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Tiedt S, Duering M, Barro C, Kaya AG, Boeck J, Bode FJ, Klein M, Dorn F, Gesierich B, Kellert L, Ertl-Wagner B, Goertler MW, Petzold GC, Kuhle J, Wollenweber FA, Peters N, Dichgans M. Serum neurofilament light: A biomarker of neuroaxonal injury after ischemic stroke. Neurology 2018; 91:e1338-e1347. [PMID: 30217937 DOI: 10.1212/wnl.0000000000006282] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 07/04/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To explore the utility of serum neurofilament light chain (NfL) as a biomarker for primary and secondary neuroaxonal injury after ischemic stroke (IS) and study its value for the prediction of clinical outcome. METHODS We used an ultrasensitive single-molecule array assay to measure serum NfL levels in healthy controls (n = 30) and 2 independent cohorts of patients with IS: (1) with serial serum sampling at hospital arrival (n = 196), at days 2, 3, and 7 (n = 89), and up to 6 months post stroke; and (2) with standardized MRI at baseline and at 6 months post stroke, and with cross-sectional serum sampling at 6 months (n = 95). We determined the temporal profile of serum NfL levels, their association with imaging markers of neuroaxonal injury, and with clinical outcome. RESULTS Patients with IS had higher serum NfL levels compared with healthy controls starting from admission until 6 months post stroke. Serum NfL levels peaked at day 7 (211.2 pg/mL [104.7-442.6], median [IQR]) and correlated with infarct volumes (day 7: partial r = 0.736, p = 1.5 × 10-15). Six months post stroke, patients with recurrent ischemic lesions on MRI (n = 19) had higher serum NfL levels compared to those without new lesions (n = 76, p = 0.002). Serum NfL levels 6 months post stroke further correlated with a quantitative measure of secondary neurodegeneration obtained from diffusion tensor imaging MRI (r = 0.361, p = 0.001). Serum NfL levels 7 days post stroke independently predicted modified Rankin Scale scores 3 months post stroke (cumulative odds ratio [95% confidence interval] = 2.35 [1.60-3.45]; p = 1.24 × 10-05). CONCLUSION Serum NfL holds promise as a biomarker for monitoring primary and secondary neuroaxonal injury after IS and for predicting functional outcome.
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Affiliation(s)
- Steffen Tiedt
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Marco Duering
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Christian Barro
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Asli Gizem Kaya
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Julia Boeck
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Felix J Bode
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Matthias Klein
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Franziska Dorn
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Benno Gesierich
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Lars Kellert
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Birgit Ertl-Wagner
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Michael W Goertler
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Gabor C Petzold
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Jens Kuhle
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Frank A Wollenweber
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Nils Peters
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany
| | - Martin Dichgans
- From the Institute for Stroke and Dementia Research, University Hospital (S.T., M. Duering, A.G.K., J.B., B.G., F.A.W., M. Dichgans), and Graduate School of Systemic Neurosciences (S.T.), LMU Munich; Munich Cluster for Systems Neurology (SyNergy) (S.T., M. Dichgans), Munich, Germany; Neurologic Clinic and Policlinic (C.B., J.K.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; German Center for Neurodegenerative Diseases (DZNE) (F.J.B., G.C.P.), Bonn; Department of Neurology (F.J.B., G.C.P.), University Hospital Bonn; Departments of Neurology (M.K., L.K.), Neuroradiology (F.D.), and Radiology (B.E.-W.), University Hospital, LMU Munich; Department of Neurology (M.W.G.), University of Magdeburg, University Hospital; German Center for Neurodegenerative Diseases (DZNE) (M.W.G.), Magdeburg, Germany; Stroke Center and Department of Neurology (N.P.), University Hospital Basel, Switzerland; and German Center for Neurodegenerative Diseases (DZNE) (M. Dichgans), Munich, Germany.
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Kamm K, Pomschar A, Ruscheweyh R, Straube A, Reiser MF, Hernádi I, László JF, Ertl-Wagner B. Static magnetic field exposure in 1.5 and 3 Tesla MR scanners does not influence pain and touch perception in healthy volunteers. Eur J Pain 2018; 23:250-259. [DOI: 10.1002/ejp.1299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 07/25/2018] [Accepted: 07/29/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Katharina Kamm
- Department of Neurology; Ludwig-Maximilians-University Hospital; Munich Germany
| | - Andreas Pomschar
- Department of Radiology; Ludwig-Maximilians-University Hospital; Munich Germany
| | - Ruth Ruscheweyh
- Department of Neurology; Ludwig-Maximilians-University Hospital; Munich Germany
| | - Andreas Straube
- Department of Neurology; Ludwig-Maximilians-University Hospital; Munich Germany
| | | | - Istvan Hernádi
- Center for Neuroscience; Department of Experimental Neurobiology and Szentagothai Research Center; University of Pécs; Pécs Hungary
| | - Janos F. László
- Department of Computer Science; University of Debrecen; Debrecen Hungary
| | - Birgit Ertl-Wagner
- Department of Radiology; Ludwig-Maximilians-University Hospital; Munich Germany
- Department of Radiology; The Hospital for Sick Children; University of Toronto; Toronto Canada
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Walter F, Maihöfer C, Schüttrumpf L, Well J, Burges A, Ertl-Wagner B, Mahner S, Belka C, Gallwas J, Corradini S. Combined intracavitary and interstitial brachytherapy of cervical cancer using the novel hybrid applicator Venezia: Clinical feasibility and initial results. Brachytherapy 2018; 17:775-781. [DOI: 10.1016/j.brachy.2018.05.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/15/2018] [Accepted: 05/24/2018] [Indexed: 10/28/2022]
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Kirsch V, Boegle R, Keeser D, Kierig E, Ertl-Wagner B, Brandt T, Dieterich M. Handedness-dependent functional organizational patterns within the bilateral vestibular cortical network revealed by fMRI connectivity based parcellation. Neuroimage 2018; 178:224-237. [DOI: 10.1016/j.neuroimage.2018.05.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/02/2018] [Accepted: 05/05/2018] [Indexed: 12/19/2022] Open
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Roth CJ, Förster KM, Hilgendorff A, Ertl-Wagner B, Wall WA, Flemmer AW. Gas exchange mechanisms in preterm infants on HFOV - a computational approach. Sci Rep 2018; 8:13008. [PMID: 30158557 PMCID: PMC6115430 DOI: 10.1038/s41598-018-30830-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 07/19/2018] [Indexed: 11/25/2022] Open
Abstract
High-frequency oscillatory ventilation (HFOV) is a commonly used therapy applied to neonates requiring ventilatory support during their first weeks of life. Despite its wide application, the underlying gas exchange mechanisms promoting the success of HVOF in neonatal care are not fully understood until today. In this work, a highly resolved computational lung model, derived from Magnetic Resonance Imaging (MRI) and Infant Lung Function Testing (ILFT), is used to reveal the reason for highly efficient gas exchange during HFOV, in the preterm infant. In total we detected six mechanisms that facilitate gas exchange during HFOV: (i) turbulent vortices in large airways; (ii) asymmetric in- and expiratory flow profiles; (iii) radial mixing in main bronchi; (iv) laminar flow in higher generations of the respiratory tract; (v) pendelluft; (vi) direct ventilation of central alveoli. The illustration of six specific gas transport phenomena during HFOV in preterm infants advances general knowledge on protective ventilation in neonatal care and can support decisions on various modes of ventilatory therapy at high frequencies.
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Affiliation(s)
- Christian J Roth
- Institute for Computational Mechanics, Technical University of Munich, 85748, Garching, Germany
| | - Kai M Förster
- Division of Neonatology, Dr. von Hauner Children's Hospital, Perinatal Center Grosshadern, LMU-Munich, 81337, Munich, Germany
- Comprehensive Pneumology Center, Helmholtz Zentrum München, Munich, Germany, Member of the German Lung Research Center (DZL), Munich, Germany
| | - Anne Hilgendorff
- Division of Neonatology, Dr. von Hauner Children's Hospital, Perinatal Center Grosshadern, LMU-Munich, 81337, Munich, Germany
- Comprehensive Pneumology Center, Helmholtz Zentrum München, Munich, Germany, Member of the German Lung Research Center (DZL), Munich, Germany
| | | | - Wolfgang A Wall
- Institute for Computational Mechanics, Technical University of Munich, 85748, Garching, Germany
| | - Andreas W Flemmer
- Division of Neonatology, Dr. von Hauner Children's Hospital, Perinatal Center Grosshadern, LMU-Munich, 81337, Munich, Germany.
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Kunz WG, Hunink MG, Dimitriadis K, Huber T, Dorn F, Meinel FG, Sabel BO, Othman AE, Reiser MF, Ertl-Wagner B, Sommer WH, Thierfelder KM. Cost-effectiveness of Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review of the Impact of Patient Age. Radiology 2018; 288:518-526. [DOI: 10.1148/radiol.2018172886] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kirsch V, Becker-Bense S, Berman A, Gerb J, Ertl-Wagner B, Dieterich M. P120. MRI of the inner ear enables differentiation of central and peripheral vestibular pathologies in a postoperative ELST patient. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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108
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Kirsch V, Becker-Bense S, Berman A, Kierig E, Ertl-Wagner B, Dieterich M. P119. Activity-dependent plasticity of the endolymphatic space in vestibular migraine – A single case study. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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109
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Suchorska B, Schüller U, Biczok A, Kreth FW, Lenski M, Albert NL, Giese A, Ertl-Wagner B, Ingrisch M, Tonn J. Contrast enhancement as a prognostic factor in IDH1/2 mutant glioma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.2029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Ulrich Schüller
- Institute of Neuropathology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Annamaria Biczok
- Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | | | - Markus Lenski
- Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Nathalie Lisa Albert
- Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Armin Giese
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-University, Munich, Germany, Munich, Germany
| | - Birgit Ertl-Wagner
- Department of Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Ingrisch
- Department of Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Joerg Tonn
- Department of Neurosurgery, University of Munich (LMU), Munich, Germany
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110
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K. Steinlein O, Ertl-Wagner B, C. Sattler E. Pulmonary Bullae as an Indicator of an Elevated Risk of Renal Carcinoma. Dtsch Arztebl Int 2018; 115:294. [PMID: 29789106 PMCID: PMC5974259 DOI: 10.3238/arztebl.2018.0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Ortrud K. Steinlein
- Interdisziplinäre BHDS-Sprechstunde, Institut für Humangenetik, Klinikum der Ludwig-Maximilians-Universität München,
| | - Birgit Ertl-Wagner
- Interdisziplinäre BHDS-Sprechstunde, Klinik und Poliklinik für Radiologie, Klinikum der Ludwig-Maximilians-Universität München
| | - Elke C. Sattler
- Interdisziplinäre BHDS-Sprechstunde, Klinik und Poliklinik für Dermatologie, Klinikum der Ludwig-Maximilians-Universität München
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111
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Kirsch V, Becker-Bense S, Berman A, Kierig E, Ertl-Wagner B, Dieterich M. Transient endolymphatic hydrops after an attack of vestibular migraine: a longitudinal single case study. J Neurol 2018; 265:51-53. [PMID: 29696496 DOI: 10.1007/s00415-018-8870-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 04/10/2018] [Accepted: 04/12/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Valerie Kirsch
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany. .,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany. .,Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, Munich, Germany.
| | - S Becker-Bense
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany
| | - A Berman
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - E Kierig
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany
| | - B Ertl-Wagner
- German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany.,Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - M Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany.,Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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112
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Kunz WG, Fabritius MP, Sommer WH, Höhne C, Scheffler P, Rotkopf LT, Fendler WP, Sabel BO, Meinel FG, Dorn F, Ertl-Wagner B, Reiser MF, Thierfelder KM. Effect of stroke thrombolysis predicted by distal vessel occlusion detection. Neurology 2018; 90:e1742-e1750. [PMID: 29678936 DOI: 10.1212/wnl.0000000000005519] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 02/26/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Among ischemic stroke patients with negative CT angiography (CTA), we aimed to determine the predictive value of enhanced distal vessel occlusion detection using CT perfusion postprocessing (waveletCTA) for the treatment effect of IV thrombolysis (IVT). METHODS Patients were selected from 1,851 consecutive patients who had undergone CT perfusion. Inclusion criteria were (1) significant cerebral blood flow (CBF) deficit, (2) no occlusion on CTA, and (3) infarction confirmed on follow-up. Favorable morphologic response was defined as smaller values of final infarction volume divided by initial CBF deficit volume (FIV/CBF). Favorable functional outcome was defined as modified Rankin Scale score of ≤2 after 90 days and decrease in NIH Stroke Scale score of ≥3 from admission to 24 hours (∆NIHSS). RESULTS Among patients with negative CTA (n = 107), 58 (54%) showed a distal occlusion on waveletCTA. There was no difference between patients receiving IVT (n = 57) vs supportive care (n = 50) regarding symptom onset, early ischemic changes, perfusion mismatch, or admission NIHSS score (all p > 0.05). In IVT-treated patients, the presence of an occlusion was an independent predictor of a favorable morphologic response (FIV/CBF: β -1.43; 95% confidence interval [CI] -1.96, -0.83; p = 0.001) and functional outcome (90-day modified Rankin Scale: odds ratio 7.68; 95% CI 4.33-11.51; p = 0.039; ∆NIHSS: odds ratio 5.76; 95% CI 3.98-8.27; p = 0.013), while it did not predict outcome in patients receiving supportive care (all p > 0.05). CONCLUSION In stroke patients with negative CTA, distal vessel occlusions as detected by waveletCTA are an independent predictor of a favorable response to IVT.
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Affiliation(s)
- Wolfgang G Kunz
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany.
| | - Matthias P Fabritius
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Wieland H Sommer
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Christopher Höhne
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Pierre Scheffler
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Lukas T Rotkopf
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Wolfgang P Fendler
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Bastian O Sabel
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Felix G Meinel
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Franziska Dorn
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Birgit Ertl-Wagner
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Maximilian F Reiser
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
| | - Kolja M Thierfelder
- From the Departments of Radiology (W.G.K., M.P.F., W.H.S., L.T.R., B.O.S., F.G.M., B.E.-W., M.F.R., K.M.T.), Neurology (C.H., P.S.), Nuclear Medicine (W.P.F.), and Neuroradiology (F.D.), University Hospital, LMU Munich; and the Institute of Diagnostic and Interventional Radiology (F.G.M., K.M.T.), University Medical Center Rostock, Germany
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113
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Franzmeier N, Hartmann JC, Taylor ANW, Araque Caballero MÁ, Simon-Vermot L, Buerger K, Kambeitz-Ilankovic LM, Ertl-Wagner B, Mueller C, Catak C, Janowitz D, Stahl R, Dichgans M, Duering M, Ewers M. Left Frontal Hub Connectivity during Memory Performance Supports Reserve in Aging and Mild Cognitive Impairment. J Alzheimers Dis 2018; 59:1381-1392. [PMID: 28731448 PMCID: PMC5611800 DOI: 10.3233/jad-170360] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Reserve in aging and Alzheimer's disease (AD) is defined as maintaining cognition at a relatively high level in the presence of neurodegeneration, an ability often associated with higher education among other life factors. Recent evidence suggests that higher resting-state functional connectivity within the frontoparietal control network, specifically the left frontal cortex (LFC) hub, contributes to higher reserve. Following up these previous resting-state fMRI findings, we probed memory-task related functional connectivity of the LFC hub as a neural substrate of reserve. In elderly controls (CN, n = 37) and patients with mild cognitive impairment (MCI, n = 17), we assessed global connectivity of the LFC hub during successful face-name association learning, using generalized psychophysiological interaction analyses. Reserve was quantified as residualized memory performance, accounted for gender and proxies of neurodegeneration (age, hippocampus atrophy, and APOE genotype). We found that greater education was associated with higher LFC-connectivity in both CN and MCI during successful memory. Furthermore, higher LFC-connectivity predicted higher residualized memory (i.e., reserve). These results suggest that higher LFC-connectivity contributes to reserve in both healthy and pathological aging.
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Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Julia C Hartmann
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | | | - Miguel Á Araque Caballero
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Lee Simon-Vermot
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
| | | | - Birgit Ertl-Wagner
- Institute for Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilian University, Munich, Germany
| | - Claudia Mueller
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Cihan Catak
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Robert Stahl
- Institute for Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilian University, Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
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114
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Merk DJ, Ohli J, Merk ND, Thatikonda V, Morrissy S, Schoof M, Schmid SN, Harrison L, Filser S, Ahlfeld J, Erkek S, Raithatha K, Andreska T, Weißhaar M, Launspach M, Neumann JE, Shakarami M, Plenker D, Marra MA, Li Y, Mungall AJ, Moore RA, Ma Y, Jones SJM, Lutz B, Ertl-Wagner B, Rossi A, Wagener R, Siebert R, Jung A, Eberhart CG, Lach B, Sendtner M, Pfister SM, Taylor MD, Chavez L, Kool M, Schüller U. Opposing Effects of CREBBP Mutations Govern the Phenotype of Rubinstein-Taybi Syndrome and Adult SHH Medulloblastoma. Dev Cell 2018; 44:709-724.e6. [PMID: 29551561 DOI: 10.1016/j.devcel.2018.02.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/08/2018] [Accepted: 02/12/2018] [Indexed: 10/17/2022]
Abstract
Recurrent mutations in chromatin modifiers are specifically prevalent in adolescent or adult patients with Sonic hedgehog-associated medulloblastoma (SHH MB). Here, we report that mutations in the acetyltransferase CREBBP have opposing effects during the development of the cerebellum, the primary site of origin of SHH MB. Our data reveal that loss of Crebbp in cerebellar granule neuron progenitors (GNPs) during embryonic development of mice compromises GNP development, in part by downregulation of brain-derived neurotrophic factor (Bdnf). Interestingly, concomitant cerebellar hypoplasia was also observed in patients with Rubinstein-Taybi syndrome, a congenital disorder caused by germline mutations of CREBBP. By contrast, loss of Crebbp in GNPs during postnatal development synergizes with oncogenic activation of SHH signaling to drive MB growth, thereby explaining the enrichment of somatic CREBBP mutations in SHH MB of adult patients. Together, our data provide insights into time-sensitive consequences of CREBBP mutations and corresponding associations with human diseases.
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Affiliation(s)
- Daniel J Merk
- Center for Neuropathology, Ludwig-Maximilians-University, 81377 Munich, Germany; Cancer Biology and Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Neurobiology, Harvard Medical School, Boston, MA 02215, USA
| | - Jasmin Ohli
- Center for Neuropathology, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Natalie D Merk
- Munich Center for Integrated Protein Science at the Chemistry Department, Technical University, 85747 Munich, Germany
| | - Venu Thatikonda
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Sorana Morrissy
- Arthur and Sonia Labatt Brain Tumour Research Centre and Division of Neurosurgery, Hospital for Sick Children (HSC), Toronto, ON M5G 1L7, Canada; Program in Developmental and Stem Cell Biology, HSC, Toronto, ON M5G 1X8, Canada
| | - Melanie Schoof
- Research Institute Children's Cancer Center Hamburg, Martinistrasse 52, N63 (HPI), Hamburg 20251, Germany
| | - Susanne N Schmid
- Center for Neuropathology, Ludwig-Maximilians-University, 81377 Munich, Germany; Department of Neuropathology, University Medical Center Göttingen, 37099 Göttingen, Germany
| | - Luke Harrison
- Center for Neuropathology, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Severin Filser
- German Center for Neurodegenerative Diseases (DZNE), Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Julia Ahlfeld
- Center for Neuropathology, Ludwig-Maximilians-University, 81377 Munich, Germany; Division of Clinical Pharmacology, Department of Internal Medicine IV, Ludwig-Maximilians-University, 80337 Munich, Germany
| | - Serap Erkek
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; European Molecular Biology Laboratory (EMBL), Genome Biology Unit, 69117 Heidelberg, Germany; German Cancer Consortium (DKTK), Core Center Heidelberg, 69120 Heidelberg, Germany
| | - Kaamini Raithatha
- Microarray and Deep-Sequencing Core Facility, University Medical Center Göttingen, 37077 Göttingen, Germany
| | - Thomas Andreska
- Institute for Clinical Neurobiology, University of Würzburg, 97078 Würzburg, Germany
| | - Marc Weißhaar
- Center for Neuropathology, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Michael Launspach
- Center for Neuropathology, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Julia E Neumann
- Center for Neuropathology, Ludwig-Maximilians-University, 81377 Munich, Germany; Institute of Neuropathology, University Medical Center, Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Mehdi Shakarami
- Walter Brendel Center of Experimental Medicine, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Dennis Plenker
- Department of Translational Genomics, University of Cologne, 50931 Cologne, Germany
| | - Marco A Marra
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC VSZ 4S6, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, BC V6H 3N1, Canada
| | - Yisu Li
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC VSZ 4S6, Canada
| | - Andrew J Mungall
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC VSZ 4S6, Canada
| | - Richard A Moore
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC VSZ 4S6, Canada
| | - Yussanne Ma
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC VSZ 4S6, Canada
| | - Steven J M Jones
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC VSZ 4S6, Canada
| | - Beat Lutz
- Institute of Physiological Chemistry, University Medical Center of the Johannes Gutenberg University, 55128 Mainz, Germany
| | - Birgit Ertl-Wagner
- Institute of Clinical Radiology, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Andrea Rossi
- Department of Pediatric Neuroradiology, Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Rabea Wagener
- Institute of Human Genetics, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; Institute for Human Genetics, Ulm University and Ulm University Medical Center, 89081 Ulm, Germany
| | - Reiner Siebert
- Institute of Human Genetics, Christian-Albrechts-University and University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany; Institute for Human Genetics, Ulm University and Ulm University Medical Center, 89081 Ulm, Germany
| | - Andreas Jung
- Institute of Pathology, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Charles G Eberhart
- Division of Neuropathology and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Boleslaw Lach
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Michael Sendtner
- Institute for Clinical Neurobiology, University of Würzburg, 97078 Würzburg, Germany
| | - Stefan M Pfister
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; German Cancer Consortium (DKTK), Core Center Heidelberg, 69120 Heidelberg, Germany; Department of Pediatric Hematology and Oncology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Michael D Taylor
- Arthur and Sonia Labatt Brain Tumour Research Centre and Division of Neurosurgery, Hospital for Sick Children (HSC), Toronto, ON M5G 1L7, Canada; Program in Developmental and Stem Cell Biology, HSC, Toronto, ON M5G 1X8, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Lukas Chavez
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Marcel Kool
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; German Cancer Consortium (DKTK), Core Center Heidelberg, 69120 Heidelberg, Germany
| | - Ulrich Schüller
- Center for Neuropathology, Ludwig-Maximilians-University, 81377 Munich, Germany; Research Institute Children's Cancer Center Hamburg, Martinistrasse 52, N63 (HPI), Hamburg 20251, Germany; Institute of Neuropathology, University Medical Center, Hamburg-Eppendorf, 20246 Hamburg, Germany; Department of Pediatric Hematology and Oncology, University Medical Center, Hamburg-Eppendorf, 20246 Hamburg, Germany.
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115
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Unterrainer M, Mahler C, Vomacka L, Lindner S, Havla J, Brendel M, Böning G, Ertl-Wagner B, Kümpfel T, Milenkovic VM, Rupprecht R, Kerschensteiner M, Bartenstein P, Albert NL. TSPO PET with [ 18F]GE-180 sensitively detects focal neuroinflammation in patients with relapsing-remitting multiple sclerosis. Eur J Nucl Med Mol Imaging 2018. [PMID: 29523925 DOI: 10.1007/s00259-018-3974-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Expression of the translocator protein (TSPO) is upregulated in activated macrophages/microglia and is considered to be a marker of neuroinflammation. We investigated the novel TSPO ligand [18F]GE-180 in patients with relapsing-remitting multiple sclerosis (RRMS) to determine the feasibility of [18F]GE-180 PET imaging in RRMS patients and to assess its ability to detect active inflammatory lesions in comparison with the current gold standard, contrast-enhanced magnetic resonance imaging (MRI). METHODS Nineteen RRMS patients were prospectively included in this study. All patients underwent TSPO genotyping and were classified as high-affinity, medium-affinity or low-affinity binders (HAB/MAB/LAB). PET scans were performed after administration of 189 ± 12 MBq [18F]GE-180, and 60-90 min summation images were used for visual analysis and assessment of standardized uptake values (SUV). The frontal nonaffected cortex served as a pseudoreference region (PRR) for evaluation of SUV ratios (SUVR). PET data were correlated with MRI signal abnormalities, i.e. T2 hyperintensity or contrast enhancement (CE). When available, previous MRI data were used to follow the temporal evolution of individual lesions. RESULTS Focal lesions were identified as hot spots by visual inspection. Such lesions were detected in 17 of the 19 patients and overall 89 [18F]GE-180-positive lesions were found. TSPO genotyping revealed 11 patients with HAB status, 5 with MAB status and 3 with LAB status. There were no associations between underlying binding status (HAB, MAB and LAB) and the signal intensity in either lesions (SUVR 1.87 ± 0.43, 1.95 ± 0.48 and 1.86 ± 0.80, respectively; p = 0.280) or the PRR (SUV 0.36 ± 0.03, 0.40 ± 0.06 and 0.37 ± 0.03, respectively; p = 0.990). Of the 89 [18F]GE-180-positive lesions, 70 showed CE on MRI, while the remainder presented as T2 lesions without CE. SUVR were significantly higher in lesions with CE than in those without (2.00 ± 0.53 vs. 1.60 ± 0.15; p = 0.001). Notably, of 19 [18F]GE-180-positive lesions without CE, 8 previously showed CE, indicating that [18F]GE-180 imaging may be able to detect lesional activity that is sustained beyond the blood-brain barrier breakdown. CONCLUSION [18F]GE-180 PET can detect areas of focal macrophage/microglia activation in patients with RRMS in lesions with and without CE on MRI. Therefore, [18F]GE-180 PET imaging is a sensitive and quantitative approach to the detection of active MS lesions. It may provide information beyond contrast-enhanced MRI and is readily applicable to all patients. [18F]GE-180 PET imaging is therefore a promising new tool for the assessment of focal inflammatory activity in MS.
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Affiliation(s)
- Marcus Unterrainer
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - C Mahler
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany.,Biomedical Center (BMC), LMU Munich, Munich, Germany
| | - L Vomacka
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - S Lindner
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - J Havla
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany.,Biomedical Center (BMC), LMU Munich, Munich, Germany
| | - M Brendel
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - G Böning
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - B Ertl-Wagner
- Institute of Clinical Radiology, University Hospital, LMU Munich, Munich, Germany
| | - T Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany.,Biomedical Center (BMC), LMU Munich, Munich, Germany
| | - V M Milenkovic
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - R Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - M Kerschensteiner
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany.,Biomedical Center (BMC), LMU Munich, Munich, Germany.,Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - P Bartenstein
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany.,Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany. .,Munich Cluster of Systems Neurology (SyNergy), Munich, Germany.
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Franzmeier N, Hartmann J, Taylor ANW, Araque-Caballero MÁ, Simon-Vermot L, Kambeitz-Ilankovic L, Bürger K, Catak C, Janowitz D, Müller C, Ertl-Wagner B, Stahl R, Dichgans M, Duering M, Ewers M. The left frontal cortex supports reserve in aging by enhancing functional network efficiency. Alzheimers Res Ther 2018; 10:28. [PMID: 29510747 PMCID: PMC5838935 DOI: 10.1186/s13195-018-0358-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 02/15/2018] [Indexed: 02/08/2023]
Abstract
Background Recent evidence derived from functional magnetic resonance imaging (fMRI) studies suggests that functional hubs (i.e., highly connected brain regions) are important for mental health. We found recently that global connectivity of a hub in the left frontal cortex (LFC connectivity) is associated with relatively preserved memory abilities and higher levels of protective factors (education, IQ) in normal aging and Alzheimer’s disease. These results suggest that LFC connectivity supports reserve capacity, alleviating memory decline. An open question, however, is why LFC connectivity is beneficial and supports memory function in the face of neurodegeneration. We hypothesized that higher LFC connectivity is associated with enhanced efficiency in connected major networks involved in episodic memory. We further hypothesized that higher LFC-related network efficiency predicts higher memory abilities. Methods We assessed fMRI during a face-name association learning task performed by 26 healthy, cognitively normal elderly participants. Using beta-series correlation analysis, we computed task-related LFC connectivity to key memory networks, including the default mode network (DMN) and dorsal attention network (DAN). Network efficiency within the DMN and DAN was estimated by the graph theoretical small-worldness statistic. We applied linear regression analyses to test the association between LFC connectivity with the DMN/DAN and small-worldness of these networks. Mediation analysis was applied to test LFC connectivity to the DMN and DAN as a mediator of the association between education and higher DMN and DAN small-worldness. Last, we tested network small-worldness as a predictor of memory performance. Results We found that higher LFC connectivity to the DMN and DAN during successful memory encoding and recognition was associated with higher small-worldness of those networks. Higher task-related LFC connectivity mediated the association between education and higher small-worldness in the DMN and DAN. Further, higher small-worldness of these networks predicted better performance in the memory task. Conclusions The present results suggest that higher education-related LFC connectivity to key memory networks during a memory task is associated with higher network efficiency and thus enhanced reserve of memory abilities in aging. Electronic supplementary material The online version of this article (10.1186/s13195-018-0358-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - Julia Hartmann
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - Alexander N W Taylor
- School of Psychology, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Miguel Á Araque-Caballero
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - Lee Simon-Vermot
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität (LMU), Nussbaumstraße 7, 80336, Munich, Germany
| | - Katharina Bürger
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE Munich), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - Cihan Catak
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - Claudia Müller
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - Birgit Ertl-Wagner
- Institute for Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Marchioninistraße 15, 81377, Munich, Germany
| | - Robert Stahl
- Institute for Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Marchioninistraße 15, 81377, Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE Munich), Feodor-Lynen Straße 17, 81377, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität (LMU), Feodor-Lynen Straße 17, 81377, Munich, Germany.
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Steinlein OK, Ertl-Wagner B, Ruzicka T, Sattler EC. Birt-Hogg-Dubé-Syndrom: ein zu selten diagnostiziertes erbliches Tumorsyndrom. J Dtsch Dermatol Ges 2018. [DOI: 10.1111/ddg.13457_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ortrud K. Steinlein
- Interdisziplinäre Sprechstunde für Birt-Hogg-Dubé-Syndrom; Institut für Humangenetik; Klinikum der Ludwig-Maximilians-Universität München
| | - Birgit Ertl-Wagner
- Interdisziplinäre Sprechstunde für Birt-Hogg-Dubé-Syndrom; Institut für Klinische Radiologie; Klinikum der Ludwig-Maximilians-Universität München
| | - Thomas Ruzicka
- Klinik und Poliklinik für Dermatologie; Klinikum der Ludwig-Maximilians-Universität München
| | - Elke C. Sattler
- Interdisziplinäre Sprechstunde für Birt-Hogg-Dubé-Syndrom; Institut für Klinische Radiologie; Klinikum der Ludwig-Maximilians-Universität München
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118
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Flatz WH, Henneberger A, Reiser MF, Gürkov R, Ertl-Wagner B. In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears. J Vis Exp 2018. [PMID: 29553505 DOI: 10.3791/57091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Analysis of neural structures in Menière's Disease (MD) is of importance, since a loss of such structures has previously been proposed for this patient group but has yet to be confirmed. This protocol describes a method of in vivo evaluation of neural changes especially well suitable for cranial nerve analysis using magnetic resonance imaging (MRI). MD-patients and normal hearing persons were examined in a 3-T MR-scanner using a scan protocol including strongly T2-weighted 3D gradient-echo-sequence (3D-CISS). In the patient group, MD was additionally confirmed using MRI-based assessment of endolymphatic hydrops. Morphometric analysis was performed using a freeware DICOM viewer. Evaluation of cranial nerves included measurements of cross-sectional areas (CSAs) of the nerves at different levels as well as orthogonal diametric measurements.
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Affiliation(s)
| | - Annika Henneberger
- Department of Otorhinolaryngology - Head and Neck Surgery, SLK-Kliniken Heilbronn GmbH
| | | | - Robert Gürkov
- Department of Otorhinolaryngology Head and Neck Surgery, Ludwig-Maximilians-University Hospital Munich, German Centre for Vertigo and Balance Disorder
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119
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Franzmeier N, Caballero MÁA, Taylor ANW, Simon-Vermot L, Buerger K, Ertl-Wagner B, Mueller C, Catak C, Janowitz D, Baykara E, Gesierich B, Duering M, Ewers M. Resting-state global functional connectivity as a biomarker of cognitive reserve in mild cognitive impairment. Brain Imaging Behav 2018; 11:368-382. [PMID: 27709513 DOI: 10.1007/s11682-016-9599-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cognitive reserve (CR) shows protective effects in Alzheimer's disease (AD) and reduces the risk of dementia. Despite the clinical significance of CR, a clinically useful diagnostic biomarker of brain changes underlying CR in AD is not available yet. Our aim was to develop a fully-automated approach applied to fMRI to produce a biomarker associated with CR in subjects at increased risk of AD. We computed resting-state global functional connectivity (GFC), i.e. the average connectivity strength, for each voxel within the cognitive control network, which may sustain CR due to its central role in higher cognitive function. In a training sample including 43 mild cognitive impairment (MCI) subjects and 24 healthy controls (HC), we found that MCI subjects with high CR (> median of years of education, CR+) showed increased frequency of high GFC values compared to MCI-CR- and HC. A summary index capturing such a surplus frequency of high GFC was computed (called GFC reserve (GFC-R) index). GFC-R discriminated MCI-CR+ vs. MCI-CR-, with the area under the ROC = 0.84. Cross-validation in an independently recruited test sample of 23 MCI subjects showed that higher levels of the GFC-R index predicted higher years of education and an alternative questionnaire-based proxy of CR, controlled for memory performance, gray matter of the cognitive control network, white matter hyperintensities, age, and gender. In conclusion, the GFC-R index that captures GFC changes within the cognitive control network provides a biomarker candidate of functional brain changes of CR in patients at increased risk of AD.
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Affiliation(s)
- N Franzmeier
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany.
| | - M Á Araque Caballero
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - A N W Taylor
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - L Simon-Vermot
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - K Buerger
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - B Ertl-Wagner
- Institute for Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilian University, Marchioninistraße 15, 81377, Munich, Germany
| | - C Mueller
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - C Catak
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - D Janowitz
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - E Baykara
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - B Gesierich
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - M Duering
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - M Ewers
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
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Sattler EC, Ertl-Wagner B, Pellegrini C, Peris K, Reithmair M, Schädle N, Ruzicka T, Steinlein OK. Cutaneous melanoma in Birt-Hogg-Dubé syndrome: part of the clinical spectrum? Br J Dermatol 2018; 178:e132-e133. [PMID: 28869776 DOI: 10.1111/bjd.15937] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E C Sattler
- Department of Dermatology and Allergology, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - B Ertl-Wagner
- Department of Radiology, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - C Pellegrini
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - K Peris
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - M Reithmair
- Institute of Human Genetics, University Hospital, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - N Schädle
- Department of Dermatology and Allergology, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - T Ruzicka
- Department of Dermatology and Allergology, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - O K Steinlein
- Institute of Human Genetics, University Hospital, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
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121
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Ikenberg E, Karin I, Ertl-Wagner B, Abicht A, Bulst S, Krause S, Schoser B, Reilich P, Walter MC. Corrigendum to ‘Rare diagnosis of telethoninopathy (LGMD2G) in a Turkish patient’ [Neuromuscular Disorders 27 (2017) 856–860]. Neuromuscul Disord 2017; 27:e1. [DOI: 10.1016/j.nmd.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
PURPOSE Invasive aspergillosis usually affects immunocompromised patients. It carries a high risk of morbidity and mortality and usually has a nonspecific clinical presentation. Early diagnosis is essential in order to start effective treatment and improve clinical outcome. MATERIALS AND METHODS In a retrospective search of the PACS databases from two medical centers, we identified 9 patients with histologically proven cerebral aspergilloma. We systematically analyzed CT and MRI imaging findings to identify typical imaging appearances of cerebral aspergilloma. RESULTS CT did not show a typical appearance of the aspergillomas. In 100 % (9/9) there was a rim-attenuated diffusion restriction on MRI imaging. Multiple hypointense layers in the aspergillus wall, especially on the internal side, were detected in 100 % on T2-weighted imaging (9/9). Aspergillomas were T1-hypointense in 66 % of cases (6/9) and partly T1-hyperintense in 33 % (3/9). In 78 % (7/9) of cases, a rim-attenuated diffusion restriction was detected after contrast agent application. CONCLUSION Nine cases were identified. Whereas CT features were less typical, we observed the following imaging features on MRI: A strong, rim-attenuated diffusion restriction (9/9); onion layer-like hypointense zones, in particular in the innermost part of the abscess wall on T2-weighted images (9/9). Enhancement of the lesion border was present in the majority of the cases (7/9). KEY POINTS · There are typical MRI imaging features of aspergillomas.. · However, these findings could be affected by the immune status of the patient.. · Swift identification of aspergilloma imaging patterns is essential to allow for adequate therapeutic decision making.. CITATION FORMAT · Gärtner F, Forstenpointner J, Ertl-Wagner B et al. CT and MRI Findings in Cerebral Aspergilloma. Fortschr Röntgenstr 2018; 190: 967 - 970.
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Affiliation(s)
- Friederike Gärtner
- Department of Radiology and Neuroradiology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany
| | - Julia Forstenpointner
- Division of Neurological Pain Research and Therapy, Department of Neurology, UKSH Kiel, Germany
| | - Birgit Ertl-Wagner
- Institute for Clinical Radiology, Ludwig-Maximilians-Universitat Munchen, Munich, Germany
| | - Babak Hooshmand
- Institute for Clinical Radiology, Ludwig-Maximilians-Universitat Munchen, Munich, Germany
| | - Christian Riedel
- Department of Radiology and Neuroradiology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany
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123
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Stöcklein V, Stoecklein S, Ertl-Wagner B, Thon N, Kreth FW, Tonn JC, Liu H. NIMG-95. RESTING STATE FUNCTIONAL MRI SHOWS DISTURBANCES IN FUNCTIONAL CONNECTIVITY IN THE NON-LESIONAL HEMISPHERE IN PATIENTS WITH HIGH-GRADE GLIOMA. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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124
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Kunz WG, Sommer WH, Höhne C, Fabritius MP, Schuler F, Dorn F, Othman AE, Meinel FG, von Baumgarten L, Reiser MF, Ertl-Wagner B, Thierfelder KM. Crossed cerebellar diaschisis in acute ischemic stroke: Impact on morphologic and functional outcome. J Cereb Blood Flow Metab 2017; 37:3615-3624. [PMID: 28084869 PMCID: PMC5669343 DOI: 10.1177/0271678x16686594] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Crossed cerebellar diaschisis (CCD) is the phenomenon of hypoperfusion and hypometabolism of the contralateral cerebellar hemisphere caused by dysfunction of the related supratentorial region. Our aim was to analyze its influence on morphologic and functional outcome in acute ischemic stroke. Subjects with stroke caused by a large vessel occlusion of the anterior circulation were selected from an initial cohort of 1644 consecutive patients who underwent multiparametric CT including whole-brain CT perfusion. Two experienced readers evaluated the posterior fossa in terms of CCD absence (CCD-) or presence (CCD+). A total of 156 patients formed the study cohort with 102 patients (65.4%) categorized as CCD- and 54 (34.6%) as CCD+. In linear and logistic regression analyses, no significant association between CCD and final infarction volume (β = -0.440, p = 0.972), discharge mRS ≤ 2 (OR = 1.897, p = 0.320), or 90-day mRS ≤ 2 (OR = 0.531, p = 0.492) was detected. CCD+ patients had larger supratentorial cerebral blood flow deficits (median: 164 ml vs. 115 ml; p = 0.001) compared to CCD-patients. Regarding complications, CCD was associated with a higher rate of parenchymal hematomas (OR = 4.793, p = 0.035). In conclusion, CCD is frequently encountered in acute ischemic stroke caused by large vessel occlusion of the anterior circulation. CCD was associated with the occurrence of parenchymal hematoma in the ipsilateral cerebral infarction but did not prove to significantly influence patient outcome.
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Affiliation(s)
- Wolfgang G Kunz
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Wieland H Sommer
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Christopher Höhne
- 2 Department of Neurology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Matthias P Fabritius
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Felix Schuler
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Franziska Dorn
- 3 Department of Neuroradiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Ahmed E Othman
- 4 Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Tuebingen, Germany
| | - Felix G Meinel
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Louisa von Baumgarten
- 2 Department of Neurology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Maximilian F Reiser
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
| | - Kolja M Thierfelder
- 1 Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
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Gerstl L, Schoppe N, Albers L, Ertl-Wagner B, Alperin N, Ehrt O, Pomschar A, Landgraf MN, Heinen F. Pediatric idiopathic intracranial hypertension - Is the fixed threshold value of elevated LP opening pressure set too high? Eur J Paediatr Neurol 2017; 21:833-841. [PMID: 28838819 DOI: 10.1016/j.ejpn.2017.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 06/15/2017] [Accepted: 08/03/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Idiopathic intracranial hypertension (IIH) in children is a rare condition of unknown etiology and various clinical presentations. The primary aim of this study was to evaluate if our pediatric IIH study group fulfilled the revised diagnostic criteria for IIH published in 2013, particularly with regard to clinical presentation and threshold value of an elevated lumbar puncture opening pressure. Additionally we investigated the potential utilization of MR-based and fundoscopic methods of estimating intracranial pressure for improved diagnosis. PATIENTS AND METHODS Clinical data were collected retrospectively from twelve pediatric patients diagnosed with IIH between 2008 and 2012 and revised diagnostic criteria were applied. Comparison with non-invasive methods for measuring intracranial pressure, MRI-based measurement (MR-ICP) and venous ophthalmodynamometry was performed. RESULTS Only four of the twelve children (33%) fulfilled the revised diagnostic criteria for a definite diagnosis of IIH. Regarding noninvasive methods, MR-ICP (n = 6) showed a significantly higher mean of intracranial pressure compared to a healthy age- and sex-matched control group (p = 0.0043). Venous ophthalmodynamometry (n = 4) showed comparable results to invasive lumbar puncture. CONCLUSION The revised diagnostic criteria for IIH may be too strict especially in children without papilledema. MR-ICP and venous ophthalmodynamometry are promising complementary procedures for monitoring disease progression and response to treatment.
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Affiliation(s)
- Lucia Gerstl
- Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
| | - Nikola Schoppe
- Department of Pediatrics, Harlaching, Munich Municipal Hospitals, Munich, Germany
| | - Lucia Albers
- Institute of Social Pediatrics and Adolescent Medicine, Division of Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- Institute of Clinical Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Noam Alperin
- Department of Radiology, University of Miami, Miami, FL, USA
| | - Oliver Ehrt
- Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Andreas Pomschar
- Institute of Clinical Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Florian Heinen
- Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
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Landgraf MN, König H, Hannibal I, Langhagen T, Bonfert MV, Klose B, Rahmsdorf B, Giese RM, Straube A, von Kries R, Albers L, Ebinger F, Ertl-Wagner B, Kammer B, Körte I, Sollmann N, Krieg S, Heinen F. Migräne im Kindes- und Jugendalter – Gehirn und Muskel? Nervenarzt 2017; 88:1402-1410. [DOI: 10.1007/s00115-017-0428-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Fabritius MP, Thierfelder KM, Meinel FG, Othman AE, Dorn F, Sabel BO, Scheffler P, Ertl-Wagner B, Sommer WH, Kunz WG. Early Imaging Prediction of Malignant Cerebellar Edema Development in Acute Ischemic Stroke. Stroke 2017; 48:2597-2600. [DOI: 10.1161/strokeaha.117.018237] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 06/09/2017] [Accepted: 06/12/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Matthias P. Fabritius
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
| | - Kolja M. Thierfelder
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
| | - Felix G. Meinel
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
| | - Ahmed E. Othman
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
| | - Franziska Dorn
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
| | - Bastian O. Sabel
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
| | - Pierre Scheffler
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
| | - Birgit Ertl-Wagner
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
| | - Wieland H. Sommer
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
| | - Wolfgang G. Kunz
- From the Institute for Clinical Radiology (M.P.F., K.M.T., F.G.M., B.O.S., B.E.-W., W.H.S., W.G.K.), Department of Neuroradiology (F.D.), and Department of Neurology (P.S.), Ludwig-Maximilians-University Hospital Munich, Germany; and Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Germany (A.E.O.)
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Jerin C, Krause E, Ertl-Wagner B, Gürkov R. Clinical features of delayed endolymphatic hydrops and intralabyrinthine schwannoma : An imaging-confirmed comparative case series. English version. HNO 2017; 65:41-45. [PMID: 27492473 DOI: 10.1007/s00106-016-0199-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of this study was to compare the clinical history and audiovestibular function test results of patients suffering from intralabyrinthine schwannoma or delayed endolymphatic hydrops (DEH). PATIENTS AND METHODS Five patients diagnosed with intralabyrinthine schwannoma by magnetic resonance imaging (MRI) and five patients diagnosed with DEH by locally enhanced inner ear MRI (LEIM) were retrospectively studied. RESULTS All patients with intralabyrinthine schwannoma or DEH initially presented with hearing loss. Vertigo occurred in two patients with intralabyrinthine schwannoma and in all patients with DEH. While audiometry achieved poorer results for patients with intralabyrinthine schwannomas, vestibular function tests revealed normal results in about half of the patients in both groups. CONCLUSION Patients with intralabyrinthine schwannomas may present with clinical symptoms similar to patients suffering from other inner ear disorders such as delayed endolymphatic hydrops and they may obtain similar findings in audiovestibular function tests. High-resolution magnetic resonance imaging with locally applied contrast agent may provide evidence of both underlying pathologies.
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Affiliation(s)
- C Jerin
- German Center for Vertigo and Balance Disorders, Grosshadern Medical Center, University of Munich, Marchioninistr. 15, 81377, Munich, Germany. .,Department of Otorhinolaryngology - Head and Neck Surgery, Grosshadern Medical Center, University of Munich, Munich, Germany.
| | - E Krause
- German Center for Vertigo and Balance Disorders, Grosshadern Medical Center, University of Munich, Marchioninistr. 15, 81377, Munich, Germany.,Department of Otorhinolaryngology - Head and Neck Surgery, Grosshadern Medical Center, University of Munich, Munich, Germany
| | - B Ertl-Wagner
- Institute of Clinical Radiology, Grosshadern Medical Center, University of Munich, Munich, Germany
| | - R Gürkov
- German Center for Vertigo and Balance Disorders, Grosshadern Medical Center, University of Munich, Marchioninistr. 15, 81377, Munich, Germany.,Department of Otorhinolaryngology - Head and Neck Surgery, Grosshadern Medical Center, University of Munich, Munich, Germany
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129
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Ikenberg E, Karin I, Ertl-Wagner B, Abicht A, Bulst S, Krause S, Schoser B, Reilich P, Walter MC. Rare diagnosis of telethoninopathy (LGMD2G) in a Turkish patient. Neuromuscul Disord 2017; 27:856-860. [PMID: 28666572 DOI: 10.1016/j.nmd.2017.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/01/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022]
Abstract
Telethoninopathy is one of the rarest forms of Limb-girdle muscular dystrophy (LGMD). So far, only a small number of LGMD type 2 G (LGMD2G) patients have been described, mostly patients from Brazil. Here we present a 35-year-old female patient of Turkish ethnicity with LGMD2G due to a novel homozygous frame-shift mutation c.90_91del (p.Ser31Hisfs*11) in the telethonin gene, probably leading to truncated protein or nonsense mediated decay. Myalgia and walking on tiptoes were the first symptoms starting in early childhood, around age 22 proximal, later distal leg muscles became affected. Muscle biopsy showed a degenerative myopathy with lobulated fibers, creatine kinase levels were elevated to 1200 U/l. No cardiomyopathy has been detected but ventricular extrasystoles were treated with verapamil. Even though telethoninopathy represents a rare condition, testing for LGMD2G should be included into the diagnostic work-up of mild myopathies with early toe walking and distal and proximal involvement.
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Affiliation(s)
- Elena Ikenberg
- Friedrich-Baur-Institute, Dept. of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Ivan Karin
- Friedrich-Baur-Institute, Dept. of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- Dept. of Radiology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Angela Abicht
- Friedrich-Baur-Institute, Dept. of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany; Medical Genetics Center - MGZ, Munich, Germany
| | | | - Sabine Krause
- Friedrich-Baur-Institute, Dept. of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Dept. of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Peter Reilich
- Friedrich-Baur-Institute, Dept. of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Maggie C Walter
- Friedrich-Baur-Institute, Dept. of Neurology, Ludwig-Maximilians-University of Munich, Munich, Germany.
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Wörsching J, Padberg F, Helbich K, Hasan A, Koch L, Goerigk S, Stoecklein S, Ertl-Wagner B, Keeser D. Test-retest reliability of prefrontal transcranial Direct Current Stimulation (tDCS) effects on functional MRI connectivity in healthy subjects. Neuroimage 2017; 155:187-201. [PMID: 28450138 DOI: 10.1016/j.neuroimage.2017.04.052] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/22/2017] [Indexed: 01/01/2023] Open
Abstract
Transcranial Direct Current Stimulation (tDCS) of the prefrontal cortex (PFC) can be used for probing functional brain connectivity and meets general interest as novel therapeutic intervention in psychiatric and neurological disorders. Along with a more extensive use, it is important to understand the interplay between neural systems and stimulation protocols requiring basic methodological work. Here, we examined the test-retest (TRT) characteristics of tDCS-induced modulations in resting-state functional-connectivity MRI (RS fcMRI). Twenty healthy subjects received 20minutes of either active or sham tDCS of the dorsolateral PFC (2mA, anode over F3 and cathode over F4, international 10-20 system), preceded and ensued by a RS fcMRI (10minutes each). All subject underwent three tDCS sessions with one-week intervals in between. Effects of tDCS on RS fcMRI were determined at an individual as well as at a group level using both ROI-based and independent-component analyses (ICA). To evaluate the TRT reliability of individual active-tDCS and sham effects on RS fcMRI, voxel-wise intra-class correlation coefficients (ICC) of post-tDCS maps between testing sessions were calculated. For both approaches, results revealed low reliability of RS fcMRI after active tDCS (ICC(2,1) = -0.09 - 0.16). Reliability of RS fcMRI (baselines only) was low to moderate for ROI-derived (ICC(2,1) = 0.13 - 0.50) and low for ICA-derived connectivity (ICC(2,1) = 0.19 - 0.34). Thus, for ROI-based analyses, the distribution of voxel-wise ICC was shifted to lower TRT reliability after active, but not after sham tDCS, for which the distribution was similar to baseline. The intra-individual variation observed here resembles variability of tDCS effects in motor regions and may be one reason why in this study robust tDCS effects at a group level were missing. The data can be used for appropriately designing large scale studies investigating methodological issues such as sources of variability and localisation of tDCS effects.
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Affiliation(s)
- Jana Wörsching
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Konstantin Helbich
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Lena Koch
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Stephan Goerigk
- Department of Psychological Methodology and Assessment, Ludwig-Maximilians-University, Munich, Germany
| | - Sophia Stoecklein
- Institute for Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
| | - Birgit Ertl-Wagner
- Institute for Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Institute for Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
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Abstract
New clinical and technological advances in the field of magnetic resonance imaging (MRI) and targeted image-guided biopsy techniques have significantly improved the detection, localization and staging as well as active surveillance of prostate cancer in recent years. Multiparametric MRI (mpMRI) is currently the main imaging technique for the detection, characterization and diagnostics of metastasizing prostate cancer and is of high diagnostic importance for local staging within the framework of the detection of prostate cancer.
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Affiliation(s)
- D Nörenberg
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland.
| | - O Solyanik
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
| | - B Schlenker
- Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, München, Deutschland
| | - G Magistro
- Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, München, Deutschland
| | - B Ertl-Wagner
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
| | - D A Clevert
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
| | - C Stief
- Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, München, Deutschland
| | - M F Reiser
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
| | - M D'Anastasi
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
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Ingrisch M, Schneider M, Nörenberg D, Negrao de Figueiredo G, Maier-Hein K, Suchorska B, Reiser M, Tonn J, Ertl-Wagner B. Prognostische Information aus präoperativen MR-Daten von Patienten mit Glioblastomen: eine Radiomics-Studie. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Ingrisch
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - M Schneider
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - D Nörenberg
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | | | - K Maier-Hein
- Deutsches Krebsforschungszentrum, Medizinische und Biologische Informatik, Heidelberg
| | - B Suchorska
- Klinikum der Universität München, Neurochirurgische Klinik und Poliklinik, München
| | - M Reiser
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - J Tonn
- Klinikum der Universität München, Neurochirurgische Klinik und Poliklinik, München
| | - B Ertl-Wagner
- Klinikum der Universität München, Institut für Klinische Radiologie, München
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Stöcklein S, Ertl-Wagner B. Diffusions-Tensor-MRT bei der Darstellung fetaler Hirnstammveränderungen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0042-118689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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134
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Fabritius M, Schuler F, Höhne C, Reiser M, Ertl-Wagner B, Sommer W, Thierfelder K, Kunz W. Prädiktiver Wert der CT-Perfusionsbildgebung bei akuter Kleinhirnischämie für die Entstehung eines malignen Kleinhirnödems. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Fabritius
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - F Schuler
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - C Höhne
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Neurologische Klinik und Poliklinik, München
| | - M Reiser
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - B Ertl-Wagner
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - W Sommer
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - K Thierfelder
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - W Kunz
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
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Schöppe F, Stöcklein S, Reiser M, Rossi A, Ertl-Wagner B. Zerebrale Mikroblutungen und kortikale Siderose bei pädiatrischen Patienten mit Down-Syndrom. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- F Schöppe
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - S Stöcklein
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - M Reiser
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - A Rossi
- Istituto Giannina Gaslini, Abteilung für Neuroradiologie, Genua (Italien)
| | - B Ertl-Wagner
- Klinikum der Universität München, Institut für Klinische Radiologie, München
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Dietrich O, Levin J, Ahmadi SA, Plate A, Reiser MF, Bötzel K, Giese A, Ertl-Wagner B. MR imaging differentiation of Fe2+ and Fe3+ based on relaxation and magnetic susceptibility properties. Neuroradiology 2017; 59:403-409. [DOI: 10.1007/s00234-017-1813-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/19/2017] [Indexed: 12/24/2022]
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137
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Wiessner M, Roos A, Munn CJ, Viswanathan R, Whyte T, Cox D, Schoser B, Sewry C, Roper H, Phadke R, Marini Bettolo C, Barresi R, Charlton R, Bönnemann CG, Abath Neto O, Reed UC, Zanoteli E, Araújo Martins Moreno C, Ertl-Wagner B, Stucka R, De Goede C, Borges da Silva T, Hathazi D, Dell’Aica M, Zahedi RP, Thiele S, Müller J, Kingston H, Müller S, Curtis E, Walter MC, Strom TM, Straub V, Bushby K, Muntoni F, Swan LE, Lochmüller H, Senderek J. Mutations in INPP5K, Encoding a Phosphoinositide 5-Phosphatase, Cause Congenital Muscular Dystrophy with Cataracts and Mild Cognitive Impairment. Am J Hum Genet 2017; 100:523-536. [PMID: 28190456 PMCID: PMC5339217 DOI: 10.1016/j.ajhg.2017.01.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/12/2017] [Indexed: 12/26/2022] Open
Abstract
Phosphoinositides are small phospholipids that control diverse cellular downstream signaling events. Their spatial and temporal availability is tightly regulated by a set of specific lipid kinases and phosphatases. Congenital muscular dystrophies are hereditary disorders characterized by hypotonia and weakness from birth with variable eye and central nervous system involvement. In individuals exhibiting congenital muscular dystrophy, early-onset cataracts, and mild intellectual disability but normal cranial magnetic resonance imaging, we identified bi-allelic mutations in INPP5K, encoding inositol polyphosphate-5-phosphatase K. Mutations impaired phosphatase activity toward the phosphoinositide phosphatidylinositol (4,5)-bisphosphate or altered the subcellular localization of INPP5K. Downregulation of INPP5K orthologs in zebrafish embryos disrupted muscle fiber morphology and resulted in abnormal eye development. These data link congenital muscular dystrophies to defective phosphoinositide 5-phosphatase activity that is becoming increasingly recognized for its role in mediating pivotal cellular mechanisms contributing to disease.
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Woersching J, Helbich K, Kumpf U, Ertl-Wagner B, Padberg F, Keeser D. P123 Repeated measure stability of prefrontal transcranial direct current stimulation (tDCS) on functional MRI connectivity in healthy subjects. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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139
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Keeser D, Weidinger E, Linhardt A, Palm U, Hasan A, Kirsch B, Pogarell O, Karali T, Paolini M, Ertl-Wagner B, Müller N, Falkai P, Padberg F. P276 Transcranial Direct Current Stimulation (tDCS) replaces Electroconvulsive Therapy (ECT) in a patient with corpus callosum agenesis and catatonic schizophrenia. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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140
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Zakaria R, Pomschar A, Jenkinson MD, Tonn JC, Belka C, Ertl-Wagner B, Niyazi M. Use of diffusion-weighted MRI to modify radiosurgery planning in brain metastases may reduce local recurrence. J Neurooncol 2017; 131:549-554. [PMID: 27844309 PMCID: PMC5350211 DOI: 10.1007/s11060-016-2320-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 11/08/2016] [Indexed: 01/09/2023]
Abstract
Stereotactic radiosurgery (SRS) is an effective and well tolerated treatment for selected brain metastases; however, local recurrence still occurs. We investigated the use of diffusion weighted MRI (DWI) as an adjunct for SRS treatment planning in brain metastases. Seventeen consecutive patients undergoing complete surgical resection of a solitary brain metastasis underwent image analysis retrospectively. SRS treatment plans were generated based on standard 3D post-contrast T1-weighted sequences at 1.5T and then separately using apparent diffusion coefficient (ADC) maps in a blinded fashion. Control scans immediately post operation confirmed complete tumour resection. Treatment plans were compared to one another and with volume of local recurrence at progression quantitatively and qualitatively by calculating the conformity index (CI), the overlapping volume as a proportion of the total combined volume, where 1 = identical plans and 0 = no conformation whatsoever. Gross tumour volumes (GTVs) using ADC and post-contrast T1-weighted sequences were quantitatively the same (related samples Wilcoxon signed rank test = -0.45, p = 0.653) but showed differing conformations (CI 0.53, p < 0.001). The diffusion treatment volume (DTV) obtained by combining the two target volumes was significantly greater than the treatment volume based on post contrast T1-weighted MRI alone, both quantitatively (median 13.65 vs. 9.52 cm3, related samples Wilcoxon signed rank test p < 0.001) and qualitatively (CI 0.74, p = 0.001). This DTV covered a greater volume of subsequent tumour recurrence than the standard plan (median 3.53 cm3 vs. 3.84 cm3, p = 0.002). ADC maps may be a useful tool in addition to the standard post-contrast T1-weighted sequence used for SRS planning.
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Affiliation(s)
- Rasheed Zakaria
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, L9 7LJ, UK.
- Institute of Integrative Biology, University of Liverpool, Liverpool, UK.
| | | | - Michael D Jenkinson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, L9 7LJ, UK
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | | | - Claus Belka
- Department of Radiation Oncology, LMU Munich, Munich, Germany
- German Cancer Research Centre (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | | | - Maximilian Niyazi
- Department of Radiation Oncology, LMU Munich, Munich, Germany
- German Cancer Research Centre (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
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141
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Franz M, von Bismarck A, Delius M, Ertl-Wagner B, Deppe C, Mahner S, Hasbargen U, Hübener C. MR pelvimetry: prognosis for successful vaginal delivery in patients with suspected fetopelvic disproportion or breech presentation at term. Arch Gynecol Obstet 2017; 295:351-359. [DOI: 10.1007/s00404-016-4276-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 12/16/2016] [Indexed: 10/20/2022]
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142
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Bamberg F, Hetterich H, Rospleszcz S, Lorbeer R, Auweter SD, Schlett CL, Schafnitzel A, Bayerl C, Schindler A, Saam T, Müller-Peltzer K, Sommer W, Zitzelsberger T, Machann J, Ingrisch M, Selder S, Rathmann W, Heier M, Linkohr B, Meisinger C, Weber C, Ertl-Wagner B, Massberg S, Reiser MF, Peters A. Subclinical Disease Burden as Assessed by Whole-Body MRI in Subjects With Prediabetes, Subjects With Diabetes, and Normal Control Subjects From the General Population: The KORA-MRI Study. Diabetes 2017; 66:158-169. [PMID: 27999110 DOI: 10.2337/db16-0630] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/04/2016] [Indexed: 11/13/2022]
Abstract
Detailed pathophysiological manifestations of early disease in the context of prediabetes are poorly understood. This study aimed to evaluate the extent of early signs of metabolic and cardio-cerebrovascular complications affecting multiple organs in individuals with prediabetes. Subjects without a history of stroke, coronary artery disease, or peripheral artery disease were enrolled in a case-control study nested within the Cooperative Health Research in the Region of Augsburg (KORA) FF4 cohort and underwent comprehensive MRI assessment to characterize cerebral parameters (white matter lesions, microbleeds), cardiovascular parameters (carotid plaque, left ventricular function, and myocardial late gadolinium enhancement [LGE]), and metabolic parameters (hepatic proton-density fat fraction [PDFF] and subcutaneous and visceral abdominal fat). Among 400 subjects who underwent MRI, 103 subjects had prediabetes and 54 had established diabetes. Subjects with prediabetes had an increased risk for carotid plaque and adverse functional cardiac parameters, including reduced early diastolic filling rates as well as a higher prevalence of LGE compared with healthy control subjects. In addition, people with prediabetes had significantly elevated levels of PDFF and total and visceral fat. Thus, subjects with prediabetes show early signs of subclinical disease that include vascular, cardiac, and metabolic changes, as measured by whole-body MRI after adjusting for cardiometabolic risk factors.
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Affiliation(s)
- Fabian Bamberg
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany
- German Center for Cardiovascular Disease Research, Munich, Germany
| | - Holger Hetterich
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
- German Center for Cardiovascular Disease Research, Munich, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Roberto Lorbeer
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
- German Center for Cardiovascular Disease Research, Munich, Germany
| | - Sigrid D Auweter
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Anina Schafnitzel
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Christian Bayerl
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Andreas Schindler
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Tobias Saam
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | | | - Wieland Sommer
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Tanja Zitzelsberger
- Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Jürgen Machann
- Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Tübingen, Tübingen, Germany
- German Centre for Diabetes Research, Tübingen, Germany
| | - Michael Ingrisch
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Sonja Selder
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Wolfgang Rathmann
- Department of Biometry and Epidemiology, German Diabetes Center, Düsseldorf, Germany
| | - Margit Heier
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - Birgit Linkohr
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - Christian Weber
- German Center for Cardiovascular Disease Research, Munich, Germany
- Institute for Cardiovascular Prevention, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Birgit Ertl-Wagner
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Steffen Massberg
- Department of Cardiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Maximilian F Reiser
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Annette Peters
- German Center for Cardiovascular Disease Research, Munich, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Cardiovascular Prevention, Ludwig-Maximilian-University Hospital, Munich, Germany
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Kunz WG, Hunink MM, Sommer WH, Beyer SE, Meinel FG, Dorn F, Wirth S, Reiser MF, Ertl-Wagner B, Thierfelder KM. Cost-Effectiveness of Endovascular Stroke Therapy. Stroke 2016; 47:2797-2804. [PMID: 27758942 DOI: 10.1161/strokeaha.116.014147] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/24/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Endovascular therapy in addition to standard care (EVT+SC) has been demonstrated to be more effective than SC in acute ischemic large vessel occlusion stroke. Our aim was to determine the cost-effectiveness of EVT+SC depending on patients’ initial National Institutes of Health Stroke Scale (NIHSS) score, time from symptom onset, Alberta Stroke Program Early CT Score (ASPECTS), and occlusion location.
Methods—
A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with both strategies applied in a US setting. Model input parameters were obtained from the literature, including recently pooled outcome data of 5 randomized controlled trials (ESCAPE [Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke], EXTEND-IA [Extending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-Arterial], MR CLEAN [Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands], REVASCAT [Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within 8 Hours of Symptom Onset], and SWIFT PRIME [Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment]). Probabilistic sensitivity analysis was performed to estimate uncertainty of the model results. Net monetary benefits, incremental costs, incremental effectiveness, and incremental cost-effectiveness ratios were derived from the probabilistic sensitivity analysis. The willingness-to-pay was set to $50 000/QALY.
Results—
Overall, EVT+SC was cost-effective compared with SC (incremental cost: $4938, incremental effectiveness: 1.59 QALYs, and incremental cost-effectiveness ratio: $3110/QALY) in 100% of simulations. In all patient subgroups, EVT+SC led to gained QALYs (range: 0.47–2.12), and mean incremental cost-effectiveness ratios were considered cost-effective. However, subgroups with ASPECTS ≤5 or with M2 occlusions showed considerably higher incremental cost-effectiveness ratios ($14 273/QALY and $28 812/QALY, respectively) and only reached suboptimal acceptability in the probabilistic sensitivity analysis (75.5% and 59.4%, respectively). All other subgroups had acceptability rates of 90% to 100%.
Conclusions—
EVT+SC is cost-effective in most subgroups. In patients with ASPECTS ≤5 or with M2 occlusions, cost-effectiveness remains uncertain based on current data.
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Affiliation(s)
- Wolfgang G. Kunz
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
| | - M.G. Myriam Hunink
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
| | - Wieland H. Sommer
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
| | - Sebastian E. Beyer
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
| | - Felix G. Meinel
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
| | - Franziska Dorn
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
| | - Stefan Wirth
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
| | - Maximilian F. Reiser
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
| | - Birgit Ertl-Wagner
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
| | - Kolja M. Thierfelder
- From the Institute for Clinical Radiology (W.G.K., W.H.S., S.E.B., F.G.M., S.W., M.F.R., B.E.-W., K.M.T.) and Department of Neuroradiology (F.D.), LMU Munich, Munich, Germany; Departments of Radiology (M.G.M.H.) and Epidemiology (M.G.M.H.), Erasmus University Medical Center, Rotterdam, The Netherlands; and Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA (M.G.M.H.)
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Havla L, Schneider MJ, Thierfelder KM, Beyer SE, Ertl-Wagner B, Reiser MF, Sommer WH, Dietrich O. Classification of arterial and venous cerebral vasculature based on wavelet postprocessing of CT perfusion data. Med Phys 2016; 43:702-9. [PMID: 26843234 DOI: 10.1118/1.4939224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The purpose of this study was to propose and evaluate a new wavelet-based technique for classification of arterial and venous vessels using time-resolved cerebral CT perfusion data sets. METHODS Fourteen consecutive patients (mean age 73 yr, range 17-97) with suspected stroke but no pathology in follow-up MRI were included. A CT perfusion scan with 32 dynamic phases was performed during intravenous bolus contrast-agent application. After rigid-body motion correction, a Paul wavelet (order 1) was used to calculate voxelwise the wavelet power spectrum (WPS) of each attenuation-time course. The angiographic intensity A was defined as the maximum of the WPS, located at the coordinates T (time axis) and W (scale/width axis) within the WPS. Using these three parameters (A, T, W) separately as well as combined by (1) Fisher's linear discriminant analysis (FLDA), (2) logistic regression (LogR) analysis, or (3) support vector machine (SVM) analysis, their potential to classify 18 different arterial and venous vessel segments per subject was evaluated. RESULTS The best vessel classification was obtained using all three parameters A and T and W [area under the curve (AUC): 0.953 with FLDA and 0.957 with LogR or SVM]. In direct comparison, the wavelet-derived parameters provided performance at least equal to conventional attenuation-time-course parameters. The maximum AUC obtained from the proposed wavelet parameters was slightly (although not statistically significantly) higher than the maximum AUC (0.945) obtained from the conventional parameters. CONCLUSIONS A new method to classify arterial and venous cerebral vessels with high statistical accuracy was introduced based on the time-domain wavelet transform of dynamic CT perfusion data in combination with linear or nonlinear multidimensional classification techniques.
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Affiliation(s)
- Lukas Havla
- Josef Lissner Laboratory for Biomedical Imaging, Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Moritz J Schneider
- Josef Lissner Laboratory for Biomedical Imaging, Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Kolja M Thierfelder
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Sebastian E Beyer
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Birgit Ertl-Wagner
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Maximilian F Reiser
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Wieland H Sommer
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Olaf Dietrich
- Josef Lissner Laboratory for Biomedical Imaging, Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr. 15, Munich 81377, Germany
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Ertl-Wagner B, Barkhausen J, Mahnken AH, Mentzel HJ, Uder M, Weidemann J, Stumpp P. White Paper: Radiological Curriculum for Undergraduate Medical Education in Germany. ROFO-FORTSCHR RONTG 2016; 188:1017-1023. [PMID: 27760438 DOI: 10.1055/s-0042-116026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: Radiology represents a highly relevant part of undergraduate medical education from preclinical studies to subinternship training. It is therefore important to establish a content base for teaching radiology in German Medical Faculties. Materials and Methods: The German Society of Radiology (DRG) developed a model curriculum for radiological teaching at German medical universities, which is presented in this article. There is also a European model curriculum for undergraduate teaching (U-level curriculum of the European Society of Radiology). In a modular concept, the students shall learn important radiological core principles in the realms of knowledge, skills and competences as well as core scientific competences in the imaging sciences. Results: The curriculum is divided into two modules. Module 1 includes principles of radiation biology, radiation protection and imaging technology, imaging anatomy as well as the risks and side effects of radiological methods, procedures and contrast media. This module is modality-oriented. Module 2 comprises radiological diagnostic decision-making and imaging-based interventional techniques for various disease entities. This module is organ system-oriented. Conclusion: The curriculum is meant as a living document to be amended and revised at regular intervals. The curriculum can be used as a basis for individual curricular development at German Medical Faculties. It can be integrated into traditional or reformed medical teaching curricula. Key Points: • Radiology is an integral and important part of medical education.• The German Society of Radiology (DRG) developed a model curriculum for teaching radiology at German Medical Faculties to help students develop the ability to make medical decisions based on scientific knowledge and act accordingly.• This curriculum can be used for individual curricular development at medical departments. It is divided into two modules with several chapters. Citation Format: • Ertl-Wagner B, Barkhausen J, Mahnken AH et al. White Paper: Radiological Curriculum for Undergraduate Medical Education in Germany. Fortschr Röntgenstr 2016; 188: 1017 - 1023.
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Affiliation(s)
- B Ertl-Wagner
- Institute of Clinical Radiology, Ludwig Maximilians University - Großhadern Campus, Munich, Germany
| | - J Barkhausen
- Department of Radiology and Nuclear Medicine, University Hopsital Schleswig Holstein Luebeck Campus, Germany
| | - A H Mahnken
- Diagnostic and Interventional Radiology, Philipps University, Marburg, Germany
| | - H J Mentzel
- Paediatric Radiology, Institute for Diagnostic and Interventional Radiology, Jena, Germany
| | - M Uder
- Radiological Institute, University Hospital Erlangen, Germany
| | - J Weidemann
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Germany
| | - P Stumpp
- Clinic and Policlinic for Diagnostic and Interventional Radiology, Leipzig, Germany
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Bismarck AV, Franz M, Delius M, Ertl-Wagner B, Hübener C, Deppe C, Mahner S, Hasbargen U. Interobserver Variabilität bei MRT-Pelvimetrien in der Geburtshilfe. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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147
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Franz M, Bismarck AV, Delius M, Ertl-Wagner B, Hübener C, Deppe C, Mahner S, Hasbargen U. MRT-Pelvimetrie zur Prognoseeinschätzung für die vaginale Geburt in Risikokollektiven. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Palm U, Keeser D, Hasan A, Kupka MJ, Blautzik J, Sarubin N, Kaymakanova F, Unger I, Falkai P, Meindl T, Ertl-Wagner B, Padberg F. Prefrontal Transcranial Direct Current Stimulation for Treatment of Schizophrenia With Predominant Negative Symptoms: A Double-Blind, Sham-Controlled Proof-of-Concept Study. Schizophr Bull 2016; 42:1253-61. [PMID: 27098066 PMCID: PMC4988747 DOI: 10.1093/schbul/sbw041] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Negative symptoms are highly relevant in the long-term course of schizophrenia and are an important target domain for the development of novel interventions. Recently, transcranial direct current stimulation (tDCS) of the prefrontal cortex has been investigated as a treatment option in schizophrenia. In this proof-of-concept study, 20 schizophrenia patients with predominantly negative symptoms were randomized to either 10 sessions of add-on active (2 mA, 20min) or sham tDCS (anode: left DLPFC/F3; cathode: right supraorbital/F4). Primary outcome measure was the change in the Scale for the Assessment of Negative Symptoms (SANS) sum score; secondary outcomes included reduction in Positive and Negative Syndrome Scale (PANSS) scores and improvement of depressive symptoms, cognitive processing speed, and executive functioning. Sixteen patients underwent 4 functional connectivity magnetic resonance imaging (fcMRI) scans (pre and post 1st and pre and post 10th tDCS) to investigate changes in resting state network connectivity after tDCS. Per-protocol analysis showed a significantly greater decrease in SANS score after active (-36.1%) than after sham tDCS (-0.7%). PANSS sum scores decreased significantly more with active (-23.4%) than with sham stimulation (-2.2%). Explorative analysis of fcMRI data indicated changes in subgenual cortex and dorsolateral prefrontal cortex (DLPFC) connectivity within frontal-thalamic-temporo-parietal networks. The results of this first proof-of-concept study indicate that prefrontal tDCS may be a promising intervention for treatment of schizophrenia with predominant negative symptoms. Large-scale randomized controlled studies are needed to further establish prefrontal tDCS as novel treatment for negative symptoms in schizophrenia.
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Affiliation(s)
- Ulrich Palm
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Munich, Germany;
| | - Daniel Keeser
- Institute for Clinical Radiology, Ludwig Maximilian University Munich, Munich, Germany
| | | | - Michael J Kupka
- Institute for Clinical Radiology, Ludwig Maximilian University Munich, Munich, Germany
| | - Janusch Blautzik
- Institute for Clinical Radiology, Ludwig Maximilian University Munich, Munich, Germany
| | - Nina Sarubin
- Hochschule Fresenius, University of Applied Sciences, Psychology School, Munich, Germany
| | | | | | | | - Thomas Meindl
- Institute for Clinical Radiology, Ludwig Maximilian University Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- Institute for Clinical Radiology, Ludwig Maximilian University Munich, Munich, Germany
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149
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Baykara E, Gesierich B, Adam R, Tuladhar AM, Biesbroek JM, Koek HL, Ropele S, Jouvent E, Chabriat H, Ertl-Wagner B, Ewers M, Schmidt R, de Leeuw FE, Biessels GJ, Dichgans M, Duering M. A Novel Imaging Marker for Small Vessel Disease Based on Skeletonization of White Matter Tracts and Diffusion Histograms. Ann Neurol 2016; 80:581-92. [PMID: 27518166 DOI: 10.1002/ana.24758] [Citation(s) in RCA: 210] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 08/08/2016] [Accepted: 08/09/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To establish a fully automated, robust imaging marker for cerebral small vessel disease (SVD) and related cognitive impairment that is easy to implement, reflects disease burden, and is strongly associated with processing speed, the predominantly affected cognitive domain in SVD. METHODS We developed a novel magnetic resonance imaging marker based on diffusion tensor imaging, skeletonization of white matter tracts, and histogram analysis. The marker (peak width of skeletonized mean diffusivity [PSMD]) was assessed along with conventional SVD imaging markers. We first evaluated associations with processing speed in patients with genetically defined SVD (n = 113). Next, we validated our findings in independent samples of inherited SVD (n = 57), sporadic SVD (n = 444), and memory clinic patients with SVD (n = 105). The new marker was further applied to healthy controls (n = 241) and to patients with Alzheimer's disease (n = 153). We further conducted a longitudinal analysis and interscanner reproducibility study. RESULTS PSMD was associated with processing speed in all study samples with SVD (p-values between 2.8 × 10(-3) and 1.8 × 10(-10) ). PSMD explained most of the variance in processing speed (R(2) ranging from 8.8% to 46%) and consistently outperformed conventional imaging markers (white matter hyperintensity volume, lacune volume, and brain volume) in multiple regression analyses. Increases in PSMD were linked to vascular but not to neurodegenerative disease. In longitudinal analysis, PSMD captured SVD progression better than other imaging markers. INTERPRETATION PSMD is a new, fully automated, and robust imaging marker for SVD. PSMD can easily be applied to large samples and may be of great utility for both research studies and clinical use. Ann Neurol 2016;80:581-592.
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Affiliation(s)
- Ebru Baykara
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University LMU, Munich, Germany
| | - Benno Gesierich
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University LMU, Munich, Germany
| | - Ruth Adam
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University LMU, Munich, Germany
| | - Anil Man Tuladhar
- Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Department of Neurology, Nijmegen, the Netherlands
| | - J Matthijs Biesbroek
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Huiberdina L Koek
- Department of Geriatrics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Eric Jouvent
- Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 National Institute for Health and Medical Research (INSERM), Paris, France.,Departement Hospitalo-Universitaire NeuroVasc Sorbonne Paris Cité, Paris, France.,Department of Neurology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | | | - Hugues Chabriat
- Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 National Institute for Health and Medical Research (INSERM), Paris, France.,Departement Hospitalo-Universitaire NeuroVasc Sorbonne Paris Cité, Paris, France.,Department of Neurology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Birgit Ertl-Wagner
- Institute of Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilians-University LMU, Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University LMU, Munich, Germany
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Frank-Erik de Leeuw
- Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Department of Neurology, Nijmegen, the Netherlands
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University LMU, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University LMU, Munich, Germany.
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150
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Mann C, Karl K, Ertl-Wagner B, Weigand H, Thaler C. Laparoscopic Chromopertubation, Myomectomy with Opening of the Uterine Cavity and Hysteroscopy during the Early Implantation Phase of an Undetected Pregnancy: Delivery of a Child with a Complex Brain Malformation. Geburtshilfe Frauenheilkd 2016; 76:906-909. [DOI: 10.1055/s-0042-106086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- C. Mann
- Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Maistr. 11, 80337 Munich, Germany
| | - K. Karl
- Prenatal Diagnosis, Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Hospital, Maistr. 11, 80337 Munich, Germany; now: Prenatal Diagnosis Munich, Tegernseer Landstr. 64, 81541 Munich, Germany
| | - B. Ertl-Wagner
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany
| | - H. Weigand
- Department of Pediatric Neurology Ludwig-Maximilians-University Hospital, Munich, Germany
| | - C. Thaler
- Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Maistr. 11, 80337 Munich, Germany
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