12 results on '"Danker-Hopfe, Heidi"'
Search Results
2. Cognitive-behavioral therapy as continuation treatment to sustain response after electroconvulsive therapy in depression: a randomized controlled trial.
- Author
-
Brakemeier EL, Merkl A, Wilbertz G, Quante A, Regen F, Bührsch N, van Hall F, Kischkel E, Danker-Hopfe H, Anghelescu I, Heuser I, Kathmann N, and Bajbouj M
- Subjects
- Aged, Combined Modality Therapy, Depressive Disorder, Major drug therapy, Female, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome, Antidepressive Agents therapeutic use, Cognitive Behavioral Therapy, Depressive Disorder, Major therapy, Electroconvulsive Therapy
- Abstract
Background: Although electroconvulsive therapy (ECT) is the most effective acute antidepressant intervention, sustained response rates are low. It has never been systematically assessed whether psychotherapy, continuation ECT, or antidepressant medication is the most efficacious intervention to maintain initial treatment response., Methods: In a prospective, randomized clinical trial, 90 inpatients with major depressive disorder (MDD) were treated with right unilateral ultra-brief acute ECT. Electroconvulsive therapy responders received 6 months guideline-based antidepressant medication (MED) and were randomly assigned to add-on therapy with cognitive-behavioral group therapy (CBT-arm), add-on therapy with ultra-brief pulse continuation electroconvulsive therapy (ECT-arm), or no add-on therapy (MED-arm). After the 6 months of continuation treatment, patients were followed-up for another 6 months. The primary outcome parameter was the proportion of patients who remained well after 12 months., Results: Of 90 MDD patients starting the acute phase, 70% responded and 47% remitted to acute ECT. After 6 months of continuation treatment, significant differences were observed in the three treatment arms with sustained response rates of 77% in the CBT-arm, 40% in the ECT-arm, and 44% in the MED-arm. After 12 months, these differences remained stable with sustained response rates of 65% in the CBT-arm, 28% in the ECT-arm, and 33% in the MED-arm., Conclusions: These results suggest that ultra-brief pulse ECT as a continuation treatment correlates with low sustained response rates. However, the main finding implicates cognitive-behavioral group therapy in combination with antidepressants might be an effective continuation treatment to sustain response after successful ECT in MDD patients., (Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
3. Effects of 3 different stimulus intensities of ultrabrief stimuli in right unilateral electroconvulsive therapy in major depression: a randomized, double-blind pilot study.
- Author
-
Quante A, Luborzewski A, Brakemeier EL, Merkl A, Danker-Hopfe H, and Bajbouj M
- Subjects
- Adult, Aged, Biophysics methods, Double-Blind Method, Electroencephalography, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Pilot Projects, Psychiatric Status Rating Scales, Recognition, Psychology physiology, Statistics, Nonparametric, Treatment Outcome, Verbal Learning physiology, Cognition Disorders etiology, Depressive Disorder, Major therapy, Electroconvulsive Therapy adverse effects, Functional Laterality physiology
- Abstract
Objective: Efficacy and cognitive outcome of ECT is depending on electrode placement, pulse width and electrical dosage. Several studies showed that high-dosage right unilateral ECT (RULECT) had a better antidepressant effects than low-dosage RULECT and less cognitive side effect than bilateral stimulation. In this prospective, randomized, double-blind trial, we examined the efficacy and cognitive side effects of RULECT with three different (high dose) stimulus intensities (4×, 7× and 10× above the seizure threshold (ST))., Methods: 41 patients with treatment resistant unipolar or bipolar depression were randomized to one of the three stimulation intensities. For stimulation, we used an ultrabrief pulse (0.3 ms). Primary outcome measures were reduction of the Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and the response rate (50% reduction of the HDRS) in the three groups. For cognitive side effects, a neuropsychological test battery was assessed., Results: All three groups responded significantly to 9 ECTs (p < 0.005), but there were no statistical significant differences in the response rates between the three intensity groups. Besides of the Verbal Learning Memory Recognition Test (VLMT), which showed significant impairments in the high dose intensity groups, no differences could be shown between the three study groups in all neuropsychological tests., Conclusion: A RULECT with ultrabrief pulse stimulation and 4× ST intensity is effective and from good tolerability. Higher intensity dosages seem to be associated with more cognitive side effects during a course of acute ECT treatment., (Copyright © 2010 Elsevier Ltd. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
4. Ultrahigh frequency repetitive transcranial magnetic stimulation in unipolar depression.
- Author
-
Jakob F, Brakemeier EL, Schommer NC, Quante A, Merkl A, Danker-Hopfe H, Anghelescu I, Heuser I, and Bajbouj M
- Subjects
- Brain physiopathology, Depressive Disorder, Major physiopathology, Double-Blind Method, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Treatment Outcome, Depressive Disorder, Major therapy, Transcranial Magnetic Stimulation
- Published
- 2008
- Full Text
- View/download PDF
5. Patterns of response to repetitive transcranial magnetic stimulation (rTMS) in major depression: replication study in drug-free patients.
- Author
-
Brakemeier EL, Wilbertz G, Rodax S, Danker-Hopfe H, Zinka B, Zwanzger P, Grossheinrich N, Várkuti B, Rupprecht R, Bajbouj M, and Padberg F
- Subjects
- Adult, Bipolar Disorder diagnosis, Bipolar Disorder physiopathology, Bipolar Disorder psychology, Clinical Trials as Topic, Combined Modality Therapy, Depressive Disorder, Major diagnosis, Depressive Disorder, Major physiopathology, Depressive Disorder, Major psychology, Dominance, Cerebral physiology, Drug Resistance, Female, Germany, Humans, Male, Meta-Analysis as Topic, Middle Aged, Multicenter Studies as Topic, Personality Inventory statistics & numerical data, Prefrontal Cortex physiopathology, Psychometrics statistics & numerical data, Recurrence, Regression Analysis, Reproducibility of Results, Bipolar Disorder therapy, Depressive Disorder, Major therapy, Transcranial Magnetic Stimulation
- Abstract
Background: Repetitive transcranial magnetic stimulation (rTMS) has been found to exert modest to moderate therapeutic effects in major depression, but mechanism of action and its clinical relevance have not been clarified yet. Previous trials have reported patterns of symptomatology predicting response to rTMS. As most patients also received concomitant antidepressant medication these response patterns may rather refer to combined treatment than rTMS alone. Thus, this study aims to replicate previous findings and explore patterns of response in drug-free patients., Methods: In the Munich-Berlin Predictor Study data of 79 patients from two open clinical trials evaluating effects of high-frequency rTMS of the left dorsolateral prefrontal cortex were pooled. Previous models predicting the response to rTMS [Fregni, F., Marcolin, M.A., Myczkowski, M., Amiaz, R., Hasey, G., Rumi, D.O., Rosa, M., Rigonatti, S.P., Camprodon, J., Walpoth, M., Heaslip, J., Grunhaus, L., Hausmann, A., Pascual-Leone, A., 2006. Predictors of antidepressant response in clinical trials of transcranial magnetic stimulation. Int. J. Neuropsychopharmacol. 9, 641-654; Brakemeier, E.L., Luborzewski, A., Danker-Hopfe, H., Kathmann, N., Bajbouj, M., 2007. Positive predictors for antidepressive response to prefrontal repetitive transcranial magnetic stimulation (rTMS). J. Psychiatr. Res. 41, 395-403.] were systematically tested and new explorative regression analyses were conducted., Results: Of the 79 patients, 34.2% showed an antidepressant response. Previous models could not be validated. Explorative regression analysis revealed a significant model with therapy resistance, HAMD items 1 (depressed mood), and 2 (feelings of guilt) as negative and retardation as positive predictors., Limitations: No controlled study; specific statistical issues; sample size; differences concerning patient population and stimulation parameters between study sites., Conclusions: In sum, this study does not confirm clinical valid and robust patterns being predictive for a response to rTMS in depression. The only exception is a high level of therapy resistance being associated with poor outcome. Future predictor studies should focus on large and homogenous samples of rTMS multicenter trials and include neurobiological variables.
- Published
- 2008
- Full Text
- View/download PDF
6. Metabolic alterations in the dorsolateral prefrontal cortex after treatment with high-frequency repetitive transcranial magnetic stimulation in patients with unipolar major depression.
- Author
-
Luborzewski A, Schubert F, Seifert F, Danker-Hopfe H, Brakemeier EL, Schlattmann P, Anghelescu I, Colla M, and Bajbouj M
- Subjects
- Adult, Brain Mapping, Depressive Disorder, Major diagnosis, Female, Glutamic Acid metabolism, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Personality Inventory, Depressive Disorder, Major physiopathology, Depressive Disorder, Major therapy, Dominance, Cerebral physiology, Prefrontal Cortex physiopathology, Transcranial Magnetic Stimulation
- Abstract
Neuroimaging studies suggest a specific role of anterior cingulate cortex (ACC) and left dorsolateral prefrontal cortex (DLPFC) in major depression. Stimulation of the latter by means of repetitive transcranial magnetic stimulation (rTMS) as an antidepressant intervention has increasingly been investigated in the past. The objective of the present study was to examine in vivo neurochemical alterations in both brain regions in 17 patients with unipolar major depression before and after 10 days of high-frequency (20Hz) rTMS of the left DLPFC using 3-tesla proton magnetic resonance spectroscopy. Six out of seventeen patients were treatment responders, defined as a 50% reduction of the Hamilton depression rating scale. No neurochemical alterations in the ACC were detected after rTMS. As compared to the non-responders, responders had lower baseline concentrations of DLPFC glutamate which increased after successful rTMS. Correspondingly, besides a correlation between clinical improvement and an increase in glutamate concentration, an interaction between glutamate concentration changes and stimulation intensity was observed. Our results indicate that metabolic, state-dependent changes within the left DLPFC in major depressive disorder involve the glutamate system and can be reversed in a dose-dependent manner by rTMS.
- Published
- 2007
- Full Text
- View/download PDF
7. Positive predictors for antidepressive response to prefrontal repetitive transcranial magnetic stimulation (rTMS).
- Author
-
Brakemeier EL, Luborzewski A, Danker-Hopfe H, Kathmann N, and Bajbouj M
- Subjects
- Combined Modality Therapy, Depressive Disorder, Major diagnosis, Depressive Disorder, Major drug therapy, Diagnostic and Statistical Manual of Mental Disorders, Female, Forecasting, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome, Antidepressive Agents therapeutic use, Depressive Disorder, Major therapy, Prefrontal Cortex physiology, Transcranial Magnetic Stimulation
- Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a brain stimulation technique which had recently been investigated as a putative antidepressant intervention. However, there is little agreement about clinically useful predictors of rTMS outcome. Therefore, the objective of the present study was to determine whether specific biographical, clinical, and psychopathological parameters are associated with the antidepressant response to rTMS in a large sample of 70 depressive patients. We performed a logistic regression analysis in 70 patients with major depressive disorder treated with rTMS of the left dorsolateral prefrontal cortex testing the predictive value of various domains of the depression syndrome as well as the variables episode duration, degree of treatment resistance, and CORE criteria. Response was defined as a 50% reduction of the initial Hamilton score (HAMD). After two weeks of treatment, 21% of the patients showed a response to rTMS. The binary logistic regression model correctly assigned 86.7% of the responders and 96.4% of the non-responders to their final response group. In the model, a high level of sleep disturbances was a significant predictor for treatment response to rTMS. Also, a low score of treatment resistance and a short duration of episode were positive predictors. These findings provide new evidence that especially pronounced sleep disturbances may be a significant clinical predictor of a response to rTMS. Prospective rTMS studies are necessary to validate the predictive value of the derived model.
- Published
- 2007
- Full Text
- View/download PDF
8. Vagus nerve stimulation improves restless legs syndrome associated with major depression: a case report.
- Author
-
Merkl A, Brakemeier EL, Danker-Hopfe H, and Bajbouj M
- Subjects
- Aged, Female, Humans, Vagus Nerve, Depressive Disorder, Major complications, Electric Stimulation Therapy, Restless Legs Syndrome etiology, Restless Legs Syndrome therapy
- Published
- 2007
- Full Text
- View/download PDF
9. Maintenance treatment of depression in old age.
- Author
-
Bajbouj M and Danker-Hopfe H
- Subjects
- Aged, Combined Modality Therapy, Humans, Secondary Prevention, Severity of Illness Index, Depressive Disorder, Major therapy, Paroxetine therapeutic use, Psychotherapy, Selective Serotonin Reuptake Inhibitors therapeutic use
- Published
- 2006
10. Evidence for impaired cortical inhibition in patients with unipolar major depression.
- Author
-
Bajbouj M, Lisanby SH, Lang UE, Danker-Hopfe H, Heuser I, and Neu P
- Subjects
- Adult, Brain Mapping, Depressive Disorder, Major diagnosis, Dominance, Cerebral physiology, Electromyography, Female, Hand innervation, Humans, Male, Middle Aged, Motor Cortex physiopathology, Reference Values, Sensory Thresholds physiology, Synaptic Transmission physiology, Transcranial Magnetic Stimulation, gamma-Aminobutyric Acid physiology, Cerebral Cortex physiopathology, Depressive Disorder, Major physiopathology, Neural Inhibition physiology
- Abstract
Background: Several lines of evidence suggest that central cortical inhibitory mechanisms, especially associated with gamma-aminobutyric acid (GABA) neurotransmission, may play a role in the pathophysiology of major depression. Transcranial magnetic stimulation is a useful tool for investigating central cortical inhibitory mechanisms associated with GABAergic neurotransmission in psychiatric and neurological disorders., Methods: By means of transcranial magnetic stimulation, different parameters of cortical excitability, including motor threshold, the cortical silent period, and intracortical inhibition/facilitation, were investigated in 20 medication-free depressed patients and 20 age- and gender-matched healthy volunteers., Results: Silent period and intracortical inhibition were reduced in depressed patients, consistent with a reduced GABAergic tone. Moreover, patients showed a significant hemispheric asymmetry in motor threshold., Conclusions: This study provides evidence of reduced GABAergic tone and motor threshold asymmetry in patients with major depression.
- Published
- 2006
- Full Text
- View/download PDF
11. Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex and cortical excitability in patients with major depressive disorder.
- Author
-
Bajbouj M, Brakemeier EL, Schubert F, Lang UE, Neu P, Schindowski C, and Danker-Hopfe H
- Subjects
- Adult, Electromyography methods, Female, Functional Laterality, Humans, Male, Middle Aged, Prefrontal Cortex physiology, Sensory Thresholds radiation effects, Treatment Outcome, Depressive Disorder, Major therapy, Evoked Potentials, Motor radiation effects, Prefrontal Cortex radiation effects, Transcranial Magnetic Stimulation methods
- Abstract
Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex is a relatively non-invasive technique with putative therapeutic effects in major depression. However, the exact neurophysiological basis of these effects needs further clarification. Therefore, we studied the impact of ten daily sessions of left, dorsolateral prefrontal rTMS on motor cortical excitability, as revealed by transcranial magnetic stimulation-elicited motor-evoked potentials in 30 patients. As compared to the non-responders, responders (33%) showed changes in parameters pointing towards a reduced cortical excitability. These results suggest that repetitive transcranial magnetic stimulation of the dorsolateral, prefrontal cortex may have inhibitory effects on motor cortical neuronal excitability in patients with major depressive disorder. Furthermore, measurement of motor cortical excitability may be a useful tool for investigating and monitoring inhibitory brain effects of antidepressant stimulation techniques like rTMS.
- Published
- 2005
- Full Text
- View/download PDF
12. Motor cortical excitability in depressive patients after electroconvulsive therapy and repetitive transcranial magnetic stimulation.
- Author
-
Bajbouj M, Luborzewski A, Danker-Hopfe H, and Lang UE
- Subjects
- Adult, Antidepressive Agents therapeutic use, Combined Modality Therapy, Humans, Male, Middle Aged, Depressive Disorder, Major therapy, Electroconvulsive Therapy, Transcranial Magnetic Stimulation
- Abstract
Electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex are brain stimulation techniques that are used as therapeutic interventions in major depression. However, the exact therapeutic mode of action needs further clarification. In this case report, we describe the impact of these stimulation techniques on motor cortical excitability, as revealed by transcranial magnetic stimulation-elicited motor-evoked potentials in 2 patients who received consecutively both rTMS and ECT. Both patients showed a decrease in motor cortical excitability after response to antidepressant brain stimulation, whereas parameters of motor cortical excitability remained unchanged after the first non-successful intervention. These results suggest that both ECT and rTMS may have an impact on parameters of motor cortical neuronal excitability. Furthermore, measurement of motor cortical excitability may be a useful tool for investigating and monitoring inhibitory brain effects of different antidepressant stimulation techniques.
- Published
- 2005
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.