Alterations of continuous MEG measures during mental activities.

In a pilot study, we investigated the topography of 11 continuous MEG measures for the eyes-opened and eyes-closed condition together with three simple mental tasks (mental arithmetic, visual imagery, word generation). One-minute recordings for each condition from 16 right-handed subjects were analyzed. The electrophysiological measures consisted of 6 spectral band measures together with spectral edge frequency and spectral entropy, plus the time-domain-based entropy of amplitudes (ENA) and the nonlinear measures correlation dimension D2 and Lyapunov exponent L1. In summary, our results indicate a pronounced task-dependent difference between the anterior and the posterior region, but no lateralization effects. Although the nonlinear measures ranged in the middle field with respect to the number of significant contrasts, they were the only ones to be partially successful in discriminating the mental tasks from each other. The most efficient measure turned out to be the ENA. Under mental activation the ENA was larger than in both no task conditions (eyes opened and eyes closed). This finding reflects lower variations of the maximum amplitude during performance of mental tasks than during no task states.

The benefit from whole body acupuncture in major depression.

BACKGROUND: In a single-blind placebo-controlled study design we investigated the efficacy of acupuncture additionally applied to drug treatment in major depression. METHODS: We randomly included 70 inpatients with a major depressive episode in three different treatment groups: verum acupuncture, placebo acupuncture and a control group. All three groups were pharmacologically treated with the antidepressant mianserin. The verum group received acupuncture at specific points considered effective in the treatment of depression. The placebo group was treated with acupuncture at non-specific locations and the control group received pharmacological treatment plus clinical management. Acupuncture was applied three times a week over a period of 4 weeks. Psychopathology was rated by judges blind to verum/placebo conditions twice a week over 8 weeks. RESULTS: Patients who experienced acupuncture improved slightly more than patients treated with mianserin alone. CONCLUSIONS: Additionally applied acupuncture improved the course of depression more than pharmacological treatment with mianserin alone. However, we could not detect any differences between placebo and verum acupuncture.

Increased bioavailability of oral melatonin after fluvoxamine coadministration.

BACKGROUND: Fluvoxamine, a selective serotonin reuptake inhibitor, is known to elevate melatonin serum concentrations. It has not been clear whether these effects might be attributed to an increased melatonin production or to an decreased elimination of melatonin. The latter hypothesis was tested by this study. METHODS: Five healthy male volunteers (one CYP2D6 poor metabolizer) received 5 mg melatonin either with or without coadministration of 50 mg fluvoxamine. Serum concentrations of melatonin and fluvoxamine were assessed from 0 to 28 hours after melatonin intake. RESULTS: Coadministration of fluvoxamine, on average, led to an 17-fold higher (P < .05) area under concentration-time curve (AUC) and a 12-fold higher (P < .01) serum peak concentration (Cmax) of melatonin. The terminal elimination half-life was not significantly affected. The AUC and Cmax of fluvoxamine were about three times higher and the half-life was about two times higher in the poor metabolizer. There was a correlation (r = 0.63; P < .01) between the melatonin and fluvoxamine serum concentrations. The poor metabolizer was found to have a more pronounced and longer-lasting effect of fluvoxamine on the pharmacokinetics of melatonin. CONCLUSION: This study showed an increase in the bioavailability of oral melatonin by coadministration of fluvoxamine. The effects of fluvoxamine on the melatonin serum concentrations in patients with depression might therefore be caused by inhibition of the elimination of melatonin and not attributable to an increased production of melatonin.

[Adjuvant whole body acupuncture in depression. A placebo-controlled study with standardized mianserin therapy]. / Adjuvante Ganzkörperakupunktur bei depression. Eine placebokontrollierte Studie unter standardisierter Mianserintherapie.

In order to examine the efficacy of whole body acupuncture additionally applied to drug treatment in depression, a single-blind placebo-controlled study with 70 inpatients administered to three different treatment groups has been carried out. All patients were pharmacologically treated with the tetracyclic antidepressant mianserin. The verum group (n = 22) received acupuncture at specific points considered to be effective in the treatment of depression. The placebo group (n = 24) was treated with acupuncture at non-specific locations and the control group (n = 24) received only pharmacological treatment. Acupuncture was applied three times a week over a period of four weeks. Psychopathology was rated by judges blind to verum/placebo conditions twice a week over eight weeks with the CGI, GAS, BRMS and BfS rating scales. Additionally applied acupuncture improved the course of depression more than pharmacological treatment with mianserin did by itself. However, we could not detect any differences between placebo and verum acupuncture.

Time course of human 40 Hz EEG activity accompanying P3 responses in an auditory oddball paradigm.

In order to quantify the time course of auditory P3-related gamma activity, root mean square (RMS) values were calculated from band-filtered (30-45 Hz) target and non-target responses in an auditory oddball experiment. Evoked (phase locked) gamma activity was evaluated from the time domain averages, whereas induced (not necessarily phase locked) activity was analyzed on the basis of single trials. Gamma RMS values were integrated across different time windows, namely the prestimulus, N50/P50, N100, pre P3, P3 and post P3 window. The single trial P3 window hereby was defined by a maximum amplitude criterion. In accordance with other studies, we found a pronounced increase of evoked gamma activity in the time window up to 80 ms after stimulus onset. In contrast, induced gamma activity as revealed by single trial analysis decreased markedly after stimulus presentation. Starting with the P3 window, induced activity recovered to baseline level for the non-target trials, whereas it remained significantly suppressed for the target responses.

The influence of lorazepam upon pre- and poststimulus EEG during sleep in man.

Enhancement of beta power in the spontaneous EEG under the influence of benzodiazepine medication is a well known phenomenon under waking conditions as well as during sleep. On the other hand, in certain frequency bands EEG activity following external stimulation is also enhanced. Therefore, the question arises what relationship exists between pre- and poststimulus EEG under the influence of benzodiazepines. Is an augmentation of beta activity during benzodiazepine medication further enhanced when external stimulation is applied? In order to address this question we compared the spectral power of pre- and poststimulus EEG under 2.5 mg lorazepam during sleep with placebo conditions. The hypothesis tested was that of Basar (1980): if the beta power is high prior to the stimulation, no further enhancement following stimulation is observed. Our results confirm the hypothesis during sleep stages II and III. At the present time it is unclear whether this effect might be dose-dependent. In any case, the investigation presented here has furnished additional information on the mechanisms by which benzodiazepines alter the brain's electrical activity.

Sequential analysis of the brain's transfer properties during consecutive REM episodes.

Classical analysis of the spontaneous sleep EEG has revealed alterations of REM sleep in psychiatric diseases and under the influence of drugs. In order to elucidate possible functional differences between different REM episodes even in healthy subjects we investigated in 10 volunteers the transfer properties of the brain by measuring auditory (AEP) and visual evoked potentials (VEP) from scalp positions Fz, Cz and Pz during the night. According to linear system theory we computed the so-called amplitude-frequency characteristics (AFC) from averaged AEPs and VEPs during the first and each of the following 3 REM episodes. These functions describe the relationship between the input and output of the investigated system. A 3-factorial analysis of variances with the independent factors frequency band, REM episode and electrode position revealed a statistically significant main effect for the factor REM episode under auditory stimulation (P = 0.05), whereas no significant main effect for REM episode was found under visual stimulation (P = 0.88). Applying a 2-factorial analysis of variance with the independent factors REM episode and electrode position in the case of auditory stimulation we could demonstrate a statistically significant main effect (P = 0.029) for the factor REM episode in the beta range (12.5-20 Hz). A subsequent analysis of contrasts revealed that the first REM episodes could be differentiated from each other. For auditory stimulation the beta resonance during the first REM episode appears enhanced compared to each of the later REM episodes. These findings point to a functional difference of the brain's transfer functions between the first and the 3 following REM episodes, indicating different information processing during consecutive paradoxical sleep.

The influence of lorazepam medication upon the transfer properties of the brain during sleep in man.

In order to get better insight into the principles of information processing by the brain during sleep and its alterations under the influence of drugs we applied some tools from linear system theory to sleep EEG data. We investigated late components of auditory and visually evoked potentials (AEPs and VEPs) during different sleep stages and calculated from these the so-called amplitude-frequency characteristics (AFC). The main advantage of this analysis is that it enables one to detect functional differences during different sleep stages. This information can hardly be obtained by conventional spectral analysis. The result of our investigation was that the transfer properties of the brain during sleep were extremely different and that lorazepam medication not only resulted in quantitative alterations of the sleep profile but mainly in highly significant alterations of the functional properties of sleep.

Nimodipine in acute alcohol withdrawal state.

The effect of the calcium channel blocker, nimodipine, in acute alcohol withdrawal was investigated in a randomized, placebo controlled, double blind study. Thirty-two male patients with a history of alcohol dependence according to DSM-III criteria, but no other substance abuse, were included. A new rating instrument which fulfilled theoretical test criteria was applied to determine the severity of the alcohol withdrawal state. The patients received nimodipine or a placebo on four separate occasions (4 x 60 mg) and, in addition, clomethiazole, according to a standardized procedure. Our investigation has shown that, in the first 48-72 h of alcohol withdrawal, both groups consumed similar amounts of additional clomethiazole medication. Thus, no significant effect of nimodipine on the acute alcohol withdrawal state could be demonstrated. There was some tendency for nimodipine to ameliorate psychosensory dysfunction.