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Biomedical subjects

N von Steinbüchel

Publications and source records attributed to N von Steinbüchel.

12 recordsLinked to original sources
PubMed2006

Chronic posttraumatic stress symptoms after nonsevere stroke.

OBJECTIVE: To determine whether posttraumatic stress disorder (PTSD)-related symptoms were present 1 year after a nonsevere stroke and, if so, to examine the relationship between PSTD, coexisting cognitive variables, and infarct localization METHODS: The authors assessed 49 patients using standard measures of memory, trauma experience, neurologic deficit, depression, anxiety, and PTSD. RESULTS: Fifteen (31%) patients had significant PTSD symptoms on the Impact of Event Scale (IES > 30). PTSD-like syndrome was independent of neurologic impairment, peristroke amnesia, long-term memory impairment, nosognosia, hypochondriac preoccupations, and physical pain during hospitalization, but was more frequent in women, less educated patients, and patients with more negative appraisals of the stroke experience. Intrusions were increased after basal ganglia strokes, suggesting that the re-experiencing phenomena may be modulated by frontosubcortical pathways. CONCLUSIONS: Posttraumatic stress disorder symptoms seem frequent in patients with nonsevere stroke and were associated with the subjective intensity of the stroke experience and accompanied by a depressive and anxious state.

Adult↗
PubMed2003

Health-related quality of life in patients with coronary artery disease treated for angina: validity and reliability of German translations of two specific questionnaires.

The German versions of two patient-perceived heart disease specific health-related quality of life (HRQL) questionnaires, the Seattle Angina Questionnaire (SAQ) and the MacNew Heart Disease questionnaire, were examined for their psychometric properties in patients with angiographically documented coronary artery disease and angina who were treated either medically or invasively and followed up for 1 year. Both HRQL questionnaires and the modified Canadian Cardiovascular Society (CCS) angina-associated disability scale were completed by 158 patients at baseline and 12 months later when they also completed a generic health status questionnaire, the SF-36. Both specific HRQL questionnaires were acceptable to patients. Three of the four MacNew scales, but none of the SAQ scales, discriminated between patients by baseline CCS disability levels I and IV. Internal consistency ranged from 0.75 to 0.94 for the SAQ and from 0.86 to 0.97 for the MacNew scales. Test-retest reliability over a 4-week period of time ranged from 0.45 to 0.81 for the SAQ scales and 0.61 to 0.68 for the MacNew scales. Over 12 months, HRQL improved (p < 0.001) on three of the five SAQ and on all four of the MacNew scales with the responsiveness statistic ranging from 0.59 to 1.55 for the SAQ and 0.86 to 1.12 for the MacNew. The 12 month scores on all SAQ and MacNew scales were significantly higher in patients who improved than those who deteriorated on the SF-36 reported health transition question. We conclude that the SAQ and the MacNew are both valid, reliable, and responsive in German, that the MacNew discriminates better between angina grades at baseline, that HRQL improves over 12 months with both measures, that the SAQ angina frequency and disease perception scales have the largest effect sizes, and that the 12-month change in HRQL with both instruments was associated with change in SF-36 reported health transition status.

Aged↗
PubMed2001

Hemispheric specialisation for self-paced motor sequences.

Temporal aspects of motor control were investigated in patients with infarction to the brain with two finger-tapping tests. In the self-paced tapping task patients with cortical left-hemispheric lesions were slowed down and patients with left-hemispheric subcortical injuries were consistently faster as compared with control subjects and patients with right hemispheric cortical lesions. The results point to the dominant control of the left-hemisphere in voluntarily timed action and to a special time range of 250-300 ms involved in motor behaviour.

Adult↗
PubMed2000

Assessment of health-related quality-of-life in patients after heart transplantation under therapy with tacrolimus or cyclosporine.

Reduction of allograft rejections remains a primary goal for patients after orthotopic heart transplantation. In an open, multicentre, prospectively randomised, parallel group study, patients with primary orthotopic heart transplantation under oral immunosuppressive treatments with tacrolimus (FK506) or cyclosporine (sandimmun) were compared with respect to medical outcome data. As health-related quality-of-life (HRQOL) is also supposed to be an important outcome parameter, it was assessed as a secondary variable in these two patient groups. Patients' self-rated generic HRQOL was assessed 6 weeks, 3 months, 6 months and 12 months after surgery with the SF-36 questionnaire, a generic HRQOL instrument. For 70 patients (46 under tacrolimus, 24 under cyclosporine), intent-to-treat analyses were carried out. The tacrolimus group showed improvements in the different HRQOL subscales of the SF-36 compared to the cyclosporine group. Especially the SF-36 subscales 'vitality' and 'mental health' showed statistically higher scores for the tacrolimus group. Aggregating psychological and cognitive subscales in the 'mental component score', patients treated with tacrolimus showed a statistically significant improvement compared to the cyclosporine group. The assessment of HRQOL variables in the evaluation of treatment effects proved to be an outcome parameter in this study. The results demonstrate the benefit of tacrolimus with respect to the HRQOL of patients, especially in the psychological dimension.

Analysis of Variance↗
PubMed1999

Auditory temporal-order judgement is impaired in patients with cortical lesions in posterior regions of the left hemisphere.

Auditory temporal-order judgement was investigated in patients suffering from unilateral focal brain lesions, localized in anterior or posterior regions of the left hemisphere (LH) (resulting in non-fluent or fluent aphasia, respectively), or in predominantly subcortical regions of this hemisphere (without aphasic syndromes) and in anterior or posterior regions of the right hemisphere. The temporal order threshold was measured as the minimum time interval between two clicks presented consecutively and binaurally via headphones (one to each ear) that was necessary for a subject to indicate the temporal order of the two stimuli. Only the patient group with fluent aphasia showed a significantly increased mean temporal-order threshold as compared to the controls. Our results indicate that fine temporal resolution for auditory stimuli is predominantly associated with posterior regions of the LH.

Aphasia↗
PubMed1999

Daily rhythm of temporal resolution in the auditory system.

Over a period of 24 hours, fusion thresholds (click durations 100 micros) were assessed in 7 subjects. Over the same period, order thresholds (click duration of 1 ms) were measured in 10 subjects (12 independent sessions). Auditory fusion thresholds showed a diurnal rhythm with a maximum performance (shortest intervals) around midnight. In contrast, order thresholds appear to be independent on the time of day. Sex specific differences in threshold levels were only observed in order thresholds but not in fusion thresholds.

Acoustics↗
PubMed1998

Temporal ranges of central nervous processing: clinical evidence.

The organization of the time frames for perceiving, generating, and updating information in the CNS has as of yet received little attention despite its elementary character for human behavior. We investigated temporal epochs in perceiving, acting, and updating in patients with anterior and posterior lesions of the left and right hemisphere, in patients with lesions in the left hemisphere without aphasia, and in healthy controls. Three temporal ranges, 30, 300, and 3000 ms, were assessed with different psychophysical paradigms. Prolongation of the temporal perception of order (30 ms) was most pronounced with left posterior lesions, of repetitive action (300 ms) with left anterior lesions, and updating (3000 ms) with left and right anterior lesions. Temporal deficits are group as well as parameter specific. Our results support the notion of coordinated coexistence of different temporal mechanisms.

Adult↗
PubMed1997

Temporal processing disorders in patients with Broca's aphasia.

We report an association between a language deficit following brain lesion and a new strategy in temporal integration. Patients with different brain lesions mentally grouped sequences of identical acoustic stimuli generated at various frequencies. They were asked while listening to the stimuli to accentuate every second, third or other stimulus to create an individual rhythmic pattern. After each sequence patients reported how many stimuli they had united into a perceptual unit. The integration interval was defined as the number of reported stimuli multiplied by the temporal interval between two successive stimuli. Results indicate different integration strategies depending on the lesion site, i.e. Broca's aphasics behaving differently than all other patient groups. At lower frequencies they showed longer, at higher frequencies they displayed shorter integration. From this observation we conclude that the Broca's patients acquired a new strategy because of the lesion; they relied on mental counting and less on automatic temporal integration, which is usually the case.

Adult↗
PubMed1996

Temporal constraints in processing of nonverbal rhythmic patterns.

This study investigates the effect of a mental content of presented stimuli, normal aging and individual differences in cognitive abilities on temporal limits of an integration mechanism. Younger and older subject grouped together the beats generated by a metronome. Subjects were asked to listen to the beats of a metronome and to accentuate mentally every second, third, fourth...etc. beat, to create a subjective rhythm. This rhythm exists, in fact, only in subjects' mind and not objectively. Subjects reported verbally how many clicks they were able to integrate into a perceptual unit. On this basis, the time interval during which subjects were able to integrate temporally separated stimuli was calculated (number of beats reported as being integrated x time distance between beats) for different metronome frequencies. The results show, firstly, that the length of integration periods significantly depends on the frequency of presented metronome beats. When the frequency of metronome beats is high, the time interval during which the subjects integrate beats into a single perceptual unit is shorter. Secondly, older adults integrate information during a longer time interval than younger ones. Thirdly, the length of an integration period is related to a subjects' level of cognitive ability. These results suggest that the length of an integration period is not a constant, stable feature, but varies across the life span depending on the mental content of the information presented and individual factors.

Acoustic Stimulation↗
PubMed1993

Domains of rehabilitation: a theoretical perspective.

On the basis of a taxonomy of functions an outline is given on potential deficits after brain lesions. The taxonomy distinguishes between "what"- and "how"-functions. Whereas for what-functions the localizing principle may apply, the how-functions being responsible for the logistics of the brain are non-locally represented. After brain injury the what- and how-functions may be differentially effected. On this basis 4 domains of functional rehabilitation can be distinguished, namely restitution and substitution of function after partly or complete losses of what-functions, activation and integration of function after alterations of activation or a disruption of functional coordination. Different strategies of functional rehabilitation are related to basic neurobiological principles which have been made responsible for restitution of function. Neuropsychological rehabilitation remains a challenge for neurobiology.

Brain Injuries↗
PubMed1990

Multistable states in intrahemispheric learning of a sensorimotor task.

We have obtained evidence from an intrahemispheric learning task using a choice-reaction-time paradigm that the acquisition of a sensorimotor skill can be discontinuous. Subjects had to react as fast as possible to either a visual or an auditory stimulus. In several successive sessions, reaction times improved markedly, however in a discontinuous way. Different levels of performance were characterized by discrete functional states, each state being associated with a particular temporal window. After sufficient learning, reactions were confined to the earlier of two such windows.

Acoustic Stimulation↗