Carbon dioxide induces erratic respiratory responses in bipolar disorder.
Carbon dioxide induces erratic respiratory responses in bipolar disorder.
复制标题
二氧化碳会导致双相情感障碍患者出现不稳定的呼吸反应。
DOI：
10.1016/j.jad.2008.03.020
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发表时间：
2009
影响因子：
6.6
通讯作者：
Lorenz,Laura
中科院分区：
文献类型：
--
作者：
Mackinnon,DeanF;Craighead,Brandie;Lorenz,Laura
CO2呼吸刺激焦虑和呼吸困难（“空气饥饿”），长期以来一直用于研究恐慌脆弱性和呼吸控制。与惊恐发作的高共病率表明双相情感障碍患者也可能对二氧化碳产生更高的焦虑反应。此外，唤醒和调节食欲的问题是躁狂症和抑郁症临床综合征的中心;因此，CO2可能引起对“空气饥饿”的异常呼吸反应。（34例双相I型，25例抑郁和双相型，13例无严重情感诊断）呼吸空气和含5%CO2的空气，经面罩呼吸各15 min;记录主观反应和呼吸反应。首先，一半的受试者偏离了对固定的轻度高碳酸血症环境的典型反应，即急剧增加呼吸，然后维持高碳酸血症平台。异常模式的最佳预测因素是双相情感障碍诊断和仅来自空气的焦虑。25个人有恐慌反应;恐慌反应从CO2更有可能在受试者与双相I相比，其他科目，但最好的预测恐慌反应的整体是焦虑从空气单独和先前的历史的恐慌attacks.LIMITATIONSHeterogeneous样本，自由定义的恐慌attacks.CONCLUSIONCO2产生异常的呼吸和提高焦虑反应的个人与双相和抑郁症。这可能是由于与恐惧和食欲有关的情绪调节缺陷。虽然是初步的，这项工作提出了一个潜在的有用的测试双相情感障碍的特定功能缺陷。
BACKGROUNDCO2respiration stimulates both anxiety and dyspnea (“air hunger”) and has long been used to study panic vulnerability and respiratory control. High comorbidity with panic attacks suggests individuals with bipolar disorder may also mount a heightened anxiety response to CO2. Moreover, problems in the arousal and modulation of appetites are central to the clinical syndromes of mania and depression; hence CO2may arouse an abnormal respiratory response to “air hunger”.METHODS72 individuals (34 bipolar I, 25 depressive and bipolar spectrum, 13 with no major affective diagnosis) breathed air and air with 5% CO2via facemask for up to 15 min each; subjective and respiratory responses were recorded.RESULTSNearly half the subjects diverged from the typical response to a fixed, mildly hypercapneic environment, which is to increase breathing acutely, and then maintain a hyperpneic plateau. The best predictors of an abnormal pattern were bipolar diagnosis and anxiety from air alone. 25 individuals had a panic response; panic responses from CO2were more likely in subjects with bipolar I compared to other subjects, however the best predictors of a panic response overall were anxiety from air alone and prior history of panic attacks.LIMITATIONSHeterogeneous sample, liberal definition of panic attack.CONCLUSIONCarbon dioxide produces abnormal respiratory and heightened anxiety responses among individuals with bipolar and depressive disorders. These may be due to deficits in emotional conditioning related to fear and appetite. Although preliminary, this work suggests a potentially useful test of a specific functional deficit in bipolar disorder.