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Background: Numerous studies show that electroconvulsive therapy (ECT) induces hippocampal neuroplasticity, but findings are inconsistent regarding its clinical relevance. This study aims to investigate ECT-induced plasticity of anterior and posterior hippocampi using mathematical complexity measures in neuroimaging, namely Higuchi's fractal dimension (HFD) for fMRI time series and the fractal dimension of cortical morphology (FD-CM). Furthermore, we explore the potential of these complexity measures to predict ECT treatment response. Methods: Twenty patients with a current depressive episode (16 with major depressive disorder and 4 with bipolar disorder) underwent MRI-scans before and after an ECT-series. Twenty healthy controls matched for age and sex were also scanned twice for comparison purposes. Resting-state fMRI data were processed, and HFD was computed for anterior and posterior hippocampi. Group-by-time effects for HFD in anterior and posterior hippocampi were calculated and correlations between HFD changes and improvement in depression severity were examined. For FD-CM analyses, we preprocessed structural MRI with CAT12′s surface-based methods. We explored group-by-time effects for FD-CM and the predictive value of baseline HFD and FD-CM for treatment outcome. Results: Patients exhibited a significant increase in bilateral hippocampal HFD from baseline to follow-up scans. Right anterior hippocampal HFD increase was associated with reductions in depression severity. We found no group differences and group-by-time effects in FD-CM. After applying a whole-brain regression analysis, we found that baseline FD-CM in the left temporal pole predicted reduction of overall depression severity after ECT. Baseline hippocampal HFD did not predict treatment outcome. Conclusion: This study suggests that HFD and FD-CM are promising imaging markers to investigate ECT-induced neuroplasticity associated with treatment response.

Chempreneurs are revolutionary entrepreneurs who have been trained at a chemistry faculty. They are expected to find innovative solutions for current challenges to the chemical industry, such as sustainability. Innovative chemical entrepreneurship is the art of commercialising innovations from chemistry for a broad audience outside the classroom. Innovative ideas that are implemented with societal relevance offer the potential for individuals/graduates to generate income and promote the economy, thus offering students the opportunity to lay the foundation for a career with innovations developed in class. The probability of a German chemistry student founding a company is 54% lower than for the average German student. Previous studies show the potential effects of social capital, the subjective norm, motives and barriers for chemistry students in Germany. In this study, we tested these hypotheses by implementing entrepreneurship education. Two surveys, one before class and one with a one-week delay, were conducted with first- and third-semester chemistry bachelor students at the Fresenius University of Applied Sciences in Idstein, Germany. We conducted the surveys to understand how students view chemistry career opportunities through entrepreneurship and how to change this mindset. Finally, we propose a pedagogy to introduce/expand entrepreneurship in chemistry and discuss approaches for future research.

In large animals, fractures of the upper long tubular bones such as forearm and humerus as well as lower and upper leg, continue to represent a major surgical challenge. An implant and a corresponding surgical procedure for intramedullary osteosynthesis in fractures of long bones were developed at fzmb GmbH. Fixation of the implanted nail to the distal drill holes has proven to be difficult and requires a high level of X-ray monitoring. Therefore, a camera-marker system (CMS) was developed without the need for X-ray monitoring during drilling. The test was performed on 10 equine femora. The results showed that 8 of 10 implants could be securely fixed and no complications occurred in the experimental procedure. For the first two implants, the distal drill holes could not be hit in the first attempt. This is due to the circumstance, that the handling of the CMS needs to be practiced to hit the distal drill holes accurately and appropriately, resulting in a hit rate of 80 %. However, the described method has great potential and does not require X-ray exposure.

Background Disrupted sense of agency (SoA)—the sense of being the agent of one’s own actions—has been demonstrated in patients with functional neurological disorder (FND), and a key area of the corresponding neuronal network is the right temporoparietal junction (rTPJ). Several functional MRI (fMRI) studies have found hypoactivation as well as hyperactivation of the rTPJ in FND. In a proof-of-concept study, we tested whether repetitive transcranial magnetic stimulation (rTMS) over the rTPJ could restore this aberrant activity.Methods In a randomised, crossover, single-blinded, sham-controlled study design, theta-burst stimulation (tb-rTMS) was applied over the rTPJ in 23 patients with FND and 19 healthy controls (HC), with each participant undergoing three stimulatory visits (inhibitory continuous TBS (cTBS), excitatory intermittent TBS (iTBS) and sham). During fMRI, participants played a visuomotor task artificially reducing their SoA (manipulated agency, MA), repeated after each neurostimulation. We compared brain activity and behavioural SoA as primary outcomes before and after tb-rTMS and investigated the feasibility of tb-rTMS over the rTPJ in FND as secondary outcome.Results At baseline, patients showed decreased accuracy in detecting reduced agency compared with controls (p

OBJECTIVES/GOALS: Ambulatory methods are useful tools to study physical and mental health in everyday life. While many studies show daily activity improves mood, the effects of daily light exposure on mood remain unknown. This study evaluated the effects of daily natural light exposure and activity on daily mood and evaluate whether depression moderate effects. METHODS/STUDY POPULATION: 82 adults with lifetime major depression disorder (25 current) and 49 healthy controls were recruited from the greater Chicago community (N = 131, 62% female, age M = 30.15, SD = 9.94). At baseline, participants completed the Inventory of Depression and Anxiety Symptoms to measure depression symptoms of anhedonia, or loss of pleasure. Positive and negative affect were then measured 3x daily for 14-days via self-report using smartphones while light exposure and activity were continuously recorded from a wrist-worn actigraphy device. Following prior studies, daily natural light exposure was measured as the total number of white light samples greater than 1000 lux each day. Multilevel models were used to separate within-person (daily level) from between-person (subject level) effects. RESULTS/ANTICIPATED RESULTS: Results revealed daily within-person activity (p < .001) and natural light exposure duration (p = .035) were independently associated with increased positive affect. Effects were significantly moderated by baseline anhedonia symptoms (3-way interaction: p = .004). Natural light exposure duration only increased positive affect on lower activity days for high anhedonia and higher activity days for low anhedonia (ps < .018). Significant results remained controlling for between-person light and activity, time of year, age, sex, negative affect, and baseline general depression symptoms. Compared to one’s own daily averages, daily activity and natural light exposure may be independent pathways to boost positive affect, especially for individuals with high anhedonia symptoms. DISCUSSION/SIGNIFICANCE: Results suggest daily natural light exposure may be an accessible, low-cost alternative to independently increase positive affect in depression on days when activity is low. Translational applications are discussed focusing on transdiagnostic implications for physical and mental health conditions that disrupt mood and limit activity.

Abstract The aim of our study was to investigate whether self-reported feeling of loneliness (FoL) and COVID-19-specific health anxiety were associated with the presence of depressive symptoms during the first coronavirus disease 2019 (COVID-19) wave. Questionnaires of 603 persons of the Swiss Multiple Sclerosis Registry (SMSR) were cross-sectionally analyzed using descriptive and multivariable regression methods. The survey response rate was 63.9%. Depressive symptoms were assessed by the Beck Depression Inventory-Fast Screen (BDI-FS). COVID-19-specific health anxiety and FoL were measured using two 5-item Likert scaled pertinent questions. High scoring FoL (2.52, 95% confidence interval (CI) (2.06—2.98)) and/or COVID-19 specific health anxiety (1.36, 95% CI (0.87–1.85)) were significantly associated with depressive symptoms. Further stratification analysis showed that the impact of FoL on depressive symptoms affected all age groups. However, it was more pronounced in younger PwMS, whereas an impact of COVID-19 specific health anxiety on depressive symptoms was particularly observed in middle-aged PwMS. FoL and COVID-19-specific health anxiety were age-dependently associated with depressive symptoms during the first COVID-19 wave in Switzerland. Our findings could guide physicians, health authorities, and self-help groups to better accompany PwMS in times of public health crises.

Full-field electroretinography (full-field ERG) forms the diagnostic basis for numerous pathologies of the eye. For this reason, fast and accurate diagnostics in the field of ophthalmology are essential. Two examination techniques, full-field ERG and pupillometry were combined in a diagnostic device developed by ICM e.V. to reduce the examination process for both examiners and patients. In this paper, the device is examined for the quality of the full-field ERG measurements. A feasibility study with 12 healthy subjects (3 f, 9 m, 36.33 ± 11.94 years) was conducted to evaluate the device. The results showed that the peak times for both light- and dark-adapted measurements were within the range of the researched literature values. However, the amplitudes were markedly lower in both measurements compared to the averaged literature values (dark-adapted about 8.5-fold and light-adapted about 5.5-fold) and are clearly outside the range of values researched. The main reason for this is the use of cup electrodes, which were placed on the skin of the lower eyelid. Nevertheless, plausible and comparable analysis values could be obtained with the eye diagnostic device PEP-2000. Further studies with wire electrodes will be performed.

Pupillometry forms the diagnostic basis for numerous pathologies of the eye. For this reason, fast and accurate diagnostics in the field of ophthalmology are essential. Two examination techniques, full-field ERG and pupillometry were combined in a diagnostic device developed by ICM e.V. to reduce the examination process for both examiners and patients. In this paper, the device is examined for the quality of the pupillometry measurements. A study with 12 healthy subjects (3 f, 9 m, 36.33 ± 11.94 years) was conducted to evaluate the device. The results showed that the minimal pupil diameter is 40 % higher than the literature values. The main reason for the differences is the low light intensity of 15 cd/m2. However, the maximum pupil diameter is within the range of the researched values. The results of the pupillary reaction measurements show that the values obtained (amplitude, contraction time and peak time) are within the range of literature values. The latency time of 690 ms is 40 % too high. The reason for this could be the moderate pupil detection rate of 50-70 %. Nevertheless, plausible and comparable analysis values could be obtained with the eye diagnostic device PEP-2000. Further work will look at improving pupil detection rates.

This is the first description of a patient in which adipsic hypernatremia, a rare autoimmune encephalitis, presented in combination with complex psychiatric symptomatology, including psychosis and catatonia. Adipsic hypernatremia is characterized by autoantibodies against the thirst center of the brain. These autoantibodies cause inflammation and apoptosis in key regions of water homeostasis, leading to lack of thirst and highly increased serum sodium. To date, the symptoms of weakness, fatigue and drowsiness have been associated with adipsic hypernatremia, but no psychiatric symptomatology. Here, we showcase the first description of an adolescent patient, in which severe and complex psychiatric symptoms presented along with adipsic hypernatremia. The patient experienced delusion, hallucinations, restlessness and pronounced depression. Further, he showed ritualized, aggressive, disinhibited and sexualized behavior, as well as self-harm and psychomotor symptoms. Due to his severe condition, he was hospitalized on the emergency unit of the child and adolescent psychiatry for 8 months. Key symptoms of the presented clinical picture are: childhood-onset complex and treatment-resistant psychosis/catatonia, pronounced behavioral problems, fatigue, absent thirst perception, hypernatremia and elevated prolactin levels. This case report renders first evidence speaking for a causal link between the autoimmune adipsic hypernatremia and the psychotic disorder. Moreover, it sheds light on a new form of autoimmune psychosis.

IntroductionGesture performance deficits are prevalent in schizophrenia patients and are strongly associated with poor social communication skills and community functioning, affecting their overall quality of life. Currently, video-recording technology is widely used in clinical settings to assess gesture production deficits in schizophrenia patients. Nevertheless, the subjective evaluation of video-recordings can encumber task assessment. The present study will aim to use virtual reality to examine its potential use as an alternative tool to objectively measure gesture performance accuracy in schizophrenia patients and healthy controls.MethodsGesture performance in the virtual reality setting will be based on the well-established Test of Upper Limb Apraxia. Participants will be immersed in a virtual environment where they will experience themselves being embodied in a collocated virtual body seen from a first-person perspective. Motion trackers will be placed on participants' hands and elbows to track upper body movements in real-time, and to record gesture movement for later analysis. Participants will see a virtual agent sitting across from them, with a virtual table in between. The agent will perform various types of gestures and the participants' task will be to imitate those gestures as accurately as possible. Measurements from the tracking devices will be stored and analyzed to address gesture performance accuracy across groups.DiscussionThis study aims to provide objective measurements of gesture performance accuracy in schizophrenia patients. If successful, the results will provide new knowledge to the gesture literature and offer the potential for novel therapeutic interventions using virtual reality technologies. Such interventions can improve gesturing and thus advance social communication skills in schizophrenia patients.

ObjectivesApraxia is a common syndrome of left hemispheric stroke. A parieto-premotor-prefrontal network has been associated with apraxia, in which the left inferior parietal lobe (IPL-L) plays a major role. We hypothesized that transcranial continuous theta burst stimulation (cTBS) over the right inferior parietal lobe (IPL-R) improves gesturing by reducing its inhibition on the contralateral IPL in left hemispheric stroke patients. It was assumed that this effect is independent of lesion volume and that transcallosal connectivity is predictive for gestural effect after stimulation.Materials and methodsNineteen stroke patients were recruited. Lesion volume and fractional anisotropy of the corpus callosum were acquired with structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Each patient had pseudorandomised sessions with sham or with stimulation over the IPL-R or over the right inferior frontal gyrus IFG-R. Gesturing was assessed in a double-blinded manner before and after each session. We tested the effects of stimulation on gesture performance using a linear mixed-effects model.ResultsPairwise treatment contrasts showed, that, compared to sham, the behavioral effect was higher after stimulation over IPL-R (12.08, 95% CI 6.04 – 18.13, p < 0.001). This treatment effect was approximately twice as high as the contrasts for IFG-R vs. sham (6.25, 95% CI –0.20 – 12.70, p = 0.058) and IPL-R vs. IFG-R vs. sham (5.83, 95% CI –0.49 – 12.15, p = 0.071). Furthermore, higher fractional anisotropy in the splenium (connecting the left and right IPL) were associated with higher behavioral effect. Relative lesion volume did not affect the changes after sham or stimulation over IPL-R or IFG-R.ConclusionOne single session of cTBS over the IPL-R improved gesturing after left hemispheric stroke. Denser microstructure in the corpus callosum correlated with favorable gestural response. We therefore propose the indirect transcallosal modulation of the IPL-L as a promising model of restoring interhemispheric balance, which may be useful in rehabilitation of apraxia.

The brain and its health are essential for our (physical mental, social, and spiritual) wellbeing, for being able to realize our potential as individuals, and also for a fair, well-functioning, and productive society. However, today the world is facing a healthcare crisis related to the very high (and increasing) burden of brain disorders. As a response to this crisis, the “Swiss Brain Health Plan” (SBHP) was conceptualized in the context of other initiatives launched to value, promote, and protect brain health over the entire life course. In the first section of this position paper, the following fundamental considerations of the SBHP are discussed: (1) the high (and increasing) burden of brain disorders in terms of prevalence (>50% of the population suffers from a brain disorder), disability, mortality, and costs; (2) the prevention of brain disorders; (3) the operational definition of brain health; (4) determinants of brain health; (5) international initiatives to promote brain (including mental) health including the World Health Organization (WHO) intersectorial global action plan on epilepsy and other neurological disorders (NDs) (IGAP) and the WHO comprehensive mental health action plan. In the second section of the paper, the five strategic objectives of the SBHP, which has the vision of promoting brain health for all across the entire life course, are presented: (1) to raise awareness; (2) strengthen cross-disciplinary and interprofessional training/educational programs for healthcare professionals; (3) foster research on brain health determinants and individualized prevention of brain disorders; (4) prioritize a holistic (non-disease-specific), integrated, person-centered public health approach to promote brain health and prevent brain disorders through collaborations across scientific, health care, commercial, societal and governmental stakeholders and insurance providers; (5) support, empower, and engage patients, caregivers, and patient organizations, and reduce the stigma and discrimination related to brain disorders. In the third section of the paper, the first (2024) steps in the implementation of the SHBP, which will be officially launched in Zurich on 22 November 2023, are presented: (1) a definition of the overall organization, governance, specific targets, and action areas of the SBHP; (2) the patronage and/or co-organization of events on such specific topics as brain research (Lausanne), dementia (Geneva), stroke (Basel), neurohumanities (Bellinzona), sleep (Lugano), and psychiatry (Zurich); (3) the conduction of a new study on the global burden of brain disorders in Switzerland; (4) the launching of an international Certificate of Advanced Studies (CAS) on Brain Health at the University of Bern. In the fourth section of the paper, there is a concise executive summary of the SBHP.