@article{DempfleHerpertzDahlmannTimmesfeldetal.2013, author = {Dempfle, Astrid and Herpertz-Dahlmann, Beate and Timmesfeld, Nina and Schwarte, Reinhild and Egberts, Karin M. and Pfeiffer, Ernst and Fleischhaker, Christian and Wewetzer, Christoph and B{\"u}hren, Katharina}, title = {Predictors of the resumption of menses in adolescent anorexia nervosa}, series = {BMC Psychiatry}, volume = {13}, journal = {BMC Psychiatry}, number = {308}, doi = {10.1186/1471-244X-13-308}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-122106}, year = {2013}, abstract = {Background: The resumption of menses is an important indicator of recovery in anorexia nervosa (AN). Patients with early-onset AN are at particularly great risk of suffering from the long-term physical and psychological consequences of persistent gonadal dysfunction. However, the clinical variables that predict the recovery of menstrual function during weight gain in AN remain poorly understood. The aim of this study was to investigate the impact of several clinical parameters on the resumption of menses in first-onset adolescent AN in a large, well-characterized, homogenous sample that was followed-up for 12 months. Methods: A total of 172 female adolescent patients with first-onset AN according to DSM-IV criteria were recruited for inclusion in a randomized, multi-center, German clinical trial. Menstrual status and clinical variables (i.e., premorbid body mass index (BMI), age at onset, duration of illness, duration of hospital treatment, achievement of target weight at discharge, and BMI) were assessed at the time of admission to or discharge from hospital treatment and at a 12-month follow-up. Based on German reference data, we calculated the percentage of expected body weight (\%EBW), BMI percentile, and BMI standard deviation score (BMI-SDS) for all time points to investigate the relationship between different weight measurements and resumption of menses. Results: Forty-seven percent of the patients spontaneously began menstruating during the follow-up period. \%EBW at the 12-month follow-up was strongly correlated with the resumption of menses. The absence of menarche before admission, a higher premorbid BMI, discharge below target weight, and a longer duration of hospital treatment were the most relevant prognostic factors for continued amenorrhea. Conclusions: The recovery of menstrual function in adolescent patients with AN should be a major treatment goal to prevent severe long-term physical and psychological sequelae. Patients with premenarchal onset of AN are at particular risk for protracted amenorrhea despite weight rehabilitation. Reaching and maintaining a target weight between the 15th and 20th BMI percentile is favorable for the resumption of menses within 12 months. Whether patients with a higher premorbid BMI may benefit from a higher target weight needs to be investigated in further studies.}, language = {en} } @phdthesis{Eckert2024, author = {Eckert, Lisa Doreen}, title = {Multimodale Verfahren zum Eisenstoffwechsel bei ADHS - Vergleichende Bildgebung}, doi = {10.25972/OPUS-34829}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-348295}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2024}, abstract = {Die Aufmerksamkeitsdefizit-/Hyperaktivit{\"a}tsst{\"o}rung (ADHS) geh{\"o}rt weltweit zu den bedeutendsten psychiatrischen Erkrankungen des Kinder- und Jugendalters. Die Pathomechanismen sind aktuell noch nicht vollst{\"a}ndig gekl{\"a}rt, wobei es deutliche Hinweise auf hirnorganische Ver{\"a}nderungen gibt. Die transkranielle Sonographie stellt eine nicht-invasive Methode dar, strukturelle Unterschiede tiefer Hirnstrukturen zu untersuchen. Bereits in vorangegangenen Studien konnte mit der Methode eine Ver{\"a}nderung der Echogenit{\"a}t der Substantia nigra (SN) bei Kindern mit ADHS im Vergleich zu gesunden Kontrollprobanden nachgewiesen werden. In dieser Studie sollen nun die m{\"o}glichen physiologischen Hintergr{\"u}nde der erh{\"o}hten Echogenit{\"a}t der Substantia Nigra in Zusammenschau mit bildgebenden Verfahren betrachtet werden. Hierzu wurde in der vorliegenden multimodalen Studie bei 20 m{\"a}nnlichen Kindern mit ADHS im Alter zwischen 8 und 12 Jahren eine transkranielle Ultraschalluntersuchung (TCS) zur Bestimmung der echogenen Fl{\"a}che der Substantia Nigra sowie ein neuromelaninsensitives cMRT zur Bestimmung des neuromelaninassoziierten Volumens der SN, sowie des neuromelaninassoziierten Kontrastes SN/Cb durchgef{\"u}hrt. Als Kennwerte des peripheren Eisenhaushalts wurden die Konzentrationen von Eisen, Ferritin und Transferrin im Blut bestimmt. In die Auswertung gingen außerdem die St{\"a}rke der ADHS-Symptomatik (Strength and Difficulties Questionaire, SDQ; Fremdbeurteilungsbogen bei ADHS, FBB-ADHS), die kognitive Begabung ({\"u}ber CFT-20-R) und das Alter der Probanden ein. Psychiatrische Komorbidit{\"a}t wurde mit Hilfe der Child Behaviour Checklist (CBCL) erhoben.}, subject = {Aufmerksamkeitsdefizit-Syndrom}, language = {de} } @article{EgbertsFeketeHaegeetal.2022, author = {Egberts, Karin and Fekete, Stefanie and H{\"a}ge, Alexander and Hiemke, Christoph and Scherf-Clavel, Maike and Taurines, Regina and Unterecker, Stefan and Gerlach, Manfred and Romanos, Marcel}, title = {Therapeutisches Drug Monitoring zur Optimierung der Psychopharmakotherapie von Kindern und Jugendlichen: Update und Leitfaden f{\"u}r die Praxis}, series = {Zeitschrift f{\"u}r Kinder- und Jugendpsychiatrie und Psychotherapie}, volume = {50}, journal = {Zeitschrift f{\"u}r Kinder- und Jugendpsychiatrie und Psychotherapie}, number = {2}, issn = {1422-4917}, doi = {10.1024/1422-4917/a000845}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-262038}, pages = {133-152}, year = {2022}, abstract = {Trotz verbesserter Evidenzbasis bestehen in der kinder- und jugendpsychiatrischen Pharmakotherapie viele Unsicherheiten {\"u}ber die Wirkung und Vertr{\"a}glichkeit der h{\"a}ufig off-label oder in Kombinationstherapie verordneten Medikamente. Gerade auch vor dem Hintergrund der in vielen F{\"a}llen notwendigen mittel- bis langfristigen Einnahme sollen unerw{\"u}nschte Arzneimittelwirkungen in dieser Altersstufe m{\"o}glichst minimiert und eine auf die individuellen Charakteristika der Patientin oder des Patienten zugeschnittene, effektive Dosierung gefunden werden. Kinder und Jugendliche scheinen nicht nur besonders anf{\"a}llig f{\"u}r bestimmte unerw{\"u}nschte Arzneimittelwirkungen, sondern sind auch iatrogenen Risiken durch Dosierungs- oder Applikationsfehler ausgesetzt, die zu Unter- oder {\"U}berdosierungen f{\"u}hren k{\"o}nnen mit entsprechend negativen Auswirkungen auf den Therapieerfolg. Neben einer strengen Indikationsstellung sind daher eine pr{\"a}zise Dosisfindung sowie systematische {\"U}berwachung der Sicherheit der Psychopharmakotherapie unverzichtbar. In diesem Artikel wird Therapeutisches Drug Monitoring als hilfreiches klinisches Instrument vorgestellt und beschrieben, wie dessen richtige Anwendung sowohl die Wirksamkeit als auch die Sicherheit und Vertr{\"a}glichkeit einer Psychopharmakotherapie im Kindes- und Jugendalter zum unmittelbaren Nutzen f{\"u}r die Patientinnen und Patienten verbessern kann.}, language = {de} } @article{EmserJohnstonSteeleetal.2018, author = {Emser, Theresa S. and Johnston, Blair A. and Steele, J. Douglas and Kooij, Sandra and Thorell, Lisa and Christiansen, Hanna}, title = {Assessing ADHD symptoms in children and adults: evaluating the role of objective measures}, series = {Behavioral and Brain Functions}, volume = {14}, journal = {Behavioral and Brain Functions}, number = {11}, doi = {10.1186/s12993-018-0143-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-175717}, year = {2018}, abstract = {Background: Diagnostic guidelines recommend using a variety of methods to assess and diagnose ADHD. Applying subjective measures always incorporates risks such as informant biases or large differences between ratings obtained from diverse sources. Furthermore, it has been demonstrated that ratings and tests seem to assess somewhat different constructs. The use of objective measures might thus yield valuable information for diagnosing ADHD. This study aims at evaluating the role of objective measures when trying to distinguish between individuals with ADHD and controls. Our sample consisted of children (n = 60) and adults (n = 76) diagnosed with ADHD and matched controls who completed self- and observer ratings as well as objective tasks. Diagnosis was primarily based on clinical interviews. A popular pattern recognition approach, support vector machines, was used to predict the diagnosis. Results: We observed relatively high accuracy of 79\% (adults) and 78\% (children) applying solely objective measures. Predicting an ADHD diagnosis using both subjective and objective measures exceeded the accuracy of objective measures for both adults (89.5\%) and children (86.7\%), with the subjective variables proving to be the most relevant. Conclusions: We argue that objective measures are more robust against rater bias and errors inherent in subjective measures and may be more replicable. Considering the high accuracy of objective measures only, we found in our study, we think that they should be incorporated in diagnostic procedures for assessing ADHD.}, language = {en} } @phdthesis{Euteneuer2006, author = {Euteneuer, Wolfram}, title = {Nierentransplantation an der Universit{\"a}t W{\"u}rzburg - eine retrospektive Datenanalyse von 1984 bis 2004}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-20759}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2006}, abstract = {Am Klinikum der Julius-Maximilians-Universit{\"a}t W{\"u}rzburg werden seit Dezember 1984 Nierentransplantationen durchgef{\"u}hrt. Die vorliegende Arbeit erfasst retrospektiv den Zeitraum zwischen 1984 und 2004 und versucht, ein Bild von der Entwicklung des Nierentransplantationsprogramms in W{\"u}rzburg und den erreichten Erfolgen zu vermitteln. Im Laufe dieser Zeit unterlag die Population der Organspender und der Organempf{\"a}nger einem stetigen Wandel, w{\"a}hrend sich die eingesetzten immunsuppressiven Schemata h{\"a}ufig ver{\"a}nderten. Viele neue Medikamente wurden im Laufe der Jahre eingef{\"u}hrt und Therapierichtlinien definiert, die zielgenauer das Immunsystem therapeutisch ausschalteten.}, language = {de} } @article{FarmerStrzelczykFinisguerraetal.2021, author = {Farmer, Adam D. and Strzelczyk, Adam and Finisguerra, Alessandra and Gourine, Alexander V. and Gharabaghi, Alireza and Hasan, Alkomiet and Burger, Andreas M. and Jaramillo, Andr{\´e}s M. and Mertens, Ann and Majid, Arshad and Verkuil, Bart and Badran, Bashar W. and Ventura-Bort, Carlos and Gaul, Charly and Beste, Christian and Warren, Christopher M. and Quintana, Daniel S. and H{\"a}mmerer, Dorothea and Freri, Elena and Frangos, Eleni and Tobaldini, Eleonora and Kaniusas, Eugenijus and Rosenow, Felix and Capone, Fioravante and Panetsos, Fivos and Ackland, Gareth L. and Kaithwas, Gaurav and O'Leary, Georgia H. and Genheimer, Hannah and Jacobs, Heidi I. L. and Van Diest, Ilse and Schoenen, Jean and Redgrave, Jessica and Fang, Jiliang and Deuchars, Jim and Sz{\´e}les, Jozsef C. and Thayer, Julian F. and More, Kaushik and Vonck, Kristl and Steenbergen, Laura and Vianna, Lauro C. and McTeague, Lisa M. and Ludwig, Mareike and Veldhuizen, Maria G. and De Couck, Marijke and Casazza, Marina and Keute, Marius and Bikson, Marom and Andreatta, Marta and D'Agostini, Martina and Weymar, Mathias and Betts, Matthew and Prigge, Matthias and Kaess, Michael and Roden, Michael and Thai, Michelle and Schuster, Nathaniel M. and Montano, Nicola and Hansen, Niels and Kroemer, Nils B. and Rong, Peijing and Fischer, Rico and Howland, Robert H. and Sclocco, Roberta and Sellaro, Roberta and Garcia, Ronald G. and Bauer, Sebastian and Gancheva, Sofiya and Stavrakis, Stavros and Kampusch, Stefan and Deuchars, Susan A. and Wehner, Sven and Laborde, Sylvain and Usichenko, Taras and Polak, Thomas and Zaehle, Tino and Borges, Uirassu and Teckentrup, Vanessa and Jandackova, Vera K. and Napadow, Vitaly and Koenig, Julian}, title = {International Consensus Based Review and Recommendations for Minimum Reporting Standards in Research on Transcutaneous Vagus Nerve Stimulation (Version 2020)}, series = {Frontiers in Human Neuroscience}, volume = {14}, journal = {Frontiers in Human Neuroscience}, issn = {1662-5161}, doi = {10.3389/fnhum.2020.568051}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234346}, year = {2021}, abstract = {Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation (tVNS) across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation(VNS) and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice.}, language = {en} } @article{FauserWeselekHauptmannetal.2020, author = {Fauser, Mareike and Weselek, Grit and Hauptmann, Christine and Markert, Franz and Gerlach, Manfred and Hermann, Andreas and Storch, Alexander}, title = {Catecholaminergic Innervation of Periventricular Neurogenic Regions of the Developing Mouse Brain}, series = {Frontiers in Neuroanatomy}, volume = {14}, journal = {Frontiers in Neuroanatomy}, doi = {10.3389/fnana.2020.558435}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-212485}, year = {2020}, abstract = {The major catecholamines—dopamine (DA) and norepinephrine (NE)—are not only involved in synaptic communication but also act as important trophic factors and might ultimately be involved in mammalian brain development. The catecholaminergic innervation of neurogenic regions of the developing brain and its putative relationship to neurogenesis is thus of pivotal interest. We here determined DA and NE innervation around the ventricular/subventricular zone (VZ/SVZ) bordering the whole ventricular system of the developing mouse brain from embryonic day 14.5 (E14.5), E16.5, and E19.5 until postnatal day zero (P0) by histological evaluation and HPLC with electrochemical detection. We correlated these data with the proliferation capacity of the respective regions by quantification of MCM\(^{2+}\) cells. During development, VZ/SVZ catecholamine levels dramatically increased between E16.5 and P0 with DA levels increasing in forebrain VZ/SVZ bordering the lateral ventricles and NE levels raising in midbrain/hindbrain VZ/SVZ bordering the third ventricle, the aqueduct, and the fourth ventricle. Conversely, proliferating MCM\(^{2+}\) cell counts dropped between E16.5 and E19.5 with a special focus on all VZ/SVZs outside the lateral ventricles. We detected an inverse strong negative correlation of the proliferation capacity in the periventricular neurogenic regions (log-transformed MCM\(^{2+}\) cell counts) with their NE levels (r = -0.932; p < 0.001), but not their DA levels (r = 0.440; p = 0.051) suggesting putative inhibitory effects of NE on cell proliferation within the periventricular regions during mouse brain development. Our data provide the first framework for further demandable studies on the functional importance of catecholamines, particularly NE, in regulating neural stem/progenitor cell proliferation and differentiation during mammalian brain development.}, language = {en} } @phdthesis{Fekete2018, author = {Fekete, Stefanie}, title = {Therapeutisches Drug Monitoring (TDM) von Kindern und Jugendlichen unter Behandlung mit Tiaprid : eine prospektive naturalistische Beobachtungsstudie}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-173085}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {Tiaprid wird bei Kindern und Jugendlichen im deutschsprachigen Raum als Mittel der ersten Wahl zur Behandlung von Ticst{\"o}rungen off-label eingesetzt. Es gilt dabei die generelle Empfehlung, Therapeutischen Drug Monitoring (TDM) bei der Behandlung von Minderj{\"a}hrigen mit Neuro-/Psychopharmaka durchzuf{\"u}hren. Therapeutische Referenzbereiche f{\"u}r Tiaprid sind bisher jedoch nur f{\"u}r erwachsene Patienten mit Chorea Huntington definiert worden (1000 bis 2000 ng/ml) (Hiemke et al., 2011). An ausgew{\"a}hlten Zentren im Rahmen des Kompetenznetzwerks Therapeutisches Drug Monitoring Kinder- und Jugendpsychiatrie (www.tdm-kjp.com) wurden von 2007 bis 2014 standardisiert TDM-Daten erfasst, um den Zusammenhang zwischen Dosis, Serumkonzentration, Wirksamkeit und UAW von Tiaprid zu untersuchen sowie Hinweise auf einen m{\"o}glichen alters- und diagnosespezifischen therapeutischen Referenzbereich zu generieren. Bei den 49 Patienten (mittleres Alter 12,5 Jahre; 84 \% m{\"a}nnlich) zeigte sich eine positive Korrelation (r= 0.76; p< .001) zwischen der Dosis (Mittelwert 354 mg) und der Serumkonzentration von Tiaprid (Mittelwert 1324 ng/ml) mit einer ausgepr{\"a}gten interindividuellen Variabilit{\"a}t, jedoch keine Beziehung zwischen Serumkonzentration und Wirkeffekt (83,3 \% profitierten) bzw. UAW in der Gesamtpopulation. Die Auswertung der Verlaufsmessungen von Patienten mit mehreren Messungen der Tiaprid-Serumkonzentration ergab beim dritten Messzeitpunkt eine negative Korrelation zwischen Wirkeffekt und Serumkonzentration (r= -.68; p= .032). Bei Patienten mit Serumkonzentrationen unter 2000 ng/ml wurde ein g{\"u}nstigerer klinischer Effekt dokumentiert als bei solchen mit Konzentrationen oberhalb dieses Wertes. Die ROC-Analyse ergab eine Sensitivit{\"a}t von 86 \%, ab einer Konzentration von 618 ng/ml zu respondieren (AUC= .524). Kein Patient litt an einer schweren UAW und nur wenige Patienten unter leichten oder mittelschweren UAW (n=13). Diese Ergebnisse lassen vermuten, dass der untere therapeutische Referenzbereich f{\"u}r jugendliche Patienten mit einer Tic-St{\"o}rung bei etwa 600 ng/ml liegt und die obere Grenze von 2000 ng/ml auch als Orientierungswert auf Kinder und Jugendliche gelten k{\"o}nnte. Bevor diesbez{\"u}glich g{\"u}ltige Empfehlungen f{\"u}r den klinischen Alltag formuliert werden, m{\"u}ssen Studien mit h{\"o}heren Fallzahlen und mehr kontrollierten Studiendesigns abgewartet werden. }, language = {de} } @article{FeketeEgbertsPreissleretal.2021, author = {Fekete, Stefanie and Egberts, K. and Preissler, T. and Wewetzer, C. and Mehler-Wex, C. and Romanos, M. and Gerlach, M.}, title = {Estimation of a preliminary therapeutic reference range for children and adolescents with tic disorders treated with tiapride}, series = {European Journal of Clinical Pharmacology}, volume = {77}, journal = {European Journal of Clinical Pharmacology}, number = {2}, doi = {10.1007/s00228-020-03000-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-279893}, pages = {163-170}, year = {2021}, abstract = {Purpose Tiapride is commonly used in Europe for the treatment of tics. The aim of this study was to examine the relationship between dose and serum concentrations of tiapride and potential influential pharmacokinetic factors in children and adolescents. In addition, a preliminary therapeutic reference range for children and adolescents with tics treated with tiapride was calculated. Methods Children and adolescents treated with tiapride at three university hospitals and two departments of child and adolescents psychiatry in Germany and Austria were included in the study. Patient characteristics, doses, serum concentrations, and therapeutic outcome were assessed during clinical routine care using standardised measures. Results In the 49 paediatric patients (83.7\% male, mean age = 12.5 years), a positive correlation was found between tiapride dose (median 6.9 mg/kg, range 0.97-19.35) and serum concentration with marked inter-individual variability. The variation in dose explained 57\% of the inter-patient variability in tiapride serum concentrations; age, gender, and concomitant medication did not contribute to the variability. The symptoms improved in 83.3\% of the patients. 27.1\% of the patients had mild or moderate ADRs. No patient suffered from severe ADRs. Conclusions This study shows that tiapride treatment was effective and safe in most patients with tics. Compared with the therapeutic concentration range established for adults with Chorea Huntington, our data hinted at a lower lower limit (560 ng/ml) and similar upper limit (2000 ng/ml).}, language = {en} } @misc{FeketeEgbertsPreissleretal.2021, author = {Fekete, Stefanie and Egberts, K. and Preissler, T. and Wewetzer, C. and Mehler-Wex, C. and Romanos, M. and Gerlach, M.}, title = {Correction to: Estimation of a preliminary therapeutic reference range for children and adolescents with tic disorders treated with tiapride}, series = {European Journal of Clinical Pharmacology}, volume = {77}, journal = {European Journal of Clinical Pharmacology}, number = {8}, doi = {10.1007/s00228-021-03159-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-329467}, pages = {1257}, year = {2021}, abstract = {Correction to: European Journal of Clinical Pharmacology (2021) 77:163-170 https://doi.org/10.1007/s00228-020-03000-0}, language = {en} }