BACKGROUND： Many researches have indicated that the imbalances of various amino acid transmitters and neurotransmitters in brain are involved in the formation of alcohol withdrawal, especially that glutamic acid is o...BACKGROUND： Many researches have indicated that the imbalances of various amino acid transmitters and neurotransmitters in brain are involved in the formation of alcohol withdrawal, especially that glutamic acid is one of the important transmitters for alcohol tolerance in central nervous system. OBJECTIVE： To observe the changes of excitatory amino acids in hippocampal dentate gyrus in rats with long-term alcohol drinking after withdrawal under consciousness, and investigate the therapeutic effect of topiramate on alcohol withdrawal. DESIGN ： A randomized control animal experiment SETTING ： Department of Neurology, Affiliated Hospital of Yanbian University MATERIALS： Thirty male Wistar rats of 4 months old, weighing 300-350 g, were purchased from the Experimental Animal Department, Medical College of Yanbian University. Topiramate was produced by Swish Cilag Company, and the batch number was 02CS063. METHODS： The experiments were carried out in the Department of Physiology, Medical College of Yanbian University from August 2005 to February 2006. ① The rats were divided randomly into three groups： control group （n=10）, alcohol group （n=10） and topiramate-treated group （n=10）. Rats in the alcohol group and topiramate-treated group were given intragastric perfusion of 500 g/L alcohol （10 mL/kg）, once a day for 4 weeks successively, and then those in the topiramate-treated group were treated with 80 mg/kg topiramate at 24 hours after the last perfusion of alcohol, once a day for 3 days successively. Rats in the control group were intragastricly given isovolume saline. ② The withdrawal symptoms were assessed at 6, 30, 48 and 72 hours after the last perfusion of alcohol by using the withdrawal rating scale set by Erden et al, which had four observational indexes of stereotyped behaviors, agitation, tail stiffness and abnormal posture, each index was scored by 5 points, the higher the score, the more obvious the symptoms. ③ The contents of aspartic acid and glutamic acid in hippocampal dentate gyrus were detected with microdialysis technique and high-performance liquid chromatograpy （HPLC） respectively at 6, 30, 48 and 72 hours after the last perfusion of alcohol in the three groups. MAIN OUTCOME MEASURES ： ① Scoring results of alcohol withdrawal symptoms; ② Changes of the contents of aspartic acid and glutamic acid in hippocampal dentate gyrus at the alcohol withdrawal symptoms, and the effects of topiramate. RESULTS： Seven rats were excluded due to inaccurate localization and natural death, and 23 rats were involved in the analysis of results. ①In the alcohol group, the scores of alcohol withdrawal symptoms at 30 and 48 hours after the last perfusion of alcohol were obviously higher than those in the control group （10.50±0.96, 14.17±1.25; 3.50±0.92, 3.16±0,31; P 〈 0.01）. In the topiramate-treated group, the scores at 30 hours after the last perfusion of alcohol （6.06±0.82, 3.50±0.92, P 〈 0.05）, and the withdrawal scores at 48 and 72 hours were close to those in the control group （4.57±0.58, 3.30±0.71; 3.16±0.31, 3.66±0.67; P 〉 0.05）.② Changes of the contents of glutamic acid in hippocampal dentate gyrus： In the alcohol group, the content of glutamic acid at 48 hours after the last perfusion of alcohol was significantly increased as compared with that at 6 hours [（143.32±11.42）%, （99.12±0.69）%; P 〈 0.05], and that at 72 hours was close to that at 6 hours [（78.50±16.40）%, （99.12±0.69）%; P 〉 0.05]. The contents of glutamic acid had no obvious differences at 6, 30, 48 and 72 hours after the last perfusion of alcohol in the topiramate-treated group [（100.30±0.37）%, （118.91±10.40）%, （99.55±12.81）%, （99.08±11.42）%; P 〉 0.05], The content of glutamic acid at 48 hours after the last perfusion of alcohol in the topiramate-treated group was obviously lower than that in the alcohol group （P 〈 0.05）, and those at 30 and 72 hours were close （P 〉 0.05）. ③ Changes of the contents of aspartic acid in hippocampal dentate gyrus： In the alcohol group, the contents of aspartic acid at 30 and 48 hours after the last perfusion of alcohol were significantly increased as compared with that at 6 hours [（126.60±8.67）%, （129.17±10.40）%, （99.25±0.87）%; P 〈 0.05], and that at 72 hours was close to that at 6 hours [（89.87±9.93）%, （99.25±0.87）%; P 〉 0.05]. The contents of aspartic acid had no obvious differences at 6, 30, 48 and 72 hours after the last perfusion of alcohol in the topiramate-treated group [（100.27±0.32）%, （120.81 ±12.63）%, （98.91±7.83）%, （85.92±8.07）%; P 〉 0.05]. The content of aspartic acid at 48 hours after the last perfusion of alcohol in the topiramate-treated group was obviously lower than that in the alcohol group （P 〈 0.05）, and those at 30 and 72 hours were close （P 〉 0.05）. CONCLUSION： ① The occurrences of alcohol withdrawal symptoms are correlated with the increased contents of excitatory amino acids in hippocampal dentate gyrus in rats. ② Topiramate can alleviate the alcohol withdrawal symptoms, which may be correlated with the decreased contents of excitatory amino acids in hippocampal dentate gyrus in rats.展开更多
Alcohol withdrawal syndrome(AWS)refers to a series of symptoms and signs that chronic al-coholics experience when they suddenly stop drinking or reduce their drinking,usually 12 to 24 h later.These in-clude tremors,fa...Alcohol withdrawal syndrome(AWS)refers to a series of symptoms and signs that chronic al-coholics experience when they suddenly stop drinking or reduce their drinking,usually 12 to 24 h later.These in-clude tremors,fatigue,sweating,hyperreflexia,and gas-trointestinal symptoms.This article will analyze the drug treatment of this disease and make a brief review.展开更多
Alcohol withdrawal syndrome(AWS)is a serious disorder affecting alcohol-dependent patients who abruptly stop or reduce their drinking.Mild or moderate AWS usually appears within 6 to 24 h after the last drink,and symp...Alcohol withdrawal syndrome(AWS)is a serious disorder affecting alcohol-dependent patients who abruptly stop or reduce their drinking.Mild or moderate AWS usually appears within 6 to 24 h after the last drink,and symptoms may include increased blood pressure and rapid pulse,tremors,high fever,irritability,anxiety,headache,nausea,and vomiting.These symptoms may progress to a more severe AWS characterized by delirium tremens,seizures,coma,cardiac arrest,and death.This article will analyze the phenobarbital(PB)treatment of AWS and make a brief review'.展开更多
Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protrac...Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.展开更多
文摘BACKGROUND： Many researches have indicated that the imbalances of various amino acid transmitters and neurotransmitters in brain are involved in the formation of alcohol withdrawal, especially that glutamic acid is one of the important transmitters for alcohol tolerance in central nervous system. OBJECTIVE： To observe the changes of excitatory amino acids in hippocampal dentate gyrus in rats with long-term alcohol drinking after withdrawal under consciousness, and investigate the therapeutic effect of topiramate on alcohol withdrawal. DESIGN ： A randomized control animal experiment SETTING ： Department of Neurology, Affiliated Hospital of Yanbian University MATERIALS： Thirty male Wistar rats of 4 months old, weighing 300-350 g, were purchased from the Experimental Animal Department, Medical College of Yanbian University. Topiramate was produced by Swish Cilag Company, and the batch number was 02CS063. METHODS： The experiments were carried out in the Department of Physiology, Medical College of Yanbian University from August 2005 to February 2006. ① The rats were divided randomly into three groups： control group （n=10）, alcohol group （n=10） and topiramate-treated group （n=10）. Rats in the alcohol group and topiramate-treated group were given intragastric perfusion of 500 g/L alcohol （10 mL/kg）, once a day for 4 weeks successively, and then those in the topiramate-treated group were treated with 80 mg/kg topiramate at 24 hours after the last perfusion of alcohol, once a day for 3 days successively. Rats in the control group were intragastricly given isovolume saline. ② The withdrawal symptoms were assessed at 6, 30, 48 and 72 hours after the last perfusion of alcohol by using the withdrawal rating scale set by Erden et al, which had four observational indexes of stereotyped behaviors, agitation, tail stiffness and abnormal posture, each index was scored by 5 points, the higher the score, the more obvious the symptoms. ③ The contents of aspartic acid and glutamic acid in hippocampal dentate gyrus were detected with microdialysis technique and high-performance liquid chromatograpy （HPLC） respectively at 6, 30, 48 and 72 hours after the last perfusion of alcohol in the three groups. MAIN OUTCOME MEASURES ： ① Scoring results of alcohol withdrawal symptoms; ② Changes of the contents of aspartic acid and glutamic acid in hippocampal dentate gyrus at the alcohol withdrawal symptoms, and the effects of topiramate. RESULTS： Seven rats were excluded due to inaccurate localization and natural death, and 23 rats were involved in the analysis of results. ①In the alcohol group, the scores of alcohol withdrawal symptoms at 30 and 48 hours after the last perfusion of alcohol were obviously higher than those in the control group （10.50±0.96, 14.17±1.25; 3.50±0.92, 3.16±0,31; P 〈 0.01）. In the topiramate-treated group, the scores at 30 hours after the last perfusion of alcohol （6.06±0.82, 3.50±0.92, P 〈 0.05）, and the withdrawal scores at 48 and 72 hours were close to those in the control group （4.57±0.58, 3.30±0.71; 3.16±0.31, 3.66±0.67; P 〉 0.05）.② Changes of the contents of glutamic acid in hippocampal dentate gyrus： In the alcohol group, the content of glutamic acid at 48 hours after the last perfusion of alcohol was significantly increased as compared with that at 6 hours [（143.32±11.42）%, （99.12±0.69）%; P 〈 0.05], and that at 72 hours was close to that at 6 hours [（78.50±16.40）%, （99.12±0.69）%; P 〉 0.05]. The contents of glutamic acid had no obvious differences at 6, 30, 48 and 72 hours after the last perfusion of alcohol in the topiramate-treated group [（100.30±0.37）%, （118.91±10.40）%, （99.55±12.81）%, （99.08±11.42）%; P 〉 0.05], The content of glutamic acid at 48 hours after the last perfusion of alcohol in the topiramate-treated group was obviously lower than that in the alcohol group （P 〈 0.05）, and those at 30 and 72 hours were close （P 〉 0.05）. ③ Changes of the contents of aspartic acid in hippocampal dentate gyrus： In the alcohol group, the contents of aspartic acid at 30 and 48 hours after the last perfusion of alcohol were significantly increased as compared with that at 6 hours [（126.60±8.67）%, （129.17±10.40）%, （99.25±0.87）%; P 〈 0.05], and that at 72 hours was close to that at 6 hours [（89.87±9.93）%, （99.25±0.87）%; P 〉 0.05]. The contents of aspartic acid had no obvious differences at 6, 30, 48 and 72 hours after the last perfusion of alcohol in the topiramate-treated group [（100.27±0.32）%, （120.81 ±12.63）%, （98.91±7.83）%, （85.92±8.07）%; P 〉 0.05]. The content of aspartic acid at 48 hours after the last perfusion of alcohol in the topiramate-treated group was obviously lower than that in the alcohol group （P 〈 0.05）, and those at 30 and 72 hours were close （P 〉 0.05）. CONCLUSION： ① The occurrences of alcohol withdrawal symptoms are correlated with the increased contents of excitatory amino acids in hippocampal dentate gyrus in rats. ② Topiramate can alleviate the alcohol withdrawal symptoms, which may be correlated with the decreased contents of excitatory amino acids in hippocampal dentate gyrus in rats.
文摘Alcohol withdrawal syndrome(AWS)refers to a series of symptoms and signs that chronic al-coholics experience when they suddenly stop drinking or reduce their drinking,usually 12 to 24 h later.These in-clude tremors,fatigue,sweating,hyperreflexia,and gas-trointestinal symptoms.This article will analyze the drug treatment of this disease and make a brief review.
基金Kunming Health Personnel Training Project[2020-SW(hou bei)-125]Health Research of Kunming City Health Commission Project(2021-03-09-001).
文摘Alcohol withdrawal syndrome(AWS)is a serious disorder affecting alcohol-dependent patients who abruptly stop or reduce their drinking.Mild or moderate AWS usually appears within 6 to 24 h after the last drink,and symptoms may include increased blood pressure and rapid pulse,tremors,high fever,irritability,anxiety,headache,nausea,and vomiting.These symptoms may progress to a more severe AWS characterized by delirium tremens,seizures,coma,cardiac arrest,and death.This article will analyze the phenobarbital(PB)treatment of AWS and make a brief review'.
基金Sponsored by Scientific Research Project,Shanghai Science and Technology Committee:No.16401902600Special Project for Clinical Research,Shanghai Municipal Health Commission:No.20174Y0009。
文摘Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.
