Josef Unterrainer

• University of Freiburg

Background Digital interventions have been suggested to facilitate access to mental health care for refugees, who experience structural, linguistic, and cultural barriers to mental health care. Sleep-e, a digital sleep intervention originally developed for German teachers, has been culturally adapted for refugees in Germany mainly coming from Afric...

Age-related cognitive decline has become an increasingly relevant public health issue. However, risk and protective factors of cognitive decline have yet to be investigated prospectively taking into account genetic, lifestyle, physical and mental health factors. Population-based data from middle-aged (40 to 59 years; N = 2,764) and older individual...

BACKGROUND Mental burden among refugees is high, but access to mental healthcare in Germany is hindered by numerous barriers. Digital interventions are being suggested to facilitate access to mental healthcare. For example, the digital sleep intervention Sleep-e has been culturally adapted for refugees in Germany mainly coming from African and Midd...

Objectives The Tower of London – Freiburg version (TOL-F) was developed in three parallel-test versions (A, B, and C) that only differ in their physical appearance by interchanged ball colors, but not in their cognitive demands. We addressed the question whether the test–retest reliability of an identical problem set differs from the parallel test–...

Purpose: To determine whether amblyopia interferes with cognitive functions requiring visuospatial processing, measured by the Tower of London (ToL) test. Methods: The current study was based on a sub-cohort from the population-based Gutenberg Health Study and included 1,569 participants aged 35 to 44 years. Amblyopia was defined as a visual acu...

The Tower of London (TOL) is probably the most often used assessment tool for planning ability in healthy and clinical samples. Various versions, including our proposed standard problem set, have proven to be feasible and reliable in adults. In contrast, reliability information for typically developing (TD) children and neurodevelopmental disorders...

Long-term childhood cancer survivors’ (CCS) quality of life can be impacted by late effects such as cognitive difficulties. Especially survivors of CNS tumors are assumed to be at risk, but reports of cognitive tests in CCS with survival times >25 years are scarce. We assessed planning ability, a capacity closely related to fluid intelligence, usin...

Objectives: The Tower of London (TOL) test has probably become the most often used task to assess planning ability in clinical and experimental settings. Since its implementation, efforts were made to provide a task version with adequate psychometric properties, but extensive normative data are not publicly available until now. The computerized TO...

Objective: Autism spectrum (ASD) and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with a high rate of comorbidity. To date, diagnosis is based on clinical presentation and distinct reliable biomarkers have been identified neither for ASD nor ADHD. Most previous neuroimaging studies investigated ASD and ADHD separ...

Background Glaucoma is a neurodegenerative disease, leading to thinning of the retinal nerve fibre layer (RNFL). The exact influence of ocular, cardiovascular, morphometric, lifestyle and cognitive factors on RNFL thickness (RNFLT) is unknown and was analysed in a subgroup of the Gutenberg Health Study (GHS). Methods Global peripapillary RNFLT was...

Background: Major depression and anxiety disorders are known to negatively influence cognitive performance. Moreover, there is evidence for greater cognitive decline in older adults with generalized anxiety disorder. Except for clinical studies, complex executive planning functions and subclinical levels of anxiety have not been examined in a popu...

Purpose: To analyze the association between myopia and cognitive performance. Methods: A cohort of the population-based Gutenberg Health Study included 3819 eligible enrollees between 40 and 79 years. We used the Tower of London (TOL) test to assess cognitive performance. Myopia was defined as a spherical equivalent (SE) ≤ -0.5 diopters (D) via...

Objective: Distressed ('Type D') personality is associated with adverse health outcomes in patients with cardiovascular disease (CVD). While personality traits from the Five-Factor Model are related to cognitive functioning, neither Type D personality nor its underlying traits negative affectivity (NA) and social inhibition (SI) have been investig...

Planning ahead the consequences of future actions is a prototypical executive function. In clinical and experimental neuropsychology, disc-transfer tasks like the Tower of London (TOL) are commonly used for the assessment of planning ability. Previous psychometric evaluations have, however, yielded a poor reliability of measuring planning performan...

Background: Working memory (WM) performance is often decreased in older adults. Despite the growing popularity of WM trainings, underlying mechanisms are still poorly understood. Resistance to proactive interference (PI) constitutes a candidate process that contributes to WM performance and might influence training or transfer effects. Here, we in...

Planning impairment is often observed in children with high-functioning autism spectrum disorders (ASD), but attempts to differentiate planning in ASD from children with attention deficit hyperactivity disorder (ADHD) and typically developing children (TD) have yielded inconsistent results. This study examined differences between these groups by fo...

Difficulties with concentration are frequent complaints of patients with depersonalization disorder (DPD). Standard neuropsychological tests suggested alterations of the attentional and perceptual systems. To investigate this, the well-validated Spatial Cueing paradigm was used with two different tasks, consisting either in the detection or in the...

Planning ability gradually increases throughout childhood. However, it remains unknown whether this is attributable to global factors such as an increased ability and willingness to inhibit premature, impulsive responding, or due to the availability of specific planning operations, such as being able to mentally plan ahead more steps ('search depth...

Encoding and maintenance of information in visual working memory have been extensively studied, highlighting the crucial and capacity-limiting role of fronto-parietal regions. In contrast, the neural basis of recognition in visual working memory has remained largely unspecified. Cognitive models suggest that recognition relies on a matching process...

Working memory (WM) as the ability to temporarily maintain and manipulate various kinds of information is known to be affected by proactive interference (PI) from previously relevant contents, but studies on developmental changes in the susceptibility to PI are scarce. In the present study, we investigated life span development of item-specific PI....

The development of planning ability in children initially aged four and five was examined longitudinally with a retest-interval of 12 months using the Tower of London task. As expected, problems to solve straightforward without mental look-ahead were mastered by most, even the youngest children. Problems demanding look-ahead were more difficult and...

Nonpharmacological secondary prevention of coronary heart disease is considered a safe and effective measure to substantially reduce mortality. Despite the effectiveness of lifestyle changes, the compliance rate of patients is very low mainly due to psychosocial barriers. Psychotherapeutic approaches that address how persons think about themselves...

Most neuroimaging studies on planning report bilateral activations of the dorsolateral prefrontal cortex (dlPFC). Recently, these concurrent activations of left and right dlPFC have been shown to double dissociate with different cognitive demands imposed by the planning task: Higher demands on the extraction of task-relevant information led to stro...

Internet Addiction (IA) is proposed to be added as a research diagnosis to the upcoming DSM-V while Pathological Gambling (PG) is proposed to be subsumed under the new section “Addiction and related disorders” as first behavioral addiction. The outpatient clinic for behavioral addiction of the clinic for psychosomatic medicine in Mainz offers couns...

The role of verbal and visuospatial information processing in Tower of London (TOL) tasks was investigated. The first part of the investigation examined the verbal and visuospatial abilities and preferred cognitive style (visualizer vs. verbalizer) of 79 participants, in an inter-individual differences approach. Visuospatial abilities significantly...

In clinical and experimental settings, planning ability is typically assessed using the Tower of London (ToL) or one of its variants. For enhancing the comparability across studies, a common ToL problem set was recently suggested comprising a collection of 4- to 7-move problems. Based on previous theoretical and empirical analyses of problem space...

Motor learning takes place in several phases. Animal experiments suggest that synaptic plasticity plays an important role in acquisition of motor skills, whereas retention of motor performance is most likely achieved by other mechanisms. This study compared two spacing approaches and investigated the time course of synaptic plasticity after spaced...

In a previous study (Unterrainer, Kaller, Halsband, & Rahm, 2006), chess players outperformed non-chess players in the Tower of London planning task but exhibited disproportionately longer processing times. This pattern of results raises the question of whether chess players' planning capabilities are superior or whether the results reflect differe...

Die Kernsymptomatik bei Patienten mit chronischer Depersonalisation (DPP) besteht in der Klage, keine Gefuhle mehr empfinden zu konnen oder sich als vollstandig abgelost von diesen zu erleben. Die psychomotorische Ausdrucksfahigkeit ist dabei vollstandig intakt. Eine Reihe von Studien konnte spezifische Unterschiede in der neurophysiologischen Vera...

It is well established that the mid-dorsolateral prefrontal cortex (dlPFC) plays a critical role in planning. Neuroimaging studies have yielded predominantly bilateral dlPFC activations, but the existence and nature of functionally specific contributions of left and right dlPFC have remained elusive. In recent experiments, 2 independent parameters...

Cognitive, clinical, and neuroimaging studies on planning abilities most frequently implement the Tower of London task or one of its variants. Yet, cumulating evidence from a series of experiments suggests that the commonly used approximation of problem difficulty in terms of the minimum number of moves for goal attainment is too coarse a measure f...

The aim of this study was to investigate the effects of obstructive sleep apnea (OSA) on procedural and declarative memory encoding in the evening prior to sleep, on memory consolidation during subsequent sleep, and on retrieval in the morning after sleep. Memory performance (procedural mirror-tracing task, declarative visual and verbal memory task...

Identifying overtly observable indicators of cognitive processes should provide a promising basis for a more precise tracking of the associated cognitive and neural events. In the current study we used recordings of eye movements to gain deeper insight into the time course of visuospatial problem solving as measured by the Tower of London. Single-t...

The ability to plan and search ahead is essential for problem solving in most situations in everyday life. To investigate the development of planning and related processes, a sample of four- and five-year-old children was examined in a variant of the Tower of London, a frequently used neuropsychological assessment tool of planning abilities. The ap...

In a behavioral experiment on 60 healthy volunteers, the Tower of London was employed as a complex visuo-spatial planning task. After each trial, participants were asked how difficult they found the task and whether they thought their solution was optimal. Results showed that objective problem difficulty affected behavioral performance as well as s...

For the first time, the therapeutic effects on subacute and chronic tinnitus of an inpatient multimodal treatment concept based on principles of Ericksonian hypnosis (EH) were examined by standardized criteria of the Tinnitus Questionnaire (TQ) and Health Survey (SF-36) within a controlled prospective, longitudinal study. A total of 393 patients we...

We assessed cognitive functions before and 3 months after interstitial radiotherapy in 14 patients with gelastic seizures caused by hypothalamic hamartoma. Cognitive functioning was assessed before temporary implantation of (125)I-seed and 3 months after seed explantation. Performance was compared with that of a selected control group of conservati...

A large body of studies demonstrates mild cognitive dysfunction in patients with Obsessive Compulsive Disorder (OCD). Few trials have investigated whether this dysfunction can be improved by treatment. Thirty unmedicated inpatients with OCD were administered a comprehensive neuropsychological test battery before and after 12 weeks of cognitive beha...

Playing chess requires problem-solving capacities in order to search through the chess problem space in an effective manner. Chess should thus require planning abilities for calculating many moves ahead. Therefore, we asked whether chess players are better problem solvers than non-chess players in a complex planning task. We compared planning perfo...

This article provides an overview of recent research on human planning and problem solving. As an introduction, these two cognitive domains will be described and discussed from the perspective of experimental and cognitive psychology. The following sections will focus on the role of the prefrontal cortex in planning and problem solving and on disor...

Situationally adaptive behavior relies on the identification of relevant target stimuli, the evaluation of these with respect to the current context and the selection of an appropriate action. We used functional magnetic resonance imaging (fMRI) to disentangle the neural networks underlying these processes within a single task. Our results show tha...

Gender-related differences in brain activation patterns and their lateralization associated with cognitive functions have been reported in the field of language, emotion, and working memory. Differences have been hypothesized to be due to different cognitive strategies. The aim of the present study was to test whether lateralization of brain activa...

To describe extend and severity of cognitive deficits in juvenile and adult patients with gelastic seizures and hypothalamic hamartoma (HH) and to analyze the impact of epilepsy-related variables on cognitive performance. Thirteen juvenile and adult patients (mean age, 25 years; seven men) underwent comprehensive neuropsychological testing assessin...

The test-retest reliability of activation patterns elicited by encoding and recognition of word-pair associates within the whole brain and a predefined medial temporal region of interest (ROI) was investigated. Twenty healthy right-handed subjects were studied within two sessions, either on the same day or 210-308 days later. Three quantitative mea...

Since the implementation of the Tower of London (ToL) test by Shallice in 1982, numerous variants differing in the tower's physical appearance have been developed. Here we compare behavioral performance (n = 31) on the original Tower of London task consisting of three rods of unequal lengths with a three-ball version of the Ward and Allport Tower T...

Several studies have attempted to identify the neuronal basis of sex differences in cognition. However, group differences in cognitive ability rather than genuine neurocognitive differences between the sexes may account for their results. Here, we compare with functional magnetic resonance imaging the relation between gender, individual task perfor...

The neuronal processes underlying correct and erroneous problem solving were studied in strong and weak problem-solvers using functional magnetic resonance imaging (fMRI). During planning, the right dorsolateral prefrontal cortex was activated, and showed a linear relationship with the participants' performance level. A similar pattern emerged in r...

Purpose: To analyse prognostic factors for long term seizure remission in patients with childhood (CAE) and juvenile absence epilepsy (JAE). Study design: A retrospective analysis of a hospital based prevalence cohort. Methods: The cohort consisted of 163 patients (104 females, 59 males) treated at the Universitatsklinik fur Neurologie, Innsbr...

The Tower of London (ToL) test is widely used for measuring planning and aspects of problem solving. The primary focus of this study was to asses the relationship among different measures on the ToL. A secondary purpose was to examine the putative relationship between intelligence and working memory with that of ToL performance. Analyses of the int...

Despite the large number of behavioral and functional neuroimaging studies employing the Tower of London (ToL), the task's structural parameters and particularly their impact on planning have not been addressed so far. In this paper, we highlight the structural properties of ToL problems and provide evidence for their systematic and substantial eff...

The Tower of London (ToL) is a well-known test of planning ability, and commonly used for the purpose of neuropsychological assessment and cognitive research. Its widespread application has led to numerous versions differing in a number of respects. The present study addressed the question whether differences in instruction, cueing, and learning pr...

This study attempted to determine those factors important for predicting the experienced severity of tinnitus. For this purpose, we examined affected patients' perception of tinnitus as an illness, comorbidity, scores on locus of control, length of time since onset of tinnitus, pitch and loudness of tinnitus sounds, and depression. One hundred and...

The purpose of this study was to investigate the fMRI response of the sensorimotor cortex to a vibration paradigm produced by a novel vibrotactile stimulator. Fifteen contiguous slices covering the sensorimotor cortex parallel to the anterior (AC) and posterior commissure (PC) line were obtained with echoplanar magnetic resonance imaging at 1.5T. C...

To analyze the spectrum of epilepsy syndromes which follow childhood febrile convulsions (FC) and to examine whether retrospective analysis of clinical features of the FC enables discrimination of patients who develop temporal lobe epilepsy (TLE) from those who develop generalized epilepsy (GE). One hundred and thirteen patients with epilepsy and a...

Mild cognitive impairment has frequently been reported for patients in the early stages of multiple sclerosis. The aim of the present study was to measure whether altered cortical activation during a sustained attention task occurs along with limited extent of neuropsychological problems. Expanded brain activation of multiple sclerosis patients wit...

The aim of the study was to implement a vibrotactile stimulator using functional magnetic resonance imaging (fMRI). A fMRI compatible vibration device consisting of a pneumatically driven dual membrane pump was developed. Brain activation during 50 Hz vibrotactile stimulation of the right hand-palm were compared to a right 2 Hz finger-to-thumb-tapp...

Background. The aim of the study was to assess the efficacy and tolerability of a new electrophysiological intervention technique as an add on treatment in patients with migraine.Methods. A randomized double-blind placebo-controlled study with a parallel group add on design and a 12-week treatment phase was conducted in a large outpatient headache...

Several studies demonstrate that the P3 component of the event-related potentials (ERP) is generated by mesial temporal structures. The P3 is considered as endogenous information processing component independent from modality. The aim of this investigation was to study whether the P3 latency elicited by auditory and visual stimuli under different a...

Zusammenfassung.Theoretischer Hintergrund: Der Tinnitus-Fragebogen von Goebel und Hiller (1998) misst Tinnitus-Belastung durch sechs teilweise korrelierte Faktoren. Diese beruhen unter anderem auf Konstrukten der Informationsverarbeitung, wie irrationale Uberzeugungen, Ubergeneralisierungen und Attituden der Hilflosigkeit. Fragestellung: In dieser...

Patients suffering from chronic tinnitus were analyzed to examine whether tinnitus impairments can be predicted by demographic and socioeconomic factors. For this purpose, subjective tinnitus complaints were measured in 153 patients using the tinnitus impairment questionnaire (THI-12) that distinguishes between emotional-cognitive and functional-co...

The P3 potential is accepted as a neurophysiological correlate of memory and attention. Delayed latencies were reported in different forms of dementias. Although the generator sites are still under debate, the thalamus may play a crucial role. The aim of this study was to investigate the influence of an unilateral thalamic ischaemic infarction on P...

The largest group of neurodegenerative disorders are extrapyramidal diseases, especially parkinsonism. The development of the cocaine derivative [123I] beta-CIT and single photon emission tomography (SPET) may help in the diagnosis of these patients. The aim of this study was to demonstrate the diagnostic value of this method and its relationship w...

Idiopathic Parkinson's disease (PD) is the most common neurodegenerative disorder. An important step in diagnosing the disease has been achieved with the development of the cocaine derivative [123I] beta-CIT for single photon emission computed tomography (SPECT). The aim of this study was to demonstrate the disease progression by repeated measuring...

The putative generators of the event-related P3 component are still a matter of debate. There is reasonable evidence that the mesial temporal lobe structures are crucial in the generation of event-related potentials. Transient global amnesia (TGA) is characterized by anterograde and retrograde amnesia without neurological deficits in which a tempor...

The brain activity of 13 right-handed students (6 men and 7 women) was determined using high resolution (99m)Tc-HMPAO brain SPECT images during visuospatial tasks. The results showed that there was no significant gender-specific difference in solving the visuospatial tasks and that no meaningful statistical difference in brain activity between the...

Mit dem vorliegenden Fragebogen konnte ein Instrument entwickelt werden, das in objektiver und ökonomischer Weise tinnitusspezifische Beeinträchtigungen erfaßt. Er ist schnell und einfach anzuwenden und zu interpretieren, es kann als Forschungsinstrument, zur Begutachtung und für weiterführende therapeutische Entscheidungen eingesetzt werden und bi...

Mit dem vorliegenden Fragebogen konnte ein Instrument entwickelt werden, das in objektiver und ökonomischer Weise tinnitusspezifische Beeinträchtigungen erfaßt. Er ist schnell und einfach anzuwenden und zu interpretieren, es kann als Forschungsinstrument, zur Begutachtung und für weiterführende therapeutische Entscheidungen eingesetzt werden und bi...

Magnetic resonance imaging (MRI) and computed tomography (CT) may not be reliable in the differential diagnosis of tumour necrosis, scar and recurrent tumour. We compared 201Tl-chloride SPET with CT and MRI for the differential diagnosis of these cerebral lesions. Brain SPET was performed in 40 patients after the intravenous injection of 201Tl-chlo...

Bei 100 Patienten mit intrazerebraler Blutung wurden Klinik sowie diagnostische Zusatzmethoden wie kranfeile Computertomographie (CT) und Kernspintomographie (MRT) ausgewertet. 53 Patienten hatten einen hämorrhagischen Infarkt (Hl), 47 ein intrazerebrales Hämatom (ICH). Es zeigten sich keine signifikanten Unterschiede in den klinischen Symptomen. D...

Clinical findings and neuroimaging techniques (cerebral computed tomography - CCT, cerebral magnetic resonance imaging - MRI) were analysed in 100 patients with intracerebral bleeding. 53 patients had haemorrhagic infarctions, 47 patients had intracerebral haematoma. There were no significant differences in the clinical symptoms. Differences were s...

In this study, the size of the corpus callosum of 24 right-handed students was measured using MRI images and was correlated to verbal performance determined by means of an extensive psychological test battery. The results showed a larger absolute callosal area in males, but there was no gender-related difference in the size when this was related to...

The relationship between anatomical sizes of different regions of the corpus callosum and functional visuospatial skills was investigated in 24 right-handed students (12 males and 12 females) using midsagittal magnetic resonance imaging (MRI). Men had significantly larger absolut callosal areas and in some cases wider callosal measurements than wom...