Archiv Fur Psychiatrie Und Nervenkrankheiten最新文献

Rest segments of superficial temporal arteries obtained during STA-MCA anastomoses were studied histologically and histometrically. Aging was found to be associated with thickening of the intimal layer and thinning of the medial layer. In comparison with the young patients, the old patients showed a larger internal diameter of the superficial temporal artery and a larger ratio of the thickness of the intimal layer to the medial layer. The internal diameter calculated angiographically and the internal diameter estimated histologically correlated well. The dilatation ratio of the superficial temporal artery did not correlate with dimensional data assessed histologically.

Glutamate concentration was determined in serum from endogenous and neurotic depressive patients, in persons with schizophrenia or schizoaffective disorder, and in normal subjects. The mean serum glutamate level in the endogenous and neurotic depressive patients was found to be significantly higher than in any of the other groups. No other statistically significant differences were found. Statistical analysis revealed that the elevated serum glutamate concentration in the endogenous and neurotic depressive patients was probably caused by medication. These results are discussed in view of the effect of antidepressants upon the serum glutamate in the affective disorders.

Analgesic drugs, physiotherapy and corticosteroids are concurrently used in the conservative treatment of lumbar pain. In 100 patients a double-blind study with dexamethasonephosphate versus placebo was performed. Lumbar pain and no findings with myelography were the basic requirements for inclusion into the study. There was no significant difference between the treatment group and the placebo group concerning the clinical investigation before and after treatment. The positive effect of dexamethasonephosphate, which was seen in a pilot study, was not confirmed in the double-blind study. Because corticosteroids are also psychotropic drugs there is a mild antidepressive effect. Considering the fact that cortisone has no effect on the symptoms of lumbar pain, it should not be used furthermore in the conservative treatment of lumbar pain.

The effect of chronic ethanol administration, 5 g/kg per day for 2 or 4 weeks, on the neurotransmitters glutamate and GABA was investigated in rats. An increase in GABA was found in the striatum, hippocampus, and substantia nigra, 8 or 12 h after the last ingestion of ethanol, this being masked by injection of barbiturate. In addition an increase of glutamate has been found in the examined brain areas. This is consistent with the known effect of ethanol on brain Dopa metabolism and release. Finally, the relevance of the results for the pathogenesis of withdrawal seizures and delirious states is discussed.

With regard to methodological shortcomings and heterogeneity of the outcome of experimental studies in the field of suicide prevention only tentative conclusions can be drawn from the results. Suicide prevention programs where contact to patients is actively established and maintained seem to be more effective in reducing the rate of further suicide attempts than passive strategies which leave it to the patients to initiate and continue a therapeutic relationship. This advantage emerges more clearly when patients are repeatedly or even continually motivated to utilize advice and treatment facilities. The intensity of outpatient aftercare services may also have a considerable influence on the effectiveness of suicide prevention.

The hypothesis is formulated that in all voluntary movements the initial neuronal event is in the supplementary motor areas (SMA) of both cerebral hemispheres. Experimental support is provided by three lines of evidence. 1. In voluntary movements many neurones of the SMA are activated probably up to 200 ms before the pyramidal tract discharge. 2. Investigations of regional cerebral blood flow by the radioactive Xenon technique reveal that there is neuronal activity in the SMA of both sides during a continual series of voluntary movements, and that this even occurs when the movement is thought of, but not executed. 3. With voluntary movement there is initiation of a slow negative potential (the readiness potential, RP) at up to 0.8 s before the movement. The RP is maximum over the vertex, i.e. above the SMA, and is large there even in bilateral Parkinsonism when it is negligible over the motor cortex. An account is given of the SMA, particularly its connectivities to the basal ganglia and the cerebellum that are active in the preprogramming of a movement. The concept of motor programs is described and related to the action of the SMA. It is proposed that each mental intention acts on the SMA in a specific manner and that the SMA has an 'inventory' and the 'addresses' of stored subroutines of all learnt motor programs. Thus by its neuronal connectivities the SMA is able to bring about the desired movement. There is a discussion of the manner in which the mental act of intention calls forth neural actions in the SMA that eventually lead to the intended movement. Explanation is given on the basis of the dualist-interactionist hypothesis of mind-brain liaison. The challenge is to the physicalists to account for the observed phenomena in voluntary movement.

The differential effects of vision on motion sickness in cars were tested under real road conditions using linear accelerations, in order to confirm earlier laboratory results on visual modulation of vestibular nausea induced by angular accelerations of the body. The 18 voluntary subjects were exposed to repetitive braking maneuvers (linear accelerations: 0.1-1.2 g) on a highway. The simultaneous visual stimulus conditions for the 3 separate days were: I) eyes open, visual control of car motion; II) eyes closed; III) eyes open, artificial stationary visual field (reading). The severity of motion sickness (magnitude estimation 1-10) was a function of the visual stimulus condition with significant differences among these conditions: I) moderate nausea (less than 1) with adequate visual motion perception; II) medium nausea (approximately equal to 2) with eyes closed and somatosensory-vestibular excitation only; III) strong nausea (greater than 5) with conflicting sensory input, when vestibular acceleration is in disagreement with the visual information of no movement. Providing ample peripheral vision of the relatively moving surround is the best strategy to alleviate car sickness.

An unselected series of 100 psychiatric inpatient admissions were interviewed at admission by a psychiatrist using the German version of the PSE (Present State Examination), with a second psychiatrist as an observer. The diagnostic agreement between the two project psychiatrists was considerably higher than the agreement between clinicians and CATEGO, a computerised diagnostic system based on PSE data. The disagreements are discussed.

The performance in the Trail Making Test (Form A) was correlated with a variety of verbal and nonverbal tests in 5 groups of patients: Broca's aphasics (N = 18), Wernicke's aphasics (N = 19) and nonaphasic patients with right hemisphere (N = 20), left hemisphere (N = 17) or diffuse (N = 18) lesions. Correlations with the Trail Making Test were found for two tests, both requiring visual search. The "Objects Finding Test" in which the target varies from item to item showed high correlations for all groups of patients. The "Hidden Patterns Test", in which the target is kept constant, correlated only on the groups of nonaphasic patients. It is concluded (1) that visual search, as tested here, is not restricted to lateralized cortical functions, and (2) that the performance in the Trail Making Test depends largely upon processes involved in visual search of varying targets.

Evoked potentials in response to unilateral stimulation of the posterior tibial nerve at the ankle were recorded above the spinous processes L5, L1, C2, and at Cz' in 30 normal subjects. The "cauda-potential" recorded above L5 consists of two small negative peaks with a mean latency of 18 and 22.5 ms respectively, whereas the "cord-potential" recorded above L1 exhibited a peak latency of 21.2 ms and on average a three-times larger amplitude than the first of the two "cauda-potentials" (Fig. 1). Leads from the spinous process C2 revealed a sharp negative peak with a mean peak latency of 28.8 ms (N 30). Scalp recordings with a midfrontal (Fz-) reference inconsistently showed 1-2 small waves (P31, N33) prior to the primary cortical response (P40). Recordings with an ear- or non-cephalic reference consistently showed a large positive deflection (P30) which corresponded in latency with the simultaneously recorded cervical response (N30) and was followed by a distinct negative potential (N33) (Fig. 2a and b). Average latencies and amplitudes of the different spinal and subcortical evoked potentials (Tables 1 and 2), as well as the diagnostically more important interpeak-intervals, amplitude relations, and side-differences of latencies and amplitudes (Tables 3 and 4) were calculated. The diagnostic significance of these parameters will be shown in selected cases with spinal cord pathology.