Ostrow D, Halaris A, Dysken M, DeMet E, Harrow M, Davis J
J Clin Psychiatry. 1984 Jul;45(7):306-9.
Plasma levels of the major norepinephrine (NE) metabolite, 3-methoxy-4-hydroxyphenylglycol (MHPG), were measured in a rapidly cycling bipolar patient and her first-degree relatives. The mood state dependence and the reciprocal relationship between noradrenergic and cholinergic activity were investigated by assessing mood, thought disorder, and plasma MHPG following the infusion of physostigmine. A correlation was found between plasma MHPG and mood states, with exceedingly high levels during mania and hypomania. Levels were significantly decreased by ECT or combined lithium and chlorpromazine administration. A pathologic diurnal MHPG pattern was detected during periods of abnormal mood changes. Infusion of physostigmine led to a prompt reduction in MHPG release and a marked decline in mood-state measurements and the overall level of thought disorder. Muscarinic receptors exerting negative feedback control over the synthesis and/or release of NE may have become supersensitive as a consequence of alpha 2-adrenoceptor densensitization.
对一名快速循环型双相情感障碍患者及其一级亲属的血浆中主要去甲肾上腺素（NE）代谢物3-甲氧基-4-羟基苯乙二醇（MHPG）水平进行了测定。通过在注入毒扁豆碱后评估情绪、思维障碍和血浆MHPG，研究了情绪状态依赖性以及去甲肾上腺素能与胆碱能活性之间的相互关系。发现血浆MHPG与情绪状态之间存在相关性，在躁狂和轻躁狂期间水平极高。通过电休克治疗（ECT）或联合使用锂盐和氯丙嗪可使水平显著降低。在情绪异常变化期间检测到病理性的MHPG昼夜模式。注入毒扁豆碱导致MHPG释放迅速减少，情绪状态测量值和思维障碍总体水平显著下降。由于α2肾上腺素能受体脱敏，对NE的合成和/或释放施加负反馈控制的毒蕈碱受体可能已变得超敏。
