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Gerber B.,Leibniz Institute For Neurobiologie Lin | Gerber B.,Center for Behavioral Brain science | Gerber B.,Otto Von Guericke University of Magdeburg | Yarali A.,Leibniz Institute For Neurobiologie Lin | And 5 more authors.
Learning and Memory | Year: 2014

Memories relating to a painful, negative event are adaptive and can be stored for a lifetime to support preemptive avoidance, escape, or attack behavior. However, under unfavorable circumstances such memories can become overwhelmingly powerful. They may trigger excessively negative psychological states and uncontrollable avoidance of locations, objects, or social interactions. It is therefore obvious that any process to counteract such effects will be of value. In this context, we stress from a basic-research perspective that painful, negative events are "Janus-faced" in the sense that there are actually two aspects about them that are worth remembering: What made them happen and what made them cease. We review published findings from fruit flies, rats, and man showing that both aspects, respectively related to the onset and the offset of the negative event, induce distinct and oppositely valenced memories: Stimuli experienced before an electric shock acquire negative valence as they signal upcoming punishment, whereas stimuli experienced after an electric shock acquire positive valence because of their association with the relieving cessation of pain. We discuss how memories for such punishment- and relief-learning are organized, how this organization fits into the threat-imminence model of defensive behavior, and what perspectives these considerations offer for applied psychology in the context of trauma, panic, and nonsuicidal self-injury. © 2014 Simpson et al.; Published by Cold Spring Harbor Laboratory Press.


Casarotto P.C.,University of Sao Paulo | Terzian A.L.B.,Max Planck Institute For Psychiatrie | Terzian A.L.B.,Ludwig Maximilians University of Munich | Aguiar D.C.,Federal University of Minas Gerais | And 4 more authors.
Neuropsychopharmacology | Year: 2012

The midbrain dorsal periaqueductal gray (dPAG) has an important role in orchestrating anxiety-and panic-related responses. Given the cellular and behavioral evidence suggesting opposite functions for cannabinoid type 1 receptor (CB 1) and transient receptor potential vanilloid type-1 channel (TRPV1), we hypothesized that they could differentially influence panic-like reactions induced by electrical stimulation of the dPAG. Drugs were injected locally and the expression of CB 1 and TRPV1 in this structure was assessed by immunofluorescence and confocal microscopy. The CB 1-selective agonist, ACEA (0.01, 0.05 and 0.5 pmol) increased the threshold for the induction of panic-like responses solely at the intermediary dose, an effect prevented by the CB 1-selective antagonist, AM251 (75 pmol). Panicolytic-like effects of ACEA at the higher dose were unmasked by pre-treatment with the TRPV1 antagonist capsazepine (0.1 nmol). Similarly to ACEA, capsazepine (1 and 10 nmol) raised the threshold for triggering panic-like reactions, an effect mimicked by another TRPV1 antagonist, SB366791 (1 nmol). Remarkably, the effects of both capsazepine and SB366791 were prevented by AM251 (75 pmol). These pharmacological data suggest that a common endogenous agonist may have opposite functions at a given synapse. Supporting this view, we observed that several neurons in the dPAG co-expressed CB 1 and TRPV1. Thus, the present work provides evidence that an endogenous substance, possibly anandamide, may exert both panicolytic and panicogenic effects via its actions at CB 1 receptors and TRPV1 channels, respectively. This tripartite set-point system might be exploited for the pharmacotherapy of panic attacks and anxiety-related disorders. © 2012 American College of Neuropsychopharmacology. All rights reserved.


Dresler M.,Max Planck Institute For Psychiatrie | Spoormaker V.I.,Max Planck Institute For Psychiatrie | Beitinger P.,Max Planck Institute For Psychiatrie | Czisch M.,Max Planck Institute For Psychiatrie | And 3 more authors.
Pharmacology and Therapeutics | Year: 2014

Until recently, neuroscience has given sleep research and discovery of better treatments of sleep disturbances little attention, despite the fact that disturbed sleep has overwhelming impact on human health. Sleep is a complex phenomenon in which specific psychological, electrophysiological, neurochemical, endocrinological, immunological and genetic factors are involved. The brain as both the generator and main object of sleep is obviously of particular interest, which makes a neuroscience-driven view the most promising approach to evaluate clinical implications and applications of sleep research. Polysomnography as the gold standard of sleep research, complemented by brain imaging, neuroendocrine testing, genomics and other laboratory measures can help to create composite biomarkers that allow maximizing the effects of individualized therapies while minimizing adverse effects. Here we review the current state of the neuroscience of sleep, sleep disorders and sleep therapeutics and will give some leads to promote the discovery and development of sleep medicines that are better than those we have today. © 2013 Elsevier Inc. All rights reserved.


V. Zerssen D.,Max Planck Institute For Psychiatrie
Fortschritte der Neurologie Psychiatrie | Year: 2011

The notion of imperial madness was coined in the historical literature and belles-lettres of the 19th century. Around that time up to the first quarter of the 20th century, it was adopted by a few German psychiatrists. Two of them viewed imperial madness as ordinary forms of insanity which became excessive only due to reactions of the social environment. Another one, however, classified it as one of mental borderland states in between insanity and normality, although he conceived the final stage of the disorder as a paranoid one. In agreement with the historians he postulated that imperial madness resulted from unlimited power of predisposed rulers. In recent times the whole concept of imperial madness was referred to the realm of legends by historians of antiquity and other historically interested authors. Yet the existence of the phenomenon cannot be denied. Despite its rarity it has played and is still playing an important role with often catastrophic consequences in various cultures all over the world. Therefore, psychiatrists and other physicians as well as clinical psychologists should be acquainted with it. From a modern point of view, it is not a paranoid disorder but rather a syndrome of addiction-like behavioural excesses representing an intensification of a Hybris syndrome as described by Anglo-Saxon psychiatrists. According to the present authors' view, it should be classified nosologically as a chronic adjustment disorder. In this case, the underlying stresses need to be extended to situations of temptation (here: the temptation to abuse almost unlimited power). © Georg Thieme Verlag KG Stuttgart · New York.


This study presents archival sources that shed light on a topic still being discussed by psychiatrists in East Germany: the death of two patients at the Leipzig Department that occurred in 1960 and 1962 under the directorship of Dietfried Müller-Hegemann. These fatalities were supposed to have been induced by obsolete psychotropic drugs and were associated with Ivan Pavlovs hypnotherapy. The incidents were investigated both by highest administrative bodies and the General State Prosecutor of the former GDR. Archival sources suggest that lower party organs and the ministerial administration tried to make use of the proceedings to bring about the downfall of the head of the Leipzig Department, who had become ideologically suspicious. However, the official General State Prosecutors investigation ascertained that both Müller-Hegemann and Christa Kohler, head of the psychotherapeutic ward, were not to be held responsible. Although the SED Central Committee at first tried to influence the outcome on the basis of ideological reservations made by the university party organisation, it finally accepted and confirmed the judgment of the General State Prosecutor. Hence, in this case, the highest party bodies followed arguments that were the result of an independent investigation and were not influenced by an individual bias or ideological motives. © Georg Thieme Verlag Stuttgart · New York.


Kagerbauer S.M.,TU Munich | Martin J.,TU Munich | Schuster T.,TU Munich | Blobner M.,TU Munich | And 2 more authors.
Journal of Neuroendocrinology | Year: 2013

The involvement of the neuropeptides oxytocin (OXT) and vasopressin (AVP) in human socio-emotional behaviours is attracting increasing attention. There is ample evidence for elevated plasma levels upon a wide variety of social and emotional stimuli and scenarios, ranging from romantic love via marital distress up to psychopathology, with cause versus consequence being largely unclear. The present study examined whether plasma levels of both OXT and AVP are reflective of central neuropeptide levels, as assumed to impact upon socio-emotional behaviours. Concomitant plasma and cerebrospinal fluid (CSF) samples were taken from 41 non-neurological and nonpsychiatric patients under basal conditions. Although OXT and AVP levels in the CSF exceeded those in plasma, there was no correlation between both compartments, clearly suggesting that plasma OXT and AVP do not predict central neuropeptide concentrations. Thus, the validity of plasma OXT and AVP as potential biomarkers of human behaviour needs further clarification. © 2013 British Society for Neuroendocrinology.


Ludwig II of Bavaria (Germany) entered the political stage at the age of 18, following the premature death of his father Maximilian II in 1864. At that time, Ludwig was a very handsome, slender young man; he was enthusiastic and had a pronounced taste for fine arts and music, and was admired by the people as a .,fairy tale king". However, already during the first years of his reign, he displayed traits that fulfilled the ICD-10 criteria for schizotypal disorder together with a combined cluster B personality disorder. They became even more pronounced over time. Towards the end of his life, Ludwig developed .,imperial madness", a typical pattern of behavioural excesses including craving for power, splendour, construction, unrestrained spending, excessive eating and sexual exploitation, revenge with a tendency for cruelty, and an inclination for theatrical and sometimes irrational acts. This complex syndrome is usually manifested in excessively egocentric rulers who have almost unlimited power or, in the case of Ludwig II, an overwhelming desire to possess it. His imperial madness was possibly contributed to by an orbitofrontal brain syndrome. One conjecture is that this condition reflected a neurodegenerative process; another is that a primary deficit, initiated by brain damage following a severe bout of meningitis during Ludwig's babyhood, played a role. In this case, functional compensation by other brain areas may have eventually been counteracted by chronic substance abuse in his thirties. The monarch's life ended tragically when he was 40 by which time he had become adipose and had lost most of his teeth; meanwhile, he was placed under tutelage, dismissed and detained. Before his death by drowning in Lake Starnberg (suicide? attempted escape), Ludwig apparently killed his psychiatrist, Bernhard von Gudden, who carelessly served as his sole attendant. Yet Ludwig's image as the beautiful fairy tale king is still alive in the hearts of successive generations of Bavarians and in the fascination demonstrated by the masses of tourists from throughout the world who visit (against his formerly declared wishes) his .,dream castles". © 2010 Springer-Verlag.


Holsboer F.,Max Planck Institute For Psychiatrie
Nervenarzt | Year: 2010

As in the past, future depression research will be oriented to the genetics and pharmacology of antidepressants as well as molecular and clinical biomarkers. Using new technologies patient populations with practically equal disease mechanisms will be identified which can be specifically treated with new drugs or a combination of presently available drugs. This signifies the integration of neuroscientific knowledge into the diagnostics of depression. The application of a personalized depression therapy supported by genetic testing and biomarkers raises the possibility of early recognition of the risk of disease and a targeted intervention before the symptoms of disease emerge. © 2010 Springer-Verlag.


We would like to provide an overview of the current scientific literature on acupuncture in the treatment of mental disorders and to discuss options of clinical application and scientific development in this field of clinical research. Introduction Acupuncture is increasingly used in the clinical treatment of mental disorders. Correspondingly, a considerable increase in scientific studies on acupuncture in this field is observed. Materials and methods This review is based on a literature search in PubMed on mental disorders and acupuncture focusing on studies, systematic reviews and meta-analyses published in 2010-2015. Results Meanwhile, scientific investigations into acupuncture have been conducted with respect to various mental disorders. Depending on the respective condition, the scope of data varies, with methods and methodological quality being rather heterogeneous. It should be emphasized that these studies consistently report the use of acupuncture to be very safe with minimal side effects. In particular, the additive use of acupuncture in the treatment of mental disorders complementing the established treatment procedures appears promising. Discussion Although several studies, systematic reviews, and meta-analyses indicate an effect of acupuncture in the treatment of various mental disorders, the heterogeneity of data allows no clear recommendation regarding the use of acupuncture so far. Certain results suggest that acupuncture may be a useful therapeutic element in a comprehensive multi-modal treatment approach. Outlook Based on the current data situation and clinical experience, further research into acupuncture in psychiatric disorders appears to be justified and is recommended. Basic research and methodologically sound clinical trials are needed to provide substantial gains in knowledge in this field. © 2016 Deutsche Ärztegesellschaft für Akupunktur (DÄGfA).


Steiger A.,Max Planck Institute For Psychiatrie
Tagliche Praxis | Year: 2016

Sleep is a time of high activity in endocrine systems. Accordingly there is a bidirectional interaction between the non-REM-REM cycle which is recorded electrophysiologically and the patterns of secretion of hormones. Certain hormones participate in sleep regulation. In this issue a reciprocal interaction of the neuropeptides growth hormone-releasing hormone and corticotropin-releasing hormone plays a key role. Changes of the objective sleep patterns occur in endocrine disorders. Here a review of the state-of-the art in sleep disturbances in endocrine disorders is given.

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