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Schennach R, Riedel M, Obermeier M, Seemüller F, Jäger M, Schmauss M, Laux G, Pfeiffer H, Naber D, Schmidt L, Gaebel W, Klosterkötter J, Heuser I, Maier W, Lemke M, Rüther E, Klingberg S, Gastpar M, Möller HJ. What are depressive symptoms in acutely ill patients with schizophrenia spectrum disorder? Eur Psychiatry 2020; 30:43-50. [DOI: 10.1016/j.eurpsy.2014.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 11/01/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022] Open
Abstract
AbstractBackground:Aim was to examine depressive symptoms in acutely ill schizophrenia patients on a single symptom basis and to evaluate their relationship with positive, negative and general psychopathological symptoms.Methods:Two hundred and seventy-eight patients suffering from a schizophrenia spectrum disorder were analysed within a naturalistic study by the German Research Network on Schizophrenia. Using the Calgary Depression Scale for Schizophrenia (CDSS) depressive symptoms were examined and the Positive and Negative Syndrome Scale (PANSS) was applied to assess positive, negative and general symptoms. Correlation and factor analyses were calculated to detect the underlying structure and relationship of the patient’s symptoms.Results:The most prevalent depressive symptoms identified were depressed mood (80%), observed depression (62%) and hopelessness (54%). Thirty-nine percent of the patients suffered from depressive symptoms when applying the recommended cut-off of a CDSS total score of > 6 points at admission. Negligible correlations were found between depressive and positive symptoms as well as most PANSS negative and global symptoms despite items on depression, guilt and social withdrawal. The factor analysis revealed that the factor loading with the PANSS negative items accounted for most of the data variance followed by a factor with positive symptoms and three depression-associated factors.Limitations:The naturalistic study design does not allow a sufficient control of study results for the effect of different pharmacological treatments possibly influencing the appearance of depressive symptoms.Conclusion:Results suggest that depressive symptoms measured with the CDSS are a discrete symptom domain with only partial overlap with positive or negative symptoms.
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Seemüller F, Riedel M, Obermeier M, Schennach-Wolff R, Spellmann I, Meyer S, Bauer M, Adli M, Kronmüller K, Ising M, Brieger P, Laux G, Bender W, Heuser I, Zeiler J, Gaebel W, Möller HJ. The validity of self-rated psychotic symptoms in depressed inpatients. Eur Psychiatry 2020; 27:547-52. [DOI: 10.1016/j.eurpsy.2011.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 12/23/2010] [Accepted: 01/03/2011] [Indexed: 12/22/2022] Open
Abstract
AbstractBackgroundSelf-ratings of psychotic experiences might be biased by depressive symptoms.MethodData from a large naturalistic multicentre trial on depressed inpatients (n = 488) who were assessed on a biweekly basis until discharge were analyzed. Self-rated psychotic symptoms as assessed with the 90-Item Symptom Checklist (SCL-90) were correlated with the SCL-90 total score, the SCL-90 depression score, the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale 21 item (HAMD-21) total score, the Montgomery Åsberg Depression Rating Scale (MADRS) total score and the clinician-rated paranoid-hallucinatory score of the Association for Methodology and Documentation in Psychiatry (AMDP) scale.ResultsAt discharge the SCL-90 psychosis score correlated highest with the SCL-90 depression score (0.78, P<0.001) and with the BDI total score (0.64, P<0.001). Moderate correlations were found for the MADRS (0.34, P<0.001), HAMD (0.37, P<0.001) and AMDP depression score (0.33, P<0.001). Only a weak correlation was found between the SCL-90 psychosis score and the AMDP paranoid-hallucinatory syndrome score (0.15, P<0.001). Linear regression showed that change in self-rated psychotic symptoms over the treatment course was best explained by a change in the SCL-90 depression score (P<0.001). The change in clinician-rated AMDP paranoid-hallucinatory score had lesser influence (P = 0.02).ConclusionsIn depressed patients self-rated psychotic symptoms correlate poorly with clinician-rated psychotic symptoms. Caution is warranted when interpreting results from epidemiological surveys using self-rated psychotic symptom questionnaires as indicators of psychotic symptoms. Depressive symptoms which are highly prevalent in the general population might influence such self-ratings.
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Joachim LK, Frölich L, Rüther E, Wiltfang J, Maier W, Kornhuber J, Bauer C, Heuser I, Peters O. Correlation of CSF- and MRI-Biomarkers and Progression of Cognitive Decline in an Open Label MCI Trial. J Prev Alzheimers Dis 2018; 5:202-206. [PMID: 29972214 DOI: 10.14283/jpad.2018.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND In several randomized controlled trials (RCT) acetylcholinesterase-inhibitors (AChE-I) were tested in patients with mild cognitive impairment (MCI) but were ineffective in delaying disease progression as determined by neuropsychological testing only. Here we present data from an open label observational extension of a multicenter RCT in order to assess if biomarkers are providing useful additional information about a drug's efficacy. We followed 83 amnestic MCI patients and performed correlational analyses of Aβ 1-42 and total-Tau in the cerebrospinal fluid (CSF), hippocampal and amygdala volume at baseline, the total duration of blinded and open label AChE-I treatment and the outcome 24 months after inclusion into the RCT. Twelve out of 83 amnestic MCI (14%) had progressed to Alzheimer's disease (AD). Overall, worsening and disease progression as measured by the Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog), Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) and Clinical Dementia Rating (CDR) did not correlate with the duration of AChE-I treatment. However, a specific multidimensional biomarker profile at baseline indicated more reliably than cognitive testing alone progression to AD. We conclude that pharmacological RCTs testing symptomatic treatment effects in MCI should include biomarker assessment.
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Affiliation(s)
- L K Joachim
- Oliver Peters, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany, Tel.: +49-30-450-517628, Fax.: +49-30-450-517942,
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Regen F, Le Bret N, Hildebrand M, Herzog I, Heuser I, Hellmann-Regen J. Inhibition of brain retinoic acid catabolism: a mechanism for minocycline's pleiotropic actions? World J Biol Psychiatry 2016; 17:634-640. [PMID: 26047390 DOI: 10.3109/15622975.2015.1036116] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Minocycline is a tetracycline antibiotic increasingly recognized in psychiatry for its pleiotropic anti-inflammatory and neuroprotective potential. While underlying mechanisms are still incompletely understood, several lines of evidence suggest a relevant functional overlap with retinoic acid (RA), a highly potent small molecule exhibiting a great variety of anti-inflammatory and neuroprotective properties in the adult central nervous system (CNS). RA homeostasis in the adult CNS is tightly controlled through local RA synthesis and cytochrome P450 (CYP450)-mediated inactivation of RA. Here, we hypothesized that minocycline may directly affect RA homeostasis in the CNS via altering local RA degradation. METHODS We used in vitro RA metabolism assays with metabolically competent synaptosomal preparations from murine brain and human SH-SY5Y neuronal cells as well as viable human SH-SY5Y neuroblastoma cell cultures. RESULTS We revealed that minocycline potently blocks RA degradation as measured by reversed-phase high-performance liquid chromatography and in a viable RA reporter cell line, even at low micromolar levels of minocycline. CONCLUSIONS Our findings provide evidence for enhanced RA signalling to be involved in minocycline's pleiotropic mode of action in the CNS. This novel mode of action of minocycline may help in developing more specific and effective strategies in the treatment of neuroinflammatory or neurodegenerative disorders.
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Affiliation(s)
- F Regen
- a Department of Psychiatry , Section Clinical Neurobiology, Campus Benjamin Franklin, Charité,University Medicine Berlin , Germany
| | - N Le Bret
- a Department of Psychiatry , Section Clinical Neurobiology, Campus Benjamin Franklin, Charité,University Medicine Berlin , Germany
| | - M Hildebrand
- a Department of Psychiatry , Section Clinical Neurobiology, Campus Benjamin Franklin, Charité,University Medicine Berlin , Germany
| | - I Herzog
- a Department of Psychiatry , Section Clinical Neurobiology, Campus Benjamin Franklin, Charité,University Medicine Berlin , Germany
| | - I Heuser
- a Department of Psychiatry , Section Clinical Neurobiology, Campus Benjamin Franklin, Charité,University Medicine Berlin , Germany
| | - J Hellmann-Regen
- a Department of Psychiatry , Section Clinical Neurobiology, Campus Benjamin Franklin, Charité,University Medicine Berlin , Germany
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Repantis D, Maier LJ, Heuser I. Correspondence arising: Modafinil for cognitive neuroenhancement in health non-sleep-deprived-subjects. Eur Neuropsychopharmacol 2016; 26:392-393. [PMID: 26706695 DOI: 10.1016/j.euroneuro.2015.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/01/2015] [Indexed: 11/29/2022]
Affiliation(s)
- D Repantis
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - L J Maier
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Konradstrasse 32, P.O. Box 8031, Zurich, Switzerland
| | - I Heuser
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
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Bocchetta M, Galluzzi S, Kehoe PG, Aguera E, Bernabei R, Bullock R, Ceccaldi M, Dartigues JF, de Mendonça A, Didic M, Eriksdotter M, Félician O, Frölich L, Gertz HJ, Hallikainen M, Hasselbalch SG, Hausner L, Heuser I, Jessen F, Jones RW, Kurz A, Lawlor B, Lleo A, Martinez-Lage P, Mecocci P, Mehrabian S, Monsch A, Nobili F, Nordberg A, Rikkert MO, Orgogozo JM, Pasquier F, Peters O, Salmon E, Sánchez-Castellano C, Santana I, Sarazin M, Traykov L, Tsolaki M, Visser PJ, Wallin ÅK, Wilcock G, Wilkinson D, Wolf H, Yener G, Zekry D, Frisoni GB. The use of biomarkers for the etiologic diagnosis of MCI in Europe: an EADC survey. Alzheimers Dement 2014; 11:195-206.e1. [PMID: 25150733 DOI: 10.1016/j.jalz.2014.06.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 04/27/2014] [Accepted: 06/11/2014] [Indexed: 12/27/2022]
Abstract
We investigated the use of Alzheimer's disease (AD) biomarkers in European Alzheimer's Disease Consortium centers and assessed their perceived usefulness for the etiologic diagnosis of mild cognitive impairment (MCI). We surveyed availability, frequency of use, and confidence in diagnostic usefulness of markers of brain amyloidosis (amyloid positron emission tomography [PET], cerebrospinal fluid [CSF] Aβ42) and neurodegeneration (medial temporal atrophy [MTA] on MR, fluorodeoxyglucose positron emission tomography [FDG-PET], CSF tau). The most frequently used biomarker is visually rated MTA (75% of the 37 responders reported using it "always/frequently") followed by CSF markers (22%), FDG-PET (16%), and amyloid-PET (3%). Only 45% of responders perceive MTA as contributing to diagnostic confidence, where the contribution was rated as "moderate". Seventy-nine percent of responders felt "very/extremely" comfortable delivering a diagnosis of MCI due to AD when both amyloid and neuronal injury biomarkers were abnormal (P < .02 versus any individual biomarker). Responders largely agreed that a combination of amyloidosis and neuronal injury biomarkers was a strongly indicative AD signature.
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Affiliation(s)
- Martina Bocchetta
- LENITEM (Laboratory of Epidemiology, Neuroimaging and Telemedicine), IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Samantha Galluzzi
- LENITEM (Laboratory of Epidemiology, Neuroimaging and Telemedicine), IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Patrick Gavin Kehoe
- Dementia Research Group, School of Clinical Sciences, University of Bristol, Frenchay Hospital, Bristol, UK
| | - Eduardo Aguera
- Servicio Neurologia, Hospital Universitario Reina Sofía Córdoba, Spain
| | - Roberto Bernabei
- Department of Gerontological, Geriatric and Psychiatric Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Mathieu Ceccaldi
- Service de Neurologie et Neuropsychologie, CHU Timone and INSERM U1106, Aix-Marseille Univ, Marseille, France
| | | | | | - Mira Didic
- Service de Neurologie et Neuropsychologie, CHU Timone and INSERM U1106, Aix-Marseille Univ, Marseille, France
| | - Maria Eriksdotter
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Olivier Félician
- Service de Neurologie et Neuropsychologie, CHU Timone and INSERM U1106, Aix-Marseille Univ, Marseille, France
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische, Gesundheit Mannheim, University of Heidelberg, Mannheim, Germany
| | - Hermann-Josef Gertz
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | | | | | - Lucrezia Hausner
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische, Gesundheit Mannheim, University of Heidelberg, Mannheim, Germany
| | - Isabell Heuser
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Bonn, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Bonn, Bonn, Germany; German Center for Neurodegenerative Disease (DZNE), Bonn, Germany
| | - Roy W Jones
- RICE - The Research Institute for the Care of Older People, Royal United Hospital, Bath, UK
| | - Alexander Kurz
- Technische Universität Psychiatrische Klinik, Munchen, Germany
| | - Brian Lawlor
- Mercer's Institue for Research on Ageing, St James' Hospital, Dublin, Ireland
| | - Alberto Lleo
- Memory Unit, Neurology Service, Hospital Santa Creu i, Sant Pau, Barcelona, Spain
| | | | - Patrizia Mecocci
- Section of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Shima Mehrabian
- Department of Neurology, Univ Hospital Alexandrovska, Sofia, Bulgaria
| | - Andreas Monsch
- Memory Clinic, University Center for Medicine of Aging Basel, Felix Platter Hospital, Basel, Switzerland
| | - Flavio Nobili
- Clinical Neurology, Dept of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Agneta Nordberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Marcel Olde Rikkert
- Department of Geriatric Medicine, Radboud University Medical Centre, Radboud Alzheimer Centre, Nijmegen, Netherlands
| | | | | | - Oliver Peters
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eric Salmon
- Université de Liège, Cyclotron Research Centre, Liege, Belgium
| | | | - Isabel Santana
- Neurology Department, Coimbra University Hospital, Coimbra, Portugal
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894, Centre Hospitalier Sainte Anne, Paris, France
| | - Latchezar Traykov
- Department of Neurology, Univ Hospital Alexandrovska, Sofia, Bulgaria
| | - Magda Tsolaki
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pieter Jelle Visser
- Alzheimer Centre, Vrije Univ Medical Centre, Amsterdam, Netherlands; Alzheimer centre Maastricht University, Maastricht, Netherlands
| | - Åsa K Wallin
- Clinical Memory Research Unit, Lund University, Memory Clinic Malmö, Sweden
| | - Gordon Wilcock
- University of Oxford, Nuffield Dept of Medicine, John Radcliffe Hospital, Oxford, UK
| | - David Wilkinson
- Memory Assessment and Research Centre MARC, Moorgreen Hospital, Southampton, UK
| | - Henrike Wolf
- German Center for Neurodegenerative Disease (DZNE), Bonn, Germany; Department of Psychiatry Research, Zurich, Switzerland
| | | | - Dina Zekry
- Department of Internal Medicine and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Giovanni B Frisoni
- LENITEM (Laboratory of Epidemiology, Neuroimaging and Telemedicine), IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Memory Clinic and Laboratoire de Neuroimagerie du Vieillissement (LANVIE), University Hospitals and University of Geneva, Geneva, Switzerland.
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Schennach R, Riesbeck M, Mayr A, Seemüller F, Maier W, Klingberg S, Heuser I, Klosterkötter J, Gastpar M, Schmitt A, Sauer H, Schneider F, Jäger M, Wölwer W, Gaebel W, Möller HJ, Riedel M. Should early improvement be re-defined to better predict the maintenance of response in first-episode schizophrenia patients? Acta Psychiatr Scand 2013; 127:474-81. [PMID: 22957829 DOI: 10.1111/acps.12006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the predictive validity of early response in first-episode schizophrenia within a 1-year follow-up trial and to compare the resulting cutoff to the currently proposed early response definition (20% improvement by week 2). METHOD Receiver operator characteristic (ROC) analyses were used to identify the predictive validity of the psychopathological improvement of treatment from week 1 to week 8, regarding the maintenance of response until week 52 as well as to define the most reasonable cutoff in 132 first-episode patients. The Youden Index (maximum of sensitivity and specificity) was used to compare the newly developed and the commonly used early response definition. RESULTS Starting with week 6, a reasonable validity to predict the maintenance of response was found (area under the curve = 0.721) with the best fitting cutoff being a 51.6% PANSS total score improvement. Using this cutoff 74 patients (56%) were correctly identified to become responder and maintain response during follow-up (sensitivity: 0.747). The Youden Index was higher applying the newly developed early response cutoff featuring higher specificity compared to the commonly used early response definition. CONCLUSION Regarding long-term treatment, it seems more appropriate to base predictions of the patient's maintenance of response not before 6 weeks of treatment.
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Affiliation(s)
- R Schennach
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich Department of Psychiatry and Psychotherapy, University of Göttingen, Germany.
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Schipke CG, Peters O, Heuser I, Grimmer T, Sabbagh MN, Sabri O, Hock C, Kunz M, Kuhlmann J, Reininger C, Blankenburg M. Impact of beta-amyloid-specific florbetaben PET imaging on confidence in early diagnosis of Alzheimer's disease. Dement Geriatr Cogn Disord 2013; 33:416-22. [PMID: 22814208 DOI: 10.1159/000339367] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early diagnosis of Alzheimer's disease (AD) may be corroborated by imaging of beta-amyloid plaques using positron emission tomography (PET). Here, we performed an add-on questionnaire study to evaluate the relevance of florbetaben imaging (BAY 949172) in diagnosis and consecutive management of probable AD patients. METHODS AD patients with a clinical diagnosis in accordance with the NINCDS-ADRDA criteria or controls were imaged using florbetaben. Referring physicians were asked on a voluntary basis about their confidence in initial diagnosis, significance of PET imaging results, and their anticipated consequences for future patient care. RESULTS 121 questionnaires for probable AD patients and 80 questionnaires for controls were evaluated. In 18% of patients who had initially received the diagnosis of probable AD, PET scans were rated negative, whereas in controls 18% of scans were positive. An increase in confidence in the initial diagnosis was frequently reported (80%). Imaging results had a significant impact on the intended patient care, as judged by the referring physicians; this was most prominent in those patients with a contradicting scan and/or a low confidence in the initial diagnosis. CONCLUSION Florbetaben amyloid imaging increases the overall confidence in diagnosis of AD and may frequently influence clinical decisions and patient management.
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Affiliation(s)
- C G Schipke
- Department of Psychiatry, Charité-Campus Benjamin Franklin, Berlin, Germany
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Schennach R, Meyer S, Seemüller F, Jäger M, Schmauss M, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkötter J, Heuser I, Maier W, Lemke MR, Rüther E, Klingberg S, Gastpar M, Möller HJ, Riedel M. Insight in schizophrenia-course and predictors during the acute treatment phase of patients suffering from a schizophrenia spectrum disorder. Eur Psychiatry 2012; 27:625-33. [PMID: 22542652 DOI: 10.1016/j.eurpsy.2012.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 12/23/2011] [Accepted: 01/04/2012] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND To analyse insight of illness during the course of inpatient treatment, and to identify influencing factors and predictors of insight. METHODS Insight into illness was examined in 399 patients using the item G12 of the Positive and Negative Syndrome Scale ("lack of insight and judgement"). Ratings of the PANSS, HAMD, UKU, GAF, SOFAS, SWN-K and Kemp's compliance scale were performed and examined regarding their potential association with insight. The item G12 was kept as an ordinal variable to compare insight between subgroups of patients. RESULTS Almost 70% of patients had deficits in their insight into illness at admission. A significant improvement of impairments of insight during the treatment (p<0.0001) was observed. At admission more severe positive and negative symptoms, worse functioning and worse adherence were significantly associated with poorer insight. Less depressive symptoms (p=0.0004), less suicidality (p=0.0218), suffering from multiple illness-episodes (p<0.0001) and worse adherence (p=0.0012) at admission were identified to be significant predictors of poor insight at discharge. CONCLUSION The revealed predictors might function as treatment targets in order to improve insight and with it outcome of schizophrenia.
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Affiliation(s)
- R Schennach
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstraße 7, 80336 Munich, Germany.
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Peters O, Lorenz D, Fesche A, Schmidtke K, Hüll M, Perneczky R, Rüther E, Möller HJ, Jessen F, Maier W, Kornhuber J, Jahn H, Luckhaus C, Gertz HJ, Schröder J, Pantel J, Teipel S, Wellek S, Frölich L, Heuser I. A combination of galantamine and memantine modifies cognitive function in subjects with amnestic MCI. J Nutr Health Aging 2012; 16:544-8. [PMID: 22659994 DOI: 10.1007/s12603-012-0062-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Mild cognitive impairment (MCI) is etiologically heterogeneous, and a substantial proportion of MCI subjects will develop different dementia disorders. One subtype of this syndrome, amnestic MCI, occurs preferentially but not exclusively in prodromal AD and is characterized by defined deficits of episodic memory. DESIGN, SETTING AND PARTICIPANTS For a 2-year, double-blinded, placebo-controlled study MCI patients, presenting with an amnestic syndrome but not necessarily based on presumed prodromal AD were randomized. INTERVENTION Patients received (a) a combination of 16 mg galantamine plus 20 mg memantine, or (b) 16 mg galantamine alone or (c) placebo. MEASUREMENTS The primary objective was to explore the differential impact of these interventions on the progression to dementia and on cognitive changes as measured by the ADAScog. RESULTS After recruitment of 232 subjects, the trial was halted before reaching the planned sample size, because safety concerns arose in other studies with galantamine in MCI. This resulted in a variable treatment duration of 2-52 weeks. The statistical analysis plan was amended for studying cognitive effects of discontinuing the study medication, which was done separately for galantamine and memantine, and under double-blind conditions. There was one death, no unexpected severe adverse events, and no differences of severe adverse events between the treatment arms. The cognitive changes on the ADAScog were not different among the groups. Only for the subgroup of amnestic MCI with presumed AD etiology, a significant improvement of ADAScog score over placebo before the discontinuation of medication was observed, while amnestic MCI presumably due to other etiologies showed no cognitive changes with broad variation. Cognitive improvement was numerically larger in the combination treatment group than under galantamine alone. Patients who received placebo declined as expected. Discontinuation of galantamine, either as part of the combination regimen or as mono treatment, resulted in a transient decline of the ADAScog score in amnestic MCI of presumed AD etiology, while discontinuation of Memantine did not change the cognitive status. CONCLUSION In an interrupted trial with amnestic MCI subjects the combination of galantamine plus memantine were generally well tolerated. In the subgroup of MCI subjects with presumed AD etiology, a cognitive benefit of a short-term combination treatment of galantamine plus memantine was observed, and cognitive decline occurred after discontinuation of galantamine.
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Affiliation(s)
- O Peters
- Department of Psychiatry, Charité - Campus Benjamin Franklin, Berlin, Germany.
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Schipke CG, Prokop S, Heppner FL, Heuser I, Peters O. Comparison of immunosorbent assays for the quantification of biomarkers for Alzheimer's disease in human cerebrospinal fluid. Dement Geriatr Cogn Disord 2011; 31:139-45. [PMID: 21304219 DOI: 10.1159/000322588] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The clinical diagnosis of Alzheimer's disease in early stages may be substantiated by the quantification of the biomarkers Abeta42, Abeta40 and total-Tau (t-Tau) in cerebrospinal fluid (CSF). Different commercially available immunosorbent assays yield reliable results, yet the absolute values obtained may differ in between tests. METHODS We used CSF samples from patients that reported to our memory clinic. Enzyme-linked immunosorbent assays obtained from Innogenetics were used for the quantification of Abeta42 and t-Tau, test kits from IBL International were used to determine Abeta42 and Abeta40 concentrations. The multiplex assay system obtained from Mesoscale Discovery (MSD) Systems was used for the quantification of all three biomarkers. RESULTS For all biomarkers, the absolute values obtained with different test systems differ. However, the data sets highly correlate for all comparisons, with the MSD test system proving to be slightly more sensitive. Correlation coefficients (c) for the Abeta42 and Abeta40 quantifications lie between c = 0.80 and c = 0.87, and for the t-Tau quantifications we determined c = 0.99. CONCLUSION We conclude that all assays evaluated give reliable results, yet absolute values obtained have to be assessed differently within the framework of diagnostic procedures, depending on the system used.
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Affiliation(s)
- C G Schipke
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Schennach-Wolff R, Obermeier M, Seemüller F, Jäger M, Messer T, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkötter J, Heuser I, Maier W, Lemke MR, Rüther E, Klingberg S, Gastpar M, Möller HJ, Riedel M. Evaluating depressive symptoms and their impact on outcome in schizophrenia applying the Calgary Depression Scale. Acta Psychiatr Scand 2011; 123:228-38. [PMID: 21029053 DOI: 10.1111/j.1600-0447.2010.01608.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine depressive symptoms, their course during treatment, and influence on outcome. METHOD Weekly Calgary Depression Scale for Schizophrenia ratings were performed in 249 inpatients with schizophrenia. Early response was defined as a 20% reduction in the total score of the Positive and Negative Syndrome Scale for Schizophrenia from admission to week 2, response as a 50% reduction in the total score of the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) from admission to discharge and remission according to the consensus criteria. RESULTS Thirty six per cent of the patients were depressed at admission, with 23% of them still being depressed at discharge. Depressed patients scored significantly higher on the PANSS negative and general psychopathology subscore, featured more impairments in subjective well-being (P < 0.0001) and functioning (P < 0.0001). They suffered from more suicidality (P = 0.0021), and had greater insight into their illness (P = 0.0105). No significant differences were found regarding early response, response, and remission. CONCLUSION Patients with depressive symptoms should be monitored closely, given the burden of negative symptoms, their impairments in well-being and functioning and the threat of suicidality.
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Affiliation(s)
- R Schennach-Wolff
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
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Henkel V, Seemüller F, Obermeier M, Adli M, Bauer M, Kronmüller K, Holsboer F, Brieger P, Laux G, Bender W, Heuser I, Zeiler J, Gaebel W, Mayr A, Riedel M, Möller HJ. Relationship between baseline severity of depression and antidepressant treatment outcome. Pharmacopsychiatry 2010; 44:27-32. [PMID: 20981642 DOI: 10.1055/s-0030-1267177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Assessment of depression severity is of key importance, since several clinical guidelines recommend choice of treatment dependent on the depression severity grade. Using different tools to assess baseline severity may result in different outcomes. METHODS This paper describes the results of a multicentre, naturalistic study investigating the relationship between depression symptom severity (using 4 different measures of symptom severity) and clinical outcome among patients hospitalised for depression (N=1 014). Moreover, the impact of differences between methods of measuring depression severity has been investigated. Statistical analyses (univariate measurements, logistic regression models) were conducted to detect coherences and differences between the various methods of severity categorisation. RESULTS Results revealed different associations between outcome and classification methods. Response or remission rates varied if baseline severity was assessed by different instruments. Moreover, the number of responders increased with higher baseline severity grades of depression, whereas the number of remitters decreased. Additional analyses dependent on outcome criteria using continuous instead of categorical data revealed similar results. DISCUSSION Baseline severity may be only one of many other important clinical variables that mediate clinical outcome, but it is surely an important one deserving further research and consideration.
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Affiliation(s)
- V Henkel
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
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Schennach-Wolff R, Möller HJ, Jäger M, Seemüller F, Obermeier M, Messer T, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkötter J, Heuser I, Maier W, Lemke MR, Rüther E, Klingberg S, Gastpar M, Riedel M. A critical analysis and discussion of the appropriateness of the schizophrenia consensus remission criteria in clinical pharmaceutical trials. Pharmacopsychiatry 2010; 43:245-51. [PMID: 20927697 DOI: 10.1055/s-0030-1262788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The aim of this paper is to apply the proposed consensus remission criteria to an acutely ill inpatient sample at admission and evaluate their adaptability in this patient population and pharmaceutical trials. METHODS The Remission in Schizophrenia Working Group's consensus criteria were applied to 272 acutely ill schizophrenia patients. Patients were examined using the PANSS, HAMD, UKU and SWN-K total scales at admission as well as the GAF, SOFAS and the Strauss-Carpenter Prognostic Scale. Sociodemographic and clinical baseline variables were assessed using a standardized documentation system. RESULTS 33 patients (12%) fulfilled the symptom severity component of the proposed remission criteria already at baseline. Almost no significant differences were found when comparing patients with achieved and failed symptom severity component that would explain the hospitalization of the patients with achieved criteria despite their apparently mild psychopathological symptoms. The only explainable difference was that patients with an achieved symptom severity component had received significantly more antipsychotics and had suffered from significantly more life events before admission. CONCLUSION The present results raise the question whether the symptom severity threshold is adequate to identify patients in remission when applied in clinical trials.
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Affiliation(s)
- R Schennach-Wolff
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
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Schennach-Wolff R, Jäger M, Seemüller F, Obermeier M, Schmauss M, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkötter J, Heuser I, Maier W, Lemke MR, Rüther E, Klingberg S, Gastpar M, Möller HJ, Riedel M. Outcome of suicidal patients with schizophrenia: results from a naturalistic study. Acta Psychiatr Scand 2010; 121:359-70. [PMID: 19878135 DOI: 10.1111/j.1600-0447.2009.01484.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Purpose was to assess suicidality before and at the time of admission in patients with schizophrenia and compare outcome differences. METHOD Biweekly PANSS (Positive and Negative Syndrome Scale), HAMD (Hamilton Depression Rating Scale) and UKU (Udvalg for Klinske Undersogelser Side Effect Rating Scale) ratings were evaluated in 339 in-patients with schizophrenic spectrum disorders. Response was defined as an initial 20% PANSS total score reduction at discharge, remission was defined according to the proposed consensus criteria by the Remission in Schizophrenia Working Group. RESULTS Suicidal patients (22%) scored significantly higher on the PANSS negative subscore, PANSS insight item and HAMD total score at admission and at discharge. They developed significantly more side effects. No differences were found concerning response and remission between the two patient subgroups. CONCLUSION Despite receiving significantly more antidepressants the suicidal patients suffered from significantly more depressive symptoms up to discharge, yet without differing regarding response and remission.
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Affiliation(s)
- R Schennach-Wolff
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
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Jäger M, Riedel M, Obermeier M, Schennach-Wolff R, Seemüller F, Messer T, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkötter J, Heuser I, Kühn KU, Lemke MR, Rüther E, Klingberg S, Gastpar M, Bottlender R, Möller HJ. Time course of antipsychotic treatment response in schizophrenia: results from a naturalistic study in 280 patients. Schizophr Res 2010; 118:183-8. [PMID: 20181461 DOI: 10.1016/j.schres.2010.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Revised: 01/29/2010] [Accepted: 02/02/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe the course of positive and negative symptoms during inpatient treatment and examine remission and response rates under routine clinical care conditions. METHODS Two hundred and eighty inpatients with schizophrenia (DSM-IV criteria) were assessed with the Positive and Negative Syndrome Scale (PANSS) at admission and at biweekly intervals until discharge from hospital. Remission was defined according to the symptom-severity component of the consensus criteria (Remission in Schizophrenia Working Group) as a rating of three or less in the relevant PANSS items at discharge, and response as a reduction of at least 20% in the PANSS total score from admission to discharge. RESULTS The mean duration of inpatient treatment was 54.8 days. Of the total sample, 78.5% achieved the criteria for response and 44.6% those for remission. Mean PANSS total scores decreased from 72.4 at admission to 52.5 at discharge (p<0.001). A reduction in PANSS total scores was found from visit to visit, up to week 8. The most pronounced decline was observed within the first two weeks of treatment. CONCLUSION Response rates were comparable to those found in efficacy studies, and remission rates were slightly higher. This may be explained by differences in the selection and the treatment of patients. Nevertheless, the findings might indicate that a complex naturalistic treatment approach is beneficial in terms of effectiveness.
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Affiliation(s)
- M Jäger
- Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstr 7, D-80336 Munich, Germany
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Klusmann V, Evers A, Schwarzer R, Schlattmann P, Reischies FM, Heuser I, Dimeo FC. Complex Mental and Physical Activity in Older Women and Cognitive Performance: A 6-month Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2010; 65:680-8. [DOI: 10.1093/gerona/glq053] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Von Reichmann H, Deuschl G, Riedel O, Spottke A, Förstl H, Henn F, Heuser I, Oertel W, Riederer P, Trenkwalder C, Dodel R, Wittchen HU. [The German Study on the Epidemiology of Parkinson's Disease with Dementia (GEPAD): more than Parkinson]. MMW Fortschr Med 2010; 152 Suppl 1:1-6. [PMID: 20942300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED It is unknown, how frequently Parkinson's disease (PD) is complicated by dementia, depression and other neuropsychiatric conditions. An epidemiologic characterisation of the situation in specialised neurologic settings is lacking. The Geman Study on the Epidemiology of Parkinson's Disease with Dementia (GEPAD) isa national representative epidemiological study of n=1449 PD patients in n=315 office-based neurological settings, designed to estimate the prevalence of dementia, depression and other neuropsychiatric conditions in patients with PD of all stages by using standardized clinical assessments. RESULTS 28.6% met DSM-IV criteria for dementia. 33.6% met criteria for depression and 61% additionally had other clinically significant psychopathological syndromes. Only 29.4% had no neuropsychiatric conditions. GEPAD reveals for the first time comprehensively that the neuropsychiatric burden of PD patients in all stages and even early stages is considerable, posing challenging questions for research and clinical management.
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Affiliation(s)
- H Von Reichmann
- Klinik für Neurologie, Medizinische Fakultät Carl Gustav Carus Dresden
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Lewczuk P, Kamrowski-Kruck H, Peters O, Heuser I, Jessen F, Popp J, Bürger K, Hampel H, Frölich L, Wolf S, Prinz B, Jahn H, Luckhaus C, Perneczky R, Hüll M, Schröder J, Kessler H, Pantel J, Gertz HJ, Klafki HW, Kölsch H, Reulbach U, Esselmann H, Maler JM, Bibl M, Kornhuber J, Wiltfang J. Soluble amyloid precursor proteins in the cerebrospinal fluid as novel potential biomarkers of Alzheimer's disease: a multicenter study. Mol Psychiatry 2010; 15:138-45. [PMID: 18663368 DOI: 10.1038/mp.2008.84] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this report, we present the results of a multicenter study to test analytic and diagnostic performance of soluble forms of amyloid precursor proteins alpha and beta (sAPP alpha and sAPP beta) in the cerebrospinal fluid (CSF) of patients with different forms of dementing conditions. CSF samples were collected from 188 patients with early dementia (mini-mental state examination >or=20 in majority of cases) and mild cognitive impairment (MCI) in 12 gerontopsychiatric centers, and the clinical diagnoses were supported by neurochemical dementia diagnostic (NDD) tools: CSF amyloid beta peptides, Tau and phospho-Tau. sAPP alpha and sAPP beta were measured with multiplexing method based on electrochemiluminescence. sAPP alpha and sAPP beta CSF concentrations correlated with each other with very high correlation ratio (R=0.96, P<0.001). We observed highly significantly increased sAPP alpha and sAPP beta CSF concentrations in patients with NDD characteristic for Alzheimer's disease (AD) compared to those with NDD negative results. sAPP alpha and sAPP beta highly significantly separated patients with AD, whose diagnosis was supported by NDD findings (sAPP alpha: cutoff, 117.4 ng ml(-1), sensitivity, 68%, specificity, 85%, P<0.001; sAPP beta: cutoff, 181.8 ng ml(-1), sensitivity, 75%, specificity, 85%, P<0.001), from the patients clinically assessed as having other dementias and supported by NDD untypical for AD. We conclude sAPP alpha and sAPP beta might be regarded as novel promising biomarkers supporting the clinical diagnosis of AD.
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Affiliation(s)
- P Lewczuk
- Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany
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Schennach-Wolff R, Seemüller F, Mayr A, Maier W, Buchkremer G, Heuser I, Klosterkötter J, Gastpar M, Häfner H, Sauer H, Schneider F, Gaebel W, Moeller HJ, Riedel M. S35-01 - Clinical influencing factors of acute treatment outcome in first-episode schizophrenia patients. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70065-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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21
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Barthel H, Gertz H, Dresel S, Heuser I, Bartenstein P, Buerger K, Reininger C, Hiemeyer F, Sabri O. FP43-TH-03 [18 F]BAY 94–9172 positron emission tomography in the detection/exclusion of cerebral amyloid beta: an open-label, multicentre study in patients with probable Alzheimer's disease compared with healthy volunteers. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Schipke C, Anghelescu I, Regen F, Heuser I, Peters O. Antidepressants act on glia cells: Calcium responses of astrocytes to citalopram and fluoxetine in the mouse brain. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Heuser I. Häufigkeit und Struktur depressiver Erkrankungen bei Parkinson-Patienten mit und ohne Demenz – Ergebnisse aus der GEPAD-Studie. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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24
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Merkl A, Schneider GH, Kühn A, Bührsch NC, Anghelescu I, Heuser I, Bajbouj M. Deep brain stimulation of the anterior subgenual cingulate (Cg 25) in treatment-resistant depression. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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van Hall F, Zahn C, Schommer N, Anghelescu I, Heuser I, Bajbouj M. rTMS as add-on to escitalopram: a way to enhance antidepressant response? A randomized, placebo controlled trial. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Klein JP, Scheibe C, Wüstenberg T, Heuser I, Heekeren HR, Colla M. Implicit and explicit processing of facial emotion involves distinct neural pathways. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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27
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Bührsch NC, Swoboda U, Quante A, Zeugmann S, Bajbouj M, Anghelescu I, Heuser I. Cortisol awakening reaction in depressed patients with and without early life stress. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0029-1240094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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28
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Lewczuk P, Kornhuber J, Vanmechelen E, Peters O, Heuser I, Maier W, Jessen F, Bürger K, Hampel H, Frölich L, Henn F, Falkai P, Rüther E, Jahn H, Luckhaus C, Perneczky R, Schmidtke K, Schröder J, Kessler H, Pantel J, Gertz HJ, Vanderstichele H, de Meyer G, Shapiro F, Wolf S, Bibl M, Wiltfang J. Amyloid beta peptides in plasma in early diagnosis of Alzheimer's disease: A multicenter study with multiplexing. Exp Neurol 2009; 223:366-70. [PMID: 19664622 DOI: 10.1016/j.expneurol.2009.07.024] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 07/07/2009] [Accepted: 07/23/2009] [Indexed: 11/15/2022]
Abstract
We measured concentrations of Abeta peptides 1-42 and 1-40, and their ratio in plasma of patients carefully categorized clinically and neurochemically as having AD or other dementias with a newly commercially available multiplexing assay, characterized by reasonable laboratory performance (intra-assay imprecision in the range of 1.3-3.8% for Abeta1-42, and 1.8-4.1% for Abeta1-40, inter-assay imprecision for Abeta1-42, Abeta1-40, and Abeta1-42/Abeta1-40 concentration ratio in the range of 2.3-11.5%, 2.2-10.4% and 4.2-9.7%, respectively). Patients with AD or mild cognitive impairment of AD type (MCI-AD) whose clinical diagnosis was supported with CSF biomarkers (n=193) had significantly lower Abeta1-42 plasma concentrations (p<0.007), and Abeta1-42/1-40 ratios (p<0.003) compared to patients with other dementias and MCI of other types (n=64). No significant differences between persons with MCI of AD type and patients with early AD were observed, or between MCI of other types versus patients with early dementia of other types. Our findings reconfirm the hypothesis that alterations of biomarker concentrations occur early in a preclinical AD stage and that these alterations are also reflected in plasma.
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Affiliation(s)
- P Lewczuk
- Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany
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Blennow K, De Meyer G, Hansson O, Minthon L, Wallin A, Zetterberg H, Lewczuk P, Vanderstichele H, Vanmechelen E, Kornhuber J, Wiltfang J, Heuser I, Maier W, Luckhaus C, Rüther E, Hüll M, Jahn H, Gertz HJ, Frölich L, Hampel H, Pernetzki R. Evolution of Abeta42 and Abeta40 levels and Abeta42/Abeta40 ratio in plasma during progression of Alzheimer's disease: a multicenter assessment. J Nutr Health Aging 2009; 13:205-8. [PMID: 19262954 DOI: 10.1007/s12603-009-0059-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To better understand the seemingly contradictory plasma beta-amyloid (Abeta) results in Alzheimer's disease (AD) patients by using a newly developed plasma Abeta assay, the INNO-BIA plasma Abeta forms, in a multicenter study. METHODS A combined retrospective analysis of plasma Abeta isoforms on mild cognitive impairment (MCI) from three large cross-sectional studies involving 643 samples from the participating German and Swedish centers. RESULTS Detection modules based on two different amino (N)-terminal specific Abeta monoclonal antibodies demonstrated that Abeta in plasma could be reliable quantified using a sandwich immunoassay technology with high precision, even for low Abeta42 plasma concentrations. Abeta40 and Abeta42 concentrations varied consistently with the ApoE genotype, while the Abeta42/Abeta40 ratio did not. Irrespective of the decrease of the Abeta42/Abeta40 ratio with age and MMSE, this parameter was strongly associated with AD, as defined in this study by elevated hyperphosphorylated (P-tau181P) levels in cerebrospinal fluid (CSF). CONCLUSION A highly robust assay for repeatedly measuring Abeta forms in plasma such as INNO-BIA plasma Abeta forms might be a useful tool in a future risk assessment of AD.
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Affiliation(s)
- K Blennow
- Sahlgrenska University Hospital, Göteborg University, Sweden
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Hornung O, Regen F, Dorn H, Anghelescu I, Kathmann N, Schredl M, Danker-Hopfe H, Heuser I. The Effects of Donepezil on Postlearning Sleep EEG of Healthy Older Adults. Pharmacopsychiatry 2009; 42:9-13. [DOI: 10.1055/s-0028-1083820] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Weber-Hamann B, Blum W, Kratzsch J, Gilles M, Heuser I, Deuschle M. Insulin-like Growth Factor-I (IGF-I) Serum Concentrations in Depressed Patients: Relationship to Saliva Cortisol and Changes during Antidepressant Treatment. Pharmacopsychiatry 2009; 42:23-8. [DOI: 10.1055/s-0028-1085442] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Roepke S, Merkl A, Dams A, Ziegenhorn A, Anghelescu I, Heuser I, Lammers C. Preliminary Evidence of Improvement of Depressive Symptoms but not Impulsivity in Cluster B Personality Disorder Patients Treated with Quetiapine: an Open Label Trial. Pharmacopsychiatry 2008; 41:176-81. [DOI: 10.1055/s-2008-1076730] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jäger M, Messer T, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkötter J, Heuser I, Maier W, Lemke MR, Rüther E, Buchkremer G, Gastpar M, Riedel M, Bottlender R, Strauss A, Möller HJ. Standardized remission criteria in schizophrenia: descriptive validity and comparability with previously used outcome measures. Pharmacopsychiatry 2008; 41:190-5. [PMID: 18763221 DOI: 10.1055/s-2008-1078745] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Standardized consensus criteria for remission in schizophrenia were recently proposed. As yet, the validity of these criteria and their comparability with previously used outcome measures are unclear. METHODS The symptom-severity component of the proposed remission criteria was applied to 288 inpatients who fulfilled the ICD-10 criteria for schizophrenia. Global functioning and psychopathological symptoms were assessed using GAF, PANSS, SANS, HAM-D and CDSS. RESULTS When patients with symptom remission at discharge from hospitalization (n=158, 54.9%) were compared to those without symptom remission, significant differences were found with respect to the global functioning (GAF) and all observed psychopathological symptom dimensions. The percentage agreement with previously used outcome measures ranged between 52.6 and 80.0%, the kappa values between 0.120 and 0.594. A moderate accordance (kappa value: 0.495) was found with a Clinical Global Impression (CGI) severity score of three or less. DISCUSSION The results indicate a high descriptive validity of the symptom-severity component of the proposed remission definition. However, the new criteria differ partially from previously used outcome measures. This aspect should be considered in the interpretation of clinical trials.
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Affiliation(s)
- M Jäger
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany.
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Hellweg R, Ziegenhorn A, Heuser I, Deuschle M. Serum concentrations of nerve growth factor and brain-derived neurotrophic factor in depressed patients before and after antidepressant treatment. Pharmacopsychiatry 2008; 41:66-71. [PMID: 18311687 DOI: 10.1055/s-2007-1004594] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Stress, glucocorticoids and anti-depressant treatment have been found to modulate the expression of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF). Recent research suggests that serum BDNF concentration is reduced in depression and that successful antidepressant treatment leads to an increase in serum BDNF concentration. METHODS We studied depressed patients receiving a standardized antidepressant treatment with either 150 mg amitriptyline (n=20) or 40 mg paroxetine (n=20) for 36 days in a prospective design. Changes in the concentrations of serum neurotrophins and salivary cortisol in response to antidepressant treatment were assessed. RESULTS Independent of clinical efficacy there was a significant 'treatment' by 'medication' interaction effect on BDNF serum concentrations that indicated a decline of BDNF by 12% in paroxetine-treated patients while there was an increase by 13% in amitriptyline-treated patients. Neither antidepressant altered NGF concentrations. The changes in cortisol and neurotrophin concentrations were not related. DISCUSSION Changes in BDNF serum concentrations as a result of antidepressant therapy depend on the antidepressant instead of being a general characteristic of response to antidepressant treatment.
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Affiliation(s)
- R Hellweg
- Central Institute of Mental Health, Mannheim, Germany.
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Schlaepfer TE, Frick C, Zobel A, Maier W, Heuser I, Bajbouj M, O'Keane V, Corcoran C, Adolfsson R, Trimble M, Rau H, Hoff HJ, Padberg F, Müller-Siecheneder F, Audenaert K, Van den Abbeele D, Stanga Z, Hasdemir M. Vagus nerve stimulation for depression: efficacy and safety in a European study. Psychol Med 2008; 38:651-661. [PMID: 18177525 DOI: 10.1017/s0033291707001924] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Vagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequency in partial-onset seizure patients. Initial trials suggest that it may be an effective treatment, with few side-effects, for intractable depression. METHOD An open, uncontrolled European multi-centre study (D03) of VNS therapy was conducted, in addition to stable pharmacotherapy, in 74 patients with treatment-resistant depression (TRD). Treatment remained unchanged for the first 3 months; in the subsequent 9 months, medications and VNS dosing parameters were altered as indicated clinically. RESULTS The baseline 28-item Hamilton Depression Rating Scale (HAMD-28) score averaged 34. After 3 months of VNS, response rates (> or = 50% reduction in baseline scores) reached 37% and remission rates (HAMD-28 score <10) 17%. Response rates increased to 53% after 1 year of VNS, and remission rates reached 33%. Response was defined as sustained if no relapse occurred during the first year of VNS after response onset; 44% of patients met these criteria. Median time to response was 9 months. Most frequent side-effects were voice alteration (63% at 3 months of stimulation) and coughing (23%). CONCLUSIONS VNS therapy was effective in reducing severity of depression; efficacy increased over time. Efficacy ratings were in the same range as those previously reported from a USA study using a similar protocol; at 12 months, reduction of symptom severity was significantly higher in the European sample. This might be explained by a small but significant difference in the baseline HAMD-28 score and the lower number of treatments in the current episode in the European study.
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Affiliation(s)
- T E Schlaepfer
- Departments of Psychiatry, University Hospital, Bern, Switzerland.
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Müller-Spahn F, Oswald W, Heuser I, Hoyer S, Leenders K, Stoppe G. Dementia - New Aspects in Early Diagnosis. Pharmacopsychiatry 2008. [DOI: 10.1055/s-2007-1014391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lewitzka U, Müller-Oerlinghausen B, Felber W, Brunner J, Hawellek B, Rujescu D, Ising M, Lauterbach E, Broocks A, Bondy B, Rao ML, Frahnert C, Heuser I, Hohagen F, Maier W, Bronisch T. Is MAO-B activity in platelets associated with the occurrence of suicidality and behavioural personality traits in depressed patients? Acta Psychiatr Scand 2008; 117:41-9. [PMID: 18028252 DOI: 10.1111/j.1600-0447.2007.01121.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Low platelet monoaminoxidase B (MAO-B) activity has been associated with various forms of impulsive behaviour and suicidality. The present study investigated the relationship between MAO-B activity in platelets and aspects of suicidality in depressed patients and controls. METHOD In 87 patients with affective spectrum disorders (58% suffering from a major depressive episode - MDE) the potential association between platelet MAO-B activity and suicidality was examined. Fifty-nine of the patients had committed suicide attempt recently (SA -'suicide attempters'), 28 patients were acutely depressed without having shown suicidal thoughts or suicidal behaviour in the past (NA -'non-suicide attempters'). RESULTS The SA and NA were comparable as to their diagnoses and general demographic and psychopathological parameters. MAO-B activity did not differ between SA and NA. No systematic correlations existed between MAO-B activity and any dimensions of suicidal behaviour or psychopathology. As a single finding only a weak positive association of higher MAO-B activity in SA with a fatal intention of the SA was observed. CONCLUSION Our findings do not support a consistent association of platelet MAO-B activity and suicidal behaviour in general, but specific facts of suicidality might be associated.
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Affiliation(s)
- U Lewitzka
- Department of Psychiatry and Psychotherapy, Technical University of Dresden, Dresden, Germany.
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de Castro AGC, Bajbouj M, Schlattmann P, Lemke H, Heuser I, Neu P. Cerebrovascular reactivity in depressed patients without vascular risk factors. J Psychiatr Res 2008; 42:78-82. [PMID: 17113598 DOI: 10.1016/j.jpsychires.2006.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Revised: 10/04/2006] [Accepted: 10/06/2006] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Cerebrovascular reactivity (CVR) seems to be gaining importance as a prognostic factor for stroke risk. CVR reflects the compensatory dilatory capacity of cerebral arterioles to a dilatory stimulus; this mechanism plays an important role in maintaining a constant cerebral blood flow. Evaluating factors that influence CVR will help prevention or early detection of cerebrovascular disease (CVD). In this study we aimed to measure the CVR in vascular-risk free depressed individuals so as to evaluate the effect depression has on CVR and hence its role as a stroke risk factor. METHODS Using acetazolamid (ACZ) stimulation, CVR was assessed with a transcranial Doppler ultrasound in 25 non-smoking depressed patients (average age: 48.48 +/- 14.40) and in 25 healthy non-smoking controls (average age: 46.76 +/- 13.69) by calculating the difference between the maximal mean blood flow velocity at baseline and the maximal mean blood flow velocity after ACZ stimulation. RESULTS Basal Cerebral Blood flow in Patients was 50.6 cm/s (SD: 11.6) versus controls 52.80 cm/s (SD: 12.70) whereas after stimulation maximal blood flow velocity was 72.64 cm/s (SD: 15.75) in patients versus 80.20 cm/s (SD: 18.43) in controls. In an analysis of covariance we found that cerebrovascular reactivity was significantly reduced in the vascular-risk free depressed sample. Age had a significant influence whereas gender did not. DISCUSSION Major Depression appears to decrease cerebrovascular reactivity supporting the idea of increased risk for stroke in depressed patients. The mechanisms leading to this phenomenon and its subtle subgroup differences should be further investigated.
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Merkl A, Sander T, Aust S, Röpke S, Reinecker H, Trahms L, Heuser I. Time course of perception in facial expression of emotion in Borderline Personality Disorder (BPD): a Magnetoencephalographic (MEG) study. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Seemüller F, Riedel M, Mayr A, Mundt C, Holsboer F, Marneros A, Laux G, Bender W, Adli M, Heuser I, Zeiler J, Gaebel W, Jäger M, Möller HJ, Henkel V. Do data from a large prospective naturalistic study (N=1014, MDD) support the new FDA recommendation concerning antidepressants suicidality risk? Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schommer NC, Schulz-Ratei B, Schlattmann P, Anghelescu I, Heuser I. Dexamethasone Suppression Test – a tool for decision making in antidepressive treatment? Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Glamann C, Hornung O, Hansen ML, Heuser I, Danker-Hopfe H. P0057 Procedural and declarative learning tasks influence the density of sleep spindles in elderly subjects. Sleep Med 2007. [DOI: 10.1016/s1389-9457(07)70316-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schredl M, Hornung O, Regen F, Albrecht N, Danker-Hopfe H, Heuser I. The effect of donepezil on sleep in elderly, healthy persons: a double-blind placebo-controlled study. Pharmacopsychiatry 2007; 39:205-8. [PMID: 17124641 DOI: 10.1055/s-2006-950396] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Previous research in younger individuals has shown that acetylcholinesterase inhibitors tend to enhance REM sleep. METHODS Forty-two healthy elderly persons participated in a double-blind placebo-controlled polysomnographic study (parallel group design). RESULTS The present study indicates that in the elderly persons, donepezil, an acetylcholinesterase inhibitor also exerts a marked effect on REM sleep parameters: REM density was increased whereas REM latency was reduced, thus, confirming the findings of our pilot study described earlier. CONCLUSION Whether the cholinergic stimulation measured by polysomnography is related to treatment efficacy is a very interesting but an open question. Based on the findings that REM sleep is associated with memory consolidation, the question whether REM sleep augmentation enhances memory performance-as suggested by the findings of the pilot study-seems to be an interesting topic for future research.
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Affiliation(s)
- M Schredl
- Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany.
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Schwertfeger N, Neu P, Schlattmann P, Lemke H, Heuser I, Bajbouj M. Cerebrovascular reactivity over time course in healthy subjects. J Neurol Sci 2006; 249:135-9. [PMID: 16859710 DOI: 10.1016/j.jns.2006.06.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Revised: 05/25/2006] [Accepted: 06/02/2006] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Cerebrovascular reactivity (CVR) reflects the compensatory dilatory capacity of cerebral arterioles to a dilatory stimulus and is an important mechanism for maintaining constant cerebral blood flow. Many pathological conditions are associated with an impaired CVR thus contributing to a higher risk of cerebrovascular disease. Since an impaired CVR might contribute to a cerebrovascular disease if it lasts for a longer period of time, it is of importance to know what the time-course of CVR might be under healthy conditions. METHODS We investigated CVR in 33 healthy subjects on baseline and on follow-up after 1 to 3 years. CVR was determined by calculating the difference between maximal blood flow velocity after stimulation with acetazolamide and during rest. Blood flow velocities were measured by transcranial Doppler ultrasound. RESULTS CVR did not differ significantly in a group of healthy persons when reevaluated after 1 to 3 years. Possible influencing factors like age, gender, interval between testing, and smoking did not show a significant influence. DISCUSSION This is the first study to investigate within-subject-differences in healthy subjects. CVR seems to remain constant under healthy conditions. Even this short period of life-span is of importance because an altered CVR can improve under treatment within weeks. Nevertheless further studies should follow-up longer periods of time.
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Affiliation(s)
- N Schwertfeger
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050 Berlin, Germany
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Riedel O, Dodel R, Spottke A, Deuschl G, Förstl H, Henn F, Heuser I, Oertel W, Reichmann H, Riederer P, Trenkwalder C, Wittchen HU. Wie beurteilen Ärzte die Häufigkeit demenzieller, depressiver und psychotischer Symptome bei Patienten mit der Parkinson-Krankheit? Akt Neurol 2006. [DOI: 10.1055/s-2005-915473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Schommer NC, Meissner N, Heuser I, Lammers CH. Endocrine and cardiovascular stress responses following psychological challenge in women with Borderline-Personality-Disorder. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-920462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bajbouj M, Lisanby SH, Lang UE, Heuser I, Neu P. Impaired cortical inhibition in patients with unipolar major depression: evidence from transcranial magnetic stimulation of the motor cortex. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Neu P, Schwertfeger N, Schlattmann P, Heuser I, Berman R. Cerebrovascular reactivity following administration of mirtazapine in healthy probands – a randomized, placebo controlled double-blind clinical study. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Colla M, Schubert F, Heidenreich J, Seifert F, Bubner M, Bajbouj M, Heuser I. 3T-Spectroscopy in the hippocampus and cognitive status of lithium-treated euthymic bipolar patients. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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