Acupuncture for reducing the south to reinforce the north on executive function and sleep structure in patients with chronic insomnia disorder of heart-kidney disharmony. / æ³»å—è¡¥åŒ—æ³•é’ˆåˆºå¯¹å¿ƒè‚¾ä¸äº¤åž‹æ ¢æ€§å¤±çœ éšœç¢æ‚£è€ æ‰§è¡ŒåŠŸèƒ½åŠç¡çœ ç»“æž„çš„å½±å“.

OBJECTIVES: To observe the efficacy of acupuncture for reducing the south to reinforce the north on executive function, sleep structure and sleep quality in patients with chronic insomnia disorder of heart-kidney disharmony. METHODS: A total of 100 patients with chronic insomnia disorder of heart-kidney disharmony were randomized into an acupuncture group (50 cases, 1 case dropped out) and a western medication group (50 cases, 2 cases dropped out). Acupuncture for reducing the south to reinforce the north was applied at Baihui (GV 20) and bilateral Shenmen (HT 7), Sanyinjiao (SP 6), Shenmai (BL 62), Zhaohai (KI 6), Xinshu (BL 15), Shenshu (BL 23) in the acupuncture group, once a day, 5 days a week. Lorazepam tablet was given orally in the western medication group, 0.5-1 mg a time, once a day. Both groups were treated for 4 weeks. The Stroop color-word test (SCWT) indexes (the time consuming and the correct number of card A, B, C and the Stroop interference effect [SIE]), sleep structure indexes (total sleep time [TST], sleep latency [SL], wake after sleep onset [WASO], sleep efficiency [SE], non-rapid eye movement period 1 [N1], non-rapid eye movement period 2 [N2], non-rapid eye movement period 3 [N3], rapid eye movement period [REM]) and Pittsburgh sleep quality index (PSQI) score were observed before and after treatment in the two groups. RESULTS: After treatment, the time consuming of card B and C, the time consuming and the correct number of SIE, SL, WASO, N1, N2, as well as the sub-item scores and total score of PSQI were decreased (P<0.05, P<0.01), the correct number of card A, B and C, TST, SE, N3 and REM were increased (P<0.01) compared with those before treatment in the acupuncture group; the time consuming of card C and SIE, the correct number of card A and SIE, TST, SE, REM were increased (P<0.05, P<0.01), SL, WASO, N1, as well as the sub-item scores of sleep quality, sleep latency, sleep duration, sleep efficiency, daytime function and total score of PSQI were decreased (P<0.01) compared with those before treatment in the western medication group. After treatment, in the acupuncture group, the time consuming of card C, the time consuming and the correct number of SIE, N1, N2, as well as the sub-item scores of sleep quality, sleep dysfunction, daytime function and total score of PSQI were lower than those in the western medication group (P<0.01), the correct number of card B and C, N3, REM were higher than those in the western medication group (P<0.01). CONCLUSIONS: Acupuncture for reducing the south to reinforce the north can improve the executive function of patients with chronic insomnia disorder of heart-kidney disharmony, adjust the sleep structure, and improve the night sleep quality and daytime body function.

Persistent catatonia following epileptic seizures: a case report and systematic literature search.

BACKGROUND: Catatonia is frequently associated with mood and psychotic disorders as well as with general medical conditions, especially with seizures. In the case of the latter, catatonia mostly resolves when the seizures respond to the anticonvulsive treatment. We report, to our knowledge, the first case of a patient without affective or psychotic disorder, who developed catatonia in the postictum and whose catatonia did not resolve with anticonvulsive treatment, but did so with lorazepam. CASE PRESENTATION: We describe a 36-year-old man, with no psychiatric history, except for a possible disorder in the use of cannabis, who developed catatonia after epileptic seizures. The catatonia did not respond to the anticonvulsant therapy, but did so to lorazepam 17 mg/d. Lorazepam could be tapered slowly and stopped without reemergence of catatonic signs. CONCLUSION: Catatonia should be part of the differential diagnosis in patients with bradyphrenia and/or remarkable postictal behavior. This report shows that lorazepam should be taken into consideration (before moving to ECT), in cases of unresolved catatonia, even if the seizures are reduced with anticonvulsants.

The Effect of Lorazepam on the Silent Period of the Motor Evoked Potential

OBJECTIVE: The purpose of this study was to find out whether the duration of the silent period evoked by magnetic transcranial stimulation could be modulated by lorazepam. METHOD: Ten healthy volunteers were tested using the transcranial magnetic stimulation. Responses were recorded in the active abductor digiti minimi muscle, and baseline values were compared to the data obtained at 2 and 5 hours after administration of a single oral dose of 2.5 mg lorazepam. RESULTS: The motor threshold and size of the motor evoked potential remained unchanged after administration of lorazepam. The duration of cortical silent period was prolonged from 169.9+/-33.7 msec at baseline study to 248.1+/-50.4 msec at 2 hours and 248.5+/-47.3 msec at 5 hours after administration of the drug (p<0.01), but the peripheral silent period did not show any significant change. CONCLUSION: We have shown that the cortical silent period evoked by magnetic transcranial stimulation can be prolonged by administration of lorazepam. And the lack of effect on the motor threshold and on the size of the motor evoked potential after administration of lorazepam may indicate that these parameters are physiologically distinct from the cortical silent period. Therefore, prolonged cortical silent period may be resulted from the reinforcement of GABA action by lorazepam at the level of the motor cortex.