Biomedical subjects

Volker Arolt

Publications and source records attributed to Volker Arolt.

At least 55 records · Page 3Linked to original sources

PubMed2003

Automatic processing of verbal emotion stimuli in schizophrenia.

In the present study, automatic processing of verbal emotion stimuli was investigated as a function of affective symptoms, emotional state and trait characteristics of chronic schizophrenia patients. A sequential pronunciation priming task was administered to 30 schizophrenia patients with a flat affect expression, 30 schizophrenia patients suffering from anhedonia, 28 schizophrenia patients not suffering from anhedonia or flat affect, and 30 healthy subjects to assess affective and semantic priming effects. The Scale for the Assessment of Negative Symptoms (Andreasen, British Journal of Psychiatry, 1989, 155, 53-58) was applied to evaluate the flat affect and anhedonia, and to categorize patients into groups. Schizophrenia patients did not differ from healthy subjects in affective and semantic priming scores. However, affective priming based on positive primes was inversely correlated with negative state and trait affectivity, and positively correlated with trait joy in the patient sample. These results support the view that a decrement in automatic processing facilitation of positive valence might play a role in the development of negative emotions. The symptoms of flat affect and anhedonia do not appear to be associated with impairments in the automatic processing of verbal emotional material in schizophrenia.

Adult↗

PubMed2003

S100B in brain damage and neurodegeneration.

S100B is a calcium-binding peptide produced mainly by astrocytes that exert paracrine and autocrine effects on neurons and glia. Some knowledge has been acquired from in vitro and in vivo animal experiments to understand S100B's roles in cellular energy metabolism, cytoskeleton modification, cell proliferation, and differentiation. Also, insights have been gained regarding the interaction between S100B and the cerebral immune system, and the regulation of S100B activity through serotonergic transmission. Secreted glial S100B exerts trophic or toxic effects depending on its concentration. At nanomolar concentrations, S100B stimulates neurite outgrowth and enhances survival of neurons during development. In contrast, micromolar levels of extracellular S100B in vitro stimulate the expression of proinflammatory cytokines and induce apoptosis. In animal studies, changes in the cerebral concentration of S100B cause behavioral disturbances and cognitive deficits. In humans, increased S100B has been detected with various clinical conditions. Brain trauma and ischemia is associated with increased S100B concentrations, probably due to the destruction of astrocytes. In neurodegenerative, inflammatory and psychiatric diseases, increased S100B levels may be caused by secreted S100B or release from damaged astrocytes. This review summarizes published findings on S100B regarding human brain damage and neurodegeneration. Findings from in vitro and in vivo animal experiments relevant for human neurodegenerative diseases and brain damage are reviewed together with the results of studies on traumatic, ischemic, and inflammatory brain damage as well as neurodegenerative and psychiatric disorders. Methodological problems are discussed and perspectives for future research are outlined.

Animals↗

PubMed2003

Acute mania is accompanied by elevated glutamate/glutamine levels within the left dorsolateral prefrontal cortex.

RATIONALE: The dorsolateral prefrontal cortex (DLPFC) participates in the pathophysiology of mania. In particular, left-sided structural and metabolic abnormalities have been described. OBJECTIVES: Clinical symptoms may be due to hyperactivity of cortical glutamatergic neurons, resulting in increased excitatory neurotransmitter flux and thus enhanced Glx levels. METHODS: Glutamate/glutamine (Glx) levels were assessed by proton magnetic resonance spectroscopy ((1)H-MRS) in eight acute manic patients compared with age- and gender-matched controls. RESULTS: Manic patients had significantly elevated Glx levels ( t-test; t=-3.1, P=0.008) within the left DLPFC. CONCLUSIONS: Our results indicate that the prefrontal cortical glutamatergic system is involved in the pathophysiology of acute mania. This may have implications for the treatment of mania.

Acute Disease↗

PubMed2003

Effective electroconvulsive therapy reverses glutamate/glutamine deficit in the left anterior cingulum of unipolar depressed patients.

Cortical glutamate/glutamine (Glx) metabolism seems to be affected by a major depressive disorder. Recently, a Glx deficit was detected by proton magnetic resonance spectroscopy (1H-MRS) in the bilateral anterior cingulum of depressives. The aim of this study was to assess the effect of successful electroconvulsive therapy (ECT) on Glx levels in the anterior cingulum. The left anterior cingulum of 17 severely depressed unipolar patients was measured by 1H STEAM spectroscopy before and after ECT, and the results were compared with those for 17 age- and gender-matched controls. We observed significantly reduced Glx levels in the patients' left cingulum compared to healthy controls. In ECT responders, in contrast to non-responders, Glx levels normalized (P=0.04) and then did not differ statistically from controls. Severe depression seems to be associated with a Glx deficit and increasing Glx may be an important mechanism of ECT action.

Depressive Disorder↗

PubMed2003

Schizophrenia spectrum disorders and eye tracking dysfunction in singleton and multiplex schizophrenia families.

One line of research which is helping to unravel the genetic susceptibility to schizophrenia (SZ) is the analysis of eye tracking dysfunction (ETD), a quantifiable phenotypic marker. To investigate if such a biological marker is also present in singleton schizophrenia families, we examined eye tracking in members of singleton families (N=53) and compared it to members of multiplex (N=76) and nonpsychiatric families (N=71) using high resolution infrared oculography. The prevalence of ETD defined by gain values (eye/target velocity) and saccadic frequencies during smooth pursuit at 15 degrees /s did not differ between multiplex and singleton families in either the schizophrenic index patients or their relatives, but was significantly different from nonpsychotic families. ETD rate was higher in those relatives with compared to those without a diagnosis of a schizophrenia spectrum disorder. In relatives with a spectrum disorder, ETD appeared to be associated with traits for "sensitivity" and "suspiciousness". In the group of relatives from singleton families without a schizophrenia spectrum disorder, we still found a higher prevalence of ETD than in nonpsychotic families. Our results suggest that eye tracking dysfunction is a very sensitive biological marker for the vulnerability to schizophrenia, even in those cases where no psychopathological symptoms or signs are obvious. ETD in schizophrenia is suggested to serve as a neurophysiological type model, indicating a perception deficit.

Adult↗

PubMed2003

Affective priming in schizophrenia with and without affective negative symptoms.

In the present study automatic perceptual sensitivity to facial affect information was examined in chronic schizophrenic patients. An affective priming task including subliminal and supraliminal presentations of sad and happy facial affect was administered to schizophrenia patients with a flat affect expression (n = 30), schizophrenia patients suffering from anhedonia (n = 30), schizophrenia patients not suffering from anhedonia or flat affect (n = 28), and a group of healthy controls (n = 30). Subjects had to judge valence of neutral Chinese ideographs. Anhedonic and flat affect patients but not patients without affect symptoms were found to be sensitive to negative facial affect on an automatic processing level. None of the schizophrenic patient groups but healthy controls showed a subliminal valence-congruent priming effect based on positive facial affect. Anhedonia as assessed by standardised psychiatric rating was related to a subliminal sensitivity to negative facial expression and a valence-inverted perception of positive facial expression. This pattern of results is largely consistent with predictions derived from Meehl's model of anhedonia. The aversive automatic perception of positive facial expression primarily found in anhedonic patients but also in schizophrenic control patients could lie in structural disturbances concerning the regulation of intimacy and distance.

Adolescent↗

PubMed2003

S100B and response to treatment in major depression: a pilot study.

S100B is a protein which exerts both detrimental and neurotrophic effects, depending on its concentration in brain tissue. An increase of S100B in micromolar concentrations is observed in traumatic brain conditions and is associated with poor outcome. Micromolar levels of extracellular S100B in vitro may have deleterious effects. However, in nanomolar concentrations S100B has multiple neurotrophic effects in vitro may in vivo be regarded as a hallmark of neuroprotective efforts. This pilot study addresses the hypothesis that S100B serum concentrations may be of predictive validity for the response to antidepressant treatment in patients with major depression. S100B plasma levels were determined in 25 patients with major depression and 25 matched healthy controls using an immunofluorimetric sandwich assay. S100B plasma levels were significantly higher in major depressive patients than in healthy controls and positively correlated with treatment response after 4 weeks of treatment. In a linear regression model, a significant predictive effect was found only for S100B and severity of depressive symptoms upon admission. These results suggest that neuroprotective functions of S100B counterbalance neurodegenerative mechanisms that are involved in the pathophysiology of major depression and in the response to antidepressant treatment.

Adult↗

PubMed2003

Metabolic changes after repetitive transcranial magnetic stimulation (rTMS) of the left prefrontal cortex: a sham-controlled proton magnetic resonance spectroscopy (1H MRS) study of healthy brain.

Rapid transcranial magnetic stimulation is being increasingly used in the treatment of psychiatric disorders, especially major depression. However, its mechanisms of action are still unclear. The aim of this study was to assess metabolic changes by proton magnetic resonance spectroscopy following high-frequency rapid transcranial magnetic stimulation (20 Hz), both immediately after a single session and 24 h after a series of five consecutive sessions. Twelve healthy volunteers were enrolled in a prospective single-blind, randomized study [sham (n = 5) vs. real (n = 7)]. Three brain regions were investigated (right, left dorsolateral prefrontal cortex, left anterior cingulate cortex). A single as well as a series of consecutive rapid transcranial magnetic stimulations affected cortical glutamate/glutamine levels. These effects were present not only close to the stimulation site (left dorsolateral prefrontal cortex), but also in remote (right dorsolateral prefrontal cortex, left cingulate cortex) brain regions. Remarkably, the observed changes in glutamate/glutamine levels were dependent on the pre-transcranial magnetic stimulation glutamate/glutamine concentration, i.e. the lower the pre-stimulation glutamate/glutamine level, the higher the glutamate/glutamine increase observed after short- or long-term stimulation (5 days). In general, the treatment was well tolerated and no serious side-effects were reported. Neither transient mood changes nor significant differences in the outcome of a series of neuropsychological test batteries after real or sham transcranial magnetic stimulation occurred in our experiment. In summary, these data indicate that rapid transcranial magnetic stimulation may act via stimulation of glutamatergic prefrontal neurons.

Adult↗

PubMed2003

[Measures of grief--a critical review].

Scientific investigations show that the course of a grieving process may have a substantial impact on the mental and physical wellbeing of those concerned. An international survey of measuring instruments designed to register grief shows little conformity with respect to the key symptoms of grieving. Only few instruments are derived from scientific theory, the majority have been developed on the basis of clinical observations and only some of the instruments are psychometrically designed. Some instruments display correlations with other constructs such as depression and anxiety, with the question of whether the symptoms are grief-specific or autonomous remaining unanswered. Only few instruments serve to differentiate between normal and pathologic grief. The fact that only two German-language instruments for registering grief are available to date also indicates that this subject matter has attracted only scant attention despite its clinical significance. In conclusion, the demands to be made on an instrument to be developed in the future are outlined.

Adult↗

PubMed2003

Dissociative disorders and traumatic childhood experiences in transsexuals.

In this first prevalence study of dissociative symptoms and different forms of childhood experiences among transsexuals, 41 transsexuals and 115 psychiatric inpatients were compared by means of the Interview for Dissociative Disorders (SCID-D-R), the Dissociative Experiences Scale (DES), and the Childhood Trauma Questionnaire (CTQ). The total score for the dissociative symptoms revealed no significant differences between the transsexuals and the psychiatric inpatients. However, the higher DES score among transsexuals compared with a normal population was found to be due largely to one item. A surprisingly high prevalence of emotional maltreatment was recorded. The results suggest that both the DES and the SCID-D-R have limited validity as instruments for screening and diagnosing dissociative disorders in transsexuals. Psychiatrists should be mindful of the possible existence of dissociative disorders in transsexual patients. Further investigations are needed to clarify the effects of traumatic childhood experiences on sexual identity in transsexuals and to throw more light on the phenomenological correlation between transsexualism and dissociative identity, using taxometric analyses.

Adult↗

PubMed2003

Outpatient psychotherapy for mothers--first empirical results.

MOTHERHOOD is a vulnerable phase in the life of any woman, one that may be associated with an increased risk of mental illness. Despite the major clinical significance of this patient group, only a few psychotherapeutic treatment programs are tailored to the needs of mothers of infants. Even when treatment is urgently needed, many mothers of infants reject inpatient psychotherapy so as not to be separated from their children. The outcome may be chronification of disorders, in some cases with a negative impact on their children's development. A new psychotherapeutic outpatient treatment program adapted to the special needs of mothers and offering a substitute to inpatient treatment is presented. First empirical results show that the presented treatment concept led to significant improvements in the symptoms, whose stabilization continued up to the follow-up two years after the start of therapy.

Adult↗

PubMed2003

Alexithymia and incidental learning of emotional words.

Alexithymia is thought to reflect a deficit in the cognitive capacity to process emotions. Prior research suggests that emotional valence has a memory enhancing effect in poor conceptual learning conditions. This study addressed the question of whether incidental learning of emotional words is a function of alexithymic tendencies. Incidental learning is unintentional learning that results from other activities. The 20-item Toronto Alexithymia Scale (TAS-20) and measures of depression and verbal intelligence were administered to 30 nonclinical subjects (15 women, 15 men) whose mean age was 35.5 yr. (SD = 8.6) along with a sequential word-word evaluation task. Partial correlations indicated that the TAS-20 subscale, Difficulties identifying feelings was negatively correlated with recall of positive distractor words but not with recall of neutral distractors or recall of positive or negative target words. Emotional valence appears to have less organizational power in the memory of individuals with difficulties in recognizing their feelings.

Adult↗

PubMed2002

Neurotrophic effects of electroconvulsive therapy: a proton magnetic resonance study of the left amygdalar region in patients with treatment-resistant depression.

Negatively balanced neurotrophic factors may be important in precipitating clinical depression. Recently, it has been reported that antidepressant therapy may exert positive neurotrophic effects. The aim of this study was to detect probable neurotrophic changes during electroconvulsive therapy (ECT). For this purpose, N-acetylaspartate (NAA), an amino acid exclusively located in neurons, and other brain metabolites such as glutamine/glutamate (Glx), choline (Cho), and creatine (Cr) were measured in patients by localized proton magnetic resonance spectroscopy. A total of 28 severely depressed patients (DSM-IV) were enrolled, and the left amygdalar region was investigated by proton STEAM spectroscopy before and after unilateral ECT. The results were compared with 28 age- and gender-matched controls using nonparametric paired and unpaired tests. A significant increase in NAA was observed only in ECT responders (n=14; p=0.019). Five out of 14 nonresponders to ECT monotherapy were remeasured following a clinical improvement after continued ECT combined with antidepressants and were then found also to present a significant increase in NAA. In all successfully treated patients, parallel observations, that is, increased levels, were made for Glx, whereas Cho and Cr were unchanged. In conclusion, our preliminary finding of increased NAA concentrations after successful ECT may indicate a probable neurotrophic effect of ECT.

Adult↗

PubMed2002

Timing of psychoeducational psychotherapeutic interventions in schizophrenic patients.

Psychoeducational interventions for schizophrenic outpatients and their key-persons have shown impressive long-term effects on the course of illness. Psychoeducation is suggested to be offered as early as possible to be most effective. This prospective randomized study examines the influence of pre-therapy duration of illness on the effects of a psychoeducative training. The controlled study covered a total of 191 schizophrenic outpatients and comprised psychoeducational training and cognitive psychotherapy. Pre-therapy duration of illness was divided at 4 and 7 years resulting in groups of short, medium, and long duration of psychosis. Study patients were examined for rehospitalization at a five year interval. In patients with long duration of illness, attendance at psychoeducation did not modify rehospitalization rate. This was true for patients with very short duration of psychosis. Only patients with medium duration of illness after psychoeducative intervention showed a reduced rehospitalization rate. In general, results do recommend psychoeducative intervention at early psychosis. However, psychoeducation was not optimally located in patients with a very short duration of illness. Psychoeducation showed a most preventive effect in patients with a medium duration of illness who already accept their illness but are not yet adhering to fatalistic assumptions often established to explain the manifestation of illness.

Adult↗

PubMed2002

[Therapeutic factors of outpatient group psychotherapy - the predictive validity of the Group Experience Questionnaire (GEQ)].

It was the aim of the study to investigate different factors of group experience in relation to therapy effects and to prove the predictive validity of the Group Experience Questionnaire (GEQ); for this purpose for each scale of the GEQ the values of later "Responders" and "Non Responders" were compared. The sample consisted of 50 patients with psychosomatic diseases who where treated with outpatient integrated psychodynamic group therapy. We found that the GEQ is able to differentiate between successful and less successful patients. Especially the therapeutic factors "autonomy and optimism" as well as "well-being" are of high predictive value. Contrary to former investigations the therapeutic factor "cohesion" was less important, which could hint at the fact that a medium amount of cohesion might be sufficient for an effective process of treatment.

Humans↗

PubMed2002

Vascular endothelial growth factor protects cultured rat hippocampal neurons against hypoxic injury via an antiexcitotoxic, caspase-independent mechanism.

The authors investigated the effect of vascular endothelial growth factor (VEGF) on hypoxic injury of cultured rat hippocampal neurons. Treatment with glutamate receptor antagonists prevented hypoxic neuron death. The same magnitude of protection was observed in cultures treated with VEGF, which also reduced excitotoxic neuron death induced directly by an exposure to -methyl-d-aspartate. Vascular endothelial growth factor did not alter the activation of the transcription factor nuclear factor-kappaB during hypoxia and protected cells in a PI-3-kinase-independent manner. Vascular endothelial growth factor failed to protect against staurosporine-induced, caspase-dependent apoptosis. These data suggest that VEGF-induced protection against hypoxic injury primarily involves the inhibition of excitotoxic processes.

Animals↗

PubMed2002

Bupropion as add-on strategy in difficult-to-treat bipolar depressive patients.

Bupropion, a selective norepinephrine and dopamine reuptake inhibitor, has been suggested for the treatment of bipolar depression, not only because of its efficacy, but also because of a probably lower risk of inducing switches to hypomania or mania. Most studies on bupropion treatment in bipolar patients have been performed in moderately ill out-patients. In contrast, we report on a sample of difficult-to-treat, predominantly severely ill, co-morbid, psychotic or therapy-refractory bipolar depressive in-patients. In this open and prospective study, 13 patients were treated with bupropion as an add-on strategy mainly to other antidepressants and to various mood stabilizers. Our data support the idea that bupropion is a first-line antidepressant in the treatment of severe bipolar depression. Eight of 13 patients showed a >50% reduction of Montgomery-Asberg Depression Scale ratings within 4 weeks. Co-medication with drugs commonly used in treatment-resistant bipolar disorder including venlafaxine, clozapine, lithium, topiramate and sodium valproate was safe in our small sample. While adhering to the suggestion of Goren and Levin not to exceed a daily dose of 450 mg of bupropion when treating bipolar depressed patients, we did not observe any switch from depression to hypomania or mania.

Antidepressive Agents, Second-Generation↗

PubMed2002

Severe tardive dyskinesia in affective disorders: treatment with vitamin E and C.

Tardive dyskinesia caused by antipsychotic treatment is a severe problem not only in the management of schizophrenia, but also of affective disorders. Vitamin E monotherapy has been used in schizophrenic patients with tardive dyskinesia. Pharmacologists warn against high dosage of vitamin E because of its pro-oxidative effects on low-density lipoprotein with consecutive cardiac risks. Addition of vitamin C probably reduces this risk because of its interactions with vitamin E, i.e. vitamin C reduces vitamin E radicals formed when vitamin E scavenges the oxygen radicals. We have therefore tested the safety and efficacy of combining vitamin C and E in a sample of patients with affective disorders and tardive dyskinesia who had previously been treated with antipsychotics due to psychotic symptoms. In all 6 patients, a reduction of tardive symptomatology was seen. In our sample, no side effects were observed. Further studies on this combination therapy are suggested.

Adult↗