Eduard Gamper (1887-1938): cases and accidents.

Eduard Gamper (1887-1938) was Head of the Department of Neuropsychiatry at the Charles University's German Faculty of Medicine in Prague. He had trained in Innsbruck, where he undertook groundbreaking work on the midbrain in an anencephalic child and in a series of patients who had died from Wernicke's encephalopathy. Gamper identified the mamillary bodies as key in the performance of declarative memory. Considered an expert in memory disorders, he was chosen by the Medical Faculty in Innsbruck to provide expert opinion on the notorious case of Philipp Halsmann, who was suspected of murdering his father. Details of the case remained unresolved and Gamper's opinion caused both professional and political controversy. When in Prague, Gamper made great efforts to improve patient care and clinical services, establishing a special ward for patients with neurological conditions. This task was not nearly completed, when he and his wife died after their car drove over a cliff into the Walchensee in Bavaria. Rumours surrounded his death: that Gamper had just examined Adolf Hitler; that he was a political victim; that the Gestapo were behind the accident. After an investigation of the available evidence, we can report that an unusual 22 cm of snow fell in the area of the Walchensee on April 20, 1938, the day of the Gampers' deaths. We were unable to find any evidence for foul play in what appears to have been a tragic accident.

[Position paper of the Austrian Alzheimer Association (Österreichische Alzheimer Gesellschaft, ÖAG) : Effects of the COVID-19 pandemic in Austria on people with dementia and their care environment-problem areas, recommendations, and strategies]. / Positionspapier der Österreichische Alzheimer Gesellschaft (ÖAG) : Auswirkungen der COVID-19-Pandemie in Österreich auf Menschen mit Demenz und deren Betreuungsumfeld ­ Problemfelder, Empfehlungen und Strategien.

Older adults are particularly affected by the current COVID-19 (SARS-CoV-2) pandemic. The risk of dying from COVID-19 increases with age and is often associated with pre-existing health conditions. Globally, more than 50 million-in Austria currently approximately 140,000 people-suffer from dementia. The co-occurrence of dementia as a "pandemic of old age" together with the COVID-19 pandemic has a double impact on persons living with dementia and their caregivers. The COVID-19 pandemic poses major challenges for individuals with dementia and their caregivers: (1) People with dementia have limited access to information on COVID-19, may have difficulties with protective measures such as wearing masks and in remembering safety regulations. (2) People with dementia live alone or with their family, or are institutionalized. To reduce the chance of infection among older people in nursing homes, Austrian local authorities have banned visitors to nursing homes and long-term care facilities and implemented strict social-distancing measures. As a result, older people lost face-to-face contact with their family members, became isolated and social activities stopped. Consequently, anxiety, stress and serious concerns about infections among staff in nursing homes increased and they developed signs of exhaustion and burnout during the full lockdown of the facilities. Thus, due to the emerging COVID-19 crisis, the Austrian Alzheimer Association (Österreichische Alzheimer Gesellschaft, ÖAG) and international societies developed recommendations to support people living with dementia and their caregivers on various issues of physical and mental health.

What Characterizes Depression in Old Age? Results from the Bruneck Study.

INTRODUCTION: Depression in old age is associated with functional disabilities, cognitive impairment, lower self-rated quality of life, and increased mortality. The aim of the study was to reveal the prevalence of depression and to investigate the characteristics of patients treated with antidepressants. METHODS: We analyzed data from the Bruneck Study 2010. All participants completed a clinical examination, cognitive screening, the 30-item Geriatric Depression Scale (GDS) (cutoff score of>8 to define relevant depressive symptoms), and the World Health Organization quality of life questionnaire (WHO-QoL). Group differences were calculated using binary logistic regression analysis. RESULTS: Out of 456 participants (mean age of 73.1±8.2 years), 22.1% showed depressive symptoms, and out of these, 30% were taking antidepressants. The depressed group compared to the GDS ≤8 group showed significantly lower WHO-QoL (p<0.001) and Mini Mental State Examination (p=0.015) score. Further, 13% of the latter compared to the GDS>8 group received antidepressants, and these had a lower WHO-QoL score (p<0.033). DISCUSSION: Depressive symptoms are frequent in the elderly population. Our results confirm the negative influence of depressive symptoms on cognition and quality of life. Patients with somatic comorbidities are likely to receive more antidepressant medication.

Changes in white matter integrity before conversion from mild cognitive impairment to Alzheimer's disease.

BACKGROUND: Mild cognitive impairment (MCI) may represent an early stage of dementia conferring a particularly high annual risk of 15-20% of conversion to Alzheimer's disease (AD). Recent findings suggest that not only gray matter (GM) loss but also a decline in white matter (WM) integrity may be associated with imminent conversion from MCI to AD. OBJECTIVE: In this study we used Voxel-based morphometry (VBM) to examine if gray matter loss and/or an increase of the apparent diffusion coefficient (ADC) reflecting mean diffusivity (MD) are an early marker of conversion from MCI to AD in a high risk population. METHOD: Retrospective neuropsychological and clinical data were collected for fifty-five subjects (MCI converters n = 13, MCI non-converters n = 14, healthy controls n = 28) at baseline and one follow-up visit. All participants underwent diffusion weighted imaging (DWI) and T1-weighted structural magnetic resonance imaging scans at baseline to analyse changes in GM density and WM integrity using VBM. RESULTS: At baseline MCI converters showed impaired performance in verbal memory and naming compared to MCI non-converters. Further, MCI converters showed decreased WM integrity in the frontal, parietal, occipital, as well as the temporal lobe prior to conversion to AD. Multiple regression analysis showed a positive correlation of gray matter atrophy with specific neuropsychological test results. CONCLUSION: Our results suggest that additionally to morphological changes of GM a reduced integrity of WM indicates an imminent progression from MCI stage to AD. Therefore, we suggest that DWI is useful in the early diagnosis of AD.

Happy and sad judgements in dependence on mode and note density in patients with mild cognitive impairment and early-stage Alzheimer's disease.

BACKGROUND: In Western cultures it has often been assumed that the experience of happy or sad emotions while listening to music is clearly correlated to the key (mode) and the tempo of the musical piece. Recent studies point towards more complex dependencies, but knowledge in this line of research is still very limited, especially regarding the experience of music for persons with memory-related disorders such as dementia. OBJECTIVE: This pilot study explores the emotional content of music for patients with mild cognitive impairment (MCI) and early-stage Alzheimer's disease (AD) and compares them to healthy subjects. METHODS: A new test was specifically designed for this study and presented to 10 patients with MCI diagnosis, 10 with AD diagnosis and 23 controls. The test comprised musical stimuli consisting of chords and short musical pieces in major and minor mode with variable note density (number of notes per second). RESULTS: In the current study no significant correlation between key and the attribution of 'happy' or 'sad' judgements to a musical piece could be found in all groups. Note density, however, was shown to exhibit a strong influence on happy/sad judgements in all groups. CONCLUSION: Our findings indicate that the note density of a musical piece is much more important for happy/sad judgements than the key. Furthermore, the diagnosis MCI and early AD had no influence on the attribution of emotional expressions to musical pieces, corroborating recent findings of spared memory for music in these patient groups.

Emission rates of selected volatile organic compounds from skin of healthy volunteers.

Gas chromatography with mass spectrometric detection (GC-MS) coupled with solid phase micro-extraction as pre-concentration method (SPME) was applied to identify and quantify volatile organic compounds (VOCs) emitted by human skin. A total of 64 C4-C10 compounds were quantified in skin emanation of 31 healthy volunteers. Amongst them aldehydes and hydrocarbons were the predominant chemical families with eighteen and seventeen species, respectively. Apart from these, there were eight ketones, six heterocyclic compounds, six terpenes, four esters, two alcohols, two volatile sulphur compounds, and one nitrile. The observed median emission rates ranged from 0.55 to 4,790 fmol cm(-2)min(-1). Within this set of analytes three volatiles; acetone, 6-methyl-5-hepten-2-one, and acetaldehyde exhibited especially high emission rates exceeding 100 fmol cm(-2)min(-1). Thirty-three volatiles were highly present in skin emanation with incidence rates over 80%. These species can be considered as potential markers of human presence, which could be used for early location of entrapped victims during Urban Search and Rescue Operations (USaR).

Monitoring of selected skin-borne volatile markers of entrapped humans by selective reagent ionization time of flight mass spectrometry in NO+ mode.

Selective reagent ionization time-of-flight mass spectrometry with NO(+) as the reagent ion (SRI-TOF-MS (NO(+))) was applied for near real-time monitoring of selected skin-borne constituents which are potential markers of human presence. The experimental protocol involved a group of 10 healthy volunteers enclosed in a body plethysmography chamber mimicking the entrapment environment. A total of 12 preselected omnipresent in human scent volatiles were quantitatively monitored. Among them there were six aldehydes (n-propanal, n-hexanal, n-heptanal, n-octanal, n-nonanal, and 2 methyl 2-propenal), four ketones (acetone, 2-butanone, 3-buten-2-one, and 6-methyl-5-hepten-2-one), one hydrocarbon (2-methyl 2-pentene), and one terpene (DL-limonene). The observed median emission rates ranged from 0.28 to 44.8 nmol × person(-1) × min(-1) (16-1530 fmol × cm(-2) × min(-1)). Within the compounds under study, ketones in general and acetone in particular exhibited the highest abundances. The findings of this study provide invaluable information about formation and evolution of a human-specific chemical fingerprint, which could be used for the early location of entrapped victims during urban search and rescue operations (USaR).

Explicit (semantic) memory for music in patients with mild cognitive impairment and early-stage Alzheimer's disease.

UNLABELLED: BACKGROUND/STUDY CONTEXT: Explicit memory for music was investigated by using a new test with 24 existing and 3 newly composed pieces. METHODS: Ten patients with mild cognitive impairment (MCI) and 10 patients with early stage of Alzheimer's disease (AD) were compared with 23 healthy subjects, in terms of verbal memory of music by the identification of familiar music excerpts and the discrimination of distortion and original timbre of musical excerpts. RESULTS: MCI and Alzheimer's patients showed significantly poorer performances in tasks requiring verbal memory of musical excerpts than the healthy participants. For discrimination of musical excerpts, MCI and AD patients surprisingly performed significantly better than the healthy comparison subjects. CONCLUSION: Our results support the notion of a specialized memory system for music.

[The current state of research in bright light therapy]. / Lichttherapie: Zum Stand der aktuellen Forschung.

The significance of light for the human organism and especially for the mental health is well-established for a long time. Therefore, the impact of light on mood and the use of bright light as a treatment-option for affective disorders have been studied extensively by scientists. Today bright light therapy is the treatment of choice for saisonal affective disorders. In the last years several clinical trials could demonstrate the therapeutic efficacy of bright light therapy for different neurological and psychiatric disorders such as sleep disorders, non-seasonal affective disorders or dementia. This article will give an overview about the neurobiological basis for light therapy and discuss different disorders responsive to light therapy. Finally a short overview about technical aspects of light therapy and new developments in light engineering will be presented.

Bright ambient light conditions reduce the effect of tryptophan depletion in healthy females.

INTRODUCTION: Tryptophan depletion (TD) is an established method to influence the serotonergic system and mood. The purpose of this study was to examine the effect of TD under different ambient light conditions, measured through serotonin-associated plasma levels and a visual analog scale (VAS), on healthy females. METHODS: Thirty-eight healthy female s-allele carriers of the serotonin transporter promoter gene (5-HTTLPR) were administered a TD under dim light conditions (75 lx). A sub-group of 8 participants repeated the procedure randomized in two additional light conditions (585 lx and 1530 lx respectively). Prior to, and 5h following administration of TD, various variables (serotonin-associated plasma levels, VAS) were measured. Due to not normal distributed data, non-parametric statistical tests were used. RESULTS: Overall analysis showed a significant mood lowering effect of TD. Moreover, TD decreased all measured serotonin-associated plasma levels significantly. Significant differences in varying light conditions were found for the VAS and plasma tryptophan, with the greatest effect of TD in the 75 lx condition. CONCLUSION: Results of our study showed an influence of even slight differences in ambient light intensity on the effect of TD concerning mood as well as on the serotonergic system.

Blood and breath levels of selected volatile organic compounds in healthy volunteers.

Gas chromatography with mass spectrometric detection (GC-MS) was used to identify and quantify volatile organic compounds in the blood and breath of healthy individuals. Blood and breath volatiles were pre-concentrated using headspace solid phase micro-extraction (HS-SPME) and needle trap devices (NTDs), respectively. The study involved a group of 28 healthy test subjects and resulted in the quantification of a total of 74 compounds in both types of samples. The concentrations of the species under study varied between 0.01 and 6700 nmol L(-1) in blood and between 0.02 and 2500 ppb in exhaled air. Limits of detection (LOD) ranged from 0.01 to 270 nmol L(-1) for blood compounds and from 0.01 to 0.7 ppb for breath species. Relative standard deviations for both measurement regimes varied from 1.5 to 14%. The predominant chemical classes among the compounds quantified were hydrocarbons (24), ketones (10), terpenes (8), heterocyclic compounds (7) and aromatic compounds (7). Twelve analytes were found to be highly present in both blood and exhaled air (with incidence rates higher than 80%) and for 32 species significant differences (Wilcoxon signed-rank test) between room air and exhaled breath were observed. By comparing blood, room air and breath levels in parallel, a tentative classification of volatiles into endogenous and exogenous compounds can be achieved.

[Working memory for music in patients with mild cognitive impairment and early stage Alzheimer's disease]. / Das Arbeitsgedächtnis für Musik bei PatientInnen mit leichter kognitiver Beeinträchtigung und beginnender Alzheimer-Krankheit.

A variety of studies demonstrated that some forms of memory for music are spared in dementia, but only few studies have investigated patients with early stages of dementia. In this pilot-study we tested working memory for music in patients with mild cognitive impairment (MCI) and early stage Alzheimer's disease (AD) with a newly created test. The test probed working memory using 7 gradually elongated tone-lines and 6 chords which were each followed by 3 similar items and 1 identical item. The participants of the study, namely 10 patients with MCI, 10 patients with early stage AD and 23 healthy subjects were instructed to select the identical tone-line or chord. Subjects with MCI and early AD showed significantly reduced performance than controls in most of the presented tasks. In recognizing chords MCI- participants surprisingly showed an unimpaired performance. The gradual increase of the impairment during the preclinical phase of AD seems to spare this special ability in MCI.

Ion mobility spectrometry for detection of skin volatiles.

Volatile organic compounds (VOCs) released by humans through their skin were investigated in near real time using ion mobility spectrometry after gas chromatographic separation with a short multi-capillary column. VOCs typically found in a small nitrogen flow covering the skin are 3-methyl-2-butenal, 6-methylhept-5-en-2-one, sec-butyl acetate, benzaldehyde, octanal, 2-ethylhexanol, nonanal and decanal at volume fractions in the low part per billion-(ppb) range. The technique presented here may contribute to elucidating some physiological processes occurring in the human skin.

[How free is free will? Neuro-scientific and philosophical aspects of motivation and decision-making]. / Wie frei ist der freie Wille? Neurowissenschaftliche und philosophische Aspekte von Motivation und Entscheidung.

The question concerning the postulated freedom of will continues to occupy the neuro-sciences, psychiatry, law and neuro-philosophy. Do current research results really show that freedom and responsibility were only illusions, since previously supposed free decisions were only accompanying features of long held neuronal activations? Did Julien de La Mettrie have a great vision, when, already in the Eighteenth Century, he expected a "monsieur Machine"?This article attempts to summarize and evaluate findings that are currently available. The autonomy of human action is not only founded in a subjectively perceived act of will but far more in the ability of the human being to act according to an inner drive which is steered consciously and rationally. The autonomy of human action is not only restricted to the perceived ego, but comprises body and soul, brain and spirit and consequently the whole human being with all their characteristics, values and aims. Modern science thereby supports the old philosophical theory of a conditional freedom of will.

Human blood and plasma partition coefficients for C4-C8 n-alkanes, isoalkanes, and 1-alkenes.

Human blood:air and plasma:air partition coefficients for C(4)-C(8) n-alkanes, isoalkanes, and 1-alkenes were determined using multiple headspace extraction coupled with solid phase microextraction and gas chromatography. Mean blood:air partition coefficients expressed in the form of dimensionless blood-to-air concentration ratio (g/mL(b)/g/mL(a)) were 0.183, 0.416, 1.08, 2.71, and 5.77 for C(4)-C(8) n-alkanes; 0.079, 0.184, 0.473, 1.3, and 3.18 for C(4)-C(8) isoalkanes; and 0.304, 0.589, 1.32, 3.5, and 7.01 for C(4)-C(8) 1-alkenes, respectively (n = 8). The reported partition coefficient values increased exponentially with boiling points, molecular weights, and the carbon atoms in the particle. The solubility of 1-alkenes in blood was higher than in plasma, whereas the blood:air and plasma:air partition coefficients of n-alkanes and isoalkanes did not differ significantly. Consequently, additional interactions of 1-alkenes with whole blood seem to occur. The presented findings are expected to be particularly useful for assessing the uptake, distribution, and elimination of hydrocarbons in human organism.

Oxytocin plasma levels in psychiatric patients with and without recent suicide attempt.

Easily available biomarkers for suicidality would be valuable for the identification of individuals at risk. Oxytocin has been shown to be associated with mental illness. We assessed basal oxytocin plasma levels of patients with (SA, n=41) and without (NSA, n=40) a 1-year history of attempted suicide. SA and NSA groups did not differ with respect to oxytocin levels. Plasma oxytocin may not be a biological suicide marker candidate.