Frequency of extreme precipitation increases extensively with event rareness under global warming

The intensity of the heaviest extreme precipitation events is known to increase with global warming. How often such events occur in a warmer world is however less well established, and the combined effect of changes in frequency and intensity on the total amount of rain falling as extreme precipitation is much less explored, in spite of potentially large societal impacts. Here, we employ observations and climate model simulations to document strong increases in the frequencies of extreme precipitation events occurring on decadal timescales. Based on observations we find that the total precipitation from these intense events almost doubles per degree of warming, mainly due to changes in frequency, while the intensity changes are relatively weak, in accordance to previous studies. This shift towards stronger total precipitation from extreme events is seen in observations and climate models, and increases with the strength - and hence the rareness - of the event. Based on these results, we project that if historical trends continue, the most intense precipitation events observed today are likely to almost double in occurrence for each degree of further global warming. Changes to extreme precipitation of this magnitude are dramatically stronger than the more widely communicated changes to global mean precipitation.

Elucidation of removal processes in sequential biofiltration (SBF) and soil aquifer treatment (SAT) by analysis of a broad range of trace organic chemicals (TOrCs) and their transformation products (TPs)

Many chemicals with different physico-chemical properties are present in municipal wastewater. In this study, the removal of a broad range of trace organic chemicals (TOrCs) was determined in two biological treatment processes differing in hydraulic retention time: sequential biofiltration (SBF) and soil-aquifer treatment (SAT), operated in Germany and Spain. Occurrence and the degree of removal of more than 150 TOrCs with different physico-chemical properties were analysed, including precursors as well as human metabolites and environmental transformation products (TPs). Ninety TOrCs were detected in the feed water of the SBF system, 40% of these showed removal efficiencies of higher than 30% during biological treatment. In SAT, 70 TOrCs were detected in the feed water, 60% of these could be reduced by more than 30% after approximately 3 days of subsurface treatment. For uncharged and negatively charged TOrCs biological degradation was mainly responsible for the removal, while positively charged TOrCs were most likely also removed by ionic interactions. The detections of TPs confirmed that biodegradation was a major removal process in both systems. The analysis of positively and negatively charged, neutral and zwitterionic TOrCs and the simultaneous analysis of precursors and their biologically formed TPs enabled a detailed understanding of underlying mechanisms of their removal in the two systems. On this basis, criteria for site-specific indicator selection were proposed.

Simulation and visualization of material flows in sanitation systems for streamlined sustainability assessment

New and alternative sanitation systems are increasingly discussed and find their way into implementation. However, discussions on sanitation concepts often are held in a rather emotional way. Furthermore, not all the available sanitation concepts might be known to the decision maker. The work presented here attempts to contribute to a good discussion and decision making process by compiling available technologies, by defining easy-to-implement criteria for a sustainability assessment method and by integrating these results into a simulation tool which allows to visualize the related resource fluxes (e.g. those on nutrients, such as N, P and K) and to analyse different sanitation options with regard to their capital and operational costs and with regard to environmental impact criteria such as greenhouse gas emissions. Whilst the calculations are to be considered as being approximate in their nature (due to uncertainties or lack of suitable input data), this tool allows the planners, with sometimes little modelling experience, to consider the characteristics of sanitation systems. Whilst starting from earlier work, such as Eawag's Sanitation Compendium and work on material flow analysis, work described in this contribution merges resource flux modelling, easy-to-use simulation and visualization and methods of life cycle assessment and life cycle costing. The simulation tool is freely available on https://www.ifak.eu/en/products/sampsons.

Acceptance of a medication refill reminder service in German community pharmacy practice

Medication refill reminder services (MRRS), having the potential to support the detection of non-adherence and to promote periodic medication refilling by addressing forgetfulness, are not generally available in community pharmacy practice. Based on a new software module, a MRRS was developed. The acceptance of this service was tested in community pharmacies in Germany. Patients were recruited by trained pharmacy staff. Supported by the software, the pharmacies reminded patients to refill their prescription. After 7 months, the service was evaluated by patients and pharmacy staff. The pharmacy owners/managers were interviewed. Ten pharmacies applied the service to 148 patients, with 806 refill reminders for 391 drugs. Seventy-five patients (50.7%) chose to be reminded by a phone call, followed by text message (n=25), and email (n=18). Of all patients, 75 (50.7%) completed the paper-based questionnaire. Sixty-eight (90.7%) rated the service as good or very good and 54 (72.0%) felt more satisfied with their pharmacy. Sixty-four patients (85.3%) considered the service as supportive and wanted to continue. Thirty-nine pharmacy staff members (61.9%) answered the online questionnaire. Twenty-four (61.5%) stated that they found it difficult to use and apply the MRRS; twenty-six (66.6%) experienced technical problems. The service was rated good by 16 (41.0%) pharmacy staff members. They regarded the service helpful for some patients and wanted to continue after the end of the study. The majority of the ten interviewed pharmacy owners/managers expressed the opinion that the service was not very suitable for increasing customer loyalty and not cost-effective. Nevertheless, six (60.0%) of them wanted to continue using the service. The MRRS seems to be feasible, apart from technical difficulties. Patients rated the service as supportive, and the personal contact seems to be of high importance; most patients would like to continue the service. However, offering the service to patients turned out to be challenging in daily German community pharmacy practice.

Neuroprotective effect of juçara (Euterpe edulis Martius) fruits extracts against glutamate-induced oxytosis in HT22 hippocampal cells

This study investigated the neuroprotective effect of juçara fruit extracts against glutamate-induced oxytosis in HT22 cells. Potential relationships between the extracts' polyphenolic composition and their protective/antioxidant capacities were also investigated. Experiments with the addition of either the crude methanolic extract or hexane, dichloromethane, ethyl acetate and butanol fractions 24 h before glutamate (pretreatment) and together with glutamate (co-treatment) were performed. At the concentration of 10 μg ml^-1, the hexane and dichloromethane fractions were able to protect cells, both in pretreatment and co-treatment. These fractions presented the highest number of quantified polyphenolics (24 and 21, respectively) although the total levels were 63-fold higher in the dichloromethane fraction. Syringaldehyde, vanillin and 4-aminobenzoic, cinnamic, salicylic and syringic acids were found only in these fractions. The dichloromethane fraction presented higher 2,2-diphenyl-1-picrylhydrazyl radical-scavenging activity, while the butanol and ethyl acetate fractions showed higher ferric reducing antioxidant power. These results suggest juçara fruits extracts as promising for the reduction of the risk of neurodegenerative diseases.

Stark Many-Body Localization

We consider spinless fermions on a finite one-dimensional lattice, interacting via nearest-neighbor repulsion and subject to a strong electric field. In the noninteracting case, due to Wannier-Stark localization, the single-particle wave functions are exponentially localized even though the model has no quenched disorder. We show that this system remains localized in the presence of interactions and exhibits physics analogous to models of conventional many-body localization (MBL). In particular, the entanglement entropy grows logarithmically with time after a quench, albeit with a slightly different functional form from the MBL case, and the level statistics of the many-body energy spectrum are Poissonian. We moreover predict that a quench experiment starting from a charge-density wave state would show results similar to those of Schreiber et al. [Science 349, 842 (2015)SCIEAS0036-807510.1126/science.aaa7432].

Blackberry (Rubus ulmifolius Schott): Chemical composition, phenolic compounds and antioxidant capacity in two edible stages

The berries of the genus Rubus has been highlighted as important source of bioactive and health promoting constituents, however, information about chemical composition and antioxidant potential of the specie Rubus ulmifolius are still scarce. In this regard, this study aimed to assess the physicochemical characteristics, total monomeric anthocyanins (TMA), individual phenolics, minerals, sugars, and antioxidant properties of mature and fully mature R. ulmifolius. With the advance of maturation, changes in the physicochemical composition suggest pleasant characteristics for consumption especially in the fully mature stage. High levels of TMA and sugars (fructose and glucose) were also verified in the fully mature stage, as well as, expressive antioxidant potential, with values of 241.06 μM Fe⁺² g^-1 for ferric reducing antioxidant power and 28.22 mg gallic acid equivalent g^-1 for Folin-Ciocalteu reducing capacity (all expressed in dry matter, DM). In contrast, minerals (potassium, calcium, sodium) and most of the studied phenolic compounds showed the highest concentrations in mature fruits. Among the phenolics investigated, 26 compounds were identified and quercetin and isoquercitrin were the predominant phenolic compounds in the fruit. The results reinforce the nutritive and antioxidant potential of Rubus ulmifolius in both maturation stages studied.

Clinical ethics consultations in psychiatric compared to non-psychiatric medical settings: characteristics and outcomes

BACKGROUND

In the recent years clinical ethics consultations (CEC) received an increasing attention not only in patients with medical conditions but also in those with mental disorders. However, the systematic and empirical knowledge is still small. The aim of this observational study was to investigate whether CECs differ between psychiatric and medical hospital inpatients regarding ethical issues, goals, characteristics, processes, and outcomes.

METHODS

This is a retrospective and in parts prospective analysis of a semi-structured CEC approach provided by the CEC service at a large German general hospital between January 2006 and June 2015.

RESULTS

A total of 259 CECs in three inpatient settings were investigated, i.e. intensive care units (ICU, 43.6%), low care units (LCU, 33.6%), and psychiatric care units (PCU, 22.8%). In all groups, most ethical issues addressed treatment intensity (80.6%) and resulted in over 93% in participants' agreement on final ethical recommendations as well as in high implementation rates (>89%). However, we found significant group differences: In PCUs patients participated more often in the CEC (p < .001), the number of all participants was higher (p < .001), CECs were more time expensive (p < .001), and more recommendations focused on interventions against the patients' declared intention (37.7% versus 0%) than in the other groups.

DISCUSSION

In spite of different clinical characteristics and ethical issues between patients and settings, consensus and implementation of the CEC recommendation could be achieved at a high rate in all groups. There are substantial differences regarding goals, participation of patients, and processes. It is worth considering adapting the CEC to the special needs in psychiatric settings, especially under the aspect of the patients' perspective and involvement.

Apple intake improves antioxidant parameters in hemodialysis patients without affecting serum potassium levels

Oxidative stress (OS) is associated with increased morbidity and mortality in hemodialysis (HD) patients, and the consumption of fruits seems to improve OS due to their antioxidant properties. Therefore, we hypothesized that Fuji apple intake improves OS markers in HD patients due to its polyphenolic compounds without increasing serum potassium levels. This trial was a 1-group, pre- and posttest comparison between 16 patients who had been on hemodialysis for at least 3 months without any acute illness or hyperkalemia. Each volunteer consumed 2 Fuji apples (~360 g) per day for 1 week. Blood samples were collected at the baseline period and after 8 days for the measurement of total antioxidant status, ascorbic acid, catalase, glutathione peroxidase, superoxide dismutase, reduced glutathione, total oxidant status, oxidative stress index, potassium, phosphorus, uric acid, glucose, and fructosamine. For tolerance evaluation, participants were asked about their bowel habits. Apple intake increased glutathione peroxidase (P = .006) and superoxide dismutase activities (P = .006) and ascorbic acid levels (P = .002). No significant changes were observed in uric acid, potassium, phosphorus, glucose, and fructosamine levels. Additionally, there was a decrease in the catalase activity (P = .021) and in the total antioxidant status values (P = .004). However, increased total oxidant status (P = .003) and oxidative stress index (P = .033) levels were observed after apple intake. In conclusion, the intake of 2 Fuji apples per day for 1 week was well tolerated and improved antioxidant parameters in HD patients without affecting serum potassium levels.

Phenolic Compounds Determined by LC-MS/MS and In Vitro Antioxidant Capacity of Brazilian Fruits in Two Edible Ripening Stages

The aim of this study was to investigate the free individual phenolics and the in vitro antioxidant capacity of blackberry, acerola, yellow guava, guabiju, jambolan and jabuticaba fruits in two edible stages. Of the thirty-three phenolics investigated by liquid chromatography - tandem mass spectrometry (LC-MS/MS), twenty-five were quantified and the major ones were catechin, isoquercitrin, epicatechin and gallic acid. The highest values for the total phenolic content (in dry matter) were observed for acerola (83.6 to 97.7 mg gallic acid equivalents g^-1 DM) and blackberry (18.9 to 28.3 mg gallic acid equivalents g^-1 DM); however, acerola, jabuticaba, and blackberry showed the highest antioxidant capacities (134.6 to 1120.4 mg Trolox equivalents g^-1 for 2,2-diphenyl-1-picrylhydrazyl and 43.6 to 501.8 μmol Trolox equivalents g^-1 for ferric reducing antioxidant power). For most fruits, the antioxidant capacity decreased during the ripening, possibly due to a decrease in the concentration of most of the phenolics.

Trends and regional variations in the administrative prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Germany

There is a controversy regarding temporal trends in prevalence of attention-deficit/hyperactivity disorder (ADHD). Using nationwide claims data containing data for approximately six million statutory health insured children we aimed to examine a) trends of ADHD administrative prevalence during 2009-2016; b) regional variations in prevalence, and c) factors associated with an increased chance of ADHD diagnosis. The ICD-10 code 'F90-hyperkinetic disorder' was used to define an ADHD case. Global and Local Moran's I tests were used to examine the spatial autocorrelation and k-means-cluster analysis to examine the course of ADHD prevalence in administrative districts over years. Two-level logistic regression was applied to examine individual- and district-level factors associated with ADHD diagnosis. The administrative prevalence of ADHD was 4.33% (95% CI: 4.31-4.34%). We observed pronounced small-area differences on the district level with prevalences ranging between 1.6% and 9.7%. There was evidence of strong spatial autocorrelation (Global Moran's I: 0.46, p < 0.0001). The k-means-method identified six clusters of different size; all with a stagnating trend in the prevalence over the observation period of eight years. On the district level, a lower proportion of foreign citizens, and a higher density of paediatric psychiatrists and paediatricians were positively associated with ADHD with a more pronounced effect in urban districts.

Fabrication of gadolinium particle-based absorption gratings for neutron grating interferometry

The imaging performance of a neutron-based Talbot-Lau interferometer depends to a great extent on the absorption characteristics of the source and analyzer gratings. Due to its high neutron attenuation, gadolinium (Gd) is the preferred material for grating fabrication, but suffers from difficulties with deposition time, stability, uniformity, and selectivity into high aspect ratio structures. Here we present a simple alternative method of Gd deposition into grating structures based on metallic particle suspension casting and subsequent doctor-blading. Surface analysis by confocal and electron scanning microscopy shows that a nearly clear, particle free silicon interface of the grating structure over a large area could be reached. Additionally, characterization by neutron radiography confirms a high effective Gd height and homogeneity over the whole grating area. In particular, grating trenches well below 10 μm width could be successfully filled with Gd and deliver excellent absorbing performance down to the sub-2 Å wavelength range. The findings confirm that we obtained an effective binary absorption profile for the fabricated gratings which is of great benefit for grating-based neutron imaging.

Neuroendoscopic lavage for the treatment of CSF infection with hydrocephalus in children

OBJECTIVE

The treatment of infectious CSF condition with ventriculitis and hydrocephalus in children is an interdisciplinary challenge. Conventional surgical treatment includes external ventricular drain (EVD) and systemic antibiotic therapy. However, infectious contamination of large ventricles combined with CSF protein overload often requires long treatment regimens. We retrospectively investigated neuroendoscopic lavage as a new option for clearance of CSF in children with hydrocephalus and active CSF infection.

PATIENTS AND METHODS

A database review identified 50 consecutive patients treated for CSF infection with hydrocephalus at our institution. Twenty-seven patients (control group, CG) were treated conventionally between 2004 and 2010, while 23 patients (neuroendoscopic group, NEG) underwent neuroendoscopic lavage for removal of intraventricular debris between 2010 and 2015. Clinical data, microbiology, laboratory measures, shunt dependency, and shunt revision rate were evaluated retrospectively.

RESULTS

The patient groups did not differ regarding basic clinical characteristics. Patients in NEG received neuroendoscopic lavage at mean of 1.6 ± 1times (1-4). No immediate postoperative complications were observed in NEG patients. Shunt rate in NEG patients was 91% as compared 100% in CG patients (p = 0.109). Within 24 months after shunt implantation, incidence of shunt revision was higher in CG (23/27) compared to NEG (5/23; p < 0.001). Reinfection was observed more often in CG (n = 17) compared to one patient in NEG (p < 0.001).

CONCLUSIONS

We experienced that neuroendoscopic lavage is a safe and effective treatment for hydrocephalus in children with infectious conditions. Neuroendoscopic lavage resulted in a decreased number of overall shunt revisions in shunt-depended patients as well as a lower number of recurrent infections.

MRI and sonography in Legg-Calvé-Perthes disease: clinical relevance of containment and influence on treatment

PURPOSE

The containment orientated treatment of Legg-Calvé-Perthes disease (LCPD) affected hip joints is broadly accepted in the literature. The prerequisite is early recognition of loss of containment. An often-used quantitative MRI containment parameter is the cartilaginous acetabulum-head-index (CAHI). Based on ultrasound (US), we analyzed the newly created 'femoral head extrusion angle' (HA) as a containment parameter in comparison with the CAHI in severe LCPD.

METHODS

In a prospective study with 40 children (mean age 5.8 years sd 2.3) with unilateral LCPD classified as Catterall group III/IV, we measured the CAHI versus HA to assess the containment of the femoral head. HA in US was determined by the tangent from the bony acetabular rim to the cartilaginous cranio-lateral femoral head.

RESULTS

The HA was significantly higher in LCPD-affected hip joints (25° sd 7°) than in healthy ones (13° sd 5°; p < 0.001). Correlation analysis of all hip joints revealed a significant correlation between HA and CAHI (r = -0.69; p < 0.001). Hip joints with a low CAHI indicating loss of containment showed a higher HA in sonography.

CONCLUSION

The results of our study suggest that the HA in US is a reliable containment parameter in severe LCPD with a HA > 22° defining a pathologic value. In comparison with the CAHI, HA measurement in ultrasound is easier than the assessment of various parameters to calculate an index. Frequent sonographical follow-up assessment in critical joints is an alternative if MRI is not available, helping to detect an impending loss of containment early enough.

LEVEL OF EVIDENCE

Level II.

A critical and quantitative review of the stratification of particles during the drying of colloidal films

For a wide range of applications, films are deposited from colloidal particles suspended in a volatile liquid. There is burgeoning interest in stratifying colloidal particles into separate layers within the final dry film to impart properties at the surface different to the interior. Here, we outline the mechanisms by which colloidal mixtures can stratify during the drying process. The problem is considered here as a three-way competition between evaporation of the continuous liquid, sedimentation of particles, and their Brownian diffusion. In particle mixtures, the sedimentation of larger or denser particles offers one means of stratification. When the rate of evaporation is fast relative to diffusion, binary mixtures of large and small particles can stratify with small particles on the top, according to physical models and computer simulations. We compare experimental results found in the scientific literature to the predictions of several recent models in a quantitative way. Although there is not perfect agreement between them, some general trends emerge in the experiments, simulations and models. The stratification of small particles on the top of a film is favoured when the colloidal suspension is dilute but when both the concentration of the small particles and the solvent evaporation rate are sufficiently high. A higher particle size ratio also favours stratification by size. This review points to ways that microstructures can be designed and controlled in colloidal materials to achieve desired properties.

The use of a smartphone-assisted ventricle catheter guide for Ommaya reservoir placement-experience of a retrospective bi-center study

BACKGROUND

For intraventricular chemotherapy (IVC) as part of many oncological treatment protocols, Ommaya reservoir is enabling repeated access to the cerebro-spinal fluid (CSF). The correct placement of the catheter in the ventricle is essential for correct application of drugs, which is enabled by sophisticated techniques such as neuronavigation.

OBJECTIVE

In a bi-center retrospective study, we reviewed our experience using a smartphone-assisted ventricle catheter guide as simple solution for correct Ommaya reservoir placement.

METHODS

Sixty Ommaya reservoirs have been placed in 60 patients between 2011 and 2017 with the smartphone-assisted ventricular catheter guidance technique. Patient characteristics, preoperative frontal and occipital horn ratio (FOHR), postoperative catheter position, and complications were assessed.

RESULTS

The majority of our patients (71.6%) have got narrow or slit-like ventricles (FOHR ≤ 0.4). All Ommaya reservoirs were placed successfully. Fifty-eight ventricular catheters (97%) were inserted at the first and 2 (3%) at the second attempt using the same technique. No immediate perioperative complications were observed. All catheters (100%) could be used for IVC. Postoperative imaging was available in 52 patients. Thirty-two (61.5%) of ventricular catheters were rated as grade I, 20 (38.5%) as grade II, and none (0%) as grade III. Four patients (6.7%) showed postoperative complications during a median follow-up of 8.5 months (hydrocephalus, n = 1; infection, n = 1; parenchymal cyst around catheter, n = 1; shunt revision, n = 1).

CONCLUSIONS

The smartphone-assisted guide offers decent accuracy of ventricle catheter placement with ease and simplicity for a small surgical intervention. We propose this technique as routine tool for Ommaya reservoir placement independent of lateral ventricular size to decrease the rate of ventricle catheter malposition as reasonable alternative to a neuronavigation system.

[Prehospital assessment of injury type and severity in severely injured patients by emergency physicians : An analysis of the TraumaRegister DGU®]

BACKGROUND

Prehospital assessment of injury type and severity by emergency medical services physicians impacts treatment including appropriate destination hospital selection, especially in (potentially) life-threatening cases. Injuries which are underestimated or overlooked by the emergency physician can delay adequate therapy and thus significantly influence the overall outcome. The current study used data from the TraumaRegister DGU® to evaluate the reliability of prehospital injury assessments made by emergency physicians.

MATERIAL AND METHODS

Data of 30,777 patients from the TraumaRegister DGU® between 1993 and 2009 were retrospectively evaluated. Using the abbreviated injury scale (AIS), subjective prehospital assessments of injury severity by emergency physicians were correlated with objectively identified injuries diagnosed after admission to hospital. For this evaluation, prehospital injury assessments rated moderate or severe by the emergency physician as well as injuries diagnosed in hospital with an AIS score ≥3 points were deemed relevant.

RESULTS

The 30,777 patients with an injury severity score (ISS) ≥ 9 suffered a total of 202,496 injuries and of these 26 % (51,839 out of 202,496) were considered relevant with an AIS ≥3 points. The most frequent relevant injuries were to the head (47 %) and chest (46 %). Of the 51,839 relevant injuries, the prehospital assessment by the emergency physician was accurate for 71 % and in 29 % of the cases relevant injuries were underestimated. Relevant injuries were unrecognized or underestimated in prehospital assessments for almost 1 out of every 7 cases of head trauma, almost 1 out of every 3 thoracic trauma and almost 1 out of every 2 abdominal and pelvic trauma.

CONCLUSION

The assessment of injury severity by emergency medical services physicians based on physical examination at the scene of the trauma is not very reliable. Thus, mechanisms of injury and overall presentation as well as identifiable injuries and vital parameters should be recognized by the emergency physician when considering treatment strategies and choice of appropriate destination hospital. The patient should be re-evaluated in a priority-oriented manner at the latest on arrival in the trauma room to avoid the consequences of unrecognized or underestimated injuries.

Factors associated with prescribing costs: analysis of a nationwide administrative database

Objective

All health care systems in the world struggle with rising costs for drugs. We sought to explore factors impacting on prescribing costs in a nationwide database of ambulatory care in Germany. Factors identified by this research can be used for adjustment in future profiling efforts.

Methods

We analysed nationwide prescription data of physicians having contractual relationships with statutory health insurance funds in 2014. Predictor and outcome variables were aggregated at the practice level. We performed analyses separately for primary care and specialties of cardiology, gastroenterology, neurology and psychiatry, pulmology as well as oncology and haematology. Bivariate robust regressions and Spearman rank correlations were computed in order to find meaningful predictors for our outcome variable prescription costs per patient.

Results

Median age of patients and proportion of DDD issued were substantial predictors for prescription costs per patient in Primary Care, Cardiology, and Pulmology with explained variances between 41 and 61%. In Neurology and Psychiatry only proportion of patients with polypharmacy ≥ 2 quarters was a significant predictor for prescription costs per patient, explaining 20% of the variance. For gastroenterologists, oncologists and haematologists no stable models could be established.

Conclusions

Any analysis of prescribing behaviour must take the degree into account to which an individual physician or practice is responsible for prescribing patients' medication. Proportion of prescriptions/DDDs is an essential confounder for future studies of drug prescribing.

Quantitative EEG-Befunde im Rahmen einer repetitiven transkraniellen Magnetstimulation bei Depressionen

Quantitative EEG Untersuchungen bei Depressionen weisen auf Asymmetrien der frontalen Alpha power hin, was mit frontalen Dysfunktionen in Zusammenhang gebracht wird. Die repetitive transkranielle Magnetstimulation (rTMS) wird basierend auf Ergebnissen klinischer Studien als wirksame antidepressive Behandlungsmethode bewertet. Frequenzabhängig ist die rTMS in der Lage, kortikale Funktionen inhibitorisch oder fazilitatorisch zu beeinflussen. Da das EEG direkte Aussagen über TMS evozierte Veränderungen neuronaler Aktivität in hoher zeitlicher Auflösung erlaubt, erfolgten in den letzten Jahren kombinierte TMSEEG-Studien. Postuliert werden könnte, dass eine hochfrequente rTMS über dem frontalen Kortex Veränderungen der frontalen Alpha power bei depressiven Patienten bewirkt. Hierzu stellen wir unsere vorläufigen Untersuchungsergebnisse zum qEEG prä und post sowie im Verlauf einer 10-Hzr-TMS-Behandlungsserie über dem linken dorsolateralen präfrontalen Kortex verglichen mit einer Scheinbehandlung vor. Weder im prä-post-Vergleich noch im Verlauf wurde eine Änderung der absoluten power aller Frequenzbänder gefunden. Die Ergebnisse werden in Bezug zu Ergebnissen aus der Literatur diskutiert.