mystery of yawning
Le bâillement, du réflexe à la pathologie
Le bâillement : de l'éthologie à la médecine clinique
Le bâillement : phylogenèse, éthologie, nosogénie
 Le bâillement : un comportement universel
La parakinésie brachiale oscitante
Yawning: its cycle, its role
Warum gähnen wir ?
 
Fetal yawning assessed by 3D and 4D sonography
Le bâillement foetal
Le bâillement, du réflexe à la pathologie
Le bâillement : de l'éthologie à la médecine clinique
Le bâillement : phylogenèse, éthologie, nosogénie
 Le bâillement : un comportement universel
La parakinésie brachiale oscitante
Yawning: its cycle, its role
Warum gähnen wir ?
 
Fetal yawning assessed by 3D and 4D sonography
Le bâillement foetal
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31 août 2012
 
 
A new model for the apomorphine test as a biological marker for cocaine-dependent patients
 
Roncero C, Fuste G, Grau-López L Daigre C,
Miquel L, Corominas M, Bachiller D, Egido A,
Castells X, Gómez-Baeza S, Alvarós J, Casas M
 
Outpatient drug clinic. Psychiatry Departament. Hospital Universitarío Vall Hebron. Psychiatry Departament. Universidad Autónoma de Barelona. Spain
Psychiatry Departament, Hospital Universitario Vall Hebron. Universidad Autónoma de Barcelona, Spain
Psychiatry and legal medicine Departament, Universidad Autónoma de Barcelona, Spain
Pharmacological Departament Universitat de Girona, Girona, Spain

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Walusinski O. Neurofisiología del bostezar y estirarse: su ontogenia y filogenia Electroneurobiología 2006; 14(4):175-202
 
 
Roncero C, Mezzatesta-Gava M, Grau-López L, Daigre C. Yawning as a dose-dependent side effect of treatment with escitalopram. Neurologia (spanish) 2012
 
Guardia J, Casas M, et al The apomorphine test: a biological marker for heroin dependence disorder? Addict Biol 2002;7(4):421-426
 
Casas M , Guardia J, Prat G, Trujols J The apomorphine test in heroin addicts Addiction1995;90:831-835

 
INTRODUCTION
Up to now, no reliable biological markers for risk and relapse among cocaine-dependent patients have been identified. Apomorphine is a D2>D1 nonselective dopamine-receptor agonist. Apomorphine produces yawning and hormonal changes. It has been suggested that addicts present an enhanced sensitivity of the dopamine neurotransmitter system (Casas et al, 1995).
 
The Apomorphine Test may be useful in assessing central dopamine system alterations associated with chronic heroin consumption (Guardia et al, 2002). The yawn-inducing Apomorphine Test has been proposed as a marker for predicting relapse during the withdrawal period in cocaine-dependent patients (Roncero et al, 2010). Also, the Complete Apomorphine Test, which includes an Apomorphine Test plus a Placebo Test or viceversa, has been proposed as a biological marker for predicting early relapse (Roncero et al, 2012).
 
OBJECTIVE
To study the Apomorphine Test as a biological marker for relapse in cocaine-dependent patients as performed on the first day and on day 11 or 12 of abstinence.
 
apomorphine test
 
MATERIAL & METHOD
39 (35 men) 31.94 (20-48) y.o. cocaine addicts were recruited and included in an addiction program involving 2 weeks of detoxification as in-patients and a 23-week follow-up period.
 
Dependence was diagnosed according to DSM-IV-TR criteria. Other principal Axis I comorbid diagnoses were excluded (schizophrenia, bipolar disorders, major depression, OCD, etc). We used SCID I and SCID II to evaluate Axis I and II disorders. Patients were evaluated using: Analogic Visual Scale (AVS) for cocaine Craving, CCQ, CSSA, WURS, ADHD-RS, BDI, STAI-R/S scales.
 
We performed a double-blind clinical trial using the Complete Apomorphine Test at the beginning (day 1) and end (day 11 or 12) of a in-patient detoxification program.
 
Each patient received 0.005 mg/kg of apomorphine and 0.005 mg/kg of placebo subcutaneously in each test. There was a 45- minute break between the Apomorphine Test and the placebo test.
 
Yawning was monitored and noted by independent observers for periods of 45 minutes following administration of the apomorphine or placebo.
 
We defined relapse as 3 consecutive positive urinoanalyses for cocaine or 5 positive ones in 4 weeks. Also, if the patient did not submit to the urinoanalysis control, it was considered to be positive.
 
Results
Patients (n = 22) who relapsed within the first 4 weeks showed higher yawn count in the combined Apomorphine Test performed on days 1and day 11 or 12 than patients (n = 17) who did not relapse within this period of time 18.85 (SD =13.12) vs. 10.71 (SD =12.40 ), Z -1.89, (p <0.05).
 
There were no differences between the two groups in the AVS, CCQ, CSSA, WURS, ADHD-RS, BDI, STAI-R/S mesures.
 
CONCLUSIONS
The increased number of yawns in early-relapse patients could be evidence of the usefulness of the combining of the yawn-inducing Apomorphine Test performed on the first and last days of the detoxification process.
 
The Apomorphine Test could be a biological marker for predicting early relapse in cocaine-dependent patients. It can give clinicians indirectly information of how affected is the dopaminergic neurotransmission.
 
References
 
Casas M, Guardia J, Prat G, Trujols J. The apomorphine test in heroin addicts. Addiction. 1995; 90(6):831-835
 
Casas M, Prat G, Guardia J, Duro P. Yawning induced by low doses of apomorphine as posible biological marker for studying the effects of CNS active compounds on the dopamine system. In: Palomo T et al., editors. Strategies for studying Brain disorders.Vol 2. London: Farrand Press;1994.p.55-70.
 
Guardia J, Casas M, Prat G, Trujols J, Segura L, Sanchez-Turet M.The apomorphine test: a biological marker for heroin dependence disorder? Addict Biol. 2002; 7(4): 421-426.
 
Roncero C, López-Ortíz C, Rodríguez-Pascual M , Corominas M, Castells X, Grau-López L, Daigre C, Gómez-Baeza S, Castrillo E, Valero S, Casas M. The apomorphine test as a biological marker for relapse in cocaine-dependent patients. Presented at 18th meeting European Psychiatric Association (AEP). Munich (Germany) 21 February -2 March 2010.
 
Roncero C, Grau-López L, Daigre C, Gonzalvo B, Corominas M, Egido A, Castells X, Gómez-Baeza S Esteve O, Casas M. A new model for the apomorphine test as a biological marker for cocaine-dependent patients. Presented at 20th meeting European Psychiatric Association (AEP). Prague (Czech Republic) 3-6 March 2012.