of thyrotropin-releasing hormone on regional cerebral blood flow in man. Acta Endocrinol 1992:126:243-6. To assess the regional changes in cerebral blood flow, 10 healthy volunteers were given 400 \ g=m\ g thyrotropin-releasing hormone iv in a double-blind, randomized, cross-over study. Regional cerebral blood flow was determined simultaneously in two slices of the brain, using a single photon emission computerized tomograph and inhalation of 1 33Xe. Thyrotropin-releasing hormone caused a significant mean increase of 3.7% (range \m=-\8.8\p=n-\22.7)in blood flow in a region consistent with the left thalamus compared to placebo (3.2% decrease). In 25 other regions no significant change was detected. The thalamic region has previously been shown to be a region especially affected by thyrotropin-releasing hormone in animal studies. The thyrotropin-releasing hormone injection was followed by a minor rise in systemic blood pressure, but not a rise that could affect the cerebral blood flow. The effect of thyrotropin-releasing hormone on the regional cerebral blood flow in the thalamic region was much lower compared to changes found in sedated animals given a hundredfold higher dose of thyrotropin\x=req-\ releasing hormone.TRH and its receptors have been demonstrated in several regions of the central nervous system (CNS), as well as in organs outside the CNS (1-4). TRH stimulates the release of thyrotropin from the pituitary, but several other physiological effects of TRH have been described (3, 5, 6), leading to the assumption that TRH might act as a neuromodulator or a neurotransmitter.In sedated rabbits, cats and rats TRH causes a considerable cerebral vasodilatation (7-9). However, the TRH effect on the cerebral blood flow has been studied mainly in animal models. This is the first report on the effect of TRH on the human regional cerebral blood flow (rCBF) in healthy adults.
Material and methodsTen healthy, male volunteers, median age 27 years (range 23-30) were examined in a double-blind, ran¬ domized, cross-over study after informed consent had been obtained. rCBF was measured on two days separ¬ ated by an interval of 14 days. It was measured 30 min before and 5 min after the iv administration of 400 yg TRH (Protirelinum®), or placebo (0.9% saline). rCBF measurements were carried out with the 133Xe inhalation technique using a fast rotating, brain dedi¬ cated single photon emission computerized tomograph, SPECT (Tomomatic 232). The li3Xe uptake and clear¬ ance in two slices (each 17 mm thick) of the brain (Fig. 1 ) were recorded for 4.5 min (10). The slices were pos¬ itioned above and parallel to a line connecting the lateral canthus of the orbital cavity with the centre of the external acoustic meatus-the OM line. The lowest slice level was OM-f-30 mm, containing the thalamus and other inferiorly located brain structures. Thus, the upper slice level was automatically obtaining information from the slice level OM + 70 mm. The spatial resolution in the transversal plane was 12 mm.The areas where the highest increm...