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药物安全性证明:关注警戒。

Proof of safety of drugs: focus on vigilance.

作者信息

Barbanoj M J, Lorenzo J L, Clos S, García-Gea C, Jané F

机构信息

Centre d'Investigació de Medicaments, Institut de Recerca, Servei de Farmacologia Clínica, Hospital de la Santa Creu i Sant Pau, Spain.

出版信息

Methods Find Exp Clin Pharmacol. 2002;24 Suppl C:51-64.

Abstract

It is well accepted that all new compounds, before administration to patients, should undergo safety evaluations in healthy subjects, including central nervous system (CNS) toxicity and as such the assessment of vigilance effects a relevant hallmark. The original concept of vigilance as a phenomenon observed only under conditions of monotony and signal regularity is increasingly falling into disfavor, embracing at present a much broader spectrum of behavior. Currently, vigilance may be regarded as a "readiness to adopt the appropriate behavior in a given situation, which thus finds outward expression through the quality and quantity of the behavior occurring in response to a given (internal or external) stimulus situation". The assumption that vigilance is a multifactorial phenomenon and not merely EEG data should be taken into account in order to study it accurately. Specifically, in drug research, apart from subjective reports and psychomotor performance tests, neurophysiological evaluations are regularly used such as Multiple Sleep Latency Test, Vigilance Epoch Classification or Parameters within a continuous scale. Although with limitations, temporal patterns of changes in activity of different frequency bands, indexes as the alpha slow-wave or the alpha anteriorization, computed from the EEG quantification, yielded different definitions of the intermediate states of the transition from wakefulness to sleep through the so-called subvigil stages. Spatial patterns are less documented. The recently proposed mathematical models to explain and predict variations in alertness are presented. Examples of the effects of different classes of drugs with the methods reported and its theoretical and practical relevance to vigilance research are introduced.

摘要

人们普遍认为,所有新化合物在给患者使用之前,都应在健康受试者中进行安全性评估,包括中枢神经系统(CNS)毒性,因此对警觉性影响的评估是一个相关的标志。最初将警觉性视为仅在单调和信号规律条件下观察到的一种现象的概念越来越不受青睐,目前它涵盖了更广泛的行为范围。目前,警觉性可被视为“在给定情况下准备采取适当行为,从而通过对给定(内部或外部)刺激情况做出反应时发生的行为的质量和数量来外在表现出来”。为了准确研究警觉性,应考虑到它是一种多因素现象而不仅仅是脑电图数据这一假设。具体而言,在药物研究中,除了主观报告和心理运动性能测试外,还经常使用神经生理学评估,如多次睡眠潜伏期测试、警觉时段分类或连续量表中的参数。尽管存在局限性,但从脑电图量化计算得出的不同频段活动变化的时间模式,如阿尔法慢波或阿尔法前移等指标,对从清醒到睡眠通过所谓的亚警觉阶段的过渡中间状态产生了不同的定义。空间模式的记录较少。介绍了最近提出的用于解释和预测警觉性变化的数学模型。介绍了不同类别药物的作用实例以及所报道的方法及其与警觉性研究的理论和实际相关性。

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