TY - JOUR A1 - Dempfle, Astrid A1 - Herpertz-Dahlmann, Beate A1 - Timmesfeld, Nina A1 - Schwarte, Reinhild A1 - Egberts, Karin M. A1 - Pfeiffer, Ernst A1 - Fleischhaker, Christian A1 - Wewetzer, Christoph A1 - Bühren, Katharina T1 - Predictors of the resumption of menses in adolescent anorexia nervosa JF - BMC Psychiatry N2 - 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. KW - girls KW - amenorrhea KW - brain KW - increases KW - return KW - menarche KW - target weight KW - adolescence anorexia nervosa KW - resumption of menses KW - recovery KW - ovarian function KW - weight gain KW - eating disorders KW - bone-mineral density KW - menstrual recovery KW - outcome KW - body mass index Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-122106 VL - 13 IS - 308 ER - TY - THES A1 - Eckert, Lisa Doreen T1 - Multimodale Verfahren zum Eisenstoffwechsel bei ADHS - Vergleichende Bildgebung T1 - Multimodal methods for iron metabolism in ADHD - Comparative imaging N2 - Die Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) gehört weltweit zu den bedeutendsten psychiatrischen Erkrankungen des Kinder- und Jugendalters. Die Pathomechanismen sind aktuell noch nicht vollständig geklärt, wobei es deutliche Hinweise auf hirnorganische Veränderungen 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 Veränderung der Echogenität der Substantia nigra (SN) bei Kindern mit ADHS im Vergleich zu gesunden Kontrollprobanden nachgewiesen werden. In dieser Studie sollen nun die möglichen physiologischen Hintergründe der erhöhten Echogenität der Substantia Nigra in Zusammenschau mit bildgebenden Verfahren betrachtet werden. Hierzu wurde in der vorliegenden multimodalen Studie bei 20 männlichen Kindern mit ADHS im Alter zwischen 8 und 12 Jahren eine transkranielle Ultraschalluntersuchung (TCS) zur Bestimmung der echogenen Fläche der Substantia Nigra sowie ein neuromelaninsensitives cMRT zur Bestimmung des neuromelaninassoziierten Volumens der SN, sowie des neuromelaninassoziierten Kontrastes SN/Cb durchgeführt. Als Kennwerte des peripheren Eisenhaushalts wurden die Konzentrationen von Eisen, Ferritin und Transferrin im Blut bestimmt. In die Auswertung gingen außerdem die Stärke der ADHS-Symptomatik (Strength and Difficulties Questionaire, SDQ; Fremdbeurteilungsbogen bei ADHS, FBB-ADHS), die kognitive Begabung (über CFT-20-R) und das Alter der Probanden ein. Psychiatrische Komorbidität wurde mit Hilfe der Child Behaviour Checklist (CBCL) erhoben. N2 - Attention deficit/hyperactivity disorder (ADHD) is one of the most important psychiatric diseases of children and adolescents worldwide. The pathomechanisms are currently not yet fully understood, although there are clear indications of organic brain changes. Transcranial sonography is a non-invasive method, to investigate structural differences in deep brain structures. In previous studies, the method was able to demonstrate a change in the echogenicity of the substantia nigra (SN) in children with ADHD compared to healthy control subjects. This study investigates the possible physiological background of the increased echogenicity of the substantia nigra including imaging procedures. For this purpose, in the present multimodal study, a transcranial ultrasound examination (TCS) to determine the echogenic area of the substantia nigra and a neuromelanin-sensitive cMRI to detect the neuromelanin-associated volume of the SN and the neuromelanin-associated Contras SN/Cb were used in 20 male children with ADHD between the ages of 8 and 12 years. The concentrations of iron, ferritin and transferrin in the blood were determined as parameters of the peripheral iron balance. The evaluation also included the strength of the ADHD symptoms (Strength and Difficulties Questionnaire, SDQ; external assessment form for ADHD, FBB-ADHD), the cognitive ability (via CFT-20-R) and the age of the test subjects. Psychiatric comorbidity was assessed using the Child Behavior Checklist (CBCL). KW - TCS KW - Neuromelanin KW - ADHS KW - Transkranielle Sonographie KW - Aufmerksamkeitsdefizit-Syndrom KW - Zweikomponentensystem KW - Eisen Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-348295 ER - TY - JOUR A1 - Egberts, Karin A1 - Fekete, Stefanie A1 - Häge, Alexander A1 - Hiemke, Christoph A1 - Scherf-Clavel, Maike A1 - Taurines, Regina A1 - Unterecker, Stefan A1 - Gerlach, Manfred A1 - Romanos, Marcel T1 - Therapeutisches Drug Monitoring zur Optimierung der Psychopharmakotherapie von Kindern und Jugendlichen: Update und Leitfaden für die Praxis JF - Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie N2 - Trotz verbesserter Evidenzbasis bestehen in der kinder- und jugendpsychiatrischen Pharmakotherapie viele Unsicherheiten über die Wirkung und Verträglichkeit der häufig off-label oder in Kombinationstherapie verordneten Medikamente. Gerade auch vor dem Hintergrund der in vielen Fällen notwendigen mittel- bis langfristigen Einnahme sollen unerwünschte Arzneimittelwirkungen in dieser Altersstufe möglichst minimiert und eine auf die individuellen Charakteristika der Patientin oder des Patienten zugeschnittene, effektive Dosierung gefunden werden. Kinder und Jugendliche scheinen nicht nur besonders anfällig für bestimmte unerwünschte Arzneimittelwirkungen, sondern sind auch iatrogenen Risiken durch Dosierungs- oder Applikationsfehler ausgesetzt, die zu Unter- oder Überdosierungen führen können mit entsprechend negativen Auswirkungen auf den Therapieerfolg. Neben einer strengen Indikationsstellung sind daher eine präzise Dosisfindung sowie systematische Überwachung 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 Verträglichkeit einer Psychopharmakotherapie im Kindes- und Jugendalter zum unmittelbaren Nutzen für die Patientinnen und Patienten verbessern kann. N2 - Despite the improved evidence base, many uncertainties remain in child and adolescent psychiatric pharmacotherapy about the efficacy and tolerability of drugs, which are often prescribed off-label or in combination therapy in this age group. Because medium- to long-term use is unavoidable in many cases, clinicians should minimize adverse drug reactions as far as possible and tailor an effective dosage to the individual characteristics of the patient. Not only are children and adolescents particularly vulnerable to certain adverse drug effects, they are also exposed to iatrogenic risks from dosing or application errors, which can lead to under- or overdosing with correspondingly negative effects on the success of the therapy. In addition to determining a strict indication, it is therefore essential to establish precise dosage and systematic monitoring of the safety of the psychopharmacotherapy. This article introduces therapeutic drug monitoring as a useful clinical tool and describes how its correct application in practice can improve the efficacy as well as the safety and tolerability of psychotropic therapy in children and adolescents for the immediate benefit of patients. T2 - Therapeutic drug monitoring to optimize psychopharmacotherapy in children and adolescents - Update and guidelines for practice KW - Psychopharmakotherapie KW - unerwünschte Arzneimittelwirkungen KW - Pharmakovigilanz KW - Therapeutisches Drug Monitoring KW - Qualitätssicherung KW - psychopharmacotherapy KW - adverse drug reactions KW - pharmacovigilance KW - therapeutic drug monitoring KW - quality assurance Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-262038 SN - 1422-4917 SN - 1664-2880 VL - 50 IS - 2 ER - TY - JOUR A1 - Emser, Theresa S. A1 - Johnston, Blair A. A1 - Steele, J. Douglas A1 - Kooij, Sandra A1 - Thorell, Lisa A1 - Christiansen, Hanna T1 - Assessing ADHD symptoms in children and adults: evaluating the role of objective measures JF - Behavioral and Brain Functions N2 - 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. KW - ADHD KW - support vector machines KW - classification KW - objective assessment KW - children/adults Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-175717 VL - 14 IS - 11 ER - TY - THES A1 - Euteneuer, Wolfram T1 - Nierentransplantation an der Universität Würzburg - eine retrospektive Datenanalyse von 1984 bis 2004 T1 - Nephrotransplantation at the University of Würzburg - a retrospective data-analysis from 1984 to 2004 N2 - Am Klinikum der Julius-Maximilians-Universität Würzburg werden seit Dezember 1984 Nierentransplantationen durchgeführt. Die vorliegende Arbeit erfasst retrospektiv den Zeitraum zwischen 1984 und 2004 und versucht, ein Bild von der Entwicklung des Nierentransplantationsprogramms in Würzburg und den erreichten Erfolgen zu vermitteln. Im Laufe dieser Zeit unterlag die Population der Organspender und der Organempfänger einem stetigen Wandel, während sich die eingesetzten immunsuppressiven Schemata häufig veränderten. Viele neue Medikamente wurden im Laufe der Jahre eingeführt und Therapierichtlinien definiert, die zielgenauer das Immunsystem therapeutisch ausschalteten. N2 - This is a retrospective data-analysis of the kidney transplantation program of the university of wuerzburg. From 1984 to 2004 about 560 transplantations were recorded in a data base. KW - Nierentransplantion KW - Transplantation KW - Immunsuppression KW - Transplantatüberleben KW - nephrotransplantation KW - renal KW - transplantation KW - immunosuppression Y1 - 2006 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-20759 ER - TY - JOUR A1 - Farmer, Adam D. A1 - Strzelczyk, Adam A1 - Finisguerra, Alessandra A1 - Gourine, Alexander V. A1 - Gharabaghi, Alireza A1 - Hasan, Alkomiet A1 - Burger, Andreas M. A1 - Jaramillo, Andrés M. A1 - Mertens, Ann A1 - Majid, Arshad A1 - Verkuil, Bart A1 - Badran, Bashar W. A1 - Ventura-Bort, Carlos A1 - Gaul, Charly A1 - Beste, Christian A1 - Warren, Christopher M. A1 - Quintana, Daniel S. A1 - Hämmerer, Dorothea A1 - Freri, Elena A1 - Frangos, Eleni A1 - Tobaldini, Eleonora A1 - Kaniusas, Eugenijus A1 - Rosenow, Felix A1 - Capone, Fioravante A1 - Panetsos, Fivos A1 - Ackland, Gareth L. A1 - Kaithwas, Gaurav A1 - O'Leary, Georgia H. A1 - Genheimer, Hannah A1 - Jacobs, Heidi I. L. A1 - Van Diest, Ilse A1 - Schoenen, Jean A1 - Redgrave, Jessica A1 - Fang, Jiliang A1 - Deuchars, Jim A1 - Széles, Jozsef C. A1 - Thayer, Julian F. A1 - More, Kaushik A1 - Vonck, Kristl A1 - Steenbergen, Laura A1 - Vianna, Lauro C. A1 - McTeague, Lisa M. A1 - Ludwig, Mareike A1 - Veldhuizen, Maria G. A1 - De Couck, Marijke A1 - Casazza, Marina A1 - Keute, Marius A1 - Bikson, Marom A1 - Andreatta, Marta A1 - D'Agostini, Martina A1 - Weymar, Mathias A1 - Betts, Matthew A1 - Prigge, Matthias A1 - Kaess, Michael A1 - Roden, Michael A1 - Thai, Michelle A1 - Schuster, Nathaniel M. A1 - Montano, Nicola A1 - Hansen, Niels A1 - Kroemer, Nils B. A1 - Rong, Peijing A1 - Fischer, Rico A1 - Howland, Robert H. A1 - Sclocco, Roberta A1 - Sellaro, Roberta A1 - Garcia, Ronald G. A1 - Bauer, Sebastian A1 - Gancheva, Sofiya A1 - Stavrakis, Stavros A1 - Kampusch, Stefan A1 - Deuchars, Susan A. A1 - Wehner, Sven A1 - Laborde, Sylvain A1 - Usichenko, Taras A1 - Polak, Thomas A1 - Zaehle, Tino A1 - Borges, Uirassu A1 - Teckentrup, Vanessa A1 - Jandackova, Vera K. A1 - Napadow, Vitaly A1 - Koenig, Julian T1 - International Consensus Based Review and Recommendations for Minimum Reporting Standards in Research on Transcutaneous Vagus Nerve Stimulation (Version 2020) JF - Frontiers in Human Neuroscience N2 - 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. KW - transcutaneous vagus nerve stimulation KW - minimum reporting standards KW - guidelines & recommendations KW - transcutaneous auricular vagus nerve stimulation KW - transcutaneous cervical vagus nerve stimulation Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234346 SN - 1662-5161 VL - 14 ER - TY - JOUR A1 - Fauser, Mareike A1 - Weselek, Grit A1 - Hauptmann, Christine A1 - Markert, Franz A1 - Gerlach, Manfred A1 - Hermann, Andreas A1 - Storch, Alexander T1 - Catecholaminergic Innervation of Periventricular Neurogenic Regions of the Developing Mouse Brain JF - Frontiers in Neuroanatomy N2 - 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. KW - brain development KW - ventricular zone KW - catecholamines KW - norepinephrine KW - dopamine KW - neurogenesis Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-212485 VL - 14 ER - TY - THES A1 - Fekete, Stefanie T1 - Therapeutisches Drug Monitoring (TDM) von Kindern und Jugendlichen unter Behandlung mit Tiaprid : eine prospektive naturalistische Beobachtungsstudie T1 - Therapeutic drug monitoring (TDM) of children and adolescents treated with tiapride N2 - Tiaprid wird bei Kindern und Jugendlichen im deutschsprachigen Raum als Mittel der ersten Wahl zur Behandlung von Ticstörungen off-label eingesetzt. Es gilt dabei die generelle Empfehlung, Therapeutischen Drug Monitoring (TDM) bei der Behandlung von Minderjährigen mit Neuro-/Psychopharmaka durchzuführen. Therapeutische Referenzbereiche für Tiaprid sind bisher jedoch nur für erwachsene Patienten mit Chorea Huntington definiert worden (1000 bis 2000 ng/ml) (Hiemke et al., 2011). An ausgewählten 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 möglichen alters- und diagnosespezifischen therapeutischen Referenzbereich zu generieren. Bei den 49 Patienten (mittleres Alter 12,5 Jahre; 84 % männlich) 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 ausgeprägten interindividuellen Variabilität, 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 günstigerer klinischer Effekt dokumentiert als bei solchen mit Konzentrationen oberhalb dieses Wertes. Die ROC-Analyse ergab eine Sensitivität 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 für jugendliche Patienten mit einer Tic-Störung bei etwa 600 ng/ml liegt und die obere Grenze von 2000 ng/ml auch als Orientierungswert auf Kinder und Jugendliche gelten könnte. Bevor diesbezüglich gültige Empfehlungen für den klinischen Alltag formuliert werden, müssen Studien mit höheren Fallzahlen und mehr kontrollierten Studiendesigns abgewartet werden.  N2 - Background: Tiapride is used off-label as first-line treatment for children and adolescents with tic disorders in German speaking countries. Methods: Standardized TDM data were collected from 2007 to 2014 within the Competence Network Therapeutic Drug Monitoring in Child and Adolescent Psychiatry (www.tdm-kjp.com) to investigate the correlation between dosage, serum concentration, effectiveness and adverse drug reactions (ADRs) of tiapride. Additionally, information about a possible age- and diagnosis-specific therapeutic reference range should be obtained as the therapeutic reference ranges for tiapride are only available for adult patients with chorea Huntington (1000 to 2000 ng/ml). Results: In the 49 paediatric patients (mean age = 12.5 years, 84% male), a positive correlation (r = 0.76; p <.001) was found between tiapride dose (mean = 353.6 mg) and serum concentration (mean = 1324.0 ng/ml) with marked interindividual variability, but no relationship between serum concentration and effect (83.3% profit) nor ADRs. No patient suffered from severe ADRs and only a few patients had mild or moderate ADRs (n = 13). The evaluation of the measurements of patients with multiple measurements of the tiapride serum concentration (N = 10) showed a negative correlation between effect and serum concentration after one year treatment with tiapride (r = -.68, p = .032). A better outcome in patients with serum concentrations below 2000 ng / ml was observed. ROC analysis revealed a sensitivity of 86% from a concentration of 618 ng/ml in regard to the therapeutic response. Discussion: These results suggest that the lower therapeutic reference range in adolescent patients with tic disorders could be about 600 ng/ml and the upper limit of the adult therapeutic reference range of 2000 ng/ml could be a reference point as a guide to children and adolescents in terms of the incidence of ADRs and the expected effect. KW - therapeutic drug monitoring KW - paediatrics KW - tiapride KW - tic disorders KW - children Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-173085 ER - TY - JOUR A1 - Fekete, Stefanie A1 - Egberts, K. A1 - Preissler, T. A1 - Wewetzer, C. A1 - Mehler-Wex, C. A1 - Romanos, M. A1 - Gerlach, M. T1 - Estimation of a preliminary therapeutic reference range for children and adolescents with tic disorders treated with tiapride JF - European Journal of Clinical Pharmacology N2 - 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). KW - Tourette syndrome KW - therapeutic drug monitoring KW - serum concentration KW - paediatrics KW - pharmacokinetics Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-279893 VL - 77 IS - 2 ER - TY - GEN A1 - Fekete, Stefanie A1 - Egberts, K. A1 - Preissler, T. A1 - Wewetzer, C. A1 - Mehler-Wex, C. A1 - Romanos, M. A1 - Gerlach, M. T1 - Correction to: Estimation of a preliminary therapeutic reference range for children and adolescents with tic disorders treated with tiapride T2 - European Journal of Clinical Pharmacology N2 - Correction to: European Journal of Clinical Pharmacology (2021) 77:163–170 https://doi.org/10.1007/s00228-020-03000-0 KW - Erratum Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-329467 VL - 77 IS - 8 ER - TY - JOUR A1 - Fekete, Stefanie A1 - Kulpok, Christine A1 - Taurines, Regina A1 - Egberts, Karin A1 - Geissler, Julia A1 - Gerlach, Manfred A1 - Malonga Makosi, Dorothée A1 - König, Jochem A1 - Urschitz, Michael S. A1 - Toni, Irmgard A1 - Neubert, Antje A1 - Romanos, Marcel T1 - Value of a web-based pediatric drug information system to prevent serious adverse drug reactions in child and adolescent psychiatry JF - Journal of Neural Transmission N2 - Psychotropic drugs are frequently prescribed ‘off-label’ to children and adolescents and carry the risk of serious adverse drug reactions (sADR). We examined the frequency of sADRs of psychotropic drugs in pediatric inpatients and explored their potential preventability through following the recommendations of a web-based pediatric drug information system (PDIS). The potential socio-economic impacts of using this online system is also addressed. Routine clinical data from all inpatients treated in a child and adolescent psychiatry department between January 2017 and December 2018 were retrospectively examined for the occurrence of sADRs as defined by the European Medicines Agency. The preventability of the sADRs was assessed based on the information of the PDIS. Furthermore, the expected prolongation of the hospital stay due to sADRs was calculated as well as the associated treatment costs. The study was supported by the Innovation Fund of the Joint Federal Committee, grant number 01NVF16021. In total, 1036 patients were screened of whom 658 (63.5%) received psychopharmacological treatment. In 53 (8.1%) of these patients 54 sADRs were documented, of which 37 sADRs were identified as potentially preventable through PDIS. Mitigating sADR through PDIS would likely have prevented prolonged hospital stays and conferred considerable savings for health insurance companies. PDIS provides systematic and evidence-based information about pediatric psychopharmacotherapy and helps to prevent prescribing errors. Therefore, PDIS is a useful tool to increase drug therapy safety in child and adolescent psychiatry. Further prospective studies are needed to confirm the results. KW - adverse effects KW - pharmacovigilance KW - drug safety KW - psychotropic drugs KW - mental health Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324817 VL - 130 IS - 1 ER - TY - JOUR A1 - Franke, Maximilian A1 - Conzelmann, Annette A1 - Grünblatt, Edna A1 - Werling, Anna M. A1 - Spieles, Helen A1 - Wewetzer, Christoph A1 - Warnke, Andreas A1 - Romanos, Marcel A1 - Walitza, Susanne A1 - Renner, Tobias J. T1 - No Association of Variants of the NPY-System With Obsessive-Compulsive Disorder in Children and Adolescents JF - Frontiers in Molecular Neuroscience N2 - Obsessive-compulsive disorder (OCD) causes severe distress and is therefore counted by the World Health Organisation (WHO) as one of the 10 most impairing illnesses. There is evidence for a strong genetic underpinning especially in early onset OCD (eoOCD). Though several genes involved in neurotransmission have been reported as candidates, there is still a need to identify new pathways. In this study, we focussed on genetic variants of the Neuropeptide Y (NPY) system. NPY is one of the most abundant neuropeptides in the human brain with emerging evidence of capacity to modulate stress response, which is of high relevance in OCD. We focussed on tag-SNPs of NPY and its receptor gene NPY1R in a family-based approach. The sample comprised 86 patients (children and adolescents) with eoOCD with both their biological parents. However, this first study on genetic variants of the NPY-system could not confirm the association between the investigated SNPs and eoOCD. Based on the small sample size results have to be interpreted as preliminary and should be replicated in larger samples. However, also in an additional GWAS analysis in a large sample, we could not observe an associations between NPY and OCD. Overall, these preliminary results point to a minor role of NPY on the stress response of OCD. KW - NPY KW - obsessive-compulsive KW - children KW - anxiety KW - neuropeptide Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-229051 VL - 12 ER - TY - THES A1 - Frey, Lillien Mara T1 - Furchtgeneralisierung und Attentional Bias bei Kindern und Jugendlichen mit einer Störung des Sozialverhaltens T1 - Fear Generalization And Attentional Bias in Children And Adolescents With Conduct Disorder N2 - Bereits vorangegangene Studien haben zeigen können, dass eine verstärke Generali- sierung von Furcht sowohl bei Erwachsenen, bei denen beispielsweise eine Angststörung oder eine PTSB diagnostiziert wurde, aber auch bei gesunden Kindern eine Rolle spielt. In unserer Studie untersuchten wir eine Gruppe Kinder und Jugendliche (n = 31, m = 25, w = 6; Alter = 13.35 ± 2.03), die eine Störung des Sozialverhaltens aufwiesen, auf die Konditionierbarkeit von Furcht und eine mögliche Furchtgeneralisierung. Diese Gruppe verglichen wir mit einer gesunden Kontrollgruppe (n = 29, m = 11, w = 18; Alter = 14.28 ± 2.43). Als Generalisierungsstimuli verwendeten wir ein Furchtgeneralisierungsparadigma mit zwei Frauengesichtern, die in vier Schritten aneinander angeglichen wurden. Zusätzlich führten wir mit beiden Probandengruppen ein Dot-Probe-Paradigma zur Objektivierung von Aufmerksamkeitsprozessen im Sinne eines Attentional Bias oder Attentional Avoidance mit emotionalen Gesichtern durch. Wir konnten eine erfolgreiche Furchtkonditionierung für beide Gruppen erreichen. Im Vergleich mit der gesunden Kontrollgruppe zeigte die externalisierende Probandengruppe eine verstärke Furchtgeneralisierung. Hinsichtlich der subjektiven Valenz- und Kontingenzratings wurden die Unterschiede besonders deutlich. Eine verstärkte Generalisierungsneigung bei erhöhter Trait-Angst konnten wir nicht finden. Die externalisierende Gruppe zeigte im Vergleich mit neutralen Gesichtern bei den emotionalen Gesichtern insgesamt einen Attentional Bias. Am deutlichsten war dabei eine verstärkte Aufmerksamkeitslenkung hin zu glücklichen Gesichtern festzustellen. Für die gesunde Kontrollgruppe konnten wir keine Besonderheiten bezüglich der Aufmerksamkeitsrichtung finden. Weiterführende Studien sollten mit größ- eren Probandengruppen und nach Geschlecht und Alter gepaarten Probanden durch- geführt werden. Mit externalisierenden Probanden sollte ein Furchtgeneralisierungs- paradigma mit neutralen Stimuli (z.B. Ringe) gewählt werden, um eine subjektive Wertung emotionaler Gesichter bei den Ratings als Störfaktor auszuschließen. Für externalisierende Probanden sollte außerdem die Ausprägung von CU-Traits erfasst und die Dauer der Testung verkürzt oder auf zwei Termine aufgeteilt werden, um eine ausreichende Konzentrationsfähigkeit zu ermöglichen. N2 - Previous studies have already been able to show that increased generalization of fear plays a role both in adults diagnosed with anxiety disorder or PTSD, but also in healthy children. In our study we examined a group of children and adolescents (n = 31, m = 25, f = 6; age = 13.35 ± 2.03) with conduct disorder for possible fear conditioning and overgeneralization of fear. We compared this group with a healthy control group (n = 29, m = 11, f = 18; age = 14.28 ± 2.43). As generalization stimuli we used a fear generalization paradigm with two female faces that were matched in four steps. In addition both groups performed a dot-probe task to objectify attentional processes in terms of attentional bias or attentional avoidance with emotional faces. We were able to achieve successful fear conditioning for both groups. Compared with the healthy control group the externalizing subject group showed increased fear generalization. Regarding the subjective valence and contingency ratings the differences were particularly evident. We could not find an increased generalization tendency for subjects with increased trait anxiety. The externalizing group showed an attentional bias towards emotional faces compared to neutral faces. Most clearly there was an increased attentional bias towards happy faces. For the healthy control group we could not find any particularities regarding attentional bias or avoidance. Further studies should be conducted with larger subject groups and subjects paired by gender and age. With externalizing subjects a fear-generalization paradigm with neutral stimuli (e.g., rings) should be chosen to exclude subjective scoring of emotional faces in the ratings as a confounding factor. For externalizing subjects, the expression of CU traits should also be recorded and the duration of testing should be shortened or divided into two sessions to enable sufficient concentration. KW - Psychische Störung KW - Kind KW - Furchtgeneralisierung KW - Attentional Bias KW - Attentional Avoidance KW - Störung des Sozialverhaltens KW - Verhaltensstörung KW - Jugend KW - Sekundärkrankheit KW - Angststörung Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259746 ER - TY - JOUR A1 - Föcker, Manuel A1 - Timmesfeld, Nina A1 - Bühlmeier, Judith A1 - Zwanziger, Denise A1 - Führer, Dagmar A1 - Grasemann, Corinna A1 - Ehrlich, Stefan A1 - Egberts, Karin A1 - Fleischhaker, Christian A1 - Wewetzer, Christoph A1 - Wessing, Ida A1 - Seitz, Jochen A1 - Herpertz-Dahlmann, Beate A1 - Hebebrand, Johannes A1 - Libuda, Lars T1 - Vitamin D level trajectories of adolescent patients with anorexia nervosa at inpatient admission, during treatment, and at one year follow up: association with depressive symptoms JF - Nutrients N2 - (1) Background: Evidence has accumulated that patients with anorexia nervosa (AN) are at higher risk for vitamin D deficiency than healthy controls. In epidemiologic studies, low 25(OH) vitamin D (25(OH)D) levels were associated with depression. This study analyzed the relationship between 25(OH)D serum levels in adolescent patients and AN and depressive symptoms over the course of treatment. (2) Methods: 25(OH)D levels and depressive symptoms were analyzed in 93 adolescent (in-)patients with AN from the Anorexia Nervosa Day patient versus Inpatient (ANDI) multicenter trial at clinic admission, discharge, and 1 year follow up. Mixed regression models were used to analyze the relationship between 25(OH)D levels and depressive symptoms assessed by the Beck Depression Inventory (BDI-II). (3) Results: Although mean 25(OH)D levels constantly remained in recommended ranges (≥50 nmol/L) during AN treatment, levels decreased from (in)patient admission to 1 year follow up. Levels of 25(OH)D were neither cross-sectionally, prospectively, nor longitudinally associated with the BDI-II score. (4) Conclusions: This study did not confirm that 25(OH)D levels are associated with depressive symptoms in patients with AN. However, increasing risks of vitamin D deficiency over the course of AN treatment indicate that clinicians should monitor 25(OH)D levels. KW - vitamin D KW - supplements KW - anorexia nervosa KW - depressive symptoms KW - adolescents Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242662 SN - 2072-6643 VL - 13 IS - 7 ER - TY - JOUR A1 - Geissler, Julia A1 - Jans, Thomas A1 - Banaschewski, Tobias A1 - Becker, Katja A1 - Renner, Tobias A1 - Brandeis, Daniel A1 - Döpfner, Manfred A1 - Dose, Christina A1 - Hautmann, Christopher A1 - Holtmann, Martin A1 - Jenkner, Carolin A1 - Millenet, Sabina A1 - Romanos, Marcel T1 - Individualised short-term therapy for adolescents impaired by attention-deficit/hyperactivity disorder despite previous routine care treatment (ESCAadol)-Study protocol of a randomised controlled trial within the consortium ESCAlife JF - Trials N2 - Background: Despite the high persistence rate of attention-deficit/hyperactivity disorder (ADHD) throughout the lifespan, there is a considerable gap in knowledge regarding effective treatment strategies for adolescents with ADHD. This group in particular often shows substantial psychosocial impairment, low compliance and insufficient response to psychopharmacological interventions. Effective and feasible treatments should further consider the developmental shift in ADHD symptoms, comorbidity and psychosocial adversity as well as family dysfunction. Thus, individualised interventions for adolescent ADHD should comprise a multimodal treatment strategy. The randomised controlled ESCAadol study addresses the needs of this patient group and compares the outcome of short-term cognitive behavioural therapy with parent-based telephone-assisted self-help. Methods/design: In step 1, 160 adolescents aged 12 to 17 years with a diagnosis of ADHD will undergo a treatment as usual (TAU) observation phase of 1 month. In step 2, those still severely affected are randomised to the intervention group with an Individualised Modular Treatment Programme (IMTP) or a telephone-assisted self-help programme for parents (TASH) as an active control condition. The IMTP was specifically designed for the needs of adolescent ADHD. It comprises 10 sessions of individual cognitive behavioural therapy with the adolescents and/or the parents, for which participants choose three out of 10 available focus modules (e.g. organisational skills and planning, emotion regulation, problem solving and stress management, dysfunctional family communication). TASH combines a bibliotherapeutic component with 10 counselling sessions for the parents via telephone. Primary outcome is the change in ADHD symptoms in a clinician-rated diagnostic interview. Outcomes are assessed at inclusion into the study, after the TAU phase, after the intervention phase and after a further 12-week follow-up period. The primary statistical analysis will be by intention-to-treat, using linear regression models. Additionally, we will analyse psychometric and biological predictors and moderators of treatment response. Discussion: ESCAadol compares two short-term non-pharmacological interventions as cost-efficient and feasible treatment options for adolescent ADHD, addressing the specific needs and obstacles to treatment success in this group. We aim to contribute to personalised medicine for adolescent ADHD intended to be implemented in routine clinical care. KW - ADHD KW - adolescents KW - attention-deficit/hyperactivity disorder KW - behaviour therapy KW - RCT KW - individualised modular treatment programme KW - telephone-assisted self-help Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-176061 VL - 19 IS - 254 ER - TY - JOUR A1 - Geissler, Julia M. A1 - Werner, Elisabeth A1 - Dworschak, Wolfgang A1 - Romanos, Marcel A1 - Ratz, Christoph T1 - German Law Reform Does Not Reduce the Prevalence of Coercive Measures in Residential Institutions for Children, Adolescents, and Young Adults With Intellectual and Developmental Disabilities JF - Frontiers in Psychiatry N2 - Background: Approximately 10% of children, adolescents and young adults with an intellectual and developmental disability (IDD) in Bavaria live in residential institutions. 2015 saw media reports raising suspicions about excessive use of coercive measures (cM) in those institutions. Until a law reform at the end of 2017 made permission from family courts mandatory for cM, their use was governed by parental consent. The REDUGIA project conducted a representative survey comparing cM and their relation to challenging behaviour (cB) and employee stress in Bavaria pre and post reform. Methods: We sent questionnaires to 65 residential institutions for children, adolescents and young adults with IDD in 2017 (pre reform, T1) and 2019 (post reform, T2). To assess changes, we analysed data from all available questionnaire pairs (T1 and T2, N = 43). We calculated paired t-test and correlative analyses concerning the relationship between cB, cM, and employee stress. Results: The number of residents overall (T1: N = 1,661; T2: N = 1,673) and per institution (T1: m = 38.6 ± 32.0; T2: m = 38.9 ± 34.5, p = 0.920) remained stable. We did not see any changes in the Index cB (p = 0.508) or the proportion of residents per institution displaying various types of challenging behaviour (all ps>0.220). There was no change in the Index cM (p = 0.089) or any indicator of employee stress, all ps > 0.323. At follow-up, the Index cB correlated positively with the Index cM (r = 0.519 p < 0.001). Regarding employee stress, the Index cB correlated positively with the frequency of sick leave (r = 0.322, p = 0.037) and physical attacks on employees (r = 0.552, p < 0.001). The Index cM also correlated positively with the frequency of sick leave (r = 0.340, p = 0.028) and physical attacks on employees (r = 0.492, p = 0.001). Discussion: Coercive measures are not a general phenomenon, but are focused on specialised institutions. The law reform did not lead to changes in the number of children, adolescents and young adults with IDD affected by coercive measures in residential institutions in Bavaria. There were still large discrepancies between institutions in the prevalence of challenging behaviour and coercive measures. Coercive measures were associated with challenging behaviour and employee stress. Taken together, findings from REDUGIA emphasise the need to prevent challenging behaviour and thus coercive measures. KW - intellectual disabilities KW - developmental disabilities KW - challenging behaviours KW - employee stress KW - coercive measures KW - residential institutions Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-249030 SN - 1664-0640 VL - 12 ER - TY - JOUR A1 - Geissler, Julia A1 - Werner, Elisabeth A1 - Dworschak, Wolfgang A1 - Romanos, Marcel A1 - Ratz, Christoph T1 - Freiheitsentziehende Maßnahmen in bayerischen Heimeinrichtungen für Kinder, Jugendliche und junge Volljährige mit Intelligenzminderung JF - Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie N2 - Fragestellung: In Bayern leben etwa 10 % aller jungen Menschen mit Intelligenzminderung in Heimeinrichtungen. 2016 wurde in Presseberichten der Vorwurf unzulässiger freiheitsentziehender Maßnahmen formuliert. Im Rahmen des Projekts REDUGIA wurde in bayerischen Heimeinrichtungen eine repräsentative Erhebung zu freiheitsentziehenden Maßnahmen (FeM), herausforderndem Verhalten (hfV) und der Mitarbeiterbelastung (MaB) durchgeführt. Methodik: 65 Einrichtungen für junge Menschen mit Intelligenzminderung in Bayern wurde ein Fragebogen zu strukturellen Gegebenheiten sowie MaB, hfV und FeM zugesendet. Neben deskriptiven Auswertungen wurden korrelative Analysen bzw. Regressionsanalysen zum Zusammenhang zwischen hfV, FeM und MaB durchgeführt. Ergebnisse: Es wurden Daten zu 1839 Personen in 61 Einrichtungen erhoben. 84.3 % der Einrichtungen berichteten geringe Raten an hfV und FeM, während 15.7 % ein gehäuftes Vorkommen von hfV und FeM angaben. Auf n = 1809 Vollzeitäquivalente kam es innerhalb von 14 Tagen zu 639 körperlichen Angriffen durch Bewohner_innen. In 12 Monaten wurden problemverhaltensassoziiert 85 Krankmeldungen sowie 33 Versetzungsanträge/Kündigungen berichtet. Es zeigte sich ein signifikant positiver Zusammenhang zwischen hfV und FeM (R² = .307, F = 21.719, p < .001). Die Mitarbeiterbelastung korrelierte positiv mit hfV (r = .507, p < .001). Schlussfolgerungen: Die Studienbefunde weisen darauf hin, dass hfV sowie FeM bei jungen Menschen mit Intelligenzminderung kein flächendeckendes Phänomen darstellen, sondern sich auf wenige spezialisierte Einrichtungen fokussieren. Mögliche Maßnahmen zur Prävention von Problemverhalten und Freiheitsentzug werden diskutiert. N2 - Objective: In Bavaria, around 10 % of youths with an intellectual disability (ID) live in residential facilities. In 2015, media raised accusations of inadmissible use of coercive measures. The REDUGIA project carried out a representative survey in Bavarian facilities regarding coercive measures (FeM), challenging behavior (hfV), and employee stress (MaB). Method: We sent a questionnaire concerning structural conditions, MaB, hfV and FeM to 65 Bavarian facilities for young people with ID. In addition to preparing descriptive evaluations, we performed correlative and regression analyses concerning the relationship between hfV, FeM, and MaB. Results: We retrieved data from 1,839 subjects in 61 facilities. 84.3 % of facilities reported low rates of hfV and FeM, while 15.7 % reported an increased incidence of hfV and FeM. For n = 1809 full-time position equivalents there were 639 physical attacks by residents over the course of 14 days. We observed 85 instances of sick leave and 33 transfer apllications/resignation associated with hfV. The frequency of hfV predicted the frequency of FeM (R² = 0.307, F = 21.719, p < .001). MaB correlated positively with hfV (r = 0.507, p < .001). Conclusions: The descriptive data indicate that hfV and FeM are not general phenomena but occur mainly in a circumscript number of highly specialized facilities. This emphasizes the need for prevention of hfV and FeM. T2 - Freedom-restricting measures in Bavarian residential facilities for children, adolescents, and young adults with intellectual disabilities KW - Geistige Behinderung KW - herausforderndes Verhalten KW - freiheitsentziehende Maßnahmen KW - Heimeinrichtungen KW - Mitarbeiterbelastung KW - intellectual disability KW - challenging behavior KW - coercive measures KW - residential institutions KW - employee stress Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-244859 SN - 1422-4917 SN - 1664-2880 VL - 49 IS - 4 ER - TY - JOUR A1 - Gerlach, Manfred A1 - Maetzler, Walter A1 - Broich, Karl A1 - Hampel, Harald A1 - Rems, Lucas A1 - Reum, Torsten A1 - Riederer, Peter A1 - Stäffler, Albrecht A1 - Streffer, Johannes A1 - Berg, Daniela T1 - Biomarker candidates of neurodegeneration in Parkinson's disease for the evaluation of disease-modifying therapeutics JF - Journal of Neural Transmission N2 - Reliable biomarkers that can be used for early diagnosis and tracking disease progression are the cornerstone of the development of disease-modifying treatments for Parkinson’s disease (PD). The German Society of Experimental and Clinical Neurotherapeutics (GESENT) has convened a Working Group to review the current status of proposed biomarkers of neurodegeneration according to the following criteria and to develop a consensus statement on biomarker candidates for evaluation of disease-modifying therapeutics in PD. The criteria proposed are that the biomarker should be linked to fundamental features of PD neuropathology and mechanisms underlying neurodegeneration in PD, should be correlated to disease progression assessed by clinical rating scales, should monitor the actual disease status, should be pre-clinically validated, and confirmed by at least two independent studies conducted by qualified investigators with the results published in peer-reviewed journals. To date, available data have not yet revealed one reliable biomarker to detect early neurodegeneration in PD and to detect and monitor effects of drug candidates on the disease process, but some promising biomarker candidates, such as antibodies against neuromelanin, pathological forms of α-synuclein, DJ-1, and patterns of gene expression, metabolomic and protein profiling exist. Almost all of the biomarker candidates were not investigated in relation to effects of treatment, validated in experimental models of PD and confirmed in independent studies. KW - disease progression KW - biomarkers KW - neuroprotection KW - disease-modifying therapies KW - Parkinson’s disease KW - surrogate endpoints KW - drug development Y1 - 2012 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-125375 VL - 119 IS - 1 ER - TY - JOUR A1 - Gerlach, Manfred A1 - Maetzler, Walter A1 - Broich, Karl A1 - Hampel, Harald A1 - Rems, Lucas A1 - Reum, Torsten A1 - Riederer, Peter A1 - Stöffler, Albrecht A1 - Streffer, Johannes A1 - Berg, Daniela T1 - Biomarker candidates of neurodegeneration in Parkinson’s disease for the evaluation of disease-modifying therapeutics JF - Journal of Neural Transmission N2 - Reliable biomarkers that can be used for early diagnosis and tracking disease progression are the cornerstone of the development of disease-modifying treatments for Parkinson’s disease (PD). The German Society of Experimental and Clinical Neurotherapeutics (GESENT) has convened a Working Group to review the current status of proposed biomarkers of neurodegeneration according to the following criteria and to develop a consensus statement on biomarker candidates for evaluation of disease-modifying therapeutics in PD. The criteria proposed are that the biomarker should be linked to fundamental features of PD neuropathology and mechanisms underlying neurodegeneration in PD, should be correlated to disease progression assessed by clinical rating scales, should monitor the actual disease status, should be pre-clinically validated, and confirmed by at least two independent studies conducted by qualified investigators with the results published in peer-reviewed journals. To date, available data have not yet revealed one reliable biomarker to detect early neurodegeneration in PD and to detect and monitor effects of drug candidates on the disease process, but some promising biomarker candidates, such as antibodies against neuromelanin, pathological forms of α-synuclein, DJ-1, and patterns of gene expression, metabolomic and protein profiling exist. Almost all of the biomarker candidates were not investigated in relation to effects of treatment, validated in experimental models of PD and confirmed in independent studies. KW - Parkinson’s disease KW - Disease-modifying therapies KW - Neuroprotection KW - Biomarkers KW - Surrogate endpoints KW - Drug development KW - Disease progression Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-133856 VL - 119 IS - 1 ER - TY - THES A1 - Gernert [geb. Baranski], Stefanie T1 - Assoziationsuntersuchung zu Neuropeptid Y-Polymorphismen bei Kindern und Jugendlichen mit Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung T1 - Association between neuropeptide Y-polymorphims and the attention-deficit/hyperactivity disorder in children and adolescens N2 - Die Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung ist eine der häufigsten psychiatrischen Erkrankung des Kindesalters, die eine hohe Heritabilität aufweist und häufig bis ins Erwachsenenalter persistiert und lebenslang zu sozialen, gesundheitlichen und ökonomischen Problemen führt. Die ADHS tritt bei vielen Patienten in Kombina-tion mit anderen psychiatrischen und nicht-psychiatrischen Erkrankungen auf. In den letzten Jahren rückte zunehmend die häufig zur ADHS komorbid auftretende Adipositas in den Fokus der Forschung. Auf der Suche nach copy number variations in Zusammenhang mit ADHS, wurde eine Duplikation auf Chromosom 7p15 – dem Genlocus des NPY – entdeckt. NPY, ist ein endogenes orexigenes Peptid, welches physiologischerweise die Nahrungsaufnahme stimuliert und neben zahlreichen Effekten, wie Blutdruck- und Knochenregulation, auch in Zusammenhang mit neuropsychiatrischen Erkrankungen gebracht werden konnte. Diese Duplikation auf einem Genort, dessen Produkt für die Regulation von Energiehaushalt und Körpergewicht zuständig ist, bildete die Grundlage, eine Assoziationsuntersuchung zu NPY-Genvarianten und dem Körpergewicht bei Kindern durchzuführen. Untersucht wurden bei 269 an ADHS erkrankten Kindern und 142 gesunden Kontrollkindern die Assoziation zwischen NPY-Genvarianten (rs16147, rs16139, rs5574, rs16124) und ADHS, sowie die Assoziation zwischen NPY-Genvarianten und BMI-Perzentilen bei ADHS. Es ergab sich keine signifikante Assoziation bezüglich der aufgestellten Hypothesen. N2 - The attention-deficit/hyperactivity disorder (ADHD) is one of the most frequent psychiatric disorders in children. It is highly heritable, often persists until adulthood and causes social, economic and health problems. While psychiatric comorbidities of ADHD have been extensively explored, in the last decade mounting evidence pointed to a possible association between ADHD and obesity. In search of copy number variations related to ADHD and this new comorbidity, a duplication on chromosome 7p15 – the gene of Neuropeptide Y (NPY) - has been identified. NPY is an orexigenic peptide, which stimulates food intake and it has also been implicated in other psychiatric diseases. Therefor we performed an association study in a case contol study design including 269 children with ADHD and 142 healthy controls. The objectiv of our investigation was to study the association between four single nucleotid polymorphisms of the NPY- gene (rs16147, rs16139, rs5574, rs16124) and ADHD, and the association between the NPY-polymorphisms and the bmi-percentiles in children with ADHD. Results: No association between the polymorphisms and ADHD in children was found. No association between bmi-percentiles and the polymorphisms was found in children with ADHD. KW - Übergewicht KW - Neuropeptid Y KW - Aufmerksamkeitsdefizit-Syndrom KW - SNP KW - ADHS KW - Kinder und Jugendliche Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-155692 ER -