Ekkehardt Kumbier

Effects of intranasal oxytocin on the neural basis of face processing in autism spectrum disorder

BACKGROUND Autism spectrum disorder (ASD) is associated with altered face processing and decreased activity in brain regions involved in face processing. The neuropeptide oxytocin has been shown to promote face processing and modulate brain activity in healthy adults. The present study examined the effects of oxytocin on the neural basis of face processing in adults with Asperger syndrome (AS). METHODS A group of 14 individuals with AS and a group of 14 neurotypical control participants performed a face-matching and a house-matching task during functional magnetic resonance imaging. The effects of a single dose of 24 IU intranasally administered oxytocin were tested in a randomized, placebo-controlled, within-subject, cross-over design. RESULTS Under placebo, the AS group showed decreased activity in the right amygdala, fusiform gyrus, and inferior occipital gyrus compared with the control group during face processing. After oxytocin treatment, right amygdala activity to facial stimuli increased in the AS group. CONCLUSIONS These findings indicate that oxytocin increases the saliency of social stimuli and in ASD and suggest that oxytocin might promote face processing and eye contact in individuals with ASD as prerequisites for neurotypical social interaction.

Oxytocin Promotes Facial Emotion Recognition and Amygdala Reactivity in Adults with Asperger Syndrome

The neuropeptide oxytocin has recently been shown to enhance eye gaze and emotion recognition in healthy men. Here, we report a randomized double-blind, placebo-controlled trial that examined the neural and behavioral effects of a single dose of intranasal oxytocin on emotion recognition in individuals with Asperger syndrome (AS), a clinical condition characterized by impaired eye gaze and facial emotion recognition. Using functional magnetic resonance imaging, we examined whether oxytocin would enhance emotion recognition from facial sections of the eye vs the mouth region and modulate regional activity in brain areas associated with face perception in both adults with AS, and a neurotypical control group. Intranasal administration of the neuropeptide oxytocin improved performance in a facial emotion recognition task in individuals with AS. This was linked to increased left amygdala reactivity in response to facial stimuli and increased activity in the neural network involved in social cognition. Our data suggest that the amygdala, together with functionally associated cortical areas mediate the positive effect of oxytocin on social cognitive functioning in AS.

Autismus und soziale Kognition

ZusammenfassungStörungen des autistischen Spektrums (frühkindlicher Autismus, Asperger-Syndrom und High-functioning-Autismus) gehören zu den tiefgreifenden Entwicklungsstörungen und weisen ein gemeinsames Muster von erheblichen Beeinträchtigungen der sozialen Interaktion auf. Dazu gehören Einschränkungen der Gesichter- und Emotionswahrnehmung und der sozialen Attribution („theory of mind“), allgemein gesprochen der „sozialen Kognition“. Einige Studien zeigen, dass sich diese Einschränkungen bereits in der frühen Kindheit zeigen, wobei als Ursache eine frühe Schädigung der neuronalen Entwicklung vermutet wird. Damit übereinstimmend konnten sowohl strukturelle als auch funktionelle Veränderungen des Gehirns bei Kindern, Jugendlichen und Erwachsenen mit Autismus nachgewiesen werden.Die vorliegende Arbeit gibt einen systematischen Überblick über die existierenden funktionellen Bildgebungsstudien mit experimentellen Paradigmen der sozialen Kognition bzw. Gesichterdiskriminierung, Emotionserkennung und sozialen Attribution („theory of mind“) bei Störungen des autistischen Spektrums.SummaryAutism spectrum disorders (autism, Asperger’s syndrome, high-functioning autism) are characterized by a common pattern of marked impairments in social interactions. Deficits have been described in face processing, facial emotion recognition, and social attribution (“theory of mind”) or generally speaking in social cognition. Some studies have shown that these impairments are already detectable in early childhood, leading to the assumption that the underlying cause is an early disruption of neuronal development. Accordingly, neuroimaging data have revealed alterations of structure and function in the brains of autistic children, adolescents, and adults. The present review gives a systematic overview of the existing literature on functional imaging studies using experimental paradigms of social cognition, i.e. face discrimination, facial emotion recognition, and theory of mind in autistic disorders.

Social cognition in autism. A survey of functional imaging studies

ZusammenfassungStörungen des autistischen Spektrums (frühkindlicher Autismus, Asperger-Syndrom und High-functioning-Autismus) gehören zu den tiefgreifenden Entwicklungsstörungen und weisen ein gemeinsames Muster von erheblichen Beeinträchtigungen der sozialen Interaktion auf. Dazu gehören Einschränkungen der Gesichter- und Emotionswahrnehmung und der sozialen Attribution („theory of mind“), allgemein gesprochen der „sozialen Kognition“. Einige Studien zeigen, dass sich diese Einschränkungen bereits in der frühen Kindheit zeigen, wobei als Ursache eine frühe Schädigung der neuronalen Entwicklung vermutet wird. Damit übereinstimmend konnten sowohl strukturelle als auch funktionelle Veränderungen des Gehirns bei Kindern, Jugendlichen und Erwachsenen mit Autismus nachgewiesen werden.Die vorliegende Arbeit gibt einen systematischen Überblick über die existierenden funktionellen Bildgebungsstudien mit experimentellen Paradigmen der sozialen Kognition bzw. Gesichterdiskriminierung, Emotionserkennung und sozialen Attribution („theory of mind“) bei Störungen des autistischen Spektrums.SummaryAutism spectrum disorders (autism, Asperger’s syndrome, high-functioning autism) are characterized by a common pattern of marked impairments in social interactions. Deficits have been described in face processing, facial emotion recognition, and social attribution (“theory of mind”) or generally speaking in social cognition. Some studies have shown that these impairments are already detectable in early childhood, leading to the assumption that the underlying cause is an early disruption of neuronal development. Accordingly, neuroimaging data have revealed alterations of structure and function in the brains of autistic children, adolescents, and adults. The present review gives a systematic overview of the existing literature on functional imaging studies using experimental paradigms of social cognition, i.e. face discrimination, facial emotion recognition, and theory of mind in autistic disorders.

50 Jahre Rodewischer Thesen – Zu den Anfängen sozialpsychiatrischer Reformen in der DDR

The so-called Rodewisch Theses of 1963 demonstrate East German psychiatrys attempts to implement social-psychiatric reforms. To mark their 50th anniversary, this article analyses their emergence, drafting and implementation. It has been known that key requirements could only be fulfilled on a regional basis, the Leipzig University Department of Psychiatry being an outstanding example, although its staff worked rather autonomously of the Rodewisch Theses. The reasons for the different degree of success of these developments in individual areas are manifold, key reasons being the lack of stark political support and of opportunity to discuss shortcomings in mental health care, as in Western Germany, due to political circumstances in particular. There was no strong social basis and support as in Western democracies.

Helmut Rennert's universal genesis of endogenous psychoses: the historical concept and its significance for today's discussion on unitary psychosis.

Next to Karl Leonhard (1904–1988), Helmut Rennert (1920–1994) was the internationally best known representative of psychiatry from the former German Democratic Republic (GDR). He rose to prominence above all through his model of the universal genesis of endogenous psychoses, which constituted an antithesis to Leonhard’s differentiated division. The ‘polar opposite’ aspects of Rennert and Leonhard are represented with an emphasis on their contrasting views of psychiatric nosology. In this respect, Rennert’s model conceptions constitute the primary focus of attention. The fact that both concepts continue to possess topical perspectives to this day is reflected in the current discussion regarding nosological, categorical, syndromatological and dimensional approaches in relation to the further development of the classification systems of mental disorders. The preparatory work on the future classification systems will potentially omit the dichotomy between schizophrenic and affective disorders. These endeavors are in accordance with Rennert’s unitarian psychopathological view and support his acceptance of the psychopathological continuity from affective to schizophrenic syndromes. The current discussion concerning the future classification is in line with Rennert, whose aim was to provide an unconventional model that unites findings from the different fields of psychiatric research. The classification of mental disorders without a previous establishment on the basis of fundamental theoretical assumptions could certainly foster a dynamic development in the future. A differentiated knowledge of the history of the ideas of unitary psychosis and their further development might be helpful in this development and can be of particular use when critically questioning explanatory approaches that are prone to simplification.

Autismus und autistische Störungen

ZusammenfassungDer Begriff Autismus hat sich seit seiner Entstehung stetig gewandelt. Im historischen Rückblick zeigt sich, dass er zunächst sowohl in der Erwachsenen- als auch der Kinderpsychiatrie als schizophrenes Symptom aufgefasst wurde. Im Laufe der Zeit vollzog sich ein Wandel, sodass Autismus als Störungsbild innerhalb der Kinderpsychiatrie eine eigenständige Entwicklung nahm. Dank Leo Kanner und Hans Asperger erhielt es seine heutige Bedeutung. Aktuell wird Autismus im Zusammenhang mit den autistischen Störungen zu den tiefgreifenden Entwicklungsstörungen gezählt und findet aufgrund der hohen Stabilität im Verlauf auch wieder verstärkt in der Erwachsenenpsychiatrie Beachtung. Zum besseren Verständnis dieser Entwicklung wird der Weg von der Entstehung einschließlich der Rezeption durch Kanner und Asperger nachgezeichnet. Auf der Suche nach zentralen Merkmalen finden sich beim Autismus Einschränkungen in der sozialen Kommunikation und Interaktion, die durch zugrunde liegende Defizite der sozialen Kognition erklärt werden. Diese Einschränkungen in der sozialen Kognition können als das zentrale Charakteristikum von Autismus verstanden werden, das sich seit Beginn der Beschreibung dieses Phänomens als Konstante findet. So wird auch der Frage nachgegangen, welchen Beitrag die experimentelle psychopathologische Forschung für ein vertieftes Verständnis des Krankheitsbildes leisten kann.AbstractSince its first use in medical literature the meaning of the term autism has constantly changed. An historical overview indicates that in both adult and child psychiatry autism was first used to refer to a symptom of schizophrenia. Later on the use of the term in child psychiatry took a different independent course, which led to present-day conceptualization of autism, mainly due to the work of Leo Kanner and Hans Asperger. Currently autism and autistic disorders are regarded as severe developmental disorders and, due to their stable nature, have gained considerable attention in adult psychiatry. In order to better understand this development, the path from onset to reception is traced via Kanner and Asperger. In the search for central characteristics of autism, one finds restrictions in social communication and interaction, which can be explained by fundamental deficits in social cognition. These restrictions in social cognition can be considered the central characteristic of autism – one which has been a constant since the phenomenon was first described. Our historical review considers to what extent experimental psychopathological research can deepen our understanding of the disorder.Since its first use in medical literature the meaning of the term autism has constantly changed. An historical overview indicates that in both adult and child psychiatry autism was first used to refer to a symptom of schizophrenia. Later on the use of the term in child psychiatry took a different independent course, which led to present-day conceptualization of autism, mainly due to the work of Leo Kanner and Hans Asperger. Currently autism and autistic disorders are regarded as severe developmental disorders and, due to their stable nature, have gained considerable attention in adult psychiatry. In order to better understand this development, the path from onset to reception is traced via Kanner and Asperger. In the search for central characteristics of autism, one finds restrictions in social communication and interaction, which can be explained by fundamental deficits in social cognition. These restrictions in social cognition can be considered the central characteristic of autism - one which has been a constant since the phenomenon was first described. Our historical review considers to what extent experimental psychopathological research can deepen our understanding of the disorder.

überlegungen zum Wirken des Neuropsychiaters Gabriel Anton (1858-1933)

Gabriel Anton (1858-1933) attained fundamental clinical neuropathological results. His scientific career and research were highly influenced by Theodor Meynert. However, in contrast to Meynert, Anton sought not only descriptions of pathological changes but also their therapy. The surgical treatment of hydrocephalus was one of his most important achievements. With this, he gave important impetus to the still new science of neurosurgery. Nowadays, Anton is still known in medical nomenclature by Antons syndrome. The detailed description and explanation of visual anosognosia and asomatoagnosia and furthermore his emphasis on their importance can be regarded as Antons most notable contribution to science. However, his research on basal ganglia disorders is not as well-known, although Antons thoughts mark the beginning of further systematic research on these disorders. In addition, he did preliminary work in the development of child and adolescent psychiatry. Today, some of his work in the field of eugenics is controversial.ZusammenfassungGabriel Anton (1858–1933) leistete grundlegende klinisch-neuropathologische Arbeiten. Sein wissenschaftlicher Werdegang und seine Forschungstätigkeit wurden durch Theodor Meynert maßgeblich bestimmt. Im Gegensatz zu Meynert suchte Anton aber neben der Beschreibung pathologischer Veränderungen auch nach therapeutischen Möglichkeiten. Eine seiner bedeutendsten Leistungen war die Anregung zur operativen Behandlung des Hydrozephalus (Anton-von-Bramann-Balkenstich). Damit gab er der noch jungen Wissenschaft der Neurochirurgie wichtige Impulse. Bekannt ist Anton heute noch durch den Eingang seines Namens in die medizinische Nomenklatur (Anton-Syndrom). Sein Verdienst ist es, eine ausführliche Darstellung bzw. einen Erklärungsversuch der visuellen Anosognosie und Hemiasomatognosie gegeben und auf die Bedeutung dieses Phänomens hingewiesen zu haben. Antons Beitrag zur Erforschung der Basalganglienerkrankungen hingegen ist heute nur wenig bekannt. Diesbezüglich bildeten Antons Überlegungen einen wichtigen Ausgangspunkt für die weitere, systematische Erforschung der Basalganglienerkrankungen. Darüber hinaus leistete er Vorarbeiten für die Entwicklung der Kinder- und Jugendpsychiatrie. Teile seines Werkes, die sich mit der Eugenik beschäftigten, sind heute umstritten.SummaryGabriel Anton (1858–1933) attained fundamental clinical neuropathological results. His scientific career and research were highly influenced by Theodor Meynert. However, in contrast to Meynert, Anton sought not only descriptions of pathological changes but also their therapy. The surgical treatment of hydrocephalus was one of his most important achievements. With this, he gave important impetus to the still new science of neurosurgery. Nowadays, Anton is still known in medical nomenclature by Anton’s syndrome. The detailed description and explanation of visual anosognosia and asomatoagnosia and furthermore his emphasis on their importance can be regarded as Anton’s most notable contribution to science. However, his research on basal ganglia disorders is not as well-known, although Anton’s thoughts mark the beginning of further systematic research on these disorders. In addition, he did preliminary work in the development of child and adolescent psychiatry. Today, some of his work in the field of eugenics is controversial.

The Development of Sayk's Cell Sedimentation Chamber: A Historical View on Clinical Cerebrospinal Fluid Diagnostics

Objective: The history of Sayks cell sedimentation chamber is examined and reviewed in the context of clinically utilizable cerebrospinal fluid (CSF) cytology. Methods: A review of the literature was undertaken in PubMed and Google Scholar to search for primary and secondary sources on the history of CSF diagnosis. Moreover, documents in the archives of the Universities of Rostock and Jena, the Brain Research Institute of Cécile and Oskar Vogt in Düsseldorf and the Centre for Neurology at Rostock University were used. Results: The cell sedimentation chamber, developed by Johannes Sayk (1923-2005) at the beginning of the 1950s, enabled, for the first time, CSF cells to be presented with a quality comparable to the blood profile, with a low technological expenditure and using all staining methods suitable for haematological cells. The procedure could be performed quickly and cost efficiently, and therefore, it was easy to integrate it into clinical routine and it quickly became a widely used procedure. In Europe, it was considered the standard method for cytodiagnosis of CSF until the 1990s. Conclusions: The procedure revolutionised CSF diagnostics and paved the way for modern qualitative CSF cytology. In course of time, the cell sedimentation chamber was superseded by the cytocentrifuge.

Autismus und autistische Störungen: Historische Entwicklung und aktuelle Aspekte

ZusammenfassungDer Begriff Autismus hat sich seit seiner Entstehung stetig gewandelt. Im historischen Rückblick zeigt sich, dass er zunächst sowohl in der Erwachsenen- als auch der Kinderpsychiatrie als schizophrenes Symptom aufgefasst wurde. Im Laufe der Zeit vollzog sich ein Wandel, sodass Autismus als Störungsbild innerhalb der Kinderpsychiatrie eine eigenständige Entwicklung nahm. Dank Leo Kanner und Hans Asperger erhielt es seine heutige Bedeutung. Aktuell wird Autismus im Zusammenhang mit den autistischen Störungen zu den tiefgreifenden Entwicklungsstörungen gezählt und findet aufgrund der hohen Stabilität im Verlauf auch wieder verstärkt in der Erwachsenenpsychiatrie Beachtung. Zum besseren Verständnis dieser Entwicklung wird der Weg von der Entstehung einschließlich der Rezeption durch Kanner und Asperger nachgezeichnet. Auf der Suche nach zentralen Merkmalen finden sich beim Autismus Einschränkungen in der sozialen Kommunikation und Interaktion, die durch zugrunde liegende Defizite der sozialen Kognition erklärt werden. Diese Einschränkungen in der sozialen Kognition können als das zentrale Charakteristikum von Autismus verstanden werden, das sich seit Beginn der Beschreibung dieses Phänomens als Konstante findet. So wird auch der Frage nachgegangen, welchen Beitrag die experimentelle psychopathologische Forschung für ein vertieftes Verständnis des Krankheitsbildes leisten kann.AbstractSince its first use in medical literature the meaning of the term autism has constantly changed. An historical overview indicates that in both adult and child psychiatry autism was first used to refer to a symptom of schizophrenia. Later on the use of the term in child psychiatry took a different independent course, which led to present-day conceptualization of autism, mainly due to the work of Leo Kanner and Hans Asperger. Currently autism and autistic disorders are regarded as severe developmental disorders and, due to their stable nature, have gained considerable attention in adult psychiatry. In order to better understand this development, the path from onset to reception is traced via Kanner and Asperger. In the search for central characteristics of autism, one finds restrictions in social communication and interaction, which can be explained by fundamental deficits in social cognition. These restrictions in social cognition can be considered the central characteristic of autism – one which has been a constant since the phenomenon was first described. Our historical review considers to what extent experimental psychopathological research can deepen our understanding of the disorder.Since its first use in medical literature the meaning of the term autism has constantly changed. An historical overview indicates that in both adult and child psychiatry autism was first used to refer to a symptom of schizophrenia. Later on the use of the term in child psychiatry took a different independent course, which led to present-day conceptualization of autism, mainly due to the work of Leo Kanner and Hans Asperger. Currently autism and autistic disorders are regarded as severe developmental disorders and, due to their stable nature, have gained considerable attention in adult psychiatry. In order to better understand this development, the path from onset to reception is traced via Kanner and Asperger. In the search for central characteristics of autism, one finds restrictions in social communication and interaction, which can be explained by fundamental deficits in social cognition. These restrictions in social cognition can be considered the central characteristic of autism - one which has been a constant since the phenomenon was first described. Our historical review considers to what extent experimental psychopathological research can deepen our understanding of the disorder.