Fortschritte Der Neurologie Psychiatrie最新文献

{"title":"[Psychopharmacotherapy with the MAO-inhibitor Tranylcypromine Key Aspects and Trends in Theory and Practice].","authors":"Sven Ulrich, Ute Lewitzka","doi":"10.1055/a-2182-5365","DOIUrl":"https://doi.org/10.1055/a-2182-5365","url":null,"abstract":"<p><p>The irreversible monoamine oxidase inhibitor tranylcypromine has been known as an antidepressant drug for more than 60 years. The aim of this review was to make an assessment of the state of the art and therapy of tranylcypromine. The recent medical-scientific literature is analyzed and discussed with respect to key aspects of and general trends in practical psychopharmacotherapy. Meta-analyses of controlled clinical studies have shown that tranylcypromine is an established approach to treatment-resistant depression. Doses (maximum dose, maintenance dose) are increasingly adapted to the requirements of treatment-resistant depression. Monoamine oxidase is not only the primary pharmacological target of tranylcypromine but determines for the first doses also the pharmacokinetics of tranylcypromine because monoamine oxidase is also an enantioselective drug-metabolizing enzyme of the monoamine oxidase inhibitor. An increased diversity of the antidepressant pharmacotherapy suggests the need to rethink the continuing assessment of tranylcypromine as a therapeutic \"ultima ratio\" in depression. In conclusion, tranylcypromine as a drug of second choice remains a valuable option in antidepressant treatment. Criteria of a switch from other antidepressant drugs to tranylcypromine should be better defined.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138290713","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":"[Vagus Nerve Stimulation (VNS) in Depression].","authors":"Erhan Kavakbasi, Bernhard T Baune","doi":"10.1055/a-2165-7860","DOIUrl":"https://doi.org/10.1055/a-2165-7860","url":null,"abstract":"<p><p>Major depressive disorder is a common mental health disease with a chronic and treatment-resistant course in about one-third of patients. Invasive vagus nerve stimulation (VNS) as a long-term adjunctive treatment option has increasingly been used in the last years. VNS was CE-certified in the European Union for use in chronic and treatment-resistant depression in 2001. Method In this narrative literature review we provide an overview on VNS as a treatment option in patients with depression. We particularly focus on aspects with high clinical relevance. Results Indication to conduct VNS is determined after comprehensive evaluation of the patients' symptoms and psychiatric history. After education of patients and caregivers and obtaining informed consent, a pacemaker-like pulse generator is implanted in the left chest in a short surgical procedure. In the first weeks after implantation, the stimulation is turned on stepwise in an outpatient setting. The left vagal nerve is stimulated for 30 sec. every 5 minutes. Hoarseness during stimulation is the most frequent side-effect. There is a delay in the onset of antidepressant action of about 6-12 months. In a large registry, the cumulative response rate after 5 years was significantly higher (67.6%) in patients treated with VNS plus treatment-as-usual (TAU) than TAU alone (40.9%). Long-term benefits of VNS on quality of life, cognition, morbidity and mortality have been described previously. Conclusion VNS is a long-term safe treatment option in severely affected patients with depression with positive impact on depression severity, quality of life and cognitive function. Increase of monoaminergic transmission and anti-inflammatory effects of VNS are possible mechanisms of action.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92153427","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: Forensic-Psychiatric Consultations in General Psychiatry].","authors":"Catharina Schmidt, Natalia Anna Seeger, Nathalie Brackmann, Angela Guldimann, Elmar Habermeyer","doi":"10.1055/a-2197-7751","DOIUrl":"https://doi.org/10.1055/a-2197-7751","url":null,"abstract":"","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479981","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":"[Telemedicine, kratom and Autism Spectrum Disorder].","authors":"Christoph Mulert","doi":"10.1055/a-2166-8620","DOIUrl":"10.1055/a-2166-8620","url":null,"abstract":"Liebe Kolleginnen und Kollegen, es freut mich sehr, Ihnen in der aktuellen Ausgabe interessante Beiträge vorzustellen zu können, die entweder aus neurologischen oder psychiatrischen Arbeitsgruppen kommen, aber jeweils auch von besonderem Interesse für das andere Fachgebiet sind.","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"91 11","pages":"442-443"},"PeriodicalIF":0.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72014093","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":"Biomarker zur Differenzierung von Migräne und Cluster-Kopfschmerz gesucht","authors":"","doi":"10.1055/a-2080-1416","DOIUrl":"https://doi.org/10.1055/a-2080-1416","url":null,"abstract":"In einer Studie der Kopfschmerzkliniken des King's College Hospital, London, wurde ein überwachter Ansatz des maschinellen Lernens und multimodale MRT-Modalitäten angewendet, um interiktale MRT-Biomarker zu identifizieren, die Migränepatienten von Cluster-Kopfschmerzpatienten unterscheiden und um Bildgebungsmerkmale aufzudecken, die diese beiden Arten von primären Kopfschmerzen gemeinsam haben.","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"129 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135564289","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":"Depressionen: funktionelle Konnektivität zur Zielplanung der Magnetstimulation","authors":"","doi":"10.1055/a-2080-1554","DOIUrl":"https://doi.org/10.1055/a-2080-1554","url":null,"abstract":"Die repetitive transkranielle Magnetstimulation (rTMS) ist ein Verfahren zur Therapie schwerer Depressionen, bei dem Magnetimpulse die Erregbarkeit von Nervenzellen beeinflussen. Obgleich heutige Protokolle die funktionelle Konnektivität des subgenuellen anterioren cingulären Kortex (sgACC) nutzen, bleibt die Studienlage unklar. Elbau et al. haben daher funktionelle Konnektivität der Stimulationsstelle und Stimulationsoutcome überprüft.","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"128 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135564292","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":"[Telemedicine Care of Dementia Patients During the COVID-19 Pandemic].","authors":"Stefan Brodoehl, Franziska Wagner, Carsten Klingner, Annie Srowig, Kathrin Finke","doi":"10.1055/a-2073-3947","DOIUrl":"10.1055/a-2073-3947","url":null,"abstract":"<p><p>In our multidisciplinary memory center at Jena University Hospital, we initiated a regular video consultation for patients at risk of developing dementia or with dementia disease and their relatives at the beginning of the SARS-CoV2 pandemic in spring 2020.Over a 12-month period, we conducted a systematic survey of satisfaction among patients in regular face-to-face contact (F2F) and video consultations (VC).The aim of this study was to evaluate the potential use of telemedicine in older people with incipient cognitive deficits in the context of dementia. In particular, we aimed to evaluate patient satisfaction and feasibility.Initial presentations to our memory center for suspected dementia were evaluated in a standardized regular on-site setting (n=50) and in a standardized video consultation (n=40). In both settings, a neuropsychologist's and a physician's consultation were performed consecutively. Both groups were similarly distributed in terms of age and sex (71.4 vs. 72.3 years, 52 vs. 50% female (F2F vs. VC)). Cognitive status was slightly better in the VC group (ACE III significant, MMST not significant).In the survey of the patients using a 12-question inventory (patient satisfaction, rated 1 to 5), there was no significant difference between the two groups overall. However, the F2F tended to be rated slightly better here in terms of advice. More than 80% of the physicians and neuropsychologists rated the technical process of VC as good/very good.A general assessment of the cognitive deficits by physicians and neuropsychologists correlated extremely highly with the results of the subsequent specific testing (MMST and ACE) in F2F and VC. With a tendency to better agreement in VC, the difference between the correlations was not significant.Overall, we could not find any significant differences in patients' satisfaction between VC and classical F2F presentation. Technical aspects in the preparation of a VC and during a VC were less problematic than initially anticipated.</p>","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":" ","pages":"444-454"},"PeriodicalIF":0.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demenzrisiko bei fokaler Epilepsie","authors":"","doi":"10.1055/a-2163-2292","DOIUrl":"https://doi.org/10.1055/a-2163-2292","url":null,"abstract":"Die Epilepsie-Erkrankung stellt mit einer Inzidenz von 30 000/Jahr und einer Prävalenz von 400 000–80 000 Betroffenen in Deutschland eine der häufigsten neurologischen Erkrankungen dar [1]. Inzidenzgipfel bestehen vor dem ersten und nach dem 65. Lebensjahr, wobei die Erstmanifestationen im höheren Alter primär durch fokale Epilepsien z. B. nach Schlaganfall, post-traumatischen Defekten oder im Rahmen von Hirnmetastasen und -tumoren bedingt wird. Dies begründet auch die zuletzt steigenden Prävalenzzahlen (4,7/1000 in 1995 auf 5,5/1000 in 2010 ) [1], nachdem angesichts des demographischen Wandels der Bevölkerungsanteil >65 Jahre von 15,6% im Jahr 1995 auf 20,7% im Jahr 2010 angestiegen ist. Eine weitere Zunahme ist zu erwarten, nachdem der Anteil der über 65-Jährigen nach Auskunft des Statistischen Bundesamtes 2021 bereits 22% erreichte [2].","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"130 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135564284","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":"Anstieg von GAP43 im Liquor deutet auf Alzheimer-Krankheit hin","authors":"","doi":"10.1055/a-2080-1347","DOIUrl":"https://doi.org/10.1055/a-2080-1347","url":null,"abstract":"Eine erhöhte präsynaptische Dysfunktion, die in der Zerebrospinalflüssigkeit (CSF) an Hand des als „Wachstums“- oder „Plastizitäts“-Protein bezeichneten Proteins GAP43 gemessen wird, kann bei der Alzheimer-Krankheit (AD) beobachtet werden. Wie aber ein Anstieg des GAP43-Liquors mit AD-Core-Pathologien, Neurodegeneration und kognitivem Abbau bei AD zusammenhängt, muss weiter untersucht werden.","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135564308","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":"Depressionen: Veränderungen der funktionellen Konnektivität nach Remission?","authors":"","doi":"10.1055/a-2080-1540","DOIUrl":"https://doi.org/10.1055/a-2080-1540","url":null,"abstract":"Zur Therapie schwerer Depressionen stehen heute als Goldstandard 2 verschiedene Behandlungsansätze zur Verfügung: Pharmakotherapie und Psychotherapie. Dunlop und Kollegium haben nun mögliche Unterschiede der funktionellen Konnektivität des Gehirns im Ruhezustand nach Remission nach einer der beiden Behandlungen genauer analysiert, und kommen in ihrer funktionellen MRT-Studie mit über 130 Erwachsenen zu einem spannenden Ergebnis.","PeriodicalId":12353,"journal":{"name":"Fortschritte Der Neurologie Psychiatrie","volume":"128 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135564293","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}