Martin Ruchsow

A 33-year-old female patient developed a hallucinogen-persisting perception disorder (HPPD) after lysergic acid diethylamide (LSD) abuse for a year at the age of 18. Specifically, she reported after images, perception of movement in her peripheral visual fields, blurring of small patterns, halo effects, and macro- and micropsia. Previous treatment with antidepressants and risperidone failed to ameliorate these symptoms. Upon commencing drug therapy with lamotrigine, these complex visual disturbances receded almost completely. Based on its hypothesized neuroprotective and mood-stabilizing effects, the antiepileptic lamotrigine may offer a promising new approach in the treatment of HPPD.

In den letzten Jahren wurde intensiv untersucht, inwiefern sich die funktionelle Magnetresonanztomographie (fMRT) als Lügendetektor einsetzen lässt. In der vorliegenden Arbeit werden Argumente für und wider eine derartige Verwendungsweise der fMRT analysiert und kritisch gewichtet. Sowohl erkenntnistheoretische als auch prinzipielle methodische Überlegungen zeigen, dass alle Rückschlüsse von fMRT-Befunden auf Mentalzustände nicht zulässig sind. Damit ist mittels fMRT auch nicht bestimmbar, was eine Person genau denkt bzw. in Bezug auf was sie lügt oder aufrichtig ist. Great efforts have been made in recent years to use functional magnetic resonance imaging (fMRI) in the context of lie detection. In the present paper the pros and cons of such an approach are analyzed and critically discussed. Both epistemological and methodical considerations have shown that all attempts to derive mental states from fMRI findings („reverse inference“) are not valid. Consequently, fMRI scans cannot reveal a person’s thoughts and whether (s)he is lying or telling the truth.

Impulsiveness has been linked to fast guesses and premature responses in reaction time tasks like the Eriksen flanker task or the Go/Nogo task. In the present study, healthy subjects without history of DSM-IV Axis I or II psychopathology were examined. Impulsiveness was determined by calculating individual reaction times (as a function of general response speed) in order to split the entire group (n = 26) in a subgroup with a more controlled response style (low impulsiveness [LI] group; n = 13) and a subgroup with a more impulsive response style (high impulsiveness [HI] group; n = 13). Subjects performed a Go/Nogo task while a multi-channel EEG was recorded. Two event-related potentials (ERP) were of special interest: the Nogo-N2 and -P3 component. HI subjects had significantly reduced (less positive) Nogo-P3 amplitudes compared to LI subjects whereas groups did not differ with regard to the Nogo-N2. These results corroborate previous findings of reduced Nogo-P3 amplitudes in samples with enhanced levels of impulsiveness. Moreover, present data suggest that there is a broader range of impulsiveness even in healthy subjects which might mask or pronounce between-group differences in clinical studies. Therefore, different levels of impulsiveness in control groups should be carefully taken into account in further ERP studies.

Cognitive deficits are common in patients with major depression. The present study investigated whether these impairments also comprise language processes such as sentence comprehension. We studied four language-related evoked potentials (early left anterior negativity [ELAN], N400, left anterior negativity [LAN], and P600) in 14 patients with major depressive disorder (MDD) in partial remission and 14 matched healthy controls using a sentence paradigm with correct, semantic mismatching, and syntactic mismatching sentences. In contrast to controls, patients showed no significant P600 effect when comparing syntactic mismatching and correct sentences. No group differences could be observed for the ELAN, N400, and LAN components. The missing P600 effect may indicate deficits in the cognitive domain of language processing in depressive patients or impairment of a more general process to detect deviances from regularities. How this result integrates into the concept of a general cognitive deficit in major depression remains a goal for future studies.

Borderline personality disorder (BPD) has been related to a dysfunction of anterior cingulate cortex, amygdala, and prefrontal cortex and has been associated clinically with impulsivity, affective instability, and significant interpersonal distress. We examined 17 patients with BPD and 17 age-, sex-, and education matched control participants with no history of Axis I or II psychopathology using event-related potentials (ERPs). Participants performed a hybrid flanker-Go/Nogo task while multichannel EEG was recorded. Our study focused on two ERP components: the Nogo-N2 and the Nogo-P3, which have been discussed in the context of response inhibition and response conflict. ERPs were computed on correct Go trials (button press) and correct Nogo trials (no button press), separately. Groups did not differ with regard to the Nogo-N2. However, BPD patients showed reduced Nogo-P3 amplitudes. For the entire group (n = 34) we found a negative correlation with the Barratt Impulsiveness Scale (BIS-10) and Becks’s depression inventory (BDI). The present study is the first to examine Nogo-N2 and Nogo-P3 in BPD and provides further evidence for impaired response inhibition in BPD patients.

Obsessive-compulsive disorder (OCD) has been related to a hyperactive cortico-striatal-pallidal-thalamic circuitry resulting clinically in an impaired inhibition of repetitive thoughts and behaviors. We examined thirteen patients with OCD and thirteen age-, sex-, and education matched healthy controls using event-related potentials (ERPs). Participants performed a hybrid flanker-Go/Nogo task while multichannel EEG was recorded. Our study focused on two ERP components: the Nogo-N2 and the Nogo-P3, which have been discussed in the context of response inhibition and response conflict. Artifact-free EEG-segments were used to compute ERPs on correct Go trials (button press) and correct Nogo trials (no button press), separately. Patients with OCD showed enhanced (more negative) Nogo-N2 amplitudes than controls, and a significant difference in amplitudes between Nogo-N2 and Go-N2 trials (more negative for Nogo trials) at central midline electrode positions. However, groups did not differ with regard to the Nogo-P3 and Go-P3. The present study replicates and extends previous findings of altered executive control processes in OCD patients.

Obsessive-compulsive disorder (OCD) has been related to a hyperactive frontal-striatal-thalamic circuit and associated with altered mechanisms of action and error monitoring. In the present study, we examined whether these results only hold for errors in choice reaction time experiments and Stroop tasks or extend to errors of commission in a Go/NoGo task, as well. We investigated the electrophysiological correlates of error monitoring in 11 patients with OCD and 11 age-, sex-, and education-matched healthy controls using event-related potentials (ERPs). Participants performed a Go/NoGo task while a 64-channel EEG was recorded. Our study focused on three ERP components: the error-related negativity (ERN)/error negativity (Ne), the “early” error positivity (“early” Pe) reflecting automatic error processing, and the “late” error positivity (“late” Pe), which is thought to mirror the awareness of erroneous responses. Artifact-free EEG-segments were used to compute ERPs on correct Go trials and incorrect NoGo trials (i.e., errors of commission), separately. Patients with OCD showed enhanced (more negative) ERN/Ne amplitudes compared to control subjects. Groups did not differ with regard to the early Pe component and the late Pe component. Our results support the view that compulsivity in OCD patients is related to hyper-functioning error monitoring processes.