ANHEDONIA A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Anhedonia: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00070-9 1. Anhedonia-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on anhedonia. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON ANHEDONIA ............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Anhedonia ..................................................................................... 4 The National Library of Medicine: PubMed ................................................................................ 20 CHAPTER 2. NUTRITION AND ANHEDONIA ................................................................................... 35 Overview...................................................................................................................................... 35 Finding Nutrition Studies on Anhedonia.................................................................................... 35 Federal Resources on Nutrition ................................................................................................... 37 Additional Web Resources ........................................................................................................... 37 CHAPTER 3. ALTERNATIVE MEDICINE AND ANHEDONIA ............................................................. 39 Overview...................................................................................................................................... 39 National Center for Complementary and Alternative Medicine.................................................. 39 Additional Web Resources ........................................................................................................... 42 General References ....................................................................................................................... 43 CHAPTER 4. DISSERTATIONS ON ANHEDONIA ............................................................................... 45 Overview...................................................................................................................................... 45 Dissertations on Anhedonia......................................................................................................... 45 Keeping Current .......................................................................................................................... 45 CHAPTER 5. PATENTS ON ANHEDONIA .......................................................................................... 47 Overview...................................................................................................................................... 47 Patent Applications on Anhedonia .............................................................................................. 47 Keeping Current .......................................................................................................................... 48 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 51 Overview...................................................................................................................................... 51 NIH Guidelines............................................................................................................................ 51 NIH Databases............................................................................................................................. 53 Other Commercial Databases....................................................................................................... 55 APPENDIX B. PATIENT RESOURCES ................................................................................................. 57 Overview...................................................................................................................................... 57 Patient Guideline Sources............................................................................................................ 57 Finding Associations.................................................................................................................... 59 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 61 Overview...................................................................................................................................... 61 Preparation................................................................................................................................... 61 Finding a Local Medical Library.................................................................................................. 61 Medical Libraries in the U.S. and Canada ................................................................................... 61 ONLINE GLOSSARIES.................................................................................................................. 67 Online Dictionary Directories ..................................................................................................... 67 ANHEDONIA DICTIONARY....................................................................................................... 69 INDEX ................................................................................................................................................ 97
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with anhedonia is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about anhedonia, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to anhedonia, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on anhedonia. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to anhedonia, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on anhedonia. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON ANHEDONIA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on anhedonia.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and anhedonia, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “anhedonia” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Erectile Dysfunction: The Role of Concomitant Diseases Source: Physician Assistant. 24(6 Supplement): 12-16. June 2000. Contact: Available from Springhouse Corporation. Physician Assistant Journal, 1111 Bethlehem Pike, P.O. Box 908, Springhouse, PA 19477-0908. (215) 628-7758 or (800) 7834903. Website: www.pajournal.com. Summary: An estimated 20 to 30 million men and their partners are affected by erectile dysfunction (ED). However, patients and health care providers can often be uncomfortable discussing the subject. Understanding the causes of ED, which can range from alterations in the hemodynamics of penile blood flow to hormonal imbalances, can be helpful in dispelling the embarrassment and discomfort surrounding this disorder. Written for physician assistants, this article reviews the causes and concomitant diseases
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associated with ED, as well as the importance of early recognition and patient education. Hypertension (high blood pressure), arteriosclerosis (deposits of plaque in the arteries, causing 'hardening'), and lipid disorders are frequently associated with ED. Diabetes can affect the microvasculature (small blood vessels) of the nerves that regulate blood flow to and from the penis. Medications used to treat common diseases such as hypertension, cardiovascular disorders, and depression can precipitate ED, as can medications used for decongestion and appetite suppression. The causes of ED are categorized in three groups: organic, psychogenic, and mixed (organic and psychogenic). Psychogenic causes of ED include depression, anxiety, stress related disorders, religious orthodoxy, obsessive compulsive disorder, anhedonia, sexual phobias, and sexual deviance. The author stresses that if the clinician can identify an erectile problem early, psychosocial sequelae such as embarrassment, anxiety, self doubt, depression, withdrawal from relationships, divorce, or other problems may be averted. One table lists common drugs that can affect erectile function; another table reprints a five item sexual health inventory for men. 3 tables. 10 references. •
Clinical Features in Depression in Old Age: A Case for Minor Depression Source: Current Opinion in Psychiatry. 4(4): 596-599. August 1991. Summary: This journal article reviews research indicating that minor depression may be an important clinical entity for resolving many of the epidemiologic and diagnostic dilemmas confronting clinical investigators of depression in late life. The first part discusses the epidemiologic dilemma presented by discrepancies between the increased burden of depressive symptoms identified in elderly populations and the relatively low prevalence of depressive disorders found in community studies of the elderly. The second section presents phenomenologic data on minor depression that may account for these discrepancies. These data suggest that minor depression is not a single entity but may include many syndromes, including those described by various authors as persistent anhedonia, recurrent depressive disorders, and chronic minor depressive disorder associated with cognitive impairment and dementia. The third section reviews findings on the pharmacologic treatment of minor depression. 19 references.
Federally Funded Research on Anhedonia The U.S. Government supports a variety of research studies relating to anhedonia. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to anhedonia. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use 2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
Studies
5
animals or simulated models to explore anhedonia. The following is typical of the type of information found when searching the CRISP database for anhedonia: •
Project Title: DEPRESSION
AMYGDALOSTRIATAL
CIRCUIT--AFFECTIVE
BEHAVIOR--
Principal Investigator & Institution: Taylor, Jane R.; Associate Professor; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 16-JUL-2002; Project End 30-JUN-2006 Summary: Neurobiological studies of major depression have identified dysfunctional cognitive-affective-motor regions; however, the details of these altered physiological and structural changes, and the molecular basis for these alterations, remain to be elucidated. Recent imaging data suggest that depressed patients have increased blood flow/metabolism in the amygdala concomitant with decreased blood flow and volume in orbitofrontal cortex and ventromedial striatum. These effects may be relevant to the psychopathology of depression because cortico-limbic - striatal dysfunction may contribute to hypersensitive stress, fea4r, and anxiety responses, anhedonia, affective alterations, and changes in cognitive function. Thus, it is critical to understand the molecular basis of neuroplasticity in these brain regions implicated in depression and mood disorders and the resulting cellular and behavioral correlates. This project will thus focus on the role for the extended amygdala (notably the central nucleus of the amygdala, and nucleus accumbens shell) in depression and alterations in PKA/CREB signaling in these regions because the involvement of PKA/CREB in learning/plasticity is well established and because antidepressant treatment increases PKA/CREB activity. Specifically the functional and molecular correlates of plasticity in response to stress and antidepressant treatment will be investigated. We hypothesize that alterations in the extended amygdala results in abnormal processing of affective/emotional stimuli and behavioral regulation by appetitive and aversive events. Combined with alterations of neural signaling within the ventral striatum that contribute to anhedonia, negative stimuli may also exert heightened suppressive consequences on behavior in depression. In addition, sustained increases PKA/CREB produced by anti-depressants would be predicted modify behavior by enhancing plasticity associated with learning and affective processes. Using direct pharmacological manipulations, transgenic murine models, vector-mediated over-expression of CREB and stress-induced animal models of depression, we will investigate the role of PKA/CREB signaling within the extended amygdala in reactivity to unconditioned aversive stimuli and/or anhedonia (sensitivity to appetitive rewards), and appropriate control procedures, as well as the mechanism of action of anti-depressant drugs in order to evaluate and validate the relevance of these processes to models of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORE--LABORATORY ANIMAL AND ASSAY Principal Investigator & Institution: Knight, David L.; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2003; Project Start 11-AUG-2003; Project End 30-JUN-2008 Summary: The Animal/Assay Core of the Emory-GSK-NIMH Collaborative Mood Disorders Initiative represents an integral component of the overall Center. The Animal/Assay core will serve as the source of all rodents used by the individual preclinicat Research Projects. Specifically, this core will produce and characterize a rat epigenetic early life stress (ELS) model associated with vulnerability to the development
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Anhedonia
of a depression-like syndrome. We will also continue the breeding and genetic selection of the "Swim-test Susceptible" (Susceptible) as well as the "Hyperactive" (Hyperactive) rat line. The efficacy of various novel antidepressant treatments in reversing aspects of a depressive-like syndrome of these rat models will be tested. To this end, this core will characterize the behavioral and HPA axis stress responsiveness of animals, provide phenotypic screening for anhedonia, anxiety-/fear-like behavior, resident intruder social defeat exposure, and provide surgical services such as chronic jugular catheterization, CNS guide cannula implantation, Alzet minipump preparation and implantation, and other protocols as required by the Research Projects. The core will provide characterized rats or will provide brain tissue, other tissue (adrenal, pituitary, etc), blood, or CSF from the various rat models to the individual Research Projects. This organization has the advantage of maintaining consistency in animal handling and implementation of all protocols so that each preclinical Research Project receives identically characterized and treated animals for study. This Core will also provide a common set of state-of-the-art biochemical analyses to Center researchers. The assay laboratories of the Core will provide assessments of hypothalamic-pituitary-adrenal (HPA) axis function, CRF and CRF mRNA expression, neurotransmitter (central and peripheral) levels, and antidepressant concentrations to the individual Research Projects of the Center. Accurate measurement of these parameters is important to characterize each of the preclinical and clinical model systems of depression and the effects of the novel antidepressants on the neurobiological consequences being investigated by the Center. Having these determinations performed by a central facility using a common set of assay modalities will provide the opportunity to compare models across strain and species while eliminating variability from having assays performed at different sites. Additionally, having a Core devoted to these analyses will guarantee high quality assay execution, allow for economies-of-scale in the purchase of assay reagents and technician time, and enable Center investigators to more fully concentrate their efforts on the unique aspects of their particular project. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORE--PSYCHOPHARMACOLOGY/BIOMEDICAL RESEARCH Principal Investigator & Institution: Katz, Ira R.; Professor; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002 Summary: The Laboratory for Psychopharmacological/Biomedical Research has been a key component of the CRC since its inception in 1986. Significant findings have include the demonstration that treatment of depression with standard tricyclic agents remains efficacious even in the oldest and most frail of patients, that those depressions associated with "failure to thrive" and dementia differ in treatment response from other disorders and that medications commonly used for treatment of medical disorders in late life can cause psychiatric symptoms. It provides an ongoing infrastructure to enable pharmacological and biomedical research through the conduct of its own intrinsic research, facilitating collaborative research with CRC scientists and others, and outreach/consultative activities with a wide array of investigators and trainees. It also actively participates in multi-center clinical trials of the treatment of the mental disorders of late life, and works to develop these studies. This application requests support for the Laboratory to continue to provide an enabling infrastructure for this line of investigation. It also requests support for three specific pilot investigations: 1) A double-blind, placebo- controlled, randomized clinical trial of venlafaxine for the treatment of depression and pain associated with osteoarthritis. This is an intervention
Studies
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development study designed to provide information on the value of pharmacological treatment for the most common disabling condition in late life and to advance our understanding of the treatment-relevant interactions between depression and pain. 2) A study of the prevalence of subcortical and deep white matter hyperintensities, and of their association with cognitive (e.g., executive function) deficits and anhedonia or apathy (non-depressed) patients with diabetes. This study is designed to determine whether patients at high risk for "subclinical cerebrovascular disease" exhibit psychiatric symptoms that may targets for (primary or secondary) preventative interventions. 3) Exploratory studies of the behavioral pharmacology of the inflammatory cytokines. These will include challenge studies in healthy young adult volunteers of the subjective, behavioral and physiological responses to typhoid vaccine, and treatment studies in frail elderly patients of Tumor Necrosis Facto antagonists. The research is designed to develop models for the treatment of cytokine-mediated sickness behavior and depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORE--RAT Principal Investigator & Institution: Plotsky, Paul M.; Glaxosmithkline Professor; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2002 Summary: The Rat Model Core (Core B) of the Emory University Silvio O. Conte Center~f6r the Neuroscience of Mental Disorders (CCNMD) represents an integral component of the overall Center. Core B will serve as the source of all rodents used by the individual preclinical Research Projects. In specific, Core B will produce and characterize a rat epigenetic early life stress (ELS) model associated with vulnerability to the development of a depression-like syndrome. Core B personnel will breed rodents, provide high quality animal care and uniformly applied neonatal manipulation protocols necessary to generate the ELS model, characterize the phenotype of all animals, ascertain the stage of the estrus cycle in adult female animals, and provide experimental manipulations as required by individual preclinical Research Projects within the Center. This epigenetic ELS model consists of Long Evans rats which are exposed to different rearing conditions from postnatal days (PND) 2-14, including: (1) animal facility reared (AFR) colony controls, (2) brief handling plus 15 min maternal separation (HMS 15) handling controls, (3) brief handling plus 180 min maternal separation (HMS 180). All individual Research projects will assess these animals for gender specific effects. Comparison of data obtained from these standardized rearing conditions among the various basic Research projects of this CCNMD will permit identification of central neurocircuit and intracellular mechanisms which are impacted by early life stress and which give rise to depressive-like syndrome; furthermore, since the animal models will be standardized, regression modeling can be used to elucidate interactions among these CNS systems in the genesis of this condition. Furthermore, the efficacy of various treatments (antidepressant, antisense, corticotropin releasing factor antagonist) in reversing aspects of depressive-like syndrome will be tested in these models. To this end, Core B will characterize the behavioral and HPA axis stress responsiveness of each animal, provide phenotypic screening for anhedonia, anxiety4fear-like behavior, as well as pr6viding surgical services such as chronic jugular catheterization, CNS guide cannula implantation, Alzet minipump preparation and implantation, resident intruder social defeat exposure, and other protocols as required by the Research Projects. Core B will provide characterized rats or will provide brain tissue, other tissue (adrenal, pituitary, etc), blood, or CSF from the HMS rats to the
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Anhedonia
individual Research Projects. This organization has the advantage of maintaining consistency in animal handling and implementation of all protocols so that each preclinical Research Project receives identically characterized and treated animals for study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEPRESSION AND CARDIOVASCULAR PATHOLOGY
HEART
FAILURE
ASSOCIATED
Principal Investigator & Institution: Johnson, Alan K.; Associate Professor; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2003; Project Start 21-JAN-2003; Project End 31-DEC-2007 Summary: Depression is both a debilitating psychological disorder and a condition that affects an individual's physical well-being. Depression is a recognized risk factor for heart disease. Research has demonstrated that depression predisposes an individual to myocardial infarction, sudden death, atherosclerosis, thrombosis and arrhythmias. While the behavioral and cognitive aspects of depression have been studied extensively, there has been much less research investigating the mechanisms responsible for the physiological consequences of mood disorders. Exposure of rodents to a series of chronic mild stressors (CMS) generates key behavioral characteristics of human depression that are observable and quantifiable. The CMS model of experimentallyinduced depression (ID) mimics the reduced responsiveness to pleasurable stimuli (anhedonia)which is a pivotal diagnostic criterion seen in depression. In the CMSdD model, anhedonia is induced by presenting mild unpredictable stressors (e.g., paired housing, stroboscopic illumination, white noise) of varying durations. In rats,anhedonia is operationally defined as a decrease in responding for a previously demonstrated reinforcer (reward). Recently, we have begun to characterize cardiovascular function in rats with CMS-ID. We have found that rats exposed to CMS for 4 weeks showed anhedonia along with cardiovascular alterations. Similar to patients with depression and with heart failure,CMSgD rats had elevated resting heart rates and reduced heart rate variability. In addition, rats exposed to CMS have increased susceptibility to experimentally-induced premature ventricular contractions. In other studies investigating the behavioral consequences of heart failure, we have found evidence of anhedonia (i.e., experimental depression) in rats with experimental myocardial infarction. The proposed research program will extend our characterization of the cardiovascular changes that accompany experimentally-induced depression and investigate the role of brain serotonergic mechanisms that are hypothesized to be common in the mediation of cardiovascular alterations that accompany both experimental depression and experimental heart failure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DO PLEASURE DEFICIENCIES FOSTER SMOKING? Principal Investigator & Institution: Werth, Jessica M.; Psychology; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2002; Project Start 11-APR-2002 Summary: The proposed research will investigate the hypothesis that smoking enables trait-anhedonic people to experience pleasure in situations that commonly invoke positive moods among those without trait-anhedonia. This premise will be tested by evaluating changes in positive moods in trait-anhedonic people vs. non trait-anhedonic people after exposure to the following conditions: a positive mood induction while
Studies
9
smoking, a positive mood induction while not smoking, and a neutral mood induction while smoking. It is hypothesized that trait-anhedonic people will only be responsive to a positive mood induction if they are allowed to smoke. In other words, it is expected that trait-anhedonic smokers will require the pharmacologic effect of nicotine in combination with a pleasurable psychological stimulus to experience a degree of positive mood elevation that nonanhedonics experience without smoking. Positive mood will be measured via self-report. This study will be the first to examine the effect of smoking on a trait-anhedonic person's ability to experience pleasure. Results will enhance understanding of mechanisms that promote smoking among those with pleasure deficits, and may contribute to the development of smoking cessation treatments and other substance control interventions for people with chronic difficulties experiencing pleasure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DOPAMINERGIC AND NORADRENERGIC SYSTEMS Principal Investigator & Institution: Kuhar, Michael J.; Candler Professor of Pharmacology; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2002 Summary: Early life stressors~have profound and lasting impact on behavior and neuroendocrine function. Indeed, clinical epidemiological studies have shown that childhood abuse and/or neglect is a significant risk factor for the development of adult psychopathology. These effects are due to changes in brain morphology and neurocircuit function that are only partially documented. Clarification of these changes could lead to new treatment strategies to ameliorate the deficiencies caused by the early life stress or by genetic factors. It has been known for many decades now that CNS catecholaminergic systems play a major role in the regulation of behavior. Depression has long been linked to dysfunction of dopaminergic and/or noradrenergic systems in the brain. This is not surprising as dopaminergic and noradrenergic systems have been linked to reward/motivation and to vigilance, respectively. These circuits also participate in regulation of the hypothalamic-pituitary-adrenal (HPA) axis. Clinical depression as well as many animal models of depression-like syndrome are characterized by aberrant vigilance expressed as anxiety, anhedonia, and dysregulation of the HPA axis. The current project will focus on a comparison Of the development and function of these important neural systems in an epigenetic (early life stress) model of depression-like syndrome in rodents. Additionally, a limited number of studies will be performed on a early liter stress nonhuman primate model. Neurochemical, molecular, behavioral, and electrophysiological approaches will be used to characterize these neural systems in these animal models throughout neonatal development and maturity under basal, stress (acute and chronic) conditions, and in response to antidepressant treatment. Both males and females will be used. We hypothesize that alterations in the development and/or function of dopaminergic and/'or noradrenergic neural systems underlie the altered mood, reward, reinforcement, and motor function in these animal models. Further, we postulate that catecholaminergic neurocircuits may become "sensitized" by early life stress leading to enhanced vulnerability to the effects of later exposure to adverse life events thus increasing their risk of developing major depression or related mood disorders. Multiple interactions with other preclinical and clinical components of the Emory University Center for the Neuroscience of Mental Disease will benefit these studies both in terms of the uniformity of the animal models and their treatment but also in terms of intellectual cross-fertilization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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•
Project Title: DEPRESSION
FRONTO-STRIATAL
DYSFUNCTION
IN
IFNA-INDUCED
Principal Investigator & Institution: Miller, Andrew H.; Professor; Psychiatry and Behavioral Scis; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2004; Project Start 01-DEC-2003; Project End 30-NOV-2008 Summary: (provided by applicant): Depression in the medically ill is a significant public health concern, occurring in up to 50% of patients and having a significant impact on treatment adherence, quality of life, and morbidity and mortality. New developments in the conceptualization of depression in the medically ill have focused on the potential role of immune activation/inflammation and the associated release of proinflammatory cytokines. Proinflammatory cytokines have been found to influence neurobiologic function including neurochemistry and behavior, and induce a depressive syndrome that has overlapping features with major depression. The long term objective of the proposed work is to further understand the neural correlates of this cytokine-induced depression as it relates to depression in the medically ill. As a model system, we plan to study patients receiving the cytokine, interferon (IFN) alpha, for the treatment of hepatitis C. IFN alpha is a potent inducer of proinflammatory cytokines (especially interleukin 6) and leads to depressive symptoms in 30-50% of patients depending on the dose. Preliminary data from our lab indicate that IFN alpha treatment is associated with reduced evoked activity in the striatum and medial prefrontal cortex as determined by functional magnetic resonance imaging (fMRI). These findings, in conjunction with clinical evidence of impaired functioning of the basal ganglia (e.g. reduced reaction time, psychomotor slowing, akathesia and anhedonia) in IFN alpha-treated patients, suggest that dysfunction of fronto-striatal neurocircuitry may underlie IFN alphainduced depressive symptoms and may represent a critical pathway by which cytokines induce depression. The fundamental hypothesis of the proposed work is that IFN alphainduced depression begins with reduced activation of striatal neurons that is associated with psychomotor slowing and anhedonia and in turn contributes to reduced activity in the prefrontal cortex. Reduced activity in the prefrontal cortex is then associated with the development of depressive symptoms and cognitive dysfunction. Thus, we hypothesize that reduced evoked activity in the striatum will 1) be predictive of the development of depressive symptoms during IFN alpha therapy, 2) will precede the development of reduced activity in the prefrontal cortex, and 3) will be a predominent feature of IFN alpha-induced depression compared to depression in medically healthy individuals. To test these hypotheses, we plan to conduct fMRIs and neuropsychiatric assessments in 40 patients with hepatitis C at various time points during IFN alpha therapy. Results will be compared to control populations of hepatitis C patients awaiting IFN alpha treatment (N=20) and medically healthy subjects with and without major depression (N=20 per group). Results from these studies will provide important new data on neural pathways by which cytokines induce depression and will establish a foundation for developing novel strategies to diagnose and treat depression in the medically ill. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GLUCOCORTICOID RECEPTORS IN STRESS AND DEPRESSION Principal Investigator & Institution: Boyle, Maureen P.; Anatomy and Neurobiology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2005
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Summary: (provided by applicant): Dysregulation of the hypothalamic-pituitaryadrenal axis (HPA), which controls the endocrine stress response, has been implicated in the pathogenesis of stress-related disorders including depression and anxiety. It is believed that at least part of the dysfunction is related to a lack of glucocorticoidmediated negative feedback to the hypothalamus. It has been hypothesized that glucocorticoid receptors (GRs) within the hippocampus (HPC) are important mediators of this inhibition. In order to investigate this hypothesis we will take advantage of recent advances in transgenic technology. We have generated mice with a conditional knockout of the GR in area CA1 of the HPC. In addition, we are in the process of generating mice with inducible expression of GRs in the HPC. Analysis of these two lines of mice will allow us to discretely address the role of GRs within the HPC in regulation of the HPA axis. We will examine these mice for changes in basal and/or stress-induced activation of the HPA axis. These mice will also be analyzed for changes in stress/depression related behaviors. Decreased hippocampal GR has been associated with a number of animal models of depression, while increased hippocampal GR is correlated with a decreased susceptibility to depression. We will therefore examine how changes in GR expression in the HPC influence depression related behaviors including anxiety, despair, anhedonia, and learning. We will further examine whether these mutations influence susceptibility to two established models of depression: chronic mild stress and social defeat. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INFORMATION-PROCESSING BIASES IN DEPRESSION Principal Investigator & Institution: Gotlib, Ian H.; Professor; Psychology; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2004; Project Start 01-JAN-1999; Project End 31-DEC-2006 Summary: (provided by applicant): Depression is among the most prevalent of all psychiatric disorders, accounting for over 20% of economic costs for all mental illness. An important public health priority is the development of methods for identifying factors that both increase individuals' vulnerability to depression and hinder recovery from this disorder. Pursuing this objective, we have been conducting research that broadens the focus of cognitive models of depression by examining patterns of biological reactivity to emotional stimuli. Extrapolating from our earlier studies and from existing models, we predicted that individuals diagnosed with Major Depressive Disorder (MDD) would exhibit increased autonomic arousal and neural activation in response to negative stimuli. But our findings indicated otherwise; in both fMRI and psychophysiological studies, MDD individuals demonstrated less activation and arousal in response to both positive and negative stimuli than did nondepressed controls. Moreover, greater activation and reactivity predicted improved functioning over the following year, independent of MDD severity. In reconciling and integrating these results with our earlier findings, we are broadening and refining cognitive theories of depression to include a consideration of affective chronometry, sensitivity to reward stimuli, and biological functioning, not only to describe the functioning of depressed individuals, but also to predict recovery from this disorder. The studies proposed in this application are designed to test a more comprehensive formulation of depression and to systematically rule out important alternative explanations for our obtained results. Based on our initial findings, we posit that when confronted with an emotionallyvalenced stimulus, depressed persons immediately attend to it; if the stimulus persists, they shut down their processing and disengage from it. Moreover, those depressed individuals who are able to stay engaged with emotional stimuli are likely to recover
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from depression most quickly. The overall objective of this proposed project is to advance our understanding of the cognitive and neurobiological responses in MDD to emotional stimuli. We are particularly interested in the effects of stimulus type (i.e., affective valence), stimulus duration (i.e., affective chronometry), and the potential effects of specific patient characteristics (e.g., anhedonia, comorbid Axis-II personality disorder) on emotional functioning in depression. We propose to examine informationprocessing biases and reward responsivity, as well as concomitant neural activation and psychophysiological arousal, in response to emotional stimuli in depressed and nondepressed participants. Findings from the proposed studies testing these formulations will contribute importantly to the development of an integrative psychobiological theory of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LIMBIC DOPAMINERGIC SYSTEM IN MAJOR DEPRESSION Principal Investigator & Institution: Ordway, Gregory A.; Associate Professor; Psychiatry and Human Behavior; University of Mississippi Medical Center 2500 N State St Jackson, Ms 39216 Timing: Fiscal Year 2002; Project Start 14-DEC-2001; Project End 30-NOV-2005 Summary: A vast amount of research reveals that central dopamine (DA) containing systems are neuronal substrates of a broad spectrum of behaviors related to rewardseeking, motivation, and environmental responsivity. Disruption of these behaviors leads to anhedonia, social isolation, and psychomotor retardation that form core symptoms of depression. While there is little debate for a critical role of limbic structures, e.g. amygdala, in the regulation of mood and affect, the role of limbic DA in the pathobiology of depressive illness is not known. Functional imaging studies report involvement of limbic structures in depression, but few have focused on dopaminergic indices. Furthermore, there is a paucity of neurochemical studies of depression that have utilized postmortem brain tissue. Studies using postmortem brain tissue offer much higher anatomical resolution than it is offered by functional imaging. In preliminary studies, we have found lower dopamine transporter (DAT) and up-regulation of D2 receptors in the basal and central nuclei of the amygdala, but not in the other nuclei of this complex region, in major depression as compared to psychiatrically normal controls. These and other findings compel us to examine the possibility that there is diminished DA neurotransmission in subjects diagnosed with major depression (who died of suicide or natural causes). The central hypothesis of this proposal is that subjects with major depression have diminished mesolimbic DA activity that can be revealed by neurochemical abnormalities in discrete regions of the mesolimbic dopaminergic system. These neurochemical measures will be performed in discrete regions of the amygdala, (Aim 1), in the nucleus accumbens (Aim 2), and in the ventral tegmental area (VTA, Aim 3), core limbic regions of the brain. We also hypothesize that a distinct constellation of neurochemical abnormalities within limbic structures is specific for major depression (Aim 4), and will differentiate the pathobiology of major depression from that of suicide or schizophrenia. Groups of subjects to be studied will be: a) subjects with major depression who committed suicide, b) subjects with major depression not dying by suicide, c) sudden death non-psychiatric controls, and d) schizophrenics not dying by suicide. The proposed research will be the first focused investigation of potential abnormalities of limbic DA in major depression utilizing psychiatrically characterized subjects. The research will establish the specificity of neurochemical findings with respect to major depression and with respect to regional brain anatomy. Uncovering the potential role of DA in the pathobiology of depression
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may lead to advancements in the pharmacological, and possibly genetic, intervention of major depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MECHANISMS OF DEPRESSION AND CARDIOVASCULAR PATHOLOGY Principal Investigator & Institution: Grippo, Angela J.; Psychology; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 01-APR-2002 Summary: (provided by applicant): This research proposal addresses physiological mechanisms and processes underlying the association between depression and cardiovascular disease. Human studies demonstrate a strong link between depression and coronary artery disease but have not progressed beyond correlational methods. The current proposal will examine the underlying mechanisms in depression and cardiovascular pathology by using a rodent model of depression (chronic mild stress) and a combination of behavioral, physiological, and pharmacological techniques. Rats will be exposed to chronic mild stress to induce the depression-associated sign of anhedonia (a reduced capacity to experience pleasure), and tested for cardiovascular impairments (Aim 1). Autonomic nervous system imbalance will be examined as a mechanism for the cardiovascular dysfunction (e.g., elevated heart rate and reduced heart rate variability) associated with the chronic mild stress model (Aim 2). In addition, central serotonin activity will be examined as a common pathophysiological factor underlying both depression and cardiovascular/autonomic dysfunction (Aim 3). This research will extend our knowledge of the interactions between psychological and physiological conditions, and possibly prompt the development of new treatments for patients with depression and/or cardiovascular disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROBEHAVIORAL PHARMACOLOGY OF STIMULANTS Principal Investigator & Institution: Cunningham, Kathryn; Associate Professor; Pharmacology and Toxicology; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2002; Project Start 01-MAY-1990; Project End 31-MAY-2005 Summary: (Adapted from the Investigator's Abstract) Illicit cocaine use continues to be a pervasive problem in the United States; the State of Texas cites cocaine abuse as its greatest illicit drug threat. Cocaine intoxication, dependence and withdrawal are marked by psychological (e.g., euphoria, depression, anxiety, anhedonia, craving) and physiological symptoms (e.g., fatigue, hyperphagia, anergia). An elucidation of the neural mechanisms that underlie the in vivo effects of cocaine is required in order to design effective psycho- and pharmacotherapeutic approaches to the treatment of cocaine addicts. The behavioral effects of cocaine are critically dependent upon mesocorticolimbic circuits, particularly the pathway that originates in dopamine (DA) cell bodies in the ventral tegmental area and terminates in the nucleus accumbens. Serotonin (5-hydroxytryptamine, 5-HT) is involved in the etiology of psychotic (e.g., schizophrenia), affective (e.g., anxiety, depression) and somatic disorders (e.g., obesity). The innervation and localization of 5-HT1B, 5-HT2C or 5-HT4 receptors in mesocorticolimbic circuits and the ability of cocaine to inhibit 5-HT reuptake suggest that 5-HT contributes to the in vivo effects of cocaine. The current literature and our preliminary data support differential roles of each receptor in modulating spontaneous
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and cocaine-stimulated behavior. In the present proposal, the role of 5-HT1B (Aim 1), 5HT2C (Aim 2) and 5-HT4 receptors (Aim 3) in the locomotor stimulant and discriminative stimulus effects of cocaine will be investigated using novel ligands and receptor knockdown techniques. The pattern of immediate early gene expression in the presence vs. absence of receptor-specific ligands will be employed to localize the site of action of each receptor. Based upon these maps, microinfusions of 5-HT1B, 5-HT2C or 5HT4 receptor ligands or antisense oligonucleotides will be targeted to identified mesocorticolimbic nuclei in order to clarify the site of action for each receptor in spontaneous and cocaine-evoked behaviors. Modifications in 5-HT1B, 5-HT2C and 5HT4 receptors during withdrawal will also be established via analysis of behavior and levels of receptor mRNA and protein expression in brain at several time-points following termination of intermittent cocaine exposure. The experiments outlined will yield significant information concerning the interplay between 5-HT receptors and cocaine, elucidate the manner in with 5-HT controls DA in vivo and help to define the specific and unique roles of these receptors in behavior. As a consequence, new insight into the potential therapeutic strategies for cocaine dependence and a number of psychiatric disorders dependent upon normal 5-HT function will be gained. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROIMAGING STUDIES OF REWARD PROCESSING IN DEPRESSION Principal Investigator & Institution: Pizzagalli, Diego A.; Assistant Professor; Psychology; Harvard University Holyoke Center 727 Cambridge, Ma 02138 Timing: Fiscal Year 2004; Project Start 07-JUN-2004; Project End 30-APR-2009 Summary: (provided by applicant): The aim of this proposal is to investigate the functional neuroanatomy of depression. A promising strategy for parsing the heterogeneity of Major Depressive Disorder (MDD) is to identify phenotypes characterized by reliable functional brain abnormalities. Anhedonia, the lack of reactivity to pleasurable stimuli, is considered a trait marker for depression. Preclinical work suggests links among phenomena associated with depression - decreased hedonic responsiveness, exaggerated stress responsiveness, and dysfunction in the dopaminergic mesolimbic system - but in humans the neural underpinnings are largely unknown. Using behavioral, event-related potential (ERP), and functional magnetic resonance imaging (fMRI) techniques, this proposal aims to investigate these processes. A monetarily reinforced button-press task will be used to dissociate the neural circuitry involved in anticipation of and reactivity to reward or punishment. Experiment 1 addresses the spatio-temporal dynamics of brain mechanisms underlying anticipation of and reactivity to reward and punishment in subjects differing on objective measures of anhedonia, operationalized as decreased responsiveness to reward-related cues in a separate signal-detection task. Compared to controls, subjects with impaired reward responsiveness (n=20) are predicted to show lower activation in regions subserving reward processing (e.g., nucleus accumbens, medial prefrontal cortex) to rewardrelated, but not to punishment-related, cues. In the ERP data, decreased late frontal negativity wave to reward cues, and decreased medial-frontal negativity and P3 to reward feedbacks, are hypothesized. Experiment 2 extends this paradigm to subjects with a DSM-IV diagnosis of MDD. These subjects (n=23) are expected to show lower activation in regions subserving reward processing than controls (n=23) in response to reward-related cues, and higher activation in regions subserving processing of withdrawal-related cues. In the ERP data, medial-frontal negativity and P3 are predicted to differentiate the subject groups. Experiment 3 addresses the effects of mental stress on
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reward processing in MDD. Compared to controls (n=21), depressed subjects (n=21) are expected to show a larger stress-induced reduction of activation in regions subserving reward processing, and a larger activation in regions subserving punishment processing. Decreased gray matter density in medial and subgenual prefrontal regions, as assessed by voxel-based MRI morphometrical analyses, is expected to be associated with the detrimental effect of stress on reward responsiveness. Overall, the integration of techniques with high temporal (ERP) and spatial (fMRI) resolution will enhance understanding of the functional neuroanatomy of depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NICOTINE: COGNITION-AFFECT INTERACTIONS Principal Investigator & Institution: Gilbert, David G.; Professor; Psychology; Southern Illinois University Carbondale 900 S. Normal Carbondale, Il 629014709 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2006 Summary: (provided by applicant): The primary objective of this revised proposal is to characterize more fully when, how, and in whom nicotine modulates affect and attention to emotional stimuli. It is hypothesized that nicotine attenuates attentional bias to negative emotional stimuli and associative processing of such stimuli, thereby decreasing negative emotional states. This attenuation of negative attentional bias and associative processing by nicotine is hypothesized to result from nicotine's enhancing attentional and associative bias to positive and neutral stimuli that in turn compete with and inhibit negative affect-related processing. Nicotine-induced attentional and associative biasing is hypothesized to occur most strongly in situations where the frequency of negative stimuli is moderate or low and the subject has a significant degree of freedom of attentional choice. Thus, the effects of attentional choice (two-picture viewing) versus no-choice (one picture viewing) conditions on nicotine's ability to reduce negative affect will be assessed by presenting blocks with a series of 64 single or dual pictures on a computer. Mood will be assessed before and after each picture series block. The frequency of negative pictures in these series will be manipulated (either 16 [low frequency] or 48 [high frequency]). In the no-choice task, single pictures will be presented centrally on the computer screen. In the two-choice task, dual picture images will be presented simultaneously in the left and right visual field. Picture series blocks (64 single or dual pictures) will consist of the following 4.5 sec. sequence: the word "blink", a fixation cross, and a picture (or dual picture). In the two-choice condition, subjects will be instructed to allocate as much or little of their gaze time to a given picture, but to always be gazing at one of two pictures. In the no-choice condition, subjects will be required to maintain a 3 sec. gaze at each picture. Neutral or positive pictures will be interspersed in both the two-choice and no-choice tasks. Eye-gaze patterns during the two-choice task and no-choice task will be obtained with an infrared, computerized tracking system. In the two-choice task, maximal dysphoriareducing effects of nicotine are predicted to occur during blocks with a high frequency of negative pictures. Nicotine is predicted to reduce gaze directed toward negative pictures and to enhance attention to positive pictures. In the no-choice task, nicotine is expected to have maximal dysphoria-reducing effects when a low frequency of negative pictures is combined with intervening positive pictures. Potential moderating influences of gender, smoker-nonsmoker status, and individual differences in trait anxiety, depression, and anhedonia will be assessed with regression analyses. This work will use new experimental procedures and technologies, including the precise assessment to individual differences in continuously monitored eye-gaze patterns with an infrared, computerized tracking system. The new knowledge derived from these studies will be
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useful in developing empirical model-based treatment strategies aimed at increasing smoking abstinence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROCESS OF CHANGE IN DRUG ABUSE BY SCHIZOPHRENICS Principal Investigator & Institution: Bellack, Alan S.; Professor; Psychiatry; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2002; Project Start 20-APR-1999; Project End 31-MAR-2004 Summary: Substance abuse by individuals with schizophrenia has reached epidemic proportions, yet little is known about why they use substances or how they can be helped to decrease use. The most widely accepted conceptualization of their substance abuse treatment needs is adapted from Prochaska and DiClemente's Transtheoretical Model (TTM). This model has proven to be quite robust in explaining the process of change in a variety of less impaired substance abusing populations, and several instruments have proven to be reliable and valid for assessing central components of the model. However, the TTM assumes intentional behavior change and full participation in the process of change by the substance abuser. Schizophrenia is marked by a number of symptomatic, neurocognitive, and psychosocial characteristics that would make it difficult for many individuals to successfully perform these complex activities, thereby raising questions about the applicability of the model for this population. Notably, patients with schizophrenia have significant impairments in cognitive function, including attention, memory, and higher level "executive" abilities, that may limit their ability to analyze the pros and cons of substance use, retain a focus on goals for decreased use over time, and form realistic efficacy expectations based on past experience. The disorder also is frequently associated with avolition and anhedonia, which may interfere with the ability to sustain motivation to reduce use. The overall purpose of this project is to examine attitudes about substance use, motivation to reduce use, and the process of change among schizophrenia patients who meet DSM-IV criteria for current Cocaine Dependence or are in Early Remission. The specific focus is the validity of the TTM for this population, and the adequacy of the standard measures of stages and processes of change developed for less impaired groups. Four groups of subjects will be assessed at Baseline, 3-, 6-, 9-, and 12-months: 70 Schizophrenia patients with current Cocaine Dependence, 70 Schizophrenia patients who are in Early Remission from Cocaine, 70 patients with Major Depression and current Cocaine Dependence, and 70 patients with Major Depression who are in Early Remission from Cocaine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ROLE OF CREB IN NUCLEUS ACCUMBENS IN MOOD AND MOTIVATION Principal Investigator & Institution: Nestler, Eric J.; Chairman; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Project 1 focuses on the ability of the transcription factor CREB in the nucleus accumbens (NAc) to regulate mood and motivational state. We have considerable evidence that increased CREB function in this brain region, which occurs under several conditions of stress, causes a decrease in an animal's sensitivity to emotional stimuli, regardless of whether the stimuli are aversive or rewarding. Reduced CREB function has the opposite effect. These findings suggest that CREB in the NAc
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may function as a key molecular gate between emotional stimuli and their behavioral responses. A possible relationship between this phenotype and symptoms of anhedonia and reduced motivation in depressed humans will be explored in further studies of animal models, including analysis of various stress models, sexual behavior, intracranial self-stimulation, and social interactions. Viral-mediated gene transfer and inducible, cell-targeted mutations in mice will be used in these experiments. Another goal of the proposed studies is to investigate the cellular specificity of stress regulation of CREB in the NAc, and its possible modification by antidepressant treatments. Related studies will explore the molecular mechanisms by which stress and antidepressants regulate CREB in this brain region. A third goal of the proposed studies is to identify target genes through which CREB produces these effects on mood and motivation. The genes encoding the opioid peptide dynorphin and the AMPA glutamate receptor subunit GluR1 are two such targets of CREB that will be examined in this Project. Additional targets will be identified with DNA microarrays. Among the targets identified in initial array experiments are BDNF and NPAS2, the major gene products of interest in Projects 2 and 4, respectively. As stated earlier, CREB function is a major theme in this Center. All of the subsequent Projects of this Grant represent extensions of our central hypothesis that CREB in the NAc is a key regulator of hedonic or affective state. Subsequent Projects extend this theme by examining other molecular constituents of NAc neurons, which are regulated by CREB and help control CREB activity, for their role in this complex behavioral, phenotype. In addition, the other Projects explore a related role for CREB in certain hypothalamic (Project 3) and VTA(ventral tegmental area) (Project 2) neurons, which, along with the NAc, form a neural circuit controlling appetitive behavior. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ROLE OF NUCLEUS ACCUMBENS CREB IN DEPRESSION Principal Investigator & Institution: Carlezon, William A.; Mc Lean Hospital (Belmont, Ma) Belmont, Ma 02478 Timing: Fiscal Year 2002; Project Start 01-JUL-2001; Project End 30-JUN-2006 Summary: From applicant's abstract): The proposed studies are designed to examine if the transcription factor CREB (cAMP response element binding protein) in the nucleus accumbens shell (NASh) plays a role in depression. Although the NASh is involved in the hedonic (pleasurable) effects of food, sex, and addictive drugs, little is known about its involvement in mood disorders. We found previously that blockade of CREB function in the NASh increases cocaine reward in rats, whereas elevated CREB function in this region eliminates cocaine reward. Because anhedonia (a diminished ability to experience pleasure) is a hallmark symptom of depression, these data suggest that CREB (and genes regulated by CREB) in the NASh may be involved in depressive syndromes. To address this question, we have examined relationships between CREB function in the NASh and behavior in the Porsolt forced swim test (FST), a model of depression. In preliminary studies, we find that exposure to the FST causes immediate increases in phospho-CREB (P-CREB, an activated form of CREB) in the NASh. To examine the significance of this effect, we elevated CREB expression in the NASh by viral-mediated gene transfer. This treatment increases immobility in the FST (suggesting increased depression), whereas blockade of CREB function in the NASh (by overexpression of a dominant negative CREB) decreases immobility (suggesting an antidepressant effect). Together, our work suggests that CREB in the NASh is a molecular regulator of at least some symptoms of depression (anhedonia, despair). We propose to further examine the interaction of CREB (and CREB-regulated genes) in the NASh with two antidepressants
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(desipramine, fluoxetine) in the FST. First, we will determine if antidepressants block CREB-induced increases in immobility. Second, we will examine the time course of FSTinduced P-CREB elevations in the NASh, and determine if they are blocked by antidepressants. Third, we will determine if the FST increases expression of dynorphin, a target gene of CREB. Fourth, we will determine if blockade of the brain receptors for dynorphin (k opioid receptors) has antidepressant actions. Finally, we will use intracranial self-stimulation (ICSS) to examine if elevated CREB expression in the NASh produces symptoms of depression in a second behavioral assay. These studies may establish that elevated CREB expression in the NASh is a "molecular trigger" for depression, and identify novel targets for pharmacotherapies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ROLE OF PROTEOGLYCANS IN COCAINE DEPENDENCE Principal Investigator & Institution: Sanna, Pietro P.; Associate Professor; Scripps Research Institute Tpc7 La Jolla, Ca 92037 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): In humans, chronic use of cocaine is often associated with a binge-like, uncontrollable pattern of use with overall tolerance and acute withdrawal. This cocaine withdrawal is characterized by severe depressive symptoms combined with irritability, anxiety, and anhedonia, lasting several hours to several days that may be one of the major motivating factors in the maintenance of the cocainedependence cycle. We have observed that the expression of Syndecan-3, a proteoglycan previously implicated in feeding behavior, is dramatically increased in the hypothalamus during withdrawal in animals self-administering cocaine and it was significantly higher in animals with an escalating pattern of cocaine self-administration. The present CEBRA proposal is aimed at investigating the role of hypothalamic Syndecan in cocaine intake. To this aim we propose to use adeno-associated (AAV) viral vectors expressing Syndecan -1, a peripheral form of Syndecan that is not cleaved by brain proteases and mimics the overexpression of Syndecan-3; constitutively shed Syndecan-1 ectodomain; or small interfering RNAs (siRNA) targeting Syndecan-3. The effect of hypothalamic injection of these constructs will be studied on cocaine selfadministration in animals with an escalating pattern of cocaine self-administration in comparison to animals that self-administer consistent low levels of cocaine. The elucidation of the neurobiological bases for the transition from non-dependent drug use to addiction is of crucial importance for the development of novel and more effective therapeutic approaches. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SENSITIZATION OF THE HUMAN STRESS RESPONSE BY TRAUMA Principal Investigator & Institution: Ganzel, Barbara L.; Human Development; Cornell University Ithaca Office of Sponsored Programs Ithaca, Ny 14853 Timing: Fiscal Year 2002; Project Start 31-AUG-2002 Summary: The proposed study is a longitudinal analysis of response to a uniform single-event stressor (graduate entrance examination) by young women (n = 22) who have experienced an assault in the past three years. Comparison will be made to a group of women of similar age who have experienced a non-assault trauma in the past three years (n = 22), and to women who have not experienced a trauma in their lifetime (n= 22). The goals of this research are: (1) to replicate and expand findings of chronic reductions in hypothalamic-pituitary-adrenal (HPA) axis reactivity in women following
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assault; and (2) to associate this dysregulation with specific socioemotional outcomes (mental health, daily mood, and substance use). Chronic sensitization of the HPA axis would be indicated here by reduced production of salivary cortisol in response to acute stress and would be expected to predict earlier onset and higher levels of anxiety and depression to acute stress, overall increases in anhedonia, and increased use of addictive drugs relative to controls (particularly opiates and alcohol). Outcomes of this investigation include indicators of depression, anxiety, and drug/alcohol use, and will have relevance to the prediction and prevention of mental disorder and substance abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SOCIAL ANHEDONIA AND SCHIZOPHRENIA PRONENESS Principal Investigator & Institution: Blanchard, Jack J.; Associate Professor; Psychology; University of Maryland College Pk Campus College Park, Md 20742 Timing: Fiscal Year 2002; Project Start 30-SEP-1994; Project End 31-MAR-2006 Summary: The accurate identification of individuals prone to the development of schizophrenia is necessary for the study of environmental and biological factors that heighten or reduce the probability of developing this disorder. The detection of such vulnerable individuals would also help in prevention efforts. Unfortunately, prior research on the psychometric detection of schizophrenia-proneness has been limited in that what has been detected is more generally psychosis-proneness. Also, there are concerns that prior research is limited by the study of non-minority college students that are not representative of the general population. In this revised application it is proposed that social anhedonia may be a promising indicator of the latent liability for schizophrenia. The role of social anhedonia in the development of schizophrenia will be studied in a randomly ascertained community sample of 18 year-olds who will be selected independently of race, education, or socio-economic status. First, this study will examine the hypothesis that taxometrically identified socially anhedonic individuals are at risk for schizophrenia and schizophrenia-spectrum disorders. Subjects (social anhedonics and controls) will be assessed for schizophrenia and other Axis I disorders, schizophrenia-spectrum personality disorders, and psychotic-like experiences at a base assessment and again at a 3-year follow-up. Second, to understand the range of outcomes in at-risk individuals, other individual difference variables will be assessed that may potentiate the expression of schizophrenia and schizophrenia-spectrum disorders. It is hypothesized that, in vulnerable individuals, reduced social support, elevated trait negative affect, and attentional impairment at the base assessment will increase the probability of clinically diagnosable illnesses and generally poorer functioning at the follow-up assessment. Third, the proposed investigation will examine the hypothesized genetic risk for schizophrenia associated with social anhedonia by directly assessing schizophrenia-related diagnoses and characteristics in the biological parents of social anhedonics and controls. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SPECTRUM OF DEPRESSION IN LATER LIFE--PRIMARY STUDY Principal Investigator & Institution: Gallo, Joseph J.; Associate Professor; Anesthesia; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 15-MAR-2000; Project End 29-FEB-2004 Summary: (Adapted from Applicant's Abstract): This study takes advantage of the primary care setting to consider whether we can identify presentations of depression in
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older adults that are characterized more by motivation disturbance (e.g., anhedonia, executive function disturbance and cognitive content related to physical illness (e.g., hopelessness, anxiety) rather than by mood disturbance (e.g. sadness). The specific aims of this proposal to be carried out in the primary care setting are: o to systematically describe and validate a depressive syndrome, apathetic depression, that does not meet standard criteria for Major Depression in older primary care patients; o to assess how physical illness, cognitive impairment, anxiety, and hopelessness among older primary care patients alters the course of depression and associated functional impairment over time; and, o to evaluate the clinical presentation of depression and associated symptoms in late life in relation to the assessment and treatment decisions of primary care physicians. An age-stratified sample of 3000 adults aged 65 years and older who have visited one of 30 participating primary care physicians will be interviewed with a revised version of the CES-D in the physician's office. Patients above a threshold will be asked to participate in a home assessment and follow-up study. Approximately 300 patients will have significant depressive symptoms and will be asked to participate in a longitudinal, observational study with a 10% random sample of persons without depression. The main study will include a baseline in-home assessment, a 3-monthly telephone follow-up, and a 12-month in-home follow-up evaluation of depression, function, and other factors. Information on assessment and treatment of depression will be obtained from participating physicians. We seek to identify, in primary care, an anhedonic depression syndrome which appears to be associated with physical illness and significant functional limitation and for which misidentification of depression could be avoided if the syndrome were better understood. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with anhedonia, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “anhedonia” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for anhedonia (hyperlinks lead to article summaries): •
A dual-task analysis of resource allocation in dysthymia and anhedonia. Author(s): Yee CM, Miller GA. Source: Journal of Abnormal Psychology. 1994 November; 103(4): 625-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7822563
3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A note on the pathology of anhedonia. Author(s): Watson CG, Jacobs L, Kucala T. Source: Journal of Clinical Psychology. 1979 October; 35(4): 740-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=511998
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A phase-overlapping anhedonia-model (animal-volunteer-patient) to predict the effects of neuroleptics. Author(s): Leonard JP, Lehr E, Meyer T, Beck J. Source: Clinical Neuropharmacology. 1992; 15 Suppl 1 Pt A: 554A-555A. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1354064
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Affective and social-behavioral correlates of physical and social anhedonia in schizophrenia. Author(s): Blanchard JJ, Bellack AS, Mueser KT. Source: Journal of Abnormal Psychology. 1994 November; 103(4): 719-28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7822573
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Affective memory and schizophrenic anhedonia. Author(s): Koh SD, Grinker RR Sr, Marusarz TZ, Forman PL. Source: Schizophrenia Bulletin. 1981; 7(2): 292-307. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7280568
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Anger, anhedonia, and the borderline syndrome. Author(s): Miller F. Source: American Journal of Psychoanalysis. 1975 Summer; 35(2): 157-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1190348
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Anhedonia and alexithymia: distinct or overlapping constructs. Author(s): Loas G, Fremaux D, Boyer P. Source: Percept Mot Skills. 1997 April; 84(2): 415-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9106828
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Anhedonia and blunted affect in major depressive disorder. Author(s): Loas G, Salinas E, Pierson A, Guelfi JD, Samuel-Lajeunesse B. Source: Comprehensive Psychiatry. 1994 September-October; 35(5): 366-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7995029
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Anhedonia and death. Author(s): Watson CG, Kucala T. Source: Psychological Reports. 1978 December; 43(3 Pt 2): 1120-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=746079
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Anhedonia and emotional responses to affect evoking stimuli. Author(s): Berenbaum H, Snowhite R, Oltmanns TF. Source: Psychological Medicine. 1987 August; 17(3): 677-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3628628
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Anhedonia and negative symptomatology in chronic schizophrenia. Author(s): Loas G, Boyer P, Legrand A. Source: Comprehensive Psychiatry. 1996 January-February; 37(1): 5-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8770519
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Anhedonia and perceptual aberration in first-episode psychotic patients and their relatives. Author(s): Katsanis J, Iacono WG, Beiser M. Source: Journal of Abnormal Psychology. 1990 May; 99(2): 202-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2348016
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Anhedonia and premorbid competence in young, nonpsychotic psychiatric inpatients. Author(s): Garnet KE, Glick M, Edell WS. Source: Journal of Abnormal Psychology. 1993 November; 102(4): 580-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8282927
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Anhedonia and relapse in alcoholism. Author(s): Marra D, Warot D, Payan C, Hispard E, Dally S, Puech AJ. Source: Psychiatry Research. 1998 August 17; 80(2): 187-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9754698
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Anhedonia and schizophrenia. Author(s): Cook M, Simukonda F. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1981 December; 139: 523-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7332857
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Anhedonia and schizophrenia. Author(s): Harrow M, Grinker RR, Holzman PS, Kayton L. Source: The American Journal of Psychiatry. 1977 July; 134(7): 794-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=869058
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Anhedonia and schizophrenia: how much is in the eye of the beholder? Author(s): Silver H, Shlomo N. Source: Comprehensive Psychiatry. 2002 January-February; 43(1): 65-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11788922
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Anhedonia and the deficit syndrome of schizophrenia. Author(s): Kirkpatrick B, Buchanan RW. Source: Psychiatry Research. 1990 January; 31(1): 25-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2315421
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Anhedonia and the intentional communication of emotion. Author(s): French C, Schuldberg D. Source: Percept Mot Skills. 1994 December; 79(3 Pt 1): 1075-88. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7898994
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Anhedonia as a function of non-affective interpretation of ambiguous stimuli and threshold for affective and neutral stimuli. Author(s): Watson CG. Source: Journal of Clinical Psychology. 1977 January; 33(1): 58-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=833330
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Anhedonia in depression and schizophrenia: a reexamination. Author(s): Romney DM, Candido CL. Source: The Journal of Nervous and Mental Disease. 2001 November; 189(11): 735-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11758655
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Anhedonia in psychotic and non psychotic disorders. Author(s): Loas G, Boyer P. Source: Clinical Neuropharmacology. 1992; 15 Suppl 1 Pt A: 558A-559A. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1498947
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Anhedonia in schizophrenia: a distinct familial subtype? Author(s): Schurhoff F, Szoke A, Bellivier F, Turcas C, Villemur M, Tignol J, Rouillon F, Leboyer M. Source: Schizophrenia Research. 2003 May 1; 61(1): 59-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12648736
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Anhedonia in schizophrenic, depressed, or alcohol-dependent patients-neurobiological correlates. Author(s): Heinz A, Schmidt LG, Reischies FM. Source: Pharmacopsychiatry. 1994 July; 27 Suppl 1: 7-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7984706
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Anhedonia in the deficit syndrome of schizophrenia. Author(s): Loas G, Boyer P, Legrand A. Source: Psychopathology. 1999 July-August; 32(4): 207-19. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10364731
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Anhedonia, alexithymia and locus of control in unipolar major depressive disorders. Author(s): Loas G, Dhee-Perot P, Chaperot C, Fremaux D, Gayant C, Boyer P. Source: Psychopathology. 1998; 31(4): 206-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9697164
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Anhedonia, asthenia, and depression. Author(s): Loas G, Robin A, Verrier A. Source: Percept Mot Skills. 2000 April; 90(2): 386. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10833728
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Anhedonia, depression and the deficit syndrome of schizophrenia. Author(s): Loas G, Noisette C, Legrand A, Boyer P. Source: Acta Psychiatrica Scandinavica. 1996 December; 94(6): 477-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9021003
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Anhedonia, depression, and suicidal ideation. Author(s): Loas G, Fremaux D, Gayant C, Boyer P. Source: Percept Mot Skills. 1995 June; 80(3 Pt 1): 978. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7567419
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Anhedonia, perceptual aberration, and the Rorschach. Author(s): Edell WS, Chapman LJ. Source: Journal of Consulting and Clinical Psychology. 1979 April; 47(2): 377-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=469086
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Anhedonia, positive and negative affect, and social functioning in schizophrenia. Author(s): Blanchard JJ, Mueser KT, Bellack AS. Source: Schizophrenia Bulletin. 1998; 24(3): 413-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9718633
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Anhedonia, self-experience in schizophrenia, and implications for treatment. Author(s): Juckel G, Sass L, Heinz A. Source: Pharmacopsychiatry. 2003 November; 36 Suppl 3: S176-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14677076
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Anhedonia, suicide ideation and dexamethasone nonsuppression in depressed patients. Author(s): Oei TI, Verhoeven WM, Westenberg HG, Zwart FM, van Ree JM. Source: Journal of Psychiatric Research. 1990; 24(1): 25-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2366212
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Anhedonia: a construct validation approach. Author(s): Peterson CA, Knudson RM. Source: Journal of Personality Assessment. 1983 October; 47(5): 539-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6644529
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Anhedonia: a neglected symptom of psychopathology. Author(s): Snaith P. Source: Psychological Medicine. 1993 November; 23(4): 957-66. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8134519
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Anhedonia: exclusion from the pleasure dome. Author(s): Snaith P. Source: Bmj (Clinical Research Ed.). 1992 July 18; 305(6846): 134. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1515824
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Animal models of anhedonia. Author(s): Auriacombe M, Reneric JP, Le Moal M. Source: Psychopharmacology. 1997 December; 134(4): 337-8; Discussion 371-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9452166
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Anticipatory pleasure deficit in subjects reporting physical anhedonia: slow cortical evidence. Author(s): Simons RF, MacMillan FW 3rd, Ireland FB. Source: Biological Psychology. 1982 May-June; 14(3-4): 298-310. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7126726
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Antidepressant reversal of interferon-alpha-induced anhedonia. Author(s): Sammut S, Bethus I, Goodall G, Muscat R. Source: Physiology & Behavior. 2002 April 15; 75(5): 765-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12020742
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Apathy, anhedonia, and psychomotor retardation in elderly psychiatric patients and healthy elderly individuals. Author(s): Lampe IK, Kahn RS, Heeren TJ. Source: Journal of Geriatric Psychiatry and Neurology. 2001 Spring; 14(1): 11-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11281310
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Assessing anhedonia in psychiatric patients. Author(s): Fawcett J, Clark DC, Scheftner WA, Gibbons RD. Source: Archives of General Psychiatry. 1983 January; 40(1): 79-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6849623
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Brain ERPs of depressed patients to complex tones in an oddball task: relation of reduced P3 asymmetry to physical anhedonia. Author(s): Bruder GE, Tenke CE, Towey JP, Leite P, Fong R, Stewart JE, McGrath PJ, Quitkin FM. Source: Psychophysiology. 1998 January; 35(1): 54-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9499706
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Calling attention to anhedonia. Author(s): Gangder PS. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1995 February; 85(2): 119-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7597529
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Clinical correlates of anhedonia and perceptual aberration in first-episode patients with schizophrenia and affective disorder. Author(s): Katsanis J, Iacono WG, Beiser M, Lacey L. Source: Journal of Abnormal Psychology. 1992 February; 101(1): 184-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1537965
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Cognitive functioning and anhedonia in subjects at risk for schizophrenia. Author(s): Franke P, Maier W, Hardt J, Hain C. Source: Schizophrenia Research. 1993 June; 10(1): 77-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8369235
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Depression in schizophrenia: are neuroleptics, akinesia, or anhedonia involved? Author(s): Harrow M, Yonan CA, Sands JR, Marengo J. Source: Schizophrenia Bulletin. 1994; 20(2): 327-38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8085135
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Depression, anhedonia and anxiety in temporomandibular joint and other facial pain syndromes. Author(s): Marbach JJ, Lund P. Source: Pain. 1981 August; 11(1): 73-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7301402
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Diagnostic differences in social anhedonia: a longitudinal study of schizophrenia and major depressive disorder. Author(s): Blanchard JJ, Horan WP, Brown SA. Source: Journal of Abnormal Psychology. 2001 August; 110(3): 363-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11502079
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Does anhedonia correlate with depression severity in chronic depression? Author(s): Schrader GD. Source: Comprehensive Psychiatry. 1997 September-October; 38(5): 260-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9298317
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Early stimulus processing in dysthymia and anhedonia. Author(s): Yee CM, Deldin PJ, Miller GA. Source: Journal of Abnormal Psychology. 1992 May; 101(2): 230-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1583213
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Electrocortical measures of information processing deficit in anhedonia. Author(s): Miller GA, Simons RF, Lang PJ. Source: Annals of the New York Academy of Sciences. 1984; 425: 598-602. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6588879
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Evaluation of contingencies and conditional probabilities. A psychophysiological approach to anhedonia. Author(s): Lutzenberger W, Birbaumer N, Rockstroh B, Elbert T. Source: Arch Psychiatr Nervenkr. 1983; 233(6): 471-88. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6667103
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Evaluation of the Pleasure Scale in the assessment of anhedonia in children. Author(s): Kazdin AE. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1989 May; 28(3): 364-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2738002
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Evidence for a dual-factor concept of psychopathological emotional deficit: anhedonia and sensation-seeking. Author(s): Watson CG, Jacobs L. Source: Journal of Clinical Psychology. 1977 April; 33(2): 385-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=870527
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Focused attention in anhedonia: a P3 study. Author(s): Dubal S, Pierson A, Jouvent R. Source: Psychophysiology. 2000 September; 37(5): 711-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11037048
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Further evidence for the depressive effects of cytokines: anhedonia and neurochemical changes. Author(s): Anisman H, Kokkinidis L, Merali Z. Source: Brain, Behavior, and Immunity. 2002 October; 16(5): 544-56. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12401468
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Hedonic capacity and schizotypy revisited: a taxometric analysis of social anhedonia. Author(s): Blanchard JJ, Gangestad SW, Brown SA, Horan WP. Source: Journal of Abnormal Psychology. 2000 February; 109(1): 87-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10740939
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Hypomanic personality, social anhedonia and impulsive nonconformity: evidence for familial aggregation? Author(s): Meyer TD, Hautzinger M. Source: Journal of Personality Disorders. 2001 August; 15(4): 281-99. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11556697
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Identifying depression: the significance of anhedonia. Author(s): Snaith RP. Source: Hosp Pract (Off Ed). 1993 September 30; 28(9A): 55-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8408359
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Illness behavior, depression and anhedonia in myofascial face and back pain patients. Author(s): Marbach JJ, Richlin DM, Lipton JA. Source: Psychotherapy and Psychosomatics. 1983; 39(1): 47-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6220421
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Information processing deficits in anhedonia and perceptual aberration: a psychophysiological analysis. Author(s): Miller GA. Source: Biological Psychiatry. 1986 January; 21(1): 100-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3942797
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Is anhedonia a good measure of depression? Author(s): Silverstone PH. Source: Acta Psychiatrica Scandinavica. 1991 April; 83(4): 249-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2028800
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Is anhedonia a specific dimension in chronic schizophrenia? Author(s): Loas G, Noisette C, Legrand A, Boyer P. Source: Schizophrenia Bulletin. 2000; 26(2): 495-506. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10885646
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Is substance abuse in schizophrenia related to impulsivity, sensation seeking, or anhedonia? Author(s): Dervaux A, Bayle FJ, Laqueille X, Bourdel MC, Le Borgne MH, Olie JP, Krebs MO. Source: The American Journal of Psychiatry. 2001 March; 158(3): 492-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11229997
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Magical ideation and social anhedonia as predictors of psychosis proneness: a partial replication. Author(s): Kwapil TR, Miller MB, Zinser MC, Chapman J, Chapman LJ. Source: Journal of Abnormal Psychology. 1997 August; 106(3): 491-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9241953
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Memory template comparison processes in anhedonia and dysthymia. Author(s): Giese-Davis JE, Miller GA, Knight RA. Source: Psychophysiology. 1993 November; 30(6): 646-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8248456
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Method to study anhedonia in hospitalized psychiatric patients. Author(s): Miller RE. Source: Journal of Abnormal Psychology. 1987 February; 96(1): 41-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3558948
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MMPI correlates of social and physical anhedonia. Author(s): Penk WE, Carpenter JC, Rylee KE. Source: Journal of Consulting and Clinical Psychology. 1979 December; 47(6): 1046-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=512159
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Neural mechanisms of anhedonia in schizophrenia: a PET study of response to unpleasant and pleasant odors. Author(s): Crespo-Facorro B, Paradiso S, Andreasen NC, O'Leary DS, Watkins GL, Ponto LL, Hichwa RD. Source: Jama : the Journal of the American Medical Association. 2001 July 25; 286(4): 427-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11466121
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Neural response to pleasant stimuli in anhedonia: an fMRI study. Author(s): Mitterschiffthaler MT, Kumari V, Malhi GS, Brown RG, Giampietro VP, Brammer MJ, Suckling J, Poon L, Simmons A, Andrew C, Sharma T. Source: Neuroreport. 2003 February 10; 14(2): 177-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12598724
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Neuroleptic-induced "anhedonia" in rats: pimozide blocks reward quality of food. Author(s): Wise RA, Spindler J, deWit H, Gerberg GJ. Source: Science. 1978 July 21; 201(4352): 262-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=566469
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Parasuicide, anhedonia, and depression. Author(s): Loas G, Perot JM, Chignague JF, Trespalacios H, Delahousse J. Source: Comprehensive Psychiatry. 2000 September-October; 41(5): 369-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11011833
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Physical anhedonia and future psychopathology: an electrocortical continuity? Author(s): Simons RF. Source: Psychophysiology. 1982 July; 19(4): 433-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7122782
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Physical anhedonia and schizophrenia. Author(s): Schuck J, Leventhal D, Rothstein H, Irizarry V. Source: Journal of Abnormal Psychology. 1984 August; 93(3): 342-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6470320
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Physical anhedonia in major depressive disorder. Author(s): Loas G, Salinas E, Guelfi JD, Samuel-Lajeunesse B. Source: Journal of Affective Disorders. 1992 June; 25(2): 139-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1644989
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Physical anhedonia in Parkinson's disease. Author(s): Isella V, Iurlaro S, Piolti R, Ferrarese C, Frattola L, Appollonio I, Melzi P, Grimaldi M. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 September; 74(9): 1308-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12933942
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Physical anhedonia, perceptual aberration, and psychosis proneness. Author(s): Chapman LJ, Edell WS, Chapman JP. Source: Schizophrenia Bulletin. 1980; 6(4): 639-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7444395
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Psychometric detection of schizotypy: perceptual aberration and physical anhedonia in relatives of schizophrenics. Author(s): Clementz BA, Grove WM, Katsanis J, Iacono WG. Source: Journal of Abnormal Psychology. 1991 November; 100(4): 607-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1757676
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Psychomotor retardation and anhedonia in depression. Author(s): Lemke MR, Puhl P, Koethe N, Winkler T. Source: Acta Psychiatrica Scandinavica. 1999 April; 99(4): 252-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10223426
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Psychophysiological response patterns in college students with high physical anhedonia: scores appear to reflect schizotypy rather than depression. Author(s): Bernstein AS, Riedel JA. Source: Biological Psychiatry. 1987 July; 22(7): 829-47. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3607112
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Relationship of anhedonia and anxiety to social rank, defeat and entrapment. Author(s): Gilbert P, Allan S, Brough S, Melley S, Miles JN. Source: Journal of Affective Disorders. 2002 September; 71(1-3): 141-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12167510
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Relationships between anhedonia, depression, and schizophrenia. Author(s): Loas G. Source: The Journal of Nervous and Mental Disease. 2002 October; 190(10): 717-8; Author Reply 718-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12409870
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Relationships of anhedonia to learning under various contigencies. Author(s): Watson CG. Source: Journal of Abnormal Psychology. 1972 August; 80(1): 43-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5045243
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Relationships of anhedonia to physiological reactivity and threshold. Author(s): Watson CG. Source: Psychological Reports. 1972 August; 31(1): 43-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5055916
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Scales for physical and social anhedonia. Author(s): Chapman LJ, Chapman JP, Raulin ML. Source: Journal of Abnormal Psychology. 1976 August; 85(4): 374-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=956504
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Sequential improvement of anxiety, depression and anhedonia with sertraline treatment in patients with major depression. Author(s): Boyer P, Tassin JP, Falissart B, Troy S. Source: Journal of Clinical Pharmacy and Therapeutics. 2000 October; 25(5): 363-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11123488
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Sexual anhedonia: disorders of sexual desire. Author(s): Chapman JD. Source: J Am Osteopath Assoc. 1983 May; 82(9 Suppl): 709-14. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6863048
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Slow cortical potentials in subjects with high or low scores on questionnaire measuring physical anhedonia and body image distortion. Author(s): Lutzenberger W, Elbert T, Rockstroh B, Birbaumer N, Stegagno L. Source: Psychophysiology. 1981 July; 18(4): 371-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7267919
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Smooth pursuit eye movements in subjects reporting physical anhedonia and perceptual aberrations. Author(s): Simons RF, Katkin W. Source: Psychiatry Research. 1985 April; 14(4): 275-89. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3860882
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Social anhedonia as a predictor of the development of schizophrenia-spectrum disorders. Author(s): Kwapil TR. Source: Journal of Abnormal Psychology. 1998 November; 107(4): 558-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9830243
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Social anhedonia in the prediction of psychosis proneness. Author(s): Mishlove M, Chapman LJ. Source: Journal of Abnormal Psychology. 1985 August; 94(3): 384-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4031235
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Spatial, object, and affective working memory in social anhedonia: an exploratory study. Author(s): Gooding DC, Tallent KA. Source: Schizophrenia Research. 2003 October 1; 63(3): 247-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12957704
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Stressor-induced anhedonia in the mesocorticolimbic system. Author(s): Zacharko RM, Anisman H. Source: Neuroscience and Biobehavioral Reviews. 1991 Fall; 15(3): 391-405. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1956607
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The course of anhedonia during 10 years of schizophrenic illness. Author(s): Herbener ES, Harrow M. Source: Journal of Abnormal Psychology. 2002 May; 111(2): 237-48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12003446
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The New York High-Risk Project: anhedonia, attentional deviance, and psychopathology. Author(s): Erlenmeyer-Kimling L, Cornblatt BA, Rock D, Roberts S, Bell M, West A. Source: Schizophrenia Bulletin. 1993; 19(1): 141-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8451608
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The New York High-Risk Project: attention, anhedonia and social outcome. Author(s): Freedman LR, Rock D, Roberts SA, Cornblatt BA, Erlenmeyer-Kimling L. Source: Schizophrenia Research. 1998 February 27; 30(1): 1-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9542784
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The prediction of outcome from anhedonia and process-reactive scales. Author(s): Watson CG, Kucala T, Jacobs L. Source: Journal of Clinical Psychology. 1978 October; 34(4): 889-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=711879
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The relationships of anhedonia and the process-reactive dimension to season of birth and infectious disease incidence in schizophrenia. Author(s): Watson CG, Kucala T, Angulski G, Vassar P. Source: The Journal of Nervous and Mental Disease. 1987 January; 175(1): 34-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3806069
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Toward an operational definition of anhedonia. Author(s): Watson CG, Klett WG, Lorei TW. Source: Psychological Reports. 1970 April; 26(2): 371-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4395027
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Use of the MMPI to assess the construct validity of the revised Social Anhedonia Scale as an index of schizotypy. Author(s): Merritt RD, Balogh DW, DeVinney SE. Source: Journal of Personality Assessment. 1993 April; 60(2): 227-38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8473962
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Visceral perception, anhedonia, and emotion. Author(s): Ferguson ML, Katkin ES. Source: Biological Psychology. 1996 January 5; 42(1-2): 131-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8770375
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Vulnerability to depression: a model centered on anhedonia. Author(s): Loas G. Source: Journal of Affective Disorders. 1996 November 4; 41(1): 39-53. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8938204
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Wrist scratching as a symptom of anhedonia: a predepressive state. Author(s): Asch SS. Source: Psychoanal Q. 1971; 40(4): 603-17. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5122957
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CHAPTER 2. NUTRITION AND ANHEDONIA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and anhedonia.
Finding Nutrition Studies on Anhedonia The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “anhedonia” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
4 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “anhedonia” (or a synonym): •
Early exposure to chronic variable stress facilitates the occurrence of anhedonia and enhanced emotional reactions to novel stressors: reversal by naltrexone pretreatment. Author(s): Departamento de Farmacologia, Facultad de Ciencias Quimicas, Universidad Nacional de Cordoba, Ciudad Universitaria, 5000, Cordoba, Argentina. Source: Zurita, A Martijena, I Cuadra, G Brandao, M L Molina, V Behav-Brain-Res. 2000 December 20; 117(1-2): 163-71 0166-4328
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Influence of S-adenosyl-L-methionine on chronic mild stress-induced anhedonia in castrated rats. Author(s): Department of Biomedical Sciences, University of Modena and Reggio Emilia, Italy.
[email protected] Source: Benelli, A Filaferro, M Bertolini, A Genedani, S Br-J-Pharmacol. 1999 June; 127(3): 645-54 0007-1188
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Parallel changes in dopamine D2 receptor binding in limbic forebrain associated with chronic mild stress-induced anhedonia and its reversal by imipramine. Author(s): Institute of Pharmacology, Polish Academy of Sciences, Krakow. Source: Papp, M Klimek, V Willner, P Psychopharmacology-(Berl). 1994 August; 115(4): 441-6 0033-3158
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Pimozide does not shift palatability: separation of anhedonia from sensorimotor suppression by taste reactivity. Author(s): Department of Psychology, University of Michigan, Ann Arbor 48109-1109, USA. Source: Pecina, S Berridge, K C Parker, L A Pharmacol-Biochem-Behavolume 1997 November; 58(3): 801-11 0091-3057
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Prior morphine facilitates the occurrence of immobility and anhedonia following stress. Author(s): Departamento de Farmacologia Facultad de Ciencias Quimicas, Universidad Nacional de Cordoba, Argentina. Source: Zurita, A Molina, V Physiol-Behavolume 1999 January 1-15; 65(4-5): 833-7 00319384
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Reversal of stress-induced anhedonia by the atypical antidepressants, fluoxetine and maprotiline. Author(s): Department of Psychology, City of London Polytechnic, UK. Source: Muscat, R Papp, M Willner, P Psychopharmacology-(Berl). 1992; 109(4): 433-8 0033-3158
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SCH 23390 blocks drug-conditioned place-preference and place-aversion: anhedonia (lack of reward) or apathy (lack of motivation) after dopamine-receptor blockade? Author(s): Institute of Experimental Pharmacology and Toxicology, University of Cagliari, Italy. Source: Acquas, E Carboni, E Leone, P Di Chiara, G Psychopharmacology-(Berl). 1989; 99(2): 151-5 0033-3158
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Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER 3. ALTERNATIVE MEDICINE AND ANHEDONIA Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to anhedonia. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to anhedonia and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “anhedonia” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to anhedonia: •
A study of the antidepressant activity of Hypericum perforatum on animal models. Author(s): Gambarana C, Tolu PL, Masi F, Rinaldi M, Giachetti D, Morazzoni P, De Montis MG. Source: Pharmacopsychiatry. 2001 July; 34 Suppl 1: S42-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11518074
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Affective response to color-slide stimuli in subjects with physical anhedonia: a threesystems analysis. Author(s): Fitzgibbons L, Simons RF. Source: Psychophysiology. 1992 November; 29(6): 613-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1461952
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Alpha wave biofeedback training therapy in alcoholics. Author(s): Passini FT, Watson CG, Dehnel L, Herder J, Watkins B.
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Source: Journal of Clinical Psychology. 1977 January; 33(1): 292-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13088 •
Antisaccade task performance in questionnaire-identified schizotypes. Author(s): Gooding DC. Source: Schizophrenia Research. 1999 January 11; 35(2): 157-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9988852
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Attentional modulation of startle in psychosis-prone college students. Author(s): Schell AM, Dawson ME, Hazlett EA, Filion DL. Source: Psychophysiology. 1995 May; 32(3): 266-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7784535
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Chronic pubertal, but not adult chronic cannabinoid treatment impairs sensorimotor gating, recognition memory, and the performance in a progressive ratio task in adult rats. Author(s): Schneider M, Koch M. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 October; 28(10): 1760-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12888772
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Efficacy of an Hypericum perforatum (St. John's wort) extract in preventing and reverting a condition of escape deficit in rats. Author(s): Gambarana C, Ghiglieri O, Tolu P, De Montis MG, Giachetti D, Bombardelli E, Tagliamonte A. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 1999 August; 21(2): 247-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10432473
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Emotional imagery and physical anhedonia. Author(s): Fiorito ER, Simons RF. Source: Psychophysiology. 1994 September; 31(5): 513-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7972606
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Exploring the latent structure of the Perceptual Aberration, Magical Ideation, and Physical Anhedonia Scales in a German sample. Author(s): Meyer TD, Keller F. Source: Journal of Personality Disorders. 2001 December; 15(6): 521-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11778394
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Exposure of mice to a predator odor increases acoustic startle but does not disrupt the rewarding properties of VTA intracranial self-stimulation. Author(s): Hebb AL, Zacharko RM, Gauthier M, Drolet G.
Alternative Medicine 41
Source: Brain Research. 2003 August 29; 982(2): 195-210. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12915255 •
Increased susceptibility to ventricular arrhythmias in a rodent model of experimental depression. Author(s): Grippo AJ, Santos CM, Johnson RF, Beltz TG, Martins JB, Felder RB, Johnson AK. Source: American Journal of Physiology. Heart and Circulatory Physiology. 2004 February; 286(2): H619-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14715499
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Notes on the treatment of anhedonia. Author(s): Shoichet RP, Oakley A. Source: Can Psychiatr Assoc J. 1978 November; 23(7): 487-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=709497
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Reaction time crossover in schizotypal subjects. Author(s): Drewer HB, Shean GD. Source: The Journal of Nervous and Mental Disease. 1993 January; 181(1): 27-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8419512
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Reflex modification in psychosis-prone young adults. Author(s): Simons RF, Giardina BD. Source: Psychophysiology. 1992 January; 29(1): 8-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1609030
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Responses of high- and low-emotional deficit patients to exciting, grating, and neutral stimuli. Author(s): Watson CG, Anderson R, Schulte D. Source: Journal of Clinical Psychology. 1977 April; 33(2): 552-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=870542
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Self regulation of electrocortical activity in schizophrenia and schizotypy: a review. Author(s): Gruzelier J. Source: Clin Electroencephalogr. 2000 January; 31(1): 23-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10638349
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Social and physical anhedonia in relation to cerebral laterality and electrodermal habituation in unmedicated psychotic patients. Author(s): Gruzelier J, Davis S.
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Source: Psychiatry Research. 1995 March 27; 56(2): 163-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7667441 •
Some recent observations on the pathogenesis of anorexia nervosa. Author(s): Garfinkel PE. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1981 June; 26(4): 218-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7296432
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State and trait depression, physical and social anhedonia, hypnotizability and subjective experiences during hypnosis. Author(s): McCloskey MS, Kumar VK, Pekala RJ. Source: Am J Clin Hypn. 1999 January; 41(3): 231-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10554385
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The relationship between absorption, openness to experience, anhedonia, and susceptibility. Author(s): Radtke HL, Stam HJ. Source: Int J Clin Exp Hypn. 1991 January; 39(1): 39-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2001896
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
• WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
Alternative Medicine 43
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON ANHEDONIA Overview In this chapter, we will give you a bibliography on recent dissertations relating to anhedonia. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “anhedonia” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on anhedonia, we have not necessarily excluded nonmedical dissertations in this bibliography.
Dissertations on Anhedonia ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to anhedonia. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
The effect of a dopamine antagonist and an agonist on rats' perception of reward quantity an examination of the anhedonia hypothesis by Martin-Iverson, Mathew Thomas; PhD from The University of British Columbia (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NL24215
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
47
CHAPTER 5. PATENTS ON ANHEDONIA Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “anhedonia” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on anhedonia, we have not necessarily excluded nonmedical patents in this bibliography.
Patent Applications on Anhedonia As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to anhedonia:
5Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm. 6 This has been a common practice outside the United States prior to December 2000.
48
•
Anhedonia
Method for treating anhedonia using dopamine agonists Inventor(s): Lehr, Erich; (Waldalgesheim, DE), Mierau, Joachim; (Mainz, DE), Pieper, Michael P.; (Bingen, DE) Correspondence: Boehringer Ingelheim Corporation; 900 Ridgebury Road; P. O. Box 368; Ridgefield; CT; 06877; US Patent Application Number: 20030036548 Date filed: August 6, 2002 Abstract: A method of treating anhedonia in a patient in need thereof, comprising administering to the patient an effective amount of a dopamine agonist Excerpt(s): Benefit under 35 U.S.C.sctn. 119(e) of prior U.S. provisional application Serial No. 60/312,332, filed Aug. 14, 2001, is hereby claimed. The invention relates to the use of dopamine agonists for preparing a pharmaceutical composition for overcoming and/or alleviating anhedonia. The term anhedonia is used in the prior art to denote a series of symptomatic conditions. Thus, the word anhedonia is used, for example, to denote loss of pleasure in life as well as an inability to derive any enjoyment from experiences or stimulations which normally give pleasure. Occasionally, anhedonia is divided into social anhedonia (for example, the loss of pleasure in being with friends) and psychic anhedonia (for example, the loss of pleasure in observing the beauty of nature). As a symptom anhedonia is found in psychiatric clinical pictures such as severe depression, schizophrenia, and dependency diseases. It may possibly also occur as a result of serious stress and extreme situations. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with anhedonia, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “anhedonia” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on anhedonia. You can also use this procedure to view pending patent applications concerning anhedonia. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
49
APPENDICES
51
APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute7: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
7
These publications are typically written by one or more of the various NIH Institutes.
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•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
•
National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
•
National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
•
National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
•
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
•
National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
•
National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
•
National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
•
National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
•
National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
•
Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
•
National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
Physician Resources
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:9 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
8 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 9 See http://www.nlm.nih.gov/databases/databases.html.
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•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway10 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “anhedonia” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 712 3 3 2 2 722
HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.14 Simply search by “anhedonia” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
10
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
11
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists15 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.16 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.17 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
15 Adapted 16
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 17 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on anhedonia can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to anhedonia. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to anhedonia. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “anhedonia”:
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Bipolar Disorder http://www.nlm.nih.gov/medlineplus/bipolardisorder.html Child Mental Health http://www.nlm.nih.gov/medlineplus/childmentalhealth.html Mental Health http://www.nlm.nih.gov/medlineplus/mentalhealth.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to anhedonia. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to anhedonia. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with anhedonia. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about anhedonia. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “anhedonia” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “anhedonia”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “anhedonia” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “anhedonia” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.18
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
18
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)19: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
19
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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ANHEDONIA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Aberrant: Wandering or deviating from the usual or normal course. [EU] Acoustic: Having to do with sound or hearing. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]
Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Akinesia: 1. Absence or poverty of movements. 2. The temporary paralysis of a muscle by the injection of procaine. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have
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nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]
Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH]
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Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Appetitive Behavior: Animal searching behavior. The variable introductory phase of an instinctive behavior pattern or sequence, e.g., looking for food, or sequential courtship patterns prior to mating. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asthenia: Clinical sign or symptom manifested as debility, or lack or loss of strength and energy. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH]
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Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Factors: Compounds made by living organisms that contribute to or influence a phenomenon or process. They have biological or physiological activities. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU]
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Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH]
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Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH]
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Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Courtship: The mutual attraction between individuals of the opposite sex. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Criterion: A standard by which something may be judged. [EU] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH]
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Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dopamine Agonists: Drugs that bind to and activate dopamine receptors. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH]
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Duct: A tube through which body fluids pass. [NIH] Dysphoria: Disquiet; restlessness; malaise. [EU] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elasticity: Resistance and recovery from distortion of shape. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other health-
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related event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Euphoria: An exaggerated feeling of physical and emotional well-being not consonant with apparent stimuli or events; usually of psychologic origin, but also seen in organic brain disease and toxic states. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Facial: Of or pertaining to the face. [EU] Facial Pain: Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as facial pain syndromes. [NIH] Failure to Thrive: A condition in which an infant or child's weight gain and growth are far below usual levels for age. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Feeding Behavior: Behavioral responses or sequences associated with eating including modes of feeding, rhythmic patterns of eating, and time intervals. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such
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as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Frail Elderly: Older adults or aged individuals who are lacking in general strength and are unusually susceptible to disease or to other infirmity. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Functional magnetic resonance imaging: A noninvasive tool used to observe functioning in the brain or other organs by detecting changes in chemical composition, blood flow, or both. [NIH]
Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
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Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Habituation: Decline in response of an organism to environmental or other stimuli with repeated or maintained exposure. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hyperphagia: Ingestion of a greater than optimal quantity of food. [NIH]
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Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]
Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the
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microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laterality: Behavioral manifestations of cerebral dominance in which there is preferential use and superior functioning of either the left or the right side, as in the preferred use of the right hand or right foot. [NIH] Lesion: An area of abnormal tissue change. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory,
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and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Maprotiline: A bridged-ring tetracyclic antidepressant that is both mechanistically and functionally similar to the tricyclic antidepressants, including side effects associated with its use. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning,
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(2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH]
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Neonatal: Pertaining to the first four weeks after birth. [EU] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural Pathways: Neural tracts connecting one part of the nervous system with another. [NIH]
Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study
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designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Orofacial: Of or relating to the mouth and face. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH]
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Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral vision: Side vision; ability to see objects and movement outside of the direct line of vision. [NIH] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phobias: An exaggerated and invariably pathological dread of some specific type of stimulus or situation. [NIH] Physician Assistants: Persons academically trained, licensed, or credentialed to provide medical care under the supervision of a physician. The concept does not include nurses, but does include orthopedic assistants, surgeon's assistants, and assistants to other specialists. [NIH]
Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postnatal: Occurring after birth, with reference to the newborn. [EU] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH]
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Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prefrontal Cortex: The rostral part of the frontal lobe, bounded by the inferior precentral fissure in humans, which receives projection fibers from the mediodorsal nucleus of the thalamus. The prefrontal cortex receives afferent fibers from numerous structures of the diencephalon, mesencephalon, and limbic system as well as cortical afferents of visual, auditory, and somatic origin. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prone: Having the front portion of the body downwards. [NIH] Proneness: Susceptibility to accidents due to human factors. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteoglycan: A molecule that contains both protein and glycosaminoglycans, which are a type of polysaccharide. Proteoglycans are found in cartilage and other connective tissues. [NIH]
Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH]
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Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Punishment: The application of an unpleasant stimulus or penalty for the purpose of eliminating or correcting undesirable behavior. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reaction Time: The time from the onset of a stimulus until the organism responds. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral
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mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH]
Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as
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the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Isolation: The separation of individuals or groups resulting in the lack of or minimizing of social contact and/or communication. This separation may be accomplished by physical separation, by social barriers and by psychological mechanisms. In the latter, there may be interaction but no real communication. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
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Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Systemic: Affecting the entire body. [NIH] Systems Analysis: The analysis of an activity, procedure, method, technique, or business to determine what must be accomplished and how the necessary operations may best be accomplished. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina
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terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]
Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thoracic: Having to do with the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the
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skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Unconditioned: An inborn reflex common to all members of a species. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Veins: The vessels carrying blood toward the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venter: Belly. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventral Tegmental Area: A region in the mesencephalon which is dorsomedial to the substantia nigra and ventral to the red nucleus. The mesocortical and mesolimbic dopaminergic systems originate here, including an important projection to the nucleus accumbens. Overactivity of the cells in this area has been suspected to contribute to the positive symptoms of schizophrenia. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral vector: A type of virus used in cancer therapy. The virus is changed in the laboratory and cannot cause disease. Viral vectors produce tumor antigens (proteins found on a tumor cell) and can stimulate an antitumor immune response in the body. Viral vectors may also be used to carry genes that can change cancer cells back to normal cells. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body,
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especially in the abdomen. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]
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INDEX A Aberrant, 9, 69 Acoustic, 40, 69 Adaptation, 69, 87 Adrenal Cortex, 69, 75 Adrenergic, 69, 76, 78, 92 Afferent, 69, 88 Affinity, 69 Agar, 69, 87 Agonist, 45, 48, 69, 76, 84, 85 Agoraphobia, 69, 81, 86 Akinesia, 26, 69 Algorithms, 69, 72 Alkaloid, 69, 74, 84, 85 Allergen, 70, 90 Alternative medicine, 70 Amenorrhea, 70 Amino Acids, 70, 86, 88 Amphetamines, 70, 74 Amygdala, 5, 12, 70, 83 Anaesthesia, 70, 81 Anal, 70, 79, 83 Analgesic, 70, 84, 86 Anatomical, 12, 70, 71, 73, 81, 90 Animal model, 5, 7, 9, 11, 17, 25, 39, 70 Anorexia, 42, 70 Anorexia Nervosa, 42, 70 Antibacterial, 70, 91 Antibiotic, 70, 91 Antibody, 69, 70, 71, 74, 80, 81, 83, 90, 91 Antidepressant, 5, 6, 7, 9, 17, 25, 39, 71, 79, 81, 83, 94 Antigen, 69, 70, 71, 74, 80, 81, 83, 90 Anti-inflammatory, 71, 76, 79 Antiviral, 71, 82 Anxiety, 4, 5, 6, 9, 11, 13, 15, 18, 19, 20, 26, 31, 32, 71, 86 Apathy, 7, 25, 36, 71 Appetitive Behavior, 17, 71 Applicability, 16, 71 Aqueous, 71, 72, 77 Arterial, 71, 75, 81, 88, 92 Arteries, 4, 71, 72, 75, 84, 89 Arterioles, 71, 72 Arteriolosclerosis, 71 Arteriosclerosis, 4, 71 Artery, 13, 71, 75, 77 Articular, 71, 82, 86
Assay, 5, 18, 71 Asthenia, 24, 71 Atrial, 71, 75, 93 Atrioventricular, 71, 75 Atrium, 71, 75, 93, 94 Attenuation, 15, 71 Atypical, 36, 72 Auditory, 72, 88 B Back Pain, 28, 72 Bacteria, 70, 71, 72, 77, 84, 91, 93, 94 Basal Ganglia, 10, 72, 83, 85 Base, 19, 72, 82, 93 Biochemical, 6, 72, 86, 90 Biological Factors, 19, 72 Biological response modifier, 72, 82 Biotechnology, 20, 53, 72 Blood Platelets, 72, 90 Blood pressure, 4, 72, 73, 81, 89 Blood vessel, 4, 72, 73, 75, 91, 92, 93, 94 Body Image, 32, 72 Breeding, 6, 72 C Calcification, 71, 72 Cannula, 6, 7, 72 Carbon Dioxide, 73, 79 Cardiac, 73, 75, 78, 84, 91, 92 Cardiovascular, 4, 8, 13, 73, 90 Cardiovascular disease, 13, 73 Catecholamine, 73, 76 Catheterization, 6, 7, 73, 82 Caudal, 73, 81, 85, 87 Caudate Nucleus, 73, 85 Cell, 13, 17, 69, 71, 72, 73, 74, 75, 76, 77, 81, 82, 84, 85, 87, 89, 92, 93, 94 Cell proliferation, 71, 73 Central Nervous System, 70, 73, 74, 79, 84, 90 Cerebral, 41, 72, 73, 78, 79, 82, 93 Cerebrovascular, 7, 73 Cerebrum, 73, 93 Chin, 73, 84 Cholinergic, 73, 85 Chronic, 4, 6, 7, 8, 9, 11, 13, 18, 22, 27, 29, 36, 40, 72, 73, 81 Clinical trial, 4, 6, 53, 73, 76, 89 Cloning, 72, 73 Coca, 73, 74
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Cocaine, 13, 16, 17, 18, 73, 74 Complement, 74, 90 Complementary and alternative medicine, 39, 43, 74 Complementary medicine, 39, 74 Computational Biology, 53, 74 Concomitant, 3, 5, 12, 74 Connective Tissue, 74, 79, 88 Consciousness, 70, 74, 76, 88 Contraindications, ii, 75 Cor, 7, 75 Coronary, 13, 73, 75, 84 Coronary heart disease, 73, 75 Coronary Thrombosis, 75, 84 Corpus, 75, 86, 93 Cortex, 5, 10, 75, 77, 78, 88, 90 Cortical, 25, 32, 75, 88 Corticosteroids, 75, 79 Cortisol, 19, 75 Cortisone, 75, 76 Courtship, 71, 75 Cranial, 17, 75, 79, 87, 93 Criterion, 8, 75 Cues, 14, 75 Cytokine, 7, 10, 75 D Degenerative, 76, 80, 86 Delusions, 76, 89 Dementia, 4, 6, 76 Dendrites, 76, 85 Dentate Gyrus, 76, 80 Depressive Disorder, 4, 11, 14, 21, 24, 26, 30, 76 Dexamethasone, 24, 76 Diagnostic procedure, 47, 76 Diastolic, 76, 81 Direct, iii, 5, 76, 87, 90 Discrete, 12, 76 Dominance, 76, 82 Dopamine, 12, 13, 36, 45, 48, 74, 76, 85 Dopamine Agonists, 48, 76 Double-blind, 6, 76 Drug Tolerance, 76, 93 Duct, 72, 73, 77, 90 Dysphoria, 15, 77 Dysphoric, 76, 77 E Efficacy, 6, 7, 16, 40, 77 Elasticity, 71, 77 Electrons, 72, 77, 82 Embolus, 77, 81 Embryo, 77, 81
Empirical, 16, 77 Emulsion, 77, 79 Endocrine System, 77, 85 Endogenous, 76, 77 Endorphins, 77, 85 Enkephalins, 77, 85 Entorhinal Cortex, 77, 80 Environmental Health, 52, 54, 77 Epidemic, 16, 77 Epidemiological, 9, 78 Epinephrine, 69, 76, 78, 85, 94 Erectile, 3, 78, 86 Erection, 78 Erythrocytes, 78, 90 Euphoria, 13, 78 Evoke, 78, 92 Excitation, 70, 78, 85 Extrapyramidal, 76, 78 Eye Movements, 32, 78 F Facial, 26, 78 Facial Pain, 26, 78 Failure to Thrive, 6, 78 Family Planning, 53, 78 Fat, 75, 77, 78, 83 Fatigue, 13, 78, 80 Feeding Behavior, 18, 78 Fissure, 76, 78, 88 Fixation, 15, 78, 90 Fluoxetine, 18, 36, 79 Forearm, 72, 79 Fovea, 79 Frail Elderly, 7, 79 Frontal Lobe, 79, 88 Functional magnetic resonance imaging, 10, 14, 79 G Ganglia, 79, 85, 87 Gastrointestinal, 78, 79, 90 Gastrointestinal tract, 79, 90 Gene, 14, 17, 72, 76, 79, 87 Gene Expression, 14, 79 Genotype, 79, 87 Gland, 69, 75, 79, 92 Glossopharyngeal Nerve, 78, 79 Glucocorticoid, 11, 76, 79 Glutamate, 17, 79 Glutamic Acid, 79, 85 Glycine, 80, 85 Glycosaminoglycans, 80, 88 Governing Board, 80, 87 Grafting, 80, 81
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H Habituation, 41, 80 Heart attack, 73, 80 Heart failure, 8, 80 Heartbeat, 80, 92 Hemodynamics, 3, 80 Hemostasis, 80, 90 Hepatitis, 10, 80 Hepatocytes, 80 Heredity, 79, 80 Heterogeneity, 14, 69, 80 Hippocampus, 11, 76, 80, 83, 92 Homologous, 80, 90, 92 Hormonal, 3, 80 Hormone, 75, 78, 80 Hydrogen, 72, 80, 84 Hyperphagia, 13, 80 Hypersensitivity, 70, 81, 90 Hypertension, 4, 71, 73, 81 Hypertrophy, 75, 81, 93 Hypothalamic, 6, 9, 11, 17, 18, 81 Hypothalamus, 11, 18, 81, 83, 93 I Imipramine, 36, 81 Immune response, 71, 75, 81, 90, 94 Immune system, 81, 94 Immunization, 81, 90 Immunosuppressive, 79, 81 Impairment, 4, 19, 20, 81, 84, 89 Implantation, 6, 7, 81 Impotence, 78, 81 In situ, 8, 15, 81 In vitro, 81 In vivo, 13, 81 Induction, 8, 81 Infarction, 8, 81 Infection, 72, 81, 92 Inflammation, 10, 71, 80, 82, 87 Innervation, 13, 82 Inotropic, 76, 82 Inpatients, 22, 82 Insight, 14, 82 Interferon, 10, 25, 82 Interferon-alpha, 25, 82 Intermittent, 14, 82 Intoxication, 13, 82, 95 Intracellular, 7, 81, 82, 89 Intrinsic, 6, 69, 82 Intubation, 73, 82 Ions, 72, 80, 82, 84 K Kb, 52, 82
L Latent, 19, 40, 82 Laterality, 41, 82 Lesion, 82, 83 Ligaments, 75, 82 Ligands, 14, 82 Limbic, 5, 12, 36, 70, 82, 88 Limbic System, 70, 82, 88 Lipid, 4, 71, 83 Liver, 77, 80, 83 Localization, 13, 83 Localized, 79, 81, 83, 87 Locomotion, 83, 87 Locomotor, 14, 83 Longitudinal study, 26, 83 Lumbar, 72, 83 M Magnetic Resonance Imaging, 83 Malaise, 77, 83 Manic, 83, 89 Manic-depressive psychosis, 83, 89 Maprotiline, 36, 83 Medial, 10, 14, 71, 83, 86 Mediate, 76, 83 Mediator, 83, 90 MEDLINE, 53, 83 Memory, 16, 21, 29, 32, 40, 70, 76, 83 Mental, iv, 4, 6, 7, 9, 11, 14, 19, 22, 23, 31, 33, 41, 52, 54, 58, 73, 76, 78, 83, 84, 88, 89, 90 Mental Disorders, 6, 7, 84, 88, 89 Mental Health, iv, 4, 19, 52, 54, 58, 84, 89 Mesolimbic, 12, 14, 84, 94 Microbiology, 69, 72, 84 Modeling, 7, 84 Modification, 17, 41, 84, 89 Molecular, 5, 9, 17, 53, 55, 72, 74, 76, 84, 89, 93 Molecular Structure, 84, 93 Molecule, 71, 72, 74, 78, 84, 88, 89, 94 Mood Disorders, 5, 8, 9, 17, 84 Morphine, 36, 84, 86 Morphology, 9, 84 Motility, 84, 90 Myocardial infarction, 8, 75, 84 Myocardium, 84 N Naloxone, 84 Naltrexone, 36, 84 Narcotic, 84 Necrosis, 7, 81, 84 Neonatal, 7, 9, 85
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Nervous System, 13, 69, 73, 83, 85, 87, 92 Neural, 5, 9, 10, 11, 13, 14, 17, 29, 30, 69, 85 Neural Pathways, 10, 85 Neuroendocrine, 9, 85 Neuronal, 12, 85 Neurons, 10, 17, 74, 76, 79, 85, 92 Neurotransmitter, 6, 76, 79, 80, 85, 92 Nicotine, 9, 15, 85 Nitrogen, 70, 79, 85, 94 Norepinephrine, 69, 76, 85 Nuclear, 72, 77, 83, 84, 85, 93 Nuclei, 12, 14, 70, 77, 83, 85, 87 Nucleus, 5, 12, 13, 14, 16, 17, 85, 88, 94 Nucleus Accumbens, 5, 12, 13, 14, 16, 17, 85, 94 O Observational study, 20, 85 Ophthalmology, 79, 86 Opiate, 84, 86 Opium, 84, 86 Optic Chiasm, 81, 86 Orofacial, 78, 86 Osteoarthritis, 6, 86 P Panic, 81, 86 Panic Disorder, 81, 86 Paralysis, 69, 86 Pathologic, 75, 81, 86 Patient Education, 4, 62, 64, 67, 86 Penis, 4, 86, 87 Peptide, 17, 86, 88 Perception, 34, 45, 86, 90 Peripheral blood, 82, 86 Peripheral Nervous System, 77, 85, 87 Peripheral vision, 87, 95 Personality Disorders, 19, 28, 40, 87 Phallic, 79, 87 Pharmacologic, 4, 9, 87, 93 Phenotype, 7, 17, 87 Phobias, 4, 87 Physician Assistants, 3, 87 Physiologic, 69, 87, 89 Plants, 69, 72, 73, 74, 84, 85, 87, 93 Plaque, 4, 87 Plasticity, 5, 87 Pleomorphic, 85, 87 Pneumonia, 75, 87 Polysaccharide, 71, 87, 88 Posterior, 70, 72, 79, 87 Postnatal, 7, 87 Practice Guidelines, 54, 87 Preclinical, 6, 7, 9, 14, 88
Precursor, 76, 77, 85, 88, 94 Prefrontal Cortex, 10, 14, 88 Presynaptic, 85, 88, 92 Prevalence, 4, 7, 88 Procaine, 69, 88 Progression, 70, 88 Progressive, 40, 71, 76, 84, 86, 88 Projection, 85, 88, 90, 94 Prone, 19, 40, 41, 88 Proneness, 19, 29, 30, 32, 88 Prospective study, 83, 88 Protein S, 72, 88 Proteins, 70, 71, 74, 84, 85, 86, 88, 89, 94 Proteoglycan, 18, 88 Psychiatric, 6, 11, 12, 14, 22, 24, 25, 29, 48, 84, 88 Psychiatry, 4, 10, 12, 16, 21, 22, 23, 25, 27, 28, 29, 30, 31, 32, 42, 78, 88 Psychic, 48, 84, 88 Psychoactive, 88, 95 Psychogenic, 4, 88 Psychopathology, 5, 9, 23, 24, 25, 30, 33, 88 Psychosis, 19, 29, 30, 32, 40, 41, 89 Public Health, 10, 11, 54, 89 Public Policy, 53, 89 Pulmonary, 72, 75, 89, 94 Pulmonary Artery, 72, 89, 94 Pulmonary hypertension, 75, 89 Punishment, 14, 89 Q Quality of Life, 10, 89 R Race, 19, 89 Radioactive, 80, 81, 85, 89 Randomized, 6, 77, 89 Randomized clinical trial, 6, 89 Reaction Time, 10, 89 Reality Testing, 89 Receptor, 13, 17, 36, 69, 71, 76, 89, 90 Receptors, Serotonin, 89, 90 Recombinant, 89, 94 Red Nucleus, 89, 94 Refer, 1, 74, 77, 79, 83, 89, 90, 93 Reflex, 41, 78, 90, 94 Refraction, 90, 91 Regimen, 77, 90 Relapse, 22, 90 Risk factor, 8, 9, 88, 90 S Saliva, 90 Salivary, 19, 90 Schizoid, 90, 95
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Schizophrenia, 12, 13, 16, 19, 21, 22, 23, 24, 26, 29, 30, 31, 32, 33, 40, 41, 48, 90, 94, 95 Schizotypal Personality Disorder, 90, 95 Sclerosis, 71, 90 Screening, 6, 7, 73, 90 Sedative, 81, 90 Sensitization, 19, 90 Serotonin, 13, 79, 85, 89, 90, 94 Sertraline, 32, 90 Shock, 90, 93 Side effect, 83, 90, 93 Signs and Symptoms, 90, 91 Skull, 91, 93 Smoking Cessation, 9, 91 Smooth muscle, 70, 84, 91 Social Environment, 89, 91 Social Isolation, 12, 90, 91 Social Support, 19, 91 Soma, 91 Somatic, 13, 79, 83, 87, 88, 91 Specialist, 59, 91 Species, 6, 78, 89, 91, 92, 94, 95 Specificity, 12, 17, 69, 91 Spectrum, 12, 19, 32, 91 Spinal cord, 73, 85, 87, 90, 91 Steroid, 75, 91 Stimulant, 14, 91 Stimulus, 9, 11, 14, 27, 78, 82, 87, 89, 90, 92, 93 Stress, 4, 5, 7, 9, 11, 13, 14, 16, 19, 36, 48, 73, 75, 92 Striatum, 5, 10, 85, 92 Stroke, 52, 73, 92 Subclinical, 7, 81, 92 Subiculum, 80, 92 Subspecies, 91, 92 Sudden death, 8, 12, 92 Suppression, 4, 36, 92 Suppressive, 5, 92 Sympathomimetic, 76, 78, 85, 92 Symptomatic, 16, 48, 92 Symptomatology, 22, 92 Synaptic, 85, 92 Synaptic Transmission, 85, 92 Systemic, 72, 78, 80, 81, 92, 93 Systems Analysis, 39, 92 Systolic, 81, 92 T Telencephalon, 72, 92 Temporal, 14, 70, 80, 93 Temporal Lobe, 70, 93
Thalamus, 83, 88, 93 Third Ventricle, 81, 93 Thoracic, 72, 93 Threshold, 20, 23, 31, 81, 93 Thrombosis, 8, 88, 92, 93 Tissue, 6, 7, 12, 71, 74, 76, 77, 78, 80, 81, 82, 83, 84, 85, 86, 91, 93 Tolerance, 18, 93 Torsion, 81, 93 Toxic, iv, 78, 85, 93 Toxicology, 13, 36, 54, 93 Toxin, 93 Transfection, 72, 93 Transmitter, 76, 83, 85, 93 Trauma, 18, 84, 93 Tricuspid Atresia, 75, 93 Tricyclic, 6, 81, 83, 93 Trigeminal, 78, 93 Tryptophan, 90, 94 Tubercle, 85, 94 Tyrosine, 76, 94 U Unconditioned, 5, 94 Urethra, 86, 94 V Vaccine, 7, 94 Vascular, 81, 82, 94 Vasodilator, 76, 94 Vector, 5, 94 Veins, 72, 94 Venlafaxine, 6, 94 Venter, 94 Ventral, 5, 12, 13, 17, 81, 85, 94 Ventral Tegmental Area, 12, 13, 17, 94 Ventricle, 70, 71, 73, 75, 80, 85, 89, 92, 93, 94 Ventricular, 8, 41, 75, 93, 94 Venules, 72, 94 Veterinary Medicine, 53, 94 Viral, 17, 18, 94 Viral vector, 18, 94 Virus, 82, 87, 94 Viscera, 91, 94 Visual field, 15, 86, 95 Vivo, 13, 95 W Withdrawal, 4, 13, 14, 18, 95 X Xenograft, 70, 95 Y Yeasts, 87, 95
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