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Mergl R, Karch S, Henl J, Meindl D, Schöpf F, Szabo SI, Hallweger P, Heiler P, Maywald M, Tschentscher N, Allgaier AK, Pogarell O. Effects of Four Different EEG-Neurofeedback Reinforcement Types in Healthy Individuals - A Pilot Study. Clin EEG Neurosci 2024; 55:305-316. [PMID: 36373604 DOI: 10.1177/15500594221138278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
EEG neurofeedback (EEG-NFB) is a promising tool for the treatment of depressive disorders. However, many methods for the presentation of neurobiological reactions are available and it is widely unknown which of these feedback options are preferrable. Moreover, the influence of motivation on NFB training success is insufficiently studied. This study analyzed the efficacy of a novel EEG protocol (FC3/Pz) based on findings for NFB in depression. The role of four feedback options (Rumination, Anxiety, Meditation Master, Moving Art) from the NFB software "Brain Assistant" and motivation in EEG-based NFB performance was studied. Regarding "Anxiety" and "Rumination" visual feedback was used to evoke emotions; reinforcement (both negative and positive operant conditioning) was continuous. Regarding "Meditation Master" visual feedback was combined with continuous positive reinforcement. Regarding "Moving Art" 20-min calm nature films with neutral character were used; both visual and auditive feedback were applied. The reinforcement was positive and continuous. 13 healthy participants completed 15 EEG sessions over four months combining simultaneous frontal (aims: reduction of theta-, alpha- and high beta-activity, increase of low and mid beta-activity) and parietal training (aims: reduction of theta-, alpha 1-, mid and high beta-activity, increase of alpha 2- and low beta-activity). We observed significantly more pronounced percentage change in the expected direction for Anxiety than Moving Art (mean difference = 3.32; p = 0.003). The association between motivation and performance was non-significant. Based on these results we conclude that feedback with both negative and positive operant conditioning and emotion evoking effects should be preferred.
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Affiliation(s)
- Roland Mergl
- Institute of Psychology, Universität der Bundeswehr München, Neubiberg, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Jennifer Henl
- Institute of Psychology, Universität der Bundeswehr München, Neubiberg, Germany
| | - Dorothea Meindl
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Felix Schöpf
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Szilard I Szabo
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Paulina Hallweger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Philipp Heiler
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Medical Practice for Neurofeedback Philipp Heiler, Munich, Germany
| | - Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nadja Tschentscher
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | | | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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Sanader Vukadinovic B, Karch S, Paolini M, Reidler P, Rauchmann B, Koller G, Pogarell O, Keeser D. Neurofeedback for alcohol addiction: Changes in resting state network activity ✰. Psychiatry Res Neuroimaging 2024; 339:111786. [PMID: 38281353 DOI: 10.1016/j.pscychresns.2024.111786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/09/2023] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
Alcohol dependence continues to be a major global burden despite significant research progress and treatment development. The aim of this study was to investigate whether neurofeedback training can alter resting state fMRI activity in brain regions that play a crucial role in addiction disorders in patients with alcohol dependence. For this purpose, a total of 52 patients were recruited for the present study, randomized, and divided into an active and a sham group. Patients in the active group received three sessions of neurofeedback training. We compared the resting state data in the active group as part of the NF training on six measurement days. When comparing the results of the active group from neurofeedback day 3 with baseline 1, a significant reduction in activated voxels in the ventral attention network area was seen. This suggests that reduced activity over the course of therapy in subjects may lead to greater independence from external stimuli. Overall, a global decrease in activated voxels within all three analysed networks compared to baseline was observed in the study. The use of resting-state data as potential biomarkers, as activity changes within these networks, may be to help restore cognitive processes and alcohol abuse-related craving and emotions.
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Affiliation(s)
- B Sanader Vukadinovic
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; University College London Hospitals NHS Foundation Trust (UCLH), London, United Kingdom.
| | - S Karch
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - M Paolini
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - P Reidler
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - B Rauchmann
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - G Koller
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - O Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - D Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
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Karch S, Maywald M, Schwartz C, Heil C, Neumüller J, Keeser D, Garcia S, Tschentscher N, Pogarell O, Paolini M, Voderholzer U. Neuronal correlates of intensification and acceptance of symptoms during exposure therapy in patients with obsessive-compulsive disorder. Front Psychol 2024; 15:1256046. [PMID: 38375106 PMCID: PMC10875107 DOI: 10.3389/fpsyg.2024.1256046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/15/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Cognitive behaviour therapy with exposure and response prevention is efficient in treating patients with obsessive-compulsive disorder (OCD). Nevertheless, it would be helpful for many patients to complement the therapeutic treatment with acceptance strategies to further increase the therapeutic benefit. The aim of the present study was to examine neurobiological responses to acceptance and intensification strategies during symptom provocation alongside the psychotherapeutic process. Method A total of 23 patients diagnosed with OCD (subtype: washing/contamination fear) was instructed to utilise either an acceptance strategy (ACS) or an intensification strategy (INS) to cope with their emotional and cognitive reactions to personalised symptom-triggering and neutral pictures. Fourteen patients participated twice: at the beginning [T1] and at the end [T2] of an inpatient multimodal treatment including cognitive behaviour therapy with response prevention to assess functional variations. Results For the contrast of T1 and T2, ACS showed increased brain activity in the left inferior frontal gyrus (IFG), left caudate body, and posterior cingulate gyrus (PCC). They also showed decreased activity in the left anterior insula. INS showed decreased activation in right lingual gyrus and right caudate body. At T2, ACS showed increased activation compared to INS in the left cerebrum: IFG, caudate nucleus, middle and superior temporal gyrus, and PCC/cuneus. For the comparison of T1 and T2, the ACS revealed increased brain activity in the left IFG, left caudate body, and right inferior parietal lobe. It showed decreased activity in the left anterior insula. The INS revealed decreased activity in right lingual gyrus and right caudate body.The psychometric questionnaires suggested that patients were able to reduce obsession, compulsion, and depression symptoms. Furthermore, patients rated the ACS as more useful for themselves compared with the INS. Conclusion The increased left IFG activity using ACS (T1 vs. T2) could be interpreted as a better inhibitory top-down process, while the increased PCC response might be due to a better reappraisal strategy after therapy. ACS seems to mobilise neuronal activations under therapy, especially in the left hemisphere. Both strategies showed reductions in emotional networks as a neuronal correlate of therapy success. Overall, ACS may be more efficient than INS, as rated by the patients and as in accordance with neurobiological findings.
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Affiliation(s)
- Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | | | - Clara Heil
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | | | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Sarah Garcia
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Nadja Tschentscher
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Marco Paolini
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
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Ruzicka M, Ibarra Fonseca GJ, Sachenbacher S, Heimkes F, Grosse-Wentrup F, Wunderlich N, Benesch C, Pernpruner A, Valdinoci E, Rueb M, Uebleis AO, Karch S, Bogner J, Mayerle J, von Bergwelt-Baildon M, Subklewe M, Heindl B, Stubbe HC, Adorjan K. Substantial differences in perception of disease severity between post COVID-19 patients, internists, and psychiatrists or psychologists: the Health Perception Gap and its clinical implications. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01700-z. [PMID: 37955681 DOI: 10.1007/s00406-023-01700-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 07/02/2023] [Accepted: 10/02/2023] [Indexed: 11/14/2023]
Abstract
Patient-reported outcome measures (PROMs) such as the Numeric Pain Rating Scale (NPRS) or Likert scales addressing various domains of health are important tools to assess disease severity in Post COVID-19 (PC) patients. By design, they are subjective in nature and prone to bias. Our findings reveal substantial differences in the perception of disease severity between patients (PAT), their attending internists (INT) and psychiatrists/psychologists (PSY). Patients rated almost all aspects of their health worse than INT or PSY. Most of the differences were statistically highly significant. The presence of fatigue and mood disorders correlated negatively with health perception. The physical health section of the WHO Quality of Life Assessment (WHOQoL-BREF) and Karnofsky index correlated positively with overall and mental health ratings by PAT and INT. Health ratings by neither PAT, PSY nor INT were associated with the number of abnormal findings in diagnostic procedures. This study highlights how strongly perceptions of disease severity diverge between PC patients and attending medical staff. Imprecise communication, different experiences regarding health and disease, and confounding psychological factors may explain these observations. Discrepancies in disease perception threaten patient-physician relationships and pose strong confounders in clinical studies. Established scores (e.g., WHOQoL-BREF, Karnofsky index) may represent an approach to overcome these discrepancies. Physicians and psychologists noting harsh differences between a patient's and their own perception of the patient's health should apply screening tools for mood disorders (i.e., PHQ-9, WHOQoL-BREF), psychosomatic symptom burden (SSD-12, FCV-19) and consider further psychological evaluation. An interdisciplinary approach to PC patients remains imperative. Trial Registration Number & Date of Registration: DRKS00030974, 22 Dec 2022, retrospectively registered.
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Affiliation(s)
- Michael Ruzicka
- Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
| | | | - Simone Sachenbacher
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Fides Heimkes
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Fabienne Grosse-Wentrup
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Nora Wunderlich
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christopher Benesch
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Anna Pernpruner
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Elisabeth Valdinoci
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Mike Rueb
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Aline Olivia Uebleis
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Johannes Bogner
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Julia Mayerle
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
| | - Michael von Bergwelt-Baildon
- Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Marion Subklewe
- Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Bernhard Heindl
- Stabstelle Strategische Unternehmenssteuerung, LMU Munich, Munich, Germany
| | - Hans Christian Stubbe
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research, Partner Site Munich, Munich, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
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Krčmář L, Jäger I, Boudriot E, Hanken K, Gabriel V, Melcher J, Klimas N, Dengl F, Schmoelz S, Pingen P, Campana M, Moussiopoulou J, Yakimov V, Ioannou G, Wichert S, DeJonge S, Zill P, Papazov B, de Almeida V, Galinski S, Gabellini N, Hasanaj G, Mortazavi M, Karali T, Hisch A, Kallweit MS, Meisinger VJ, Löhrs L, Neumeier K, Behrens S, Karch S, Schworm B, Kern C, Priglinger S, Malchow B, Steiner J, Hasan A, Padberg F, Pogarell O, Falkai P, Schmitt A, Wagner E, Keeser D, Raabe FJ. The multimodal Munich Clinical Deep Phenotyping study to bridge the translational gap in severe mental illness treatment research. Front Psychiatry 2023; 14:1179811. [PMID: 37215661 PMCID: PMC10196006 DOI: 10.3389/fpsyt.2023.1179811] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/14/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Treatment of severe mental illness (SMI) symptoms, especially negative symptoms and cognitive dysfunction in schizophrenia, remains a major unmet need. There is good evidence that SMIs have a strong genetic background and are characterized by multiple biological alterations, including disturbed brain circuits and connectivity, dysregulated neuronal excitation-inhibition, disturbed dopaminergic and glutamatergic pathways, and partially dysregulated inflammatory processes. The ways in which the dysregulated signaling pathways are interconnected remains largely unknown, in part because well-characterized clinical studies on comprehensive biomaterial are lacking. Furthermore, the development of drugs to treat SMIs such as schizophrenia is limited by the use of operationalized symptom-based clusters for diagnosis. Methods In line with the Research Domain Criteria initiative, the Clinical Deep Phenotyping (CDP) study is using a multimodal approach to reveal the neurobiological underpinnings of clinically relevant schizophrenia subgroups by performing broad transdiagnostic clinical characterization with standardized neurocognitive assessments, multimodal neuroimaging, electrophysiological assessments, retinal investigations, and omics-based analyzes of blood and cerebrospinal fluid. Moreover, to bridge the translational gap in biological psychiatry the study includes in vitro investigations on human-induced pluripotent stem cells, which are available from a subset of participants. Results Here, we report on the feasibility of this multimodal approach, which has been successfully initiated in the first participants in the CDP cohort; to date, the cohort comprises over 194 individuals with SMI and 187 age and gender matched healthy controls. In addition, we describe the applied research modalities and study objectives. Discussion The identification of cross-diagnostic and diagnosis-specific biotype-informed subgroups of patients and the translational dissection of those subgroups may help to pave the way toward precision medicine with artificial intelligence-supported tailored interventions and treatment. This aim is particularly important in psychiatry, a field where innovation is urgently needed because specific symptom domains, such as negative symptoms and cognitive dysfunction, and treatment-resistant symptoms in general are still difficult to treat.
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Affiliation(s)
- Lenka Krčmář
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Iris Jäger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Emanuel Boudriot
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Hanken
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Vanessa Gabriel
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Julian Melcher
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nicole Klimas
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Fanny Dengl
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Schmoelz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Pauline Pingen
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Mattia Campana
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Joanna Moussiopoulou
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Vladislav Yakimov
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Georgios Ioannou
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sven Wichert
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Silvia DeJonge
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Peter Zill
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Valéria de Almeida
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sabrina Galinski
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nadja Gabellini
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Genc Hasanaj
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Matin Mortazavi
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Temmuz Karali
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alexandra Hisch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Marcel S Kallweit
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Verena J. Meisinger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Lisa Löhrs
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Karin Neumeier
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Stephanie Behrens
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Benedikt Schworm
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
| | - Christoph Kern
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
| | | | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Johann Steiner
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Laboratory of Translational Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Center for Health and Medical Prevention, Magdeburg, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- NeuroImaging Core Unit Munich, University Hospital, LMU Munich, Munich, Germany
- Munich Center for Neurosciences, LMU Munich, Munich, Germany
| | - Florian J. Raabe
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
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Maurus I, Wagner S, Campana M, Roell L, Strauss J, Fernando P, Muenz S, Eichhorn P, Schmitt A, Karch S, Pogarell O, Engel RR, Falkai P, Hasan A, Wagner E. The relationship between blood-brain barrier dysfunction and neurocognitive impairments in first-episode psychosis: findings from a retrospective chart analysis. BJPsych Open 2023; 9:e60. [PMID: 37038760 PMCID: PMC10134348 DOI: 10.1192/bjo.2023.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Even before the onset of psychotic symptoms, individuals with schizophrenia display cognitive impairments. Simultaneously, increasing amounts of individuals exhibit dysfunction of the blood-brain barrier (BBB). However, the impact of BBB dysfunction on neurocognitive impairment in people with first-episode psychosis has not yet been investigated. AIMS To advance understanding of said relationship, we considered one of the largest first-episode psychosis cohorts with cerebrospinal fluid parameters available, and investigated whether BBB dysfunction is related to working memory, working speed and attention. METHOD We conducted a retrospective chart review of 121 in-patients diagnosed with a first episode of a schizophrenia spectrum disorder. Patients underwent neurocognitive testing and a lumbar puncture within routine clinical care. To define BBB dysfunction, albumin cerebrospinal fluid/serum quotients, immunoglobulin G ratios and oligoclonal band types were evaluated, and gender-specific differences investigated. Neurocognitive functioning was assessed by the Wechsler Adult Intelligence Scale, Test of Attentional Performance and Repeatable Battery for the Assessment of Neuropsychological Status. We performed simple and multiple linear regression analyses to interpret associations of interest. RESULTS Of those tested, 16% showed an alteration in albumin quotients and 12% had an oligoclonal band type indicating BBB dysfunction. Notably, male patients were more likely to have an increased albumin quotient and a higher immunoglobulin G ratio than female patients. We found no significant association between BBB dysfunction and neurocognitive assessments. CONCLUSIONS The hypothesised relationship between BBB and neurocognitive impairments was not detectable in our retrospective cohort. Further cerebrospinal fluid-based studies with a longitudinal assessment of cognitive functioning and disease trajectory are urgently needed.
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Affiliation(s)
- Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Sarah Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Mattia Campana
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Lukas Roell
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Johanna Strauss
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Piyumi Fernando
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Germany
| | - Susanne Muenz
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Peter Eichhorn
- Institute of Laboratory Medicine, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany; and Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, Brazil
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Rolf R Engel
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany; and Max Planck Institute of Psychiatry, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Germany
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Germany
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7
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Tschentscher N, Woll CFJ, Tafelmaier JC, Kriesche D, Bucher JC, Engel RR, Karch S. Neurocognitive Deficits in First-Episode and Chronic Psychotic Disorders: A Systematic Review from 2009 to 2022. Brain Sci 2023; 13:brainsci13020299. [PMID: 36831842 PMCID: PMC9954070 DOI: 10.3390/brainsci13020299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023] Open
Abstract
Cognitive impairment in patients suffering from schizophrenia spectrum disorders has been discussed as a strong predictor for multiple disease outcome variables, such as response to psychotherapy, stable relationships, employment, and longevity. However, the consistency and severity of cognitive deficits across multiple domains in individuals with first-episode and chronic psychotic disorders is still undetermined. We provide a comprehensive overview of primary research from the years 2009 to 2022. Based on a Cochrane risk assessment, a systematic synthesis of 51 out of 3669 original studies was performed. Impairment of cognitive functioning in patients diagnosed with first-episode psychotic disorders compared with healthy controls was predicted to occur in all assessed cognitive domains. Few overall changes were predicted for chronically affected patients relative to those in the first-episode stage, in line with previous longitudinal studies. Our research outcomes support the hypothesis of a global decrease in cognitive functioning in patients diagnosed with psychotic disorders, i.e., the occurrence of cognitive deficits in multiple cognitive domains including executive functioning, memory, working memory, psychomotor speed, and attention. Only mild increases in the frequency of cognitive impairment across studies were observed at the chronically affected stage relative to the first-episode stage. Our results confirm and extend the outcomes from prior reviews and meta-analyses. Recommendations for psychotherapeutic interventions are provided, considering the broad cognitive impairment already observed at the stage of the first episode. Based on the risk of bias assessment, we also make specific suggestions concerning the quality of future original studies.
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Affiliation(s)
- Nadja Tschentscher
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
- Correspondence:
| | - Christian F. J. Woll
- Section of Clinical Psychology of Children and Adolescents, Department of Psychology and Educational Sciences, Ludwig Maximilian University of Munich, Leopoldstr. 13, 80802 Munich, Germany
| | - Julia C. Tafelmaier
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Dominik Kriesche
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Julia C. Bucher
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Rolf R. Engel
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Susanne Karch
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU Hospital Munich, Nußbaumstr. 7, 80336 Munich, Germany
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Krause D, Chrobok A, Karch S, Keeser D, Manz KM, Koch W, Brendel M, Rominger A, Koller G, Behle N, Pogarell O. Binding potential changes of SERT in patients with depression are associated with remission: A prospective [¹²³I]β-CIT-SPECT study. Exp Clin Psychopharmacol 2023; 31:219-227. [PMID: 35604719 DOI: 10.1037/pha0000566] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/26/2023]
Abstract
The status of remission in patients with major depressive disorder treated with selective serotonin reuptake inhibitors (SSRIs) is mostly evaluated with clinical rating scales. Morphological correlates of the remission status remain a rare event. Addressing this challenge, we investigated functional correlates of remission by assessment of serotonin and dopamine transporter availability (SERT and DAT) using single-photon emission computed tomography (SPECT). Our purpose was to identify changes in the SERT/DAT binding potential in accordance with the clinical improvement. Nineteen drug-naïve patients with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of major depression were included. [¹²³I]2β-carbomethoxy-3β-(4-iodophenyl)tropane(β-CIT) SPECT was obtained from each participant before (baseline) and after 6 weeks (follow-up) of standardized treatment with escitalopram. The [¹²³I]β-CIT-SPECT recordings were acquired 4 hr (SERT-weighted) and 20-24 hr p.i (DAT-weighted), and binding potentials (˜BPND: baseline, follow-up, and rate of change) were calculated for thalamus, midbrain, pons (SERT), and striatum (DAT). From all study participants, neuropsychiatric symptoms were assessed using Hamilton depression (HAM-D) and Beck Depression Inventory scores. At follow-up, patients were divided into responders and nonresponders (as well as remitters and nonremitters). Compared to nonremitted, remitted patients showed over the course of 6 weeks a significantly higher loss of SERT binding potential in the thalamus (p = .036) and in the midbrain (p = .019). Additionally, the correlation of HAM-D with SERT binding potential in the thalamus showed a trend toward significance (p = .057) with higher HAM-D scores (at baseline) leading to lower SERT binding potential. No significant associations were identified for the analysis of baseline prediction of therapy response with SERT and DAT. Our results suggest that patients who remit from their depressive symptoms under escitalopram are characterized by stronger decreases of SERT, indicating that escitalopram blocking of SERT leads to clinical improvement. Therefore, this study shows that measuring SERT availability with SPECT could be an efficient and applicable technique to illustrate a possible underlying pathophysiology of symptom remission in response to treatment. In addition, the present results could help to stimulate new treatment approaches based on SERT and DAT binding. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Maywald M, Pogarell O, Levai S, Paolini M, Tschentscher N, Rauchmann BS, Krause D, Stöcklein S, Goerigk S, Röll L, Ertl-Wagner B, Papazov B, Keeser D, Karch S, Chrobok A. Neurofunctional differences and similarities between persistent postural-perceptual dizziness and anxiety disorder. Neuroimage Clin 2023; 37:103330. [PMID: 36696807 PMCID: PMC9879992 DOI: 10.1016/j.nicl.2023.103330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Persistent postural-perceptual dizziness (PPPD) (ICD-11) and anxiety disorders (ANX) share behavioural symptoms like anxiety, avoidance, social withdrawal, hyperarousal, or palpitation as well as neurological symptoms like vertigo, stance and gait disorders. Furthermore, previous studies have shown a bidirectional link between vestibulo-spatial and anxiety neural networks. So far, there have been no neuroimaging-studies comparing these groups. OBJECTIVES The aim of this explorative study was to investigate differences and similarities of neural correlates between these two patient groups and to compare their findings with a healthy control group. METHODS 63 participants, divided in two patient groups (ANX = 20 and PPPD = 14) and two sex and age matched healthy control groups (HC-A = 16, HC-P = 13) were included. Anxiety and dizziness related pictures were shown during fMRI-measurements in a block-design in order to induce emotional responses. All subjects filled in questionnaires regarding vertigo (VSS, VHQ), anxiety (STAI), depression (BDI-II), alexithymia (TAS), and illness-perception (IPQ). After modelling the BOLD response with a standard canonical HRF, voxel-wise t-tests between conditions (emotional-negative vs neutral stimuli) were used to generate statistical contrast maps and identify relevant brain areas (pFDR < 0.05, cluster size >30 voxels). ROI-analyses were performed for amygdala, cingulate gyrus, hippocampus, inferior frontal gyrus, insula, supramarginal gyrus and thalamus (p ≤ 0.05). RESULTS Patient groups differed from both HC groups regarding anxiety, dizziness, depression and alexithymia scores; ratings of the PPPD group and the ANX group did differ significantly only in the VSS subscale 'vertigo and related symptoms' (VSS-VER). The PPPD group showed increased neural responses in the vestibulo-spatial network, especially in the supramarginal gyrus (SMG), and superior temporal gyrus (STG), compared to ANX and HC-P group. The PPPD group showed increased neural responses compared to the HC-P group in the anxiety network including amygdala, insula, lentiform gyrus, hippocampus, inferior frontal gyrus (IFG) and brainstem. Neuronal responses were enhanced in visual structures, e.g. fusiform gyrus, middle occipital gyrus, and in the medial orbitofrontal cortex (mOFC) in healthy controls compared to patients with ANX and PPPD, and in the ANX group compared to the PPPD group. CONCLUSIONS These findings indicate that neuronal responses to emotional information in the PPPD and the ANX group are comparable in anxiety networks but not in vestibulo-spatial networks. Patients with PPPD revealed a stronger neuronal response especially in SMG and STG compared to the ANX and the HC group. These results might suggest higher sensitivity and poorer adaptation processes in the PPPD group to anxiety and dizziness related pictures. Stronger activation in visual processing areas in HC subjects might be due to less emotional and more visual processing strategies.
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Affiliation(s)
- Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Levai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Marco Paolini
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Nadja Tschentscher
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Daniela Krause
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sophia Stöcklein
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Lukas Röll
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Agnieszka Chrobok
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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Paolini M, Keeser D, Rauchmann BS, Gschwendtner S, Jeanty H, Reckenfelderbäumer A, Yaseen O, Reidler P, Rabenstein A, Engelbregt HJ, Maywald M, Blautzik J, Ertl-Wagner B, Pogarell O, Rüther T, Karch S. Correlations Between the DMN and the Smoking Cessation Outcome of a Real-Time fMRI Neurofeedback Supported Exploratory Therapy Approach: Descriptive Statistics on Tobacco-Dependent Patients. Clin EEG Neurosci 2022; 53:287-296. [PMID: 34878329 PMCID: PMC9174614 DOI: 10.1177/15500594211062703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/28/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to explore the potential of default mode network (DMN) functional connectivity for predicting the success of smoking cessation in patients with tobacco dependence in the context of a real-time function al MRI (RT-fMRI) neurofeedback (NF) supported therapy.Fifty-four tobacco-dependent patients underwent three RT-fMRI-NF sessions including resting-state functional connectivity (RSFC) runs over a period of 4 weeks during professionally assisted smoking cessation. Patients were randomized into two groups that performed either active NF of an addiction-related brain region or sham NF. After preprocessing, the RSFC baseline data were statistically evaluated using seed-based ROI (SBA) approaches taking into account the smoking status of patients after 3 months (abstinence/relapse).The results of the real study group showed a widespread functional connectivity in the relapse subgroup (n = 10) exceeding the DMN template and mainly low correlations and anticorrelations in the within-seed analysis. In contrast, the connectivity pattern of the abstinence subgroup (n = 8) primarily contained the core DMN in the seed-to-whole-brain analysis and a left lateralized correlation pattern in the within-seed analysis. Calculated Multi-Subject Dictionary Learning (MSDL) matrices showed anticorrelations between DMN regions and salience regions in the abstinence group. Concerning the sham group, results of the relapse subgroup (n = 4) and the abstinence subgroup (n = 6) showed similar trends only in the within-seed analysis.In the setting of a RT-fMRI-NF-assisted therapy, a widespread intrinsic DMN connectivity and a low negative coupling between the DMN and the salience network (SN) in patients with tobacco dependency during early withdrawal may be useful as an early indicator of later therapy nonresponse.
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Affiliation(s)
- Marco Paolini
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sarah Gschwendtner
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Hannah Jeanty
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Arne Reckenfelderbäumer
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Omar Yaseen
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Paul Reidler
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Hessel Jan Engelbregt
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Hersencentrum Mental Health Institute, Amsterdam, the
Netherlands
| | - Maximilian Maywald
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Janusch Blautzik
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Institute for Radiology and Nuclear
Medicine St. Anna, Luzern, Switzerland
| | - Birgit Ertl-Wagner
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Division of Neuro-Radiology, The Hospital for Sick Children,
University of Toronto, Toronto, Canada
| | - Oliver Pogarell
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Rüther
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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Karch S, Krause D, Lehnert K, Konrad J, Haller D, Rauchmann BS, Maywald M, Engelbregt H, Adorjan K, Koller G, Reidler P, Karali T, Tschentscher N, Ertl-Wagner B, Pogarell O, Paolini M, Keeser D. Functional and clinical outcomes of FMRI-based neurofeedback training in patients with alcohol dependence: a pilot study. Eur Arch Psychiatry Clin Neurosci 2022; 272:557-569. [PMID: 34622344 PMCID: PMC9095551 DOI: 10.1007/s00406-021-01336-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 09/22/2021] [Indexed: 01/20/2023]
Abstract
Identifying treatment options for patients with alcohol dependence is challenging. This study investigates the application of real-time functional MRI (rtfMRI) neurofeedback (NF) to foster resistance towards craving-related neural activation in alcohol dependence. We report a double-blind, placebo-controlled rtfMRI study with three NF sessions using alcohol-associated cues as an add-on therapy to the standard treatment. Fifty-two patients (45 male; 7 female) diagnosed with alcohol dependence were recruited in Munich, Germany. RtfMRI data were acquired in three sessions and clinical abstinence was evaluated 3 months after the last NF session. Before the NF training, BOLD responses and clinical data did not differ between groups, apart from anger and impulsiveness. During NF training, BOLD responses of the active group were decreased in medial frontal areas/caudate nucleus, and increased, e.g. in the cuneus/precuneus and occipital cortex. Within the active group, the down-regulation of neuronal responses was more pronounced in patients who remained abstinent for at least 3 months after the intervention compared to patients with a relapse. As BOLD responses were comparable between groups before the NF training, functional variations during NF cannot be attributed to preexisting distinctions. We could not demonstrate that rtfMRI as an add-on treatment in patients with alcohol dependence leads to clinically superior abstinence for the active NF group after 3 months. However, the study provides evidence for a targeted modulation of addiction-associated brain responses in alcohol dependence using rtfMRI.
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Affiliation(s)
- Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
| | - Daniela Krause
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany.
| | - Kevin Lehnert
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
| | - Julia Konrad
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
| | - Dinah Haller
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
| | - Hessel Engelbregt
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
- Hersencentrum Mental Health Institute, Amsterdam, The Netherlands
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU, Munich, Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
| | - Paul Reidler
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Temmuz Karali
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Nadja Tschentscher
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
| | - Birgit Ertl-Wagner
- Department of Radiology, University Hospital LMU, Munich, Germany
- Division of Neuroradiology, Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
| | - Marco Paolini
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Nußbaumstr. 7, 80336, Munich, Germany
- Department of Radiology, University Hospital LMU, Munich, Germany
- Munich Center for Neurosciences (MCN), LMU, Munich, Germany
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Hanshans C, Maisch B, Zauner J, Faust MMR, Bröll LM, Karch S. Virtual Therapeutics – Requirements to deliver value with virtual reality and biofeedback applications for alcohol addiction therapy. Current Directions in Biomedical Engineering 2021. [DOI: 10.1515/cdbme-2021-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The application of virtual reality (VR) as a supportive tool in psychotherapy has gained great popularity in recent years. Especially for addiction therapy, a combination of virtual exposure and learning or training coping skills by using biofeedback has a high potential to improve conventional therapy. To add value, the new therapy system has to meet the needs of patients and practitioners likewise. Added values consistently named by experts included, but were not limited to, new possibilities of creating individual exposition or coping scenarios, enhanced psychoeducation, a shorter duration of treatment, telemedical aspects, the possibility of measuring and predicting craving and finally an improvement in abstinence. Besides literature research, we evaluated existing technical solutions in the field of virtual addiction treatment, surveyed experts and evolved a concept that led to a first prototype. The prototype consists of a wireless VR headset and a wireless multi-sensor system for measuring the physiological reaction to stimuli or the effectiveness of coping strategies by means of biofeedback. For further studies we developed both, a virtual exposure and a coping scenario and tested the hardware and software in a pilot study in order to elaborate factors that could negatively affect the therapy adherence, the effectiveness of exposition (immersion) and possible hurdles in practical use. Cybersickness and the lack of haptic feedback turned out to be the main limiting factors. Concepts for the next iteration of the therapy system will reflect these points for upcoming clinical studies. In our proof of concept, we demonstrated that virtual therapy can be implemented with a reasonable effort of time and costs. The combination of software and hardware, that supplements the traditional therapeutic approach, lays the foundation for upcoming clinical use and trials to prove the better outcome of VR enhanced addiction therapy.
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Affiliation(s)
- Christian Hanshans
- HM Hochschule München University of Applied Sciences, Lothstr.34 80335 München , Germany
| | - Bettina Maisch
- Hochschule München University of Applied Sciences, München , Germany
| | - Johannes Zauner
- Hochschule München University of Applied Sciences, München , Germany
| | | | - Lukas M. Bröll
- Hochschule München University of Applied Sciences, München , Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich , Germany
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Mallock N, Rabenstein A, Gernun S, Laux P, Hutzler C, Karch S, Koller G, Henkler-Stephani F, Parr MK, Pogarell O, Luch A, Rüther T. Nicotine delivery and relief of craving after consumption of European JUUL e-cigarettes prior and after pod modification. Sci Rep 2021; 11:12078. [PMID: 34103661 PMCID: PMC8187405 DOI: 10.1038/s41598-021-91593-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/21/2021] [Indexed: 11/28/2022] Open
Abstract
The emergence of e-cigarettes on the consumer market led to a tremendous rise in e-cigarette consumption among adolescents in the United States. The success of JUUL and other pod systems was linked to its high nicotine delivery capacity. In compliance with the European Tobacco Product directive, liquid nicotine contents in the European JUUL variants are limited to 20 mg/mL or below. A short time after launching the initial version in Europe, JUUL pods have been modified in terms of the wick material used. This modification has been demonstrated previously to lead to an elevated aerosol generation, consequently, to a larger amount of nicotine per puff generated. The present study was designed to assess whether the mentioned differences between the "initial" and "modified" JUUL versions may cause a significant difference during consumption, and how nicotine delivery compares with tobacco cigarettes. In this single-center three-arm study, nicotine pharmacokinetics and influence on urge to smoke/vape were compared for tobacco cigarettes, the "initial" version of the European JUUL, and the "modified" version of the European JUUL. Participants, 15 active smokers and 17 active e-cigarette users, were instructed to consume their study product according to a pre-directed puffing protocol. Venous blood was sampled for nicotine analysis to cover the acute phase and the first 30 min after starting. Nicotine delivery and the reduction of urge to smoke/vape upon usage of both European JUUL variants were lower in comparison to tobacco cigarettes. This suggests a lower addictive potential. Modification of the pod design did not result in significant differences at the first ten puffs, as confirmed by a vaping machine experiment. Apparently, the limitations by the initially used wick material only come into effect after longer usage time.
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Affiliation(s)
- Nadja Mallock
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Str. 8-10, 10589, Berlin, Germany.
- Department of Biology, Chemistry, Pharmacy, Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Str. 2+4, 14195, Berlin, Germany.
| | - Andrea Rabenstein
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstrasse 7, 80336, Munich, Germany
| | - Solveig Gernun
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstrasse 7, 80336, Munich, Germany
| | - Peter Laux
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
| | - Christoph Hutzler
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstrasse 7, 80336, Munich, Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstrasse 7, 80336, Munich, Germany
| | - Frank Henkler-Stephani
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
| | - Maria Kristina Parr
- Department of Biology, Chemistry, Pharmacy, Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Str. 2+4, 14195, Berlin, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstrasse 7, 80336, Munich, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
- Department of Biology, Chemistry, Pharmacy, Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Str. 2+4, 14195, Berlin, Germany
| | - Tobias Rüther
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstrasse 7, 80336, Munich, Germany
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Adorjan K, Langgartner S, Maywald M, Karch S, Pogarell O. A cross-sectional survey of internet use among university students. Eur Arch Psychiatry Clin Neurosci 2021; 271:975-986. [PMID: 33200241 PMCID: PMC8236031 DOI: 10.1007/s00406-020-01211-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/27/2020] [Indexed: 12/22/2022]
Abstract
The last 2 decades have seen an increase in the number of reports of excessive internet use. Therefore, this study aimed to examine internet use among university students to gain more insight into the novel phenomenon of addictive internet use (AIU). Data were collected by the means of an online questionnaire sent to 4391 students. Approximately 10% of the 4391 students could be included in the statistical analysis. Of those 483 students, almost all (99.2%) used the internet, and a quarter (24.8%) showed AIU. The students used the internet mostly for information searches, random browsing, social networking, and online shopping; however, AIU was seen most often in the areas of social networking, random browsing, information searches, gaming, and pornography. One in four of the respondents showed addictive behavior in at least one area of internet use. Students with AIU in the area of random browsing were significantly less far advanced in their studies than those without AIU, and well-being was significantly poorer across AIU groups than in those who did not show AIU. The study confirms the importance of AIU, as reflected in the high prevalence of AIU among the students and the significantly lower level of well-being in those with AIU. Undifferentiated consideration of AIU does not do justice to its various facets, and future research should consider all areas of internet use, with the aim to increase understanding of the underlying mechanisms of AIU and develop more differentiated treatment approaches.
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Affiliation(s)
- Kristina Adorjan
- Department of Psychiatry and Psychotherapy, Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany. .,Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.
| | - Simon Langgartner
- Department of Psychiatry and Psychotherapy, Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Maximilian Maywald
- Department of Psychiatry and Psychotherapy, Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
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15
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Hartmann A, Giegling I, Genius J, Konte B, Maul S, Straube A, Eggert T, Mulert C, Leicht G, Karch S, Hegerl U, Pogarell O, Hölter-Koch S, Möller HJ, Graw J, Rujescu D. Polymorphisms in CRYBB2 encoding alpha-B2-crystallin are associated with sensorimotor gating and memory function. PHARMACOPSYCHIATRY 2020. [DOI: 10.1055/s-0039-3403009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A Hartmann
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - I Giegling
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - J Genius
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - B Konte
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - S Maul
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - A Straube
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - T Eggert
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - C Mulert
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - G Leicht
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - S Karch
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - U Hegerl
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - O Pogarell
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - S Hölter-Koch
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - H-J Möller
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - J Graw
- Universität Halle-Wittenberg, Halle (Saale), Germany
| | - D Rujescu
- Universität Halle-Wittenberg, Halle (Saale), Germany
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16
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Hasan A, Roeh A, Leucht S, Langguth B, Hansbauer M, Oviedo-Salcedo T, Kirchner SK, Papazova I, Löhrs L, Wagner E, Maurus I, Strube W, Rossner MJ, Wehr MC, Bauer I, Heres S, Leucht C, Kreuzer PM, Zimmermann S, Schneider-Axmann T, Görlitz T, Karch S, Egert-Schwender S, Schossow B, Rothe P, Falkai P. Add-on spironolactone as antagonist of the NRG1-ERBB4 signaling pathway for the treatment of schizophrenia: Study design and methodology of a multicenter randomized, placebo-controlled trial. Contemp Clin Trials Commun 2020; 17:100537. [PMID: 32072071 PMCID: PMC7013159 DOI: 10.1016/j.conctc.2020.100537] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 01/18/2020] [Accepted: 01/26/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Preclinical studies recently showed that the mineralocorticoid antagonist spironolactone acts also as an antagonist of the NRG1-ERBB4 signaling pathway and improves schizophrenia-like behaviour in Nrg1 transgenic mouse model. As this signaling pathway is critically linked to the pathophysiology of schizophrenia, especially in the context of working-memory dysfunction, spironolactone may be a novel treatment option for patients with schizophrenia targeting cognitive impairments. AIMS To evaluate whether spironolactone added to an ongoing antipsychotic treatment improves cognitive functioning in schizophrenia. METHODS The add-on spironolactone for the treatment of schizophrenia trial (SPIRO-TREAT) is a multicenter randomized, placebo-controlled trial with three arms (spironolactone 100 mg, spironolactone 200 mg and placebo). Schizophrenia patients are treated for three weeks and then followed-up for additional nine weeks. As primary outcome, we investigate changes in working memory before and at the end of the intervention phase. We will randomize 90 patients. Eighty-one patients are intended to reach the primary endpoint measure at the end of the three-week intervention period. Secondary endpoints include other measures of cognition, psychopathology, safety measures and biological measures. CONCLUSIONS SPIRO-TREAT is the first study evaluating the efficacy of the mineralocorticoid receptor antagonist spironolactone to improve cognitive impairments in schizophrenia patients targeting the NRG1-ERBB4 signaling pathway. With SPIRO-TREAT, we intend to investigate a novel treatment option for cognitive impairments in schizophrenia that goes beyond the established concepts of interfering with dopaminergic neurotransmission as key pathway in schizophrenia treatment. CLINICAL TRIAL REGISTRATION International Clinical Trials Registry Platform: http://apps.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2014-001968-35-DE.
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Affiliation(s)
- Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Astrid Roeh
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Faculty of Medicine, Klinikum Rechts der Isar, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Maximilian Hansbauer
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Tatiana Oviedo-Salcedo
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Sophie K. Kirchner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Irina Papazova
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Lisa Löhrs
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Wolfgang Strube
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Moritz J. Rossner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Michael C. Wehr
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Ingrid Bauer
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Faculty of Medicine, Klinikum Rechts der Isar, Germany
| | - Stephan Heres
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Faculty of Medicine, Klinikum Rechts der Isar, Germany
| | - Claudia Leucht
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Faculty of Medicine, Klinikum Rechts der Isar, Germany
| | - Peter M. Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | | | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Thomas Görlitz
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
| | - Silvia Egert-Schwender
- Münchner Studienzentrum, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Beate Schossow
- Münchner Studienzentrum, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Philipp Rothe
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University München, Germany
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17
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Abstract
In psychiatry, routine EEGs are often abnormal and not very specific, raising questions about the clinical relevance and consequences of potential anomalies. One such question is whether the administration of anticonvulsants would be useful if epileptic discharges are detected in patients without any clinical correlates. With regard to this question, we present a case study in which abnormal EEG patterns were observed in a patient with chronic migraine and cannabis addiction. The patient was a 34-year-old woman with a 14-year history of cannabis abuse who, during withdrawal, showed epileptic spikes, without any corresponding clinical symptoms, and migraine attacks of increasing intensity and frequency. This case study is in line with the new DSM-5 diagnostic tool that for the first time includes the diagnosis of cannabis withdrawal.
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Affiliation(s)
- Kristina Adorjan
- Department of Psychiatry and Psychotherapy, Medical Center of the University of Munich, Munich, Germany.,Institute of Psychiatric Phenomics and Genomics, Medical Center of the University of Munich, Munich, Germany
| | - Agnieszka I Chrobok
- Department of Psychiatry and Psychotherapy, Medical Center of the University of Munich, Munich, Germany
| | - Gabi Koller
- Department of Psychiatry and Psychotherapy, Medical Center of the University of Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, Medical Center of the University of Munich, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Medical Center of the University of Munich, Munich, Germany
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18
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Adorjan K, Karch S, Martin G, Plörer D, Winter C, Hantschk I, Koller G, Erbas B, Pogarell O. [Adult attention deficit hyperactivity disorder (ADHD) with comorbid addictive disorder. Therapeutic challenges using the example of a survey of clinical practice]. MMW Fortschr Med 2019; 161:7-12. [PMID: 31313269 DOI: 10.1007/s15006-019-0740-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/06/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND ADHD in childhood and adolescence is characterized by the symptoms hyperactivity, impulsivity, and inattentiveness; these symptoms may persist into adulthood or may manifest as restlessness, emotional instability, and disorganized behavior. In adults ADHD often occurs with increased substance use and is associated with an early onset of substance use, development of severe addiction, and decreased treatment effectiveness. METHOD This overview will present and critically discuss current study results and evidence-based and consensus-oriented recommendations that ensure the most adequate care for patients with ADHD and addictive disorder. RESULTS AND CONCLUSIONS For drug therapy, the current S3 guideline recommends methylphenidate, amphetamine salts, and atomoxetine, among others. Treatment of adult patients with ADHD and addiction with stimulants tends to be viewed critically; if required, long-acting medications should be used. Integrated treatment of ADHD and addiction, consisting of a combination of pharmacotherapy and psychotherapy, is recommended.
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Affiliation(s)
- Kristina Adorjan
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Nußbaumstraße 7, 80336, München, Deutschland.
- Institut für Psychiatrische Phänomik und Genomik (IPPG), Klinikum der Universität München (LMU), München, Deutschland.
| | - Susanne Karch
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Nußbaumstraße 7, 80336, München, Deutschland
| | - Gabi Martin
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Nußbaumstraße 7, 80336, München, Deutschland
| | - Diana Plörer
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Nußbaumstraße 7, 80336, München, Deutschland
| | - Catja Winter
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Nußbaumstraße 7, 80336, München, Deutschland
| | - Irmgard Hantschk
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Nußbaumstraße 7, 80336, München, Deutschland
| | - Gabi Koller
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Nußbaumstraße 7, 80336, München, Deutschland
| | - Beate Erbas
- Bayerische Akademie für Sucht- und Gesundheitsfragen (BAS) München, München, Deutschland
| | - Oliver Pogarell
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München (LMU), Nußbaumstraße 7, 80336, München, Deutschland
- Bayerische Akademie für Sucht- und Gesundheitsfragen (BAS) München, München, Deutschland
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19
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Harting I, Karch S, Moog U, Seitz A, Pouwels PJW, Wolf NI. Oculodentodigital Dysplasia: A Hypomyelinating Leukodystrophy with a Characteristic MRI Pattern of Brain Stem Involvement. AJNR Am J Neuroradiol 2019; 40:903-907. [PMID: 31048294 DOI: 10.3174/ajnr.a6051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/12/2019] [Indexed: 11/07/2022]
Abstract
Oculodentodigital dysplasia, a rare genetic disorder caused by mutations in the gene encoding gap junction protein 1, classically presents with typical facial features, dental and ocular anomalies, and syndactyly. Oligosymptomatic patients are common and difficult to recognize, in particular if syndactyly is absent. Neurologic manifestation occurs in approximately 30% of patients, and leukodystrophy or T2 hypointensity of gray matter structures or both have been noted in individual patients. To investigate MR imaging changes in oculodentodigital dysplasia, we retrospectively and systematically reviewed 12 MRIs from 6 genetically confirmed patients. Diffuse supratentorial hypomyelination, T2-hypointense Rolandic and primary visual cortex, and symmetric involvement of middle cerebellar peduncle, pyramidal tract, and medial lemniscus was present in all, T2-hypointense pallidum and dentate nucleus in 2 patients each. This consistent, characteristic pattern of diffuse supratentorial hypomyelination and brain stem involvement differs from other hypomyelinating and nonhypomyelinating leukodystrophies with brain stem involvement, and its recognition should trigger genetic testing for oculodentodigital dysplasia.
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Affiliation(s)
- I Harting
- From the Department of Neuroradiology (I.H., A.S.)
| | - S Karch
- Centre for Child and Adolescent Medicine (S.K.), Clinic I, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - U Moog
- Institute of Human Genetics (U.M.), Heidelberg University, Heidelberg, Germany
| | - A Seitz
- From the Department of Neuroradiology (I.H., A.S.)
| | - P J W Pouwels
- Departments of Radiology and Nuclear Medicine (P.J.W.P.)
| | - N I Wolf
- Child Neurology (N.I.W.), VU University Medical Center and Amsterdam Neuroscience, Amsterdam, the Netherlands
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20
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Krause D, Jobst A, Langemak SM, Keeser D, Chrobok AI, Langgartner S, Adorjan K, Gertzen M, Pogarell O, Karch S. Event-Related Potentials Are Associated With Unexpected Gain and Loss: Using a Gambling Paradigm. Clin EEG Neurosci 2019; 50:154-160. [PMID: 30477341 DOI: 10.1177/1550059418814987] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/15/2022]
Abstract
OBJECTIVE Previous neuroimaging studies have described altered activity in brain areas associated with reward processing following reward or punishment. This study examines the extent to which feedback-based experience of gain and loss is associated with electrophysiological correlates. METHODS Twenty-nine healthy participants used a gambling task that focused on actual nonpredictable gains and losses. During the task, an electroencephalography recording was performed in order to assess reward processing. Event-related potentials were analyzed when participants were receiving gain/loss feedback. RESULTS Event-related potentials revealed higher feedback-related negativity for both overall gain and loss compared with a neutral condition in fronto-centro-parietal electrodes. P3 potentials were significantly increased for high gains/losses compared to neutral and small gains/losses. CONCLUSION These results indicate that the paradigm is suitable to evoke specific patterns of reward-related electrophysiological responses. The wavelet analysis showed that electroencephalography frequency variations depended on the amount of gains/losses. SIGNIFICANCE This gambling paradigm is appropriate to measure aspects of feedback processing and could help analyze disease-specific alterations of the reward system in patients.
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Affiliation(s)
- Daniela Krause
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Andrea Jobst
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Shari Marie Langemak
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Daniel Keeser
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Agnieszka I Chrobok
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Simon Langgartner
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Kristina Adorjan
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Markus Gertzen
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Oliver Pogarell
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Susanne Karch
- 1 Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany
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21
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Karch S, Paolini M, Gschwendtner S, Jeanty H, Reckenfelderbäumer A, Yaseen O, Maywald M, Fuchs C, Rauchmann BS, Chrobok A, Rabenstein A, Ertl-Wagner B, Pogarell O, Keeser D, Rüther T. Real-Time fMRI Neurofeedback in Patients With Tobacco Use Disorder During Smoking Cessation: Functional Differences and Implications of the First Training Session in Regard to Future Abstinence or Relapse. Front Hum Neurosci 2019; 13:65. [PMID: 30886575 PMCID: PMC6409331 DOI: 10.3389/fnhum.2019.00065] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/08/2019] [Indexed: 02/04/2023] Open
Abstract
One of the most prominent symptoms in addiction disorders is the strong desire to consume a particular substance or to show a certain behavior (craving). The strong association between craving and the probability of relapse emphasizes the importance of craving in the therapeutic process. Former studies have demonstrated that neuromodulation using real-time fMRI (rtfMRI) neurofeedback (NF) can be used as a treatment modality in patients with tobacco use disorder. The aim of the present project was to determine whether it is possible to predict the outcome of NF training plus group psychotherapy at the beginning of the treatment. For that purpose, neuronal responses during the first rtfMRI NF session of patients who remained abstinent for at least 3 months were compared to those of patients with relapse. All patients were included in a certified smoke-free course and took part in three NF sessions. During the rtfMRI NF sessions tobacco-associated and neutral pictures were presented. Subjects were instructed to reduce their neuronal responses during the presentation of smoking cues in an individualized region of interest for craving [anterior cingulate cortex (ACC), insula or dorsolateral prefrontal cortex]. Patients were stratified to different groups [abstinence (N = 10) vs. relapse (N = 12)] according to their individual smoking status 3 months after the rtfMRI NF training. A direct comparison of BOLD responses during the first NF-session of patients who had remained abstinent over 3 months after the NF training and patients who had relapsed after 3 months showed that patients of the relapse group demonstrated enhanced BOLD responses, especially in the ACC, the supplementary motor area as well as dorsolateral prefrontal areas, compared to abstinent patients. These results suggest that there is a probability of estimating a successful withdrawal in patients with tobacco use disorder by analyzing the first rtfMRI NF session: a pronounced reduction of frontal responses during NF training in patients might be the functional correlate of better therapeutic success. The results of the first NF sessions could be useful as predictor whether a patient will be able to achieve success after the behavioral group therapy and NF training in quitting smoking or not.
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Affiliation(s)
- Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marco Paolini
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Sarah Gschwendtner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Hannah Jeanty
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Arne Reckenfelderbäumer
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Omar Yaseen
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Christina Fuchs
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Agnieszka Chrobok
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Tobias Rüther
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
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22
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Konte B, Leicht G, Giegling I, Pogarell O, Karch S, Hartmann AM, Friedl M, Hegerl U, Rujescu D, Mulert C. A genome-wide association study of early gamma-band response in a schizophrenia case-control sample. World J Biol Psychiatry 2018; 19:602-609. [PMID: 28922980 DOI: 10.1080/15622975.2017.1366054] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Disturbances in the gamma-frequency band of electroencephalography (EEG) measures are among the most consistently observed intermediate phenotypes in schizophrenia. We assessed whether genetic variations are associated with gamma-band activity. METHODS We performed a genome-wide association analysis of the early auditory evoked gamma-band response in schizophrenia affected subjects and healthy control individuals (in total N = 315). RESULTS No marker surpassed the threshold for genome-wide significant association. Several of the markers that were closest to significance mapped to genes involved in neuronal development and the Neuregulin-ErbB signalling network, such as NRG2 and KALRN. Using a gene-set enrichment analysis, we found suggestive evidence for association with genes involved in EEG abnormality (P = .048). CONCLUSIONS We identified no marker genome-wide significantly associating with gamma response; independent replication of the gene-set analysis result and larger sample sizes will be required to provide leads to cellular pathways involved in gamma-band activity.
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Affiliation(s)
- Bettina Konte
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Martin-Luther-University Halle-Wittenberg , Halle , Germany
| | - Gregor Leicht
- b Psychiatry Neuroimaging Branch, Imaging Center NeuroImage Nord and Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Ina Giegling
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Martin-Luther-University Halle-Wittenberg , Halle , Germany
| | - Oliver Pogarell
- c Department of Psychiatry and Psychotherapy , Ludwig-Maximilians-University , Munich , Germany
| | - Susanne Karch
- c Department of Psychiatry and Psychotherapy , Ludwig-Maximilians-University , Munich , Germany
| | - Annette M Hartmann
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Martin-Luther-University Halle-Wittenberg , Halle , Germany
| | - Marion Friedl
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Martin-Luther-University Halle-Wittenberg , Halle , Germany
| | - Ulrich Hegerl
- d Department of Psychiatry and Psychotherapy , University of Leipzig , Leipzig , Germany
| | - Dan Rujescu
- a Department of Psychiatry, Psychotherapy and Psychosomatics , Martin-Luther-University Halle-Wittenberg , Halle , Germany
| | - Christoph Mulert
- b Psychiatry Neuroimaging Branch, Imaging Center NeuroImage Nord and Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Weinmann T, Vetter C, Karch S, Nowak D, Radon K. Shift work and cognitive impairment in later life - results of a cross-sectional pilot study testing the feasibility of a large-scale epidemiologic investigation. BMC Public Health 2018; 18:1256. [PMID: 30428871 PMCID: PMC6234599 DOI: 10.1186/s12889-018-6171-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/31/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The effect of shift work on impairment of cognition in later life has not yet been sufficiently investigated. Therefore, we aimed at testing the feasibility of a large-scale epidemiologic study examining this putative association in a pilot study. METHODS Between January and April 2017, a cross-sectional study invited a random sample of 425 former and current employees of a German university hospital aged 55 years and older to undergo a cognitive test battery (including the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test, Letter-Number Span, and Vocabulary Test) and to complete a self-administered questionnaire on socio-demographic characteristics, chronotype, sleep, occupational history including shift work, and medical history. Fifty percent of the invitees were registered in the hospital's occupational records as currently working or having worked in a shift system. The feasibility of a large-scale study was evaluated by the response of the study sample and the completeness of data. In addition, we calculated the prevalence of shift work and cognitive impairment in the study population. RESULTS Seventy five subjects (18%) completed the questionnaire, of whom 47 (11% of the total sample) participated in cognitive testing. In all but four items assessed in the questionnaire, the proportion of missing data was below 10 %, suggesting that the quality of collected data can be considered as high. Eighty percent of the participants reported that they ever worked in a shift system, indicating selective participation by exposure to shift work. With respect to chronotype, the majority of the study subjects rated themselves as rather evening type, while a quarter considered themselves as definite morning type. All cognitive tests could be carried out completely. We observed slight difficulties in at least one of the cognitive tests in 17 participants (36%) while two participants (4%) showed more pronounced signs of cognitive impairment. CONCLUSION The present pilot study only partially supported the feasibility of the planned large-scale study. As response rates were low and depended on exposure to shift work, a better way of sampling and recruitment needs to be identified. The questionnaire and the test battery appear to be viable instruments.
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Affiliation(s)
- Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Center of Health Sciences (MC-Health), Munich, Germany
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, CO USA
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Center of Health Sciences (MC-Health), Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Center of Health Sciences (MC-Health), Munich, Germany
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Buchheim A, Labek K, Taubner S, Kessler H, Pokorny D, Kächele H, Cierpka M, Roth G, Pogarell O, Karch S. Modulation of Gamma Band Activity and Late Positive Potential in Patients with Chronic Depression after Psychodynamic Psychotherapy. Psychother Psychosom 2018; 87:252-254. [PMID: 29768272 DOI: 10.1159/000488090] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 03/02/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Anna Buchheim
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Karin Labek
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Svenja Taubner
- Institute of Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Dan Pokorny
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Horst Kächele
- International Psychoanalytic University, Berlin, Germany
| | - Manfred Cierpka
- Institute of Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Gerhard Roth
- Brain Research Institute, University of Bremen, Bremen, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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Rüther T, Schultz Y, Wirth C, Chrobok A, Rabenstein A, Keeser D, Ertl-Wagner B, Pogarell O, Karch S. Effect of smoking status on neuronal responses to graphic cigarette warning labels. PLoS One 2018; 13:e0201360. [PMID: 30235214 PMCID: PMC6147412 DOI: 10.1371/journal.pone.0201360] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 07/13/2018] [Indexed: 11/19/2022] Open
Abstract
Background Smoking is responsible for a large proportion of cancer, respiratory and cardiovascular deaths. Nevertheless the health risks of smoking are still underestimated in many smokers. The present study aimed to examine neurobiological responses to graphical warnings on cigarette packings in non-smokers and patients with tobacco dependence. Methods Twenty non-smokers and twenty-four patients with tobacco dependence participated in a functional MRI study during that pictures of different categories were presented ((a) EU-warning pictures, (b) text-only warnings, (c) neutral pictures with short information). Patients contributed twice in the experiment (after 10 hours nicotine withdrawal / about 5 minutes after nicotine consumption). Results Smokers during withdrawal demonstrated increased neuronal responses predominantly in subcortical, temporal and frontal brain regions that are associated with emotional and cognitive processes during the presentation of graphical warnings compared to neutral pictures. In smokers after smoking and non-smokers, the differences between graphical warnings and neutral pictures were increased compared to smokers during withdrawal. The comparison of the graphical warnings with text-only labels demonstrated the importance of affective brain regions especially in smokers after smoking and in non-smokers. During withdrawal, the neural responses associated with graphical warnings and text-only labels differed only marginally. Discussion and conclusion The results suggest that emotional and cognitive reactions to graphical warnings are predominantly seen in smokers after smoking and in non-smokers. The impact of these pictures during withdrawal seems to be less pronounced; in this case, more unspecific processes seem to be important, including the projection of sensory signals to the cerebral cortex.
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Affiliation(s)
- Tobias Rüther
- Department of Psychiatry und Psychotherapy, Ludwig Maximilian University, Munich, Germany
- * E-mail:
| | - Yannick Schultz
- Department of Psychiatry und Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Christina Wirth
- Department of Psychiatry und Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Agnieszka Chrobok
- Department of Psychiatry und Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry und Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry und Psychotherapy, Ludwig Maximilian University, Munich, Germany
- Institute of Clinical Radiology, Ludwig Maximilian University, Munich, Germany
| | - Birgit Ertl-Wagner
- Institute of Clinical Radiology, Ludwig Maximilian University, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry und Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry und Psychotherapy, Ludwig Maximilian University, Munich, Germany
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Adorjan K, Thoma C, Tchipeva E, Janjic K, Leidger A, Hoch E, Koller G, Falkai P, Pogarell O, Karch S. [An effective treatment concept for patients with substance use disorders]. MMW Fortschr Med 2017; 159:1-5. [PMID: 29557094 DOI: 10.1007/s15006-017-0079-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 09/12/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND At the Department of Psychiatry and Psychotherapy of the University of Munich a "day clinic for substance use disorders" was opened in 2014. A multimodal treatment concept for patients with addictions was developed. Employees of the clinic performed a first scientific study to assess the effects of treatment approaches on the course of the disease. METHOD Data were collected over two years to evaluate the treatment concept. I. a., the severity of depressive symptoms, anxiety symptoms, craving and several aspects of the subjective quality of life were documented. In addition, participants were examined about their contentment with the day-clinic treatment. RESULTS Symptoms of depression, anxiety and craving were significantly reduced during the day-clinic treatment. The subjective quality of life increased almost in all areas. CONCLUSION In order to stabilize patients with addictions, a multimodal treatment concept can be applied effectively.
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Affiliation(s)
- Kristina Adorjan
- Tagklinik für Suchterkrankungen Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Nußbaumstr. 7, 80336, München, Deutschland.
| | - Carmen Thoma
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Elitza Tchipeva
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Klaudia Janjic
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Anne Leidger
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Eva Hoch
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Gabriele Koller
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Peter Falkai
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Oliver Pogarell
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Susanne Karch
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
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Langgartner S, Strube W, Oviedo T, Hansbauer M, Karch S, Wirth S, Falkai P, Hasan A. Treatment-resistant Schizophrenia and Global Cortical Atrophy in a Patient with Turner Syndrome. Pharmacopsychiatry 2016; 49:262-263. [PMID: 27458742 DOI: 10.1055/s-0042-111207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- S Langgartner
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich
| | - W Strube
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich
| | - T Oviedo
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich
| | - M Hansbauer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich
| | - S Karch
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich
| | - S Wirth
- Department of Clinical Radiology, Ludwig-Maximilians University, Munich
| | - P Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich
| | - A Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University, Munich
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Hasan A, Guse B, Cordes J, Wölwer W, Winterer G, Gaebel W, Langguth B, Landgrebe M, Eichhammer P, Frank E, Hajak G, Ohmann C, Verde PE, Rietschel M, Ahmed R, Honer WG, Malchow B, Karch S, Schneider-Axmann T, Falkai P, Wobrock T. Cognitive Effects of High-Frequency rTMS in Schizophrenia Patients With Predominant Negative Symptoms: Results From a Multicenter Randomized Sham-Controlled Trial. Schizophr Bull 2016; 42:608-18. [PMID: 26433217 PMCID: PMC4838079 DOI: 10.1093/schbul/sbv142] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cognitive impairments are one of the main contributors to disability and poor long-term outcome in schizophrenia. Proof-of-concept trials indicate that repetitive transcranial magnetic stimulation (rTMS) applied to the left dorsolateral prefrontal cortex (DLPFC) has the potential to improve cognitive functioning. We analyzed the effects of 10-Hz rTMS to the left DLPFC on cognitive deficits in schizophrenia in a large-scale and multicenter, sham-controlled study. A total of 156 schizophrenia patients with predominant negative symptoms were randomly assigned to a 3-week intervention (10-Hz rTMS, 15 sessions, 1000 stimuli per session) with either active or sham rTMS. The Rey Auditory Verbal Learning Test, Trail Making Test A and B, Wisconsin Card Sorting Test, Digit Span Test, and the Regensburg Word Fluency Test were administered before intervention and at day 21, 45, and 105 follow-up. From the test results, a neuropsychological composite score was computed. Both groups showed no differences in any of the outcome variables before and after intervention. Both groups improved markedly over time, but effect sizes indicate a numeric, but nonsignificant superiority of active rTMS in certain cognitive tests. Active 10-Hz rTMS applied to the left DLPFC for 3 weeks was not superior to sham rTMS in the improvement of various cognitive domains in schizophrenia patients with predominant negative symptoms. This is in contrast to previous preliminary proof-of-concept trials, but highlights the need for more multicenter randomized controlled trials in the field of noninvasive brain stimulation.
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Affiliation(s)
- Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; These authors contributed equally to the article.
| | - Birgit Guse
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany; These authors contributed equally to the article
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany
| | - Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany
| | - Georg Winterer
- The Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Düsseldorf, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, kbo-Lech-Mangfall-Klinik, Agatharied, Germany
| | - Peter Eichhammer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Elmar Frank
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Göran Hajak
- Department of Psychiatry, Psychosomatics and Psychotherapy, Sozialstiftung Bamberg, Bamberg, Germany
| | - Christian Ohmann
- Coordination Centre for Clinical Trials, Heinrich-Heine University, Düsseldorf, Germany
| | - Pablo E Verde
- Coordination Centre for Clinical Trials, Heinrich-Heine University, Düsseldorf, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Institute of Central Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Raees Ahmed
- Institut für anwendungsorientierte Forschung und klinische Studien GmbH, Göttingen, Germany
| | - William G Honer
- Institute of Mental Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Thomas Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen, Germany; County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
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Krause D, Folkerts M, Karch S, Keeser D, Chrobok AI, Zaudig M, Hegerl U, Juckel G, Pogarell O. Prediction of Treatment Outcome in Patients with Obsessive-Compulsive Disorder with Low-Resolution Brain Electromagnetic Tomography: A Prospective EEG Study. Front Psychol 2016; 6:1993. [PMID: 26834658 PMCID: PMC4722125 DOI: 10.3389/fpsyg.2015.01993] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 12/14/2015] [Indexed: 11/24/2022] Open
Abstract
The issue of predicting treatment response and identifying, in advance, which patient will profit from treating obsessive-compulsive disorder (OCD) seems to be an elusive goal. This prospective study investigated brain electric activity [using Low-Resolution Brain Electromagnetic Tomography (LORETA)] for the purpose of predicting response to treatment. Forty-one unmedicated patients with a DSM-IV diagnosis of OCD were included. A resting 32-channel EEG was obtained from each participant before and after 10 weeks of standardized treatment with sertraline and behavioral therapy. LORETA was used to localize the sources of brain electrical activity. At week 10, patients were divided into responders and non-responders (according to a reduction of symptom severity >50% on the Y-BOCS). LORETA analysis revealed that at baseline responders showed compared to non-responders a significantly lower brain electric activity within the beta 1 (t = 2.86, p < 0.05), 2 (t = 2.81, p < 0.05), and 3 (t = 2.76, p < 0.05) frequency bands and ROI analysis confirmed a reduced activity in alpha 2 (t = 2.06, p < 0.05) in the anterior cingulate cortex (ACC). When baseline LORETA data were compared to follow-up data, the analysis showed in the responder group a significantly lower brain electrical resting activity in the beta 1 (t = 3.17. p < 0.05) and beta 3 (t = 3.11. p < 0.05) frequency bands and equally for the ROI analysis of the orbitofrontal cortex (OFC) in the alpha 2 (t = 2.15. p < 0.05) frequency band. In the group of non-responders the opposite results were found. In addition, a positive correlation between frequency alpha 2 (rho = 0.40, p = 0.010), beta 3 (rho = 0.42, p = 0.006), delta (rho = 0.33, p = 0.038), theta (rho = 0.34, p = 0.031), alpha 1 (rho = 0.38, p = 0.015), and beta1 (rho = 0.34, p = 0.028) of the OFC and the bands delta (rho = 0.33, p = 0.035), alpha 1 (rho = 0.36, p = 0.019), alpha 2 (rho = 0.34, p = 0.031), and beta 3 (rho = 0.38, p = 0.015) of the ACC with a reduction of the Y-BOCS scores was identified. Our results suggest that measuring brain activity with LORETA could be an efficient and applicable technique to prospectively identify treatment responders in OCD.
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Affiliation(s)
- Daniela Krause
- Department of Neurophysiology and Functional Neuroimaging, Ludwig Maximilians University Munich Munich, Germany
| | - Malte Folkerts
- Department of Neurophysiology and Functional Neuroimaging, Ludwig Maximilians University Munich Munich, Germany
| | - Susanne Karch
- Department of Neurophysiology and Functional Neuroimaging, Ludwig Maximilians University Munich Munich, Germany
| | - Daniel Keeser
- Department of Neurophysiology and Functional Neuroimaging, Ludwig Maximilians University Munich Munich, Germany
| | - Agnieszka I Chrobok
- Department of Neurophysiology and Functional Neuroimaging, Ludwig Maximilians University Munich Munich, Germany
| | | | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig Leipzig, Germany
| | - Georg Juckel
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr-University Bochum Bochum, Germany
| | - Oliver Pogarell
- Department of Neurophysiology and Functional Neuroimaging, Ludwig Maximilians University Munich Munich, Germany
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Karch S, Loy F, Krause D, Schwarz S, Kiesewetter J, Segmiller F, Chrobok AI, Keeser D, Pogarell O. Increased Event-Related Potentials and Alpha-, Beta-, and Gamma-Activity Associated with Intentional Actions. Front Psychol 2016; 7:7. [PMID: 26834680 PMCID: PMC4722116 DOI: 10.3389/fpsyg.2016.00007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 01/04/2016] [Indexed: 12/02/2022] Open
Abstract
Objective: Internally guided actions are defined as being purposeful, self-generated and offering choices between alternatives. Intentional actions are essential to reach individual goals. In previous empirical studies, internally guided actions were predominantly related to functional responses in frontal and parietal areas. The aim of the present study was to distinguish event-related potentials and oscillatory responses of intentional actions and externally guided actions. In addition, we compared neurobiological findings of the decision which action to perform with those referring to the decision whether or not to perform an action. Methods: Twenty-eight subjects participated in adapted go/nogo paradigms, including a voluntary selection condition allowing participants to (1) freely decide whether to press the response button or (2) to decide whether they wanted to press the response button with the right index finger or the left index finger. Results: The reaction times were increased when participants freely decided whether and how they wanted to respond compared to the go condition. Intentional processes were associated with a fronto-centrally located N2 and P3 potential. N2 and P3 amplitudes were increased during intentional actions compared to instructed responses (go). In addition, increased activity in the alpha-, beta- and gamma-frequency range was shown during voluntary behavior rather than during externally guided responses. Conclusion: These results may indicate that an additional cognitive process is needed for intentional actions compared to instructed behavior. However, the neural responses were comparatively independent of the kind of decision that was made (1) decision which action to perform; (2) decision whether or not to perform an action). Significance: The study demonstrates the importance of fronto-central alpha-, beta-, and gamma oscillations for voluntary behavior.
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Affiliation(s)
- Susanne Karch
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany
| | - Fabian Loy
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-UniversityMunich, Germany; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Ludwig-Maximilians-UniversityMunich, Germany
| | - Daniela Krause
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany
| | - Sandra Schwarz
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany
| | - Jan Kiesewetter
- Institute for Medical Education, Ludwig-Maximilians-University Munich, Germany
| | - Felix Segmiller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany
| | - Agnieszka I Chrobok
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Germany
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Engelbregt HJ, Keeser D, van Eijk L, Suiker EM, Eichhorn D, Karch S, Deijen JB, Pogarell O. Short and long-term effects of sham-controlled prefrontal EEG-neurofeedback training in healthy subjects. Clin Neurophysiol 2016; 127:1931-7. [PMID: 26971473 DOI: 10.1016/j.clinph.2016.01.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 11/24/2014] [Revised: 12/15/2015] [Accepted: 01/08/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In this study we evaluated long-term effects of frontal beta EEG-neurofeedback training (E-NFT) on healthy subjects. We hypothesized that E-NFT can change frontal beta activity in the long-term and that changes in frontal beta EEG activity are accompanied by altered cognitive performance. METHODS 25 healthy subjects were included and randomly assigned to active or sham E-NFT. On average the subjects underwent 15 E-NFT training sessions with a training duration of 45 min. Resting-state EEG was recorded prior to E-NFT training (t1) and in a 3-year follow-up (t3). RESULTS Compared to sham E-NFT, which was used for the control group, real E-NFT increased beta activity in a predictable way. This increase was maintained over a period of three years post training. However, E-NFT did not result in significantly improved cognitive performance. CONCLUSION Based on our results, we conclude that EEG-NFT can selectively modify EEG beta activity both in short and long-term. SIGNIFICANCE This is a sham controlled EEG neurofeedback study demonstrating long-term effects in resting state EEG.
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Affiliation(s)
- H J Engelbregt
- Hersencentrum, Amsterdam, The Netherlands; Dept. of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
| | - D Keeser
- Dept. of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - L van Eijk
- Hersencentrum, Amsterdam, The Netherlands; VU University, Department of Clinical Neuropsychology, Amsterdam, The Netherlands
| | - E M Suiker
- Hersencentrum, Amsterdam, The Netherlands
| | - D Eichhorn
- Hersencentrum, Amsterdam, The Netherlands; VU University, Department of Clinical Neuropsychology, Amsterdam, The Netherlands
| | - S Karch
- Dept. of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - J B Deijen
- VU University, Department of Clinical Neuropsychology, Amsterdam, The Netherlands
| | - O Pogarell
- Dept. of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
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Schiepek G, Heinzel S, Karch S, Plöderl M, Strunk G. Synergetics in Psychology: Patterns and Pattern Transitions in Human Change Processes. Understanding Complex Systems 2016. [DOI: 10.1007/978-3-319-27635-9_12] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Karch S, Keeser D, Paolini M, Hümmer S, Konrad J, Haller D, Kirsch V, Koller G, Kupka M, Blautzik J, Pogarell O. Real-time fMRI neurofeedback: application in patients with substance use disorder. Pharmacopsychiatry 2015. [DOI: 10.1055/s-0035-1558015] [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: 10/23/2022]
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Pogarell O, Karch S, Dunkel G, Segmiller F, Engelbregt H, Keeser D. Resting state EEG and functional connectivity in patients with major depression and under electro-convulsive therapy. Pharmacopsychiatry 2015. [DOI: 10.1055/s-0035-1558024] [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: 10/23/2022]
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Chrobok A, Länger A, Karch S, Keeser D, Lehmann K, Leicht G, Mulert C, Eser-Valeri D, Ertl-Wagner B, Dieterich M, Rupprecht R, Pogarell O. Anticipatory anxiety in phobic postural vertigo patients – functional indicators for anxiety-related disorder. Pharmacopsychiatry 2015. [DOI: 10.1055/s-0035-1558006] [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: 10/23/2022]
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36
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Karch S, Keeser D, Paolini M, Hümmer S, Konrad J, Haller D, Kirsch V, Koller G, Kupka M, Blautzik J, Pogarell O. Real-time fMRI neurofeedback: application in patients with substance use disorder. Pharmacopsychiatry 2015. [DOI: 10.1055/s-0035-1557964] [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: 10/23/2022]
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Karch S, Keeser D, Hümmer S, Paolini M, Kirsch V, Karali T, Kupka M, Rauchmann BS, Chrobok A, Blautzik J, Koller G, Ertl-Wagner B, Pogarell O. Modulation of Craving Related Brain Responses Using Real-Time fMRI in Patients with Alcohol Use Disorder. PLoS One 2015. [PMID: 26204262 PMCID: PMC4512680 DOI: 10.1371/journal.pone.0133034] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
LITERATURE One prominent symptom in addiction disorders is the strong desire to consume a particular substance or to display a certain behaviour (craving). Especially the strong association between craving and the probability of relapse emphasises the importance of craving in the therapeutic process. Neuroimaging studies have shown that craving is associated with increased responses, predominantly in fronto-striatal areas. AIM AND METHODS The aim of the present study is the modification of craving-related neuronal responses in patients with alcohol addiction using fMRI real-time neurofeedback. For that purpose, patients with alcohol use disorder and healthy controls participated once in neurofeedback training; during the sessions neuronal activity within an individualized cortical region of interest (ROI) (anterior cingulate cortex, insula, dorsolateral prefrontal cortex) was evaluated. In addition, variations regarding the connectivity between brain regions were assessed in the resting state. RESULTS AND DISCUSSION The results showed a significant reduction of neuronal activity in patients at the end of the training compared to the beginning, especially in the anterior cingulate cortex, the insula, the inferior temporal gyrus and the medial frontal gyrus. Furthermore, the results show that patients were able to regulate their neuronal activities in the ROI, whereas healthy subjects achieved no significant reduction. However, there was a wide variability regarding the effects of the training within the group of patients. After the neurofeedback-sessions, individual craving was slightly reduced compared to baseline. The results demonstrate that it seems feasible for patients with alcohol dependency to reduce their neuronal activity using rtfMRI neurofeedback. In addition, there is some evidence that craving can be influenced with the help of this technique. FUTURE PROSPECTS In future, real-time fMRI might be a complementary neurophysiological-based strategy for the psychotherapy of patients with psychiatric or psychosomatic diseases. For that purpose, the stability of this effect and the generalizability needs to be assessed.
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Affiliation(s)
- Susanne Karch
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- * E-mail:
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sebastian Hümmer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Marco Paolini
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Valerie Kirsch
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Temmuz Karali
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Kupka
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | | | - Agnieszka Chrobok
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Janusch Blautzik
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Gabi Koller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
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Rominger A, Cumming P, Brendel M, Xiong G, Zach C, Karch S, Tatsch K, Bartenstein P, la Fougère C, Koch W, Pogarell O. Altered serotonin and dopamine transporter availabilities in brain of depressed patients upon treatment with escitalopram: A [123 I]β-CIT SPECT study. Eur Neuropsychopharmacol 2015; 25:873-81. [PMID: 25819144 DOI: 10.1016/j.euroneuro.2014.12.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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] [Received: 03/25/2014] [Revised: 11/25/2014] [Accepted: 12/24/2014] [Indexed: 01/13/2023]
Abstract
Altered SERT and DAT availabilities during treatment with escitalopram were investigated with [(123)I]2β-carbomethoxy-3β-(4-iodophenyl)tropane (β-CIT) SPECT in a series of patients fulfilling the criteria for unipolar major depressive disorder (MDD). 27 patients (10m, 42±16y) with diagnosis of MDD were recruited for the study. All patients underwent neuropsychiatric testing for assessment of Hamilton Depression (HAM-D) and Beck Depression Inventory (BDI) scores. At baseline, [(123)I]β-CIT SPECT recordings were acquired 4h (SERT-weighted) and 20-24h p.i (DAT-weighted). Follow-up scans and neuropsychiatric testing were performed after six weeks of stable escitalopram medication. Voxel-wise parametric maps of specific/ non-specific ratios-1 (~BPND) were calculated. At baseline, DAT-weighted BPND was 5.06±0.81 in striatum and SERT-weighted BPND was 0.94±0.18 in thalamus. There were significant negative correlations with age for DAT in striatum (R=-0.60; p<0.01) and SERT in thalamus (R=-0.45; p<0.05). Under SSRI treatment there was an apparent 42% occupancy of SERT in thalamus (p<0.0001), whereas DAT availability increased significantly by 20% in striatum (p<0.001); higher apparent SERT occupancy in thalamus was associated with lesser DAT increase in striatum (R=-0.62; p<0.005). The low apparent SERT occupancy may be confounded by alterations in SERT expression during treatment. Thus, [(123)I]β-CIT SPECT revealed age-dependent declines in DAT and SERT availabilities in un-medicated MDD patients, comparable to that seen previously in healthy controls. At follow-up, the SSRI-evoked increase in DAT was less pronounced in the older patients, even though apparent SERT occupancy and clinical improvement were not age-dependent. Present findings may have implications for escitalopram dosage and side effect profile in younger MDD patients.
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Affiliation(s)
- A Rominger
- Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
| | - P Cumming
- Department of Psychiatry, University of Oslo, Oslo, Norway
| | - M Brendel
- Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - G Xiong
- Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - C Zach
- Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - S Karch
- Department of Psychiatry, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - K Tatsch
- Department of Nuclear Medicine, Municipal Hospital Karlsruhe Inc., Karlsruhe, Germany
| | - P Bartenstein
- Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - C la Fougère
- Department of Nuclear Medicine, University of Tubingen, Tubingen, Germany
| | - W Koch
- Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - O Pogarell
- Department of Psychiatry, Ludwig-Maximilians-University of Munich, Munich, Germany
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Koerte IK, Lin AP, Muehlmann M, Merugumala S, Liao H, Starr T, Kaufmann D, Mayinger M, Steffinger D, Fisch B, Karch S, Heinen F, Ertl-Wagner B, Reiser M, Stern RA, Zafonte R, Shenton ME. Altered Neurochemistry in Former Professional Soccer Players without a History of Concussion. J Neurotrauma 2015; 32:1287-93. [PMID: 25843317 DOI: 10.1089/neu.2014.3715] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Soccer is played by more than 250 million people worldwide. Repeatedly heading the ball may place soccer players at high risk for repetitive subconcussive head impacts (RSHI). This study evaluates the long-term effects of RSHI on neurochemistry in athletes without a history of clinically diagnosed concussion, but with a high exposure to RSHI. Eleven former professional soccer players (mean age 52.0±6.8 years) and a comparison cohort of 14 age- and gender-matched, former non-contact sport athletes (mean age 46.9±7.9 years) underwent 3T magnetic resonance spectroscopy (MRS) and neurocognitive evaluation. In the soccer players a significant increase was observed in both choline (Cho), a membrane marker, and myo-inositol (ml), a marker of glial activation, compared with control athletes. Additionally, ml and glutathione (GSH) were significantly correlated with lifetime estimate of RSHI within the soccer group. There was no significant difference in neurocognitive tests between groups. Results of this study suggest an association between RSHI in soccer players and MRS markers of neuroinflammation, suggesting that even subconcussive head impacts affect the neurochemistry of the brain and may precede neurocognitive changes. Future studies will need to determine the role of neuroinflammation in RSHI and the effect on neurocognitive function.
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Affiliation(s)
- Inga K Koerte
- 1 Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts.,2 Institute for Clinical Radiology, Ludwig-Maximilian-University , Munich, Germany .,3 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University , Munich, Germany
| | - Alexander P Lin
- 1 Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts.,4 Department of Radiology, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts
| | - Marc Muehlmann
- 1 Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts.,2 Institute for Clinical Radiology, Ludwig-Maximilian-University , Munich, Germany .,3 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University , Munich, Germany
| | - Sai Merugumala
- 4 Department of Radiology, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts
| | - Huijun Liao
- 4 Department of Radiology, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts
| | - Tyler Starr
- 4 Department of Radiology, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts
| | - David Kaufmann
- 2 Institute for Clinical Radiology, Ludwig-Maximilian-University , Munich, Germany .,5 Department of Radiology, Charité Berlin , Berlin, Germany
| | - Michael Mayinger
- 1 Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts.,2 Institute for Clinical Radiology, Ludwig-Maximilian-University , Munich, Germany
| | - Denise Steffinger
- 2 Institute for Clinical Radiology, Ludwig-Maximilian-University , Munich, Germany
| | - Barbara Fisch
- 2 Institute for Clinical Radiology, Ludwig-Maximilian-University , Munich, Germany
| | - Susanne Karch
- 6 Department of Psychiatry, Ludwig-Maximilian-University , Munich, Germany
| | - Florian Heinen
- 7 Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-University , Munich, Germany
| | - Birgit Ertl-Wagner
- 2 Institute for Clinical Radiology, Ludwig-Maximilian-University , Munich, Germany
| | - Maximilian Reiser
- 2 Institute for Clinical Radiology, Ludwig-Maximilian-University , Munich, Germany
| | - Robert A Stern
- 8 Departments of Neurology, Neurosurgery, and Anatomy and Neurobiology, Boston University Alzheimer's Disease Center, Boston University School of Medicine , Boston, Massachusetts
| | - Ross Zafonte
- 9 Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School , Boston, Massachusetts
| | - Martha E Shenton
- 1 Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts.,4 Department of Radiology, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts.,10 Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School , Boston, Massachusetts.,11 VA Boston Healthcare System , Boston, Massachusetts
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Wigand M, Kubicki M, von Hohenberg CC, Leicht G, Karch S, Eckbo R, Pelavin PE, Hawley K, Rujescu D, Bouix S, Shenton ME, Mulert C. Auditory verbal hallucinations and the interhemispheric auditory pathway in chronic schizophrenia. World J Biol Psychiatry 2015; 16:31-44. [PMID: 25224883 PMCID: PMC4698973 DOI: 10.3109/15622975.2014.948063] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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 The interhemispheric auditory pathway has been shown to play a crucial role in the processing of acoustic stimuli, and alterations of structural and functional connectivity between bilateral auditory areas are likely relevant to the pathogenesis of auditory verbal hallucinations (AVHs). The aim of this study was to examine this pathway in patients with chronic schizophrenia regarding their lifetime history of AVHs. METHODS DTI scans were acquired from 33 healthy controls (HC), 24 schizophrenia patients with a history of AVHs (LT-AVH) and nine schizophrenia patients without any lifetime hallucinations (N-LT-AVH). The interhemispheric auditory fibre bundles were extracted using streamline tractography. Subsequently, diffusivity indices, namely Fractional Anisotropy (FA), Trace, Mode, Axial and Radial diffusivity, were calculated. RESULTS FA was decreased over the entire pathway in LT-AVH compared with N-LT-AVH. Moreover, LT-AVH displayed decreased FA and Mode as well as increased radial diffusivity in the midsagittal section of the fibre tract. CONCLUSIONS These findings indicate complex microstructural changes in the interhemispheric auditory pathway of schizophrenia patients with a history of AVHs. Alterations appear to be absent in patients who have never hallucinated.
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Affiliation(s)
- Marlene Wigand
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany,Department of Psychiatry, Psychiatry Neuroimaging Branch, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marek Kubicki
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Radiology, Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Christian Clemm von Hohenberg
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany,Department of Psychiatry, Psychiatry Neuroimaging Branch, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Gregor Leicht
- Department of Psychiatry, Psychiatry Neuroimaging Branch, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Karch
- Department of Psychiatry, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - Ryan Eckbo
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Paula E. Pelavin
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn Hawley
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Dan Rujescu
- Department of Psychiatry, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany,Department of Psychiatry, University Hospital and Faculty of Medicine, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Sylvain Bouix
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Radiology, Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Martha E. Shenton
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Radiology, Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA,Department of Psychiatry, Veterans Affairs Boston Healthcare System and Harvard Medical School, Brockton, MA, USA
| | - Christoph Mulert
- Department of Psychiatry, Psychiatry Neuroimaging Branch, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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O'Donoghue T, Morris DW, Fahey C, Da Costa A, Moore S, Cummings E, Leicht G, Karch S, Hoerold D, Tropea D, Foxe JJ, Gill M, Corvin A, Donohoe G. Effects of ZNF804A on auditory P300 response in schizophrenia. Transl Psychiatry 2014; 4:e345. [PMID: 24424391 PMCID: PMC3905225 DOI: 10.1038/tp.2013.115] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 10/07/2013] [Accepted: 10/29/2013] [Indexed: 12/23/2022] Open
Abstract
The common variant rs1344706 within the zinc-finger protein gene ZNF804A has been strongly implicated in schizophrenia (SZ) susceptibility by a series of recent genetic association studies. Although associated with a pattern of altered neural connectivity, evidence that increased risk is mediated by an effect on cognitive deficits associated with the disorder has been equivocal. This study investigated whether the same ZNF804A risk allele was associated with variation in the P300 auditory-evoked response, a cognitively relevant putative endophenotype for SZ. We compared P300 responses in carriers and noncarriers of the ZNF804A risk allele genotype groups in Irish patients and controls (n=97). P300 response was observed to vary according to genotype in this sample, such that risk allele carriers showed relatively higher P300 response compared with noncarriers. This finding accords with behavioural data reported by our group and others. It is also consistent with the idea that ZNF804A may have an impact on cortical efficiency, reflected in the higher levels of activations required to achieve comparable behavioural accuracy on the task used.
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Affiliation(s)
- T O'Donoghue
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - D W Morris
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
| | - C Fahey
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
| | - A Da Costa
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
| | - S Moore
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
| | - E Cummings
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
| | - G Leicht
- The Cognitive Neurophysiology Lab, Children's Evaluation and Rehabilitation Center (CERC), Departments of Pediatrics and Neuroscience, Albert Einstein College of Medicine, Bronx, NY, USA
| | - S Karch
- The Cognitive Neurophysiology Lab, Children's Evaluation and Rehabilitation Center (CERC), Departments of Pediatrics and Neuroscience, Albert Einstein College of Medicine, Bronx, NY, USA
| | - D Hoerold
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - D Tropea
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
| | - J J Foxe
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
- The School of Psychology, The National University of Ireland, Galway, Ireland
| | - M Gill
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - A Corvin
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - G Donohoe
- Neuropsychiatric Genetics Group and Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, St James Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
- The School of Psychology, The National University of Ireland, Galway, Ireland
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Chrobok A, Länger A, Karch S, Lehmann K, Keeser D, Eser-Valeri D, Ertl-Wagner B, Dieterich M, Rupprecht R, Pogarell O. EPA-1581 - Anxiety-related neuronal responses in phobic postural vertigo. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78737-1] [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: 10/25/2022] Open
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43
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Karch S, Voelker JM, Thalmeier T, Ertl M, Leicht G, Pogarell O, Mulert C. Deficits during Voluntary Selection in Adult Patients with ADHD: New Insights from Single-Trial Coupling of Simultaneous EEG/fMRI. Front Psychiatry 2014; 5:41. [PMID: 24795657 PMCID: PMC4001047 DOI: 10.3389/fpsyt.2014.00041] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 04/02/2014] [Indexed: 11/13/2022] Open
Abstract
Deficits in executive functions, including voluntary decisions are among the core symptoms of attention deficit/hyperactivity disorder (ADHD) patients. In order to clarify the spatiotemporal characteristics of these deficits, a simultaneous EEG/functional MRI (fMRI) study was performed. Single-trial coupling was used to integrate temporal EEG information in the fMRI analyses and to correlate the trial by trial variation in the different event-related potential amplitudes with fMRI BOLD responses. The results demonstrated that during voluntary selection early electrophysiological responses (N2) were associated with responses in similar brain regions in healthy participants as well as in ADHD patients, e.g., in the medial-frontal cortex and the inferior parietal gyrus. However, ADHD patients presented significantly reduced N2-related BOLD responses compared to healthy controls especially in frontal areas. These results support the hypothesis that in ADHD patients executive deficits are accompanied by early dysfunctions, especially in frontal brain areas.
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Affiliation(s)
- Susanne Karch
- Neurophysiology and Functional Neuroimaging, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University , Munich , Germany
| | - Julia Madeleine Voelker
- Neurophysiology and Functional Neuroimaging, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University , Munich , Germany
| | - Tobias Thalmeier
- Neurophysiology and Functional Neuroimaging, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University , Munich , Germany
| | - Matthias Ertl
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Gregor Leicht
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Oliver Pogarell
- Neurophysiology and Functional Neuroimaging, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University , Munich , Germany
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Keeser D, Karch S, Kirsch V, Davis J, Länger A, Chrobok A, Loy F, Surmeli T, Engelbregt H, Thatcher R, Pogarell O. EPA-1603 - Changes of resting-state eeg and functional connectivity in the sensor and source space of patients with major depression. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78755-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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45
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Pogarell O, Rominger A, Karch S, Segmiller F, Tatsch K, Bartenstein P, Koch W. EPA-1577 - Serotonin and dopamine transporter availabilities in patients with depression under treatment with ssri. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78733-4] [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: 10/25/2022] Open
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46
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Karch S, Tominschek I, Heinzel S, Aigner M, Windischberger C, Moser E, Pogarell O, Schiepek G. EPA-0997 – Neurobiological aspects of psychotherapy in OCD. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78295-1] [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: 11/16/2022] Open
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Labek K, Karch S, Taubner S, Kessler H, Kächele H, Cierpka M, Roth G, Chrobok A, Pogarell O, Buchheim A. EPA-1756 - EEG activity in the gamma band and late positive potential (LPP) during processing attachment-related stimuli. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78886-8] [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: 10/25/2022] Open
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48
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Hümmer S, Karch S, Keeser D, Paolini M, Kirsch V, Koller G, Rauchmann B, Kupka M, Blautzik J, Pogarell O. EPA-1638 – Neurofeedback using real-time fmri in patients with alcohol use disorder. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78787-5] [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: 10/25/2022] Open
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Engelbregt H, Keeser D, Suiker E, Karch S, Deijen J, Pogarell O. EPA-1676 – Long-term effects of placebo-controlled prefrontal eeg-neurofeedback training in healthy subjects. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78820-0] [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: 11/16/2022] Open
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Reichenbach N, Karch S, Klemme J, Keeser D, Ludwig H, Zeren A, Paolini M, Blautzik J, Pogarell O, Padberg F, Rüther T. EPA-1578 - Modifications of human brain activity due to transcranial direct current stimulation (tdcs) in patients with nicotine dependence. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78734-6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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