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Insurers often commission psychiatric experts to evaluate the eligibility of workers with mental disorders for disability benefits, by estimating their residual work capacity (RWC). We investigated the validity of a standardized, computer-based battery of established diagnostic instruments, for evaluating the personality, cognition, performance, symptom burden, and symptom validity of claimants. One hundred and fifty-three claimants for benefits were assessed by the assembled test battery, which was applied in addition to a conventional clinical work disability evaluation. A principal component analysis of the test and questionnaire battery data revealed six factors (Negative Affectivity, Self-Perceived Work Ability, Behavioral Dysfunction, Working Memory, Cognitive Processing Speed, and Excessive Work Commitment). Claimants with low, medium, and high RWC exclusively varied in the factor Negative Affectivity. Importantly, this factor also showed a strong association to psychiatric ratings of capacity limitations in psychosocial functioning. The findings demonstrate that the used test battery allows a substantiation of RWC estimates and of psychiatric ratings by objective and standardized data. If routinely incorporated in work disability evaluations, the test battery could increase their transparency for all stakeholders (insurers, claimants, medical experts, expert case-coordinators, and legal practitioners) and would open new avenues for research in the field of insurance medicine.Implications for rehabilitationThe residual work capacity (RWC) estimation by medical experts is internationally good practice, but plagued by a relatively low interrater agreement.The current study shows that psychiatric RWC estimates and capacity limitation ratings can be substantiated by data from objective, standardized psychometric instruments.Systematically using such instruments might help to improve the poor interrater agreement for RWC estimates in work disability evaluations.Such data could also be used for adopting vocational trainings and return-to-work programs to the individual needs of workers with mental health problems. The residual work capacity (RWC) estimation by medical experts is internationally good practice, but plagued by a relatively low interrater agreement. The current study shows that psychiatric RWC estimates and capacity limitation ratings can be substantiated by data from objective, standardized psychometric instruments. Systematically using such instruments might help to improve the poor interrater agreement for RWC estimates in work disability evaluations. Such data could also be used for adopting vocational trainings and return-to-work programs to the individual needs of workers with mental health problems.

Background The suitability of driving simulators for the prediction of driving behaviour in road traffic has been able to be confirmed in respect of individual assessment parameters. However, there is a need for overarching approaches that take into account the interaction between various influencing factors in order to establish proof of validity. The aim of this study was to explore the validity of our driving simulator in respect of its ability to predict driving behaviour based on participants‘ observed driving errors and driver’s individual characteristics. Method 41 healthy participants were assessed both in a Smart-Realo-Simulator and on the road. By means of linear modelling, the correlation between observed driving errors was investigated. In addition, the influence of self-reported and externally assessed driving behaviour as well as individual parameters (education and training; driving history) were analysed. Results By including these factors, 58% of the variance could be explained. For observed driving errors, a relative validity was established. For self-reported and externally assessed driving behaviour, an absolute to relative validity emerged. The amount of time spent in education and training proved to have a significant influence on driving performance in the simulator, but not on the road. Discussion In general, our results confirmed the validity of our driving simulator with regard to observed and self-reported driving behaviour. It emerged that education and training as potential indicators of cognitive resources played a differential role regarding the study conditions. Since real road driving is considerably automated in experienced drivers, this result suggests that simulation-related behavioural regulation is challenged by additional cognitive demands as opposed to behavioural regulation extending to real road driving. However, the source of these additional cognitive demands remains currently elusive and may form the subject of future research.

Previous studies were not able to show that presentation of change stimuli leads to dishabituation of the auditory evoked potential (AEP) component N1 for repeated stimuli. However, these change stimuli were usually themselves repeatedly presented. Here, we tested whether the presentation of non-repeating distractor stimuli ('novels') would lead to N1 dishabituation. The study sample consisted of 18 healthy participants who had to identify auditory target stimuli (´targets´) among repeated standard stimuli and rare novels. AEPs to standards were separately averaged, depending on the preceding stimulus (standards after standards, standards after targets, and standards after novels) and were compared by F statistics and Bayesian t-test. Moreover, N1 repetition effects within recording blocks were analyzed in single trial analyses. The analyses showed that targets elicited significantly larger N1 amplitudes than standards and standards elicited larger N1 amplitudes than novels. In contrast, the N1 amplitude to standards did not vary with the preceding stimulus. The single trial analyses revealed significant, but similar N1 amplitude decreases within the recording blocks for all standards. The current study revealed no evidence for N1 dishabituation, as the N1 amplitude for standards after novels was not increased as compared to the N1 for standards after standards. Thus, stimulus variation had no impact on the N1 of repeated standards, as also suggested by the single trial analyses. The lack of N1 dishabituation is at odds with the assumption that the N1 amplitude decrease after repeated stimulation results from habituation.

High prevalence rates of non-authentic complaints identified by experts in the field of insurance medicine draw attention to the risk of services, which are of limited availability and financially compensated, being used in ways that are not goal-oriented. Therefore, symptom validity testing has become a growing issue to prevent non-targeted monetary compensations. This paper outlines the best-evaluated methods and instruments. Based on the data currently available, their validity, in particular in the context of medico-legal assessment, is assessed. It is concluded that symptom validity assessment allows inferences about the degree of certainty of clinical judgements on the authenticity of reported symptoms. Thus, the application of the suggested instruments enhances significantly the quality of medical and psychological expertise. However, the integration of the additional results into the overall assessment is challenging and needs to be further clarified.

Functional somatic syndromes are mostly associated with pain and emotional distress. As one marker for the autonomic stress response, the distal skin temperature decreases during psychological stress. In patients with functional somatic syndromes, the distal skin temperature under baseline conditions (without stress induction) is usually lower than in healthy subjects, which could be due to the sustained presence of pain-related stress in such patients. The aim of our study was to investigate whether patients with functional somatic syndromes show altered skin temperatures also under everyday life conditions. 14 patients with functional somatic syndromes and 14 matched healthy control subjects were investigated under ambulatory conditions over six consecutive days. During this time, distal and proximal skin temperatures were continuously recorded and sleep-wake cycles were monitored by actimetry and sleep-wake diaries. Unexpectedly, the patients showed higher distal skin temperatures than control subjects in the afternoon. The objective temperature data did not match the patients' subjective experience: ratings of thermal comfort did not vary between the two groups. Moreover, similar levels of daytime activity were recorded in the two samples, even though patients reported more tiredness and more body tension than controls. We interpret the observed dissociation between objective skin temperature measurements and subjective ratings of the bodily thermal comfort as support for the notion of an alexisomia account (reduced bodily awareness) for functional somatic syndromes. Moreover, findings indicate that subjective complaints of tiredness and tension do not necessarily result in physical avoidance behaviour.

In today's society, there is an increasing number of workplaces in virtual environments (VE). But, there are only a few reports dealing with occupational health issues or age effects. The question arises how VR generally interferes with cognitive processes. This interference might have relevant implications for workability and work-efficiency in virtual environments. Event-related potentials are known to reflect different stages of stimulus reception, evaluation, and response. We have established an electroencephalographic (EEG) monitoring, focussing on event-related potentials (N100; mismatch negativity, i.e., MMN) to obtain access to attention dependent and pre-attentive processing of sensory stimuli applied in VE. The MMN is known to be correlated with the ability of subjects to react to an unexpected event. The aim of the present study was to investigate cognitive responses to distracting auditory stimuli in two different age groups in a virtual environment (VE) and in a real environment ("real reality"), and to compare characteristic neurophysiological response patterns. Data show that stimulus detection as given by the N100 amplitude and latency does not differ in both age groups and task conditions. In contrast, the pre-attentive processing as given by the MMN is altered in the VR such as the non-VR condition in an age-related manner. A relevant finding of the present study was that the age related differences seen in the non-VR condition were not strengthened in VR.

Objective Impaired response inhibition might play a role in child sexual offences. Recording of event-related potentials (ERPs) can help to clarify whether child sexual offenders (CSOs) show an altered processing of stop signals and commission errors. Methods In the current ERP study, we investigated these processes in a Go/Nogo task on two groups of CSOs, pedophilic contact CSOs and non-contact CSOs (child pornography offenders), as well as on non-offenders as controls. Results Behaviorally, CSOs showed a slight, but non-significant increase of the false alarm rate to Nogo cues, as compared to controls. The amplitudes of the ERP components N2 and P3 to Nogo cues followed by correctly withhold responses did not vary between CSOs and controls. The analysis of the ERPs to committed errors showed that the Ne amplitudes (reflecting error detection) did not differ between the groups either, whereas the Pe amplitudes (reflecting error evaluation and error awareness) were strongly diminished in CSOs. This diminishment was primarily found in contact CSOs. Conclusions The findings suggest that response inhibition, processing of stop signals, and error detection are not necessarily impaired in CSOs. However, CSOs appear to dedicate less cognitive resources to the evaluation of committed errors. Significance This selective alteration could reflect a reduced sense of responsibility for misconduct in this offender group, which might contribute to their delinquent behavior.

High prevalence rates of non-authentic complaints identified by experts in the field of insurance medicine draw attention to the risk of services, which are of limited availability and financially compensated, being used in ways that are not goal-oriented. Therefore, symptom validity testing has become a growing issue to prevent non-targeted monetary compensations. This paper outlines the best-evaluated methods and instruments. Based on the data currently available, their validity, in particular in the context of medico-legal assessment, is assessed. It is concluded that symptom validity assessment allows inferences about the degree of certainty of clinical judgements on the authenticity of reported symptoms. Thus, the application of the suggested instruments enhances significantly the quality of medical and psychological expertise. However, the integration of the additional results into the overall assessment is challenging and needs to be further clarified.

Background Work capacity evaluations by independent medical experts are widely used to inform insurers whether injured or ill workers are capable of engaging in competitive employment. In many countries, evaluation processes lack a clearly structured approach, standardized instruments, and an explicit focus on claimants’ functional abilities. Evaluation of subjective complaints, such as mental illness, present additional challenges in the determination of work capacity. We have therefore developed a process for functional evaluation of claimants with mental disorders which complements usual psychiatric evaluation. Here we report the design of a study to measure the reliability of our approach in determining work capacity among patients with mental illness applying for disability benefits. Methods/Design We will conduct a multi-center reliability study, in which 20 psychiatrists trained in our functional evaluation process will assess 30 claimants presenting with mental illness for eligibility to receive disability benefits [Reliability of Functional Evaluation in Psychiatry, RELY-study]. The functional evaluation process entails a five-step structured interview and a reporting instrument (Instrument of Functional Assessment in Psychiatry [IFAP]) to document the severity of work-related functional limitations. We will videotape all evaluations which will be viewed by three psychiatrists who will independently rate claimants’ functional limitations. Our primary outcome measure is the evaluation of claimant’s work capacity as a percentage (0 to 100 %), and our secondary outcomes are the 12 mental functions and 13 functional capacities assessed by the IFAP-instrument. Inter-rater reliability of four psychiatric experts will be explored using multilevel models to estimate the intraclass correlation coefficient (ICC). Additional analyses include subgroups according to mental disorder, the typicality of claimants, and claimant perceived fairness of the assessment process. Discussion We hypothesize that a structured functional approach will show moderate reliability (ICC ≥ 0.6) of psychiatric evaluation of work capacity. Enrollment of actual claimants with mental disorders referred for evaluation by disability/accident insurers will increase the external validity of our findings. Finding moderate levels of reliability, we will continue with a randomized trial to test the reliability of a structured functional approach versus evaluation-as-usual.

— In commodity LC flat-panel displays, the traditional CCFL backlight is being replaced more and more by LEDs. The typical spectrum of LED-lit displays shows a significantly higher amount of blue light in the range around 464 nm. Blue light in this wavelength area suppresses the melatonin level in humans and thus effects the biological clock. Our hypothesis was that the amount of blue light reaching the human eye from a LED-backlit display is sufficient to have a significant effect on the biological clock. The results of clinical user studies comparing the effects of LED- vs. CCFL-backlit displays on humans, resulting from the emitted amount of 464-nm light, will be presented. It was found that the LED-backlit display causes significant suppression of melatonin, which effects the biological clock of the test persons, indicating the necessity for displays with a controllable 464-nm emission. A technical concept for a display with such functionality will be presented.

Conflict-related cognitive processes are critical for adapting to sudden environmental changes that confront the individual with inconsistent or ambiguous information. Thus, these processes play a crucial role to cope with daily life. Generally, conflicts tend to accumulate especially in complex and threatening situations. Therefore, the question arises how conflict-related cognitive processes are modulated by the close succession of conflicts. In the present study, we investigated the effect of interactions between different types of conflict on performance as well as on electrophysiological parameters. A task-irrelevant auditory stimulus and a task-relevant visual stimulus were presented successively. The auditory stimulus consisted of a standard or deviant tone, followed by a congruent or incongruent Stroop stimulus. After standard prestimuli, performance deteriorated for incongruent compared to congruent Stroop stimuli, which were accompanied by a widespread negativity for incongruent versus congruent stimuli in the event-related potentials (ERPs). However, after deviant prestimuli, performance was better for incongruent than for congruent Stroop stimuli and an additional early negativity in the ERP emerged with a fronto-central maximum. Our data show that deviant auditory prestimuli facilitate specifically the processing of stimulus-related conflict, providing evidence for a conflict-priming effect.

QUESTIONS In Switzerland, evaluation of work capacity in individuals with mental disorders has come under criticism. We surveyed stakeholders about their concerns and expectations of the current claim process. METHODS We conducted a nationwide online survey among five stakeholder groups. We asked 37 questions addressing the claim process and the evaluation of work capacity, the maximum acceptable disagreement in judgments on work capacity, and its documentation. RESULTS Response rate among 704 stakeholders (95 plaintiff lawyers, 285 treating psychiatrists, 129 expert psychiatrists evaluating work capacity, 64 social judges, 131 insurers) varied between 71% and 29%. Of the lawyers, 92% were dissatisfied with the current claim process, as were psychiatrists (73%) and experts (64%), whereas the majority of judges (72%) and insurers (81%) were satisfied. Stakeholders agreed in their concerns, such as the lack of a transparent relationship between the experts' findings and their conclusions regarding work capacity, medical evaluations inappropriately addressing legal issues, and the experts' delay in finalising the report. Findings mirror the characteristics that stakeholders consider important for an optimal work capacity evaluation. For a scenario where two experts evaluate the same claimant, stakeholders considered an inter-rater difference of 10%‒20% in work capacity at maximum acceptable. CONCLUSIONS Plaintiff lawyers, treating psychiatrists and experts perceive major problems in work capacity evaluation of psychiatric claims whereas judges and insurers see the process more positively. Efforts to improve the process should include clarifying the basis on which judgments are made, restricting judgments to areas of expertise, and ensuring prompt submission of evaluations.

Fully immersive and stereoscopic Virtual Environments (VE) represent a powerful multimedia tool for laboratory-based simulations of distinct scenarios including scenarios for evaluating stressful situations resembling reality. Thus far, cortisol secretion as a neuroendocrine parameter of stress has not been evaluated within a Virtual Reality (VR)-based paradigm. In this study 94 healthy volunteers were subjected to a provocative VR-paradigm and a cognitive stress task. Provocative in this context means the VE was designed to provoke physiological reactions (cortisol secretion) within the respective users by purpose. It was tested (a) if a fully dynamic VE as opposed to a static VE can be regarded as a stressor and (b) if such a fully dynamic VE can modify an additional response to a cognitive stressor presented within the VE additionally. Furthermore, possible gender-related impacts on cortisol responses were assessed. A significant cortisol increase was observed only after the combined application of the fully dynamic VE and the cognitive stressor, but not after application of the dynamic VE or the cognitive stressor alone. Cortisol reactivity was greater for men than for women. We conclude that a fully dynamic VE does not affect cortisol secretion per se, but increases cortisol responses to a dual task paradigm that includes performance of a stressful mental task. This provides the basis for the application of VR-based technologies in neuroscientific research, including the assessment of the human Hypothalamus-Pituitary-Adrenal (HPA) axis regulation.

Immersive, stereoscopic virtual reality (VR) systems provide a powerful multimedia tool for a laboratory simulation of distinct scenarios including stressful situations close to reality. Thus far, cortisol secretion as a neuroendocrine parameter of stress has not been evaluated within a VR paradigm. Ninety-four healthy subjects were subjected to a VR paradigm and a cognitive stress task. It was tested (a) if the modification of reality induced by dynamic VR as opposed to static VR can be regarded as a stressor and (b) if it can modify an additional cognitive stress response. In addition, the impact of gender on cortisol responses was assessed. A significant cortisol increase was observed only after the combined application of both conditions, but not after the dynamic VR or the cognitive stress alone. Cortisol reactivity was greater for men than for women. We conclude that dynamic VR does not affect cortisol secretion per se, but increases cortisol responses in a dual task paradigm. This provides the basis for the application of VR in neuroscientific research, which includes the assessment of hypothalamus-pituitary-adrenal axis regulation.

Spezifische Phobien sind weit verbreitet.Die aktuell international anerkannte Behandlungsstrategie ist eine Verhaltenstherapie mit Exposition. Die Praktikabilitat und Effizienz von Virtual Reality zur Behandlung spezifischer Phobien soll am Beispiel der Hohenangst im Rahmen einer explorativen Studie uberpruft werden.Die Exposition in virtueller Realitat wird manualgeleitet durchgefuhrt. Fur diese Pilotstudie wurde ein Cross-over-Design mit Warteliste und Zwischenpause gewahlt. Die Ergebnisse von 2 Interventionsgruppen zeigen im Vergleich zu einer Wartelisten-Bedingung, dass die Methode von den Probanden angenommen wird, eine ausreichende Angstprovokation erfolgt und ein klinisch bedeutsamer Effekt eintritt.

Cue reactivity to drug-related stimuli is a frequently observed phenomenon in drug addiction. Cue reactivity refers to a classical conditioned response pattern that occurs when an addicted subject is exposed to drug-related stimuli. This response consists of physiological and cognitive reactions. Craving, a subjective desire to use the drug of choice, is believed to play an important role in the occurrence of relapse in the natural setting. Besides craving, other subjective cue-elicited reactions have been reported, including withdrawal symptoms, drug-agonistic effects, and mood swings. Physiological reactions that have been investigated include skin conductance, heart rate, salivation, and body temperature. Conditioned reactivity to cues is an important factor in addiction to alcohol, nicotine, opiates, and cocaine. Cue exposure treatment (CET) refers to a manualized, repeated exposure to drug-related cues, aimed at the reduction of cue reactivity by extinction. In CET, different stimuli are presented, for example, slides, video tapes, pictures, or paraphernalia in nonrealistic, experimental settings. Most often assessments consist in subjective ratings by craving scales. Our pilot study will show that immersive virtual reality (IVR) is as good or even better in eliciting subjective and physiological craving symptoms as classical devices.

Performance in virtual environments (VEs) is strongly modulated by attention-related factors such as the preattentive state of the brain. Because this state changes over time and might also be infl...

OBJECTIVE Lithium is known to be neurotoxic at higher serum levels. In rare cases patients develop symptoms of intoxication or full blown intoxications even when lithium levels are normal. Our aim was to detect predicting factors of lithium neurotoxicity at normal serum lithium levels in order to allow prevention of those constellations. METHODS We report two cases of severe lithium intoxications at normal serum lithium levels and review the current literature concerning lithium neurotoxicity at normal serum levels. RESULTS It appears that the probability of developing signs of lithium intoxications in patients treated with lithium is increased with advanced age, co-morbidity with pre-existing neurological or other general diseases, especially those associated with fever, and in combination with the use of antipsychotics, antidepressants or mood stabilizers. The serum lithium level does not necessarily detect an intoxication. CONCLUSIONS In patients developing signs of intoxication under lithium therapy, further investigations should include serum levels and an EEG. Because intoxications can occur even in normal serum levels, discontinuation of lithium medication should be taken into account on the basis of clinical signs of intoxication.

Background: The failure to inhibit pleasurable but inappropriate urges is associated with frontal lobe pathology and has been suggested as a possible cause of pedophilic behavior. However, imaging and neuropsychological findings about frontal pathology in pedophilia are heterogeneous. In our study we therefore address inhibition behaviorally and by means of functional imaging, aiming to assess how inhibition in pedophilia is related to a differential recruitment of frontal brain areas. Method: Eleven pedophilic subjects and 7 nonpedophilic controls underwent fMRI while performing a go/no-go task composed of neutral letters. Results: Pedophilic subjects showed a slower reaction time and less accurate visual target discrimination. fMRI voxel-level ANOVA revealed as a main effect of the go/no-go task an activation of prefrontal and parietal brain regions in the no-go condition, while the left anterior cingulate, precuneus and gyrus angularis became more activated in the go condition. In addition, a group × task interaction was found in the left precuneus and gyrus angularis. This interaction was based on an attenuated deactivation of these brain regions in the pedophilic group during performance of the no-go condition. The positive correlation between blood oxygen level-dependent imaging signal and reaction time in these brain areas indicates that attenuated deactivation is related to the behavioral findings. Conclusion: Slower reaction time and less accurate visual target discrimination in pedophilia was accompanied by attenuated deactivation of brain areas belonging to the default mode network. Our findings thus support the notion that behavioral differences might also derive from self-related processes and not necessarily from frontal lobe pathology.

Three different GABA-insensitive Cl − channels could be resolved in cultured hippocampal neurons using the inside-out patch clamp configuration. The most commonly observed channel revealed an inward rectification with a chord conductance of 40 pS in symmetrical Cl − solutions at a membrane potential of −50 mV and had voltage sensitive gating kinetics. Channel openings were not observed in cell-attached patch, and after excision, several minutes of perfusion of the cytoplasmic side were required before detecting the first openings. The open state probability was increased by guanosine 5′- O -(3-thiotriphospate) (GTP-γ-S 10 −4 M) and reduced by guanosine 5′- O -(2-thiophosphate) (GDP-β-S 10 −4 M) suggesting its regulation by G proteins. This new identified chloride channel may account for the previously described voltage-sensitive, inward-rectifying whole cell Cl − current which was enhanced by adenosine in a pertussis toxin-sensitive manner.

Background Most neuroimaging studies investigating sexual arousal in paedophilia used erotic pictures together with a blocked fMRI design and long stimulus presentation time. While this approach allows the detection of sexual arousal, it does not enable the assessment of the immediate processing of erotically salient stimuli. Our study aimed to identify neuronal networks related to the immediate processing of erotic stimuli in heterosexual male paedophiles and healthy age-matched controls. Methods We presented erotic pictures of prepubescent children and adults in an event related fMRI-design to eight paedophilic subjects and age-matched controls. Results Erotic pictures of females elicited more activation in the right temporal lobe, the right parietal lobe and both occipital lobes and erotic pictures of children activated the right dorsomedial prefrontal cortex in both groups. An interaction of sex, age and group was present in the right anteriolateral oribitofrontal cortex. Conclusions Our event related study design confirmed that erotic pictures activate some of the brain regions already known to be involved in the processing of erotic pictures when these are presented in blocks. In addition, it revealed that erotic pictures of prepubescent children activate brain regions critical for choosing response strategies in both groups, and that erotically salient stimuli selectively activate a brain region in paedophilic subjects that had previously been attributed to reward and punishment, and that had been shown to be implicated in the suppression of erotic response and deception.

1. Neurones enzymatically dissociated from the rat dorsal lateral geniculate nucleus (LGN) were identified as GABAergic local circuit interneurones and geniculocortical relay cells, based upon quantitative analysis of soma profiles, immunohistochemical detection of GABA or glutamic acid decarboxylase, and basic electrogenic behaviour. 2. During whole-cell current-clamp recording, isolated LGN neurones generated firing patterns resembling those in intact tissue, with the most striking difference relating to the presence in relay cells of a Ca2+ action potential with a low threshold of activation, capable of triggering fast spikes, and the absence of a regenerative Ca2+ response with a low threshold of activation in local circuit cells. 3. Whole-cell voltage-clamp experiments demonstrated that both classes of LGN neurones possess at least two voltage-dependent membrane currents which operate in a range of membrane potentials negative to the threshold for generation of Na(+)-K(+)-mediated spikes: the T-type Ca2+ current (IT) and an A-type K+ current (IA). Taking into account the differences in membrane surface area, the average size of IT was similar in the two types of neurones, and interneurones possessed a slightly larger A-conductance. 4. In local circuit neurones, the ranges of steady-state inactivation and activation of IT and IA were largely overlapping (VH = 81.1 vs. -82.8 mV), both currents activated at around -70 mV, and they rapidly increased in amplitude with further depolarization. In relay cells, the inactivation curve of IT was negatively shifted along the voltage axis by about 20 mV compared with that of IA (Vh = -86.1 vs. -69.2 mV), and the activation threshold for IT (at -80 mV) was 20 mV more negative than that for IA. In interneurones, the activation range of IT was shifted to values more positive than that in relay cells (Vh = -54.9 vs. -64.5 mV), whereas the activation range of IA was more negative (Vh = -25.2 vs. -14.5 mV). 5. Under whole-cell voltage-clamp conditions that allowed the combined activation of Ca2+ and K+ currents, depolarizing voltage steps from -110 mV evoked inward currents resembling IT in relay cells and small outward currents indicative of IA in local circuit neurones. After blockade of IA with 4-aminopyridine (4-AP), the same pulse protocol produced IT in both types of neurones. Under current clamp, 4-AP unmasked a regenerative membrane depolarization with a low threshold of activation capable of triggering fast spikes in local circuit neurones.(ABSTRACT TRUNCATED AT 400 WORDS)

Many people spend an increasing amount of time in front of computer screens equipped with light-emitting diodes (LED) with a short wavelength (blue range). Thus we investigated the repercussions on melatonin (a marker of the circadian clock), alertness, and cognitive performance levels in 13 young male volunteers under controlled laboratory conditions in a balanced crossover design. A 5-h evening exposure to a white LED-backlit screen with more than twice as much 464 nm light emission {irradiance of 0,241 Watt/(steradian × m2) [W/(sr × m2)], 2.1 × 1013 photons/(cm2 × s), in the wavelength range of 454 and 474 nm} than a white non-LED-backlit screen [irradiance of 0,099 W/(sr × m2), 0.7 × 1013 photons/(cm2 × s), in the wavelength range of 454 and 474 nm] elicited a significant suppression of the evening rise in endogenous melatonin and subjective as well as objective sleepiness, as indexed by a reduced incidence of slow eye movements and EEG low-frequency activity (1–7 Hz) in frontal brain regions. Concomitantly, sustained attention, as determined by the GO/NOGO task; working memory/attention, as assessed by “explicit timing”; and declarative memory performance in a word-learning paradigm were significantly enhanced in the LED-backlit screen compared with the non-LED condition. Screen quality and visual comfort were rated the same in both screen conditions, whereas the non-LED screen tended to be considered brighter. Our data indicate that the spectral profile of light emitted by computer screens impacts on circadian physiology, alertness, and cognitive performance levels. The challenge will be to design a computer screen with a spectral profile that can be individually programmed to add timed, essential light information to the circadian system in humans.

Stimulus train-evoked decreases of the extracellular Ca2+ concentration (ΔCa) were measured with ion-sensitive electrodes in the CA1 area of rat hippocampal slices. The adenosine receptor antagonist, theophylline, led led to a marked increase of ΔCa in the synaptic and in the soma layer reflecting an increased activation and enhanced frequency potentiation of pyramidal neurons in the absence of endogenous adenosine action. The theophylline effect was significantly reduced in the presence of the Cl− channel blocker, 4,4′-diisothiocyano-2,2′-stilbenedisulfonate (DIDS) or of the Cl− pump blocker, furosemide. The data indicate that the adenosine-mediated modulation of the repetitive input strength is related to the function of Cl− ions.

Lithium is known to be neurotoxic at higher serum levels. In rare cases patients develop symptoms of intoxication or full blown intoxications even when lithium levels are normal. Our aim was to detect predicting factors of lithium neurotoxicity at normal serum lithium levels in order to allow prevention of those constellations.We report two cases of severe lithium intoxications at normal serum lithium levels and review the current literature concerning lithium neurotoxicity at normal serum levels.It appears that the probability of developing signs of lithium intoxications in patients treated with lithium is increased with advanced age, co-morbidity with pre-existing neurological or other general diseases, especially those associated with fever, and in combination with the use of antipsychotics, antidepressants or mood stabilizers. The serum lithium level does not necessarily detect an intoxication.In patients developing signs of intoxication under lithium therapy, further investigations should include serum levels and an EEG. Because intoxications can occur even in normal serum levels, discontinuation of lithium medication should be taken into account on the basis of clinical signs of intoxication.

In the present paper a VR (Virtual Reality) exposure treatment program for Acrophobia (fear of heights) is introduced and evaluated against an in vivo exposure with the same success rate. During the VR exposure psychophysiological parameters (heart rate, respiratory rate) are collected. VR offers the good opportunity to study psychophysiological effects under almost standardized conditions. The findings reflect partly the somatic correlates during an anxiety attack. Beside the opportunity of standardized circumstances other advantages of VR techniques are discussed (cost effectiveness, enhancement of the narration process, higher user acceptance).

In this paper we present current and future approaches to merge intelligent interfaces with immersive Virtual Environments (VEs). The aim of this paper is to substantiate the introductory presentation in the session "Facing Virtual Environments with innovative interaction techniques" at HCI 2007. Although VEs and multimodal interfaces tried to make Human-Computer-Interaction as natural as possible, they have shown serious usability problems. We describe concepts to aid users in supporting their personal cognitive and perceptual capabilities, where the Virtual Environment will adapt dynamically and in real-time to the users' physiological constitution, previous behaviour and desires. With our concept, human performance can be significantly enhanced by adapting interfaces and environments to the users' mental condition and their information management capacity. Health and usability problems caused by stress, workload and fatigue will be avoided. We intend to encourage discussions on this topic among the experts, which are gathered this session.

Cognitive tasks involving conflicting stimuli and responses are associated with an early age-related decline in performance. Conflict and conflict-induced interference can be stimulus- or response-related. In classical stimulus-response compatibility tasks, such as the Stroop task, the event-related potential (ERP) usually reveals a greater negativity on incongruent versus congruent trials which has often been linked with conflict processing. However, it is unclear whether this negativity is related to stimulus- or response-related conflict, thus rendering the meaning of age-related changes inconclusive. In the present study, a modified Stroop task was used to focus on stimulus-related interference processes while excluding response-related interference. Since we intended to study work-relevant effects ERPs and performance were determined in young (about 30 years old) and middle-aged (about 50 years old) healthy subjects (total n=80). In the ERP, a broad negativity developed after incongruent versus congruent stimuli between 350 and 650 ms. An age-related increase of the latency and amplitude of this negativity was observed. These results indicate age-related alterations in the processing of conflicting stimuli already in middle age.

Cognitive tasks involving distraction are associated with an early age-related decline in performance. Involuntary shifts in attention to irrelevant stimulus features and subsequent reorientation were studied in young and middle-aged subjects focussing on behavioural and event-related potential (ERP) measures. Subjects were asked to discriminate between equiprobable short and long auditory stimuli. Irrelevant rare frequency deviations prolonged reaction times (RT’s), while an age-related effect on RT’s was not observed. In contrast, notably after short deviant tones the error rate was considerably increased in the middle-aged subjects. ERP measures after deviant stimuli elicited a sequence of mismatch negativity (MMN), P3a and reorienting negativity (RON). The latency and amplitude of the MMN did not differ between age groups indicating an unchanged deviance detection. However, the consecutive process of attention orientation (P3a) was delayed and the subsequent reorienting (RON) to the primary task was strongly attenuated in the middle-aged subjects. After short deviants the RON was virtually absent in the middle-aged subjects, which might account for the observed decline of accuracy.

Background There is a growing debate about injectable opioid treatment programs in many Western countries. This is the first placebo-controlled study of the safety of injectable opioids in a controlled treatment setting. Methods Twenty-five opioid-dependent patients on intravenous (IV) heroin or IV methadone maintenance treatment were randomly assigned to either their individual prescribed IV maintenance dose or placebo. Acute drug effects were recorded, focusing on electrocardiography, respiratory movements, arterial blood oxygen saturation, and electroencephalography (EEG). Results After heroin injection, marked respiratory depression progressing to a Cheyne–Stokes pattern occurred. Peripheral arterial blood oxygenation decreased to 78.9 ± 8.7% (mean ± SD) ranging from 52%–90%. During hypoxia, 7 of the 16 subjects experienced intermittent and somewhat severe bradycardia. Five subjects exhibited paroxysmal EEG patterns. After methadone injection, respiratory depression was less pronounced than after heroin injection. No relevant bradycardia was noted. Conclusions Opioid doses commonly prescribed in IV opioid treatment induce marked respiratory and circulatory depression, as well as occasionally irregular paroxysmal EEG activity. Further studies are needed to optimize the clinical practice of IV opioid treatment to prevent serious complications. Moreover, the extent of the observed effects raises questions about the appropriateness of IV opioid treatment in the present form.

Exposure therapy is a behavioral technique that is reported to be the most effective, long-lasting treatment for patients suffering from specific phobia. During the performance in enclosed spaces, the patients show a strong psychophysiological response to the phobic stimulus that is normally avoided. This psychophysiological response changes characteristically during the course of exposure. We implemented an electroencephalographic monitoring focusing on event-related potentials to resolve the modulation of preattentive information processing by the anxiety state of the subject. Therefore, mismatch-negativity (MMN) was chosen as parameter using a passive auditory oddball paradigm that does not interfere with performance in the virtual environment. The results of this neurophysiological monitoring are demonstrated in one patient suffering from claustrophobia.

We present the results of clinical user studies comparing the effects of LED- vs. CCFL-backlit displays on humans, resulting from the emitted amount of 464 nm light. The LED-lit display causes significant effects on the user. We present a concept of a display with controllable 464 nm emission.

ObjectivesRecent research about pedophilia suggested an association between pedophilia, neurocognitive disturbance and specific personality profiles. Especially neuropsychological functions associated with the prefrontal and motor processing loops showed to be impaired in pedophilia. But in most studies about pedophilia subjects were recruited from high security forensic hospitals. The results might therefore be influenced by selection bias. To overcome this bias we conducted a study that aimed to compare neurocognitive disturbance and specific personality profiles of pedophile sexual abusers, pedophile internet abusers and controls.MethodsWe included until now 5 male pedophile sexual abusers, 4 male pedophile internet abusers and 6 male control subjects. Subjects were matched for age and IQ. Personality profiles were assessed by SKID and MMPI. Response inhibition was tested in a classical Go/NoGo task.ResultsAssessments of personality profiles showed similar sub threshold profiles for the controls and the group of internet abusers while subjects from security forensic hospital setting fulfilled criteria of personality disorders. Accordingly showed the Go/NoGo task higher rates of failed response inhibition in the group of paedophilic subjects from high security forensic hospital setting and lower rates for pedophile internet abusers and/or controls.ConclusionsOur preliminary data suggests that results of recent studies about neurocognitive disturbance and neuroimaging correlates of paedophilia might be influenced by selection bias and might rather reflect impairment of personality and social interaction in a broader sense. Future research about paedophilia should consequently aim to disentangle personality impairment from sexual orientation.

Nitric oxide (NO) is considered a diffusible messenger involved in neuronal communication, although the postsynaptic target cells of NO action and the associated biological function in the CNS are still a matter of controversy. Within the discrete pattern of NO-synthesizing neurons in the brain, NO synthase is specifically colocalized with the cholinergic brain stem-thalamic system, which is thought to regulate the state-dependent activity of the thalamocortical circuit. Here we report evidence indicating that the release of NO onto thalamocortical neurons results in an alteration in voltage dependence of the hyperpolarization-activated cation conductance, probably mediated via the cGMP system. NO selectively dampens oscillatory neuronal activity, indicating a rapidly diffusing signaling mechanism that controls the functional state of the thalamocortical network.

Different classes of potassium (K+) outward current activated by depolarization were characterized in relay neurons acutely isolated from the rat lateral geniculate nucleus (LGN), using the whole-cell version of the patch-clamp technique. A fast-transient current (IA), activated at around - 70 mV, declined rapidly with a voltage-dependent time constant (tau=6 ms at + 45 mV), was 50% steady-state inactivated at - 70 mV, and rapidly recovered from inactivation with a monoexponential time course (tau=21 ms). IA was blocked by 4-aminopyridine (4-AP, 2 - 8 mM) and was relatively insensitive to tetraethylammonium (TEA, 2 - 10 mM). After elimination of IA by a conditioning prepulse (30 ms to - 50 mV), a slow-transient K+ current could be studied in isolation, and was separated into three components, IKm, IKs and a calcium (Ca2+)-dependent current, IK[Ca]. The slow-transient current was not consistently affected by 4-AP (up to 8 mM), while TEA (2 - 10 mM) predominantly blocked IKs and IK[Ca]. The component IKm persisted in a solution containing TEA and 4-AP, activated at around - 55 mV, declined monoexponentially during maintained depolarization (tau=98 ms at + 45 mV), was 50% inactivated at - 39 mV, and recovered with tau=128 ms from inactivation. IKs activated at a similar threshold, but declined much slower with tau=2662 ms at + 45 mV. Steady-state inactivation of IKs was half-maximal at - 49 mV, and recovery from inactivation occurred relatively fast with tau=116 ms. From these data and additional current-clamp recordings it is concluded that the K+ currents, due to their wide range of kinetics and dependence on membrane voltage or internal Ca2+ concentration, are capable of cooperatively controlling the firing threshold and of shaping the different states of electrophysiological behaviour in LGN relay cells.

The persistent infection of human glial cells with HIV-1 is characterized by prominent expression of the Nef protein. In order to evaluate the possible role of Nef in the development of HIV-1-associated neurological disorders, we compared Nef with known neuroactive proteins. We found that HIV Nef shares sequence and structural features with scorpion peptides known to interact with K+ channels. Sequence similarity encompasses two distinct regions of scorpion peptides. Based on crystallography data, both regions in scorpion peptides cooperate in forming a common domain stabilized by ion pairs between charged amino-acid residues. Recombinant Nef protein, as well as a synthetic part of a scorpion channel active peptide (M10), reversibly increased the total K+ current of chick dorsal root ganglions in patch-clamp experiments without killing the cells. These results indicate that a region conserved in HIV Nef and scorpion peptides concurs in both structure and electrophysiological activity and suggest that Nef, like scorpion peptides, may affect neuronal cell function.