(2011) An overview is shown in Figure 1 The contrast of interes

(2011). An overview is shown in Figure 1. The contrast of interest compared the alcohol cue minus the juice cue. Contrast maps from individual subject analyses were registered to the MNI152 template in a two-step registration process using registration parameters from the registration of the mean EPI image to the individual subject’s T1 image, and the registration of the T1 to the MNI152 template. All steps used FLIRT. FA-BOLD correlations Correlations between

averaged FA values and the whole-brain contrast maps (alcohol minus litchi) from the alcohol Inhibitors,research,lifescience,medical cue task were analyzed to identify BMS-754807 cell line task-related regions that were significantly associated with white matter integrity. This step was done for each FA map by a linear regression of the averaged FA values with each voxel of the BOLD contrast maps across the subjects. Age is associated with FA decreases

independent of alcohol intake (Giorgio et al. Inhibitors,research,lifescience,medical 2010; Michielse et al. 2010) and could be a potential confound. In this sample, a linear, negative correlation was observed for age and averaged FA for 15 of 18 of the tracts of interest, with significant Pearson’s r’s ranging from −0.128 to −0.472. Because of the relation between FA and age, which was consistent Inhibitors,research,lifescience,medical with the aging literature cited above, age was included as a covariate in regression analyses. However, results did Inhibitors,research,lifescience,medical not change appreciably when age was not included as a covariate. Four participants with acceptable DTI data did not have fMRI taste task data and were excluded from analysis. In addition, 15 participants had FA values that were outliers of >3 standard deviations (SDs) on at least one white matter region of interest (ROI). Outliers on a given ROI were excluded for that analysis, and the number of excluded participants

ranged from 0 to 7 for the 18 white matter ROIs. For each correlation, the thresholded image was Inhibitors,research,lifescience,medical corrected for multiple comparisons using cluster-based thresholding as implemented in FSL, with a voxel-wise threshold of z > 2.3 and a cluster threshold of P < 0.05. Results The sample Idoxuridine included 332 individuals (102 female, 230 male) with a mean of 31.2 (SD = 9.4) years of age. Table 1 summarizes demographic and clinical characteristics of the sample. On average, participants endorsed a moderate level of alcohol problem severity on the ADS and AUDIT. On the ADS, 64% of the sample scored ≥9, reflecting a high likelihood of diagnosis of alcohol dependence (Allen and Wilson 2003). Moreover, 96% of participants scored ≥8 on the AUDIT, indicating hazardous drinking and possible dependence (Babor et al. 2001). Table 1 Demographic and clinical characteristics (N = 332).

In the present study, all cases underwent head CT on the day of a

In the present study, all cases underwent head CT on the day of admission. Cases with low-density area in the globus pallidus were significantly more likely to develop DNS. CO produces parenchymal necrosis in fragile areas in the cerebral gray matter, particularly bilateral symmetric necrosis of the globus pallidus, which has been reported to be characteristic of CO poisoning [8]. Other areas often Bortezomib mw affected Inhibitors,research,lifescience,medical include the hippocampus, cerebellum and substantia nigra, where

affected parts appear as low-density areas on CT. While CO gas concentration multiplied by duration of exposure is considered an important determinant of the severity of acute CO poisoning as mentioned above, in clinical settings it is often difficult to accurately find out how long the unconscious patient has been exposed to CO. However, a report has proposed a cut-off value of 570 min as a duration of exposure above which abnormal CT/MRI findings Inhibitors,research,lifescience,medical are predicted to be observed at the initial stage [27]. Using this threshold, it should be possible to estimate, from head CT findings at emergency admission, whether or not the patient has had prolonged exposure. A number of reports have identified abnormal CT/MRI findings [26] as a risk factor for developing

DNS, which is also the case with this study. On the other hand, 20% of the cases with no abnormal CT findings did develop DNS, suggesting that even cases without abnormal Inhibitors,research,lifescience,medical findings require attention to the clinical course. Hematology results show that abnormally high CK, CK-MB and LDH levels are significantly associated with the development of DNS. In acute CO poisoning cases, hypoxia and impaired cellular respiration caused by CO induce damage to multiple organs. Inhibitors,research,lifescience,medical These high CK levels are caused by damage to skeletal muscles. In this regard, the effect of pressure Inhibitors,research,lifescience,medical ulcer formation, which was seen in a number of cases due to prolonged immobility in the same position, should also be taken into account. LDH is an enzyme found in almost all cells and is released into the bloodstream when cells are damaged. As such, it is used as an indicator for assessing

the severity of general condition [28]. The high LDH and CK-MB levels are considered to have been caused by myocardial injury. While these high levels have both been caused by prolonged exposure to CO, the the hematological changes observed are regarded as nonspecific and not characteristic of CO poisoning [11]. The CO -Hb level only indicates the binding ratio between CO and Hb. As such, it decreases with time once CO inhalation is stopped, and decreases more efficiently as a result of oxygen administration in the ambulance. For this reason, CO-Hb levels following emergency admission are not directly associated with the degree of systemic tissue damage, as seen in the results of this study, which failed to show a significant association between CO-Hb levels and the development of DNS. In fact, the non-DNS-developing group had a higher mean CO-Hb level.

7 For the two early intervention studies, two groups of atrisk pe

7 For the two early intervention studies, two groups of atrisk persons are selected from the larger group of persons referred to the early-recognition centers, according to their presumed prodromal stage. Based on previous longitudinal observations, an “early initial

prodromal stage” is assumed in case subjects report predictive Inhibitors,research,lifescience,medical basic symptoms in the ERI8 or in case they have a first-degree relative with schizophrenia and show a marked decline in global functioning. “Late initial prodromal stages” are defined by the occurrence of brief limited intermittent psychotic symptoms (BLIPS) or by attenuated positive symptoms. Persons at risk for psychosis in the early prodromal state are included into an early intervention study examining the effects of a newly developed cognitivebehavioral therapy (CBT) strategy for prodromal persons, which

is compared with Sunitinib cell line clinical management, within a randomized control design over a 24-month Inhibitors,research,lifescience,medical period.9-10 Persons in the late prodromal state of psychosis are included into a second Inhibitors,research,lifescience,medical early intervention study, which compares the effects of atypical antipsychotic medication with amisulpride in combination with clinical management (supported by crisis intervention or family counseling in case of need, but no regular psychotherapy) to such clinical management alone.11 This is a phase-Ill study with an open-label, randomized parallel design, with a treatment period of 2 Inhibitors,research,lifescience,medical years. Effects

of both studies will be evaluated with regard to improvement of prodromal symptoms, prevention of social decline, and suppression, or at least, delay, of progression to psychosis. Preliminary results of both studies are encouraging, indicating a benefit for at-risk persons treated with CBT or amisulpride, respectively, Inhibitors,research,lifescience,medical compared with the control treatments with regard to these outcome variables. Should these trends be validated in the final analyses, Megestrol Acetate the use of early recognition and early intervention strategies as developed within the GRNS would be an important, step in the management, of developing psychosis. Example II: acute and long-term treatment in first-episode schizophrenia Though a number of studies have shown advantages of “atypical” second-generation antipsychotics compared with conventional antipsychotics in acute treatment (for review see ref 12) as well as in long-term treatment, of schizophrenia (for review see ref 13) it is still under debate whether these results may be biased by the high dosages of conventional antipsychotics usually used in these studies.

Table IV T3 Enhancement of antidepressants Thyroxine This thyro

Table IV. T3 Enhancement of antidepressants. Thyroxine This thyroid hormone has been used in two ways in the treatment of mood disorders. First, it has been used as an augmentation agent for the treatment of antidepressant nonresponders, and, second, as a mood stabilizer for rapidcycling bipolar disorder. The latter will not be discussed. T4 has received less attention as an augmentation agent, as most of the initial studies were

carried out using T3. However, there is a limited database on the use of T4 augmentation, and these studies are summarized in Table V Table V. Antidepressant augmentation with T4. T3, tri-iodothyronine; Inhibitors,research,lifescience,medical T4, thyroxine;

RCT, randomized controlled trial; SSRI, selective serotonin reuptake inhibitor These studies generally involve open designs using various diagnoses, including both unipolar and bipolar subjects in one study48 and chronic depression or dysthymic Inhibitors,research,lifescience,medical patients in another study.50 All involve small sample designs. Nonetheless, in each of these studies, T4 showed augmentation effects in antidepressant nonresponders. The efficacy of T4 and its comparable efficacy to T3 remain unresolved issues. A large-scale, well-designed, placebo-controlled Inhibitors,research,lifescience,medical study directly comparing the efficacy T3 and T4 in SSRI nonresponders with major depression would Inhibitors,research,lifescience,medical address this important issue. In conclusion, the database on thyroid hormone treatment provides mixed findings in studies, often with methodological limitations and inconclusive data. The strongest evidence is for an antidepressant augmentation effect of T3 in

antidepressant nonresponders, but the use of T3 in other ways to accelerate and enhance antidepressant treatment, as well as the clinical utility of other hormones of the thyroid axis, require further study. In Inhibitors,research,lifescience,medical addition, issues such as tolerability, long-term safety, and duration, as well as dose of treatment need to be addressed. The doses employed in all these studies are less than the amount of endogenous T3 daily production so that there is little risk of induction of clinical and C646 purchase hyperthyroidism. Another important issue for future study is whether particular subtypes of depression respond preferentially to thyroid hormone or in fact any hormonal treatment. As greater knowledge is obtained about genetic and biological variability of major depression as well as the regulation of thyroid hormones in the body in general and the brain in particular, we may be able to identify preferential responders to thyroid hormone and, analogously, to other hormone strategies.

When light exposure was administered at a symptomfree period at t

When light exposure was administered at a symptomfree period at the beginning of autumn, however, it was not successful in preventing the development of winter depression.57 Partonen and Lonnqvist,58 in contrast, did find that bright light given well in advance of the emerging symptoms of winter SAD prevented a depressive episode. Effects on hypersomnia Hypersomnia has been associated with a superior response to morning light.59 In an open study design, Lam et al60 found that patients

with winter depression Inhibitors,research,lifescience,medical who had hypersomnia had greater improvement, particularly in Afatinib atypical depression symptoms than patients with insomnia. Evening subjective sleepiness improves with morning light, even a short 15-min exposure, Inhibitors,research,lifescience,medical in patients with winter depression.61 Comparison with antidepressant medication Wirz-Justlce et al62 described a woman with SAD who, after remitting within a week in each of 6 separate trials of light therapy, remitted within 2 weeks of initiating citalopram, despite the delayed sleep and intermittent awakening induced with citalopram, but not with light therapy. Ruhrmann et al63 found that 70% of 40 SAD patients treated with bright light (3000 lux 2 h daily) were responders compared with 65% treated with fluoxetine (20 mg daily for 5 weeks). Light treatment Inhibitors,research,lifescience,medical improved

depression scores faster, while fluoxetine had a faster effect on atypical symptoms. In 13 SAD patients, Ghadirian et al64 compared light therapy for 2 weeks or tryptophan for 4 weeks in an open repeated-measures design. Tryptophan was equally effective to light therapy in treating SAD, but relapse after withdrawal of tryptophan occurred more slowly. Improvement of atypical depressive symptoms after 1 h of light

therapy Inhibitors,research,lifescience,medical positively correlated with improvement after 2 weeks of therapy.65 Comparison with natural light Eastman66 Inhibitors,research,lifescience,medical documented that the perceived sunlight exposure in SAD patients in Chicago was twice as much in summer than in winter: the perceived daylength was 4 to 5 h longer in summer than in winter, with a later perceived dusk contributing more to the lengthening than an earlier perceived dawn. Wirz- Justice et al67 observed that 50% of patients with SAD remitted after a daily 1-h morning walk outdoors in natural light, which phase-advanced the onset and/or offset of salivary melatonin secretion, and decreased morning Cortisol compared with low-dose artificial light, which did not modify depression self-ratings, or melatonin or Astemizole Cortisol patterns. The effects of bright light treatment (2500 lux) on subsyndromal SAD in the workplace have been studied,68 and both morning and afternoon exposure resulted in similar levels of improvement in mood, energy, alertness, and productivity. Side effects Terman et al69 reviewed the ocular effects of particularly the more recent treatment approach of using approximately 10 000 lux light exposure for 30 min.

In addition, the E E of PEG-Fe3O4 was inferior to CTS-Fe3O4 not

In addition, the E.E. of PEG-Fe3O4 was inferior to CTS-Fe3O4 notably for the lack of electrostatic attraction. Figure 1 The size and zeta potential of the CTS-Fe3O4. (a) Size of distribution of the CTS-Fe3O4; (b) zeta potential of the CTS-Fe3O4. 3.2. Target Distribution In Vivo The different organs from the mice injected with polymer-Fe3O4 were taken out and made into tissue slices. Target distribution of polymer Fe3O4 in vivo was demonstrated with the help of outer static magnetic Inhibitors,research,lifescience,medical field. Figure 2(b) shows a large number of iron particles scattered in the hepatic tissue; many

of them were distributed along the hepatic sinusoid 2h after injection. The iron particles decreased gradually over time and disappeared 24h after injection (data not shown). The shape of the liver Inhibitors,research,lifescience,medical cells was seen under a high-power microscope to be integrated. There was no iron staining in the other organs, such as the lungs (Figure 2(d)), the spleen, and the heart. And there was no obvious side effect observed in the injected mice. Figure 2 Target distribution of magnetic CTS-Fe3O4 in liver and lung tissue. Figures were shown by Prussian blue and neutral red staining Inhibitors,research,lifescience,medical (×250), with outer static magnetic field for 2 hours. (a) Normal liver tissue; (b) liver tissue injected CTS-Fe3O … 3.3. Test of Polymer-Fe3O4-Loaded

DNA In Vitro Protection of DNA from DNaseI degradation was detected by 1% agarose gel electrophoresis. Naked pEGFP-C1 without Inhibitors,research,lifescience,medical PLX4032 ic50 digestion and naked pEGFP-C1 following digestion by DNaseI were used as controls. We could evidence partial protection of DNA coated by polymer Fe3O4 from nuclease-mediated DNA degradation (unpublished data). It was assumed that DNA degradation occurs in several layers; external Inhibitors,research,lifescience,medical layers will be degraded easily but not internal layers. Furthermore, CTS-Fe3O4 nanoparticles offered higher protection for DNA than PEG-Fe3O4, as the DNA chains could be attached more strongly to the former. In addition, DNaseI digestion resulted in a shift

in the most distribution of the DNA isoforms: supercoiled plasmid in nontreated samples was replaced by the open loop form in treated samples. The in vitro release rates of DNA from polymer-Fe3O4 complexes were studied at different volume ratios. A significant proportion (30%) of the adsorbed DNA was released very rapidly from the CTS-Fe3O4 nanoparticles in the initial 12 hours. After Metalloexopeptidase 48h, the amount of released DNA reached 55% at the optimal E.E. And the remainder of the adsorbed DNA was released slowly, reaching 70% at 96h (Figure 3(a)). Compared to DNA release from CTS-Fe3O4, a burst release phase of more than 61% from PEG-Fe3O4 was observed. The release curve showed that the DNA was released more rapidly; more than 80% of DNA was discharged from PEG-Fe3O4 after 24h at the optimal E.E., and the entire release was mostly completed at 72h (Figure 3(b)).

113 It remains uncertain whether widespread genotyping prior to t

113 It remains uncertain whether widespread genotyping prior to the onset of treatment therapy can contribute substantially to therapeutic outcome. Challenges facing the field include phenotypic and etiological heterogeneity, technological limitations, and contemporary research approaches. It seems that genetic testing for side-effect prediction has the highest likelihood of being incorporated into clinical practice. Supporting this, a test for clozapine-induced

agranulocytosis is now available with satisfying sensitivity and specificity.114 Computational Inhibitors,research,lifescience,medical models that include gene variants and other factors associated with antipsychoticinduced weight gain have yielded promising results.115 Tests related to treatment response may follow through the inclusion of more sophisticated genotyping techniques (eg, sequencing) and the analysis of refined endophenotypes, Inhibitors,research,lifescience,medical such as specific symptoms or symptom clusters. Future development of algorithm-based approaches requires the integration of additional genetic and nongenetic factors. Neuroimaging research has produced encouraging

associations between imaging endophenotypes and treatment outcome, such as the 5-HTTLPR x PFC/amygdala interaction. Nonetheless, these observations Inhibitors,research,lifescience,medical lack the positive and negative predictive value required to reliably distinguish responders from nonresponders to be used clinically. Based on current research, imaging markers explain a significant, but modest, portion Inhibitors,research,lifescience,medical of the

total variance. More research is required with larger, less heterogeneous samples in conjunction with other markers, eg, genotyping and electrophysiological measures. Most neuroscience research thus far involves the application of various theoretical approaches (ie, neuroimaging, genetics, neuropsychological, and physiological, etc) in isolation. The next step in the development of personalized medicine Inhibitors,research,lifescience,medical is the formation of standardized multimodal research models to better characterize markers of treatment response. Now is a time for optimism in the emerging ability of pharmacogenetics and neuroimaging to Wortmannin order provide meaningful help to the physician in developing individually tailored treatments for complex, heterogeneous psychiatric disorders. Selected abbreviations Metalloexopeptidase and acronyms 5-HT serotonin 5-HTTLPR serotonin transporter-linked polymorphic region ACC Anterior cingulate cortex BDNF brain-derived neurotrophic factor CYP cytochrome P450 PM poor drug metabolizer UM ultrarapid drug metabolizer
Schizophrenia (SCZ) is a disease with an estimated lifetime morbid risk approaching 1% worldwide,1 and its public health consequences (mortality- and morbidity) are severe.

20 The final diagnoses were made by consensus of the two psychiat

20 The final diagnoses were made by consensus of the two psychiatrists, blinded to the endocrine data. Everolimus mouse suicide history attempt assessment and statistical analysis were conducted following the same procedures described above for depressed patients. The schizophrenic patients as a whole showed no significantly different baseline PRL values (13.9+7 µg/L versus

15.6±7 µg/L; P>0.8 by the U test) Inhibitors,research,lifescience,medical when compared with healthy controls. However, DPRL was significantly lower in this group when compared with normal volunteers (2±6.1 µg/L versus 6.6±5.3 µg/L; P<0.Ql by the U test). This difference was mainly accounted for by the significantly lower PRL levels in suicidal patients, since a subgroup analysis showed that patients with schizophrenia and a suicide history exhibit lower

levels of PRL in response to D-FEN compared with patients with schizophrenia without such a history, and also compared with healthy controls. No difference in APRL levels was found between patients with schizophrenia without Inhibitors,research,lifescience,medical a suicide history and controls. Healthy controls and patients with schizophrenia, subgrouped by suicide history, presented no difference in demographic characteristics or baseline hormonal values as shown in Table III. The patients with schizophrenia and a suicide attempt history showed no demographic, clinical, or anamnestic differences compared with Inhibitors,research,lifescience,medical patients without such a history. Age in years (30.4+11.1 versus 32±11.7; P>0.9 by U test), weight (61.3±8.8 kg versus 62.2±9.2 kg; P>0.75 by U test), age of illness onset in years (21.3±4.9 versus 24.9±8.7; P>0.3 by U test), number of previous hospitalizations (3.0±1.7 versus 2.8±1.9;/>>0.5 by U test), and distribution Inhibitors,research,lifescience,medical of schizophrenia subtypes (paranoid 5 versus 11; undifferentiated 3 versus 2; and disorganized 4 versus 8) were not statistically different between patients with schizophrenia with or without a suicidal history. Psychopathological data (HAM-D-17 and Brief Psychiatric Rating Scale [BPRS]) was also evaluated. No differences in HAM-D-17 scores or in the BPRS total or factor Inhibitors,research,lifescience,medical scores were found between patients with or without a history of suicide attempt. (Table IV). Table III. Demographic characteristics

and biological data for normal controls and patients with schizophrenia according to their suicide history. Values are expressed as means±SD. BPRL, basal prolactin concentration; APRL indicates peak concentration minus … Table IV. Psychopathological data first for patients with schizophrenia according to their suicide history. Values are expressed as means±SD. HAM-D-17, Hamilton Rating Scale for Depression, 17-item version; BPRS, Brief Psychiatric Rating Scale; SHSP, patients … Patients with a recent suicide attempt. (n=5) exhibited comparable basal and post-fenfluramine hormonal levels when compared with patients with a past suicide attempt (n=7). Demographic and clinical characteristics were similar between these two subgroups (Table V). Table V.

Next, empirical evidence for the immunologic and neuroimaging asp

Next, empirical evidence for the immunologic and neuroimaging aspects of bereavement, and of CG specifically, will be reviewed. Finally, the article ends with a summary of some of the gaps in knowledge of the neurobiological and immunological aspects of CG. Bereavement models and theories Why investigate the immunological and neuroimaging biomarkers of CG? Certainly there is value in the mere evidence of these biomarkers, but in addition, the physiological

components or correlates Inhibitors,research,lifescience,medical of CG may help us to understand how CG arises, predict who it may affect, and provide suggestions for how to treat it. However, these latter reasons are best served when there is a clear theory behind

the study of the biomarkers. Theory points us in the direction for study, and the results of the studies inform and refine Inhibitors,research,lifescience,medical our theories. The following section reviews cognitive stress theory, attachment theory, and the biopsychosocial model of CG. Cognitive stress theory suggests that the death of a loved one is stressful Inhibitors,research,lifescience,medical because it is a disruptive event requiring a great deal of adjustment.2 In addition, at exactly the moment when one must cope with a significant stressor, a primary source of support may be absent (ie, the deceased), reducing one’s emotional and instrumental resources. This is one definition of stress: the perceived demands of the situation tax or exceed the individual’s perceived coping resources.3 Attachment Inhibitors,research,lifescience,medical theory states that the bonds between parent and child, and romantic partners, is a product of behavioral conditioning whereby an association is developed between the attachment figure and: (i) a reduction in distress; and (ii) the generation of pleasure.4 Inhibitors,research,lifescience,medical This conditioning explains a variety of behaviors, such as the maintenance of close proximity between bonded individuals, the development of mental schemas, or working models, that provide comfort during absence of the attachment figure, and distress that is generated upon separation

from the attachment figure. For bereavement, attachment theory has specific predictions. Bereavement Linifanib (ABT-869) includes a gradual extinction of this conditioning, in which the regulatory benefits conferred by mental representations of the attachment figure diminish slowly over time. Bowlby4 described the end point of successful mourning as a Small molecule library psychological reorganization of one’s thoughts and feelings about a deceased attachment figure (for review, see ref 5). In a very elegant study comparing cognitive stress theory and attachment theory, Stroebe and colleagues2 examined a prospective dataset of older adults. At the baseline, both members of the couple were alive. At the second time point, one of the spouses had died.

15,17 Given the strong representation of synaptic activity in the

15,17 Given the strong representation of synaptic activity in the EEG, the question arises as to whether fMRI signals are related to similar or different aspects of neuronal activity, such as neuronal spiking. In fact, in many experimental situations, synaptic activity is highly correlated with the firing rate of the neuron to which the synapses

under consideration belong. Accordingly, it is not surprising that in many cases the fMRI signal correlates equally well with LFPs and spiking activity. However, in a few studies, there has been successful differentiation Inhibitors,research,lifescience,medical between synaptic activity and spiking activity with regard to the related hemodynamic changes.18 These studies have provided evidence for a much closer relationship between the blood oxygenation level-dependent (BOLD) contrast mechanism Inhibitors,research,lifescience,medical and presynaptic and postsynaptic processing of incoming afferents to a region and only to a lesser degree the activity of its output efferents.19-22 In summary, although obviously very different in terms of the signal that is Inhibitors,research,lifescience,medical actually measured, both EEG and fMRI have a considerable overlap concerning the neuronal activity that they represent, which is mainly synaptic activity. Technique: safety and quality issues From the very early days of simultaneous EEG-fMRI, safety issues have been an important aspect. Radiofrequency-related heating of electrodes or brain tissue has to be

considered, and there are several factors that are relevant such as the scanning sequence, the number of EEG electrodes, or the field strength of the MRI scanner.23 Taking all aspects into account, simultaneous EEG-fMRI recordings have been Inhibitors,research,lifescience,medical safely performed at many different MRI centers, and simultaneous EEG-fMRI is considered as a standard imaging technique. Since simultaneous EEG-fMRI recordings today are typically Inhibitors,research,lifescience,medical performed with commercially available MR-compatible EEG equipment, specific safety instructions are provided by the companies. Another issue in simultaneous EEG-fMRI is the quality of the EEG recorded in mafosfamide the scanner. Here, two main artefacts have to be considered: the cardiac pulse-related

artefact and the image acquisition artefact. For both types of artefacts, today there are post-processing artefact removal strategies available with sufficient efficacy. The pulse-related artefact, which is often also referred to as a ballistocardiogram, or BCG artefact, is complex in its origin with a role of pulsatile movements of scalp vessels on adjacent electrodes and head rotation. Post-processing strategies are based buy trans-isomer either on waveform removal approaches such as the average artefact subtraction algorithm24 or on pattern removal approaches such as independent component analysis.25 In addition to a priori avoiding of BCG artefacts,26 new strategies include the application of optical motion tracking systems.