TY - JOUR A1 - Heinzel, Stephan A1 - Lorenz, Robert C. A1 - Quynh-Lam Duong, A1 - Rapp, Michael A. A1 - Deserno, Lorenz T1 - Prefrontal-parietal effective connectivity during working memory in older adults JF - Neurobiology of Aging N2 - Theoretical models and preceding studies have described age-related alterations in neuronal activation of frontoparietal regions in a working memory (WM)load-dependent manner. However, to date, underlying neuronal mechanisms of these WM load-dependent activation changes in aging remain poorly understood. The aim of this study was to investigate these mechanisms in terms of effective connectivity by application of dynamic causal modeling with Bayesian Model Selection. Eighteen healthy younger (age: 20-32 years) and 32 older (60-75 years) participants performed an n-back task with 3 WM load levels during functional magnetic resonance imaging (fMRI). Behavioral and conventional fMRI results replicated age group by WM load interactions. Importantly, the analysis of effective connectivity derived from dynamic causal modeling, indicated an age-and performance-related reduction in WM load-dependent modulation of connectivity from dorsolateral prefrontal cortex to inferior parietal lobule. This finding provides evidence for the proposal that age-related WM decline manifests as deficient WM load-dependent modulation of neuronal top-down control and can integrate implications from theoretical models and previous studies of functional changes in the aging brain. KW - Aging KW - Dynamic causal modeling (DCM) KW - Effective connectivity KW - Functional magnetic resonance imaging (fMRI) KW - Working memory Y1 - 2017 U6 - https://doi.org/10.1016/j.neurobiolaging.2017.05.005 SN - 0197-4580 SN - 1558-1497 VL - 57 SP - 18 EP - 27 PB - Elsevier CY - New York ER - TY - JOUR A1 - Heinzel, Stephan A1 - Rimpel, Jérôme A1 - Stelzel, Christine A1 - Rapp, Michael A. T1 - Transfer Effects to a Multimodal Dual-Task after Working Memory Training and Associated Neural Correlates in Older Adults BT - A Pilot Study JF - Frontiers in human neuroscience N2 - Working memory (WM) performance declines with age. However, several studies have shown that WM training may lead to performance increases not only in the trained task, but also in untrained cognitive transfer tasks. It has been suggested that transfer effects occur if training task and transfer task share specific processing components that are supposedly processed in the same brain areas. In the current study, we investigated whether single-task WM training and training-related alterations in neural activity might support performance in a dual-task setting, thus assessing transfer effects to higher-order control processes in the context of dual-task coordination. A sample of older adults (age 60–72) was assigned to either a training or control group. The training group participated in 12 sessions of an adaptive n-back training. At pre and post-measurement, a multimodal dual-task was performed in all participants to assess transfer effects. This task consisted of two simultaneous delayed match to sample WM tasks using two different stimulus modalities (visual and auditory) that were performed either in isolation (single-task) or in conjunction (dual-task). A subgroup also participated in functional magnetic resonance imaging (fMRI) during the performance of the n-back task before and after training. While no transfer to single-task performance was found, dual-task costs in both the visual modality (p < 0.05) and the auditory modality (p < 0.05) decreased at post-measurement in the training but not in the control group. In the fMRI subgroup of the training participants, neural activity changes in left dorsolateral prefrontal cortex (DLPFC) during one-back predicted post-training auditory dual-task costs, while neural activity changes in right DLPFC during three-back predicted visual dual-task costs. Results might indicate an improvement in central executive processing that could facilitate both WM and dual-task coordination. KW - working memory KW - cognitive training KW - modality KW - dual-task KW - aging KW - transfer KW - fMRI KW - neuroimaging Y1 - 2017 U6 - https://doi.org/10.3389/fnhum.2017.00085 VL - 11 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Jacob, Louis A1 - Rapp, Michael A. A1 - Kostev, Karel T1 - Long-term use of benzodiazepines in older patients in Germany BT - a retrospective analysis JF - Therapeutic Advances in Psychopharmacology N2 - Background: The purpose of this study was to analyze the prevalence of long-term benzodiazepine use in older adults treated in general and neuropsychiatric practices in Germany. Methods: This study included 32,182 patients over the age of 65 years who received benzodiazepine prescriptions for the first time between January 2010 and December 2014 in general and neuropsychiatric practices in Germany. Follow up lasted until July 2016. The main outcome measure was the proportion of patients treated with benzodiazepines for >6 months. Results: The proportion of patients with benzodiazepine therapy for >6 months increased with age (65-70 years: 12.3%; 71-80 years: 15.5%; 81-90 years: 23.7%; >90 years: 31.6%) but did not differ significantly between men (15.5%) and women (17.1%). The proportion of patients who received benzodiazepines for >6 months was higher among those with sleep disorders (21.1%), depression (20.8%) and dementia (32.1%) than among those with anxiety (15.5%). By contrast, this proportion was lower among people diagnosed with adjustment disorders (7.7%) and back pain (3.8%). Conclusion: Overall, long-term use of benzodiazepines is common in older people, particularly in patients over the age of 80 and in those diagnosed with dementia, sleep disorders, or depression. KW - benzodiazepines KW - Germany KW - long-term use KW - older people KW - risk factors Y1 - 2017 U6 - https://doi.org/10.1177/2045125317696454 SN - 2045-1253 SN - 2045-1261 VL - 7 IS - 6/7 SP - 191 EP - 200 PB - Sage Publ. CY - London ER - TY - JOUR A1 - Kallies, Gunnar A1 - Rapp, Michael A. A1 - Fydrich, Thomas A1 - Fehm, Lydia A1 - Tschorn, Mira A1 - Teran, Christina A1 - Schwefel, Melanie A1 - Pietrek, Anou F. A1 - Henze, Romy A1 - Hellweg, Rainer A1 - Ströhle, Andreas A1 - Heinzel, Stephan A1 - Heissel, Andreas T1 - Serum brain-derived neurotrophic factor (BDNF) at rest and after acute aerobic exercise in major depressive disorder JF - Psychoneuroendocrinology N2 - Physiological mechanisms of an anti-depressive effect of physical exercise in major depressive disorder (MDD) seem to involve alterations in brain-derived neurotrophic factor (BDNF) level. However, previous studies which investigated this effect in a single bout of exercise, did not control for confounding peripheral factors that contribute to BDNF-alterations. Therefore, the underlying cause of exercise-induced BDNF-changes remains unclear. The current study aims to investigate serum BDNF (sBDNF)-changes due to a single-bout of graded aerobic exercise in a group of 30 outpatients with MDD, suggesting a more precise analysis method by taking plasma volume shift and number of platelets into account. Results show that exercise-induced increases in sBDNF remain significant (p<.001) when adjusting for plasma volume shift and controlling for number of platelets. The interaction of sBDNF change and number of platelets was also significant (p=.001) indicating larger sBDNF-increase in participants with smaller number of platelets. Thus, findings of this study suggest an involvement of peripheral as well as additional possibly brain-derived mechanisms explaining exercise-related BDNF release in MDD. For future studies in the field of exercise-related BDNF research, the importance of controlling for peripheral parameters is emphasized. KW - Brain-derived neurotrophic factor (BDNF) KW - Platelets KW - Major depressive disorder KW - Physical exercise Y1 - 2018 U6 - https://doi.org/10.1016/j.psyneuen.2018.12.015 SN - 0306-4530 VL - 102 SP - 212 EP - 215 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - Meiberth, Dix Urs A1 - Rapp, Michael A. A1 - Jessen, Frank T1 - Gedächtnisambulanzstrukturen in Deutschland – Ergebnisse einer Klinikbefragung JF - Psychiatrische Praxis N2 - Ziel der Studie Erfassung der Strukturen zur Frühdiagnostik von Demenzen an Krankenhäusern in Deutschland. Methodik Fragebogenerhebung. Ergebnisse 14 % von 1758 kontaktierten Einrichtungen antworteten. 52 % berichteten über ein entsprechendes Angebot, zum großen Teil mit leitlinienorientierten Verfahren, wie Liquordiagnostik. Das Diagnosespektrum umfasste zu 46 % Demenzen und zu 41 % Diagnosen der leichten oder subjektiven kognitiven Störung. Schlussfolgerung Leitlinienbasierte Diagnostik und Früherkennungskonzepte sind in Gedächtnisambulanzen weitgehend etabliert. N2 - Objective To assess the structures for early and differential diagnosis of dementia in hospitals in Germany. Methods Written questionnaire to all German hospitals. Results 14 % of 1.758 hospitals responded. Of those, 52 % reported to offer a special service for early dementia diagnosis, mostly on an outpatient basis. The applied methods were in agreement with the national guideline for diagnosis and treatment of dementias, including technical diagnostics, such as neuroimaging and cerebrospinal fluid examinations. 46 % of the diagnostic spectrum were dementia. 41 % were either diagnosed as mild cognitive impairment (MCI) or as subjective cognitive decline (SCD). Conclusion Despite mostly insufficient reimbursement, a large proportion of the responding hospitals offer a specialized service, which largely adheres to guideline-based diagnostic procedures. The concepts of at-risk and prodromal stages of dementia seem to be largely established. T2 - Memory Clinics in Germany - Results of a Hospital Survey KW - dementia KW - Alzheimer KW - memory clinic KW - early diagnosis KW - Demenz KW - Alzheimer KW - Gedächtnisambulanz KW - Frühdiagnose Y1 - 2019 U6 - https://doi.org/10.1055/a-0825-9049 SN - 0303-4259 SN - 1439-0876 VL - 46 IS - 4 SP - 213 EP - 216 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Sebold, Miriam A1 - Spitta, G. A1 - Gleich, T. A1 - Dembler-Stamm, T. A1 - Butler, Oisin A1 - Zacharias, Kristin A1 - Aydin, S. A1 - Garbusow, Maria A1 - Rapp, Michael A. A1 - Schubert, Florian A1 - Buchert, Ralph A1 - Gallinat, Jürgen A1 - Heinz, A. T1 - Stressful life events are associated with striatal dopamine receptor availability in alcohol dependence JF - Journal of neural transmission N2 - Stress plays a key role in modulating addictive behavior and can cause relapse following periods of abstinence. Common effects of stress and alcohol on the dopaminergic system have been suggested, although the precise mechanisms are unclear. Here, we investigated 20 detoxified alcohol-dependent patients and 19 matched healthy controls and assessed striatal D2/D3 availability using [F-18]-fallypride positron emission tomography and stressful life events. We found a strong association between striatal D2/D3 availability and stress in patients, but not in healthy controls. Interestingly, we found increased D2/D3 receptor availability in patients with higher stress levels. This mirrors complex interactions between stress and alcohol intake in animal studies and emphasizes the importance to investigate stress exposure in neurobiological studies of addiction. KW - Stressful life events KW - Dopamine D2 KW - D3 receptor KW - Positron emission tomography KW - Striatum KW - Alcohol dependence Y1 - 2019 U6 - https://doi.org/10.1007/s00702-019-01985-2 SN - 0300-9564 SN - 1435-1463 VL - 126 IS - 9 SP - 1127 EP - 1134 PB - Springer CY - Wien ER - TY - JOUR A1 - Bohlken, Jens A1 - Weber, Simon A. A1 - Siebert, Anke A1 - Forstmeier, Simon A1 - Kohlmann, Thomas A1 - Rapp, Michael A. T1 - Reminiscence therapy for depression in dementia BT - An observational study with matched pairs JF - GeroPsych - The Journal of gerontopsychology and geriatric psychiatry N2 - We investigated the efficacy of reminiscence therapy (RT) on symptoms of depression in patients with mild to moderate dementia. Out of 227 patients with mild to moderate dementia from a specialized physician’s office, 27 pairs (N = 54; mean age 79.04 ± 6.16 years) who had either received treatment as usual (TAU) or TAU combined with RT, were matched retrospectively according to age as well as cognitive and depressive symptom scores. After controlling for age and sex, symptoms of depression significantly decreased over time in the RT group compared to TAU (F1,52 = 4.36; p < .05). RT is a promising option for the treatment of depression in mild to moderate dementia. Larger randomized-controlled trials are needed. KW - reminiscence KW - life story book Y1 - 2017 U6 - https://doi.org/10.1024/1662-9647/a000175 SN - 1662-9647 SN - 1662-971X VL - 30 SP - 145 EP - 151 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Tschorn, Mira A1 - Schulze, Susanne A1 - Förstner, Bernd Rainer A1 - Holmberg, Christine A1 - Spallek, Jacob A1 - Heinz, Andreas A1 - Rapp, Michael A. T1 - Predictors and prevalence of hazardous alcohol use in middle-late to late adulthood in Europe JF - Aging & mental health N2 - Objectives: Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU. Methods: We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent-child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week). Results: Overall, past week alcohol consumption was 5.0 units (+/- 7.8), prevalence of HAU was 25.4% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent-child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender. Conclusions: HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders. KW - Hazardous alcohol use KW - older adults KW - middle-aged adults KW - Europe KW - alcohol KW - drug and alcohol abuse KW - cross-national KW - international studies KW - environmental factors KW - housing KW - rural-urban factors KW - epidemiology (mental health) Y1 - 2022 U6 - https://doi.org/10.1080/13607863.2022.2076208 SN - 1360-7863 SN - 1364-6915 VL - 27 IS - 5 SP - 1001 EP - 1010 PB - Routledge, Taylor & Francis Group CY - Abingdon ER - TY - JOUR A1 - Garbusow, Maria A1 - Ebrahimi, Claudia A1 - Riemerschmid, Carlotta A1 - Daldrup, Luisa A1 - Rothkirch, Marcus A1 - Chen, Ke A1 - Chen, Hao A1 - Belanger, Matthew J. A1 - Hentschel, Angela A1 - Smolka, Michael A1 - Heinz, Andreas A1 - Pilhatsch, Maximilan A1 - Rapp, Michael A. T1 - Pavlovian-to-instrumental transfer across mental disorders BT - a review JF - Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography N2 - A mechanism known as Pavlovian-to-instrumental transfer (PIT) describes a phenomenon by which the values of environmental cues acquired through Pavlovian conditioning can motivate instrumental behavior. PIT may be one basic mechanism of action control that can characterize mental disorders on a dimensional level beyond current classification systems. Therefore, we review human PIT studies investigating subclinical and clinical mental syndromes. The literature prevails an inhomogeneous picture concerning PIT. While enhanced PIT effects seem to be present in non-substance-related disorders, overweight people, and most studies with AUD patients, no altered PIT effects were reported in tobacco use disorder and obesity. Regarding AUD and relapsing alcohol-dependent patients, there is mixed evidence of enhanced or no PIT effects. Additionally, there is evidence for aberrant corticostriatal activation and genetic risk, e.g., in association with high-risk alcohol consumption and relapse after alcohol detoxification. In patients with anorexia nervosa, stronger PIT effects elicited by low caloric stimuli were associated with increased disease severity. In patients with depression, enhanced aversive PIT effects and a loss of action-specificity associated with poorer treatment outcomes were reported. Schizophrenic patients showed disrupted specific but intact general PIT effects. Patients with chronic back pain showed reduced PIT effects. We provide possible reasons to understand heterogeneity in PIT effects within and across mental disorders. Further, we strengthen the importance of reliable experimental tasks and provide test-retest data of a PIT task showing moderate to good reliability. Finally, we point toward stress as a possible underlying factor that may explain stronger PIT effects in mental disorders, as there is some evidence that stress per se interacts with the impact of environmental cues on behavior by selectively increasing cue-triggered wanting. To conclude, we discuss the results of the literature review in the light of Research Domain Criteria, suggesting future studies that comprehensively assess PIT across psychopathological dimensions. KW - Pavlovian-to-instrumental transfer KW - dimensional psychopathology KW - mental disorders KW - reliability Y1 - 2022 U6 - https://doi.org/10.1159/000525579 SN - 0302-282X SN - 1423-0224 VL - 81 IS - 5 SP - 418 EP - 437 PB - Karger CY - Basel ER - TY - JOUR A1 - Sebold, Miriam A1 - Chen, Hao A1 - Önal, Aleyna A1 - Kuitunen-Paul, Sören A1 - Mojtahedzadeh, Negin A1 - Garbusow, Maria A1 - Nebe, Stephan A1 - Wittchen, Hans-Ulrich A1 - Huys, Quentin J. M. A1 - Schlagenhauf, Florian A1 - Rapp, Michael A. A1 - Smolka, Michael N. A1 - Heinz, Andreas T1 - Stronger prejudices are associated with decreased model-based control JF - Frontiers in psychology N2 - Background: Prejudices against minorities can be understood as habitually negative evaluations that are kept in spite of evidence to the contrary. Therefore, individuals with strong prejudices might be dominated by habitual or "automatic" reactions at the expense of more controlled reactions. Computational theories suggest individual differences in the balance between habitual/model-free and deliberative/model-based decision-making. Methods: 127 subjects performed the two Step task and completed the blatant and subtle prejudice scale. Results: By using analyses of choices and reaction times in combination with computational modeling, subjects with stronger blatant prejudices showed a shift away from model-based control. There was no association between these decision-making processes and subtle prejudices. Conclusion: These results support the idea that blatant prejudices toward minorities are related to a relative dominance of habitual decision-making. This finding has important implications for developing interventions that target to change prejudices across societies. KW - subtle and blatant prejudice KW - immigrant KW - social behavior; KW - decision-making KW - computational modeling KW - reinforcement learning Y1 - 2022 U6 - https://doi.org/10.3389/fpsyg.2021.767022 SN - 1664-1078 VL - 12 PB - Frontiers Research Foundation CY - Lausanne ER -