use-real-time-functional-magnetic-resonance-imaging-based

Use of Real-Time Functional Magnetic Resonance Imaging-Based Neurofeedback to Downregulate Insular Cortex in Nicotine-Addicted Smokers

It has been more than a decade since the first functional magnetic resonance imaging (fMRI)-based neurofeedback approach was successfully implemented. ...

Antibodies to serotonin in serum were investigated by ELISA in patients with paranoid schizophrenia (N=27), schizoaffective psychosis (N=38), depression (N=67), Alzheimer's disease (N=21), chronic alcoholism (N=43), rheumatoid arthritis (N=25), and multiple sclerosis (N=16), and in healthy volunteers (N=60). Increased antibody reactivity to serotonin was found in schizoaffective psychosis, chronic alcoholism, and rheumatoid arthritis. Decreased antibody reactivity to serotonin was found in multiple sclerosis and depression. These anti-serotonin antibodies belong to the class of so-called natural autoantibodies. Alterations of these natural autoantibodies could indicate a disturbance to the immune system. It is possible that these antibodies could also influence receptor function. Autoantibodies to neurotransmitters in a wide spectrum of psychiatric disorders have not previously been reported.

Autoantibodies to serotonin in serum of patients with psychiatric disorders.

Addiction and the search for integrated theory.

Smoking reduction may provide a harm-reduction alternative treatment for smokers who are not ready to quit smoking. This study evaluated the efficacy of nicotine gum in helping smokers reduce or quit smoking.

Smoking reduction treatment with 4-mg nicotine gum: a double-blind, randomized, placebo-controlled study.

As the inhibitory neurotransmitter gamma aminobutyric acid (GABA) modulates ethanol consumption, alcohol withdrawal symptoms and seizure generation by interacting with the GABAB receptor, the genes encoding for the GABAB receptor can be considered as candidate genes for alcoholism and alcohol withdrawal seizures (AWS). As the polymorphism GABABR1 T1974C[rs29230] of the GABAB receptor gene had been associated with alcoholism and EEG abnormalities in prior studies, the present examination investigated if the polymorphism is associated with the diagnosis of alcoholism or AWS. After genotyping the allele and genotype frequencies of a group of alcoholics with a history of AWS (n = 69) were compared with the results of a group of alcoholics with only mild withdrawal symptoms (n = 97). Additionally a group of healthy controls (n = 101) was compared with individuals with the diagnosis of alcoholism (n = 220). As no significant differences were found between the compared groups, this study gave no further evidence for GABABR1 T1974C[rs29230] as a candidate for alcoholism or AWS.

The polymorphism GABABR1 T1974C[rs29230] of the GABAB receptor gene is not associated with the diagnosis of alcoholism or alcohol withdrawal seizures.

Funding support--cui bono?

The objective of this observational study was to identify multidimensional smoker profiles to aid the development of future tailored treatments for different smoker subtypes. Based on findings in the literature, it was hypothesized that smokers reporting higher levels of novelty seeking/hyperactivity, depressivity, and nicotine dependence would evince greater odds of postintervention smoking than smokers reporting lower symptom levels across these dimensions. Adult regular smokers (N=165) in southwest Germany completed self-report questionnaires assessing psychological and smoking variables and received a pharmacobehavioral intervention. A k-means cluster analysis involving indicators of depressivity, novelty seeking/hyperactivity, and nicotine dependence confirmed the hypothesized smoker profiles. These clusters evinced robustness on cross-validation and predicted smoking on follow-up. Specifically, smokers with depressive, novelty-seeking/hyperactive, and higher dependence profiles evinced significantly greater odds of smoking on follow-up than smokers with low-scoring profiles.

Multidimensional smoker profiles and their prediction of smoking following a pharmacobehavioral intervention.

The present study assessed 25 patients with unipolar major depression and 34 patients with schizophrenia along with 50 healthy, non-psychiatric controls for the presence of serum antinuclear (ANA), smooth muscle (SMA), anti-endothelial (AEA), anti-sarcolemma (ASA), thyroid gland (TGA) and parietal cell (PCA) antibodies. In the group of patients with major depression, the frequency of elevated ANA, TGA and PCA was significantly higher than in the control group. In addition, the group of patients with schizophrenia significantly more often showed increased levels of ANA and SMA than the control group of healthy volunteers. When the two psychiatric groups were compared, PCA serum titers in major depression and SMA values in schizophrenia were significantly more frequently elevated, whereas values of AEA and ASA showed no difference. These results point towards the existence of an unspecific (auto) immune disposition or reaction in at least a subgroup of patients with major depression and schizophrenia.

Autoantibody reactivity in serum of patients with major depression, schizophrenia and healthy controls.

The World Health Organisation (WHO) considers smoking to be the biggest avoidable health risk. The consumption of tobacco leads to health hazards and resulting diseases, the consequences of which are far more serious than those emanating from other addictive substances. Approximately 27% of the German adult population smoke regularly and the proportion of smokers addicted to tobacco or nicotine is estimated to be around 60%. Many of these smokers have undertaken numerous unsuccessful attempts at abstinence. A professional support for smokers who are motivated to give up smoking enhances the chances of success. The current treatment guidelines recommend a combination of psychotherapeutic techniques (e.g. motivational interviewing, behavioural therapy-oriented support either individually or in groups) together with pharmacological support (e.g. nicotine replacement therapy, bupropion or varenicline). Certain subgroups (e.g. pregnant smokers, juvenile smokers and, in particular, smokers with a psychiatric co-morbidity) require a more intense psychotherapy and when necessary pharmacotherapeutic support.

[Treatment of tobacco dependence: a responsibility of psychiatry and addiction medicine].

A. Batra, S.E. Collins, I. Torchalla, M. Schröter, and G. Buchkremer (2008) showed that smokers reporting higher levels of nicotine dependence, novelty seeking/hyperactivity, and depressivity (i.e., at-risk smokers) evinced higher rates of posttreatment smoking than smokers reporting lower scores on self-report psychological symptom measures (i.e., lower risk smokers). This study aimed to replicate the smoker subgroups and test the comparative effectiveness of standard pharmacobehavioral smoking cessation versus modified smoking cessation matched to at-risk smokers' needs. On the basis of their self-report responses, adult regular smokers (N = 268) were classified into smoker subgroups. At-risk smokers were randomly assigned to receive the standard or modified treatments; lower risk smokers received standard treatment. Modified treatment produced higher abstinence rates than the standard treatment for depressive smokers but not for other at-risk smokers. Overall, abstinence rates among at-risk smokers receiving modified treatment were not significantly different from those of lower risk smokers; however, abstinence among higher dependence smokers receiving modified treatment decreased at higher rates than among lower risk smokers.

A cluster-randomized effectiveness trial of smoking cessation modified for at-risk smoker subgroups.

Negative mood states are characterized by both stress hormone dysregulation and serotonergic dysfunction, reflected by altered thalamic serotonin transporter (5-HTT) levels. However, so far, no study examined the individual association between cortisol response and cerebral in vivo 5-HTT levels in patients suffering from negative mood states.

Central serotonin transporter levels are associated with stress hormone response and anxiety.

110 000 to 140 000 people die in Germany each year of tobacco-related diseases. Thus, measures should be taken to lower the number of persons who start smoking, encourage smokers to stop, and keep those who have stopped from starting again, in order to achieve a sustained benefit in public health.

Treatment of tobacco dependence.

[Emergency care in patients with alcohol withdrawal delirium].

It was the aim of this study to investigate the impact of major depressive disorder (MDD) on judgment of emotions expressed at the verbal (semantic content) and non-verbal (prosody) level and to assess whether evaluation of verbal content correlate with self-ratings of depression-related symptoms as assessed by Beck Depression Inventory (BDI). We presented positive, neutral, and negative words spoken in happy, neutral, and angry prosody to 23 MDD patients and 22 healthy controls (HC) matched for age, sex, and education. Participants rated the valence of semantic content or prosody on a 9-point scale. MDD patients attributed significantly less intense ratings to positive words and happy prosody than HC. For judgment of words, this difference correlated significantly with BDI scores. No such correlation was found for prosody perception. MDD patients exhibited attenuated processing of positive information which generalized across verbal and non-verbal channels. These findings indicate that MDD is characterized by impairments of positive rather than negative emotional processing, a finding which could influence future psychotherapeutic strategies as well as provide straightforward hypotheses for neuroimaging studies investigating the neurobiological correlates of impaired emotional perception in MDD. 

Judgment of emotional information expressed by prosody and semantics in patients with unipolar depression.

Cannabis is a psychotomimetic agent that induces impairment of sensory perception. We present detailed clinical and electrophysiological data of patients with hallucinogen persisting perception disorder (HPPD) after marijuana consumption.

Ophthalmological assessment of cannabis-induced persisting perception disorder: is there a direct retinal effect?

Tobacco consumption is one of the major preventable health risk factors. In Germany approximately 110,000 people prematurely die from tobacco-related diseases and approximately 50% of regular smokers are considered to be tobacco dependent. Nevertheless, motivation to quit smoking is low and the long-term abstinence rates after attempts to stop smoking without professional support are far below 10%. As part of the S3 treatment guidelines 78 recommendations for motivation and early interventions for smokers unwilling to quit as well as psychotherapeutic and pharmacological support for smokers willing to quit were formulated after an systematic search of the current literature. More than 50 professional associations adopted the recommendations and background information in a complex certification process. In this article the scientific evidence base regarding the psychotherapeutic and pharmacological treatment options as well as recommendations and further information about indications and treatment implementation are presented. By following these guidelines for treatment of heavy smokers who are willing to quit combined with individual and group therapies on the basis of behavioral treatment strategies and pharmacological support, long-term success rates of almost 30% can be achieved.

[Psychotherapy and pharmacotherapy for harmful tobacco use and tobacco dependency].

[S3 guidelines on alcohol and tobacco-related disorders].

Blockade of the μ-opioid receptor (MOR) by naltrexone reduces relapse risk in a subpopulation of alcohol-dependent patients. Previous positron-emission-tomography (PET) studies using the MOR ligand [(11)C]carfentanil have found increased MOR availability in abstinent alcoholics, which may reflect either increased MOR expression or lower endogenous ligand concentration. To differentiate between both effects, we investigated two cohorts of alcoholic subjects using either post-mortem or clinical PET analysis. Post-mortem brain tissue of alcohol-dependent subjects and controls (N=43/group) was quantitatively analyzed for MOR ([(3)H]DAMGO)-binding sites and OPRM1 mRNA in striatal regions. [(11)C]carfentanil PET was performed in detoxified, medication free alcohol-dependent patients (N=38), followed by a randomized controlled study of naltrexone versus placebo and follow-up for 1 year (clinical trial number: NCT00317031). Because the functional OPRM1 variant rs1799971:A>G affects the ligand binding, allele carrier status was considered in the analyses. MOR-binding sites were reduced by 23-51% in post-mortem striatal tissue of alcoholics. In the PET study, a significant interaction of OPRM1 genotype, binding potential (BPND) for [(11)C]carfentanil in the ventral striatum, and relapse risk was found. Particularly in G-allele carriers, lower striatal BPND was associated with a higher relapse risk. Interestingly, this effect was more pronounced in the naltrexone treatment group. Reduced MOR is interpreted as a neuroadaptation to an alcohol-induced release of endogenous ligands in patients with severe alcoholism. Low MOR availability may explain the ineffectiveness of naltrexone treatment in this subpopulation. Finally, low MOR-binding sites are proposed as a molecular marker for a negative disease course.

Article	Year
Autoantibodies to serotonin in serum of patients with psychiatric disorders. Psychiatry research\| PubMed ID: 14572623	2003
Addiction and the search for integrated theory. Addiction (Abingdon, England)\| PubMed ID: 15585039	2004
Smoking reduction treatment with 4-mg nicotine gum: a double-blind, randomized, placebo-controlled study. Clinical pharmacology and therapeutics\| PubMed ID: 16338284	2005
The polymorphism GABABR1 T1974C[rs29230] of the GABAB receptor gene is not associated with the diagnosis of alcoholism or alcohol withdrawal seizures. Addiction biology\| PubMed ID: 16800828	2006
Funding support--cui bono? Addiction (Abingdon, England)\| PubMed ID: 17567386	2007
Multidimensional smoker profiles and their prediction of smoking following a pharmacobehavioral intervention. Journal of substance abuse treatment\| PubMed ID: 17931825	2008
Autoantibody reactivity in serum of patients with major depression, schizophrenia and healthy controls. Psychiatry research\| PubMed ID: 18096244	2008
[Treatment of tobacco dependence: a responsibility of psychiatry and addiction medicine]. Der Nervenarzt\| PubMed ID: 19693479	2009
A cluster-randomized effectiveness trial of smoking cessation modified for at-risk smoker subgroups. Journal of substance abuse treatment\| PubMed ID: 19819661	2010
Central serotonin transporter levels are associated with stress hormone response and anxiety. Psychopharmacology\| PubMed ID: 20585760	2011
Treatment of tobacco dependence. Deutsches Arzteblatt international\| PubMed ID: 21912578	2011
[Emergency care in patients with alcohol withdrawal delirium]. MMW Fortschritte der Medizin\| PubMed ID: 23614197	2013
Judgment of emotional information expressed by prosody and semantics in patients with unipolar depression. Frontiers in psychology\| PubMed ID: 23888149	2013
Ophthalmological assessment of cannabis-induced persisting perception disorder: is there a direct retinal effect? Documenta ophthalmologica. Advances in ophthalmology\| PubMed ID: 25612939	2015
[Psychotherapy and pharmacotherapy for harmful tobacco use and tobacco dependency]. Der Nervenarzt\| PubMed ID: 26666768	2016
[S3 guidelines on alcohol and tobacco-related disorders]. Der Nervenarzt\| PubMed ID: 26670022	2016
Low μ-Opioid Receptor Status in Alcohol Dependence Identified by Combined Positron Emission Tomography and Post-Mortem Brain Analysis. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology\| PubMed ID: 27510425	2017

Anil Batra

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