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Ahmadsei M, Christ S, Seiler A, Vlaskou Badra E, Willmann J, Hertler C, Guckenberger M. PO-1063 Quality-of-life and perceptions in cancer patients treated with multiple courses of radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03027-4] [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: 11/25/2022]
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2
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Hanke JM, Schindler KA, Seiler A. On the relationships between epilepsy, sleep, and Alzheimer's disease: A narrative review. Epilepsy Behav 2022; 129:108609. [PMID: 35176650 DOI: 10.1016/j.yebeh.2022.108609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/10/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 12/21/2022]
Abstract
Epilepsy, sleep, and Alzheimer's disease (AD) are tightly and potentially causally interconnected. The aim of our review was to investigate current research directions on these relationships. Our hope is that they may indicate preventive measures and new treatment options for early neurodegeneration. We included articles that assessed all three topics and were published during the last ten years. We found that this literature corroborates connections on various pathophysiological levels, including sleep-stage-related epileptiform activity in AD, the negative consequences of different sleep disorders on epilepsy and cognition, common biochemical pathways as well as network dysfunctions. Here we provide a detailed overview of these topics and we discuss promising diagnostic and therapeutic consequences.
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Affiliation(s)
- Julie M Hanke
- Department of Neurology, Inselspital, Sleep-Wake-Epilepsy-Center, Bern University Hospital, University Bern, Bern, Switzerland
| | - Kaspar A Schindler
- Department of Neurology, Inselspital, Sleep-Wake-Epilepsy-Center, Bern University Hospital, University Bern, Bern, Switzerland
| | - Andrea Seiler
- Department of Neurology, Inselspital, Sleep-Wake-Epilepsy-Center, Bern University Hospital, University Bern, Bern, Switzerland.
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Seiler A, Schettle M, Amann M, Gaertner S, Wicki S, Christ SM, Theile G, Feuz M, Hertler C, Blum D. Virtual Reality Therapy in Palliative Care: A Case Series. J Palliat Care 2022:8258597221086767. [PMID: 35293818 DOI: 10.1177/08258597221086767] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 11/16/2022]
Abstract
OBJECTIVES Virtual reality (VR) opens a variety of therapeutic options to improve symptom burden in patients with advanced disease. Until to date, only few studies have evaluated the use of VR therapy in the context of palliative care. This case series aims to evaluate the feasibility and acceptability of VR therapy in a population of palliative care patients. METHODS In this single-site case series, we report on six palliative care patients undergoing VR therapy. The VR therapy consisted of a one-time session ranging between 20 to 60 minutes depending on the patient's needs and the content chosen for the VR sessions. A semi-structured survey was conducted and the Edmonton Symptom Assessment System (ESAS) and the Distress Thermometer were performed pre- and post-intervention. RESULTS Overall, VR therapy was well accepted by all patients. Five out of six patients reported having appreciated VR therapy. There were individual differences of perceived effects using VR therapy. The semi-structured survey revealed that some patients felt a temporary detachment from their body and that patients were able to experience the VR session as a break from omnipresent worries and the hospital environment ("I completely forgot where I am"). There was a considerable reduction in the total ESAS score post-treatment (T0 ESASTot = 27.2; T1 ESASTot = 18.8) and a slightly reduction in distress (T0 DTTot = 4.4; T1 DTTot = 3.8). However, two patients were more tired after the intervention.Significance of Results: Our preliminary results demonstrate that VR therapy is acceptable, feasible and safe for use within a palliative care population and appears to be a viable treatment option. Clinical trials are both warranted and necessary to confirm any therapeutic effects of VR therapy, as is the need to tailor VR systems better for use in palliative care settings.
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Affiliation(s)
- A Seiler
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - M Schettle
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
| | - M Amann
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
| | - Sophie Gaertner
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
| | - Stefan Wicki
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
- Internal Medicine Centre, Hirslanden Klinik Aarau, Switzerland
| | - S M Christ
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
| | - G Theile
- Clinic Susenberg, Zurich, Switzerland
| | - M Feuz
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
| | - C Hertler
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
| | - D Blum
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
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Blum D, Seiler A, Schmidt E, Pavic M, Strasser F. Patterns of integrating palliative care into standard oncology in an early ESMO designated center: a 10-year experience. ESMO Open 2021; 6:100147. [PMID: 33984671 PMCID: PMC8134655 DOI: 10.1016/j.esmoop.2021.100147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 02/01/2021] [Revised: 03/26/2021] [Accepted: 04/09/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Integration of specialist palliative care (PC) into standard oncology care is recommended. This study investigated how integration at the Cantonal Hospital St. Gallen (KSSG) was manifested 10 years after initial accreditation as a European Society for Medical Oncology (ESMO) Designated Center (ESMO-DC) of Integrated Oncology and Palliative Care. METHODS A chart review covering the years 2006-2009 and 2016 was carried out in patients with an incurable malignancy receiving PC. Visual graphic analysis was utilized to identify patterns of integration of PC into oncology based on the number and nature of medical consultations recorded for both specialties. A follow-up cohort collected 10 years later was analyzed and changes in patterns of integrating specialist PC into oncology were compared. RESULTS Three hundred and forty-five patients from 2006 to 2009 and 64 patients from 2016 were included into analyses. Four distinct patterns were identified using visual graphic analysis. The 'specialist PC-led pattern' (44.9%) and the 'oncology-led pattern' (20.3%) represent disciplines that took primary responsibility for managing patients, with occasional and limited involvement from other disciplines. Patients in the 'concurrent integrated care pattern' (18.3%) had medical consultations that frequently bounced between specialist PC and oncology. In the 'segmented integrated care pattern' (16.5%), patients had sequences of continuous consultations provided by one discipline before alternating to a stretch of consultations provided by the other specialty. In the 2016 follow-up, while the 'oncology-led pattern' occurred significantly less frequently relative to the 'specialist PC-led pattern' and the 'segmented integrated care pattern', the 'concurrent integrated care pattern' emerged more frequently when compared with the 2006-2009 follow-up. CONCLUSION The 'specialist PC-led pattern' was the most prominent pattern in this data. The 2016 follow-up showed that a growing number of patients received a collaborative pattern of care, indicating that integration of specialist PC into standard oncology can manifest as either segmented or concurrent care pathways. Our data suggest a closer, more dynamic and flexible collaboration between oncology and specialist PC early in the disease course of patients with advanced cancer and concurrent with active treatment.
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Affiliation(s)
- D. Blum
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland,Correspondence to: Dr David Blum, Competence Center Palliative Care, Department of Radiation Oncology, University Hospital Zurich (USZ), Rämistrasse 100, CH-8091 Zürich, Switzerland. Tel: +044-255-37-42; Mob: +079-154-87-47
| | - A. Seiler
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland,Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - E. Schmidt
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland,Oncological Palliative Medicine, Clinic Oncology/Hematology, Cantonal Hospital St. Gallen, Switzerland
| | - M. Pavic
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, Zurich, Switzerland
| | - F. Strasser
- Oncological Palliative Medicine, Clinic Oncology/Hematology, Cantonal Hospital St. Gallen, Switzerland
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Ni H, Kumbrink J, Mayr D, Seiler A, Hagemann F, Degenhardt T, Sagebiel S, Wuerstlein R, Harbeck N, Eggersmann T. 55P Molecular risk factors for distant metastases in premenopausal patients with HR+/HER2- EBC. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.069] [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: 10/21/2022] Open
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6
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Bernasconi C, Ott SR, Fanfulla F, Miano S, Horvath T, Seiler A, Cereda CW, Brill AK, Young P, Nobili L, Manconi M, Bassetti CLA. SAS CARE 2 - a randomized study of CPAP in patients with obstructive sleep disordered breathing following ischemic stroke or transient ischemic attack. Sleep Med X 2020; 2:100027. [PMID: 33870178 PMCID: PMC8041126 DOI: 10.1016/j.sleepx.2020.100027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 09/29/2020] [Indexed: 12/23/2022] Open
Abstract
Objective/background The benefit of Continuous Positive Airway Pressure (CPAP) treatment following ischemic stroke in patients with obstructive sleep-disordered breathing (SDB) is unclear. We set out to investigate this open question in a randomized controlled trial as part of the SAS-CARE study. Patients/methods. Non-sleepy patients (ESS < 10) with ischemic stroke or transient ischemic attack (TIA) and obstructive SDB (AHI ≥ 20) 3 months post-stroke were randomized 1:1 to CPAP treatment (CPAP+) or standard care. Primary outcome was the occurrence of vascular events (TIA/stroke, myocardial infarction/revascularization, hospitalization for heart failure or unstable angina) or death within 24 months post-stroke. Secondary outcomes included Modified Rankin Scale (mRS) and Barthel Index. Results Among 238 SAS-CARE patients 41 (17%) non-sleepy obstructive SDB patients were randomized to CPAP (n = 19) or standard care (n = 22). Most patients (80%) had stroke and were males (78%), mean age was 64 ± 7 years and mean NIHSS score 0.6 ± 1.0 (range: 0–5). The primary endpoint was met by one patient in the standard care arm (a new stroke). In an intent-to treat analysis disregarding adherence, this corresponds to an absolute risk difference of 4.5% or an NNT = 22. mRS and Barthel Index were stable and similar between arms. CPAP adherence was sufficient in 60% of evaluable patients at month 24. Conclusion No benefit of CPAP started three months post-stroke was found in terms of new cardio- and cerebrovascular events over 2 years. This may be related to the small size of this study, the mild stoke severity, the exclusion of sleepy patients, the delayed start of treatment, and the overall low event rate. No benefit of CPAP started 3 months post-stroke was found. A sufficient CPAP compliance was observed over 2 years in 60% of patients. Studies of CPAP in mild stroke need to be large and include long-term outcomes.
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Affiliation(s)
- C Bernasconi
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - S R Ott
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Pulmonary and Sleep Medicine, St. Claraspital, Basel, Switzerland
| | - F Fanfulla
- Sleep Medicine, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.,Sleep Medicine Unit, Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | - S Miano
- Sleep Medicine, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - T Horvath
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - A Seiler
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - C W Cereda
- Stroke Center EOC, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland
| | - A-K Brill
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - P Young
- University Hospital Münster, Department of Neurology, Münster, Germany
| | - L Nobili
- Department of Neurology, Ospedale Niguarda, Milano, Italy.,DINOGMI, University of Genoa, Genoa, Italy
| | - M Manconi
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Sleep Medicine, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - C L A Bassetti
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Sleep-Wake-Epilepsy Center, Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Neurology Department, Sechenov First Moscow State Medical University, Moscow, Russia
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7
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Ni H, Kurt A, Kumbrink J, Seiler A, Mayr D, Hagemann F, Degenhardt T, Würstlein R, Harbeck N, Eggersmann T. Gene expression profiles in premenopausal women with HR+ HER2- early breast cancer. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717863] [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: 10/23/2022] Open
Affiliation(s)
- H Ni
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - A Kurt
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - J Kumbrink
- Faculty of Medicine, Institute of Pathology, University of Munich (LMU)
| | - A Seiler
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - D Mayr
- Faculty of Medicine, Institute of Pathology, University of Munich (LMU)
| | - F Hagemann
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - T Degenhardt
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - R Würstlein
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - N Harbeck
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - T Eggersmann
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
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8
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Ni H, Kurt A, Kumbrink J, Seiler A, Mayr D, Degenhardt T, Hagemann F, Würstlein R, Harbeck N, Eggersmann T. Gene expression profiles in premenopausal women with HR+ HER2− early breast cancer. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30731-0] [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: 10/23/2022]
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9
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Ott SR, Fanfulla F, Miano S, Horvath T, Seiler A, Bernasconi C, Cereda CW, Brill AK, Young P, Nobili L, Manconi M, Bassetti CLA. SAS Care 1: sleep-disordered breathing in acute stroke an transient ischaemic attack - prevalence, evolution and association with functional outcome at 3 months, a prospective observational polysomnography study. ERJ Open Res 2020; 6:00334-2019. [PMID: 32577418 PMCID: PMC7293990 DOI: 10.1183/23120541.00334-2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/24/2020] [Indexed: 12/27/2022] Open
Abstract
Sleep-disordered breathing (SDB) is frequent in patients with acute stroke. Little is known, however about the evolution of SDB after stroke. Most of our knowledge stems from smaller cohort studies applying limited cardiopulmonary sleep recordings or from cross-sectional data collected in different populations. This study aims to determine prevalence, type and intra-individual evolution of SDB based on full-night polysomnography (PSG) in acute stroke and 3 months thereafter. Furthermore, we aimed to identify predictors of SDB in the acute and chronic phase and to evaluate associations between SDB and functional outcome at 3 months (M3). A total of 166 patients with acute cerebrovascular events were evaluated by full PSG at baseline and 105 again at M3. The baseline prevalence of SDB (apnoea–hypopnoea index (AHI)>5·h−1) was 80.5% and 25.4% of the patients had severe SDB (AHI>30·h−1). Obstructive sleep apnoea was more prevalent than central sleep apnoea (83.8% versus 13%). Mean±SD AHI was 21.4±17.6·h−1and decreased significantly at M3 (18±16.4·h−1; p=0.018). At M3, 91% of all patients with baseline SDB still had an AHI>5·h−1 and in 68.1% the predominant type of SDB remained unchanged (78.9% in obstructive sleep apnoea and 44.4% in central sleep apnoea). The only predictors of SDB at baseline were higher age and body mass index and in the chronic phase additionally baseline AHI. Baseline AHI was associated with functional outcome (modified Rankin score >3) at M3. The high prevalence of SDB in acute stroke, its persistence after 3 months, and the association with functional outcome supports the recommendation for a rapid SDB screening in stroke patients. The high prevalence of SDB in acute stroke, its persistence after 3 months and its association with functional outcome support the recommendation for rapid SDB screening in stroke patientshttps://bit.ly/3bFWqV7
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Affiliation(s)
- Sebastian R Ott
- Dept of Pulmonary Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Sleep-Wake-Epilepsy Center, Dept of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Pulmonary and Sleep Medicine, St Claraspital, Basel, Switzerland.,These authors contributed equally
| | - Francesco Fanfulla
- Neurocentre of Southern Switzerland, Lugano, Switzerland.,Sleep Medicine Unit, Istituti Clinici Scientifici Maugeri, Pavia, Italy.,These authors contributed equally
| | - Silvia Miano
- Neurocentre of Southern Switzerland, Lugano, Switzerland
| | - Thomas Horvath
- Dept of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Andrea Seiler
- Dept of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Corrado Bernasconi
- Dept of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Carlo W Cereda
- Neurocentre of Southern Switzerland, Lugano, Switzerland
| | - Anne-Kathrin Brill
- Dept of Pulmonary Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Sleep-Wake-Epilepsy Center, Dept of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Peter Young
- Dept of Neurology, University Hospital Münster, Münster, Germany
| | - Lino Nobili
- Dept of Neurology, Ospedale Niguarda, Milan, Italy.,Dept of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Child and Maternal Health (DINOGMI), University of Genova, Genoa, Italy
| | - Mauro Manconi
- Neurocentre of Southern Switzerland, Lugano, Switzerland.,Dept of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Claudio L A Bassetti
- Sleep-Wake-Epilepsy Center, Dept of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Dept of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.,Dept of Neurology, Sechenow University, Moscow, Russia
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Affiliation(s)
- A. Stuck
- Medizinische Poliklinik University of Rerne Regionalspital Riel, Switzerland
| | - A. Seiler
- Medizinische Poliklinik University of Rerne Regionalspital Riel, Switzerland
| | - F.J. Frey
- Medizinische Poliklinik University of Rerne Regionalspital Riel, Switzerland
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Tarakji K, Zweibel S, Seiler A, Roberts P, Shaik N, Silverstein J, Patwala A, Mittal S, Molon G, Augello G, Porfilio A, Holloman K, Varma N, Sears S, Turakhia M. P577Early experience with the first pacemakers to directly connect with smart devices for remote monitoring. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Remote monitoring is associated with improved patient outcomes; however, adoption and adherence to remote monitoring via home-based consoles remains suboptimal. BlueSync technology in new generation pacemaker and CRT-P models enables the implanted device to communicate directly with patient-owned, Bluetooth-equipped smartphones/tablets and an app (MyCareLink Heart). The app can automatically retrieve information from the cardiac device and transmit the data to the remote network, eliminating the need for traditional remote monitoring consoles.
Objectives
To characterize the communication process between implanted pacemakers and smart device remote monitoring apps by assessing the success of prescheduled remote transmissions in the first month of follow-up. Additionally, to assess the feedback of both patients and clinicians about the process of device pairing.
Methods
Enrollment in the BlueSync Field Evaluation began in April 2018 and was completed November 2018. Follow-up is ongoing. Prior to enrollment in the evaluation, patients completed the device pairing process with the app using their own compatible smartphone or tablet. Patient and clinician questionnaires were completed at the time of the device pairing process. After enrollment, successful completion of scheduled transmissions occurring in the first month were analyzed.
Results
Preliminary data includes 241 enrolled patients with mean age of 64.7±15.5 yrs (min 20, max 90 yrs), who completed device pairing between their implanted device and their smart device app. Of enrolled patients, 79% felt that the device paring was easy to do, 85% were satisfied with the amount of time it took to complete it, and 93% felt that they would be comfortable using the app. Clinicians reported that 67% of the device pairings took less than 20 minutes and 78% felt patients would be able to use the app independently. At the time of analysis 174 patients had at least one scheduled transmission within the first month, and collectively had a total of 322 scheduled transmissions. Out of these, 309 (96%, 95% CI: 93%-98%) were successfully completed.
MyCareLink Heart App
Conclusions
Initial experience with the world's first app based remote monitoring system for Bluetooth enabled pacemakers demonstrated success to scheduled transmissions in the first month across a wide range of patient ages. Patients and clinicians reported high satisfaction with this novel technology.
Acknowledgement/Funding
Medtronic PLC
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Affiliation(s)
- K Tarakji
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Zweibel
- Hartford Hospital, Hartford, United States of America
| | - A Seiler
- Moses Cone Heart and Vascular Center, Greensboro, United States of America
| | - P Roberts
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - N Shaik
- Cardiovascular Institutes, Orlando, United States of America
| | | | - A Patwala
- North Staffordshire NHS Trust, Cardiology, Stoke on Trent, United Kingdom
| | - S Mittal
- The Valley Hospital, Ridgewood, United States of America
| | - G Molon
- Sacred Heart Hospital of Negrar, Negrar, Italy
| | - G Augello
- Istituto Clinico Citta Studi, Cardiology, Milano, Italy
| | - A Porfilio
- Provincia Religiosa San Pietro Di Roma, Roma, Italy
| | - K Holloman
- Medtronic PLC, Clinical Research, Mounds View, United States of America
| | - N Varma
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Sears
- East Carolina University, Greenville, United States of America
| | - M Turakhia
- Stanford University, Palo Alto, United States of America
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12
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Pauselius-Fuchs U, Seiler A, Proebstl C, Donnerbauer E, Von Meyer A, Falbo R, Brandt I, Song J, Klopprogge K, Zimmermann S, Horstmann M, Mccaughey A. The cobas® SonicWash reduces sample carryover on cobas C 503 and cobas ISE analytical unit. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.127] [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: 10/26/2022]
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13
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Caporro M, Rossetti AO, Seiler A, Kustermann T, Nguepnjo Nguissi NA, Pfeiffer C, Zimmermann R, Haenggi M, Oddo M, De Lucia M, Zubler F. Electromyographic reactivity measured with scalp-EEG contributes to prognostication after cardiac arrest. Resuscitation 2019; 138:146-152. [DOI: 10.1016/j.resuscitation.2019.03.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/03/2019] [Accepted: 03/06/2019] [Indexed: 01/02/2023]
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14
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Spielmann H, Genschow E, Brown NA, Piersma AH, Verhoef A, Spanjersberg MQI, Huuskonen H, Paillard F, Seiler A. Validation of the Rat Limb Bud Micromass Test in the International ECVAM Validation Study on Three In Vitro Embryotoxicity Tests. Altern Lab Anim 2019; 32:245-74. [PMID: 15588167 DOI: 10.1177/026119290403200306] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A detailed report is presented on the performance of the rat limb bud micromass (MM) test in a European Centre for the Evaluation of Alternative Methods (ECVAM)-sponsored formal validation study on three in vitro tests for embryotoxicity. Twenty coded test chemicals, classified as non-embryotoxic, weakly embryotoxic or strongly embryotoxic on the basis of their in vivo effects on animals and/or humans, were tested in four laboratories. The outcome showed that the MM test is an experimentally validated test, which holds promise for use for identifying strongly embryotoxic chemicals, but which needs to be improved before it can be recommended for use for regulatory purposes.
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Affiliation(s)
- Horst Spielmann
- Centre for Documentation and Evaluation of Alternative Methods to Animal Experiments (ZEBET) at the Federal Institute for Risk Assessment (BfR), Diedersdorfer Weg 1, 12277 Berlin, Germany.
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Spielmann H, Seiler A, Bremer S, Hareng L, Hartung T, Ahr H, Faustman E, Haas U, Moffat GJ, Nau H, Vanparys P, Piersma A, Sintes JR, Stuart J. The Practical Application of Three Validated In Vitro Embryotoxicity Tests. Altern Lab Anim 2019; 34:527-38. [PMID: 17121476 DOI: 10.1177/026119290603400504] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Horst Spielmann
- National Centre for Documentation and Evaluation of Alternative Methods to Animal Experiments (ZEBET), Federal Institute for Risk Assessment (BfR), Berlin, Germany
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Genschow E, Seiler A, Spielmann H. Considering the Test Performance for Three Class Data Using Linear Discriminant Analysis: A Case Study. Altern Lab Anim 2019; 32 Suppl 1B:713-23. [DOI: 10.1177/026119290403201s119] [Citation(s) in RCA: 5] [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] [Indexed: 11/17/2022]
Abstract
The results of a European Centre for the Validation of Alternative Methods validation study on the embryonic stem (ES) cell test were used as an example for the test performance for “three-class” data using linear discriminant analysis (LDA). Applying LDA, a biostatistical prediction model was developed to assign test chemicals to three classes of embryotoxicity. Three endpoint values were identified to classify the embryotoxic potential of chemicals: a) the inhibition of differentiation of ES cells into cardiomyocytes (ID50), b) the decrease of viability of adult 3T3 cells (IC503T3), and c) the decrease of viability of ES cells (IC50D3) in an MTT cytotoxicity test. It could be demonstrated that an objective statistical method was required in order to minimise the probability of misclassification. The management team of the validation study defined performance criteria, taking into consideration the hit rate for three classes obtained just by chance. An additional purpose of the study reported here was to calculate a hypothetical prevalence and evaluate its influence on the classification results.
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Affiliation(s)
- Elke Genschow
- National Centre for Documentation and Evaluation of Alternative Methods to Animal Experiments (ZEBET), Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Andrea Seiler
- National Centre for Documentation and Evaluation of Alternative Methods to Animal Experiments (ZEBET), Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Horst Spielmann
- National Centre for Documentation and Evaluation of Alternative Methods to Animal Experiments (ZEBET), Federal Institute for Risk Assessment (BfR), Berlin, Germany
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Seiler A, Camilo M, Korostovtseva L, Haynes AG, Brill AK, Horvath T, Egger M, Bassetti CL. Prevalence of sleep-disordered breathing after stroke and TIA: A meta-analysis. Neurology 2019; 92:e648-e654. [PMID: 30635478 DOI: 10.1212/wnl.0000000000006904] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 12/14/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To perform a systematic review and meta-analysis on the prevalence of sleep-disordered breathing (SDB) after stroke. METHODS We searched PubMed, Embase (Ovid), the Cochrane Library, and CINAHL (from their commencements to April 7, 2017) for clinical studies reporting prevalence and/or severity of SDB after stroke or TIA. Only sleep apnea tests performed with full polysomnography and diagnostic devices of the American Academy of Sleep Medicine categories I-IV were included. We conducted random-effects meta-analysis. PROSPERO registration number: CRD42017072339. RESULTS The initial search identified 5,211 publications. Eighty-nine studies (including 7,096 patients) met inclusion criteria. Fifty-four studies were performed in the acute phase after stroke (after less than 1 month), 23 studies in the subacute phase (after 1-3 months), and 12 studies in the chronic phase (after more than 3 months). Mean apnea-hypopnea index was 26.0/h (SD 21.7-31.2). Prevalence of SDB with apnea-hypopnea index greater than 5/h and greater than 30/h was found in 71% (95% confidence interval 66.6%-74.8%) and 30% (95% confidence interval 24.4%-35.5%) of patients, respectively. Severity and prevalence of SDB were similar in all examined phases after stroke, irrespective of the type of sleep apnea test performed. Heterogeneity between studies (I 2) was mostly high. CONCLUSION The high prevalence of SDB after stroke and TIA, which persists over time, is important in light of recent studies reporting the (1) feasibility and (2) efficacy of SDB treatment in this clinical setting.
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Affiliation(s)
- Andrea Seiler
- From the Sleep Wake Epilepsy Center (A.S., M.C., L.K., A.-K.B., T.H., C.L.B.), and Departments of Neurology (A.S., M.C., L.K., T.H., C.L.B.) and Pulmonary Medicine (A.-K.B.), Bern University Hospital, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Hypertension Department (L.K.), Somnology Group, Almazov National Medical Research Center, St. Petersburg, Russia; and CTU Bern (A.G.H.), and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Millene Camilo
- From the Sleep Wake Epilepsy Center (A.S., M.C., L.K., A.-K.B., T.H., C.L.B.), and Departments of Neurology (A.S., M.C., L.K., T.H., C.L.B.) and Pulmonary Medicine (A.-K.B.), Bern University Hospital, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Hypertension Department (L.K.), Somnology Group, Almazov National Medical Research Center, St. Petersburg, Russia; and CTU Bern (A.G.H.), and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Lyudmila Korostovtseva
- From the Sleep Wake Epilepsy Center (A.S., M.C., L.K., A.-K.B., T.H., C.L.B.), and Departments of Neurology (A.S., M.C., L.K., T.H., C.L.B.) and Pulmonary Medicine (A.-K.B.), Bern University Hospital, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Hypertension Department (L.K.), Somnology Group, Almazov National Medical Research Center, St. Petersburg, Russia; and CTU Bern (A.G.H.), and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Alan G Haynes
- From the Sleep Wake Epilepsy Center (A.S., M.C., L.K., A.-K.B., T.H., C.L.B.), and Departments of Neurology (A.S., M.C., L.K., T.H., C.L.B.) and Pulmonary Medicine (A.-K.B.), Bern University Hospital, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Hypertension Department (L.K.), Somnology Group, Almazov National Medical Research Center, St. Petersburg, Russia; and CTU Bern (A.G.H.), and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Anne-Kathrin Brill
- From the Sleep Wake Epilepsy Center (A.S., M.C., L.K., A.-K.B., T.H., C.L.B.), and Departments of Neurology (A.S., M.C., L.K., T.H., C.L.B.) and Pulmonary Medicine (A.-K.B.), Bern University Hospital, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Hypertension Department (L.K.), Somnology Group, Almazov National Medical Research Center, St. Petersburg, Russia; and CTU Bern (A.G.H.), and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Thomas Horvath
- From the Sleep Wake Epilepsy Center (A.S., M.C., L.K., A.-K.B., T.H., C.L.B.), and Departments of Neurology (A.S., M.C., L.K., T.H., C.L.B.) and Pulmonary Medicine (A.-K.B.), Bern University Hospital, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Hypertension Department (L.K.), Somnology Group, Almazov National Medical Research Center, St. Petersburg, Russia; and CTU Bern (A.G.H.), and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Matthias Egger
- From the Sleep Wake Epilepsy Center (A.S., M.C., L.K., A.-K.B., T.H., C.L.B.), and Departments of Neurology (A.S., M.C., L.K., T.H., C.L.B.) and Pulmonary Medicine (A.-K.B.), Bern University Hospital, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Hypertension Department (L.K.), Somnology Group, Almazov National Medical Research Center, St. Petersburg, Russia; and CTU Bern (A.G.H.), and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Claudio L Bassetti
- From the Sleep Wake Epilepsy Center (A.S., M.C., L.K., A.-K.B., T.H., C.L.B.), and Departments of Neurology (A.S., M.C., L.K., T.H., C.L.B.) and Pulmonary Medicine (A.-K.B.), Bern University Hospital, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Brazil; Hypertension Department (L.K.), Somnology Group, Almazov National Medical Research Center, St. Petersburg, Russia; and CTU Bern (A.G.H.), and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland.
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Rummel C, Slavova N, Seiler A, Abela E, Hauf M, Burren Y, Weisstanner C, Vulliemoz S, Seeck M, Schindler K, Wiest R. Publisher Correction: Personalized structural image analysis in patients with temporal lobe epilepsy. Sci Rep 2018; 8:681. [PMID: 29317667 PMCID: PMC5760623 DOI: 10.1038/s41598-017-16213-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Eggersmann TK, Seiler A, Würstlein R, Kumbrink J, Mayr D, Mahner S, Harbeck N. Long-term distant recurrence in premenopausal receptor-positive early stage breast cancer: Prognostic impact of molecular subtypes, risk of recurrence score, and clinical-pathological factors. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671515] [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: 10/28/2022] Open
Affiliation(s)
- TK Eggersmann
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
| | - A Seiler
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
| | - R Würstlein
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
| | - J Kumbrink
- University of Munich (LMU), Institute of Pathology, Faculty of Medicine, Munich, Deutschland
| | - D Mayr
- University of Munich (LMU), Institute of Pathology, Faculty of Medicine, Munich, Deutschland
| | - S Mahner
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
| | - N Harbeck
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
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Pace M, Camilo MR, Seiler A, Duss SB, Mathis J, Manconi M, Bassetti CL. Rapid eye movements sleep as a predictor of functional outcome after stroke: a translational study. Sleep 2018; 41:5056018. [DOI: 10.1093/sleep/zsy138] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Indexed: 12/18/2022] Open
Affiliation(s)
- Marta Pace
- Center for Experimental Neurology (ZEN), Department of Neurology, University Hospital (Inselspital), Bern, Switzerland
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia (IIT), Genova, Italy
| | - Millene R Camilo
- Department of Neurology, University Hospital-Inselspital, Bern, Switzerland
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Andrea Seiler
- Department of Neurology, University Hospital-Inselspital, Bern, Switzerland
| | - Simone B Duss
- Department of Neurology, University Hospital-Inselspital, Bern, Switzerland
| | - Johannes Mathis
- Department of Neurology, University Hospital-Inselspital, Bern, Switzerland
| | - Mauro Manconi
- Department of Neurology, University Hospital-Inselspital, Bern, Switzerland
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Lugano, Switzerland
| | - Claudio L Bassetti
- Center for Experimental Neurology (ZEN), Department of Neurology, University Hospital (Inselspital), Bern, Switzerland
- Department of Neurology, University Hospital-Inselspital, Bern, Switzerland
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Zubler F, Seiler A, Horvath T, Roth C, Miano S, Rummel C, Gast H, Nobili L, Schindler KA, Bassetti CL. Stroke causes a transient imbalance of interhemispheric information flow in EEG during non-REM sleep. Clin Neurophysiol 2018; 129:1418-1426. [DOI: 10.1016/j.clinph.2018.03.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 02/21/2018] [Accepted: 03/19/2018] [Indexed: 12/12/2022]
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Seiler A, Deichmann R, Nöth U, Lauer A, Pfeilschifter W, Singer OC, Wagner M. Extent of Microstructural Tissue Damage Correlates with Hemodynamic Failure in High-Grade Carotid Occlusive Disease: An MRI Study Using Quantitative T2 and DSC Perfusion. AJNR Am J Neuroradiol 2018; 39:1273-1279. [PMID: 29748200 DOI: 10.3174/ajnr.a5666] [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] [Received: 11/28/2017] [Accepted: 03/15/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Chronic hemodynamic impairment in high-grade carotid occlusive disease is thought to cause microstructural abnormalities that might be subclinical or lead to subtle symptoms including cognitive impairment. Quantitative MR imaging allows assessing pathologic structural changes beyond macroscopically visible tissue damage. In this study, high-resolution quantitative T2 mapping combined with DSC-based PWI was used to investigate quantitative T2 changes as a potential marker of microstructural damage in relation to hemodynamic impairment in patients with unilateral high-grade carotid occlusive disease. MATERIALS AND METHODS Eighteen patients with unilateral high-grade ICA or MCA stenosis/occlusion were included in the study. T2 values and deconvolved perfusion parameters, including relative CBF, relative CBV, and the relative CBF/relative CBV ratio as a potential indicator of local cerebral perfusion pressure, were determined within areas with delayed TTP and compared with values from contralateral unaffected areas after segmentation of normal-appearing hypoperfused WM and cortical regions. Hemispheric asymmetry indices were calculated for all parameters. RESULTS Quantitative T2 was significantly prolonged (P < .01) in hypoperfused tissue and correlated significantly (P < .01) with TTP delay and relative CBF/relative CBV reduction in WM. Significant correlations (P < .001) between TTP delay and the relative CBF/relative CBV ratio were found both in WM and in cortical areas. CONCLUSIONS Quantitative T2 can be used as a marker of microstructural tissue damage even in normal-appearing GM and WM within a vascular territory affected by high-grade carotid occlusive disease. Furthermore, the extent of damage correlates with the degree of hemodynamic failure measured by DSC perfusion parameters.
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Affiliation(s)
- A Seiler
- From the Department of Neurology (A.S., W.P., O.C.S.)
| | | | - U Nöth
- Brain Imaging Center (R.D., U.N.)
| | - A Lauer
- Institute of Neuroradiology (A.L., M.W.), Goethe University Frankfurt, Frankfurt, Germany
| | | | - O C Singer
- From the Department of Neurology (A.S., W.P., O.C.S.)
| | - M Wagner
- Institute of Neuroradiology (A.L., M.W.), Goethe University Frankfurt, Frankfurt, Germany
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Seiler A, Camilo M, Korostovtseva L, Haynes AG, Brill A, Horvath T, Egger M, Bassetti CL. 0464 Prevalence Of Sleep-disordered Breathing After Stroke And Transitory Ischemic Attack: A Meta-analysis. Sleep 2018. [DOI: 10.1093/sleep/zsy061.463] [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: 11/14/2022] Open
Affiliation(s)
- A Seiler
- Sleep Wake Epilepsy Center, Department of Neurology, University Hospital and University of Bern, Bern, SWITZERL
| | - M Camilo
- Sleep Wake Epilepsy Center, Department of Neurology, University Hospital and University of Bern, Bern, SWITZERL
| | - L Korostovtseva
- Sleep Wake Epilepsy Center, Department of Neurology, University Hospital and University of Bern, Bern, SWITZERL
| | - A G Haynes
- Clinical Trials Unit, University of Bern, Bern, SWITZERL
| | - A Brill
- Department of Pulmonary Medicine, University Hospital and University of Bern, Bern, SWITZERL
| | - T Horvath
- Sleep Wake Epilepsy Center, Department of Neurology, University Hospital and University of Bern, Bern, SWITZERL
| | - M Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, SWITZERL
| | - C L Bassetti
- Sleep Wake Epilepsy Center, Department of Neurology, University Hospital and University of Bern, Bern, SWITZERL
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Manconi M, Fanfulla F, Ferri R, Miano S, Haba-Rubio J, Heinzer R, Horvath T, Proserpio P, Young P, Moschovitis G, Seiler A, Cereda C, Nobili L, Wiest R, Ott SR, Bassetti CL. Periodic limb movements during sleep in stroke/TIA: Prevalence, course, and cardiovascular burden. Neurology 2018; 90:e1663-e1672. [PMID: 29643080 DOI: 10.1212/wnl.0000000000005471] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/15/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To define the prevalence, time course, and associated factors of periodic limb movements during sleep (PLMS) in patients with ischemic stroke or TIA. METHODS Patients enrolled in the prospective Sleep-Disordered Breathing in Transient Ischemia Attack (TIA)/Ischemic Stroke and Continuous Positive Airway Pressure (CPAP) Treatment Efficacy (SAS-CARE) study underwent a double polysomnographic investigation in the acute and chronic phases after stroke/TIA, together with a MRI brain scan and a 24-hour blood pressure evaluation. The prevalence of PLMS in patients was compared with that in a matched sample of randomly selected healthy controls from the HypnoLaus cohort. One hundred sixty-nine recordings were performed in the acute phase and 191 after 3 months (210 recordings were obtained from the same 105 patients in both phases) and were compared to those of 162 controls. RESULTS The mean number of PLMS per hour and the percentage of participants with a PLMS index >10 and >15 per hour were similar between patients and controls. PLMS remained stable from the acute to the chronic phase after stroke. Factors positively associated with PLMS were age, body mass index, and history of hypertension. Blood pressure over 24 hours and the burden of cerebrovascular damage were similar between the groups with PLMS and without PLMS. CONCLUSIONS PLMS are equally frequent in patients with stroke/TIA and the general population. The absence of higher blood pressure values and of a greater vascular brain damage found in patients with PLMS compared to those without PLMS might be due to a greater use of antihypertensive medication among patients with PLMS, which corresponds to a higher prevalence of previous diagnosis of hypertension in these patients.
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Affiliation(s)
- Mauro Manconi
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland.
| | - Francesco Fanfulla
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Raffaele Ferri
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Silvia Miano
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Josè Haba-Rubio
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Raphael Heinzer
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Thomas Horvath
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Paola Proserpio
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Peter Young
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Giorgio Moschovitis
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Andrea Seiler
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Carlo Cereda
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Lino Nobili
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Roland Wiest
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Sebastian R Ott
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland
| | - Claudio L Bassetti
- From the Sleep and Epilepsy Center (M.M., F.F., S.M., C.C.,), Neurocenter of Southern Switzerland, Civic Hospital of Lugano; Neurology Department Inselspital (M.M., T.H., A.S., C.L.B.), Bern University Hospital, Switzerland; Sleep Medicine Unit (F.F.), Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Pavia; Sleep Research Centre (R.F.), Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy; Center for Investigation and Research in Sleep (J.H.-R., R.H.), Lausanne University Hospital, Switzerland; C. Munari Center of Epilepsy Surgery (P.P., L.N.), Niguarda Hospital, Milan, Italy; Klinik für Schlafmedizin und Neuromuskuläre Erkrankungen (P.Y.), Universitätsklinikum Münster, Germany; Department of Cardiology (G.M.), Regional Hospital of Lugano, Switzerland; Department of Neuroscience (L.N.), University of Genoa, Italy; University Institute of Diagnostic and Interventional Neuroradiology (R.W.), Inselspital, Bern University Hospital, University of Bern, Switzerland; and Department of Pulmonary Medicine and University of Bern (S.R.O.), Inselspital, University Hospital, Bern, Switzerland.
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25
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Brill AK, Horvath T, Seiler A, Camilo M, Haynes AG, Ott SR, Egger M, Bassetti CL. CPAP as treatment of sleep apnea after stroke: A meta-analysis of randomized trials. Neurology 2018. [PMID: 29523641 DOI: 10.1212/wnl.0000000000005262] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effectiveness of continuous positive airway pressure (CPAP) in stroke patients with sleep disordered breathing (SDB). METHODS In a systematic literature search of electronic databases (MEDLINE, Embase, and the Cochrane Library) from 1980 to November 2016, we identified RCTs that assessed CPAP compared to standard care or sham CPAP in adult patients with stroke or TIA with SDB. Mean CPAP use, odds ratios (ORs), and standardized mean differences (SMDs) were calculated. The prespecified outcomes were adherence to CPAP, neurologic improvement, adverse events, new vascular events, and death. RESULTS Ten RCTs (564 participants) with CPAP as intervention were included. Two studies compared CPAP with sham CPAP; 8 compared CPAP with usual care. Mean CPAP use across the trials was 4.53 hours per night (95% confidence interval [CI] 3.97-5.08). The OR of dropping out with CPAP was 1.83 (95% CI 1.05-3.21, p = 0.033). The combined analysis of the neurofunctional scales (NIH Stroke Scale and Canadian Neurological Scale) showed an overall neurofunctional improvement with CPAP (SMD 0.5406, 95% CI 0.0263-1.0548) but with a considerable heterogeneity (I2 = 78.9%, p = 0.0394) across the studies. Long-term survival was improved with CPAP in 1 trial. CONCLUSION CPAP use after stroke is acceptable once the treatment is tolerated. The data indicate that CPAP might be beneficial for neurologic recovery, which justifies larger RCTs.
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Affiliation(s)
- Anne-Kathrin Brill
- From the Department of Pulmonary Medicine (A.-K.B., S.R.O.), Department of Neurology (T.H., A.S., M.C., C.L.B.), and Sleep Wake Epilepsy Center (A.-K.B., T.H., A.S., M.C., S.R.O., C.L.B.), Inselspital, University Hospital Bern, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, University of São Paulo, Brazil; and CTU Bern (A.G.H.) and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Thomas Horvath
- From the Department of Pulmonary Medicine (A.-K.B., S.R.O.), Department of Neurology (T.H., A.S., M.C., C.L.B.), and Sleep Wake Epilepsy Center (A.-K.B., T.H., A.S., M.C., S.R.O., C.L.B.), Inselspital, University Hospital Bern, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, University of São Paulo, Brazil; and CTU Bern (A.G.H.) and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Andrea Seiler
- From the Department of Pulmonary Medicine (A.-K.B., S.R.O.), Department of Neurology (T.H., A.S., M.C., C.L.B.), and Sleep Wake Epilepsy Center (A.-K.B., T.H., A.S., M.C., S.R.O., C.L.B.), Inselspital, University Hospital Bern, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, University of São Paulo, Brazil; and CTU Bern (A.G.H.) and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Millene Camilo
- From the Department of Pulmonary Medicine (A.-K.B., S.R.O.), Department of Neurology (T.H., A.S., M.C., C.L.B.), and Sleep Wake Epilepsy Center (A.-K.B., T.H., A.S., M.C., S.R.O., C.L.B.), Inselspital, University Hospital Bern, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, University of São Paulo, Brazil; and CTU Bern (A.G.H.) and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Alan G Haynes
- From the Department of Pulmonary Medicine (A.-K.B., S.R.O.), Department of Neurology (T.H., A.S., M.C., C.L.B.), and Sleep Wake Epilepsy Center (A.-K.B., T.H., A.S., M.C., S.R.O., C.L.B.), Inselspital, University Hospital Bern, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, University of São Paulo, Brazil; and CTU Bern (A.G.H.) and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Sebastian R Ott
- From the Department of Pulmonary Medicine (A.-K.B., S.R.O.), Department of Neurology (T.H., A.S., M.C., C.L.B.), and Sleep Wake Epilepsy Center (A.-K.B., T.H., A.S., M.C., S.R.O., C.L.B.), Inselspital, University Hospital Bern, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, University of São Paulo, Brazil; and CTU Bern (A.G.H.) and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Matthias Egger
- From the Department of Pulmonary Medicine (A.-K.B., S.R.O.), Department of Neurology (T.H., A.S., M.C., C.L.B.), and Sleep Wake Epilepsy Center (A.-K.B., T.H., A.S., M.C., S.R.O., C.L.B.), Inselspital, University Hospital Bern, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, University of São Paulo, Brazil; and CTU Bern (A.G.H.) and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland
| | - Claudio L Bassetti
- From the Department of Pulmonary Medicine (A.-K.B., S.R.O.), Department of Neurology (T.H., A.S., M.C., C.L.B.), and Sleep Wake Epilepsy Center (A.-K.B., T.H., A.S., M.C., S.R.O., C.L.B.), Inselspital, University Hospital Bern, University of Bern, Switzerland; Neurology Division (M.C.), Department of Neuroscience and Behavioral Sciences, University of São Paulo, Brazil; and CTU Bern (A.G.H.) and Institute of Social and Preventive Medicine (A.G.H., M.E.), University of Bern, Switzerland.
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26
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Lippert J, Duss S, Seiler A, Müri R, Bassetti CL. Die Rolle des Schlafes in der Neurorehabilitation nach einem Hirninfarkt und traumatischen Hirnverletzungen. Therapeutische Umschau 2017; 74:479-484. [DOI: 10.1024/0040-5930/a000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Der Artikel gibt eine kurze Übersicht über die bisherigen Erkenntnisse zum Einfluss des Schlafes im Wiederherstellungsprozess eingeschränkter motorischer und kognitiver Funktionen bei Patienten mit Hirnschlag und traumatischen Hirnverletzungen. Es werden potenzielle zugrundeliegende neuronale Mechanismen sowie mögliche neue Therapieansätze im Rahmen der Neurorehabilitation diskutiert.
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Affiliation(s)
- Julian Lippert
- Universitätsklinik für Neurologie, Inselspital Bern, Bern
| | - Simone Duss
- Universitätsklinik für Neurologie, Inselspital Bern, Bern
| | - Andrea Seiler
- Universitätsklinik für Neurologie, Inselspital Bern, Bern
| | - René Müri
- Universitätsklinik für Neurologie, Inselspital Bern, Bern
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27
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Rummel C, Slavova N, Seiler A, Abela E, Hauf M, Burren Y, Weisstanner C, Vulliemoz S, Seeck M, Schindler K, Wiest R. Personalized structural image analysis in patients with temporal lobe epilepsy. Sci Rep 2017; 7:10883. [PMID: 28883420 PMCID: PMC5589799 DOI: 10.1038/s41598-017-10707-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/15/2017] [Indexed: 12/29/2022] Open
Abstract
Volumetric and morphometric studies have demonstrated structural abnormalities related to chronic epilepsies on a cohort- and population-based level. On a single-patient level, specific patterns of atrophy or cortical reorganization may be widespread and heterogeneous but represent potential targets for further personalized image analysis and surgical therapy. The goal of this study was to compare morphometric data analysis in 37 patients with temporal lobe epilepsies with expert-based image analysis, pre-informed by seizure semiology and ictal scalp EEG. Automated image analysis identified abnormalities exceeding expert-determined structural epileptogenic lesions in 86% of datasets. If EEG lateralization and expert MRI readings were congruent, automated analysis detected abnormalities consistent on a lobar and hemispheric level in 82% of datasets. However, in 25% of patients EEG lateralization and expert readings were inconsistent. Automated analysis localized to the site of resection in 60% of datasets in patients who underwent successful epilepsy surgery. Morphometric abnormalities beyond the mesiotemporal structures contributed to subtype characterisation. We conclude that subject-specific morphometric information is in agreement with expert image analysis and scalp EEG in the majority of cases. However, automated image analysis may provide non-invasive additional information in cases with equivocal radiological and neurophysiological findings.
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Affiliation(s)
- Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland.
| | - Nedelina Slavova
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Andrea Seiler
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland.,Sleep-Wake- Epilepsy-Center, Department of Neurology, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Eugenio Abela
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland.,Sleep-Wake- Epilepsy-Center, Department of Neurology, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Martinus Hauf
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland.,Epilepsy Clinic, Tschugg, Switzerland
| | - Yuliya Burren
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland.,University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Christian Weisstanner
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Serge Vulliemoz
- Presurgical Epilepsy Evaluation Unit, Neurology Department, University Hospital of Geneva, Geneva, Switzerland
| | - Margitta Seeck
- Presurgical Epilepsy Evaluation Unit, Neurology Department, University Hospital of Geneva, Geneva, Switzerland
| | - Kaspar Schindler
- Sleep-Wake- Epilepsy-Center, Department of Neurology, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland
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Pradip R, Piekarz P, Bosak A, Merkel DG, Waller O, Seiler A, Chumakov AI, Rüffer R, Oleś AM, Parlinski K, Krisch M, Baumbach T, Stankov S. Erratum: Lattice Dynamics of EuO: Evidence for Giant Spin-Phonon Coupling [Phys. Rev. Lett. 116, 185501 (2016)]. Phys Rev Lett 2017; 119:079903. [PMID: 28949658 DOI: 10.1103/physrevlett.119.079903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Indexed: 06/07/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.116.185501.
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Seiler A, Piekarz P, Ibrahimkutty S, Merkel DG, Waller O, Pradip R, Chumakov AI, Rüffer R, Baumbach T, Parlinski K, Fiederle M, Stankov S. Anomalous Lattice Dynamics of EuSi_{2} Nanoislands: Role of Interfaces Unveiled. Phys Rev Lett 2016; 117:276101. [PMID: 28084777 DOI: 10.1103/physrevlett.117.276101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Indexed: 06/06/2023]
Abstract
We report a systematic lattice dynamics study of EuSi_{2} films and nanoislands by in situ nuclear inelastic scattering on ^{151}Eu and ab initio theory. The Eu-partial phonon density of states of the nanoislands exhibits anomalous excess of phonon states at low and high energies, not present in the bulk and at the EuSi_{2}(001) surface. We demonstrate that atomic vibrations along the island-substrate interface give rise to phonon states both at low and high energies, while atomic vibrations across the island-island interface result in localized high-energy phonon modes.
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Affiliation(s)
- A Seiler
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
| | - P Piekarz
- Institute of Nuclear Physics, Polish Academy of Sciences, PL-31342 Kraków, Poland
| | - S Ibrahimkutty
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
| | - D G Merkel
- ESRF-The European Synchrotron, F-38000 Grenoble, France
| | - O Waller
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
| | - R Pradip
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
| | - A I Chumakov
- ESRF-The European Synchrotron, F-38000 Grenoble, France
| | - R Rüffer
- ESRF-The European Synchrotron, F-38000 Grenoble, France
| | - T Baumbach
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
- ANKA Synchrotron Radiation Facility, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
| | - K Parlinski
- Institute of Nuclear Physics, Polish Academy of Sciences, PL-31342 Kraków, Poland
| | - M Fiederle
- Freiburg Materials Research Center, University of Freiburg, D-79104 Freiburg, Germany
| | - S Stankov
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
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Duss SB, Seiler A, Schmidt MH, Pace M, Adamantidis A, Müri RM, Bassetti CL. The role of sleep in recovery following ischemic stroke: A review of human and animal data. Neurobiol Sleep Circadian Rhythms 2016; 2:94-105. [PMID: 31236498 PMCID: PMC6575180 DOI: 10.1016/j.nbscr.2016.11.003] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [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] [Received: 07/17/2016] [Revised: 11/04/2016] [Accepted: 11/07/2016] [Indexed: 01/02/2023] Open
Abstract
Despite advancements in understanding the pathophysiology of stroke and the state of the art in acute management of afflicted patients as well as in subsequent neurorehabilitation training, stroke remains the most common neurological cause of long-term disability in adulthood. To enhance stroke patients’ independence and well-being it is necessary, therefore, to consider and develop new therapeutic strategies and approaches. We postulate that sleep might play a pivotal role in neurorehabilitation following stroke. Over the last two decades compelling evidence for a major function of sleep in neuroplasticity and neural network reorganization underlying learning and memory has evolved. Training and learning of new motor skills and knowledge can modulate the characteristics of subsequent sleep, which additionally can improve memory performance. While healthy sleep appears to support neuroplasticity resulting in improved learning and memory, disturbed sleep following stroke in animals and humans can impair stroke outcome. In addition, sleep disorders such as sleep disordered breathing, insomnia, and restless legs syndrome are frequent in stroke patients and associated with worse recovery outcomes. Studies investigating the evolution of post-stroke sleep changes suggest that these changes might also reflect neural network reorganization underlying functional recovery. Experimental and clinical studies provide evidence that pharmacological sleep promotion in rodents and treatment of sleep disorders in humans improves functional outcome following stroke. Taken together, there is accumulating evidence that sleep represents a “plasticity state” in the process of recovery following ischemic stroke. However, to test the key role of sleep and sleep disorders for stroke recovery and to better understand the underlying molecular mechanisms, experimental research and large-scale prospective studies in humans are necessary. The effects of hospital conditions, such as adjusting light conditions according to the patients’ sleep-wake rhythms, or sleep promoting drugs and non-invasive brain stimulation to promote neuronal plasticity and recovery following stroke requires further investigation. Sleep fosters neuroplasticity improving learning and memory. Recovery after stroke results from functional and structural reorganization of damaged brain circuits due to neuroplasticity. Animal and human data provide evidence that promotion of sleep (and treatment of sleep disorders) is neuroprotective in the acute phase of stroke and promotes neuroplasticity and by this recovery after stroke. A better understanding of the molecular mechanisms underlying the interactions between sleep and stroke is expected to offer new pharmacological and non-pharmacological opportunities to improve recovery of patients with stroke.
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Affiliation(s)
- Simone B Duss
- Sleep-Wake-Epilepsy-Center, Department of Neurology, Bern University Hospital, Bern, Switzerland
| | - Andrea Seiler
- Sleep-Wake-Epilepsy-Center, Department of Neurology, Bern University Hospital, Bern, Switzerland
| | - Markus H Schmidt
- Sleep-Wake-Epilepsy-Center, Department of Neurology, Bern University Hospital, Bern, Switzerland.,Center for Experimental Neurology (ZEN), Department of Neurology, Bern University Hospital, Bern, Switzerland
| | - Marta Pace
- Center for Experimental Neurology (ZEN), Department of Neurology, Bern University Hospital, Bern, Switzerland
| | - Antoine Adamantidis
- Center for Experimental Neurology (ZEN), Department of Neurology, Bern University Hospital, Bern, Switzerland
| | - René M Müri
- Division of Cognitive and Restorative Neurology, Department of Neurology, Bern University Hospital, Bern, Switzerland
| | - Claudio L Bassetti
- Sleep-Wake-Epilepsy-Center, Department of Neurology, Bern University Hospital, Bern, Switzerland.,Center for Experimental Neurology (ZEN), Department of Neurology, Bern University Hospital, Bern, Switzerland.,Division of Cognitive and Restorative Neurology, Department of Neurology, Bern University Hospital, Bern, Switzerland
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Aschner M, Ceccatelli S, Daneshian M, Fritsche E, Hasiwa N, Hartung T, Hogberg HT, Leist M, Li A, Mundi WR, Padilla S, Piersma AH, Bal-Price A, Seiler A, Westerink RH, Zimmer B, Lein PJ. Reference compounds for alternative test methods to indicate developmental neurotoxicity (DNT) potential of chemicals: example lists and criteria for their selection and use. ALTEX 2016; 34:49-74. [PMID: 27452664 PMCID: PMC5250586 DOI: 10.14573/altex.1604201] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [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: 04/20/2016] [Accepted: 07/09/2016] [Indexed: 11/23/2022]
Abstract
There is a paucity of information concerning the developmental neurotoxicity (DNT) hazard posed by industrial and environmental chemicals. New testing approaches will most likely be based on batteries of alternative and complementary (non-animal) tests. As DNT is assumed to result from the modulation of fundamental neurodevelopmental processes (such as neuronal differentiation, precursor cell migration or neuronal network formation) by chemicals, the first generation of alternative DNT tests target these processes. The advantage of such types of assays is that they capture toxicants with multiple targets and modes-of-action. Moreover, the processes modelled by the assays can be linked to toxicity endophenotypes, i.e. alterations in neural connectivity that form the basis for neurofunctional deficits in man. The authors of this review convened in a workshop to define criteria for the selection of positive/negative controls, to prepare recommendations on their use, and to initiate the setup of a directory of reference chemicals. For initial technical optimization of tests, a set of >50 endpoint-specific control compounds was identified. For further test development, an additional “test” set of 33 chemicals considered to act directly as bona fide DNT toxicants is proposed, and each chemical is annotated to the extent it fulfills these criteria. A tabular compilation of the original literature used to select the test set chemicals provides information on statistical procedures, and toxic/non-toxic doses (both for pups and dams). Suggestions are provided on how to use the >100 compounds (including negative controls) compiled here to address specificity, adversity and use of alternative test systems.
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Affiliation(s)
| | | | - Mardas Daneshian
- Center for Alternatives to Animal Testing-Europe (CAAT-Europe), University of Konstanz, Germany
| | - Ellen Fritsche
- Leibniz Research Institute for Environmental Medicine (IUF), Düsseldorf, Germany
| | - Nina Hasiwa
- Center for Alternatives to Animal Testing-Europe (CAAT-Europe), University of Konstanz, Germany
| | - Thomas Hartung
- Center for Alternatives to Animal Testing-Europe (CAAT-Europe), University of Konstanz, Germany.,Center for Alternatives to Animal Testing (CAAT), The Johns Hopkins University, Baltimore, MD, USA
| | - Helena T Hogberg
- Center for Alternatives to Animal Testing (CAAT), The Johns Hopkins University, Baltimore, MD, USA
| | - Marcel Leist
- Center for Alternatives to Animal Testing-Europe (CAAT-Europe), University of Konstanz, Germany.,In vitro Toxicology and Biomedicine, Dept inaugurated by the Doerenkamp-Zbinden Foundation at the University of Konstanz, Konstanz, Germany.,Konstanz Research School Chemical Biology (KoRS-CB), Konstanz University
| | - Abby Li
- Exponent Inc.,San Francisco, USA
| | - William R Mundi
- United States Environmental Protection Agency (USEPA), NHEERL, Research Triangle Park, NC, USA
| | - Stephanie Padilla
- United States Environmental Protection Agency (USEPA), NHEERL, Research Triangle Park, NC, USA
| | - Aldert H Piersma
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Anna Bal-Price
- European Commission Joint Research Centre, Institute for Health and Consumer Protection, Ispra, Italy
| | - Andrea Seiler
- Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Remco H Westerink
- Neurotoxicology Research Group, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | | | - Pamela J Lein
- Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University, Portland, USA.,Department of Molecular Biosciences, University of California, Davis, USA
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32
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Pradip R, Piekarz P, Bosak A, Merkel DG, Waller O, Seiler A, Chumakov AI, Rüffer R, Oleś AM, Parlinski K, Krisch M, Baumbach T, Stankov S. Lattice Dynamics of EuO: Evidence for Giant Spin-Phonon Coupling. Phys Rev Lett 2016; 116:185501. [PMID: 27203332 DOI: 10.1103/physrevlett.116.185501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Indexed: 06/05/2023]
Abstract
Comprehensive studies of lattice dynamics in the ferromagnetic semiconductor EuO have been performed by a combination of inelastic x-ray scattering, nuclear inelastic scattering, and ab initio calculations. A remarkably large broadening of the transverse acoustic phonons was discovered at temperatures above and below the Curie temperature T_{C}=69 K. This result indicates a surprisingly strong momentum-dependent spin-phonon coupling induced by the spin dynamics in EuO.
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Affiliation(s)
- R Pradip
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
| | - P Piekarz
- Institute of Nuclear Physics, Polish Academy of Sciences, PL-31342 Kraków, Poland
| | - A Bosak
- ESRF-The European Synchrotron, F-38000 Grenoble, France
| | - D G Merkel
- ESRF-The European Synchrotron, F-38000 Grenoble, France
| | - O Waller
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
| | - A Seiler
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
| | - A I Chumakov
- ESRF-The European Synchrotron, F-38000 Grenoble, France
| | - R Rüffer
- ESRF-The European Synchrotron, F-38000 Grenoble, France
| | - A M Oleś
- Max-Planck-Institut für Festkörperforschung, D-70569 Stuttgart, Germany
- Marian Smoluchowski Institute of Physics, Jagiellonian University, PL-30348 Kraków, Poland
| | - K Parlinski
- Institute of Nuclear Physics, Polish Academy of Sciences, PL-31342 Kraków, Poland
| | - M Krisch
- ESRF-The European Synchrotron, F-38000 Grenoble, France
| | - T Baumbach
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
- ANKA, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
| | - S Stankov
- Laboratory for Applications of Synchrotron Radiation, Karlsruhe Institute of Technology, D-76131 Karlsruhe, Germany
- Institute for Photon Science and Synchrotron Radiation, Karlsruhe Institute of Technology, D-76344 Eggenstein-Leopoldshafen, Germany
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33
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Abela E, Missimer JH, Federspiel A, Seiler A, Hess CW, Sturzenegger M, Wiest R, Weder BJ. A Thalamic-Fronto-Parietal Structural Covariance Network Emerging in the Course of Recovery from Hand Paresis after Ischemic Stroke. Front Neurol 2015; 6:211. [PMID: 26528235 PMCID: PMC4602136 DOI: 10.3389/fneur.2015.00211] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [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] [Received: 05/13/2015] [Accepted: 09/17/2015] [Indexed: 01/20/2023] Open
Abstract
AIM To describe structural covariance networks of gray matter volume (GMV) change in 28 patients with first-ever stroke to the primary sensorimotor cortices, and to investigate their relationship to hand function recovery and local GMV change. METHODS Tensor-based morphometry maps derived from high-resolution structural images were subject to principal component analyses to identify the networks. We calculated correlations between network expression and local GMV change, sensorimotor hand function and lesion volume. To verify which of the structural covariance networks of GMV change have a significant relationship to hand function, we performed an additional multivariate regression approach. RESULTS Expression of the second network, explaining 9.1% of variance, correlated with GMV increase in the medio-dorsal (md) thalamus and hand motor skill. Patients with positive expression coefficients were distinguished by significantly higher GMV increase of this structure during stroke recovery. Significant nodes of this network were located in md thalamus, dorsolateral prefrontal cortex, and higher order sensorimotor cortices. Parameter of hand function had a unique relationship to the network and depended on an interaction between network expression and lesion volume. Inversely, network expression is limited in patients with large lesion volumes. CONCLUSION Chronic phase of sensorimotor cortical stroke has been characterized by a large scale co-varying structural network in the ipsilesional hemisphere associated specifically with sensorimotor hand skill. Its expression is related to GMV increase of md thalamus, one constituent of the network, and correlated with the cortico-striato-thalamic loop involved in control of motor execution and higher order sensorimotor cortices. A close relation between expression of this network with degree of recovery might indicate reduced compensatory resources in the impaired subgroup.
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Affiliation(s)
- Eugenio Abela
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - John H Missimer
- Laboratory of Biomolecular Research, Paul Scherrer Institute , Villigen , Switzerland
| | - Andrea Federspiel
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern , Bern , Switzerland
| | - Andrea Seiler
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, University of Bern , Bern , Switzerland ; Department of Neurology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - Christian Walter Hess
- Department of Neurology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - Matthias Sturzenegger
- Department of Neurology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, University of Bern , Bern , Switzerland
| | - Bruno J Weder
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, University of Bern , Bern , Switzerland ; Department of Neurology, Kantonsspital St. Gallen , St. Gallen , Switzerland
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34
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Rocker J, Cornu D, Kieseritzky E, Seiler A, Bondarchuk O, Hänsel-Ziegler W, Risse T, Freund HJ. High field electron paramagnetic resonance spectroscopy under ultrahigh vacuum conditions--a multipurpose machine to study paramagnetic species on well defined single crystal surfaces. Rev Sci Instrum 2014; 85:083903. [PMID: 25173280 DOI: 10.1063/1.4893729] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A new ultrahigh vacuum (UHV) electron paramagnetic resonance (EPR) spectrometer operating at 94 GHz to investigate paramagnetic centers on single crystal surfaces is described. It is particularly designed to study paramagnetic centers on well-defined model catalysts using epitaxial thin oxide films grown on metal single crystals. The EPR setup is based on a commercial Bruker E600 spectrometer, which is adapted to ultrahigh vacuum conditions using a home made Fabry Perot resonator. The key idea of the resonator is to use the planar metal single crystal required to grow the single crystalline oxide films as one of the mirrors of the resonator. EPR spectroscopy is solely sensitive to paramagnetic species, which are typically minority species in such a system. Hence, additional experimental characterization tools are required to allow for a comprehensive investigation of the surface. The apparatus includes a preparation chamber hosting equipment, which is required to prepare supported model catalysts. In addition, surface characterization tools such as low energy electron diffraction (LEED)/Auger spectroscopy, temperature programmed desorption (TPD), and infrared reflection absorption spectroscopy (IRAS) are available to characterize the surfaces. A second chamber used to perform EPR spectroscopy at 94 GHz has a room temperature scanning tunneling microscope attached to it, which allows for real space structural characterization. The heart of the UHV adaptation of the EPR experiment is the sealing of the Fabry-Perot resonator against atmosphere. To this end it is possible to use a thin sapphire window glued to the backside of the coupling orifice of the Fabry Perot resonator. With the help of a variety of stabilization measures reducing vibrations as well as thermal drift it is possible to accumulate data for a time span, which is for low temperature measurements only limited by the amount of liquid helium. Test measurements show that the system can detect paramagnetic species with a density of approximately 5 × 10(11) spins/cm(2), which is comparable to the limit obtained for the presently available UHV-EPR spectrometer operating at 10 GHz (X-band). Investigation of electron trapped centers in MgO(001) films shows that the increased resolution offered by the experiments at W-band allows to identify new paramagnetic species, that cannot be differentiated with the currently available methodology.
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Affiliation(s)
- J Rocker
- Fritz-Haber-Institut der MPG, Faradayweg 4-6, 14195 Berlin, Germany
| | - D Cornu
- Fritz-Haber-Institut der MPG, Faradayweg 4-6, 14195 Berlin, Germany
| | - E Kieseritzky
- Fritz-Haber-Institut der MPG, Faradayweg 4-6, 14195 Berlin, Germany
| | - A Seiler
- Fritz-Haber-Institut der MPG, Faradayweg 4-6, 14195 Berlin, Germany
| | - O Bondarchuk
- Fritz-Haber-Institut der MPG, Faradayweg 4-6, 14195 Berlin, Germany
| | - W Hänsel-Ziegler
- Fritz-Haber-Institut der MPG, Faradayweg 4-6, 14195 Berlin, Germany
| | - T Risse
- Fritz-Haber-Institut der MPG, Faradayweg 4-6, 14195 Berlin, Germany
| | - H-J Freund
- Fritz-Haber-Institut der MPG, Faradayweg 4-6, 14195 Berlin, Germany
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35
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Abela E, Seiler A, Missimer JH, Federspiel A, Hess CW, Sturzenegger M, Weder BJ, Wiest R. Grey matter volumetric changes related to recovery from hand paresis after cortical sensorimotor stroke. Brain Struct Funct 2014; 220:2533-50. [PMID: 24906703 PMCID: PMC4549385 DOI: 10.1007/s00429-014-0804-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [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: 11/27/2013] [Accepted: 05/17/2014] [Indexed: 12/29/2022]
Abstract
Preclinical studies using animal models have shown that grey matter plasticity in both perilesional and distant neural networks contributes to behavioural recovery of sensorimotor functions after ischaemic cortical stroke. Whether such morphological changes can be detected after human cortical stroke is not yet known, but this would be essential to better understand post-stroke brain architecture and its impact on recovery. Using serial behavioural and high-resolution magnetic resonance imaging (MRI) measurements, we tracked recovery of dexterous hand function in 28 patients with ischaemic stroke involving the primary sensorimotor cortices. We were able to classify three recovery subgroups (fast, slow, and poor) using response feature analysis of individual recovery curves. To detect areas with significant longitudinal grey matter volume (GMV) change, we performed tensor-based morphometry of MRI data acquired in the subacute phase, i.e. after the stage compromised by acute oedema and inflammation. We found significant GMV expansion in the perilesional premotor cortex, ipsilesional mediodorsal thalamus, and caudate nucleus, and GMV contraction in the contralesional cerebellum. According to an interaction model, patients with fast recovery had more perilesional than subcortical expansion, whereas the contrary was true for patients with impaired recovery. Also, there were significant voxel-wise correlations between motor performance and ipsilesional GMV contraction in the posterior parietal lobes and expansion in dorsolateral prefrontal cortex. In sum, perilesional GMV expansion is associated with successful recovery after cortical stroke, possibly reflecting the restructuring of local cortical networks. Distant changes within the prefrontal-striato-thalamic network are related to impaired recovery, probably indicating higher demands on cognitive control of motor behaviour.
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Affiliation(s)
- E. Abela
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland
- Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - A. Seiler
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland
| | - J. H. Missimer
- Laboratory of Biomolecular Research, Paul Scherrer Institute, Villigen, Switzerland
| | - A. Federspiel
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry and University of Bern, Bern, Switzerland
| | - C. W. Hess
- Department of Neurology, University Hospital Inselspital and University of Bern, Bern, Switzerland
| | - M. Sturzenegger
- Department of Neurology, University Hospital Inselspital and University of Bern, Bern, Switzerland
| | - B. J. Weder
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland
- Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - R. Wiest
- Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland
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36
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Abela E, Seiler A, Missimer J, Federspiel A, Hess C, Sturzenegger M, Wiest R, Weder B. Perilesional and subcortical plasticity after focal ischemic stroke is associated with motor recovery: A tensor-based morphometry study. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.906] [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: 11/17/2022]
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37
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Eckardt K, Kaltenhäuser J, Kilb C, Seiler A, Stahlmann R. Relative potency of albendazole and its sulfoxide metabolite in two in vitro tests for developmental toxicity: The rat whole embryo culture and the mouse embryonic stem cell test. Reprod Toxicol 2012; 34:378-84. [DOI: 10.1016/j.reprotox.2012.05.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 04/03/2012] [Accepted: 05/11/2012] [Indexed: 10/28/2022]
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Tralau T, Riebeling C, Pirow R, Oelgeschläger M, Seiler A, Liebsch M, Luch A. Wind of change challenges toxicological regulators. Environ Health Perspect 2012; 120:1489-94. [PMID: 22871563 PMCID: PMC3556610 DOI: 10.1289/ehp.1104782] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 08/07/2012] [Indexed: 05/09/2023]
Abstract
BACKGROUND In biomedical research, the past two decades have seen the advent of in vitro model systems based on stem cells, humanized cell lines, and engineered organotypic tissues, as well as numerous cellular assays based on primarily established tumor-derived cell lines and their genetically modified derivatives. OBJECTIVE There are high hopes that these systems might replace the need for animal testing in regulatory toxicology. However, despite increasing pressure in recent years to reduce animal testing, regulators are still reluctant to adopt in vitro approaches on a large scale. It thus seems appropriate to consider how we could realistically perform regulatory toxicity testing using in vitro assays only. DISCUSSION AND CONCLUSION Here, we suggest an in vitro-only approach for regulatory testing that will benefit consumers, industry, and regulators alike.
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Affiliation(s)
- Tewes Tralau
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments (ZEBET), Berlin, Germany
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Reis I, Krämer V, Seiler A, Topa D, Keller E. Pb5.0(1)In8.4(1)Bi1.6(1)S20, a new quaternary lead indium bismuth sulfide. Acta Crystallogr C 2012; 68:i12-6. [PMID: 22382529 DOI: 10.1107/s0108270112001011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 01/10/2012] [Indexed: 11/10/2022] Open
Abstract
The title phase, first detected in the early 1980s but hitherto unpublished, has been resynthesized and structurally characterized. Unambiguous determination of the chemical composition was not possible by structure analysis alone, but required additional analytical methods. The complex structure shows a close similarity to the structures of two related compounds, one known by the formula Pb(1.6)In(8)Bi(4)S(19) and the other being the ternary compound Pb(6)In(10)S(21). This is despite the fact that the three phases correspond to very different Pb:Bi ratios. A geometric mechanism is described by which the three structures can be transformed into each other, provided that the heavy atoms Pb and Bi are treated as equivalent.
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Affiliation(s)
- I Reis
- Kristallographie, Institut für Geowissenschaften, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
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40
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Liebsch M, Grune B, Seiler A, Butzke D, Oelgeschläger M, Pirow R, Adler S, Riebeling C, Luch A. Alternatives to animal testing: current status and future perspectives. Arch Toxicol 2011; 85:841-58. [PMID: 21607681 PMCID: PMC3149673 DOI: 10.1007/s00204-011-0718-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [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] [Indexed: 11/26/2022]
Abstract
On the occasion of the 20th anniversary of the Center for Alternative Methods to Animal Experiments (ZEBET), an international symposium was held at the German Federal Institute for Risk Assessment (BfR) in Berlin. At the same time, this symposium was meant to celebrate the 50th anniversary of the publication of the book “The Principles of Humane Experimental Technique” by Russell and Burch in 1959 in which the 3Rs principle (that is, Replacement, Reduction, and Refinement) has been coined and introduced to foster the development of alternative methods to animal testing. Another topic addressed by the symposium was the new vision on “Toxicology in the twenty-first Century”, as proposed by the US-National Research Council, which aims at using human cells and tissues for toxicity testing in vitro rather than live animals. An overview of the achievements and current tasks, as well as a vision of the future to be addressed by ZEBET@BfR in the years to come is outlined in the present paper.
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Affiliation(s)
- Manfred Liebsch
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Barbara Grune
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Andrea Seiler
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Daniel Butzke
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Michael Oelgeschläger
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Ralph Pirow
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Sarah Adler
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Christian Riebeling
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Andreas Luch
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
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Riebeling C, Pirow R, Becker K, Buesen R, Eikel D, Kaltenhäuser J, Meyer F, Nau H, Slawik B, Visan A, Volland J, Spielmann H, Luch A, Seiler A. The embryonic stem cell test as tool to assess structure-dependent teratogenicity: the case of valproic acid. Toxicol Sci 2011; 120:360-70. [PMID: 21227905 PMCID: PMC3061479 DOI: 10.1093/toxsci/kfr001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 01/03/2011] [Indexed: 01/21/2023] Open
Abstract
Teratogenicity can be predicted in vitro using the embryonic stem cell test (EST). The EST, which is based on the morphometric measurement of cardiomyocyte differentiation and cytotoxicity parameters, represents a scientifically validated method for the detection and classification of chemicals according to their teratogenic potency. Furthermore, an abbreviated protocol applying flow cytometry of intracellular marker proteins to determine differentiation into the cardiomyocyte lineage is available. Although valproic acid (VPA) is in worldwide clinical use as antiepileptic drug, it exhibits two severe side effects, i.e., teratogenicity and hepatotoxicity. These limitations have led to extensive research into derivatives of VPA. Here we chose VPA as model compound to test the applicability domain and to further evaluate the reliability of the EST. To this end, we study six closely related congeners of VPA and demonstrate that both the standard and the molecular flow cytometry-based EST are well suited to indicate differences in the teratogenic potency among VPA analogs that differ only in chirality or side chain length. Our data show that identical results can be obtained by using the standard EST or a shortened protocol based on flow cytometry of intracellular marker proteins. Both in vitro protocols enable to reliably determine differentiation of murine stem cells toward the cardiomyocyte lineage and to assess its chemical-mediated inhibition.
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Affiliation(s)
- Christian Riebeling
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Ralph Pirow
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Klaus Becker
- Bayer Schering Pharma AG, Nonclinical Drug Safety, Genetic Toxicology, 13342 Berlin, Germany
| | - Roland Buesen
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Daniel Eikel
- Institute of Food Toxicology and Chemical Analysis, University of Veterinary Medicine Hanover, 30173 Hanover, Germany
| | - Johanna Kaltenhäuser
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
- Bayer Schering Pharma AG, Nonclinical Drug Safety, Genetic Toxicology, 13342 Berlin, Germany
| | - Frauke Meyer
- Nycomed GmbH, Institute for Pharmacology and Preclinical Drug Safety (IPAS), Hamburg, 22885 Barsbüttel, Germany
| | - Heinz Nau
- Institute of Food Toxicology and Chemical Analysis, University of Veterinary Medicine Hanover, 30173 Hanover, Germany
| | - Birgitta Slawik
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Anke Visan
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Jutta Volland
- Nycomed GmbH, Institute for Pharmacology and Preclinical Drug Safety (IPAS), Hamburg, 22885 Barsbüttel, Germany
| | - Horst Spielmann
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Andreas Luch
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
| | - Andrea Seiler
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments—ZEBET, 12277 Berlin, Germany
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Groebe K, Hayess K, Klemm-Manns M, Schwall G, Wozny W, Steemans M, Peters AK, Sastri C, Jaeckel P, Stegmann W, Zengerling H, Schöpf R, Poznanovic S, Stummann TC, Seiler A, Spielmann H, Schrattenholz A. Protein Biomarkers for in Vitro Testing of Embryotoxicity. J Proteome Res 2010; 9:5727-38. [DOI: 10.1021/pr100514e] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [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)
- Karlfried Groebe
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Katrin Hayess
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Martina Klemm-Manns
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Gerhard Schwall
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Woijciech Wozny
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Margino Steemans
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Annelieke K. Peters
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Chaturvedala Sastri
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Petra Jaeckel
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Werner Stegmann
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Helmut Zengerling
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Rainer Schöpf
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Slobodan Poznanovic
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Tina C. Stummann
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Andrea Seiler
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - Horst Spielmann
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
| | - André Schrattenholz
- ProteoSys AG, Carl-Zeiss.-Str. 51, D-55129 Mainz, Germany, Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments - ZEBET Diedersdorfer Weg 1, 12277 Berlin, Germany, Johnson & Johnson PRD, a division of Janssen Pharmaceutical, 2340 Beerse, Belgium, European Centre for the Validation of Alternative Methods (ECVAM) (IHCP, JRC), Via Fermi, 121020 Ispra, Italy
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Mossoba MM, Seiler A, Steinhart H, Kramer JKG, Rodrigues-Saona L, Griffith AP, Pierceall R, van de Voort FR, Sedman J, Ismail AA, Barr D, Da Costa Filho PA, Li H, Zhang Y, Liu X, Bradley M. Regulatory Infrared Spectroscopic Method for the Rapid Determination of Total Isolated Trans Fat: A Collaborative Study. J AM OIL CHEM SOC 2010. [DOI: 10.1007/s11746-010-1648-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [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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Schenk B, Weimer M, Bremer S, van der Burg B, Cortvrindt R, Freyberger A, Lazzari G, Pellizzer C, Piersma A, Schäfer WR, Seiler A, Witters H, Schwarz M. The ReProTect Feasibility Study, a novel comprehensive in vitro approach to detect reproductive toxicants. Reprod Toxicol 2010; 30:200-18. [PMID: 20493943 DOI: 10.1016/j.reprotox.2010.05.012] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 04/23/2010] [Accepted: 05/07/2010] [Indexed: 10/19/2022]
Abstract
ReProTect is a project within the 6th European Framework Program which has developed alternative methods aimed to reduce or replace animal experimentation in the field of reproductive toxicology. In its final year, a ring trial, named the "Feasibility Study", was conducted, in which 10 blinded chemicals with toxicologically well-documented profiles were analyzed by employing a test battery of 14 in vitro assays. EC(50) (half maximal effective concentration) or equivalent endpoints were determined and the test compounds were ranked relative to chemicals previously assayed in the tests of the battery. This comparative analysis together with a weight of evidence approach allowed a robust prediction of adverse effects on fertility and embryonic development of the 10 test chemicals in vivo. In summary, the vast majority of the predictions made based on the in vitro results turned out to be correct when compared to the whole animal data. The procedure used here, a nearest neighbor analysis coupled with a weight of evidence approach, may guide future activities in the field of alternative toxicity testing.
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Affiliation(s)
- Barbara Schenk
- Institute of Experimental and Clinical Pharmacology and Toxicology, Department of Toxicology, Tübingen, Germany
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Kretlow A, Butzke D, Goetz ME, Grune B, Halder M, Henkler F, Liebsch M, Nobiling R, Oelgeschlaeger M, Reifenberg K, Schaefer B, Seiler A, Luch A. Implementation and enforcement of the 3Rs principle in the field of transgenic animals used for scientific purposes. Report and recommendations of the BfR expert workshop, May 18-20, 2009, Berlin, Germany. ALTEX 2010; 27:117-134. [PMID: 21445538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In 2007, 2.7 million vertebrates were used for animal experiments and other scientific purposes in Germany alone. Since 1998 there has been an increase in the number of animals used for research purposes, which is partly attributable to the growing use of transgenic animals. These animals are, for instance, used as in vivo models to mimic human diseases like diabetes, cancer or Alzheimer's disease. Here, transgenic model organisms serve as valuable tools, being instrumental in facilitating the analysis of the molecular mechanisms underlying human diseases, and might contribute to the development of novel therapeutic approaches. Due to variable and, sometimes low, efficiency (depending on the species used), however, the generation of such animals often requires a large number of embryo donors and recipients. The experts evaluated methods that could possibly be utilised to reduce, refine or even replace experiments with transgenic vertebrates in the mid-term future. Among the promising alternative model organisms available at the moment are the fruit fly Drosophila melanogaster and the roundworm Caenorhabditis elegans. Specific cell culture experiments or three-dimensional (3D) tissue models also offer valuable opportunities to replace experiments with transgenic animals or reduce the number of laboratory animals required by assisting in decision-making processes. Furthermore, at the workshop an in vitro technique was presented which permits the production of complete human antibodies without using genetically modified ("humanised") animals. Up to now, genetically modified mice are widely used for this purpose. Improved breeding protocols, enhanced efficiency of mutagenesis as well as training of laboratory personnel and animal keepers can also help to reduce the numbers of laboratory animals. Well-trained staff in particular can help to minimise the pain, suffering and discomfort of animals and, at the same time, improve the quality of data obtained from animal experiments. This, in turn, can lead to a reduction in the numbers of animals needed for each experiment. The experts also came to the conclusion that the numbers of laboratory animals can be reduced by open access to a central database that provides detailed documentation of completed experiments involving transgenic animals. This documentation should not be restricted to experiments with substantial scientific results that warrant publication, but should also include those with "negative" outcome, which are usually not published. Capturing all kinds of results within such a database provides added value to the respective scientists and the scientific community as a whole; it could also help to stimulate collaborations and to ensure funding for future research. An important aspect to be considered in the generation of this kind of database is the quality and standardisation of the information provided on existing in vitro models and the respective opportunities for their use. The experts felt that the greatest potential for reducing the numbers of laboratory animals in the near future realistically might not be offered by the complete replacement of transgenic animal models but by opportunities to examine specific questions to a greater degree using in vitro models, such as cell and tissue cultures including organotypic models. The use of these models would considerably reduce the number of in vivo experiments using transgenic animals. However, the overall number of experimental animals may still be increasing or remain unaffected, e.g. when transgenic animals continue to serve as the source of primary cells and organs/tissues for in vitro experiments.
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Affiliation(s)
- Ariane Kretlow
- Department Safety of Consumer Products, German Federal Institute for Risk Assessment, Berlin, Germany.
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Kretlow A, Seiler A, Haase A, Luch A. Adverse effects of nanoparticulate metal oxides in neuronal cells in vitro characterized by means of X-ray fluorescence and FTIR microspectroscopy. Toxicol Lett 2009. [DOI: 10.1016/j.toxlet.2009.06.642] [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: 11/16/2022]
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Marx-Stoelting P, Adriaens E, Ahr HJ, Bremer S, Garthoff B, Gelbke HP, Piersma A, Pellizzer C, Reuter U, Rogiers V, Schenk B, Schwengberg S, Seiler A, Spielmann H, Steemans M, Stedman DB, Vanparys P, Vericat JA, Verwei M, van de Water F, Weimer M, Schwarz M. A Review of the Implementation of the Embryonic Stem Cell Test (EST). Altern Lab Anim 2009; 37:313-28. [DOI: 10.1177/026119290903700314] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Philip Marx-Stoelting
- Institut für Klinische & Experimentelle Pharmakologie & Toxikologie, Universität Tübingen, Germany
| | | | - Hans-Jürgen Ahr
- Bayer Schering Pharma AG, GDD-Global Early Development, Special Toxicology, Wuppertal, Germany
| | - Susanne Bremer
- Institute for Health and Consumer Protection, In Vitro Methods Unit/ECVAM, Joint Research Centre, Ispra, Italy
| | | | | | - Aldert Piersma
- National Institute of Health and the Environment, Laboratory for Health Effects, RIVM, Bilthoven, The Netherlands
| | - Cristian Pellizzer
- Institute for Health and Consumer Protection, In Vitro Methods Unit/ECVAM, Joint Research Centre, Ispra, Italy
| | | | | | - Barbara Schenk
- Institut für Klinische & Experimentelle Pharmakologie & Toxikologie, Universität Tübingen, Germany
| | | | - Andrea Seiler
- Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments (ZEBET), Berlin, Germany
| | - Horst Spielmann
- Federal Institute for Risk Assessment, Center for Alternative Methods to Animal Experiments (ZEBET), Berlin, Germany
| | - Margino Steemans
- Johnson & Johnson Research and Development, Mechanistic Toxicology, Beerse, Belgium
| | | | | | | | | | - Femke van de Water
- Schering Plough, Department of Toxicology and Drug Disposition, Oss, The Netherlands
| | - Marc Weimer
- Zentrale Einheit Biostatistik, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Michael Schwarz
- Institut für Klinische & Experimentelle Pharmakologie & Toxikologie, Universität Tübingen, Germany
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Buesen R, Genschow E, Slawik B, Visan A, Spielmann H, Luch A, Seiler A. Embryonic stem cell test remastered: comparison between the validated EST and the new molecular FACS-EST for assessing developmental toxicity in vitro. Toxicol Sci 2009; 108:389-400. [PMID: 19168572 DOI: 10.1093/toxsci/kfp012] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The embryonic stem cell test (EST) represents a reliable, scientifically validated in vitro system for the detection and classification of compounds according to their teratogenic potency. However, some serious issues were frequently raised against the widespread implementation and practicability of the EST in its original version. Most importantly, the evaluation of the morphological endpoint of beating cell agglomerates requires extensive experimental experience and is prone to misjudgment. Also, the testing period of 10 days is too long and costly to be attractive for industries interested in high-throughput screening of potential drug candidates. These drawbacks prompted us to work out a new molecular approach based on analysis of the expression of certain marker proteins specific for developing heart tissue. We have previously reported that quantitative flow cytometry of marker proteins (i.e., sarcomeric myosin heavy chain and alpha-actinin) can be performed at day 7 in embryonic stem cells from mice and combined with concurrent cell viability analysis. In the present study, extensive investigations were performed in order to explore the predictive power and validity of the newly established EST, subsequently referred to as molecular fluorescence activated cell sorting (FACS)-EST, by applying and comparing a set of 10 well-known embryotoxicants that encompasses the full range of chemical inherent embryotoxic potencies possible. While the molecular FACS-EST offered the same sensitivity compared to the validated EST protocol, the test duration could be significantly reduced. Due to significant improvements, this new molecular method holds promise as a sensitive, more rapid and reproducible screen highly suited to predict developmental toxicity in vivo from in vitro data.
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Affiliation(s)
- Roland Buesen
- German Federal Institute for Risk Assessment (BfR), Center for Alternative Methods to Animal Experiments - ZEBET, Berlin, Germany
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