Clinical Neuroscience

[Endogenous psychopharmacology]

BÁNKI M. Csaba1

SEPTEMBER 30, 2006

Clinical Neuroscience - 2006;59(09-10)


  1. Szabolcs-Szatmár-Bereg Megyei Önkormányzat Pszichiátriai Szakkórháza, Nagykálló



Further articles in this publication

Clinical Neuroscience



[The temporal lobe epilepsy (TLE) is the most important kind of partial epilepsy both from practical and research point of view, where studies brought many new results in the last years. This article is a state of art review with a special emphasis on medial temporal lobe epilepsy (MTLE). We show the clinical symptoms, EEG and neuroimaging signs, the psychiatric co-morbidities and psyhosocial consequences. Etiological factors, among them hippocampal sclerosis and hippocampal reorganisation is assessed in a more detailed form. The possibilities of pharmacological and surgical treatment are also shown, together with the brief outline of the Hungarian situation. TLE is presented as a model for the development of partial epilepsies.]

Clinical Neuroscience



[The most effective type of epilepsy surgery in adults is temporal lobe epilepsy (TLE) surgery. Three quarter of the patients become seizure free, however the remaining patients experience seizures after resection. In our study we analyzed retrospectively the possible electro-clinical, neuroimaging and surgery-related outcome predictors in 94 adult patients who had anterior temporal lobectomy (ATL) from the material of Epilepsy Centre of the National Institute of Psychiatry and Neurology, Budapest since the beginning of the surgery program in 1989 until 2001. Three outcome endpoints were chosen: the seizure status at the last visit, the longest seizure free period and the time to the first non-acute postoperative seizure. The predictors were assessed by multivariate and Cox regression methods. After one year of surgery 72% of the patients were seizure free, after two years 67% and after five years 59%. Factors predicting favorable outcome in TLE surgery were: typical temporomesial aura, strictly unilateral interictal anterotemporal spikes, unilateral ictal onset, slow contralateral propagation, hippocampal sclerosis (HS) as etiology. Factors predicting poor outcome in TLE surgery were: increase in seizure frequency in the last two preoperative years, presence of preoperative psychiatric disturbances, ictal contralateral propagation, MRI lesion distant from the surgery site, incongruency of data of preoperative investigations, postoperative sequels and non-HS type MR residuum.]

Clinical Neuroscience


Clinical Neuroscience

[We do need change in the education of neurosurgeons]


Clinical Neuroscience


PAPP Mátyás, KOVÁCS Tibor

[Multiple system atrophy (MSA) belongs to the neurodegenerative diseases of the nervous system, but it is different from them in many aspects: it has no familiar form and no genetic factor was identified in the pathomechanism. Its neuropathology is unique too, because oligodendroglial cells are harbouring the main pathological burden. It was described in MSA that there is no elective neuronal degeneration in neurodegenerative disorders: the glial cells show the same patochemical and structural abnormalities as found in the neurones. The discovery of the glial cytoplasmic inclusions, as a pathognostic marker for MSA, has directed attention to the glial cells in other neurodegenerative disorders. As a result of this, there are several neurodegenerative diseases nowadays in which glial inclusions were described, similar to the neuronal inclusions in their structural and biochemical properties and some of them became the diagnostic marker of the disease. In our review we summarize the clinical features, the history and the neuropathology of MSA and we discuss its special features.]

All articles in the issue

Related contents

Lege Artis Medicinae

[Clozapine - the last resort antipsychotic for treatment resistant schizophrenia ]


[More than 60 years old is the first antipschychotic drug that is operating atypically as well. With its multifarious history it gained the golden standard title of all therapy resistent schisophrenic cases for the last three decades. In this article we place clozapine on the map of psychopharmacology and review its history’s most important chapters. In the third part we discuss some of the most relevant effects and side effects of clozapine in the light of latest research and practical considerations touching the problem of the optimal start timing. ]

Hypertension and nephrology

[Statin therapy and hyperuricemia in hyperlipidemia - the clinical importance of atorvastatin]

CSIKY Botond

[Population based studies have proven that serum level of uric acid is a cardiovascular risk factor. Uric acid is produced in the human body as a result of the degradation of endogenous and exogenous purin nucleotids. It is eliminated mainly by the kidneys and in a small amount through the gastrointestinal tract. Serum uric acid can be decreased by some medical therapies. It has been demonstrated that atorvastatin treatment can decrease significantly uric acid level in patients with hyperlipidemia. Other statins do not seem to have such an effect. The uric acid lowering effect of atorvastatin is dose-dependent, and it most likely acts by increasing the renal elimination. The cholesterol, trgiglycerid and uric acid lowering effect of atorvastatin may have an important role in decreasing cardiovascular risk.]

Clinical Neuroscience

[The antinociceptive effect of kynurenic acid]

KÉKESI Gabriella, HORVÁTH Gyöngyi

[It is well known that glutamate receptors have significant role in the pain transmission. The activation of N-methyl-Daspartate receptors causes persistent pain, therefore the antagonists acting on these receptors cause antinociception in chronic pain states. As the synthetic N-methyl-D-aspartate receptor antagonists have several side effects, they are not used generally in the clinical therapy. The tryptophan metabolite kynurenic acid is an endogenous antagonist of N-methyl-D-aspartate receptors. Although some data proved its neuroprotective effect, only a few studies suggest the antinociceptive potential of kynurenic acid. The goal of this review to summarise the possible role of kynurenic acid in the pain therapy based on the results of animal studies. Data available concerning this subject demonstrated that kynurenic acid is not an appropriate agent for antinociception neither in single nor in continuous administration because of its side-effect resulting in motor deficiency. On the other hand the combination of low doses of kynurenic acid and endomorphin-1 provides effective antinociception without side-effects on inflammatory pain test, thus may offer a new treatment modality in human pain therapy.]

Lege Artis Medicinae


DURA Eszter

[Recent data suggest that the copper-containing semicarbazide-sensitive amine oxidase enzyme (SSAO) may play a role in vascular endothelial damage through conversion of certain endogenous monoamines, such as methylamine, into cytotoxic aldehydes, hydrogen peroxide and ammonia. SSAO is present in various human tissues and in the serum. Elevated SSAO activities have been reported in patients with both types of diabetes mellitus. We have demonstrated that the activity of serum SSAO is significantly higher in type 2 diabetic patients with high-risk proliferative diabetic retinopathy compared to those without retinopathy. Our clinical results support the hypothesis that elevated SSAO activity may be involved in the pathogenesis of microvascular diabetic late complications, such as retinopathy. The enzymatic conversion of the endogenous monoamines (e.g. methylamine, aminoacetone) into toxic aldehydes and hydrogenperoxide may be one of the possible mechanisms of the development of microangiopathy. Also, the vascular adhesion protein-1 (VAP-1) function of the molecule can cause leukostasis and leukocyte activation through increased leukocyte adhesion, resulting in worsening of the capillary circulation and hypoxia. Further prospective, larger studies are needed to elucidate the role of the possible association between serum SSAO activity and highrisk proliferative retinopathy in patients with type 2 diabetes. The pharmacological manipulation of SSAO activity might be an interesting new concept for prevention and treatment of diabetic retinopathy.]

Lege Artis Medicinae

[The newest DPP-4-inhibitor: linagliptin]

KIS János Tibor

[Linagliptin is a xantin-based, highly selective, potent inhibitor of dipeptidyl peptidase- IV (DPP-4). By inhibiting DPP-4, linagliptin reduces the degradation of endogenous incretin hormones, and thus increases insulin secretion and decreases glucagon secretion in the pancreatic islets in a glucose-dependent manner. The author summarises the most important clinical trials with linagliptin, which highlight those features of linagliptin that distinguish it from other DPP-4 inhibitors.]