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Faustmann P, Schroeder JC, Mix L, Harland L, Riedel A, Vogel W, Lengerke C, Wirths S. Real-world evidence on tagraxofusp for blastic plasmacytoid dendritic cell neoplasm - collected cases from a single center and case reports. Front Oncol 2024; 14:1384172. [PMID: 38665943 PMCID: PMC11043520 DOI: 10.3389/fonc.2024.1384172] [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: 02/08/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Introduction Blastic plasmacytoid dendritic cell neoplasia (BPDCN) is a rare, aggressive hematologic malignancy. Until recently, the only curative treatment consisted of intensive chemotherapy, followed by hematopoietic cell transplantation (HCT) in eligible adult cases. Tagraxofusp, a CD123-targeted protein-drug conjugate and the first approved targeted treatment for BPDCN, might enhance outcomes especially in patients not eligible for intensive therapies. Methods Here, we report real-world outcomes of five male patients with a median age of 79 years who received tagraxofusp as first-line treatment for BPDCN. Results Tagraxofusp was found to be well-tolerated in this elderly cohort, with only one patient requiring discontinuation. Three patients responded to the treatment (two patients achieved a CR and one patient achieved a partial response), of which two subsequently underwent allogeneic (allo) HCT. One patient is alive and well after ≥ 4 years after alloHCT, and one patient shows sustained CR after now 13 cycles of tagraxofusp. The other three patients died of progressive disease 4-11 months after initiation of treatment. Discussion In line with results from 13 published cases outside clinical trials in the literature, sustained responses were associated with CR after tagraxofusp treatment and subsequent alloHCT. Our results provide real-world evidence for safety and efficacy of tagraxofusp as first-line treatment for BPDCN.
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Riedel A, Faul C, Reuss K, Schröder JC, Lang PJ, Lengerke C, Weissert N, Hengel H, Gröschel S, Schoels L, Bethge WA. Allogeneic hematopoietic cell transplantation for adult metachromatic leukodystrophy: a case series. Blood Adv 2024; 8:1504-1508. [PMID: 38330194 DOI: 10.1182/bloodadvances.2023011836] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024] Open
Abstract
ABSTRACT Metachromatic leukodystrophy (MLD) is a rare genetic disorder caused by pathogenic variants of the ARSA gene, leading to a deficiency of the arylsulfatase A enzyme (ARSA) and consecutive accumulation of galactosylceramide-3-0-sulfate in the nervous system. The condition leads to severe neurological deficits and subsequently results in profound intellectual and motoric disability. Especially, the adult form of MLD, which occurs in individuals aged >16 years, poses significant challenges for treating physicians because of the rarity of cases, limited therapeutic options, and different allogeneic hematopoietic cell transplantation (allo-HCT) protocols worldwide. Here, we report the results of allo-HCT treatment in 4 patients with a confirmed adult MLD diagnosis. Bone marrow or mobilized peripheral progenitor cells were infused after a reduced intensity conditioning regime consisting of fludarabine and treosulfan. In 3 patients, allo-HCT was followed by an infusion of mesenchymal cells to further consolidate ARSA production. We observed a good tolerability and an increase in ARSA levels up to normal range values in all patients. A full donor chimerism was detected in 3 patients within the first 12 months. In a 1-year follow-up, patients with complete donor chimerism showed a neurological stable condition. Only 1 patient with an increasing autologous chimerism showed neurological deterioration and a decline in ARSA levels in the first year. In summary, allo-HCT offers a therapeutic option for reconstituting ARSA enzyme levels in adult patients with MLD, with tolerable side effects.
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Affiliation(s)
- Andreas Riedel
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Tuebingen, Germany
| | - Christoph Faul
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Tuebingen, Germany
| | - Kristina Reuss
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Tuebingen, Germany
| | - Jan C Schröder
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Tuebingen, Germany
| | - Peter J Lang
- Department I, General Pediatrics, Hematology and Oncology, University Children's Hospital Tuebingen, Tuebingen, Germany
| | - Claudia Lengerke
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Tuebingen, Germany
| | - Nadine Weissert
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Tuebingen, Germany
- Department of Neurology and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Holger Hengel
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Tuebingen, Germany
- Department of Neurology and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Samuel Gröschel
- Department III, Neuropediatrics, University Children's Hospital Tuebingen, Tuebingen, Germany
| | - Ludger Schoels
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Tuebingen, Germany
- Department of Neurology and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Wolfgang A Bethge
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Tuebingen, Germany
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Riedel A, Michael M, Grünberg J, Mehralivand S, Böehm K, Hachtel J, Platzek I, Sommer U, Baunacke M, Thomas C, Borkowetz A. The Role of Multiparametric MRI (mpMRI) in the Prediction of Adverse Prostate Cancer Pathology in Radical Prostatectomy Specimen. Urol Int 2024; 108:146-152. [PMID: 38246150 DOI: 10.1159/000536256] [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: 10/14/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Prostate cancer (PCa) risk stratification is essential in guiding therapeutic decision. Multiparametric magnetic resonance tomography (mpMRI) holds promise in the prediction of adverse pathologies (AP) after prostatectomy (RP). This study aims to identify clinical and imaging markers in the prediction of adverse pathology. METHODS Patients with PCa, diagnosed by targeted biopsy after mpMRI and undergoing RP, were included. The predictive accuracy of mpMRI for extraprostatic extension (ECE), seminal vesicle infiltration (SVI), and lymph node positivity was calculated from the final histopathology. RESULTS 846 patients were involved. Independent risk parameters include imaging findings such as ECE (OR 3.12), SVI (OR 2.55), and PI-RADS scoring (4: OR 2.01 and 5: OR 4.34). mpMRI parameters such as ECE, SVI, and lymph node metastases showed a high prognostic accuracy (73.28% vs. 95.35% vs. 93.38%) with moderate sensitivity compared to the final histopathology. The ROC analysis of our combined scoring system (D'Amico classification, PSA density, and MRI risk factors) improves the prediction of adverse pathology (AUC: 0.73 vs. 0.69). CONCLUSION Our study supports the use of mpMRI for comprehensive pretreatment risk assessment in PCa. Due to the high accuracy of factors like ECE, SVI, and PI-RADS scoring, utilizing mpMRI data enabled accurate prediction of unfavorable pathology after RP.
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Affiliation(s)
- Andreas Riedel
- Department of Urology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany,
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Tuebingen, Germany,
| | - Marlene Michael
- Department of Urology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Jenny Grünberg
- Department of Urology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Sherif Mehralivand
- Department of Urology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Katharina Böehm
- Department of Urology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Jakob Hachtel
- Department of Urology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Ivan Platzek
- Department of Radiology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Ulrich Sommer
- Department of Pathology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Martin Baunacke
- Department of Urology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Christian Thomas
- Department of Urology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Angelika Borkowetz
- Department of Urology, Medical Faculty and University Hospital Carl Gustav Carus Dresden, Dresden, Germany
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Klein C, Miczuga T, Röring H, Kost M, Bast N, Thiemann U, Jarczok T, Fleischhaker C, Tebartz van Elst L, Riedel A, Biscaldi M. Sensorische Auffälligkeiten bei
Autismus-Spektrum-Störung: Validierung und Adaptation des
englischsprachigen „Sensory Perception Quotient“ (SPQ) von
Tavassoli und Kollegen. Fortschr Neurol Psychiatr 2024; 92:11-18. [PMID: 36070771 DOI: 10.1055/a-1839-6095] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Although the DSM-5 has emphasised the relevance of sensory abnormalities in autism spectrum disorders (ASD), there are hardly any measures to assess them in German speaking countries. The present study translated the "Sensory Perception Questionnaire" (SPQ) by Tavassoli et al. (2014) to German and validated this scale. The SPQ is a self-rating scale for adults which focuses on perceptual aspects rather than cognitive or motivational antecedents or consequences of such perceptual processes. A total of 188 subjects participated in this study, including n=85 participants with ASD and n=103 neurotypical controls. The autism spectrum quotient (AQ) and the empathy quotient (EQ) were also administered, the IQ was measured using the CFT20-R, and participants were clinically evaluated using the SKID-I. Alternative items were generated to improve the semantic and psychometric properties of the SPQ. Of the 92 original SPQ items, 33 separated the clinical groups significantly and linguistically clearly in the sense of sensory hyper-sensitivity. These items covered primarily the sensory modalities of hearing, touch and vision. Increased sensory hyper-sensitivity was associated with greater scores in the AQ and increased slightly with increasing age. Sensory hyper-sensitivity in participants with ASD was, however, not significantly correlated with the EQ and the IQ. Due to the item-analytical rather than dimensional item selection, the short versions presented here exhibit a clearly better group separation with comparable concurrent validities when compared to Tavassoli's short version of the scale. Pending replication and proper norming, the SPQ short version presented here can be employed for screening purposes and supplement the clinical diagnostic process.
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Affiliation(s)
- Christoph Klein
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Freiburg
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Köln
- Abteilung für Psychiatrie 2, Nationale Universität Athen
| | - Teresa Miczuga
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Freiburg
| | - Hannah Röring
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Freiburg
| | - Marie Kost
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Freiburg
| | - Nico Bast
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Frankfurt
| | - U Thiemann
- Abteilung für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, LVR-Klinik Bonn
| | - TomaszA Jarczok
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Frankfurt
| | - C Fleischhaker
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Freiburg
| | - Ludger Tebartz van Elst
- Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Universitätsklinikum Freiburg
| | - Andreas Riedel
- Luzerner Psychiatrie, Ambulante Dienste, Luzern, Schweiz
| | - Monica Biscaldi
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universitätsklinikum Freiburg
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Baumann F, Bergamaschi V, Warnke I, Corbisiero S, Felleiter KG, Fellmann S, Ludwig F, Riedel A, Znoj H, Schmidt S. Study protocol of an observational study in acute psychiatric home treatment: How does home treatment work? Identification of common factors and predictors of treatment success. Neuropsychiatr 2023; 37:214-220. [PMID: 36941465 DOI: 10.1007/s40211-023-00457-0] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/21/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Systematic reviews indicated that home treatment is an effective and cost-saving alternative to conventional acute psychiatric treatment options. Treatment success has often been defined as a reduction of hospital admissions. In the current study, symptoms and well-being are assessed regularly during treatment as an indicator for treatment success. Patients' characteristics such as diagnosis, age, substance use, and motivation for treatment were discussed as predictors for treatment success. A second focal point of the study lies in the examination of the therapeutic relationship in terms of the outcome, which has not yet been systematically investigated in home treatment. METHODS This is an observational study with a prospective naturalistic design. Measurements are carried out at baseline, during and at the end of treatment as well as at the 3‑month follow-up. Patients' characteristics as potential predictors for treatment success will be assessed at baseline. In addition, the perceived relationship between the patients and the team will be measured daily and weekly throughout the treatment. Treatment success is by the changes in symptoms and general well-being assessed weekly. We aim to include 82 participants assigned to home treatment. Variance analyses with repeated measurements will be conducted to evaluate treatment success. CONCLUSION By examining potential patient- and relationship-related predictors of treatment success, insights into relevant determining variables of treatment success in this setting are expected. The results might help to better identify who benefits the most from home treatment.
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Affiliation(s)
- Felix Baumann
- Institute of Psychology, University of Berne, Berne, Switzerland.
- GiA Stadt, Lucerne Psychiatry, Voltastr. 42, 6005, Lucerne, Switzerland.
| | - Vera Bergamaschi
- Institute of Psychology, University of Berne, Berne, Switzerland.
- GiA Stadt, Lucerne Psychiatry, Voltastr. 42, 6005, Lucerne, Switzerland.
| | | | | | | | | | | | | | - Hansjörg Znoj
- Institute of Psychology, University of Berne, Berne, Switzerland
| | - Stefanie Schmidt
- Institute of Psychology, University of Berne, Berne, Switzerland
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Maier S, Düppers AL, Runge K, Dacko M, Lange T, Fangmeier T, Riedel A, Ebert D, Endres D, Domschke K, Perlov E, Nickel K, Tebartz van Elst L. Increased prefrontal GABA concentrations in adults with autism spectrum disorders. Autism Res 2022; 15:1222-1236. [PMID: 35587691 DOI: 10.1002/aur.2740] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 11/16/2021] [Accepted: 04/28/2022] [Indexed: 11/10/2022]
Abstract
The excitatory-inhibitory imbalance hypothesis postulates dysregulation of the gamma-aminobutyric acid (GABA) and glutamate (Glu) neurotransmitter systems as a common underlying deficit in individuals with autism spectrum disorders (ASD). Previous studies suggest an important role of these systems in the pathophysiology of ASD, including a study of our group reporting decreased glutamate concentrations in the pregenual anterior cingulate cortex (ACC) of adults with ASD. The aim of this study was to replicate our previous findings of impaired glutamate metabolism in ASD in a new sample and to additionally quantify GABA in the ACC and dorsolateral prefrontal cortex (dlPFC). Concentrations of GABA and glutamate-glutamine (Glx; combined glutamate and glutamine signal) were quantified in the ACC and dlPFC of 43 adults with ASD and 43 neurotypical controls (NTC) by magnetic resonance spectroscopy (MRS). The ASD group showed increased absolute GABA concentrations and elevated GABA/creatine ratios in the left dlPFC compared to NTC, while no group differences were detected in the pregenual and dorsal ACC. Previous findings of altered Glx concentration in the pregenual ACC of the ASD group could not be replicated. Regarding Glx concentrations and Glx/creatine ratios, there were no significant differences in the dlPFC and ACC either. The study supports the hypothesis of an altered GABA and glutamate equilibrium, indicating an imbalance between excitatory and inhibitory metabolism in ASD patients. However, inconsistent results across studies and brain regions suggest a complex underlying phenomenon. LAY SUMMARY: Adults of the autism spectrum exhibit elevated levels of the inhibitory neurotransmitter GABA in the left dorsolateral prefrontal cortex. This finding supports the hypothesis of an imbalance between excitatory and inhibitory equilibrium in patients with autism spectrum disorders.
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Affiliation(s)
- Simon Maier
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Kimon Runge
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Dacko
- Department of Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Lange
- Department of Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Fangmeier
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Riedel
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Luzerner Psychiatrie, Ambulante Dienste, Luzern, Switzerland
| | - Dieter Ebert
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Evgeniy Perlov
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Clinic for Psychiatry Luzern, Hospital St. Urban, St. Urban, Switzerland
| | - Kathrin Nickel
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Ganser K, Eckert F, Riedel A, Stransky N, Paulsen F, Noell S, Krueger M, Schittenhelm J, Beck-Wödl S, Zips D, Ruth P, Huber SM, Klumpp L. Patient-individual phenotypes of glioblastoma stem cells are conserved in culture and associate with radioresistance, brain infiltration and patient prognosis. Int J Cancer 2022; 150:1722-1733. [PMID: 35085407 DOI: 10.1002/ijc.33950] [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] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/30/2021] [Accepted: 01/12/2022] [Indexed: 11/08/2022]
Abstract
Identification of prognostic or predictive molecular markers in glioblastoma resection specimens may lead to strategies for therapy stratification and personalized treatment planning. Here, we analyzed in primary glioblastoma stem cell (pGSC) cultures the mRNA abundances of 7 stem cell (MSI1, Notch1, nestin, Sox2, Oct4, FABP7, ALDH1A3), and 3 radioresistance or invasion markers (CXCR4, IKCa , BKCa ). From these abundances, an mRNA signature was deduced which describes the mesenchymal-to-proneural expression profile of an individual GSC culture. To assess its functional significance, we associated the GSC mRNA signature with the clonogenic survival after irradiation with 4 Gy and the fibrin matrix invasion of the GSC cells. In addition, we compared the molecular pGSC mRNA signature with the tumor recurrence pattern and the overall survival of the glioblastoma patients from whom the pGSC cultures were derived. As a result, the molecular pGSC mRNA signature correlated positively with the pGSC radioresistance and matrix invasion capability in vitro. Moreover, patients with a mesenchymal (> median) mRNA signature in their pGSC cultures exhibited predominantly a multifocal tumor recurrence and a significantly (univariate log rank test) shorter overall survival than patients with proneural (≤ median mRNA signature) pGSCs. The tumors of the latter recurred predominately unifocally. We conclude that our pGSC cultures induce/select those cell subpopulations of the heterogeneous brain tumor that determine disease progression and therapy outcome. In addition, we further postulate a clinically relevant prognostic/predictive value for the 10 mRNAs-based mesenchymal-to-proneural signature of the GSC subpopulations in glioblastoma.
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Affiliation(s)
- Katrin Ganser
- Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Franziska Eckert
- Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Andreas Riedel
- Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Nicolai Stransky
- Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tübingen, Auf der Morgenstelle 8, 72076, Tübingen, Germany
| | - Frank Paulsen
- Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Susan Noell
- Department of Neurosurgery, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Marcel Krueger
- Preclinical Imaging and Radiopharmacy, Werner Siemens Imaging Center, University of Tübingen, Röntgenweg 13, 72076, Tübingen, Germany
| | - Jens Schittenhelm
- Department of Neuropathology, Calwerstr. 3, 72076, Tübingen, Germany
| | - Stefanie Beck-Wödl
- Institute of Medical Genetics und Applied Genomics, University of Tübingen, Calwerstr. 6, 72076, Tübingen, Germany
| | - Daniel Zips
- Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Peter Ruth
- Department of Pharmacology, Toxicology and Clinical Pharmacy, Institute of Pharmacy, University of Tübingen, Auf der Morgenstelle 8, 72076, Tübingen, Germany
| | - Stephan M Huber
- Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Lukas Klumpp
- Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
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8
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Klein C, Miczuga T, Kost MS, Röring H, Jarczok TA, Bast N, Thiemann U, Fleischhaker C, Tebartz Van Elst L, Riedel A, Biscaldi M. An German Short-Version of the "Sensory Perception Quotient" for Adults With Autism Spectrum Disorder. Front Psychiatry 2022; 13:781409. [PMID: 35774088 PMCID: PMC9238434 DOI: 10.3389/fpsyt.2022.781409] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Sensory features in autism spectrum disorder (ASD) have received increasing interest in clinical work and research during the recent years. With the Sensory Perception Quotient (SPQ), Tavasolli and colleagues have produced a self-rating scale for adults with ASD that measures sensory hyper-sensitivity in different sensory modalities, without also tapping cognitive or motivational aspects that precede or follow autistic sensory experiences. Here, we present the results of a translation of the SPQ to German and its short version as well as their validation in samples of autistic or neuro-typical participants. We, furthermore, present the psychometric properties and validities of Tavasolli's original SPQ-short version as well as an alternative short version based on different psychometric item-selection criteria. We can show here that our alternative SPQ-short version, overlapping with the original short-version in 61% of its items, exhibits superior reliabilities, reasonable concurrent validities with other related measures. It, furthermore, exhibits excellent differentiation between autistic and non-autistic samples, underscoring its utility as a screening instrument in research and a clinical instrument to supplement the ASD diagnostic process.
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Affiliation(s)
- Christoph Klein
- Clinic for Psychiatry, Psychosomatics und Psychotherapy in Children Adolescents, Medical Faculty, University Hospital Freiburg, Freiburg, Germany.,Clinic for Psychiatry, Psychosomatics und Psychotherapy in Children and Adolescents, Medical Faculty, University Hospital Cologne, Cologne, Germany.,Second Psychiatry Department, National and Kapodistrian University of Athens, Medical School, University General Hospital "ATTIKON, " Athens, Greece
| | - Teresa Miczuga
- Clinic for Psychiatry, Psychosomatics und Psychotherapy in Children Adolescents, Medical Faculty, University Hospital Freiburg, Freiburg, Germany
| | - Marie Sophie Kost
- Clinic for Psychiatry, Psychosomatics und Psychotherapy in Children Adolescents, Medical Faculty, University Hospital Freiburg, Freiburg, Germany
| | - Hannah Röring
- Clinic for Psychiatry, Psychosomatics und Psychotherapy in Children Adolescents, Medical Faculty, University Hospital Freiburg, Freiburg, Germany
| | - Tomasz A Jarczok
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany
| | - Nico Bast
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany
| | - Ulf Thiemann
- Clinic for Psychiatry, Psychosomatics und Psychotherapy in Children and Adolescents, Medical Faculty, University Hospital Cologne, Cologne, Germany.,Clinic for Psychiatry, Psychosomatics und Psychotherapy in Children and Adolescents, LVR Hospital, Bonn, Germany
| | - Christian Fleischhaker
- Clinic for Psychiatry, Psychosomatics und Psychotherapy in Children Adolescents, Medical Faculty, University Hospital Freiburg, Freiburg, Germany
| | - Ludger Tebartz Van Elst
- Clinic for Psychiatry und Psychotherapy, Medical Faculty, University Hospital Freiburg, Freiburg, Germany
| | - Andreas Riedel
- Clinic for Psychiatry und Psychotherapy, Medical Faculty, University Hospital Freiburg, Freiburg, Germany.,Clinic for Psychiatry, Medical Faculty, University of Luzern, Lucerne, Switzerland
| | - Monica Biscaldi
- Clinic for Psychiatry, Psychosomatics und Psychotherapy in Children Adolescents, Medical Faculty, University Hospital Freiburg, Freiburg, Germany
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9
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Wahl K, van den Hout M, Heinzel CV, Kollárik M, Meyer A, Benoy C, Berberich G, Domschke K, Gloster A, Gradwohl G, Hofecker M, Jähne A, Koch S, Külz AK, Moggi F, Poppe C, Riedel A, Rufer M, Stierle C, Voderholzer U, Walther S, Lieb R. Rumination about obsessive symptoms and mood maintains obsessive-compulsive symptoms and depressed mood: An experimental study. J Abnorm Psychol 2021; 130:435-442. [PMID: 34472881 DOI: 10.1037/abn0000677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Rumination is common in individuals diagnosed with obsessive-compulsive disorder (OCD). We sought to clarify the causal role of rumination in the immediate and intermediate maintenance of obsessive-compulsive symptoms and depressed mood. In total, 145 individuals diagnosed with OCD were asked to read aloud their most distressing obsessive thought (OT). OT activation was followed by a thought-monitoring phase in which frequency of the OT was assessed. Participants were randomly allocated to one of three experimental conditions: rumination about obsessive-compulsive symptoms, rumination about mood, or distraction. Ratings of distress, urge to neutralize, and depressed mood and frequency ratings of the OTs were taken before and after the experimental manipulation. Obsessive-compulsive symptom severity and affect were assessed 2, 4, and 24 hr after the laboratory experiment using ecological momentary assessment. Compared to distraction, both types of rumination resulted in an immediate reduced decline of distress, urge to neutralize, depressed mood, and frequency of OTs, with medium to large effect sizes. Rumination about obsessive-compulsive symptoms did not have a stronger immediate effect than rumination about mood. Rumination about obsessive-compulsive symptoms increased obsessive-compulsive symptom severity and reduced positive affect compared to rumination about mood 24 hr later. Regarding negative affect, there was no difference in effect between the two types of rumination in the intermediate term. To conclude, rumination in OCD has an immediate and intermediate maintaining effect on obsessive-compulsive symptoms and mood and may require additional psychological interventions that supplement cognitive behavioral therapy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Michael Rufer
- Department of Psychiatry, Psychotherapy and Psychosomatics
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10
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Riedel A, Klumpp L, Menegakis A, De-Colle C, Huber SM, Schittenhelm J, Neumann M, Noell S, Tatagiba M, Zips D. γH2AX foci assay in glioblastoma: Surgical specimen versus corresponding stem cell culture. Radiother Oncol 2021; 159:119-125. [PMID: 33775712 DOI: 10.1016/j.radonc.2021.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/29/2020] [Revised: 12/02/2020] [Accepted: 03/17/2021] [Indexed: 11/29/2022]
Abstract
AIM To assess radiation response using γH2AX assay in surgical specimens from glioblastoma (GB) patients and their corresponding primary gliosphere culture. To test the hypothesis that gliospheres (stem cell enriched) are more resistant than specimens (bulky cell dominated) but that the interpatient heterogeneity is similar. MATERIAL AND METHODS Ten pairs of specimens and corresponding gliospheres derived from patients with IDH-wildtype GB were studied. Specimens and gliospheres were irradiated with graded doses and after 24 h the number of residual γH2AX foci was counted. RESULTS Gliospheres showed a higher Nestin expression than specimens and exhibited two different phenotypes: free floating (n = 7) and attached (n = 3). Slope analysis revealed an interpatient heterogeneity with values between 0.15 and 1.30 residual γH2AX foci/Gy. Free-floating spheres were more resistant than their parental specimens (median slope 0.13 foci/Gy versus 0.53) as well as than the attached spheres (2.14). The slopes of free floating spheres did not correlate with their corresponding specimens while a trend for a positive correlation was found for the attached spheres and the respective specimens. Association with MGMT did not reach statistical significance. CONCLUSION Consistent with the clinical phenotype and our previous experiments, GB specimens show low radiation sensitivity. Stem-cell enriched free-floating gliospheres were more resistant than specimens supporting the concept of radioresistance in stem cell-like cells. The lack of correlation between specimens and their respective gliosphere cultures needs validation and may have a profound impact on future translational studies using γH2AX as a potential biomarker for personalized radiation therapy.
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Affiliation(s)
- Andreas Riedel
- Radiation Oncology, Medical Faculty and University Hospital Tübingen, Germany
| | - Lukas Klumpp
- Radiation Oncology, Medical Faculty and University Hospital Tübingen, Germany
| | - Apostolos Menegakis
- Netherlands Cancer Institute, Division of Cell Biology, Amsterdam, The Netherlands
| | - Chiara De-Colle
- Radiation Oncology, Medical Faculty and University Hospital Tübingen, Germany
| | - Stephan M Huber
- Radiation Oncology, Medical Faculty and University Hospital Tübingen, Germany
| | - Jens Schittenhelm
- Division of Neuropathology, Medical Faculty and University Hospital Tübingen, Germany
| | - Manuela Neumann
- Division of Neuropathology, Medical Faculty and University Hospital Tübingen, Germany
| | - Susan Noell
- Department of Neurosurgery, Medical Faculty and University Hospital Tübingen, Germany
| | - Marcos Tatagiba
- Department of Neurosurgery, Medical Faculty and University Hospital Tübingen, Germany
| | - Daniel Zips
- Radiation Oncology, Medical Faculty and University Hospital Tübingen, Germany; German Cancer Consortium (DKTK), Partner Site Tübingen, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany.
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11
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Riedel A, Maier S, Wenzler K, Feige B, Tebartz van Elst L, Bölte S, Neufeld J. A case of co-occuring synesthesia, autism, prodigious talent and strong structural brain connectivity. BMC Psychiatry 2020; 20:342. [PMID: 32605557 PMCID: PMC7329514 DOI: 10.1186/s12888-020-02722-w] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 06/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Synesthesia is a sensory phenomenon where certain domain-specific stimuli trigger additional sensations of e.g. color or texture. The condition occurs in about 4% of the general population, but is overrepresented in individuals with Autism Spectrum Disorder (ASD), where it might also be associated with the presence of prodigious talents. CASE PRESENTATION Here we describe the case of a young transsexual man with Asperger Syndrome, synesthesia and a prodigious talent for foreign language acquisition. In our case, not only letters, numbers, spoken words, music, noises, weekdays and months lead to highly consistent, vivid color sensations but also his own and others' emotions, geometric shapes, any mathematical symbol, and letters from an unfamiliar alphabet (Hebrew). These color associations seem to aid categorization, differentiation and storage of information and might thereby contribute to the young man's language acquisition ability. We investigated the young man's structural brain connectivity in comparison to adults with or without ASD, applying global fiber tracking to diffusion-weighted Magnetic Resonance Imaging (MRI) data. The case presented with increased connectivity, especially between regions involved in visual and emotion processing, memory, and higher order associative binding regions. An electroencephalography experiment investigating synesthetic color and shape sensations while listening to music showed a negligible occipital alpha suppression, indicating that these internally generated synesthetic sensations derive from a different brain mechanism than when processing external visual information. CONCLUSIONS Taken together, this case study endorses the notion of a link between synesthesia, prodigious talent and autism, adding to the currently still sparse literature in this field. It provides new insights into the possible manifestations of synesthesia in individuals with ASD and its potential contribution to prodigious talents in people with an otherwise unexceptional cognitive profile. Additionally, this case impressively illustrates how synesthesia can be a key element not only of sensory perception but also social and emotional processing and contributes to existing evidence of increased brain connectivity in association with synesthesia.
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Affiliation(s)
- Andreas Riedel
- grid.7708.80000 0000 9428 7911Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Simon Maier
- grid.7708.80000 0000 9428 7911Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Kerstin Wenzler
- grid.7708.80000 0000 9428 7911Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Bernd Feige
- grid.7708.80000 0000 9428 7911Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- grid.7708.80000 0000 9428 7911Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Sven Bölte
- grid.4714.60000 0004 1937 0626Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden ,grid.1032.00000 0004 0375 4078Curtin Autism Research Group, Essential Partner Autism CRC, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia ,grid.467087.a0000 0004 0442 1056Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Janina Neufeld
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
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12
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Ioannou C, Seernani D, Stefanou ME, Riedel A, Tebartz van Elst L, Smyrnis N, Fleischhaker C, Biscaldi-Schaefer M, Boccignone G, Klein C. Comorbidity Matters: Social Visual Attention in a Comparative Study of Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder and Their Comorbidity. Front Psychiatry 2020; 11:545567. [PMID: 33192661 PMCID: PMC7555692 DOI: 10.3389/fpsyt.2020.545567] [Citation(s) in RCA: 4] [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: 03/25/2020] [Accepted: 08/19/2020] [Indexed: 12/20/2022] Open
Abstract
Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) represent two common neurodevelopmental disorders with considerable co-occurrence. Their comorbidity (ASD + ADHD) has been included in the latest diagnostic guidelines (DSM-V, 2013). The present study focuses on social visual attention that i) is a main aspect of social attention reflecting social cognition and ii) its atypicalities have been suggested as a potential biomarker for ASD. Considering the possible shared background of both disorders and their comorbidity, it is important to compare such traits directly. Here, 73 children and adolescents paired for age and IQ diagnosed with ASD (N = 12), ADHD (N = 21), comorbid ASD + ADHD (N = 15), and "typically developing" (TD) controls (N = 25), were shown static real-life social scenes while their gaze movements were recorded with eye-tracking. Scenes with two levels of social complexity were presented: low complexity (one person depicted) and high (four interacting individuals). Gaze fixation variables were investigated. Fixation duration on faces was significantly reduced only in ASD + ADHD which also required longer time to fixate all faces at least once. Fixation duration on faces in ASD was reduced, compared to TD, only when looking at scenes with high versus low social complexity. ADHD individuals did not differ from TD. Concluding, the observed alterations of social visual attention support the existence of possible dysfunctional particularities differentiating ASD, ADHD, and ASD + ADHD, which can be revealed with the new method of eye-tracking technique. The objective gaze measurements provided contribute to the development of biomarkers enabling early diagnosis, amelioration of care and further interventions specified for each group.
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Affiliation(s)
- Chara Ioannou
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Divya Seernani
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Maria Elena Stefanou
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany.,School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Andreas Riedel
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Nikolaos Smyrnis
- Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Christian Fleischhaker
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Monica Biscaldi-Schaefer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | | | - Christoph Klein
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany.,Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.,Department of Child and Adolescent Psychiatry, University Hospital Cologne, Cologne, Germany
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13
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Maier S, Tebartz van Elst L, Perlov E, Düppers AL, Nickel K, Fangmeier T, Endres D, Riedel A. Cortical properties of adults with autism spectrum disorder and an IQ>100. Psychiatry Res Neuroimaging 2018; 279:8-13. [PMID: 30031235 DOI: 10.1016/j.pscychresns.2018.06.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 11/23/2017] [Revised: 06/20/2018] [Accepted: 06/23/2018] [Indexed: 11/29/2022]
Abstract
Previous studies on cortical volume and thickness measures in autism spectrum disorders (ASD) show inconsistent results. We acquired structural magnetic resonance images of 30 individuals with ASD and individually matched controls and extracted surface-based and deformation-based morphometry measures. All participants had an IQ>100. Neither surface-based cortical thickness nor deformation based gyrification measures differed significantly across groups. Significant decreases but no increases of the gyrification index and sulcus depth could only be observed in the ASD group before correcting for multiple comparisons. This finding suggests that possible cortical anomalies in ASD are either weak or, given the heterogeneity of findings in earlier studies, might only apply to small ASD-subgroups.
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Affiliation(s)
- Simon Maier
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany; Freiburg Center for Diagnosis and Treatment of Autism, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany.
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany; Freiburg Center for Diagnosis and Treatment of Autism, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany
| | - Evgeniy Perlov
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany; Luzerner Psychiatrie, Hospital St. Urban, Schafmattstrasse 1, CH-4915 St. Urban, Switzerland
| | - Ansgard Lena Düppers
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany
| | - Kathrin Nickel
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany
| | - Thomas Fangmeier
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany; Freiburg Center for Diagnosis and Treatment of Autism, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany
| | - Dominique Endres
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany; Freiburg Center for Diagnosis and Treatment of Autism, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany
| | - Andreas Riedel
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany; Freiburg Center for Diagnosis and Treatment of Autism, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, Freiburg D-79104, Germany
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14
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Nickel K, Tebartz van Elst L, Domschke K, Gläser B, Stock F, Endres D, Maier S, Riedel A. Heterozygous deletion of SCN2A and SCN3A in a patient with autism spectrum disorder and Tourette syndrome: a case report. BMC Psychiatry 2018; 18:248. [PMID: 30071822 PMCID: PMC6090917 DOI: 10.1186/s12888-018-1822-8] [Citation(s) in RCA: 6] [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: 11/28/2017] [Accepted: 07/19/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mutations in voltage-gated sodium channel (SCN) genes are supposed to be of importance in the etiology of psychiatric and neurological diseases, in particular in the etiology of seizures. Previous studies report a potential susceptibility region at the chromosomal locus 2q including SCN1A, SCN2A and SCN3A genes for autism spectrum disorder (ASD). To date, there is no previous description of a patient with comorbid ASD and Tourette syndrome showing a deletion containing SCN2A and SCN3A. CASE PRESENTATION We present the unique complex case of a 28-year-old male patient suffering from developmental retardation and exhibiting a range of behavioral traits since birth. He received the diagnoses of ASD (in early childhood) and of Tourette syndrome (in adulthood) according to ICD-10 and DSM-5 criteria. Investigations of underlying genetic factors yielded a heterozygous microdeletion of approximately 719 kb at 2q24.3 leading to a deletion encompassing the five genes SCN2A (exon 1 to intron 14-15), SCN3A, GRB14 (exon 1 to intron 2-3), COBLL1 and SCL38A11. CONCLUSIONS We discuss the association of SCN2A, SCN3A, GRB14, COBLL1 and SCL38A11 deletions with ASD and Tourette syndrome and possible implications for treatment.
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Affiliation(s)
- Kathrin Nickel
- Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, D-79104, Freiburg, Germany.
| | - Ludger Tebartz van Elst
- grid.5963.9Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany
| | - Katharina Domschke
- grid.5963.9Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany
| | - Birgitta Gläser
- grid.5963.9Institute of Human Genetics, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 33, D-79106 Freiburg, Germany
| | - Friedrich Stock
- grid.5963.9Institute of Human Genetics, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 33, D-79106 Freiburg, Germany
| | - Dominique Endres
- grid.5963.9Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany
| | - Simon Maier
- grid.5963.9Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany
| | - Andreas Riedel
- grid.5963.9Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany
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15
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Best V, Riedel A, Feige B, Tebartz van Elst L, Riemann D, Spiegelhalder K. Subjektive schlafbezogene Parameter bei Patienten mit Autismus-Spektrum-Störung. Somnologie 2018. [DOI: 10.1007/s11818-018-0156-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Nickel K, Tebartz van Elst L, Manko J, Unterrainer J, Rauh R, Klein C, Endres D, Kaller CP, Mader I, Riedel A, Biscaldi M, Maier S. Inferior Frontal Gyrus Volume Loss Distinguishes Between Autism and (Comorbid) Attention-Deficit/Hyperactivity Disorder-A FreeSurfer Analysis in Children. Front Psychiatry 2018; 9:521. [PMID: 30405459 PMCID: PMC6206215 DOI: 10.3389/fpsyt.2018.00521] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/02/2018] [Indexed: 01/23/2023] Open
Abstract
Objective: Autism spectrum (ASD) and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with a high rate of comorbidity. To date, diagnosis is based on clinical presentation and distinct reliable biomarkers have been identified neither for ASD nor ADHD. Most previous neuroimaging studies investigated ASD and ADHD separately. Method: To address the question of structural brain differences between ASD and ADHD, we performed FreeSurfer analysis in a sample of children with ADHD (n = 30), with high-functioning ASD (n = 14), with comorbid high-functioning ASD and ADHD (n = 15), and of typically developed controls (TD; n = 36). With FreeSurfer, an automated brain imaging processing and analyzing suite, we reconstructed the cerebral cortex and calculated gray matter volumes as well as cortical surface parameters in terms of cortical thickness and mean curvature. Results: A significant main effect of the factor ADHD was detected for the left inferior frontal gyrus (Pars orbitalis) volume, with the ADHD group exhibiting smaller Pars orbitalis volumes. Dimensional measures of autism (SRS total raw score) and ADHD (DISYPS-II FBB-ADHD score) had no significant influence on the left Pars orbitalis volume. Both, ASD and ADHD tended to have an effect on cortical thickness or mean curvature, which did not survive correction for multiple comparisons. Conclusion: Our results underline that ADHD rather than ASD is associated with volume loss in the left inferior frontal gyrus (Pars orbitalis). This area might play a relevant role in modulating symptoms of inattention and/or impulsivity in ADHD. The effect of comorbid ADHD in ASD samples and vice versa, on cortical thickness and mean curvature, requires further investigation in larger samples.
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Affiliation(s)
- Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Jacek Manko
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Josef Unterrainer
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Reinhold Rauh
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Christoph Klein
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Christoph P Kaller
- Department of Neurology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Irina Mader
- Department of Neuroradiology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Andreas Riedel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Monica Biscaldi
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Simon Maier
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
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17
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Nickel K, Tebartz van Elst L, Perlov E, Endres D, Müller GT, Riedel A, Fangmeier T, Maier S. Altered white matter integrity in adults with autism spectrum disorder and an IQ >100: a diffusion tensor imaging study. Acta Psychiatr Scand 2017; 135:573-583. [PMID: 28407202 DOI: 10.1111/acps.12731] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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] [Accepted: 03/13/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE White matter (WM) alterations have been reported in children and adults with autism spectrum disorder (ASD). In particular, impaired connectivity of limbic structures may be related to social deficits. Heterogeneous findings could be explained in terms of differences in sample characteristics and methodology. In this context, non-syndromic forms might differ substantially in WM structure from secondary ASD forms. METHOD In an attempt to recruit a homogeneous study sample, we included adults with high-functioning ASD and an IQ > 100 to decrease the influence of syndromic forms being often associated with cognitive deficits. Diffusion tensor imaging (DTI) was performed in 30 participants with ASD and 30 pairwise-matched controls. Fractional anisotropy (FA) and mean diffusivity (MD) as surrogate imaging markers for WM integrity were calculated. RESULTS We found a significant FA decrease in the ASD group in the genu and body of the corpus callosum (CC). Increased MD was detected in the subgenual anterior cingulate cortex (sACC). CONCLUSION The finding of decreased WM integrity in the genu of the CC is in line with earlier studies reporting a decreased number of interhemispheric fibers in the frontal lobe of ASD. Alterations in the sACC might be associated with 'Theory of mind' deficits.
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Affiliation(s)
- K Nickel
- Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany
| | - L Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany
| | - E Perlov
- Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany.,Luzerner Psychiatrie, Hospital St. Urban, St. Urban, Switzerland
| | - D Endres
- Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany
| | - G T Müller
- Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany
| | - A Riedel
- Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany
| | - T Fangmeier
- Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany
| | - S Maier
- Section for Experimental Neuropsychiatry, Department for Psychiatry & Psychotherapy, Medical Center - University of Freiburg, Freiburg, Germany
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Endres D, Maier S, Feige B, Posielski NA, Nickel K, Ebert D, Riedel A, Philipsen A, Perlov E, Tebartz van Elst L. Altered Intermittent Rhythmic Delta and Theta Activity in the Electroencephalographies of High Functioning Adult Patients with Autism Spectrum Disorder. Front Hum Neurosci 2017; 11:66. [PMID: 28265243 PMCID: PMC5316544 DOI: 10.3389/fnhum.2017.00066] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/31/2017] [Indexed: 12/27/2022] Open
Abstract
Background: Autism spectrum disorder (ASD) is often associated with epilepsy. Previous studies have also shown increased rates of electroencephalographic (EEG) alteration in ASD patients without epilepsy. The aim of this study was to compare the rate of intermittent rhythmic delta and theta activity (IRDA/IRTA) events between high-functioning adult patients with ASD and matched healthy controls. Materials and Methods: Routine EEG records of 19 ASD patients and 19 matched controls were screened for IRDA/IRTA using a fully data driven analysis with fixed thresholds. IRDA/IRTA rates before and after hyperventilation (HV) as well as the HV-induced difference in IRDA/IRTA rates (HV difference) were analyzed. For inter-group measures, we used the Wilcoxon rank sum test. Results: Significantly increased HV difference was detected in the ASD group (p = 0.0497). However, the groups showed no difference in IRDA/IRTA rates before HV (p = 0.564) and after HV (p = 0.163). Conclusions: The lack of any group differences regarding IRDA/IRTA before HV might be related to the fact that we only studied non-secondary high-functioning autism in a small sample of epilepsy-free adult patients. A significantly increased HV difference might be regarded as a marker of subtle neuronal network instability possibly causing short-term disturbances via local area network inhibition and long-term effects via epileptic encephalopathy.
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Affiliation(s)
- Dominique Endres
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg, University of Freiburg Freiburg, Germany
| | - Simon Maier
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg, University of Freiburg Freiburg, Germany
| | - Bernd Feige
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg, University of Freiburg Freiburg, Germany
| | - Nicole A Posielski
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg, University of Freiburg Freiburg, Germany
| | - Kathrin Nickel
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg, University of Freiburg Freiburg, Germany
| | - Dieter Ebert
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg, University of Freiburg Freiburg, Germany
| | - Andreas Riedel
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg, University of Freiburg Freiburg, Germany
| | - Alexandra Philipsen
- Medical Campus University of Oldenburg, School of Medicine and Health Sciences, Psychiatry and Psychotherapy-University Hospital, Karl-Jaspers-Klinik Bad Zwischenahn, Germany
| | - Evgeniy Perlov
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg, University of Freiburg Freiburg, Germany
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg, University of Freiburg Freiburg, Germany
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Endres D, Tebartz van Elst L, Meyer SA, Feige B, Nickel K, Bubl A, Riedel A, Ebert D, Lange T, Glauche V, Biscaldi M, Philipsen A, Maier SJ, Perlov E. Glutathione metabolism in the prefrontal brain of adults with high-functioning autism spectrum disorder: an MRS study. Mol Autism 2017; 8:10. [PMID: 28316774 PMCID: PMC5351053 DOI: 10.1186/s13229-017-0122-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 02/14/2017] [Indexed: 12/12/2022] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disease characterized by difficulties in social communication, unusually restricted, repetitive behavior and interests, and specific abnormalities in language and perception. The precise etiology of ASD is still unknown and probably heterogeneous. In a subgroup of patients, toxic environmental exposure might lead to an imbalance between oxidative stress and anti-oxidant systems. Previous serum and postmortem studies measuring levels of glutathione (GSH), the main cellular free radical scavenger in the brain, have supported the hypothesis that this compound might play a role in the pathophysiology of autism. Methods Using the method of single-voxel proton magnetic resonance spectroscopy (MRS), we analyzed the GSH signal in the dorsal anterior cingulate cortex (dACC) and the dorsolateral prefrontal cortex (DLPFC) of 24 ASD patients with normal or above average IQs and 18 matched control subjects. We hypothesized that we would find decreased GSH concentrations in both regions. Results We did not find overall group differences in neurometabolites including GSH, neither in the dorsal ACC (Wilks’ lambda test; p = 0.429) nor in the DLPFC (p = 0.288). In the dACC, we found a trend for decreased GSH signals in ASD patients (p = 0.076). Conclusions We were unable to confirm our working hypothesis regarding decreased GSH concentrations in the ASD group. Further studies combining MRS, serum, and cerebrospinal fluid measurements of GSH metabolism including other regions of interest or even whole brain spectroscopy are needed.
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Affiliation(s)
- Dominique Endres
- Section for Experimental Neuropsychiatry, Department of Psychiatry, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department of Psychiatry, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Simon A Meyer
- Section for Experimental Neuropsychiatry, Department of Psychiatry, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Bernd Feige
- Section for Experimental Neuropsychiatry, Department of Psychiatry, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Kathrin Nickel
- Section for Experimental Neuropsychiatry, Department of Psychiatry, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Anna Bubl
- Department for Psychiatry and Psychotherapy, Saarland University Medical Center, Kirrberger Str. 100, 66421 Homburg, Saar Germany
| | - Andreas Riedel
- Section for Experimental Neuropsychiatry, Department of Psychiatry, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Dieter Ebert
- Section for Experimental Neuropsychiatry, Department of Psychiatry, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Thomas Lange
- Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 60a, 79106 Freiburg, Germany
| | - Volkmar Glauche
- Department of Neurology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany
| | - Monica Biscaldi
- Department for Child and Adolescent Psychiatry and Psychotherapy, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 8, 79104 Freiburg, Germany
| | - Alexandra Philipsen
- School of Medicine and Health Sciences, Psychiatry and Psychotherapy - University Hospital, Karl-Jaspers-Klinik, Medical Campus University of Oldenburg, Hermann-Ehlers-Str. 7, 26160 Bad Zwischenahn, Germany
| | - Simon J Maier
- Section for Experimental Neuropsychiatry, Department of Psychiatry, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Evgeniy Perlov
- Section for Experimental Neuropsychiatry, Department of Psychiatry, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany.,Clinic for Psychiatry Luzern, Schafmattstrasse 1, 4915 St. Urban, Switzerland
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Rosenkranz S, Lang IM, Blindt R, Bonderman D, Bruch L, Diller GP, Felgendreher R, Gerges C, Hohenforst-Schmidt W, Holt S, Jung C, Kindermann I, Kramer T, Kübler WM, Mitrovic V, Riedel A, Rieth A, Schmeisser A, Wachter R, Weil J, Opitz C. [Pulmonary hypertension associated with left heart disease: recommendations of the Cologne Consensus Conference 2016]. Dtsch Med Wochenschr 2016; 141:S48-S56. [PMID: 27760450 DOI: 10.1055/s-0042-114522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension are also valid for Germany. While the guidelines contain detailed recommendations regarding pulmonary arterial hypertension (PAH), they contain only a relatively short paragraph on other, much more common forms of PH such as PH due to left heart disease. Despite the lack of data, targeted PAH treatments are increasingly being used for PH associated with left heart disease. This development is of concern because of limited ressources and the need to base treatments on scientific evidence. On the other hand, PH is a frequent problem that is highly relevant for morbidity and mortality in patients with left heart disease, representing an unmet need of targeted PH therapies. It that sense, the practical implementation of the European Guidelines in Germany requires the consideration of several specific issues and already existing novel data. This requires a detailed commentary to the guidelines, and in some aspects an update already appears necessary. In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany. This conference aimed to solve practical and controversial issues surrounding the implementation of the European Guidelines in Germany. To this end, several working groups were initiated, one of which was specifically dedicated to PH associated with left heart disease. This article summarizes the results and recommendations of this working group.
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Tebartz van Elst L, Riedel A, Maier S. Autism as a Disorder of Altered Global Functional and Structural Connectivity. Biol Psychiatry 2016; 79:626-7. [PMID: 26997116 DOI: 10.1016/j.biopsych.2016.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 02/04/2016] [Accepted: 02/04/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Ludger Tebartz van Elst
- Section for Neuropsychiatry and Neurodevelopmental Disorder Research Group, University Clinic for Psychiatry and Psychotherapy, Freiburg, Germany.
| | - Andreas Riedel
- Section for Neuropsychiatry and Neurodevelopmental Disorder Research Group, University Clinic for Psychiatry and Psychotherapy, Freiburg, Germany
| | - Simon Maier
- Section for Neuropsychiatry and Neurodevelopmental Disorder Research Group, University Clinic for Psychiatry and Psychotherapy, Freiburg, Germany
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Tebartz van Elst L, Fleck M, Bartels S, Altenmüller DM, Riedel A, Bubl E, Matthies S, Feige B, Perlov E, Endres D. Increased Prevalence of Intermittent Rhythmic Delta or Theta Activity (IRDA/IRTA) in the Electroencephalograms (EEGs) of Patients with Borderline Personality Disorder. Front Behav Neurosci 2016; 10:12. [PMID: 26941624 PMCID: PMC4763016 DOI: 10.3389/fnbeh.2016.00012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 02/16/2015] [Accepted: 01/25/2016] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION An increased prevalence of pathological electroencephalography (EEG) signals has been reported in patients with borderline personality disorder (BPD). In an elaborative case description of such a patient with intermittent rhythmic delta and theta activity (IRDA/IRTA), the BPD symptoms where linked to the frequency of the IRDAs/IRTAs and vanished with the IRDAs/IRTAs following anticonvulsive therapy. This observation raised a question regarding the prevalence of such EEG abnormalities in BPD patients. The aim of this retrospective study was to identify the frequency of EEG abnormalities in a carefully analyzed psychiatric collective. Following earlier reports, we hypothesized an increased prevalence of EEG abnormalities in BPD patients. PARTICIPANTS AND METHODS We recruited 96 consecutive patients with BPD from the archive of a university clinic for psychiatry and psychotherapy, and compared the prevalence of EEG abnormalities to those of 76 healthy controls subjects. The EEGs were rated by three different blinded clinicians, including a consultant specializing in epilepsy from the local epilepsy center. RESULTS We found a significant increase in the prevalence of IRDAs and IRTAs in BPD patients (14.6%) compared to the control subjects (3.9%; p = 0.020). DISCUSSION In this blinded retrospective case-control study, we were able to confirm an increased prevalence of pathological EEG findings (IRDAs/IRTAs only) in BPD patients. The major limitation of this study is that the control group was not matched on age and gender. Therefore, the results should be regarded as preliminary findings of an open uncontrolled, retrospective study. Future research performing prospective, controlled studies is needed to verify our findings and answer the question of whether such EEG findings might predict a positive response to anticonvulsive pharmacological treatment.
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Affiliation(s)
- Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany
| | - Max Fleck
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany
| | - Susanne Bartels
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany
| | - Dirk-Matthias Altenmüller
- Department of Neurosurgery, Freiburg Epilepsy Center, University Medical Center Freiburg Freiburg, Germany
| | - Andreas Riedel
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany
| | - Emanuel Bubl
- Department for Psychiatry and Psychotherapy, Saarland University Medical Center Homburg, Germany
| | - Swantje Matthies
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany
| | - Bernd Feige
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany
| | - Evgeniy Perlov
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany
| | - Dominique Endres
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, University Medical Center Freiburg Freiburg, Germany
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Endres D, Dersch R, Stich O, Buchwald A, Perlov E, Feige B, Maier S, Riedel A, van Elst LT. Vitamin D Deficiency in Adult Patients with Schizophreniform and Autism Spectrum Syndromes: A One-Year Cohort Study at a German Tertiary Care Hospital. Front Psychiatry 2016; 7:168. [PMID: 27766084 PMCID: PMC5052261 DOI: 10.3389/fpsyt.2016.00168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 09/23/2016] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Vitamin D has many immunomodulatory, anti-inflammatory, and neuroprotective functions, and previous studies have demonstrated an association between vitamin D deficiency and neuropsychiatric disease. The aim of our study was to analyze the prevalence of vitamin D deficiency in a 1-year cohort of adult inpatients with schizophreniform and autism spectrum syndromes in a naturalistic inpatient setting in Germany. PARTICIPANTS AND METHODS Our study was comprised of 60 adult schizophreniform and 23 adult high-functioning autism spectrum patients who were hospitalized between January and December of 2015. We compared our findings with a historical German reference cohort of 3,917 adults using Pearson's two-sided chi-squared test. The laboratory measurements of 25-hydroxyvitamin D2/3 [25(OH)vitamin D] were obtained using a chemiluminescence immunoassay. RESULTS In the schizophreniform group, we found decreased (<20 ng/ml) 25(OH)vitamin D levels in 48/60 (80.0%) of the patients. In the autism spectrum group, decreased levels were detected in 18/23 (78.3%) of the patients. 25(OH)vitamin D deficiencies were found in 57.3% of the historical control group. Particularly, severe deficiencies (<10 ng/ml) occurred much more frequently in the schizophreniform (38.3%) and autism spectrum groups (52.2%), when compared to the control group (16.3%). The recommended 25(OH)vitamin D values of >30 ng/ml were observed in only 5% of the schizophreniform patients, 8.7% of the autism spectrum patients, and 21.9% of the healthy controls. DISCUSSION We found very high rates of 25(OH)vitamin D deficiencies in both patient groups and have discussed whether our findings might be related to alterations in the immunological mechanisms. Irrespective of the possible pathophysiological links between vitamin D deficiency and schizophrenia or autism spectrum disorders, a more frequent measurement of vitamin D levels seems to be justified in these patient groups. Further prospective, controlled, blinded, and randomized research should be conducted to analyze the effectiveness of vitamin D supplementation on the improvement of psychiatric symptoms.
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Affiliation(s)
- Dominique Endres
- Section of Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg , Freiburg , Germany
| | - Rick Dersch
- Department of Neurology, Medical Center - University of Freiburg , Freiburg , Germany
| | - Oliver Stich
- Department of Neurology, Medical Center - University of Freiburg , Freiburg , Germany
| | - Armin Buchwald
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Center - University of Freiburg , Freiburg , Germany
| | - Evgeniy Perlov
- Section of Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg , Freiburg , Germany
| | - Bernd Feige
- Section of Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg , Freiburg , Germany
| | - Simon Maier
- Section of Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg , Freiburg , Germany
| | - Andreas Riedel
- Section of Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg , Freiburg , Germany
| | - Ludger Tebartz van Elst
- Section of Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg , Freiburg , Germany
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Maier S, Tebartz van Elst L, Beier D, Ebert D, Fangmeier T, Radtke M, Perlov E, Riedel A. Increased hippocampal volumes in adults with high functioning autism spectrum disorder and an IQ>100: A manual morphometric study. Psychiatry Res 2015; 234:152-5. [PMID: 26337007 DOI: 10.1016/j.pscychresns.2015.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 02/25/2015] [Revised: 06/18/2015] [Accepted: 08/09/2015] [Indexed: 12/21/2022]
Abstract
Previous studies concerning the volumes of the amygdala and the hippocampus in autism spectrum disorders (ASD) show inconsistent results. We acquired magnetic resonance images of 30 individuals with ASD and individually matched controls. All participants had an IQ>100 to increase the likelihood of including non-syndromal forms of ASD. Manually defined amygdala volumes showed no significant group difference, while hippocampi were significantly enlarged in ASD. This finding is discussed with regard to the 'intense world hypothesis'.
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Affiliation(s)
- Simon Maier
- Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany; Freiburg Brain Imaging, Medical Center, University of Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany; Freiburg Brain Imaging, Medical Center, University of Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany; Universitäres Zentrum Autismus Spektrum, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany.
| | - Daniel Beier
- Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Dieter Ebert
- Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany; Universitäres Zentrum Autismus Spektrum, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Thomas Fangmeier
- Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany; Universitäres Zentrum Autismus Spektrum, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Martina Radtke
- Universitäres Zentrum Autismus Spektrum, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - Evgeniy Perlov
- Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany; Freiburg Brain Imaging, Medical Center, University of Freiburg, Breisacher Str. 64, 79106 Freiburg, Germany
| | - Andreas Riedel
- Section for Experimental Neuropsychiatry, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany; Universitäres Zentrum Autismus Spektrum, Clinic for Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
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Tebartz van Elst L, Bach M, Blessing J, Riedel A, Bubl E. Normal Visual Acuity and Electrophysiological Contrast Gain in Adults with High-Functioning Autism Spectrum Disorder. Front Hum Neurosci 2015; 9:460. [PMID: 26379525 PMCID: PMC4549567 DOI: 10.3389/fnhum.2015.00460] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 02/23/2015] [Accepted: 08/06/2015] [Indexed: 12/29/2022] Open
Abstract
A common neurodevelopmental disorder, autism spectrum disorder (ASD), is defined by specific patterns in social perception, social competence, communication, highly circumscribed interests, and a strong subjective need for behavioral routines. Furthermore, distinctive features of visual perception, such as markedly reduced eye contact and a tendency to focus more on small, visual items than on holistic perception, have long been recognized as typical ASD characteristics. Recent debate in the scientific community discusses whether the physiology of low-level visual perception might explain such higher visual abnormalities. While reports of this enhanced, "eagle-like" visual acuity contained methodological errors and could not be substantiated, several authors have reported alterations in even earlier stages of visual processing, such as contrast perception and motion perception at the occipital cortex level. Therefore, in this project, we have investigated the electrophysiology of very early visual processing by analyzing the pattern electroretinogram-based contrast gain, the background noise amplitude, and the psychophysical visual acuities of participants with high-functioning ASD and controls with equal education. Based on earlier findings, we hypothesized that alterations in early vision would be present in ASD participants. This study included 33 individuals with ASD (11 female) and 33 control individuals (12 female). The groups were matched in terms of age, gender, and education level. We found no evidence of altered electrophysiological retinal contrast processing or psychophysical measured visual acuities. There appears to be no evidence for abnormalities in retinal visual processing in ASD patients, at least with respect to contrast detection.
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Affiliation(s)
- Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Albert-Ludwigs-University, Freiburg, Germany
| | - Michael Bach
- Section Visual Function, Eye Center, University Medical Center, Freiburg, Germany
| | - Julia Blessing
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Albert-Ludwigs-University, Freiburg, Germany
| | - Andreas Riedel
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Albert-Ludwigs-University, Freiburg, Germany
| | - Emanuel Bubl
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Albert-Ludwigs-University, Freiburg, Germany
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Riedel A, Schröck C, Ebert D, Fangmeier T, Bubl E, Tebartz van Elst L. [Well Educated Unemployed--On Education, Employment and Comorbidities in Adults with High-Functioning Autism Spectrum Disorders in Germany]. Psychiatr Prax 2015; 43:38-44. [PMID: 25891885 DOI: 10.1055/s-0034-1387494] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Based on clinical experience there is a discrepancy between the educational records and vocational performance in patients with high functioning autism spectrum disorder (ASD). METHOD In order to assess psychosocial and vocational specificities of adult ASD patients we analyzed the demographic and hospital data of consecutively diagnosed patients employing descriptive statistics. RESULTS We were able to include 255 patients into our sample who were consecutively diagnosed between October 2009 and October 2011. The gender ratio was 162:93 in favor of male patients. The educational records of our patient sample was comparatively good [50 % highest level of German schooling system (allgemeine Hochschulreife), 39 % university degree], however, the vocational records were poor with 58 % of our patients being unemployed. The psychiatric comorbidity was high, 57 % of the patients suffered from depression. CONCLUSION There is a high need for special support programs for adult high functioning ASD patients focusing on adaptive vocational skills to avoid unemployment and secondary psychiatric problems.
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Affiliation(s)
- Andreas Riedel
- Zentrum für psychische Erkrankungen, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg
| | - Constanze Schröck
- Zentrum für psychische Erkrankungen, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg
| | - Dieter Ebert
- Zentrum für psychische Erkrankungen, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg
| | - Thomas Fangmeier
- Zentrum für psychische Erkrankungen, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg
| | - Emanuel Bubl
- Zentrum für psychische Erkrankungen, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg
| | - Ludger Tebartz van Elst
- Zentrum für psychische Erkrankungen, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg
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Bubl E, Dörr M, Riedel A, Ebert D, Philipsen A, Bach M, Tebartz van Elst L. Elevated background noise in adult attention deficit hyperactivity disorder is associated with inattention. PLoS One 2015; 10:e0118271. [PMID: 25693192 PMCID: PMC4333120 DOI: 10.1371/journal.pone.0118271] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 09/13/2014] [Accepted: 01/12/2015] [Indexed: 12/21/2022] Open
Abstract
Background Inattention and distractibility are core symptoms of attention deficit hyperactivity disorder (ADHD). Still the neuronal organization is largely unknown. Previously we studied the electrophysiological activity of a distinct neuronal network—the retina—and found no change in stimulus-driven neural activity in patients with ADHD. However there is growing evidence for an elevated non stimulus-driven neural activity, or neuronal background noise, as underlying pathophysiological correlate. To further examine the biological bases that might underlie ADHD and problems with inattention, we performed a new analysis to test the hypothesis of an elevated background noise as underlying neuronal correlate for ADHD and problems with inattention in humans. A direct measure of background noise in patients with ADHD has not been described yet. Methods The retinal background noise was assessed based on pattern electroretinogram (PERG) data in 20 unmedicated ADHD patients and 20 healthy controls. The PERG is an electrophysiological measure for retinal ganglion cell function. ADHD severity was assessed by interview and questionnaire. Results Noise amplitude was significantly higher (138%) in patients with ADHD compared to the control group (p = 0.0047). Noise amplitude correlated significantly with psychometric measures for ADHD (CAARS) especially inattention (r = 0.44, p = 0.004). Conclusions The data provide evidence that an elevated background noise is associated with symptoms of inattention in ADHD and support the use of therapeutic interventions that reduce noise and distraction in patients with ADHD.
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Affiliation(s)
- Emanuel Bubl
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
- * E-mail:
| | - Michael Dörr
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
| | - Andreas Riedel
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
| | - Dieter Ebert
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
| | - Michael Bach
- University Eye Hospital, Albert-Ludwigs-University of Freiburg, Killianstrasse 5, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
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Riedel A, Suh H, Haser V, Hermann I, Ebert D, Riemann D, Bubl E, Tebartz van Elst L, Hölzel LP. Freiburg Questionnaire of linguistic pragmatics (FQLP): psychometric properties based on a psychiatric sample. BMC Psychiatry 2014; 14:374. [PMID: 25539681 PMCID: PMC4296675 DOI: 10.1186/s12888-014-0374-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 08/08/2014] [Accepted: 12/19/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Asperger's Syndrome (AS) is an autism spectrum disorder that is characterized by significant difficulties in social interaction and nonverbal communication, and restricted and repetitive patterns of behavior and interests. Difficulties with respect to pragmatic speech, reading emotional and social cues, differentiating between fact and fiction, and taking into account the influence of context on a statement are commonly described features. However, hitherto established questionnaires did not focus on these symptoms. METHODS In this study we present a short (11 questions) questionnaire which focuses on self-rated pragmatic speech abilities, the Freiburg Questionnaire of linguistic pragmatics (FQLP). Psychometric properties of the questionnaire were explored in a sample of 57 patients with Asperger's Syndrome, 66 patients with other psychiatric disorders, and a convenience sample of 56 people. RESULTS Reliability analysis showed a high Cronbach's α. Strong correlations could be demonstrated for the FQLP with the Autism Quotient and the Empathy Quotient. Concerning divergent validity a moderate correlation was found between the FQLP and self-rated symptoms of personality disorders. No significant correlation was found between the FQLP and the vocabulary skills. The receiver operating characteristics curve showed an excellent diagnostic accuracy of the FQLP (.97). CONCLUSIONS As the control group consisted of people without mental disorder and patients with different psychiatric disorders, the results indicate that the construct examined by the FQLP is quite specific to the peculiarities of AS. The FQLP is a reliable, brief and valid instrument. First results regarding sensitivity and specificity are highly promising.
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Affiliation(s)
- Andreas Riedel
- Clinic for Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, Freiburg, 79104, Germany.
| | - Heejung Suh
- Clinic for Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, Freiburg, 79104, Germany.
| | - Verena Haser
- Department of English Linguistics, University of Freiburg, Freiburg, Germany.
| | - Ismene Hermann
- Clinic for Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, Freiburg, 79104, Germany.
| | - Dieter Ebert
- Clinic for Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, Freiburg, 79104, Germany.
| | - Dieter Riemann
- Clinic for Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, Freiburg, 79104, Germany.
| | - Emanuel Bubl
- Clinic for Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, Freiburg, 79104, Germany.
| | - Ludger Tebartz van Elst
- Clinic for Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, Freiburg, 79104, Germany.
| | - Lars P Hölzel
- Clinic for Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, Freiburg, 79104, Germany.
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Tischler D, Riedel A, Schwabe R, Siegel L, Friebel K, Heine T, Göring A, Kaschabek S, Schlömann M. Evolution der Styrol-Monooxygenase StyA1/StyA2B aus Variovorax paradoxusEPS und seine biotechnologische Anwendung. CHEM-ING-TECH 2014. [DOI: 10.1002/cite.201450048] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Koelkebeck K, Riedel A, Ohrmann P, Biscaldi M, Tebartz van Elst L. [High-functioning autism spectrum disorders in adulthood]. Nervenarzt 2014; 85:891-902. [PMID: 24969950 DOI: 10.1007/s00115-014-4050-6] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The prevalence of autism spectrum disorders in the general population is approximately 1 %. Some individuals with high-functioning autism graduate from regular schools without autism having been diagnosed and problems only occur when the demands for social competence increase. Then patients often present with secondary psychiatric symptoms, such as depression, anxiety or interpersonal problems. At this time, typical autistic features, such as social interaction deficits, restricted interests and stereotypic behavior can be camouflaged by high compensatory skills, particularly in highly intelligent patients. Therefore, missed or wrong diagnoses are frequent. Interviews, questionnaires and neuropsychological tests might be used to support the diagnosis. In cases where there is evidence for a secondary cause of autistic symptoms, somatic disorders should be excluded. Pharmacological treatment should be symptom-oriented. Individualized psychotherapeutic approaches are becoming increasingly more available; however, pragmatic solutions often need to be deployed.
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Affiliation(s)
- K Koelkebeck
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Deutschland,
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Kornmeier J, Wörner R, Riedel A, Bach M, Tebartz van Elst L. A different view on the checkerboard? Alterations in early and late visually evoked EEG potentials in Asperger observers. PLoS One 2014; 9:e90993. [PMID: 24632708 PMCID: PMC3954585 DOI: 10.1371/journal.pone.0090993] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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: 07/14/2013] [Accepted: 02/06/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Asperger Autism is a lifelong psychiatric condition with highly circumscribed interests and routines, problems in social cognition, verbal and nonverbal communication, and also perceptual abnormalities with sensory hypersensitivity. To objectify both lower-level visual and cognitive alterations we looked for differences in visual event-related potentials (EEG) between Asperger observers and matched controls while they observed simple checkerboard stimuli. METHODS In a balanced oddball paradigm checkerboards of two checksizes (0.6° and 1.2°) were presented with different frequencies. Participants counted the occurrence times of the rare fine or rare coarse checkerboards in different experimental conditions. We focused on early visual ERP differences as a function of checkerboard size and the classical P3b ERP component as an indicator of cognitive processing. RESULTS We found an early (100-200 ms after stimulus onset) occipital ERP effect of checkerboard size (dominant spatial frequency). This effect was weaker in the Asperger than in the control observers. Further a typical parietal/central oddball-P3b occurred at 500 ms with the rare checkerboards. The P3b showed a right-hemispheric lateralization, which was more prominent in Asperger than in control observers. DISCUSSION The difference in the early occipital ERP effect between the two groups may be a physiological marker of differences in the processing of small visual details in Asperger observers compared to normal controls. The stronger lateralization of the P3b in Asperger observers may indicate a stronger involvement of the right-hemispheric network of bottom-up attention. The lateralization of the P3b signal might be a compensatory consequence of the compromised early checksize effect. Higher-level analytical information processing units may need to compensate for difficulties in low-level signal analysis.
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Affiliation(s)
- Juergen Kornmeier
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
- Eye Center, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Rike Wörner
- PPD Germany GmbH & Co Kg, Karlsruhe, Germany
| | - Andreas Riedel
- Section for Experimental Neuropsychiatry, Clinic for Psychiatry & Psychotherapy, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Michael Bach
- Eye Center, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Clinic for Psychiatry & Psychotherapy, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
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Hermann I, Haser V, van Elst LT, Ebert D, Müller-Feldmeth D, Riedel A, Konieczny L. Automatic metaphor processing in adults with Asperger syndrome: a metaphor interference effect task. Eur Arch Psychiatry Clin Neurosci 2013; 263 Suppl 2:S177-87. [PMID: 24081827 DOI: 10.1007/s00406-013-0453-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Accepted: 09/16/2013] [Indexed: 03/04/2023]
Abstract
This paper investigates automatic processing of novel metaphors in adults with Asperger Syndrome (AS) and typically developing controls. We present an experiment combining a semantic judgment task and a recognition task. Four types of sentences were compared: Literally true high-typical sentences, literally true low-typical sentences, apt metaphors, and scrambled metaphors (literally false sentences which are not readily interpretable as metaphors). Participants were asked to make rapid decisions about the literal truth of such sentences. The results revealed that AS and control participants showed significantly slower RTs for metaphors than for scrambled metaphors and made more mistakes in apt metaphoric sentences than in scrambled metaphors. At the same time, there was higher recognition of apt metaphors compared with scrambled metaphors. The findings indicate intact automatic metaphor processing in AS and replicate previous findings on automatic metaphor processing in typically developing individuals.
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Affiliation(s)
- Ismene Hermann
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
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Riedel A, Bohnert M, Scholz C, Laengin T, Melchior W, Elke E, Gencay M. P5.071 Evaluation of Elecsys ®Immunoassay System For Determination of Type-Specific IgG Antibodies to HSV-1 and HSV-2. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hayn D, Riedel A, Falgenhauer M, Fruhwald F, Schreier G. Validation of Different Parameters Extracted from 3D Images for Leg Oedema Detection. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-K/bmt-2013-4244/bmt-2013-4244.xml. [DOI: 10.1515/bmt-2013-4244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hohenforst-Schmidt W, Riedel A, Zarogoulidis P, Franke C, Gschwendtner A, Huang H, Machairiotis N, Dramba V, Zarogoulidis K, Brachmann J. Chronic eosinophilic pneumonia due to radiographic contrast administration: an orphan disease? Drug Des Devel Ther 2012; 6:385-9. [PMID: 23251088 PMCID: PMC3523559 DOI: 10.2147/dddt.s37937] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Pulmonary eosinophilia comprises a heterogeneous group of diseases that are defined by eosinophilia in pulmonary infiltrates or in tissue. Drugs can cause almost all histopathologic patterns of interstitial pneumonias, such as cellular and fibrotic nonspecific interstitial pneumonia, pulmonary infiltrates and eosinophilia, organizing pneumonia, lymphocytic interstitial pneumonia, desquamative interstitial pneumonia, a pulmonary granulomatosis-like reaction, and a usual interstitial pneumonia-like pattern. We present a very rare case of chronic eosinophilic pneumonia due to radiographic contrast infusion diagnosed with video-assisted thoracoscopy. The patient after 1 year is still under corticosteroid treatment with the disease stabilized.
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Hohenforst-Schmidt W, Riedel A, Franke C, Brachmann J, Gschwendtner A. Chronisch interstitielle und fibrosierende Pneumonitis mit interstitiellen Eosinophilen – eine seltene Reaktion nach Kontrastmittelgabe bei einer Koronarangiografie. Pneumologie 2012. [DOI: 10.1055/s-0032-1302698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Two reversed-phase high-performance liquid chromatography (RP-HPLC) methods were developed to investigate the degradation of the acid-labile proton-pump-inhibitor omeprazole in organic polymer solutions and aqueous dispersions of enteric coating polymers (Eudragit L-100, S-100, CAP, HP-55, HPMCAS-HF, -LF, and shellac). The overall goal of the study was to determine the influence of the polymer structure on the degradation of omeprazole, i.e., whether the acid structure of the enteric coating polymers caused an instability of the proton pump inhibitor. Moreover, it was investigated whether a difference in omeprazole degradation could be detected between organic polymer solutions and aqueous dispersions. pKa values of the polymers and pH values of the aqueous dispersions were determined to see whether there was a correlation with the extent of degradation of omeprazole induced by enteric polymers. As the polymers containing phthalate moieties are very susceptible to hydrolysis, the influence of free phthalic acid on omeprazole stability was investigated. Finally, the degradation kinetics of omeprazole in organic polymer solutions were determined. Omeprazole degradation is more pronounced in aqueous polymer dispersions than in organic polymer solutions. The influence of organic polymer solutions on the stability of omeprazole depends on the amount of acidic groups in the polymeric structure, whereas the influence of aqueous polymer dispersions depends on the pH value of the dispersion. The amount of free acids present in some polymers as by-products also cause a degradation of the proton pump inhibitor. Among all investigated polymers, shellac showed the least influence on the stability of omeprazole. The decomposition of omeprazole in organic polymer solutions followed first-order kinetics. The decrease of omeprazole peak area in organic polymer solutions was in the order Eudragit L-100> HPMCAS-HF>shellac.
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Affiliation(s)
- A Riedel
- Institute for Pharmacy, Pharmaceutical Technology, University of Leipzig, Leipzig, Germany
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Friedland KJ, Hey R, Kostial H, Riedel A. Longitudinal-commensurable resistance oscillations in the ballistic transport of electrons on cylindrical surfaces. ACTA ACUST UNITED AC 2008. [DOI: 10.1002/pssc.200779237] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Riedel A, Gutjahr P, Hohenfellner R. Operative und perioperative Komplikationen in der Wilms-Tumor-Behandlung. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1057772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Riedel A, Gutjahr P, Hohenfellner R. Stellenwert der Operation in der modernen Wilms-Tumor-Behandlung. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1058198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Riedel-Baima B, Riedel A. Female pattern hair loss may be triggered by low oestrogen to androgen ratio. Endocr Regul 2008; 42:13-16. [PMID: 18333699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE In both sexes the androgenetic alopecia is known to be mediated by the conversion of circulating androgens into dihydrotestosterone within the hair follicle. However, there are a number of differences between male and female pattern baldness with estrogen known to be protective against hair loss in women. Since androgen levels in women with female pattern hair loss are mostly within the normal range, we decided to calculate the ratio of estrogens to androgens in order to find a putative trigger for their hair loss. METHODS We studied 20 premenopausal women with female pattern hair loss and 9 healthy women for serum levels of LH, FSH, estradiol, free and total testosterone, sex hormone binding globulin (SHBG) and dehydroepiandrosterone sulfate (DHEAS) on the first day of their menstrual cycle. RESULTS Although the absolute levels of androgens were normal in both groups, the ratio of estradiol to free testosterone and the ratio of estradiol to DHEAS were significantly lower in patients than in the control group. CONCLUSIONS We put up a hypothesis that in the presence of a genetic susceptibility, it is the estrogen to androgen ratio, as represented by the ratio of estradiol to free testosterone that might be responsible for triggering female pattern hair loss in women.
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Affiliation(s)
- B Riedel-Baima
- Sana Health Centre Berlin (Sana Gesundheitszentrum Berlin), 10178 Berlin, Germany.
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Abstract
OBJECTIVE To identify the most common causes of death during sports activity in the population of Hamburg, Germany, and to identify which groups of sportspeople are particularly in danger of dying during sports and in which types of sport most fatalities occur. DESIGN AND SETTING We performed a 10-year autopsy-based retrospective study of all 48,335 fatalities in Hamburg and the surrounding areas that were subjected to police investigations between 1997 and 2006 and screened for sports-related deaths. The main outcome measure was cause of death depending on form of sport, age and risk factors. RESULTS Most of the fatalities were male. In natural deaths, cardiac causes were the most frequent causes found, with running and football being the most frequent forms of sport in which death had occurred. In some of the cases, sports medical examinations had been performed before death, certifying eligibility for the respective activity. Traumatic deaths were found in all age groups, with younger age groups more likely to have traumatic than natural deaths, and as expected, occurred more commonly in "risky" outdoor activities. CONCLUSIONS Although exercise can have beneficial effects on health, fatalities related to sports activity occur. Cardiac disease is the main cause of sudden death from natural causes. In patients with pre-existing coronary heart disease, left ventricular hypertrophy constitutes a risk factor for exercise-related sudden death. Traumatic deaths often happen on holiday outside the person's country of dwelling, and are most commonly attributable to drowning and blunt trauma. Preparticipation medical screening cannot always prevent fatal incidents during sports activity. Postmortem macroscopic and histological examination can clarify the cause of death and legal issues.
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Affiliation(s)
- E E Turk
- Institute of Legal Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
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Magerkurth C, Riedel A, Braune S. Permanent increase in endothelin serum levels in vasovagal syncope. Clin Auton Res 2005; 15:299-301. [PMID: 16032385 DOI: 10.1007/s10286-005-0291-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2005] [Accepted: 04/24/2005] [Indexed: 10/25/2022]
Abstract
Of 40 normal volunteers tilted on two separate occasions, seven subjects had vasovagal syncope only during one upright tilt, but showed increased endothelin plasma levels in the supine position and during head-up tilt on both occasions, independent of vasovagal syncope, compared to control subjects.
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Riedel A, Leopold CS. Quantification of omeprazole degradation by enteric coating polymers: an UV-VIS spectroscopy study. Pharmazie 2005; 60:126-30. [PMID: 15739901] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The aim of this study was to investigate the degradation of the acid-labile proton-pump-inhibitor omeprazole in organic polymer solutions and aqueous dispersions of enteric coating polymers by UV spectroscopy. Furthermore, data were compared with those obtained in a previous HPLC study. For comparative purposes the cationic Eudragit RS 100 and the monomeric acid acetic acid were included in this study. The discolorations of degraded omeprazole solutions were analysed by VIS spectroscopy. UV-VIS spectra were recorded after preparation of the solutions and after 180 min of storage. The change of absorption was calculated as the difference of the absorption values at 305 nm. Degradation of omeprazole depends on the amount of acidic groups in the polymer structure. This decomposition manifests itself in a shifting of the absorption maximum to lower wavelengths and a decrease of absorption intensity. UV-VIS spectroscopy was used to determine the extent of degradation induced by enteric polymers. A good correlation of these results with previous HPLC data was found when excluding UV absorbing polymers. Nevertheless, values obtained by UV-VIS spectroscopy were always lower than those obtained by HPLC. For evaluation of the discoloration of degraded omeprazole solutions, VIS spectroscopy is a simple and fast method.
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Affiliation(s)
- A Riedel
- Institute for Pharmacy, Pharmaceutical Technology, University of Leipzig, Germany
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Faugeras C, Martinez G, Riedel A, Hey R, Friedland KJ, Bychkov Y. Fröhlich mass in GaAs-based structures. Phys Rev Lett 2004; 92:107403. [PMID: 15089242 DOI: 10.1103/physrevlett.92.107403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2003] [Indexed: 05/24/2023]
Abstract
The Fröhlich interaction is one of the main electron-phonon intrinsic interactions in polar materials originating from the coupling of one itinerant electron with the macroscopic electric field generated by any longitudinal optical (LO) phonon. Infrared magnetoabsorption measurements of doped GaAs quantum well structures have been carried out in order to test the concept of Fröhlich interaction and polaron mass in such systems. These new experimental results lead one to question the validity of this concept in a real system.
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Affiliation(s)
- C Faugeras
- Grenoble High Magnetic Field Laboratory, MPI-FKF and CNRS, BP 166, 38042 Grenoble 9, France
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Kulkarni J, Riedel A, de Castella AR, Fitzgerald PB, Rolfe TJ, Taffe J, Burger H. A clinical trial of adjunctive oestrogen treatment in women with schizophrenia. Arch Womens Ment Health 2002; 5:99-104. [PMID: 12510212 DOI: 10.1007/s00737-002-0001-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A double-blind, 28-day, placebo-controlled study was conducted with three groups of women of child-bearing age (N = 12 in each group) who received standardised antipsychotic medication plus a) 50 microg transdermal estradiol or b) 100 microg transdermal estradiol or c) transdermal placebo. Preliminary analyses show that women receiving 100 microg of estradiol made greater improvements in the symptoms of schizophrenia than either the 50 microg estradiol or placebo groups. The addition of 100 microg adjunctive transdermal oestrogen significantly enhanced treatment responsivity of acute, severe psychotic symptoms in women with schizophrenia. The positive impact of oestrogen treatment on psychotic symptoms via a multiplicity of possible actions (see accompanying articles in this issue) may prove clinically useful in the overall treatment of women with schizophrenia.
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Affiliation(s)
- J Kulkarni
- Dandenong Psychiatry Research Centre, Monash University Department of Psychological Medicine, Melbourne, Australia.
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Braune S, Riedel A, Schulte-Mönting J, Raczek J. Influence of a radiofrequency electromagnetic field on cardiovascular and hormonal parameters of the autonomic nervous system in healthy individuals. Radiat Res 2002; 158:352-6. [PMID: 12175313 DOI: 10.1667/0033-7587(2002)158[0352:ioaref]2.0.co;2] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The potential health risks of radiofrequency electromagnetic fields (EMFs) emitted by mobile phones are of considerable public interest. The present study investigated the hypothesis, based on the results of our previous study, that exposure to EMFs can increase sympathetic vasoconstrictor activity. Forty healthy young males and females underwent a single-blind, placebo-controlled protocol once on each of two different days. Each investigation included successive periods of placebo and EMF exposure, given in a randomized order. The exposure was implemented by a GSM-like signal (900 MHz, pulsed with 217 Hz, 2 W) using a mobile phone mounted on the right-hand side of the head in a typical telephoning position. Each period of placebo exposure and of EMF exposure consisted of 20 min of supine rest, 10 min of 70 degrees upright tilt on a tilt table, and another 20 min of supine rest. Blood pressure, heart rate and cutaneous capillary perfusion were measured continuously. In addition, serum levels of norepinephrine, epinephrine, cortisol and endothelin were analyzed in venous blood samples taken every 10 min. Similar to the previous study, systolic and diastolic blood pressure each showed slow, continuous, statistically significant increases of about 5 mmHg during the course of the protocol. All other parameters either decreased in parallel or remained constant. However, analysis of variance showed that the changes in blood pressure and in all other parameters were independent of the EMF exposure. These findings do not support the assumption of a nonthermal influence of EMFs emitted by mobile phones on the cardiovascular autonomic nervous system in healthy humans.
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Affiliation(s)
- S Braune
- Department of Neurology, University of Freiburg, Germany.
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Riedel A, Härtig W, Seeger G, Gärtner U, Brauer K, Arendt T. Principles of rat subcortical forebrain organization: a study using histological techniques and multiple fluorescence labeling. J Chem Neuroanat 2002; 23:75-104. [PMID: 11841914 DOI: 10.1016/s0891-0618(01)00142-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In the present study, we introduce new views on neuro- and chemoarchitectonics of the rat forebrain subcortex deduced from traditional and current concepts of anatomical organization and from our own results. It is based on double and triple immunofluorescence of markers for transmitter-related enzymes, calcium-binding proteins, receptor proteins, myelin basic protein (MBP) and neuropeptides, and on histological cell/myelin stains. The main findings can be summarized as follows: (i) the dorsal striatum of rat and other myomorph rodents reveals a small caudate equivalent homotopic to the caudate nucleus (C) of other mammals, and a large putamen (Pu). (ii) Shell and core can be distinguished also in the 'rostral pole' of nucleus accumbens (ACC) with the calretinin/calbindin and neuropeptide Y (NPY) immunostaining. The shell reveals characteristics of a genuine striatal but not of an extended amygdala (EA) subunit. (iii) EA and lateral septum show striking similarities in structure and fiber connections and may therefore represent a separate parastriatal complex. (iv) The meandering dense layer (DL) of olfactory tubercle (OT) forms longitudinal gyrus- and sulcus-like structures converging in its rostral pole. (v) The core regions of the islands of Calleja that border the ventral pallidum (VP) sharing some of its features are invaded by myelinated fibers of the medial forebrain bundle (MFB). The island of Calleja magna is also apposed to an inconspicuous, slender dorsal appendage of VP. (vi) The VP is composed of a large dorsal reticulated part traversed by the myelinated GABAergic parvalbumin-immunoreactive axons of the MFB and a slender ventral non-reticulate part close to the islands of Calleja. (vii) Considering their close association to the limbic system, ventral striatum (VS) and VP may represent the oldest part of basal ganglia, whereas dorsal striatopallidal subunits were progressively developed in parallel to the growing neocortical influence on motor behavior.
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Affiliation(s)
- A Riedel
- Department of Neuroanatomy, Paul Flechsig Institute for Brain Research, University of Leipzig, Jahnallee 59, D-04109, Leipzig, Germany
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Abstract
Estrogen has been shown in animal studies to modulate both the dopamine and serotonin neurotransmitter systems - the main neurotransmitters implicated in the pathogenesis of schizophrenia. A double blind, 28 day, placebo-controlled study was conducted with three groups of women of child-bearing age (N=12 in each group) who received standardized antipsychotic medication plus 50mcg transdermal estradiol or 100mcg transdermal estradiol or transdermal placebo. Analyses show that women receiving 100mcg of estradiol made greater improvements in the symptoms of schizophrenia than both the 50mcg estradiol and placebo groups. Women receiving 50mcg estradiol had more improvement in their symptoms compared with the placebo group. The 100mcg estradiol group had significantly lower mean lutenizing hormone (LH) and higher mean prolactin levels across the study period compared with both the 50mcg and placebo groups. The addition of 100mcg adjunctive transdermal estrogen significantly enhanced the treatment of acute, severe psychotic symptoms in women with schizophrenia. The differential response of adding 50mcg versus 100mcg estradiol on the types of symptom affected may be related to the estrogen effect on LH and prolactin. The positive impact of estrogen treatment on psychotic symptoms by a direct effect on dopamine and serotonin systems or via an indirect prolactin-mediated effect may be very useful in the overall treatment of women with schizophrenia.
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Affiliation(s)
- J Kulkarni
- Dandenong Psychiatry Research Centre, Monash University Department of Psychological Medicine, David St., Dandenong, Victoria 3175, Melbourne, Australia.
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