Neurochemical substrates and neuroanatomical generators of the event-related P300

The present review focuses on the current knowledge of the neurochemical processes and neuronal structures involved in the generation of P300. The increasing knowledge in this area facilitates the physiological interpretation of P300 findings as well as the link between P300 research and other research findings in biological psychiatry. Concerning the question of neurochemical substrates, the glutamatergic, GABAergic, cholinergic, noradrenergic, dopaminergic and serotonergic influences on P300 are reviewed. The knowledge of the generating structures of P300 is summarized from intracranial studies, magnetoencephalographic investigations, lesion and animal studies

Platelet monoamine oxidase activity in alcoholics with and without a family history of alcoholism

A number of studies point at platelet monoamine oxidase (MAO) activity being reduced in alcoholics with a family history of drinking, this being a possible vulnerability marker for alcoholism. To test this hypothesis, we examined a group of recently detoxified alcoholics with high (n = 25) and low genetic loading for alcoholism (n = 28) and a group of healthy controls (n = 21). Clinical assessments were made using the SCID II interview for psychiatric disorders, the Family History Assessment Module and the Semi-Structural Assessment of Genetics in Alcoholism, a questionnaire especially designed for genetic studies. Platelet MAO activity with and without ethanol stimulation and the percentage of MAO activity with ethanol did not differ between groups. The only significant difference was a lower inhibition of MAO activity with ethanol in alcoholics both with and without a family history compared to controls. In patients with antisocial personality traits, platelet MAO activity was also not found to be different from other alcoholics. Our findings question the hypothesis of reduced platelet MAO activity to be a possible vulnerability marker for alcoholism. Copyright (C) 2000 S. Karger AG. Basel

Lithium-induced EEG changes in patients with affective disorders

In 12 patients with affective disorders (ICD-10: F31, F32, F33), EEGs were recorded before and after 4.4 months of lithium treatment. Effects of lithium on the EEG were analyzed by power spectral analysis controlled for vigilance. We found (1) an increase in relative power in both delta and theta band which was related to the lithium plasma level, (2) a decrease in relative alpha power especially at occipital leads and (3) a reduction of the dominant alpha frequency. The changes in relative power were more pronounced in the right hemisphere, which is in contrast to the hypothesis of a site-specific localization of lithium effects only in left anterior regions. Copyright (C) 2000 S. Karger AG,Basel

Kinematic analysis of handwriting movements in patients with Alzheimer's disease, mild cognitive impairment, depression and healthy subjects

A variety of studies have demonstrated that motor disorders, parkinsonism and extrapyramidal motor symptoms (EPMS) are common in patients with Alzheimer's disease (AD). Several studies have reported an association of EPMS with severity, progression and poor prognosis of AD. The majority of these studies used clinical assessments for the rating of EPMS. In this study, kinematic handwriting analysis was used to quantify differences in fine hand motor function in patients with probable AD and mild cognitive impairment (MCl, as an assumed initial stage of AD) compared to depressed patients and healthy controls. Both patients with MCl and patients with probable AD exhibited loss of fine motor performance. Movements of AD patients were significantly less regular than those of healthy controls. Copyright (C) 2003 S. Karger AG, Basel

Periodic motor impairments in a case of 48-hour bipolar ultrarapid cycling before and under treatment with valproate

Motor impairments of psychiatric patients can be assessed with digital recordings of handwriting tasks. The investigation of patients with bipolar affective disorders differentiates intraindividual changes related to the patient's fluctuating affective states. An unmedicated 67-year-old male with 48-hour bipolar ultrarapid cycling was investigated during 8 consecutive days of ultrarapid cycling and 4 weeks later, after remission under treatment with valproate. The handwriting skills of the patient followed the same rhythmic changes of the psychopathology in the first part of the study and a steady pattern in the second phase, after remission. Therefore, it can be assumed that the handwriting skills reflect a state marker of the disease. Poorer handwriting skills on the manic days, as compared to the depressive ones, support the hypothesis of a low arousal in manic patients. Copyright (C) 2000 S. Karger AG, Basel

Facial expressions and personality: A kinematical investigation during an emotion induction experiment

Background/Aims: In order to elucidate the relationship between personality traits and expression of positive emotions in healthy volunteers, standardized personality inventories and kinematical analysis of facial expressions can be helpful and were applied in the present study. Methods: Markers fixed at distinct points of the face emitting ultrasonic signals at high frequency gave a direct measure of facial movements with high spatial-temporal resolution. Forty-six healthy participants (mean age: 40.7 years; 20 males, 26 females) watching a witty movie ('Mr. Bean') were investigated. Results: Speed of `laughing' was associated with higher scores on Zuckerman's Sensation Seeking Scale and NEO-FFI (Openness to Experience). Conclusion: Kinematical analysis of facial expressions seems to reflect sensation seeking and related personality styles. Higher speed of facial movements in sensation seekers suggests lowered serotonergic function. Copyright (c) 2006 S. Karger AG, Basel

Additive Effekte kombinierter Psycho- und Pharmakotherapie für depressive Patienten: Illusion oder Tatsache?

This article qualitatively reviews the comparative efficacy of pharmacotherapy and psychotherapy vs either modality alone. Recent results are confirming AHCPR statements, that, on the basis of current data, in acute treatment of Major Depressive Disorders (MDD), the routine use of both psychotherapy and pharmacotherapy is not warranted. But a methodologically outstanding study from the work-group around Frank shows that, in longterm treatment of MDD-patients, combined psycho-pharmaocotherapy is superior compared to interpersonal psychotherapy alone, but not compared to tricyclics alone. In two settings patients might benefit substantially from a combination treatment compared to both psychotherapy and pharmacotherapy alone: 1) Acute and long-term treatment of more severe chronic depression, and 2) long-term treatment of elderly MDD-patients. More severely depressed MDD-patients profit more and faster if treated with combined psycho-pharmacotherapy compared compared to psychotherapy alone

Are Treatment Preferences Relevant in Response to Serotonergic Antidepressants and Cognitive-Behavioral Therapy in Depressed Primary Care Patients? Results from a Randomized Controlled Trial Including a Patients' Choice Arm

Background Little is known about the influence of depressed patients' preferences and expectations about treatments upon treatment outcome We investigated whether better clinical outcome in depressed primary care patients is associated with receiving their preferred treatment Methods Within a randomized placebo-controlled single-centre 10-week trial with 5 arms (sertraline, placebo, cognitive-behavioral group therapy, CBT-G, moderated self-help group control, treatment with sertraline or CBT-G according to patients' choice), outcomes for 145 primary care patients with mild-to-moderate depressive disorders according to DSM-IV criteria were investigated Preference for medication versus psychotherapy was assessed at screening using a single item Post-baseline difference scores for the Hamilton Depression Rating Scale (HAMD-17) were used to assess treatment outcome (mixed-model repeated-measures regression analysis) Results Depressed patients receiving their preferred treatment (n = 63), whether sertraline or CBT-G, responded significantly better than those who did not receive their preferred therapy (n = 54, p = 0 001) The difference in outcome between both groups was 8 0 points on the HAMD-17 for psychotherapy and 2 9 points on the HAMD-17 for treatment with antidepressants Results were not explained by differences in depression severity or dropout rates Conclusions Patients' relative preference for medication versus psychotherapy should be considered when offering a treatment because receiving the preferred treatment conveys an additional and clinically relevant benefit (HAMD-17 +2 9 points for drugs, +8 0 points for CBT-G) in outcome Copyright (C) 2010 S Karger AG Base