Dr. rer. nat. Max Toepper, Dipl.-Psych. Clinical Neuropsychologist GNP. Working group: Aging and Cognitive Neuroscience

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1 Dr. rer. nat. Max Toepper, Dipl.-Psych. Clinical Neuropsychologist GNP Evangelisches Klinikum Bethel Department of Psychiatry and Psychotherapy Department of Geriatric Psychiatry Research Division Head of the working group Aging and Cognitive Neuroscience Contact information Tel.: Working group: Aging and Cognitive Neuroscience Head of working group: Dr. rer. nat. Max Toepper, Dipl.-Psych. The working group Aging and Cognitive Neuroscience focuses on neural changes during normal and pathological aging and associated cognitive decline. Further goals are the development of neuropsychological tests for the early detection of neurodegenerative disorders, the identification of risk factors for driving seniors, and the creation of signs and symbols to facilitate orientation in patients with dementia. Next to neuropsychology, methodological approaches comprise functional magnetic resonance imaging (fmri), diffusion tensor imaging (DTI), voxel-based morphometry (VBM), and the analysis of cerebrospinal fluid (CSF). The different projects particularly include patients suffering from Alzheimer s disease, Mild Cognitive Impairment and Major Depressive Disorder, as well as healthy seniors. Past projects Deficient inhibitory processes in neurodegenerative disorders This project focused on neurodegenerative disorders and related neuropsychological deficits. Results show that patients suffering from Alzheimer s disease show an inhibitory dysfunction, specifically if active inhibition is required. This dysfunction already manifests in prodromal stages of the disease (amnestic MCI) and was identified with a multiple-item spatial working memory paradigm that additionally requires the inhibition of spatial distracters (Block-Suppression-Test; Beblo et al., 2004). Prof. Dr. rer. nat. Thomas Beblo Prof. Dr. med. Martin Driessen

2 Recent projects Functional and structural cerebral changes during normal and pathological aging This project explores functional and structural cerebral changes during normal and pathological aging and the effects of these changes on cognitive performance. Up to now, the project includes three fmri studies, one DTI study and one VBM study. In particular, these studies investigate the cerebral activation of different brain regions, their structural and functional connections, as well as the impact of these factors on spatial working memory performance and inhibition. The studies reveal cerebral and cognitive dysfunctions associated with normal aging (healthy younger adults versus healthy seniors) and neurodegenerative disorders (healthy seniors versus patients suffering from Alzheimer s disease or Mild Cognitive Impairment). Prof. Dr. rer. nat. Thomas Beblo Prof. Dr. med. Martin Driessen Dr. med. Stefan Kreisel, M.Sc. Dr. rer. nat. Eva Bauer Prof. Dr. med. Bernd Gallhofer Helge Gebhardt, Dipl.-Psych. Prof. Dr. Hans. J. Markowitsch Prof. Dr. Gebhard Sammer Dr. med. Friedrich Woermann Linking CSF and cognition in Alzheimer s disease Alzheimer s disease (AD) leads to severe cognitive decline caused by pathological cerebral changes. An analysis of cerebrospinal fluid (CSF) allows the identification of different markers for these changes. Such an analysis requires a lumbar puncture which is after all an invasive method with potential complications. For that reason, this project examines whether and how accurately specific neuropsychological test scores allow an estimation of specific AD-related CSF markers. Prof. Dr. rer. nat. Thomas Beblo Sebastian Bödeker, M.Sc. Prof. Dr. med. Martin Driessen Michael Guhra Dr. med. Stefan Kreisel, M.Sc.

3 Symbol processing in dementia Clinical experts consistently suggest signs or symbols to facilitate the orientation of demented patients on hospital wards. However, there are hardly any studies that confirm whether or how much demented patients actually benefit from signs or symbols. Moreover, it is unknown which cognitive abilities are required for an adequate symbol comprehension and which symbol characteristics may facilitate or impede symbol processing. The project includes patients suffering from Alzheimer s disease, Mild Cognitive Impairment and Major Depressive Disorder, as well as healthy seniors. Symbol comprehension is assessed with a symbol processing task (SPT) developed by our working group (Toepper et al., 2014). Next to a better understanding of symbol processing in general, the project will have important practical and diagnostic implications. Prof. Dr. rer. nat. Thomas Beblo Sebastian Bödeker, M.Sc. Prof. Dr. med. Martin Driessen Dr. rer. nat. Eva Bauer Prof. Dr. Hans. J. Markowitsch Prof. Dr. Gebhard Sammer The identification of potential risk factors for impaired driving skills in patients with neurological and psychiatric disorders Neurological and psychiatric disorders are often associated with cognitive deficits that lead to impaired driving skills. Nevertheless, depending from the respective national legislation, many of these impaired drivers still drive. To protect these drivers and the driving public, it is very important to indentify impaired drivers, to inform them about potential risk factors and to discuss possible transport alternatives. The main aim of this project is to develop a reliable and valid questionnaire that is able to quantify possible risk factors for impaired driving skills in order to improve the consultation quality for driving seniors. Dr. med. Stefan Spannhorst Dr. med. Stefan Kreisel, M.Sc. Philipp Schulz, B.Sc.

4 Dr. rer. nat. Max Toepper, Dipl.-Psych. Clinical Neuropsychologist GNP Evangelisches Klinikum Bethel Department of Psychiatry and Psychotherapy Department of Geriatric Psychiatry Research Division Head of the working group Aging and Cognitive Neuroscience Contact information Tel.: Fields of work - Clinical Neuropsychology - Aging research Research topics - Cognitive neuroscience - Imaging - Neuropsychology - Working memory - Executive functioning - Inhibition - Symbol comprehension - Driving abilities - Alzheimer s disease - Mild Cognitive Impairment (MCI) - Aging Research articles Schulz, M., Toepper, M., & Behrens, J. (2004). Rauchverhalten von Mitarbeitern und Patienten der psychiatrischen Abteilung eines Allgemeinkrankenhauses. Das Gesundheitswesen, 66 (2), doi: /s Toepper, M., Beblo, T., Thomas, C., Driessen, M. (2008). Early detection of Alzheimer s disease: a new working memory paradigm. International Journal of Geriatric Psychiatry, 23, doi: /gps Wingenfeld, K., Rullkoetter, N., Mensebach, C., Beblo, T., Mertens, M., Kreisel, S., Toepper, M., Driessen, M., Woermann, F. G. (2009). Neural correlates of the individual emotional Stroop in women with borderline personality disorder. Psychoneuroendocrinology, 34, doi: /j.psyneuen Toepper, M., Gebhardt, H., Beblo, T., Thomas, C., Driessen, M., Bischoff, M., Blecker, C. R., Vaitl, D., Sammer, G. (2010). Functional correlates of distractor suppression during spatial working memory encoding. Neuroscience, 165, doi: /j.neuroscience Toepper, M., Markowitsch, H. J., Gebhardt, H., Beblo, T., Thomas, C., Gallhofer, B., Driessen, M., Sammer, G. (2010). Hippocampal involvement in working memory encoding of changing locations: an fmri study. Brain Research, 1354, doi: /j.brainres Toepper, M., Beblo, T., Beckmann, N., Gebhardt, H., Thomas, C., Driessen, M., Sammer, G. (2013). The block suppression test uncovers specific inhibitory deficits in mild cognitive impairment. International Journal of Geriatric Psychiatry, 28, doi: /gps Toepper, M., Gebhardt, H., Bauer, E., Haberkamp, A., Beblo, T., Gallhofer, B., Driessen, M., Sammer, G. (2014). The impact of age on load-related dorsolateral prefrontal cortex activation. Frontiers in Aging Neuroscience, 6. doi: /fnagi

5 Toepper, M., Markowitsch, H., Gebhardt, H., Beblo, T., Bauer, E., Wörmann, F., Driessen, M., Sammer, G. (2014). The impact of age on prefrontal cortex integrity during spatial working memory retrieval. Neuropsychologia, 59, doi: /j.neuropsychologia Toepper, M., Steuwe, C., Beblo, T., Bauer, E., Boedeker, S., Thomas, C., Markowitsch, H., Driessen, M., Sammer, G. (2014). Deficient symbol processing in Alzheimer's disease. Alzheimer s Disease and Associated Disorders, 28, doi: /WAD Toepper, M., Boedeker, S., Westphal, S., Driessen, M., Beblo, T. (2014). Does Mount Vesuvius indicate an outbreak of Alzheimer s disease? Journal of the American Geriatrics Society, 62, doi: /jgs Spannhorst, S., Kreisel, S., Toepper, M., Thomas, C. (2014). Fahrtauglichkeit. Konsensusverfahren zur Beratung von Senioren in der Gedächtnissprechstunde. Neurotransmitter, 25, doi: /s y. Bauer, E., Toepper, M., Gebhardt, H., Gallhofer, B., Sammer, G. (2015). The significance of caudate volume for age-related associative memory decline. Brain research, 1622, doi: /j.brainres Bauer, E., Sammer, G., Toepper, M. (2015). Trying to put the puzzle together: age and performance level modulate the neural response to increasing task load within left rostral prefrontal cortex. BioMed Research International, vol doi: /2015/ Guhra, M., Thomas, C., Boedeker, S., Kreisel, S., Driessen, M., Beblo, T., Ohrmann, P., Toepper, M. (2016). Linking CSF and Cognition in Alzheimer s Disease: Reanalysis of Clinical Data. Experimental Gerontology, 73, doi: /j.exger Schulz, P., Spannhorst, S., Beblo, T., Thomas, C., Kreisel, S., Driessen, M., Toepper, M. (2016). Preliminary validation of a questionnaire covering risk factors for impaired driving skills in elderly patients. Geriatrics 2016, 1(1), 5. doi: /geriatrics Spannhorst, S.; Toepper, M., Schulz, P., Wenzel, G., Driessen, M., Kreisel, S. (2016). Advice for elderly drivers in a German memory clinic: A case report on medical, ethical and legal consequences. Geriatrics 2016, 1(1), 9. doi: /geriatrics Toepper, M., Sammer, G., Bauer, E. (2016). Reproducibility of complex fmri effects. Journal of the American Geriatrics Society, 64, e62. doi: /jgs Schulz, P., Spannhorst, S., Iffland, B., Toepper, M. (2016). Do self-reports provide valid information about driving fitness in seniors? International Journal of Geriatric Psychiatry, 32, doi: /gps Toepper, M. (2017). Dissociating normal aging from Alzheimer's disease: a view from cognitive neuroscience. Journal of Alzheimer s Disease, 57, doi: /JAD Book chapters Thomas, C., Wittmiß, S., Toepper, M., & Driessen, M. (2009). Religiöse Motivation und Depression im Alter Erste Ergebnisse einer klinisch prospektiven Studie. In: G. Thomas & I. Karle (Hrsg.), Krankheitsdeutung in der postsäkularen Gesellschaft Theologische Ansätze im interdisziplinären Gespräch (S ). Stuttgart: Kohlhammer. Wittmiß, S., Toepper, M., Driessen, M., & Thomas, C. (2009). Religiöse Deutungspraxis und Depression. In: G. Adler, H. Gutzmann, M. Haupt, R. Kortus, & D. K. Wolter (Hrsg.), Seelische Gesundheit und Lebensqualität im Alter Depression-Demenz-Versorgung (S ). Stuttgart: Kohlhammer.

6 Personal information Name Dr. rer. nat. Max Toepper Address Evangelisches Klinikum Bethel Department of Psychiatry and Psychotherapy Research Division Remterweg D Bielefeld, Germany Phone number 0521/ Date of birth July 29, 1974 Curriculum vitae 2005 Diploma in Psychology (University of Bielefeld, Germany) 2006 Bender Institute of Neuroimaging (BION), Giessen, Germany PhD (University of Giessen, Germany) Postgraduate education in Clinical Neuropsychology GNP since 2007 Clinical neuropsychologist (Evangelisches Klinikum Bethel) since 2011 Post-doc research fellow (Evangelisches Klinikum Bethel) since 2014 Head of working group Aging and Cognitive Neuroscience (Evangelisches Klinikum Bethel) Reviewer Cortex Frontiers in Behavioral Neuroscience Neurocase Awards Poster award (DGS 2003 in Munich) Poster award (DGGPP 2013 in Essen) Poster award (GNP/FESN 2013 in Berlin) Poster award (DGGPP 2015 in Essen) Poster award (DGVP/DGVM 2015 in St Gallen)

7 Abstracts Schulz, M., Toepper, M., & Behrens, J. (2004). Rauchverhalten von Mitarbeitern und Patienten der psychiatrischen Abteilung eines Allgemeinkrankenhauses. Suchtmedizin, 5 (2), S Toepper, M., Beblo, T., Thomas, C., & Driessen, M. (2007). Der Block-Suppressions-Test: Sensitivität bei der Frühdiagnose der senilen Demenz vom Alzheimer-Typ. Neurogeriatrie 4, S. 28. Toepper, M., Gebhardt, H., Bischoff, M., Beblo, T., Thomas, C., Blecker, C. R., Vaitl, D., Sammer, G. (2007). Unterdrückung von Störreizen bei visuell-räumlichen Arbeitsgedächtnisprozessen: eine fmrt-studie. Zeitschrift für Neuropsychologie 18 (2), S Toepper, M., Beblo, T., Sammer, G., & Thomas, C. (2008). Suppressions-Prozesse bei Demenzerkrankten und Gesunden: Verhalten und neuronale Grundlagen. Der Nervenarzt 79 (Supplement 4), S Toepper, M., Beblo, T., Gebhardt, H., Haberkamp, A., Thomas, C., Woermann, F. G., Driessen, M., Markowitsch, H. J., Sammer, G. (2009). Behavioural and neural correlates of inhibitory functioning in patients with Alzheimer's disease and healthy control subjects. INS mid-year meeting 2009: Program and abstracts, S. 34. Kreisel, S. H., Röwekamp, M., Toepper, M., Labudda, K., Wörmann, F. G., Thomas, C. (2009). Delirium in patients with Alzheimer s Disease: structural pathologies in cholinergic innervation? A diffusion-tensor imaging study. European Delirium Association 2009 in Leeds.. Thomas, C., Kreisel, S. H., Toepper, M., Oster, P., Inouye, S. K. (2009). Attention deficits indicative of delirium Evaluation in demented patients. European Delirium Association 2009 in Leeds, Abstractband. Haberkamp, A., Brück, C., Toepper, M., Sammer, G. (2009). Visuospatial working memory and aging. Perception 38, S Toepper, M., Beblo, T., Mensebach, C., Driessen, M. (2009). Der Einfluss emotional neutraler und negativer Ablenkung auf die Lernleistung depressiver Patienten und die Beziehung zu kognitiven Problemen im Alltag. Zeitschrift für Neuropsychologie 20 (3), S Toepper, M., Markowitsch, H. J., Gebhardt, H., Beblo, T., Thomas, C., Driessen, M., Sammer, G. (2009). Der rechte Hippocampus und seine Beteiligung an räumlichen Arbeitsgedächtnisprozessen: eine fmrt-studie. Zeitschrift für Neuropsychologie 20 (3), S Toepper, M., Markowitsch, H. J., Gebhardt, H., Beblo, T., Thomas, C., Kreisel, S., Gallhofer, B., Driessen, M., Sammer, G. (2010). Hippocampal involvement in working memory encoding of changing target locations. 16th Annual Meeting of the Organization for Human Brain Mapping in Barcelona, Abstractband. Toepper, M., Wiehler, A., Risius, O. (2010). Gedächtniskonzepte und Testdiagnostik. 47. Kongress der deutschen Gesellschaft für Psychologie, Abstractband, S Toepper, M., Haberkamp, A., Gebhardt, H., Sammer, G. (2010). Alterskorrelierte Hirnaktivierung bei der Speicherung und dem Abruf räumlicher Arbeitsgedächtnisinhalte steigender Komplexität. Zeitschrift für Neuropsychologie 21 (3), S Toepper, M., Markowitsch, H. J., Gebhardt, H., Beblo, T., Thomas, C., Kreisel, S., Labudda, K., Mertens, M., Wörmann, F., Driessen, M., Gallhofer, B., Sammer, G. (2012). Functional hippocampal changes within the working memory network in patients with amnestic MCI. 18th Annual Meeting of the Organization for Human Brain Mapping in Peking, Abstractband. Toepper, M., Sammer, G. (2012). Altern, Hirnfunktion und Neurobildgebung. Zeitschrift für Neuropsychologie 23 (3), S Toepper, M., Gebhardt, H., Bauer, E., Beblo, T., Sammer, G. (2012). CRUNCHING HAROLD: Neuronale Korrelate abnehmender Arbeitsgedächtnisleistungen im Alter. Zeitschrift für Neuropsychologie 23 (3), S Steuwe, C., Toepper, M., Bauer, E., Piefke, M., Beblo, T., Sammer, G. (2012). Symbolverarbeitung bei Patienten mit Demenz vom Alzheimer Typ. Zeitschrift für Neuropsychologie 23 (3), S Gmehlin, D., Kreisel, S., Toepper, M., Arolt, V., Weisbrod, M., Thomas, C. (2012). Inhibitorische Netzwerke als Korrelat neuropsychologischer Defizite bei Alzheimer Demenz. Zeitschrift für Neuropsychologie 23 (3), S Guhra, M., Thomas, C., Kreisel, S., Boedeker, S., Toepper, M. (2013). Der Zusammenhang zwischen Liquor- Markern und Kognition bei Patienten mit Demenz vom Alzheimer-Typ. Neurogeriatrie 10, S

8 Toepper, M., Markowitsch, H. J., Saradjuk, B., Gebhardt, H., Beblo, T., Bauer, E., Kreisel, S., Wörmann, F., Thomas, C., Driessen, M., Sammer, G. (2013). Age-related reduction of prefrontal cortex integrity during spatial working memory retrieval. Behavioural Neurology 3 (27). Toepper, M., Markowitsch, H. J., Kater, L., Gebhardt, H., Beblo, T., Bauer, E., Kreisel, S., Wörmann, F., Thomas, C., Driessen, M., Sammer, G. (2013). Neural correlates of impaired inhibitory processes in mild cognitive impairment. Behavioural Neurology 3 (27). Toepper, M., Markowitsch, H. J., Gebhardt, H., Beblo, T., Bauer, E., Wörmann, F., Driessen, M., Sammer, G. (2014). Age-related changes in frontal neural circuits during spatial working memory retrieval. 20th Annual Meeting of the Organization for Human Brain Mapping in Hamburg, Abstractband. Toepper, M., Bödeker, S., Bauer, E., Beblo, T., Driessen, M., Markowitsch, H. J., Sammer, G. (2014). Symbolverarbeitung bei Alzheimer-Demenz und Depression. Zeitschrift für Neuropsychologie 25(3), S Toepper, M., Kreisel, S., Bödeker, S., Bauer, E., Beblo, T., Driessen, M., Markowitsch, H. J., Sammer, G. (2015). Symbolverarbeitung bei Alzheimer-Demenz und Depression. Neurogeriatrie 12, S Toepper, M., Gebhardt, H., Bauer, E., Haberkamp, A., Beblo, T., Gallhofer, B., Driessen, M., Sammer, G. (2015). Decreasing DLPFC activation with age in response to increasing working memory load. Proceedings of the Third International Conference on Aging & Cognition, S. 151, ISBN Spannhorst, S., Schulz, P., Toepper, M., Kreisel, S. (2015). Beratung zur Fahreignung in der Gedächtnissprechstunde Erfahrungen mit strukturiertem, individualisiertem Konsensusprozess. Blutalkohol Alcohol, Drugs, Behavior and Traffic Safety 52, Sup I, S. 22. Schulz, P., Spannhorst, S., Kreisel, S., Beblo, T., Driessen, M., Toepper, M. (2016). Seniorenberatung aufgrund fahreignungsrelevanter Einschränkungen. Zeitschrift für Neuropsychologie 27(3), S Beblo, T., Marschner-Preuth, N., Toepper, M., Gehner, A., Veips, J., Driessen, M., Schäbitz, W.-R. (2016). Entwicklung eines nonverbalen Instruments zur Erfassung depressiver Symptome Das Bethel-Depressions- Screening (BDS). Zeitschrift für Neuropsychologie 27(3), S. 221.