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Biomedical subjects

A Rothenberger

Publications and source records attributed to A Rothenberger.

At least 37 records · Page 2Linked to original sources
PubMed2001

Evaluation of sensorimotor training in children with ADHD.

Reduced ability to regulate motor behavior seems to be an essential aspect of Attention-Deficit Hyperactivity Disorder (ADHD) and may reflect deficits in behavioral response inhibition. In this respect, pragmatic clinical experience over the last two decades, in daily practice, training of motor control has played an important role within multimodal treatment approaches, although an adequate proof of its efficacy is still lacking. Therefore, to examine the efficacy of sensorimotor training, 12 children with ADHD (two groups of six) were treated with both sensorimotor training and (as control) cognitive behavioral training using a within-subject cross-over design. Each treatment had a duration of 4 months (20 sessions), yielding a total of 40 sessions for the completed cross-over design. Results showed that Sensorimotor Training improved sensorimotor coordination slightly, while Cognitive Behavioral Training ameliorated cognitive impulse control. Hyperactivity and anxious-depressive/aggressive behavior were markedly reduced by Sensorimotor Training but not by Cognitive Behavioral Training. In conclusion, a combined treatment may be recommended since compensation and regulation of inhibitory deficits in ADHD come into play within the framework of both kinds of training.

Attention Deficit Disorder with Hyperactivity↗
PubMed2001

Older female inpatients in Arkansas.

The purpose of this study was to examine age and Major Diagnostic Categories (MDCs) and compare the variables to mortality and length of stay among inpatient women age 50 and over. Archival statistical data were obtained for 2,238 inpatients in a private, nonprofit hospital in 1998. The ages ranged from 50 to 107 years old, with a mean age of 71.21 years. Quantitative analyses were conducted to examine the data from a private, nonprofit hospital and determine if there were significant relationships between age, major diagnostic category, length of stay, and mortality in older women. The MDC distribution indicated that the highest frequency of diseases and disorders were in the following three systems: circulatory system, musculoskeletal system and connective tissue, and the digestive system. The average length of stay was 8.01 days. The 30-day readmission percentage and the 365-day readmission percentage were 12.24% and 28.02%, respectively. The mortality rate was 6%. In addition, 63.97% went home after discharge, and 67.07% were Medicare recipients. The risk of musculoskeletal diseases and disorders increased with age (p = .0001). The conditional probability of death was nearly nine times higher for the diseases of the nervous system, myeloproliferative diseases and disorders, poorly differentiated neoplasms and respiratory diseases. As age increased, the probabilities of a long hospital stay decreased. The mortality analyses found that the lowest probabilities of survival were in categories of myeloproliferative diseases and disorders, poorly differentiated neoplasms, and infectious and parasitic diseases. According to current health statistics, our society is getting older. Not only are people living longer, they are accessing more health care (American Association for World Health, 1999). Overall, the average life expectancy at birth has been identified at 76.5 years. The female has a longer life expectancy than the male, averaging 5.8 years longer. The highest life expectancy has been identified in the white female, who can expect to live to 79. The black woman has the second-highest life expectancy, 74.7 years. Peters, Kochanek, and Murphy reported an all-time-low age-adjusted death rate for the United States and a continuing trend in the decline in mortality for all age groups. With a growing number of people living longer, there is a need to know about the most common health issues that affect quality of life. The top three national causes of death in older Americans were diseases of the heart, malignant neoplasms, and cerebrovascular diseases/stroke. Arkansas health statistics mirror the national statistics. In April 1999, the Arkansas Department of Health reported that 30.5% percent of all female deaths were caused by heart disease. Malignant neoplasms were responsible for 20.1%, followed by cerebrovascular diseases at 10.8%. Other than three Connecticut hospital studies that explored the relationship of diagnosis code, mortality, and readmission, research is meager in this area. There is a need for hospital-based research that addresses the diagnosis categories and the relationship to age and other variables.

Age Factors↗
PubMed2001

Children with comorbid attention-deficit-hyperactivity disorder and tic disorder: evidence for additive inhibitory deficits within the motor system.

For children with attention-deficit-hyperactivity disorder (ADHD) or tic disorder (TD), we recently reported deficient inhibitory mechanisms within the motor system by using transcranial magnetic stimulation. These deficits--stated as reduced intracortical inhibition in ADHD and shortened cortical silent period in TD--could be seen as neurophysiological correlates of motor hyperactivity and tics, respectively. To investigate neurophysiological aspects of comorbidity, we measured motor system excitability for the first time also in children with combined ADHD and TD. The findings of a reduced intracortical inhibition as well as a shortened cortical silent period in these comorbid children provide evidence for additive effects at the level of motor system excitability.

Adolescent↗
PubMed2000

Gamma band response in children is related to task-stimulus processing.

The present study described the functional characteristics of early phase-locked electroencephalographic gamma band (30-60 Hz) responses (GBRs) in 9- to 12-year-old healthy children. GBRs were elicited in an auditory selective-attention task. Target stimuli required motor responding when presented to the right or to the left (attended side). Effects of stimulus type relevance and attended side were evaluated for GBR power and phase-locking within 0-120 ms. GBRs in children were frontally distributed, were larger and better phase-locked to targets relative to non-targets, but did not depend on the attended side. These results demonstrate that the auditory GBR is related to task-stimulus processing and imply that early target selection in children is guided by a sensory or sensorimotor preparatory set, rather than by an internal attentional focus to the side of stimulation.

Attention↗
PubMed2000

Deficient intracortical inhibition in drug-naive children with attention-deficit hyperactivity disorder is enhanced by methylphenidate.

In children with attention-deficit hyperactivity disorder (ADHD), motoric hyperactivity is one of the striking abnormalities. Because this symptom might be due to an insufficient motor control, motor system excitability in 18 drug-naive ADHD-children aged 8-12 years was compared to 18 age-matched healthy children using the technique of transcranial magnetic stimulation (TMS). Whereas motor thresholds, cortical silent period, and intracortical facilitation did not differ between the two groups, ADHD-children had significantly reduced intracortical inhibition compared to healthy controls. In all ADHD-children, a second TMS could be started after their first intake of 10 mg methylphenidate. Under this medication, a significant enhancement in intracortical inhibition could be stated. This study provides the first evidence for inhibitory deficits within the motor cortex in ADHD-children and for an enhancement of inhibitory mechanisms in this brain region by methylphenidate.

Attention Deficit Disorder with Hyperactivity↗
PubMed2000

Age-associated changes in the densities of presynaptic monoamine transporters in different regions of the rat brain from early juvenile life to late adulthood.

The binding parameters of highly selective ligands of serotonin (5-HT) transporters ([3H]paroxetine), noradrenaline (NE) transporters ([3H]nisoxetine), and of dopamine (DA) transporters ([3H]GBR-12935) were determined on membrane preparations from frontal cortex, striatum, midbrain and brain stem of Wistar rats on postnatal days 25, 50, 90 and 240, i.e., from the time of weaning till late adulthood. No age-dependent alterations in the affinity-parameters (K(D)-values) of all three monoamine transporters were observed. Age-associated changes in B(max)-values of the binding of all three specific ligands were most pronounced in the phylogenetically younger, late maturing brain regions (frontal cortex, striatum). Most likely, these changes reflect age-related changes in 5-HT, NE and DA-innervation densities. In the frontal cortex, 5-HT-transporter density increased steadily from weaning (day 25) till late adulthood, whereas the density of NE-transporters was highest at weaning, declined till puberty (day 50) and remained at this level until old age. DA-transporter density in the frontal cortex was not reliably measurable by [3H]GBR-binding assays. In the striatum, DA-transporter density increased till puberty and declined thereafter considerably and steadily to about one-fourth of the pubertal values at old age. No such age-associated changes in DA-transporter density were seen in the midbrain. Densities of 5-HT and NE remained at the level reached already at weaning until old age in the striatum, midbrain and brain stem. These findings provide the first comprehensive description of the normally occurring changes in the densities of all three presynaptically located monoamine transporters in the rat brain throughout the life span from weaning to late adulthood.

Aging↗
PubMed2000

Comorbidity in ADHD-children: effects of coexisting conduct disorder or tic disorder on event-related brain potentials in an auditory selective-attention task.

In children with attention-deficit hyperactivity disorder (ADHD) some deficits in auditory information processing seem to exist. Further, comorbidity of ADHD with conduct disorder (CD) and tic disorder (Tic) is quite common but not yet fully understood. Thus, we investigated the effects of these two disturbances, when combined with ADHD, on electrophysiological correlates of auditory information processing. An auditory selective-attention task was used, and temporal as well as frontal lobe sensitive event-related electrical brain activity indicators like mismatch negativity (MMN) and negative difference wave (Nd), as well as P300 were registered in four groups of children (healthy controls, ADHD-only, and combined ADHD + CD as well as ADHD + Tic; total number 42). Performance measures showed that ADHD + CD had a higher impact on errors and reaction times than ADHD + Tic. The MMN effect indicated that all ADHD groups showed lower MMN amplitudes compared to normals, but only the group with ADHD + CD suffered from a significant deficiency in automatic auditory information processing. Nd and P300 amplitudes showed no significant group differences. It may be assumed that neurodynamic sufficiency in ADHD-only and ADHD + Tic children seems to be similarly impaired while there might be a greater deficit in ADHD + CD.

Attention↗
PubMed2000

Comparing the German versions of the Strengths and Difficulties Questionnaire (SDQ-Deu) and the Child Behavior Checklist.

The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioural screening questionnaire that can be completed in about 5 minutes by the parents and teachers of 4-16 year olds. The scores of the English version correlate well with those of the considerably longer Child Behavior Checklist (CBCL). The present study compares the German versions of the questionnaires. Both SDQ and CBCL were completed by the parents of 273 children drawn from psychiatric clinics (N = 163) and from a community sample (N = 110). The children from the community sample also filled in the SDQ self-report and the Youth Self Report (YSR). The children from the clinic sample received an ICD-10 diagnosis if applicable. Scores from the parent and self-rated SDQ and CBCL/YSR were highly correlated and equally able to distinguish between the community and clinic samples, with the SDQ showing significantly better results regarding the total scores. They were also equally able to distinguish between disorders within the clinic sample, the only significant difference being that the SDQ was better able to differentiate between children with and without hyperactivity-inattention. The study shows that like the English originals, the SDQ-Deu and the German CBCL are equally valid for most clinical and research purposes.

Adolescent↗
PubMed2000

Quantitative and qualitative aspects of obsessive-compulsive behaviour in children with attention-deficit hyperactivity disorder compared with tic disorder.

OBJECTIVE: Within the framework of associated psychopathology in child psychiatric disorders, this study focused on quantitative and qualitative aspects of obsessive-compulsive behaviour (OCB) in both attention-deficit hyperactivity disorder (ADHD) and chronic tic disorder/Tourette's disorder (TD). METHOD: Forty-two healthy controls, 41 children with ADHD and 38 children with TD, aged 9-13 years, were investigated using the Leyton Obsessional Inventory--Child Version (LOI-CV), the Child Behaviour Checklist (CBCL) and an expert-rated structured parent interview to reflect a cross-informant view of OCB. RESULTS: Unexpectedly, self-reports of children with ADHD rather than children with TD showed the highest OCB scores in the LOI-CV. Qualitatively, ADHD-related OCB focused on the item subsets concerning 'dirt and contamination', 'repetition', 'overconscientiousness', and 'hoarding'. In the parent-rated CBCL, similar levels of OCB were reported for ADHD and TD patients. In contrast, only children with TD showed clinically relevant OCB according to expert ratings. CONCLUSION: Not only young TD patients but also children with ADHD should be investigated and monitored carefully for quantitative and qualitative aspects of OCB comorbidity.

Adolescent↗
PubMed1999

The First Bismuth Phosphide Complex:

Thermally unstable crystals of the title compound-the first bismuth phosphide complex to be structurally characterized (see picture)-are obtained by the reaction of [Bi(NMe(2))(3)] with [tBuPHLi] (1:3) in THF/hexane. Berry pseudorotation of the pseudo-trigonal-bipyramidal [{(tBuP)(3)}(2)Bi](-) ion is prevented for steric reasons.

Journal Article↗
PubMed1999

Deficient motor control in children with tic disorder: evidence from transcranial magnetic stimulation.

Decreased motor inhibition was reported in adult patients with tic disorder (TD) using the technique of transcranial magnetic stimulation. Since tics usually begin during childhood, motor threshold, cortical silent period (CSP) and intracortical inhibition/facilitation were measured in 21 TD children and 25 healthy children aged 10-16 years. In TD children motor threshold was normal. The CSP was significantly shortened compared to healthy controls but did not depend on tic localization. Intracortical inhibition and facilitation did not differ between the two groups. This study confirms that the finding of decreased motor control in adult patients also holds true for children wherever the tics in the latter group were located.

Adolescent↗
PubMed1999

[Relationship between tics and compulsion].

In children and adolescents motor/vocal tics and obsessive-compulsive behavior are known to be closely related. Thereby, a continuum of symptoms ranging from single tics to a mixed picture of tics/rituals/obsessive-compulsive traits to clinically relevant obsessions and compulsions could be described. As neurobiological substrates dysfunctions in corresponding cortico-striato-thalamocortical circuits (sensorimotor circuit in tic symptomatology, orbitofrontal circuit in obsessive-compulsive behavior) were postulated. For both disturbances behavioral therapy can be used to improve control mechanisms to counterregulate tics and obsessive-compulsive behavior, respectively, and psychopharmacological agents can be administered to compensate dysbalances in neurotransmitter systems. In case of a mixed symptomatologic picture it is necessary to include interventions for both pols of the symptom-continuum in the therapeutic programme to achieve extensive improvement as a basis for a further positive development of the patient.

Adolescent↗
PubMed1999

Persistently increased density of serotonin transporters in the frontal cortex of rats treated with fluoxetine during early juvenile life.

This experimental animal study was performed in order to assess possible long-term effects of the administration of the selective serotonin reuptake inhibitor fluoxetine (Prozac) during early periods of juvenile life on the developing central serotonergic and noradrenergic systems. Fluoxetine was administered via the drinking water (5 mg/kg/day) for a period of two weeks to very young (day 25) and somewhat older (day 50) rats. The effect of this treatment on the density of serotonin and noradrenaline transporters was measured by ligand-binding assays in various brain regions. The Bmax-values of [3H]-nisoxetine binding were not affected by either treatment schedule, but a significant increase of the Bmax-values of [3H]-paroxetine binding was found in the brains of early fluoxetine-treated rats. This increase was restricted to the frontal cortex and persisted long after the termination of the treatment into adulthood (day 90). The most likely explanation of this observation is a stimulatory effect of the fluoxetine treatment on the outgrowth of serotonergic projections in the frontal cortex of very young rats. This is the first empirical demonstration of long-lasting effects of the administration of a selective serotonin reuptake inhibitor during juvenile life on the maturation of the central serotonergic system.

Aging↗
PubMed1999

Single-sweep analysis of event-related potentials by wavelet networks--methodological basis and clinical application.

OBJECTIVE: Trial-to-trial variabilities in event-related potentials (ERP's), which are neglected by investigating averaged ERP's, can be important to establish group-specific effects in clinical studies. Single ERP responses have to be analyzed to quantify these variations. In order to overcome the disadvantages of existing single-sweep estimators, we have developed a new procedure based on wavelet networks (WN's) and applied this novel approach in a study concerning attention deficit hyperactivity disorder (ADHD) in children. METHOD: WN's represent signals as a linear combination of wavelet nodes, i.e., components characterized by time-frequency features related to the wavelet transformation. In single-sweep analysis, each wavelet node is restricted to a specific region of the time-frequency plane during the recursive WN training process. This is achieved by means of tapering and bandpass filtering with Gaussian functions which are automatically adapted and closely related to the Morlet basis wavelet. The time course of a single event-related response can be reliably estimated. Furthermore, the WN method automatically provides well-defined parameters for single event-related responses, respectively ERP trial-to-trial variabilities. RESULTS: In a psychophysiological study on ADHD using auditory evoked potentials (AEP's), latency and amplitude parameters extracted from averaged ERP's did not reveal any significant differences between 25 control and 25 ADHD boys. In contrast, interesting group-specific differences could be established by WN single-sweep analysis. CONCLUSION: WN single-sweep analysis can be recommended as a sensitive tool for clinical ERP studies which should be applied in addition to the investigation of averaged responses. INDEX TERMS: Attention deficit hyperactivity disorder (ADHD), event-related potentials, single-sweep estimation, single-sweep parameterization, time-frequency method, wavelet networks.

Adolescent↗
PubMed1998

[Lithium salts in child and adolescent psychiatry].

Lithium is--besides neuroleptics--the drug of choice for the treatment of manic episodes. If the use of antidepressive drugs, during unipolar depressive illness, does not lead to a positive response, the additional administration of lithium is appropriate, even during a depressive episode. Lithium is also considered as the drug of choice for prophylactic treatment of bipolar affective disorders. This holds true also for adolescents. In contrast to the indications in adults, in adolescents an early administration is desirable to reduce risk factors of psychosocial development. Additional indications may be the presence of severe aggressivity in conduct disordered children. In these cases, a treatment with lithium salts can result in a behavioral improvement. This may be also the case in impulsive self-injurious behavior. The dosage and serum levels of lithium, as well as its adverse effects are comparable with those known from adults. At present, lithium treatment cannot be recommended for children under 12 years of age--except under in-patient conditions.

Adolescent↗