Markers of mineralocorticoid receptor function: changes over time and relationship to response in patients with major depression

The renin–angiotensin–aldosterone system and its hormone receptors, i.e. the angiotensin and mineralocorticoid receptor (MR), have emerged as important targets for central nervous system disorders and in particular for major depression. We have recently characterized baseline MR function as a predictor for treatment outcome with standard antidepressants. The aims of this study are (i) to characterize how strongly an early biomarker change (after 2 weeks) is related to outcome and (ii) whether these biomarker changes are related to the final outcome, that is, could serve as surrogate markers for response. Twenty-four of 30 patients with unipolar major depression completed the observational trial. MR-related biomarkers were assessed at baseline, 2 weeks, and 6 weeks of standard antidepressant treatment. These biomarkers included slow wave sleep (SWS), salivary cortisol and aldosterone after awakening, heart rate variability measured as respiratory sinus arrhythmia (RSA), systolic blood pressure, salt taste intensity (STI), salt pleasantness (SP), and plasma electrolytes. The Hamilton depression rating scale with 21 items was primarily used to determine depression severity. In the overall sample, STI increased and SP decreased significantly with treatment without a clear relationship with treatment outcome. No other significant changes were observed. Reductions in cortisol and aldosterone after 2 weeks of treatment were significantly related to improvement after 6 we...
Source: International Clinical Psychopharmacology - Category: Psychiatry Tags: ORIGINAL ARTICLES Source Type: research

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Sleep disturbance and respiratory sinus arrhythmia (RSA) are well-known to be independently associated with depression. Yet, it remains unclear how sleep disturbance and impaired physiological regulation (indexed by RSA) may synergistically contribute to d...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Distraction, Fatigue, Chronobiology, Vigilance, Workload Source Type: news
Publication date: Available online 16 May 2019Source: Journal of Psychiatric ResearchAuthor(s): Jessica L. Hamilton, Jonathan P. Stange, Taylor A. Burke, Peter L. Franzen, Lauren B. AlloyAbstractSleep disturbance and respiratory sinus arrhythmia (RSA) are well-known to be independently associated with depression. Yet, it remains unclear how sleep disturbance and impaired physiological regulation (indexed by RSA) may synergistically contribute to depression risk. The current study examined the relationship between sleep disturbance (duration, insomnia) on daily depressive symptoms, and whether RSA moderated this relationshi...
Source: Journal of Psychiatric Research - Category: Psychiatry Source Type: research
Sara AlMarabeh, Mohammed H. Abdulla and Ken D. O'Halloran* Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland Renal sensory nerves are important in the regulation of body fluid and electrolyte homeostasis, and blood pressure. Activation of renal mechanoreceptor afferents triggers a negative feedback reno-renal reflex that leads to the inhibition of sympathetic nervous outflow. Conversely, activation of renal chemoreceptor afferents elicits reflex sympathoexcitation. Dysregulation of reno-renal reflexes by suppression of the inhibitory refle...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Most years I write an update on any big developments in AF ablation. This year’s version will be a short one. I have little new to report. But it’s worth reviewing some basic issues. We still do not know the cause of atrial fibrillation (AF). That makes it hard to fix with ablation. Knowledge Deficits: To explain why not knowing the cause of AF impairs our ability to ablate it, it’s useful to compare AF ablation to WPW ablation. Wolfe-Parkinson-White or WPW syndrome causes rapid heart rates because of an extra pathway from the top to the bottom (atria and ventricle) of the heart. You can cure WPW by ablat...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs
AbstractPurpose of ReviewObstructive sleep apnea (OSA) is a systemic disease that is due to a narrow upper airway that collapses and obstructs during sleep, which results in frequent nocturnal hypoxemia, sympathetic overdrive, tachycardia, nocturnal hypertension, and oxidative metabolic stress. Symptoms include unrefreshed sleep, daytime tiredness, loss of memory, irritability, lack of concentration, poor work productivity, poor quality of life (QOL), mood swings, and even depression. This upper airway disorder can lead to systemic diseases such as hypertension, cardiovascular events, myocardial infarct, and fatal arrhythm...
Source: Current Otorhinolaryngology Reports - Category: ENT & OMF Source Type: research
Quitting substance abuse by myself? Have you ever asked yourself: Do I need to spend money on treatment? Do I really need to spend months away to get better? Can I quit by myself? You might be wondering if you can do it all yourself and quit cold turkey, without having to go to the “extreme” lengths of checking into a treatment center. The answer? Having an experienced team help you on your path to sobriety can be a great benefit in accomplishing long term sober living. Not only is the detoxification process in itself risky, it comes with many side effects and sometimes can be fatal. Having medically train...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Addiction Addiction Recovery Addiction Treatment and Program Resources Alcohol Rehab Information Alcoholism Drug Rehab Information Drug Treatment Substance Abuse clean relapse sober sober living sobriety treatment center Source Type: blogs
The objective of this systematic review was to evaluate the impact of CR programs on physical and mental health outcomes in patients with all forms of AF. Six electronic databases were searched to identify all studies that reported on the impact of CR in AF patients. Searching identified 5771 potential articles, of which 12 were included. The physical health outcomes evaluated included: cardiometabolic health indicators; aerobic and functional capacity; symptom severity and AF recurrence; hospitalizations; and, mortality. The mental health outcomes assessed included: quality of life; anxiety; depression; and, sleep quality...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
CONCLUSIONS: A combination of the longest QTc and autonomic imbalance during night-time sleep in early infancy may be responsible for development of life-threatening arrhythmia in LQTS infants. Critical cases should be included in future studies. PMID: 29952348 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Obstructive sleep apnea (OSA) is characterized by repetitive pharyngeal collapse during sleep. The result is fragmented sleep, excessive daytime sleepiness; hypoxia and hypercarbia; decreased vigilance, motor coordination, and executive function; depression; and decreased quality of life. If untreated, the patient can develop hypertension, arrhythmias, congestive heart failure, a higher risk for cardiovascular events, and type 2 diabetes mellitus. Both stroke and all-cause mortality are both increased as OSA increases in severity.
Source: Dental Abstracts - Category: Dentistry Tags: Inquiry Source Type: research
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