpful researches concerning more effective therapeutic strategies of depression in this age are insufficient. The aim of our study is to evaluate the effectiveness and safety of fluoxetine monotherapy in comparison with combined olanzapine/fluoxetine therapy in acute 6-week treatment of depression in adolescence. We found that combined therapeutic strategy, using olanzapine augmentation is predicted to be more useful in the treatment of adolescent depression.
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Affiliation(s)
- D. Cesneková
- Comenius University in Bratislava , Jessenius Faculty of Medicine in Martin, Biomedical Center Martin , Martin , Slovak Republic
| | - I. Ondrejka
- Comenius University in Bratislava , Jessenius Faculty of Medicine in Martin, Biomedical Center Martin , Martin , Slovak Republic
| | - M. Oppa
- Comenius University in Bratislava , Jessenius Faculty of Medicine in Martin, Biomedical Center Martin , Martin , Slovak Republic
| | - I. Tonhajzerová
- Comenius University in Bratislava , Jessenius Faculty of Medicine in Martin, Biomedical Center Martin , Martin , Slovak Republic
| | - G. Nosáľová
- Comenius University in Bratislava , Jessenius Faculty of Medicine in Martin, Department of Pharmacology , Martin , Slovak Republic
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Mahmood S, Evinová A, Škereňová M, Ondrejka I, Lehotský J. Association of EGF, IGFBP-3 and TP53 Gene Polymorphisms with Major Depressive Disorder in Slovak Population. Cent Eur J Public Health 2017; 24:223-230. [PMID: 27755861 DOI: 10.21101/cejph.a4301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/27/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a main public health concern worldwide. Despite extensive investigations, the exact mechanisms responsible for MDD have not been identified. Epidermal growth factor (EGF) and insulin growth factor binding protein-3 (IGFBP-3) are involved in brain function. Tumour suppressor protein p53 is widely involved in neuronal death in response to different forms of acute insults and neurological disorders. The present study focuses on the possible associations of the single-nucleotide polymorphisms (SNP) of EGF A61G (rs4444903), IGFBP-3 C32G (rs2854746) and TP53 G72C (rs1042522) genes with MDD risk in the Slovak population. METHODS The present case-control association study was carried out in 111 confirmed MDD patients and 207 healthy subjects. Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism methods. RESULTS Logistic regression analysis showed no association between SNPs of selected genes and MDD risk in the Slovak population. However, the stratification of individuals by gender revealed that males carrying IGFBP-3 G alleles (G32G or GG) had marginally increased risk for developing MDD as compared to CC homozygous males (p=0.09). In women, inverse association was observed between SNP rs1042522 and MDD risk (p=0.04 for recessive model). CONCLUSION Our results suggest the protective effect of minor allele 72C of TP53 gene towards MDD. The disruption of mechanisms involved in cell survival and death regulation may be involved in pathophysiology of MDD.
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Affiliation(s)
- Silvia Mahmood
- Department of Molecular Medicine, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Biomedical Centre Martin (BioMed Martin), Martin, Slovakia.,Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Andrea Evinová
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Mária Škereňová
- Department of Clinical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin University Hospital, Martin, Slovakia
| | - Igor Ondrejka
- Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Clinic of Psychiatry, Martin University Hospital, Martin, Slovakia
| | - Ján Lehotský
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia.,Department of Neurosciences, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Biomedical Centre Martin (BioMed Martin), Martin, Slovakia
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Abstract
Abstract
Vortioxetine is a novel antidepressant with two mechanisms of action – direct effect on several serotonin receptors and serotonin re-uptake inhibition. It shows antidepressant, anxiolytic and cognitive effects during the treatment of major depressive disorder (MDD). The aim of this article was to summarize the use of vortioxetine in clinical studies and assess the efficacy and tolerability. Most of the studies reported a statistically significant efficacy for vortioxetine versus placebo. In addition, vortioxetine showed efficacy in patients with an inadequate response to selective serotonin re-uptake inhibitors (SSRI) or serotonin-noradrenaline re-uptake inhibitors (SNRI) monotherapy and improved cognitive function in patients with MDD. In these studies, vortioxetine was well tolerated – most common observed adverse effect was nausea – and it was not associated with clinically important changes in laboratory test results or vital signs. Vortioxetine showed a relatively low incidence of sexual dysfunction.
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Affiliation(s)
- M Oppa
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital Martin, Department of Pharmacology
- Clinic of Psychiatry, Slovakia
| | - D Cesnekova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital Martin, Department of Pharmacology
- Clinic of Psychiatry, Slovakia
| | - G Nosalova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital Martin, Department of Pharmacology
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava
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Oppa M, Kulhan T, Nosáľová G, Ondrejka I. Acute phase of depression treatment - current research and its perspectives on Jessenius Faculty of Medicine. European Pharmaceutical Journal 2016. [DOI: 10.1515/afpuc-2016-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
In the previous research at Jessenius Faculty of Medicine in Martin has been studied depression and its treatment from the aspects of the quality of life and functioning of the patients, as well as comparing the efficacy and safety of venlafaxine versus venlafaxine and olanzapine treatment. Last years have been studied the parameters of the autonomic nervous system in the context of depression. Our new work will build on these findings, during the exploration of efficacy and safety of a novel antidepressant vortioxetine in monotherapy and in combination with olanzapine. Since combination of vortixetine and olanzapine is not yet understood, it is unknown whether the effect of the treatment of depressive symptoms and associated problems will be stronger and faster compared to vortioxetine monotherapy.
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Affiliation(s)
- M. Oppa
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Clinic of Psychiatry, Martin Slovakia
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Pharmacology, Martin, Slovakia
| | - T. Kulhan
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Clinic of Psychiatry, Martin, Slovakia
| | - G. Nosáľová
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Department of Pharmacology, Martin Slovakia
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Biomedical Center Martin, Martin, Slovakia
| | - I. Ondrejka
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Clinic of Psychiatry, Martin, Slovakia
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Tonhajzerova I, Farsky I, Mestanik M, Visnovcova Z, Mestanikova A, Hrtanek I, Ondrejka I. Symbolic dynamics of heart rate variability — a promising tool to investigate cardiac sympathovagal control in attention deficit/hyperactivity disorder (ADHD)? Can J Physiol Pharmacol 2016; 94:579-87. [DOI: 10.1139/cjpp-2015-0375] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We aimed to evaluate complex cardiac sympathovagal control in attention deficit/hyperactivity disorder (ADHD) by using heart rate variability (HRV) nonlinear analysis — symbolic dynamics. We examined 29 boys with untreated ADHD and 25 healthy boys (age 8–13 years). ADHD symptoms were evaluated by ADHD-RS-IV scale. ECG was recorded in 3 positions: baseline supine position, orthostasis, and clinostasis. Symbolic dynamics indices were used for the assessment of complex cardiac sympathovagal regulation: normalised complexity index (NCI), normalised unpredictability index (NUPI), and pattern classification measures (0V%, 1V%, 2LV%, 2UV%). The results showed that HRV complexity was significantly reduced at rest (NUPI) and during standing position (NCI, NUPI) in ADHD group compared to controls. Cardiac-linked sympathetic index 0V% was significantly higher during all posture positions and cardiovagal index 2LV% was significantly lower to standing in boys suffering from ADHD. Importantly, ADHD symptom inattention positively correlated with 0V%, and negatively correlated with NCI, NUPI. Concluding, symbolic dynamics revealed impaired complex neurocardiac control characterised by potential cardiac beta-adrenergic overactivity and vagal deficiency at rest and to posture changes in boys suffering from ADHD that is correlated with inattention. We suggest that symbolic dynamics indices could represent promising cardiac biomarkers in ADHD.
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Affiliation(s)
- Ingrid Tonhajzerova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU), Department of Physiology JFM CU and Biomedical Center Martin JFM CU, Mala Hora 4C, 03601 Martin, Slovak Republic
| | - Ivan Farsky
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU), Clinic of Psychiatry JFM CU, University Hospital Martin, Kollarova 2 and Department of Nursing JFM CU, Mala Hora 5, 03601 Martin, Slovak Republic
| | - Michal Mestanik
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU), Department of Physiology JFM CU and Biomedical Center Martin JFM CU, Mala Hora 4C, 03601 Martin, Slovak Republic
| | - Zuzana Visnovcova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU), Department of Physiology JFM CU and Biomedical Center Martin JFM CU, Mala Hora 4C, 03601 Martin, Slovak Republic
| | - Andrea Mestanikova
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU), Department of Physiology JFM CU and Biomedical Center Martin JFM CU, Mala Hora 4C, 03601 Martin, Slovak Republic
| | - Igor Hrtanek
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU), Clinic of Psychiatry JFM CU and University Hospital Martin, Kollarova 2, 03601 Martin, Slovak Republic
| | - Igor Ondrejka
- Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU), Clinic of Psychiatry JFM CU and University Hospital Martin, Kollarova 2, 03601 Martin, Slovak Republic
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Snircova E, Marcincakova-Husarova V, Hrtanek I, Kulhan T, Ondrejka I, Nosalova G. Anxiety reduction on atomoxetine and methylphenidate medication in children with ADHD. Pediatr Int 2016; 58:476-81. [PMID: 26579704 DOI: 10.1111/ped.12847] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/21/2015] [Accepted: 11/13/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atomoxetine and methylphenidate are widely used to treat attention-deficit-hyperactivity disorder (ADHD) with similar effectiveness after 8 weeks of treatment, when atomoxetine has reached its a full effect. Both drugs have also been shown to have an effect on comorbid anxiety. To the best of our knowledge, no study has compared their effect on the dynamics of anxiety symptom reduction. The aim of this study was to compare the medication effect on core and comorbid anxiety symptom dynamics in children with ADHD. METHODS Sixty-nine patients participated in the study: 36 patients were taking atomoxetine and 33 patients, methylphenidate. Therapeutic effect on core symptoms of ADHD was measured on the ADHD-rating scale IV, and symptoms of anxiety were measured using the Conners Parent Rating Scale (CPRS). Symptoms were measured prior to and every 2 weeks during 8 weeks of treatment. RESULTS There was a significant decrease in CPRS anxiety subscale score in both medication groups. Anxiety subscale score was significantly lower in the atomoxetine group in the fourth week, and lasted through to 8 weeks of medication. CONCLUSION Both atomoxetine and methylphenidate reduced the symptoms of ADHD and anxiety. Atomoxetine was more effective in anxiety symptom reduction from the fourth week of treatment.
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Affiliation(s)
- Eva Snircova
- Institute of Pharmacology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.,Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Veronika Marcincakova-Husarova
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.,Institute of Physiology, Medical Faculty Comenius University, Bratislava, Slovakia
| | - Igor Hrtanek
- Institute of Pharmacology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.,Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Tomas Kulhan
- Institute of Pharmacology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.,Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Gabriela Nosalova
- Institute of Pharmacology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
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Husarova VM, Lakatosova S, Pivovarciova A, Babinska K, Bakos J, Durdiakova J, Kubranska A, Ondrejka I, Ostatnikova D. Plasma Oxytocin in Children with Autism and Its Correlations with Behavioral Parameters in Children and Parents. Psychiatry Investig 2016; 13:174-83. [PMID: 27081377 PMCID: PMC4823192 DOI: 10.4306/pi.2016.13.2.174] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 05/08/2015] [Accepted: 06/04/2015] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Oxytocin (OT) has been implicated to play an important role in autism spectrum disorders (ASD) etiology. We aimed to find out the differences in plasma OT levels between children with autism and healthy children, the associations of OT levels with particular autism symptoms and the associations of particular parental autistic traits with their ASD children OT levels. METHODS We included 19 boys with autism and 44 healthy age-matched boys. OT levels were analyzed by ELISA method. Children with autism were scored by Childhood Autism Rating Scale and Autism Diagnostic Interview (ADI), adjusted research version. Autism Spectrum Quotient (AQ), Systemizing Quotient (SQ) and Empathizing Quotient were completed by parents of children with autism. RESULTS Children with autism had significantly lower plasma OT levels than controls. OT levels positively correlated with ADI Reciprocal Interaction and Communication scores. AQ and SQ of fathers positively correlated with children plasma OT level. CONCLUSION Our results support the hypothesis of OT deficiency in autism. The "paradoxical" associations of OT levels and social skills in children with autism indicate disturbances at various levels of OT system. We first reported associations of OT levels in children with autism and behavioral measures in fathers indicating that OT abnormalities stay between parental autistic traits and autism symptoms in their children.
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Affiliation(s)
- Veronika Marcincakova Husarova
- Institute of Physiology, Medical Faculty Comenius University, Bratislava, Slovakia
- Clinic of Psychiatry, Martin University Hospital and Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Silvia Lakatosova
- Institute of Physiology, Medical Faculty Comenius University, Bratislava, Slovakia
| | - Anna Pivovarciova
- Institute of Physiology, Medical Faculty Comenius University, Bratislava, Slovakia
| | - Katarina Babinska
- Institute of Physiology, Medical Faculty Comenius University, Bratislava, Slovakia
| | - Jan Bakos
- Institute of Physiology, Medical Faculty Comenius University, Bratislava, Slovakia
| | - Jaroslava Durdiakova
- Institute of Physiology, Medical Faculty Comenius University, Bratislava, Slovakia
| | - Aneta Kubranska
- Institute of Physiology, Medical Faculty Comenius University, Bratislava, Slovakia
| | - Igor Ondrejka
- Clinic of Psychiatry, Martin University Hospital and Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia
| | - Daniela Ostatnikova
- Institute of Physiology, Medical Faculty Comenius University, Bratislava, Slovakia
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Mestanikova A, Ondrejka I, Mestanik M, Hrtanek I, Snircova E, Tonhajzerova I. Electrodermal Activity in Adolescent Depression. Advances in Experimental Medicine and Biology 2016; 935:83-8. [DOI: 10.1007/5584_2016_40] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Hrtanek I, Ondrejka I, Tonhajzerova I, Snircova E, Kulhan T, Farsky I, Nosalova G. The Effect of Methylphenidate on Neurological Soft Signs in ADHD. Psychiatry Investig 2015; 12:545-50. [PMID: 26508967 PMCID: PMC4620313 DOI: 10.4306/pi.2015.12.4.545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/11/2015] [Accepted: 02/16/2015] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Neurological soft signs are very common in children with the attention deficit hyperactivity disorder (ADHD), and the first line medication of this disorder is methylphenidate. The aim of the study was to assess the effect of methylphenidate on the neurological soft signs in children and adolescents suffering from ADHD depending on the dose of methylphenidate. METHODS Thirty five patients with ADHD were investigated by the ADHD RS-IV parent version questionnaire and the Revised Neurological Examination for Subtle Signs before treatment adjustment and after four weeks of methylphenidate medication. The changes in hyperactivity symptomatology, neurological soft signs during therapy and the influence of the methylphenidate dose were statistically analyzed. RESULTS A significant decrease in hyperactivity symptomatology was found after one month of methylphenidate medication (p=0.0001) and significant decrease in neurological soft signs was demonstrated in 21 from a total of 26 items (p<0.05). Correlation analysis showed no relationship between the dose of methylphenidate and the improvement of neurological soft signs. Similarly, the improvement of ADHD symptomatology had not correlation with the improvement of neurological soft signs. CONCLUSION The study demonstrated the positive effect of methylphenidate on neurological soft signs in which improvement occurred independently of the dose, indicating that their progress may be due to methylphenidate treatment of any dose. The unrelated effect of methylphenidate on the attention deficit hyperactivity disorder and neurological soft signs suggest that methylphenidate might be useful in the therapy of clumsy child syndrome and in ADHD treatment of non-responders.
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Affiliation(s)
- Igor Hrtanek
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
- Clinic of Psychiatry, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Eva Snircova
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
- Clinic of Psychiatry, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Tomas Kulhan
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
- Clinic of Psychiatry, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Ivan Farsky
- Clinic of Psychiatry, Jessenius Faculty of Medicine and University Hospital in Martin, Comenius University in Bratislava, Martin, Slovakia
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Gabriela Nosalova
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
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Husarova V, Bittsansky M, Ondrejka I, Dobrota D. Correlations of ADHD symptoms with neurometabolites measured by 1H magnetic resonance spectroscopy. ACTA ACUST UNITED AC 2015; 115:635-42. [PMID: 25573731 DOI: 10.4149/bll_2014_123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Despite the number of studies on neurometabolite changes in ADHD (Attention deficit/hyperactivity disorder), there is lack of evidence on neurometabolite associations with ADHD symptoms. BACKGROUND We aimed to find the correlations of neurometabolites with ADHD symptoms. METHODS Twenty ADHD children were examined by means of 1H-MRS. The spectra were taken from dorsolateral prefrontal cortex (DLPFC) and white matter behind DLPFC, bilaterally. Neurometabolites were correlated with ADHD-RS-IV (ADHD-Rating Scales IV), CPRS (Conners Parent rating Scale) and DPREMB (Daily Parent Rating of Evening and Morning Behavior) scores. RESULTS NAA/Cr (N-acetylaspartate/creatine) in the right DLPFC positively correlated with CPRS subscale IV learning problems and negatively correlated in the left white matter with DPREMB morning behavior subscale and ADHD-RS-IV score. Glx/Cr (glutamate + glutamine/creatine) positively correlated in the right white matter with ADHD-RS-IV and negatively correlated in the left white matter with DPREMB morning behavior subscale score. Cho/Cr (choline/creatine) in the left white matter negatively correlated with DPREMB morning behavior subscale and ADHD-RS-IV score. CONCLUSION ADHD symptoms could result from different activities of the left- and right-hemisphere prefrontal circuits. In consequence to impulses to novel task searching the increased right prefrontal circuit activity could be mediated by different motivational control (Fig. 9, Ref. 73).
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Tonhajzerova I, Ondrejka I, Mestanik M, Mikolka P, Hrtanek I, Mestanikova A, Bujnakova I, Mokra D. Inflammatory Activity in Autism Spectrum Disorder. Adv Exp Med Biol 2015; 861:93-8. [PMID: 26022900 DOI: 10.1007/5584_2015_145] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Autism spectrum disorder (ASD) is a severe neurodevelopmental disorder in early childhood characterized by impairment in communication and behavior. Recent research is focused on the immune dysregulation as a potential pathomechanism leading to ASD. Thus, we addressed the hypothesis that inflammatory activity might be enhanced in children suffering from ASD. We examined 15 children with ASD (13 boys/2 girls, mean age of 9.3 ± 0.7 years) and 20 age/gender-matched healthy subjects as a control group. All children were medication free and in good health. Hematological parameters in venous blood and plasma levels of pro-inflammatory cytokines - tumor necrosis factor alpha (TNF-α), interleukin 1ß (IL-1ß), and interleukin 8 (IL-8) - were assessed in each subject using human ultra-sensitive ELISA kits. In addition, TBARS as a marker of oxidative stress was evaluated. We found that the level of IL-8 was significantly increased in the ASD children, whereas the other markers remained unappreciably changed compared to controls (p = 0.003). In conclusion, the study demonstrates a discrete immune dysfunction in ASD of pro-inflammatory character.
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Affiliation(s)
- I Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4, 036 01, Martin, Slovakia
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Nosálová G, Sivová V, Ray B, Fraňová S, Ondrejka I, Flešková D. Antitussive activity of Withania somnifera and opioid receptors. Adv Exp Med Biol 2014; 838:19-25. [PMID: 25252908 DOI: 10.1007/5584_2014_79] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Arabinogalactan is a polysaccharide isolated from the roots of the medicinal plant Withania somnifera L. It contains 65% arabinose and 18% galactose. The aim of the present study was to evaluate the antitussive activity of arabinogalactan in conscious, healthy adult guinea pigs and the role of the opioid pathway in the antitussive action. A polysaccharide extract was given orally in a dose of 50 mg/kg. Cough was induced by an aerosol of citric acid in a concentration 0.3 mol/L, generated by a jet nebulizer into a plethysmographic chamber. The intensity of cough response was defined as the number of cough efforts counted during a 3-min exposure to the aerosol. The major finding was that arabinogalactan clearly suppressed the cough reflex; the suppression was comparable with that of codeine that was taken as a reference drug. The involvement of the opioid system was tested with the use of a blood-brain barrier penetrable, naloxone hydrochloride, and non-penetrable, naloxone methiodide, to distinguish between the central and peripheral mu-opioid receptor pathways. Both opioid antagonists acted to reverse the arabinogalactan-induced cough suppression; the reversion was total over time with the latter antagonist. We failed to confirm the presence of a bronchodilating effect of the polysaccharide, which could be involved in its antitussive action. We conclude that the polysaccharide arabinogalactan from Withania somnifera has a distinct antitussive activity consisting of cough suppression and that this action involves the mu-opioid receptor pathways.
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Affiliation(s)
- Gabriela Nosálová
- Department of Pharmacology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia,
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Tonhajzerova I, Ondrejka I, Chladekova L, Farsky I, Visnovcova Z, Calkovska A, Jurko A, Javorka M. Heart rate time irreversibility is impaired in adolescent major depression. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:212-7. [PMID: 22771778 DOI: 10.1016/j.pnpbp.2012.06.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 06/15/2012] [Accepted: 06/29/2012] [Indexed: 01/26/2023]
Abstract
UNLABELLED We aimed to study heart rate time irreversibility--a nonlinear qualitative characteristics of heart rate variability indicating complexity of cardiac autonomic control at rest and in response to physiological stress (orthostasis) in never-treated major depressive disorder (MDD) adolescent female patients. METHODS We studied 20 MDD girls and 20 healthy age-matched girls at the age of 15 to 18 years. The ECG was recorded in supine position and in response to position change from lying to standing (orthostasis). Time irreversibility analysis was performed using Porta's (P%), Guzik's (G%) and Ehlers' (E) index. The depressive disorder severity was evaluated using Montgomery-Asberg Depression Rating Scale (MADRS) and Children's Depression Inventory (CDI). RESULTS Resting heart rate time irreversibility indices (logG%, logP%, Ehlers' index) were significantly reduced in MDD female patients without significant differences in response to orthostasis in MDD girls compared to controls. No significant correlations between time irreversibility and MDD severity were observed. CONCLUSION This study revealed the impaired heart rate asymmetry pattern indicating an altered complexity of cardiac autonomic regulation in adolescent female patients suffering from MDD.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
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Husarova V, Bittsansky M, Ondrejka I, Kerna V, Dobrota D. Hippocampal neurometabolite changes in depression treatment: a (1)H magnetic resonance spectroscopy study. Psychiatry Res 2012; 201:206-13. [PMID: 22507761 DOI: 10.1016/j.pscychresns.2011.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 05/31/2011] [Accepted: 07/10/2011] [Indexed: 01/08/2023]
Abstract
Previous studies using magnetic resonance spectroscopy have related abnormalities in hippocampal metabolism to depression. Current evidence is consistent with the conclusion that the hippocampal formation plays an important role in the presentation of depressive symptoms. Eighteen adult patients with major depressive disorder, aged 20 to 60 years, underwent magnetic resonance spectroscopy of the hippocampus during a period of depressive symptomatology and after 7-11 weeks of antidepressant medication with at least 50% reduction in the Montgomery-Åsberg Depression Rating Scale ()MADRS score. During therapy, we found a significantly decreased Lac/Cr ratio in the left hippocampus. The Ins/Cr ratio showed a significant negative correlation with the severity of depression as assessed by the MADRS at baseline. Moreover, we found a negative association of NAA/Cho with age and a positive association of Cho/Cr with age, both on the left and right sides at baseline. In light of our findings and previous studies results we hypothesize that mitochondrial dysfunction leading to predominantly anaerobic glycolysis in connection with the intracellular signaling pathways disturbances and decreased astrocytic function/number might subsequently lead to decreased brain neuroplasticity in depression. These mechanisms could be positively influenced by antidepressant treatment with selective serotonin or norepineprine reuptake inhibitors, with potential effects on untimely neuronal aging in depression.
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Evinova A, Babusikova E, Straka S, Ondrejka I, Lehotsky J. Analysis of genetic polymorphisms of brain-derived neurotrophic factor and methylenetetrahydrofolate reductase in depressed patients in a Slovak (Caucasian) population. Gen Physiol Biophys 2012; 31:415-22. [DOI: 10.4149/gpb_2012_049] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Goetz M, Yeh CB, Ondrejka I, Akay A, Herczeg I, Dobrescu I, Kim BN, Jin X, Riley AW, Martényi F, Harrison G, Treuer T. A 12-month prospective, observational study of treatment regimen and quality of life associated with ADHD in central and eastern europe and eastern Asia. J Atten Disord 2012; 16:44-59. [PMID: 20858785 DOI: 10.1177/1087054710381480] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This prospective, observational, non-randomized study aimed to describe the relationship between treatment regimen prescribed and the quality of life (QoL) of ADHD patients in countries of Central and Eastern Europe (CEE) and Eastern Asia over 12 months. METHODS 977 Male and female patients aged 6-17 years seeking treatment for symptoms of ADHD were assessed using the Child and Adolescent Symptom Inventory-4 Parent Checklists, and the Clinical Global Impressions-ADHD-Severity scale. QoL was assessed using the Child Health and Illness Profile-Child Edition parent report form. Patients were grouped according to whether they were prescribed psycho- and/or pharmacotherapy (treatment) or not (no/'other' treatment). RESULTS No statistically significant differences were observed between cohorts (treatment vs. no/'other' treatment) in terms of change in QoL, although there was improvement over 12 months, with a greater improvement experienced by patients in the treatment cohort in both study regions (CEE and Eastern Asia). Psychoeducation/counselling and methylphenidate were the predominant ADHD treatments prescribed. CONCLUSIONS Although both treatment and no/'other' treatment cohorts showed improvements in mean QoL over 12 months, the difference was small and not statistically significant. A major limitation was the higher than anticipated number of patients switching treatments, predominantly from the no/'other' treatment cohort.
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Affiliation(s)
- Michal Goetz
- Charles University, Second Medical Faculty, Prague, Czech Republic
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Ondrejka I, Abali O, Paclt I, Gácser M, Iftene F, Walton R, Harrison G, Treuer T, Martényi F. A prospective observational study of attention-deficit/hyperactivity disorder in Central and Eastern Europe and Turkey: Symptom severity and treatment options in a paediatric population. Int J Psychiatry Clin Pract 2010; 14:116-26. [PMID: 24922471 DOI: 10.3109/13651500903556511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Objective. This study investigates the relationship between treatment regimen, symptom severity, comorbidities and health outcomes of paediatric patients with attention-deficit/hyperactivity disorder (ADHD) in Central and Eastern Europe (CEE). Methods. Males and females aged 6-17 years with ADHD symptoms participated in this 12-month, prospective, observational, non-randomised study. Symptoms and comorbidities were assessed using the Child and Adolescent Symptom Inventory-4 Parent Checklists (CSI-4; ASI-4, categories L/O), and the Clinical Global Impressions-ADHD-Severity scale (CGI-ADHD-S). Baseline data are presented. Results. The study included 566 patients from Czech Republic, Hungary, Romania, Slovakia and Turkey. Psychiatrists made all diagnoses using The American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV), World Health Organization International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), and "other" criteria (73, 27 and 0.4%, respectively). Patients were grouped into two cohorts based on whether they were prescribed psycho- and/or pharmacotherapy (n=443) or not (n=123). Patients receiving prescribed treatment were older and demonstrated higher symptom severity scores than those receiving no or "other" treatment. Most patients were prescribed conventional treatment for ADHD at baseline. Conclusions. Continued assessment of this population may aid the treatment and outcomes of ADHD in CEE.
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Affiliation(s)
- Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic
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Tonhajzerova I, Ondrejka I, Javorka K, Turianikova Z, Farsky I, Javorka M. Cardiac autonomic regulation is impaired in girls with major depression. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:613-8. [PMID: 20219623 DOI: 10.1016/j.pnpbp.2010.02.023] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 02/22/2010] [Accepted: 02/22/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED We aimed to study short-term heart rate variability (HRV) as an index of cardiac autonomic control in never-treated major depressive disorder (MDD) adolescent patients using linear and nonlinear analysis. METHODS We have examined 20 MDD girls and 20 healthy age-matched girls at the age of 15 to 18yr. The ECG was recorded in three positions: the 1st supine rest, orthostasis, the 2nd supine position. HRV magnitude was quantified by time and frequency-domain analysis (mean RR interval, SDRR, RMSSD, spectral powers in low [LF] and high frequency [HF] bands). In addition to linear measures, HRV complexity was assessed by nonlinear (symbolic dynamics) indices: normalized complexity index (NCI), normalized unpredictability index (NUPI), and pattern classification measures (0V%, 1V%, 2LV%, 2UV%). RESULTS HRV magnitude (RMSSD, SDRR, LF and HF powers) was significantly decreased in MDD group in a supine rest and after posture change. HRV complexity was significantly reduced (lower NCI) in the standing position. Pattern classification analysis revealed significantly higher 0V% and lower 2LV% in MDD group in supine position and orthostasis. CONCLUSION The HRV linear and nonlinear analysis revealed decreased magnitude and complexity of heart rate time series indicating altered neurocardiac regulation in girls with major depression without pharmacotherapy.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology and Center of Excellence for Perinatology Research, Jessenius Faculty of Medicine, Comenius University, 036 01 Martin, Slovak Republic.
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Husarova V, Ondrejka I, Tonhajzerova I. Potential pathomechanisms of ADHD based on neurometabolite changes. Neuro Endocrinol Lett 2010; 31:438-445. [PMID: 20802444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 06/10/2010] [Indexed: 05/29/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a most common psychiatric disorder in the childhood. The exact pathomechanisms related to ADHD core symptoms--hyperactivity, impulsivity and inattention--are still unclear. The developmental dysfunction of cortical-striatal-thalamic-cortical network combined with the dysregulation of catecholamine neurotransmitters could be responsible for symptoms of the disorder. Magnetic resonance spectroscopy is a method which allows a partial view on molecular mechanisms of biochemical and metabolic processes in human brain by in vivo measurement. We address the hypothesis of a potential pathomechanisms associated with ADHD symptoms which is based on the studies concerning magnetic resonance spectroscopy method and ADHD.
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Affiliation(s)
- Veronika Husarova
- Clinic of Psychiatry, Department of Physiology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
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Kerna V, Nosalova G, Ondrejka I. Metabolic risk in selected second-generation antipsychotics. BRATISL MED J 2010; 111:640-643. [PMID: 21384731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Many studies have reported higher incidence of metabolic abnormalities in patients receiving antipsychotic medications than in general population. OBJECTIVES The objective of our study was to determine the prevalence of metabolic syndrome in a group of patients receiving long-lasting antipsychotic treatment and also whether the cardiovascular risk among different second-generation antipsychotics varies. METHODS Our study group consisted of 71 patients who were on antipsychotic monotherapy for at least 12 months. In each patient, fasting plasma glucose, HDL cholesterol, triglycerides, liver enzymes, bilirubin and plasma immunoreactive insulin levels were examined. We measured body weight, height, body mass index, waist circumference and body fat percentage together with blood pressure and heart rate. We assessed metabolic syndrome prevalence in the study group and correlations among its components as well as between them and other variables. The data were processed by statistics programme STATISTICA 8.0. For detection of correlations Spearman's rank correlation test was used. RESULTS The prevalence of metabolic syndrome in our sample reached 41%. The highest prevalence rate of 50% was detected in the olanzapine subgroup. Identical prevalence of 40% was observed in quetiapine and risperidone subgroups. The lowest prevalence of 25% and 31% was observed in sertindol and amisulpirid subgroup, respectively. The prevalence rate of metabolic syndrome in men was 51% compared to 34% in women. CONCLUSION According to metabolic syndrome prevalence rates olanzapine appears to be associated with the highest cardiovascular risk, amisulpirid and sertindol appear to be much safer (Tab. 2, Ref. 13).
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Affiliation(s)
- V Kerna
- Institute of Pharmacology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Slovakia.
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Tonhajzerova I, Ondrejka I, Adamik P, Hruby R, Javorka M, Trunkvalterova Z, Mokra D, Javorka K. Changes in the cardiac autonomic regulation in children with attention deficit hyperactivity disorder (ADHD). Indian J Med Res 2009; 130:44-50. [PMID: 19700800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND & OBJECTIVE ADHD is one of the most common mental disorders among children. We hypothesized that ADHD is associated with the impairment of the cardiac autonomic regulation. The aim of this study was to evaluate the cardiac autonomic regulation in children with ADHD at the rest and during orthostasis using short-term heart rate variability (HRV) analysis. METHODS Eighteen children with ADHD admitted to the Department of Children and Adolescent Psychiatry, Clinic of Psychiatry, University Hospital in Martin, Slovak Republic between January and September 2006 and 18 matched healthy subjects were recruited. HRV analysis was carried out in three positions: supine (S1)-orthostasis (O)-supine (S2). Evaluated parameters were: the mean R-R interval, mean squared successive difference (MSSD), spectral powers in low (LF) and high frequency (HF) bands, total power (TP), coefficients of component variance (CCV LF, CCV HF), LF/HF ratio. RESULTS The mean R-R interval was significantly shorter in ADHD group compared to controls in all positions (P<0.05, P<0.001). S1: The parameters MSSD, CCV HF, logHFpower were significantly lower (P<0.05, P<0.05, P<0.01) and ratio LF/HF was significantly higher (P<0.05) in ADHD group compared to controls. O: The parameters MSSD, CCVHF, logHFpower, logTP were significantly lower in ADHD group compared to controls (P<0.01, P<0.05, P<0.01, P<0.01). S2: The parameters MSSD and logHFpower were significantly lower in children with ADHD compared to controls (P<0.05). INTERPRETATION & CONCLUSION The children with ADHD had decreased cardiac vagal modulation and tachycardia in supine positions with altered ability of dynamic activation of the autonomic nervous system in response to orthostasis indicating changes in the cardiac autonomic regulation. Further studies need to be done on a larger sample to confirm these findings and to understand the underlying mechanisms.
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Affiliation(s)
- Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine, Comenius University, Martin Faculty Hospital, Martin, Slovak Republic.
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Hruby R, Nosalova G, Ondrejka I, Preiss M. Personality changes during antidepressant treatment. Psychiatr Danub 2009; 21:25-32. [PMID: 19270618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES We have investigated the changes of Temperament and Character Inventory (TCI) dimensions of personality in outpatients during 6 months of antidepressant treatment. SUBJECTS AND METHODS 30 outpatients were treated for mild or moderate depressive episode, current mild or moderate episode of reccurent depressive disorder or mixed anxiety and depressive disorder (ICD-10). The intensity of depression was assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) at the beginning of treatment and then after the 1st, 3rd and 6th month of treatment. The TCI dimensions were assessed by the Temperament and Character Inventory-Revised (TCI-R) at the same time periods as the MADRS. The mean scores of the TCI-R dimensions and MADRS were processed by Wilcoxon pair test. RESULTS We have observed a significant decrease in harm avoidance (HA) score after 6 months of treatment (p<0.05), between the 1st and 6th month (p<0.05), between the 3rd and 6th month, (p=0.033), significant increase in persistance (P) between the 1st and 6th month (p<0.05) and a significant decrease in self-transcendence (ST) score after 3 months (p<0.05) and after 6 months (p<0.05). In the MADRS total score we have observed a significant decrease after the 1st (p<0.001), 3rd (p<0.001) and also 6th month (p<0.001). CONCLUSIONS Our findings showed changes of personality dimensions HA, P and ST in outpatients during antidepressant treatment.
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Affiliation(s)
- Radovan Hruby
- Clinic of Psychiatry, Jessenius Faculty of Medicine, Martin, Slovak Republic.
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