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Alexander Sartorius

Publications and source records attributed to Alexander Sartorius.

9 recordsLinked to original sources
PubMed2007

Subcortical and medial temporal MR-detectable metabolite abnormalities in unipolar major depression.

The purpose of the present study was to determine whether MR-detectable alterations of choline-containing compounds in two key neural systems involved in major depression disorder namely the hippocampus and the basal ganglia can be detected. Multislice proton magnetic resonance spectroscopic imaging was applied in 11 patients with major depressive disorder (MDD) and ten matched healthy subjects. Voxels were selected from the left and right side of the hippocampus and the putamen. Significantly lower choline-containing compounds in the hippocampus and significantly higher choline-containing compounds in the putamen of patients with MDD compared to healthy subjects were found. No significant differences were found for the other metabolites in the two regions evaluated. Abnormal levels of choline-containing compounds most likely reflect altered membrane phospholipid metabolism. A reduced level in the hippocampus and an increased level in the putamen suggest regionally opponent membrane abnormalities.

Adult↗
PubMed2006

Correlation between MR-spectroscopic rat hippocampal choline levels and phospholipase A2.

Hippocampal choline-containing compounds (Cho) determined with 1H MR spectroscopy (MRS) are decreased in major depression episodes and return to baseline levels after antidepressive electroconvulsive therapy (ECT). A rise in hippocampal Cho has been observed in rats upon electroconvulsive shocks (ECS), an analogue of human ECT. Choline production involves the activity of various phospholipases. In order to investigate whether the increase of Cho correlates with an enhanced expression of phosphoslipase A2 (PLA2) we took rectangular tissue samples from the region of the MRS voxel for immunoblotting. Our data show a significant inverse correlation (p = 0.018) between PLA2 protein levels and MRS Cho/NAA levels suggesting a possible downregulation of PLA2 in compensation for an upregulation of other phospholipases.

Animals↗
PubMed2005

[Continuation ECT].

A renaissance of electroconvulsive therapy in psychiatry can be observed in Germany. Here, ECT was named as a first line therapy for treating psychotic depression, depressive stupor, schizoaffective psychoses with severe depressive symptoms. Suprisingly, ECT is most commonly not used as a continuation therapy after achieving acute remission. With rare exceptions, antidepressive medication is chosen for this purpose. The use of continuation ECT (cECT) and subsequent maintenance ECT (mECT) is not (or just marginally) mentioned in practice guidelines. In our case report we report a successful cECT and mECT of a geriatric patient with severe comorbidity. This case is exemplified with respect to recent guidelines and study results. Particularly suggestions for interval duration, total duration of treatment, effects on cognition and memory, comorbidity and comedication, and reflections on quality of life and costs were discussed. We would therefore recommend a broader use of this proven treatment tool for keeping major depressions in remission.

Aged↗
PubMed2005

Lithium and ECT--concurrent use still demands attention: three case reports.

Bipolar disorders as well as recurrent major depressive episodes can be most effectively treated with electroconvulsive therapy (ECT). Since continuation/maintenance ECT is not well established, prophylactic therapy in recurrent illnesses is more commonly carried out using antidepressive medication alone or more often in combination with lithium. In case of relapse the clinically important question of discontinuation of lithium versus the concurrent use of ECT and lithium may arise. The safety of concurrent use has also to be balanced when lithium treatment is started within an ECT course. Since recent studies have reported no negative interactions with concurrent use, we here report three cases (one case of a prolonged seizure, a serotonin syndrome and a focal seizure) of severe lithium-induced side effects while patients underwent ECT without complications and lithium serum levels were still subtherapeutic. Clinical consequences are discussed and disturbances of the blood brain barrier system as a speculative cause are hypothesized taking previous studies, animal studies and an additional reported clinical case into account.

Adult↗
PubMed2003

Specific creatine rise in learned helplessness induced by electroconvulsive shock treatment.

Metabolic changes in the hippocampus formation can be investigated with in vivo magnetic resonance spectroscopy (MRS). Learned helplessness (LH) is a well validated animal model of depression which we established in Sprague-Dawley rats defining some as "learned helpless" (LH) or not "learned helpless" (NLH). Helpless and non-helpless rats received a course of daily administered electroconvulsive shocks (ECS) for 6 days. MRS measurements were performed on a 4.7 T animal scanner with an average voxel size within the rat hippocampus of 10 microl. In LH rats hippocampal creatine/NAA rose significantly (14%) whereas creatine/NAA of NLH rats showed no increase at all. A possible connection between hippocampal creatine levels and major depressive disorders as a reflection of changes in energy metabolism is discussed.

Animals↗
PubMed2003

Choline rise in the rat hippocampus induced by electroconvulsive shock treatment.

BACKGROUND: Human hippocampal choline decreases in major depression episodes. This decrease was recently measured by 1H magnetic resonance spectroscopy (MRS), and it has been found that its level normalizes during antidepressive electroconvulsive therapy. We hypothesized a hippocampal choline increase in the rat brain under electroconvulsive shock (ECS) treatment. METHODS: Rat hippocampi (n = 28) were investigated via magnetic resonance spectroscopy and signal intensities of choline (Cho), total creatine (tCr), and N-acetyl aspartate (NAA) were measured and expressed as ratios before and after six ECS treatments. RESULTS: After ECS treatment, hippocampal choline increases significantly: Cho/tCr ratio: +13% and Cho/NAA ratio: +19% increase. CONCLUSIONS: We found a rise of relative choline concentration induced by ECS treatment in rat hippocampus measured in vivo with magnetic resonance spectroscopy. This increase corresponds to the increase of choline in human hippocampus after electroconvulsive shock treatment. Because choline measured via 1H-spectroscopy is believed to represent primarily phosphocholine and glycerophosphocholine, and therefore phospholipase A2 activity and membrane turnover, our results are in good agreement with reported ECS-induced hippocampal mossy fiber sprouting, increased synaptic plasticity, and neurogenesis.

Animals↗
PubMed2002

Electroconvulsive therapy in a patient receiving rivastigmine.

We report the case of an 81-year-old woman, suffering from a major depressive episode and incipient Alzheimer disease, whom we treated with ECT without interrupting therapy with the acetylcholinesterase inhibitor (ACHE-I) rivastigmine. After eight right unilateral ECT sessions, the patient remitted completely without any significant deterioration of memory and cognitive abilities or cholinergic side effects. This report demonstrates that ECT was safely used in one elderly and mildly demented person with continuous ACHE-I therapy. The hypothesis that this drug may indeed protect against unfavorable side effects of ECT should be further tested in clinical trials.

Aged↗