H M Emrich's research while affiliated with Hannover Medical School and other places

Publications (272)

Article
Grapheme-color synesthesia is a condition in which letters are perceived with an additional color dimension. To identify brain regions involved in this type of synesthesia and to analyze functional connectivity of these areas, 18 grapheme-color synesthetes and 18 matched controls were stimulated with letters and pseudo-letters presented in black an...
Article
This study was designed to investigate to what extent guidelines regarding the pharmacological treatment of patients suffering from schizophrenia-like psychosis are adopted in a naturalistic treatment setting. Medical records of n=819 patients undergoing inpatient treatment for schizophrenia-like psychosis in 11 psychiatric hospitals in northwester...
Article
In synesthesia, certain stimuli to one sensory modality lead to sensory perception in another unstimulated modality. In addition to other models, a two-stage model is discussed to explain this phenomenon, which combines two previously formulated hypotheses regarding synesthesia: direct cross-activation and hyperbinding. The direct cross-activation...
Article
In auditory-visual synaesthesia, all kinds of sound can induce additional visual experiences. To identify the brain regions mainly involved in this form of synaesthesia, functional magnetic resonance imaging (fMRI) has been used during non-linguistic sound perception (chords and pure tones) in synaesthetes and non-synaesthetes. Synaesthetes showed...
Article
The study aimed to explore by means of single-trial event-related potentials (ERPs), whether and how the medication change from older neuroleptics to quetiapine in schizophrenic patients led to a significant cognitive enhancement. This single-trial ERP analysis helps to investigate attention and memory processes in the single patient before and aft...
Article
Speech perception is an essential part of social interaction. Visual information (lip movements, facial expression) may supplement auditory information in particular under inadvertent listening situations. Schizophrenia patients have been shown to have a deficit in integrating articulatory motions with the auditory speech input. The goal of this st...
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Full-text available
Schizophrenia is a serious and disabling mental disorder with symptoms such as auditory hallucinations, disordered thinking and delusions, avolition, anhedonia, blunted affect and apathy. In this review article we seek to present the current scientific findings from linkage studies and susceptible genes and the pathophysiology of white matter in sc...
Article
Background: It is documented in the literature that inpatient stay is shorter in a general hospital in the USA com-pared to Germany. The aim of this study was to compare psychiatric inpatient stay in a hospital in the USA to a hospital in Germany, focusing on major psychiatric diseases and suggesting possible differences. Methods: The data was coll...
Article
Die Komplexität der affektiven Erkrankungen zugrunde liegenden Pathomechanismen erschwert den therapeutischen Zugang zu diesen Störungen. Während die medikamentöse Therapie depressiver Erkrankungen bisher hauptsächlich auf die Beeinflussung monoaminerger Neurotransmittersysteme zielte, mehren sich Hinweise, dass auch bisher weniger beachtete Regelk...
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Der Anteil psychischer Erkrankungen in den Verfahren zur Berentung aufgrund verminderter Erwerbsfähigkeit ist seit Jahren steigend. Modernere Behandlungsmaßnahmen scheinen diesen Trend nicht zu beeinflussen. Es gibt relativ umfangreiches wissenschaftliches Material über Risikofaktoren für die Entstehung einer Depression. Wenig Informationen existie...
Article
Depression hat insofern einen zeitphilosophischen Hintergrund, als es gerade das „Hereinragen der Vergangenheit in die Gegenwart” (M. Theunissen) ist, das in der Melancholie das psychische Leben bestimmt und die Gegenwart despontaneisiert. Insofern sind Depressive in einer Verfasstheit der Rückwendung gefangen. Den neurobiologischen Hintergründen w...
Article
Farben hören – Geschmack sehen: Synsthetiker erleben eine Vermischung ihrer Sinne. Die Erforschung dieses Phnomens liefert spannende Einblicke in die Art und Weise, wie Sinneseindrücke im menschlichen Gehirn verarbeitet werden. Synsthesie als Lebensform erweist sich als Paradigma eines Selbstverstndnisses des Menschen, jenseits einer Physik der Rev...
Article
With a prevalence of 2 to 4 %, ADHD is one of the most frequently seen disorders in adulthood. Due to the putative addiction potential the treatment of this disorder with the amphetamine derivate methylphenidate is discussed controversially, particularly by the treatment of ADHD and comorbid addiction. Atomoxetine, a selective norepinephrine reupta...
Article
Atypical antipsychotics like olanzapine are more efficacious in treating negative symptoms and have less side effects. Nevertheless, important adverse effects of olanzapine are, for example, weight gain and hyperglycemia. Perazine in combination with carbamazepine has shown satisfying results in several single-schizophrenia patients, leading to the...
Article
The different aspects of the neurobiology of psychotic disorders are presently discussed under the perspective of Arvid Calssons neurochemical theory of mesolimbic/cortico-thalamic loops. In this regard the question as to whether--neuropsychologically--a "filter-defect" or a disturbance of "internal censorship" is causative for psychoses. This topi...
Article
In a single-blinded and randomized pilot study efficacy and tolerability of oxcarbazepine versus carbamazepine were investigated in 29 patients during therapy of alcohol withdrawal. No initial differences were found regarding sociodemographic data and alcohol-related parameters, indicating successful randomization. The oxcarbazepine group showed a...
Article
Accidental intrarterial injections are not uncommon in medical treatments. This is also true for uncontrolled injections by drug-addicts. Since 2002 a number of 600 heavy opiate addicts in Germany are substituted in a country-wide study with pure diacetylmorphine (Heroine). We report the course and outcome of three cases of accidental intraarterial...
Article
Die akzidentelle intraarterielle Injektion von Medikamenten und Begleitstoffen stellt eine nicht seltene medizinische Komplikation dar. Dies gilt auch fur unkontrollierte Autoinjektionen drogenabhangiger Patienten. Seit dem Jahre 2002 werden im Rahmen der bundesdeutschen Studie zur heroingestutzten Behandlung Opiatabhangiger ca. 600 Schwerstabhangi...
Article
Nichols (J Psychoactive Drugs 1986: 18, 305-311) characterized the Entactogens as a class of substances with a unique spectrum of pharmacological and psychological effects separating them from stimulants and hallucinogens. The clinical relevance of these substances derives from their most prominent members MDMA (Methylenedioxymethamphetamine), MDE...
Article
Attention deficit/hyperactivity disorder (ADHD) is of great clinical importance not only because of its high prevalence but also due to the frequent comorbid illnesses that are connected with this disorder. Several studies were able to demonstrate that ADHD constitutes a significant risk factor for the exacerbation of habit-forming illnesses, i.e....
Article
The aim of this study was to further evaluate the oestrogen hypothesis of schizophrenia, which postulates low oestradiol levels to be a risk factor for these disorders. A possible influence of neuroleptic-induced hyperprolactinaemia was to be addressed. Sex hormones were measured and cycle phase assessed in 50 acutely psychotic women on admission a...
Article
Although relatively little attention has been paid to the question how acute alcohol withdrawal might affect cognitive functions, this factor remains of particular interest because it influences psychotherapeutic treatment during detoxification. The clinical outcome and neuropsychological state of 37 inpatients with alcohol withdrawal was investiga...
Article
We report on the successful treatment of four patients suffering from confusion psychosis according to the classification of Leonhard. The patients did not sufficiently respond to neuroleptic treatment or mood stabilizers like carbamazepine and valproate, but improved when lamotrigine was added, showing a marked reduction in clinical signs and symp...
Article
Based upon neuropharmacology, neurophysiology, biochemistry, and clinical experience, the “dopamine hypothesis” of schizophrenic and the “catecholamine hypothesis” of depressive psychoses represent an important part of the current knowledge about the etiology and pathophysiology of these psychiatric disorders. These hypotheses, however, are challen...
Article
For more than 1000 years cannabinoids are used as therapeutic drugs. In the last years there is growing interest in the medical utilization of cannabinoids like Dronabinol. The basis for this development is the understanding that cannabinoids act via specific receptors in the brain. These receptors are located in specific brain areas, particularly...
Article
The therapeutic value of anticonvulsants in affective and schizoaffective disorders was documented in several clinical trials. Oxcarbazepine (OXC), a keto-derivative of carbamazepine, which appears to have a preferable side effect profile compared to carbamazepine, has also shown antimanic efficacy in affective and schizoaffective disorders in clin...
Article
Antikonvulsiva wie Carbamazepin und Valproat werden erfolgreich in der Behandlung der Manien und zur Prophylaxe affektiver und schizoaffektiver Erkrankungen eingesetzt. Auch Oxcarbazepin, ein Ketoderivat des Carbamazepins, zeigte sich bereits in den frühen 80er-Jahren bei diesen Erkrankungen als antimanisch wirksam. Im Vergleich zu Carbamazepin wei...
Article
An 18-year old man suffering from catatonic schizophrenia was unsuccessfully treated with several antipsychotic regimen and refused electro-convulsive therapy after nine sessions with limited improvement. Because of this multiple drug resistance and reports of estradiol to constitute a protective factor in schizophrenia, gonadal function was invest...
Article
Background: Preliminary studies suggested that delta-9-tetrahydrocannabinol (THC), the major psychoactive ingredient of Cannabis sativa L., might be effective in the treatment of Tourette syndrome (TS). This study was performed to investigate for the first time under controlled conditions, over a longer-term treatment period, whether THC is effecti...
Article
Recent neurobiological concepts about sensomotor processes in animals exhibit that voluntary motor behavior is not due primarily to external cues but to internal activation-processes ("initial activity"). Thus questions are raised as to the role of internal "limbic" valuation-processes in relation to contexts of the past. These are not limited to t...
Article
Over the last few years, there has been a growing tendency for opioid addicts to abuse multiple drugs, although many patients are in substitution therapy with methadone. Abuse of multiple drugs leads to a more complicated withdrawal syndrome; it is therefore necessary to investigate new drug strategies as a treatment for detoxification. Buprenorphi...
Article
The seeds of the Hawaiian baby woodrose ( Argyreia nervosa) are used by adolescents as a supposed hallucinogenic drug. These seeds are legally available and broadly sold. The active components are alkaloids structurally related to lysergic acid diethylamide (LSD). However, the psychic effects are very different from those of LSD and are dominated b...
Article
Die Samen der Hawaiianischen Holzrose (Argyreia nervosa) werden von Jugendlichen immer häufiger als vermeintlich halluzinogene Droge verwendet. Die Samen sind frei verkäuflich und werden breit vertrieben. Die wirksamen Inhaltsstoffe sind als Alkaloide mit Indolstruktur dem LSD ähnlich. Nach Einnahme zeigen sich jedoch keine eigentlich halluzinogene...
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Full-text available
Carbamazepine intoxication is associated with seizures, coma, arrhythmias and death. In acute intoxication, charcoal hemoperfusion is employed for removal of the drug. This can be associated with thrombocytopenia, coagulopathy, hypothermia and hypocalcemia. Alternatively, we used high-efficiency hemodialysis with a batch dialysis system (Genius), l...
Article
Charles Bonnet syndrome (CBS) is characterized by the presence of visual hallucinations in elderly, mentally healthy people. We report a visually impaired 90-year-old woman suddenly complaining of visual hallucinations, suffering from hyperthyroidism and a relative digitalis overdose. The diagnosis of CBS could be made after the exclusion of an int...
Article
Unter Charles-Bonnet-Syndrom (CBS) versteht man das Auftreten visueller Halluzinationen bei geistig gesunden älteren Personen. Wir berichten über eine sehbehinderte 90-jährige Patientin mit einer manifesten Hyperthyreose und relativer Digitalis-Überdosierung, bei der plötzlich optische Halluzinationen auftraten. Wir stellten die Verdachtsdiagnose e...
Article
Anecdotal reports in Tourette's syndrome (TS) have suggested that marijuana (cannabis sativa) and delta-9-tetrahydrocannabinol (Delta(9)-THC), the major psychoactive ingredient of marijuana, reduce tics and associated behavioral disorders. We performed a randomized double-blind placebo-controlled crossover single-dose trial of Delta(9)-THC (5.0, 7....
Article
We report on a 70-year-old man who suffered from persecutory delusions during the last 20 years. During first visits, he showed neither cognitive impairment nor Schneiderian first rank symptoms. Inpatient and day clinic treatment as well as further outpatient therapy led to reintegration into social life and trusting relationships between the patie...
Article
Binocular depth inversion represents an illusion of visual perception, serving to invert the perception of implausible hollow objects, e.g. a hollow face into a normal face. Such inversion occurs frequently, especially when objects with a high degree of familiarity (e.g. photographs of faces) are displayed. Under normal conditions, cognitive factor...
Article
The broadening of the classification systems for manic-depressive illness towards a spectrum of bipolar disorders implicates a more differentiated use of pharmacotherapies. However, many questions still remain open. This implies that all consensus guidelines and recommendations have to be considered as preliminary. On the other hand, research in th...
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Wir berichten über einen Patienten, der erstmals im 70. Lebensjahr Kontakt mit der Psychiatrie aufnahm, nachdem er bereits seit 20 Jahren einen Verfolgungswahn hatte, ohne initial kognitiv-demenzielle Störungen oder Symptome 1. Ranges nach Schneider aufzuweisen. Die langfristige Behandlung im ambulanten, tagesklinischen und stationären Setting ermö...
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Full-text available
When humans perceive an object, their perceptory organs transform the properties of the object into percepts of different modalities, which are then related with one another in such a way that the object appears as a unified entity in consciousness. This neurobiological process, which is still largely unknown, is called "binding". When during the p...
Article
Die Erweiterung der Klassifikation der manisch-depressiven Erkrankung hin zum Spektrum bipolarer Erkrankungen bedingt eine differenziertere Pharmakotherapie. Da noch deutlicher Forschungsbedarf besteht, müssen gegenwärtige Konsensusrichtlinien und Therapieempfehlungen als vorläufig begriffen werden. Umgekehrt hat jedoch die Forschung des letzten Ja...
Chapter
In der psychiatrischen Therapie wird Valproinsäure (valproic acid, VPA) in den letzten Jahren in zunehmendem Maße eingesetzt. Vor dem Hintergrund früherer Erfahrungen mit anderen Antikonvulsiva wie Phenytoin (PHT), Dipropylacetamid (DPA, das Säureamid des Valproats) und im Vergleich zu Carbamazepin (CBZ) spielt Valproinsäure einerseits auf dem Gebi...
Chapter
Full-text available
Neben Lithium haben sich in den letzten Jahren Carbamazepin und Valproat bei affektiven Psychosen als phasenprophylaktisch wirksam erwiesen, wobei diese Substanzen entweder als Alternativen zu Lithium oder als Adjuvantien, in Kombination mit Lithium, eingesetzt werden.
Article
Objectives– to examine postsynaptic dopamine D2 receptors in Tourette syndrome (TS). Material and methods– Seventeen patients and a control group were investigated using single photon emission computed tomography (SPECT) and iodobenzamide (123I-IBZM). Results– In neuroleptic treated patients (n=7) 123I-IBZM-binding was significantly reduced compare...
Article
Anticonvulsants have been successfully used in pharmacopsychiatry after their therapeutic value in affective and schizoaffective disorders had been documented in several clinical trials. As the authorities in several countries registered newer anticonvulsants with fewer side effects, their therapeutic value in psychiatric disorders was studied. Cli...
Article
The Gilles de la Tourette Syndrome (TS) and Obsessive Compulsive Disorder (OCD) have been shown to display impaired cognitive and motor inhibition. This study investigated inhibitory mechanisms of motor responses in order to expand the understanding of sensorimotor integration processes in both disorders. We hypothesized that both patient groups wo...
Article
Der Morbus Huntington (HD) ist durch choreatiforme Bewegungsstörungen, Verhaltensauffälligkeiten und eine demenzielle Entwicklung gekennzeichnet und wird molekulargenetisch nachgewiesen. HD weist klinisch viele Ähnlichkeiten mit der Choreoakanthozytose (CA) auf. Die CA ist eine selten auftretende, progressiv verlaufende neurologische Multisystemerk...
Article
We report on the successful treatment of two female patients with the clinical features of severe confusional psychosis. The clinical picture of these cases was characterized by lability of mood, disorientation, delusions, hallucinations, misidentification of persons, severe thought disorder and impaired memory. A 55-year old female inpatient suffe...
Article
Schizophrenia simplex is a negative subtype of schizophrenia with a low prevalence but poor prognosis. We report on a 22-year-old male who responded well to atypical neuroleptics (clozapine and risperidone).
Article
Bei der Schizophrenia simplex handelt es sich um eine schizophrene Psychose mit niedriger Prävalenz aber schlechter Prognose, bei der Negativsymptome im Vordergrund stehen. Wir berichten über einen 22-jährigen Mann, der sich unter einer Therapie mit atypischen Neuroleptika (Clozapin, Risperidon) erfreulich stabilisiert hat. Schizophrenia simplex i...
Article
Estradiol has been postulated to constitute a protective factor for schizophrenia, which could provide women at risk to experience a psychotic episode with a relative protection in phases of high estradiol levels, i.e. before menopause and during the peri- and postovulatory phases of their cycle. Women suffering from schizophrenia have been reporte...
Article
Previous studies have suggested that marijuana (cannabis sativa) and delta-9-tetrahydrocannabinol (delta9-THC), the major psychoactive ingredient of marijuana, are effective in the therapy of tics and associated behavioral disorders in Tourette Syndrome (TS). Because there is also evidence that cannabis sativa may cause cognitive impairment in heal...
Article
One of the most frequent and neuropsychologically well investigated symptoms in depression is reduced memory capacity. In this study, we investigated the course of disease in 16 patients with moderate depression and Borna disease virus (BDV) infection. Recently, it could be shown that BDV infection might play an important role in the etiology of su...
Article
Repetitive transcranial magnetic stimulation (rTMS) has been tried therapeutically in major depression. In order to investigate the therapeutic efficacy of rTMS in psychotic patients, 12 participants (four women, eight men) with schizophrenia according to DSM-IV criteria, aged 25 to 63 years (mean (+/-s.d) 40.4+/-11.0), were enrolled in the study....