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Introduction
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January 2012 - present
January 1996 - December 2012
Ludwig-Maximilians-Universität München
Publications
Publications (329)
Background
Neurosteroids have recently gained in interest as a treatment strategy for affective disorders. Etifoxine is known for its dual mode of action, one of which is to stimulate endogenous neurosteroid synthesis. The gut microbiome has been studied in affective disorders, but it has not been investigated in the context of human etifoxine or n...
Depressive Disorders in Adolescence: Current State of Studies Concerning the Microbiota-Gut-Brain Axis Abstract. Depressive disorders increase during adolescence and often lead to significant impairment in affected individuals - despite treatment. Current research efforts aim to further investigate the pathophysiology of depression, considering the...
Importance:
Insufficient treatment response and resulting chronicity constitute a major problem in depressive disorders. Remission rates range as low as 15% to 40% and treatment-resistant depression (TRD) is associated with low-grade inflammation, suggesting anti-inflammatory interventions as a rational treatment strategy. Minocycline, which inhib...
The molecular pathomechanisms of major depressive disorder (MDD) are still not completely understood. Here, we follow the hypothesis, that mitochondria dysfunction which is inevitably associated with bioenergetic disbalance is a risk factor that contributes to the susceptibility of an individual to develop MDD. Thus, we investigated molecular mecha...
The molecular pathomechanisms of major depressive disorder (MDD) are still not completely understood. Here, we follow the hypothesis, that mitochondria dysfunction which is inevitably associated with bioenergetic disbalance is a risk factor that contributes to the susceptibility of an individual to develop MDD. Thus, we investigated molecular mecha...
The prevalence and public health burden of chronic heart failure (CHF) in Europe is steadily increasing mainly caused by the ageing population and prolonged survival of CHF patients. Frequent hospitalizations, high morbidity and mortality rates, and enormous healthcare costs contribute to the health related burden. However, multidisciplinary framew...
Depression is a chronic disease with a complex multifactorial and still not fully clarified etiology. Due to new insights after recent investigations of the microbiota-gut-brain (MGB) axis, a relationship between a disrupted gut microbiota composition and the probability to develop a depression can be assumed. This hypothesis is supported by eviden...
The pandemic spread of the corona virus SARS-CoV-2 has even-handedly shattered national and international health systems and economies almost in an instant. As numbers of infections and COVID-19–related deaths rise from day to day, fears and uncertainties on how to deal with this unknown threat are extremely present both for individuals and societi...
Mitochondrial malfunction is supposed to be involved in the etiology and pathology of major depressive disorder (MDD). Here, we aimed to identify and characterize the molecular pathomechanisms related to mitochondrial dysfunction in adult human skin fibroblasts, which were derived from MDD patients or non-depressive control subjects. We found that...
Mitochondrial malfunction is supposed to be involved in the etiology and pathology of major depressive disorder (MDD). Here, we aimed to identify and characterize the molecular pathomechanisms related to mitochondrial disfunction in adult human skin fibroblasts which were derived from MDD patients or non-depressive control subjects. We found that M...
ZUSAMMENFASSUNG
Gegenstand und Ziel Die vorliegende Studie zeigt einen alternativen Weg zur Operationalisierung des Begriffs „regionale Pflichtversorgung“ in der stationären Psychiatrie und Psychotherapie auf.
Material und Methoden In einer explorativen Analyse von 9659 Behandlungsfällen von psychiatrischen Fachabteilungen an 3 Standorten wurden au...
ZUSAMMENFASSUNG
Gegenstand und Ziel: Analysen des Dickdarm-Mikrobioms sind ein international zunehmend intensiver untersuchter Forschungsschwerpunkt. Die zahlreichen Schwierigkeiten solcher Studien sind oft nicht bekannt, worauf hier vermehrt aufmerksam gemacht werden soll. Antidepressiva und Antibiotika zeigen teils ähnliche Wirkmechanismen, wesha...
Major depression is a complex disease and ‐ among others, inflammation appears to play an important role in its pathophysiology. In this study, we investigated a broad range of cytokines in depressed patients. Plasma levels of IL‐12/ IL‐23p40, IL‐15, IL‐16, IL‐17A, IL‐1α, IL‐7, TNFβ and VEGF were compared in 48 patients suffering from major depress...
Major depressive disorder is the main cause of disability worldwide with imperfect treatment options. However, novel therapeutic approaches are currently discussed, from augmentation strategies to novel treatments targeting the immune system or the microbiome-gut-brain axis. Therefore, we examined the potential beneficial effects of minocycline, a...
Background:
Cardiovascular disorders (CVD) and major depressive disorder (MDD) are the most frequent diseases worldwide responsible for premature death and disability. Behavioral and immunological variables influence the pathophysiology of both disorders. We therefore determined frequency and severity of MDD in CVD and studied whether MDD without...
Background:
In a previous single center study we found that a standardized drug treatment algorithm (ALGO) was more cost effective than treatment as usual (TAU) for inpatients with major depression. This report aimed to determine whether this promising initial finding could be replicated in a multicenter study.
Methods:
Treatment costs were calc...
Introduction:
Inflammatory processes play an important and complex role in the pathophysiology of major depressive disorder (MDD), but, so far, no specific investigation of chemokines exists.
Methods:
In this study, we investigated the changes of plasma chemokine levels (eotaxin-1, eotaxin-3, IP-10, MCP-1, MCP-4, MDC, MIP-1α, MIP-1β, and TARC) i...
Recently, there has been renewed interest in the role played by microbiome in both human health and human disease. A correct equilibrium between the human host and their microorganisms is important for an appropriate physiological function. Extensive research has shown that microbes that inhabit the gastrointestinal tract—or gut microbiota—are invo...
Background:
Treatment algorithms are are considered as key to improve outcomes by enhancing the quality of care. This is the first randomized controlled study to evalutate the clinical effect of algorithm-guided treatment in inpatients with major depressive disorder (MDD).
Methods:
Inpatients, aged 18-70 years with MDD from 10 German psychiatric...
Die Elektrokonvulsionstherapie (EKT) ist ein nichtpharmakologisches biologisches Behandlungsverfahren, dessen Wirksamkeit bei depressiven Störungsbildern, aber auch bei Schizophrenie gut belegt werden konnte. In den letzten Jahrzehnten wurden viele weitere Methoden zur elektrischen bzw. elektromagnetischen Stimulation des Gehirns entwickelt und die...
Introduction
Depression occurs frequently in patients suffering from Parkinson's disease (PD). However, the neural basis of depression in PD remains unclear. Diffusion magnetic resonance imaging (DMRI) connectometry is based on the spin distribution function (SDF), which quantifies the density of diffusing water.
Aim
The aim of this study was to a...
Genetic variations in the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR) have been associated with maladaptive stress responses and major depressive disorder (MDD). In a case–control study design, we examined whether single nucleotide polymorphisms (SNPs) and haploid genotype (haplotype) associations of MR gene NR3C2, GR gene...
Objectives:
The main aims of this paper are to review and evaluate the neurobiology of the depressive syndrome from a neurodevelopmental perspective.
Methods:
An English language literature search was performed using PubMed.
Results:
Depression is a complex syndrome that involves anatomical and functional changes that have an early origin in t...
Microbiological ecology and its ambition to describe the complete genome of complex living communities as a whole, have given us powerful tools to characterize the human gut microbiome on a genetic and, hence, taxonomic and abundance level; for a decade now, they have become sufficiently inexpensive, fast and feasible. Thus, opportunities arose to...
Parkinson's disease (PD) is a progressive neurodegenerative disorder assumed to involve different areas of CNS and PNS. In PD patients and in primates with experimental Parkinsonism indicating that retinal dopamine deficiency is an important factor in the pathogenesis of PD visual dysfunction. Visual signs and symptoms of PD may include defects in...
Introduction: A promising candidate in the field of pharmacological treatment options regarding major depressive disorder (MDD) is the mitochondrial translocator protein (18 kDa) (TSPO). TSPO is crucial for neurosteroid synthesis, which is in turn important for the regulation of emotions. It has already been shown that TSPO expression in platelets...
Der menschliche Körper wird von sehr vielen Mikroorganismen kolonisiert, die in ihrer Gesamtheit als Mikrobiota und deren genetisches Material als Mikrobiom bezeichnet wird. Sie kommen unter anderem auch im menschlichen Darm vor und können die Hirnfunktion und stressassoziiertes Verhalten beeinflussen [1]. Aktuelle Studien weisen darauf hin, dass d...
Introduction:
This report from the World Psychiatric Association Section on Pharmacopsychiatry examines the possible relationship of antiepileptic drugs with suicide-related clinical features and behaviors in patients with epilepsy.
Materials and methods:
A systematic review of the MEDLINE search returned 1039 papers, of which only 8 were consid...
Approximately 20–30% of patients with Major depressive disorder (MDD) develop a chronic course of their disease. Chronic depression is associated with increased health care utilisation, hospitalisation and a higher disease burden. We identified clinical correlates and differences in treatment response of chronic MDD (cMDD) patients compared with no...
Die 48-jährige Frau S. berichtet, dass sie sich wie ein Baum fühlt, der im Sturm schwankt. Sie hat zu nichts Lust, massive Entscheidungs- und Konzentrationsprobleme sowie Insuffizienzgefühle. Sie hat in den letzten Wochen fünf Kilogramm abgenommen und ist ständig nervös. Sie spürt „Stresskribbeln“ am Haaransatz und klagt über Verspannungen im Rücke...
The tryptophan metabolism and immune activation play a role in pathophysiology of major depressive disorders. The pro-inflammatory cytokine interferon-γ transcriptionally induces the indoleamine 2,3-dioxygenase enzyme that degrades the tryptophan and thus induces serotonin depletion. The polymorphism of certain cytokine genes was reported to be ass...
Zusammenfassung
Die hohe Koinzidenz von somatischen Erkrankungen und Depressionen macht deutlich, wie wichtig ein generelles Screening bezüglich depressiver Störungen in den somatischen Fachdisziplinen ist. Aktuelle Erkenntnisse zur Depressionshäufigkeit, Pathophysiologie, prognostischen Bedeutung und der Therapie von depressiven Syndromen bei ausg...
The high coincidence of somatic disorders and depression demonstrates the importance of a general screening for depressive disorders also in somatic disciplines. With respect to prevalence, pathophysiology, prognostic significance, and treatment of depressive syndromes current knowledge on depression in selected somatic diseases are presented: diab...
The translocator protein (18kD) (TSPO) plays a crucial role for the synthesis of neurosteroids by promoting the transport of cholesterol to the inner mitochondrial membrane, which is the rate-limiting step in neurosteroidogenesis. Neurosteroids are allosteric modulators of GABA(A) receptor function, which plays an important role in the pathophysiol...
The angiotensin converting enzyme (ACE) has been repeatedly discussed as susceptibility factor for major depression (MD) and the bi-directional relation between MD and cardiovascular disorders (CVD). In this context, functional polymorphisms of the ACE gene have been linked to depression, to antidepressant treatment response, to ACE serum concentra...
Bipolar disorders are severe psychiatric disorders with extensive individual and health economic consequences. Starting in 2007 the first German evidence and consensus based guideline for diagnostics and treatment of bipolar disorders was developed which holds the potential of increasing confidence of therapists, patients and relatives in the decis...
We report about a 25-year-old patient with transnasal ketamine abuse over years presenting with severe irritative urinary dysfunction (imperative urinary urgency, pollakisuria, dysuria) and severe alguria. Cystoscopia showed ketamine-induced vesicopathy with errosive cystitis; other etiologies could be excluded. Despite serious effort the patient w...
Introduction
Cardiovascular disease (CVD) and major depressive disorders (MDD) are frequent diseases worldwide with a high comorbidity rate. Omega-3 fatty acids have been suggested as disease modulators for both CVD and MDD.
Objective and aims
Therefore, we studied whether polyunsaturated fatty acids and the Omega-3 Index may represent markers for...
We report about two patients with denial of pregnancy. While the first patient was free of psychopathological symptoms besides denial of pregnancy until rupture of the membranes, and was able to accomodate the new born, the second patient with psychotic denial of pregnancy could not accomodate the child because of the schizophrenia, so that an adop...
Current gold standard in the treatment of depression includes pharmacotherapeutic and psychotherapeutic strategies together with social support. Due to the actually discussed controversies concerning the differential efficacy of antidepressants, a contribution to a comprehensive clarification seems to be necessary to avert further deterioration and...
Current gold standard approaches to the treatment of depression include pharmacotherapeutic and psychotherapeutic interventions with social support. Due to current controversies concerning the efficacy of antidepressants in randomized controlled trials, the generalizability of study findings to wider clinical practice and the increasing importance...
Anxiety disorders are frequent and highly disabling diseases with considerable socio-economic impact. In the treatment of anxiety disorders, benzodiazepines (BZDs) as direct modulators of the GABA(A) receptor are used as emergency medication because of their rapid onset of action. However, BZDs act also as sedatives and rather quickly induce tolera...
The case of a 29-year-old patient in the 21st gestational week with severe hyperemesis gravidarum which did not respond to conventional antiemetic treatment is reported. Nausea and vomiting improved within 48 h after i.v. administration of 30 mg mirtazapine/day. The pathophysiological and therapeutic implications are discussed.
In this case report, we describe a 29 year-old male patient with a history of chronic cannabis abuse presenting with recurrent vomiting, intense nausea and abdominal pain. Abstinence from cannabis resolved both vomiting and abdominal pain. We conclude that in case of chronic cannabis abuse, patients presenting with severe and chronic nausea, vomiti...
In the past decades considerable evidence has emerged that so-called neuroactive steroids do not only act as transcriptional factors in the regulation of gene expression but may also alter neuronal excitability through interactions with specific neurotransmitter receptors such as the GABA A receptor. In particular, 3α-reduced neuroactive steroids s...
There is evidence that the anti-glycation enzyme glyoxalase-1 (GLO1) may play a role in anxiety-related behaviour. However, discordant findings between GLO1 expression and anxiety-related behaviour have been observed in animal models. Because no data are available on the relation between GLO1 mRNA expression and human anxiety so far, we investigate...
During the past decade a variety of promising new compounds was launched onto the market not only enhancing serotonergic and noradrenergic neurotransmission, but also influencing the dopamine and the melatonergic receptor system. The main advantages of the newer drugs are the broadening of the treatment spectra and a far better tolerability profile...
Seit Anfang des 20. Jahrhunderts wurden mehrere pharmakologische, aber auch nichtpharmakologische , biologisch fundierte Therapien zur Behandlung der Depression eingeführt . Abb. 29.1). Unter den nichtpharmakologischen Behandlungen hat sich die Elektrokonvulsionstherapie (Elektrokonvulsionstherapie, EKT ) weltweit als eine sehr effektive Behandlung...
Objectives
There is evidence that the antioxidant enzyme glyoxalase-1 (Glx-1) may play a role in anxiety-related behaviour. However, discordant findings between Glx-1 expression and anxiety-related behaviour have been observed in animal models. Because no data are available on the relation between Glx-1 mRNA expression and human anxiety so far, we...
Introduction
The effectiveness of electroconvulsive therapy (ECT) in pharmacotherapy resistant major depression and schizophrenia has been shown for all age groups. Nevertheless, age specific side effects such as greater cognitive impairment and higher somatic risks due to medical comorbidities and concomitant medication may be limiting factors in...
The aim of our article is to give an overview on the most important strategies for the treatment with antidepressant agents. Furthermore, we like to give an overview of the multifaceted pharmacological treatment options of depressive disorders and the occurrence of depression in case of some important comorbid somatic disorders. In conclusion, it m...
The translocator protein (18 kDa) (TSPO) is localized primarily in the outer mitochondrial membrane of steroid-synthesizing cells, including those in the central and peripheral nervous system. One of its main functions is the transport of the substrate cholesterol into mitochondria, a prerequisite for steroid synthesis. TSPO expression may constitu...
Cardiovascular disease (CVD) and major depressive disorder (MDD) are frequent worldwide and have a high comorbidity rate. Omega-3 fatty acids have been suggested as disease modulators for both CVD and MDD. Therefore, we studied whether polyunsaturated fatty acids and the Omega-3 Index may represent markers for assessment of the cardiovascular risk...
The objective of this study was to explore the prevalence of anxious depression in an inpatient population, to describe its clinical and sociodemographic correlates, and to compare treatment outcomes between patients with anxious and nonanxious depression. Furthermore, the efficacy of algorithm-guided treatment versus treatment as usual in patients...
Introduction:
Depressive disorders are among the main causes of disability due to disease. In spite of recent progress in the pharmacotherapy of depression, there is still a high nonresponse rate of ∼30% to the first antidepressant treatment. Furthermore, the latency of several weeks until sufficient clinical improvement and the risk of side effect...
Among the neuroactive steroids, 3alpha,5alpha-tetrahydrodeoxycorticosterone (3alpha,5alpha-THDOC) is at least in part produced in the adrenal gland and is therefore under the control of the hypothalamic-pituitary-adrenocortical (HPA) system. The antidepressant mirtazapine has been shown to attenuate HPA axis activity and to increase the concentrati...
The effectiveness of electroconvulsive therapy (ECT) in pharmacotherapy-resistant major depressive disorder and schizophrenia has been shown for all age groups. Nevertheless, age-specific adverse effects such as greater cognitive impairment and higher somatic risks due to medical comorbidities and concomitant medication may be limiting factors in g...
Identified SNPs in the human TPH2 gene. The positions of base exchanges are indicated according the TPH2 mRNA reference sequence (GenBank NM_173353) and the described nomenclature system.
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TPH2a and TPH2b editing in the amygdala of the tested individuals with psychiatric disorders.
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Exon-intron boundaries of Tph2 genes of higher vertebrates. The consensus sequence of the five species is indicated by ‘cons’. Alternative 3′-SDS in rats giving rise to four rTPH2 isoforms.
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Compiled kinetic constants for mammalian TPH1/2 isoforms.
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TPH2 primers used for PCR amplification.
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Brain serotonin (5-HT) neurotransmission plays a key role in the regulation of mood and has been implicated in a variety of neuropsychiatric conditions. Tryptophan hydroxylase (TPH) is the rate-limiting enzyme in the biosynthesis of 5-HT. Recently, we discovered a second TPH isoform (TPH2) in vertebrates, including man, which is predominantly expre...
Transcranial direct current stimulation (tDCS) of the prefrontal cortex (PFC) has been reported to exert significant antidepressant effects in patients with major depression. Several recent studies found an improvement of depressive symptoms in drug-free patients. Here we report the case of a 66-year-old female patient suffering from recurrent majo...
![-A, PAS and CGI-score for tiagabine [TGB] and placebo [PLC] at...](profile/Thomas-Baghai/publication/38100317/figure/tbl1/AS:601601781805057@1520444450246/A-PAS-and-CGI-score-for-tiagabine-TGB-and-placebo-PLC-at-baseline-study-endpoint_Q320.jpg)
There is evidence that a decreased GABAergic tone plays a role in the pathophysiology of panic disorder (PD). Selective GABAergic treatment has been suggested as a new therapeutic strategy in PD. In this pilot-study anxiolytic effects of the GABA reuptake inhibitor tiagabine (TGB) were investigated in PD.
A total of 19 patients were treated with TG...
About 10% of the general population report multiple and persisting physical symptoms resulting in extensive screening but with no organic explanation found.
The authors sought to determine whether these somatoform-disorder patients show characteristics of the affective disorder spectrum, with the cyclothymic temperament likely showing the highest s...
