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Colla M, Offenhammer B, Scheerer H, Kronenberg G, Vetter S, Mutschler J, Mikoteit T, Bankwitz A, Adank A, Schaekel L, Eicher C, Brühl AB, Seifritz E. Oral prolonged-release ketamine in treatment-resistant depression - A double-blind randomized placebo-controlled multicentre trial of KET01, a novel ketamine formulation - Clinical and safety results. J Psychiatr Res 2024; 173:124-130. [PMID: 38522166 DOI: 10.1016/j.jpsychires.2024.03.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/26/2024] [Accepted: 03/03/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION We investigated the antidepressant effects of a novel oral prolonged-release formulation of racemic ketamine (KET01) in patients suffering from treatment-resistant depression (TRD) as add-on therapy. MATERIAL AND METHODS Patients were randomized to an additional 160 mg/day or 240 mg/day KET01 or placebo for 14 days. The primary endpoint was change in Montgomery-Åsberg Depression Rating Scale (MADRS) scores from baseline to day 15. For treatment group comparisons, we used ANOVA with pairwise least squares mean difference tests in a mixed model repeated measures analysis. RESULTS Twenty-seven patients completed the double-blind protocol before trial premature termination due to poor recruitment during the COVID-19 pandemic. Mean (SD) MADRS scores on day 15 were 23 (10.32) in placebo, 25 (8.28) with 160 mg/day and 17 (10.32) with 240 mg/day KET01. MADRS change was numerically larger but statistically non-significant in the 240 mg/day KET01 group vs placebo on day 7 (-5.67; p = 00.106) and day 15 was (difference: 4.99; p = 00.15). In exploratory analysis, baseline leukocyte count correlated with response to KET01 (p = 00.01). Distribution of adverse event rates were comparable between the treatment arms. Safety analysis did not identify increased risk of suicidality, dissociation, hear rate, systolic and diastolic blood pressure associated with trial treatment. DISCUSSION Our results suggest that adjunctive oral administration of prolonged-release ketamine at a dose of 240 mg/day shows a positive, although statistically non-significant, trend towards antidepressant efficacy, however, the benefit could not be confirmed due to premature trial termination. Given its ease of use and low side effects, further trials are warranted to investigate this route of ketamine administration as a promising potential treatment of TRD.
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Affiliation(s)
- M Colla
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland.
| | - B Offenhammer
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - H Scheerer
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - G Kronenberg
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - S Vetter
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - J Mutschler
- Psychiatric Hospital Meiringen, Meiringen, Switzerland; Psychiatric Services Lucerne, Lucerne, Switzerland
| | - T Mikoteit
- Psychiatric Services Solothurn and University of Basel, Solothurn, Switzerland
| | - A Bankwitz
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - A Adank
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - L Schaekel
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - C Eicher
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
| | - A B Brühl
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland; University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - E Seifritz
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Switzerland
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Stassen HH, Bachmann S, Bridler R, Cattapan K, Seifritz E. Polypharmacy in psychiatry and weight gain: longitudinal study of 832 patients hospitalized for depression or schizophrenia, along with data of 3180 students from Europe, the U.S., South America, and China. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01767-2. [PMID: 38462586 DOI: 10.1007/s00406-024-01767-2] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/19/2024] [Indexed: 03/12/2024]
Abstract
Epidemiologic data indicate that overweight and obesity are on the rise worldwide. Psychiatric patients are particularly vulnerable in this respect as they have an increased prevalence of overweight and obesity, and often experience rapid, highly undesirable weight gain under psychotropic drug treatment. Current treatment strategies in psychiatry are oriented towards polypharmacy, so that the information on drug-induced weight gain from earlier monotherapy studies is of very limited validity. We have analyzed the longitudinal data of 832 inpatients with ICD-10 diagnoses of either F2 (schizophrenia; n = 282) or F3 (major depression; n = 550) with the goal of ranking treatment regimens in terms of weight gain, side effects, and response to treatment. The patient data were complemented by the data of 3180 students aged 18-22 years, with which we aimed to identify factors that enable the early detection and prevention of obesity and mental health problems. After 3 weeks of treatment, 47.7% of F2 patients and 54.9% of F3 patients showed a weight gain of 2 kg and more. Major predictive factors were "starting weight" (r = 0.115), "concurrent medications" (r = 0.176), and "increased appetite"(r = 0.275). Between 11 and 30% of the observed variance in weight gain could be explained by these factors, complemented by sex and age. The comparison between monotherapy (n = 409) and polypharmacy (n = 399) revealed significant drawbacks for polypharmacy: higher weight gain (p = 0.0005), more severe side effects (p = 0.0011), and lower response rates (F2: p = 0.0008); F3: p = 0.0101). The data of 3180 students made it clear that overweight and obesity often begin early in life among those affected, and are interconnected with personality traits, while increasing the risk of developing psychosomatic disturbances, mental health problems, or somatic illnesses. Although the available data did not readily lead to a comprehensive, clinically applicable model of unwanted weight gain, our results have nevertheless demonstrated that there are ways to successfully counteract such weight gain at early stages of treatment.
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Affiliation(s)
- H H Stassen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Institute for Response-Genetics, Psychiatric University Hospital, 8032, Zurich, Switzerland.
| | - S Bachmann
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University of Halle, 06112, Halle, Germany
- Germany and Clienia AG, Psychiatric Hospital, 9573, Littenheid, Switzerland
- Department of Psychiatry, Geneva University Hospitals, 1226, Thônex, Switzerland
| | - R Bridler
- Sanatorium Kilchberg, 8802, Kilchberg, Switzerland
| | - K Cattapan
- Sanatorium Kilchberg, 8802, Kilchberg, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - E Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, 8032, Zurich, Switzerland
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Stassen HH, Bachmann S, Bridler R, Cattapan K, Hartmann AM, Rujescu D, Seifritz E, Weisbrod M, Scharfetter C. Analysis of genetic diversity in patients with major psychiatric disorders versus healthy controls: A molecular-genetic study of 1698 subjects genotyped for 100 candidate genes (549 SNPs). Psychiatry Res 2024; 333:115720. [PMID: 38224633 DOI: 10.1016/j.psychres.2024.115720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND This study analyzed the extent to which irregularities in genetic diversity separate psychiatric patients from healthy controls. METHODS Genetic diversity was quantified through multidimensional "gene vectors" assembled from 4 to 8 polymorphic SNPs located within each of 100 candidate genes. The number of different genotypic patterns observed per gene was called the gene's "diversity index". RESULTS The diversity indices were found to be only weakly correlated with their constituent number of SNPs (20.5 % explained variance), thus suggesting that genetic diversity is an intrinsic gene property that has evolved over the course of evolution. Significant deviations from "normal" diversity values were found for (1) major depression; (2) Alzheimer's disease; and (3) schizoaffective disorders. Almost one third of the genes were correlated with each other, with correlations ranging from 0.0303 to 0.7245. The central finding of this study was the discovery of "singular genes" characterized by distinctive genotypic patterns that appeared exclusively in patients but not in healthy controls. Neural Nets yielded nonlinear classifiers that correctly identified up to 90 % of patients. Overlaps between diagnostic subgroups on the genotype level suggested that (1) diagnoses-crossing vulnerabilities are likely involved in the pathogenesis of major psychiatric disorders; (2) clinically defined diagnoses may not constitute etiological entities. CONCLUSION Detailed analyses of the variation of genotypic patterns in genes along with the correlation between genes lead to nonlinear classifiers that enable very robust separation between psychiatric patients and healthy controls on the genotype level.
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Affiliation(s)
- H H Stassen
- Institute for Response-Genetics, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, Zurich CH-8032, Switzerland.
| | - S Bachmann
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University of Halle, Halle D-06112, Germany; Clienia AG, Psychiatric Hospital, Littenheid CH-9573, Switzerland; Department of Psychiatry, Geneva University Hospitals, Thônex CH-1226, Switzerland
| | - R Bridler
- Sanatorium Kilchberg, Kilchberg CH-8802, Switzerland
| | - K Cattapan
- Sanatorium Kilchberg, Kilchberg CH-8802, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern CH-3012, Switzerland
| | - A M Hartmann
- Clinical Division of General Psychiatry, Medical University of Vienna, Wien A-1090, Austria
| | - D Rujescu
- Clinical Division of General Psychiatry, Medical University of Vienna, Wien A-1090, Austria
| | - E Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, Zurich CH-8032, Switzerland
| | - M Weisbrod
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg D-69115, Germany; SRH Hospital Karlsbad-Langensteinbach, Karlsbad D-76307, Germany
| | - Chr Scharfetter
- Institute for Response-Genetics, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, Zurich CH-8032, Switzerland
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Stassen HH, Bachmann S, Bridler R, Cattapan K, Herzig D, Schneeberger A, Seifritz E. Detailing the effects of polypharmacy in psychiatry: longitudinal study of 320 patients hospitalized for depression or schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 272:603-619. [PMID: 34822007 PMCID: PMC9095543 DOI: 10.1007/s00406-021-01358-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/08/2021] [Indexed: 01/29/2023]
Abstract
Current treatment standards in psychiatry are oriented towards polypharmacy, that is, patients receive combinations of several antidepressants, antipsychotics, mood stabilizers, anxiolytics, hypnotics, antihistamines, and anticholinergics, along with other somatic treatments. In tandem with the beneficial effects of psychopharmacological drug treatment, patients experience significant adverse reactions which appear to have become more frequent and more severe with the rise of ubiquitous polypharmacy. In this study, we aimed to assess today's acute inpatient treatment of depressive and schizophrenic disorders with focus on therapeutic strategies, medications, adverse side effects, time course of recovery, and efficacy of treatments. Of particular interest was the weighing of the benefits and drawbacks of polypharmacy regimens. We recruited a total of 320 patients hospitalized at three residential mental health treatment centers with a diagnosis of either schizophrenic (ICD-10: "F2x.x"; n = 94; "F2 patients") or depressive disorders (ICD-10: "F3x.x"; n = 226; "F3 patients"). The study protocol included (1) assessment of previous history by means of the SADS Syndrome Check List SSCL-16 (lifetime version); (2) repeated measurements over 5 weeks assessing the time course of improvement by the Hamilton Depression Scale HAM-D and the Positive and Negative Syndrome Scale PANSS, along with medications and adverse side effects through the Medication and Side Effects Inventory MEDIS; and (3) the collection of blood samples from which DNA and serum were extracted. Polypharmacy was by far the most common treatment regimen (85%) in this study. On average, patients received 4.50 ± 2.68 medications, consisting of 3.30 ± 1.84 psychotropic drugs, plus 0.79 ± 1.13 medications that alleviate adverse side effects, plus 0.41 ± 0.89 other somatic medications. The treating psychiatrists appeared to be the main determining factor in this context, while «previous history» and «severity at baseline» played a minor role, if at all. Adverse drug reactions were found to be an inherent component of polypharmacy and tended to have a 2-3 times higher incidence compared to monotherapy. Severe adverse reactions could not be attributed to a particular drug or drug combination. Rather, the empirical data suggested that severe side effects can be triggered by virtually all combinations of drugs, provided patients have a respective vulnerability. In terms of efficacy, there were no advantages of polypharmacy over monotherapy. The results of this study underlined the fact that polypharmacy regimens are not equally suited for every patient. Specifically, such regimens appeared to have a negative impact on treatment outcome and to obfuscate the "natural" time course of recovery through a multitude of interfering factors. Evidence clearly speaks against starting just every therapeutic intervention in psychiatry with a combination of psychopharmaceuticals. We think that it is time for psychiatry to reconsider its treatment strategies, which are far too one-sidedly fixated on psychopharmacology and pay far too little attention to alternative approaches, especially in mild cases where psychotherapy without concurrent medication should still be an option. Also, regular exercises and sports can definitely be an effective therapeutic means in a considerable number of cases. General practitioners (GPs) are particularly in demand here.
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Affiliation(s)
- H. H. Stassen
- Institute for Response-Genetics, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, CH-8032 Zurich, Switzerland
| | - S. Bachmann
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University of Halle, D-06112 Halle, Germany
- Psychiatric Hospital, Clienia AG, CH-9573 Littenheid, Switzerland
| | - R. Bridler
- Sanatorium Kilchberg, CH-8802 Kilchberg, Switzerland
| | - K. Cattapan
- Sanatorium Kilchberg, CH-8802 Kilchberg, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - D. Herzig
- Institute for Response-Genetics, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, CH-8032 Zurich, Switzerland
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University of Halle, D-06112 Halle, Germany
- Psychiatric Hospital, Clienia AG, CH-9573 Littenheid, Switzerland
| | - A. Schneeberger
- Institute for Response-Genetics, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, CH-8032 Zurich, Switzerland
| | - E. Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, CH-8032 Zurich, Switzerland
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Imboden C, Claussen MC, Seifritz E, Gerber M. Physical activity for the treatment and prevention of depression: a rapid review of meta-analyses. Dtsch Z Sportmed 2021. [DOI: 10.5960/dzsm.2021.499] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aim: We conducted an umbrella review of 55 meta-analyses to summarize current evidence on the effects of exercise on depression. Results: Aerobic, resistance or combined exercise for several weeks as well as mind-body exercise has shown to yield significant moderate effects on depression severity in adult patients, including the elderly. The effect diminishes when only high-quality studies are analyzed but reaches similar magnitude of other efficacious treatments. Additionally, exercise showed positive effects on sleep, cardiorespiratory fitness and quality of life in depressed patients. In children and adolescents and during the peripartum period, exercise interventions have been found have small-to-moderate effects, but studies varied in methodology and methodical quality could be improved (heterogeneous samples, blinding). Regular physical activity has been shown to have a protective effect on incident depression in adults, reducing odds by 17 to 21%. In children and adolescents, the effect tends to be smaller. Across 15 meta-analyses in samples with physical diseases, exercise-regimes have been shown to have positive effects on depressive symptoms in chronic conditions (such as pain, obesity or cardiovascular disease), cancer survivors, and in post-stroke, neurological and cardiovascular conditions, as well as in diabetes, chronic kidney disease, arthritis and HIV. Discussion: Exercise and physical activity have a wide range of benefits for depression and depressive symptoms in at-risk populations. Further research is needed to find optimal dose and duration of exercise-treatment and ways to sustainably increase physical activity in psychiatric populations and patients with chronic diseases. Key Words: Exercise, Aerobic, Resistance, Depressive Symptoms, At-Risk Population
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Stassen HH, Bachmann S, Bridler R, Cattapan K, Herzig D, Schneeberger A, Seifritz E. Inflammatory processes linked to major depression and schizophrenic disorders and the effects of polypharmacy in psychiatry: evidence from a longitudinal study of 279 patients under therapy. Eur Arch Psychiatry Clin Neurosci 2021; 271:507-520. [PMID: 32696276 PMCID: PMC7981316 DOI: 10.1007/s00406-020-01169-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 04/01/2020] [Accepted: 07/13/2020] [Indexed: 12/27/2022]
Abstract
Over the past 2 decades, polypharmacy has become the de-facto standard of acute treatment in psychiatry where patients with psychiatric disorders receive a multiple medication regimen. There is growing evidence for a potential link between major psychiatric disorders and inflammatory processes. Combining these two aspects aims at avoiding polypharmacy attempts among patients with inflammatory activation through alternative treatment strategies. In this study, we addressed the following questions: (1) to what extent can polypharmacy be explained through the factors "diagnosis", "previous history", "severity at baseline", "age", "gender", and "psychiatrist in charge"; (2) what are the differences between polypharmacy and monotherapy regarding efficacy and side effect profiles; and (3) what amount of between-patient variance is explainable by the natural antibody immunoglobulin M (IgM) within each diagnostic group. This naturalistic longitudinal study was comprised of 279 patients under therapy with a clinical diagnosis of depressive (ICD-10: "F3x.x"; n = 195) or schizophrenic disorders (ICD-10: "F2x.x"; n = 84). The study protocol included (1) assessment of previous history by the SADS Syndrome Check List SSCL-16 (lifetime version); (2) repeated measurements over 5 weeks assessing the time course of improvement by the Hamilton Depression Scale HAM-D and the Positive and Negative Syndrome Scale PANSS, along with medication and unwanted side effects through the Medication and Side Effects Inventory MEDIS; and (3) the collection of blood samples from which DNA and serum were extracted. The association between inflammatory response system and psychiatric disorders was detailed by fitting multi-layer Neural Net (NN) models to the observed data ("supervised learning"). The same approach was used to set up prediction models of side effects. Our data showed that polypharmacy was omnipresent. Yet the various polypharmacy regimens had no advantage over monotherapy: we even found slightly larger baseline score reductions under monotherapy, independent of primary diagnoses and for comparable baseline severities. Most patients experienced unwanted side effects. The close link between side effects and treatment regimen was revealed by a linear model in which the mere number of drugs explained a significant (p < 0.001) proportion of the observed variance. As to the inflammatory response system: For the F2 patients, our NN model identified a 22.5% subgroup exhibiting a significant correlation of r = 0.746 (p = 0.0004) between global schizophrenia scores and IgM levels, along with a correct prediction of response of 94.4%, thus explaining 55.7% of the observed between-patient variance. For the F3 patients, our NN model identified a 19.6% subgroup exhibiting a significant correlation of r = 0.644 (p = 0.00003) between global depression scores and IgM levels, along a correct prediction of response of 89.6%, thus explaining 41.4% of the observed between-patient variance. Polypharmacy is omnipresent in today's acute treatment of psychiatric disorders. Given the large proportion of patients with unwanted side effects and the strong correlation between side effects and the number of drugs, polypharmacy approaches are not equally suited for every patient. In terms of efficacy, there are no advantages of polypharmacy over monotherapy. Most notably, our study appears to have cleared the way for the reliable identification of a subgroup of patients for whom the inflammatory response system is a promising target of therapeutic intervention.
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Affiliation(s)
- H. H. Stassen
- grid.412004.30000 0004 0478 9977Institute for Response-Genetics, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric Hospital, 8032 Zurich, Switzerland
| | - S. Bachmann
- grid.9018.00000 0001 0679 2801Department of Psychiatry, Psychotherapy, and Psychosomatics, University of Halle, 06112 Halle, Germany ,Clienia AG, Psychiatric Hospital, 9573 Littenheid, Switzerland
| | - R. Bridler
- grid.492890.e0000 0004 0627 5312Sanatorium Kilchberg, 8802 Kilchberg, Switzerland
| | - K. Cattapan
- grid.492890.e0000 0004 0627 5312Sanatorium Kilchberg, 8802 Kilchberg, Switzerland
| | - D. Herzig
- grid.412004.30000 0004 0478 9977Institute for Response-Genetics, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric Hospital, 8032 Zurich, Switzerland ,grid.9018.00000 0001 0679 2801Department of Psychiatry, Psychotherapy, and Psychosomatics, University of Halle, 06112 Halle, Germany ,Clienia AG, Psychiatric Hospital, 9573 Littenheid, Switzerland
| | - A. Schneeberger
- grid.412004.30000 0004 0478 9977Institute for Response-Genetics, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric Hospital, 8032 Zurich, Switzerland
| | - E. Seifritz
- grid.412004.30000 0004 0478 9977Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Psychiatric Hospital, 8032 Zurich, Switzerland
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Wade-Bohleber LM, Boeker H, Grimm S, Gärtner M, Ernst J, Recher DA, Buergi N, Seifritz E, Richter A. Depression is associated with hyperconnectivity of an introspective socio-affective network during the recall of formative relationship episodes. J Affect Disord 2020; 274:522-534. [PMID: 32663985 DOI: 10.1016/j.jad.2020.05.110] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/27/2020] [Accepted: 05/16/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Depression and the experience of early adversity are associated with impairments in interpersonal and social cognitive functioning. The neural mechanisms involved in these impairments remain insufficiently understood. METHODS In a sample of 48 depressed and 50 healthy participants, we explored seed-to-voxel functional connectivity (FC) during the recall of formative relationship episodes using functional magnetic resonance imaging. RESULTS While depressive symptoms were associated with increased FC of brain regions that form an introspective socio-affective network, such as the precuneus, bilateral anterior insula, dorsal anterior cingulate cortex, left amygdala, and medial prefrontal cortex, early adversity linked to decreased FC of brain regions mediating emotion processing such as the bilateral anterior insula and increased FC of the bilateral parahippocampal gyrus. LIMITATIONS We report both results that are corrected for the number of seeds tested in FC analyses using strict Bonferroni adjustments and unadjusted results as part of an exploratory analysis. DISCUSSION Our findings suggest that depression and early adversity are associated with differential FC patterns in the brain during the recall of formative relationship episodes. Hyperconnectivity of an introspective socio-affective network associated with depressive symptoms may link to enhanced self-focus and emotional reactivity. Patterns of neural activation associated with early adversity may underpin numbed affective states or enhanced affective memory regulation. Overall, these findings inform about the neural underpinnings of a reflective ability that is predictive of the adaptation to depression and to early adversity and relevant for psychotherapy outcomes.
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Affiliation(s)
- L M Wade-Bohleber
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland; School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - H Boeker
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - S Grimm
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland; Medical School Berlin, Berlin, Germany; Department of Psychiatry, Charité, Campus Benjamin Franklin, Berlin, Germany
| | - M Gärtner
- Medical School Berlin, Berlin, Germany; Department of Psychiatry, Charité, Campus Benjamin Franklin, Berlin, Germany
| | - J Ernst
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - D A Recher
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - N Buergi
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - E Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Switzerland
| | - A Richter
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Switzerland
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Maeder T, Whitford J, Feinaigle P, Karlen W, Seifritz E, Pace-Schott EF, Kleim B. 0552 Investigating Pre-Sleep Processes and How They Influence Sleep: A Diary and Actigraphy Study. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The current study examined the relationship between pre-sleep processes and sleep in the context of real-world stress exposure in medical students during an internship. Medical students are often exposed to a variety of stressors and potentially traumatic events and have been shown to be at risk to develop psychopathology. Previous research has shown an association between stress, psychological distress, and sleep disturbances. In this context, studies have investigated possible predictors for sleep disturbances. Recently, the period just prior to sleep onset has received increased interest. At the moment, little is known, however, about the influence of such pre-sleep processes. In this study, we investigated the influence of pre-sleep rumination and mindfulness on sleep disturbances.
Methods
In a prospective study, we examined a sample of 50 medical students from the University of Zurich. All participants completed their first medical internship over 9 months as part of medical school. Pre-sleep processes and sleep were indexed mid-internship using sleep diaries over seven consecutive days. Additionally, a Fitbit tracking device was used to objectively measure sleep. Correlational analyses and multilevel linear models were conducted.
Results
Results show associations between pre-sleep processes and sleep disturbances in this stress-exposed at-risk population. Multilevel mixed-effects models showed that over the period of 7 consecutive nights, pre-sleep rumination was a significant predictor of lower subjective sleep quality (B = -.085, SE = .036, p = .02), lower subjective total sleep time (B = -.124, SE = .043, p = .005), higher subjective sleep onset latency (B = 1.535, SE = .678, p = .025), and higher subjective wake-up frequency (B = .033, SE = .011, p = .003).
Conclusion
Together, our data suggest pre-sleep processes as potential targets for stress-prevention programs that could help reduce the negative influence of stress in at risk populations.
Support
NA
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Affiliation(s)
- T Maeder
- University of Zurich, Zurich, SWITZERLAND
| | - J Whitford
- University of Zurich, Zurich, SWITZERLAND
| | | | - W Karlen
- Swiss Federal Institute of Technology Zurich, Zurich, SWITZERLAND
| | - E Seifritz
- Psychiatric University Hospital Zurich, Zurich, SWITZERLAND
| | - E F Pace-Schott
- Massachusetts General Hospital, Harvard Medical School, Charlestown, MA
| | - B Kleim
- University of Zurich, Zurich, SWITZERLAND
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Abstract
The human insular cortex is involved in a wide range of functions. A recent study done by conducting an activation likelihood estimate (ALE) meta-analysis suggests that there are anatomical subregions with functional specializations for motor processing, auditory perception and homeostatic control, which plays an important role in emotional processing (Mutschler et al., 2009). An increasing number of studies propose the involvement of the anterior insula in experiencing pain and empathy for pain, e.g. when someone perceives a loved one feeling pain (Craig, 2009, Singer et al., 2004). In this present work, the activation likelihood estimate (ALE) method (Turkeltaub et al., 2002) was applied and 59 studies reporting pain processing and 19 investigating empathy for pain entered the meta-analysis to investigate the questions whether there are functional specializations within the insular cortex for pain processing and empathy for pain. Pain studies revealed activation in the posterior and mid-anterior part of the insula. In contrast, the ALE-maximum of studies investigating empathy for pain was located more anterior than studies investigating physically induced pain. The present findings provide insights into the organization of the human anterior insula and support the posterior-to-anterior gradient for interoceptive representations in the Insula proposed by Craig (2009). According to this view, an increasingly elaborate and complex representation of bodily states may progress from the posterior to the anterior insula region. Meta-analyses represent an important methodological approach for ruling out false positive results and contribute to the generation of hypotheses which can be experimentally proven.
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10
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Dornbierer DA, Boxler M, Voegel CD, Stucky B, Steuer AE, Binz TM, Baumgartner MR, Baur DM, Quednow BB, Kraemer T, Seifritz E, Landolt HP, Bosch OG. Nocturnal Gamma-Hydroxybutyrate Reduces Cortisol-Awakening Response and Morning Kynurenine Pathway Metabolites in Healthy Volunteers. Int J Neuropsychopharmacol 2019; 22:631-639. [PMID: 31504554 PMCID: PMC6822136 DOI: 10.1093/ijnp/pyz047] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/03/2019] [Accepted: 08/27/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gamma-hydroxybutyrate (GHB; or sodium oxybate) is an endogenous GHB-/gamma-aminobutyric acid B receptor agonist. It is approved for application in narcolepsy and has been proposed for the potential treatment of Alzheimer's disease, Parkinson's disease, fibromyalgia, and depression, all of which involve neuro-immunological processes. Tryptophan catabolites (TRYCATs), the cortisol-awakening response (CAR), and brain-derived neurotrophic factor (BDNF) have been suggested as peripheral biomarkers of neuropsychiatric disorders. GHB has been shown to induce a delayed reduction of T helper and natural killer cell counts and alter basal cortisol levels, but GHB's effects on TRYCATs, CAR, and BDNF are unknown. METHODS Therefore, TRYCAT and BDNF serum levels, as well as CAR and the affective state (Positive and Negative Affect Schedule [PANAS]) were measured in the morning after a single nocturnal dose of GHB (50 mg/kg body weight) in 20 healthy male volunteers in a placebo-controlled, balanced, randomized, double-blind, cross-over design. RESULTS In the morning after nocturnal GHB administration, the TRYCATs indolelactic acid, kynurenine, kynurenic acid, 3-hydroxykynurenine, and quinolinic acid; the 3-hydroxykynurenine to kynurenic acid ratio; and the CAR were significantly reduced (P < 0.05-0.001, Benjamini-Hochberg corrected). The quinolinic acid to kynurenic acid ratio was reduced by trend. Serotonin, tryptophan, and BDNF levels, as well as PANAS scores in the morning, remained unchanged after a nocturnal GHB challenge. CONCLUSIONS GHB has post-acute effects on peripheral biomarkers of neuropsychiatric disorders, which might be a model to explain some of its therapeutic effects in disorders involving neuro-immunological pathologies. This study was registered at ClinicalTrials.gov as NCT02342366.
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Affiliation(s)
- D A Dornbierer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland,Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland,Correspondence: Dario A. Dornbierer, MSc, Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital, University of Zurich Lenggstrasse 31, CH-8032 Zurich, Switzerland ()
| | - M Boxler
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - C D Voegel
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - B Stucky
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland,Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
| | - A E Steuer
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - T M Binz
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - M R Baumgartner
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - D M Baur
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland,Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
| | - B B Quednow
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,Neuroscience Center Zurich, University Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - T Kraemer
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - E Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland,Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland,Neuroscience Center Zurich, University Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - H P Landolt
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland,Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland,Neuroscience Center Zurich, University Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - O G Bosch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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11
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Herwig U, Lutz J, Scherpiet S, Scheerer H, Kohlberg J, Opialla S, Preuss A, Steiger V, Sulzer J, Weidt S, Stämpfli P, Rufer M, Seifritz E, Jäncke L, Brühl A. Training emotion regulation through real-time fMRI neurofeedback of amygdala activity. Neuroimage 2019; 184:687-696. [DOI: 10.1016/j.neuroimage.2018.09.068] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 08/03/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022] Open
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12
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Grimm O, Kraehenmann R, Preller KH, Seifritz E, Vollenweider FX. Psilocybin modulates functional connectivity of the amygdala during emotional face discrimination. Eur Neuropsychopharmacol 2018; 28:691-700. [PMID: 29703645 DOI: 10.1016/j.euroneuro.2018.03.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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: 08/28/2017] [Revised: 12/28/2017] [Accepted: 03/22/2018] [Indexed: 11/26/2022]
Abstract
Recent studies suggest that the antidepressant effects of the psychedelic 5-HT2A receptor agonist psilocybin are mediated through its modulatory properties on prefrontal and limbic brain regions including the amygdala. To further investigate the effects of psilocybin on emotion processing networks, we studied for the first-time psilocybin's acute effects on amygdala seed-to-voxel connectivity in an event-related face discrimination task in 18 healthy volunteers who received psilocybin and placebo in a double-blind balanced cross-over design. The amygdala has been implicated as a salience detector especially involved in the immediate response to emotional face content. We used beta-series amygdala seed-to-voxel connectivity during an emotional face discrimination task to elucidate the connectivity pattern of the amygdala over the entire brain. When we compared psilocybin to placebo, an increase in reaction time for all three categories of affective stimuli was found. Psilocybin decreased the connectivity between amygdala and the striatum during angry face discrimination. During happy face discrimination, the connectivity between the amygdala and the frontal pole was decreased. No effect was seen during discrimination of fearful faces. Thus, we show psilocybin's effect as a modulator of major connectivity hubs of the amygdala. Psilocybin decreases the connectivity between important nodes linked to emotion processing like the frontal pole or the striatum. Future studies are needed to clarify whether connectivity changes predict therapeutic effects in psychiatric patients.
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Affiliation(s)
- O Grimm
- University Hospital Frankfurt, Departement of Psychiatry, Psychosomatics and Psychotherapy, Frankfurt am Main, Germany; Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland.
| | - R Kraehenmann
- Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland
| | - K H Preller
- Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland
| | - E Seifritz
- Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland
| | - F X Vollenweider
- Psychiatric Hospital Zürich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zürich, Switzerland
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13
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Cathomas F, Azzinnari D, Bergamini G, Sigrist H, Buerge M, Hoop V, Wicki B, Goetze L, Soares S, Kukelova D, Seifritz E, Goebbels S, Nave KA, Ghandour MS, Seoighe C, Hildebrandt T, Leparc G, Klein H, Stupka E, Hengerer B, Pryce CR. Oligodendrocyte gene expression is reduced by and influences effects of chronic social stress in mice. Genes, Brain and Behavior 2018; 18:e12475. [DOI: 10.1111/gbb.12475] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 03/18/2018] [Accepted: 03/19/2018] [Indexed: 12/16/2022]
Affiliation(s)
- F. Cathomas
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
| | - D. Azzinnari
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
- Neuroscience Center Zurich; University of Zurich and ETH Zurich; Zurich Switzerland
| | - G. Bergamini
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
- Neuroscience Center Zurich; University of Zurich and ETH Zurich; Zurich Switzerland
| | - H. Sigrist
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
| | - M. Buerge
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
| | - V. Hoop
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
- Institute of Human Movement Sciences and Sport; ETH Zurich; Zurich Switzerland
| | - B. Wicki
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
| | - L. Goetze
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
| | - S. Soares
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
| | - D. Kukelova
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
| | - E. Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
| | - S. Goebbels
- Department of Neurogenetics; Max Planck Institute of Experimental Medicine; Goettingen Germany
| | - K.-A. Nave
- Department of Neurogenetics; Max Planck Institute of Experimental Medicine; Goettingen Germany
| | - M. S. Ghandour
- Center of Neurochemistry, University of Strasbourg, UMR 7357; Strasbourg France
- Department of Anatomy and Neurobiology; Virginia Commonwealth University; Richmond Virginia
| | - C. Seoighe
- School of Mathematics, Statistics & Applied Mathematics; National University of Ireland; Galway Ireland
| | - T. Hildebrandt
- Target Discovery Germany; Boehringer Ingelheim Pharma GmbH & Co. KG.; Biberach Germany
| | - G. Leparc
- Target Discovery Germany; Boehringer Ingelheim Pharma GmbH & Co. KG.; Biberach Germany
| | - H. Klein
- Target Discovery Germany; Boehringer Ingelheim Pharma GmbH & Co. KG.; Biberach Germany
| | - E. Stupka
- Target Discovery Germany; Boehringer Ingelheim Pharma GmbH & Co. KG.; Biberach Germany
| | - B. Hengerer
- CNS Diseases Research Germany; Boehringer Ingelheim Pharma GmbH & Co. KG.; Biberach Germany
| | - C. R. Pryce
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics; Psychiatric Hospital, University of Zurich; Zurich Switzerland
- Neuroscience Center Zurich; University of Zurich and ETH Zurich; Zurich Switzerland
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14
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Abstract
A substantial proportion of the burden of depression arises from its recurrent nature. The risk of relapse after antidepressant medication (ADM) discontinuation is high but not uniform. Predictors of individual relapse risk after antidepressant discontinuation could help to guide treatment and mitigate the long-term course of depression. We conducted a systematic literature search in PubMed to identify relapse predictors using the search terms '(depress* OR MDD*) AND (relapse* OR recurren*) AND (predict* OR risk) AND (discontinu* OR withdraw* OR maintenance OR maintain or continu*) AND (antidepress* OR medication OR drug)' for published studies until November 2014. Studies investigating predictors of relapse in patients aged between 18 and 65 years with a main diagnosis of major depressive disorder (MDD), who remitted from a depressive episode while treated with ADM and were followed up for at least 6 months to assess relapse after part of the sample discontinued their ADM, were included in the review. Although relevant information is present in many studies, only 13 studies based on nine separate samples investigated predictors for relapse after ADM discontinuation. There are multiple promising predictors, including markers of true treatment response and the number of prior episodes. However, the existing evidence is weak and there are no established, validated markers of individual relapse risk after antidepressant cessation. There is little evidence to guide discontinuation decisions in an individualized manner beyond overall recurrence risk. Thus, there is a pressing need to investigate neurobiological markers of individual relapse risk, focusing on treatment discontinuation.
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Affiliation(s)
- I. M. Berwian
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Lenggstrasse 31, 8032 Zürich, Switzerland
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Wilfriedstrasse 6, 8032 Zürich, Switzerland
| | - H. Walter
- Mind and Brain, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - E. Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Lenggstrasse 31, 8032 Zürich, Switzerland
| | - Q. J. M. Huys
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Lenggstrasse 31, 8032 Zürich, Switzerland
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Wilfriedstrasse 6, 8032 Zürich, Switzerland
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15
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Ernst J, Hock A, Henning A, Seifritz E, Boeker H, Grimm S. Increased pregenual anterior cingulate glucose and lactate concentrations in major depressive disorder. Mol Psychiatry 2017; 22:113-119. [PMID: 27184123 DOI: 10.1038/mp.2016.73] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/25/2016] [Accepted: 03/31/2016] [Indexed: 12/27/2022]
Abstract
There is ample evidence that glucose metabolism in the pregenual anterior cingulate cortex (PACC) is increased in major depressive disorder (MDD), whereas it is still unknown whether glucose levels per se are also elevated. Elevated cerebrospinal fluid (CSF) lactate concentrations in MDD patients might indicate that increased glycolytical metabolization of glucose to lactate in astrocytes either alone or in conjunction with mitochondrial dysfunction results in an accumulation of lactate and contributes to pathophysiological mechanisms of MDD. However, until now, no study investigated in vivo PACC glucose and lactate levels in MDD. Proton magnetic resonance spectroscopy was therefore used to test the hypothesis that patients with MDD have increased PACC glucose and lactate levels. In 40 healthy and depressed participants, spectra were acquired from the PACC using a maximum echo J-resolved spectroscopy protocol. Results show significant increases of glucose and lactate in patients, which are also associated with depression severity. These findings indicate impaired brain energy metabolism in MDD with increased fraction of energy utilization via glycolysis and reduced mitochondrial oxidative clearance of lactate. Targeting these metabolic disturbances might affect the balance of metabolic pathways regulating neuronal energetics and result in an attenuation of the elevated basal activity of brain regions within the neural circuitry of depression.
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Affiliation(s)
- J Ernst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - A Hock
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - A Henning
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland.,Max Planck Institute for Biological Cybernetics, Tuebingen, Germany
| | - E Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
| | - H Boeker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - S Grimm
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,Department of Psychiatry, Charité, Campus Benjamin Franklin, Berlin, Germany
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16
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Holper L, Scholkmann F, Seifritz E. Time-frequency dynamics of the sum of intra- and extracerebral hemodynamic functional connectivity during resting-state and respiratory challenges assessed by multimodal functional near-infrared spectroscopy. Neuroimage 2016; 125:1174. [PMID: 28800681 DOI: 10.1016/j.neuroimage.2015.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- L Holper
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
| | - F Scholkmann
- Biomedical Optics Research Laboratory, Division of Neonatology, University Hospital Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland
| | - E Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
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17
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Hulka LM, Vonmoos M, Preller KH, Baumgartner MR, Seifritz E, Gamma A, Quednow BB. Changes in cocaine consumption are associated with fluctuations in self-reported impulsivity and gambling decision-making. Psychol Med 2015; 45:3097-3110. [PMID: 26081043 DOI: 10.1017/s0033291715001063] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND In cross-sectional studies, cocaine users generally display elevated levels of self-reported and cognitive impulsivity. To what extent these impairments are stable v. variable markers of cocaine use disorder, and, thus, are pre-existing or drug-induced, has not yet been systematically investigated. METHOD We conducted a longitudinal study with cocaine users who changed or maintained their consumption intensity, measuring self-reported impulsivity with the Barratt Impulsiveness Scale (BIS-11), and cognitive impulsivity with the Rapid Visual Processing task (RVP), Iowa Gambling task (IGT), and Delay Discounting task (DD) at baseline and at 1-year follow-up. We assessed 48 psychostimulant-naive controls and 19 cocaine users with decreased, 19 users with increased, and 19 users with unchanged cocaine intake after 1 year as confirmed by hair analysis. RESULTS Results of linear multilevel modelling showed significant group × time interactions for the BIS-11 total score and the IGT total card ratio. Increasers showed a trend for elevated scores, whereas decreasers exhibited reduced self-reported impulsivity scores within 1 year. Surprisingly, increasers' IGT performance was improved after 1 year, whereas decreasers' performance deteriorated. By contrast, neither RVP response bias B" nor DD total score showed substantial group × time interactions. Importantly, BIS-11 and DD revealed strong test-retest reliabilities. CONCLUSION Self-reported impulsivity (BIS-11) and decision-making impulsivity (IGT) covary with changing cocaine use, whereas response bias and delay discounting remain largely unaffected. Thus, self-reported impulsivity and gambling decision-making were strongly state-dependent in a stimulant-using population and may be suitable to monitor treatment success, whereas delay of gratification was confirmed as a potential endophenotype of stimulant addiction.
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Affiliation(s)
- L M Hulka
- Experimental and Clinical Pharmacopsychology,Department of Psychiatry,Psychotherapy, and Psychosomatics, Psychiatric Hospital,University of Zurich,Switzerland
| | - M Vonmoos
- Experimental and Clinical Pharmacopsychology,Department of Psychiatry,Psychotherapy, and Psychosomatics, Psychiatric Hospital,University of Zurich,Switzerland
| | - K H Preller
- Experimental and Clinical Pharmacopsychology,Department of Psychiatry,Psychotherapy, and Psychosomatics, Psychiatric Hospital,University of Zurich,Switzerland
| | - M R Baumgartner
- Center of Forensic Hairanalytics,Institute of Forensic Medicine,University of Zurich,Switzerland
| | - E Seifritz
- Director of the Department of Psychiatry,Psychotherapy, and Psychosomatics,Psychiatric Hospital,University of Zurich,Switzerland
| | - A Gamma
- Division of ADHD Research,Department of Psychiatry, Psychotherapy, and Psychosomatics,Psychiatric Hospital,University of Zurich,Switzerland
| | - B B Quednow
- Experimental and Clinical Pharmacopsychology,Department of Psychiatry,Psychotherapy, and Psychosomatics, Psychiatric Hospital,University of Zurich,Switzerland
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18
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Holper L, Scholkmann F, Seifritz E. Time-frequency dynamics of the sum of intra- and extracerebral hemodynamic functional connectivity during resting-state and respiratory challenges assessed by multimodal functional near-infrared spectroscopy. Neuroimage 2015; 120:481-92. [PMID: 26169319 DOI: 10.1016/j.neuroimage.2015.07.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/29/2015] [Accepted: 07/07/2015] [Indexed: 12/13/2022] Open
Abstract
Monitoring respiratory processes is important for evaluating neuroimaging data, given their influence on time-frequency dynamics of intra- and extracerebral hemodynamics. Here we investigated the time-frequency dynamics of the sum of intra- and extracerebral hemodynamic functional connectivity states during hypo- and hypercapnia by using three different respiratory challenge tasks (i.e., hyperventilation, breath-holding, and rebreathing) compared to resting-state. The sum of intra- and extracerebral hemodynamic responses were assessed using functional near-infrared spectroscopy (fNIRS) within two regions of interest (i.e., the dorsolateral and the medial prefrontal cortex). Time-frequency fNIRS analysis was performed based on wavelet transform coherence to quantify functional connectivity in terms of positive and negative phase-coupling within each region of interest. Physiological measures were assessed in the form of partial end-tidal carbon dioxide, heart rate, arterial tissue oxygen saturation, and respiration rate. We found that the three respiration challenges modulated time-frequency dynamics differently with respect to resting-state: 1) Hyperventilation and breath-holding exhibited inverse patterns of positive and negative phase-coupling. 2) In contrast, rebreathing had no significant effect. 3) Low-frequency oscillations contributed to a greater extent to time-frequency dynamics compared to high-frequency oscillations. The results highlight that there exist distinct differences in time-frequency dynamics of the sum of intra- and extracerebral functional connectivity not only between hypo- (hyperventilation) and hypercapnia but also between different states of hypercapnia (breath-holding versus rebreathing). This suggests that a multimodal assessment of intra-/extracerebral and systemic physiological changes during respiratory challenges compared to resting-state may have potential use in the differentiation between physiological and pathological respiratory behavior accompanied by the psycho-physiological state of a human.
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Affiliation(s)
- L Holper
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
| | - F Scholkmann
- Biomedical Optics Research Laboratory, Division of Neonatology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland
| | - E Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
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19
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Chumbley J, Späti J, Dörig N, Brakowski J, Grosse Holtforth M, Seifritz E, Spinelli S. BDNF Val66Met polymorphism influence on striatal blood-level-dependent response to monetary feedback depends on valence and agency. Neuroscience 2014; 280:130-41. [PMID: 25234319 DOI: 10.1016/j.neuroscience.2014.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 07/03/2014] [Revised: 09/01/2014] [Accepted: 09/08/2014] [Indexed: 10/24/2022]
Abstract
Animal work implicates the brain-derived neurotrophic factor (BDNF) in function of the ventral striatum (VS), a region known for its role in processing valenced feedback. Recent evidence in humans shows that BDNF Val66Met polymorphism modulates VS activity in anticipation of monetary feedback. However, it remains unclear whether the polymorphism impacts the processing of self-attributed feedback differently from feedback attributed to an external agent. In this study, we emphasize the importance of the feedback attribution because agency is central to computational accounts of the striatum and cognitive accounts of valence processing. We used functional magnetic resonance imaging and a task, in which financial gains/losses are either attributable to performance (self-attributed, SA) or chance (externally-attributed, EA) to ask whether BDNF Val66Met polymorphism predicts VS activity. We found that BDNF Val66Met polymorphism influenced how feedback valence and agency information were combined in the VS and in the right inferior frontal junction (IFJ). Specifically, Met carriers' VS response to valenced feedback depended on agency information, while Val/Val carriers' VS response did not. This context-specific modulation of valence effectively amplified VS responses to SA losses in Met carriers. The IFJ response to SA losses also differentiated Val/Val from Met carriers. These results may point to a reduced allocation of attention and altered motivational salience to SA losses in Val/Val compared to Met carriers. Implications for major depressive disorder are discussed.
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Affiliation(s)
- J Chumbley
- Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Switzerland
| | - J Späti
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - N Dörig
- Department of Psychology, University of Zurich, Switzerland; Neuroscience Center, University and ETH Zurich, Switzerland
| | - J Brakowski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Switzerland
| | - M Grosse Holtforth
- Department of Psychology, University of Zurich, Switzerland; Department of Psychology, University of Bern, Switzerland
| | - E Seifritz
- Neuroscience Center, University and ETH Zurich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland
| | - S Spinelli
- Neuroscience Center, University and ETH Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland; Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Switzerland.
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Hulka LM, Treyer V, Scheidegger M, Preller KH, Vonmoos M, Baumgartner MR, Johayem A, Ametamey SM, Buck A, Seifritz E, Quednow BB. Smoking but not cocaine use is associated with lower cerebral metabotropic glutamate receptor 5 density in humans. Mol Psychiatry 2014; 19:625-32. [PMID: 23628984 DOI: 10.1038/mp.2013.51] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 03/18/2013] [Indexed: 12/18/2022]
Abstract
Long-lasting neuroadaptations in the glutamatergic corticostriatal circuitry have been suggested to be responsible for the persisting nature of drug addiction. In particular, animal models have linked the metabotropic glutamate receptor 5 (mGluR5) to drug-seeking behavior and extinction learning. Accordingly, blocking mGluR5s attenuated self-administration of cocaine and other addictive drugs in rats. How these animal findings extend to humans remains unclear. Therefore, we investigated if human cocaine users (CU) exhibit altered mGluR5 availability compared with drug-naïve control subjects. Seventeen male controls (11 smokers) and 18 male cocaine users (13 smokers) underwent positron emission tomography with (11)C-ABP688 to quantify mGluR5 availability in 12 volumes of interest in addiction-related brain areas. Drug use was assessed by self-report and quantitative hair toxicology. CU and controls did not significantly differ in regional mGluR5 availability. In contrast, smokers (n=24) showed significantly lower mGluR5 density throughout the brain (mean 20%) compared with non-smokers (n=11). In terms of effect sizes, lower mGluR5 availability was most pronounced in the caudate nucleus (d=1.50, 21%), insula (d=1.47, 20%), and putamen (d=1.46, 18%). Duration of smoking abstinence was positively associated with mGluR5 density in all brain regions of interest, indicating that lower mGluR5 availability was particularly pronounced in individuals who had smoked very recently. Specifically tobacco smoking was associated with lower mGluR5 availability in both CU and controls, while cocaine use was not linked to detectable mGluR5 alterations. These findings have important implications regarding the development of novel pharmacotherapies aimed at facilitating smoking cessation.
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Affiliation(s)
- L M Hulka
- Experimental and Clinical Pharmacopsychology, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - V Treyer
- Division of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - M Scheidegger
- 1] Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland [2] Institute for Biomedical Engineering, University and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - K H Preller
- Experimental and Clinical Pharmacopsychology, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - M Vonmoos
- Experimental and Clinical Pharmacopsychology, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - M R Baumgartner
- Institute of Legal Medicine, University of Zurich, Zurich, Switzerland
| | - A Johayem
- Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology Zurich, University of Zurich, Zurich, Switzerland
| | - S M Ametamey
- 1] Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology Zurich, University of Zurich, Zurich, Switzerland [2] Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - A Buck
- 1] Division of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland [2] Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - E Seifritz
- 1] Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland [2] Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - B B Quednow
- 1] Experimental and Clinical Pharmacopsychology, University Hospital of Psychiatry Zurich, Zurich, Switzerland [2] Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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21
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Hulka LM, Eisenegger C, Preller KH, Vonmoos M, Jenni D, Bendrick K, Baumgartner MR, Seifritz E, Quednow BB. Altered social and non-social decision-making in recreational and dependent cocaine users. Psychol Med 2014; 44:1015-1028. [PMID: 23870112 DOI: 10.1017/s0033291713001839] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Maladaptive decision-making is assumed to be a core feature of cocaine addiction. Indeed, numerous studies have reported deficits in non-social decision-making tasks and reward-related impulsivity in dependent cocaine users. However, social decision-making has not been examined in cocaine users yet. Moreover, it is unknown if even recreational and non-dependent cocaine use is linked to decision-making deficits. Therefore, we investigated whether recreational and dependent cocaine users exhibit alterations in social and non-social decision-making. METHOD The performance of healthy controls (n = 68), recreational cocaine users (n = 68) and dependent cocaine users (n = 30) in classical decision-making paradigms (Iowa Gambling Task, Delay Discounting) and in social interaction paradigms (Distribution Game, Dictator Game) was assessed. RESULTS Decisions in the social interaction tasks of both cocaine user groups were more self-serving compared with controls as cocaine users preferred higher monetary payoffs for themselves. In the Iowa Gambling Task, only dependent cocaine users were more likely to choose disadvantageous card decks, reflecting worse decision-making. They were also more likely to choose immediate smaller rewards over larger delayed rewards in the Delay Discounting task. CONCLUSIONS Our results imply that both recreational and dependent cocaine users are more concerned with their own monetary gain when interacting with another person. Furthermore, primarily dependent cocaine users are less foresighted and more impulsive regarding immediate reward. Overall, social interaction deficits are already present in recreational users, while non-social decision-making deficits occur predominantly in dependent cocaine users. Thus, social interaction training and cognitive remediation strategies may improve treatment success and quality of life in cocaine dependence.
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Affiliation(s)
- L M Hulka
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - C Eisenegger
- Behavioural and Clinical Neuroscience Institute, Department of Experimental Psychology, University of Cambridge, Cambridge, UK
| | - K H Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - M Vonmoos
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - D Jenni
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - K Bendrick
- Department of Economics, University of Konstanz, Konstanz, Germany
| | - M R Baumgartner
- Institute of Legal Medicine, University of Zurich, Zurich, Switzerland
| | - E Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - B B Quednow
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
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Vetter J, Bohleber L, Ernst J, Himmighofen H, Seifritz E, Boeker H. EPA-0779 – Investigation of the process during psychotherapy with depressed patients using psychodynamic diagnostics. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78125-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Egger S, Ernst J, Grimm S, Boeker H, Vetter S, Seifritz E, Schuepbach D. EPA-1297 - Lateralization of cerebral hemodynamics in schizophrenia during the trail making test: a functional transcranial doppler sonography study. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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24
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Ernst J, Bohleber L, Richter A, Vetter J, Himmighoffen H, Hofmann E, Seifritz E, Böker H. EPA-0866 – Using an individualized neuroimaging approach to investigate effects of psychotherapy in depression. First results of the zurich depression study. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78197-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pryce C, Azzinnari D, Sigrist H, Seifritz E, Fuertig R, Ceci A, Hengerer B. EPA-1343 – Chronic psychosocial stress in mice causes neuro-immune-monoamine changes in brain and depression-relevant behaviour that is reversible by anti-inflammatory treatment. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78558-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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26
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Bohleber L, Ernst J, Seifritz E, Böker H. EPA-0771 – How can we investigate neural correlates of psychotherapy in depression? a systematic review of experimental designs used in neuroimaging studies. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Sulzer J, Haller S, Scharnowski F, Weiskopf N, Birbaumer N, Blefari M, Bruehl A, Cohen L, deCharms R, Gassert R, Goebel R, Herwig U, LaConte S, Linden D, Luft A, Seifritz E, Sitaram R. Real-time fMRI neurofeedback: progress and challenges. Neuroimage 2013; 76:386-99. [PMID: 23541800 PMCID: PMC4878436 DOI: 10.1016/j.neuroimage.2013.03.033] [Citation(s) in RCA: 289] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 03/14/2013] [Accepted: 03/19/2013] [Indexed: 01/30/2023] Open
Abstract
In February of 2012, the first international conference on real time functional magnetic resonance imaging (rtfMRI) neurofeedback was held at the Swiss Federal Institute of Technology Zurich (ETHZ), Switzerland. This review summarizes progress in the field, introduces current debates, elucidates open questions, and offers viewpoints derived from the conference. The review offers perspectives on study design, scientific and clinical applications, rtfMRI learning mechanisms and future outlook.
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Affiliation(s)
- J. Sulzer
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology, (ETH), Zurich CH-8092, Switzerland
| | - S. Haller
- University of Geneva, Geneva University Hospital CH-1211, Switzerland
| | - F. Scharnowski
- Department of Radiology and Medical Informatics - CIBM, University of Geneva, Switzerland
- Institute of Bioengineering, Swiss Institute of Technology Lausanne (EPFL) CH-1015, Switzerland
| | - N. Weiskopf
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London WC1E 6BT, UK
| | - N. Birbaumer
- The Institute of Medical Psychology and Behavioral Neurobiology, University of Tuebingen 72074, Germany
- Ospedale San Camillo, IRCCS, Venice 30126, Italy
| | - M.L. Blefari
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology, (ETH), Zurich CH-8092, Switzerland
| | - A.B. Bruehl
- Department of Psychiatry, Psychotherapy and Psychosomatica, Zürich University Hospital for Psychiatry, Zurich CH-8032, Switzerland
| | - L.G. Cohen
- National Institutes of Health, Bethesda 20892, USA
| | | | - R. Gassert
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology, (ETH), Zurich CH-8092, Switzerland
| | - R. Goebel
- Department of Neurocognition, University of Maastricht 6200, The Netherlands
| | - U. Herwig
- Department of Psychiatry, Psychotherapy and Psychosomatica, Zürich University Hospital for Psychiatry, Zurich CH-8032, Switzerland
- Department of Psychiatry and Psychotherapy III, University of Ulm, Germany
| | - S. LaConte
- Virginia Tech Carilion Research Institute 24016, USA
| | | | - A. Luft
- Department of Neurology, University Hospital Zurich, Switzerland
- University of Zurich CH-8008, Switzerland
| | - E. Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatica, Zürich University Hospital for Psychiatry, Zurich CH-8032, Switzerland
| | - R. Sitaram
- The Institute of Medical Psychology and Behavioral Neurobiology, University of Tuebingen 72074, Germany
- Department of Biomedical Engineering, University of Florida, Gainesville 32611, USA
- Sri Chitra Tirunal Institute of Medical Science and Technology, Trivandrum, India
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Pude I, Boeker H, Seifritz E, Schuepbach D. 1779 – Spectral analysis of cerebral hemodynamics and gender during set shifting and set maintenance. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76755-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Grimm S, Scheidegger M, Henning A, Walter M, Weigand A, Böker H, Bajbouj M, Seifritz E. Emotionalcognitive processing and brain metabolism after pharmacological challenge with ketamine. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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30
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Scheidegger M, Henning A, Walter M, Fuchs A, Krähenmann R, Böker H, Bösiger P, Seifritz E, Grimm S. Acute ketamine administration modulates glutamatergic neurotransmission and functional brain activation in prefrontal cortex implications for major depression. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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31
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Himmighoffen H, Seifritz E, Boeker H. Serotonin syndrome after discontinuation of olanzapine in a combined treatment with duloxetine -- case report. Pharmacopsychiatry 2010; 44:75-6. [PMID: 21161885 DOI: 10.1055/s-0030-1268420] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Habermeyer B, Händel N, Lemoine P, Seifritz E, Mager R, Dittmann V, Graf M. PW01-118 - Personality traits and response inhibition in pedophile sexual abusers, pedophile internet abusers and controls - preliminary results. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71517-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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33
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Kraus A, Valerius G, Seifritz E, Ruf M, Bremner JD, Bohus M, Schmahl C. Script-driven imagery of self-injurious behavior in patients with borderline personality disorder: a pilot FMRI study. Acta Psychiatr Scand 2010; 121:41-51. [PMID: 19522883 PMCID: PMC3233769 DOI: 10.1111/j.1600-0447.2009.01417.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Self-injurious behavior (SIB) is one of the most distinctive features of borderline personality disorder (BPD) and related to impulsivity and emotional dysregulation. METHOD Female patients with BPD (n = 11) and healthy controls (n = 10) underwent functional magnetic resonance imaging while listening to a standardized script describing an act of self-injury. Experimental sections of the script were contrasted to the neutral baseline section and group-specific brain activities were compared. RESULTS While imagining the reactions to a situation triggering SIB, patients with BPD showed significantly less activation in the orbitofrontal cortex compared with controls. Furthermore, only patients with BPD showed increased activity in the dorsolateral prefrontal cortex during this section and a decrease in the mid-cingulate while imagining the self-injurious act itself. CONCLUSION This pattern of activation preliminary suggests an association with diminished emotion regulation, impulse control as well as with response selection and reappraisal during the imagination of SIB.
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Affiliation(s)
- A. Kraus
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - G. Valerius
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - E. Seifritz
- Clinic of Affective Disorders and General Psychiatry, Psychiatric University Hospital, Zuerich, Switzerland
| | - M. Ruf
- Department of Neuroimaging, Central Institute of Mental Health, Mannheim, Germany
| | - J. D. Bremner
- Departments of Psychiatry and Behavioral Sciences and Radiology, Emory University School of Medicine; Atlanta VAMC, Decatur, GA, USA
| | - M. Bohus
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - C. Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
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Habermeyer B, Esposito F, Stefani O, Klarhöfer M, Kuhl HC, Müller-Spahn F, Seifritz E, Mager R. Modulation of Stroop interference by auditory pre-stimulation. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70997-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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35
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Wirtz G, Baas U, Hofer H, Nyffeler T, Seifritz E, Müri R, Gutbrod K. [Psychopathology of Ganser's syndrome. Literature review and case report]. Nervenarzt 2008; 79:543-57. [PMID: 18274720 DOI: 10.1007/s00115-008-2411-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The key feature of Ganser's syndrome includes approximate answers to simple questions. The cause of this rare syndrome remains uncertain. Current classification systems categorise it as a dissociative disorder, the symptoms of which are judged as psychogenic in origin. Our review of the literature (n=151) demonstrates however that Ganser's syndrome is frequently associated with brain injury, although detailed imaging, neuropsychological, and neurological data of this for the most part do not exist. We describe a right-handed patient with Ganser's syndrome after a large left-hemispheric middle cerebral artery infarction. Detailed neuropsychological examination showed atypical lateralisation of cognitive functions with so-called crossed nonaphasia and pronounced frontal-executive dysfunctions. Regarding both psychiatric and neuropsychological aspects, we discuss how the key feature of approximate answers may be associated with frontal-executive cerebral dysfunctions.
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Affiliation(s)
- G Wirtz
- Universitäre Psychiatrische Dienste Bern, Universitätsklinik für Klinische Psychiatrie, Bern, Switzerland
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Hättenschwiler J, Baumann P, Hatzinger M, Höck P, HolsboerTrachsler E, Jost M, Nil R, Ramseier F, Seifritz E, Zullino D, Angst J. Begünstigen Antidepressiva die Suizidalität und die Suizidrate von Depressiven? ACTA ACUST UNITED AC 2007. [DOI: 10.4414/smf.2007.06287] [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: 11/18/2022]
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Bach DR, Moggi F, Müller TJ, Seifritz E, Strik WK, Wirtz G. [Possible genetic link between Darier's disease and depression. Review of the literature and case history]. Nervenarzt 2007; 78:81-4. [PMID: 16786359 DOI: 10.1007/s00115-006-2116-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Darier's disease is a rare, inherited autosomal dominant skin disorder caused by a mutation in the sarcoendoplasmatic reticulum calcium transporter (SERCA)-2-gene. In a number of pedigrees, Darier's disease closely relates with affective disorder. The most likely hypothesis for this is a susceptibility gene for affective disorder near the SERCA-2-gene. A 6.5-megabase region could be identified as a susceptibility locus. This region constitutes a susceptability locus also in affective disorder without Darier's disease. The underlying gene has not yet been identified.
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Affiliation(s)
- D R Bach
- Universitätsklinik für klinische Psychiatrie, Universität Bern
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Rahm B, Opwis K, Kaller CP, Spreer J, Schwarzwald R, Seifritz E, Halsband U, Unterrainer JM. Tracking the subprocesses of decision-based action in the human frontal lobes. Neuroimage 2005; 30:656-67. [PMID: 16256375 DOI: 10.1016/j.neuroimage.2005.09.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2005] [Revised: 09/20/2005] [Accepted: 09/23/2005] [Indexed: 11/21/2022] Open
Abstract
Situationally adaptive behavior relies on the identification of relevant target stimuli, the evaluation of these with respect to the current context and the selection of an appropriate action. We used functional magnetic resonance imaging (fMRI) to disentangle the neural networks underlying these processes within a single task. Our results show that activation of mid-ventrolateral prefrontal cortex (PFC) reflects the perceived presence of a target stimulus regardless of context, whereas context-appropriate evaluation is subserved by mid-dorsolateral PFC. Enhancing demands on response selection by means of response conflict activated a network of regions, all of which are directly connected to motor areas. On the midline, rostral anterior paracingulate cortex was found to link target detection and response selection by monitoring for the presence of behaviorally significant conditions. In summary, we provide new evidence for process-specific functional dissociations in the frontal lobes. In target-centered processing, target detection in the VLPFC is separable from contextual evaluation in the DLPFC. Response-centered processing in motor-associated regions occurs partly in parallel to these processes, which may enhance behavioral efficiency, but it may also lead to reaction time increases when an irrelevant response tendency is elicited.
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Affiliation(s)
- B Rahm
- Neuropsychology, Department of Psychology, University of Freiburg, Engelberger Str. 41, D-79085 Freiburg i. Br., Germany.
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Abderhalden C, Grieser M, Kozel B, Seifritz E, Rieder P. Wie kann der pflegerische Beitrag zur Einschätzung der Suizidalität systematisiert werden? ACTA ACUST UNITED AC 2005. [DOI: 10.1055/s-2005-858213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hemmeter U, Hatzinger M, Seifritz E, Holsboer-Trachsler E. GABAergic modulation during PSD, effects on microsleep and NonREM-sleep in volunteers and patients with major depression. Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Di Salle F, Esposito F, Elefante A, Scarabino T, Volpicelli A, Cirillo S, Elefante R, Seifritz E. High field functional MRI. Eur J Radiol 2003; 48:138-45. [PMID: 14680904 DOI: 10.1016/j.ejrad.2003.08.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2003] [Revised: 08/11/2003] [Accepted: 08/13/2003] [Indexed: 11/23/2022]
Abstract
Functional magnetic resonance imaging (fMRI) has become the most widely used approach for studying brain functions in humans. The rapid and widespread diffusion of fMRI has been favoured by the properties this technique presents, and particularly by its sensitivity in analysing brain functional phenomena and by the lack of biological invasiveness, resulting in an unprecedented and unparalleled flexibility of use. These properties of fMRI brought the functional examination of the brain within the reach of the whole neuroscience community and have appreciably stimulated the research on the functional processes of the living brain. Among the main features of fMRI, its spatial and temporal resolution represents clear advantages compared with the other methods of functional neuroimaging. In fact, the high spatial resolution of fMRI permits to produce more precise and better localised information, and its temporal resolution provides the potential of a better understanding of neural dynamics at the level of single functional areas and of the neural constituents of functional patterns. A fundamental possibility of improving spatial and temporal resolution without excessively degrading signal-to-noise ratio consists in the use of high magnetic field intensity fMRI units. Besides, high field units make the use of more demanding fMRI paradigms, like single trial event related studies, much more compatible with the need of a solid statistical evaluation. This has notably promoted the diffusion of high field MRI units for human studies throughout the world, with very high field MRI units, up to 8 T, working in a few research centres, and a larger number of MRI units with field intensity ranging between 3 and 5 T.
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Affiliation(s)
- F Di Salle
- Department of Neurological Sciences, University Federico II of Naples, via Pansini 5, 80131 Naples, Italy.
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Haselhorst R, Dürsteler-MacFarland KM, Scheffler K, Ladewig D, Müller-Spahn F, Stohler R, Seelig J, Seifritz E. Frontocortical N-acetylaspartate reduction associated with long-term i.v. heroin use. Neurology 2002; 58:305-7. [PMID: 11805264 DOI: 10.1212/wnl.58.2.305] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To examine possible metabolic frontal lobe alterations in i.v. heroin-dependent patients with different histories of concomitant substance use, N-acetylaspartate (NAA), a putative marker of neuronal viability, was measured by (1)H-MRS. Compared with controls, NAA levels in patients were reduced by 7% in gray matter (p = 0.015) but not in white matter. To what extent comorbid conditions or substance use, including alcohol, contributed to these frontocortical metabolic changes remains to be elucidated.
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Hruz P, Zechner S, Heimberg D, Hobi V, Schönenberger GA, Scheffler K, Müller-Spahn F, Seifritz E. Intranasal administration of delta sleep-inducing peptide increases P300. J Clin Psychopharmacol 2001; 21:626-8. [PMID: 11763019 DOI: 10.1097/00004714-200112000-00021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Moore P, Seifritz E, Schlosser A, Greenfield D, Stahl S, Rapaport M, Kelsoe J. Rapid tryptophan depletion plus a serotonin 1A agonist: competing effects on sleep in healthy men. Neuropsychopharmacology 2001; 25:S40-4. [PMID: 11682272 DOI: 10.1016/s0893-133x(01)00326-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In the present study, we hypothesized that the REM-suppressing effects of 5-HT(1A) receptor stimulation would counteract the REM-disinhibiting effects of rapid tryptophan depletion (RTD), and vice versa. We administered RTD plus ipsapirone (10 mg, p.o.) or RTD plus placebo to 10 healthy men. In contrast to our previous findings but partially consistent with other studies, RTD in combination with placebo did not produce a significant enhancement of any REM sleep measure. The combination of RTD and ipsapirone produced a significant suppression of REM sleep that was remarkably similar to the effect of ipsapirone alone. These data appear to deepen the mystery of variable and inconsistent RTD-induced responses in healthy subjects. In the case of REM sleep measures, this differs markedly from the consistent RTD-induced REM-disinhibiting effect seen in medicated depressed patients.
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Affiliation(s)
- P Moore
- National Multi-Site Training Program in Basic Sleep Research, UCLA Neuroscience Interdepartmental Graduate Program and Brain Research Institute, Los Angeles, CA, USA.
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Scheffler K, Seifritz E, Bilecen D, Venkatesan R, Hennig J, Deimling M, Haacke EM. Detection of BOLD changes by means of a frequency-sensitive trueFISP technique: preliminary results. NMR Biomed 2001; 14:490-496. [PMID: 11746942 DOI: 10.1002/nbm.726] [Citation(s) in RCA: 69] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A new method is introduced to detect magnetic field modulation arising from brain activation-induced BOLD effects. This approach uses a two-dimensional high-bandwidth, high-resolution conventional gradient-echo steady-state imaging sequence known as TrueFISP. The ability to visualize changes in oxygen saturation comes from the fact that the method is sensitive to the local field. As is well known, as the oxygen saturation changes so does the local field associated with the venous blood. We demonstrate that it is possible to visualize not only venous blood with this approach on a macroscopic level for major veins, but also to measure conventional oscillatory like signal changes during activated and resting states. Unfortunately, the method has two major drawbacks. First, a long TR is needed to maximize signal changes and, second, the field must be very well shimmed or numerous experiments need to be run to find the activation, as the signal response is sensitive to the starting frequency in the resting state. Nevertheless, these images can be compared directly with anatomical images collected with the same method without the need for distortion correction.
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Affiliation(s)
- K Scheffler
- Section of Medical Physics, University of Freiburg, Germany.
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Abstract
Among the best characterized neurobiological changes in mood disorders are specific alterations in electroencephalographic (EEG) sleep, including disinhibited rapid eye movement (REM) sleep and suppressed slow wave sleep. A strong link between mood disorders and sleep is that depressive symptoms are alleviated by one night of sleep deprivation and reoccur after sleeping. Sleep underlies homeostatic and circadian mechanisms that interact in complex ways. These relationships have been formalized in electrophysiological, neurochemical and neuroendocrinological models that extend to the pathophysiology of affective illness. Sleep research as a pathophysiological window to the brain has contributed extensively to the understanding of the neurobiology of depression and has been a substantial guide for the advancement of model-driven clinical and preclinical research. Pharmacological probes of normal and depressed sleep play an important role. It is anticipated that the combination of novel topographical EEG and neuroimaging techniques with traditional experimental methods will provide us with further insight into the neurobiology of sleep and depression.
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Affiliation(s)
- E Seifritz
- Department of Psychiatry, University of Basel, Wilhelm Kleinstrasse 27, CH-4025, Basel, Switzerland.
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Schumann G, Benedetti F, Voderholzer U, Kammerer N, Hemmeter U, Travers HW, Fiebich B, Holsboer-Trachsler E, Berger M, Seifritz E, Ebert D. Antidepressive response to sleep deprivation in unipolar depression is not associated with dopamine D3 receptor genotype. Neuropsychobiology 2001; 43:127-30. [PMID: 11287789 DOI: 10.1159/000054879] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [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: 11/19/2022]
Abstract
The psychostimulant theory of antidepressive sleep deprivation (SD) proposes a contribution of dopamine D3 receptors (DRD3) in the limbic system to the antidepressant effects of SD. Neuroendocrinological studies suggest a positive correlation of clinical response to SD and cortisol secretion. We hypothesized that the clinical response to SD and amount of cortisol secretion upon SD is associated with the 1-1 genotype of the Bal1 polymorphism of DRD3 on exon 1. In this study, aiming at evaluating the feasibility of screening large patient samples, 52 inpatients (19 males/33 females) with unipolar depression and a score of 18 or more on the 21-item Hamilton Depression Rating Scale were treated with 1 night of total SD. We found that 31% of our patients responded to SD. There was no association between response to SD and the genotype of the DRD3 Bal1 polymorphism (p < 0.879). There was also no association between increase in cortisol secretion after SD and DRD3 genotypes (p < 1.000) in a subgroup of patients. Statistical power analysis ruled out a major effect of the DRD3 Bal1 polymorphism on clinical response to SD. These results suggest that the DRD3 Bal1 polymorphism is not a promising lead to be followed up in larger patient samples.
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Affiliation(s)
- G Schumann
- Department of Psychiatry, University of Freiburg, Germany.
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Wetzel SG, Haselhorst R, Bilecen D, Lyrer PA, Seifritz E, Bongartz G, Radue EW, Scheffler K. Preliminary experience with dynamic MR projection angiography in the evaluation of cervicocranial steno-occlusive disease. Eur Radiol 2001; 11:295-302. [PMID: 11218031 DOI: 10.1007/s003300000618] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [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: 11/29/2022]
Abstract
The application of a contrast-enhanced, two-dimensional MR technique, which provides dynamic projection angiograms at a subsecond temporal frame rate for depiction of the cervical and intracranial arteries, was evaluated in three healthy volunteers and seven patients with various cervicocranial steno-occlusive diseases. Intra-arterial digital subtraction angiography (DSA) served as standard of reference for findings in the patients. Magnetic resonance projection angiography (MRPA) was performed on a standard 1.5-T clinical MR imaging system at intravenous injection of a single dose of contrast agent (0.1 mmol/kg GdDTPA-BMA). Sixty consecutive images of the cerebral circulation were acquired at a temporal frame rate of 900 ms per image in the coronal plane. The collateral flow and the perfusion of the compromised vessel territory were readily assessed by MPRA in patients with occlusion of the internal cerebral artery (ICA) or middle cerebral artery (MCA). The leptomeningeal collateralisation of these patients was displayed in a dynamic fashion. Furthermore, quantitative perfusion measurement provided a difference between both MCA territories in the time to peak (deltaDTTP) of the contrast bolus of 1.12 +/- 0.28 s in five patients with severe stenosis or occlusion of the ICA (healthy volunteers 0.19 +/- 0.05 s). However, important pathological findings, such as the evaluation of carotid artery stenoses and the intracranial collateral flow pattern in patients with severe carotid stenoses, were not sufficiently assessable as compared with DSA. We conclude that the possibility of obtaining simultaneously information about morphology and perfusion dynamics of the cervicocranial vessels is unique in MPRA as compared with other MR techniques. However, in the applied form, the technique is not a reliable tool for the complete evaluation of the cervicocranial vessels in patients with steno-occlusive disease.
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Affiliation(s)
- S G Wetzel
- Section of Neuroradiology, University Hospitals, Kantonsspital Basel, Switzerland
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Seifritz E, Di Salle F, Bilecen D, Radü EW, Scheffler K. Auditory system: functional magnetic resonance imaging. Neuroimaging Clin N Am 2001; 11:275-96, ix. [PMID: 11489740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Functional MR imaging (fMRI) is being used increasingly to explore the human central auditory system. The considerable background noise produced by echo-planar imaging (EPI) and other fMRI sequences, however, interferes in an unpredictable way with the experimental stimuli. Several approaches exist to overcome this problem. Each has its advantages and disadvantages. These different approaches allow researchers to tailor the experimental designs to specific research questions. Recent studies have yielded significant information about human auditory function. Compared with other sensory systems such as the visual system, the auditory database still is relatively small. It is expected that novel methodologic approaches will stimulate scientific exploration of auditory processing and eventually lead to clinically meaningful applications of auditory fMRI.
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Affiliation(s)
- E Seifritz
- Department of Psychiatry, University of Basel, Basel, Switzerland.
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