Fortschritte der Neurologie-Psychiatrie
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Fortschr Neurol Psychiatr · Feb 2002
Review[Fundamentals of functional magnetic resonance imaging in clinical psychology and psychiatry].
In the last few years, functional magnetic resonance imaging (fMRI) has become the preferred technique for brain mapping because of its superior spatial and temporal resolution. Other factors that have contributed to the popularity of this imaging method are the increasing availability of scanners and the technological advances made in data acquisition and analysis. ⋯ In particular, it focuses on blood oxygenation level dependent (BOLD) contrast, on the experimental procedures, as well as on possible imaging techniques and statistical analyses. Examples for studying brain-behavior-relationships come from research in the context of emotion in healthy subjects as well as in emotional dysfunctions in psychiatric patients.
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Fortschr Neurol Psychiatr · Feb 2002
Review[Syncope - a systematic overview of classification, pathogenesis, diagnosis and management].
Syncope is defined as a temporary interruption of cerebral perfusion with a sudden and transient loss of consciousness and spontaneous recovery. Approximately one third of the population experiences syncope at least once during a lifetime. Presyncopal signs and symptoms, including weakness, headache, blurred vision, diaphoresis, nausea, and vomiting are sometimes present for seconds or minutes prior to loss of consciousness. ⋯ The antidiuretic, V2-receptor specific, vasopressin analogue desmopressin increases the intravascular volume. Erythropoietin improves anemia and red blood cell decrease and augments blood pressure and cerebral oxygenation. In postprandial hypotension, octreotide, a somatostatin analogue, prostaglandin inhibitors such as indomethacin or ibuprofen, as well as metoclopramide or two cups of coffee per day might be beneficial.
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Fortschr Neurol Psychiatr · Feb 2002
Review[Mechanism-based treatment principles of neuropathic pain].
Traditionally, neuropathic pain has been classified due to aetiology of nerve damage-traumatic, inflammatory or metabolic, for instance. Based on this classification, pain therapy often is insufficient. Recent research revealed different mechanisms, which are responsible for the generation of pain after nerve lesion. ⋯ Each individual mechanism could be treated specifically by current available drugs, or by non-drug therapy. However, future research has to focus on exploring tools to recognise individual pain mechanisms in single patients. Thereby treatment will become more effective.
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Fortschr Neurol Psychiatr · Jan 2002
[Atypical symptoms in carpal tunnel syndrome - treatment and results].
Additionally to the typical carpal tunnel symptoms, the patients of this study had atypical complaints. Other reasons for these symptoms than those caused by the compression of the median nerve could be excluded using medical examination or imaging techniques. Purpose of this study was to investigate whether decompression of the median nerve may reduce or even abolish the atypical complaints. ⋯ This study shows that patients with carpal tunnel syndrome may also suffer from atypical complaints. These symptoms have been shown to be associated with the compression of the median nerve. They may be caused by spinal synaptic interaction between sensory and sympathetic/parasympathetic neuronal pathways by somatically-induced reflex responses.
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Fortschr Neurol Psychiatr · Oct 2001
[Frequency and causes of premature termination (drop-out) during in-patient opiate detoxification].
A typical problem concerning in-patient detoxification is the high drop-out rate. This phenomenon represents a significant problem for both the patient and the therapeutic team, as it is a factor which reduces motivation. While several studies confirm a positive shift of early drop-out behavior with the aid of methadone-supported detoxification, the overall drop-out rate still saw no improvement. ⋯ As expected, patients terminating their treatment against medical advice evaluated the therapeutic program more critically than the others. Interestingly drop outs rated their own mental and somatic condition very pessimistic. We concluded from these results two essentials being necessary to improve staying power of drug patients during clinical detoxification: systematic induction of (1) a positive self concept and (2) an optimistic view of chances to reach social adjustment and health.