TY - JOUR A1 - Bohle, Hannah A1 - Rimpel, Jérôme A1 - Schauenburg, Gesche A1 - Gebel, Arnd A1 - Stelzel, Christine A1 - Heinzel, Stephan A1 - Rapp, Michael A. A1 - Granacher, Urs T1 - Behavioral and Neural Correlates of Cognitive-Motor Interference during Multitasking in Young and Old Adults JF - Neural Plasticity N2 - The concurrent performance of cognitive and postural tasks is particularly impaired in old adults and associated with an increased risk of falls. Biological aging of the cognitive and postural control system appears to be responsible for increased cognitive-motor interference effects. We examined neural and behavioral markers of motor-cognitive dual-task performance in young and old adults performing spatial one-back working memory single and dual tasks during semitandem stance. On the neural level, we used EEG to test for age-related modulations in the frequency domain related to cognitive-postural task load. Twenty-eight healthy young and 30 old adults participated in this study. The tasks included a postural single task, a cognitive-postural dual task, and a cognitive-postural triple task (cognitive dual-task with postural demands). Postural sway (i.e., total center of pressure displacements) was recorded in semistance position on an unstable surface that was placed on top of a force plate while performing cognitive tasks. Neural activation was recorded using a 64-channel mobile EEG system. EEG frequencies were attenuated by the baseline postural single-task condition and demarcated in nine Regions-of-Interest (ROIs), i.e., anterior, central, posterior, over the cortical midline, and both hemispheres. Our findings revealed impaired cognitive dual-task performance in old compared to young participants in the form of significantly lower cognitive performance in the triple-task condition. Furthermore, old adults compared with young adults showed significantly larger postural sway, especially in cognitive-postural task conditions. With respect to EEG frequencies, young compared to old participants showed significantly lower alpha-band activity in cognitive-cognitive-postural triple-task conditions compared with cognitive-postural dual tasks. In addition, with increasing task difficulty, we observed synchronized theta and delta frequencies, irrespective of age. Taskdependent alterations of the alpha frequency band were most pronounced over frontal and central ROIs, while alterations of the theta and delta frequency bands were found in frontal, central, and posterior ROIs. Theta and delta synchronization exhibited a decrease from anterior to posterior regions. For old adults, task difficulty was reflected by theta synchronization in the posterior ROI. For young adults, it was reflected by alpha desynchronization in bilateral anterior ROIs. In addition, we could not identify any effects of task difficulty and age on the beta frequency band. Our results shed light on age-related cognitive and postural declines and how they interact. Modulated alpha frequencies during high cognitive-postural task demands in young but not old adults might be reflective of a constrained neural adaptive potential in old adults. Future studies are needed to elucidate associations between the identified age-related performance decrements with task difficulty and changes in brain activity. Y1 - 2019 U6 - https://doi.org/10.1155/2019/9478656 SN - 2090-5904 SN - 1687-5443 PB - Hindawi CY - New York ER - TY - JOUR A1 - Bohlken, Jens A1 - Jacob, Louis A1 - Schaum, Peter A1 - Rapp, Michael A. A1 - Kostev, Karel T1 - Hip fracture risk in patients with dementia in German primary care practices JF - Dementia N2 - The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3% of patients and 0.7% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2% versus 4.3%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices. KW - hip fracture KW - dementia KW - nursing homes KW - osteoporosis KW - risk factors Y1 - 2015 U6 - https://doi.org/10.1177/1471301215621854 SN - 1471-3012 SN - 1741-2684 VL - 16 SP - 853 EP - 864 PB - Sage Publ. CY - London ER - TY - JOUR A1 - Garbusow, Maria A1 - Schad, Daniel A1 - Sommer, Christian A1 - Juenger, Elisabeth A1 - Sebold, Miriam A1 - Friedel, Eva A1 - Wendt, Jean A1 - Kathmann, Norbert A1 - Schlagenhauf, Florian A1 - Zimmermann, Ulrich S. A1 - Heinz, Andreas A1 - Huys, Quentin J. M. A1 - Rapp, Michael A. T1 - Pavlovian-to-instrumental transfer in alcohol dependence: a pilot study JF - Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography N2 - Background: Pavlovian processes are thought to play an important role in the development, maintenance and relapse of alcohol dependence, possibly by influencing and usurping ongoing thought and behavior. The influence of pavlovian stimuli on ongoing behavior is paradigmatically measured by pavlovian-to-instrumental transfer (PIT) tasks. These involve multiple stages and are complex. Whether increased PIT is involved in human alcohol dependence is uncertain. We therefore aimed to establish and validate a modified PIT paradigm that would be robust, consistent and tolerated by healthy controls as well as by patients suffering from alcohol dependence, and to explore whether alcohol dependence is associated with enhanced PIT. Methods: Thirty-two recently detoxified alcohol-dependent patients and 32 age- and gender-matched healthy controls performed a PIT task with instrumental go/no-go approach behaviors. The task involved both pavlovian stimuli associated with monetary rewards and losses, and images of drinks. Results: Both patients and healthy controls showed a robust and temporally stable PIT effect. Strengths of PIT effects to drug-related and monetary conditioned stimuli were highly correlated. Patients more frequently showed a PIT effect, and the effect was stronger in response to aversively conditioned CSs (conditioned suppression), but there was no group difference in response to appetitive CSs. Conclusion: The implementation of PIT has favorably robust properties in chronic alcohol-dependent patients and in healthy controls. It shows internal consistency between monetary and drug-related cues. The findings support an association of alcohol dependence with an increased propensity towards PIT. KW - Pavlovian-to-instrumental transfer KW - Alcohol dependence KW - Human Y1 - 2014 U6 - https://doi.org/10.1159/000363507 SN - 0302-282X SN - 1423-0224 VL - 70 IS - 2 SP - 111 EP - 121 PB - Karger CY - Basel ER - TY - JOUR A1 - Rapp, Michael A. A1 - Mell, Thomas A1 - Majic, Tomislav A1 - Treusch, Yvonne A1 - Nordheim, Johanna A1 - Niemann-Mirmehdi, Mechthild A1 - Gutzmann, Hans A1 - Heinz, Andreas T1 - Agitation in Nursing Home Residents With Dementia (VIDEANT Trial) - Effects of a Cluster-Randomized, Controlled, Guideline Implementation Trial JF - Journal of the American Medical Directors Association N2 - Objective: To test the effect of a complex guideline-based intervention on agitation and psychotropic prescriptions. Design, Setting, Participants: Cluster randomized controlled trial (VIDEANT) with blinded assessment of outcome in 18 nursing homes in Berlin, Germany, comprising 304 dementia patients. Intervention: Training, support, and activity therapy intervention, delivered at the level of each nursing home, focusing on the management of agitation in dementia. Control group nursing homes received treatment as usual. Measurements: Levels of agitated and disruptive behavior (Cohen-Mansfield agitation inventory [CMAI]) as the primary outcome. Number of neuroleptics, antidepressants, and cholinesterase inhibitors (ChEIs) prescribed in defined daily dosages (DDDs). Results: Of 326 patients screened, 304 (93.3%) were eligible and cluster-randomized to 9 intervention (n = 163) and 9 control (n = 141) nursing homes. Data were collected from 287 (94.4%) patients at 10 months. At 10 months, compared with controls, nursing home residents with dementia in the intervention group exhibited significantly less agitation as measured with the CMAI (adjusted mean difference, 6.24; 95% CI 2.03-14.14; P = .009; Cohen's d = 0.43), received fewer neuroleptics (P < .05), more ChEIs (P < .05), and more antidepressants (P < .05). Conclusion: Complex guideline-based interventions are effective in reducing agitated and disruptive behavior in nursing home residents with dementia. At the same time, increased prescription of ChEIs and antidepressants together with decreased neuroleptic prescription suggests an effect toward guideline-based pharmacotherapy. KW - Dementia KW - agitation KW - nursing home KW - guideline KW - trial Y1 - 2013 U6 - https://doi.org/10.1016/j.jamda.2013.05.017 SN - 1525-8610 VL - 14 IS - 9 SP - 690 EP - 695 PB - Elsevier CY - New York ER - TY - JOUR A1 - Treusch, Yvonne A1 - Majic, Tomislav A1 - Page, Julie A1 - Gutzmann, Hans A1 - Heinz, Andreas A1 - Rapp, Michael A. T1 - Apathy in nursing home residents with dementia: Results from a cluster-randomized controlled trial JF - European psychiatry : the journal of the Association of European Psychiatrists N2 - Purpose: Here we evaluate an interdisciplinary occupational and sport therapy intervention for dementia patients suffering from apathy. Subjects and methods: A prospective, controlled, rater-blinded, clinical trial with two follow-ups was conducted as part of a larger cluster-randomized trial in 18 nursing homes in Berlin. n = 117 dementia patients with apathy, defined as a score of 40 or more on the apathy evaluation scale (AES) or presence of apathy on the Neuropsychiatric Inventory (NPI), were randomly assigned to intervention or control group. The intervention included 10 months of brief activities, provided once a week. The primary outcome measure was the total score on the AES scale measured directly after the intervention period and again after 12 months. Results: We found significant group differences with respect to apathy during the 10 month intervention period (F-2,F-82 = 7.79, P < 0.01), which reflected an increase in apathy in the control group, but not in the intervention group. Within one year after the intervention was ceased, the treatment group worsened and no longer differed significantly from the control group (P = 0.55). Conclusions: Our intervention was effective for the therapy of apathy in dementia, when applied, but not one year after cessation of therapy. (C) 2014 Elsevier Masson SAS. All rights reserved. KW - Dementia KW - Apathy KW - Non-pharmacological intervention KW - Occupational therapy KW - Sport therapy Y1 - 2015 U6 - https://doi.org/10.1016/j.eurpsy.2014.02.004 SN - 0924-9338 SN - 1778-3585 VL - 30 IS - 2 PB - Elsevier CY - Paris ER - TY - JOUR A1 - Bauer, M. A1 - Banaschewski, Tobias A1 - Heinz, A. A1 - Kamp-Becker, I. A1 - Meyer-Lindenberg, A. A1 - Padberg, F. A1 - Rapp, Michael A. A1 - Rupprecht, R. A1 - Schneider, F. A1 - Schulze, T. G. A1 - Wittchen, Hans-Ulrich T1 - The German Research Network for mental Disorders JF - Der Nervenarzt : Organ der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft für Neurologie N2 - Mental disorders are among the greatest medical and social challenges facing us. They can occur at all stages of life and are among the most important commonly occurring diseases. In Germany 28 % of the population suffer from a mental disorder every year, while the lifetime risk of suffering from a mental disorder is almost 50 %. Mental disorders cause great suffering for those affected and their social network. Quantitatively speaking, they can be considered to be among those diseases creating the greatest burden for society due to reduced productivity, absence from work and premature retirement. The Federal Ministry of Education and Research is funding a new research network from 2015 to 2019 with up to 35 million euros to investigate mental disorders in order to devise and develop better therapeutic measures and strategies for this population by means of basic and translational clinical research. This is the result of a competitive call for research proposals entitled research network for mental diseases. It is a nationwide network of nine consortia with up to ten psychiatric and clinical psychology partner institutions from largely university-based research facilities for adults and/or children and adolescents. Furthermore, three cross-consortia platform projects will seek to identify shared causes of diseases and new diagnostic modalities for anxiety disorders, attention deficit hyperactivity disorders (ADHS), autism, bipolar disorders, depression, schizophrenia and psychotic disorders as well as substance-related and addictive disorders. The spectrum of therapeutic approaches to be examined ranges from innovative pharmacological and psychotherapeutic treatment to novel brain stimulation procedures. In light of the enormous burden such diseases represent for society as a whole, a sustainable improvement in the financial support for those researching mental disorders seems essential. This network aims to become a nucleus for long overdue and sustained support for a German center for mental disorders. Y1 - 2016 U6 - https://doi.org/10.1007/s00115-016-0169-y SN - 0028-2804 SN - 1433-0407 VL - 87 SP - 989 EP - 1010 PB - Springer CY - New York ER - TY - JOUR A1 - Stelzel, Christine A1 - Schauenburg, Gesche A1 - Rapp, Michael A. A1 - Heinzel, Stephan A1 - Granacher, Urs T1 - Age-Related Interference between the Selection of Input-Output Modality Mappings and Postural Control BT - a Pilot Study JF - Frontiers in psychology N2 - Age-related decline in executive functions and postural control due to degenerative processes in the central nervous system have been related to increased fall-risk in old age. Many studies have shown cognitive-postural dual-task interference in old adults, but research on the role of specific executive functions in this context has just begun. In this study, we addressed the question whether postural control is impaired depending on the coordination of concurrent response-selection processes related to the compatibility of input and output modality mappings as compared to impairments related to working-memory load in the comparison of cognitive dual and single tasks. Specifically, we measured total center of pressure (CoP) displacements in healthy female participants aged 19–30 and 66–84 years while they performed different versions of a spatial one-back working memory task during semi-tandem stance on an unstable surface (i.e., balance pad) while standing on a force plate. The specific working-memory tasks comprised: (i) modality compatible single tasks (i.e., visual-manual or auditory-vocal tasks), (ii) modality compatible dual tasks (i.e., visual-manual and auditory-vocal tasks), (iii) modality incompatible single tasks (i.e., visual-vocal or auditory-manual tasks), and (iv) modality incompatible dual tasks (i.e., visual-vocal and auditory-manual tasks). In addition, participants performed the same tasks while sitting. As expected from previous research, old adults showed generally impaired performance under high working-memory load (i.e., dual vs. single one-back task). In addition, modality compatibility affected one-back performance in dual-task but not in single-task conditions with strikingly pronounced impairments in old adults. Notably, the modality incompatible dual task also resulted in a selective increase in total CoP displacements compared to the modality compatible dual task in the old but not in the young participants. These results suggest that in addition to effects of working-memory load, processes related to simultaneously overcoming special linkages between input- and output modalities interfere with postural control in old but not in young female adults. Our preliminary data provide further evidence for the involvement of cognitive control processes in postural tasks. KW - cognitive-postural dual task KW - postural stability KW - working memory KW - modality compatibility KW - aging Y1 - 2017 U6 - https://doi.org/10.3389/fpsyg.2017.00613 SN - 1664-1078 VL - 8 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Stelzel, Christine A1 - Bohle, Hannah A1 - Schauenburg, Gesche A1 - Walter, Henrik A1 - Granacher, Urs A1 - Rapp, Michael A. A1 - Heinzel, Stephan T1 - Contribution of the Lateral Prefrontal Cortex to Cognitive-Postural Multitasking JF - Frontiers in psychologie N2 - There is evidence for cortical contribution to the regulation of human postural control. Interference from concurrently performed cognitive tasks supports this notion, and the lateral prefrontal cortex (lPFC) has been suggested to play a prominent role in the processing of purely cognitive as well as cognitive-postural dual tasks. The degree of cognitive-motor interference varies greatly between individuals, but it is unresolved whether individual differences in the recruitment of specific lPFC regions during cognitive dual tasking are associated with individual differences in cognitive-motor interference. Here, we investigated inter-individual variability in a cognitive-postural multitasking situation in healthy young adults (n = 29) in order to relate these to inter-individual variability in lPFC recruitment during cognitive multitasking. For this purpose, a oneback working memory task was performed either as single task or as dual task in order to vary cognitive load. Participants performed these cognitive single and dual tasks either during upright stance on a balance pad that was placed on top of a force plate or during fMRI measurement with little to no postural demands. We hypothesized dual one-back task performance to be associated with lPFC recruitment when compared to single one-back task performance. In addition, we expected individual variability in lPFC recruitment to be associated with postural performance costs during concurrent dual one-back performance. As expected, behavioral performance costs in postural sway during dual-one back performance largely varied between individuals and so did lPFC recruitment during dual one-back performance. Most importantly, individuals who recruited the right mid-lPFC to a larger degree during dual one-back performance also showed greater postural sway as measured by larger performance costs in total center of pressure displacements. This effect was selective to the high-load dual one-back task and suggests a crucial role of the right lPFC in allocating resources during cognitivemotor interference. Our study provides further insight into the mechanisms underlying cognitive-motor multitasking and its impairments. KW - balance KW - dual task KW - fMRI KW - postural control KW - working memory Y1 - 2018 U6 - https://doi.org/10.3389/fpsyg.2018.01075 SN - 1664-1078 VL - 9 PB - Frontiers CY - Lausanne ER - TY - JOUR A1 - Heinzel, Stephan A1 - Lorenz, Robert C. A1 - Brockhaus, Wolf-Ruediger A1 - Wuestenberg, Torsten A1 - Kathmann, Norbert A1 - Heinz, Andreas A1 - Rapp, Michael A. T1 - Working memory load-dependent brain response predicts behavioral training gains in older adults JF - The journal of neuroscience N2 - In the domain of working memory (WM), a sigmoid-shaped relationship between WM load and brain activation patterns has been demonstrated in younger adults. It has been suggested that age-related alterations of this pattern are associated with changes in neural efficiency and capacity. At the same time, WM training studies have shown that some older adults are able to increase their WM performance through training. In this study, functional magnetic resonance imaging during an n-back WM task at different WM load levels was applied to compare blood oxygen level-dependent (BOLD) responses between younger and older participants and to predict gains in WM performance after a subsequent 12-session WM training procedure in older adults. We show that increased neural efficiency and capacity, as reflected by more "youth-like" brain response patterns in regions of interest of the frontoparietal WM network, were associated with better behavioral training outcome beyond the effects of age, sex, education, gray matter volume, and baseline WM performance. Furthermore, at low difficulty levels, decreases in BOLD response were found after WM training. Results indicate that both neural efficiency (i. e., decreased activation at comparable performance levels) and capacity (i. e., increasing activation with increasing WM load) of a WM-related network predict plasticity of the WM system, whereas WM training may specifically increase neural efficiency in older adults. KW - aging KW - fMRI KW - neuroimaging KW - plasticity KW - training KW - working memory Y1 - 2014 U6 - https://doi.org/10.1523/JNEUROSCI.2463-13.2014 SN - 0270-6474 VL - 34 IS - 4 SP - 1224 EP - 1233 PB - Society for Neuroscience CY - Washington ER - TY - JOUR A1 - Sebold, Miriam A1 - Deserno, Lorenz A1 - Nebe, Stefan A1 - Schad, Daniel A1 - Garbusow, Maria A1 - Haegele, Claudia A1 - Keller, Juergen A1 - Juenger, Elisabeth A1 - Kathmann, Norbert A1 - Smolka, Michael N. A1 - Rapp, Michael A. A1 - Schlagenhauf, Florian A1 - Heinz, Andreas A1 - Huys, Quentin J. M. T1 - Model-based and model-free decisions in alcohol dependence JF - Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography N2 - Background: Human and animal work suggests a shift from goal-directed to habitual decision-making in addiction. However, the evidence for this in human alcohol dependence is as yet inconclusive. Methods: Twenty-six healthy controls and 26 recently detoxified alcohol-dependent patients underwent behavioral testing with a 2-step task designed to disentangle goal-directed and habitual response patterns. Results: Alcohol-dependent patients showed less evidence of goal-directed choices than healthy controls, particularly after losses. There was no difference in the strength of the habitual component. The group differences did not survive controlling for performance on the Digit Symbol Substitution Task. Conclusion: Chronic alcohol use appears to selectively impair goal-directed function, rather than promoting habitual responding. It appears to do so particularly after nonrewards, and this may be mediated by the effects of alcohol on more general cognitive functions subserved by the prefrontal cortex. KW - Alcohol dependence KW - Decision-making KW - Reinforcement learning KW - Dopamine KW - Computational psychiatry Y1 - 2014 U6 - https://doi.org/10.1159/000362840 SN - 0302-282X SN - 1423-0224 VL - 70 IS - 2 SP - 122 EP - 131 PB - Karger CY - Basel ER - TY - JOUR A1 - Heissel, Andreas A1 - Sanchez, Alba A1 - Pietrek, Anou F. A1 - Bergau, Theresa A1 - Stielow, Christiane A1 - Rapp, Michael A. A1 - Van der Kaap-Deeder, Jolene T1 - Validating the German Short Basic Psychological Need Satisfaction and Frustration Scale in Individuals with Depression JF - Healthcare N2 - Satisfaction and frustration of the needs for autonomy, competence, and relatedness, as assessed with the 24-item Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS), have been found to be crucial indicators of individuals’ psychological health. To increase the usability of this scale within a clinical and health services research context, we aimed to validate a German short version (12 items) of this scale in individuals with depression including the examination of the relations from need frustration and need satisfaction to ill-being and quality of life (QOL). This cross-sectional study involved 344 adults diagnosed with depression (Mage (SD) = 47.5 years (11.1); 71.8% females). Confirmatory factor analyses indicated that the short version of the BPNSFS was not only reliable, but also fitted a six-factor structure (i.e., satisfaction/frustration X type of need). Subsequent structural equation modeling showed that need frustration related positively to indicators of ill-being and negatively to QOL. Surprisingly, need satisfaction did not predict differences in ill-being or QOL. The short form of the BPNSFS represents a practical instrument to measure need satisfaction and frustration in people with depression. Further, the results support recent evidence on the importance of especially need frustration in the prediction of psychopathology. KW - basic psychological need frustration KW - need satisfaction KW - mental health KW - ill-being KW - depression Y1 - 2023 U6 - https://doi.org/10.3390/healthcare11030412 SN - 2227-9032 VL - 11 IS - 3 PB - MDPI CY - Basel ER - TY - JOUR A1 - Heissel, Andreas A1 - Pietrek, Anou F. A1 - Flunger, Barbara A1 - Fydrich, Thomas A1 - Rapp, Michael A. A1 - Heinzel, Stephan A1 - Vansteenkiste, Maarten T1 - The Validation of the German Basic Psychological Need Satisfaction and Frustration Scale in the Context of Mental Health JF - European Journal of Health Psychology N2 - The primary aim of the current study was to examine the unique contribution of psychological need frustration and need satisfaction in the prediction of adults’ mental well-being and ill-being in a heterogeneous sample of adults (N = 334; Mage = 43.33, SD = 32.26; 53% females). Prior to this, validity evidence was provided for the German version of the Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS) based on Self-Determination Theory (SDT). The results of the validation analyses found the German BPNSFS to be a valid and reliable measurement. Further, structural equation modeling (SEM) showed that both need satisfaction and frustration yielded unique and opposing associations with well-being. Specifically, the dimension of psychological need frustration predicted adults’ ill-being. Future research should examine whether frustration of psychological needs is involved in the onset and maintenance of psychopathology (e.g., major depressive disorder). KW - basic psychological need frustration KW - need satisfaction KW - mental health KW - well-being KW - depression Y1 - 2018 U6 - https://doi.org/10.1027/2512-8442/a000017 SN - 2512-8442 SN - 2512-8450 VL - 25 IS - 4 SP - 119 EP - 132 PB - Hogrefe CY - Göttingen ER - TY - JOUR A1 - Schad, Daniel A1 - Garbusow, Maria A1 - Friedel, Eva A1 - Sommer, Christian A1 - Sebold, Miriam A1 - Hägele, Claudia A1 - Bernhardt, Nadine A1 - Nebe, Stephan A1 - Kuitunen-Paul, Sören A1 - Liu, Shuyan A1 - Eichmann, Uta A1 - Beck, Anne A1 - Wittchen, Hans-Ulrich A1 - Walter, Henrik A1 - Sterzer, Philipp A1 - Zimmermann, Ulrich S. A1 - Smolka, Michael N. A1 - Schlagenhauf, Florian A1 - Huys, Quentin J. M. A1 - Heinz, Andreas A1 - Rapp, Michael A. T1 - Neural correlates of instrumental responding in the context of alcohol-related cues index disorder severity and relapse risk JF - European archives of psychiatry and clinical neuroscience : official organ of the German Society for Biological Psychiatry N2 - The influence of Pavlovian conditioned stimuli on ongoing behavior may contribute to explaining how alcohol cues stimulate drug seeking and intake. Using a Pavlovian-instrumental transfer task, we investigated the effects of alcohol-related cues on approach behavior (i.e., instrumental response behavior) and its neural correlates, and related both to the relapse after detoxification in alcohol-dependent patients. Thirty-one recently detoxified alcohol-dependent patients and 24 healthy controls underwent instrumental training, where approach or non-approach towards initially neutral stimuli was reinforced by monetary incentives. Approach behavior was tested during extinction with either alcohol-related or neutral stimuli (as Pavlovian cues) presented in the background during functional magnetic resonance imaging (fMRI). Patients were subsequently followed up for 6 months. We observed that alcohol-related background stimuli inhibited the approach behavior in detoxified alcohol-dependent patients (t = -3.86, p < .001), but not in healthy controls (t = -0.92, p = .36). This behavioral inhibition was associated with neural activation in the nucleus accumbens (NAcc) (t((30)) = 2.06, p < .05). Interestingly, both the effects were only present in subsequent abstainers, but not relapsers and in those with mild but not severe dependence. Our data show that alcohol-related cues can acquire inhibitory behavioral features typical of aversive stimuli despite being accompanied by a stronger NAcc activation, suggesting salience attribution. The fact that these findings are restricted to abstinence and milder illness suggests that they may be potential resilience factors. KW - Alcohol dependence KW - Human neuroimaging KW - Nucleus accumbens KW - Pavlovian-instrumental transfer KW - Relapse Y1 - 2018 U6 - https://doi.org/10.1007/s00406-017-0860-4 SN - 0940-1334 SN - 1433-8491 VL - 269 IS - 3 SP - 295 EP - 308 PB - Springer CY - Heidelberg ER - TY - JOUR A1 - Gleich, Tobias A1 - Spitta, Gianna A1 - Butler, Oisin A1 - Zacharias, Kristin A1 - Aydin, Semiha A1 - Sebold, Miriam A1 - Garbusow, Maria A1 - Rapp, Michael A. A1 - Schubert, Florian A1 - Buchert, Ralph A1 - Heinz, Andreas A1 - Gallinat, Jürgen T1 - Dopamine D2/3 receptor availability in alcohol use disorder and individuals at high risk BT - towards a dimensional approach JF - Addiction Biology N2 - Alcohol use disorder (AUD) is the most common substance use disorder worldwide. Although dopamine-related findings were often observed in AUD, associated neurobiological mechanisms are still poorly understood. Therefore, in the present study, we investigate D2/3 receptor availability in healthy participants, participants at high risk (HR) to develop addiction (not diagnosed with AUD), and AUD patients in a detoxified stage, applying F-18-fallypride positron emission tomography (F-18-PET). Specifically, D2/3 receptor availability was investigated in (1) 19 low-risk (LR) controls, (2) 19 HR participants, and (3) 20 AUD patients after alcohol detoxification. Quality and severity of addiction were assessed with clinical questionnaires and (neuro)psychological tests. PET data were corrected for age of participants and smoking status. In the dorsal striatum, we observed significant reductions of D2/3 receptor availability in AUD patients compared with LR participants. Further, receptor availability in HR participants was observed to be intermediate between LR and AUD groups (linearly decreasing). Still, in direct comparison, no group difference was observed between LR and HR groups or between HR and AUD groups. Further, the score of the Alcohol Dependence Scale (ADS) was inversely correlated with D2/3 receptor availability in the combined sample. Thus, in line with a dimensional approach, striatal D2/3 receptor availability showed a linear decrease from LR participants to HR participants to AUD patients, which was paralleled by clinical measures. Our study shows that a core neurobiological feature in AUD seems to be detectable in an early, subclinical state, allowing more individualized alcohol prevention programs in the future. KW - alcohol KW - D2/3 receptors KW - dependence KW - dopamine KW - high risk KW - PET Y1 - 2020 U6 - https://doi.org/10.1111/adb.12915 SN - 1369-1600 VL - 26 IS - 2 SP - 1 EP - 10 PB - Wiley-Blackwell CY - Hoboken ER - TY - JOUR A1 - Haegele, Claudia A1 - Schlagenhauf, Florian A1 - Rapp, Michael A. A1 - Sterzer, Philipp A1 - Beck, Anne A1 - Bermpohl, Felix A1 - Stoy, Meline A1 - Stroehle, Andreas A1 - Wittchen, Hans-Ulrich A1 - Dolan, Raymond J. A1 - Heinz, Andreas T1 - Dimensional psychiatry: reward dysfunction and depressive mood across psychiatric disorders JF - Psychopharmacology N2 - A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries. We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment. During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation. Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities. KW - Dimensional KW - fMRI KW - Reward system KW - Ventral striatum KW - Monetary incentive delay task KW - Depressive symptoms Y1 - 2015 U6 - https://doi.org/10.1007/s00213-014-3662-7 SN - 0033-3158 SN - 1432-2072 VL - 232 IS - 2 SP - 331 EP - 341 PB - Springer CY - New York ER - TY - JOUR A1 - Majic, Tomislav A1 - Gutzmann, Hans A1 - Heinz, Andreas A1 - Lang, Undine E. A1 - Rapp, Michael A. T1 - Animal-assisted therapy and agitation and depression in nursing home residents with dementia - a matched case-control trial JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry N2 - Objectives: To investigate the efficacy of animal-assisted therapy (AAT) on symptoms of agitation/aggression and depression in nursing home residents with dementia in a randomized controlled trial. Previous studies have indicated that AAT has beneficial effects on neuropsychiatric symptoms in various psychiatric disorders but few studies have investigated the efficacy of AAT in patients suffering from dementia. Methods: Of 65 nursing home residents with dementia (mean [standard deviation] age: 81.8 [9.2] years; mean Mini-Mental State Examination score: 7.1 [0.7]), 27 matched pairs (N = 54) were randomly assigned to either treatment as usual or treatment as usual combined with AAT, administered over 10 weekly sessions. Blinded raters assessed cognitive impairment with the Mini-Mental State Examination, presence of agitation/aggression with the Cohen-Mansfield Agitation Inventory, and depression with the Dementia Mood Assessment Scale at baseline and during a period of 4 weeks after AAT intervention. Results: In the control group, symptoms of agitation/aggression and depression significantly increased over 10 weeks; in the intervention group, patients receiving combined treatment displayed constant frequency and severity of symptoms of agitation/aggression (F-1,F-48 = 6.43; p <0.05) and depression (F-1,F-48 = 26.54; p <0.001). Symptom amelioration did not occur in either group. Conclusions: AAT is a promising option for the treatment of agitation/aggression and depression in patients with dementia. Our results suggest that AAT may delay progression of neuropsychiatric symptoms in demented nursing home residents. Further research is needed to determine its long-time effects. KW - AAT KW - Alzheimer disease KW - agitation KW - animal-assisted therapy KW - BPSD KW - depression KW - dog-assisted therapy KW - nursing home Y1 - 2013 U6 - https://doi.org/10.1016/j.jagp.2013.03.004 SN - 1064-7481 SN - 1545-7214 VL - 21 IS - 11 SP - 1052 EP - 1059 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Heinzel, Stephan A1 - Lawrence, Jimmy B. A1 - Kallies, Gunnar A1 - Rapp, Michael A. A1 - Heissel, Andreas T1 - Using Exercise to Fight Depression in Older Adults BT - A Systematic Review and Meta-Analysis JF - GeroPsych : the journal of gerontopsychology and geriatric psychiatry N2 - Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully. KW - depression KW - exercise KW - older adults KW - meta-analysis KW - review Y1 - 2015 U6 - https://doi.org/10.1024/1662-9647/a000133 SN - 1662-9647 SN - 1662-971X VL - 28 SP - 149 EP - 162 PB - Hogrefe CY - Cambridge, Mass. ; Göttingen [u.a.] ER - TY - JOUR A1 - Kaminski, Jakob A. A1 - Schlagenhauf, Florian A1 - Rapp, Michael A. A1 - Awasthi, Swapnil A1 - Ruggeri, Barbara A1 - Deserno, Lorenz A1 - Banaschewski, Tobias A1 - Bokde, Arun L. W. A1 - Bromberg, Uli A1 - Büchel, Christian A1 - Quinlan, Erin Burke A1 - Desrivieres, Sylvane A1 - Flor, Herta A1 - Frouin, Vincent A1 - Garavan, Hugh A1 - Gowland, Penny A1 - Ittermann, Bernd A1 - Martinot, Jean-Luc A1 - Martinot, Marie-Laure Paillere A1 - Nees, Frauke A1 - Orfanos, Dimitri Papadopoulos A1 - Paus, Tomas A1 - Poustka, Luise A1 - Smolka, Michael N. A1 - Fröhner, Juliane H. A1 - Walter, Henrik A1 - Whelan, Robert A1 - Ripke, Stephan A1 - Schumann, Gunter A1 - Heinz, Andreas T1 - Epigenetic variance in dopamine D2 receptor BT - a marker of IQ malleability? JF - Translational Psychiatry N2 - Genetic and environmental factors both contribute to cognitive test performance. A substantial increase in average intelligence test results in the second half of the previous century within one generation is unlikely to be explained by genetic changes. One possible explanation for the strong malleability of cognitive performance measure is that environmental factors modify gene expression via epigenetic mechanisms. Epigenetic factors may help to understand the recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events. The possible manifestation of malleable biomarkers contributing to variance in cognitive test performance, and thus possibly contributing to the "missing heritability" between estimates from twin studies and variance explained by genetic markers, is still unclear. Here we show in 1475 healthy adolescents from the IMaging and GENetics (IMAGEN) sample that general IQ (gIQ) is associated with (1) polygenic scores for intelligence, (2) epigenetic modification of DRD2 gene, (3) gray matter density in striatum, and (4) functional striatal activation elicited by temporarily surprising reward-predicting cues. Comparing the relative importance for the prediction of gIQ in an overlapping subsample, our results demonstrate neurobiological correlates of the malleability of gIQ and point to equal importance of genetic variance, epigenetic modification of DRD2 receptor gene, as well as functional striatal activation, known to influence dopamine neurotransmission. Peripheral epigenetic markers are in need of confirmation in the central nervous system and should be tested in longitudinal settings specifically assessing individual and environmental factors that modify epigenetic structure. Y1 - 2018 U6 - https://doi.org/10.1038/s41398-018-0222-7 SN - 2158-3188 VL - 8 PB - Nature Publ. Group CY - New York ER - TY - JOUR A1 - Deeken, Friederike A1 - Häusler, Andreas A1 - Nordheim, Johanna A1 - Rapp, Michael A. A1 - Knoll, Nina A1 - Rieckmann, Nina T1 - Psychometric properties of the Perceived Stress Scale in a sample of German dementia patients and their caregivers JF - International psychogeriatrics N2 - Background: The aim of the present study was to investigate the psychometric characteristics of the Perceived Stress Scale (PSS) in a sample of dementia patients and their spousal caregivers. Methods: We investigated the reliability and validity of the 14-item PSS in a sample of 80 couples, each including one spouse who had been diagnosed with mild to moderate dementia (mean age 75.55, SD = 5.85, 38.7% female) and one spousal caregiver (mean age 73.06, SD = 6.75, 61.3% female). We also examined the factor structure and sensitivity of the scale with regard to gender differences. Results: Exploratory factor analysis of the PSS revealed a two-factor solution for the scale; the first factor reflected general stress while the second factor consisted of items reflecting the perceived ability to cope with stressors. A confirmatory factor analysis verified that the data were a better fit for the two-factor model than a one-factor model. The two factors of the PSS showed good reliability for patients as well as for caregivers ranging between alpha = 0.73 and alpha = 0.82. Perceived stress was significantly positively correlated with depressive symptomatology in both caregivers and patients. Mean PSS scores did not significantly differ between male and female patients nor did they differ between male and female caregivers. Conclusion: The present data indicate that the PSS provides a reliable and valid measure of perceived stress in dementia patients and their caregivers. KW - Perceived Stress Scale KW - psychometric properties KW - dementia KW - caregiver Y1 - 2017 U6 - https://doi.org/10.1017/S1041610217001387 SN - 1041-6102 SN - 1741-203X VL - 30 IS - 1 SP - 39 EP - 47 PB - Cambridge Univ. Press CY - New York ER - TY - JOUR A1 - Herold, Fabian A1 - Theobald, Paula A1 - Gronwald, Thomas A1 - Rapp, Michael A. A1 - Müller, Notger Germar T1 - Going digital – a commentary on the terminology used at the intersection of physical activity and digital health JF - European review of aging and physical activity N2 - In recent years digital technologies have become a major means for providing health-related services and this trend was strongly reinforced by the current Coronavirus disease 2019 (COVID-19) pandemic. As it is well-known that regular physical activity has positive effects on individual physical and mental health and thus is an important prerequisite for healthy aging, digital technologies are also increasingly used to promote unstructured and structured forms of physical activity. However, in the course of this development, several terms (e.g., Digital Health, Electronic Health, Mobile Health, Telehealth, Telemedicine, and Telerehabilitation) have been introduced to refer to the application of digital technologies to provide health-related services such as physical interventions. Unfortunately, the above-mentioned terms are often used in several different ways, but also relatively interchangeably. Given that ambiguous terminology is a major source of difficulty in scientific communication which can impede the progress of theoretical and empirical research, this article aims to make the reader aware of the subtle differences between the relevant terms which are applied at the intersection of physical activity and Digital Health and to provide state-of-art definitions for them. KW - Digital Health KW - Electronic Health KW - Mobile Health KW - Telehealth KW - Telemedicine KW - Physical activity KW - Physical training KW - Aging Y1 - 2022 U6 - https://doi.org/10.1186/s11556-022-00296-y SN - 1861-6909 VL - 19 PB - Springer CY - Berlin ; Heidelberg ER -