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Biomedical subjects

Volker Arolt

Publications and source records attributed to Volker Arolt.

At least 37 records · Page 2Linked to original sources
PubMed2005

Basal prolactin values correlate with response to reboxetine treatment in major depression, but not with response to citalopram.

Little is known about variables that might predict outcome in major depression. Recently, basal prolactin values (BPV) have been suggested to predict response to treatment with tricyclic antidepressive drugs. In order to examine whether BPV predict response to selective mono-aminergic therapy, 24 in-patients with major depression were treated in a single-masked, randomised study using the most selective noradrenergic or serotonergic reuptake inhibitors available for antidepressant treatment, i.e. reboxetine and citalopram. A significant correlation between BPV and treatment response to reboxetine was found, but not between BPV and response to citalopram. As BPV are influenced by noradrenergic activity, it can be hypothesized that depressed patients with comparatively high BPV have a relatively high noradrenergic function. This might explain why in our study depressed patients with the highest BPV responded strongest to selective noradrenergic treatment with reboxetine. As measurement of BPV is simple, further studies are suggested to examine the possible clinical value of the link between prolactin, noradrenergic function in major depression and treatment response.

Adrenergic Uptake Inhibitors↗
PubMed2005

Different activation patterns of proinflammatory cytokines in melancholic and non-melancholic major depression are associated with HPA axis activity.

BACKGROUND: Recent studies showed an activation of the cytokine system and the HPA axis in major depression, although with inconsistent results. While the non-melancholic subtype displayed a proinflammatory cytokine pattern, the melancholic subtype showed signs of impaired cytokine production. In order to understand the potential pathogenic significance of these systems further, the interplay between the cytokine system and the HPA axis in depressive subtypes as well as potential changes of these systems during the course of disease were investigated. METHODS: N=37 initially unmedicated patients with acute major depression were sub-classified (melancholic vs. non-melancholic) and compared with N=37 matched healthy controls. Upon admission and after complete clinical remission, basal plasma ACTH and serum cortisol levels as well as cytokine productions (IL-1beta, IL-1 receptor antagonist (IL-1RA)) upon mitogen stimulation (PHA) were measured in a whole blood assay. RESULTS: ACTH and cortisol concentrations were significantly elevated on admission in the melancholic but not the non-melancholic subgroup. Non-melancholic patients produced significantly more IL-1beta and IL-1RA upon admission than controls or melancholic patients. The IL-1 RA/IL-1beta ratio was significantly lower in the non-melancholic compared to the melancholic subgroup and increased significantly upon remission. LIMITATIONS: Patient treatment was not standardized. No Dex/CRH test was performed. CONCLUSIONS: Melancholic patients demonstrated an activation of the HPA axis in acute stage with partial normalization upon remission but no signs of inflammation. Non-melancholic patients showed signs of inflammation in acute depression with normalization upon remission while the function of the HPA axis was normal.

Adrenocorticotropic Hormone↗
PubMed2005

[The immunology of psychiatric disorders].

Immunological alterations in psychiatric disorders have gained increasing scientific attention throughout the last decade. Particularly in two disorders, major depression and schizophrenia, some substantial findings have been reported. Although such results stand not uncontradicted, they nevertheless stimulate current research into the neurobiological underpinnings of these diseases. In this review, immunological dysfunctions in major depression and schizophrenia are described in detail, together with studies on posttraumatic stress disorders, panic- and obsessive-compulsive disorders. Possible future research directions are delineated.

Depressive Disorder↗
PubMed2005

Automatic processing of facial emotion in schizophrenia with and without affective negative symptoms.

INTRODUCTION: It is assumed that people spontaneously evaluate any incoming stimulus as pleasant or unpleasant. The evaluative response appears to structure perception and to have direct links to emotional states. METHODS: To investigate the automatic processing of face valence a sequential priming task based on emotional face stimuli was administered to schizophrenia patients with a flat affect expression, schizophrenia patients suffering from anhedonia, schizophrenia patients not suffering from anhedonia or flat affect, and healthy controls. The Scale for the Assessment of Negative Symptoms (Andreasen, 1989) was applied to evaluate affective symptoms and categorize patients into groups. RESULTS: Schizophrenia patients without affective negative symptoms exhibited reversed priming effects similar to that of healthy subjects. In contrast, flat affect patients and anhedonic patients showed only a prime effect due to negative facial valence. In the flat affect patient group, negative prime faces facilitated the evaluation of target faces, whereas in the anhedonic patient group negative prime faces tended to inhibit the evaluation of subsequent target faces. CONCLUSIONS: The present findings support the idea that chronic schizophrenia patients extract automatically the valence of emotional facial expression but they also suggest processing differences between schizophrenia patients as a function of affective symptoms.

Journal Article↗
PubMed2005

Reduced awareness of others' emotions in unipolar depressed patients.

The present study was conducted to examine depressed patients' awareness of their own and other persons' emotions in the course of an inpatient psychotherapeutic treatment program. To this aim, the Levels of Emotional Awareness Scale (LEAS) was administered twice, approximately 7 weeks apart, to 22 patients with a unipolar depression and 22 normal controls. From test 1 to test 2, severity of patients' depressive symptoms as measured by the Beck Depression Inventory improved significantly. Depressed patients did not differ from normal individuals on the LEAS-self score, but at time 1, they exhibited lower LEAS-other scores than normal controls. In the whole sample, LEAS-other scores increased significantly from time 1 to time 2. Acutely depressed patients seem not to be impaired in the complexity of their own emotional experience, but they exhibit a reduction in the ability to empathize with other persons.

Adult↗
PubMed2004

Spatial processing of facial emotion in patients with unipolar depression: a longitudinal study.

BACKGROUND: In this study, a face-in-the-crowd task was applied to examine the spatial detection of facial emotion as a function of depression and comorbid anxiety in the course of a psychotherapeutic inpatient treatment. METHODS: Patients with unipolar depression (n=22) and normal controls (n=22) were tested twice, about 7 weeks apart, on a face-in-the-crowd task using displays of schematic faces. Half the patients were suffering from a comorbid anxiety disorder. RESULTS: From test 1 to test 2, depressivity, frequency of negative thoughts, and worrying of patients improved significantly. At both sessions, depressed patients, irrespective of the presence of comorbid anxiety disorders, showed no performance differences in the detection of negative faces compared to controls. However, depressed patients with but not those without comorbid anxiety disorders were slower in responding to positive faces than controls. Both patient groups were slower in responding to the neutral faces' condition than controls. CONCLUSIONS: Our data indicate a spatial processing deficit for positive facial expression in depressives with a comorbid anxiety disorder. This impairment, which appears to persist during remission, might be due to deficits in effortful visual search processes.

Adult↗
PubMed2004

The astroglial protein S100B and visually evoked event-related potentials before and after antidepressant treatment.

RATIONALE: S100B is an astrocytic, calcium-binding protein which in nanomolar concentrations has neuroprotective and regenerating effects on neurons and glial cells. Increased levels have been shown to be positively correlated with therapeutic response in major depression. Event-related potentials (ERP) have been reported to be impaired in depressed patients. OBJECTIVES: The aim of our study was to assess the relationship between S100B and visually evoked ERP in depression. METHODS: ERP and S100B serum concentration were studied in 18 patients with major depression, before and after 4 weeks of antidepressant treatment. RESULTS: The S100B concentration in patients was increased at intake and after 4 weeks of treatment compared to healthy controls. Initially increased P3-latency normalized and P2-latency significantly decreased after 4 weeks of treatment, although only in patients with clearly elevated initial S100B levels (mean plus 2 SD of the healthy controls). CONCLUSION: The neuroregenerative activity of moderately increased S100B levels in major depression might be a factor contributing to a decrease of prolonged ERP parameters in major depression during antidepressant treatment.

Adrenergic Uptake Inhibitors↗
PubMed2004

Proton magnetic resonance spectroscopy in anorexia nervosa: correlations with cognition.

The aim of this study was to investigate the relationship between cognitive impairment and cerebral metabolites in patients with anorexia nervosa (AN). N-acetylaspartate (NAA), creatine/phosphocreatine (Cr), choline-containing compounds, glutamate/glutamine (Glx) and myoinositol were measured by proton magnetic resonance spectroscopy (H-MRS) of the left prefrontal cortex. Compared with healthy controls, AN patients displayed a significantly poorer performance in verbal learning and in attentional and executive tasks. Performance in the divided attention task was correlated with NAA and Cr in the dorsolateral prefrontal cortex, while executive functioning and depressive symptomatology were associated with Glx levels in the anterior cingulate. Our results provide evidence for cognitive impairment in AN patients which is associated with cerebral metabolism in the prefrontal cortex.

Adult↗
PubMed2004

Target evaluation processing and serum levels of nerve tissue protein S100B in patients with remitted major depression.

Selective attention processes (N2 and P3 components of event-related potentials (ERPs)) have been shown to be impaired in depressed patients but findings have been mixed. Part of this variability might be explained by neurobiological factors. ERPs (Go/Nogo paradigm) were investigated in patients with remitted major depression in relation to S100B. S100B, an astroglial protein with neuroplastic properties, has been shown to be increased in depression. Its pathophysiologic role in depression, however, is not yet sufficiently understood. Patients with increased S100B serum levels (n=6) showed a normal N2- and P3-amplitude in contrast to a reduced N2- and P3-amplitude in patients with normal S100B serum levels (n=6). These findings provide evidence of a correlation between S100B levels and attentional processes in patients with recurrent depression and further substantiate S100B's role as a marker in the course of affective disorders.

Attention↗
PubMed2004

A brief diagnostic screening instrument for mental disturbances in general medical wards.

OBJECTIVE: Mental illness is prevalent among general hospital ward patients but often goes unrecognised. The aim of this study was to validate the SCL-8d as a brief questionnaire for mental disturbances for use in general hospitals. METHODS: The study included 2040 patients, 18 years or older, consecutively admitted to 11 general internal medicine wards in seven European countries. All patients were screened on admission by means of the SCL-8d questionnaire. The psychometric performance (i.e., the internal validity) of the SCL-8d scale was tested using modern item response theory (IRT) in the form of the Rasch model. RESULTS: Differences between sample characteristics were considerable. Even so, the SCL-8d scale showed a remarkable, statistically significant fit in terms of internal homogeneity (P>.01) in all individual settings, except in Spain and Germany where the item "Everything is an effort" had to be excluded to obtain a fit. When pooling data from all centres, an excellent statistical significance of fit (P>.05) was obtained by exclusion of the "Effort" item. The scale was homogeneous as to gender (P>.05), but not age as it performed better among young patients than among patients older than 60 years (P<.01). In these two patient groups both internal and external homogeneity (gender, median age) was achieved. The SCL-8d sum score showed a marked correlation with current and previous treatment for mental illness. CONCLUSION: Apart from the "Effort" item ranking differently on the latent severity dimension as to age, the SCL-8d seems very robust from a psychometric point of view. Besides being short, the SCL-8d scale contains only emotional symptoms. It would therefore seem to be an excellent diagnostic tool for use in medical settings.

Adolescent↗
PubMed2004

S100B in schizophrenic psychosis.

Recent findings have strengthened the hypothesis that a dysfunction of neuronal synapses and dendrites is relevant for the pathogenesis of schizophrenia. It might be present during neurodevelopment as well as in degenerative and regenerative processes of the mature brain. S1OOB, a small, Ca2+-binding, astrocytic protein, plays an important role in modulating the proliferation and differentiation of neurons and glia cells. It is involved in the regulation of cellular energy metabolism and interacts with many immunological functions of the brain. This review addresses findings from cell cultural and animal experiments potentially pertinent for the pathogenesis of schizophrenic psychoses. Morphological and functional data are analyzed and clinical studies reporting alterations of S1OOB concentrations in schizophrenic patients are reviewed. Evidence and limitations of the available studies are pointed out and promising future research strategies are outlined.

Animals↗
PubMed2004

S100B serum levels and long-term improvement of negative symptoms in patients with schizophrenia.

S100B, a calcium-binding protein produced by astroglial cells, mediates paracrine and autocrine effects on neurons and glial cells. It regulates the balance between proliferation and differentiation in neurons and glial cells by affecting protective and apoptotic mechanisms. Post-mortem studies have demonstrated a deficit in synapses and dendrites in brains of schizophrenics. Recent studies have shown increased S100B levels in medicated acutely psychotic schizophrenic patients as well as unmedicated or drug naive schizophrenics. One study reported a positive correlation between negative symptoms and S100B. S100B serum levels (quantitative immunoassay) and psychopathology (Positive and Negative Syndrome Scale, PANSS) were examined upon study admission and after 12 and 24 weeks of standardized treatment in 98 chronic schizophrenic patients with primarily negative symptoms. Compared to age- and sex-matched healthy controls, the schizophrenic patients showed significantly increased S100B concentrations upon admission and after 12 and 24 weeks of treatment. High PANSS negative scores were correlated with high S100B levels. Regression analysis comparing psychopathology subscales and S100B identified negative symptomatology as the predicting factor for S100B. S100B is not just elevated during acute stages of disease since it remains elevated for at least 6 months following an acute exacerbation. With regard to psychopathology, negative symptomatology appears to be the predicting factor for the absolute S100B concentration. This might indicate that S100B in schizophrenic patients either promotes apoptotic mechanisms by itself or is released from astrocytes as part of an attempt to repair a degenerative or destructive process.

Adult↗
PubMed2004

Search for atypical lymphocytes in schizophrenia.

The existence of atypical lymphocytes with specific morphological characteristics in the peripheral blood of schizophrenic patients has been suggested in several reports over the last 40 years. In our study this observation was examined not only by using the formerly applied method of light microscopy for general cell distribution and lymphocyte morphology but also by applying flow cytometry, a well established immunological method for lymphocyte patterns such as lymphocyte subgroups and lymphocyte activity. In contrast to the previously published data, our results demonstrated no differences in cell distribution (lymphocytes, polymorphonuclear cells, eosinophil and basophil granulocytes, monocytes), lymphocyte morphology ("atypical lymphocytes" vs. "normal lymphocytes"), distribution of lymphocyte-subtypes (T-cells (CD3(+)), T-helper-cells (CD3(+)/CD4(+)), cytotoxic T-cells (CD3(+)/CD8(+)), B-cells (CD19(+)), NK-cells (CD3(-)/CD56(+))) or state of T-lymphocyte activity (CD25(+) or HLA-DR(+)-cells) in schizophrenic patients compared to healthy controls. We suggest that possible immunological alterations in schizophrenia do not correlate with morphological characteristics of lymphocytes observable by light microscopy or an altered state activity of T-lymphocytes examined by flow cytometric parameters. Further studies should concentrate on intracellular and functional aspects of the different lymphocyte subgroups.

Adult↗
PubMed2003

Detection of facial expressions of emotions in schizophrenia.

The aim of the present study was to examine spatial processing of facial emotion in schizophrenic patients suffering from affective symptoms. A face-in-the-crowd task using schematic stimuli was administered to schizophrenic patients with flat affect (n=30), schizophrenic patients suffering from anhedonia (n=30), schizophrenic patients not suffering from anhedonia or flat affect (n=28), and a group of healthy controls (n=30). Participants searched displays of neutral schematic faces for a face with a positive or negative mouth expression. Schizophrenic patients manifested a general slowing of response speed compared to normal subjects. All patient groups as well as normal subjects found negative faces more quickly than positive faces amongst neutral faces. Unexpectedly, with increasing anhedonia as assessed by psychiatric rating, a more efficient spatial detection of positive facial expression was observed. For flat-affect patients only, efficiency of search for negative facial expression did not differ from that in the neutral face control condition. This response pattern indicates that, in flat-affect schizophrenic patients, spatial search of negative facial expression might be slowed after the initial engagement of search processes. Potential explanations of the face processing effects found in anhedonia are discussed.

Adult↗