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Schweiger JI, Bilek E, Schäfer A, Braun U, Moessnang C, Harneit A, Post P, Otto K, Romanczuk-Seiferth N, Erk S, Wackerhagen C, Mattheisen M, Mühleisen TW, Cichon S, Nöthen MM, Frank J, Witt SH, Rietschel M, Heinz A, Walter H, Meyer-Lindenberg A, Tost H. Effects of BDNF Val 66Met genotype and schizophrenia familial risk on a neural functional network for cognitive control in humans. Neuropsychopharmacology 2019; 44:590-597. [PMID: 30375508 PMCID: PMC6333795 DOI: 10.1038/s41386-018-0248-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/25/2018] [Accepted: 10/16/2018] [Indexed: 12/16/2022]
Abstract
Cognitive control represents an essential neuropsychological characteristic that allows for the rapid adaption of a changing environment by constant re-allocation of cognitive resources. This finely tuned mechanism is impaired in psychiatric disorders such as schizophrenia and contributes to cognitive deficits. Neuroimaging has highlighted the contribution of the anterior cingulate cortex (ACC) and prefrontal regions (PFC) on cognitive control and demonstrated the impact of genetic variation, as well as genetic liability for schizophrenia. In this study, we aimed to examine the influence of the functional single-nucleotide polymorphism (SNP) rs6265 of a plasticity-related neurotrophic factor gene, BDNF (Val66Met), on cognitive control. Strong evidence implicates BDNF Val66Met in neural plasticity in humans. Furthermore, several studies suggest that although the variant is not convincingly associated with schizophrenia risk, it seems to be a modifier of the clinical presentation and course of the disease. In order to clarify the underlying mechanisms using functional magnetic resonance imaging (fMRI), we studied the effects of this SNP on ACC and PFC activation, and the connectivity between these regions in a discovery sample of 85 healthy individuals and sought to replicate this effect in an independent sample of 253 individuals. Additionally, we tested the identified imaging phenotype in relation to schizophrenia familial risk in a sample of 58 unaffected first-degree relatives of schizophrenia patients. We found a significant increase in interregional connectivity between ACC and PFC in the risk-associated BDNF 66Met allele carriers. Furthermore, we replicated this effect in an independent sample and demonstrated its independence of structural confounds, as well as task specificity. A similar coupling increase was detectable in individuals with increased familial risk for schizophrenia. Our results show that a key neural circuit for cognitive control is influenced by a plasticity-related genetic variant, which may render this circuit particular susceptible to genetic and environmental risk factors for schizophrenia.
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Piel JH, Lett TA, Wackerhagen C, Plichta MM, Mohnke S, Grimm O, Romanczuk-Seiferth N, Degenhardt F, Tost H, Witt S, Nöthen M, Rietschel M, Heinz A, Meyer-Lindenberg A, Walter H, Erk S. The effect of 5-HTTLPR and a serotonergic multi-marker score on amygdala, prefrontal and anterior cingulate cortex reactivity and habituation in a large, healthy fMRI cohort. Eur Neuropsychopharmacol 2018; 28:415-427. [PMID: 29358097 DOI: 10.1016/j.euroneuro.2017.12.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/06/2017] [Accepted: 12/08/2017] [Indexed: 12/16/2022]
Abstract
Major depressive disorder (MDD) is characterized by low mood for at least two weeks. Impaired emotion regulation has been suggested to be the consequence of dysfunctional serotonergic regulation of limbic and prefrontal regions, especially the amygdala, the anterior cingulate cortex (ACC) and the prefrontal cortex (PFC). The impact of genetic variation on brain function can be investigated with intermediate phenotypes. A suggested intermediate phenotype of MDD is emotion recognition: The 5-HTTLPR polymorphism of SLC6A4 as well as other serotonergic genes have been associated with amygdala and prefrontal function during emotion recognition. Previously, it has been suggested that habituation is a more reliable index of emotion recognition than functional activation. We examined the relationship of genes involved in serotonergic signaling with amygdala as well as prefrontal functional activation and habituation during an emotion recognition task in 171 healthy subjects. While effects of 5-HTTLPR and of a serotonergic multi-marker score (5-HTTLPR, TPH1(rs1800532), TPH2(rs4570625), HTR1A(rs6295) and HTR2A(rs6311)) on amygdala activation did not withstand correction for multiple regions of interest, we observed a strong correlation of the multi-marker score and habituation in the amygdala, DLPFC, and ACC. We replicated a well-studied intermediate phenotype for association with 5-HTTLPR and provided additional evidence for polygenic involvement. Furthermore, we showed that task habituation may be influenced by genetic variation in serotonergic signaling, particularly by a serotonergic multi-marker score. We provided preliminary evidence that PFC activation is an important intermediate phenotype of MDD. Future studies are needed to corroborate the results in larger samples.
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Abstract
ZusammenfassungBelohnungen, oder allgemeiner positive Verstärkung, beeinflussen unser tägliches Leben in hohem Maße. Sie stellen Handlungsanreize und Motivatoren dar, und eine angemessene Reaktion auf lohnende Anreize ist eine wichtige Voraussetzung für Entscheidungsfindung und zielgerichtetes, effektives Verhalten. Die funktionelle Bildgebung hat in jüngster Zeit viel zu einem besseren Verständnis beigetragen, wie Belohnungen im menschlichen Gehirn verarbeitet werden. Befunde aus der tierexperimentellen Forschung wurden bestätigt und differenziert und neue Erkenntnisse zu Motivation und Lernvorgängen im Zusammenhang mit Belohnungen gewonnen. Für die wichtigsten beteiligten Strukturen, das ventrale Striatum, den orbitofrontalen Kortex und die Amygdala, wurden differenzierte Funktionen herausgearbeitet. Die so gewonnenen Erkenntnisse über das mesolimbisch-mesokortikale Dopaminsystem, das auf diese Regionen einwirkt, können nicht nur helfen, Reaktionen auf Belohnungsreize besser zu verstehen, sondern auch helfen, die Pathophysiologie von Suchterkrankungen, der Parkinson-Krankheit und Schizophrenie aufzuklären.
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Erk S, Mohnke S, Ripke S, Lett TA, Veer IM, Wackerhagen C, Grimm O, Romanczuk-Seiferth N, Degenhardt F, Tost H, Mattheisen M, Mühleisen TW, Charlet K, Skarabis N, Kiefer F, Cichon S, Witt SH, Nöthen MM, Rietschel M, Heinz A, Meyer-Lindenberg A, Walter H. Functional neuroimaging effects of recently discovered genetic risk loci for schizophrenia and polygenic risk profile in five RDoC subdomains. Transl Psychiatry 2017; 7:e997. [PMID: 28072415 PMCID: PMC5545733 DOI: 10.1038/tp.2016.272] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 11/13/2016] [Indexed: 12/23/2022] Open
Abstract
Recently, 125 loci with genome-wide support for association with schizophrenia were identified. We investigated the impact of these variants and their accumulated genetic risk on brain activation in five neurocognitive domains of the Research Domain Criteria (working memory, reward processing, episodic memory, social cognition and emotion processing). In 578 healthy subjects we tested for association (i) of a polygenic risk profile score (RPS) including all single-nucleotide polymorphisms (SNPs) reaching genome-wide significance in the recent genome-wide association studies (GWAS) meta-analysis and (ii) of all independent genome-wide significant loci separately that showed sufficient distribution of all allelic groups in our sample (105 SNPs). The RPS was nominally associated with perigenual anterior cingulate and posterior cingulate/precuneus activation during episodic memory (PFWE(ROI)=0.047) and social cognition (PFWE(ROI)=0.025), respectively. Single SNP analyses revealed that rs9607782, located near EP300, was significantly associated with amygdala recruitment during emotion processing (PFWE(ROI)=1.63 × 10-4, surpassing Bonferroni correction for the number of SNPs). Importantly, this association was replicable in an independent sample (N=150; PFWE(ROI)<0.025). Other SNP effects previously associated with imaging phenotypes were nominally significant, but did not withstand correction for the number of SNPs tested. To assess whether there was true signal within our data, we repeated single SNP analyses with 105 randomly chosen non-schizophrenia-associated variants, observing fewer significant results and lower association probabilities. Applying stringent methodological procedures, we found preliminary evidence for the notion that genetic risk for schizophrenia conferred by rs9607782 may be mediated by amygdala function. We critically evaluate the potential caveats of the methodological approaches employed and offer suggestions for future studies.
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Schreiter S, Spengler S, Willert A, Mohnke S, Herold D, Erk S, Romanczuk-Seiferth N, Quinlivan E, Hindi-Attar C, Banzhaf C, Wackerhagen C, Romund L, Garbusow M, Stamm T, Heinz A, Walter H, Bermpohl F. Neural alterations of fronto-striatal circuitry during reward anticipation in euthymic bipolar disorder. Psychol Med 2016; 46:3187-3198. [PMID: 27573157 DOI: 10.1017/s0033291716001963] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Bipolar disorder (BD), with the hallmark symptoms of elevated and depressed mood, is thought to be characterized by underlying alterations in reward-processing networks. However, to date the neural circuitry underlying abnormal responses during reward processing in BD remains largely unexplored. The aim of this study was to investigate whether euthymic BD is characterized by aberrant ventral striatal (VS) activation patterns and altered connectivity with the prefrontal cortex in response to monetary gains and losses. METHOD During functional magnetic resonance imaging 20 euthymic BD patients and 20 age-, gender- and intelligence quotient-matched healthy controls completed a monetary incentive delay paradigm, to examine neural processing of reward and loss anticipation. A priori defined regions of interest (ROIs) included the VS and the anterior prefrontal cortex (aPFC). Psychophysiological interactions (PPIs) between these ROIs were estimated and tested for group differences for reward and loss anticipation separately. RESULTS BD participants, relative to healthy controls, displayed decreased activation selectively in the left and right VS during anticipation of reward, but not during loss anticipation. PPI analyses showed decreased functional connectivity between the left VS and aPFC in BD patients compared with healthy controls during reward anticipation. CONCLUSIONS This is the first study showing decreased VS activity and aberrant connectivity in the reward-processing circuitry in euthymic, medicated BD patients during reward anticipation. Our findings contrast with research supporting a reward hypersensitivity model of BD, and add to the body of literature suggesting that blunted activation of reward processing circuits may be a vulnerability factor for mood disorders.
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Li M, Luo XJ, Rietschel M, Lewis CM, Mattheisen M, Müller-Myhsok B, Jamain S, Leboyer M, Landén M, Thompson PM, Cichon S, Nöthen MM, Schulze TG, Sullivan PF, Bergen SE, Donohoe G, Morris DW, Hargreaves A, Gill M, Corvin A, Hultman C, Toga AW, Shi L, Lin Q, Shi H, Gan L, Meyer-Lindenberg A, Czamara D, Henry C, Etain B, Bis JC, Ikram MA, Fornage M, Debette S, Launer LJ, Seshadri S, Erk S, Walter H, Heinz A, Bellivier F, Stein JL, Medland SE, Arias Vasquez A, Hibar DP, Franke B, Martin NG, Wright MJ, Su B. Allelic differences between Europeans and Chinese for CREB1 SNPs and their implications in gene expression regulation, hippocampal structure and function, and bipolar disorder susceptibility. Mol Psychiatry 2014; 19:452-61. [PMID: 23568192 PMCID: PMC3937299 DOI: 10.1038/mp.2013.37] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 01/28/2013] [Accepted: 03/06/2013] [Indexed: 02/07/2023]
Abstract
Bipolar disorder (BD) is a polygenic disorder that shares substantial genetic risk factors with major depressive disorder (MDD). Genetic analyses have reported numerous BD susceptibility genes, while some variants, such as single-nucleotide polymorphisms (SNPs) in CACNA1C have been successfully replicated, many others have not and subsequently their effects on the intermediate phenotypes cannot be verified. Here, we studied the MDD-related gene CREB1 in a set of independent BD sample groups of European ancestry (a total of 64,888 subjects) and identified multiple SNPs significantly associated with BD (the most significant being SNP rs6785[A], P=6.32 × 10(-5), odds ratio (OR)=1.090). Risk SNPs were then subjected to further analyses in healthy Europeans for intermediate phenotypes of BD, including hippocampal volume, hippocampal function and cognitive performance. Our results showed that the risk SNPs were significantly associated with hippocampal volume and hippocampal function, with the risk alleles showing a decreased hippocampal volume and diminished activation of the left hippocampus, adding further evidence for their involvement in BD susceptibility. We also found the risk SNPs were strongly associated with CREB1 expression in lymphoblastoid cells (P<0.005) and the prefrontal cortex (P<1.0 × 10(-6)). Remarkably, population genetic analysis indicated that CREB1 displayed striking differences in allele frequencies between continental populations, and the risk alleles were completely absent in East Asian populations. We demonstrated that the regional prevalence of the CREB1 risk alleles in Europeans is likely caused by genetic hitchhiking due to natural selection acting on a nearby gene. Our results suggest that differential population histories due to natural selection on regional populations may lead to genetic heterogeneity of susceptibility to complex diseases, such as BD, and explain inconsistencies in detecting the genetic markers of these diseases among different ethnic populations.
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Schott BH, Assmann A, Schmierer P, Soch J, Erk S, Garbusow M, Mohnke S, Pöhland L, Romanczuk-Seiferth N, Barman A, Wüstenberg T, Haddad L, Grimm O, Witt S, Richter S, Klein M, Schütze H, Mühleisen TW, Cichon S, Rietschel M, Noethen MM, Tost H, Gundelfinger ED, Düzel E, Heinz A, Meyer-Lindenberg A, Seidenbecher CI, Walter H. Epistatic interaction of genetic depression risk variants in the human subgenual cingulate cortex during memory encoding. Transl Psychiatry 2014; 4:e372. [PMID: 24643163 PMCID: PMC3966038 DOI: 10.1038/tp.2014.10] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 01/06/2014] [Indexed: 12/14/2022] Open
Abstract
Recent genome-wide association studies have pointed to single-nucleotide polymorphisms (SNPs) in genes encoding the neuronal calcium channel CaV1.2 (CACNA1C; rs1006737) and the presynaptic active zone protein Piccolo (PCLO; rs2522833) as risk factors for affective disorders, particularly major depression. Previous neuroimaging studies of depression-related endophenotypes have highlighted the role of the subgenual cingulate cortex (CG25) in negative mood and depressive psychopathology. Here, we aimed to assess how recently associated PCLO and CACNA1C depression risk alleles jointly affect memory-related CG25 activity as an intermediate phenotype in clinically healthy humans. To investigate the combined effects of rs1006737 and rs2522833 on the CG25 response, we conducted three functional magnetic resonance imaging studies of episodic memory formation in three independent cohorts (N=79, 300, 113). An epistatic interaction of PCLO and CACNA1C risk alleles in CG25 during memory encoding was observed in all groups, with carriers of no risk allele and of both risk alleles showing higher CG25 activation during encoding when compared with carriers of only one risk allele. Moreover, PCLO risk allele carriers showed lower memory performance and reduced encoding-related hippocampal activation. In summary, our results point to region-specific epistatic effects of PCLO and CACNA1C risk variants in CG25, potentially related to episodic memory. Our data further suggest that genetic risk factors on the SNP level do not necessarily have additive effects but may show complex interactions. Such epistatic interactions might contribute to the 'missing heritability' of complex phenotypes.
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Rietschel M, Mattheisen M, Degenhardt F, Mühleisen TW, Kirsch P, Esslinger C, Herms S, Demontis D, Steffens M, Strohmaier J, Haenisch B, Breuer R, Czerski PM, Giegling I, Strengman E, Schmael C, Mors O, Mortensen PB, Hougaard DM, Ørntoft T, Kapelski P, Priebe L, Basmanav FF, Forstner AJ, Hoffman P, Meier S, Nikitopoulos J, Moebus S, Alexander M, Mössner R, Wichmann HE, Schreiber S, Rivandeneira F, Hofman A, Uitterlinden AG, Wienker TF, Schumacher J, Hauser J, Maier W, Cantor RM, Erk S, Schulze TG, Craddock N, Owen MJ, O'Donovan MC, Børglum AD, Rujescu D, Walter H, Meyer-Lindenberg A, Nöthen NM, Ophoff RA, Cichon S. Association between genetic variation in a region on chromosome 11 and schizophrenia in large samples from Europe. Mol Psychiatry 2012; 17:906-17. [PMID: 21747397 DOI: 10.1038/mp.2011.80] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Recent molecular studies have implicated common alleles of small to moderate effect and rare alleles with larger effect sizes in the genetic architecture of schizophrenia (SCZ). It is expected that the reliable detection of risk variants with very small effect sizes can only be achieved through the recruitment of very large samples of patients and controls (that is tens of thousands), or large, potentially more homogeneous samples that have been recruited from confined geographical areas using identical diagnostic criteria. Applying the latter strategy, we performed a genome-wide association study (GWAS) of 1169 clinically well characterized and ethnically homogeneous SCZ patients from a confined area of Western Europe (464 from Germany, 705 from The Netherlands) and 3714 ethnically matched controls (1272 and 2442, respectively). In a subsequent follow-up study of our top GWAS results, we included an additional 2569 SCZ patients and 4088 controls (from Germany, The Netherlands and Denmark). Genetic variation in a region on chromosome 11 that contains the candidate genes AMBRA1, DGKZ, CHRM4 and MDK was significantly associated with SCZ in the combined sample (n=11 540; P=3.89 × 10(-9), odds ratio (OR)=1.25). This finding was replicated in 23 206 independent samples of European ancestry (P=0.0029, OR=1.11). In a subsequent imaging genetics study, healthy carriers of the risk allele exhibited altered activation in the cingulate cortex during a cognitive control task. The area of interest is a critical interface between emotion regulation and cognition that is structurally and functionally abnormal in SCZ and bipolar disorder.
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Jessen F, Spottke A, Malotki A, Walter H, Wagner M, Erk S. Detection of Neural Compensation at the Pre-Dementia State. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1268268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Erk S, Spottke A, Malotki A, Walter H, Jessen F. Neural mechanisms of subjective memory impairment. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70162-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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von Boberfeld CO, Walter H, Schnell K, Arnold C, Esslinger C, Kirsch P, Hadad L, Meyer-Lindenberg A, Erk S. Validation of an fMRI episodic memory paradigm for imaging genetics. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70495-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ciaramidaro A, Adenzato M, Enrici I, Erk S, Pia L, Bara BG, Walter H. The intentional network: how the brain reads varieties of intentions. Neuropsychologia 2007; 45:3105-13. [PMID: 17669444 DOI: 10.1016/j.neuropsychologia.2007.05.011] [Citation(s) in RCA: 209] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Revised: 05/16/2007] [Accepted: 05/17/2007] [Indexed: 11/17/2022]
Abstract
Social neuroscience provides insights into the neural correlates of the human capacity to explain and predict other people's intentions, a capacity that lies at the core of the Theory of Mind (ToM) mechanism. Results from neuroimaging research describe a widely distributed neural system underlying ToM, including the right and left temporo-parietal junctions (TPJ), the precuneus, and the medial prefrontal cortex (MPFC). Nevertheless, there is disagreement in the literature concerning the key region for the ToM network. Some authors point to the MPFC, others to the right TPJ. In the effort to make a contribution to the debate, we propose a model of a dynamic ToM network consisting of four regions. We also introduce a novel theoretical distinction among varieties of intention, which differ by the nature of an individual's pursued goal (private or social) and by the social interaction's temporal dimension (present or future). Our results confirm the crucial role of both the MPFC and the right TPJ, but show that these areas are differentially engaged depending on the nature of the intention involved. Whereas the right TPJ and the precuneus are necessary for processing all types of prior intentions, the left TPJ and the anterior paracingulate cortex are specifically involved in the understanding of social intention. More specifically, the left TPJ is activated only when a subset of social intentions are involved (communicative intentions). Taken together, these results demonstrate the progressive recruitment of the ToM network along the theoretical dimensions introduced in the present paper.
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Hausen J, Bandel G, Esch W, Nitsche R, Doehring H, Staudinger H, Heuer W, Schulz GV, Kolleck L, R�hrs W, Forrer M, Amigo A, Krahl M, Rossi LM, Peakes GL, Mooney M, Speitmann M, Noll A, Kuntze W, Vieweg R, Batsch H, Meissner A, Erk S, Keller A, Poltz H, Steger W. Kunststoffe. Anal Bioanal Chem 1941. [DOI: 10.1007/bf01324136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Erk S. Aufgabe und Bedeutung der Flie�kunde. Colloid Polym Sci 1939. [DOI: 10.1007/bf01525215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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15
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Wyk A, Meyer KH, Payne EH, Miller CC, Schneider HF, Mc Connell TA, da C. Andrade EN, Chiong YS, Rotherham L, Erk S, Eck H, Daneš VZ, Healy CS, Pfund AH, Greenfield EW. Viscosimetrie. Anal Bioanal Chem 1938. [DOI: 10.1007/bf01602299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Wigner E, Bartels J, Betz A, Erk S. Besprechungen. Naturwissenschaften 1930. [DOI: 10.1007/bf01495094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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