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

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

Death Anxiety and Depression in Amyotrophic Lateral Sclerosis Patients and Their Primary Caregivers

Background: Given the lethal severity of amyotrophic lateral sclerosis (ALS), the aim of this study was to illuminate the coherence of depression and death anxiety in both ALS patients and caregivers and in how far patients and caregivers are influenced by the mindset of their respective counterpart.Methods: 30 couples of patients (mean age 60.57; 13 women, 17 men) and primary caregivers (mean age 57.33; 16 women, 14 men) were included into the study. Death anxiety was assessed using the newly developed BOFRETTA scale, depression via Beck Depression Inventory, anxiety by means of State Trait Anxiety Inventory and caregivers' exertion using the Caregiver Strain Index. Patients' impairment was assessed with the ALS functional rating scale.Results: We found that while death anxiety was related to depression in both patients and caregivers, death anxiety was related to anxiety only in patients. Caregiver strain correlated with both caregiver‘s depression and anxiety. Moreover, patients' and caregivers’ depression, anxiety and death anxiety correlated to the ones of their counterpart.Conclusion: These results suggest that despite little depressive symptoms in ALS patients the fatal prognosis of the disease takes into account, depression and death anxiety influence each other and might be addressed together in pharmacological and especially psychotherapeutic interventions to the benefit of the patient. Medical professionals should not forget to offer sufficient support to caregivers tending patients affected by depression and death anxiety as they are likely to mirror their patient's feelings

Understanding Another Person's Emotions—An Interdisciplinary Research Approach

An interdisciplinary research perspective is developed concerning the question of how we understand others' emotions and how reliable our judgment about others' emotion can be. After an outline of the theoretical background of emotions, we briefly discuss the importance of prior experiences and context information for the recognition of emotions. To clarify this role, we describe a study design, utilizing emotional expressions and context information while controlling for prior experiences and the actual emotional situation to systematically approach these questions

Cooperation and Deception Recruit Different Subsets of the Theory-of-Mind Network

The term “theory of mind” (ToM) describes an evolved psychological mechanism that is necessary to represent intentions and expectations in social interaction. It is thus involved in determining the proclivity of others to cooperate or defect. While in cooperative settings between two parties the intentions and expectations of the protagonists match, they diverge in deceptive scenarios, in which one protagonist is intentionally manipulated to hold a false belief about the intention of the other. In a functional magnetic resonance imaging paradigm using cartoons showing social interactions (including the outcome of the interaction) between two or three story characters, respectively, we sought to determine those brain areas of the ToM network involved in reasoning about cooperative versus deceptive interactions. Healthy volunteers were asked to reflect upon the protagonists' intentions and expectations in cartoons depicting cooperation, deception or a combination of both, where two characters cooperated to deceive a third. Reasoning about the mental states of the story characters yielded substantial differences in activation patterns: both deception and cooperation activated bilateral temporoparietal junction, parietal and cingulate regions, while deception alone additionally recruited orbitofrontal and medial prefrontal regions. These results indicate an important role for prefrontal cortex in processing a mismatch between a character's intention and another's expectations as required in complex social interactions

Suicidal behaviour in the social environment: Does exposure moderate the relationship between an individual's own suicidal ideation and behaviour?

Introduction: Suicidal behaviour still cannot be sufficiently predicted. Exposure to suicidal behaviour in the personal social environment is assumed to moderate the individual's transition from suicidal ideation to suicidal behaviour within the integrated motivational-volitional model of suicidal behaviour (IMV model). This study aimed to investigate this moderating effect in a German high-risk sample. Methods: We interviewed 308 psychiatric inpatients (53% female) aged 18 to 81 years (M = 36.9, SD = 14.30) admitted after attempted suicide (53%) or due to an acute suicidal crisis (47%) regarding exposure events in their social environment. Four types of exposure events were analysed using moderation analyses: familial suicides/suicide attempts and non-familial suicides/suicide attempts. Additionally, the numbers of reported exposure events were compared between patients with and without a recent suicide attempt as well as between patients with lifetime suicide attempts and lifetime suicidal ideation. Results: Neither moderating effects of exposure events on the relationship between lifetime suicidal ideation and recent suicidal behaviour nor group differences between suicidal ideators and suicide attempters regarding the exposure events were found. Conclusions: Exposure events might have differential and possibly protective effects on suicidal behaviour-depending on type and quality (intensity, personal relevance and recency) of event-and on the outcome (suicide vs. suicide attempt)

Prediction of Treatment Outcome in Patients with Obsessive-Compulsive Disorder with Low-Resolution Brain Electromagnetic Tomography: A Prospective EEG Study

The issue of predicting treatment response and identifying, in advance, which patient will profit from treating obsessive-compulsive disorder (OCD) seems to be an elusive goal. This prospective study investigated brain electric activity [using Low-Resolution Brain Electromagnetic Tomography (LORETA)] for the purpose of predicting response to treatment. Forty-one unmedicated patients with a DSM-IV diagnosis of OCD were included. A resting 32-channel EEG was obtained from each participant before and after 10 weeks of standardized treatment with sertraline and behavioral therapy. LORETA was used to localize the sources of brain electrical activity. At week 10, patients were divided into responders and non-responders (according to a reduction of symptom severity > 50% on the Y-BOCS). LORETA analysis revealed that at baseline responders showed compared to non-responders a significantly lower brain electric activity within the beta 1 (t = 2.86, p < 0.05), 2 (t = 2.81, p < 0.05), and 3 (t = 2.76, p < 0.05) frequency bands and ROI analysis confirmed a reduced activity in alpha 2 (t = 2.06, p < 0.05) in the anterior cingulate cortex (ACC). When baseline LORETA data were compared to follow-up data, the analysis showed in the responder group a significantly lower brain electrical resting activity in the beta 1 (t = 3.17. p < 0.05) and beta 3 (t = 3.11. p < 0.05) frequency bands and equally for the ROI analysis of the orbitofrontal cortex (OFC) in the alpha 2 (t = 2.15. p < 0.05) frequency band. In the group of non responders the opposite results were found. In addition, a positive correlation between frequency alpha 2 (rho = 0.40, p = 0.010), beta 3 (rho = 0.42, p = 0.006), delta (rho = 0.33, p = 0.038), theta (rho = 0.34, p = 0.031), alpha 1 (rho = 0.38, p = 0.015), and betal (rho = 0.34, p = 0.028) of the OFC and the bands delta (rho = 0.33, p = 0.035), alpha 1 (rho = 0.36, p = 0.019), alpha 2 (rho = 0.34, p = 0.031), and beta 3 (rho = 0.38, p = 0.015) of the ACC with a reduction of the Y-BOGS scores was identified. Our results suggest that measuring brain activity with LORETA could be an efficient and applicable technique to prospectively identify treatment responders in OCD

ARE ROUTINE METHODS GOOD ENOUGH TO STAIN SENILE PLAQUES AND NEUROFIBRILLARY TANGLES IN DIFFERENT BRAIN REGIONS OF DEMENTED PATIENTS?

Introduction: Numerous clinical cases have been reported showing the clinical picture of dementia but not meeting the neuropathological criteria for Alzheimer’s dementia (AD). Different methods used to stain senile plaques (SPs) and neurofibrillary tangles (NFTs) might account for this discrepancy. Subjects and methods: Here, brains of 11 patients with dementia were examined. Cryosections and paraffin sections from 6 different brain regions (frontal medial, temporal medial and occipital gyrus, hippocampus, superior parietal lobe and cerebellum) of all cases were stained with Bielschowsky, Campbell, Gallyas and Congo red stains each. Results: The study shows that the Bielschowsky silver stain is insufficient for detecting SPs and NFTs, whereas two other methods proved to be more accurate. SPs were found in similar frequency in all brain regions examined (exception: cerebellum). The highest amount was shown with Campbell silver stain in paraffin sections. In Congo red only 25 percent of these SPs were stained, which is probably due to a great number of them not containing any amyloid. NFTs were found almost exclusively in the hippocampus. The highest number was detected with Gallyas silver stain in cryosections. Conclusion: These results may suggest that Campbell stain for SPs and Gallyas stain for NFTs should be the methods routinely used