Frank Schneider

William Penn University, Filadelfia, Pennsylvania, United States

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Publications (358)1031.36 Total impact

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    ABSTRACT: In functional magnetic resonance imaging (fMRI) studies that apply a “subsequent memory” approach, successful encoding is indicated by increased fMRI activity during the encoding phase for hits vs. misses, in areas underlying memory encoding such as the hippocampal formation. Signal-detection theory (SDT) can be used to analyze memory-related fMRI activity as a function of the participant’s memory trace strength (d′). The goal of the present study was to use SDT to examine the relationship between fMRI activity during incidental encoding and participants’ recognition performance. To implement a new approach, post-experimental group assignment into High- or Low Performers (HP or LP) was based on 29 healthy participants’ recognition performance, assessed with SDT. The analyses focused on the interaction between the factors group (HP vs. LP) and recognition performance (hits vs. misses). A whole-brain analysis revealed increased activation for HP vs. LP during incidental encoding for remembered vs. forgotten items (hits > misses) in the insula/temporo-parietal junction (TPJ) and the fusiform gyrus (FFG). Parameter estimates in these regions exhibited a significant positive correlation with d′. As these brain regions are highly relevant for salience detection (insula), stimulus-driven attention (TPJ), and content-specific processing of mnemonic stimuli (FFG), we suggest that HPs’ elevated memory performance was associated with enhanced attentional and content-specific sensory processing during the encoding phase. We provide first correlative evidence that encoding-related activity in content-specific sensory areas and content-independent attention and salience detection areas influences memory performance in a task with incidental encoding of facial stimuli. Based on our findings, we discuss whether the aforementioned group differences in brain activity during incidental encoding might constitute the basis of general differences in memory performance between HP and LP.
    Frontiers in Behavioral Neuroscience 11/2015; 9(305). DOI:10.3389/fnbeh.2015.00305 · 3.27 Impact Factor

  • 11/2015; 26(S14):12-14. DOI:10.1007/s15016-015-0894-7
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    ABSTRACT: Background: Violence has many faces and often results in a variety of consequences. Some studies indicated different types of violence and health consequences in men and women. However, it is still unclear whether this is reflected in clinical context, for example in a patient sample of a German university hospital. Objectives: The primary goal of the present study was to analyze associations of violence with health, gender and social, economic, job-related, psychological and physical consequences. In addition, the effects of psychological treatment were examined. Materials and methods: One line of research refers to the survey of more than 5000 patients of the university hospital Aachen, evaluating violence experience and several health complaints anonymously. Another line of research deals with detailed interviews with victims of violence and their experienced consequences. A final data source stems from the evaluation of psychological counseling of patients with prior experience of violence. Changes in subjectively perceived depressive symptoms and acceptance of the treatment are evaluated. Results and conclusions: Experience of violence increases the risk for several health problems, especially the experience of multiple types of violence. The interviews showed that more than 60 % of the victims had a clinical diagnosis - independent of sex. The risk for a clinical diagnosis increased with multiple violence experiences during childhood. Patients with a clinical diagnosis indicated more subjective consequences of violence, and consequences of violence were more pronounced in patients that experienced multiple types of violence. The good acceptance as well as the effects on symptomatology and other relevant therapeutic variables provides a first indication for a successful treatment of victims of violence in a clinical context.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 10/2015; DOI:10.1007/s00103-015-2258-7 · 1.42 Impact Factor
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    ABSTRACT: Recent evidence suggests that the experience of stress can be communicated between individuals via chemosensory cues. Little is known, however, about the impact of these cues on neurophysiological responses during a socially threatening situation. In the current investigation we implemented a widely used paradigm to study social exclusion-Cyberball-to examine whether chemosensory cues signaling anxiety modulate the neuronal effects of ostracism. In a double-blind, within-subjects design, 24 healthy, normosmic participants were presented with chemosensory cues of anxiety (or control samples) and completed the Cyberball task while in a 3T fMRI scanner. Axillary sweat collected from male students awaiting an oral examination served as the anxiety cues while the chemosensory control stimuli consisted of sweat collected from the same individuals participating in an ergometer training session. The neuroimaging data revealed that under the control chemosensory condition, exclusion from Cyberball was associated with significantly higher orbitofrontal cortex and anterior cingulate cortex activity, which is consistent with previous studies in the field. However, when participants were primed with the anxiety sweat, the activity in these regions was not observed. Further, under exposure to anxiety cues during ostracism the participants showed deactivations in brain regions involved in memory (hippocampus), social cognition (middle temporal gyrus, superior temporal gyrus) and processing of salience (inferior frontal gyrus). These results suggest that successful communication of anxiety via the chemosensory domain may moderate the experience of social exclusion. It is possible that the anxiety signals make it easier for the individuals to detach from the group, pointing to the communicative role of chemosensory anxiety cues in enhancing adjustment mechanisms in light of a distressing situation.
    Frontiers in Psychology 10/2015; 6(1475). DOI:10.3389/fpsyg.2015.01475 · 2.80 Impact Factor
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    ABSTRACT: Background Empathy is a basic human ability, and patients with schizophrenia show dysfunctional empathic abilities on the behavioural and neural level.AimsThese dysfunctions may precede the onset of illness; thus, it seems mandatory to examine the empathic abilities in individuals at clinical high risk for psychosis.Method Using functional magnetic resonance imaging, we measured 15 individuals at clinical high risk of psychosis (CHR group) and compared their empathy performance with 15 healthy volunteers and 15 patients with schizophrenia.ResultsBehavioural data analysis indicated no significant deficit in the CHR group. Functional data analysis revealed hyperactivation in a frontotemporoparietal network including the amygdala in the CHR group compared with the other two groups.Conclusions Despite normal behavioural performance, the CHR group activated the neural empathy network differently and specifically showed hyperactivation in regions critical for emotion processing. This could suggest a compensatory mechanism reflecting emotional hypersensitivity or dysfunctional emotion regulation. Further investigations should clarify the role of these neural alterations for development and exacerbation of psychosis. © The Royal College of Psychiatrists 2015.
    The British journal of psychiatry: the journal of mental science 08/2015; DOI:10.1192/bjp.bp.114.159004 · 7.99 Impact Factor
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    ABSTRACT: Schizophrenia is a heterogeneous disorder that presents differently in men and women: men show a higher propensity to negative symptoms, lower social functioning, earlier age at onset and co-morbid substance abuse, whereas women display more affective symptoms. It is unknown whether these differences extend to subjects at high risk (HR) of psychosis. Thus, the aim of the present study was to address this question. Clinical symptoms and functioning were assessed using structured interviews in 239 HR subjects (female, n = 80). The definition of being at HR was based on the criteria used in the European Prediction of Psychosis Study (EPOS). Men displayed more pronounced negative symptoms, higher rates of past substance abuse disorders and higher deficits in social functioning. No gender difference was found for depression, which affected almost 50% of the cohort, or age at onset for the fulfilment of HR criteria. The higher impairment in specific symptoms observed in male schizophrenia patients was also present in subjects at HR for psychosis. Further studies are required to determine whether these symptoms are gender-specific predictors of transition to psychosis and whether they warrant gender-specific interventions. The high propensity to depression in the present cohort, which was particularly pronounced in the male cohort compared with the general population, in conjunction with the observed increase in negative symptoms and functional impairment, should alert clinicians to the necessity for the identification and treatment of HR subjects, irrespective of the degree to which these features are associated with transition risk. © 2015 Wiley Publishing Asia Pty Ltd.
    Early Intervention in Psychiatry 03/2015; DOI:10.1111/eip.12240 · 1.95 Impact Factor
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    ABSTRACT: Glucose is the primary source of energy for the human brain. Previous literature has shown that varying blood glucose levels may have a strong impact on behaviour, subjective mood, and the intensity of the BOLD signal measured in fMRI. Therefore, blood glucose levels varying even within the normal range may interact with cognitive and emotional processing as well as BOLD signal. Here, in a placebo-controlled, double-blind crossover study on 20 healthy women, we show that overnight fasting, compared to an elevated glucose condition, influences brain activation and the affective state during mood induction. Results indicate that our brain may compensate for low glucose levels during fasting by stronger recruitment of the brain areas relevant to the task at hand. Additionally, we systematically tested the effect of prior cognitive effort on behavioural and neural patterns and found that elevated activation is only associated with maintained performance as long as no prior cognitively challenging task is administered. Prior cognitive effort leads to deteriorated performance and a further increase in emotion-associated brain activation in the pregenual anterior and posterior cingulate, the superior frontal gyrus, and the pre-SMA. These results are in line with the strength model of self-regulation. Our results corroborate the strength model of self-regulation and extend it to affect regulation processes. Additionally, our observations suggest that experimentally controlling for fasting state or glucose levels may be beneficial, especially when studying processes that involve self-regulation. Copyright © 2015 Elsevier Inc. All rights reserved.
    NeuroImage 03/2015; 113. DOI:10.1016/j.neuroimage.2015.03.024 · 6.36 Impact Factor
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    ABSTRACT: Glucose metabolism serves as the central source of energy for the human brain. Little is known about the effects of blood glucose level (BGL) on higher-order cognitive functions within a physiological range (e.g., after overnight fasting). In this randomized, placebo-controlled, double blind study, we assessed the impact of overnight fasting (14h) on brain activation during a working memory task. We sought to mimic BGLs that occur naturally in healthy humans after overnight fasting. After standardized periods of food restriction, 40 (20 male) healthy participants were randomly assigned to receive either glucagon to balance the BGL or placebo (NaCl). A parametric fMRI paradigm, including 2-back and 0-back tasks, was used. Subclinically low BGL following overnight fasting was found to be linked to reduced involvement of the bilateral dorsal midline thalamus and the bilateral basal ganglia, suggesting high sensitivity of those regions to minimal changes in BGLs. Our results indicate that overnight fasting leads to physiologically low levels of glucose, impacting brain activation during working memory tasks even when there are no differences in cognitive performance. Hum Brain Mapp, 2014. © 2014 Wiley Periodicals, Inc.
    Human Brain Mapping 03/2015; 36(3). DOI:10.1002/hbm.22668 · 5.97 Impact Factor
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    ABSTRACT: Deficits in emotion processing and social interaction are prominent symptoms of autism spectrum disorder (ASD). ASD has also been associated with aggressive tendencies towards self and others. The prevalence of aggressive behav-ior in this disorder, its etiology and its impact on social life are still unclear. This study investigated behavioral and physiological effects of social provocation in patients with ASD and healthy controls. We used a modified Taylor Aggression Paradigm in 24 high-functioning patients with ASD and 24 healthy controls. Participants were instructed to play against a fictitious human opponent. Money withdrawals toward the participant represented provocation and money deduction by the participant denoted aggressive behavior. Throughout the measurement, electrodermal activ-ity (EDA) was recorded. Healthy controls showed higher aggressive responses to high provocation compared to low provocation, which demonstrated the effectiveness of the used procedure in eliciting aggression. Patients' responses were not influenced by the level of social provocation, although in both groups aggression was higher after lost com-pared to won trials. Physiologically, controls showed fewer but higher EDA amplitudes when responding aggressively, whereas patients displayed the opposite pattern of more but lower EDA amplitudes. The modified Taylor Aggression Paradigm successfully elicited aggression and revealed different behavioral and neurophysiological responses in patients and healthy controls. Patients' aggressive behavior as well as their physiological responses were less modulated by level of provocation compared to controls. Therapeutic attempts for patients might concentrate on improving empathic abilities and the understanding of social situations, including provocation and aggressive behavior.
    Autism Research 01/2015; 8(3). DOI:10.1002/aur.1446 · 4.33 Impact Factor
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    ABSTRACT: Background Individuals with schizophrenia and people with depression both show abnormal behavioural and neural responses when perceiving and responding to emotional stimuli, but pathology-specific differences and commonalities remain mostly unclear. Aims To directly compare empathic responses to dynamic multimodal emotional stimuli in a group with schizophrenia and a group with depression, and to investigate their neural correlates using functional magnetic resonance imaging (fMRI). Method The schizophrenia group (n = 20), the depression group (n = 24) and a control group (n = 24) were presented with portrait-shot video clips expressing emotion through three possible communication channels: facial expression, prosody and content. Participants rated their own and the actor's emotional state as an index of empathy. Results Although no group differences were found in empathy ratings, characteristic differences emerged in the fMRI activation patterns. The schizophrenia group demonstrated aberrant activation patterns during the neutral speech content condition in regions implicated in multimodal integration and formation of semantic constructs. Those in the depression group were most affected during conditions with trimodal emotional and trimodal neutral stimuli, in key regions of the mentalising network. Conclusions Our findings reveal characteristic differences in patients with schizophrenia compared with those with depression in their cortical responses to dynamic affective stimuli. These differences indicate that impairments in responding to emotional stimuli may be caused by pathology-specific problems in social cognition. Royal College of Psychiatrists.
    The British journal of psychiatry: the journal of mental science 01/2015; 206(3). DOI:10.1192/bjp.bp.113.143040 · 7.99 Impact Factor
  • Article: [Lifestyle]
    F Schneider · C Weiller ·

    Der Nervenarzt 12/2014; 85(12):1499-500. DOI:10.1007/s00115-013-3971-9 · 0.79 Impact Factor
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    ABSTRACT: Deficits in emotion regulation are a prominent feature of psychiatric conditions and a promising target for treatment. For instance, cognitive reappraisal is regarded as an effective strategy for emotion regulation. Neurophysiological models have established the lateral prefrontal cortex (LPFC) as a key structure in the regulation of emotion processing through modulations of emotion-eliciting structures such as the amygdala. Feedback of the LPFC activity by real-time functional magnetic resonance (fMRI) may thus enhance the efficacy of cognitive reappraisal. During cognitive reappraisal of aversive visual stimuli, LPFC activity was fed back to the experimental group, whereas control participants received no such information. As a result, during reappraisal, amygdala activity was lower in the experimental group than in the controls. Furthermore, an increase of inter-hemispheric functional connectivity emerged in the feedback group. The current study extends the neurofeedback literature by suggesting that fMRI feedback can modify brain activity during a given task. Copyright © 2014. Published by Elsevier B.V.
    Behavioural Brain Research 11/2014; 281. DOI:10.1016/j.bbr.2014.11.027 · 3.03 Impact Factor
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    ABSTRACT: Gender dysphoria (also known as "transsexualism") is characterized as a discrepancy between anatomical sex and gender identity. Research points towards neurobiological influences. Due to the sexually dimorphic characteristics of the human voice, voice gender perception provides a biologically relevant function, e.g. in the context of mating selection. There is evidence for a better recognition of voices of the opposite sex and a differentiation of the sexes in its underlying functional cerebral correlates, namely the prefrontal and middle temporal areas. This fMRI study investigated the neural correlates of voice gender perception in 32 male-to-female gender dysphoric individuals (MtFs) compared to 20 non-gender dysphoric men and 19 non-gender dysphoric women. Participants indicated the sex of 240 voice stimuli modified in semitone steps in the direction to the other gender. Compared to men and women, MtFs showed differences in a neural network including the medial prefrontal gyrus, the insula, and the precuneus when responding to male vs. female voices. With increased voice morphing men recruited more prefrontal areas compared to women and MtFs, while MtFs revealed a pattern more similar to women. On a behavioral and neuronal level, our results support the feeling of MtFs reporting they cannot identify with their assigned sex.
    PLoS ONE 11/2014; 9(11):e111672. DOI:10.1371/journal.pone.0111672 · 3.23 Impact Factor
  • H Dreßing · K Foerster · J Leygraf · F Schneider ·
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    ABSTRACT: Die Beurteilung der Geschäfts- und Testierunfähigkeit ist eine der schwierigsten forensisch-psychiatrischen Tätigkeiten. Um diese Aufgabe korrekt durchführen zu können, ist eine gründliche Kenntnis der rechtlichen Rahmenbedingungen und der einschlägigen Rechtsprechung unerlässlich. Die vorliegende Arbeit erläutert die Begriffe der Geschäftsunfähigkeit, der partiellen Geschäftsunfähigkeit sowie der Testierunfähigkeit. Das praktische gutachtliche Vorgehen wird am Beispiel der wichtigsten psychischen Störungen erläutert.
    Der Nervenarzt 09/2014; 85(11). DOI:10.1007/s00115-014-4138-z · 0.79 Impact Factor
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    ABSTRACT: Previous literature has shown that hypoglycemia influences the intensity of the BOLD signal. A similar but smaller effect may also be elicited by low normal blood glucose levels in healthy individuals. This may not only confound the BOLD signal measured in fMRI, but also more generally interact with cognitive processing, and thus indirectly influence fMRI results. Here we show in a placebo-controlled, crossover, double-blind study on 40 healthy subjects, that overnight fasting and low normal levels of glucose contrasted to an activated, elevated glucose condition have an impact on brain activation during basal visual stimulation. Additionally, functional connectivity of the visual cortex shows a strengthened association with higher-order attention-related brain areas in an elevated blood glucose condition compared to the fasting condition. In a fasting state visual brain areas show stronger coupling to the inferior temporal gyrus. Results demonstrate that prolonged overnight fasting leads to a diminished BOLD signal in higher-order occipital processing areas when compared to an elevated blood glucose condition. Additionally, functional connectivity patterns underscore the modulatory influence of fasting on visual brain networks. Patterns of brain activation and functional connectivity associated with a broad range of attentional processes are affected by maturation and aging and associated with psychiatric disease and intoxication. Thus, we conclude that prolonged fasting may decrease fMRI design sensitivity in any task involving attentional processes when fasting status or blood glucose is not controlled.
    Brain Structure and Function 09/2014; DOI:10.1007/s00429-014-0898-2 · 5.62 Impact Factor
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    N Chechko · E I Drexler · B Voss · T Kellermann · A Finkelmeyer · F Schneider · U Habel ·
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    ABSTRACT: People with mild cognitive impairment (MCI) are at an elevated risk of developing Alzheimer's disease or other forms of dementia. Although the neural correlates of successful memory performance in MCI have been widely investigated, the neural mechanisms involved in unsuccessful memory performance remain unknown. The current study examines the differences between patients suffering from stable amnestic MCI with multiple deficit syndromes and healthy elderly controls in relation to the neural correlates of both successful and unsuccessful encoding and recognition. Forty-six subjects (27 controls, 19 MCI) from the HelMA (Helmholtz Alliance for Mental Health in an Aging Society) completed a comprehensive neuropsychological test battery and participated in an fMRI experiment for associative face-name memory. In patients, the areas of frontal, parietal, and temporal cortices were less involved during unsuccessful encoding and recognition. A temporary dysfunction of the top-down control of frontal or parietal (or both) areas is likely to result in a non-selective propagation of task-related information to memory.
    Frontiers in Aging Neuroscience 08/2014; 6:201. DOI:10.3389/fnagi.2014.00201 · 4.00 Impact Factor
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    ABSTRACT: G72 (syn. DAOA, D-amino acid oxidase activator) is a susceptibility gene for both schizophrenia and bipolar disorder. Diffusion tensor imaging studies hint at changes in fiber tract integrity in both disorders. We aimed to investigate whether a G72 susceptibility haplotype causes changes in fiber tract integrity in young healthy subjects. We compared fractional anisotropy in 47 subjects that were either homozygous for the M23/M24 risk haplotype (n = 20) or homozygous for M23(rs3918342)/M24(rs1421292) wild type (n = 27) using diffusion tensor imaging with 3 T. Tract-based spatial statistics, a method especially developed for diffusion data analysis, was used to delineate the major fiber tracts. We found clusters of increased FA values in homozygous risk haplotype carriers in the right periinsular region and in the right inferior parietal lobe (IPL). We did not find clusters indicating decreased FA values. The insula and the IPL have been implicated in both schizophrenia and bipolar pathophysiology. Increased FA values might reflect changes in dendritic morphology as previously described by in vitro studies. These findings further corroborate the hypothesis that a shared gene pool between schizophrenia and bipolar disorder might lead to neuroanatomic changes that confer an unspecific vulnerability for both disorders.
    European Archives of Psychiatry and Clinical Neuroscience 07/2014; 265(4). DOI:10.1007/s00406-014-0516-6 · 3.53 Impact Factor
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    ABSTRACT: The neurobiological organization of action-oriented working memory is not well understood. To elucidate the neural correlates of translating visuo-spatial stimulus sequences into delayed (memory-guided) sequential actions, we measured brain activity using functional magnetic resonance imaging while participants encoded sequences of four to seven dots appearing on fingers of a left or right schematic hand. After variable delays, sequences were to be reproduced with the corresponding fingers. Recall became less accurate with longer sequences and was initiated faster after long delays. Across both hands, encoding and recall activated bilateral prefrontal, premotor, superior and inferior parietal regions as well as the basal ganglia, whereas hand-specific activity was found (albeit to a lesser degree during encoding) in contralateral premotor, sensorimotor, and superior parietal cortex. Activation differences after long versus short delays were restricted to motor-related regions, indicating that rehearsal during long delays might have facilitated the conversion of the memorandum into concrete motor programs at recall. Furthermore, basal ganglia activity during encoding selectively predicted correct recall. Taken together, the results suggest that to-be-reproduced visuo-spatial sequences are encoded as prospective action representations (motor intentions), possibly in addition to retrospective sensory codes. Overall, our study supports and extends multi-component models of working memory, highlighting the notion that sensory input can be coded in multiple ways depending on what the memorandum is to be used for. Hum Brain Mapp, 2013. © 2013 Wiley Periodicals, Inc.
    Human Brain Mapping 07/2014; 35(7). DOI:10.1002/hbm.22415 · 5.97 Impact Factor
  • C Weiller · F Schneider ·

    Der Nervenarzt 06/2014; 85(6):669-70. DOI:10.1007/s00115-013-3970-x · 0.79 Impact Factor
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    ABSTRACT: One of the most consistent neuropsychological findings in autism spectrum disorders (ASD) is a reduced interest in and impaired processing of human faces. We conducted an activation likelihood estimation meta-analysis on 14 functional imaging studies on neural correlates of face processing enrolling a total of 164 ASD patients. Subsequently, normative whole-brain functional connectivity maps for the identified regions of significant convergence were computed for the task-independent (resting-state) and task-dependent (co-activations) state in healthy subjects. Quantitative functional decoding was performed by reference to the BrainMap database. Finally, we examined the overlap of the delineated network with the results of a previous meta-analysis on structural abnormalities in ASD as well as with brain regions involved in human action observation/imitation. We found a single cluster in the left fusiform gyrus showing significantly reduced activation during face processing in ASD across all studies. Both task-dependent and task-independent analyses indicated significant functional connectivity of this region with the temporo-occipital and lateral occipital cortex, the inferior frontal and parietal cortices, the thalamus and the amygdala. Quantitative reverse inference then indicated an association of these regions mainly with face processing, affective processing, and language-related tasks. Moreover, we found that the cortex in the region of right area V5 displaying structural changes in ASD patients showed consistent connectivity with the region showing aberrant responses in the context of face processing. Finally, this network was also implicated in the human action observation/imitation network. In summary, our findings thus suggest a functionally and structurally disturbed network of occipital regions related primarily to face (but potentially also language) processing, which interact with inferior frontal as well as limbic regions and may be the core of aberrant face processing and reduced interest in faces in ASD.
    Brain Structure and Function 05/2014; 220(4). DOI:10.1007/s00429-014-0791-z · 5.62 Impact Factor

Publication Stats

7k Citations
1,031.36 Total Impact Points


  • 2015
    • William Penn University
      Filadelfia, Pennsylvania, United States
  • 2004-2015
    • University Hospital RWTH Aachen
      • Department of Neurology
      Aachen, North Rhine-Westphalia, Germany
    • RWTH Aachen University
      • • Department of Psychiatry, Psychotherapy and Psychosomatics
      • • Department of Child and Adolescent Psychiatry and Psychotherapy
      • • Institute of Human Genetics
      Aachen, North Rhine-Westphalia, Germany
  • 2007-2014
    • Central Institute of Mental Health
      • Klinik für Abhängiges Verhalten und Suchtmedizin
      Mannheim, Baden-Württemberg, Germany
  • 2012
    • Justus-Liebig-Universität Gießen
      • Institut für Geschichte der Medizin
      Gießen, Hesse, Germany
  • 1997-2012
    • Heinrich-Heine-Universität Düsseldorf
      • • Klinik und Poliklinik für Psychiatrie und Psychotherapie der HHU, Rheinische Kliniken Düsseldorf
      • • Faculty of Medicine
      Düsseldorf, North Rhine-Westphalia, Germany
  • 1970-2011
    • Deutsche Gesellschaft für Psychiatrie, Psychotherapie, Psychosomatik und Nervenheilkunde 
      Aachen, North Rhine-Westphalia, Germany
  • 2010
    • University Medical Center Hamburg - Eppendorf
      Hamburg, Hamburg, Germany
    • University of Vienna
      • Institut für Klinische, Biologische und Differentielle Psychologie
      Vienna, Vienna, Austria
  • 2006
    • University of Cologne
      Köln, North Rhine-Westphalia, Germany
    • Universitätsklinikum Freiburg
      • Department of Psychiatry and Psychotherapy
      Freiburg, Lower Saxony, Germany
  • 2000-2005
    • University of Bonn
      Bonn, North Rhine-Westphalia, Germany
  • 2003
    • Universitätsklinikum Düsseldorf
      Düsseldorf, North Rhine-Westphalia, Germany
    • Lukaskrankenhaus Neuss
      Neuss, North Rhine-Westphalia, Germany
    • Sana Kliniken Düsseldorf
      Düsseldorf, North Rhine-Westphalia, Germany
  • 1990-1996
    • University of Tuebingen
      • Department of Neurology
      Tübingen, Baden-Württemberg, Germany
  • 1994
    • University of Pennsylvania
      • Department of Psychiatry
      Filadelfia, Pennsylvania, United States