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Cerebral circulation and EEG alpha frequency in relation to daily fluctuations in psychotic behavior
Abstract:
Aspects of the cerebral circulation were monitored daily by cerebral electrical impedance plethysmography in one chronic schizophrenic girl for 9 months and seven other chronic schizophrenic patients for a period of 8 months. An additional manic-depressive patient was monitored while in a remission phase over 2 months. Simultaneous electroencephalogram (EEG) recordings were made on the schizophrenic patients. Daily Malamud-Sands (MS) psychiatric rating scales were completed by trained nursing staff on all patients. Correlation coefficients were obtained between this behavioral variable and the EEG-measured alpha frequency. Correlations were also run between the dimensions of the MS rating scale and three indices of the cerebral circulation and between two indices of cervical blood flow. Results indicated significant correlations between the "stuporous" scores of the MS scale and the cerebrovascular measurements in one catatonic patient. EEG alpha frequency correlated significantly with "excitement" scores in the same patient. The manic-depressive patient monitored in her remission phase showed no correlations with MS scores but relatively unchanging normal cerebral hemodynamics. The remaining seven chronic schizophrenic patients were followed daily for 8 months during a drug regimen in which phenelzine and L-tryptophan were administered. Significant relationships were found between the daily fluctuations of behavior and cerebral circulatory variables in a majority of the patients, and the extent of these correlations appeared to be increased by the addition of the metabolically active agents. Only a minority of correlations between MS scores and EEG dominant frequency were found in this group of patients. It is concluded that the MS scale affords a useful ethological monitor of psychotic behavior and that cerebral electrical impedance plethysmography and EEG alpha frequency correlate significantly with the fluctuations it records.