General psychiatry and psychotherapy with outpatient clinic

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Address: Calwerstraße 14
72076 Tübingen

Person profile: 07071 29-82311

Fax number: 07071 29-4141

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Neurophysiology and Interventional Neuropsychiatry (NiN)

NiN is concerned with the fundamentals and therapeutic use of the brain's adaptability (neuroplasiticity). By investigating the effects of transcranial brain stimulation procedures and targeted training, insights are gained into the healthy functioning of the brain and its impairments. The goal is to use this approach to develop new, effective and tolerable ways to treat mental illness.

The area includes clinical care as well as basic and patient-oriented research and teaching tasks.

The methodological focus is on transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and the use of playful elements in cognitive training programs (gamification) for psychiatric disorders. Effect and mode of action are investigated with clinical, neuropsychological, neurophysiological and imaging examination methods. As part of the treatment routine, TMS, EEG diagnostics, individualized cognitive training programs and electroconvulsive therapy (ECT) are performed and scientifically evaluated.

Contact

Secretariat:
Diana Thoma

+49 7071 29-86119

christian.plewnia@uni-tuebingen.de

Management:

frontend.sr-only_#{element.contextual_1.children.icon}: Prof. Dr. med. Christian Plewnia

More about the person

Clinic

Clinic

TMS provides a method to measure brain activity and to modulate it non-invasively in a targeted and controlled manner. Thus, this technique represents an important research tool in biological psychiatry and also offers interesting therapeutic options for various psychiatric and neurological disorders.

In the field of psychiatric disorders, this technique is currently used in particular for the treatment of depression and auditory hallucinations. We offer this therapy method within the Center for Brain Stimulation (ZfH) and coordinate several large, multi-center studies on the clinical application and further development of this treatment method.

ECT is a scientifically founded procedure which represents the best possible treatment for certain psychiatric illnesses and is associated with a low risk in relation to the desired therapeutic success. It is used in our clinic primarily for the treatment of therapy-resistant severe depression and catatonia. Indications and treatment are determined in accordance with the guidelines and internal procedural instructions.

Statement of the Medical Association on ECT

THS, also known as a "brain pacemaker", is an effective and well-tolerated treatment option for neurological movement disorders that cannot be adequately treated by other means. Via a surgically implanted stimulator, similar to a cardiac pacemaker, electrical impulses are continuously delivered via a cable to specific regions of the brain. This stimulation influences the brain activity that is responsible for the disabling disease symptoms. In recent years, THS has also been successfully applied to psychiatric disorders and is used here in cooperation Neurosurgical and Neurological University Hospital in individual cases (Plewniaet al. Int J Psychopharm 2008, Rzesnitzek et al. Neurology 2011). In addition, the Department of Psychiatry and Psychotherapy is involved in the treatment of all patients with THS.

The EEG is an important neurophysiological method of psychiatric diagnostics and also serves to monitor the course of treatment of special drug therapies.

Center for Brain Stimulation

The Center for Brain Stimulation (ZfH) of the Department of Psychiatry and Psychotherapy offers targeted therapy with all innovative brain stimulation methods.

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Research

Research

A characteristic feature of the human brain is its ability to adapt to changes in the environment, the body and itself (neuroplasticity). The underlying neurophysiological mechanisms are still largely unknown. Adaptive neuroplasticity supports recovery from damage to brain structure or function. 'Maladaptive' neuroplasticity, however, may also underlie a variety of psychiatric and neurological disorders.

The work of our group focuses on the physiological and pathophysiological basis of adaptive and maladaptive neuroplasticity. Corresponding studies are performed in healthy individuals and for patients with psychiatric disorders. Electrophysiological methods, invasive and non-invasive brain stimulation procedures, cognitive training programs and imaging techniques are used for research and experimental therapeutic modulation of brain functions. Here is a selection of the current research focus areas:

Theta Burst Stimulation (TBS) is a new TMS protocol that was first used successfully in our clinic in a controlled pilot clinical trial for the treatment of depressive symptoms (Plewniaet al. J Aff Neurosci 2014). More recently, it has been confirmed to have comparable good efficacy in the treatment of depression although considerably faster (Blumbergeret al. Lancet 2018). Therefore, this procedure is now being used worldwide in the treatment of depression. Against the background of the still lacking acceptance and availability of TMS in Germany, the BMBF has been funding a multicenter controlled clinical trial initiated and coordinated by us since the beginning of 2020 in which the efficacy of bilateral TBS in depression will be further proven in comparison to placebo treatment.

With tDCS it is possible to temporarily influence the activity of the brain by a weak current flow. First studies from our group and others could show effects on cognitive processes and performance. This makes it possible to investigate the conditions and mechanisms of cognitive processing in more detail. We are currently investigating whether and with which stimulation parameters tDCS can actually support the effects of cognitive training in the sense of adaptive neuroplasticity (Ruf et al.Scientific Reports 2017, Weller et al. Brain Stimulation 2020).


Executive functions are the group of cognitive skills responsible for planning and controlling complex goal-directed behavior. More or less specific disorders in this area are found in most mental illnesses. In many cases, these impairments are an essential part of the disease symptomatology and are often associated with disturbances of local brain activity. Improvement of executive function deficits can contribute to the treatment of specific clinical pictures. Non-invasive brain stimulation techniques such as TMS and tDCS can modulate regional cortical activity. Accordingly, we are investigating the complex effects of focal modulation of physiological and pathological brain activity on executive functions in healthy individuals (Dockeryet al. J Neurosci 2009, Zwissler et al. J Neurosci 2014, Schroeder et al. J Cogn Neurosci 2016, Wiegand et al. Sci Rep 2019) and patients with mental illness (Wolkenstein & Plewnia Biol Psych 2013, Wolkenstein et al. Cortex 2014, Schwippel et al. 2018). We are also particularly interested in individual predictors of effect such as genetics (Plewniaet al. Cortex 2013, Nieratschker et al. Brain Stim 2015), gender, hemodynamic (Ehlis et al.Neuroimage 2016) and oscillatory activity (Faehling & PlewniaFront Cell Neurosci 2016). These studies expand our understanding of normal and impaired executive functions and contribute to the development of new therapies (Plewniaet al. Lancet Psychiatry 2015).


Lack of cognitive control of perception, processing, and memory of negative information is a central feature of depressive symptomatology. Training this skill can significantly support the treatment of depression. However, the implementation of such a treatment has so far also been very limited due to the specific symptomatology of the patients and has therefore hardly been used. With the current digital possibilities, however, a much more low-threshold application of this therapy method is possible through different playful elements and the use of mobile devices. We are investigating the extent and mechanisms of the effect of these techniques, particularly in depression, and are using in-depth documentation of user experiences to continuously improve these applications.

  • C. Plewnia, A. Fallgatter (BMBF FKZ 01KG2003): 'C. Plewnia, A. Fallgatter: Treatment of major depressive disorder with bilateral theta burst stimulation' (2020-2023)
  • C. Plewnia, P. Schröder (EU DESIGNSCAPES #763784): 'Back in the Game: Gamified Cognitive Training to treat Depression' (2020-2021)
  • C. Plewnia, A. Fallgatter, A. Hasan (BMBF FKZ 01EE1407H): Research Network for Mental Illness, ESPRIT Network, Project 'Transcranial Direct Current Stimulation to Improve Cognitive Training in Schizophrenia' (2015-2020)
  • C. Plewnia, A. Fallgatter BMBF (FKZ 01EE1403D): Research Network for Mental Diseases, Collaborative GCBS, Project 'Sustained improvement of poor cognitive control by training supported with transcranial direct current stimulation (tDCS)' (2015-2020)
  • C. Plewnia (DFG PL 525/4-1): clinical trial 'Treatment of auditory hallucinations in schizophrenia with bilateral theta burst stimulation' (2016-2020)
  • C. Plewnia, K. Giel (DFG (PL 525/7-1): in-kind grant 'Enhancing cognitive control in binge eating disorder by electrical brain stimulation' (2016-2019) *€280,390*.
  • J Svaldi, A Fallgatter, B Tuschen-Caffier, C Plewnia (DFG PL 525/6-1;: In-kind grant 'Augmentative effects of tDCS on body-based attention modification training in women with bulimia nervosa'.
The team

Teaching

Teaching

Teaching offerings include elective courses, doctoral colloquia, and residency training events.

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Jobs, internships and theses

We offer interested parties the opportunity to join us in the form of Bufdi positions, HiWi jobs, internships or final theses (Bachelor, Master, Doctorate).

Our work in research and treatment is wide-ranging. As a result, you will have the opportunity to work on a variety of ongoing projects with us, or to develop your own ideas. Potential areas of work may include, for example, conducting screening phone calls and diagnostic interviews, data processing, using non-invasive brain stimulation techniques, digital interventions, or other novel therapeutic methods. You will work closely with us yet also independently on current research projects. The exact tasks and scope of work will be agreed upon individually.

  • A current or completed university degree in psychology, medicine or a related natural science field. For Bufdi positions, a completed school education.
  • Good knowledge of German and English.
  • Reliability and a desire to work in a team.
  • Flexibility and willingness to learn new topics.
  • Interest in and empathy for people with mental illness.

If you are interested or if you would like to send us a speculative application, please send your application documents to:

nin@med.uni-tuebingen.de

Further links

Certificates and Associations

Focus: Top Nationales Krankenhaus 2024

Die deutschen Universitätsklinika

Kooperation für Transparenz und Qualität im Gesundheitswesen

Qualitätspartnerschaft mit der PKV

Blauer Sterne Betrieb

Erfolgsfaktor Familie

Die Altersvorsorge für den Öffentlichen Dienst