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Valproate is widely used in the treatment of epilepsy, bipolar disorder, and chronic pain disorders, but its exact mechanisms of action is still incompletely understood.
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Transcranial direct current stimulation (tDCS) has been reintroduced as a noninvasive method to guide neuroplasticity and modulate cortical function by tonic stimulation with weak direct currents. Within the last several years, it...
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Transcranial direct current stimulation (tDCS) has been reintroduced as a noninvasive method to guide neuroplasticity and modulate cortical function by tonic stimulation with weak direct currents. Within the last several years, it has received increasing attention as an innovative tool for the treatment of a variety of neurologic and psychiatric diorders.1 Adverse effects have been reported to be rare, mild, and transient under the application of tDCS, according to the present tDCS safety guidelines.2"4 Concerning the skin, contact transient irritations such as light itching, slight burning, mild pain,3 and transient redness4 have been documented.
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The potential of antipsychotic drugs to lower body temperature was known before its antipsychotic efficacy was discovered. Chlorpromazine, the first antipsychotic drug, has been used in anesthesia since 1952 to induce a lowering o...
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The potential of antipsychotic drugs to lower body temperature was known before its antipsychotic efficacy was discovered. Chlorpromazine, the first antipsychotic drug, has been used in anesthesia since 1952 to induce a lowering of body temperature, causing some kind of so-called artificial hibernation. Hyperthermia, a cardinal symptom of malignant neu-roleptic syndrome, was first described in 1960 by Delay et al as a severe and potentially life-threatening adverse drug reaction.
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Background: Repetitive transcranial magnetic stimulation (rTMS) has been proposed for stabilizing the antidepressant effect of sleep deprivation (SD) by preventing the relapse after a night of recovery sleep. In this study, we aim...
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Background: Repetitive transcranial magnetic stimulation (rTMS) has been proposed for stabilizing the antidepressant effect of sleep deprivation (SD) by preventing the relapse after a night of recovery sleep. In this study, we aimed to replicate these data coming from a small pilot study in a larger patient sample. Methods: Thirty-seven patients were randomly assigned to receive either active or sham rTMS on four consecutive days after one night of SD. The majority of the participants had experienced an antidepressant effect of SD in the past. At each rTMS session 1000 stimuli were applied over the left dorsolateral prefrontal cortex at 10 Hz with an intensity of 110% resting motor threshold. For sham stimulation, a sham-coil system was used. Treatment effects were assessed with a modified version of the Hamilton Depression Rating Scale and a self-report well-being scale (BfS) before SD, after SD, during rTMS and 3 days after rTMS. Results: SD led to a highly significant reduction of depressive symptoms in the whole group as reflected by a mean Hamilton Depression Rating Scales score reduction of 56% (with omission of sleep items). In both the active and the sham-stimulated group, the symptom reduction remained stable for the whole observation period. No difference between active and sham rTMS was observed. Conclusions: SD is capable of inducing pronounced antidepressant effects. In contrast to a previous study, active rTMS was not superior to sham rTMS in stabilizing the antidepressant effects of SD, which was mainly due to a pronounced effect in the sham group in this study population.
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Objectives. Neurotoxic effects of alcohol consumption are well-known. There is plenty of literature on frontal lobe impairment on the behavioural and structural brain imaging level. However, only few functional imaging studies inv...
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Objectives. Neurotoxic effects of alcohol consumption are well-known. There is plenty of literature on frontal lobe impairment on the behavioural and structural brain imaging level. However, only few functional imaging studies investigated altered neural patterns and even less abstinence-related neural recovery. Methods. In a cross-sectional design three patient groups (acute withdrawal, detoxified, abstinent) and healthy controls (each n = 20) performed a phonological and semantic verbal fluency task (VFT) while brain activity was measured with near-infrared spectroscopy (NIRS). Results. First, for the phonological condition withdrawal patients and detoxified patients showed less fluency-related frontal lobe activation compared to controls despite equal performance. Second, significant linear trend effects from withdrawal patients over detoxified and abstinent patients up to healthy controls indicated more normal activation patterns in the abstinent group that did not differ significantly from the controls. In the detoxified group brain activation increased with time since detoxification. Conclusions. Our results are compatible with an increase in frontal brain activity from alcohol dependence over abstinence up to normal functioning. However, as cross-sectional designs do not allow to assess causal relations, results have to be considered preliminary and longitudinal studies are needed to further elucidate recovery processes in alcohol dependence.
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Introduction: Venlafaxine (VEN) is a modern antidepressant which exerts both serotonin and norepinephrine reuptake inhibition. In this study we examined the influence of age, sex, smoking, and co-medication on serum levels of VEN ...
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Introduction: Venlafaxine (VEN) is a modern antidepressant which exerts both serotonin and norepinephrine reuptake inhibition. In this study we examined the influence of age, sex, smoking, and co-medication on serum levels of VEN and its metabolite O-desmethylvenlafaxine (ODVEN) in patients treated with VEN under naturalistic conditions. Methods: We retrospectively evaluated 478 TDM analyses of VEN requested in the Pychiatric University Hospitals of Mainz, Regensburg, and Würzburg. The determination of serum levels was performed by virtually identical chromatographic methods in the TDM laboratories of the participating hospitals. Results: Serum levels varied widely on each dose level. Women had about 30% higher dose-corrected serum levels of VEN and ODVEN than men (p<0.01), and patients older than 60 years showed about 46% higher levels of both compounds than younger ones (p<0.01). In smokers, mean serum levels of ODVEN were 21% lower than in non-smokers. Combining these variables a considerable increase of the differences between the subgroups was found indicating an additive effect. ANOVA over the 8 different groups was significant for ODVEN (p<0.01) and sum (p<0.01), but not for VEN (n.s.). Co-medication with other psychotropic drugs was associated with a decreasing ODVEN/VEN ratio indicating a reduced metabolism in patients receiving polypharmacy. Discussion: These findings show that TDM is useful to identify factors affecting the pharmacokinetic properties of VEN. It is concluded that sex, age and smoking should be considered for optimal dosing of patients with VEN.
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We appreciate the comment of Dr. Melcher on our manuscript "Auditory cortex is implicated in tinnitus distress: a voxel-based morphometry study" (Brain Structure and Function; 2013 Feb 24; [Epub ahead of print]). Dr. Melcher point...
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We appreciate the comment of Dr. Melcher on our manuscript "Auditory cortex is implicated in tinnitus distress: a voxel-based morphometry study" (Brain Structure and Function; 2013 Feb 24; [Epub ahead of print]). Dr. Melcher points out in her Letter to the Editor that we did not cite her study. She and her co-workers found no structural differences between the participants who had tinnitus and those of a matched control group. In a subsequent analysis of the same sample, they found that hearing threshold in the high-frequency range may represent a potentially significant third variable that may explain some of the variance in voxel-based morphometry (VBM) studies of tinnitus.
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A large part of the literature of functional near-infrared spectroscopy (fNIRS) deals with overt verbal fluency. It has been claimed that fNIRS has a low susceptibility to movement related artefacts as, for example, associated wit...
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A large part of the literature of functional near-infrared spectroscopy (fNIRS) deals with overt verbal fluency. It has been claimed that fNIRS has a low susceptibility to movement related artefacts as, for example, associated with overt speech. However, so far, no study has investigated this assumption in an experimental design. Therefore, we examined a group of 16 healthy subjects during performance of two verbal fluency tasks (experiment 1: phonological fluency; experiment 2: semantical fluency, paced answers, pronouncing vs. writing). We measured changes of oxygenated (O(2)Hb) and deoxygenated haemoglobin (HHb) over fronto-temporal (brain) areas via fNIRS, while temporalis muscle activity was simultaneously assessed by means of electromyography (EMG). Statistical analyses indicated comparable word production, higher increases of O(2)Hb and higher decreases of HHb over fronto-temporal areas during word fluency in contrast to the control task weekday reciting. This fNIRS pattern indicates fluency related activation and was found for pronouncing and for writing in both experiments. Regarding the EMG data, fluency related activity was only found for pronouncing, not for writing. Thus, muscle activity cannot account for fluency related fNIRS activity during writing. Additionally, correlation analyses showed no systematic associations of fNIRS and EMG signals. In conclusion, we found arguments that fNIRS actually allows for the measurement of brain activity over fronto-temporal areas during verbal fluency. Nonetheless, further studies should evaluate more direct associations between fNIRS and EMG signals by specific experimental manipulations and data analysing approaches that allow dealing fNIRS and EMG raw data simultaneously.
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OBJECTIVE: Hypersensitivity to electromagnetic fields is frequently claimed to be linked to a variety of unspecific somatic and/or neuropsychological complaints. Whereas provocation studies often failed to demonstrate a causal rel...
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OBJECTIVE: Hypersensitivity to electromagnetic fields is frequently claimed to be linked to a variety of unspecific somatic and/or neuropsychological complaints. Whereas provocation studies often failed to demonstrate a causal relationship between electromagnetic field exposure and symptom formation, neurophysiological examinations highlight baseline deviations in people claiming to be electrosensitive. METHODS: To elucidate a potential role of dysfunctional cortical regulations in mediating hypersensitivity to electromagnetic fields, cortical excitability parameters were measured by transcranial magnetic stimulation in subjectively electrosensitive patients (n=23) and two control groups (n=49) differing in their level of unspecific health complaints. RESULTS: Electrosensitive patients showed reduced intracortical facilitation as compared to both control groups, while motor thresholds and intracortical inhibition were unaffected. CONCLUSIONS: This pilot study gives additional evidence that altered central nervous system function may account for symptom manifestation in subjectively electrosensitive patients as has been postulated for several chronic multisymptom illnesses sharing a similar clustering of symptoms.
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Tinnitus, the phantom perception of sound, is a frequent disorder that causes significant morbidity. The pathophysiological mechanisms involved in tinnitus generation are still under exploration. Electrophysiological and functiona...
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Tinnitus, the phantom perception of sound, is a frequent disorder that causes significant morbidity. The pathophysiological mechanisms involved in tinnitus generation are still under exploration. Electrophysiological and functional neuroimaging studies give increasing evidence for abnormal functioning both within the central auditory system and in non-auditory brain areas. However, observed changes show great variability, hence lacking a conclusive picture. Recently, structural alterations in the central nervous system have been detected in tinnitus patients by voxel-based morphometry (VBM). Here we aimed to replicate these findings in an independent study sample. We performed structural MRI scans in 28 tinnitus patients with normal audiometry and used VBM to compare results with a control group, matched for age, sex and hearing status. As major results we found significant grey matter decreases in the tinnitus group in the right inferior colliculus and in the left hippocampus. However, neither changes in the subcallosal area nor in the thalamus as described recently have been observed. Our results underscore that (1.) VBM allows to detect structural alterations in tinnitus patients, which seem to be related to tinnitus pathophysiology. (2.) Both, areas in the auditory and the limbic system are involved giving further evidence for the important role of the limbic system in the pathophysiology of tinnitus. (3.) Even groups with similar clinical characteristics might differ in the underlying neurobiological changes.
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