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Biomedical subjects

P Bräunig

Publications and source records attributed to P Bräunig.

At least 19 recordsLinked to original sources
PubMed2005

Long-acting risperidone in stable patients with schizoaffective disorder.

Oral and long-acting risperidone has been shown to be effective for acute and maintenance treatment of patients with schizoaffective disorders. The present analysis investigated the efficacy and tolerability of direct transition from other antipsychotics to risperidone long-acting injectable in patients with schizoaffective disorder. Patients aged > or = 18 years with schizoaffective disorder (DSM-IV), who required a change of medication, received risperidone long-acting injectable 25 mg (increased to 37.5 or 50 mg, if necessary) every 2 weeks for 6 months. The analysis included 249 patients (47% male; mean age 43 years), of whom 74% completed the 6-month study. Mean scores for the total Positive and Negative Syndrome Scale (PANSS) and all three subscales were significantly reduced from baseline to week 4 (p < 0.001), with further improvements until treatment endpoint. Significant improvements from baseline to endpoint were seen in the mood symptom domains of anxiety/depression (10.4+/-4.1 vs 8.7+/-3.9) and uncontrolled hostility/excitement (7.6+/-3.6 vs 6.9+/-3.8). Mean Global Assessment of Function (GAF) score improved significantly from 59.4+/-15.6 at baseline to 66.4+/-17.7 (p < 0.001) at endpoint. Of 87 patients hospitalized at baseline, 67% were discharged at endpoint. Both quality of life (SF-36) and satisfaction with treatment were improved significantly at endpoint. Total ESRS scores fell progressively throughout the study, and the reduction was already statistically significant (p < 0.001) at 4 weeks. Small but statistically significant (p < 0.001) mean shifts of 1.8% were seen in body weight and Body Mass Index (BMI). Patients with schizoaffective disorder derived several benefits from a change to risperidone long-acting injectable, including reductions in psychiatric symptoms (particularly the mood symptom domains) and a reduction in the severity of drug-induced neurological movement disorders.

Adult↗
PubMed2004

Properties of descending dorsal unpaired median (DUM) neurons of the locust suboesophageal ganglion.

A group of six dorsal unpaired median (DUM) neurons of the suboesophageal ganglion (SOG) of locusts was studied with neuroanatomical and electrophysiological techniques. The neurons are located posteriorly in the SOG and have axons that descend into the ganglia of the ventral nerve cord, some as far as the terminal abdominal ganglion. Within thoracic ganglia the neurons have profuse dendritic ramifications in many neuropiles, including ventral sensory neuropiles. Based on their projection patterns three different morphological types of neurons can be distinguished. These neurons receive excitatory inputs through sensory pathways that ascend from the thoracic ganglia and are activated by limb movements. They may be involved in the modulation of synaptic transmission in thoracic ganglia.

Animals↗
PubMed2002

[Psychopharmacotherapy of bipolar affective diseases].

The broadening of the classification systems for manic-depressive illness towards a spectrum of bipolar disorders implicates a more differentiated use of pharmacotherapies. However, many questions still remain open. This implies that all consensus guidelines and recommendations have to be considered as preliminary. On the other hand, research in the last decade has developed many new treatment alternatives, both for mood stabilizers and antidepressants as well as antipsychotics. These recommendations, which have been developed in the process of two consensus meetings, try to consider the broadening of the concept of bipolar disorder by differentiating between subgroups according to acute symptomatology and characteristics of the long-term course, e.g., rapid cycling. In particular, the emerging role and new indications of mood stabilizing antiepileptic drugs, atypical antipsychotics, and new antidepressants will be discussed.

Antidepressive Agents↗
PubMed2001

Feeding-related motor patterns of the locust suboesophageal ganglion induced by pilocarpine and IBMX.

The mandibular motor pattern induced by the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine (IBMX) in isolated locust suboesophageal ganglia (SOG) was investigated and compared with the motor pattern induced by pilocarpine in an already established preparation of the SOG. Motor patterns occurring after bath application of IBMX or pilocarpine were recorded extracellularly from suitable nerves of isolated SOG. For a quantitative evaluation of long (15 min) sequences of rhythmic neural activity containing several hundred cycles, spectral analysis of spike trains was applied. Using a set of characteristic parameters extracted from spectra computed for each individual preparation, quantitative comparisons of the rhythms induced by IBMX and pilocarpine were made. Significant differences in regularity, frequency of oscillation, and intra-burst frequency were found whereas the phase relationships of different motor pools were similar. Differences in the effect of the drugs on the activity recorded extracellularly from mandibular closer motoneurones were investigated further using intracellular recordings. Our findings imply that the IBMX-induced motor pattern is a suitable in vitro model of mandibular central motor control like the pilocarpine induced pattern. The better regularity is an advantageous feature for further experiments on central pattern generation. Information on second messengers involved in central pattern generation provided by the pharmacological profile of IBMX forms a basis for pharmacological and histological investigations on the mandibular central pattern generating network.

Journal Article↗
PubMed2001

Insect mouthpart motor patterns: central circuits modified for highly derived appendages?

The interrelationships of motor patterns controlling the mouthparts and the salivary gland of the migratory locust were studied in a deafferented preparation activated by the muscarinic agonist pilocarpine. The aim of the study was to check whether motor output of different neuromeres of the suboesophageal ganglion and the brain is coherent and functionally adequate in the absence of sensory feedback. Our analysis shows that motor output to labial, maxillar, and labral muscles and to the salivary gland is strongly coupled to the mandibular motor pattern. Bilateral coupling is of similar strength. For a muscle of the labial palp, however, an independent pattern is shown. From our findings it is concluded that for stable coordination of most muscles involved in mouthpart movements sensory feedback is not essential. This is in contrast to motor patterns controlling thoracic appendages in similar insect model systems. As mouthparts are widely accepted to be homologous to thoracic appendages, it is concluded that during the evolutionary process which led to derived features of mouthparts also the central nervous networks controlling these structures were reconfigured accordingly.

Action Potentials↗
PubMed2000

Comorbidity of obsessive-compulsive disorder in recovered inpatients with bipolar disorder.

OBJECTIVE: To determine the frequency of obsessive-compulsive disorder (OCD) in inpatient subjects with bipolar disorder (BD) and to examine the clinical characteristics of BD subjects with OCD. METHOD: The sample consisted of 143 inpatient subjects with DSM-III-R BD-I and BD-NOS (BD-II), recovered from a current episode of either depression or mania. Demographic and clinical variables were obtained on the day of admission. Current comorbid conditions including OCD were determined by the Structured Clinical Interview for DSM-III-R Ifollowing recovery from the acute affective episode. RESULTS: The frequency of current OCD was 7% (N = 10). All BD subjects with OCD were BD-II, were male, and had a diagnosis of current dysthymia. They had fewer episodes and a higher incidence of prior suicide attempts than bipolar subjects without OCD. None of the bipolar subjects with OCD fulfilled criteria for cyclothymia. CONCLUSIONS: Our findings suggest that BD-II, OCD, dysthymia, and suicidality cluster together in some subjects with BD. We discuss the clinical implications of our findings.

Adult↗
PubMed2000

Prevalence of obsessive-compulsive disorder in schizophrenia and significance of motor symptoms.

To investigate the differences between schizophrenic subjects with and without obsessive-compulsive disorder (OCD), the authors systematically assessed 76 schizophrenic subjects for OCD. Subjects with and without OCD were then compared with regard to motor symptoms, including catatonia, and several measures of psychopathology. Treatment strategies were evaluated retrospectively. The 12 subjects with OCD (15.8%) had more motor symptoms, including catatonia, than non-OCD schizophrenic subjects. Some differences were found with regard to psychopathological symptoms. Treatment strategies also differed in the two groups. The high prevalence of motor symptoms in these subjects supports the hypothesis of a basal ganglia-frontal lobe connection linking OCD with schizophrenia.

Adult↗
PubMed2000

[Karl Ludwig Kahlbaum (1828-1899)--a protagonist in modern psychiatry].

Kahlbaum was one of the most influencial psychiatrists of the 19th century. He paved the way for Kraepelin and inspired the development of 20th century clinical psychiatry. With his work he contributed to new ideas in general psychopathology and in psychiatric nosology. He described "clinical state-course-entities" and developed the concept of "exogenous reaction types", which would later be known as the "Bonhoeffer-paradigm". Kahlbaum was also the first to differentiate between centripetal, intracentral and centrifugal psychic functions, which was later transformed into the "psychic reflex circuit" by Wernicke. The concept of organic versus non-organic psychoses proved to be a heuristically fruitful classification system even for modern psychiatry. Kahlbaum was the first German psychiatrist to describe several disorders and syndromes and to coin new psychiatric terminology for them, including paraphrenia, hebephrenia, catatonia and cyclothymia. These terms and their originally associated meaning are still in use today. Kahlbaum's ambitious scientific aim was to develop specific therapeutic strategies which were based on a methodologically and etiologically sound classification system.

Germany↗
PubMed1999

[Coenesthesia--an important differential diagnosis in chronic pain syndromes].

BACKGROUND: Coenesthesias can be defined as disorders of body perception or body hallucinations, projected in different parts of the body. Patients complain of intractable pain or dysesthesia. These symptoms are reported even from organs where we usually have no perception. Coenesthesia must be regarded as a symptom that can be observed in various psychiatric diseases, e.g., schizophrenia. However, in rare cases coenesthesias can be documented in neurological diseases, e.g., intracranial tumors or infections. Therefore, accurate assessment of possible differential diagnoses is important. In late stages, coenesthesias can easily be recognized because of their "bizarre" character. In early stages, however, patients often complain of intractable, unlocalizable burning pain. They frequently undergo operations because of their great suffering. The drug treatment of first choice is neuroleptics, but the results are unpredictable. CASES AND THERAPY: The case studies of three patients are presented and discussed (patient 1 with coenaesthetic schizophrenia, patient 2 with coenesthesia in the course of a delusional (paranoid) disorder; patient 3 with coenesthesia caused by carcinomatous meningitis).

English Abstract↗
PubMed1999

[Stability and variability of catatonic symptoms in the longitudinal course of illness. Videotape documentation in catatonic schizophrenia].

The symptomatology of a female patient with catatonic schizophrenia is presented with respect to its longitudinal course. The stability and variability of catatonic symptoms are investigated using videotape technique. It is demonstrated that catatonic symptoms are stable in the longitudinal course but due to unsteady arousal the severity of the catatonic symptoms varies markedly. There are fluctuating symptom patterns that dominate the clinical picture: a hyperkinetic form with prevailing restlessness or excitement, with abnormal involuntary movements, stereotypies, and parakinetic movements, and a hypokinetic form with various inhibition phenomena, mutism and stupor. The clinical impression of the catatonic syndrome changes according to the dominating symptom patterns at different times, whereas the less severe symptoms recede into the background and thus, may be overlooked. Considering this finding the problem of a 'diagnostic threshold' is discussed. The authors intend to emphasize videotape documentation of catatonic motor disturbances as most useful. This technique may contribute to differentiating illness related from neuroleptic induced movement disorders.

Adult↗
PubMed1999

[Encephalopathies caused by valproate].

Valproic acid (VPA)-induced encephalopathy is a rarely considered side effect, with somnolence, reduced motor activity and severe deterioration of cognitive and behavioural abilities. In accordance with the increasing clinical importance of valproate clinical symptoms, causes and possibilities of treatment are reviewed by reporting on two cases of valproate-induced encephalopathy. In comparison to VPA intoxication, which is associated to increased VPA blood levels, the mechanisms of encephalopathy may include interactions of the hepatic enzymes, a direct toxic effect on the cerebral receptors, as well as drug interactions, a paradoxical epileptogenic effect and metabolic interactions. In most cases withdrawal of VPA produces regression of the symptoms within a few days; the role of L-carnitin or citrullin supplementation in clinical treatment remains unclear.

Adult↗
PubMed1999

[Prevalence and clinical significance of catatonic symptoms in mania].

OBJECTIVE: The study investigates the prevalence, clinical characteristics and implications of catatonic symptoms in mania. METHODS: Sixty-one in patients with DSM-III-R bipolar disorder, manic or mixed episode established by SCID were assessed for the presence of catatonia by a 21-item rating scale. Associated symptoms, comorbidity and severity of the manic episode were also systematically assessed. RESULTS: Nineteen patients fulfilled criteria for catatonic mania exhibiting between 5 and 16 catatonic symptoms. Catatonic manics had more mixed episodes, more severe manic symptoms, more general psychopathology, a higher prevalence of comorbidity, longer hospitalization and lower GAF-scores than the non-catatonics. CONCLUSIONS: The results indicate that catatonic symptoms are a marker of a more severe course and outcome in mania.

Adult↗
PubMed1997

[Neuroleptic-induced supersensitivity].

Psychopharmacological agents may cause changes in receptor sensitivity. Long-term treatment with high doses of neuroleptics has been shown to lead to supersensitivity of postsynaptic dopamine and noradrenaline receptors. Receptor supersensitivity is seen more frequently with neuroleptics known to have a high receptor affinity. The mechanism by which psychoses of the supersensitivity type work is presented and is illustrated by two case reports. Possible pathophysiological mechanisms for the emergence of these psychoses and implications for the treatment of patients suffering from them are discussed.

Antipsychotic Agents↗
PubMed1997

[Akathisia].

The syndrome of akathisia typically consists of a subjective component, e.g. inner restlessness and an urge to move, and observable symptoms such as restless legs and inability to sit still. In most cases akathisia is caused by neuroleptics. There are several subtypes of akathisia according to the time of onset in the course of neuroleptic treatment. In clinical routine extrapyramidal motor disturbances are often underestimated or misinterpreted. As far as akathisia is concerned, differential diagnosis of restlessness or of repetitive movement patterns may be problematic. Non-compliance and impulsive behaviour are regarded as possible complications of akathisia, but systematic investigations are lacking. The pathophysiology of akathisia is not clear, but it probably differs from other pharmacologically induced motor disturbances. If warrantable, the first step in akathisia treatment is dose-reduction of the causing agent. Anticholinergic drugs, benzodiazepines, and beta-receptor blockers may be effective. Clinical assessment and survey of the patient's behaviour, e.g. during occupational therapy and group therapy is important for an early diagnosis of akathisia so that complications may be minimised.

Adrenergic beta-Antagonists↗
PubMed1997

Morphology according to cranial computed tomography of first-episode cycloid psychosis and its long-term-course: differences compared to schizophrenia.

Cranial computed tomography (CCT) findings for 37 patients with cycloid psychosis and 19 patients with DSM-III-R schizophrenia were compared with findings for age- and sex-matched controls. Schizophrenic patients showed enlarged ventricles compared both to controls and to patients suffering from cycloid psychosis. In patients with cycloid psychosis, neither at the first episode nor after many years (mean 16.6 years) of disease were significant differences found compared to control subjects. Over the course of the illness, patients with cycloid psychosis showed ventricular enlargement which was correlated with age but not with the duration of illness. The morphological differences provide further evidence for the proposed nosological distinction between cycloid psychosis and schizophrenia.

Adult↗
PubMed1996

Morphology of locust neurosecretory cells projecting into the Nervus corporis allati II of the suboesophageal ganglion.

The morphology of neurosecretory cells that project from the suboesophageal ganglion into the retrocerebral complex via the Nervus corporis allati II (NCA II) was studied in the migratory locust, Locusta migratoria, using backfilling techniques and intracellular staining. There are two populations of cells located ventrally in the ganglion: an anterior group of four larger cells, and a posterior group of up to 22 smaller cells. Apart from cell body size and position, members of both cell groups have almost all features in common. They show long-lasting soma spikes with large amplitudes typical for arthropod neurosecretory cells. Their dendritic arborisations are found in the same regions of the neuropile. Both types project into the corpora cardiaca and an additional putative neurohaemal region associated with posterior pharyngeal dilator muscles. The axons of the cells bypass the corpora allata, but frequently form putative release sites on the surface of nerve branches in the vicinity of these glands. Finally, using double-labelling techniques, both anterior and posterior cells are shown to be identical with immunoreactive suboesophageal ganglion cells detected in previous studies using antisera directed against either bovine pancreatic polypeptide (BPP) or locustamyotropin II (Lom-MT-II).

Animals↗