PubMed Health⌕ Search

Biomedical subjects

C Albani

Publications and source records attributed to C Albani.

At least 19 recordsLinked to original sources
PubMed2001

[Central relationship patterns in comparison with different objects].

In the present study the Relationship Episode Paradigm Interviews of 70 female patients with different psychoneurotic diseases were analysed with respect to object-specific patterns with the CCRT method. The most frequent categories are the same in all relationship episodes and in subsamples of relationship episodes with mother and father. These categories are also predominant in episodes with women and men. Relationship episodes with mother do not differ from episodes with father, and relationship episodes with women are not different from episodes with men. But there are substantial differences in relationship episodes with the mother and women and between episodes with the father and men. Patients recount much more positive relationship patterns with women and men than with their parents. This could be understood as a hint of interpersonal resources.

Adult↗
PubMed2000

[Method of plan formulation: first German language rehabilitation study of the Joseph Weiss "control mastery theory"].

The paper gives a survey of the "Control Mastery Theory" (CMT) of Joseph Weiss. CMT is a cognitive-affective, psychoanalytic theory of the psychotherapeutic process. The San Francisco Psychotherapy Research Group empirically investigated und confirmed several concepts of the CMT. Some research results are summarized and the "Plan Formulation Method" is described in detail. The results of the first German reliability study applying the plan formulation method on the case "Amalie" show that the method can be used reliably for research purposes outside the USA.

Adult↗
PubMed1999

[Critical review of the categorical structures of the core Conflictual Relationship Theme Method (CCRT)].

The CCRT-method developed by Lester Luborsky is the most widespread and best established method to assess relationship structures in the field of psychodynamic psychotherapy research. Although its categorical structures are criticised in many different ways there have not been any attempts to modify them. This article points out the inconsistency of the current categorical system and demonstrates first approaches to alternative solutions. For this purpose genetic algorithms are used. Their application in psychotherapy research is demonstrated here for the first time.

Algorithms↗
PubMed1998

Analysis of double-joint movements in controls and in parkinsonian patients.

The motor performance of seven patients with Parkinson's disease and seven control subjects was tested in a choice reaction aiming task. The subjects were instructed to aim as fast and as accurately as possible to a light stimulus, which defined one of eight possible target positions. In order to reach the targets, elbow flexions had to be combined with forearm supinations or with forearm pronations. For single-joint movements, forearm supinations or pronations were executed faster than the long elbow flexions in both groups. In the double-joint movements of the control group, the flexion movement times (flex.MTs) and the supination movement times (sup.MTs) or pronation movement times (pron.MTs) were similar to the MTs of the corresponding single-joint movements. MTs of parkinsonian patients were significantly longer than those of control subjects. MTs were most increased in the forearm supination and forearm pronation of double-joint movements. In contrast to the controls, sup.MT and pron.MT were significantly increased in double-joint movements as compared to single-joint movements. The variations in the flex.MT and sup.MT of the double-joint movements neither correlated for a control subject nor for a parkinsonian patient. For controls, the independent MTs in double-joint movements cannot be explained by minimal principles (minimum energy, minimal torque change), but suggest that two separate motor programs are superimposed. In Parkinson's disease, there seems to be a deficit in superimposing two separate motor programs.

Adult↗
PubMed1997

A dynamic model of motor basal ganglia functions.

Fast aiming movements were measured in a choice reaction paradigm in a healthy control group and in Parkinsonian patients. The patients were tested without ('off') and with 3,4-dihydroxyphenylalanine ('on') (L-dopa) medication. The movement trajectories were used to estimate the parameters of a dynamic linear model. The model is based on the functional structure of the basal ganglia-thalamocortical circuit with direct and indirect pathways linking the putamen to the basal ganglia output nuclei (Albin et al. 1989). The output of the circuit is connected to a model for the motor neuron-musculo-skeletal system. The gain kd for the direct pathway and the gain ki for the indirect pathway were estimated. They were found to be significantly decreased for Parkinsonian patients in 'off' compared with the control group. L-dopa therapy in Parkinsonian patients increased the gains of the direct and the indirect pathway almost to normal values which implies that the long-term dopamine level in the striatum was excitatory for the direct and for the indirect pathway. This result is restricted to movements of correct size. For movements of diminished size, which are typical for Parkinsonian patients, the model predicts that the dopamine level in the striatum is excitatory for the direct pathway but inhibitory for the indirect pathway. The simulated values for neuronal activities are in agreement with expected values according to the experimental data. The proposed model of the 'motor' basal ganglia thalamocortical circuit implies that information about biomechanical properties of the musculo-skeletal system is stored in the 'motor' basal ganglia-thalamocortical circuit, and that the basal ganglia are involved in computation of the desired movement amplitude.

Antiparkinson Agents↗
PubMed1997

A model of human aiming movements applied to Parkinson's disease.

Healthy control subjects and Parkinsonian patients with and without l-DOPA medication were tested in a motor paradigm. The subjects were instructed to aim with the forearm as fast and as accurately as possible to the illuminated target. A quantitative dynamic model for planning and execution of voluntary aiming movements is developed. The proposed 'motor model' reproduces Parkinsonian symptoms and the therapeutic effects of the drug. The proposed model implies that the basal ganglia store movement and limb specific parameters which are necessary for the control of voluntary aiming movements. The model is contrasted against analytic concepts of motor control. Analytic concepts assume that movements are planned in space coordinates and then transformed to neural activities corresponding to the muscle force. In contrast, the neuronal activities simulated in the proposed 'motor model' can not be described by the terms 'planned trajectory', 'muscle force' or similar terms but suggest a more abstract dynamic concept.

Algorithms↗
PubMed1995

Iodine-123-IBF SPECT evaluation of extrapyramidal diseases.

UNLABELLED: Iodine-123-IBF is a dopaminergic antagonist suitable for SPECT imaging of D2 receptors. Initial animal studies demonstrated that its affinity for D2 receptors is approximately four times that of the commonly used SPECT D2 ligand [123I]IBZM. In this study we investigated whether this higher affinity would lead to an improved accuracy in differentiating between various extrapyramidal diseases. METHODS: SPECT imaging was performed in 17 patients with idiopathic Parkinson's syndrome (IPS); 4 patients with progressive supranuclear palsy (PSP), 2 patients with multiple system atrophy (MSA) and 7 age-matched control subjects. SPECT imaging was performed 5, 60, 120 and 180 min following intravenous bolus injection of 150-250 MBq of [123I]IBF. The ratio of ligand uptake in the basal ganglia and frontal cortex was determined as a measure of receptor status. RESULTS: In PSP and MSA patients, the basal ganglia-to-frontal cortex ratio reached a plateau at 2 hr; in the control subjects and the IPS patients the ratio was steadily increasing. At 3 hr the basal ganglia-to-frontal cortex ratio was 2.66 +/- 0.29 (control subjects), 3.01 +/- 0.41 (IPS), 2.09 +/- 0.22 (PSP) and 2.10 (MSA). In the IPS patients with predominantly one-sided symptoms, the striatum contralateral to symptoms showed a tendency towards relatively increased ligand uptake. Despite the higher affinity of IBF for the D2 receptor compared to IBZM, the separation of individual PSP and MSA patients from the control subjects was not as clear cut as reported for IBZM due to a relatively high variation in the control subjects. We hypothesize that the latter is due to imaging in nonequilibrium conditions. CONCLUSION: The data suggest that IBF-SPECT can help in discriminating extrapyramidal disease. The accuracy might be improved by an administration protocol that allows imaging in "true equilibrium" conditions, such as a bolus injection followed by a constant infusion.

Aged↗
PubMed1994

[Akinetic crisis in Parkinson disease].

The akinetic crisis is an "off" state that lasts more than 48 hours with akinesia, rigidity and bradykinesia, occurring with signs of CNS dysregulation in advanced stages of Parkinson's disease. 7 akinetic crises lasting 4 to 14 days (average 9.3) were observed in 744 hospitalizations over a period of 7 years. The age of the patients with akinetic crisis and the mean duration and the severity of the disease were significantly higher than in the other patients. While bradykinesia and rigor are the most relevant clinical signs in some 40% of parkinsonian patients, 6 of our 7 patients (86%) had an akinetic-rigid form of the disease. Levodopa withdrawal preceded the akinetic crisis in 4 patients: in 3 patients the akinetic crisis occurred despite adequate dopaminergic therapy, in one patient after benzodiazepine withdrawal, in another case after gastrointestinal bleeding, and in one case without known cause. Hyperthermia, tachycardia and sweating were the most common collateral manifestations. Apomorphine given subcutaneously was effective in four cases, apomorphine and amantidine were effective in one case, and one patient died during an akinetic crisis. The akinetic crisis is a distinct form of motor fluctuation in advanced stages of Parkinson's disease, with clinical signs resembling malignant neuroleptic syndrome (NMS). While NMS is related to dopaminergic receptor blockade or dopaminergic depletion, akinetic crisis can occur despite adequate dopaminergic therapy as a symptom of severe basal ganglia dysfunction related to the advanced stages of Parkinson's disease. Outcome and therapy of akinetic crisis depend on the underlying causes.

Aged↗
PubMed1992

[Subcutaneous apomorphine infusion in the treatment of Parkinson disease].

Apomorphine, a dopamine-agonist was applied as s. c. infusions to 7 patients with idiopathic Parkinson's disease. The indications were longlasting akinetic episodes (4 patients) and therapeutically resistant invalidating motoric fluctuations ("on-off") as well as hyperkinesia (3 patients) on anti-Parkinson medication. The effect of apomorphine as an anti-Parkinson therapeutic was verified using clinical scales and a portable activity-monitoring device. The s. c. infusion therapy (20-90 mg/die, or 0.025-0.01 mg/kg/die respectively) was effective in the akinetic patients interrupting akinesia and the inability to swallow. An improvement was also registered in patients with "on-off" and hyperkinesia using longlasting subcutaneous apomorphine infusions. The therapy was continued over a longer period of time with 2 patients as outpatients. The side-effects were nausea and local subcutaneous indurations at sites of infusions.

Aged↗
PubMed1989

Optimization of symptomatic therapy in Parkinson's disease.

A third-order nonlinear mathematical model of the dose-effect relationship of levodopa, one of the most common drugs used for the symptomatic therapy of Parkinson's disease, is derived with the aid of a visual tracking based method which allows the measurement of some Parkinsonian symptoms quantitatively and objectively. The parameters of this model are identified for each subject separately due to the large interpatient variability in response to treatment. The model is then used to optimize the dosage regimen for each patient individually (according to the clinical particularities and needs of each patient) with respect to an objective function which includes the symptoms dynamically and the total amount of levodopa which is to be administered. Encouraging clinical results of this control engineering approach to therapy optimization are presented. The advantages and drawbacks of this approach are discussed and further research directions are indicated.

Benserazide↗
PubMed1987

[Long-term problems of levodopa therapy in Parkinson disease].

The dependence of motor side effects of L-DOPA therapy on clinical and pharmacodynamic parameters was investigated in 28 patients with Parkinson's disease. Duration of disease and degree of motor impairment were significantly less in a first group of 12 patients without motor side effects than in a second group of 16 patients with fluctuations of antiparkinsonian effects and dyskinesias. The two groups showed different pharmacodynamic patterns: the antiparkinsonian effect in the first group remained unchanged, with decreasing DOPA plasma concentrations (Type I), whereas in the second group a direct correlation between DOPA plasma levels and antiparkinsonian effect was observed (Type II). A possible mechanism for the different pharmacodynamic patterns and its relevance for therapy are discussed.

Adult↗