Hartmut Heinrich

neurocare group

The development of the complex clinical picture of motor and vocal tics in children and adolescents with Tourette syndrome (TS) must be paralleled by changes in the underlying pathophysiology. Electrophysiological methods such as EEG and event-related potentials (ERPs) are non-invasive, safe and easy to apply and thus seem to provide an adequate me...

Introduction Quantitative Electroencephalogram- (QEEG-)informed neurofeedback is a method in which standard neurofeedback protocols are assigned, based on individual EEG characteristics in order to enhance effectiveness. Thus far clinical effectiveness data have only been published in a small sample of 21 ADHD patients. Therefore, this manuscript a...

In Anorexia nervosa (AN) attentional biases towards, as well as away from, food cues have been found using different paradigms. In the current study, adult and adolescent AN patients and control participants performed two tasks while their eye movements were recorded. The tasks involved viewing and rating: 1. Single photographs of food items; 2. Pa...

Background Maternal depressive symptoms are a common phenomenon during pregnancy and are related to negative outcomes for child development and health. Modifications in child DNA methylation are discussed as an underlying mechanism for the association between prenatal depressive symptoms and alterations in child outcomes. However, formerly reported...

Neurofeedback training (NFT) provides strategies for children with ADHD to achieve changes on the neurophysiological and behavioral level to attenuate ADHD symptoms. We assume self-efficacy (an “active attitude”), a core variable in successful NFT. In a randomized, double-blind controlled study, we investigated the impact of a “placebo instruction”...

Different components of body image processing seem to be reflected by different neural mechanisms. A core symptom of Anorexia nervosa (AN) is a disturbance of body image with correlates found on a neural level. The present study focuses on the neural processing of visual body stimuli of different weight categories in adolescent and adult AN patient...

The aim of the present work is to investigate the association of salivary and cumulative cortisol levels with emotional and behavioral symptoms in a Franconian Cognition and Emotion Studies (FRANCES) general population cohort of 158 6- to 9 year old children. Salivary cortisol values were measured by one-day diurnal cortisol profile, whereas cumula...

Neurofeedback (NF) has gained increasing interest in the treatment of attention-deficit/hyperactivity disorder (ADHD). Given learning principles underlie NF, lasting clinical treatment effects may be expected. This systematic review and meta-analysis addresses the sustainability of neurofeedback and control treatment effects by considering randomiz...

Background As children with attention-deficit/hyperactivity disorder (ADHD) usually show psychopathological signs beyond their core symptoms (e.g. elevated scores of the dysregulation profile (DP) in 30–40%), treatments with a broader approach to self-regulation skills may be supportive. Neurofeedback (NF) may reflect such an option. Aim of the pre...

Unfavourable intrauterine environmental factors increase the risk of delivery complications as well as postpartum developmental and behavioural problems in children and adolescents with ongoing effects into older age. Biomarker studies show that maternal stress and the use of alcohol and tobacco during pregnancy are associated with a higher intraut...

Objective Different components of body image processing seem to be reflected by different neural mechanisms. A core symptom of Anorexia nervosa (AN) is a disturbance of body image with correlates found on a neural level. The present study focusses at the neural processing of visual body stimuli of different weight categories in adolescent and adult...

Differential effects of blue- and red-enriched light on attention and sleep have been primarily described in adults. In our cross-over study in typically developing adolescents (11–17 years old), we found attention enhancing effects of blue- compared to red-enriched light in the morning (high intensity of ca. 1000 lx, short duration: <1 h) in two o...

Aim: This case-control study examined the long-term consequences of surgical correction for ventricular septal defect (VSD; the most common congenital heart defect) in infancy. It assessed children who had undergone VSD surgery and the factors related to maternal conditions, surgery, and hospital stay. Method: Thirty-nine children (23 females, 1...

Prenatal alcohol exposure (PAE) is known to elicit a broad range of systemic effects, including neurophysiological alterations that result in adverse behavioral and cognitive outcomes. However, molecular pathways underlying these long-term intrauterine effects remain to be investigated. Here, we tested a hypothesis that PAE may lead to epigenetic a...

Neurophysiology allows us to understand and modulate the neural mechanisms in ADHD with high time- and/or frequency-resolution. These non-invasive methods include electroencephalographic recordings at rest and during tasks, with spontaneous and event-related oscillations and potentials tracking covert processing and transcranial neuromodulation thr...

Attachment security is an important protective factor for children’s emotional development as the attachment relationship is one of the main developmental contexts for children’s emerging emotional competencies. Deficits in this domain are closely linked to the development of psychopathology. So far the influence of the postnatal environment on the...

Epigenetic DNA modifications in genes related to the hypothalamic–pituitary–adrenal (HPA) axis are discussed as a mechanism underlying the association between prenatal depression and altered child HPA activity. In a longitudinal study, DNA methylation changes related to prenatal depressive symptoms were investigated in 167 children aged 6 to 9 year...

Background A constant preoccupation with food and restrictive eating are main symptoms of anorexia nervosa (AN). Imaging studies revealed aberrant neural activation patterns in brain regions processing hedonic and reward reactions as well as–potentially aversive–emotions. An imbalance between so called “bottom-up” and “top-down” control areas is di...

High-calorie and low-calorie food stimuli. (TIF)

Regions of interest. Selected regions of interest based on previous studies on processing of emotional and food stimuli in EDs and in the developing brain. (DOCX)

Results from the whole-brain group comparison (patients vs. controls). Regions with group differences are listed. (DOCX)

IAPS stimuli. IAPS numbers of positive, neutral and negative pictures. (DOCX)

The second-to-forth digit length ratio (2D:4D) is considered to be a biomarker for intrauterine androgen levels. It is associated with adult and child mental health problems, primarily with behavioral symptoms and predominantly in males. Using a cross-sectional design, we examined whether 2D:4D was associated with conduct disorder (CD) symptoms in...

IntroductionVentricular septal defect (VSD) is the most common congenital heart defect, with larger VSDs typically being corrected with an open-heart surgery during infancy. Long-term consequences of a VSD-corrective surgery on stress systems of child and mother are still unknown. The aim of the present study is to investigate the associations of a...

Studies have shown that child development is negatively affected by prenatal depression. A dysregulated hypothalamic-pituitary-adrenal axis in the pregnant woman, passed to the fetus, is one discussed key mechanism. Studies, investigating primary-school age children, have found effects on antisocial behavior. Effects on internalizing symptoms were...

Background: Alcohol intake during pregnancy is considered to be a risk factor for child development. Child biomarkers of intrauterine alcohol exposure have been rarely studied. We investigated whether a meconium alcohol metabolite (ethyl glucuronide, EtG) was associated with cognitive development, ADHD-related behaviour and neurophysiological mark...

Background Aberrant reward mechanisms with regard to slim body shapes are discussed in patients with anorexia nervosa (AN). The aim of the present study was to examine of cue reactivity toward body shapes in AN via the late positive potential (LPP), an event-related electroencephalography (EEG) component. By including adolescents and adults, aspect...

In order to better understand the underpinnings of attention-deficit/hyperactivity disorder (ADHD), we targeted the relationship of attentional, cognitive control and motivational processes with DNA methylation patterns of 60 candidate genes in boys at early school age. Participants (6 to 8 years; N = 82) were selected from a German longitudinal co...

Growing evidence highlights the importance of prenatal risk factors for maladaptive child development. The aim of this study was to assess long term effects of prenatal maternal depression and fetal alcohol exposure on child emotional competencies, attachment security and behavioral and emotional problems and to investigate developmental pathways c...

Objective: Alcohol dependence is more prevalent in men than in women. The evidence for how prenatal and adult androgens influence alcohol dependence is limited. We investigated the effects of prenatal and adult androgen activity on alcohol dependence. Moreover, we studied how the behaviours of pregnant women affect their children's prenatal androg...

Zusammenfassung. Die Schwangerschaft stellt einen Lebensabschnitt der Frau dar, der mit korperlichen und hormonellen Veranderungen sowie einer erhohten emotionalen und psychischen Beanspruchung einhergeht. Fur das Kind gilt die Zeit im Mutterleib dabei als besonders sensible Phase, in der ungunstige intrauterine Bedingungen sowohl die fetale als au...

Neurofeedback (NF) is increasingly used as a therapy for attention-deficit/hyperactivity disorder (ADHD), however behavioral improvements require 20 plus training sessions. More economic evaluation strategies are needed to test methodological optimizations and mechanisms of action. In healthy adults, neuroplastic effects have been demonstrated dire...

In Deutschland weist jedes fünfte Kind ein erhöhtes Risiko für psychische Auffälligkeiten auf, welche eng mit Defiziten in der kindlichen Emotionsregulation assoziiert sind. Die Entwicklung dieser Fähigkeit vollzieht sich vorrangig im Kontext früher Bindungsbeziehungen, eine Vulnerabilität für regulatorische Defizite kann jedoch bereits durch depre...

Consuming alcohol during pregnancy is one of the most verified prenatal risk factors for impaired child development. Information about the amount of alcohol consumed prenatally is needed to anticipate negative effects and to offer timely support. Women’s self-reports are not reliable, often influenced by social stigmas and retrospective recall bias...

Recently several new tests have received US Federal Drug Administration (FDA) marketing approval as aids in the diagnostic process for attention deficit hyperactivity disorder (ADHD), including the Neuropsychiatric electroencephalogram (EEG)-Based ADHD Assessment Aid (NEBA) Health test. The NEBA test relies upon an EEG-based measure, called the the...

Body image disturbance in anorexia nervosa (AN) has been widely studied with regard to the patient's own body, but little is known about perception of or attitude towards other women's bodies in AN. The aim of the present study was to investigate how 20 girls aged 12-18 years and 19 adult women suffering from AN compared to 37 healthy adolescent gi...

To elucidate basic mechanisms underlying neurofeedback we investigated neural mechanisms of training of slow cortical potentials by considering EEG- and fMRI. Additionally, we analyzed the feasibility of a double-blind, placebo-controlled design in NF research based on regulation performance during treatment sessions and self-assessment of the part...

Motor system excitability can be tested by transcranial magnetic stimulation CFMS). In this article, an overview of recent methodological developments and research findings related to attention deficit/hyperactivity disorder (ADHD) is provided. Different TMS parameters that reflect the function of interneurons in the motor cortex may represent neur...

In children with attention-deficit/hyperactivity disorder (ADHD), different neurofeedback (NF) protocols have been applied, with the most prominent differentiation between EEG frequency-band (e.g., theta/beta) training and training of slow cortical potentials (SCPs). However, beyond distinctions between such basic NF variables, there are also compe...

In attention-deficit/hyperactivity disorder (ADHD), a reduced phasic alerting response (event-related potential component P3 to cue stimuli) has been reported for different subtypes and task types in a series of studies. In order to get a refined picture of this attentional deficit, which is based on the analysis of averaged event-related potential...

Objective: In children with attention-deficit/hyperactivity disorder (ADHD), an increased theta/beta ratio in the resting EEG typically serves as a rationale to conduct theta/beta neurofeedback (NF) training. However, this finding is increasingly challenged. As NF may rather target an active than a passive state, we studied the EEG in a condition t...

Neurofeedback (NF) is being successfully applied, among others, in children with ADHD and as a peak performance training in healthy subjects. However, the neuronal mechanisms mediating a successful NF training have not yet been sufficiently uncovered for both theta/beta (T/B), and slow cortical potential (SCP) training, two protocols established in...

Knowledge about the core neural mechanisms of attention-deficit hyperactivity disorder, a pathophysiologically heterogeneous psychiatric disorder starting in childhood, is still limited. Progress may be achieved by combining different methods and levels of investigation. In the present study, we investigated neural mechanisms of motor control in 19...

Difficulties with performance and brain activity related to attentional orienting (Cue-P3), cognitive or response preparation (Cue-CNV) and inhibitory response control (Nogo-P3) during tasks tapping executive functions are familial in ADHD and may represent endophenotypes. The aim of this study was to clarify the impact of dopamine receptor D4 (DRD...

We carried out a caging field experiment to assess the potential effects of an untreated, sewage effluent on the health status of Prochilodus lineatus. We analyzed multiple biomarker, responses, which included morphological indices, biochemical and hematological parameters as well, as oxidative stress markers. In addition, we investigated the energ...

The N100 component, evoked by transcranial magnetic stimulation (TMS) and electroencephalography is associated with the activation of inhibitory cortical circuits and has recently been suggested as a potential marker of inhibition in attention-deficit/hyperactivity disorder (ADHD). The aim of the present ADHD study was to investigate the modulation...

Objective: The aim of this study was to provide data on child and adolescent psychiatric emergencies focusing on factors leading to immediate hospitalization. Method: A half-year sample consisting of 306 consecutive outpatient emergencies at a large general child and adolescent psychiatric hospital in Germany was examined. Results: 85.3% of the pre...

In the light of personalized medicine, future studies should not only address the question of whether one therapy is generally superior than another but also investigate which therapy may work best in a particular patient. In this respect, the article by Schulz and colleagues,1 in which the neural mechanisms of methylphenidate and atomoxetine durin...

Among the different neuromodulation techniques, neurofeedback (NF) is gaining increasing interest in the treatment of children with attention-deficit/hyperactivity disorder (ADHD). In this article, a methodological framework is summarised considering the training as a neuro-behavioural treatment. Randomised controlled trials are selectively reviewe...

BACKGROUND: Patients with attention deficit-hyperactivity disorder (ADHD) exhibit difficulties in multiple attentional functions. Although high heritability rates suggest a strong genetic impact, aetiological pathways from genes and environmental factors to the ADHD phenotype are not well understood. Tracking the time course of deviant task process...

Objective: In anorexia nervosa (AN), aspects of motivational salience and reward are increasingly discussed. Event related potentials, particularly the late positive potential (LPP), have been investigated as a marker for motivational salience of stimuli, for example in addictive disorders. The aim of this study was to assess the LPP as a possible...

Short interval intracortical inhibition (SICI) of motor cortex, measured by transcranial magnetic stimulation (TMS) in a passive (resting) condition, has been suggested as a neurophysiological marker of hyperactivity in attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to determine motor excitability in a go/nogo task at st...

Tomographic neurofeedback (tNF) training was evaluated as a treatment for attention-deficit/hyperactivity disorder (ADHD). To investigate the specificity of the treatment, outcomes were related to learning during tNF. Thirteen children with ADHD trained over 36 lessons to regulate their brain activity in the anterior cingulate cortex (ACC) using bo...

Methylphenidate (MPH) and atomoxetine (ATX) are effective medications in the treatment of attention deficit/hyperactivity disorder (ADHD). The aim of this study was to investigate differential effects of MPH and ATX on attentional functions at the performance and the neuronal level in children with ADHD. Using the Attention Network Test (ANT), diff...

Neurofeedback (NF), a type of neurobehavioral training, has gained increasing attention in recent years, especially concerning the treatment of children with ADHD. Promising results have emerged from recent randomized controlled studies, and thus, NF is on its way to becoming a valuable addition to the multimodal treatment of ADHD. In this review,...

Seeking for the mechanisms by which methylphenidate (MPH) improves behavior has demonstrated that MPH modulates excitability in the primary motor cortex. However, little is known about the influence of MPH on top-down controlled mechanisms in the sensory domain. The present study explored the effects of MPH on the activation of visual cortices in h...

Visual attention allocation of adolescent girls with and without an eating disorder while viewing body images of underweight, normal-weight and overweight women was studied using eye tracking. While all girls attended more to specific body parts (e.g. hips, upper legs), eating-disordered girls showed an attentional bias towards unclothed body parts...

Brain activity assessed by electroencephalography (EEG) has been demonstrated to respond to conditioning techniques. The concept of modulating this activity has been called EEG biofeedback, more recently neurofeedback, and is based on operant learning principles. Technological advancements have significantly enhanced the ease and affordability of r...

Neurofeedback is a computer-based behavior training, which is gaining increasing interest in the treatment of children with attention-deficit/hyperactivity disorder (ADHD). This article gives an introduction to neurofeedback and summarizes the state of research, discussing inter alia methodical aspects (e. g., requirements to a control training). E...

Besides genetic susceptibility, environmental factors and gene-environment interactions are of central interest in research on attention deficit/hyperactivity disorder in children. Focusing on maternal behaviour during pregnancy, prenatal maternal alcohol consumption is associated with behavioural disorders in children. In animal models, developmen...

A variety of event-related potential (ERP) based studies have shown differences in neuronal processes underlying attention, inhibition and error processing in children with attention-deficit/hyperactivity disorder (ADHD) compared to controls. However, so far there are no studies that have compared children with ADHD and typically developing (TD) ch...

The neuronal processes underlying response inhibition are often studied using either event-related potentials (ERPs) or by applying transcranial magnetic stimulation (TMS) to investigate excitatory and inhibitory processes in the motor system. We performed a more refined analysis of response inhibition by combining both approaches with the aim of i...