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Der Beitrag von Stephan Wolff rekonstruiert Entscheidungsprozesse bei der Auswahl von Urlaubskartenmotiven. Er geht von der These aus, dass sowohl das Lesen als auch das Schreiben von Urlaubskarten (unter Berücksichtigung des jeweiligen Textes, Bildes und Briefmarkenmotivs) darin besteht, Lesbarkeitshinweise zu platzieren oder zu realisieren. Die implizite Kategorisierung von Personen, Tätigkeiten, Eigenschaften und Sachverhalten wird als zentrale Praxis zur Herstellung sozialer Lesbarkeit vorgestellt und an empirischen Beispielen verdeutlicht. Die Studie bedient sich der ethnomethodologischen Teildisziplin der Teilnehmerkategorisierungsanalyse.

Hypersexuality in medicated patients with PD is caused by an increased influence of motivational drive areas and a decreased influence of inhibitory control areas due to dopaminergic medication. In this pilot study, we test a newly developed paradigm investigating the influence of dopaminergic medication on brain activation elicited by sexual pictures with and without inhibitory contextual framing. Twenty PD patients with and without hypersexuality were examined with fMRI either OFF or ON standardized dopaminergic medication. The paradigm consisted of a priming phase where either a neutral context or an inhibitory context was presented. This priming phase was either followed by a sexual or a neutral target. Sexual, compared to neutral pictures resulted in a BOLD activation of various brain regions implicated in sexual processing. Hypersexual PD patients showed increased activity compared to PD controls in these regions. There was no relevant effect of medication between the two groups. The inhibitory context elicited less activation in inhibition-related areas in hypersexual PD, but had no influence on the perception of sexual cues. The paradigm partially worked: reactivity of motivational brain areas to sexual cues was increased in hypersexual PD and inhibitory contextual framing lead to decreased activation of inhibitory control areas in PD. We could not find a medication effect and the length of the inhibitory stimulus was not optimal to suppress reactivity to sexual cues. Our data provide new insights into the mechanisms of hypersexuality and warrant a replication with a greater cohort and an optimized stimulus length in the future.

Understanding the neural correlates of risk-sensitive skin conductance responses can provide insights into their connection to emotional and cognitive processes. To provide insights into this connection, we studied the cortical correlates of risk-sensitive skin conductance peaks using electroencephalography. Fluctuations in skin conductance responses were elicited while participants played a threat-of-shock card game. Precise temporal information about skin conductance peaks was obtained by applying continuous decomposition analysis on raw electrodermal signals. Shortly preceding skin conductance peaks, we observed a decrease in oscillatory power in the frequency range between 3 and 17 Hz in occipitotemporal cortical areas. Atlas-based analysis indicated the left lingual gyrus as the source of the power decrease. The oscillatory power averaged across 3-17 Hz showed a significant negative relationship with the skin conductance peak amplitude. Our findings indicate a possible interaction between attention and threat perception.

ZusammenfassungAus einer ethnomethodologischen Perspektive werden einige grundlegende Aspekte der Urteilsbildung in sozialen Diensten vorgestellt, sowie Medien, Orte und Technologien angesprochen, die damals wie heute, zum Teil freilich mit anderen Akzenten, die Urteilsbildung in der Sozialen Arbeit prägen.

Introduction: The structural and functional changes in atrial myocardium create a substrate for atrial fibrillation. The pathophysiology include enlargement of the cavities and replacing the cardiomyocytes with connective tissue. That slows down the conduction velocity and creates focal conduction block zones and slow conduction areas promoting the re-entrant circuits. The described changes influence the duration and amplitude of the P wave in the ECG. Materials and methods: The study group consisted of 54 patients diagnosed with atrial fibrillation. There were 19 women and 35 men, aged 65.8+/-10.0 years. 22 patients had paroxysmal AF, in sinus rhythm during the examination and 32 had persistent AF, in whom the direct current cardioversion was performed in order to achieve sinus rhythm. In patients with persistent atrial fibrillation the P wave duration after the restoration the sinus rhythm was significantly longer in comparison to patients with paroxysmal atrial fibrillation (159.2+/-14.3 vs 171.2+/-16.6 ms, p=0.006). Results: The patients with persistent AF showed higher positive amplitude in lead V1 as well as higher negative amplitude than patients with paroxysmal AF: positive amplitude (0.053+/-0.023 vs 0.084+/-0.040 mV, p=0.002), negative amplitude (0.045+/-0.018vs 0.075+/-0.037 mV, p=0.001). Discusion: In conclusions: In patients with incomplete Bachmann’s bundle block and atrial fibrillation the duration of the P wave is prolonged, more in the persistent arrhythmia group. The P wave duration and morphology correlate with the interatrial conduction disturbances. The P wave morphology changes indicate the causal relationship of AF rather with interatrial conduction delay than with left atrial hypertrophy.

BACKGROUND Functional and structural changes in the atrial muscle constitute a substrate for atrial fibrillation (AF). The pathological changes in the left atrium decrease the conduction velocity and result in prolongation of the P wave duration. OBJECTIVES To assess the duration of the P wave in patients with AF in different clinical presentations of arrhythmia. MATERIAL AND METHODS The study group consisted of 119 patients diagnosed with AF: 57 women and 62 men, aged 65.3 ±9.4 years. There were 65 patients with paroxysmal AF and 54 with persistent AF. In this group, electrical cardioversion was performed. The P wave duration was measured using an electrophysiological system in all leads at a paper speed of 200 mm/s. RESULTS The patients did not differ in terms of age, gender or comorbidities. The patients with persistent AF had longer P wave duration (159.9 ±22.3 ms compared to 144.6 ±17.2 ms; p < 0.001) and higher glucose concentration (119.4 ±33.4 mg/dL compared to 108.0 ±24.6 mg/dL; p = 0.015). These results were not influenced by the anti-arrhythmic treatment. CONCLUSIONS Persistent AF shows a longer P wave duration than the paroxysmal AF, independent of age, gender and anti-arrhythmic medication. The prolongation of the P wave related to persistent arrhythmia should force physicians to restore the sinus rhythm earlier in order to more successfully maintain it in the long term.

Background: Essential tremor (ET) occurs with steeply increasing prevalence in the elderly, and apart from disease duration, age is independently associated with an increase of tremor amplitude and a decrease of frequency. White matter hyperintensities (WMHs) are a common finding in the elderly, and their role in the pathophysiology of ET is unknown. The aims of this study were to examine whether ET patients differ in their total or region-specific WMH volumes from healthy controls and to determine the impact of WMH on tremor characteristics.Methods: A total of 47 elderly ET patients with a mean age of 72 years and 39 age-matched healthy controls underwent a thorough clinical assessment and 3T MRI. Total WMH volumes were derived from T2-weighted fluid-attenuated inversion recovery (FLAIR) MR images. Additionally, region of interest-based WMH volumes for the Johns Hopkins University (JHU) white matter tracts and labels were calculated, and WMHs were assessed semiquantitatively using the Fazekas scale.Results: Essential tremor patients and healthy controls did not differ in their total or tract-specific WMH volumes or Fazekas scores. However, WMH volume was significantly positively correlated with tremor severity on the TETRAS scale, and there was a significant negative correlation with the mean accelerometric tremor frequency. In a multiple linear regression model including disease duration, age, and age-adjusted total WMH volume, only the WMH volume significantly predicted tremor severity, while age and disease duration were not significant.Conclusion: We found evidence for a direct association between WMH volume and tremor severity. If confirmed by larger studies, our findings could explain the well-known relation between age and tremor severity.

Problem gamblers discount delayed rewards more rapidly than do non-gambling controls. Understanding this impulsivity is important for developing treatment options. In this article, we seek to make two contributions: First, we ask which of the currently debated economic models of intertemporal choice (exponential versus hyperbolic versus quasi-hyperbolic) provides the best description of gamblers’ discounting behavior. Second, we ask how problem gamblers differ from habitual gamblers and non-gambling controls within the most favored parametrization. Our analysis reveals that the quasi-hyperbolic discounting model is strongly favored over the other two parametrizations. Within the quasi-hyperbolic discounting model, problem gamblers have both a significantly stronger present bias and a smaller long-run discount factor, which suggests that gamblers’ impulsivity has two distinct sources.

The current treatment of patients with heart failure and concomitant atrioventricular conduction delay is difficult. Recommendations indicate the possibility to use the classic resynchronization but in the presence of narrow QRS-complex such approach could be even harmful. Without a sufficient LBBB morphology as indication for classical CRT, those patients would lose their narrow QRS complex with negative consequences for the hearts functional status. A new therapeutic option for those patients to re-establish the physiological atrioventricular mechanical sequence is the permanent His-bundle pacing (pHBP). Advantages like physiological activation sequence of the ventricular myocardium, less affected by AF compared to classical CRT and reversal of mitral regurgitation should be enumerated to show it's beneficial effect. Additionally the use of Bachmann's-bundle pacing can correct the prolonged interatrial conduction thus further contribute to the echocardiographic and clinical improvement. The aim of the study is to assess the influence of Bachmann's-bundle pacing and His-bundle pacing on the reversed remodeling of the heart in patients with heart failure and atrioventricular block. The study group included 21 patients (7 women and 14 men) undergoing cardiac resynchronization using Bachmann's-bundle pacing and permanent His-bundle pacing from LV channel for atrioventricular conduction delay. All the patients had narrow QRS-complex which prevented us to use classic resynchronization. 13 CRT-D and 8 CRT-P devices were implanted according to the ejection fraction and ventricular arrhythmia risk assessment. In all patients the direct His-bundle pacing was successfully achieved, selective in 17 and non-selective in 4 patients. The mean follow-up (FU) period was 8.8 months (1–26 months). The echocardiographic, clinical and ECG results are presented in the table 1. Conclusions 1. The correction of atrioventricular and interatrial conduction delay resulting in improvement of atrioventricular mechanical coupling can contribute to the reversed remodeling of the heart. 2. This also improves the patient's functional status. 3. In some patients this approach could lead to the normalization of echocardiographic parameters of the left ventricle. Funding Acknowledgement Type of funding source: None

Problem gamblers discount delayed rewards more rapidly than do non-gambling controls. Understanding this impulsivity is important for developing treatment options. In this article, we seek to make two contributions: First, we ask which of the currently debated economic models of inter-temporal choice (exponential versus hyperbolic versus quasi-hyperbolic) provides the best description of gamblers' discounting behavior. Second, we ask how problem gamblers differ from habitual gamblers and non-gambling controls within the most favored parametrization. Our analysis reveals that the quasi-hyperbolic discounting model is strongly favored over the other two parameterizations. Within the quasi-hyperbolic discounting model, problem gamblers have both a significantly stronger present bias and a smaller long-run discount factor, which suggests that gamblers' impulsivity has two distinct sources.

Writer's cramp (WC) is a focal task-specific dystonia characterized by sustained or intermittent muscle contractions while writing, particularly with the dominant hand. Since structural lesions rarely cause WC, it has been assumed that the disease might be caused by a functional maladaptation within the sensory-motor system. Therefore, our objective was to examine the differences between patients suffering from WC and a healthy control (HC) group with regard to the effective connectivity that describes causal influences one brain region exerts over another within the motor network. The effective connectivity within a network including contralateral motor cortex (M1), supplementary motor area (SMA), globus pallidus (GP), putamen (PU) and ipsilateral cerebellum (CB) was investigated using dynamic causal modeling (DCM) for fMRI. Eight connectivity models of functional motor systems were compared. Fifteen WC patients and 18 age-matched HC performed a sequential, five-element finger-tapping task with the non-dominant and non-affected left hand within a 3 T MRI-scanner as quickly and accurately as possible. The task was conducted in a fixed block design repeated 15 times and included 30 s of tapping followed by 30 s of rest. DCM identified the same model in WC and HC as superior for reflecting basal ganglia and cerebellar motor circuits of healthy subjects. The M1-PU, as well as M1-CB connectivity, was more strongly influenced by tapping in WC, but the intracortical M1-SMA connection was more facilitating in controls. Inhibiting influences originating from GP to M1 were stronger in controls compared to WC patients whereby facilitating influences the PU exerts over CB and CB exerts over M1 were not as strong. Although the same model structure explains the given data best, DCM confirms previous research demonstrating a malfunction in effective connectivity intracortically (M1-SMA) and in the cortico-basal ganglia circuitry in WC. In addition, DCM analysis demonstrates abnormal reciprocal excitatory connectivity in the cortico-cerebellar circuitry. These results highlight the dysfunctional cerebello-cortical as well as basalganglio-cortical interaction in WC., Highlights • Effective connectivity in writer`s cramp differs under sequential finger movements. • We found a deficient inhibitory pallido-cortical connectivity in writer`s cramp. • We found a diverging effective connectivity in the cortico-cerebellar loop. • We found a diverging effective connectivity in the cortico-basal ganglia pathway. • Pathophysiological interaction between the cerebellum and the basal ganglia.

Background. Hypokinetic dysarthria is highly prevalent in idiopathic Parkinson disease (PD), and effectiveness of high-intensity voice treatment is well established. However, the neural correlates remain largely unknown. Objective. We aimed to specify cerebral pathophysiology of hypokinetic dysarthria and treatment-induced changes using functional magnetic resonance imaging (fMRI). Methods. We used fMRI to investigate healthy controls (HCs) and patients with idiopathic PD–associated dysarthria before and after treatment according to the Lee Silverman Voice Treatment LOUD (LSVT). During fMRI, participants covertly read sentences with normal (eg, conversation in a quiet room) or high (eg, shouting on a windy beach) intensity. In addition, we tested LSVT effects on intelligibility and different speech features (intensity, pitch, articulation). Results. LSVT effectively improved intelligibility, articulation, and pitch in patients. Covert high-intensity speech compared with covert normal-intensity speech led to increased activation of mainly secondary motor areas and bilateral superior and medial temporal regions. Prior to LSVT, patients showed less activity in several speech-associated areas compared with HCs. As a neural correlate of effective LSVT, increased right-sided superior temporal activity correlated with improved intelligibility. Conclusion. This is the first brain imaging study using a covert speech paradigm in PD, which revealed cortical hypoactivation as correlate of hypokinetic dysarthria. Furthermore, cortical correlates of effective LSVT treatment colocalized with the neuronal network, showing increased activation during high- versus normal-intensity speech generation.

Objective: Multifocal epileptic activity is an unfavourable feature of a number of epileptic syndromes (Lennox-Gastaut syndrome, West syndrome, severe focal epilepsies) which suggests an overall vulnerability of the brain to pathological synchronization. However, the mechanisms of multifocal activity are insufficiently understood. This explorative study investigates whether pathological connectivity within brain areas of the default mode network as well as thalamus, brainstem and retrosplenial cortex may predispose individuals to multifocal epileptic activity. Methods: 33 children suffering from multifocal and monofocal (control group) epilepsies were investigated using EEG-fMRI recordings during sleep. The blood oxygenated level dependent (BOLD) signal of 15 regions of interest was extracted and temporally correlated (resting-state functional connectivity). Results: Patients with monofocal epilepsies were characterized by strong correlations between the corresponding interhemispheric homotopic regions. This pattern of correlations with pronounced short-distance and weak long-distance functional connectivity resembles the connectivity pattern described for healthy children. Patients with multifocal epileptic activity, however, demonstrated significantly stronger correlations between a large number of regions of the default mode network as well as thalamus and brainstem, with a significant increase in long-distance connectivity compared to children with monofocal epileptic activity. In the group of patients with multifocal epilepsies there were no differences in functional connectivity between patients with or without Lennox-Gastaut syndrome. Conclusion: This explorative study shows that multifocal activity is associated with generally increased long-distance functional connectivity in the brain. It can be suggested that this pronounced connectivity may represent either a risk to pathological over-synchronization or a consequence of the multifocal epileptic activity. Fil: Siniatchkin, Michael. Christian-Albrechts-Universität zu Kiel; Alemania Fil: Moehring, Jan. Christian-Albrechts-Universität zu Kiel; Alemania Fil: Kroeher, Bianca. Christian-Albrechts-Universität zu Kiel; Alemania Fil: Galka, Andreas. Christian-Albrechts-Universität zu Kiel; Alemania Fil: Ondarza, Gisela von. Christian-Albrechts-Universität zu Kiel; Alemania Fil: Moeller, Friederike. Christian-Albrechts-Universität zu Kiel; Alemania Fil: Wolff, Stephan. Christian-Albrechts-Universität zu Kiel; Alemania Fil: Tagliazucchi, Enzo Rodolfo. Christian-Albrechts-Universität zu Kiel; Alemania. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Física de Buenos Aires; Argentina Fil: Steinmann, Elisabeth. Christian-Albrechts-Universität zu Kiel; Alemania Fil: Boor, Rainer. Christian-Albrechts-Universität zu Kiel; Alemania Fil: Stephani, Ulrich. Christian-Albrechts-Universität zu Kiel; Alemania

The electrophysiological activity of the heart is recorded and presented in form of electrocardiogram (ECG). In 1998 the concept of P wave dispersion as the risk factor for atrial fibrillation (AF) recurrence was introduced. It was calculated as the difference between the longest and the shortest P wave. The aim of our study is to prove that the P wave dispersion is an artifact of low accuracy in P wave measurement. The study included 186 patients (78M 108F) aged 59.7 ± 12.9 years, undergoing various electrophysiological procedures. The P wave was measured twice: first, at the paper speed of 50 mm/s, enhancement 8× (standard – imprecise) and the second time at 200 mm/s, 64–256× (precise). The imprecise measurement method resulted in different duration of all P wave parameters in comparison with precise measurement. The difference between Δ P max and Δ P min indicated a higher value for the latter parameter. It was indicated that the imprecise P wave dispersion value correlated most significantly with the maximal P wave duration, which was measured in a similar way. In contrast with the imprecise measurement method, the minimal and maximal durations of the P waves, being measured accurately, were almost identical. Using precise methodology, the P wave dispersion reaches negligible values and tends to zero. The measurements of the P wave have to be precise to assure the highest scientific and medical sincerity. The highest clinical value is related to the P wave duration.

Graphical abstract, Highlights • Comparing different sensory network models in Writeŕs cramp and healthy controls. • DCM revealed abnormal insula-striatal connectivity within the somatosensory network. • Functional network connectivity of the cortex and the cerebellums remain mainly intact., Background Writer’s cramp (WC), a task specific form of dystonia, is considered to be a motor network disorder, but abnormal sensory tactile processing has also been acknowledged. The sensory spatial discrimination threshold (SDT) can be determined with a spatial acuity test (JVP domes). In addition to increased SDT, patients with WC exhibited dysfunctional sensory processing in the sensory cortex, insula, basal ganglia and cerebellum in a functional magnetic resonance imaging (fMRI) study while performing the spatial acuity test. Objectives To assess whether effective connectivity (EC) in the sensory network including cortical, basal ganglia, thalamic and cerebellar regions of interest in WC patients is abnormal. Methods We used fMRI and applied a block design, while 19 WC patients and 13 age-matched healthy controls performed a spatial discrimination task. Before we assessed EC using dynamic causal modelling, we compared three model structures based on the current literature. We enclosed regions of interest that are established for sensory processing during right hand stimulation: Left thalamus, somatosensory, parietal and insular cortex, posterior putamen, and right cerebellum. Results The EC analysis revealed task-dependent decreased unidirectional connectivity between the insula and the posterior putamen. The connectivity involving the primary sensory cortex, parietal cortex and cerebellum were not abnormal in WC. The two groups showed no differences in their behavioural data. Conclusions Perception and integration of sensory information requires the exchange of information between the insula cortex and the putamen, a sensory process that was disturbed in WC patients.

Previous receptor binding studies suggest dopamine function is altered in the basal ganglia circuitry in task-specific dystonia, a condition characterized by contraction of agonist and antagonist muscles while performing specific tasks. Dopamine plays a role in reward-based learning. Using fMRI, this study compared 31 right-handed writer's cramp patients to 35 controls in reward-based learning of a probabilistic reversal-learning task. All subjects chose between two stimuli and indicated their response with their left or right index finger. One stimulus response was rewarded 80%, the other 20%. After contingencies reversal, the second stimulus response was rewarded in 80%. We further linked the DRD2/ANKK1-TaqIa polymorphism, which is associated with 30% reduction of the striatal dopamine receptor density with reward-based learning and assumed impaired reversal learning in A + subjects. Feedback learning in patients was normal. Blood-oxygen level dependent (BOLD) signal in controls increased with negative feedback in the insula, rostral cingulate cortex, middle frontal gyrus and parietal cortex (pFWE, Graphical abstract, Highlights • What is the impact of abnormal dopamine signaling on decision making in task specific dystonia? • We studied the neural response in a reinforcement context using fMRI in 31 writer's cramp patients compared to 35 controls. • Patients showed specific increased response after negative feedback in middle ACC (BA 32) • This finding demonstrated disturbed integration of reinforcement history in a task specific dystonia. • The reward system might contribute to the pathogenesis in writer’s cramp

Problem gambling is a serious socioeconomic problem involving high individual and social costs. In this article, we study risk preferences of problem gamblers including their risk attitudes in the gain and loss domains, their weighting of probabilities, and their degree of loss aversion. Our findings indicate that problem gamblers are systematically more risk taking and less sensitive toward changes in probabilities in the gain domain only. Neither their risk attitudes in the loss domain nor their degree of loss aversion are significantly different from the controls. Additional evidence for a similar degree of sensitivity toward negative outcomes is gained from skin conductance data-a psychophysiological marker for emotional arousal-in a threat-of-shock task. (PsycINFO Database Record

Previous studies demonstrated the influence of the post-learning period on procedural motor memory consolidation. In an early period after the acquisition, motor skills are vulnerable to modifications during wakefulness. Indeed, specific interventions such as world-list learning within this early phase of motor memory consolidation seem to enhance motor performance as an indicator for successful consolidation. This finding highlights the idea that manipulations of procedural and declarative memory systems during the early phase of memory consolidation over wakefulness may influence off-line consolidation. Using functional magnetic resonance imaging (fMRI) during initial motor sequence learning and motor sequence recall, we indirectly assess the influence of a secondary task taken place in the early phase of memory consolidation. All participants were scanned using fMRI during the learning phase of a serial reaction time task (SRTT) at 8 a.m.. Afterwards, they were randomly assigned to one of five conditions. One group performed a declarative verbal, one a declarative nonverbal learning task. Two groups worked on attention tasks. A control group passed a resting condition. Participants stayed awake the whole day and performed the SRTT in the MRI scanner 12 hours later at 8 p.m.. At the behavioral level, the analysis of reaction times failed to show a significant difference between the groups. The primary analysis assessing fMRI data based on the contrast [sequence – random] between learning and retrieval also did not show any significant group differences. Therefore, our main analysis do not support the hypothesis that a secondary task influences the retrieval of the SRTT. In a more liberal fMRI analysis, we compared the sequence phases of the SRTT from learning to recall. BOLD signal decreased in the ipsilateral cerebellum and the supplementary motor area solely in the verbal learning group. Although our primary analysis failed to show significant changes between our groups, results of the secondary analysis could be an indication for a beneficial effect of the verbal declarative task in the early post-learning phase. A nonverbal learning task did not affect the activation within the motor network. Further studies are needed to replicate this finding and assessing the usefulness of this manipulation.

Obesity is associated with hypothalamic inflammation (HI) in animal models. In the current study, we examined the mediobasal hypothalamus (MBH) of 57 obese human subjects and 54 age- and sex- matched nonobese control subjects by MRI and analyzed the T2 hyperintensity as a measure of HI. Obese subjects exhibited T2 hyperintensity in the left but not the right MBH, which was strongly associated with systemic low-grade inflammation. MRS revealed the number of neurons in the left hypothalamic region to be similar in obese versus control subjects, suggesting functional but not structural impairment due to the inflammatory process. To gain mechanistic insights, we performed nutritional analysis and 16S rDNA microbiome sequencing, which showed that high-fat diet induces reduction of Parasutterella sp. in the gut, which is significantly correlated with MBH T2 hyperintensity. In addition to these environmental factors, we found subjects carrying common polymorphisms in the JNK or the MC4R gene to be more susceptible to HI. Finally, in a subgroup analysis, bariatric surgery had no effect on MBH T2 hyperintensity despite inducing significant weight loss and improvement of peripheral insulin sensitivity. In conclusion, obesity in humans is associated with HI and disturbances in the gut-brain axis, which are influenced by both environmental and genetic factors.

Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles) not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system) to an over-active nurturing system. To test this hypothesis we exposed pedophiles and healthy controls to pictures of infant and adult animals during functional magnetic resonance imaging of the brain. By using pictures of infant animals (instead of human infants), we aimed to elicit nurturing processing without triggering sexual processing. We hypothesized that elevated brain responses to nurturing stimuli will be found – in addition to other brain areas – in the anterior insula of pedophiles because this area was repeatedly found to be activated when adults see pictures of babies. Behavioral ratings confirmed that pictures of infant or adult animals were not perceived as sexually arousing neither by the pedophilic participants nor by the heathy controls. Statistical analysis was applied to the whole brain as well as to the anterior insula as region of interest. Only in pedophiles did infants relative to adult animals increase brain activity in the anterior insula, supplementary motor cortex, and dorsolateral prefrontal areas. Within-group analysis revealed an increased brain response to infant animals in the left anterior insular cortex of the pedophilic participants. Currently, pedophilia is considered the consequence of disturbed sexual or executive brain processing, but details are far from known. The present findings raise the question whether there is also an over-responsive nurturing system in pedophilia.

Summary Purpose Dravet syndrome (DS) or severe myoclonic epilepsy of infancy is an intractable epileptic encephalopathy of early childhood that is caused by a mutation in the SCN1A gene in most patients. The aim of this study was to identify a syndrome-specific epileptic network underlying interictal epileptiform discharges (IEDs) in patients with DS. Methods Ten patients with the diagnosis of DS associated with mutations in the SCN1A gene were investigated using simultaneous recording of electroencephalography and functional magnetic resonance imaging ((EEG-fMRI). Time series of IEDs were used as regressors for the statistical fMRI analysis. Key Findings In nine patients with DS, individual blood oxygenation level–dependent (BOLD) signal changes were seen. In three patients the thalamus was involved. Furthermore, regions of the default mode network were activated in seven patients. However, a common activation pattern associated with IEDs could not be detected. Significance The study demonstrates that, despite a common genetic etiology in DS, different neuronal networks underlie the individual IEDs.

In the presurgical evaluation of children and juvenile patients with refractory focal epilepsy, the main challenge is to localize the point of seizure onset as precisely as possible. We compared results of the conventional electroencephalography-functional magnetic resonance imaging (EEG-fMRI) analysis with those obtained with a newly developed method using voltage maps of average interictal epileptiform discharges (IEDs) recorded during clinical long-term monitoring and with the results of the electric source imaging (ESI).

SUMMARY Purpose: Photosensitivity or photoparoxysmal response (PPR) is an electroencephalography trait that is highly associated with idiopathic generalized epilepsies (IGEs) and characterized by changes in cortical excitability in response to photic stimulation. Studying functional and structural changes of PPR might provide important insights into the pathogenesis of IGE. Recent studies revealed a functional network consisting of occipital, parietal, and precentral areas that might be implicated in PPR. Herein, we investigate the microstructural changes associated with PPR. Methods: Twelve healthy subjects with PPR, nine patients with IGE and PPR (IGE-PPR group), and 18 healthy controls were studied with diffusion magnetic resonance imaging. Tract-based spatial statistics were used to test for regional differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, and radial diffusivity between groups. Key Findings: Subjects with PPR exhibited higher FA in the right precentral juxtacortical white matter and higher MD in lateral occipital areas relative to controls. Patients with IGE-patients showed additional increases in regional FA in the thalamus and juxtacortical precentral and parietal areas. Both subjects with PPR and patients with IGE-PPR presented axial and radial diffusivity changes in the occipital regions. Significance: Our results show that PPR is associated with subcortical microstructural changes in precentral, parietal, and occipital regions. The coexistence of PPR and IGE is associated with white matter abnormalities in the thalamus and precuneus. PPR and epilepsy share similar functional and structural networks in widespread cortical and subcortical areas.

Migraine patients are characterized by altered cortical excitability and information processing between attacks. The relationship between these abnormalities is still poorly understood. In this study, visual evoked potentials (VEP) and proton magnetic resonance spectroscopy were recorded simultaneously in migraineurs and healthy subjects. In order to investigate the homeostatic-like plasticity in the visual cortex, cortical excitability was modified using transcranial direct current stimulation (tDCS). Before any stimulation, migraineurs showed significantly higher glutamate/creatine ratios (Glx/Cr) than healthy subjects. In healthy subjects, excitatory (anodal) tDCS caused an increase and inhibitory (cathodal) tDCS a decrease in the Glx/Cr ratio. Subsequent photic stimulation (PS) reversed the changes in Glx/Cr ratios, which returned back to baseline, demonstrating homeostatic-like metaplasticity in the control group. In migraine patients, both anodal and cathodal tDCS decreased the Glx/Cr ratio, which did not return to baseline after PS. While healthy subjects showed an increase in VEP amplitude under anodal and a reduction under cathodal tDCS, the modifiability of VEP under tDCS was reduced in migraineurs. The results demonstrate a reduced responsiveness of the occipital cortex to interventions that change cortical excitability in migraine. Moreover, altered glutamatergic neurotransmission seems to mediate the relation between abnormal cortical information processing and excitability in migraineurs.

The analysis of time series obtained by functional magnetic resonance imaging (fMRI) may be approached by fitting predictive parametric models, such as nearest-neighbor autoregressive models with exogeneous input (NNARX). As a part of the modeling procedure, it is possible to apply instantaneous linear transformations to the data. Spatial smoothing, a common preprocessing step, may be interpreted as such a transformation. The autoregressive parameters may be constrained, such that they provide a response behavior that corresponds to the canonical haemodynamic response function (HRF). We present an algorithm for estimating the parameters of the linear transformations and of the HRF within a rigorous maximum-likelihood framework. Using this approach, an optimal amount of both the spatial smoothing and the HRF can be estimated simultaneously for a given fMRI data set. An example from a motor-task experiment is discussed. It is found that, for this data set, weak, but non-zero, spatial smoothing is optimal. Furthermore, it is demonstrated that activated regions can be estimated within the maximum-likelihood framework.

Zusammenfassung Für kompetente Mitglieder der Gesellschaft ist die Inkorporierung von Technologien in alltägliche Handlungsvollzüge etwas Selbstverständliches. Die Arbeit „mit“ der Technologie wird routinemäßig erledigt und nur in seltenen Fällen thematisiert. Als Konversationsanalytiker interessiert uns, worin diese Arbeit besteht und welche systematischen Prozeduren bei ihr zur Anwendung gelangen. Auf der Basis von 52 (Beratungs-) Gesprächen, die in Jobcentern als Tondokument aufgezeichnet wurden, können wir zeigen, dass neben der Arbeit „mit“ dem PC Interaktionsarbeit anfällt, wenn sich die Teilnehmer in Gesprächen auf den PC beziehen, und, dass es verschiedene Variationen dieser Orientierung am Computer gibt. Manchmal wird der PC in den Hintergrund der Interaktion verschoben und erhält nur minimale Aufmerksamkeit, während sich die Vertreter des Jobcenters und ihre Klienten deutlich aneinander als Personen orientieren. In anderen Fällen entscheiden sich die Vertreter der Institution dafür, den PC gewissermaßen zu „animieren“, indem sie ihm z. B. Fragen stellen. In einer weiteren Variante wenden sich die Vertreter der Institution ausschließlich dem PC zu, während die Klienten in der Warteschleife gehalten werden. Auch Fälle einer aktiven Neutralisierung des PC lassen sich finden. Kompetente Gesellschaftsmitglieder beziehen sich also nicht nur auf Gegenstände (Computer) und zeigen sich diese wechselseitig an, sondern bedienen sich auch unterschiedlicher Modalitäten, um diese Gegenstände in die soziale Welt ihrer Begegnung einzuführen, wodurch sich der Charakter ihrer Begegnung fundamental verändern kann.

Simultaneous recording of EEG and functional MRI (EEG-fMRI) is a promising tool that may be applied in patients with epilepsy to investigate haemodynamic changes associated with interictal epileptiform discharges (IED). As the yield of the EEG-fMRI technique in children with epilepsy is still unclear, the aim of this study was to evaluate whether the combination of EEG-fMRI and EEG source analysis could improve localization of epileptogenic foci in children. Six children with an unambiguous focus localization were selected based on the criterion of the consistency of ictal EEG, PET and ictal SPECT. IEDs were taken as time series for fMRI analysis and as averaged sweeps for the EEG source analysis based on the distributed linear local autoregressive average (LAURA) solution. In four patients, the brain area with haemodymanic changes corresponded to the epileptogenic zone. However, additional distant regions with haemodynamic response were observed. Source analysis located the source of the initial epileptic activity in all cases in the presumed epileptogenic zone and revealed propagation in five cases. In three cases there was a good correspondence between haemodynamic changes and source localization at both the beginning and the propagation of IED. In the remaining three cases, at least one area of haemodynamic changes corresponded to either the beginning or the propagation. In most children analysed, EEG-fMRI revealed extended haemodynamic response, which were difficult to interpret without an appropriate reference, i.e. a priori hypothesis about epileptogenic zone. EEG source analysis may help to differentiate brain areas with haemodynamic response.

In a photosensitive patient intermittent photic stimulation (IPS) accidentally provoked a generalized tonic-clonic seizure during simultaneous recordings of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). Before seizure onset, IPS consistently induced generalized photoparoxysmal responses (PPRs). These PPRs were associated with increases in blood oxygen level dependent (BOLD) signal in the visual cortex, the thalamus, and both superior colliculi, and a decrease in BOLD signal in the frontoparietal areas. The BOLD signal in the visual cortex increased in magnitude during consecutive epochs of IPS associated with PPRs. We propose that repeated IPS led to an excessive amount of neuronal activity in the visual cortex that evoked PPRs and finally exceeded a critical threshold and triggered a generalized seizure.

The ballistocardiogram (BCG) represents one of the most prominent sources of artifacts that contaminate the electroencephalogram (EEG) during functional MRI. The BCG artifacts may affect the detection of interictal epileptiform discharges (IED) in patients with epilepsy, reducing the sensitivity of the combined EEG–fMRI method. In this study we improved the BCG artifact correction using a multiple source correction (MSC) approach. On the one hand, a source analysis of the IEDs was applied to the EEG data obtained outside the MRI scanner to prevent the distortion of EEG signals of interest during the correction of BCG artifacts. On the other hand, the topographies of the BCG artifacts were defined based on the EEG recorded inside the scanner. The topographies of the BCG artifacts were then added to the surrogate model of IED sources and a combined source model was applied to the data obtained inside the scanner. The artifact signal was then subtracted without considerable distortion of the IED topography. The MSC approach was compared with the traditional averaged artifact subtraction (AAS) method. Both methods reduced the spectral power of BCG-related harmonics and enabled better detection of IEDs. Compared with the conventional AAS method, the MSC approach increased the sensitivity of IED detection because the IED signal was less attenuated when subtracting the BCG artifacts. The proposed MSC method is particularly useful in situations in which the BCG artifact is spatially correlated and time-locked with the EEG signal produced by the focal brain activity of interest.

To identify cortical and subcortical regions involved in voluntary pelvic floor muscle control, functional magnetic resonance imaging (fMRI) was performed at 1.5 T in thirty healthy subjects (15 women, 15 men). The participants performed rhythmical (1 Hz) pelvic floor muscle contractions, which imitated the repetitive interruption of voiding. Since previous reports concerning the representation of pelvic floor muscles in the cortex of the medial wall are inconsistent, a conservative statistical threshold (FWE-corrected P

Human faces can motivate nurturing behaviour or sexual behaviour when adults see a child or an adult face, respectively. This suggests that face processing is tuned to detecting age cues of sexual maturity to stimulate the appropriate reproductive behaviour: either caretaking or mating. In paedophilia, sexual attraction is directed to sexually immature children. Therefore, we hypothesized that brain networks that normally are tuned to mature faces of the preferred gender show an abnormal tuning to sexual immature faces in paedophilia. Here, we use functional magnetic resonance imaging (fMRI) to test directly for the existence of a network which is tuned to face cues of sexual maturity. During fMRI, participants sexually attracted to either adults or children were exposed to various face images. In individuals attracted to adults, adult faces activated several brain regions significantly more than child faces. These brain regions comprised areas known to be implicated in face processing, and sexual processing, including occipital areas, the ventrolateral prefrontal cortex and, subcortically, the putamen and nucleus caudatus. The same regions were activated in paedophiles, but with a reversed preferential response pattern.

Introduction The pathophysiology of writer's cramp, a task-specific dystonia, remains unclear. The objective of this study was to investigate the basal ganglia circuit and the cerebellum during a complex motor sequence learning task carried out with the nonaffected hand in writer's cramp patients. Methods We applied structural and functional imaging in 22 writer's cramp patients and 28 matched controls using 3T MRI. With the asymptomatic left hand all participants learned a complex, sequential, five-element sequence-tapping task as accurately and quickly as possible. Functional imaging was measured during a repeated (15 times), fixed block design with tapping (30 sec) and rest (30 sec). Additionally, gray matter volume of the basal ganglia was analyzed using voxel-based morphometry (VBM). Results While behavior was comparable between groups, after small volume correction the anterior part of the right putamen and the left globus pallidus exhibited reduced blood oxygen level-dependent (BOLD) activity in patients during the sequential finger-tapping task. VBM analysis showed larger gray matter volume bilateral in the posterior part of the putamen and globus pallidus. There were no group differences in the cerebellum. Conclusion The results indicate an impairment of anterior basal ganglia loops involved in producing complex sequential movements of the unaffected hand. These findings are in line with previous reports of reduced neuronal activity in the globus pallidus internus. Higher gray matter volume of the putamen and globus pallidus may stem from elevated activity of the direct pathway, which could reflect a compensatory phenomenon or a primary predisposition, that is, endophenotypic trait.

Atypical benign partial epilepsy (ABPE) is a subgroup among the idiopathic focal epilepsies of childhood. Aim of this study was to investigate neuronal networks underlying ABPE and compare the results with previous electroencephalography (EEG)-functional magnetic resonance imaging (fMRI) studies of related epilepsy syndromes. Ten patients with ABPE underwent simultaneous EEG-fMRI recording. In all 10 patients several types of interictal epileptiform discharges (IEDs) were recorded. Individual IED-associated blood oxygen level-dependent (BOLD) signal changes were analyzed in a single subject analysis for each IED type (33 studies). A group analysis was also performed to determine common BOLD signal changes across the patients. IED-associated BOLD signal changes were found in 31 studies. Focal BOLD signal changes concordant with the spike field (21 studies) and distant cortical and subcortical BOLD signal changes (31 studies) were detected. The group analysis revealed a thalamic activation. This study demonstrated that ABPE is characterized by patterns similar to studies in rolandic epilepsy (focal BOLD signal changes in the spike field) as well as patterns observed in continuous spikes and waves during slow sleep (CSWS) (distant BOLD signal changes in cortical and subcortical structures), thereby underscoring that idiopathic focal epilepsies of childhood form a spectrum of overlapping syndromes.

Zusammenfassung In Strafverfahren finden sich auffällig viele ironische Äußerungen. In einer konversationsanalytischen Rekonstruktion dieser Passagen werden die für Ironie typische Beteiligtenstruktur und Sequentialität herausgearbeitet. Dies wiederum eröffnet Perspektiven einerseits auf ein genuin soziologisches Verständnis der Ironie, zum anderen auf die besonderen Funktionen von ironischen Äußerungen im spezifischen Verfahrenskontext. Ironie dient danach als Instrument für Verständigung und Ausgrenzung gleichermaßen; sie erleichtert die Ausbildung eines für das betreffende Verfahren relevanten kollektiven Gedächtnisses und hilft überdies die Ernsthaftigkeit des Verfahrens zu sichern.