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May 1958

Autonomic and Adrenal Responsivity in Psychiatric Patients: Effect of Methacholine and Corticotropin

AMA Arch NeurPsych. 1958;79(5):549-553. doi:10.1001/archneurpsyc.1958.02340050077010

The advent of the tranquilizers has reawakened interest in the role of the hypothalamus and diencephalic centers in behavior,1 which the evidence adduced by clinicians and neurophysiologists over many years had linked with affective disturbances. However, more than a decade ago Alpers2 reiterated Bard's conclusion3 that the expression rather than the cause of rage in animals was dependent upon diencephalic mechanisms. Nevertheless, Hoskins, in pointing to the many disturbances of homeostasis found in schizophrenia, repeated Ranson's belief that the solution to this disease might be found in the hypothalamus.4

In recent years Funkenstein and his co-workers5 reported that a prolonged hypotensive response to methacholine was linked with good outcome following electroconvulsive therapy. Gellhorn interpreted such vascular responses as indicative of the degree of central sympathetic excitability and suggested that methacholine might prove to be a sensitive indicator of such central, and especially hypothalamic, responsivity.6 Although