Cortical plasticity associated with stuttering therapy

Neuroimaging studies have indicated that persistent developmental stuttering (PDS) may be associated both with an abnormality in white matter of left-hemispheric speech areas and a right-hemispheric hyperactivity. The latter may compensate for the deficient structural connectivity in the left hemisphere. To investigate the effects of stuttering therapy on brain activity nine male adults with PDS underwent functional magnetic resonance imaging (fMRI) before and within 12 weeks after fluency shaping therapy. Brain response differences during overt sentence reading before and after therapy were assessed by utilizing random effects analyses. After therapy, a more widespread activation was observed in frontal speech and language regions and temporal areas of both hemispheres, particularly and more pronounced on the left side. Interestingly, distinct posttreatment left-sided activation increases were located directly adjacent to a recently detected area of white matter anomaly [M. Sommer, M.A. Koch, W. Paulus, C. Weiller, C. Buchel (2002). Disconnection of speech-relevant brain areas in persistent developmental stuttering. The Lancet, 360, 380-383] suggesting that fluency shaping techniques reorganize neuronal communication between left-sided speech motor planning, motor execution, and temporal areas. Hence, a therapeutic mechanism can be assumed to remodel brain circuitry close to the source of the dysfunction instead of reinforcing compensation via homologous contralateral brain networks. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (1) describe brain activation changes detected shortly after fluency-shaping therapy; (2) identify left-hemispheric regions where a (re)functionalization after fluency-shaping therapy seems to occur adjacent to a recently described abnormal white matter region in PDS subjects; and (3) discuss how an effective cerebral compensation mechanism for stuttering could work.     

Coordination in arm movements during crawl stroke in elite swimmers with a loco-motor disability

The purpose of this study was to investigate selected kinematics parameters of the arm stroke in crawl swimmers with disabilities and to examine the potential use of an index of arm coordination (IdC) to evaluate the stroking technique of swimmers with diverse functional abilities. The degree of overlap in the propulsive phases (superposition model) and lag time between the propulsive phases (catch-up model) was examined in 18 well-trained swimmers with loco-motor disabilities, 9 females and 9 males, from functional classes S3-S10 with S10 being most functional. Based on the results, correct coordination appears to be fundamental to swimming crawl stroke in both able-bodied swimmers as well as swimmers with a disability. Some swimmers with disabilities examined here exhibited extreme values at both ends of the index scale. This might be essential to maintaining balance while swimming when not all limb activity contributes to the forward movement.     

Cortico-subcortical contributions to executive control

The term "executive functions" refers to a range of cognitive processes, their common feature being the coordination of information processing and action control. Cortico-subcortical circuits which connect the prefrontal cortex (PFC), the basal ganglia and the cerebellum via the thalamus are believed to serve as neuroanatomical substrates of executive processing. This paper focuses on information processing related to executive functions by the PFC and related subcortical regions. Findings are mainly derived from neuropsychological investigations of brain-damaged patients but also from imaging studies in healthy subjects. There is evidence for subtle differences between these regions with respect to the cognitive mechanisms contributing to inhibition of habitual responses, task management/multitasking and set shifting, although the data base is sparse so far.     

Nosologic classification of Fazio-Londe disease

The observation of a progressive bulbar paralysis with lethal exit in a 20 years old patient, whose mother had died in the age of 29 years after a similar course of disease, is coordinated as Fazio: Londe-disease. But peculiarities are mentioned, that refer to traits of the special form of progressive bulbar paralysis described by Kennedy and of Kugelberg-Welander-disease. A genetic basis of variability is supposed.     

Psychological Distress,Anxiety, and Depression of Cancer-Affected BRCA1/2 Mutation Carriers: a Systematic Review

Understanding the intermediate- and long-term psychological consequences of genetic testing for cancer patients has led to encouraging research, but a clear consensus of the psychosocial impact and clinical routine for cancer-affected BRCA1 and BRCA2 mutation carriers is still missing. We performed a systematic review of intermediate- and long-term studies investigating the psychological impact like psychological distress, anxiety, and depression in cancer-affected BRCA mutation carriers compared to unaffected mutation carriers. This review included the screening of 1243 studies. Eight intermediate- and long-term studies focusing on distress, anxiety, and depression symptoms among cancer-affected mutation carriers at least six months after the disclosure of genetic testing results were included. Studies reported a great variety of designs, methods, and patient outcomes. We found evidence indicating that cancer-affected mutation carriers experienced a negative effect in relation to psychological well-being in terms of an increase in symptoms of distress, anxiety, and depression in the first months after test disclosure. In the intermediate- and long-term, no significant clinical relevant symptoms occurred. However, none of the included studies used specific measurements, which can clearly identify psychological burdens of cancer-affected mutation carriers. We concluded that current well-implemented distress screening instruments are not sufficient for precisely identifying the psychological burden of genetic testing. Therefore, future studies should implement coping strategies, specific personality structures, the impact of genetic testing, supportive care needs and disease management behaviour to clearly screen for the possible intermediate- and long-term psychological impact of a positive test disclosure.     

Wie können wir in das psychodynamische Erstinterview einführen?

We reflect on which traditional texts are suitable for the introduction into psychodynamic thinking for bachelor students in the faculty of psychology. We come to the conclusion that the use of works known and individually valued by the students from the world and/or trivial literature are suitable to allow students to carry out fictive preliminary conversations with their heroes from novels or films.     

Initial experiences in the detection of psychodynamic conflicts

A few extracts from an "anamnesis sheet for neurotics" are presented that has been in use at the psychotherapy department of the neurological clinic of the Charité since 1981. The author reports on the experience that has been gained in the use of this sheet.