Harald R. Bliem

Explicit (Semantic) Memory for Music in Patients with Mild Cognitive Impairment and Early-Stage Alzheimer's Disease

Background/Study Context: Explicit memory for music was investigated by using a new test with 24 existing and 3 newly composed pieces. Methods: Ten patients with mild cognitive impairment (MCI) and 10 patients with early stage of Alzheimers disease (AD) were compared with 23 healthy subjects, in terms of verbal memory of music by the identification of familiar music excerpts and the discrimination of distortion and original timbre of musical excerpts. Results: MCI and Alzheimers patients showed significantly poorer performances in tasks requiring verbal memory of musical excerpts than the healthy participants. For discrimination of musical excerpts, MCI and AD patients surprisingly performed significantly better than the healthy comparison subjects. Conclusion: Our results support the notion of a specialized memory system for music.

Cholinergic neurodegeneration in an Alzheimer mouse model overexpressing amyloid-precursor protein with the Swedish-Dutch-Iowa mutations

Alzheimers disease (AD) is a chronic neurodegenerative disorder that is mainly characterized by beta-amyloid (Aβ) plaque deposition, Tau pathology and dysfunction of the cholinergic system causing memory impairment. The aim of the present study was to examine (1) anxiety and cognition, (2) Aβ plaque deposition and (3) degeneration of cholinergic neurons in the nucleus basalis of Meynert (nbM) and cortical cholinergic innervation in an Alzheimer mouse model (APP_SweDI; overexpressing amyloid precursor protein (APP) with the Swedish K670N/M671L, Dutch E693Q, and Iowa D694N mutations). Our results show that 12-month-old APP_SweDI mice were more anxious and had more memory impairment. A large number of Aβ plaques were already visible at the age of 6 months and increased with age. A significant decrease in cholinergic neurons was seen in the transgenic mouse model in comparison to the wild-type mice, identified by immunohistochemistry against choline acetyltransferase (ChAT) and p75 neurotrophin receptor as well as by in situ hybridization. Moreover, a significant decrease in cortical cholinergic fiber density was found in the transgenic mice as compared to the wild-type. In the cerebral cortex of APP_SweDI mice, swollen cholinergic varicosities were seen in the vicinity of Aβ plaques. In conclusion, the present study shows that in an AD mouse model (APP_SweDI mice) a high Aβ plaque load in the cortex causes damage to cholinergic axons in the cortex, followed by subsequent retrograde-induced cell death of cholinergic neurons and some forms of compensatory processes. This degeneration was accompanied by enhanced anxiety and impaired cognition.

The Development of Acceptance of Chronic Tinnitus in the Course of a Cognitive-Behavioral Group Therapy.

OBJECTIVE Cognitive-behavioral treatment (CBT) is an effective treatment for tinnitus distress. Recently, acceptance-based approaches have received growing attention within the treatment of chronic tinnitus. The development of tinnitus acceptance within CB treatment remains unclear. This study investigates the efficacy of a CBT group therapy and the corresponding change in tinnitus acceptance. METHODS 68 outpatients took part in a CBT group therapy over a 3-month period. Effect sizes and paired t-tests were used to evaluate the effectiveness of the CBT treatment and to investigate the development of acceptance. RESULTS Results showed a significant decrease in tinnitus distress and an increase in tinnitus acceptance. Improvements were maintained over a 6-month follow-up period in which large effect sizes were observed. CONCLUSIONS CBT is considered an effective treatment for tinnitus distress in patients with chronic tinnitus. Acceptance of chronic tinnitus clearly improved within a CBT group therapy.

Acute effects of different light spectra on simulated night-shift work without circadian alignment

ABSTRACT Short-wavelength and short-wavelength-enhanced light have a strong impact on night-time working performance, subjective feelings of alertness and circadian physiology. In the present study, we investigated acute effects of white light sources with varied reduced portions of short wavelengths on cognitive and visual performance, mood and cardiac output.Thirty-one healthy subjects were investigated in a balanced cross-over design under three light spectra in a simulated night-shift paradigm without circadian adaptation.Exposure to the light spectrum with the largest attenuation of short wavelengths reduced heart rate and increased vagal cardiac parameters during the night compared to the other two light spectra without deleterious effects on sustained attention, working memory and subjective alertness. In addition, colour discrimination capability was significantly decreased under this light source.To our knowledge, the present study for the first time demonstrates that polychromatic white light with reduced short wavelengths, fulfilling current lighting standards for indoor illumination, may have a positive impact on cardiac physiology of night-shift workers without detrimental consequences for cognitive performance and alertness.

Elektronisches Routine-Outcome-Monitoring (eROM) in Psychiatrie und klinischer Psychologie

ZusammenfassungSelbstberichte von Patienten („patient-reported outcomes“, PROs) ermöglichen eine systematische Sammlung, Auswertung und Dokumentation von Patientenangaben. Sie rücken die Sichtweise der Patienten in den Mittelpunkt und ermöglichen so individualisierte Behandlungsentscheidungen.An der Station für Psychosomatische Medizin der Medizinischen Universität Innsbruck wurde in vier Schritten ein elektronisches Routine-Outcome-Monitoring (eROM) implementiert. Alle Patienten, die die Einschlusskriterien erfüllten, wurden ab Juni 2015 in das Programm eingeschlossen und bearbeiteten ein vorgegebenes Set von PRO-Instrumenten.Von Juni 2015 bis Mai 2018 wurden 300 Patienten im Rahmen ihres stationären Aufenthaltes in das eROM eingeschlossen. Die Erhebung wird am Beispielverlauf der ersten routinemäßig befragten Patientin beschrieben, der sich über drei stationäre Aufenthalte erstreckte.Das implementierte eROM ist eine praktikable Methode, um standardisiert PRO-Daten im Längsschnitt zu erheben und diese für die individuelle Behandlung zu nutzen. Des Weiteren können diese Daten auch auf Kollektivebene für wissenschaftliche Zwecke ausgewertet werden.AbstractPatient-reported outcomes (PROs) allow standardized assessment, analysis and documentation of the patient perspective, fostering patient-centred care and individual treatment decisions.At the University Hospital of Psychiatry II at the Medical University of Innsbruck, electronic routine outcome monitoring (eROM) was implemented in a four step process. Starting in June 2015, all patients meeting the inclusion criteria were asked to complete a specific set of PRO instruments.From June 2015 to May 2018, 300 patients completed eROM as part of their inpatient stay. The case example of the first patient participating in eROM, covering the time frame of three inpatient stays, illustrates the assessment procedure and the clinical relevance of PRO data.The implemented eROM offers a feasible possibility to collect PRO data covering patients’ subjective health status, providing important information for individual treatment adjustment. Furthermore, the assessed data can be used for research purposes, e. g. group level analysis.

Prävalenz und Charakteristika von Mobbingerfahrungen in einer klinischen Stichprobe von Jugendlichen

Prevalence and characteristics of peer victimisation in adolescent psychiatric inpatients Abstract. OBJECTIVE Repeated and long-lasting victimisation, as defined by bullying, represents a wide spread health hazard. The aim of the present study was to present the prevalence of bullying in adolescent psychiatric inpatients. We analysed relations between bullying and sociodemographic and psychopathological variables. Furthermore, we investigated the number and nature of bullies, feasible resources, and parental perception on bullying in adolescence. METHOD In total, 128 adolescent inpatients were surveyed with a bullying questionnaire and youth self-report. In addition, their clinical symptomatology was investigated. RESULTS Bullying affected one third of our sample. Male and female victims showed significantly more internal problems. Girls in addition revealed more external behaviour problems. Unlike non-suicidal, self-harming behaviour, suicidal ideation and suicidal behaviour occurred significantly more in patients with bullying experience. CONCLUSION A significant number of adolescent in our sample experienced bullying and associated psychological strains. This should especially be considered in child and adolescent anamnesis.

Auditory and cognitive development in a partially deaf child with bilateral electro-acoustic stimulation: a case study

Abstract Objective: To study the long-term evolution of speech and intelligence in a child with partial deafness and normal hearing in the low frequencies after sequentially receiving cochlear implants in both ears. Design: Retrospective chart review. Study sample: Male child aged 6 years was followed over a time period of four years. Results: The paediatric patient had normal hearing up to 1 kHz and profound hearing loss at all higher frequencies symmetrical in both ears. Deprivation of high-frequency sounds resulted in retarded development of speech, language and cognitive skills. The choice for rehabilitation was cochlear implantation with the aim of preserving a considerable amount of low-frequency hearing. With natural hearing at low frequencies and electrical stimulation at high frequencies, the child was able to compensate most of his developmental deficits. Moreover, spatial hearing was almost normal. Conclusions: Electro-natural stimulation without amplification of the low frequencies (electro-natural hearing) provides access to the whole audible frequency range for children, who suffer from partial deafness in the high frequencies and are normal hearing at low frequencies. Such provision allows for regular speech development and favours the development of spatial hearing. The case report also demonstrates a strong impact on intellectual performance.

Validation of the Internal Structure of a German-Language Version of the Gender Role Conflict Scale – Short Form

The Gender Role Conflict Scale – Short Form (GRCS-SF) assesses a person’s masculine gender role conflict. Masculine gender role conflict results when a person experiences discomfort showing a certain behavior because it is in conflict with masculine norms. The aim of the study was to test the questionnaire’s psychometric properties in an Austrian sample of older men. Three alternative structural models of the GRCS-SF were tested with confirmatory factor analyses (CFA). The maximum-likelihood method and the Bollen–Stine Bootstrap Method were used to estimate the fit indices of the CFA. Convergent validity was tested by correlating the GRCS-SF with the Sexual Performance Belief Scale (SPBS). Participating in the study were 127 male in-patients of a university hospital. Men’s average age was 59.5 (SD = 14.6) years. The one-factor model did not fit the empirical data well. In contrast, both the four-factor structure model and the bifactor structure model were supported. Good internal consistencies indicated acceptable reliabilities of the questionnaire’s scales. As expected, moderate to large correlations with the SPBS were detected. These findings support the claim that the GRCS-SF is a reliable and valid tool for assessing men’s gender role conflict also in a sample of older men in Austria.

Subjective Positive and Negative Sleep Variables Differentially Affect Cellular Immune Activity in a Breast Cancer Survivor: A Time-series Analysis Approach

This study on a breast cancer survivor suffering from cancer-related fatigue (CaRF) and depression investigated the bidirectional relationship between cellular immune activity and subjective sleep. The 49-year-old patient (breast cancer diagnosis 5 years before the study, currently in remission) collected her full urine output for 28 days in 12-h intervals (8:00 p.m. to 8:00 a.m. and 8:00 a.m. to 8:00 p.m.). These urine samples were used to determine urinary neopterin (cellular immune activation marker) and creatinine concentrations via high-pressure liquid chromatography (HPLC). Each morning, the patient answered questions on five sleep variables: sleep quality (SQ), sleep recreational value (SRV), total sleep time (TST), total wake time (TWT), and awakenings during sleep period (ADS). For the purpose of this study, the time series of the nighttime urinary neopterin levels and the five sleep variables were determined. Using centered moving average (CMA) smoothing and cross-correlational analysis, this study showed that increases in the positive sleep variables SQ and SRV were followed by urinary neopterin concentration decreases after 96–120 h (SQ, lag 4: r = −0.411; p = 0.044; SRV: lag 4: r = −0.472; p = 0.021) and 120–144 h (SRV, lag 5: r = −0.464; p = 0.026). Increases in the negative sleep variable TWT, by contrast, were followed by increases in urinary neopterin concentrations 72–96 h later (lag 3: r = 0.522; p = 0.009). No systematic effects in the other direction, i.e., from urinary neopterin levels to sleep, were observed in this study. Although preliminary, the findings of this study highlight the benefit of carefully investigating temporal delays and directions of effects when studying the dynamic relationship between sleep and immune variables in the natural context of everyday life.

Psychophysiological Effects of a Single, Short, and Moderately Bright Room Light Exposure on Mildly Depressed Geriatric Inpatients: A Pilot Study

Background: Light interventions typically exert their mood-related effects during morning bright light exposures over several weeks. Evidence about immediate ambient room light effects on depressed individuals is still sparse. Objective: The present study aimed at examining the acute effects of a single moderately bright room light exposure on mood, and behavioural and cardiac stress reactions of mildly depressed geriatric inpatients during a short cognitive stimulation and while resting. Methods: Twenty-one inpatients were tested in a balanced cross-over design on 2 consecutive days under either conventional room light (standard light) or artificial sunlight conditions for 30 min. Room illumination was implemented with an artificial skylight, which perfectly imitated solar indoor illumination (e.g., cloudless sky and bright artificial sun). Light-induced changes of mood, heart rate, and heart rate variability were recorded while performing a perseveration test (acted as cognitive stimulation) twice. Additionally, light-related behaviour was observed during a resting period between the cognitive tests and various subjective ratings were obtained. Results: Compared to standard light, exposure to artificial sunlight had a subjective calming effect over time (p = 0.029) as well as decreased heart rate and increased vagal tone (root mean squared of successive inter-beat intervals), both under cognitive workload and in resting conditions. Effect sizes of reported cardiac reactions were large. Cognitive variables were not influenced by light. Additionally, under the higher corneal illuminance of the artificial sunlight, patients perceived stronger glare (p = 0.030) and kept their eyes closed for longer times (p = 0.033) during the resting period. However, patients did not avoid bright light exposure while resting but voluntarily stayed within the area directly lit by the artificial sun nearly all the time (97%). Conclusion: To our knowledge, this study for the first time demonstrated immediate psychophysiological effects of a single, short room light exposure in mildly depressed geriatric inpatients during a short cognitive stimulation and while resting. The findings complement reported evidence on immediate alerting and mood-related effects of bright light exposures.