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Research

One key ability of the human brain is to adopt to changes in the environment, the body and its self (neuroplasticity). The basic neurophysiological mechanisms of neuroplasticity are broadly unknown. Adaptive neuroplasticity supports the regenaration after structure or functionality of the brain had been damaged. 'Maladaptive' neuroplasticity on the other hand might lead to a variaty of psychiatric and neurlogical diseases.

Our group's work addresses the physiological and pathophysiological background of adaptive and maladaptive neuroplasticity. Corresponding studies are conducted with healthy volunteers and patients suffering from psychiatric disorder. We apply electrophysiological methods, invasive and non-invasive brain stimulation and imaging techniques to explore and modulate brain functioning in experimental and therapeutic settings.

 

Modulation of executive functions with transcranial stimulation

Executive functions are a group of cognitive proficiencies crucial to plan and control complex goal-directed behaviour. Impairments of executive functions to more or less specific degrees are detectable in most psychiatric disorders. These impairments are often significant components of psychiatric pathology and are frequently associated with disrupted local brain activity. Therefor, the improvement of executive deficits can contribute to the treatment of specific disease patterns.

 

Regional cortical activity can be modulated with the help of non-invasive brain stimulation such as transcranial magnetic or transcranial direct current stimulation. Thus, we study the effects of focal modulation of physiological and pathophysiological brain activity on executive functions in healthy volunteers and patients with psychiatrid disorders. These studies augment our understanding of intact and impaired executive functions and contribute to the development of supportive procedures for cognitiv-behavioural therapy.

 

 
 
  • Zwissler, B., Sperber, C., Aigeldinger, S., Schindler, S., Kissler, J., & Plewnia, C. (2014). Shaping Memory Accuracy by Left Prefrontal Transcranial Direct Current Stimulation. The Journal of Neuroscience, 34(11), 4022-4026.
  • Plewnia, C., Zwissler, B., Längst, I., Maurer, B., Giel, K., & Krüger, R. (2013). Effects of transcranial direct current stimulation (tDCS) on executive functions: Influence of COMT Val/Met polymorphism. Cortex, 49(7), 1801-1807.
  • Wolkenstein, L., & Plewnia, C. (2013). Amelioration of cognitive control in depression by transcranial direct current stimulation. Biological psychiatry, 73(7), 646-651.
  • Dockery C, Hueckel-Weng R, Birbaumer N, Plewnia C. (2009) Enhancement of planning ability by transcranial direct current stimulation. Journal of Neuroscience. 29:7271-7277.

 

 
 

 

Pathophysiology and experimental therapy of auditory hallucinations

The efficacy of transcranial stimulation (TMS and tDCS) to treat otherwise therapy-resistent auditory hallucinations is subject to our work. 

 

 
 
  • Eberle MC, Wildgruber D, Wasserka B, Fallgatter AJ, Plewnia C. (2010) Relief from chronic intractable auditory hallucinations after long-term bilateral theta burst stimulation. American Journal of Psychiatry 167:1410.
     
  • Plewnia C, Bischof F, Reimold M (2007) Suppression of verbal hallucinations and changes in regional cerebral blood flow after intravenous lidocaine: A case report. Prog Neuropsychopharm Biol Psy. 31(1):301-3.
 
 

 

Studies: Experimental therapy of depression with TMS

The antidepressant effect of TMS has been studied for several years. We contribute to the development and exploration of new stimulation procedures that might be helpful to treat depression.

 

 
  
  • Plewnia C, Padberg F. Transkranielle und invsive Hirnstimulationsverfahren bei Depression. (2012) Nervenarzt DOI 10.1007/s00115-012-3573-y.
      Download Article (pdf, ca. 412 KB)
     
  • Herwig U, Fallgatter AJ, Höppner J, Eschweiler GW, Kron M, Hajak G, Padberg F, Naderi-Heiden A, Abler B, Eichhammer P, Grossheinrich N, Hay B, Kammer T, Langguth B, Laske C, Plewnia C, Richter MM, Schulz M, Unterecker S, Zinke A, Spitzer M, Schönfeldt-Lekuona C. (2007) Antidepressant effects of transcranial magnetic stimulation - a randomized double-blind multi-centre trial. British Journal of Psychiatry. 191:441-448.
     
  • Hajak G, Padberg F, Herwig U, Eschweiler G, Cohrs S, Langgut B, Schönfeldt-Lecuona C, Fallgatter AJ, Höppner J, Plewnia C, Eichhammer P (2005) Repetitive transkranielle Magnetstimulation. Konsensus zum therapeutischen Einsatz bei psychiatrischen Erkrankungen. Nervenheilkunde, 24, 48-58
     
  • Eschweiler GW, Plewnia C, Bartels M (2001) Welche depressiven Patienten profitieren von präfrontaler repetitiver transkranieller Magnetstimulation (RTMS)? Fortschr Neurol Psychiat 69, 1-8.
     
  • Eschweiler GW, Plewnia C, Batra A, Bartels M (2000) Does clinical response to repetitive prefrontal transcranial magnetic stimulation (rTMS) predict response to electroconvulsive therapy (ECT) in cases of major depression? Can J Psychiatry 45, 845-856.
 
 

 

Measurement and modulation of cortico-cortical connectivity

The successful processing of information in the central nervous system is based on effective cooperation of diverse cortical and subcortical areas. One correlat of interregional cooperation is the coherrence of oscillatory activity of brain areas that build a functional netwrk for a certain amount of time. Both the association of coherent interregional activity with multimodal integration as well as the positive relation between the degree of coherence and the success of multimodal cooperation were experimentally detectable. The targeted improvement of coherent activity might result in improved achievements, which is based on the effective cooperation of involved areas. TMS is a well-established non-invasive method to stimulate cortical neurons. By applying repetitive TMS one can achieve outlasting effects that are not limited by a stimulated area and functional relevant.

 

 
 
  • Rilk A, Soekadar SR, Sauseng P, Plewnia C. (2011) Alpha coherence predicts accuracy during a visuomotor tracking task. Neuropsychologia 49:3704- 3709.
     
  • Plewnia C, Rilk A, Soekadar SR, Arfeller C, Huber H, Sauseng P, Hummel F, Gerloff C (2008) Enhancement of long-range EEG coherence by synchronous bifocal transcranial magnetic stimulation. Eur J Neurosci. 27:1577-1583
 
 

 

Deep brain stimulation (DBS)

Deep brain stimulation is an effective and registered method to treat Parkinson's disease. We attend the psychiatric aspects of this method and investigate possible applications in psychiatric disorders.

 

 
 
  • Lengerer S, Kipping J, Rommel N, Weiss D, Breit S, Gasser T, Plewnia C, Krüger R, Wächter T. (2012) Deep Brain Stimulation does not Impair Deglutition in Parkinson's Disease. Parkinsonism & Related Disorders 18:847-53.
  • Weiss D, Brockmann K, Sruljes K, Meisner C, Klotz R, Reinbold S, Hauser AK, Schulte C, Berg D, Gasser T, Plewnia C, Gharabaghi A, Breit S, Wächter T, Krüger R. (2012) Long-term follow-up of subthalamic nucleus stimulation in glucocerebrosidase-associated Parkinson's disease. Journal of Neurology 259:1970-2.
  • Rzesnitzek L, Waechter T, Gharabaghi A, Kruger R, and Plewnia C. (2011) Suppression of extrapyramidal side effects of doxepin by thalamic DBS for Tourette Syndrome. Neurology 77:1708-9
     
  • Weiss D, Wächter T, Meisner C, Fritz M, Gharabaghi A, Plewnia C, Breit S, Krüger R. (2011) Combined STN/SNr-DBS for the treatment of refractory gait disturbances in Parkinson's disease: study protocol for a randomized controlled trial. Trials 12:222.
  • Weiss D, Govindan RB, Rilk A, Wächter T, Breit S, Haarmeier T, Plewnia C, Krüger R, Gharabaghi A. (2011) Central oscillators underlying neuropathic tremor: evidence from intraoperative LFP recordings. Movement disorders 26:323-7.
  • Weiss D, Breit S, Wächter T, Plewnia C, Gharabaghi A, Krüger R. (2011) Combined stimulation of the substantia nigra pars reticulata and the subthalamic nucleus is effective in hypokinetic gait disturbance in Parkinson's disease. J Neurology 258:1183-5.
  • Plewnia C, Schober F, Rilk A, Buchkremer G, Reimold M, Wächter T, Breit S, Weiss D, Krüger R, Freudenstein D. (2008) Sustained improvement of obsessive-compulsive disorder by deep brain stimulation in a woman with residual schizophrenia. Int Journal Neuropsychopharmacology 11:1181-1183.
 
 

 

Pathophysiology and experimental therapy of chronic tinnitus

Decisive factors of the pathogenesis of tinnitus are considered i.e. maladaptive cerebral processes of re-organisation. Focal hyperactivity in cortical areas of the auditory system and of multimodal information processing might represent the common final track of diverse pathophysiological mechanisms. We were able to demonstrate tempoparietal cortext areas to be a functional relevnt part of a neuronal network ot tinnitus with the help of repetitive transcranial magnetic stimulation (rTMS). Consecutive studies proved the temporally constrained suppression of tinnitus perception through the application of low frequent rTMS (1 Hz) which reduces cortical activity and thereby implemented functional imaging and individually navigated rTMS. However, a therapeutic efficacy of rTMS in regard of a clinically relevant improvement of tinnitus-related strain was not verifiable in a larger randomized clinical trial.

 

 
 
  • Schraven S, Plontke SK, Rahne T, Wasserka B, Plewnia C. Hearing safety of long-term treatment with theta burst stimulation. (2012) Brain Stimulation (in press)
  • Plewnia C, Vonthein R, Wasserka B, Arfeller C, Naumann A,  Schraven SP, Plontke SK. (2012) Treatment of chronic tinnitus with theta burst stimulation: A randomized controlled trial. Neurology  78:1628-34.
     
  • Plewnia C. (2011) Brain stimulation: New vistas for the exploration and treatment of tinnitus. CNS Neuroscience & Therapeutics  17:449-61.
     
  • Arfeller C, Vonthein R, Plontke SK, Plewnia C. (2009) Efficacy and safety of bilateral continuous theta burst stimulation (cTBS) for the treatment of chronic tinnitus: design of a three-armed randomized controlled trial. Trials  10:74
     
  • Plewnia C, Reimold M, Najib A, Reischl G, Plontke S, Gerloff C (2007) Moderate therapeutic efficacy of PET-navigated repetitive transcranial magnetic stimulation against chronic tinnitus: A randomized, controlled pilot study. J Neurol Neurosurg Psych. 78(2):152-6.
  • Plewnia C, Reimold M, Najib A, Brehm B, Reischl G, Plontke S, Gerloff C (2007) Dose-dependent attenuation of auditory phantom perception (tinnitus) by PET-guided repetitive transcranial magnetic stimulation. Hum Brain Mapp. 28(3):238-46.
     
  • Plewnia C, Kammer T, Gerloff C (2004) Treating tinnitus with transccranial magnetic stimulation. Biol Psych, 55:1117
     
  • Plewnia C, Bartels M, Gerloff C (2003) Suppressing tinnitus by repetitive transcranial magnetic stimulation to the temporoparietal cortex. Ann Neurol 53, 263-266.
     
  • Plewnia C, Bartels M, Gerloff C. (2000) Cortical Mapping of Auditory Phantom Perception (Tinnitus). A Pilot Study. Akt Neurol 27: S203
 
 

Research grants:

 






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We offer targeted therapies using transcranial brain stimulation in the Center for Brain Stimulation (Zentrum für Hirnstimulation ZfH).
ZfH Website (in German)
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Neurophysiology and Interventional Neuropsychiatry
Calwerstraße 14
Tübingen 72076
Tel. +49 7071 29-86074
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