Cerebral glucose metabolism in adults with hyperactivity of childhood onset

Article Abstract:

Two to four percent of school children are afflicted by hyperactivity, a condition which was recently re-named as attention deficit-hyperactivity disorder. Individuals affected by the disorder appear restless, have difficulty paying attention, become easily distracted, and exhibit an impulsiveness in their behavior. The cause of the condition is unknown, and an underlying neurological or biochemical basis has not been found. As a result, the condition and its current treatment, the administration of stimulants, is controversial. Recently, positron emission tomography (PET) has been used to detect the rate of metabolism of radioactively labeled glucose by brain tissue as an index of regional brain activity. The researchers used this method to study the brains of adults who had symptoms of hyperactivity as children, continued to display some symptoms of the condition as adults (40 to 60 percent of patients do so), and also had a child who had been diagnosed as hyperactive. Adults rather than children were used because of the ethics of giving radioactively labeled substances to children. Fifty normal adults (controls) and 25 hyperactive adults were examined using this technique. The brains of the hyperactive patients had significantly lower levels of glucose utilization at 30 of 60 measured sites, and the global level of glucose utilization was also found to be depressed in the hyperactive subjects. In no area did the brains of afflicted patients demonstrate elevated glucose utilization when compared with normal controls. The locations of greatest decreased glucose utilization occurred in the premotor cortex and superior prefrontal areas, zones already associated with attention and motor activity by other methods. The findings support a speculation that such decreased metabolic function, particularly in the brain areas mentioned above, is related to or is the cause of hyperactivity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Brain, Blood sugar, Blood glucose

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Transplacental passage of insulin in pregnant women with insulin-dependent diabetes mellitus: its role in fetal macrosomia

Article Abstract:

Infants born to women with insulin-dependent diabetes were studied to determine whether insulin can cross the placenta from the mother to the fetus. The insulin administered to diabetic patients may be of human or animal (pork or beef) origin. Insulin is also secreted by the pancreas of infants and therefore simply testing the presence of maternal insulin in amniotic fluid was not considered reliable for the purposes of this study. Insulin is used by the fetus as a growth factor and placental transfer of insulin may result in a complication of maternal diabetes known as fetal macrosomia, abnormally large size at birth. Previous research in this area has suggested that insulin administered to pregnant women does not cross the placenta. The umbilical cord blood of 45 infants was tested for the presence of maternal insulin. Twenty-one infants had macrosomia and 24 had normal birth weights. The concentration of human insulin was higher in the infants with macrosomia than those without, and in 28 infants in whom animal insulin was detected, 12 had macrosomia, while 12 had normal weight. Among infants in whom a combination of human and animal insulin was detected, there was a significant correlation with fetal growth. Even when maternal blood glucose was maintained at a normal level, fetal macrosomia still occurred. The cause of fetal macrosomia is believed to be directly proportional to the concentration of glucose and other nutrients in the mother and fetus and an excess of these substances leads to fetal hyperinsulinism and macrosomia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Measurement, Maternal-fetal exchange, Complications and side effects, Diabetes in pregnancy, Gestational diabetes, Insulin, Fetal macrosomia, Placental extracts

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Problems in the management of attention-deficit-hyperactivity disorder

Article Abstract:

Attention-deficit-hyperactivity disorder (ADHD) can be successfully treated with several different strategies. ADHD is characterized by inability to concentrate, hyperactivity, and impulsive behavior. Research has revealed differences in brain anatomy in children with ADHD compared to children without the disorder. There also seems to be a hereditary component. Diagnosis is based on behavioral problems noticed by the child, family members or teachers. Other medical conditions can cause similar symptoms. Treatments include behavior modification, education, social skills training, counseling, and methylphenidate or dextroamphetamine.

Care and treatment, Attention deficit hyperactivity disorder

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