Aims: The brain derived neurotrophic factor (BDNF) is known for almost 30 years. Several investigations described an important role of this neurotrophine not only in fetal brain growth but also in differentiation and repair of neurons in the adult brain. BDNF plasma levels are proven to be lower in depressed patients than in healthy subjects which is supposed to cause a lack of neurogenesis. In a couple of studies, treatment with antidepressants, ECT and TMS led to a significant BDNF plasma level increase. Other studies found no correlation. Method: Here we report the findings of a placebo-controlled, randomized tDCS trial in 20 patients with therapy-resistant major depression. All patients underwent an active 1 resp. 2 mA and sham tDCS over two weeks in a double-blind cross over design. BDNF was measured at baseline, after two, four and six weeks. Results: There was no correlation between severity of depressive symptoms and BDNF plasma level. Overall, clinical improvement by tDCS was modest and did not result in BDNF plasma level increase. Contrarily, tDCS led to a BDNF plasma level decrease by trend. 1 mA and 2 mA tDCS was not superior to sham tDCS in clinical results and BDNF changes. Discussion: Our study population consisted in therapy-resistant patients with probably severily decreased neuronal activity. This might have a restraining effect on BDNF-evoked neuroplasticity. In conclusion, results of BDNF trials are widespread and this question should be addr
Transcranial direct current stimulation (tDCS) of the prefrontal cortex (PFC) has been reported to exert significant antidepressant effects in patients with major depression. Several recent studies found an improvement of depressive symptoms in drug-free patients. Here we report the case of a 66-year-old female patient suffering from recurrent major depressive episodes who underwent anodal tDCS of the left dorsolateral PFC over 4 weeks as an add-on treatment to a stable antidepressant medication. Only a modest improvement of depressive symptoms was observed after tDCS, i.e. reduction of the baseline scores in the Hamilton Depression Rating Scale from 23 to 19 and in the Beck Depression Inventory from 27 to 20. However, there was an increase from 52 to 90% in the Regensburg Verbal Fluency Test. In addition, EEG was used to assess the acute effects of tDCS. Low resolution brain electromagnetic tomography (LORETA) showed a left unilateral focal effect (25–40% reduced power) in the delta, theta and alpha frequency bands. The same effect appeared in the surface analysis of the EEG. The absolute, as well as the relative power decreased significantly in the delta, theta and alpha bands after a comparison of the spectral analysis. Though tDCS over 4 weeks did not exert clinically meaningful antidepressant effects in this case of therapy-resistant depression, the findings for cognitive measures and EEG suggest that beneficial effects may occur in depressed subjects and future studies need to further explore this approach also in therapy-resistant major depression.
Recent clinical data indicate that Silexan, an oral Lavender oil preparation (LO), exerts safe therapeutic effects in the treatment of patients affected by general anxiety disorders and specifically patients with subtreshold anxiety. Comparing LO's effects with those of pregabalin it was demonstrated that LO can similarly inhibit the opening of voltage dependent calcium channels (VOCCs) in synaptosomes and primary hippocampal neurons at a concentration comparable to that used in clinical trials (i.e. 80 mg/d). Surprisingly, LO displayed additional effects as compared to pregabalin: specifically, it increased behavioural scores in the forced swimming test in vivo and stimulated the neurogenesis in PC12 cells in vitro. These effects, considered necessary for an effective and long-lasting antidepressant activity, are generally linked with the the activation of the cAMP response element-binding protein (CREB). In this study, we first demonstrated that LO stimulates neurogenesis by increasing levels of growth associateted proteins and increased ratio values of P-CREB vs. CREB. Next, we tried to identify the pathways involved in CREB's activation using different kinase's inhibitors. In particular, we tested the role of a series of signal molecules known to be involved in the cascade that finally leads to CREB's phosphorylation. Our results showed that kinases such as PKA, PI3K, MAPK and CaMK IV are clearly involved in the neurotrophic effects of LO. This study was supported by Schwabe
Über die Sexualität behinderter Jugendlicher gibt es nur wenige Daten. Der vorliegende Artikel vergleicht erstmals die Sexualität von Jugendlichen mit und ohne Behinderung hinsichtlich des sexuellen Wissens und der Erfahrung mit Geschlechtsverkehr. Analysiert wurden 140 Jugendliche mit Körper-, Hör- und Sehbehinderungen und 306 nichtbehinderte Jugendliche im Alter von 14 bis 17 Jahren aus Sachsen. 28 % der behinderten Jugendlichen berichteten über Erfahrungen mit Geschlechtsverkehr, bei den nichtbehinderten Jugendlichen waren dies 39 %. Jugendliche ohne Behinderung zeigten ein besseres Verhütungsverhalten und waren besser über den Zeitpunkt der Ovulation informiert als Jugendliche mit Behinderungen. Insgesamt waren behinderte Jugendliche subjektiv und objektiv weniger aufgeklärt und sexuell unerfahrener als ihre nichtbehinderten Altersgenossen, was für den Ausbau schulischer Sexualaufklärung an Förderschulen spricht.
Background: Direct current stimulation (DCS) for modulating membrane potentials is known since the 1960s. Recently, Transcranial direct current stimulation (tDCS) has been rediscovered in motor cortex neurophysiology and investigated as therapeutic intervention in neuropsychiatric disorders. Based on the role of the dorsolateral prefrontal cortex (DLPFC) in the pathophysiology of depression and previous studies with repetitive transcranial magnetic stimulation (rTMS) in depression, Fregni et al. investigated anodal tDCS of the left DLPFC in three consecutive trials yielding promising results. However, no data are available so far in therapy-resistant depression where new effective interventions are urgently needed. Here, we report preliminary findings from a double-blind, placebo-controlled trial in therapy-resistant depression.
Background TDCS for modulating neurophysiology is known since the 1960s. tDCS trials in patients with depression showed promising results. Methods 22 patients with therapy resistant major depression (DSM-IV criteria) were included in a four week cross-over trial, 10 received 1 mA tDCS, 12 received 2 mA tDCS, 2 dropped out. Patients received add-on tDCS under a stable antidepressant treatment over 3 weeks and were randomized to active or sham tDCS treatment. The sham condition was evaluated in 10 healthy volunteers and was indistinguishable.Both, active (1 mA resp. 2 mA) and placebo tDCS were applied for 20 min per day and for two weeks and then switched to the other condition. The anode was positioned over F3 and the cathode over the contralateral supraorbital region. For placebo tDCS a novel sham device (neuroConn, llmenau, Germany) was used which is indistinguishable for the applying person. Severity of depression was assessed by HAMD, BDI, CGI and CORE scales and raters were blind to treatment conditions. Results Mean HAMD decreased by 25% in the whole population after four weeks of tDCS. Active tDCS performed significantly better (p = 0.0492) than the control treatment. However this positive association was restricted to the first study phase as there was also a significant (p = 0.0271) influence of the study phase in the cross-over design and an almost significant (p = 0.0864) interaction between treatment and study phase. Conclusion Though active tDCS was not superior to sham treatment, we observed hangover effects in weeks 3 and 4 depending on the first condition.
