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March 2003 - December 2008
January 2011 - present
Publications
Publications (127)
Esta guía internacional propone mejorar los prospectos de la clozapina en todo el mundo mediante la inclusion de información sobre la titulación del fármaco en función de la ascendencia del paciente. Las bases de datos de reacciones adversas a medicamentos (RAM) sugieren que la clozapina es el tercer fármaco más tóxico en los Estados Unidos de Amér...
Correction to guideline. This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by a...
This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocard...
Background:
Previous trials have shown that pridopidine might reduce motor impairment in patients with Huntington's disease. The aim of this study was to ascertain whether higher doses of pridopidine than previously tested reduce motor symptoms in a dose-dependent manner while maintaining acceptable safety and tolerability.
Methods:
PRIDE-HD was...
Background:
The frequency of late-onset Huntington's disease (>59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive.
Objective:
Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients fr...
Zusammenfassung
Die neu überarbeiteten Leitlinien Chorea/Morbus Huntington geben auf S2k Niveau einen Überblick über den Stand der Forschung zum Erkrankungsverlauf sowie zu neuen Ansätzen der symptomatischen und verlaufsmodifizierenden Therapie bei der Huntington-Krankheit. Im Gegensatz zu vielen anderen Leitlinien bevorzugen die Autoren aus den de...
Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify...
Background:
In Huntington's Disease (HD) cognitive decline can occur before unequivocal motor signs become apparent. As cognitive decline often starts early in the course of the disease and has a progressive nature over time, cognition can be regarded as a key target for symptomatic treatment. The specific progressive profile of cognitive decline...
Background
Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify...
Since 1978, two systematic evidence-based reviews of the available data on religiosity and mental health in the field of psychiatry have been done. More than 70 % found a relationship between level of religious/spiritual involvement and less mental disorder (positive), some found mixed results (positive and negative), and only about 5 % reported mo...
Background
BN82451B is a small, orally active molecule with good CNS penetration. Preclinical studies in tgHD R6/2 mice suggested improved motor function and prolonged survival. In addition antidyskinetic activity was observed in other models. The proposed mechanisms of action (MOA) are (1) antiexcytotoxic due to a sodium channel blocking potential...
The assessment of health-related quality of life (hrQoL) is an important tool in therapy studies and in the treatment of patients with Huntington's disease (HD). In the absence of causal interventions, HD therapy targets the alleviation of symptoms aiming to improve impaired hrQoL. The aim of this study was to determine the impact of disease charac...
The majority of Huntington's disease (HD) mutation carriers experience some psychopathology during their lifetime, varying from irritability to psychosis, but prevalences of particular symptoms vary widely due to diverse study populations in different stages of HD and the use of different assessment methods.
The study population consisted of 1993 H...
Religionswissenschaftliche Studien haben kulturübergreifend sechs Stärken und Tugenden herausdestilliert, mit deren Hilfe der Mensch sein Leben lebenswert machen kann: (1) Weisheit und Wissen, (2) Mut, (3) Liebe und Humanität, (4) Gerechtigkeit, (5) Mäßigung sowie (6) Spiritualität und Transzendenz. Diese Eigenschaften weisen erstaunliche Parallele...
Seit 2007 steigt in Deutschland die Suizidrate wieder an, nachdem sie nach 1980 kontinuierlich abgenommen hatte. Im Jahre 2011 starben in ganz Deutschland 10.144 Menschen durch Selbsttötung, das sind 12,4 Menschen je 100.000 Einwohner. 1980 hingegen starben in der BRD noch 20,9 Personen je 100.000 Einwohner durch Selbstmord, in der DDR sogar 33,3 a...
Die religiösen und spirituellen Dimensionen sind in der wissenschaftlich-psychiatrischen Forschung
der letzten 150 Jahre stark vernachlässigt worden. Im späten 19. Jahrhundert haben Jean Charcot und Sigmund Freud begonnen, Religion mit Hysterie und Neurose zu assoziieren (▶ Kap. 2). Damit begann eine Separation des religiösen Erlebens vom psychiatr...
Übertragungs- und Gegenübertragungsphänomene sind in der Psychotherapie seit Langem bekannt und können – solange sie dem Therapeuten bewusst sind – sogar diagnostisch und therapeutisch genutzt werden. Unbewusst und unreflektiert allerdings entwickeln sie Sprengkraft und haben das Potenzial, der Therapie und dem Klienten zu schaden. In der Therapiea...
Die lange, manchmal sogar lebenslange Dauer der Verbitterung kommt dadurch zustande, dass die Betroffenen oft in einer passiven Opferrolle verharren. Insbesondere die trotzige Verbitterungsemotion führt dann häufig zu einer Ablehnung aller therapeutischen Hilfsangebote: „Die Welt kann ruhig sehen, was mir angetan wurde“. Allerdings ist die Lebensre...
In weiten Teilen der Psychotherapie sind Schuldgefühle
lange mit Pathologie gleichgesetzt worden. Es ist beeindruckend, dass im über tausendseitigen Gesamtregister (Band XVIII) von Freuds 19-bändiger Gesamtausgabe (1951) zwar drei Seiten lang die verwendeten Begriffe „Schuldgefühl“ und „Schuldbewusstsein“ aufgelistet sind, der Begriff „Schuld
“ hin...
The available treatment options for Huntington’s disease (HD) are only symptomatic, partly with a limited symptom control and often accompanied by serious side effects. This review summarizes the current management of HD and elucidates why pridopidine might represent a turning point in the treatment of the condition. Pharmacology, clinical evidence...
The cause of Huntington disease (HD) is a polyglutamine repeat expansion of more than 36 units in the huntingtin protein, which is inversely correlated with the age at onset of the disease. However, additional genetic factors are believed to modify the course and the age at onset of HD. Recently, we identified the V471A polymorphism in the autophag...
Religion/spirituality has been increasingly examined in medical research during the past two decades. Despite the increasing number of published studies, a systematic evidence-based review of the available data in the field of psychiatry has not been done during the last 20 years. The literature was searched using PubMed (1990-2010). We examined or...
Huntington's disease (HD) is an autosomal-dominant, inherited, neuropsychiatric disease which gives rise to progressive motor, cognitive, and behavioral symptoms. It affects about 1 in 10 000 individuals. The onset of symptoms typically occurs in the third or fourth decade of life, though it may appear at any age. The molecular basis of the disease...
Depressive symptoms and religious/spiritual (R/S) practices are widespread around the world, but their intersection has received relatively little attention from mainstream mental health professionals. This paper reviews and synthesizes quantitative research examining relationships between R/S involvement and depressive symptoms or disorders during...
Editorial to introduce special issue on religious and spiritual factors in depression
Huntington's disease (HD) and multiple sclerosis (MS) are both chronic progressive illnesses posing a serious challenge to affected patients and families. Sexual dysfunction in HD as well as in MS is a very common problem, although it is unclear whether the dysfunction is caused by the chronic illness itself or by the sociopsychiatric burden relate...
Beschrieben wird die klinische, diagnostische und therapeutische Entwicklung eines bei Krankheitsbeginn 59-jährigen, rechtshändigen
Patienten. Der uncharakteristische Beginn mit Dyskinesien der Gesichtsmuskulatur und Sprachstörungen erschwerte die Diagnose
und Therapie ebenso wie der Verlauf mit zwischenzeitlichem Verdacht auf Vasculitis bei positi...
We studied relative cortical blood flow (relCBF) patterns associated to correct performance (CP) and perseverative error (PE) during Wisconsin Card Sorting Test (WCST) execution, in controls and patients with schizophrenia.
relCBF (regional cortical blood flow (rCBF) / whole cortex blood flow) of 10 well defined cortical regions was measured in 18...
There is still considerable discussion of whether schizophrenia is a lateralized brain disorder. In fact, schizophrenic patients appear to exhibit a shift away from dexterity, as confirmed by the majority of the 23 publications dealing with this question (14 positive, seven null, two paradoxical). However, quite a few of these positive studies have...
Since intensive care medicine enables us to maintain blood circulation and respiration artificially for some time, the usual criteria for death, such as cardiac arrest and cessation of respiration, are not applicable in all cases. Thus, the irreversible breakdown of the brain functions have come to be accepted as the most prominent factor for the o...
Summary In comparison to its social impact, religiosity is widely underrepresented in scientific papers in the last century. We try
to analyze the possible connection between religiosity and mental health. As result we present three groups of evidence: 1)
psychiatric disorders widely lacking scientific evidence in this area (like dementia, schizoph...
Perseverative error (PE) is a core symptom of schizophrenia which has been proposed as a phenotypic marker of the illness. Moreover, hypofrontality observed in functional neuroimaging studies while executing a cognitive task has also been suggested as a characteristic sign of schizophrenia. We propose combining symptom and sign to demonstrate the e...
Kortikaler Blutfluss in Ruhe und während Aktivität bei schizophrenen Patienten Zusammenfassung. Hintergrund: Ziel der Studie war festzustellen, ob schizophrene Patienten, die mit dem Wisconsin Card Sorting Test (WCST) kognitiv aktiviert wurden, sich in ihrer cerebralen Durchblutung von Kon-trollpersonen unterscheiden. Methoden: Eine 99mTc-SPECT Stu...
The aim of this study is to examine if patients with schizophrenia differ in prefrontal, orbitofrontal, temporal, parietal and occipital blood flow from healthy controls during performance of the Wisconsin Card Sorting Test (WCST).
We conducted a 99mTc-hexamethylpropylene amine oxime-SPECT study in patients with schizophrenia (n = 21) and in health...
Until today, morphometric neuroimaging studies on affective disorders concentrate on the limbic system, especially the hippocampus, amygdala, and anterior cingulate. In most of the studies and reviews available today, the basal ganglia are of secondary interest. It seems that the basal ganglia are interest of neurologist, whereas the limbic system...
Sexuality and partnership have an important influence on the quality of life of every person and also on people with chronic disorders such as multiple sclerosis. The findings in literature show high evidence that people with multiple sclerosis experience high levels of sexual dysfunction, most of them with hypoactive sexual behaviour often associa...
People with MCI suffer from a moderate memory impairment, from deficits in attention and cognitive flexibility but do not fulfil the diagnostic criteria of dementia. These patients feel forgetful, and sometimes may have problems with their jobs and families because of their forgetfulness. In many cases (10-15% per year), MCI is leading to Alzheimer...
Huntington's disease (HD) is a devastating neuropsychiatric disorder for which therapeutic interventions have been rather fruitless to date, except in a slight symptomatic relief. Even the discovery of the gene related to HD in 1993 has not effectively advanced treatments. This article is essentially a review of available double-blind, placebo-cont...
Dopaminergic treatment is very effective in restless legs syndrome (RLS) and periodic leg movements in sleep (PLMS). However, neuroreceptor imaging studies that addressed altered striatal dopaminergic function have given controversial results. In this present study, 14 patients with idiopathic RLS (iRLS) and PLMS with a good response to dopaminergi...
Wie kaum bei einer anderen psychischen Störung wogt die Diskussion um den primären Einsatz von Psychopharmako-Therapie oder Psychotherapie ungebremst hin und her. Es klingt tiefst überzeugend und ist es auch, dass ein offensichtlich vorhandener äußerer Auslöser, der den Menschen aus der Lebensbahn wirft, psychische Spuren hinterlässt, wo es nahelie...
Wie bei kaum einer anderen psychiatrischen Erkrankung zeigt sich bei der PTBS ein Zusammenhang zwischen dem auslösenden Ereignis, psychischen Auffälligkeiten und neurobiologischen Auswirkungen. So sind die biologischen Aspekte der PTBS schon längere Zeit Gegenstand der Forschung und wurden auch schon in mehreren übersichtsarbeiten beschrieben (Ehle...
In clinical practice, we deal with a great proportion of elderly people. Many times, we are able to identify cognitive deficits (although not too scarce, we overlook dementia in our patients). However, the further division into the several subtypes of dementing disorders may be complicated and laborious for patients, caregivers, and physicians due...
An abstract is unavailable. This article is available as HTML full text and PDF.
We report the case of a 69-year-old patient referred to our clinic because of mania. When examined by neuroradiological imaging, there were lesions seen appearing and disappearing in different regions of the brain during a period of 2 months. Differential diagnosis of these changing lesions, progressive severe illness, and the role of glucocorticoi...
Article abstract-Fourteen drug-naive and 11 levodopa-treated patients with idiopathic restless legs syndrome (RLS), and 10 controls age-matched to each RLS group separately were examined with polysomnography (PSG), [ 123 I]-(N)-(3-iodopropen-2-yl)-2β-carbomethoxy-3β-(4-chlorophenyl) tropane ( 123 I-IPT) SPECT, and [ 123 I]-(S)-2-hydroxy-3-iodo-6-me...
Wir berichten über den Fall eines 69-jährigen Patienten, der bei der Aufnahme ein manisches Zustandsbild bot. Diskutiert werden
die Differenzialdiagnosen der sowohl in Größe als auch in Lokalisation wechselnden raumfordernden Läsionen in der Neuroradiologie
bei rapid progredienter neurologischer Symptomatik mit zwischenzeitlicher Remission unter St...
Bei progressiver supranukleärer Blickparese (engl. progressive supranuclear palsy) handelt es sich um eine neurodegenerative Erkrankung aus dem Formenkreis des atypischen Parkinson-Syndroms. Die Erkrankung ist in erster Linie durch eine Blickparese nach unten charakterisiert. Weiters treten Gleichgewichtsstörungen, Fallneigung (vor allem nach hinte...
The few reports available on olanzapine in Huntington's disease (HD) are insufficiently documented and/or insufficiently dosed. We describe a 30-year-old woman with genetically confirmed HD who presented with severe chorea. She was not able to eat or dress without help and did not respond to haloperidol; the motor scale of the Unified HD Rating Sca...
We report a patient with genetically confirmed Huntington's disease (HD) presenting apraxia of eyelid closure (AEC). She was unable to close her eyes at command but was able to blink. Chorea and AEC ameliorated significantly during treatment with olanzapine and riluzole, an inhibitor of glutamate release. AEC is reported in progressive supranuclear...
In der Literatur sind nur wenige Fälle von hypoglykämischer Neuropathie beschrieben; keine davon betraf den Bereich der Hirnnerven. Wir beschreiben den Fall einer 56-jährigen Patientin, die aufgrund eines Insulinoms seit Jahren an einem primären Hyperinsulinismus leidet. Als Nebenbefund besteht Zustand nach papillärem Schilddrüsenkarzinom. Die Hypo...
Lithium is a very effective drug for the stabilization of mood disorder in bipolar patients. We examine the development of this drug therapy since its introduction into psychiatry in 1949. Since that time, lithium has been examined in the treatment of a variety of neuropsychiatric conditions, but it is in the treatment of bipolar disorder that it i...
