-
[show abstract]
[hide abstract]
ABSTRACT: According to the Seligman theory of learned helplessness, depression is caused by a repetitive experience of loss of control resulting in internal, stable and global attributional styles for negative events. In depressed patients and healthy controls experiencing such events, an increased amplitude of the post-imperative negative variation (PINV) has been described. The aim of the study was to investigate a possible correlation between migraine, depression, learned helplessness and PINV. 24 patients suffering from migraine without aura and 24 healthy controls were exposed to a situation of loss of control whilst the contingent negative variation (CNV) from C3, C4 and Cz were recorded. Before conducting the experiment, the subjects were asked to answer the Beck Depression Inventory (BDI) and the German attributional style questionnaire (GASQ). Amplitudes of total CNV, early and late component and PINV were calculated in eight blocks of four recordings each. The results confirm findings of a pronounced PINV in situations of loss of control, though high amplitudes were not correlated with low values in the GASQ and therefore with learned helplessness. High PINV in migraine patients correlated with high scores in the BDI and the list of the complaints questionnaire. However, this was not the case in healthy controls. In this experimental situation, PINV in migraine patients can be interpreted as an expectancy potential in order to avoid failure and helplessness.
Acta Neurovegetativa 06/2012; 119(10):1213-21. · 2.73 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study examined the combined effects of methylphenidate (MPD) and response cost and token strategy (RCT), administered in an intensive ADHD Summer Camp Training (ASCT) format, on neuropsychological functions. Forty children with ADHD were randomly assigned to either the ASCT treatment (MPD plus RCT) or a control group (MPD plus a 1-hour session of standardized parental education/counselling [SPC]). This latter group was structured to be similar to the more typical current treatment. The ASCT treatment was administered for 2½ weeks and included RCT, consisting of elements of social skill training, attention training, and sports participation. RCT was systematically applied in all daily situations and activities. Executive functions and state of regulation using the Test for Attention Performance (TAP) and the Trail-Making Test (TMT) were assessed before training and at a 6-month follow-up. Participants receiving the ASCT improved specific neuropsychological functions in attention regulation and inhibitory control tasks at the 6-month follow-up. No changes occurred for participants assigned to the control condition. The data suggest that an intensive multimodal summer camp treatment program including strategies of instrumental learning can lead to substantial and enduring improvements in neuropsychological functioning of children and adolescents with ADHD.
Child Neuropsychology 05/2012; 18(3):242-255. · 1.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Cortical attention and habituation parameters are altered in patients suffering from tinnitus. The aim of the study was to quantify cortical attention and habituation parameters in tinnitus patients by recording the contingent negative variation (CNV) response and to correlate amplitudes of different CNV parameters with duration of disease. Twenty patients suffering from tinnitus (median: 44 years) and twenty age- and sex-matched healthy controls (median: 41 years) were tested by a CNV paradigm. We recorded overall CNV, initial CNV, and terminal CNV and calculated habituation slopes. All CNV parameters were Spearman-correlated with individual duration of disease. Highly significant between groups differences emerged in total (tinnitus: -8.4 uV vs. controls: -3.8 uV), initial (-11.2 vs. -6.0 uV), and terminal CNV (-11.9 vs. -6.5 uV) demonstrating higher negative amplitudes in tinnitus patients. Habituation differed in total and terminal CNV, indicating missing habituation in tinnitus patients. Overall CNV (ϱ = -.365) and initial CNV (ϱ = -.529) showed a medium Spearman correlation with duration of disease. We conclude that the correlation between duration of tinnitus and the initial CNV amplitudes indicates an altered state of cortical excitability that can also be observed in more negative CNV-amplitudes in tinnitus patients. We assume that this state indicates a chronicity process in tinnitus disease.
Applied Psychophysiology and Biofeedback 03/2012; 37(3):187-93. · 1.13 Impact Factor
-
Michael Siniatchkin,
Nora Glatthaar,
Gabriele Gerber von Müller,
Alexander Prehn-Kristensen,
Stephan Wolff,
Silja Knöchel,
Elisabeth Steinmann,
Anna Sotnikova,
Ulrich Stephani,
Franz Petermann, Wolf-Dieter Gerber
[show abstract]
[hide abstract]
ABSTRACT: Response cost and token approach (RCT) within the scope of a summer camp training is an effective treatment program for attention deficit hyperactivity disorder (ADHD). It is likely that intensive RCT training influences networks responsible for ADHD symptoms. Functional magnetic resonance imaging (fMRI) was carried out in 12 children with ADHD before and after the RCT program and in 12 healthy control children twice. For fMRI, a Go/No-go paradigm was used to investigate the influence of RCT training on attention and impulsivity. The No-go condition revealed only weak activation in the dorsal part of the anterior cingulate cortex (ACC), parietal and dorsolateral prefrontal cortex (DLPFC) before the training in children with ADHD compared to healthy children. However, this activation in these brain regions was significantly more pronounced after the training. This increase in hemodynamic response cannot be attributed merely to repetition of the measurement since the effect was not observed in healthy children. The increase in hemodynamic response in the ACC and right DLPFC was significantly associated with a reduction in response time variability and clinical symptoms in ADHD patients. After the RCT training, the children with ADHD demonstrated more pronounced activation of cortical structures which are typically related to response monitoring and self-control. It seems likely that children with ADHD learned more cognitive control in a continuous performance task as was revealed by both neuropsychological outcome and fMRI.
Brain Topography 03/2012; 25(3):332-44. · 3.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In the present study, the possibility of component-specific self-regulation of the contingent negative variation (CNV) and the functional significance of the iCNV (initial or early CNV component) and tCNV (terminal or late CNV component) were investigated in twenty-four healthy volunteers. The subjects were able to achieve control over a particular CNV component within four sessions. Regulation of the tCNV was more successful than for the iCNV. Specific control over iCNV was associated with strategies mainly related to the pre-stimulus interval or the warning stimulus (S1), while regulation of the tCNV was assigned to activities during the whole interstimulus interval or around the imperative stimulus (S2). It can be concluded that component-specific regulation of the CNV can be used in studies of the psychophysiological meaning of this potential, representing different stages of information processing. The role of cortical pre-activation in the generation of the iCNV and the phasic performance-directed activation of the tCNV can be hypothesized.
Applied Psychophysiology and Biofeedback 03/2011; 36(1):15-25. · 1.13 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Migraine is a disorder of central information processing which may be characterized by increased amplitudes and reduced habituation of evoked and event-related potentials. In this pilot study, special behavioural training of habituation to aversive stimuli (MIPAS-Family = Migraine Patient Seminar for Families) was developed and proven effective in children suffering from migraine without aura.
13 children with migraine participated in the MIPAS-Family programme and 13 other children with migraine were treated with biofeedback. The influence of both treatments on abnormal cortical information processing in migraine was assessed using recordings of the contingent negative variation (CNV), an event-related slow cortical potential.
Both MIPAS training and biofeedback caused an equal reduction of migraine frequency and severity. However, MIPAS treatment was associated with a significant increase in iCNV habituation. Changes in the clinical course of migraine correlated positively with normalization of habituation: the greater the reduction in headache frequency, the greater the increase in CNV habituation was. These effects were not observed in the biofeedback group.
This study demonstrates that the specific treatment programme which was evolved from knowledge of pathogenetic mechanisms of migraine influences central information processing and leads to a clinical effect.
Cephalalgia 11/2010; 31(5):562-72. · 3.43 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Several meta-analyses have demonstrated that the combination of electrical muscle activity and Temperature Biofeedback could be regarded as gold standard in chronic pediatric headaches. However, these techniques seem to be uneconomical and furthermore they are not directed to improve the social competence as well as resolve possible impairments in daily activities of the child. Therefore, multi-modal behavioral techniques have been proposed, but no studies comparing these with the gold standard were conducted. The present study compared the impact of a new multi-modal behavioral education and training program--MIPAS-Family--with a combined Biofeedback treatment, evaluating clinical efficacy as well as the effect on the quality of life (QoL) of children with chronic headaches. Thirty-four children and adolescents with recurrent headache, ranging from 7 to 16 years, were randomly assigned to the MIPAS-Family (N = 19) or the Biofeedback (N = 15) condition. All patients were diagnosed by the criteria of the International Headache Society. The children and their parents completed headache diaries, diaries of daily living activities and a QoL questionnaire (KINDL). Both groups showed significant improvements concerning the headache intensity and headache duration. We found no significant differences in the main headache parameters between both treatments. After the treatments, the children were less disturbed by their headaches in the domains school, homework, and leisure time. In conclusion, MIPAS-Family is as effective as Biofeedback but it is more cost-effective and addresses the whole family and the daily activities.
The Journal of Headache and Pain 04/2010; 11(3):215-25. · 2.43 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: It has been hypothesized that abnormalities of information processing in migraine may be attributed to impairment of cerebral maturation. However, the most evidences for this hypothesis have come from cross-sectional studies during childhood. We performed a longitudinal study and recorded contingent negative variation (CNV), an event-related slow cortical potential, in migraine children (n = 27) and age-matched healthy individuals (n = 23) in 1998 and 8 years later (2006). Amplitudes of all CNV components were reduced and habituation of the initial CNV (iCNV) increased in the observed time. However, the reduction of the iCNV amplitude was more pronounced in migraine patients who were in remission in 2006 and in healthy subjects and less pronounced in migraineurs with persisting headaches. Patients with the worsened migraine demonstrated the most pronounced loss of iCNV habituation in 1998 and significantly increased iCNV amplitudes in 2006. This longitudinal study supports the hypothesis of impaired cerebral maturation in migraine and shows that migraine manifestation is a key factor interfering with the natural maturation process of central information processing.
The Journal of Headache and Pain 12/2009; 11(2):105-13. · 2.43 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Migraine patients are characterized by increased amplitudes and reduced habituation of the contingent negative variation (CNV) response, especially before a migraine attack. As shown previously, migraine provoking and precipitating agents can cause CNV abnormalities. However, it is unclear whether the temporal relation to the migraine attack determines how the brain reacts to a migraine precipitant. In this study, experimentally-induced achievement stress, one of the typical precipitants for migraine, was examined for its effects upon the CNV response. CNV was recorded during conditions of rest and stress, both before and after a migraine attack, as well as during a headache-free interval. The neurophysiological reactivity to stress in migraineurs was compared with those of healthy subjects. Before a migraine attack, migraine patients demonstrated significantly more pronounced neurophysiological reactivity to stress: the amplitude of the early CNV component was more increased and its habituation was more reduced in the stress condition, especially 1-3 days before an attack compared with changes of CNV amplitudes and habituation under stress obtained after an attack, during the headache-free interval, or in healthy controls. The study demonstrates that the brain of migraine patients is characterized by increased susceptibility to migraine provoking agents before an actual attack.
Neuroscience Letters 06/2006; 400(1-2):121-4. · 2.11 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Psychophysiological data support the concept that migraine is the result of cortical hypersensitivity, hyperactivity, and a lack of habituation. There is evidence that this is a brain-stem related information processing dysfunction. This cortical activity reflects a periodicity between 2 migraine attacks and it may be due to endogenous or exogenous factors. In the few days preceding the next attack slow cortical potentials are highest and habituation delay experimentally recorded during contingent negative variation is at a maximum. These striking features of slow cortical potentials are predictors of the next attack. The pronounced negativity can be fed back to the patient. The data support the hypothesis that a change in amplitudes of slow cortical potentials is caused by altered habituation during the recording session. This kind of neurofeedback can be characterized as "empirically based" because it improves habituation and it proves to be clinically efficient.
Applied Psychophysiology and Biofeedback 10/2002; 27(3):203-13. · 1.13 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of the study was the determination of the relationships between neurophysiological and psychosocial factors within the pathogenesis of migraine.
The contingent negative variation (CNV), parent-child interactions and theirs relationship were investigated in 30 families with a migraine child and 20 healthy families.
(1) None of the groups of children, independent of diagnosis, differed according to amplitude or habituation of the CNV. (2) Parents from migraine families exerted significantly more control over migraine children compared with interactions with healthy brothers/sisters. (3) The strong relation between CNV habituation/amplitude and abnormal pattern of parent-child interactions (especially overwhelming dominance and control) was found only for young migraineurs. This relation was not seen in healthy families or for healthy siblings of migraine children.
This study provides significant evidence for a strong influence of family interactions on the development and maintenance of neurophysiological abnormalities in the migraineous headache. The role of psychosocial factors in the etiopathogenesis of migraine has to be investigated in further studies in more detail.
Journal of Psychosomatic Research 05/2002; 52(4):215-22. · 3.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Migraine is a familial disorder. The aim of this study was to compare the relationship between specific neurophysiologic pathogenetic mechanisms of migraine such as abnormal information processing and enhanced cortical excitability on the one hand, and parent-child-interactions and personality traits such as neuroticism and extraversion on the other hand in migraine and healthy families. The correlation and factor analyses demonstrated that the stronger the control over a child and the more intensive the suppression of a child's independence by a parent during a stressful situation in migraine families, the more pronounced the loss of habituation of the contingent negative variation (CNV), and the greater the neuroticism in a migraine child. The CNV amplitude was independent of psychosocial conditions in the family but represented similarities in information processing between parents and their children suffering from migraine. This could be possibly explained by genetic influences on information processing in migraine. In healthy families only the relationship between parameters of parent-child-interaction could be observed. This investigation demonstrates that the neurophysiological disposition to a migraine attack as well as personality traits in migraine could be influenced by psychosocial factors such as parent-child interactions and that different parameters of information processing in headache patients are related to either non-genetic familial conditions (habituation) or functional genetic factors (amplitude).
Praxis der Kinderpsychologie und Kinderpsychiatrie 04/2002; 51(3):194-208. · 0.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Reliability parameters of a test indicate the stability (and quality) of the test itself. Reliability coefficients greater than 0.70 suggest an attribute as being sufficiently stable over time to be characterized as a trait. Reliability parameters of contingent negative variation (CNV) amplitudes in 27 healthy individuals were determined using a test-retest design. CNV was recorded at Cz, with an interstimulus interval of 3 s, on 2 separate occasions: initial session and 10 days later. Correlation coefficients between the 2 recording sessions were 0.675 for the total-CNV (tCNV), 0.855 for the early component (iCNV), 0.631 for the late component (lCNV), and 0.420 for the post-imperative negative variation (PINV). Statistical retest parameters for Spearman Brown were 0.806 for tCNV, 0.922 for iCNV, 0.774 for lCNV, and 0.655 for PINV. The iCNV, more than the other parameters, remained stable over the period of 10 days. It is suggested that the described standardized CNV recording procedure ensures reproducible and stable results in healthy subjects.
Applied Psychophysiology and Biofeedback 02/2000; 25(1):33-41. · 1.13 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Die Angaben zur Wirksamkeit verschiedener Migräneprophylaktika und nichtmedikamentöser Behandlungsverfahren schwanken in der
Literatur erheblich. Ein wesentlicher Grund dafür liegt in der Uneinheitlichkeit der verwendeten Forschungsmethoden. Dieser
Beitrag diskutiert die verschiedenen methodischen Ansätze bei der Planung und Durchführung von klinischen Therapiestudien
bei chronischen Kopfschmerzen. Ausgehend von versuchsplanerischen Überlegungen werden traditionelle Gruppenexperimente und
deren implizite Forderungen (Doppelblind-Experimente, Placebokontrolle, Randomisierung) in Frage gestellt. Einzelfallanalytische
Verfahren werden als mögliche methodische Alternative vorgestellt. Dabei werden spezifische Effizienzkriterien operational
definiert. Der Vorteil von zeitreihenanalytischen Auswertungsverfahren insbesonderen bei Verlaufsmessungen mittels Kopfschmerztagebücher
wird aufgezeigt. Der Beitrag soll Möglichkeiten der Anlage von Kopfschmerzstudien aufzeigen und zugleich zur Vereinheitlichung
und Transparenz in der Kopfschmerzforschung anregen.
A review of studies on migraine therapy shows a large heterogeneity in the clinical evaluation of different drugs and behavioral
approaches. The percentages of efficacy of beta-blockers or behavior therapy (relaxation, biofeedback) range from 30% to 80%.
Methodological differences from one author to another in the design and conduct of the studies might be causes of this variation.
For both clinical practice and empirical research (e.g. replication of treatment studies) an uniformity in the application
of different methodological techniques should be sought. This paper discusses the influence of methodological aspects on the
success rates of treatment for chronic headaches, especially migraine. We question the present practice of applying traditional
group experiments in headache research. Double-blind and placebo-controlled studies are often required, but this demand often
cannot be niet in empirical reality because of the individuality of the patient or the heterogeneity of the symptoms. We discuss
some alternative approaches that could be used in empirical research on headache therapy. The application of single-case experiments
as well as methods of time-series analysis are described as a more appropriate approach to the evaluation of studies on chronic
headaches.
Der Schmerz 04/1987; 1(2):81-91. · 0.88 Impact Factor
-
Verhaltenstherapie 08/1970; 18(4):247-255. · 0.59 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: During the pain-free interval migraine patients display increased negative amplitudes in recordings of slow cortical potentials compared to healthy controls. This fact can be linked to diminished or absent habituation during the recording session. This difference in amplitude and habituation is at its maximum the day before the migraine attack. After the attack, amplitudes and habituation course are comparable with those of healthy controls. This observation enables the migraine patient to predict the next migraine attack and to become acquainted with other symptoms which indicate an imminent attack and which can be present one or two days before it. During this period, when the attack has begun but the pain has not yet developed, novel therapeutic strategies for preventing the full-blown attack can be introduced. These "pre-emptive" strategies--which may include intake of tranquillizers to reduce the high cortical arousal, but also non-medical relaxation methods--constitute neither acute treatment (because there is no acute pain) nor prophylaxis.
Functional neurology 20(4):193-7. · 1.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Neurophysiologic studies suggest that migraineurs without aura have a dysfunction of cortical information processing in the pain-free interval. In this study, the advanced method of nonlinear multielectrode sleep-EEG analysis is used to investigate changes of cortical activity in the preictal time span. Five patients (four women, one man; age range, 29 to 58 years) experiencing migraine without aura participated in the study. The patients spent two blocks in the sleep laboratory. The first block was taken in a headache-free interictal time interval, and the second block when the onset of a migraine attack was most likely. After a nocturnal migraine attack, the patient was asked to mark the maximum of migraine pain in a surface-head scheme. The comparison of preictal and interictal EEGs enabled the authors to obtain a topographical view of changes in cortical dynamics. In each patient map, an area was found that displayed a pronounced focus indicating the region of maximum change in dimensional complexity. It shows a clearly recognizable correspondence with the scalp topography of the later pain perception. These findings indicate an association between cortical status and pain lateralization in the preictal time span.
Journal of Clinical Neurophysiology 21(2):99-104. · 1.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study aimed to correlate the general well-being of patients and their judgment about their dental appearance.
Based on internationally accepted guidelines regarding dental esthetics, a questionnaire was developed to measure subjective assessments of dental appearance. Fourteen items defined an esthetic sum score (0 = satisfied; 56 = dissatisfied). Further, general well-being was evaluated with a long-established and highly reliable test. Eighty participants were included (47 women, 33 men). Participants were.drawn from 4 different groups (n = 20): natural dentition (group N), fixed partial dentures (group F), removable partial dentures (group R), and patients who had an esthetic problem with their teeth (group P).
Seventy-five participants showed a normal well-being. Five participants showed a depressive state and formed a new group (group D). The medians of the sum scores (25th, 75th percentile) were: group N: 12 (10, 14); group F: 14 (8, 29); group R: 14 (9, 27); group P: 23 (18, 35); group D: 30 (26, 35). Significant differences were found between groups N and P, as well as between group D and groups N, F, and R.
Because of the significant difference between groups N and P, basis validation of the sum score was achieved. Further, self-assessments of dental appearance appeared to be more negative for participants with a depressive state compared with the other groups. In clinical studies, selection bias can be prevented by using a test that measures well-being to verify if a study sample includes a normal number of depressive subjects and therefore represents the general population.
The International journal of prosthodontics 19(5):449-54. · 1.38 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate whether divers with varying levels of experience and without a history of reported decompression sickness (DCS) show neuropsychometric alterations possibly as a result of so-called repetitive "silent" paradoxical gas embolisms.
Using reaction time as a psychometric measure, 17 experienced military divers (ED, logging between 150 and 1,200 diving hours) and eight very experienced military divers (VED, logging between 2,800 and 9,800 diving hours) with no decompression sickness (DCS) in their medical histories were compared to 23 healthy controls without any diving history, matched as closely as possible with respect to age for the two diving groups. Motor reaction time, decision reaction time and error rates were measured during completion of both simple and complex reaction time tasks.
Compared to their control group, VED showed significantly higher motor reaction times on both tasks and significantly higher decision reaction times in the complex task. ED were not found to be different from their respective controls. No changes in performance quality in terms of increased errors were observed in any of the tasks for either diving group.
The findings support the proposed possibility that minimal cerebral lesions occur after diving even without DCS. Further studies with this highly selective population of very experienced divers using more elaborate neurocognitive and neuromotor tasks seem warranted.
Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc 38(3):197-204. · 0.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The effect of an increased nitrogen partial pressure under hyperbaric conditions is known as nitrogen narcosis (NN). At an ambient pressure of about 4 bar, reduced cognitive performance as well as euphoric effects are reported. We examined the effect of NN on pain perception. 22 subjects completed an experimental (50 meters = 6 bar) and a simulated control dive (0 m = 1 bar) in a hyperbaric chamber. Before and during each dive a standardized cold pressure test was performed. The intensity of pain perceived was assessed with the help of a visual analogue scale; additionally, subjects assessed the subjective effect of NN. The study showed that the perceived pain intensity is significantly reduced under nitrogen narcosis conditions (F1.21 = 5.167, p < 0.034) when compared to the perceived pain intensity under the control dive conditions (F1.21 = 0.836, p = 0.371). A connection between perceived pain intensity and subjects experience of the NN was not found under the experimental dive condition (r = 0.287, p = 0.195). We could show that even relatively moderate hyperbaric conditions may have an influence on the perception of pain. The results are highly relevant since nitrogen narcosis occurs in divers as well as in medical personnel or construction workers, working under hyperbaric conditions.
Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc 39(1):569-76. · 0.80 Impact Factor
