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Helmfried E Klein

Publications and source records attributed to Helmfried E Klein.

16 recordsLinked to original sources
PubMed2006

Quantitative analysis of motor disturbances in schizophrenic patients.

The presence of neurological signs and disturbed psychomotor performance have been consistently confirmed by clinical studies in schizophrenic patients. These parameters are mainly assessed by using clinical rating scales. In recent years, new approaches such as ultrasonic movement analysis systems have been introduced in order to objectively evaluate motor disturbances in schizophrenic patients. Ultrasonic movement analysis systems calculate the three-dimensional positions of tiny markers, which are attached to moving body parts, with high spatial and temporal resolution. Thus, key parameters of gait and hand movements can be determined precisely. This article summarizes and discusses several studies using these new methods. Results indicate that schizophrenia causes a specific motor deficit pattern, with a predominant disturbance of spatial parameters. Conventional antipsychotic treatment usually worsens these deficits, whereas the effects of atypical antipsychotic treatments are less pronounced. Disturbed motor performance can be normalized by external sensory stimuli, but only when no major attentional processes are required, and it can be enhanced by an attentional strategy, but not to the extent that motor parameters are normalized.

Attention↗
PubMed2005

Clustering and switching on verbal and figural fluency functions in adults with attention deficit hyperactivity disorder.

INTRODUCTION: Neuropsychological studies of adult patients with ADHD have revealed marked disturbances of executive functions including impairments of attention, working memory, impulsivity, shifting, and divergent thinking. Phonemic fluency tasks, in particular, have been shown to be sensitive measures for the assessment of executive functions of adults with ADHD. METHODS: The present study has examined figural fluency and both phonemic and semantic verbal fluency in 34 adult patients with ADHD and 34 healthy participants. For evaluation of fluency performance the number of words or designs, the number of repetitions and the number of deviations from test rules were calculated. Furthermore, clustering strategies and switching responses were analysed. In comparison with healthy participants, patients with ADHD produced significantly fewer words or designs, but they did not differ from healthy participants in the number of repetitions or rule violations. RESULTS: Analysis of switching and clustering showed that patients produced significantly fewer switching responses on both verbal fluency tasks, although patients tended to generate smaller clusters. Switching on the figural fluency task was unimpaired. CONCLUSIONS: The results of the present study suggest that adult patients with ADHD may suffer from a dysfunction that may affect retrieval processes and the categorisation of knowledge.

Journal Article↗
PubMed2004

[Changes in the emotional processing in depressive patients: a study with functional magnetoresonance tomography under the employment of pictures with affective contents].

OBJECTIVE: The influence of emotional contents on brain activation was examined using functional magnetic resonance tomography (fMRT). METHOD: Aquiring 100 EPI-measurements of the whole brain, series of positive and negative pictures from the International Affective Picture System (IAPS) were shown to eight depressed males and to healthy controls. RESULTS: In depression, there was an overactivation in hippocampal area during positive stimulation, whereas an overactivation of amygdala, orbital and prefrontal regions was seen during negative stimulation. CONCLUSIONS: These results emphasize the importance of functional interaction between the neural network associated with emotion. We could show that depression is connected to dysregulation and disturbed functional connectivity during emotional processing.

Adult↗
PubMed2004

[Evidence-based hospital management considering data from the psychiatric basic documentation system].

OBJECTIVE: The study aimed to demonstrate how data from the psychiatric basic documentation system (DGPPN-BADO) are able to support the hospital management in making evidence-based decisions. METHODS: Data from 14 327 psychiatric in-patients in the years 1997, 1999 and 2001 were analysed. RESULTS: About 40 % of patients were admitted without any medical sending, 20 % were referred by a general practitioner and 10 % by a psychiatrist in private practice. Between 1997 and 2001 an increase of patients with affective disorders and personality disorders was found. Comparing 1999 to 2001, patients showed greater deficits in their psychosocial capability (measured with GAF) at admission, but also at discharge. Outpatient aftercare was recommended to more than 80 % of in-patients, about 50 % by a general practitioner and about 33 % by a psychiatrist in private practice. 10 % of patients were cared by the own outpatient clinic. CONCLUSIONS: Data from the psychiatric basic documentation system could be shown as being relevant for evidence-based hospital management ensuring an effective and efficient in-patient treatment.

Aftercare↗
PubMed2004

[Psychotherapy units in Bavarian state mental hospitals].

OBJECTIVE AND METHOD: In this paper we report about the situation of psychotherapeutic inpatient treatment in Bavarian state mental hospitals, based on data coming from surveys in those hospitals. RESULTS AND CONCLUSION: 22 State mental hospitals in Bavaria have 1217 beds for acute psychotherapy, proofed on the basis of quality criteria. More than 50 per cent of all psychotherapy beds are located in those hospitals.

Germany↗
PubMed2004

[Familial plaque-only Alzheimer's disease in the Rottal-Inn and Passau counties].

We describe the kindred of Alois Alzheimer's second patient, who died from plaque-only Alzheimer's disease (AD) in 1910. There is a neuropathologically defined subtype of AD without or only few tangles. This plaque-only form is found in about 6 % of autopsied cases of AD. We recruited of AD patients with age of onset before 70 years from the Rottal-Inn and Passau counties in Bavaria and extended a kindred with familial dementia using genealogies deduced from historic parish records. 1247 individuals were documented genealogically. In the maternal branch of the kindred we documented 40 deceased individuals with possible Alzheimer's disease, whereas other branches of the family had no suspicious entries. We conclude, that there is a familial predisposition to dementia with variable age of onset between 36 and 80 years of age in the kindred of Johann F.

Adult↗
PubMed2003

Abnormalities in emotion processing within cortical and subcortical regions in criminal psychopaths: evidence from a functional magnetic resonance imaging study using pictures with emotional content.

BACKGROUND: Neurobiology of psychopathy is important for our understanding of current neuropsychiatric questions. Despite a growing interest in biological research in psychopathy, its neural underpinning remains obscure. METHODS: We used functional magnetic resonance imaging to study the influence of affective contents on brain activation in psychopaths. Series containing positive and negative pictures from the International Affective Picture System were shown to six male psychopaths and six male control subjects while 100 whole-brain echo-planar-imaging measurements were acquired. Differences in brain activation were evaluated using BrainVoyager software 4.6. RESULTS: In psychopaths, increased activation through negative contents was found right-sided in prefrontal regions and amygdala. Activation was reduced right-sided in the subgenual cingulate and the temporal gyrus, and left-sided in the dorsal cingulate and the parahippocampal gyrus. Increased activation through positive contents was found left-sided in the orbitofrontal regions. Activation was reduced in right medial frontal and medial temporal regions. CONCLUSIONS: These findings underline the hypotheses that psychopathy is neurobiologically reflected by dysregulation and disturbed functional connectivity of emotion-related brain regions. These findings may be interpreted within a framework including prefrontal regions that provide top-down control to and regulate bottom-up signals from limbic areas. Because of the small sample size, the results of this study have to be regarded as preliminary.

Adult↗
PubMed2003

[Segregated or mixed sex treatment in the psychiatric clinic--what do patients prefer?].

OBJECTIVE: Preference on separate or mixed sex treatment should be evaluated from the viewpoint of patients of a psychiatric hospital. METHODS: The preference of patients were surveyed by questionnaire before and after mixing four single sex wards. The adjusted response rate was 74.5%. RESULTS: About 75% of psychiatric patients prefer a mixed sex ward, about 25% prefer a single sex ward. Females more frequently confirm the type of ward to whom they were actually allocated. By contrast, males are in favour for mixed sex wards independently of the presently experienced type of ward. Younger patients, voluntarily admitted patients, and patients with substance addiction prefer mixed sex wards. After mixing the sexes of formerly single sex wards a significant increase in preference of mixed sex wards was found, due to increased affirmation by female patients. CONCLUSION: If single sex wards can be established in a psychiatric hospital considering their size, specialisation of wards, and sector of care, patients are enabled to choose between a single and mixed sex ward at admission.

Adult↗
PubMed2003

[No association of 141C-ins/del polymorphism in the D2 dopamine receptor gene in schizophrenia].

Recently, a putative functional polymorphism (-141C Ins/Del) in the 5'-flanking region of the dopamine D2 receptor was found. An association of the Ins allele with schizophrenia has been described in a Japanese sample. In the present study this association was examined in a German schizophrenia patient population. In a family based approach 190 German family trios were analyzed for the -141C Ins/Del genotype. Using the transmission disequilibrium test (TDT) we found no evidence for an association of the Ins allele with schizophrenia (TDT = 0.152, P = 0.696). In parallel, we performed an independent case control study with 268 schizophrenic patients and 244 controls. Again, we did not detect an overrepresentation of the Ins allele in patients (P = 0.124). Thus, our data do not support the hypothesis that the -141C Ins variant plays a major role in predisposition to schizophrenia. To confirm our conclusion further preferentially family based studies are needed.

Adult↗
PubMed2003

["Acquired psychopathy" and the neurobiology of emotion and violence].

"Psychopathy" describes a type of personality disorder characterized by a dysregulation of emotion processing. Social behaviour, emotion regulation and competency are of particular relevance in forensic psychiatry. Structural-morphological and functional imaging studies prove that emotion regulation, aggressive-impulsive behaviour and learning from negative experiences are greatly influenced by frontal brain regions. These abilities are impaired in severe cases of dissocial personality disorders and in traumatic "pseudopsychopathy". We illustrate the importance functional neurobiological changes in patients personality disorders and "acquired psychopathy" by two case reports on patients who were admitted to a forensic-psychiatric facility for sexual crimes.

Adult↗
PubMed2002

Alzheimer's second patient: Johann F. and his family.

Alois Alzheimer evaluated five cases of Alzheimer's disease in the early 20th century. We focused on the family of "Johann F.," Alzheimer's second patient, who died in October 1910 at age 57 years, and whose brain pathology is typical of a subgroup of Alzheimer's disease, the so-called "plaque-only type." It was perhaps Emil Kraepelin's personal knowledge of this patient and the histological data of the other four cases that influenced Kraepelin to coin the term Alzheimer's disease. The church archive in Passau has a genealogical database drawn from sacramental registers dating from approximately 1580 to 1900. The genealogical data of the "Johann F." family, which comes from villages in Lower Bavaria, extends as far back as 1670. We found documentation starting around 1830 about cause of death in the church records, which shows a familial predisposition to dementia. Affected family members include the mother, maternal grandfather, maternal great-aunt, maternal great-grandfather as well as three of Johann F.'s eight siblings. The offspring (children and grandchildren) of these affected siblings also were affected by mental illness. We conclude that "Johann F." represents the index case of a family with a predisposition to presenile dementia with variable age of onset (30s to 60s).

Alzheimer Disease↗
PubMed2002

Frontal lobe atrophy due to a mutation in the cholesterol binding protein HE1/NPC2.

This is the first description of slowly progressive Niemann-Pick disease type C (NPC) without the typical lysosomal storage in bone marrow and viscera in two descendants of a group of 17th century French-Canadians. The index patient was a married 43-year-old woman with onset of dementia in her thirties, later followed by the development of ataxia and athetoid movements. Her autopsy disclosed frontal lobe atrophy, neurolysosomal storage with oligolamellar inclusion and tau-positive neurofibrillary tangles. Of the 119 family members screened, only a married 42-year-old sister displayed symptoms of a dementia. Both women displayed vertical supranuclear ophthalmoplegia; expressive aphasia; concrete, stimulus-bound, perseverative behavior; and impaired conceptualization and planning. Cultured fibroblasts showed decreased cholesterol esterification and positive filipin staining, but no mutation was detected in coding or promoter regions of the NPC1 gene using conformation sensitive gel electrophoresis and sequencing. Sequencing showed a homozygous gene mutation that is predicted to result in an amino acid substitution, V39M, in the cholesterol binding protein HE1 (NPC2). Adult-onset NPC2 with lysosomal storage virtually restricted to neurons represents a novel phenotypic and genotypic variant with diffuse cognitive impairment and focal frontal involvement described for the first time.

Adult↗
PubMed2002

Subcortical overactivation in untreated schizophrenic patients: a functional magnetic resonance image finger-tapping study.

Functional magnetic resonance imaging (fMRI) is a well established, non-invasive technique for mapping the working brain. Yet imaging of subcortical regions has proven to be difficult. We studied 40 subjects performing an unilateral self-paced finger-tapping task. Patients with schizophrenia according to DSM-IV treated with olanzapine (n =10) or haloperidol (n=10) were compared to healthy controls (n =10) and untreated patients (n=10). Brainvoyager software was used for data-analyzing. All subjects showed highly significant activation in the contralateral sensorimotor area, the supplementary motor area and the ipsilateral cerebellum. In every investigated subject contralateral subcortical regions were also significantly activated (P < 0.001). Activation in ipsilateral pallidum was significantly higher in untreated patients compared with the other groups indicating an increase in subcortical coactivation. In addition, significant correlations were revealed within groups. This study emphasizes the possibility of investigating subcortical brain activation in patients with schizophrenia. The results of the present study outline the importance of further fMRI studies to investigate interindividual activation differences under different conditions especially focusing on basal ganglia.

Adult↗
PubMed2001

The impact of tricyclic antidepressants and selective serotonin re-uptake inhibitors on handwriting movements of patients with depression.

RATIONALE: Psychomotor retardation is a common symptom of patients with major depressive disorder. While a variety of clinical examinations using different techniques have been undertaken to assess the motor component of psychomotor retardation in depression, the effects of antidepressants on psychomotor functions have been examined less extensively. OBJECTIVE: The aim of the present study was to examine the effect of various pharmacological treatments on handwriting movements of patients with depression. METHODS: Kinematic data of automated handwriting movements of 18 depressed patients receiving tricyclic antidepressants (TCAs), 18 patients on selective serotonin re-uptake inhibitors (SSRIs) and 18 healthy subjects was recorded and analysed. Groups were matched according to age, sex, handedness and education level. For the assessment of fine motor movements, a digitising tablet was used. Subjects were asked to perform a simple writing task. Movement time, velocity and acceleration of the handwriting movements were measured. RESULTS: Statistical analysis of writing movements revealed motor slowing in patients receiving TCAs. In comparison with both healthy subjects and patients receiving SSRIs, the TCA group displayed an increased movement time, reduced automation of handwriting, lower maximum velocities and reduced acceleration of descending strokes. CONCLUSIONS: The results suggest either that TCAs have adverse effects on motor functioning or that they are less effective in the treatment of motor retardation than SSRIs.

Adult↗
PubMedDate not supplied

Novel PS1 mutation in a Bavarian kindred with familial Alzheimer disease.

We describe a novel Leu174Arg PS1 mutation in two members of a Bavarian family which were initially diagnosed with frontotemporal dementia. Intriguingly, there is the possibility that there is an 18th century founder effect and that this family is related to original kindreds with familial Alzheimer disease described in the early 20th century.

Alzheimer Disease↗