TY - GEN A1 - Wippert, Pia-Maria A1 - Puschmann, Anne-Katrin A1 - Drießlein, David A1 - Arampatzis, Adamantios A1 - Banzer, Winfried A1 - Beck, Heidrun A1 - Schiltenwolf, Marcus A1 - Schmidt, Hendrik A1 - Schneider, Christian A1 - Mayer, Frank T1 - Development of a risk stratification and prevention index for stratified care in chronic low back pain. Focus: yellow flags (MiSpEx network) N2 - Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges. Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S). Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined. Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly. Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 351 KW - Back pain prognosis KW - Back pain diagnosis KW - Pain screening KW - PROGRESS/TRIPOD KW - Prediction of disability/intensity KW - Yellow flags KW - Exercise Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-403424 ER - TY - JOUR A1 - Wippert, Pia-Maria A1 - Puschmann, Anne-Katrin A1 - Drießlein, David A1 - Arampatzis, Adamantios A1 - Banzer, Winfried A1 - Beck, Heidrun A1 - Schiltenwolf, Marcus A1 - Schmidt, Hendrik A1 - Schneider, Christian A1 - Mayer, Frank T1 - Development of a risk stratification and prevention index for stratified care in chronic low back pain. Focus: yellow flags (MiSpEx network) JF - Pain reports N2 - Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges. Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S). Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined. Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly. Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments. KW - Back pain prognosis KW - Back pain diagnosis KW - Pain screening KW - PROGRESS/TRIPOD KW - Prediction of disability/intensity KW - Yellow flags KW - Exercise Y1 - 2017 U6 - https://doi.org/10.1097/PR9.0000000000000623 VL - 9 SP - 1 EP - 11 PB - Wolters Kluwer Health CY - Riverwoods, IL ER - TY - CHAP A1 - Haegele, Claudia A1 - Friedel, Eva A1 - Schlagenhauf, Florian A1 - Sterzer, Philipp A1 - Beck, Anne A1 - Bermpohl, Felix A1 - Rapp, Michael Armin A1 - Stoy, Meline A1 - Stroehle, Andreas A1 - Dolan, Raymond J. A1 - Heinz, Andreas T1 - Reward expectation and affective responses across psychiatric disorders - A dimensional approach T2 - Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry KW - dimensional KW - transdiagnostic KW - reward system KW - ventral striatum KW - fMRI Y1 - 2014 SN - 0006-3223 SN - 1873-2402 VL - 75 IS - 9 SP - 91S EP - 92S PB - Elsevier CY - New York ER - TY - JOUR A1 - Lorenz, Robert C. A1 - Gleich, Tobias A1 - Beck, Anne A1 - Poehland, Lydia A1 - Raufelder, Diana A1 - Sommer, Werner A1 - Rapp, Michael Armin A1 - Kuehn, Simone A1 - Gallinat, Jürgen T1 - Reward anticipation in the adolescent and aging brain JF - Human brain mapping : a journal devoted to functional neuroanatomy and neuroimaging N2 - Processing of reward is the basis of adaptive behavior of the human being. Neural correlates of reward processing seem to be influenced by developmental changes from adolescence to late adulthood. The aim of this study is to uncover these neural correlates during a slot machine gambling task across the lifespan. Therefore, we used functional magnetic resonance imaging to investigate 102 volunteers in three different age groups: 34 adolescents, 34 younger adults, and 34 older adults. We focused on the core reward areas ventral striatum (VS) and ventromedial prefrontal cortex (VMPFC), the valence processing associated areas, anterior cingulate cortex (ACC) and insula, as well as information integration associated areas, dorsolateral prefrontal cortex (DLPFC), and inferior parietal lobule (IPL). Results showed that VS and VMPFC were characterized by a hyperactivation in adolescents compared with younger adults. Furthermore, the ACC and insula were characterized by a U-shape pattern (hypoactivation in younger adults compared with adolescents and older adults), whereas the DLPFC and IPL were characterized by a J-shaped form (hyperactivation in older adults compared with younger groups). Furthermore, a functional connectivity analysis revealed an elevated negative functional coupling between the inhibition-related area rIFG and VS in younger adults compared with adolescents. Results indicate that lifespan-related changes during reward anticipation are characterized by different trajectories in different reward network modules and support the hypothesis of an imbalance in maturation of striatal and prefrontal cortex in adolescents. Furthermore, these results suggest compensatory age-specific effects in fronto-parietal regions. Hum Brain Mapp 35:5153-5165, 2014. (c) 2014 Wiley Periodicals, Inc. KW - reward anticipation KW - lifespan KW - aging KW - adolescence KW - fMRI KW - connectivity Y1 - 2014 U6 - https://doi.org/10.1002/hbm.22540 SN - 1065-9471 SN - 1097-0193 VL - 35 IS - 10 SP - 5153 EP - 5165 PB - Wiley-Blackwell CY - Hoboken ER -