Life Situations, Emotions, and Neurocirculatory Asthenia (Anxiety Neurosis, Neurasthenia, Effort Syndrome)

Cohen, Mandel E.; White, Paul D.

doi:10.1097/00006842-195111000-00001

Cited by 126 publications

(34 citation statements)

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“…Exaggerated increases in serum lactate following both exercise and caffeine ingestion have been reported in PD. 13,15,22,23 However, the exercise and caffeine findings may have been confounded by a lower level of aerobic fitness and/or a lesser degree of pharmacological tolerance to caffeine, respectively, in the panic patients compared to the control subjects. 24 Controlled hyperventilation has been a useful paradigm for studying lactate metabolism in PD.…”

Section: Introductionmentioning

confidence: 99%

Elevated brain lactate responses to neural activation in panic disorder: a dynamic 1H-MRS study

et al. 2008

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Converging evidence suggests that patients with panic disorder have a metabolic disturbance that may influence the regulation of arousal systems and confer vulnerability to 'spontaneous' panic attacks. The consistent finding of elevated brain lactate responses to various metabolic challenges in panic disorder appears to support this model, although the mechanism of this effect is not understood. Several mechanisms have been proposed to account for elevated brain lactate responses in panic disorder, including (1) brain hypoxia due to excessive cerebral vasoconstriction, and (2) a metabolic disturbance affecting lactate metabolism. Recent studies have shown that neural activation (for example, sensory stimulation) causes local lactate accumulation in the presence of increased oxygen availability. The current study used proton magnetic resonance spectroscopic measures of visual cortex lactate changes during visual stimulation in 15 untreated patients with panic disorder and 15 matched volunteers to critically test these two proposed mechanisms of elevated brain lactate responses in panic disorder. Visual cortex lactate/N-acetylaspartate increased during visual stimulation in both groups. The increase was significantly greater in the panic patients than in the comparison group. There were no group differences in end-tidal pCO 2 . The finding that visual stimulation leads to significantly greater visual cortex lactate responses in panic patients is not predicted by the hypoxia model. These results suggest that a metabolic disturbance affecting the production or clearance of lactate is the cause of the elevated brain lactate responses consistently observed in panic disorder and provide further support for metabolic models of vulnerability to this illness.

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Section: Introductionmentioning

confidence: 99%

Elevated brain lactate responses to neural activation in panic disorder: a dynamic 1H-MRS study

et al. 2008

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“…This type of patient is usually dis tinguished by higher levels of anxiety and depression. Various studies have described an increase in different measurements of anxiety and depression in patients with psychophysiologic disorders, for example in sufferers of tensional headaches [Martin, 1966[Martin, , 1983Ziegler, 1979;Weatherhead, 1980;Andrasik et al, 1982], in insomniacs [Monroe, 1976;Kales et al, 1983] and in patients who present losses of consciousness of neurocirculatory dystonic origin [Cohen and White, 1951;Mantysaari, 1984]. A group of healthy individuals was introduced in order to contrast the results obtained with those of the group of patients since the correlation between personality and biochemical variables could very well be conditioned by the psychopathological state of these subjects.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Thyroxine and Thyroid-Stimulating Hormone with Personality Measurements: A Study in Psychosomatic Patients and Healthy Subjects

Arqué¹,

Segura²,

Torrubia

1987

Neuropsychobiology

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A comparative study performed in psychosomatic patients and healthy subjects reveals different profiles of thyroxine (T₄) and thyroid-stimulating hormone (TSH) correlations with personality measurements (Minnesota Multiphasic Personality Inventory (MMPI); Sensation-Seeking Scale (SSS), and Susceptibility to Punishment Scale (SP). Three distinct sets of results may be enumerated, namely: (1) a negative correlation between sensation-seeking and TSH; (2) a positive correlation between the most indicative scales predisposing to depression-anxiety (hypochondriasis, depression, social introversion, susceptibility to punishment) and T₄, and (3) the Hypomania Scale (Ma) showed a significant negative correlation with T₄ in the patient group and a positive but nonsignificant relationship in the healthy group.

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“…Da Costa [12] in 1871, Hecker [22] in 1893,and/rri> !^ [ 17] in 1895. Historically,pan ic attacks have been included in syndromes such as anxiety reaction, anxiety neurosis, neurasthenia, neurocirculatory asthenia, Da Costa's syndrome, soldier's heart, and soma tization psychogenic cardiovascular reaction [11], In DSM-III, panic attacks are represent ed within the anxiety disorders by panic dis order and agoraphobia with panic attacks [1].…”

Section: Introductionmentioning

confidence: 99%

“…The principal symptoms of a panic attack are apprehensiveness; a fear of dying; losing control; going crazy; breathlessness; smother ing; palpitations; chest pain; dizziness; faint ness or syncope; sweating; hot flashes and cold chills; urinary frequency; vomiting and diarrhea; paresthesias, and trembling and shaking [11], The symptoms, which last from a few seconds to about 30 min, can be classi fied into six groups: emotional or mental; pulmonary; cardiovascular; autonomic; neu rological, and metabolic. Some of the symp toms in these groups overlap, and other clas sifications are possible, but these have re ceived the most attention.…”

Section: Introductionmentioning

confidence: 99%

“…Many patients with panic attacks are exercise intolerant, experiencing panic at tacks and producing more lactic acid than nonpsychiatric control subjects under mod erate work loads [10,13,23,24]. An un known defect of aerobic or anaerobic metab olism may also account for the symptoms [11]. The lactate anion may complex calcium at the surfaces of excitable membranes, pro ducing local hypocalcemia with symptoms of muscular irritability, tetany, and anxiety [14,28,29], Finally, many of the symptoms are similar to the pharmacological effects of in travenously administered epinephrine, sug gesting the adrenergic nervous system may be involved [3], Anxiety states resembling panic attacks occur during intravenous infusions of so dium lactate in 75-90% of patients with anx iety neurosis/panic disorder and 0-20% of nonpsychiatric control subjects [2,5,25,29], This finding is directly or indirectly related to three of the hypotheses of panic attack patho genesis -that is, lactate produces a metabolic alkalosis, is a product of the intermediary metabolism of carbohydrates, and can com plex free calcium as calcium lactate.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Lactate and Isoproterenol Anxiety States

et al. 1984

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Both sodium lactate and isoproterenol can produce anxiety symptoms in patients with panic attacks. We administered both substances intravenously under placebo-controlled, double-blind conditions to patients with panic attacks and normal control subjects. We measured changes in anxiety levels using the Hamilton Anxiety Scale, State-Trait Anxiety Inventory, and a Panic Severity Scale. Measurements of respiratory rate and blood pH, pO₂ pCO₂, HCO₃, and base excess were used to determine the relationship of hyperventilation to the symptoms induced by the infusions. Heart rate, epinephrine and norepinephrine levels were measured to determine whether there are changes related to palpitations and chest pain. Finger temperature and galvanic skin response were monitored to see whether any changes correlate with subject reports of hot or cold flashes and sweating. In this presentation, we will describe the clinical and biochemical changes that occur during panic attacks.

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Life Situations, Emotions, and Neurocirculatory Asthenia (Anxiety Neurosis, Neurasthenia, Effort Syndrome)

Cited by 126 publications

References 0 publications

Elevated brain lactate responses to neural activation in panic disorder: a dynamic 1H-MRS study

Elevated brain lactate responses to neural activation in panic disorder: a dynamic 1H-MRS study

Correlation of Thyroxine and Thyroid-Stimulating Hormone with Personality Measurements: A Study in Psychosomatic Patients and Healthy Subjects

A Comparison of Lactate and Isoproterenol Anxiety States

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