Grundlagen und Methoden der Psychiatrie: Teil 2

1201 Pages·1980·29.777 MB·German

by  D. Richter (auth.), J. Angst Prof. Dr., A. Carlsson Dr., J. Gross Prof. Dr., R. Jung Prof. Dr., P. Kempe Dr., H. Künkel Prof. Dr., L. Laitinen Dr., N. Matussek Prof. Dr., J.-O. Ottosson Prof. Dr., D. Ploog Prof. Dr., D. Richter Prof. Dr., B. Woggon Dr., E. Zerbin-Rüdin Prof. Dr., D. von Zerssen Prof. Dr. (eds.)

PSYCHIATRIE DER GEGENWART
FORSCHUNG UND PRAXIS
lierausgegeben von
K. P. Kisker,]. E. Meyer, C. Miiller,
E. Stromgren
Band I
Zweite Auflage
Springer-Verlag Berlin lieidelberg New York 1980
GRUNDLAGEN UNO METHODEN
OER PSYCHIATRIE
Teil2
Bearbeitet von
).Angst, A. Carlsson, ).Gross, R.Jung, P.Kempe, H.Kiinkel,
L. Laitinen, N. Matussek, ).-0. Ottosson, D. Ploog, D. Richter, B.Woggon,
E. Zerbin-Riidin, D. von Zerssen
Mit t 84 Abbildungen
Springer-Verlag Berlin Heidelberg New York 1980
Professor Dr. Dr. K.P. KISKER, Medizinische Hochschule, Psychiatrische Klinik, Karl
Wiechert-Allee 9, 0-3000 Hannover 61
Professor Dr. J .E. MEYER, Psychiatrische Universitatsklinik, von-Siebold-Str. 5, 0-3400
G6ttingen
Professor Dr. C. MULLER, H6pital de Cery, Clinique Psychiatrique Universitaire, Canton
de Vaud, CH-IOOS Prilly
Professor Dr. E. STROMGREN, Psychiatrisches Krankenhaus, OK-S240 Risskov
[SBN-I3: 978-3-642-67417-4 e-ISBN-13: 978-3-642-674[6-7
001: 10.1007/978-3-642-674 [6-7
CIP-Kurztitelaufnahme der Deutschen Bibliothek
Psychiatrie der Gegenwart: Forschung u. Praxis / hrsg. von K.P. Kisker ... -
Berlin. Heidelberg, New York: Springer.
NE: Kisker. Karl Peter (Hrsg.) Bd. I. - Grundlagen und Methoden der Psychiatrie Teil. 2 / Bearb.
von J. Angst ... - 2. Aufl. - 1979. (Psychiatric der Gegenwart; Bd. I)
NE: Angst. Jules (Bearb.)
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© by Springer-Verlag Berhn Heidelberg 1980.
Softcover reprint ofthe hardcover 2nd edition 1980
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Inhaltsverzeichnis
D. Biologische Grundlagen
Neurochemistry. By D. RICHTER. With 4 Figures. . . . . . . . . . . . . . . . . . . .
Stoffwechselpathologie der Zyklothymie und Schizophrenic. Von N. MATUSSEK. Mit 15 Abbil-
dungen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Elektroenzephalographie und Psychiatrie. Von H. KeNKEl.. Mit 36 Abbildungen . 115
Psychopharmacology: Basic Aspects. By A. CARLSSON. With 3 Figures 197
Psychopharmakotherapic. Von J. ANGST und B. WOGGON . 243
Convulsive Therapy. By J.-O. OTTOSSON. With 1 Figure .... . 315
Psychosurgery. By L. LAITINEN. With 5 Figures ....... . 351
Soziobiologic der Primaten. Von D. PLOOG. Mit 62 Abbildungen. 379
Psychiatrische Genetik. Von E. ZERBIN-RuDiN. . . . . . . . . 545
Konstitution. Von D. VON ZERSSEN. Mit 12 Abbildungen .... 619
Deprivationsforschung und Psychiatrie. Von P. KEMPE und J. GROSS 707
Neurophysiologie und Psychiatrie. Von R. Jt.:NG. Mit 46 Abbildungen 753
Namenverzeichnis - Author Index 1105
Sachverzeichnis - Subject Index . 1187
Inhaltsverzeichnis Band 1/1
A. Klinische und psychopathologische Grundlagen
Psychopathologie. Von H. HEIMANN. Mit 2 Abbildungen
Psychodynamik als Grundlagenforschung der Psychiatrie. Von G. BENEDETTI
Psychophysiologie. Von 1. FAHRENBERG. Mit I Abbildung
Neuropsychologie. Von G. ASSAL und H. HECAEN
Endokrinologische Psychiatrie. Von M. BLEuLER
Zum Problem der psychiatrischen Primiirpriivention. Von L. CIOMPI
Psychiatric Therapy of Mentally Abnormal Offenders. Is it Possible? By B.B. SVENDSENt
B. Psychologische Grundlagen
Theoretische Grundlagen psychologischer Forschungsmethoden in der Psychiatrie. Von H. LE
GEWIE. Mit 5 Abbildungen
Lerntheoretische Grundlagen fiir Theorie und Praxis der Psychiatrie. Von 1. BERGOLD. Mit
3 Abbildungen
Grundlagen und Probleme der Einstellungsforschung. Von H. FELDMANN. Mit 5 Abbildungen
Sprache, Personlichkeitsstruktur und psychoanalytisches Verfahren. Von A. LORENZER
C. Sozial-und geisteswissenschaftliche Grundlagen
Kommunikation und Interaktion in psychiatrischer Sicht. Von P. WATZLAWICK. Mit I Abbil
dung
Longitudinal Methods in the Study of Normal and Pathological Development. By L. N. ROBINS
Demographic and Epidemiological Methods in Psychiatric Research. By B. COOPER. With
I Figure
Crosscultural Psychiatry. Von N. SARTORIUS
Ethnopsychiatrie. Von G. HOFER
Psychiatrie und Gesellschaftstheorien. Von K. DORNER
Antipsychiatrie. Von K.P. KISKER
Psychiatrie und Philosophie. Von W. BLANKENBURG
Psychiatrie und Kunst. Von A. BADER und L. NAVRATIL. Mit 10 Abbildungen
Namenverzeichnis
Sachverzeichnis
Mitarbeiterverzeichnis
ANGST. J .. Prof. Dr.. Psychiatrische Universitiitsklil1ik. Forschungsdirektion. CH-8029 Ziirich 8
CARLSSON, A .. Dr., Goteborgs Universitet, Farmakologiska Institutionen, Fack, S-400 33 Goteborg
GROSS. J .. Prof. Dr., Universitats-Krankenhaus Eppendorf, Psychiatrische und Nervenklinik, Marti
nistraBe 52, D-2000 Hamburg 20
JUNG, R., Prof. Dr.. Klinikum der Albert-Ludwigs-Universitat, Abt. Klinische Neurologie und
Neurophysiologie, Hansastr. 9, D-7800 Freiburg
KEMPE, P., Dr., Universitiits-Krankenhaus Eppendorf. Psychiatrische und Nervenklinik, Martini
straBe 52, D-2000 Hamburg 20
KUNKEL, H., Prof. Dr., Medizinische Hochschule, Abt. fiir Klinische Neurophysiologie und Experi
mentelle Neurologie, Karl-Wiechert-Allee 9. D-3000 Hannover 61
LAITlNEN. L.. Dr .. Department of Neurosurgery. 5016 Haukeland Sykehus. N-Bergen
MATUSSEK, N., Prof. Dr.. Nervenklinik der Universitiit, Psychiatrische Klinik und Poliklinik. NuB
baumstraBe 7, D-8000 Miinchen 2
OTTOSSON. J.-O., Prof. Dr., Goteborgs Universitet, Psykiatriska Kliniken I. Sahlgrenska Sjukhuset,
S-413 45 Goteborg
PLOOG. D .. Prof. Dr., Max-Planck-Institut fiir Psychiatrie, Deutsche Forschungsanstalt fiir Psych
iatrie, KraepelinstraBe 2 und 10, 0-8000 Miinchen 40
RICHTER, D., Prof. Dr., International Brain Research Organisation, WaIton-on-the-Hill, GB-Tad
worth. Surrey KT20 7TT
WOGGON, B., Dr., Psychiatrische Universitiitsklinik, Forschungsdirektion, CH-8029 Ziirich 8
ZERBIN-RuDlN, E., Prof. Dr.. Max-Planck-Institut fiir Psychiatrie, KraepelinstraBe 2 und 10, D-8000
Miinchen 40
ZERSSEN, D. VON, Prof. Dr.. Max-Planck-Institut fiir Psychiatrie. Klinik. KraepelinstraBe 10, 0-8000
Miinchen 40
Neurochemistry
By
D. RICHTER
Contents
A. Introduction . . . . . . . . . . . 2
I. Development of Neurochemistry 2
II. Present Review . . . . . 3
B. Experimental Approaches . . . 4
I. Mammalian Brain in Vivo. 4
II. Brain Metabolism in Vivo. 6
Ill. Brain Perfusion Techniques 7
IV. Incorporation of Labelled Metabolites in Vivo. 7
V. Tissue Slice Techniques in Vitro . . . 8
VI. Tissue Culture Methods. . . . . . . 9
VII. Separation of Neurons and Glial Cells \0
VIII. Subcellular Fractionation II
I. Myelin ... II
2. Cell Nuclei . . 12
3. Mitochondria . 12
4. Synaptosomes. 13
5. Synaptic Membranes. 13
6. Synaptic Vesicles . . 14
7. Microtubules . . . . 14
8. Microsomal Fraction. 14
IX. Histochemical Methods. 14
C. Chemical Composition of Neural Tissues 15
I. Distribution of Components. 15
II. Lipids . . . . . . . . . . . 17
I. Extraction of Lipids . . . . 17
2. Composition of Brain Lipids 18
II I. Proteins. . . . . . . . 20
I. Soluble Brain Proteins . 20
2. Membrane Proteins . . 21
3. Neuroreceptor Proteins. 24
IV. Neurotransmitters . . . . 26
I. Chemical Transmission. 26
2. Acetylcholine . . . . . 28
3. Dopamine . . . . . . 28
4. Noradrenalin (Norepinephrine) 31
5. Adrenaline (Epinephrine). . . 32
6. 5-Hydroxytryptamine (Serotonin) 34
2 D. RICHTER: Neurochemistry
7. Amino Acids . . . 35
8. Histamine . . . . 37
9. Neural Modulators 38
V. Peptide Neuroeffectors 39
I. Metabolism. 39
2. Substance P. 39
3. Somatostatin 40
4. Encephalins 40
5. Oxytocin and Vasopressin 41
6. Hypothalamic Regulatory Factors 41
D. Barrier Systems and Compartmentation 44
I. Blood-Brain Barrier . . . . 44
II. Blood-CSF Barrier. . . . . 45
III. Metabolic Compartmentation 46
E. Metabolism and Function . 47
1. Metabolism of Growth 47
II. Protein Metabolism . 49
Ill. Lipid Metabolism . . 51
IV. Energy Metabolism and Function 52
V. Pathological Deviations. 53
References . . . 55
A. Introduction
I. Development of Neurochemistry
Neurochemistry is the branch of neurobiology that is concerned with the
structure and functions of the nervous system at a molecular level. It attempts
to relate the neurological mechanisms involved in behaviour to the metabolic
processes occurring in brain and nerve and aims to give an adequate and accept
able description of molecular dynamics in the living cells and tissues.
Neurochemistry is one of the younger of the neurosciences, and the study
in depth of the biochemical characteristics of neural tissues has developed only
in recent years. The earliest approach was that of determining the chemical
composition of tissue samples taken from different parts of the brain and from
peripheral nerves. In that way, a general idea was obtained of the main classes
of lipids, proteins and carbohydrates that are present. Grey matter was separated
from the white matter of the brain, and some differences were noted in the
composition of different anatomical areas. The analytical methods at first avail
able could be applied only to relatively large samples of tissue obtained by
manual dissection, and it took many years before micromethods were developed
that made it possible to determine metabolites in microgram quantities of tissue
and even in single isolated nerve cells. The development of tracer techniques
and of sensitive new methods for the microassay of enzymes then brought
information about the dynamics of the metabolic processes in different regions
of the brain. Attention was at first directed mainly towards the energy metabo
lism, but gradually the field was enlarged to include the metabolism of the
proteins, lipids and transmitter compounds in neural tissues. New techniques
for the isolation of specific cell types and subcellular organelles then greatly
3
Introduction
extended our understanding of the localization of metabolic function. In this
way, it became possible to study the metabolic characteristics, not only of differ
ent types of neuronal and glial cells, but also of specific nerve ending and mem
brane structures, so laying the foundations for our current concepts on the
mechanisms of synaptic transmission.
The recent rapid growth of neurochemistry is in part a reflection of the
natural interest of scientists in the basic mechanisms of the brain. Besides being
the organ that is the most complex and least understood, it is now recognised
to be one of the most metabolically active organs in the body. Interest has
also derived from the appreciation of the relevance of neurochemical data to
problems in the related fields of neurophysiology, neuroendocrinology, neuropa
thology and pharmacology. The early work of GARROD (1923) in showing an
association between mental deficiency and inborn errors of metabolism drew
attention to the relevance of neurochemical mechanisms to the operation of
genetic factors that influence thinking and behaviour. Another important in
fluence was the work of GJESSING (1947) who demonstrated for the first time
in periodic catatonia a form of psychosis associated with specific changes in
the protein metabolism of the brain. The increasing awareness of the many
applications of neurochemistry to problems in other fields helped to make
what had started as no more than a minor branch of biochemistry develop
into one of the most active of the neurosciences. Present indications suggest
that this is still only a beginning and that neurochemistry will continue to
develop.
The growth of interest in neurochemistry brought a corresponding increase
in the literature. Before the 1950s, PAGE'S Chemistry of the Brain (1937) was
the only general textbook on the subject and there was no neurochemical journal.
In 1952 an international group of neurochemists agreed to organize a series
of symposia arranged for the primary purpose of collecting information on
important aspects of neurochemistry, and the first volume of the series, Biochem
istry of the Dere/oping Nerrous System, edited by W AELSCH, appeared in 1955.
Subsequent volumes on Metabolism of the Nerrous System (RICHTER, 1957),
Chemical Pathology of the Nerrous System (FOLCH-PI, 1961), Regional Neu
rochemistry (KETY and ELKES, 1961), and Comparatil'e Neurochemistry (RICH
TER, 1964) helped to establish the modern literature of neurochemistry. The
textbook Neurochemistry (ELLIOTT, PAGE and QUASTEL) appeared in 1955
and the Journal of Neurochemistry (1956- ) then provided an internation
al journal. More recently several excellent textbooks have been produced on
different aspects of the subject, and special mention must be made of the
comprehensive Handbook of Neurochemistry, in seven volumes, edited by LAJTHA
(1969).
II. Present Review
The present review gives a selection of those aspects of neurochemistry
that appear to be most relevant to the problems of psychiatry. Emphasis has
been laid on biochemical factors in which neural tissues differ from other organs
and especially on studies of the mammalian brain. Attention has been given
4 D. RICHTER: Neurochemistry
to the neurotransmitter and receptor systems in the brain and to biochemical
mechanisms that may be concerned in the therapeutic actions of drugs.
The validity of neurochemical data of various kinds depends very much
on the reliability of the methods by which they were obtained. Their proper
appreciation requires an understanding of the experimental methods employed,
and in the following section, an outline is therefore given of some of the main
techniques that have been used in neurochemical research.
Most of the older neurochemical work has now been recorded in the text
books, where reference to original sources can be found. In the present review,
the general policy has been to give references to recent review articles and
to quote later papers in a series, rather than attempting to cite all the relevant
literature including the earlier investigations that are already well-documented
elsewhere.
B. Experimental Approaches
I. Mammalian Brain in Vi"o
If the living brain is observed with a microscope through a small hole
in the skull, it is seen to be constantly pulsating as the walls of the arterioles
dilate with each beat of the heart, and arterial blood is forced in bursts into
the deeper structures of the brain. The blue tint of the blood reappearing
at the surface in the veins reveals a rapid gaseous exchange due mainly to
the combustion of glucose in the dendrites of the nerve cells, where the metabolic
rate is especially high. Rapid changes in blood flow are seen to occur in response
to the ever-changing pattern of neuronal activity, which can be recorded through
electrodes applied to the surface of the brain or inserted in the deeper layers.
By the use of windows in the skull, it is possible to study the circulatory
changes induced by metabolic factors or by drugs, and those occurring during
seizures and in other pathologic states.
The neurons and glial cells normally live and function in the fluid environ
ment of the extracellular space, which occupies some 15%-20% of the total
volume of the brain. This is far from a static environment for, besides the
pulsation of the arterioles, there is a constant local disturbance as the red
blood corpuscles, around 7 J.l in diameter, push their way through the narrowed
lumen of the capillaries that intertwine among the processes of the neurons
and glial cells. There is evidence of movement also in the oligodendrocytes,
which are the most numerous cells in the mammalian brain; when grown in
tissue culture, the cell body of the oligodendrocyte shows a characteristic rhyth
mic contraction similar to that of a muscle cell (LUMSDEN and POMERAT, 1951).
It is thought that in this way the oligodendrocytes may aid the flow of axoplasm
in the neuronal axons to which they are attached. The oligodendrocytes account
for most of the metabolic activity of the white matter of the brain and their
relatively high metabolic activity and content of mitochondria would be consis
tent with a physiological function of this kind.