Different modes of action of alprazolam in the treatment of panic attacks

2000 ◽  
Vol 12 (2) ◽  
pp. 41-45
Author(s):  
Dominique Van Gool
Keyword(s):  
Panic Disorder ◽  
Locus Coeruleus ◽  
Chemical Structure ◽  
Platelet Activating Factor ◽  
Panic Attacks ◽  
Modes Of Action ◽  
Potent Drug ◽  
The Right ◽  
Parahippocampal Area ◽  
Stimulation Of

SUMMARYAlprazolam (a benzodiazepine in the group of the triazolo-benzodiazepines) is a potent drug for the treatment of panic disorder. This is possible due to four different interactions with neurotransmitter systems. First, it facilitates, as all diazepines, the inhibitory acitivity of gamma-amino-butyricacid (GABA). The chemical structure differs from the benzodiazepines by incorporation of the triazoloring. Due to this triazoloring, the drug has three additional modes of action. These modes of action inhibit the locus coeruleus which plays a role in the origin of panic disorder. A first specific action is a stimulation of the serotonergic system. Triazolobenzodiazepines are also α2-adrenoreceptor agonists. Both mechanisms are responsible for inhibition of the locus coeruleus. Triazolo-benzodiazepines inhibit the platelet-activating-factor (PAF). PAF stimulates the corticotropin-releasing-hormone (CRH). This hormone stimulates the locus coeruleus. CRH in patients with panic attacks is elevated. This could be a result of hyperactive metabolism of the right parahippocampal area, which is observed in patients with panic attacks. Triazolo-benzodiazepines decrease the activity of the locus coeruleus because of a low CRH-level due to inhibited PAF.

The role of the ‘central’ cholecystokinin-B receptor in panic disorder

1996 ◽  
Vol 8 (4) ◽  
pp. 99-101
Author(s):  
H.J.G.M. Van Megen ◽  
H.G.M. Westenberg ◽  
J.A. Den Boer
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Animal Studies ◽  
Panic Attacks ◽  
Neuronal System ◽  
Receptor Agonists ◽  
Neuronal Systems ◽  
Cckb Receptor ◽  
Stimulation Of

SummaryResearch investigating the neurobiological underpinnings of anxiety disorder have mainly been focused on dysfunction of the GABA, noradrenergic and serotonergic (5-HT) neuronal systems. Just recently, in both animal and human studies, evidence has been found for a possible role of the cholecystokinin (CCK) neuronal system in the pathogenesis of anxiety disorder.Behaviorally, animal studies revealed anxiogenic-like properties for the ‘central’ CCKB receptor agonists, while CCKB receptor antagonists displayed intrinsic anxiolytic properties. Similarly, in man, CCKB receptor agonists, like pentagastrin and CCK4, were found to be able to elicited panic attacks in both panic disorder (PD) patients and healthy volunteers. These effects appear due to stimulation of the CCKB receptor. In addition, clinically effective panicolytic agents reduce the sensitivity to CCK4 in PD patients. Taken together, these findings may suggest a role for CCK in the neurobiology of PD. On the other hand, there is circumstantial evidence for involvement of several other neuronal systems, such as the serotonergic, noradrenergic and GABA-ergic system, in the regulation of anxiety. Interestingly, evidence has been found for an interaction between CCK and 5-HT and that this interaction plays a role in the mediation of anxiety.This presentation will critically discuss the evidence for the role of the CCKB receptor in anxiety and in addition, will focus on the putative evidence that the role of CCK in anxiety is mediated by its interaction with the serotonergic neuronal system.

scholarly journals Neural basis of implicit cognitive reappraisal in panic disorder: an event-related fMRI study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hai-Yang Wang ◽  
Guo-Qing Xu ◽  
Ming-Fei Ni ◽  
Cui-Hong Zhang ◽  
Xue-Lin Li ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Panic Disorder ◽  
Emotional Regulation ◽  
Block Design ◽  
Cognitive Reappraisal ◽  
Emotional Dysregulation ◽  
Panic Attacks ◽  
Interactive Effects ◽  
Neural Basis ◽  
The Right

Abstract Background Panic disorder (PD) is thought to be related with deficits in emotion regulation, especially in cognitive reappraisal. According to the cognitive model, PD patients’ intrinsic and unconscious misappraisal strategies are the cause of panic attacks. However, no studies have yet been performed to explore the underlying neuromechanism of cognitive reappraisal that occur on an unconscious level in PD patients. Methods Twenty-six patients with PD and 25 healthy controls (HC) performed a fully-verified event-block design emotional regulation task aimed at investigating responses of implicit cognitive reappraisal during an fMRI scan. Participants passively viewed negatively valanced pictures that were beforehand neutrally, positively, or adversely portrayed in the task. Results Whole-brain analysis of fMRI data showed that PD patients exhibited less activation in the right dorsolateral prefrontal cortex (dlPFC) and right dorsomedial prefrontal cortex (dmPFC) compared to HC, but presented greater activation in parietal cortex when negative pictures were preceded by positive/neutral vs negative descriptions. Simultaneously, interactive effects of Group × Condition were observed in the right amygdala across both groups. Furthermore, activation in dlPFC and dmPFC was is negatively correlated to severity of anxiety and panic in PD when negative images were preceded by non-negative vs negative descriptions. Conclusions Emotional dysregulation in PD is likely the result of deficient activation in dlPFC and dmPFC during implicit cognitive reappraisal, in line with impaired automatic top-down regulation. Correlations between severity of anxiety and panic attack and activation of right dlPFC and dmPFC suggest that the failure to engage prefrontal region during implicit cognitive reappraisal might be associated wtih the severity of anxiety and panic; such functional patterns might be the target of possible treatments.

Phosphene perceptions and safety of chronic visual cortex stimulation in a blind subject

2020 ◽  
Vol 132 (6) ◽  
pp. 2000-2007 ◽  
Author(s):  
Soroush Niketeghad ◽  
Abirami Muralidharan ◽  
Uday Patel ◽  
Jessy D. Dorn ◽  
Laura Bonelli ◽  
...  
Keyword(s):  
Visual Cortex ◽  
Adverse Events ◽  
Clinical Intervention ◽  
Occipital Cortex ◽  
Neuronal Population ◽  
Serious Adverse Events ◽  
Stimulation Parameters ◽  
The Right ◽  
Visual Cortical ◽  
Stimulation Of

Stimulation of primary visual cortices has the potential to restore some degree of vision to blind individuals. Developing safe and reliable visual cortical prostheses requires assessment of the long-term stability, feasibility, and safety of generating stimulation-evoked perceptions.A NeuroPace responsive neurostimulation system was implanted in a blind individual with an 8-year history of bare light perception, and stimulation-evoked phosphenes were evaluated over 19 months (41 test sessions). Electrical stimulation was delivered via two four-contact subdural electrode strips implanted over the right medial occipital cortex. Current and charge thresholds for eliciting visual perception (phosphenes) were measured, as were the shape, size, location, and intensity of the phosphenes. Adverse events were also assessed.Stimulation of all contacts resulted in phosphene perception. Phosphenes appeared completely or partially in the left hemifield. Stimulation of the electrodes below the calcarine sulcus elicited phosphenes in the superior hemifield and vice versa. Changing the stimulation parameters of frequency, pulse width, and burst duration affected current thresholds for eliciting phosphenes, and increasing the amplitude or frequency of stimulation resulted in brighter perceptions. While stimulation thresholds decreased between an average of 5% and 12% after 19 months, spatial mapping of phosphenes remained consistent over time. Although no serious adverse events were observed, the subject experienced mild headaches and dizziness in three instances, symptoms that did not persist for more than a few hours and for which no clinical intervention was required.Using an off-the-shelf neurostimulator, the authors were able to reliably generate phosphenes in different areas of the visual field over 19 months with no serious adverse events, providing preliminary proof of feasibility and safety to proceed with visual epicortical prosthetic clinical trials. Moreover, they systematically explored the relationship between stimulation parameters and phosphene thresholds and discovered the direct relation of perception thresholds based on primary visual cortex (V1) neuronal population excitation thresholds.

INFLUENCE OF RIGHT VENTRICULAR LEAD IMPLANTATION SITE CHOICE ON PACING EFFICIENCY

2020 ◽  
pp. 13-17
Author(s):  
Dmitrii Aleksandrovich Lopyn ◽  
Stanislav Valerevich Rybchynskyi ◽  
Dmitrii Evgenevich Volkov
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Treatment Options ◽  
Global Longitudinal Strain ◽  
Optimal Method ◽  
Cardiac Stimulation ◽  
Ventricular Lead ◽  
The Right ◽  
Stimulation Of

Currently the electrophysiological treatment options have been considered to be the most effective for many patients with arrhythmogenic cardiomyopathies, as well as in those with arrhythmias on the background of heart failure. Currently, the dependence of efficiency of the pacemakers on the location of the electrodes has been proven. In order to study the effect of a myocardial dysynchrony on the effectiveness of pacing depending on the location of the right ventricular electrode, an investigation has been performed. This study comprised the patients with a complete atrioventricular block, preserved ejection fraction of the left ventricle (more than 50 %), with no history of myocardial infarction, who were implanted with the two−chamber pacemaker. It has been established that the best results were achieved with a stimulation of the middle and lower septal zone of the right ventricle, the worst ones were obtained with a stimulation of its apex. It has been found that the dynamics of the magnitude of segmental strains and a global longitudinal strain coincided with the dynamics of other parameters of the pacemaker effectiveness, which indicated the pathogenetic value of myocardial dysynchrony in the progression of heart failure after implantation of the pacemaker. Therefore it could be concluded that the studying of myocardial mobility by determining a longitudinal strain for assessing the functional state of the myocardium and the effectiveness of pacing is highly advisable. It is emphasized that the use of the latest strains−dependent techniques for cardiac performance evaluation in the patients with bradyarrhythmia have a great potential to predict the development of chronic heart failure and to choose the optimal method of physiological stimulation of the heart. Key words: right ventricular lead, cardiac stimulation, myocardial dyssynchrony.

СТИМУЛИРОВАНИЕ ПРАВОПОСЛУШНОГО ПОВЕДЕНИЯ ОСУЖДЕННЫХ В МЕСТАХ ЛИШЕНИЯ СВОБОДЫ В СОВЕТСКОМ И СОВРЕМЕННОМ РОССИЙСКОМ ЗАКОНОДАТЕЛЬСТВЕ

2020 ◽  
Author(s):  
Stanislav Kuzmin ◽  
Irina Polyanskaya
Keyword(s):  
Criminal Punishment ◽  
Personal Time ◽  
Labor Camps ◽  
Archival Documents ◽  
Legal Position ◽  
Executive System ◽  
The Right ◽  
Stimulation Of

Статья подготовлена на основе использования нормативных правовых актов и архивных документов различных исправительно-трудовых лагерей, указанных в сносках, что позволяет судить о территориальных рамках источников. Исследуется генезис становления и развития практики стимулирования правопослушного поведения осужденных посредством норм, не изменяющих их правовое положение в период отбывания уголовного наказания в виде лишения свободы на различных этапах функционирования исправительно-трудовой (уголовно-исполнительной) системы. На основе изученных документов можно сделать вывод, что в основу дифференциации поощрительных норм, распространявшихся на осужденных, положены следующие критерии: 1) поощрения, не изменяющие условия отбывания уголовного наказания в виде лишения свободы; 2) поощрения, изменяющие условия содержания осужденных. Из ранее применявшихся мер поощрений в современном уголовно-исполнительном законодательстве используются следующие: объявление благодарности с занесением в личное дело, материальное поощрение, право на дополнительную посылку, передачу и др. Среди других мер поощрения можно выделить увеличение времени ежедневной прогулки до двух часов для осужденных, содержащихся в строгих условиях отбывания наказания в колониях и тюрьмах. Также законодатель предусмотрел возможность проводить праздничные и выходные дни за пределами учреждения для осужденных, содержащихся в колониях-поселениях.The article is prepared on the basis of the use of normative legal acts and archival documents of various correctional labor camps mentioned in the footnotes, which allows to judge the territorial scope of the sources. The Genesis of formation and development of practice of stimulation of law-abiding behavior of condemned by means of the norms which are not changing their legal position during serving of criminal punishment in the form of imprisonment at various stages of functioning of correctional labor (criminal Executive) system is investigated. On the basis of the studied documents, it can be concluded that the basis for the differentiation of incentive norms that apply to convicts are the following criteria: 1) incentives that do not change the conditions of serving a criminal sentence in the form of imprisonment; 2) incentives that change the conditions of detention of convicts. Of the previously applied measures of incentives in the modern penal legislation the following are used: the announcement of gratitude with entering in personal time, material encouragement, the right to an additional parcel, transfer, etc. Among other measures of encouragement it is possible to allocate increase in time of daily walk to two hours for condemned detainees in strict conditions of serving of punishment in colonies and prisons. Also, the legislator provided the opportunity to spend holidays and weekends outside the institution for convicts held in colonies-settlements.

scholarly journals Stimulation of the right entorhinal white matter enhances visual memory encoding in humans

2021 ◽  
Vol 14 (1) ◽  
pp. 131-140
Author(s):  
Emily A. Mankin ◽  
Zahra M. Aghajan ◽  
Peter Schuette ◽  
Michelle E. Tran ◽  
Natalia Tchemodanov ◽  
...  
Keyword(s):  
White Matter ◽  
Visual Memory ◽  
Memory Encoding ◽  
The Right ◽  
Stimulation Of

Role of Vasopressin in the Cardiovascular Response to Stimulation of the Locus Coeruleus*

Endocrinology ◽  
1986 ◽  
Vol 118 (5) ◽  
pp. 1829-1834 ◽  
Author(s):  
KATHLEEN H. BERECEK ◽  
TERRI N. MITCHUM
Keyword(s):  
Locus Coeruleus ◽  
Cardiovascular Response ◽  
Stimulation Of

scholarly journals STUDIES WITH THE ELECTROCARDIOGRAPH ON THE ACTION OF THE VAGUS NERVE ON THE HUMAN HEART

1911 ◽  
Vol 14 (3) ◽  
pp. 217-234 ◽  
Author(s):  
G. Canby Robinson ◽  
George Draper
Keyword(s):  
Vagus Nerve ◽  
Mechanical Stimulation ◽  
Human Heart ◽  
Appreciable Effect ◽  
Vagus Stimulation ◽  
Ventricular Systole ◽  
Constant Change ◽  
The Right ◽  
Stimulation Of

In hearts showing auricular fibrillation mechanical stimulation of the right vagus nerve causes, as a rule, marked slowing or stoppage of ventricular rhythm, without producing any appreciable effect in the electrocardiographic record of the auricular fibrillation. The ventricular pauses are apparently due to the blocking of stimuli from the auricles. The force of ventricular systole is distinctly weakened for several beats after vagus stimulation, and ectopic ventricular systoles have been seen in several instances, apparently the result of the vagus action. There may, in some cases, be lowered excitability of the ventricles, while no constant change is seen in the size of the electrical complexes representing ventricular systole.

Modulation of rat brain ?-adrenoreceptor populations four weeks after stimulation of the nucleus locus coeruleus

1981 ◽  
Vol 74 (3) ◽  
pp. 226-231 ◽  
Author(s):  
Lydia Velley ◽  
Bernard Cardo ◽  
Jo�l Bockaert
Keyword(s):  
Locus Coeruleus ◽  
Rat Brain ◽  
Stimulation Of
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