Effects of rapid tryptophan depletion in patients with seasonal affective disorder in natural summer remission
Effects of rapid tryptophan depletion in patients with seasonal affective disorder in natural summer remission
复制标题
快速色氨酸消耗对季节性情感障碍患者夏季自然缓解的影响
作者：
R. Lam;T. Bowering;E. Tam;A. Grewal;L. Yatham;I. Shiah;A. Zis
背景。季节性情感障碍（SAD）的病理生理机制和强光治疗的治疗效果已被提出5 -羟色胺能机制。先前，我们发现SAD患者在冬季接受光疗后临床缓解，在快速色氨酸消耗（RTD）技术后经历短暂性抑郁复发，导致脑血清素水平降低。本研究的目的是探讨RTD对夏季自然缓解的SAD患者的影响。方法。12名符合DSM-IV标准的无药SAD患者和10名正常受试者参加了这项双盲、安慰剂对照、交叉研究。SAD患者的夏季自然缓解期至少为8周。在摄入氨基酸（AA）混合物±色氨酸前和摄入后5 h，测定小鼠的行为评分和血浆色氨酸水平。实验RTD与对照组间隔1周。结果。与对照组相比，RTD组血浆总色氨酸和游离色氨酸水平显著降低。使用重复测量方差分析对行为数据进行分析。本分析发现时间（AA摄入后得分较高）和诊断（SAD患者得分较高）有显著的主要影响，但疗程没有主要影响，三个因素之间也没有显著的相互作用。因此，与虚假消耗控制会话相比，RTD没有显著的行为影响。结论。SAD患者的夏季缓解与光疗后的缓解不同，不依赖于血浆色氨酸水平（可能也不依赖于脑血清素功能）。这些结果与其他实验室的结果相冲突，可能是因为研究样本的差异。
Background. Serotonergic mechanisms have been proposed for the pathophysiology of seasonal affective disorder (SAD) and the therapeutic effect of bright-light treatment. Previously, we showed that SAD patients, in clinical remission with light therapy during the winter, experienced transient depressive relapses after a rapid tryptophan depletion (RTD) technique, which results in decreased brain serotonin levels. The objective of this study was to investigate the effect of RTD in SAD patients who were in natural summer remission. Methods. Twelve drug-free patients with SAD by DSM-IV criteria and 10 normal subjects participated in this double-blind, placebo-controlled, crossover study. SAD patients were in natural summer remission for at least 8 weeks. Behavioural ratings and plasma tryptophan levels were obtained before, and 5 h after, ingesting an amino acid (AA) mixture±tryptophan. Experimental RTD and control sessions were scheduled 1 week apart. Results. The RTD session resulted in significant reduction in total and free plasma tryptophan levels compared to the control session. The behavioural data were analysed using repeated measures analysis of variance. This analysis found significant main effects of time (higher scores after AA ingestion) and diagnosis (higher scores in SAD patients), but no main effect of session or significant interaction effects between the three factors. Thus, there were no significant behavioural effects of RTD compared to the sham depletion control session. Conclusions. The summer remission experienced by SAD patients is not dependent on plasma tryptophan levels (and presumably brain serotonin function) in the same manner as that of remission after light therapy. These results conflict with those of other laboratories, perhaps because of differences in study samples.
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影响因子：
--
作者：
Moore,P;Gillin,C;Bhatti,T;DeModena,A;Seifritz,E;Clark,C;Stahl,S;Rapaport,M;Kelsoe,J
通讯作者：
Kelsoe,J
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DOI：
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发表时间：
1989
期刊：
The Journal of clinical psychiatry
影响因子：
--
作者：
O'Rourke,D;Wurtman,JJ;Wurtman,RJ;Chebli,R;Gleason,R
通讯作者：
Gleason,R
影响因子：
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作者：
R. Spitzer;Janet B W Williams;M. Gibbon;M. First
通讯作者：
R. Spitzer;Janet B W Williams;M. Gibbon;M. First
影响因子：
9.3
作者：
George M. Anderson;Young Jg;D. Cohen;K. Schlicht;Nirav Patel
通讯作者：
George M. Anderson;Young Jg;D. Cohen;K. Schlicht;Nirav Patel
影响因子：
--
作者：
Delgado,PL;Charney,DS;Price,LH;Aghajanian,GK;Landis,H;Heninger,GR
通讯作者：
Heninger,GR