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Biomedical subjects

W Sperling

Publications and source records attributed to W Sperling.

At least 19 recordsLinked to original sources
PubMed2006

Memantine fails to facilitate partial cigarette deprivation in smokers--no role of Memantine in the treatment of nicotine dependency?

The efficacy of Memantine in the treatment of nicotine dependency in humans remained to be evaluated. The aims of our pilot study were to investigate (1) the effectiveness of Memantine in facilitating smoking reduction and (2) the influence of Memantine on the perception of nicotine. In order to achieve these aims we conducted a placebo controlled double-blind parallel group study in smokers (n = 20 per group). Before the beginning of the treatment-phase (10/20 mg Memantine per day) all participants were instructed to reduce smoking (partial deprivation). Before and during partial deprivation we registered the daily cigarette consumption and craving estimates. Following nasal stimulation with nicotine enantiomers hedonic and intensity estimates and the discrimination ability were assessed. Memantine failed to facilitate smoking reduction and did not influence the perception of nicotine with the exception of a weak reduction of olfactory intensity estimates reaching statistical significance for one nicotine enantiomer only.

Adult↗
PubMed2003

Hyperhomocysteinemia as a new risk factor for brain shrinkage in patients with alcoholism.

Chronic alcohol consumption can induce brain atrophy, whereby the exact mechanism of brain damage in alcoholics remains unknown. There is evidence that chronic alcoholism is associated with hyperhomocysteinemia. Homocysteine is an excitatory amino acid which markedly enhances the vulnerability of neuronal cells to excitotoxic and oxidative injury in vitro and in vivo. The present volumetric magnetic resonance imaging study included 52 chronic alcoholics and 30 non-drinking healthy controls. Patients were active drinkers and had an established diagnosis of alcohol dependence. We investigated the influence of different variables on the hippocampal volume of patients suffering from chronic alcoholism. We observed that pathological raised levels of plasma homocysteine showed the most significant correlation to hippocampal volume reduction (P<0.001, multiple regression analysis). Raised plasma levels of homocysteine are associated with hippocampal (brain) atrophy in alcoholism.

Adult↗
PubMed2003

Apolipoprotein E epsilon 4 is associated with hippocampal volume reduction in females with alcoholism.

There is evidence that a higher incidence of diverse neurodegenerative diseases is associated with the apolipoprotein E epsilon4 allele (ApoE4). Most recently it has been found that the ApoE4 allele is specifically related to an accelerated hippocampal atrophy in patients with Alzheimer's disease. Therefore, the aim of the present study was to investigate the association between ApoE4 genotypes and brain hippocampal volume reduction in alcoholics by using volumetric high-resolution MR imaging. In the present study, female alcoholics with the ApoE4 genotype were found to have significantly smaller hippocampal volumes than those not carrying an epsilon4 allele (ANOVA, p < 0.05), whereas no differences in hippocampal volume were seen in male alcoholics. Since hippocampal volume reduction is lately discussed to be proportional to brain atrophy, we propose that the alcohol-related brain atrophy in patients suffering from chronic alcoholism, is more pronounced in female carriers of the apoE epsilon4 allele. These findings indicate a genetic disposition for alcohol related brain atrophy in female carrying the ApoE4 genotype, which may also explain why female alcoholics are more susceptible to alcohol-induced brain damage.

Adult↗
PubMed2003

[Excitatory neurotransmission in alcoholism].

Glutamate is the neurotransmitter at the majority of excitatory synapses in the mammalian CNS. It has been proposed that neurotoxicity linked to chronic alcoholism is mediated primarily by activation of glutamate N-methyl-D-aspartate (NMDA) receptors. Since ethanol stabilizes the membrane potential of NMDA receptors a persistent attenuation of glutamatergic neurotransmission occurs in chronic alcoholism resulting in a compensatory up-regulation of NMDA receptors. Thus, delayed neurotoxicity can be triggered by rebound activation of NMDA receptor-mediated neurotransmission during the withdrawal state. Besides glutamate, homocysteine and excitatory amino acids (EAA) have been shown to act as endogenous agonists at the NMDA receptor and increase excitatory postsynaptic potentials. There is evidence that chronic alcoholism is associated with a derangement in this sulfur amino acid metabolism. These findings indicate the role of hyperhomocysteinemia for withdrawal symptoms, the withdrawal state, and alcoholism-associated brain atrophy. The role of alcoholism-associated hyperhomocysteinemia in respect to NMDA-receptor mediated neurotoxicity and excitotoxicity is discussed.

Alcoholism↗
PubMed2002

Spontaneous, slow and fast magnetoencephalographic activity in patients with schizophrenia.

A 2* 37 channel biomagnetic system (Magnes II) was used to record spontaneous magnetic activity for the frequency ranges 2-6 Hz and 12.5-30 Hz in 30 patients with schizophrenia (23 men and 17 women) and 30 healthy volunteers in both hemispheres during a resting condition. The dipole localization was calculated by the dipole density plot (DDP) method, which is a spatial averaging in order to decrease the influence of the nonfocal activity. The quantified DDP results were superimposed to T2-weighted MR-images of each patient's head as isocontour lines. To superimpose the MEG results to 3-D MRI data, the scanned head data set was fitted to the reconstructed MRI head shape using a surface fit programme developed by our department. The absolute dipole values were correlated with the psychopathological findings and the cumulative neuroleptic dosage for each patient. The group of patients with schizophrenia differed overall from the healthy subjects in the elevation of absolute dipole values measured in both hemispheres. For the region of slow dipole activity (2-6 Hz), a high correlation was found between the intensity of dipole concentration and productive psychotic symptoms (PANSS, P1-P7). Dipole localization (for both frequency ranges) showed a concentration effect (DCE) in the temporoparietal region in patients with schizophrenia.

Adult↗
PubMed2001

Risk assessment of alcohol withdrawal seizures with a Kohonen feature map.

Recently, it has been suggested that alcohol-induced hyperhomocysteinaemia in patients suffering from chronic alcoholism might be a risk factor for alcohol withdrawal seizures. In the present follow-up study 12 patients with chronic alcoholism who suffered from withdrawal seizures had significantly higher levels of homocysteine (Hcy) on admission (71.43 +/- 25.84 mol/l) than patients (n = 37) who did not develop seizures (32.60 +/- 24.87 mol/l; U = 37.50, p = 0.0003). Using a logistic regression analysis, withdrawal seizures were best predicted by a high Hcy level on admission (p < 0.01; odds ratio 2.07). Based on these findings we developed an artificial neural network system (Kohonen feature map, KFM) for an improved prediction of the risk of alcohol withdrawal seizures. Forty-nine patients with chronic alcoholism (12 with alcohol withdrawal seizures and 37 without seizures) were randomized into a training set and a test set. Best results for sensitivity of the KFM was 83.3% (five of six seizure patients were predicted correctly) with a specificity of 94.4% (one false positive prediction of 19 patients). We conclude that in patients with alcohol-induced hyperhomocysteinaemia the KFM is a useful tool to predict alcohol withdrawal seizures.

Adult↗
PubMed2000

Evaluation of neuronal effects of electroconvulsive therapy by magnetoencephalography (MEG).

1. Interictal spontaneous MEG was investigated in five male patients with major depressive disorder (according to DSM IV) treated with right hemispheric ECT over a period of five weeks. Spontaneous MEG-activity was also recorded in five male patients treated with tricyclic antidepressants during the same time period. 2. The analysis of slow (0-7Hz) and fast (12.5-30Hz) MEG activity was done with the dipole density plot, which uses consecutively estimated dipoles across a given analyzing time and delivers quantified dipole concentrations in three dimensions 3. In the ECT group the authors found a significant increase in the dipole concentration in the slow activity range (0-7Hz) after the first and the subsequent treatments, which could not be found in patients treated with tricyclic antidepressants. The localisation of the dipoles showed an "anteriorposterior"--gradient with a maximum concentration in the frontal and temporal region. 4. In the fast activity range (12.5-30Hz) the ECT group differed from the control group by a significant decrease of dipole activity, which was concentrated in the temporal and parietal region. 5. These results in part confirm interictal EEG findings after right hemispheric ECT and also lend strong support to ECT-effects in the fast activity ranges.

Adult↗
PubMed2000

[The carbamazepine hypersensitivity syndrome. Differential diagnosis and a representative case history].

In psychiatry the efficacy of the anticonvulsant carbamazepine in the prophylaxis of bipolar affective disorders is very known and so this drug has been used for a long time. But one very important and dangerous side effect of carbamazepine must be emphasized: the "carbamazepine-hypersensitivity-syndrome", which will be presented in this article in a representative example. The allergic reaction can be difficult in differential diagnostic aspects: the clinical symptoms of this reaction can be very similar to viral infections; in the histological view aspects of a lymphoma can even be found. Because of the systemic reactions there are dramatic and very serious courses. So the psychiatrist has to remember the dramatic side effects and must inform the patients about them in using carbamazepine.

Adult↗
PubMed1999

Spontaneous slow and fast MEG activity in male schizophrenics treated with clozapine.

RATIONALE: The atypical neuroleptic clozapine induces specific electroencephalogram changes, which have not been investigated using the technique of magnetoencephalography (MEG). OBJECTIVE: The present study investigated whether spontaneous magnetoencephalographic (MEG) activity in patients treated with clozapine differs from that in patients treated with haloperidol and untreated control subjects. METHODS: A 2 x 37 channel biomagnetic system was used to record spontaneous magnetic activity for the frequency ranges (2-6 Hz), (7.5-12 Hz), (12.5-30 Hz) in schizophrenic patients and controls in two trials within 3 weeks. After data acquisition, the processed data were digitally filtered and the spatial distribution of dipoles was determined by a 3-D convolution with a Gaussian envelope. The dipole localisation was calculated by the dipole density plot and the principal component analysis. The target parameters were absolute dipole values and the dipole localisations. The relationship between absolute dipole values, dipole localisations and psychopathological findings (documented by the use of the PANSS, BPRS-scale) during a 3 week period with constant doses of clozapine and haloperidol was investigated using correlation analysis. RESULTS: Our results lend strong support to the assumption of a significant elevation of absolute dipole values [dipole density maximum (Dmax), dipole number (Dtotal), absolute and relative dipole density] in the fast frequency range (12.5-30 Hz) over the left hemisphere, especially in the temporoparietal region by clozapine. In this area, we found a dipole concentration effect only in patients treated with the atypical neuroleptic, whereas the dipole distribution in patients treated with haloperidol and healthy controls was concentrated in the central region. With regard to the absolute dipole values in the frequency ranges 2-6 Hz (delta, theta) and 7.5-12 Hz (alpha), we found no statistically significant differences between the groups investigated. In the slow frequency range (2-6 Hz) no difference was found between the clozapine and haloperidol group for the dipole localisation, which predominated in the temporoparietal region, in contrast to the central dipole distribution in control subjects. CONCLUSIONS: The results of an increase in beta activity under clozapine demonstrate a smaller reduction in activity in terms of unspecific sensory and motor paradigms in comparison with typical neuroleptics. The temporoparietal concentration of dipoles, in particular over the left half of the brain, might illustrate either their special role in the disease process, or the effects of the medication. The latter possibility was supported by the differing dipole distribution in the clozapine group with a left temporoparietal centre in both frequency ranges, and a deviating central dipole localisation in the fast activity range in the haloperidol group.

Adult↗
PubMed1997

Influence of season on manifestation of schizophrenic subtypes.

In the modern classification systems ICD-10 and DSM-III-R, the term seasonality has been given a separate significance in the diagnostic categorization of affective disorders. Its definition is oriented not merely to the increased seasonal prevalence in the autumn and winter months, but also to symptoms that do not occur in nonseasonal attacks. To date, research work on seasonality in schizophrenia has concentrated on birth seasonality, while no results based on large populations of patients have yet become available on the manifestation seasonality of schizophrenic subtypes. Within the framework of a retrospective study carried out in the period between 1983 and 1995, involving 2, 119 patients suffering from recurrent attacks of schizophrenia, seasonal manifestations were recorded in accordance with the criteria defined in DSM-III-R. It was found that the two subtypes of paranoid hallucinatory and schizoaffective psychoses met the criterion of seasonality significantly more frequently than did the subtypes disorganized and catatonic disorders. In addition, seasonal courses within the groups just mentioned clearly differed from the nonseasonal forms in terms of their symptomatology.

Adult↗
PubMed1996

[Dissection of the carotid artery and vertebral artery--diagnosis and therapy].

Carotid and vertebral artery dissections typically occur in young adults after major trauma, although they can arise spontaneously or after trivial injury. Many patients with carotid dissections have minor symptoms such as a subject bruit or Horner's syndrome. Cephalic pain is also frequent and often inaugural in carotid dissection. However, extracranial dissection is a well recognised cause of ischaemic stroke. The diagnosis of dissection was based on angiographic findings. Noninvasive imaging also allows prompt and reliable diagnosis. Our goal was to demonstrate the spectrum of neuroradiologic (CT, MR and angiographic) findings in craniocervical arterial dissection and compare the diagnostic utility of CT, MR, MR angiography. Clinical data imaging studies, and outcome were reviewed and compared with the results in four patients with carotid artery dissection.

Adolescent↗
PubMed1995

[Psychiatric consultation before liver transplantation].

BASIC REMARKS: Since the long-term results of transplantations are highly dependent on patient compliance, prior to the decision to undertake such an operation, the psychiatrist is often asked whether there are any conditions presenting that would militate against the necessary cooperation. METHOD: Between 1992 and 1993, 35 patients were sent for psychiatric counselling prior to liver transplantation, and were evaluated using a standardised questionnaire. 23 of the 35 patients were submitted to psychological testing. RESULTS: in 23 cases, a psychiatric diagnosis was established in accordance with the ICD-10 criteria. The largest group was formed by the addictive diseases in this study, in particular alcohol dependence. Eight patients proved to have organ-related mental disturbances, other diagnoses such as depressive disorders or personality disorders were less common. In four cases, the psychiatrist was unable to recommend the liver transplantation. In such cases as these, the tasks of the psychiatrist is not restricted simply to a diagnostic assessment, but must also include a therapeutic approach intended to enable the patient to cope with the coming stresses and requirements.

Adaptation, Psychological↗
PubMed1995

[Anticholinergic delirium--diagnosis and therapy].

Anticholinergic delirium is a common side effect of various psychotropic drugs. The correct diagnosis is often delayed. The anticholinergic potential of many psychotropic agents is not known; it may become more manifest as a result of combination and cumulation effects. When the correct diagnosis has been established, a dose reduction or discontinuation of the drug involved may prove effective treatment.

Cholinergic Antagonists↗
PubMed1995

Perinatal outcomes in the pregnancies of asthmatic women: a prospective controlled analysis.

Prior studies have found an increased incidence of adverse perinatal outcomes of pregnancies in asthmatic mothers, but these studies have been poorly controlled for asthma therapy and other confounding factors. The purpose of this study was to assess perinatal outcomes in actively managed pregnant asthmatic women as compared with matched nonasthmatic controls. Using an inception cohort design, we studied a volunteer sample of 486 pregnant (< 28 wk) women with documented asthma and 486 pregnant nonasthmatic controls with normal pulmonary function. Cases and controls were matched for age, smoking status, parity, and year of delivery. Asthma was managed with step therapy to prevent acute asthmatic episodes and asthma symptoms that interfered with sleep or normal activity. Chronic hypertension was significantly more common (p = 0.007) in asthmatic subjects (3.7%) than in matched controls (1.0%). However, no significant differences in incidences of preeclampsia, perinatal mortality, preterm births, low-birth-weight infants, intrauterine growth retardation, or congenital malformations were observed in the pregnancies of the asthmatic women as compared with the matched controls. Trends were observed toward relationships between more severe asthma requiring emergency therapy or corticosteroids and increased incidences of preeclampsia and low-birth-weight infants, but these associations were not statistically significant. These data suggest that the overall perinatal prognosis for women with actively managed asthma during pregnancy is comparable to that for the nonasthmatic population.

Adult↗
PubMed1993

[The early childhood form of negativistic catatonia].

In a case report the clinical manifestation of negativistic catatonia with its modified symptomatology by first onset in early childhood is presented. The symptomatology consists of negativism, negativistic excitations with (auto)aggressivity and impulsive behaviour. Development of expressive language is lacking or is arrested. Physical development is retarded. These conditions are seldom recognized but diagnosed as organic brain syndrome or more unspecifically as "pervasive developmental disorder" (DSM III-R, ICD 10).

Adult↗
PubMed1989

Retinal isomer ratio in dark-adapted purple membrane and bacteriorhodopsin monomers.

On the basis of data obtained by spectroscopic analysis and chromatography of retinal extracts, a consensus has been adopted that dark-adapted purple membrane (pm) contains 13-cis- and all-trans-retinal in equal amounts, whereas the light-adapted membrane contains all-trans-retinal only. We have developed an improved extraction technique which extracts up to 70% of the retinal in pm within 4 min. In the extracts from dark-adapted pm at room temperature, we consistently find 66-67% 13-cis-retinal and 33-34% all-trans-retinal, and more than 98.5% all-trans isomer in light-adapted samples. The spectrum obtained by reconstitution of bacterioopsin with 13-cis-retinal at 2 degrees C (to minimize isomerization) shows an absorbance maximum at 554 nm and agrees well with the spectrum for the 13-cis component calculated from the dark-adapted and light-adapted bR spectra with our extraction data. The ratio of 13-cis:all-trans isomer in dark-adapted pm is 2:1 and nearly constant between 0 and 38 degrees C but begins to decrease distinctly above 40 degrees C, and more rapidly near 70 degrees C, reaching 0.75 at 90 degrees C. The van't Hoff plot of the isomer ratio shows a nonlinear temperature dependence above 40 degrees C, indicating a more complex system than a simple thermal 13-cis/all-trans isomer equilibrium. We attribute the broadening, absorbance decrease, and blut shift of the visible absorption band with increasing temperature to the appearance of at least one and possibly two or three new chromophores which contain, mainly or exclusively, the all-trans isomer.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteriorhodopsins↗
PubMed1988

The course of asthma during pregnancy, post partum, and with successive pregnancies: a prospective analysis.

We studied 366 pregnancies in 330 prospectively managed women with asthma to determine the effect of pregnancy on asthma. Asthma activity was assessed by (1) daily symptom and medication diaries and (2) monthly auscultation and spirometry during pregnancy and for 3 months post partum. At 3 months post partum, subjects were asked to assess the overall course of their asthma during pregnancy compared to the usual course for them, and the course of their asthma during the 3 months post partum compared to the asthma during pregnancy. Asthma worsened during pregnancy in 35% of the women, improved in 28%, and was unchanged in 33%. Based on diary-card analysis, asthma was significantly less frequent and less severe during the last 4 weeks of pregnancy than during any other gestational interval. In women whose asthma improved during pregnancy, diary-card analysis revealed a gradual improvement with progressive pregnancy, whereas in women whose asthma worsened during pregnancy, there was an increase in asthma symptoms during 29 to 36 weeks gestation. During labor and delivery, asthma symptoms occurred in 10% of women with approximately equal proportions of these women receiving either no treatment or inhaled bronchodilators; only two subjects required intravenous aminophylline. During the 3 months post partum, asthma reverted toward its prepregnancy course in 73% of women. In 34 subjects prospectively studied for two successive pregnancies, there existed a significant concordance between the asthma course during the first and second pregnancies. The mechanistic and clinical implications of these findings are discussed.

Asthma↗