Fortschritte Der Neurologie Psychiatrie最新文献

{"title":"[Treatment-refractory chronic depression in a CADASIL patient with a symptom-free somatic course: a case report].","authors":"Sebastian Wurthmann, Oliver Kastrup, Cornelius Wurthmann, Norbert Scherbaum, Patrik Roser","doi":"10.1055/a-2512-7605","DOIUrl":"https://doi.org/10.1055/a-2512-7605","url":null,"abstract":"<p><p>Depressive disorders are very common psychiatric disorders that are usually well treatable. However, special attention is required if the depressive symptoms do not improve despite guideline-compliant treatment and if brain structural changes can be detected on neuroimaging.We report on a genetically newly diagnosed 63-year-old patient with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) with a two-decade course of severe affective symptoms in the absence of classical somatic disease characteristics although we found a pathogenic variant in the EGFr 4 domain of the NOTCH3 protein.CADASIL is a rare inherited disease of the small cerebral vessels which is caused by mutations in the NOTCH3 gene. The disease typically begins in young adulthood and is characterized by ischemic strokes, migraine-like headaches, psychiatric disturbance, and cognitive decline. Pathogenic variants in NOTCH3 EGFr domains 1-6 are associated with a more severe somatic phenotype. Our case report highlights the phenotypic heterogeneity of CADASIL with only psychiatric symptoms despite mutation within EGFr domain 4; therefore, CADASIL should be considered in the presence of affective disorders, lack of response to antidepressants and typical MR changes.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnostic utility of the MTA-Score depending on age and cerebral microangiopathy in times of automated volumetry].","authors":"Pauline Klara Sander, Cathrin Sauer, Arne Grey, Pawel Krukowski, Jennifer Linn, Moritz D Brandt, Robert Haussmann","doi":"10.1055/a-2512-7931","DOIUrl":"https://doi.org/10.1055/a-2512-7931","url":null,"abstract":"<p><p>  To investigate the diagnostic value of the MTA score according to age, cerebral small vessel disease and in times of automated volumetry.  Retrospective analysis of patients with subjective cognitive decline (SCD), amnestic mild cognitive impairment (aMCI), Alzheimer's disease (AD) and mixed dementia (MD) who presented to our outpatient dementia clinic between February 2018 and October 2020. Patients underwent cranial magnetic resonance imaging (MRI) including specific MRI sequences needed for automated volumetry. MRI data sets were analyzed regarding MTA score, Fazekas score, hippocampal und temporal lobe percentile and total white matter lesion volume.  Within the study period, 242 patients (100 male, 142 female, mean age 74.7±9.9 years) with SCD (n=20), aMCI (n=110), AD (n=62) and MD (n=50) were analyzed. MTA score strongly correlated with age (ρ=0.545; p<0.001), especially regarding the aMCI and AD group. MTA score differentiated only between prodromal and dementia stages (aMCI vs. AD: p=0.005), whereas hippocampal percentile also showed a trend in differentiating between SCD and aMCI. There was a correlation between MTA score and hippocampal percentile (ρ=-0.385; p<0.001), which, on a single group level, could only be shown for the aMCI and AD group. There was significant correlation between MTA score with hippocampal and temporal lobe percentile. MTA score also correlated with Fazekas score (ρ=0.451; p<0.001) which again could only be detected within the aMCI and AD group. But there was no correlation between hippocampal percentile and total white matter lesion volume.  When interpreting the MTA score, patient's age needs to be taken into consideration. Especially, in early dementia diagnostics, automated volumetric procedures might be advantageous, but due to the strong correlation of MTA score with hippocampal percentile, the MTA score still is a valid diagnostic marker. Whether hippocampal atrophy is modulated by cerebral small vessel disease still needs to be elucidated.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Neurological evaluation of \"post-COVID-19 syndrome\" (PCS)].","authors":"Jens D Rollnik","doi":"10.1055/a-2465-3570","DOIUrl":"https://doi.org/10.1055/a-2465-3570","url":null,"abstract":"<p><p>The so-called \"post-COVID-19 syndrome\" (PCS) includes a variety of subjective complaints and represents a challenge to medical evaluation. The review focuses on symptom validation of the most common neurological, neuropsychiatric and neuropsychological PCS symptoms like fatigue, loss of smell and taste, problems speaking or communicating, cognitive disorders, dysaesthesia and persistent muscle pain.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correction: The pioneers Schwerin and Brandenburg-Görden in the development of alcohol use disorder therapy in the GDR].","authors":"Nadja Pontzen, Holger Steinberg","doi":"10.1055/a-2503-2447","DOIUrl":"https://doi.org/10.1055/a-2503-2447","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Antipsychotic Treatment of Alcohol Withdrawal Syndrome with Focus on Delirium Tremens: a Systematic Review].","authors":"Timo Jendrik Faustmann, Myrella Paschali, Georg Kojda, Leonhard Schilbach, Daniel Kamp","doi":"10.1055/a-2029-6387","DOIUrl":"10.1055/a-2029-6387","url":null,"abstract":"<p><strong>Background: </strong>Delirium tremens (DT) is a common complication of alcohol withdrawal. Pharmacological treatment of hospitalized patients with DT is important in addiction medicine but also in other medical disciplines where DT can occur as a complication of hospitalization. Patients suffering from DT require treatment with benzodiazepines (short-acting benzodiazepines for elderly patients to reduce accumulation), and in cases of psychotic symptoms, treatment with antipsychotics. Benzodiazepines are a first-line treatment for DT. A specific guideline for the use of antipsychotics has yet to be developed. This review discusses the current guidelines and literature on the antipsychotic treatment options in DT.</p><p><strong>Aim: </strong>Systematic presentation of relevant antipsychotics for the treatment of DT.</p><p><strong>Methods: </strong>A systematic literature search was conducted using Scopus and PubMed. The last search was conducted on May 22nd 2022. Original articles and reviews on antipsychotic treatment in alcohol withdrawal and DT were included in this review. Further, international guidelines were also considered. The review was registered using the PROSPERO database (https://www.crd.york.ac.uk/prospero/); CRD42021264611.</p><p><strong>Results: </strong>Haloperidol is mainly recommended for use in the intensive care unit. There is little literature on the use of atypical antipsychotics to treat DT. Treatment with antipsychotics always should be combined with benzodiazepines, and physicians should watch out for complications like neuroleptic malignant syndrome, QTc interval prolongation, extrapyramidal symptoms and withdrawal seizures resulting from lowering the threshold for seizures.</p><p><strong>Conclusion: </strong>Antipsychotic treatment should depend on the experience of the physician. Beside haloperidol, no other clear recommendations are available.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"36-52"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9536084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pacemaker, organ or walking stick? Pre-op association with and post-op subjective perception of a deep brain stimulation device].","authors":"Henriette Krug, Anna Scharf, Karsten Weber, Andrea A Kühn, Patricia Krause, Sonja Haug","doi":"10.1055/a-2202-9772","DOIUrl":"10.1055/a-2202-9772","url":null,"abstract":"<p><strong>Aim of the study: </strong>This study was conducted in a pre-post design with a survey of patients who had undergone deep brain stimulation (DBS) as treatment for a neurological movement disorder. The aim of the study was to compare patients' expectations and beliefs before a DBS intervention with patients' subjective experience of this intervention.</p><p><strong>Methodology: </strong>The longitudinal study of patients (n=132) with an indication for DBS therapy was based on a written survey at the time points of preoperative screening (pre-op) and one-year follow-up (post-op).</p><p><strong>Results: </strong>Preoperatively, a clear majority of respondents believed DSB to be similar to a pacemaker intervention, but one year after the intervention less than one third did so, as they compared DBS to using a walking stick or glasses.</p><p><strong>Conclusion: </strong>The experience of DBS in the patient's own body seems to be comparable by means of individually different associations, whereby the comparison with non-invasive aids predominates postoperatively. The discussion of these descriptions in the educational interview can contribute to a realistic horizon of patients' expectations before DBS.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"12-18"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparative Harm/Benefit Analysis of Various Psychotropic Substances from the Perspective of German Drug Users and Addiction Medicine Experts - A Contribution to Psychoeducation of Substance-Addicted Individuals and Restriction/Legalization Debates].","authors":"Ann-Kristin Kanti, Michael Specka, Norbert Scherbaum, Udo Bonnet","doi":"10.1055/a-1971-9558","DOIUrl":"10.1055/a-1971-9558","url":null,"abstract":"<p><strong>Background: </strong>To date, we cannot find any current international comparative study on the assessment of a benefit/harm profile of various licit and illicit psychoactive substances conducted by adult drug users and addiction experts as well. Particularly, there is no study from the German-speaking area of Western Europe.</p><p><strong>Methods: </strong>In addition to the data already published by 101 German addiction medicine experts (published in this journal, [1]), we carried out interviews using a structured questionnaire with 100 German substance dependent users, residing in acute and rehabilitation clinical setting, to evaluate 34 psychoactive substances regarding their health and social harm potential for users and others as well as their potential benefit.</p><p><strong>Results: </strong>Both, users and experts estimated traditional illicit drugs, such as heroin, crack/cocaine and methamphetamine, to be particularly harmful. Synthetic cannabinoids, alcohol and benzodiazepines were in the upper midfield, cannabis and psychotropic mushrooms in the lower midfield, and gabapentinoids at the bottom of the harm rankings of both, users and experts. In comparison with the experts, the users estimated methadone and benzodiazepines to be significantly more harmful. In the benefit analysis, users rated traditional illicit drugs including cannabis and psychotropic mushrooms as well as nicotine as significantly more useful than the experts. In contrast to the experts (traditional illicit drugs), the users did not assess any substance as very harmful and very useless at the same time. Only a few users reported to have experiences with opioid analgesics which, however, did not differ between the users´ and experts´ harm/benefit-assessments. Neither users nor experts predicted cannabis-legalization to change the overall risk potential of cannabis. Specific cognitive valuation biases seemed to be prominent in both groups.</p><p><strong>Conclusion: </strong>This study presents first harm/benefit assessments of psychotropic substances from the perspective of German addiction medicine experts and drug users. The results can be valuable to the psychoeducation of substance-addicted individuals and to current restriction or legalization debates.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"19-35"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10706051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Psyche in Climate Crisis?An Update on Ecological Psychiatry and Psychotherapy].","authors":"Eva-Lotta Brakemeier, Sebastian Karl, Sarah Stapel, Andreas Meyer-Lindenberg","doi":"10.1055/a-2444-5039","DOIUrl":"https://doi.org/10.1055/a-2444-5039","url":null,"abstract":"<p><p>The human-caused climate crisis is advancing relentlessly and poses a global threat. But to what extent is our psyche also in crisis due to climate change? This article explores the profound impacts of the climate crisis and environmental destruction on mental health, advocating for a comprehensive, ecologically-oriented approach to psychiatry and psychotherapy.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"93 1-02","pages":"57-70"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Emerging suicidal ideation in a bipolar patient after taking pregabalin: a case report].","authors":"Christine Wagner, Augusto Montecino","doi":"10.1055/a-2374-2182","DOIUrl":"10.1055/a-2374-2182","url":null,"abstract":"<p><p>Bipolar disorder is a severe mental illness and often occurs with comorbidities like anxiety or alcohol abuse. Thus pregabalin could be a promising drug. We present a case report of a 37-year-old woman with bipolar II disorder suffering from a depressive episode with features of anxiety and increased alcohol consumption. The patient was started on quetiapine as monotherapy. After a few days of add-on pregabalin, we observed suicidal ideations and self-harming behaviour, although expression of anxiety as well as alcohol consumption showed a decrease. When we stopped pregabalin and increased the dosage of quetiapine, suicidal behaviour almost disappeared. In the relevant literature, there is disagreement on the use of pregabalin. On the one hand, pregabalin is described as a safe and well-tolerated drug, and on the other hand, there are also concerns about the suicidal effect of anticonvulsants. In conclusion, we recommend the cautious use of pregabalin and other anticonvulsant drugs in patients with affective disorder. There could be a promising effect on the comorbidities but the effect on mood remains still unclear.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"53-56"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The pioneers Schwerin and Brandenburg-Görden in the development of alcohol use disorder therapy in the GDR].","authors":"Nadja Pontzen, Holger Steinberg","doi":"10.1055/a-2452-8376","DOIUrl":"10.1055/a-2452-8376","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to provide insights into the addiction therapy concepts applied at the clinics of Hugo von Keyserlingk in Schwerin and Hubertus Windischmann in Brandenburg and to enable an understanding of the specific problems in this subsector of psychiatric care in the GDR.</p><p><strong>Methods: </strong>Works published primarily in the GDR were identified, analyzed and contextualized, with expert interviews with von Keyserlingk and Windischmann complementing the findings.</p><p><strong>Results: </strong>Initially limited approaches to alcoholism treatment after the Second World War gradually developed into more complex and diverse structures. Thus, from the 1960s on, von Keyserlingk established an addiction clinic, while Windischmann established an addiction treatment center in Brandenburg with various therapeutic options.</p><p><strong>Conclusions: </strong>Von Keyserlingk's and Windischmann's contributions play a significant role in the development of therapeutic concepts. The study shows that they played a pioneering role in alcohol patient care in the GDR.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}