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Biomedical subjects

Peter Scheuerpflug

Publications and source records attributed to Peter Scheuerpflug.

3 recordsLinked to original sources

[Encopresis--predictive factors and outcome].

OBJECTIVES: comparison of diagnostic, clinical and therapeutic features and their predictive value for the outcome of encopresis in children and adolescents. METHODS: 85 children and adolescents (aged 9.6 +/- 3.2 years) with severe encopresis (ICD 10: F98.1) were investigated during inpatient treatment and 35 of them again 5.5 +/- 1.8 years later. Mentally retarded patients were excluded. Inpatient therapy consisted of treating constipation and/or stool regulation by means of laxatives, behavioural approaches, and the specific therapy of comorbid psychiatric disorders. RESULTS: During inpatient treatment 22% of the patients experienced total remission, 8% an unchanged persistence of symptoms. Of the 35 patients studied at follow-up 5.5 years later, 40% were symptom-free. As main result, prognostic outcome depended significantly on sufficient treatment of obstipation. Another important factor was the specific therapeutic approach to psychiatric comorbidity, especially to ADHD. The outcome for patients with comorbid ICD 10: F43 was significantly better than for the other patients. Those who were symptom-free at discharge had significantly better long-term outcomes. CONCLUSIONS: Decisive to the success of encopresis treatment were the stool regulation and the specific therapy of associated psychiatric illnesses, in particular of ADHD. Inpatient treatment revealed significantly better long-term outcomes where total remission had been achieved by the time of discharge from hospital.

Adolescent↗

Altered response control and anterior cingulate function in attention-deficit/hyperactivity disorder boys.

OBJECTIVE: To investigate mechanisms and structures underlying prefrontal response control and inhibition in boys suffering from attention-deficit/hyperactivity disorder (ADHD). METHOD: Sixteen boys with ADHD and 19 healthy controls were investigated electrophysiologically during performance of a visual Go-Nogo task (Continuous Performance Test, CPT). An electrophysiological source localization method was employed to further analyze the data. RESULTS: The ADHD boys showed a significantly diminished central Nogo-P3, due to a lack of Nogo-related frontalization of the positive brain electrical field in this group. This two-dimensional effect was associated with a significantly reduced activation of the anterior cingulate cortex (ACC) in the ADHD boys in the Nogo condition of the CPT. Both groups did not significantly differ regarding the amplitude of the Nogo-N2. CONCLUSIONS: The results indicate deficits in prefrontal response control in unmedicated ADHD boys that do not seem to be specifically inhibitory in nature. A supposed dysfunction of the ACC in ADHD was confirmed.

Attention Deficit Disorder with Hyperactivity↗

Multicenter P300 brain mapping of impaired attention to cues in hyperkinetic children.

OBJECTIVE: To measure specific neurophysiological attention deficits in children with hyperkinetic disorders (HD; the ICD-10 diagnosis for severe and pervasive attention-deficit/hyperactivity disorder [ADHD]). METHOD: In a multicenter sample of 148 children with HD and control children aged 8 to 14 years, event-related potential maps were recorded during a cued continuous performance test (A-X/O-X). Maps to cues (requiring attention but no response) and distractors and performance were tested for differences between age- and sex-matched HD and control groups (n = 57 each), as well as between clinics (n = 5). RESULTS: The N1, P3a, and P3b maps revealed reliable attention effects, with larger amplitudes after cues than after distractors, and only minor differences across clinics. Children with HD missed more targets, made more false alarms, and had larger N1 followed by smaller P3b amplitudes after cues than did controls. Cue-P3b amplitude correlated with detecting subsequent targets. Cue-P3b tomography indicated posterior sources that were attenuated in children with HD. CONCLUSIONS: Brain mapping indicates that children with HD attend to cues (preceding potential targets) with increased initial orienting (N1) followed by insufficient resource allocation (P3b). These multiple, condition-specific attention deficits in HD within 300 msec extend previous results on ADHD and underline the importance of high temporal resolution in mapping severe attention deficits.

Adolescent↗