Neurochemical correlates of sympathetic activation during severe alcohol withdrawal.
Cerebrospinal fluid (CSF) was obtained from 17 patients during acute alcohol withdrawal. Eight of these 17 patients had a second lumbar puncture a mean of 11.9 +/- 8.1 (SD) days later, when the clinical signs of alcohol withdrawal had subsided. CSF 3-methoxy-4-hydroxyphenylglycol concentrations declined significantly (p < 0.05) during the course of alcohol withdrawal from 52.0 +/- 22.1 (SD) to 39.6 +/- 12.6 pM/ml. In early withdrawal, there was a significant positive correlation between CSF norepinephrine (NE) and corticotropin releasing hormone (CRH) concentrations (r = 0.95, p < 0.001). Both NE and CRH concentrations correlated positively with diastolic blood pressure (r = 0.88, p < 0.001 and r = 0.62, p < 0.05, respectively). In all samples, CSF 5-hydroxyindole acetic acid concentrations correlated positively with CSF-homovanillic acid concentrations (r = 0.83, p < 0.001). These findings indicate significant perturbations of the noradrenergic neuronal system and a change in CRH-NE interactions during acute alcohol withdrawal.
Hawley
R J
RJ
Neurology Department, VA Medical Center, Washington, D.C.
Nemeroff
C B
CB
Bissette
G
G
Guidotti
A
A
Rawlings
R
R
Linnoila
M
M
D000328:Adult; D000368:Aged; D000430:Alcohol Withdrawal Delirium / Q000503:physiopathology*; D000437:Alcoholism / Q000503:physiopathology / Q000534:rehabilitation*; D001143:Arousal / Q000502:physiology*; D002352:Carrier Proteins / Q000134:cerebrospinal fluid; D003346:Corticotropin-Releasing Hormone / Q000502:physiology*; D026261:Diazepam Binding Inhibitor; D000431:Ethanol / Q000009:adverse effects*; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D008875:Middle Aged; D009460:Neurologic Examination; D009638:Norepinephrine / Q000502:physiology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*
D002352:Carrier Proteins; D026261:Diazepam Binding Inhibitor; D000431:Ethanol; D008734:Methoxyhydroxyphenylglycol; D003346:Corticotropin-Releasing Hormone; D009638:Norepinephrine; D006719:Homovanillic Acid