Biomedical subjects

Josef B Aldenhoff

Publications and source records attributed to Josef B Aldenhoff.

11 recordsLinked to original sources

PubMed2007

Effects of short- and long-term pulsed radiofrequency electromagnetic fields on night sleep and cognitive functions in healthy subjects.

There has been wide public discussion on whether the electromagnetic fields of mobile telephones and their base stations affect human sleep or cognitive functioning. As there is evidence for learning and memory-consolidating effects of sleep and particularly of REM sleep, disturbance of sleep by radiofrequency electromagnetic fields might also impair cognitive functions. Previously realized sleep studies yielded inconsistent results regarding short-term exposure. Moreover, data are lacking on the effect that short- and long-term exposure might have on sleep as well as on cognitive functions. Therefore, 10 healthy young male subjects were included and nocturnal sleep was recorded during eight consecutive nights. In the second, third, and last night, we investigated polysomnographic night sleep and cognitive functions. After the adaptation and baseline nights, the participants were exposed to a defined radiofrequency electromagnetic field during the following six nights. We analyzed polysomnographic night sleep according to Rechtschaffen and Kales [1968, Manual of Standardized Terminology, Techniques and Scoring System for Sleep of Human Subjects] as well as by power spectra and correlation dimension. Cognitive functions were investigated by an array of neuropsychological tests. Data analysis was done by comparing the baseline night with the first and last exposure night and the first two sleep cycles of the respective nights. We did not find significant effects, either on conventional sleep parameters or on power spectra and correlation dimension, nor were there any significant effects on cognitive functions. With our results, we are unable to reveal either short-term or cumulative long-term effects of radiofrequency electromagnetic fields on night sleep and cognitive functions in healthy young male subjects.

Adult↗

PubMed2005

Case management for the treatment of patients with major depression in general practices--rationale, design and conduct of a cluster randomized controlled trial--PRoMPT (PRimary care Monitoring for depressive Patient's Trial) [ISRCTN66386086]--study protocol.

BACKGROUND: Depression is a disorder with high prevalence in primary health care and a significant burden of illness. The delivery of health care for depression, as well as other chronic illnesses, has been criticized for several reasons and new strategies to address the needs of these illnesses have been advocated. Case management is a patient-centered approach which has shown efficacy in the treatment of depression in highly organized Health Maintenance Organization (HMO) settings and which might also be effective in other, less structured settings. METHODS/DESIGN: PRoMPT (PRimary care Monitoring for depressive Patients Trial) is a cluster randomised controlled trial with General Practice (GP) as the unit of randomisation. The aim of the study is to evaluate a GP applied case-management for patients with major depressive disorder. 70 GPs were randomised either to intervention group or to control group with the control group delivering usual care. Each GP will include 10 patients suffering from major depressive disorder according to the DSM-IV criteria. The intervention group will receive treatment based on standardized guidelines and monthly telephone monitoring from a trained practice nurse. The nurse investigates the patient's status concerning the MDD criteria, his adherence to GPs prescriptions, possible side effects of medication, and treatment goal attainment. The control group receives usual care--including recommended guidelines. Main outcome measure is the cumulative score of the section depressive disorders (PHQ-9) from the German version of the Prime MD Patient Health Questionnaire (PHQ-D). Secondary outcome measures are the Beck-Depression-Inventory, self-reported adherence (adapted from Moriskey) and the SF-36. In addition, data are collected about patients' satisfaction (EUROPEP-tool), medication, health care utilization, comorbidity, suicide attempts and days out of work. The study comprises three assessment times: baseline (T0) , follow-up after 6 months (T1) and follow-up after 12 months (T2). DISCUSSION: Depression is now recognized as a disorder with a high prevalence in primary care but with insufficient treatment response. Case management seems to be a promising intervention which has the potential to bridge the gap of the usually time-limited and fragmented provision of care. Case management has been proven to be effective in several studies but its application in the private general medical practice setting remains unclear.

Adult↗

PubMed2005

[Signals for the initiation of structured diagnostic procedures for depression in primary health care. A practice-relevant evaluation of international guidelines].

BACKGROUND AND OBJECTIVES: Almost every tenth patient of a general practitioner (GP) suffers from depression. However, only 20-25% of these patients are correctly diagnosed during a GP consultation. How do international guidelines for depression in primary care initiate structured diagnostic procedures for depression? METHODS: We performed a systematic literature search on guidelines for the diagnosis of depression with focus on primary care. The quality of the guidelines was rated according to base of evidence, existence of pilot studies, data on implementation, presentation and specificity for primary care settings, and conflict of interest. We also screened whether and how the guidelines comment on the initiation of structured diagnostic procedures for depression. RESULTS: Of the 22 identified guidelines, only 15 address primary care. Only 3 of these were tested in pilot studies, 3 provided data on implementation, 9 were evidence-based. The best guideline (6 out of 6 criteria met) is available in Dutch and established for The Netherlands only. We ranked the guidelines from NHG, VHA and ICSI as very good in terms of methodological quality. They present 'red flags' that initiate structured diagnostic procedures by 'opportunistic screening'. This is followed by the application of a self-rating instrument and an ICD-10-based diagnostic checklist identifying up to 98% of all patients with depression in a given consultation time of 10 minutes on average. CONCLUSION: Based on these criteria a national diagnostic depression guideline should, from our point of view, explicitly include keys such as "red flags" for the initiation of structured diagnostic procedures.

Depressive Disorder↗

PubMed2004

Perinatal MK-801 treatment affects age-related changes in locomotor activity from childhood to later adulthood in rats.

Neuronal degeneration underlying the pathology of schizophrenia is already present during childhood. However, most of these studies were done in adult humans or animals. The present study therefore investigated age-related changes of behavior in an innovative version of the Open Field Maze following perinatal chronic administration of the noncompetitive N-methyl-D-aspartate antagonist MK-801. The waxing and waning pattern of locomotor activity during aging with a peak around the age of 90 days was profoundly attenuated by MK-801. MK-801 further reduced locomotion and body weight in mature rats. However, it increased explorative behavior in immature rats. Therefore, the chronic perinatal administration of MK-801 seems to be a model to investigate the pathological mechanisms of psychomotor retardation and body weight dysregulation in schizophrenia.

Age Factors↗

PubMed2003

Morning headaches in patients with sleep disorders: a systematic polysomnographic study.

OBJECTIVES: Patients with sleep disorders suffer more often from headache after awakening than healthy subjects. However, it still is a matter of controversy whether this applies only to patients with sleep apnea syndrome (SAS) or also to patients with other diagnoses of sleep disorders. METHODS: We asked all patients in our sleep laboratory about the frequency of past headaches and also ascertained the occurrence of morning headaches after awakening in the sleep laboratory. Polysomnographic recordings from nights before morning headache were compared with nights without following headache. Four hundred and thirty-two patients with sleep disorders (age range 18-86 years, 37% women) and 30 healthy subjects (age range 24-55 years, 27% women) participated in this prospective study. RESULTS: The reported frequency of past headaches and the frequency of morning headache in the sleep laboratory were significantly increased in patients with SAS and other sleep disorders compared with healthy subjects. The occurrence of morning headache in the sleep laboratory was associated polysomnographically with a decrease in total sleep time, sleep efficiency and amount of rapid eye movement sleep and with an increase in the wake-time during the preceding night. CONCLUSIONS: We conclude that morning headaches in patients with sleep disorders might be associated with particular disturbances of the preceding night's sleep. We speculate that dysregulation in anatomically identical central regions modulating sleep and nociception might be relevant to morning headache, rather than one particular sleep disorder such as SAS.

Adult↗

PubMed2003

Convergent and divergent effects of odors and emotions in depression.

The aim of the present study was to investigate the similarities and differences in the olfactory and visual processing of emotional stimuli in healthy subjects and in patients with major depressive disorder (MDD). Twenty-five inpatients were investigated after admission to the psychiatric clinic. Fifteen of them participated a second time, shortly before their discharge from the hospital. A group of healthy subjects, matched according to age and sex, served as a control. Chemsosensory event-related potentials (CSERPs) were recorded using the constant flow method. In addition, event-related potentials (ERPs), in response to colors and emotional slides, were obtained to control modality and emotion-specific effects. The subjects' task was to discriminate the colors (red/yellow) and odors (phenyl-ethylalcohol = rose/ isobutyraldehyde = rotten butter) according to their quality and to judge the valence of the emotional slides (IAPS slides). The EEG was recorded from 32 scalp locations. At the beginning of the therapy, visual stimulus processing was attenuated in depressive subjects at a relatively late processing level (reduced amplitudes of the P3 and pSW in response to colors and emotional slides), whereas olfactory stimulus processing had already been affected at an early level (reduced amplitudes of the P2 and P3-1 peaks in MDD patients). However, after successful medical treatment, ERPs did not differentiate between depressive patients and healthy controls. We discuss whether functional deviations within the primary olfactory cortex are responsible for the lower olfactory sensitivity, as well as for the altered emotional stimulus processing in MDD patients.

Adult↗

PubMed2002

Novel object presentation affects sleep-wake behavior in rats.

Sleep is suggested to be crucial for the processing and storage of new information. Several learning tasks have been shown to increase the amount of rapid eye movement sleep (REMS) with its typical theta activity (6-8 Hz) relative to total sleep time. Vice versa, REMS deprivation is able to affect memory consolidation following some, but not all learning tasks. Furthermore, recent studies have shown an increase of spindle activity (12-15 Hz) within the electroencephalogram (EEG) of nonREMS as well. The enhancement of both spindle and theta activity is suggested to serve as background activity for the synchronization of those neuronal pathways that were involved in the registration and, later on, participate in the long-term storage of new information in defined brain regions. In the present study, the presentation of a novel object to rats enhanced the amount of preREMS, an intermediate sleep stage with high spindle activity, within the first 2 h of the subsequent sleeping phase. Four hours later, the amount of REMS was increased as well. However, there were no changes in the EEG power spectra of nonREMS, preREMS and REMS. We therefore hypothesize that the increase of preREMS and REMS amounts and the related spindle and theta activity stand for the processing and storage of new information about the presented novel objects.

Action Potentials↗

PubMedDate not supplied

Changes in CREB-phosphorylation during recovery from major depression.

For decades psychiatrists have been looking for biological state markers measurable by easy blood test in order to follow up and predict early on treatment response in patients with major depression. In the present study we investigated whether or not measuring CREB (cAMP-response-element-binding-protein) phosphorylation in peripheral blood T lymphocytes is a state marker of treatment response. CREB is an ubiquitous key-element of intracellular signal transduction cascades and its transcriptional activity depends on phosphorylation at Ser-133. Several studies in animals demonstrated that the transcriptional activity of CREB is up-regulated by antidepressant treatment. Therefore, it has been hypothesized that antidepressant treatment exerts its therapeutic effect by this mechanism. In the present study, we investigated CREB-phosphorylation in T-lymphocytes of 20 patients before and in the end of week one and two of either psychopharmacological or psychotherapeutic treatment. After two weeks, 15 patients fulfilled the criteria of treatment response (i.e. 30% reduction in HAMD score compared to baseline), whereas five patients did not. In the end of week two, the responders showed a significant increase in CREB-phosphorylation (P = 0.018) compared to the non-responders. This was true for all patients with either treatment regimen. In conclusion, these results indicate for the first time that the increase in CREB-phosphorylation might be a molecular state marker for the response to antidepressant treatment.

Antidepressive Agents↗

PubMedDate not supplied

Differential effects of fluoxetine and imipramine on the phosphorylation of the transcription factor CREB and cell-viability.

It has been shown that antidepressants increase the expression of CREB (cAMP-response-element-binding-protein) and BDNF (brain derived neurotrophic factor) in vivo. Apparently inconsistent to these survival-promoting properties for many years antidepressants are known to induce apoptosis in various cell types in vitro. In the present study we evaluated if the antidepressants imipramine and fluoxetine are capable to influence the translational expression and phosphorylation of CREB (pCREB) in cells known to be apoptosis-inducible by antidepressants. We therefore used jurkat cells and quantified apoptosis via propidiumiodid-staining and FACS-analysis. CREB-expression and -phosphorylation was quantified via western blot. Both antidepressants induced apoptosis within 24 h. Fluoxetin starts to induce significant apoptosis at a concentration of 20 microM, whereas imipramine at 100 microM. At these concentrations both antidepressants also increased the phosphorylation of CREB within 6 h. But even in concentrations to low to induce apoptosis both antidepressants still increased CREB-phosphorylation. Treating cells with lowest concentrations only imipramine revealed an increase of CREB-phosphorylation after long-time treatment over 3 weeks. In all experiments overall CREB-expression remained unchanged. In conclusion our experiments indicate that antidepressants are capable to increase CREB-phosphorylation without induction of apoptosis depending on concentration and duration of treatment. We further assume that antidepressants induce CREB-phosphorylation via signal transduction pathways that are different from those inducing apoptosis.

Antidepressive Agents, Second-Generation↗

PubMedDate not supplied

[Interpersonal psychotherapy (IPT) in depressions].

Evidence-based medicine gains more importance within psychotherapy as well, although some problems occur in trying to follow the principles of evidence-based-medicine in the field of psychotherapy very strictly. The Interpersonal Psychotherapy (IPT) for depression, which has been developed more than 30 years ago may be taken as an example for evidence-based-psychotherapy: the concept was built on empirical observations and manualised. Further on it was evaluated in many clinical trails that showed the good efficacy and later effectiveness. IPT reaches a high level of evidence and is to be seen as well-established psychotherapy. Psychotherapy research tries to point out the effectiveness for different subtypes of depressive disorders. Moreover it is investigated which connection exist between therapy outcome and neurobiological changes in the central nervous system.

Depressive Disorder↗

PubMedDate not supplied

[In-patient treatment concept for acute crises of borderline patients on the basis of dialectical-behavioral therapy].

Whereas the Dialectical-Behavioral Therapy (DBT) by Marsha Linehan for chronic suicidal female patients with borderline personality disorder has also been successfully implemented for in-patient treatment, the management of recurrent crisis has continued to be a significant challenge especially for hospitals taking part in the mandatory health coverage. Therefore, we have established an acute, short-term crisis treatment concept for both genders on a locked unit which takes the different circumstances of acute crisis into account. It ought to be used under the conditions of acute psychiatry and at the same time meet psychotherapeutic demands of borderline treatment. The treatment basis is DBT. The treatment focus is to improve stress-tolerance, especially by skills-training, regarding the individual situation and problems at time of admittance. The in-patient treatment should not take more than three weeks. The short-time aim is a fast reintegration in ambulant treatment or motivation for a specific therapy as DBT, middle- and long-time aims are the improvement of the ability to cope with crises and to demand less in-patient care.

Behavior Therapy↗