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Ertl M, Moser M, Boegle R, Conrad J, zu Eulenburg P, Dieterich M. The cortical spatiotemporal correlate of otolith stimulation: Vestibular evoked potentials by body translations. Neuroimage 2017; 155:50-59. [DOI: 10.1016/j.neuroimage.2017.02.044] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 02/15/2017] [Accepted: 02/15/2017] [Indexed: 12/01/2022] Open
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Boegle R, Ertl M, Stephan T, Dieterich M. Magnetic vestibular stimulation influences resting-state fluctuations and induces visual-vestibular biases. J Neurol 2017; 264:999-1001. [PMID: 28271404 DOI: 10.1007/s00415-017-8447-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/01/2017] [Indexed: 10/20/2022]
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Oh SY, Boegle R, Eulenburg PZ, Ertl M, Kim JS, Dieterich M. Longitudinal multi-modal neuroimaging in opsoclonus–myoclonus syndrome. J Neurol 2017; 264:512-519. [DOI: 10.1007/s00415-016-8389-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/20/2016] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
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Salzl S, Ertl M, Knör G. Evidence for photosensitised hydrogen production from water in the absence of precious metals, redox-mediators and co-catalysts. Phys Chem Chem Phys 2017; 19:8141-8147. [DOI: 10.1039/c6cp07725k] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
New approaches for sunlight-powered proton reduction and photocatalytic hydrogen evolution from aqueous salt solutions using earth-abundant components and molecular photosensitisers.
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Ertl M, Aigner R, Krost M, Karnasová Z, Müller K, Naumann M, Schlachetzki F. Measuring changes in the optic nerve sheath diameter in patients with idiopathic normal-pressure hydrocephalus: a useful diagnostic supplement to spinal tap tests. Eur J Neurol 2016; 24:461-467. [DOI: 10.1111/ene.13225] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 11/14/2016] [Indexed: 11/29/2022]
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Von Heyking K, Roth L, Ertl M, Schmidt O, Calzada-Wack J, Neff F, Lawlor E, Burdach S, Richter G. The posterior HOXD locus: Its contribution to phenotype and malignancy of Ewing sarcoma. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32726-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pfadenhauer K, Ertl M, Berlis A, Hittinger M. Zerebrale Ischämie bei aktiver Riesenzellarteriitis: Klinische und diagnostische Besonderheiten bei 36 Patienten. AKTUELLE NEUROLOGIE 2016. [DOI: 10.1055/s-0042-109048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pfadenhauer K, Ertl M, Hittinger M, Berlis A. Cerebral Ischemia in Active Giant Cell Arteritis: Clinical and Diagnostic Aspects in 36 Patients. AKTUELLE NEUROLOGIE 2016. [DOI: 10.1055/s-0042-119566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Background: Cerebral ischemia (CI) is an uncommon, sometimes life-threatening complication of active giant cell arteritis (aGCA) due to affection of the precerebral arteries.
Aim of the Study: To analyze and describe clinical findings and results of multimodal vascular imaging of the craniocervical arteries.
Patients and Methods: Out of 317 aGCA patients, 36 (11%) presented with CI. All patients underwent vascular imaging including ultrasonography (US) of the temporal arteries (TA) and precerebral arteries, biopsies were taken in 27, CTA/MRA were performed in 21 and FDG-PET in 18 patients.
Results: In 72% of patients, CI was located in the posterior circulation and in14% of patients, it occurred after beginning of steroid therapy. TA were normal on clinical and US examination in 10 patients (with normal biopsies in 5) but PET demonstrated GCA of the precerebral arteries in 9 of them. Abnormalities of the precerebral arteries typical of GCA were demonstrated by US as halos in 67% (in 61% halos of the vertebral arteries), CTA/MRA in 43% and PET in 72% of patients. Concurrent etiologies for CI were evident in 19% of patients (including >50% ICA stenosis in 3 and atrial fibrillation in 4 patients).
Conclusions: Awareness for GCA as a cause of CI requiring specific diagnostic and therapeutic steps is important. US, CTA, MRA and PET are valuable diagnostic tools for rapid detection of GCA involving the precerebral arteries in different stages of the disease even if the TA look normal.
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Ertl M, Moser M, Boegle R, Conrad J, Dieterich M. ID 383 – On the impact of stimulus intensity on vestibular evoked potentials (VestEPs). Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Boegle R, Stephan T, Ertl M, Glasauer S, Dieterich M. Magnetic vestibular stimulation modulates default mode network fluctuations. Neuroimage 2016; 127:409-421. [PMID: 26666898 DOI: 10.1016/j.neuroimage.2015.11.065] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 11/23/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022] Open
Abstract
Strong magnetic fields (>1 Tesla) can cause dizziness and it was recently shown that healthy subjects (resting in total darkness) developed a persistent nystagmus even when remaining completely motionless within a MR tomograph. Consequently, it was speculated that this magnetic vestibular stimulation (MVS) might influence fMRI results, as nystagmus is indicative of an imbalance in the vestibular system, potentially influencing other systems via multisensory vestibular interactions. The objective of our study was to investigate whether MVS does indeed modulate BOLD signal fluctuations. We recorded eye movements, as well as, resting-state fMRI of 30 volunteers in darkness at 1.5 T and 3.0 T to answer the question whether MVS modulated parts of the default mode resting-state network (DMN) in accordance with the Lorentz-force model for MVS, while distinguishing this from the known signal increase due to field strength related imaging effects. Our results showed that modulation of the default mode network occurred mainly in areas associated with vestibular and ocular motor function, and was in accordance with the Lorentz-force model, i.e., double than the expected signal scaling due to field strength alone. We discuss the implications of our findings for the interpretation of studies using resting-state fMRI, especially those concerning vestibular research. We conclude that MVS needs to be considered in vestibular research to avoid biased results, but it might also offer the possibility of manipulating network dynamics and may thus help in studying the brain as a dynamical system.
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Bremova T, Caushaj A, Ertl M, Strobl R, Böttcher N, Strupp M, MacNeilage PR. Comparison of linear motion perception thresholds in vestibular migraine and Menière's disease. Eur Arch Otorhinolaryngol 2016; 273:2931-9. [PMID: 26728484 PMCID: PMC5014886 DOI: 10.1007/s00405-015-3835-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 11/09/2015] [Indexed: 12/28/2022]
Abstract
Linear motion perceptual thresholds (PTs) were compared between patients with Menière’s disease (MD) and vestibular migraine (VM). Twenty patients with VM, 27 patients with MD and 34 healthy controls (HC) were examined. PTs for linear motion along the inter-aural (IA), naso-occipital axes (NO), and head-vertical (HV) axis were measured using a multi-axis motion platform. Ocular and cervical vestibular evoked myogenic potentials (o/c VEMP) were performed and the dizziness handicap inventory (DHI) administered. In order to discriminate between VM and MD, we also evaluated the diagnostic accuracy of applied methods. PTs depended significantly on the group tested (VM, MD and HC), as revealed by ANCOVA with group as the factor and age as the covariate. This was true for all motion axes (IA, HV and NO). Thresholds were highest for MD patients, significantly higher than for all other groups for all motion axes, except for the IA axis when compared with HC group suggesting decreased otolith sensitivity in MD patients. VM patients had thresholds that were not different from those of HC, but were significantly lower than those of the MD group for all motion axes. The cVEMP p13 latencies differed significantly across groups being lowest in VM. There was a statistically significant association between HV and NO thresholds and cVEMP PP amplitudes. Diagnostic accuracy was highest for the IA axis, followed by cVEMP PP amplitudes, NO and HV axes. To conclude, patients with MD had significantly higher linear motion perception thresholds compared to patients with VM and controls. Except for reduced cVEMP latency, there were no differences in c/oVEMP between MD, VM and controls.
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Gassner R, Zsifkovits C, Steinkuhler J, Ertl M, Ertl P, Kapferer W, Lepperdinger G. Implants: science meets technology. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ertl M, Moser M, Dieterich M. V19. Neural correlates of otolith stimulation: Results of an EEG study. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ertl M, Schierling W, Kasprzak P, Schömig B, Brückl C, Schlachetzki F, Pfister K. P6. Optic nerve sheath diameter measurement – A tool to identify high risk patients for spinal ischemia after endovascular thoracoabdominal aortic aneurysm repair? Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ertl M, Kirsch V, Gerb J, Boegle R, Krafczyk S, Dieterich M. Appraisal of the signal-to-noise-ratio of uni- and bipolar recordings of ocular vestibular evoked myogenic potentials. ACTA ACUST UNITED AC 2015; 25:9-14. [DOI: 10.3233/ves-150545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ocular vestibular evoked myogenic potentials (oVEMPs) are a non-invasive method to investigate otolith function mediated via the superior vestibular nerve. However, the herein used recordings and protocols may alter within different studies. In particular the diverging use of electrode configuration regarding polarity or even electrode position varies across studies. Therefore, a systematic analysis and appraisal of the different electrode configuration seems mandatory. In this study we compared the quality of uni- and bipolar recordings based on the signal to noise ratio (SNR). We recoded oVEMPs using a uni- and bipolar electrode configuration simultaneously and compared the recorded amplitudes and latencies and calculated the SNR. The amplitudes recorded by the unipolar configurations were significantly (p < 0.01) increased compared to the bipolar configuration. However, the SNR of the bipolar setup was significantly better (p < 0.05) when compared to the unipolar setup. Additionally, we estimated a transfer function that enabled a comparison of uni- and bipolar recordings. To conclude, the variety of setups used for oVEMP recording hinder a comparison of results and unipolar electrode configurations have clear disadvantages.
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Ertl M, Boegle R, Kirsch V, Dieterich M. On the impact of examiners on latencies and amplitudes in cervical and ocular vestibular-evoked myogenic potentials evaluated over a large sample (N = 1,038). Eur Arch Otorhinolaryngol 2015; 273:317-23. [PMID: 25628238 DOI: 10.1007/s00405-015-3510-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 01/14/2015] [Indexed: 11/26/2022]
Abstract
Vestibular-evoked myogenic potentials (VEMPs) are frequently used in the clinical diagnosis and research of vertigo syndromes. Altered latencies or amplitudes are typically interpreted as an indication of disturbance in the processing of vestibular stimuli along the otolithic pathways. Correct interpretation, however, can be difficult as VEMP amplitudes can vary greatly across subjects and across laboratories, likely because they are very sensitive to measurement conditions. Here, we attempted to quantify the impact of examiner differences on VEMP data. We collected data from 1,038 people using eight different experimental examiners, and investigated the effect of examiner on VEMP latencies and amplitudes. We found that the examiner collecting the data had a strong effect on outcome measures with significant differences (p < 0.001) in cVEMP and oVEMP latencies and in oVEMP amplitudes. No significant differences between examiners were found for the cVEMP amplitudes. When we compared the healthy and pathological sides of patients with a clinically diagnosed unilateral disease, no significant differences between sides were found. Given our results and the results reported in the literature, we conclude that the signal features of VEMPs are very sensitive to variables that may be influenced by the examiner. The field should therefore work on a better standard for VEMP recordings.
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Ertl M, Wöβ E, Knör G. Antimony porphyrins as red-light powered photocatalysts for solar fuel production from halide solutions in the presence of air. Photochem Photobiol Sci 2015; 14:1826-30. [DOI: 10.1039/c5pp00238a] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Stable light-harvesting sensitizers for the two-electron oxidation of halide ions are reported. Photocatalysis is studied in solution, in aqueous micellar medium and with surface immobilized samples for convenient photocatalyst recycling.
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Ertl M, Barinka F, Torka E, Altmann M, Pfister K, Helbig H, Bogdahn U, Gamulescu MA, Schlachetzki F. Ocular color-coded sonography - a promising tool for neurologists and intensive care physicians. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2014; 35:422-431. [PMID: 24647767 DOI: 10.1055/s-0034-1366113] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Ocular color-coded duplex sonography (OCCS), when performed within the safety limits of diagnostic ultrasonography, is an easy noninvasive technique with high potential for diagnosis and therapy in diseases with raised intracranial pressure and vascular diseases affecting the eye. Despite the capabilities of modern ultrasound systems and its scientific validation, OCCS has not gained widespread use in neurological practice. In this review, the authors describe the technique and main parameter settings of OCCS systems to reduce potential risks as thermal or cavitational effects for sensitive orbital structures. Applications of OCCS are the determination of intracranial pressure in emergency medicine, and follow-up evaluations of idiopathic intracranial hypertension and ventricular shunting by measuring the optic nerve sheath diameter. A diameter of 5.7 - 6.0 mm corresponds well with symptomatically increased intracranial pressure (> 20 cmH2O). OCCS also helps to discriminate between different etiologies of central retinal artery occlusion - by visualization of a "spot sign" and Doppler flow analysis of the central retinal artery - and aids the differential diagnosis of papilledema. At the end perspectives are illustrated that combine established ultrasound methods such as transcranial color-coded sonography with OCCS.
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Steinmann S, Leicht G, Ertl M, Andreou C, Polomac N, Westerhausen R, Friederici AD, Mulert C. Conscious auditory perception related to long-range synchrony of gamma oscillations. Neuroimage 2014; 100:435-43. [PMID: 24945670 DOI: 10.1016/j.neuroimage.2014.06.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 05/08/2014] [Accepted: 06/05/2014] [Indexed: 10/25/2022] Open
Abstract
While the role of synchronized oscillatory activity in the gamma-band frequency range for conscious perception is well established in the visual domain, there is limited evidence concerning neurophysiological mechanisms in conscious auditory perception. In the current study, we addressed this issue with 64-channel EEG and a dichotic listening (DL) task in twenty-five healthy participants. The typical finding of DL is a more frequent conscious perception of the speech syllable presented to the right ear (RE), which is attributed to the supremacy of the contralateral pathways running from the RE to the speech-dominant left hemisphere. In contrast, the left ear (LE) input initially accesses the right hemisphere and needs additional transfer via interhemispheric pathways before it is processed in the left hemisphere. Using lagged phase synchronization (LPS) analysis and eLORETA source estimation we examined the functional connectivity between right and left primary and secondary auditory cortices in the main frequency bands (delta, theta, alpha, beta, gamma) during RE/LE-reports. Interhemispheric LPS between right and left primary and secondary auditory cortices was specifically increased in the gamma-band range, when participants consciously perceived the syllable presented to the LE. Our results suggest that synchronous gamma oscillations are involved in interhemispheric transfer of auditory information.
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Ertl M, Kirsch V, Gerb J, Krafczyk S, Dieterich M. P125: Appraisal of the signal-to-noise-ratio of uni- and bipolar recordings of ocular vestibular evoked myogenic potentials. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kirsch V, Ertl M, Krafczyk S, Dieterich M. Neuronal correlates of passive body rotation – an EEG study. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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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] [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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Leicht G, Troschütz S, Andreou C, Karamatskos E, Ertl M, Naber D, Mulert C. Relationship between oscillatory neuronal activity during reward processing and trait impulsivity and sensation seeking. PLoS One 2013; 8:e83414. [PMID: 24376698 PMCID: PMC3869783 DOI: 10.1371/journal.pone.0083414] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 11/13/2013] [Indexed: 11/25/2022] Open
Abstract
Background The processing of reward and punishment stimuli in humans appears to involve brain oscillatory activity of several frequencies, probably each with a distinct function. The exact nature of associations of these electrophysiological measures with impulsive or risk-seeking personality traits is not completely clear. Thus, the aim of the present study was to investigate event-related oscillatory activity during reward processing across a wide spectrum of frequencies, and its associations with impulsivity and sensation seeking in healthy subjects. Methods During recording of a 32-channel EEG 22 healthy volunteers were characterized with the Barratt Impulsiveness and the Sensation Seeking Scale and performed a computerized two-choice gambling task comprising different feedback options with positive vs. negative valence (gain or loss) and high or low magnitude (5 vs. 25 points). Results We observed greater increases of amplitudes of the feedback-related negativity and of activity in the theta, alpha and low-beta frequency range following loss feedback and, in contrast, greater increase of activity in the high-beta frequency range following gain feedback. Significant magnitude effects were observed for theta and delta oscillations, indicating greater amplitudes upon feedback concerning large stakes. The theta amplitude changes during loss were negatively correlated with motor impulsivity scores, whereas alpha and low-beta increase upon loss and high-beta increase upon gain were positively correlated with various dimensions of sensation seeking. Conclusions The findings suggest that the processing of feedback information involves several distinct processes, which are subserved by oscillations of different frequencies and are associated with different personality traits.
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Ertl M, Hildebrandt M, Ourina K, Leicht G, Mulert C. Emotion regulation by cognitive reappraisal — The role of frontal theta oscillations. Neuroimage 2013; 81:412-421. [DOI: 10.1016/j.neuroimage.2013.05.044] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 04/16/2013] [Accepted: 05/07/2013] [Indexed: 11/26/2022] Open
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Leicht G, Mulert C, Eser D, Sämann PG, Ertl M, Laenger A, Karch S, Pogarell O, Meindl T, Czisch M, Rupprecht R. Benzodiazepines counteract rostral anterior cingulate cortex activation induced by cholecystokinin-tetrapeptide in humans. Biol Psychiatry 2013; 73:337-44. [PMID: 23059050 DOI: 10.1016/j.biopsych.2012.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 09/04/2012] [Accepted: 09/04/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND Benzodiazepines modulate γ-aminobutyric acid type A (GABA(A)) receptors throughout the brain. However, it is not fully understood which brain regions within anxiety-related brain circuits are really responsible for their anxiolytic effects and how these regions interact. METHODS We investigated whether the benzodiazepine alprazolam affects activity in distinct brain regions within anxiety-related circuits during an experimental anxiety paradigm by means of functional magnetic resonance imaging (fMRI). Panic symptoms were elicited by a bolus injection of the neuropeptide cholecystokinin-tetrapeptide (CCK-4) in 16 healthy male subjects in a double-blind, placebo-controlled design. Functional brain activation patterns were determined before and during the CCK-4-challenge without pretreatment and after treatment with either placebo or 1 mg alprazolam. RESULTS The CCK-4 induced anxiety and elicited widely distributed activation patterns in anxiety-related brain circuits, especially in the rostral anterior cingulate cortex (rACC), which was attenuated after alprazolam treatment. In contrast to placebo, alprazolam abolished the activation of the rACC after challenge with CCK-4 (p<.005, corrected for multiple comparisons) and increased functional connectivity between the rACC and other anxiety-related brain regions such as amygdala and prefrontal cortex. Moreover, the reduction in the CCK-4 induced activation of the rACC correlated with the anxiolytic effect of alprazolam (r(p) = .52; p = .04). CONCLUSIONS These findings put forward the rACC as a target for benzodiazepines and suggest that the CCK-4/fMRI paradigm might represent a human translational model for the investigation of anxiolytic drugs.
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