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W Schultz

Publications and source records attributed to W Schultz.

At least 37 records · Page 2Linked to original sources
PubMed2003

[Gait-analytical studies in patients treated by valgus tibial head osteotomy].

So far, the use of imaging methods has been the only way of evaluating unicompartmental gonarthritis caused by malalignment of lower extremity axes and the results of operative correction. Unfortunately, radiological visualization does not give any information about the actual loads on the joint, i.e.the forces and moments acting on it under dynamic conditions. These can be determined by means of gait-analytical measurements. The authors explain how the anomalous loading that occurs in the knee joint in the case of varus gonarthritis can be calculated and assessed. The mean maximum varus moment of knee joints in a group of patients with varus deformity was 0.74 Nm\kg, which was significantly higher than that in a control group (0.63 Nm\kg). Even after correction of the axes, increased maximum moments--some of them independent of the angle of the knee and of the correction angle--were observed in 30% of the cases investigated. These cases were found to be characterized by a predisposition to revarization. Knee joints in which the preoperative varus moment was significantly high or there was a tendency to under-correction were especially likely to show these features. For these reasons, valgus tibial head osteotomies should generally be performed with slight overcorrection. If the preoperative gait analysis has already confirmed that significantly increased varus forces are in play, a definite overcorrection to about 5 degrees beyond the physiological angle should be the aim.

Adult↗
PubMed2003

Neural activity related to the processing of increasing monetary reward in smokers and nonsmokers.

This study investigated the processing of increasing monetary reward in nonsmoking and smoking subjects. The choice of the subject populations has been motivated by the observation of differences between nonsmokers and smokers in response to rewarding stimuli in a previous study. Subjects performed a pattern recognition task with delayed response, while rCBF was measured with [H215O] PET. Correct responses to the task were reinforced with three different amounts of monetary reward. The subjects received the sum of the rewards at the end of the experiment. The results show that a cortico-subcortical loop, including the dorsolateral prefrontal cortex, the orbitofrontal cortex, the cingulate gyrus and the thalamus is involved in processing increasing monetary reward. Furthermore, the striatal response differentiates nonsmokers from smokers. Thus, we found significant correlations between rCBF increases in striatum and increasing monetary reward and between striatal rCBF increases and mood in nonsmokers, but not in smokers. Moreover, no significant mood changes among the different monetary rewards could be observed in smokers. We infer that the response of the striatum to reward is related to changes in subjective feelings. The differences between smokers and nonsmokers confirm our previous conclusions that the association between blood flow, performance, mood and amount of reward is more direct in nonsmokers.

Adult↗
PubMed2002

Autologous chondrocyte transplantation for osteochondritis dissecans of the talus.

Eight patients with osteochondritis dissecans of the talus were reviewed. The average followup was 17.6 months (range, 8-26 months). The mean age of the patients was 31.8 years (range, 22-42 years). All patients had a preoperative examination, magnetic resonance imaging, and radiologic classification of the lesion through regular anteroposterior and lateral radiographs. Diagnostic arthroscopy and biopsies of healthy cartilage were done, which then had chondrocyte extraction and culture. After an average of 2.5 weeks, an arthrotomy, malleolar osteotomy, subchondral bone sclerosis debridement, and autologous chondrocyte transplantation were done. The postoperative treatment included nonweightbearing for 6 to 7 weeks, physiotherapy, and continuous passive motion. According to the postoperative evaluation score, all results were excellent to good with an average score of 0.6. No complications occurred. The arthroscopic reexamination of three patients at the sixth postoperative month and the radiologic evaluation of all patients showed the existence of cartilagelike tissue with complete coverage of the chondral defect. This method enables reconstructive intervention for unicompartmental defects of articular cartilage through implantation of new chondrocytes, establishment of a subchondral blood supply, and reconstruction of the articular surface.

Adult↗
PubMed2001

Dopamine responses comply with basic assumptions of formal learning theory.

According to contemporary learning theories, the discrepancy, or error, between the actual and predicted reward determines whether learning occurs when a stimulus is paired with a reward. The role of prediction errors is directly demonstrated by the observation that learning is blocked when the stimulus is paired with a fully predicted reward. By using this blocking procedure, we show that the responses of dopamine neurons to conditioned stimuli was governed differentially by the occurrence of reward prediction errors rather than stimulus-reward associations alone, as was the learning of behavioural reactions. Both behavioural and neuronal learning occurred predominantly when dopamine neurons registered a reward prediction error at the time of the reward. Our data indicate that the use of analytical tests derived from formal behavioural learning theory provides a powerful approach for studying the role of single neurons in learning.

Animals↗
PubMed2001

[Hemialloarthroplasty of the knee joint. Results of 2 different gliding prosthesis models].

The outcome of 2 different unicompartimental knee arthroplasty procedures (St. Georg, Link AG, and Wessinghage, Sulzer Medica AG) is presented. The clinical results were evaluated by use of the Insall Score (Knee Society Rating System). According to this system, the subjective opinion of the patients are presented as a "Function Score" and the clinical evaluations is shown as a "Knee Score". In this study, the median follow-up for the St. Georg implant was 7 years and 6 months with good results reported by both scores. The median follow-up for the Wessinghage implant was 3 years and 2 months and it also showed good results. Despite the high average age of the patients in this study as well as the high percentage of female patients, both types of prostheses produced good results. If any, partial or complete radioluciencies were mainly observed in the tibial component. However, they had no clinical consequence. It should be noted, however, that arthritis in the compartment not receiving arthroplasty surgery progressed in almost 2/3 of the patients. By implantation of both implants a physiological axis of the leg could be achieved. The survivorship of the St. Georg implant was 88.92% (10 years survivorship). For the Wessinghage implant it was 98.35% (5 years survivorship).

Aged↗
PubMed2001

Changes in brain activation associated with reward processing in smokers and nonsmokers. A positron emission tomography study.

Tobacco smoking is the most frequent form of substance abuse. Several studies have shown that the addictive action of nicotine is mediated by the mesolimbic dopamine system. This system is implicated in reward processing. In order to better understand the relationship between nicotine addiction and reward in humans, we investigated differences between smokers and nonsmokers in the activation of brain regions involved in processing reward information. Using [H2(15O)] positron emission tomography (PET), we measured regional cerebral blood flow (rCBF) in healthy smokers and nonsmokers while they performed a prelearned, pattern-recognition task. We compared two conditions involving nonmonetary reinforcement or monetary reward with a baseline condition in which nonsense feedback was presented. With monetary reward, we found activation in the frontal and orbitofrontal cortex, occipital cortex, cingulate gyrus, cerebellum, and midbrain in both groups. Additionally, monetary reward activated typical dopaminergic regions such as the striatum in nonsmokers but not in smokers. We found a similar pattern of activation associated with nonmonetary reinforcement in nonsmokers, whereas activation was found in smokers only in the cerebellum. The different patterns of activation suggest that the brains of smokers react in a different way to reward than those of nonsmokers. This difference involves in particular the regions of the dopaminergic system including the striatum. In principle these observations could be interpreted either as a consequence of tobacco use or as a primitive condition of the brain that led people to smoke. Supported by related nonimaging studies, we interpret these differences as a consequence of tobacco smoking, even if a short-term effect of smoking prior to the experiment cannot be excluded.

Adult↗
PubMed2001

Behavioral reactions reflecting differential reward expectations in monkeys.

Learning theory emphasizes the importance of expectations in the control of instrumental action. This study investigated the variation of behavioral reactions toward different rewards as an expression of differential expectations of outcomes in primates. We employed several versions of two basic behavioral paradigms, the spatial delayed response task and the delayed reaction task. These tasks are commonly used in neurobiological studies of working memory, movement preparation, and event expectation involving the frontal cortex and basal ganglia. An initial visual instruction stimulus indicated to the animal which one of several food or liquid rewards would be delivered after each correct behavioral response, or whether or not a reward could be obtained. We measured the reaction times of the operantly conditioned arm movement necessary for obtaining the reward, and the durations of anticipatory licking prior to liquid reward delivery as a Pavlovian conditioned response. The results showed that both measures varied depending on the reward predicted by the initial instruction. Arm movements were performed with significantly shorter reaction times for foods or liquids that were more preferred by the animal than for less preferred ones. Still larger differences were observed between rewarded and unrewarded trials. An interesting effect was found in unrewarded trials, in which reaction times were significantly shorter when a highly preferred reward was delivered in the alternative rewarded trials of the same trial block as compared to a less preferred reward. Anticipatory licks preceding the reward were significantly longer when highly preferred rather than less preferred rewards, or no rewards, were predicted. These results demonstrate that behavioral reactions preceding rewards may vary depending on the predicted future reward and suggest that monkeys differentially expect particular outcomes in the presently investigated tasks.

Animals↗
PubMed2001

Reward mechanisms in the brain and their role in dependence: evidence from neurophysiological and neuroimaging studies.

This article reviews neuronal activity related to reward processing in primate and human brains. In the primate brain, neurophysiological methods provide a differentiated view of reward processing in a limited number of brain structures. Dopamine neurons respond to unpredictable rewards and produce a global reinforcement signal. Some neurons in the striatum also react to the expectation and detection of reward. Other striatal neurons show reward-related activities related to the preparation, initiation and execution of movement. Orbitofrontal neurons discriminate among different rewards and code reward preferences. In the human brain, regions belonging to a meso-striatal and meso-corticolimbic loop respond to reinforcement stimuli in control subjects. These observations corroborate results obtained in primates. Additionally, reward induces activation in regions specific to task performance. Our results also show a similar pattern of reward-related activation in nicotine and opiate addicts. Thus, in contrast to healthy subjects, typical reward-related regions respond in addicts to monetary reward but not to nonmonetary reinforcement. Reduced activation in performance-related regions is also observed in both groups of dependent subjects. The results of animal and human studies suggest that dopamine and dopamine-related regions are associated with the integration of motivational information and movement execution. Dopamine-related pathological disorders can be associated with movement disorders, such as Parkinson's disease or with false motivational attributions such as drug dependence.

Animals↗
PubMed2001

Changes in reward-induced brain activation in opiate addicts.

Many studies indicate a role of the cerebral dopaminergic reward system in addiction. Motivated by these findings, we examined in opiate addicts whether brain regions involved in the reward circuitry also react to human prototypical rewards. We measured regional cerebral blood flow (rCBF) with H(2)(15)O positron emission tomography (PET) during a visuo-spatial recognition task with delayed response in control subjects and in opiate addicts participating in a methadone program. Three conditions were defined by the types of feedback: nonsense feedback; nonmonetary reinforcement; or monetary reward, received by the subjects for a correct response. We found in the control subjects rCBF increases in regions associated with the meso-striatal and meso-corticolimbic circuits in response to both monetary reward and nonmonetary reinforcement. In opiate addicts, these regions were activated only in response to monetary reward. Furthermore, nonmonetary reinforcement elicited rCBF increases in limbic regions of the opiate addicts that were not activated in the control subjects. Because psychoactive drugs serve as rewards and directly affect regions of the dopaminergic system like the striatum, we conclude that the differences in rCBF increases between controls and addicts can be attributed to an adaptive consequence of the addiction process.

Adult↗
PubMed2001

The small proteoglycans decorin and biglycan in human articular cartilage of late-stage osteoarthritis.

OBJECTIVE: Disturbances in proteoglycan metabolism of hyaline cartilage play an essential role in the pathology of degenerative joint disease. We investigated the relation between transcript expression, protein synthesis and the ultrastructural localization of the matrix-organizing proteoglycans decorin and biglycan within intra- and extracellular compartments of late-stage osteoarthritic human articular cartilage. METHODS: Human cartilage samples of a macroscopically intact area, the adjoining area and an area of the main defect from knee joints of 10 patients with late stage osteoarthritis were investigated. In situ hybridization and immunogold histochemistry were carried out separately and in combination at the light and electron microscopic level. RESULTS: Ultrastructurally, three main chondrocyte types were identified. The highest levels of mRNA of decorin and biglycan were produced by elongated secretory type 2 cells, already known to synthesize type I collagen. Cells with high levels of mRNA also translated the corresponding proteins to be found in the extracellular compartment. The highest production rate of decorin and biglycan was seen in the tissue area adjoining the main defect. CONCLUSION: The results indicate that at late stages of osteoarthritis the levels of transcription and translation for decorin and biglycan are up-regulated, probably in an effort to compensate for the general proteoglycan loss, characteristic of this disease stage.

Aged↗
PubMed2001

Influence of expectation of different rewards on behavior-related neuronal activity in the striatum.

This study investigated how different expected rewards influence behavior-related neuronal activity in the anterior striatum. In a spatial delayed-response task, monkeys reached for a left or right target and obtained a small quantity of one of two juices (apple, grenadine, orange, lemon, black currant, or raspberry). In each trial, an initial instruction picture indicated the behavioral target and predicted the reward. Nonmovement trials served as controls for movement relationships. Consistent preferences in special reward choice trials and differences in anticipatory licks, performance errors, and reaction times indicated that animals differentially expected the rewards predicted by the instructions. About 600 of >2,500 neurons in anterior parts of caudate nucleus, putamen, and ventral striatum showed five forms of task-related activations, comprising responses to instructions, spatial or nonspatial activations during the preparation or execution of the movement, and activations preceding or following the rewards. About one-third of the neurons showed different levels of task-related activity depending on which liquid reward was predicted at trial end. Activations were either higher or lower for rewards that were preferred by the animals as compared with nonpreferred rewards. These data suggest that the expectation of an upcoming liquid reward may influence a fraction of task-related neurons in the anterior striatum. Apparently the information about the expected reward is incorporated into the neuronal activity related to the behavioral reaction leading to the reward. The results of this study are in general agreement with an account of goal-directed behavior according to which the outcome should be represented already at the time at which the behavior toward the outcome is performed.

Animals↗
PubMed2001

Temporal difference model reproduces anticipatory neural activity.

Anticipatory neural activity preceding behaviorally important events has been reported in cortex, striatum, and midbrain dopamine neurons. Whereas dopamine neurons are phasically activated by reward-predictive stimuli, anticipatory activity of cortical and striatal neurons is increased during delay periods before important events. Characteristics of dopamine neuron activity resemble those of the prediction error signal of the temporal difference (TD) model of Pavlovian learning (Sutton & Barto, 1990). This study demonstrates that the prediction signal of the TD model reproduces characteristics of cortical and striatal anticipatory neural activity. This finding suggests that tonic anticipatory activities may reflect prediction signals that are involved in the processing of dopamine neuron activity.

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PubMed2001

Reward signaling by dopamine neurons.

Dopamine projections from the midbrain to the striatum and frontal cortex are involved in behavioral reactions controlled by rewards, as inferred from deficits in parkinsonism, schizophrenia, and drug addiction. Recent experiments have shown that dopamine neurons are not directly modulated in relation to movements. Rather, they appear to code the rewarding aspects of environmental stimuli. They show short, phasic increases of activity following primary food and liquid rewards ("unconditioned stimuli") and conditioned, reward-predicting stimuli of visual, auditory, and somatosensory modalities. They also display smaller activation-depression sequences after stimuli resembling rewards and after novel or particularly intense stimuli. Rewards are only reported as far as they occur differently than predicted. According to learning theories, a "prediction error" message may constitute a powerful teaching signal for behavior and learning. The phasic reward message is different from the more tonic enabling function of dopamine that is deficient in Parkinson's disease, indicating that dopamine neurons subserve different functions at different time scales. Neurons in other brain structures, such as the striatum, orbitofrontal cortex, and amygdala, code the quality, quantity, and preference of rewards. The dopamine reward prediction error signal may cooperate with these reward perception signals during the learning and performance of behavioral reactions to motivating environmental stimuli.

Animals↗
PubMed2000

Reduced reward processing in the brains of Parkinsonian patients.

Regional cerebral blood flow (rCBF) in healthy controls and non-demented, non-depressed Parkinsonian patients was measured using H2(15)O PET while subjects performed a prelearned pattern recognition task with delayed response. To investigate differences between the two groups in response to reward, the experimental design consisted of three reinforcement conditions: no reinforcement consisting of nonsense feedback, positive symbolic reinforcement and monetary reward. In the controls, monetary reward activated bilaterally the striatum and anterior cingulate gyrus, as well as unilaterally the left cerebellum, midbrain and medial frontal gyrus. Symbolic reinforcement revealed a similar pattern of activation, except that the striatum and left midbrain showed no activation. The Parkinsonian patients responded to monetary reward with increased activation bilaterally in the cerebellum, medial frontal gyrus, and anterior cingulate gyrus as well as unilaterally in the right fusiform gyrus and midbrain and left caudate nucleus and precentral gyrus. Symbolic reinforcement induced significantly increased rCBF in the right cerebellum only. Compared with symbolic reinforcement, monetary reward produced extended activation of temporoparietal association cortex. The pattern observed in the controls demonstrates the role in reward processing of dopaminergic mesolimbic pathways in the healthy human brain, whereas the pattern in the Parkinsonian patients suggests the involvement of compensatory cortical loops in the diseased brain.

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PubMed2000

Involvement of basal ganglia and orbitofrontal cortex in goal-directed behavior.

An impressive array of neural processing appears to be dedicated to the extraction of reward-related information from environmental stimuli and use of this information in the generation of goal-directed behaviors. While other structures are certainly involved in these processes, the characteristics of activations seen in mesencephalic dopamine neurons, striatal neurons and neurons of the orbitofrontal cortex provide distinct examples of the different ways in which reward-related information is processed. In addition, the differences in activations seen in these three regions demonstrate the different roles they may play in goal-directed behavior. A principal role played by dopamine neurons is that of a detector of an error in reward prediction. The homogeneity of responsiveness across the population of dopamine neurons indicates that this error signal is widely broadcast to dopamine terminal regions where it could provide a teaching signal for synaptic modifications underlying the learning of goal-directed appetitive behaviors. The responses of these same neurons to conditioned stimuli associated with reward could also serve as a signal of prediction error useful for the learning of sequences of environmental stimuli leading to reward. Dopamine neuron responses to both rewards and conditioned stimuli are not contingent on the behavior executed to obtain the reward and thus appear to reflect a relatively pure signal of a reward prediction error. It is not yet clear whether these activations, and responses to novel stimuli, have an additional function in engaging neural systems involved in the representation and execution of goal-directed behaviors. This representation of goal-directed behaviors may involve the striatal regions studied, where processing of reward-related information appears to be much more heterogeneous. Different subpopulations of striatal neurons are activated at different stages in the course of goal-directed behaviors, with largely separate populations activated following presentation of conditioned stimuli, preceding reinforcers, and following reinforcers. Neurons exhibiting each of these types of activation appear to differentiate between rewarding and non-rewarding outcomes of behavioral acts and, as a population, appear to be biased towards processing reward vs. non-reward. These activations observed in the striatum were often contingent on the behavioral act associated with obtaining reward, reflecting an integration of information not observed in dopamine neurons. Another difference between reward processing in striatal neurons and dopamine neurons is the influence of predictability on neuronal responsiveness. Unlike dopamine neurons, many striatal neurons respond to predicted rewards, although at least some may reflect the relative degree of predictability in the magnitude of the responses to reward. Thus, striatal processing of reward-related information is in some ways more complex than that observed in dopamine neurons, incorporating information on behavior and potentially providing more detailed information regarding predictability. These activations could serve as a component of the neural representation of the goal, and/or the behavioral aspects of goal-directed behaviors. As such they would be of use for the execution of appropriate goal-directed behaviors in response to known environmental stimuli, as well as for generating behaviors in response to novel stimuli that may be associated with desirable goals. Neuronal activations in the orbitofrontal cortex appear to involve less integration of behavioral and reward-related information, but rather incorporate another aspect of reward, the relative motivational significance of different rewards. These activations would serve a function similar to those striatal neurons that encode exclusively reward-related information in situations in which only a single outcome is obtainable. (ABSTRACT TRUNCATED)

Animals↗
PubMed2000

Multiple reward signals in the brain.

The fundamental biological importance of rewards has created an increasing interest in the neuronal processing of reward information. The suggestion that the mechanisms underlying drug addiction might involve natural reward systems has also stimulated interest. This article focuses on recent neurophysiological studies in primates that have revealed that neurons in a limited number of brain structures carry specific signals about past and future rewards. This research provides the first step towards an understanding of how rewards influence behaviour before they are received and how the brain might use reward information to control learning and goal-directed behaviour.

Animals↗
PubMed2000

Massive intraosseous ganglion of the talus: reconstruction of the articular surface of the ankle joint.

We report on the outcome after autologous chondrocyte and spongiosal bone transplantation in a case of a massive intraosseous ganglion of the talus in a young patient. A 24-year-old man suffered from decreased ankle joint motion, recurrent swelling, and pain. Diagnostic evaluation by plain radiographs, computed tomography, and magnetic resonance imaging revealed cystic lesions in the head and the body of the talus with additional involvement of the cartilage surface. Operative treatment consisted primarily of an initial diagnostic arthroscopy, which established grade VI articular damage according to the arthroscopic classification of Bauer and Jackson. Pathological examination of intralesional biopsy tissue revealed the existence of an intraosseous ganglion. Additionally, healthy cartilage biopsy specimens were obtained and sent for chondrocyte extraction and cultivation with 60 mL of autologous serum. To retain the function of the ankle joint and to minimize the number of necessary operative interventions, 3 weeks after the initial arthroscopic operation, we performed a simultaneous curettage of the cystic lesion followed by autologous spongiosal bone and cultivated chondrocytes transplantation of the talus. Continuous passive motion was applied postoperatively and full weight bearing was allowed after 8 weeks. There were no complications. The clinical result after 18 months was excellent, with a fully functional, pain-free, and weight-bearing ankle joint. The postoperative evaluation score of Finsen (modified Weber score) of 2/6 = 0.3 showed an improvement comparison with the preoperative value of of 21/6 = 3.5 (0 = normal, 4 = pathologic). We encountered no complications postoperatively. Clinical success was achieved by this method of treatment on a patient too young to be treated through arthrodesis.

Adult↗