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Biomedical subjects

Thomas Dietrich

Publications and source records attributed to Thomas Dietrich.

At least 19 recordsLinked to original sources

Electrophysiological and hemodynamic evidence for late maturation of hand power grip and force control under visual feedback.

Several human imaging studies have described the neural network involved in power grip under visual control and the subset of cortical areas within this network that are sensitive to force modulation. As there is behavioral evidence for late maturation in even simple hand motor tasks involving visual feedback, we aimed at identifying the neural correlates of these developmental changes. Subjects from three developmental age groups (9-11, 15-17, and adults) performed the same power grip task in both a functional magnetic resonance imaging and an event-related potential (ERP) session. Trials started with a visual target indicating whether to squeeze at 20%, 40%, or 75% of their maximum and online visual feedback on the actual amount of force was provided. Longer reaction times and more shallow slopes of the force curve characterized the behavior of the younger age groups, especially the children. Both neurophysiological methods detected both general as well as force modulation-specific maturational changes. General development was characterized by decreasing ERP amplitudes and increasing deactivation of an extended network, closely resembling the so-called "default" network. The most pronounced developmental changes specific for force control were observed in an ERP component and brain regions involved in feedback processing. In contrast to adult subjects, we found evidence for a stronger dependency on visual feedback information in the younger age groups. Our results also suggest that the ability to deactivate task-irrelevant networks might be a late developmental achievement.

Adolescent↗

Motor brain regions are involved in the encoding of delayed intentions: a fMRI study.

In studies of prospective memory, recall of the content of delayed intentions is normally excellent, probably because they contain actions that have to be enacted at a later time. Action words encoded for later enactment are more accessible from memory than those encoded for later verbal report [Freeman, J.E., and Ellis, J.A. 2003a. The representation of delayed intentions: A prospective subject-performed task? Journal of Experimental Psychology: Learning, Memory, and Cognition, 29, 976-992.]. As this higher assessibility is lost when the intended actions have to be enacted during encoding, or when a motor interference task is introduced concurrent to intention encoding, Freeman and Ellis suggested that the advantage of to-be-enacted actions is due to additional preparatory motor operations during encoding. Accordingly, in a fMRI study with 10 healthy young participants, we investigated whether motor brain regions are differentially activated during verbal encoding of actions for later enactment with the right hand in contrast to verbal encoding of actions for later verbal report. We included an additional condition of verbal encoding of abstract verbs for later verbal report to investigate whether the semantic motor information inherent in action verbs in contrast to abstract verbs activates motor brain regions different from those involved in the verbal encoding of actions for later enactment. Differential activation for the verbal encoding of to-be-enacted actions in contrast to to-be-reported actions was found in brain regions known to be involved in covert motor preparation for hand movements, i.e. the postcentral gyrus, the precuneus, the dorsal and ventral premotor cortex, the posterior middle temporal gyrus and the inferior parietal lobule. There was no overlap between these brain regions and those differentially activated during the verbal encoding of actions in contrast to abstract verbs for later verbal report. Consequently, the results of this fMRI study suggest the presence of preparatory motor operations during the encoding of delayed intentions requiring a future motor response, which cannot be attributed to semantic information inherent to action verbs.

Adult↗

Risk of tooth loss after cigarette smoking cessation.

INTRODUCTION: Little is known about the effect of cigarette smoking cessation on risk of tooth loss. We examined how risk of tooth loss changed with longer periods of smoking abstinence in a prospective study of oral health in men. METHODS: Research subjects were 789 men who participated in the Veterans Administration Dental Longitudinal Study from 1968 to 2004. Tooth status and smoking status were determined at examinations performed every 3 years, for a maximum follow-up time of 35 years. Risk of tooth loss subsequent to smoking cessation was assessed sequentially at 1-year intervals with multivariate proportional hazards regression models. Men who never smoked cigarettes, cigars, or pipes formed the reference group. Hazard ratios were adjusted for age, education, total pack-years of cigarette exposure, frequency of brushing, and use of floss. RESULTS: The hazard ratio for tooth loss was 2.1 (95% confidence interval [CI], 1.5-3.1) among men who smoked cigarettes during all or part of follow-up. Risk of tooth loss among men who quit smoking declined as time after smoking cessation increased, from 2.0 (95% CI, 1.4-2.9) after 1 year of abstinence to 1.0 (95% CI, 0.5-2.2) after 15 years of abstinence. The risk remained significantly elevated for the first 9 years of abstinence but eventually dropped to the level of men who never smoked after 13 or more years. CONCLUSION: These results indicate that smoking cessation is beneficial for tooth retention, but long-term abstinence is required to reduce the risk to the level of people who have never smoked.

Adult↗

Impaired neural networks for approximate calculation in dyscalculic children: a functional MRI study.

BACKGROUND: Developmental dyscalculia (DD) is a specific learning disability affecting the acquisition of mathematical skills in children with otherwise normal general intelligence. The goal of the present study was to examine cerebral mechanisms underlying DD. METHODS: Eighteen children with DD aged 11.2 +/- 1.3 years and twenty age-matched typically achieving schoolchildren were investigated using functional magnetic resonance imaging (fMRI) during trials testing approximate and exact mathematical calculation, as well as magnitude comparison. RESULTS: Children with DD showed greater inter-individual variability and had weaker activation in almost the entire neuronal network for approximate calculation including the intraparietal sulcus, and the middle and inferior frontal gyrus of both hemispheres. In particular, the left intraparietal sulcus, the left inferior frontal gyrus and the right middle frontal gyrus seem to play crucial roles in correct approximate calculation, since brain activation correlated with accuracy rate in these regions. In contrast, no differences between groups could be found for exact calculation and magnitude comparison. In general, fMRI revealed similar parietal and prefrontal activation patterns in DD children compared to controls for all conditions. CONCLUSION: In conclusion, there is evidence for a deficient recruitment of neural resources in children with DD when processing analog magnitudes of numbers.

Journal Article↗

Prediction of serum total antioxidant activity from the concentration of individual serum antioxidants.

BACKGROUND: Redox mechanisms are implicated in the pathogenesis of many diseases and several assays of total antioxidant capacity (TAOC) have been reported. Large epidemiological databases contain information on individual serum antioxidants as well as disease-specific phenotypic data. However, antioxidants work co-operatively in biological systems and it is important to be able to translate individual antioxidant measures into those of global antioxidant defence. Models therefore need developing to quantify contributions made by individual species to global antioxidant defence. OBJECTIVE: To develop a predictive model that translates individual antioxidant concentrations into an index of TAOC, enabling interrogation of epidemiological databases that contain information about individual antioxidants, but not about TAOC. METHODS: Sera from 256 volunteers were simultaneously assayed for key antioxidants and TAOC by enhanced chemiluminescence (TAOC(ECL)). A predictive model was developed for serum TAOC using multiple linear regression analysis. RESULTS: The model explained 86% of TAOC(ECL) variability in serum. The strongest predictor of TAOC(ECL) was uric acid (1 SD increase associated with TAOC(ECL) increase of 103 micromol/l Teq-95% CI: 96.8-109), followed by vitamins A, C, E. CONCLUSIONS: The reported model represents a powerful tool for interrogating databases where individual serum antioxidant concentrations are known, and TAOC measures are required.

Antioxidants↗

Maturation of luminance- and motion-defined form perception beyond adolescence: a combined ERP and fMRI study.

Abilities to discriminate forms defined by motion continue to develop throughout childhood. To investigate late development of the visual motion system, we measured brain activity with event-related EEG potentials (ERPs) and functional magnetic resonance imaging (fMRI) in groups of adolescents (15-17 years) and adults (20-30 years) during a visual form discrimination task--with forms being either defined by motion or luminance contrast. We further explored whether possible developmental changes varied with the degree of motion coherence reflecting maturation specific to global motion processing. Both the fMRI activation patterns and ERP topographies were very similar between adolescents and adults, suggesting that the basic visual networks for processing motion and form are established by the age of 15-17. The ERP response to luminance- and motion-defined forms was dominated by a posterior negativity (N1: 120-270 ms). The N1 of the motion contrast was delayed in adolescents, whereas the N1 of the static condition did not differ between groups. Since the motion-evoked N1 is thought to arise in the middle temporal area MT/V5, our results indicate that visual motion processing in MT continues to get faster, becoming still more efficient during late development. Neither the ERP nor the fMRI results revealed maturation effects specific to motion coherence. This indicates that the specific mechanisms to process global dot motion are already mature in adolescence. The present findings support the view that static perception matures earlier than dynamic perception, and that these visual systems have different developmental courses.

Adolescent↗

The effect of alveolar bone loss on the load capability of restored endodontically treated teeth: a comparative in vitro study.

OBJECTIVES: The aim of the present investigation was to study the influence of a reduced bone support on the fracture resistance of endodontically treated teeth restored with glass fibre-reinforced posts (FRC). METHODS: 30 caries-free maxillary central incisors were divided into 3 groups (n=10). Endodontic treatment was performed. Teeth were flattened 2 mm above the cemento-enamel junction. Group I (control) simulated a clinical situation without horizontal bone loss. In group II a horizontal bone loss of 25% and in group III of 50% was simulated. All specimens received FRC posts and composite core restorations. All-ceramic crowns were adhesively cemented. Specimens were exposed to thermal cycling and mechanical loading (TCML) and finally statically loaded until failure in a universal testing machine (v=1 mm/min). Non-parametric tests were used to compare median fracture loads between groups. Fracture modes were compared using Fisher's exact test. RESULTS: The median fracture load values (min/max) in [N] were: group I=501 (326/561), group II=422 (323/495); group III=352 (266/406), p=0.004. Two specimens in each group II and III failed during TCML. Statistical analysis revealed statistically significant differences between all test groups regarding maximum fracture load and mode of fracture. CONCLUSIONS: The fracture resistance of endodontically treated teeth restored adhesively with a FRC post, composite core, and all-ceramic crown is dependent on the level of surrounding supporting periodontal bone. Loss of alveolar bone loss due to periodontal disease may lead to an increased risk of failure.

Alveolar Bone Loss↗

Intake of fruits and vegetables and risk of cancer of the upper aero-digestive tract: the prospective EPIC-study.

Epidemiologic studies suggest that a high intake of fruits and vegetables is associated with decreased risk of cancers of the upper aero-digestive tract. We studied data from 345,904 subjects of the prospective European Investigation into Cancer and Nutrition (EPIC) recruited in seven European countries, who had completed a dietary questionnaire in 1992-1998. During 2,182,560 person years of observation 352 histologically verified incident squamous cell cancer (SCC) cases (255 males; 97 females) of the oral cavity, pharynx, larynx, and esophagus were identified. Linear and restricted cubic spline Cox regressions were fitted on variables of intake of fruits and vegetables and adjusted for potential confounders. We observed a significant inverse association with combined total fruits and vegetables intake (estimated relative risk (RR) = 0.91; 95% confidence interval (95% CI) 0.83-1.00 per 80 g/d of consumption), and nearly significant inverse associations in separate analyses with total fruits and total vegetables intake (RR: 0.97 (95% CI: 0.92-1.02) and RR = 0.89 (95% CI: 0.78-1.02) per 40 g/d of consumption). Overall, vegetable subgroups were not related to risk with the exception of intake of root vegetables in men. Restricted cubic spline regression did not improve the linear model fits except for total fruits and vegetables and total fruits with a significant decrease in risk at low intake levels (<120 g/d) for fruits. Dietary recommendations should consider the potential benefit of increasing fruits and vegetables consumption for reducing the risk of cancers of the upper aero-digestive tract, particularly at low intake.

Carcinoma, Squamous Cell↗

Acquired dyslexia after stroke in the prereading stage: a single case treatment study with f MRI.

The authors report a treatment study of a child (CK) who suffered a left-hemisphere stroke at age 6.3 years, a few months before beginning school. Despite complete recovery of spoken language abilities, CK failed to acquire written language abilities. Neurolinguistic assessment 2 years after the stroke revealed marked impairments in working memory, deficits in acquiring a sublexical reading strategy, and a very rudimentary orthographic network. Functional imaging demonstrated activation in posterior language areas during reading of familiar words while the attempt to read unfamiliar words activated peri- and contralesional structures of the anterior language areas. It was assumed that despite sufficient neural plasticity, the acquisition of a sublexical reading strategy was prevented by severe working memory deficits. Therefore, a specific treatment intervention was developed, choosing a compensatory strategy for reading remediation. Reading development was monitored over three months before and three months after an intensive training was conducted. Data showed significant gains in reading performance only after the specific intervention. These gains remained stable in a catamnesis 2 years later.

Child↗

Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes.

Recent evidence suggests that vitamin D intakes above current recommendations may be associated with better health outcomes. However, optimal serum concentrations of 25-hydroxyvitamin D [25(OH)D] have not been defined. This review summarizes evidence from studies that evaluated thresholds for serum 25(OH)D concentrations in relation to bone mineral density (BMD), lower-extremity function, dental health, and risk of falls, fractures, and colorectal cancer. For all endpoints, the most advantageous serum concentrations of 25(OH)D begin at 75 nmol/L (30 ng/mL), and the best are between 90 and 100 nmol/L (36-40 ng/mL). In most persons, these concentrations could not be reached with the currently recommended intakes of 200 and 600 IU vitamin D/d for younger and older adults, respectively. A comparison of vitamin D intakes with achieved serum concentrations of 25(OH)D for the purpose of estimating optimal intakes led us to suggest that, for bone health in younger adults and all studied outcomes in older adults, an increase in the currently recommended intake of vitamin D is warranted. An intake for all adults of > or =1000 IU (25 microg) [DOSAGE ERROR CORRECTED] vitamin D (cholecalciferol)/d is needed to bring vitamin D concentrations in no less than 50% of the population up to 75 nmol/L. The implications of higher doses for the entire adult population should be addressed in future studies.

Age Factors↗

Evaluation of tobacco use cessation (TUC) counselling in the dental office.

Tobacco use cessation (TUC) in dentistry is critical to reducing the effect of a major risk factor for both oral and systematic diseases. The effect of TUC interventions has been widely reported. The data show that the success of TUC without professional support is negligible but that behavioural and pharmacological interventions are effective. Furthermore, the greater the intensity of support, the greater the quit rate and success rates are similar comparing different health care professionals including dental professionals. Although few studies have been performed in dental practice, it is clear that TUC should be embedded in routine oral health care. In addition to evaluating the effect of TUC, several studies have investigated barriers to implementing TUC in dental settings. A large number of barriers have been reported. These studies highlight the importance of further training for dental professionals but also identify the need for major cultural and policy changes to facilitate the provision of TUC. Research on barriers to TUC in dental care could be facilitated by employing qualitative or mixed methods designs and studies that evaluate the impact of changing such barriers on TUC provision. Such an approach will help to close the gap between research findings and implementation. Regarding the measurement of outcomes from TUC, no gold standards exist currently. Therefore both self-reported and biochemical measures of tobacco use should be reported in evaluation studies. It is also clear that feedback from biochemical testing of tobacco use can increase success rates in tobacco use cessation.

Counseling↗

Evidence for developmental changes in the visual word processing network beyond adolescence.

Late development of specialization in the visual word processing system was examined using event-related potentials (ERP) and functional magnetic resonance imaging (fMRI) of word and symbol string processing in groups of adolescents (15.2-17.3 years) and adults (19.8-30.8 years). We focused our ERP analyses on fast visual activity: the occipital P1 (82-131 ms) modulated by physical stimulus characteristics and the occipito-temporal N1 (132-256 ms) reflecting visual tuning for print. Our fMRI analyses concentrated on basal occipito-temporal activations in the visual word form area VWFA. For words, the correlation of fMRI activation in the VWFA and N1 amplitude confirmed the close relationship of the electrophysiological N1 with metabolic activity in the VWFA. Further support for this relationship came from low resolution electromagnetic tomography localizing the word-specific N1 near the VWFA. Both imaging techniques revealed age-independent differences between words and symbol strings. Late development, however, was preferentially detected with ERPs. Decreases of P1 and N1 amplitudes with age were not limited to words and suggested further maturation of the underlying brain microstructure and function. Following adolescence, decreasing N1 latencies specific to words point to continued specialization of the visual word processing system. Both N1 and fMRI measures correlated with reading performance. In summary, the similarity of global fMRI activation patterns between groups suggests a fully established distribution of the reading network in adolescence, while the decreasing N1 latencies for words indicate protracted fine tuning after adolescence.

Adolescent↗

Placebo in emotional processing--induced expectations of anxiety relief activate a generalized modulatory network.

Placebo analgesia and reward processing share several features. For instance, expectations have a strong influence on the subsequent emotional experience of both. Recent imaging data indicate similarities in the underlying neuronal network. We hypothesized that placebo analgesia is a special case of reward processing and that placebo treatment could modulate emotional perception in the same way as does pain perception. The behavioral part of this study indicates that placebo treatment has an effect on how subjects perceive unpleasant pictures. Furthermore, event-related fMRI demonstrated that the same modulatory network, including the rostral anterior cingulate cortex and the lateral orbitofrontal cortex, is involved in both emotional placebo and placebo analgesia. These effects were correlated with the reported placebo effect and were predicted by the amount of treatment expectation induced on a previous day. Thus, the placebo effect may be considered to be a general process of modulation induced by the subjects' expectations.

Adult↗

Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials.

CONTEXT: The role and dose of oral vitamin D supplementation in nonvertebral fracture prevention have not been well established. OBJECTIVE: To estimate the effectiveness of vitamin D supplementation in preventing hip and nonvertebral fractures in older persons. DATA SOURCES: A systematic review of English and non-English articles using MEDLINE and the Cochrane Controlled Trials Register (1960-2005), and EMBASE (1991-2005). Additional studies were identified by contacting clinical experts and searching bibliographies and abstracts presented at the American Society for Bone and Mineral Research (1995-2004). Search terms included randomized controlled trial (RCT), controlled clinical trial, random allocation, double-blind method, cholecalciferol, ergocalciferol, 25-hydroxyvitamin D, fractures, humans, elderly, falls, and bone density. STUDY SELECTION: Only double-blind RCTs of oral vitamin D supplementation (cholecalciferol, ergocalciferol) with or without calcium supplementation vs calcium supplementation or placebo in older persons (> or =60 years) that examined hip or nonvertebral fractures were included. DATA EXTRACTION: Independent extraction of articles by 2 authors using predefined data fields, including study quality indicators. DATA SYNTHESIS: All pooled analyses were based on random-effects models. Five RCTs for hip fracture (n = 9294) and 7 RCTs for nonvertebral fracture risk (n = 9820) met our inclusion criteria. All trials used cholecalciferol. Heterogeneity among studies for both hip and nonvertebral fracture prevention was observed, which disappeared after pooling RCTs with low-dose (400 IU/d) and higher-dose vitamin D (700-800 IU/d), separately. A vitamin D dose of 700 to 800 IU/d reduced the relative risk (RR) of hip fracture by 26% (3 RCTs with 5572 persons; pooled RR, 0.74; 95% confidence interval [CI], 0.61-0.88) and any nonvertebral fracture by 23% (5 RCTs with 6098 persons; pooled RR, 0.77; 95% CI, 0.68-0.87) vs calcium or placebo. No significant benefit was observed for RCTs with 400 IU/d vitamin D (2 RCTs with 3722 persons; pooled RR for hip fracture, 1.15; 95% CI, 0.88-1.50; and pooled RR for any nonvertebral fracture, 1.03; 95% CI, 0.86-1.24). CONCLUSIONS: Oral vitamin D supplementation between 700 to 800 IU/d appears to reduce the risk of hip and any nonvertebral fractures in ambulatory or institutionalized elderly persons. An oral vitamin D dose of 400 IU/d is not sufficient for fracture prevention.

Aged↗

Association between serum concentrations of 25-hydroxyvitamin D and gingival inflammation.

BACKGROUND: Vitamin D has been shown to have immunomodulatory effects in in vitro and in animal studies. However, data from clinical studies of inflammatory diseases are scarce. OBJECTIVE: The purpose of this study was to evaluate the association between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and gingival inflammation. DESIGN: We analyzed data from 77,503 gingival units (teeth) in 6700 never smokers aged 13 to >90 y from the third National Health and Nutrition Examination Survey. Multiple logistic regression models adjusted for subject- and site-specific covariates included age, sex, race-ethnicity, income, body mass index, diabetes, use of oral contraceptives and hormone replacement therapy among women, intake of vitamin C, missing teeth, full crown coverage, presence of calculus, frequency of dental visits, and dental examiner and survey phase. Generalized estimating equations were used to account for correlated observations within subjects. RESULTS: Compared with sites in subjects in the lowest 25(OH)D quintile, sites in subjects in the highest 25(OH)D quintile were 20% (95% CI: 8%, 31%) less likely to bleed on gingival probing (P for trend < 0.001). The association appeared to be linear over the entire 25(OH)D range, was consistent across racial or ethnic groups, and was similar among men and women as well as among users and nonusers of vitamin and mineral supplements. CONCLUSIONS: Vitamin D may reduce susceptibility to gingival inflammation through its antiinflammatory effects. Gingivitis may be a useful clinical model to evaluate the antiinflammatory effects of vitamin D.

Adolescent↗

The accuracy of individual self-reported items to determine periodontal disease history.

The objective of this study was to evaluate the validity of self-reported periodontal disease and symptoms to predict periodontal disease history in a German population. We analysed data from 246 patients who answered a self-administered questionnaire on self-perceived periodontal disease and self-reported symptoms of periodontal disease. Actual periodontal status was assessed from panoramic radiographs and periodontal disease was defined as > or = 3 teeth with radiographic alveolar bone loss (ABL) > 5 mm (prevalence 39%). Sensitivity (SN) and specificity (SP) of self-reported items for diagnosis of periodontal disease history were calculated. The diagnostic accuracy of any individual item was generally low. For example, self-perceived periodontal disease had SN of 49% and SP of 67%. All self-reported items had low sensitivity, while self-reported professionally diagnosed bone loss, tooth loss caused by periodontal disease and mobility had SP > 90%. In conclusion, we did not identify a single individual question that can assess periodontal disease from self-reporting with satisfactory validity. Future studies will evaluate whether multivariate prediction rules using information from several self-reported variables are a valid means to ascertain periodontal disease history.

Adult↗

Risk factors for failure of glass fiber-reinforced composite post restorations: a prospective observational clinical study.

Glass fiber-reinforced endodontic posts are considered to have favorable mechanical properties for the reconstruction of endodontically treated teeth. The aim of the present investigation was to evaluate the survival of two tapered and one parallel-sided glass fiber-reinforced endodontic post systems in teeth with different stages of hard tissue loss and to identify risk factors for restoration failure. One-hundred and forty-nine glass fiber-reinforced endodontic posts in 122 patients were followed-up for 5-56 months [mean +/- standard deviation (SD): 39 +/- 11 months]. Glass fiber-reinforced endodontic posts were adhesively luted and the core was built with a composite resin. Cox proportional hazards models were used to evaluate the association of clinical variables and failure rate. Higher failure rates were found for restorations of anterior teeth compared with posterior teeth [Hazard-Ratios (HR): 3.1; 95% confidence interval (CI): 1.3-7.4], for restorations in teeth with no proximal contacts compared with at least one proximal contact (HR: 3.0; 95% CI: 1.0-9.0), and for teeth restored with single crowns compared with fixed bridges (HR: 4.3; 95% CI: 1.1-16.2). Tooth type, type of final restoration and the presence of adjacent teeth were found to be significant predictors of failure rates in endodontically treated teeth restored with glass fiber-reinforced endodontic posts.

Adolescent↗