Publications by authors named "Ulla Knorr"

This study is the first to investigate the association between a comprehensive panel of cerebrospinal fluid (CSF) synaptic protein biomarkers and cognitive function using data from a prospective cohort study including N = 59 patients with bipolar disorder (BD) in remission and N = 37 healthy control individuals (HC). The CSF synaptic protein biomarkers included neuronal pentraxin (NPTX)1, NPTX2, 14-3-3 proteins, AP-2 complex subunit-beta, beta-synuclein, complexin-2, gamma-synuclein, NPTX-receptor, phosphatidylethanolamine-binding proteins, rab GDP dissociation inhibitor-alpha, syntaxins-1B and 7. The biomarkers of synaptic dysfunction were analyzed by targeted mass spectrometry.

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Cognitive impairment affects approximately 50 % of patients with mood disorders during remission, which correlates with poorer daily-life functioning. The hierarchical organisation of cognitive processes may mean that some cognitive deficits, e.g.

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Introduction: Alcohol use disorder (AUD) is a massive burden for the individual, relatives and society. Despite this, the treatment gap is wide compared with other mental health disorders. Treatment options are sparse, with only three Food and Drug Administration (FDA)-approved pharmacotherapies.

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This is a letter to the editor on the "Correspondence on "An algorithm for pharmacological treatment of mania during hospitalisation" Dan Med J 2024;71(5):A08230525.

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Hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity measured by the combined dexamethasone-CRH test (DEX-CRH test) has been found in patients with major depressive disorder (MDD), whereas hypoactivity has been found in patients with work-related stress. We aimed to investigate the DEX-CRH test as a biomarker to distinguish between MDD and work-related stress (exhaustion disorder - ED). We hypothesized that there would be lower cortisol and ACTH response in participants with ED compared to MDD and healthy controls (HC).

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Background: This exploratory study investigated cerebrospinal fluid (CSF) synaptic protein biomarkers in bipolar disorder (BD), aiming to highlight the neurobiological basis of the disorder. With shared cognitive impairment features between BD and Alzheimer's disease, and considering increased dementia risk in BD patients, the study explores potential connections.

Methods: Fifty-nine well-characterized patients with BD and thirty-seven healthy control individuals were examined and followed for one year.

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Article Synopsis
  • Current evidence for treating mania with medication during hospital stays is lacking due to a shortage of large, well-conducted randomized trials.
  • There is a wide discrepancy in how medications are prescribed for mania in clinical practice during hospitalization.
  • The review suggests an algorithm for better pharmacological treatment of mania in hospitals, aiming for improved scientific evaluation of these methods.
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Background: Abnormalities in cerebrospinal fluid (CSF)-amyloid-beta (Aβ)42, CSF-Aβ40, CSF-Aβ38, CSF-soluble amyloid precursor proteins α and β, CSF-total-tau, CSF-phosphorylated-tau, CSF-neurofilament light protein (NF-L), CSF-neurogranin, plasma-Aβ42, plasma-Aβ40, plasma-total-tau, plasma-NF-L and, serum-S100B during affective episodes may reflect brain changes that could impact cognitive function in patients with bipolar disorder (BD). The study aimed to investigate the association between these biomarkers indicative of Alzheimer's disease and those reflecting neurodegeneration alongside their impact on cognitive function in patients with BD and healthy control individuals (HC). The primary hypothesis was that GL and VL would increase with increasing levels of CSF-Aβ42 based on data from T0 and T3 in BD and HC jointly.

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Background: Patients with major depression exhibit circadian disturbance of sleep and mood, and when they are discharged from inpatient wards, this disturbance poses a risk of relapse. We developed a circadian reinforcement therapy (CRT) intervention to facilitate the transition from the inpatient ward to the home for these patients. CRT focuses on increasing the zeitgeber strength for the circadian clock through social contact, physical activity, diet, daylight exposure, and sleep timing.

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Introduction: A substantial proportion of patients with bipolar disorder experience daily subsyndromal mood swings, and the term "mood instability" reflecting the variability in mood seems associated with poor prognostic factors, including impaired functioning, and increased risk of hospitalization and relapse. During the last decade, we have developed and tested a smartphone-based system for monitoring bipolar disorder. The present SmartBipolar randomized controlled trial (RCT) aims to investigate whether (1) daily smartphone-based outpatient monitoring and treatment including clinical feedback versus (2) daily smartphone-based monitoring without clinical feedback or (3) daily smartphone-based mood monitoring only improves mood instability and other clinically relevant patient-related outcomes in patients with bipolar disorder.

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Persistent cognitive impairments occur in a large proportion of patients with bipolar disorder (BD) but their underlying pathological cellular processes are unclear. The aims of this longitudinal study of BD and healthy control (HC) participants were to investigate (i) the association of brain erythropoietin (EPO) and oxidative stress with cognitive functions and (ii) the changes in brain EPO during and after affective episodes. Participants underwent neurocognitive testing, lumbar punctures for cerebrospinal fluid (CSF) sampling and provided urine spot tests at baseline (all), after an affective episode (patients) and after one year (all).

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Introduction: Bipolar disorder (BD) is a heterogeneous mental disorder characterized by recurrent relapses of affective episodes: Subgroups of patients with BD have cognitive deficits, and an increased risk of dementia.

Methods: This prospective, longitudinal, one-year follow-up, case-control study investigated biomarkers for AD and neurodegenerative diseases, namely: cerebrospinal fluid (CSF) amyloid beta (Aβ) isoforms and ratios (Aβ42, Aβ40, Aβ38), CSF soluble amyloid precursor protein (sAPP) α and β, CSF total (t-tau) and phosphorylated tau (p-tau), CSF neurofilament-light (NF-L), CSF neurogranin (NG), plasma-isoforms Aβ42 and Aβ40, plasma-tau, plasma-NF-L, and serum S100B, in patients with BD (N = 62, aged 18-60) and gender-and-age-matched healthy control individuals (N = 40). CSF and plasma/serum samples were collected at baseline, during and after an affective episode, if it occurred, and after a year.

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Objective: Patients with neurodegenerative disorders, schizophrenia, and bipolar disorder present with increased oxidative stress markers. Not only is oxidative stress associated with development of disease, but also with increased disease progression and mortality. Oxidative stress reflects an increase in pro-oxidants, which subsequently leads to oxidative modifications of cellular components, such as RNA and DNA.

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Background: Visible light, predominantly in the blue range, affects mood and circadian rhythm partly by activation of the melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs). The light-induced responses of these ganglion cells can be evaluated by pupillometry. The study aimed to assess the blue light induced pupil constriction in patients with bipolar disorder (BD).

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Background: The International Society for Bipolar Disorders Targeting Cognition Task Force recommends screening for and monitoring of cognitive impairments in patients with bipolar disorder (BD) with the Screen for Cognitive Impairment in Psychiatry (SCIP). The study aimed to provide the first demographically adjusted norms and change norms for the SCIP and to compare the cognitive trajectory over one year in remitted BD patients with normative cognitive change.

Methods: Patients with fully or partially remitted BD and healthy controls (HC) were assessed with the SCIP at baseline and at a one-year follow-up.

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Background: The relationship between cognitive function and relapse of affective episodes in bipolar disorder (BD) is rarely studied. The aim of this prospective, longitudinal, case-control study was to assess the trajectory of cognitive function and mood occilations within a one-year period in patients with BD relative to healthy control (HC) individuals.

Methods: The sample included 86 outpatients with BD in euthymia, and 44 gender-and-age-matched HC.

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Background: Bipolar disorder (BD) has been associated with impaired functioning during periods of euthymia. This prospective one-year case-control study investigated the impact of a new affective episode on psychosocial functioning, quality of life (QoL) and perceived stress in newly diagnosed patients with BD in euthymia.

Methods: Clinically evaluated psychosocial functioning (Functioning Assessment Short Test, FAST), self-reported QoL (WHOQoL-BREF scale) and stress (Cohens' Perceived Stress Scale) were collected from 87 patients with BD with (BD-E) (n=38) and without (BD-NE) (n=44) clinical relapse and 44 age and gender matched healthy control (HC) individuals at baseline (T0), following an episode if it occurred (T2) and at one-year follow-up (T3).

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Introduction: Retrospective studies conducted in psychiatric inpatient wards have shown a relation between the intensity of daylight in patient rooms and the length of stay, pointing to an antidepressant effect of ambient lighting conditions. Light therapy has shown a promising antidepressant effect when administered from a light box. The emergence of light-emitting diode (LED) technology has made it possible to build luminaires into rooms and to dynamically mimic the spectral and temporal distribution of daylight.

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Background: Retrospective studies conducted in psychiatric wards have indicated a shorter duration of stay for depressed inpatients in bright compared to dim daylight-exposed rooms, pointing to a possible antidepressant effect of daylight conditions. Dynamic LED lighting, aiming to mimic daylight conditions, are currently been installed in several hospitals, but their feasibility is poorly investigated.

Methods: To investigate the feasibility of these systems, we developed and installed a LED-lighting system in four rooms in a psychiatric inpatient ward.

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Bipolar disorder (BD) is a mental disorder characterized by recurrent relapses of affective episodes, cognitive impairment, illness progression, and reduced life expectancy. Increased systemic oxidatively generated nucleoside damage have been found in some neurodegenerative disorders and in BD. As the first, this naturalistic prospective, longitudinal follow-up case-control study investigated cerebrospinal fluid (CSF) oxidative stress markers 8-oxo-7,8-dihydroguanosine (8-oxoGuo) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) that relate to RNA and DNA damage, respectively.

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Objective: This study reanalyzed data from a randomized placebo-controlled trial that failed to find an effect of the selective serotonin reuptake inhibitor escitalopram on neuroticism and state anxiety in a nonclinical sample. The purpose was to test for unique effects on two neuroticism factors, trait anxiety and mood instability, and to explore whether neuroticism moderated the effect of escitalopram on state anxiety.

Methods: The sample included 80 adults who had a first-degree relative with major depression but without any psychiatric disorders themselves.

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Selective serotonin reuptake inhibitors (SSRIs) are the first-line drugs in the treatment of depression. Investigations of the effects of SSRIs in healthy individuals is a useful model to understand the mechanisms of SSRI action and potentially the underlying pathophysiology of depression. We conducted an updated systematic review of all randomized multiple-dose, placebo-controlled trials on the effect of intervention with SSRI for ≥ 7 days in healthy nonpsychiatric subjects.

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