Effects of Acth on Cerebral Blood Flow and Oxygen Consumption

MENTAL aberrations, ranging from personality changes to psychoses of varying severity, have frequently been reported to follow the prolonged or intensive administration of pituitary adrenocorticotropic hormone (ACTH). Changes in mood and behavior have been described as occurring in high incidence within three days after initiation of therapy and have been correlated with electroencephalographic abnormalities appearing three to five days after ACTH treatment was begun.1If these alterations could be shown to be accompanied with changes in cerebral metabolism and hemodynamics, it seemed reasonable to hope that psychotic clinical states might also be presaged by detectable deviations from the normal levels of cerebral oxygen uptake and cerebral blood flow. The opportunity to investigate this premise was presented in four patients who were given ACTH in amounts too small and over too short a period to cause obvious mental changes. The hormone was administered for treatment of a variety of clinical