PubMed Health⌕ Search

Biomedical subjects

R Niethammer

Publications and source records attributed to R Niethammer.

9 recordsLinked to original sources

Nongenetic pathologic developments of brain-wave patterns in monozygotic twins discordant and concordant for schizophrenia.

Evidence from previous studies has suggested that the inter-individual differences in human brain-wave patterns (EEG) are predominantly determined by genetic factors. In particular, the within-pair EEG concordance of monozygotic (mz) twins was found to be typically as high as r = 0.81 across channels and frequency bands, thus being comparable to that between repeated assessments on the same individual with typically r = 0.83. Yet our investigations into mz twins discordant and concordant for schizophrenia yielded a significantly reduced within-pair EEG concordance for both, the pairs discordant for schizophrenia and the pairs concordant for schizophrenia (with concordance for schizophrenia assessed through a syndrome-oriented approach). A multivariate discriminant function of EEG parameters distinguished in a reproducible way between affected and unaffected subjects at an overall performance of >75% correctly classified subjects, while the severity of illness, as derived from EEG-differences between affected and unaffected subjects, was closely related to the severity of illness as provided by psychopathology syndrome scores. Consequently, EEG anomalies associated with schizophrenia and manifested differently in the mz co-twins concordant for schizophrenia are likely the effect of nongenetic, pathologic processes that evolved independently in the co-twins' genetically identical brains once the illness began to progress. The existence of such nongenetic processes would suggest a modification of the standard phenotype-to-genotype search strategies of molecular-genetic studies that aim to link the schizophrenia phenotype to genetic vulnerability factors.

Adult↗

Genetic influence on laterality in schizophrenia? A twin study of neurological soft signs.

OBJECTIVE: This study explored the genetic basis of neurological soft signs in schizophrenia and addressed disturbed hemispheric lateralization. METHOD: The authors investigated neurological soft signs in 30 monozygotic twin pairs, 13 pairs discordant for schizophrenia or schizoaffective disorder and 17 healthy comparison twin pairs. RESULTS: The twins with schizophrenia showed higher total scores for neurological soft signs than did the comparison subjects. The total scores for neurological soft signs of the nonaffected discordant twins were significantly higher than those of the comparison twins. There was a significant difference between the nonaffected and affected discordant twins in total scores for neurological soft signs. In contrast to the comparison subjects, the nonaffected and affected twins of the discordant pairs showed a trend toward higher scores for neurological soft signs on the left body half. CONCLUSIONS: These results suggest that the occurrence of neurological soft signs and, more specifically, their lateralization to the left body half are genetically transmitted.

Adult↗

[Delirium syndrome as a side-effect of lithium in normal lithium levels].

Lithium is used with great success in the treatment of manic patients and for prophylaxis of bipolar disorders. There are only few reports about neuropsychiatric side effects at therapeutic serum levels. We report on a 38 year old woman with bipolar disorder who was treated with lithium for 20 years without side-effects. Subsequent to a manic episode, she became disoriented at night and showed marked memory deficits. The patient did not show any neurological or gastrointestinal signs of intoxication. Lithium serum-levels were in therapeutic range. The psychiatric symptoms disappeared when lithium was stopped. We interpret these symptoms as delirant syndrome with pseudo-dementia at therapeutic lithium serum levels. This side-effect must be taken into account even in patients on successful longtime lithium therapy.

Adult↗

Genetic influence on auditory information processing in schizophrenia: P300 in monozygotic twins.

BACKGROUND: It is widely accepted that schizophrenia is to some extent genetically determined. Abnormalities of the P300 component are one of the most robust biological findings in schizophrenia. They outlast clinical impairment and are present also in relatives of schizophrenic patients. In the present study on schizophrenic twins, the heritability of auditory P300 abnormalities and the influence of task difficulty on heritability was examined. METHODS: Twenty-two monozygotic twin pairs were included into this study (eight pairs discordant, five pairs concordant for schizophrenia or schizoaffective psychosis according to ICD-10 criteria, and nine control pairs). Two different versions of the auditory oddball paradigm were used to control for deficient stimulus perception. RESULTS: Compared to healthy controls, P300 amplitudes were significantly smaller in affected twins as well as in the non-affected co-twins of the discordant pairs. CONCLUSIONS: Our results suggest that P300 amplitude reduction is a genetically transmitted vulnerability marker for schizophrenia. Because the findings were independent of the difficulty of the task and could be demonstrated even when pitch disparity was adjusted to the subjects' ability to discriminate tones, the findings can not be related to the genetic influence on higher information processing.

Adult↗

Structural and functional correlates of subsyndromes in chronic schizophrenia.

Recent psychopathological studies consistently identified a delusional, a negative, and a disorganized subsyndrome in chronic schizophrenia. The aim of our studies was to investigate the subsyndromes with respect to their underlying cerebral changes using computed tomography (CT) and positron emission tomography (PET). In a CT study 50 DSM III schizophrenics were subgrouped according to four factors identified by a factor analysis of BPRS ratings. This procedure identified three chronic clusters (delusional ideation, negative symptoms, and disorganization) and one cluster with a remitting course of the disorder. Both the negative and the delusional subsyndrome were associated with a widening of the frontal interhemispheric fissure. Disorganization was associated with neurological soft signs, an increased ventricle brain ratio, and width of the 3rd ventricle. The same subgrouping was applied in a 18F-deoxyglucose PET study of 79 neuroleptic free DSM III schizophrenic patients and 47 healthy controls. The delusional subsyndrome was associated with a decreased hippocampal function, while the negative subsyndrome showed a prominent hypofrontality and left temporal cortex changes. Both the delusional and the negative subsyndrome were associated with a decreased activity in the medial frontal gyrus in comparison to the other schizophrenic patients and the healthy controls. The disorganized subsyndrome was characterized by an overactivity in the parietal cortex and motor strip and a decreased activity in the corpus callosum. These findings support the differentiation of three subsyndromes in chronic schizophrenia. The subsyndromes seem to be characterized by deviant patterns of cerebral alterations, rather than deficits in a single location.

Brain↗

Differentiating subtotal carotid artery stenoses from occlusions by colour-coded duplex sonography.

During a 9-month period the carotid arteries of 2420 consecutive patients were investigated by conventional Doppler and duplex ultrasonography as well as by colour-coded duplex sonography. Of 186 internal carotid arteries showing a diameter reduction at the bifurcation level of 95% or more by conventional techniques, 131 underwent X-ray angiography which revealed a subtotal stenosis in 25 and an occlusion in 106 cases. Using a total of ten criteria for describing the colour-coded duplex findings, the "distal colour filling", a combination of three single criteria, could be found in all subtotal stenoses and none of the occlusions. "Distal colour filling" was diagnosed if a colour signal was present for a length of at least 1.5 cm directly behind an assumed stenosis comprising the whole area between the vessel walls. Our results suggest that non-invasive colour-coded duplex sonography is superior to conventional Doppler and duplex techniques and comparable to invasive X-ray angiography in differentiating extracranial subtotal carotid artery stenoses from occlusions.

Arterial Occlusive Diseases↗

[Discrete motor and sensory disorders (neurologic soft signs) in the acute course of endogenous psychoses].

Neurological soft signs (NSS) were investigated in 67 patients with DSM-III schizophrenia (remitting course, n = 23, chronic course, n = 27) and affective psychosis (n = 17). Patients were examined on admission, 7 days later and before discharge when being in a stable condition. In all diagnostic groups the NSS scores varied in the clinical course with a significant decline towards discharge. The variation of the NSS in the clinical course was further investigated with respect to psychopathological and clinical variables. Significant correlations between NSS, thought disorders, negative symptoms and a worse premorbid adaptation were found. To characterize NSS more precisely, all subjects executed a battery of standard neuropsychological tests on discharge. This step revealed significant correlations between NSS, graphomotoric and mnestic performance, the subscale "thought processes" of the Tübinger Luria Christiansen Scale and--to a lower extent--attentional performance. Our study provides two major findings: first, NSS vary in the clinical course and second, NSS are associated with other neuropsychological, such as mnestic and attentional, disorders. Thus, one may hypothesize, that NSS do not only reflect a primary motoric and sensoric deficiency but may be characterized as heterogeneous phenomena which occur frequently in the clinical course of endogenous psychosis.

Acute Disease↗

Neurological soft signs in schizophrenia.

A new scale for neurological soft signs (NSS) was constructed and consists of 17 items compiled from the literature. The scale was found to have a high internal reliability (Cronbach's alpha 0.83) and a high interrater reliability (0.88). According to the results of a factor analysis, NSS are covered by five factors: 'motor coordination', 'integrative functions', 'complex motor tasks', 'righ/left and spatial orientation' and 'hard signs'. Using this scale, the associations of NSS with clinical course and brain alterations were investigated. NSS varied with the clinical course and were significantly correlated with some BPRS subscales, in particular 'thought disorder'. In addition, the 'motor coordination' soft signs were found to correlate with morphological alterations in the basal ganglia.

Adult↗