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Tao Y, Schubert T, Wiley R, Stark C, Rapp B. Cortical and Subcortical Mechanisms of Orthographic Word-form Learning. J Cogn Neurosci 2024; 36:1071-1098. [PMID: 38527084 DOI: 10.1162/jocn_a_02147] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
We examined the initial stages of orthographic learning in real time as literate adults learned spellings for spoken pseudowords during fMRI scanning. Participants were required to learn and store orthographic word forms because the pseudoword spellings were not uniquely predictable from sound to letter mappings. With eight learning trials per word form, we observed changes in the brain's response as learning was taking place. Accuracy was evaluated during learning, immediately after scanning, and 1 week later. We found evidence of two distinct learning systems-hippocampal and neocortical-operating during orthographic learning, consistent with the predictions of dual systems theories of learning/memory such as the complementary learning systems framework [McClelland, J. L., McNaughton, B. L., & O'Reilly, R. C. Why there are complementary learning systems in the hippocampus and neocortex: Insights from the successes and failures of connectionist models of learning and memory. Psychological Review, 102, 419-457, 1995]. The bilateral hippocampus and the visual word form area (VWFA) showed significant BOLD response changes over learning, with the former exhibiting a rising pattern and the latter exhibiting a falling pattern. Moreover, greater BOLD signal increase in the hippocampus was associated with better postscan recall. In addition, we identified two distinct bilateral brain networks that mirrored the rising and falling patterns of the hippocampus and VWFA. Functional connectivity analysis revealed that regions within each network were internally synchronized. These novel findings highlight, for the first time, the relevance of multiple learning systems in orthographic learning and provide a paradigm that can be used to address critical gaps in our understanding of the neural bases of orthographic learning in general and orthographic word-form learning specifically.
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Borzello M, Ramirez S, Treves A, Lee I, Scharfman H, Stark C, Knierim JJ, Rangel LM. Assessments of dentate gyrus function: discoveries and debates. Nat Rev Neurosci 2023; 24:502-517. [PMID: 37316588 PMCID: PMC10529488 DOI: 10.1038/s41583-023-00710-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 06/16/2023]
Abstract
There has been considerable speculation regarding the function of the dentate gyrus (DG) - a subregion of the mammalian hippocampus - in learning and memory. In this Perspective article, we compare leading theories of DG function. We note that these theories all critically rely on the generation of distinct patterns of activity in the region to signal differences between experiences and to reduce interference between memories. However, these theories are divided by the roles they attribute to the DG during learning and recall and by the contributions they ascribe to specific inputs or cell types within the DG. These differences influence the information that the DG is thought to impart to downstream structures. We work towards a holistic view of the role of DG in learning and memory by first developing three critical questions to foster a dialogue between the leading theories. We then evaluate the extent to which previous studies address our questions, highlight remaining areas of conflict, and suggest future experiments to bridge these theories.
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Affiliation(s)
- Mia Borzello
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
| | - Steve Ramirez
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | | | - Inah Lee
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, South Korea
| | - Helen Scharfman
- Departments of Child and Adolescent Psychiatry, Neuroscience and Physiology and Psychiatry and the Neuroscience Institute, New York University Langone Health, New York, NY, USA
- The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Craig Stark
- Department of Neurobiology and Behaviour, University of California, Irvine, Irvine, CA, USA
| | - James J Knierim
- Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, MD, USA
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA
| | - Lara M Rangel
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA.
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Gudmundson AT, Koo A, Virovka A, Amirault AL, Soo M, Cho JH, Oeltzschner G, Edden RA, Stark C. Meta-analysis and Open-source Database for In Vivo Brain Magnetic Resonance Spectroscopy in Health and Disease. bioRxiv 2023:2023.02.10.528046. [PMID: 37205343 PMCID: PMC10187197 DOI: 10.1101/2023.02.10.528046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Proton ( 1 H) Magnetic Resonance Spectroscopy (MRS) is a non-invasive tool capable of quantifying brain metabolite concentrations in vivo . Prioritization of standardization and accessibility in the field has led to the development of universal pulse sequences, methodological consensus recommendations, and the development of open-source analysis software packages. One on-going challenge is methodological validation with ground-truth data. As ground-truths are rarely available for in vivo measurements, data simulations have become an important tool. The diverse literature of metabolite measurements has made it challenging to define ranges to be used within simulations. Especially for the development of deep learning and machine learning algorithms, simulations must be able to produce accurate spectra capturing all the nuances of in vivo data. Therefore, we sought to determine the physiological ranges and relaxation rates of brain metabolites which can be used both in data simulations and as reference estimates. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we've identified relevant MRS research articles and created an open-source database containing methods, results, and other article information as a resource. Using this database, expectation values and ranges for metabolite concentrations and T 2 relaxation times are established based upon a meta-analyses of healthy and diseased brains.
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Affiliation(s)
- Aaron T. Gudmundson
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Annie Koo
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Anna Virovka
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Alyssa L. Amirault
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Madelene Soo
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Jocelyn H. Cho
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Richard A.E. Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Craig Stark
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
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Saeed D, Stark C, Loforte A, Zimpfer D, Bernhardt A, Schibilsky D, Riebandt J, Jawad K, Lichtenberg A, Haneya A, Potapov E, Albert A, Otto W, Huenges K, Aubin H, Lewin D, Raweh A, Morshuis M, Jorde U, Reichenspurner H, Borger M, Gummert J. Optimal Patient Selection on Extra-Corporeal Life Support for Durable Mechanical Circulatory Support: Validation Study on Behalf of Durable MCS after ECLS Study Group. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1532] [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: 04/05/2023] Open
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Xie L, Ng DQ, Heshmatipour M, Acharya M, Coluzzi P, Guerrero N, Lee S, Malik S, Parajuli R, Stark C, Tain R, Zabokrtsky K, Torno L, Chan A. Electroacupuncture for the management of symptom clusters in cancer patients and survivors (EAST). BMC Complement Med Ther 2023; 23:92. [PMID: 36973688 PMCID: PMC10041509 DOI: 10.1186/s12906-023-03926-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Neuropsychiatric symptoms, comprising cognitive impairment, fatigue, insomnia, depression, and anxiety, are prevalent and may co-occur during and after chemotherapy treatment for cancer. Electroacupuncture (EA), which involves mild electrical stimulation with acupuncture, holds great potential in addressing the management of individual symptoms. However, there is a lack of studies evaluating if EA can manage concurrent neuropsychiatric symptoms in cancer (i.e., symptom cluster). Hence, we designed a trial to evaluate the efficacy, safety, and feasibility of administering EA as an intervention to mitigate neuropsychiatric symptom clusters amongst cancer patients and survivors. METHODS The EAST study is a randomized, sham-controlled, patient- and assessor-blinded clinical trial. Sixty-four cancer patients and survivors with complaints of one or more neuropsychiatric symptom(s) in the seven days prior to enrollment are recruited from the University of California Irvine (UCI) and Children's Hospital of Orange County (CHOC). Individuals with needle phobia, metastases, bleeding disorders, electronic implants, epilepsy, exposure to acupuncture in the three months prior to enrollment, and who are breastfeeding, pregnant, or planning to get pregnant during the duration of the study will be excluded. Screening for metal fragments and claustrophobia are performed prior to the optional neuroimaging procedures. Recruited patients will be randomized (1:1) in random blocks of four or six to receive either ten weekly verum EA (treatment arm, vEA) or weekly sham EA (control arm, sEA) treatment visits with a follow-up appointment four to twelve weeks after their last treatment visit. The treatment arm will receive EA at 13 acupuncture points (acupoints) chosen for their therapeutic effects, while the control arm receives minimal EA at 7 non-disease-related acupoints. Questionnaires and cognitive assessments are administered, and blood drawn to assess changes in symptom clusters and biomarkers, respectively. CONCLUSION The EAST study can provide insight into the efficacy of EA, an integrative medicine modality, in the management of cancer symptom clusters in routine clinical practice. TRIAL REGISTRATION This trial is registered with clinicaltrials.gov NCT05283577.
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Affiliation(s)
- Lifang Xie
- Susan Samueli Integrative Health Institute, University of California Irvine Health, Irvine, CA, USA
| | - Ding Quan Ng
- Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California Irvine, Irvine, CA, USA
| | - Matthew Heshmatipour
- Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California Irvine, Irvine, CA, USA
| | - Munjal Acharya
- School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Paul Coluzzi
- School of Medicine, University of California Irvine, Irvine, CA, USA
- Pacific Breast Cancer Center, University of California Irvine Health, Irvine, CA, USA
| | - Nerida Guerrero
- Department of Pediatric Hematology/Oncology, Hyundai Cancer Institute at Children's Healthcare of Orange County, Orange, CA, USA
| | - Sanghoon Lee
- School of Medicine, University of California Irvine, Irvine, CA, USA
- College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Shaista Malik
- Susan Samueli Integrative Health Institute, University of California Irvine Health, Irvine, CA, USA
- School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Ritesh Parajuli
- School of Medicine, University of California Irvine, Irvine, CA, USA
- UCI Chao Family Comprehensive Cancer Center, Orange, CA, USA
| | - Craig Stark
- The Facility for Imaging and Brain Research (FIBRE), University of California Irvine, Irvine, CA, USA
| | - Rongwen Tain
- The Facility for Imaging and Brain Research (FIBRE), University of California Irvine, Irvine, CA, USA
| | - Keri Zabokrtsky
- Department of Pediatric Hematology/Oncology, Hyundai Cancer Institute at Children's Healthcare of Orange County, Orange, CA, USA
| | - Lilibeth Torno
- Department of Pediatric Hematology/Oncology, Hyundai Cancer Institute at Children's Healthcare of Orange County, Orange, CA, USA
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California Irvine, Irvine, CA, USA.
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Hui SCN, Mikkelsen M, Zöllner HJ, Ahluwalia V, Alcauter S, Baltusis L, Barany DA, Barlow LR, Becker R, Berman JI, Berrington A, Bhattacharyya PK, Blicher JU, Bogner W, Brown MS, Calhoun VD, Castillo R, Cecil KM, Choi YB, Chu WCW, Clarke WT, Craven AR, Cuypers K, Dacko M, de la Fuente-Sandoval C, Desmond P, Domagalik A, Dumont J, Duncan NW, Dydak U, Dyke K, Edmondson DA, Ende G, Ersland L, Evans CJ, Fermin ASR, Ferretti A, Fillmer A, Gong T, Greenhouse I, Grist JT, Gu M, Harris AD, Hat K, Heba S, Heckova E, Hegarty JP, Heise KF, Honda S, Jacobson A, Jansen JFA, Jenkins CW, Johnston SJ, Juchem C, Kangarlu A, Kerr AB, Landheer K, Lange T, Lee P, Levendovszky SR, Limperopoulos C, Liu F, Lloyd W, Lythgoe DJ, Machizawa MG, MacMillan EL, Maddock RJ, Manzhurtsev AV, Martinez-Gudino ML, Miller JJ, Mirzakhanian H, Moreno-Ortega M, Mullins PG, Nakajima S, Near J, Noeske R, Nordhøy W, Oeltzschner G, Osorio-Duran R, Otaduy MCG, Pasaye EH, Peeters R, Peltier SJ, Pilatus U, Polomac N, Porges EC, Pradhan S, Prisciandaro JJ, Puts NA, Rae CD, Reyes-Madrigal F, Roberts TPL, Robertson CE, Rosenberg JT, Rotaru DG, O'Gorman Tuura RL, Saleh MG, Sandberg K, Sangill R, Schembri K, Schrantee A, Semenova NA, Singel D, Sitnikov R, Smith J, Song Y, Stark C, Stoffers D, Swinnen SP, Tain R, Tanase C, Tapper S, Tegenthoff M, Thiel T, Thioux M, Truong P, van Dijk P, Vella N, Vidyasagar R, Vovk A, Wang G, Westlye LT, Wilbur TK, Willoughby WR, Wilson M, Wittsack HJ, Woods AJ, Wu YC, Xu J, Lopez MY, Yeung DKW, Zhao Q, Zhou X, Zupan G, Edden RAE. Frequency drift in MR spectroscopy at 3T. Neuroimage 2021; 241:118430. [PMID: 34314848 PMCID: PMC8456751 DOI: 10.1016/j.neuroimage.2021.118430] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/18/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Heating of gradient coils and passive shim components is a common cause of instability in the B0 field, especially when gradient intensive sequences are used. The aim of the study was to set a benchmark for typical drift encountered during MR spectroscopy (MRS) to assess the need for real-time field-frequency locking on MRI scanners by comparing field drift data from a large number of sites. METHOD A standardized protocol was developed for 80 participating sites using 99 3T MR scanners from 3 major vendors. Phantom water signals were acquired before and after an EPI sequence. The protocol consisted of: minimal preparatory imaging; a short pre-fMRI PRESS; a ten-minute fMRI acquisition; and a long post-fMRI PRESS acquisition. Both pre- and post-fMRI PRESS were non-water suppressed. Real-time frequency stabilization/adjustment was switched off when appropriate. Sixty scanners repeated the protocol for a second dataset. In addition, a three-hour post-fMRI MRS acquisition was performed at one site to observe change of gradient temperature and drift rate. Spectral analysis was performed using MATLAB. Frequency drift in pre-fMRI PRESS data were compared with the first 5:20 minutes and the full 30:00 minutes of data after fMRI. Median (interquartile range) drifts were measured and showed in violin plot. Paired t-tests were performed to compare frequency drift pre- and post-fMRI. A simulated in vivo spectrum was generated using FID-A to visualize the effect of the observed frequency drifts. The simulated spectrum was convolved with the frequency trace for the most extreme cases. Impacts of frequency drifts on NAA and GABA were also simulated as a function of linear drift. Data from the repeated protocol were compared with the corresponding first dataset using Pearson's and intraclass correlation coefficients (ICC). RESULTS Of the data collected from 99 scanners, 4 were excluded due to various reasons. Thus, data from 95 scanners were ultimately analyzed. For the first 5:20 min (64 transients), median (interquartile range) drift was 0.44 (1.29) Hz before fMRI and 0.83 (1.29) Hz after. This increased to 3.15 (4.02) Hz for the full 30 min (360 transients) run. Average drift rates were 0.29 Hz/min before fMRI and 0.43 Hz/min after. Paired t-tests indicated that drift increased after fMRI, as expected (p < 0.05). Simulated spectra convolved with the frequency drift showed that the intensity of the NAA singlet was reduced by up to 26%, 44 % and 18% for GE, Philips and Siemens scanners after fMRI, respectively. ICCs indicated good agreement between datasets acquired on separate days. The single site long acquisition showed drift rate was reduced to 0.03 Hz/min approximately three hours after fMRI. DISCUSSION This study analyzed frequency drift data from 95 3T MRI scanners. Median levels of drift were relatively low (5-min average under 1 Hz), but the most extreme cases suffered from higher levels of drift. The extent of drift varied across scanners which both linear and nonlinear drifts were observed.
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Affiliation(s)
- Steve C N Hui
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Mark Mikkelsen
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Helge J Zöllner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Vishwadeep Ahluwalia
- GSU/GT Center for Advanced Brain Imaging, Georgia Institute of Technology, Atlanta, GA USA
| | - Sarael Alcauter
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro, Mexico
| | - Laima Baltusis
- Center for Cognitive and Neurobiological Imaging, Stanford University, Stanford, CA USA
| | - Deborah A Barany
- Department of Kinesiology, University of Georgia, and Augusta University/University of Georgia Medical Partnership, Athens, GA USA
| | - Laura R Barlow
- Department of Radiology, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Robert Becker
- Center for Innovative Psychiatry and Psychotherapy Research, Department Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jeffrey I Berman
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA USA
| | - Adam Berrington
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | | | - Jakob Udby Blicher
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Wolfgang Bogner
- Department of Biomedical Imaging and Image-guided Therapy, High-Field MR Center, Medical University of Vienna, Vienna, Austria
| | - Mark S Brown
- Department of Radiology, Medical Physics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Vince D Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA USA
| | - Ryan Castillo
- NeuRA Imaging, Neuroscience Research Australia, Randwick, Australia
| | - Kim M Cecil
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH USA
| | - Yeo Bi Choi
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH USA
| | - Winnie C W Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - William T Clarke
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Alexander R Craven
- Department of Biological and Medical Psychology, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Koen Cuypers
- REVAL Rehabilitation Research Institute (REVAL), Hasselt University, Diepenbeek, Belgium; Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Michael Dacko
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry & Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Patricia Desmond
- Department of Radiology, University of Melbourne/ Royal Melbourne Hospital, Melbourne, Australia
| | - Aleksandra Domagalik
- Brain Imaging Core Facility, Malopolska Centre of Biotechnology, Jagiellonian University, Kraków, Poland
| | - Julien Dumont
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UMS 2014 - PLBS, F-59000 Lille, France
| | - Niall W Duncan
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Ulrike Dydak
- School of Health Sciences, Purdue University, West Lafayette, IN USA
| | - Katherine Dyke
- School of Psychology, University of Nottingham, Nottingham, UK
| | - David A Edmondson
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH USA
| | - Gabriele Ende
- Center for Innovative Psychiatry and Psychotherapy Research, Department Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lars Ersland
- Department of Clinical Engineering, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | | | - Alan S R Fermin
- Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Hiroshima, Japan
| | - Antonio Ferretti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Ariane Fillmer
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig und Berlin, Germany
| | - Tao Gong
- Department of Imaging and Nuclear Medicine, Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Ian Greenhouse
- Department of Human Physiology, University of Oregon, Eugene, OR USA
| | - James T Grist
- Department of Physiology, Anatomy, and Genetics, Oxford Centre for Magnetic Resonance / Department of Radiology, The Churchill Hospital, The University of Oxford, Oxford, UK
| | - Meng Gu
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Ashley D Harris
- Department of Radiology, University of Calgary, Calgary, Canada
| | - Katarzyna Hat
- Consciousness Lab, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Stefanie Heba
- Department of Neurology, BG University Hospital Bergmannsheil, Bochum, Germany
| | - Eva Heckova
- Department of Biomedical Imaging and Image-guided Therapy, High-Field MR Center, Medical University of Vienna, Vienna, Austria
| | - John P Hegarty
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | | | - Shiori Honda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Aaron Jacobson
- Department of Radiology / Psychiatry, University of California San Diego, San Diego, CA USA
| | - Jacobus F A Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Stephen J Johnston
- Psychology Department / Clinical Imaging Facility, Swansea University, Swansea, UK
| | - Christoph Juchem
- Departments of Biomedical Engineering and Radiology, Columbia University, New York, NY USA
| | - Alayar Kangarlu
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Adam B Kerr
- Center for Cognitive and Neurobiological Imaging, Stanford University, Stanford, CA USA
| | - Karl Landheer
- Departments of Biomedical Engineering and Radiology, Columbia University, New York, NY USA
| | - Thomas Lange
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Phil Lee
- Department of Radiology / Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS USA
| | | | - Catherine Limperopoulos
- Developing Brain Institute, Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC USA
| | - Feng Liu
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - William Lloyd
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, UK
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Maro G Machizawa
- Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Hiroshima, Japan
| | - Erin L MacMillan
- Department of Radiology, Faculty of Medicine, The University of British Columbia, Vancouver, Canada; Philips Canada, Markham, ON, Canada
| | - Richard J Maddock
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Imaging Research Center, Davis, CA USA
| | - Andrei V Manzhurtsev
- Department of Radiology, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russia; Emanuel Institute of Biochemical Physics of the Russian Academy of Sciences, Moscow, Russia
| | - María L Martinez-Gudino
- Departamento de Imágenes Cerebrales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Jack J Miller
- Department of Physics, University of Oxford, Oxford, UK; The MR Research Centre & The PET Research Centre, Aarhus University, Aarhus, DK
| | - Heline Mirzakhanian
- Department of Radiology / Psychiatry, University of California San Diego, San Diego, CA USA
| | - Marta Moreno-Ortega
- Department of Psychiatry, Columbia University Irving Medical Center/New York State Psychiatric Institute, New York, NY USA
| | - Paul G Mullins
- Bangor Imaging Unit, Department of Psychology, Bangor University, Bangor, Wales, UK
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Jamie Near
- Douglas Mental Health University Institute and Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Wibeke Nordhøy
- NORMENT, Division of Mental Health and Addiction and Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital / Department of Psychology, University of Oslo, Oslo, Norway
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Raul Osorio-Duran
- Departamento de Imágenes Cerebrales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Maria C G Otaduy
- LIM44, Instituto e Departamento de Radiologia, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Erick H Pasaye
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro, Mexico
| | - Ronald Peeters
- Department of Imaging & Pathology, Department of Radiology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Scott J Peltier
- Functional MRI Laboratory, University of Michigan, Ann Arbor, MI USA
| | - Ulrich Pilatus
- Institute of Neuroradiology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Nenad Polomac
- Institute of Neuroradiology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Eric C Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, College of Public Health and Health Professions. Department of Neuroscience, College of Medicine, University of Florida, Gainesville, USA
| | - Subechhya Pradhan
- Developing Brain Institute, Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC USA
| | - James Joseph Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC USA
| | - Nicolaas A Puts
- Department of Forensic & Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, King's College London, London, UK
| | - Caroline D Rae
- NeuRA Imaging, Neuroscience Research Australia, Randwick, Australia
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry & Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Timothy P L Roberts
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA USA
| | - Caroline E Robertson
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH USA
| | - Jens T Rosenberg
- McKnight Brain Institute, AMRIS, University of Florida, Gainesville, FL USA
| | - Diana-Georgiana Rotaru
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ruth L O'Gorman Tuura
- Center for MR Research, University Children's Hospital, Zurich, University of Zurich, Switzerland
| | - Muhammad G Saleh
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, USA
| | - Kristian Sandberg
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Ryan Sangill
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | | | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Natalia A Semenova
- Department of Radiology, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russia; Emanuel Institute of Biochemical Physics of the Russian Academy of Sciences, Moscow, Russia
| | - Debra Singel
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rouslan Sitnikov
- Clinical Neuroscience, MRI Centre, Karolinska Institute, Stockholm, Sweden
| | - Jolinda Smith
- Lewis Center for Neuroimaging, University of Oregon, Eugene, OR USA
| | - Yulu Song
- Department of Imaging and Nuclear Medicine, Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Craig Stark
- Department of Neurobiology and Behavior, Facility for Imaging and Brain Research (FIBRE) & Campus Center for Neuroimaging (CCNI), School of Biological Sciences, University of California, Irvine, Irvine, CA USA
| | - Diederick Stoffers
- Spinoza Centre for Neuroimaging, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | | | - Rongwen Tain
- Department of Neurobiology and Behavior, Facility for Imaging and Brain Research (FIBRE) & Campus Center for Neuroimaging (CCNI), School of Biological Sciences, University of California, Irvine, Irvine, CA USA
| | - Costin Tanase
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Imaging Research Center, Davis, CA USA
| | - Sofie Tapper
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Martin Tegenthoff
- Department of Neurology, BG University Hospital Bergmannsheil, Bochum, Germany
| | - Thomas Thiel
- Institute of Clinical Neuroscience and Medical Psychology, University Dusseldorf, Medical Faculty, Düsseldorf, Germany
| | - Marc Thioux
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Truong
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Pim van Dijk
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nolan Vella
- Medical Physics, Mater Dei Hospital, Imsida, Malta
| | - Rishma Vidyasagar
- Melbourne Dementia Research Centre, Florey Institute of Neurosciences and Mental Health, Melbourne, Australia
| | - Andrej Vovk
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Guangbin Wang
- Department of Imaging and Nuclear Medicine, Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction and Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital / Department of Psychology, University of Oslo, Oslo, Norway
| | - Timothy K Wilbur
- Department of Radiology, University of Washington, Seattle, WA USA
| | - William R Willoughby
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL USA
| | - Martin Wilson
- Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, UK
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, College of Public Health and Health Professions. Department of Neuroscience, College of Medicine, University of Florida, Gainesville, USA
| | - Yen-Chien Wu
- Department of Radiology, TMU-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Junqian Xu
- Department of Radiology and Psychiatry, Baylor College of Medicine, Houston, USA
| | | | - David K W Yeung
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Qun Zhao
- Bioimaging Research Center, Department of Physics and Astronomy, University of Georgia, Athens, GA USA
| | - Xiaopeng Zhou
- School of Health Sciences, Purdue University, West Lafayette, IN USA
| | - Gasper Zupan
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
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7
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Gago-Veiga AB, Huhn JI, Latysheva N, Vieira Campos A, Torres-Ferrus M, Alpuente Ruiz A, Sacco S, Frattale I, Ornello R, Ruscheweyh R, Marques IB, Gryglas-Dworak A, Stark C, Gallardo VJ, Pozo-Rosich P. InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers. J Headache Pain 2021; 22:43. [PMID: 34030634 PMCID: PMC8142511 DOI: 10.1186/s10194-021-01258-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/04/2021] [Accepted: 05/12/2021] [Indexed: 12/03/2022] Open
Abstract
Background There is currently a wide therapeutic arsenal for migraine patients, without a single first-line preventive drug and we choose the different available alternatives taking into account comorbidities, national guidelines, previous treatments and personal experiences. Our objective was to evaluate the differences in the use of migraine treatments between neurologists from different countries. Methods This is a multi-centre observational study carried out by neurologists from specialized headache units in seven countries, retrospective with consecutive inclusion of all patients presenting with a migraine diagnosis, over a period of three months. Results A total of 734 patients were recruited but only 600 were considered in the analysis in order to homogenize the patient cohorts from countries: 200 Spain (ES), 100 Italy (IT), 85 Russia (RUS), 80 Germany (DE), 60 Portugal (PT), 45 Poland (PL) and 30 Australia (AU). 85.4 % of patients were women with a mean age of 42.6 ± 11.8 years. Considering previous and current preventive treatment, the order of use was: antidepressants (69.3 %), antiepileptic drugs (54.7 %), beta-blockers and antihypertensive drugs (49.7 %), OnabotulinumtoxinA (44.0 %) and others (36.2 %). Statistically significant differences were found between all pharmacological classes: antidepressants were commonly used in all countries, with the exception of Poland (AU: 76.7 %, IT: 71.0 %, DE: 60.0 %, PL: 31.1 %, PT: 71.7 %, RUS: 70.6 %, ES: 78.5 %; p < 0.0001); antiepileptic drugs were more frequently prescribed in Portugal, Australia and Spain (AU: 73.3 %, IT: 40.0 %, DE: 37.5 %, PL: 48.9 %, PT: 85.0 %, RUS: 29.4 % and ES: 69.0 %; p < 0.0001); beta-blockers and antihypertensive drugs were frequently used in all countries except Italy (AU: 60.0 %, IT: 14.0 %, DE: 53.8 %, PL: 48.9 %, PT: 68.3 %, RUS: 49.4 % and ES: 59.0 %; p < 0.0001); BTX-A were predominately used in Spain, Italy and Australia (AU:56.7 %, IT:58.0 %, DE:20.0 %, PL: 42.2 %, PT: 26.7 %, RUS: 24.7 % and ES: 58.5 %; p < 0.0001) and others were most frequently used in Poland (AU: 0.0 %, IT: 19.0 %, DE: 42.5 %, PL: 95.6 %, PT: 31.7 %, RUS: 3.5 % and ES: 49.5 %; p < 0.0001). If only patients without comorbidities are considered (200/600), statistically differences between countries persist in all preventive treatments. Conclusions There is heterogeneity in the choice of preventive treatment between different countries. Prospective comparative studies of the different oral and subcutaneous alternatives would help to create a global therapeutic algorithm that would guarantee the best option for our patients.
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Affiliation(s)
- A B Gago-Veiga
- Headache Unit, Department of Neurology, La Princesa Research Institute. Hospital Universitario de la Princesa, Madrid, Spain.
| | - J-I Huhn
- Praxis Gendolla. Zentrum für Neurologie und Schmerztherapie, Essen, Germany
| | - N Latysheva
- Department of Neurology, Institute for Professional Education, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A Vieira Campos
- Headache Unit, Department of Neurology, La Princesa Research Institute. Hospital Universitario de la Princesa, Madrid, Spain
| | - M Torres-Ferrus
- Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Alpuente Ruiz
- Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Sacco
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L´Aquila, Italy
| | - I Frattale
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L´Aquila, Italy
| | - R Ornello
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L´Aquila, Italy
| | - R Ruscheweyh
- Department of Neurology, Ludwig Maximilians University Munich, Munich, Germany
| | - I B Marques
- Department of Neurology, Hospital da Luz Lisboa, Lisbon, Portugal
| | | | - C Stark
- Austin Health, Heidelberg, Australia
| | - V J Gallardo
- Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Pozo-Rosich
- Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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Suthana N, Ekstrom AD, Yassa MA, Stark C. Pattern Separation in the Human Hippocampus: Response to Quiroga. Trends Cogn Sci 2021; 25:423-424. [PMID: 33820660 DOI: 10.1016/j.tics.2021.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Nanthia Suthana
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, USA; Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, USA; Department of Psychology, University of California, Los Angeles, CA 90095, USA; Department of Bioengineering, University of California, Los Angeles, CA 90095, USA.
| | - Arne D Ekstrom
- Psychology Department, University of Arizona, Tucson, AZ 85721, USA; Evelyn McKnight Brain Institute, University of Arizona, Tucson, AZ 85721, USA
| | - Michael A Yassa
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA 92697, USA; Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA 92697, USA
| | - Craig Stark
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA 92697, USA; Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA 92697, USA
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9
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Papp KV, Rentz DM, Maruff P, Sun CK, Raman R, Donohue MC, Schembri A, Stark C, Yassa MA, Wessels AM, Yaari R, Holdridge KC, Aisen PS, Sperling RA. The Computerized Cognitive Composite (C3) in an Alzheimer's Disease Secondary Prevention Trial. J Prev Alzheimers Dis 2021; 8:59-67. [PMID: 33336226 PMCID: PMC7755110 DOI: 10.14283/jpad.2020.38] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Computerized cognitive assessments may improve Alzheimer's disease (AD) secondary prevention trial efficiency and accuracy. However, they require validation against standard outcomes and relevant biomarkers. OBJECTIVE To assess the feasibility and validity of the tablet-based Computerized Cognitive Composite (C3). DESIGN Cross-sectional analysis of cognitive screening data from the A4 study (Anti-Amyloid in Asymptomatic AD). SETTING Multi-center international study. PARTICIPANTS Clinically normal (CN) older adults (65-85; n=4486). MEASUREMENTS Participants underwent florbetapir-Positron Emission Tomography for Aβ+/- classification. They completed the C3 and standard paper and pencil measures included in the Preclinical Alzheimer's Cognitive Composite (PACC). The C3 combines memory measures sensitive to change over time (Cogstate Brief Battery-One Card Learning) and measures shown to be declining early in AD including pattern separation (Behavioral Pattern Separation Test- Object- Lure Discrimination Index) and associative memory (Face Name Associative Memory Exam- Face-Name Matching). C3 acceptability and completion rates were assessed using qualitative and quantitative methods. C3 performance was explored in relation to Aβ+/- groups (n=1323/3163) and PACC. RESULTS C3 was feasible for CN older adults to complete. Rates of incomplete or invalid administrations were extremely low, even in the bottom quartile of cognitive performers (PACC). C3 was moderately correlated with PACC (r=0.39). Aβ+ performed worse on C3 compared with Aβ- [unadjusted Cohen's d=-0.22 (95%CI: -0.31,-0.13) p<0.001] and at a magnitude comparable to the PACC [d=-0.32 (95%CI: -0.41,-0.23) p<0.001]. Better C3 performance was observed in younger, more educated, and female participants. CONCLUSIONS These findings provide support for both the feasibility and validity of C3 and computerized cognitive outcomes more generally in AD secondary prevention trials.
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Affiliation(s)
- K V Papp
- Kathryn V. Papp, Center for Alzheimer Research and Treatment; 60 Fenwood Road; Boston, MA 02115, Telephone: 617-643-5322; Fax: 857-5461, Email Address:
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Sayegh A, Zipkin J, Stark C, Keating L, Herr A, Siskin G. 4:12 PM Abstract No. 80 Scheduling elective interventional radiology procedures on weekends: implications for length of stay, cost, and efficiency. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.106] [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] Open
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11
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Nersesian G, Spillmann F, Gromann T, Tschoepe C, Schoenrath F, Stark C, Falk V, Potapov EV. P2626Outcome of patients in cardiogenic shock supported with a micro-axial blood pump providing 5 l/min blood flow. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0949] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Percutaneous mechanical circulatory support devices are increasingly used in acute cardiogenic shock (CS), despite limited evidence for their effectiveness. The aim of this study was to evaluate outcomes associated with use of the full support Impella 5 and 5.5 as a short- term left ventricular device (LVAD) and to identify preoperative predictors of short -term mortality.
Methods
Data of patients in CS (n=51) treated with the Impella 5 (n=48) and 5.5 (n=3) devices at our institution were collected retrospectively. The primary endpoint was 30-day all-cause mortality. Clinical follow up including adverse events was analyzed.
Results
Mean age was 58.2±12.1 years; 80.4% were male. 13 patients had BMI >30 kg/m2. CS was caused by acute myocardial infarction (n=14), decompensated chronic heart failure (n=29), postcardiotomy syndrom and acute myocarditis (n=4 each). Before implantation, median Intermacs profile was 1 (range 1–3) and 31 patients (61%) were on respiratory support. In 49 patients the axillary artery was used for vascular access (n=4 left and n=45 right) employing a 10mm dacron graft tunneled through the skin, in one patient left femoral artery and ascending aorta, respectively. Median support time was 14 days.
In 12 cases the pump was removed for myocardial recovery. In 15 patients a continuous flow permanent LVAD was implanted. Bleeding (n=9), thromboembolic event (n=5), pump dislodgement (n=7) requiring revision occurred during support. Seven patients developed ventricular arrhythmia requiring flow reduction. In 5 cases the pump was explanted for hemolysis, in 2 other patients pump exchange was performed. The overall 30-day survival was 53% (95% CI: 38.8–67.1%). Penalized multivariable logistic regression analysis identified preoperative elevated lactate (p=0.027) and CK-MB (p=0.022) as predictors for 30- day mortality. On the basis of these data, a nomogram to estimate 30d-mortality after Impella implantation was created.
Conclusion
Stabilization of patients suffering from CS employing temporary full support Impella LVAD is feasible and results in acceptable survival. Preoperative degree of shock and myocardial damage predict the short-term mortality. Effect of full support Impella LVAD in earlier stages of shock may prevent irreversible end organ damage.
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Affiliation(s)
| | - F Spillmann
- Charite - Campus Virchow-Klinikum (CVK), Berlin, Germany
| | - T Gromann
- German Heart Centre Berlin, Berlin, Germany
| | - C Tschoepe
- Charite - Campus Virchow-Klinikum (CVK), Berlin, Germany
| | | | - C Stark
- German Heart Centre Berlin, Berlin, Germany
| | - V Falk
- German Heart Centre Berlin, Berlin, Germany
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12
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Duran I, Martakis K, Bossier C, Stark C, Rehberg M, Semler O, Schoenau E. Interaction of body fat percentage and height with appendicular functional muscle-bone unit. Arch Osteoporos 2019; 14:65. [PMID: 31222628 DOI: 10.1007/s11657-019-0610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/25/2019] [Accepted: 05/22/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED The interaction of body fat percentage and height with appendicular BMC for LBM was analyzed. Only body fat had significant negative correlation with the appendicular BMC for LBM. PURPOSE/INTRODUCTION For the clinical evaluation of the functional muscle-bone unit, it was proposed to evaluate the adaptation of the bone to the acting forces. A frequently used parameter for this is the total body less head bone mineral content (TBLH-BMC) determined by dual-energy X-ray absorptiometry (DXA) in relation to the total body lean body mass (LBM). Body fat percentage seemed to correlate negatively and height positively with TBLH-BMC for LBM. It was supposed that appendicular BMC for LBM is a more accurate surrogate for the functional muscle-bone unit since appendicular LBM does not incorporate the mass of internal organs. The aim of this study was to analyze the interaction of body fat percentage and height with appendicular BMC for LBM. METHODS As part of the National Health and Nutrition Examination Survey (NHANES) study, between the years 1999 and 2004, whole-body DXA scans on randomly selected Americans from 8 years of age were carried out. From all eligible DXA scans, three major US ethnic groups were evaluated (non-Hispanic Whites, non-Hispanic Blacks, and Mexican Americans) for further statistical analysis. RESULTS For the statistical analysis, the DXA scans of 8190 non-Hispanic White children and adults (3903 female), of 4931 non-Hispanic Black children and adults (2250 female), and 5421 of Mexican American children and adults (2424 female) were eligible. Only body fat had a significant negative correlation with the appendicular BMC for LBM. CONCLUSIONS Only body fat had significant negative correlation with appendicular BMC for LBM, and thus, should be addressed when evaluating functional muscle-bone unit.
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Affiliation(s)
- Ibrahim Duran
- Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany.
| | - K Martakis
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany.,Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - C Bossier
- Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany
| | - C Stark
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany.,Cologne Centre for Musculoskeletal Biomechanics, University of Cologne, Cologne, Germany
| | - M Rehberg
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany
| | - O Semler
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany.,Center for Rare Skeletal Diseases in Childhood, Medical Faculty and University Hospital, Cologne, Germany
| | - E Schoenau
- Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany.,Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne, Cologne, Germany
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13
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Duran I, Martakis K, Hamacher S, Stark C, Semler O, Schoenau E. Are there effects of age, gender, height, and body fat on the functional muscle-bone unit in children and adults? Osteoporos Int 2018; 29:1069-1079. [PMID: 29455248 DOI: 10.1007/s00198-018-4401-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/17/2018] [Indexed: 01/20/2023]
Abstract
UNLABELLED The aim was to describe the effect of age, gender, height, different stages of human life, and body fat on the functional muscle-bone unit. All these factors had a significant effect on the functional muscle-bone unit and should be addressed when assessing functional muscle-bone unit in children and adults. INTRODUCTION For the clinical evaluation of the functional muscle-bone unit, it was proposed to evaluate the adaptation of the bone to the acting forces. A frequently used parameter for this is the total body less head bone mineral content (TBLH-BMC) determined by dual-energy X-ray absorptiometry (DXA) in relation to the lean body mass (LBM by DXA). LBM correlates highly with muscle mass. Therefore, LBM is a surrogate parameter for the muscular forces acting in everyday life. The aim of the study was to describe the effect of age and gender on the TBLH-BMC for LBM and to evaluate the impact of other factors, such as height, different stages of human life, and of body fat. METHODS As part of the National Health and Nutrition Examination Survey (NHANES) study, between the years 1999-2006 whole-body DXA scans on randomly selected Americans from 8 years of age were carried out. From all eligible DXA scans (1999-2004), three major US ethnic groups were evaluated (non-Hispanic Whites, non-Hispanic Blacks, and Mexican Americans) for further statistical analysis. RESULTS For the statistical analysis, the DXA scans of 8190 non-Hispanic White children and adults (3903 female), of 4931 non-Hispanic Black children and adults (2250 female) and 5421 of Mexican-American children and adults (2424 female) were eligible. Age, gender, body height, and especially body fat had a significant effect on the functional muscle-bone unit. CONCLUSIONS When assessing TBLH-BMC for LBM in children and adults, the effects of age, gender, body fat, and body height should be addressed. These effects were analyzed for the first time in such a large cohort.
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Affiliation(s)
- I Duran
- Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany.
| | - K Martakis
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
- Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - S Hamacher
- Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - C Stark
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
- Cologne Centre for Musculoskeletal Biomechanics, University of Cologne, Cologne, Germany
| | - O Semler
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
- Center for Rare Skeletal Diseases in Childhood, University of Cologne, Cologne, Germany
| | - E Schoenau
- Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
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14
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Kiss J, Nykänen A, Stark C, Lemström K. The Effect of Preoperative use of Mechanical Circulatory Support on Survival After Heart Transplantation in Finland. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1127] [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: 11/29/2022] Open
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Carrelli P, Degeyter K, Collins D, Keating L, Mandato K, Herr A, Englander M, Stark C, Siskin G. Abstract No. 427 Proximal splenic embolization: an important role for IR in the treatment of splenic trauma. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.472] [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: 11/30/2022] Open
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16
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Stark C, Hartman C, Mahler HC, Singh S. Injection Site Reactions to PCSK9i Monoclonal Antibody Therapies are caused by Polysorbates in the Products. J Clin Lipidol 2018. [DOI: 10.1016/j.jacl.2018.03.069] [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: 10/17/2022]
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17
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Duran I, Martakis K, Stark C, Alberg E, Bossier C, Semler O, Schoenau E. Experience with jumping mechanography in children with cerebral palsy. J Musculoskelet Neuronal Interact 2017; 17:237-245. [PMID: 28860426 PMCID: PMC5601269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Jumping mechanography provides robust motor function indicators among healthy children. The aim of the study was to assess the reproducibility and validity of jumping mechanography conducted as single two-legged jump (S2LJ) in children with cerebral palsy (CP). METHODS 215 S2LJ investigations from a sample of 75 children with CP were eligible for evaluation. For the estimation of the reproducibility, only the baseline set of data per patient were used. Gross motor function was evaluated by the Gross Motor Function Measure (GMFM-66). In 135 S2LJ investigations, GMFM-66 was assessed within a week in the same child. This data was used for validity assessment. RESULTS Coefficients of variation for the main outcome parameters ranged between 6.15-9.71%, except for jump height (CV%=27.3%). The intraclass correlation coefficients for peak velocity (Vmax) and peak power relative to body weight (Pmax/mass) was 0.927 and 0.931. Vmax and Pmax/mass were also the test parameters with the strongest correlation to the GMFM-66 score (⟩0.7). CONCLUSIONS S2LJ assessed in the present study provided reproducible outcome measures particularly for Vmax and Pmax/mass in children with CP. Further, Vmax and Pmax/mass showed the strongest correlation with the GMFM-66 score and seem to be the most relevant evaluation criteria.
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Affiliation(s)
- I. Duran
- University of Cologne, Center of Prevention and Rehabilitation, Germany,Corresponding author: Ibrahim Duran, MD, University of Cologne, Centre of Prevention and Rehabilitation, Lindenburger Allee 44, 50931 Cologne, Germany E-mail:
| | - K. Martakis
- University of Cologne, Children’s and Adolescent’s Hospital, Germany,Maastricht University, Department of International Health, School CAPHRI, Care and Public Health Research Institute, the Netherlands
| | - C. Stark
- University of Cologne, Children’s and Adolescent’s Hospital, Germany,University of Cologne, Cologne Centre for Musculoskeletal Biomechanics (CCMB), Germany
| | - E. Alberg
- University of Cologne, Center of Prevention and Rehabilitation, Germany
| | - C. Bossier
- University of Cologne, Center of Prevention and Rehabilitation, Germany
| | - O. Semler
- University of Cologne, Children’s and Adolescent’s Hospital, Germany,University of Cologne, Center for rare skeletal diseases in childhood, Germany
| | - E. Schoenau
- University of Cologne, Center of Prevention and Rehabilitation, Germany,University of Cologne, Children’s and Adolescent’s Hospital, Germany,University of Cologne, Center for rare skeletal diseases in childhood, Germany
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Duran I, Schütz F, Hamacher S, Semler O, Stark C, Schulze J, Rittweger J, Schoenau E. The functional muscle-bone unit in children with cerebral palsy. Osteoporos Int 2017; 28:2081-2093. [PMID: 28365851 DOI: 10.1007/s00198-017-4023-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/27/2017] [Indexed: 11/24/2022]
Abstract
UNLABELLED Our results suggest that the prevalence of bone health deficits in children with CP was overestimated, when using only age- and height-adjusted bone mineral content (BMC) and areal bone mineral density (aBMD). When applying the functional muscle-bone unit diagnostic algorithm (FMBU-A), the prevalence of positive results decreased significantly. We recommend applying the FMBU-A when assessing bone health in children with CP. INTRODUCTION The prevalence of bone health deficits in children with cerebral palsy (CP) might be overestimated because age- and height-adjusted reference percentiles for bone mineral content (BMC) and areal bone mineral density (aBMD) assessed by dual-energy X-ray absorptiometry (DXA) do not consider reduced muscle activity. The aim of this study was to compare the prevalence of positive DXA-based indicators for bone health deficits in children with CP to the prevalence of positive findings after applying a functional muscle-bone unit diagnostic algorithm (FMBU-A) considering reduced muscle activity. METHODS The present study was a monocentric retrospective analysis of 297 whole body DXA scans of children with CP. The prevalence of positive results of age- and height-adjusted BMC and aBMD defined as BMC and aBMD below the P3 percentile and of the FMBU-A was calculated. RESULTS In children with CP, the prevalence of positive results of age-adjusted BMC were 33.3% and of aBMD 50.8%. Height-adjusted results for BMC and aBMD were positive in 16.8 and 36.0% of cases. The prevalence of positive results applying the FMBU-A regarding BMC and aBMD were significantly (p < 0.001) lower than using age- and height-adjusted BMC and aBMD (8.8 and 14.8%). CONCLUSIONS Our results suggest that the prevalence of bone health deficits in children with CP was overestimated, when using age- and height-adjusted BMC and aBMD. When applying the FMBU-A, the prevalence decreased significantly. We recommend applying the FMBU-A when assessing bone health in children with CP.
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Affiliation(s)
- I Duran
- Center of Prevention and Rehabilitation, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany.
| | - F Schütz
- Center of Prevention and Rehabilitation, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany
| | - S Hamacher
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - O Semler
- Center of Prevention and Rehabilitation, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany
- Children's Hospital, University of Cologne, Cologne, Germany
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - C Stark
- Center of Prevention and Rehabilitation, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany
- Children's Hospital, University of Cologne, Cologne, Germany
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - J Schulze
- Center of Prevention and Rehabilitation, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany
| | - J Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - E Schoenau
- Center of Prevention and Rehabilitation, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany
- Children's Hospital, University of Cologne, Cologne, Germany
- Cologne Center for Musculoskeletal Biomechanics (CCMB), University of Cologne, Cologne, Germany
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Nykänen A, Halme M, Stark C, Hämmäinen P, Lemström K, Raivio P. Normal Impact of Restrictive and Obstructive Subtypes of Chronic Lung Allograft Dysfunction on Graft Survival - Single Center 13 Year Experience. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Stark C, Herkenrath P, Hollmann H, Waltz S, Becker I, Hoebing L, Semler O, Hoyer-Kuhn H, Duran I, Hero B, Hadders-Algra M, Schoenau E. Early vibration assisted physiotherapy in toddlers with cerebral palsy - a randomized controlled pilot trial. J Musculoskelet Neuronal Interact 2016; 16:183-92. [PMID: 27609033 PMCID: PMC5114341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES to investigate feasibility, safety and efficacy of home-based side-alternating whole body vibration (sWBV) to improve motor function in toddlers with cerebral palsy (CP). METHODS Randomized controlled trial including 24 toddlers with CP (mean age 19 months (SD±3.1); 13 boys). INTERVENTION 14 weeks sWBV with ten 9-minute sessions weekly (non-individualized). Group A started with sWBV, followed by 14 weeks without; in group B this order was reversed. Feasibility (≥70% adherence) and adverse events were recorded; efficacy evaluated with the Gross Motor Function Measure (GMFM-66), Pediatric Evaluation of Disability Inventory (PEDI), at baseline (T0), 14 (T1) and 28 weeks (T2). RESULTS Developmental change between T0 and T1 was similar in both groups; change scores in group A and B: GMFM-66 2.4 (SD±2.1) and 3.3 (SD±2.9) (p=0.412); PEDI mobility 8.4 (SD±6.6) and 3.5 (SD±9.2) (p=0.148), respectively. In two children muscle tone increased post-sWBV. 24 children received between 67 and 140 sWBV sessions, rate of completed sessions ranged from 48 to 100% and no dropouts were observed. CONCLUSION A 14-week home-based sWBV intervention was feasible and safe in toddlers with CP, but was not associated with improvement in gross motor function.
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Affiliation(s)
- C. Stark
- University of Cologne, Children’s Hospital, Germany,University of Cologne, Cologne Centre for Musculoskeletal Biomechanics (CCMB), Germany,Corresponding author: Christina Stark, PT, M.Sc., Children’s Hospital, University of Cologne, Kerpener Str. 62, 50939 Köln, Germany E-mail:
| | - P. Herkenrath
- University of Cologne, Department of Neuropediatrics, Germany
| | - H. Hollmann
- LVR-Clinics Bonn, Centre of Child Neurology, Germany
| | - S. Waltz
- Clinics of the City of Cologne, Children’s Hospital, Germany
| | - I. Becker
- University of Cologne, Institute of Medical Statistics, Informatics and Epidemiology (IMSIE), Germany
| | - L. Hoebing
- University of Cologne, Children’s Hospital, Germany
| | - O. Semler
- University of Cologne, Children’s Hospital, Germany,University of Cologne, Cologne Centre for Musculoskeletal Biomechanics (CCMB), Germany
| | | | - I. Duran
- UniReha GmbH, Pediatric Rehabilitation Centre, Germany
| | - B. Hero
- University of Cologne, Children’s Hospital, Germany
| | - M. Hadders-Algra
- University of Groningen, University Medical Center Groningen (UMCG), Department of Pediatrics - Div. Developmental Neurology, Netherlands
| | - E. Schoenau
- University of Cologne, Children’s Hospital, Germany,University of Cologne, Cologne Centre for Musculoskeletal Biomechanics (CCMB), Germany,UniReha GmbH, Pediatric Rehabilitation Centre, Germany
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Stark C, Murray T, Gooday C, Nunney I, Hutchinson R, Loveday D, Dhatariya K. 5 year retrospective follow-up of new cases of Charcot neuroarthropathy-A single centre experience. Foot Ankle Surg 2016; 22:176-180. [PMID: 27502226 DOI: 10.1016/j.fas.2015.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/08/2015] [Accepted: 07/10/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Few data describe the natural history of Charcot neuroarthropathy treated with a total contact plaster cast (TCC). METHODS A 5 year retrospective analysis of 50 patients presenting with an acute CN, Assessing time to clinical resolution into appropriate footwear and assessing if initial immobilisation device influenced resolution time. RESULTS During the study period 42 patients (84%) of patients went into remission, 2 died during their treatment, 4 had major amputations, in 2 patients treatment was ongoing. 36 patients were treated with combination offloading devices, 6 were treated with one modality only. Median time to resolution for patients initially treated with a TCC was not significantly shorter than for those treated with a removable below knee boot. 34.9% required re-casting due to clinical deterioration in the removable device. CONCLUSIONS More precise measures of resolution of CN are needed to assess the impact of initial treatment modality on time to resolution.
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Affiliation(s)
- C Stark
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - T Murray
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - C Gooday
- Diabetic Foot Clinic, Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - I Nunney
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - R Hutchinson
- Department of Orthopaedic Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - D Loveday
- Department of Orthopaedic Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - K Dhatariya
- Diabetic Foot Clinic, Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
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Stark C, Hoyer-Kuhn HK, Semler O, Hoebing L, Duran I, Cremer R, Schoenau E. Neuromuscular training based on whole body vibration in children with spina bifida: a retrospective analysis of a new physiotherapy treatment program. Childs Nerv Syst 2015; 31:301-9. [PMID: 25370032 DOI: 10.1007/s00381-014-2577-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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] [Received: 10/13/2014] [Accepted: 10/20/2014] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Spina bifida is the most common congenital cause of spinal cord lesions resulting in paralysis and secondary conditions like osteoporosis due to immobilization. Physiotherapy is performed for optimizing muscle function and prevention of secondary conditions. Therefore, training of the musculoskeletal system is one of the major aims in the rehabilitation of children with spinal cord lesions. INTERVENTION AND METHODS The neuromuscular physiotherapy treatment program Auf die Beine combines 6 months of home-based whole body vibration (WBV) with interval blocks at the rehabilitation center: 13 days of intensive therapy at the beginning and 6 days after 3 months. Measurements are taken at the beginning (M0), after 6 months of training (M6), and after a 6-month follow-up period (M12). Gait parameters are assessed by ground reaction force and motor function by the Gross Motor Function Measurement (GMFM-66). Sixty children (mean age 8.71 ± 4.7 years) who participated in the program until February 2014 were retrospectively analyzed. RESULTS Walking velocity improved significantly by 0.11 m/s (p = 0.0026) and mobility (GMFM-66) by 2.54 points (p = 0.001) after the training. All changes at follow-up were not significant, but significant changes were observed after the training period. Decreased contractures were observed with increased muscle function. CONCLUSION Significant improvements in motor function were observed after the active training period of the new neuromuscular training concept. This first analysis of the new neuromuscular rehabilitation concept Auf die Beine showed encouraging results for a safe and efficient physiotherapy treatment program which increases motor function in children with spina bifida.
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Affiliation(s)
- C Stark
- Children's Hospital, University of Cologne, Cologne, Germany,
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Fiedler F, Stark C, Mueller S. Track F. New developments in monitoring. BIOMED ENG-BIOMED TE 2015; 60 Suppl 1:s118-31. [DOI: 10.1515/bmt-2015-5005] [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: 11/15/2022]
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Hoyer-Kuhn H, Semler O, Stark C, Struebing N, Goebel O, Schoenau E. A specialized rehabilitation approach improves mobility in children with osteogenesis imperfecta. J Musculoskelet Neuronal Interact 2014; 14:445-453. [PMID: 25524970] [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: 06/04/2023]
Abstract
OBJECTIVE Osteogenesis imperfecta (OI) is a rare disease leading to recurrent fractures, hyperlaxicity of ligaments, short stature and muscular weakness. Physiotherapy is one important treatment approach. The objective of our analysis was to evaluate the effect of a new physiotherapy approach including side alternating whole body vibration on motor function in children with OI. METHODS In a retrospective analysis data of 53 children were analyzed. The 12 months approach included 6 months of side alternating whole body vibration training, concomitant physiotherapy, resistance training, treadmill training and 6 months follow up. Primary outcome parameter was the Gross Motor Function Measure after 12 months (M12). RESULTS 53 children (male: 32; age (mean±SEM): 9.1±0.61, range 2.54-24.81 years) participated in the treatment approach. A significant increase of motor function (GMFM-66 score 55.47±2.45 to 58.67±2.83; p=0.001) and walking distance (47.04 m±6.52 to 63.36±8.25 m (p<0.01) between M0 and M12 was seen. Total body without head bone mineral density increased significantly at M12 (p=0.0189). CONCLUSIONS In the cohort of OI children which participated in the specialized treatment approach improvements of motor function were observed. Therefore this program should be considered as additional therapeutic approach for children with severe OI.
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Affiliation(s)
- H Hoyer-Kuhn
- Children's Hospital, University of Cologne, Cologne, Germany
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Stark C, Hoyer-Kuhn H, Knoop K, Schoenau H, Schoenau E, Semler O. [Secondary forms of osteoporosis. Special features of diagnostics in childhood and adolescence]. Z Rheumatol 2014; 73:335-41. [PMID: 24714928 DOI: 10.1007/s00393-013-1326-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Rheumatic diseases in childhood and adolescence can lead to secondary osteoporosis based on various pathophysiologies. The underlying disease, medication and immobility resulting in a reduced osteoanabolic stimulus contribute to the development of a fragile skeletal system. For diagnostic purposes dual-energy X-ray absorptiometry (DXA) is the most frequently used technology. For interpretation of the areal bone mineral density, age and gender matched reference data have to be used. Particularly in the pediatric field, body height must additionally be taken into consideration. Further techniques which can provide detailed information are peripheral quantitative computed tomography and high resolution magnetic resonance imaging. Nowadays, skeletal assessments have to be interpreted in the context of the muscular system. The concept of the functional muscle-bone unit is widely accepted and uses the muscles as the dominating factor. In a second step the adaptation of the skeletal system to the applied muscle force is evaluated. This allows a differentiation between primary and secondary skeletal diseases depending on the ratio of muscles to bone. Therapeutic options for secondary osteoporosis include reduction of the causative medication, treatment of the underlying disease, antiresorptive treatment with bisphosphonates and different programs to activate the muscles. A multimodal interval rehabilitation program including alternating side vibration shows positive effects on mobility, muscle function and bone mass in children and adolescents.
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Affiliation(s)
- C Stark
- Klinik für Kinder- und Jugendmedizin, Uniklinik Köln, Kerpener Str. 62, 50931, Köln, Deutschland
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Sapp JC, Dong D, Stark C, Ivey LE, Hooker G, Biesecker LG, Biesecker BB. Parental attitudes, values, and beliefs toward the return of results from exome sequencing in children. Clin Genet 2013; 85:120-6. [PMID: 24033230 DOI: 10.1111/cge.12254] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 08/13/2013] [Accepted: 08/13/2013] [Indexed: 12/18/2022]
Abstract
Exome sequencing is being offered for children with undiagnosed conditions to identify a primary (causative) variant. Parental preferences for learning secondary (incidental) variants are largely unexplored. Our objective was to characterize values and beliefs that shape parents' preferences for learning their children's sequencing results. We conducted semi-structured interviews with 25 parents of 13 minor probands with a variety of rare genetic conditions. Parents were asked to discuss their preferences to receive four types of results from exome sequencing. Many parents preferred to receive all types of results. Parents had the most positive attitudes toward learning about variants that predispose to disorders treatable or preventable in childhood. They had reservations about learning about predispositions for untreatable adult-onset conditions and carrier status for recessive conditions. Parents described their success in coping with their child's condition as evidence for an ability to manage any additional negative health information. They felt responsible for learning about secondary variants, desiring a gain in control over their child's health. Our findings suggest that investigators should incorporate parents' perceptions of the value in receiving secondary variant information about their children when designing studies employing exome sequencing.
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Affiliation(s)
- J C Sapp
- Genetic Diseases Research Branch
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Honka H, Mäkinen J, Hannukainen JC, Tarkia M, Oikonen V, Teräs M, Fagerholm V, Ishizu T, Saraste A, Stark C, Vähäsilta T, Salminen P, Kirjavainen A, Soinio M, Gastaldelli A, Knuuti J, Iozzo P, Nuutila P. Validation of [18F]fluorodeoxyglucose and positron emission tomography (PET) for the measurement of intestinal metabolism in pigs, and evidence of intestinal insulin resistance in patients with morbid obesity. Diabetologia 2013; 56:893-900. [PMID: 23334481 DOI: 10.1007/s00125-012-2825-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 12/17/2012] [Indexed: 01/09/2023]
Abstract
AIMS/HYPOTHESIS The role of the intestine in the pathogenesis of metabolic diseases is gaining much attention. We therefore sought to validate, using an animal model, the use of positron emission tomography (PET) in the estimation of intestinal glucose uptake (GU), and thereafter to test whether intestinal insulin-stimulated GU is altered in morbidly obese compared with healthy human participants. METHODS In the validation study, pigs were imaged using [(18)F]fluorodeoxyglucose ([(18)F]FDG) and the image-derived data were compared with corresponding ex vivo measurements in tissue samples and with arterial-venous differences in glucose and [(18)F]FDG levels. In the clinical study, GU was measured in different regions of the intestine in lean (n = 8) and morbidly obese (n = 8) humans at baseline and during euglycaemic hyperinsulinaemia. RESULTS PET- and ex vivo-derived intestinal values were strongly correlated and most of the fluorine-18-derived radioactivity was accumulated in the mucosal layer of the gut wall. In the gut wall of pigs, insulin promoted GU as determined by PET, the arterial-venous balance or autoradiography. In lean human participants, insulin increased GU from the circulation in the duodenum (from 1.3 ± 0.6 to 3.1 ± 1.1 μmol [100 g](-1) min(-1), p < 0.05) and in the jejunum (from 1.1 ± 0.7 to 3.0 ± 1.5 μmol [100 g](-1) min(-1), p < 0.05). Obese participants failed to show any increase in insulin-stimulated GU compared with fasting values (NS). CONCLUSIONS/INTERPRETATION Intestinal GU can be quantified in vivo by [(18)F]FDG PET. Intestinal insulin resistance occurs in obesity before the deterioration of systemic glucose tolerance.
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Affiliation(s)
- H Honka
- Turku PET Centre, University of Turku, PL 52, FIN-20520 Turku, Finland
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Stark C, Innes A, Szymczynska P, Forrest L, Proctor K. Dementia knowledge transfer project in a rural area. Rural Remote Health 2013; 13:2060. [PMID: 23351122] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Rural Scotland has an ageing population. There has been an increase in the number of people with dementia and as the proportion of people aged over 75 years continues to rise, this will increase still further. The Scottish Government has produced a dementia strategy and implementing this will be a challenge for rural Scotland. METHODS Transferring academic knowledge into practice is challenging. A Knowledge Transfer Partnership was formed between NHS Highland and the University of Stirling. A literature review was undertaken of the rural dementia literature; local services were surveyed and described; and interviews were undertaken with people with dementia and carers. Work was conducted on training, diagnostic service provision and local policy. Throughout the project, a collaborative approach was used, which aimed at the joint production of knowledge. RESULTS Involving University staff in local service development had a substantial impact. Reviewing existing research knowledge and setting it in the context of local services, and of experience of service use, allowed the relevant priorities to be identified. As well as identifying training needs and providing training, the work influenced local decisions on diagnostic service design and standards, and on policy. CONCLUSION This embedded engagement model appeared to produce more rapid change than traditional models of use of academic knowledge.
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Affiliation(s)
- C Stark
- Centre for Rural Health, University of Aberdeen, Inverness, Scotland
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Faustino A, Paiva L, Providencia R, Barra S, Trigo J, Botelho A, Costa G, Costa M, Leitao-Marques A, Haavisto M, Tarkia M, Stark C, Vahasilta T, Savunen T, Strandberg M, Lepomaki V, Saukko P, Saraste A, Knuuti J, Dieden A, Bech-Hanssen O, Cameli M, Lisi M, D'ascenzi F, Losito M, Sparla S, Righini F, Menci D, Favilli R, Fineschi M, Mondillo S, Eindhoven J, Van Den Bosch A, Cuypers J, Witsenburg M, Boersma E, Roos-Hesselink J, Jalanko M, Jaaskelainen P, Laine M, Nieminen M, Laakso M, Helio T, Kuusisto J, Marchel M, Kochanowski J, Piatkowski R, Serafin A, Madej A, Filipiak K, Hausmanowa-Petrusewicz I, Opolski G, Dipietro E, Di Panzillo EA, Crispo S, Spinelli L, Buccheri S, Leggio S, Monte I, Bottari V, Blundo A, Licciardi S, Tamburino C, Cameli M, Righini F, Lisi M, Galderisi M, Mondillo S, Maksuti E, Widman E, Larsson M, Bjallmark A, Caidahl K, D'hooge J, Michalski B, Szymczyk E, Westfal B, Simiera M, Lipiec P, Kasprzak J, Simova I, Katova T, Haralanov L, Hong S, Lee Y, Lee J, Ryu J, Choi J, Chang S, Kim K, Montoro Lopez M, Gemma D, Lopez Fernandez T, De Celix MGR, Ramirez U, Mesa J, De Torres Alba F, Iniesta Manjavacas A, Moreno Yanguela M, Lopez Sendon J, Acosta Velez J, Rodriguez Palomares J, Gisela Teixido G, Gutierrez L, Gonzalez-Alujas T, Carro A, Moral S, Evangelista A, Garcia-Dorado D, Piazzese C, Sotaquira M, Kronzon I, Lang R, Caiani E. Club 35 Poster Session Thursday 6 December: Intracardiac flows and pressures. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes253] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
BACKGROUND The perinatal or early life environment may influence the development of mental illness in adulthood. It is not clear how, or when, any such influences might be mediated. Foetal exposure to maternal stress in the intrauterine environment has been suggested as a possible mediator of foetal origins of mental illness but the postnatal environment may also be of importance. This study aimed to test the foetal origins hypothesis by using retrograde and antegrade interbirth intervals (time to mother's most recent and next deliveries respectively) as proxy measures of antenatal and postnatal maternal stress. METHOD Linked datasets of the Scottish Morbidity Record (SMR) were used to identify a birth cohort. Where applicable, the dates of each mother's most recent previous and/or next subsequent delivery were noted, allowing birth intervals to be calculated. The cohort was followed up into young adulthood, using self-harm, substance misuse, psychotic disorder and affective disorder as outcome measures. Data were analysed using Cox regression. RESULTS No significant relationship was observed between affective disorders and interbirth interval, neither retrograde nor antegrade. Short (<18-month) antegrade birth intervals were independently associated with increased risk of psychotic disorder and self-harm. Long (>72-month) retrograde intervals were associated with increased risk of self-harm and substance misuse. CONCLUSIONS The data do not provide evidence for the foetal origins of mental disorders but, in the cases of psychotic disorders, and of self-harm, suggest that the early postnatal rather than the antenatal environment may be of greater importance.
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Gutman JA, Miller S, Kuenne S, Oppenheim J, Quinones R, Freed BM, Stark C, Zarlengo G. Cord blood collection after cesarean section improves banking efficiency. Transfusion 2011; 51:2050-1. [DOI: 10.1111/j.1537-2995.2011.03249.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bakker A, Krauss G, Albert M, Stark C, Bassett S, Gallagher M. P4‐349: Clinical efficacy of low dose levetiracetam for hippocampal hyperactivity in amnestic mild cognitive impairment. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.09.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Arnold Bakker
- Johns Hopkins UniversityBaltimoreMarylandUnited States
| | - Gregory Krauss
- Johns Hopkins University School of MedicineBaltimoreMarylandUnited States
| | - Marilyn Albert
- Johns Hopkins University School of MedicineBaltimoreMarylandUnited States
| | - Craig Stark
- University of California at IrvineIrvineCaliforniaUnited States
| | - Susan Bassett
- Johns Hopkins UniversityBaltimoreMarylandUnited States
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Stark C, Nikopoulou-Smyrni P, Stabrey A, Semler O, Schoenau E. Effect of a new physiotherapy concept on bone mineral density, muscle force and gross motor function in children with bilateral cerebral palsy. J Musculoskelet Neuronal Interact 2010; 10:151-158. [PMID: 20516632] [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: 05/29/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the effect of a new physiotherapy concept on bone density, muscle force and motor function in bilateral spastic cerebral palsy children. METHODS In a retrospective data analysis 78 children were analysed. The concept included whole body vibration, physiotherapy, resistance training and treadmill training. The concept is structured in two in-patient stays and two periods of three months home-based vibration training. Outcome measures were dual-energy x-ray absorption (DXA), Leonardo Tilt Table and a modified Gross Motor Function Measure before and after six months of training. RESULTS Percent changes were highly significant for bone mineral density, -content, muscle mass and significant for angle of verticalisation, muscle force and modified Gross Motor Function Measure after six months training. CONCLUSIONS The new physiotherapy concept had a significant effect on bone mineral density, muscle force and gross motor function in bilateral spastic cerebral palsy children. This implicates an amelioration in all International Classification of Functioning, Disability and Health levels. The study serves as a basis for future research on evidence based paediatric physiotherapy taking into account developmental implications.
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Affiliation(s)
- C Stark
- Brunel University of West London, School of Health Science and Social Care, UK.
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Hennenberg M, Trebicka J, Stark C, Kohistani AZ, Heller J, Sauerbruch T. Sorafenib targets dysregulated Rho kinase expression and portal hypertension in rats with secondary biliary cirrhosis. Br J Pharmacol 2009; 157:258-70. [PMID: 19338580 DOI: 10.1111/j.1476-5381.2009.00158.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND PURPOSE Extrahepatic vasodilation and increased intrahepatic vascular resistance represent attractive targets for the medical treatment of portal hypertension in liver cirrhosis. In both dysfunctions, dysregulation of the contraction-mediating Rho kinase plays an important role as it contributes to altered vasoconstrictor responsiveness. However, the mechanisms of vascular Rho kinase dysregulation in cirrhosis are insufficiently understood. They possibly involve mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK)-dependent mechanisms in extrahepatic vessels. As the multikinase inhibitor sorafenib inhibits ERK, we tested the effect of sorafenib on haemodynamics and dysregulated vascular Rho kinase in rats with secondary biliary cirrhosis. EXPERIMENTAL APPROACH Secondary biliary cirrhosis was induced by bile duct ligation (BDL). Sorafenib was given orally for 1 week (60 mg.kg(-1).d(-1)). Messenger RNA levels were determined by quantitative real time polymerase chain reaction, protein expressions and protein phosphorylation by Western blot analysis. Aortic contractility was studied by myographic measurements, and intrahepatic vasoregulation by using livers perfused in situ. In vivo, haemodynamic parameters were assessed invasively in combination with coloured microspheres. KEY RESULTS In BDL rats, treatment with sorafenib decreased portal pressure, paralleled by decreases in hepatic Rho kinase expression and Rho kinase-mediated intrahepatic vascular resistance. In aortas from BDL rats, sorafenib caused up-regulation of Rho kinase and an improvement of aortic contractility. By contrast, mesenteric Rho kinase remained unaffected by sorafenib. CONCLUSIONS AND IMPLICATIONS Intrahepatic dysregulation of vascular Rho kinase expression is controlled by sorafenib-sensitive mechanisms in rats with secondary biliary cirrhosis. Thus, sorafenib reduced portal pressure without affecting systemic blood pressure.
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Affiliation(s)
- M Hennenberg
- Department of Internal Medicine I, University of Bonn, Germany.
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Abstract
PRIMARY OBJECTIVE The purpose of this study was to explore and extend previous findings that training with variant items improves generalization performance on novel semantic sentences in an individual with amnesia. RESEARCH DESIGN A case study of an individual with severe amnesia, Patient T.E., who participated in an extended training and multiple testing paradigm. METHODS AND PROCEDURES Patient T.E. participated in 16 training sessions and eight test sessions on his recognition and recall performance for novel 3-word sentences. Three conditions were compared: No Variance (one version of each sentence studied), Early Variance (three versions of each sentence studied from the onset) and Late Variance (each of three versions of each sentence gradually introduced throughout training). Performance on studied items and semantically related items was evaluated. MAIN OUTCOMES AND RESULTS Patient T.E. demonstrated better learning for Variance items than No Variance items and better generalization to semantically related items for the Late Variance condition. However, he showed an advantage for the No Variance condition on the recall task. CONCLUSIONS Gradually introducing the variant items into training may be the optimal strategy for training an individual with severe amnesia to learn and generalize new semantic information.
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Affiliation(s)
- Shauna Stark
- Department of Neurology, Cognitive Neurology/Neuropsychology, Johns Hopkins University, Baltimore, MD, USA.
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Mihaylov S, Stark C, McColl E, Steen N, Vanoli A, Rubin G, Curless R, Barton R, Bond J. Stepped treatment of older adults on laxatives. The STOOL trial. Health Technol Assess 2008; 12:iii-iv, ix-139. [DOI: 10.3310/hta12130] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - J Bond
- Clinical Trials Unit, Institute of Health and Society, Newcastle University, UK
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Semler O, Fricke O, Vezyroglou K, Stark C, Schoenau E. Preliminary results on the mobility after whole body vibration in immobilized children and adolescents. J Musculoskelet Neuronal Interact 2007; 7:77-81. [PMID: 17396011] [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: 05/14/2023]
Abstract
The present article is a preliminary report on the effect of Whole Body Vibration (WBV) on the mobility in long-term immobilized children and adolescents. WBV was applied to 6 children and adolescents (diagnoses: osteogenesis imperfecta, N=4; cerebral palsy, N=1; dysraphic defect of the lumbar spine, N=1) over a time period of 6 months. WBV was applied by a vibrating platform constructed on a tilt-table. The treatment effect was measured by alternations of the tilt-angle of the table and with the "Brief assessment of motor function" (BAMF). All 6 individuals were characterized by an improved mobility, which was documented by an increased tilt-angle or an improved BAMF-score. The authors concluded WBV might be a promising approach to improve mobility in severely motor-impaired children and adolescents. Therefore, the Cologne Standing-and-Walking- Trainer powered by Galileo is a suitable therapeutic device to apply WBV in immobilized children and adolescents.
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Affiliation(s)
- O Semler
- Children's Hospital, University of Cologne, Cologne, Germany
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Stark C, Liepelt S, Dieckvoss M, Bartsch D, Ziegenhagen B, Ulrich A. Fast and Simple Monitoring of Introgressive Gene Flow from Wild Beet into Sugarbeet. ACTA ACUST UNITED AC 2006. [DOI: 10.5274/jsbr.43.4.145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Stark C, Gibbs D, Hopkins P, Belbin A, Hay A, Selvaraj S. Suicide in farmers in Scotland. Rural Remote Health 2006; 6:509. [PMID: 16563050] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
INTRODUCTION Farmers and farm workers have higher than expected rates of suicide and undetermined deaths in UK studies, and some rural areas of Scotland have higher than average male suicide rates. Firearm access seems to be an influencing factor in England and Wales. Type of farming, and farming social networks may also be important. This article describes suicide and undetermined deaths in male farmers and farm workers in Scotland from 1981-1999 using anonymised, routine data. METHOD Deaths of men aged 15-74 years from suicide or undetermined cause were identified from anonymised Scottish death records. Farmers and farm workers were identified using occupation codes. Methods of suicide used by farmers were compared with those of the general male population of the same age. A multiple linear regression was used to examine the influence of farm type, and the proportion of farmers in the working population of an area. RESULTS 307 male farmers or farm workers died by suicide or undetermined cause in the time period. The overall rate was 31.4/100,000 per year (95% CI 28.1-35.1). Deaths using firearms were over-represented (29% of farming deaths compared with 3.6% in the general male population). There was no significant association between the male suicide rate in an area, and the farming suicide rate. Areas with lower proportions of farmers tended to have higher rates of farming suicide and undetermined deaths. This one factor described 85% of the variance among areas. CONCLUSION Deaths were substantially more likely to involve firearms than suicide and undetermined deaths in the general male population. Less use of other methods did not completely compensate for this, indicating that method availability is likely to contribute to farming suicide rates. Farmers in areas where farming is less common were more likely to die by suicide, and this described most of the differences among areas. Networks and social supports may be important protective factors for farmers.
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Affiliation(s)
- C Stark
- Centre for Rural Health, University of Aberdeen, The Green House, Beechwood Business Park North, Inverness, Scotland.
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Miller MI, Beg MF, Ceritoglu C, Stark C. Increasing the power of functional maps of the medial temporal lobe by using large deformation diffeomorphic metric mapping. Proc Natl Acad Sci U S A 2005; 102:9685-90. [PMID: 15980148 PMCID: PMC1172268 DOI: 10.1073/pnas.0503892102] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The functional magnetic resonance imagery responses of declarative memory tasks in the medial temporal lobe (MTL) are examined by using large deformation diffeomorphic metric mapping (LDDMM) to remove anatomical variations across subjects. LDDMM is used to map the structures of the MTL in multiple subjects into extrinsic atlas coordinates; these same diffeomorphic mappings are used to transfer the corresponding functional data activation to the same extrinsic coordinates. The statistical power in the averaged LDDMM mapped signals is significantly increased over conventional Talairach-Tournoux averaging. Activation patterns are highly localized within the MTL. Whereas the present demonstration has been aimed at enhancing alignment within the MTL, this technique is general and can be applied throughout the brain.
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Affiliation(s)
- Michael I Miller
- Center for Imaging Science, The Whiting School of Engineering, The Johns Hopkins University, 301 Clark Hall, Baltimore, MD 21218, USA.
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Abstract
New learning of semantic information is impaired in amnesia. Several reports have demonstrated that "errorless" learning techniques have allowed patients with amnesia to acquire at least some form of new semantic information, although this information appears to be relatively inflexible. Using insights and principles from connectionist modeling of cortical and medial temporal lobe memory systems, the authors describe why errorless learning procedures act as a poor proxy for the medial temporal lobe, suggesting that they artificially eliminate the variability that defines semantic information. The authors trained a patient with severe amnesia on new semantic sentences both with and without variance and then tested him on both repeated and related novel sentences to assess generalization. He successfully learned new semantic information in both conditions but demonstrated better generalization of semantic concepts following training with variance.
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Affiliation(s)
- Craig Stark
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, MD 21218, USA.
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Abstract
The media is an important source of public information on mental ill-health. A man with a serious psychiatric illness attacked a minister with a knife at a Remembrance Sunday service in a remote, rural part of the Highlands, inflicting a severe facial wound. We aimed to identify lessons for the National Health Service (NHS) from the media coverage of the incident and of a subsequent court case and NHS Highland inquiry and in addition to explore how newspaper reporters approached reporting such incidents. We searched local and regional, national Scottish, and the Scottish editions of three UK newspapers for relevant coverage. We also conducted structured telephone interviews with eight reporters who had attended the inquiry press conference. Most of the media coverage was associated with the assault and the court case, rather than the inquiry results. Only three of 10 inquiry recommendations were mentioned in any reports. Coverage largely dealt with identified shortfalls, rather than proposed solutions. The NHS had made little comment in advance of the announcement of the inquiry results. Most of the newspaper coverage had already occurred. The NHS therefore limited its opportunity to influence newspaper coverage. The interpretation of the results is limited by the size of the study, but the coverage of such events forms part of the discourse on mental health in the media episodes and may have some affect on public perception of mental health issues. We conclude that, without providing confidential information, the NHS should take a more active stance in providing information on the nature and treatment of mental illness in such instances, even in advance of court cases.
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Affiliation(s)
- C Stark
- Consultant in Public Health, Highland NHS Board Assynt House, Inverness and Honorary Senior Lecturer, Highlands and Islands Health Research Institute, University of Aberdeen, Aberdeen, UK
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Jorgensen P, Breitkreutz BJ, Breitkreutz K, Stark C, Liu G, Cook M, Sharom J, Nishikawa JL, Ketela T, Bellows D, Breitkreutz A, Rupes I, Boucher L, Dewar D, Vo M, Angeli M, Reguly T, Tong A, Andrews B, Boone C, Tyers M. Harvesting the genome's bounty: integrative genomics. Cold Spring Harb Symp Quant Biol 2004; 68:431-43. [PMID: 15338646 DOI: 10.1101/sqb.2003.68.431] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- P Jorgensen
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada M5G 1X5
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Abstract
We investigated the neural bases for false memory with fMRI by examining neural activity during retrieval processes that yielded true or false memories. We used a reality monitoring paradigm in which participants saw or imagined pictures of concrete objects. (A subsequent misinformation task was also used to increase false memory rates.) At test, fMRI data were collected as the participants determined whether they had seen or had only imagined the object at study. True memories were of seen pictures accurately endorsed as seen, and for false memories were of imagined pictures falsely endorsed as seen. Three distinct patterns of activity were observed: Left frontal and parietal activity was not different for true and for false memories, whereas activity was greater for true than for false memories in occipital visual regions and posterior portions of the parahippocampal gyrus, and activity was greater for false than for true memories in right anterior cingulate gyrus. Possible interpretations are discussed.
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Affiliation(s)
- Yoko Okado
- Johns Hopkins University, Baltimore, Maryland 21218, USA
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Stark C. The New Medical Conversation: Media, Patients, Doctors, and the Ethics of Scientific Communication. West J Med 2003. [DOI: 10.1136/bmj.327.7417.755-a] [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: 11/04/2022]
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Paterson B, Bradley P, Stark C, Saddler D, Leadbetter D, Allen D. Deaths associated with restraint use in health and social care in the UK. The results of a preliminary survey. J Psychiatr Ment Health Nurs 2003; 10:3-15. [PMID: 12558917 DOI: 10.1046/j.1365-2850.2003.00523.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Many aspects of the management of acutely disturbed behaviour have only relatively recently come under systematic scrutiny. Perhaps regrettably one of the last amongst the range of strategies that may be employed to be subjected to rigorous examination has been physical restraint. Considerable debate has recently taken place around what represents good practice in this sensitive and controversial area but the continuing dearth of research in some aspects of this area of practice has meant that this discussion has arguably been over reliant on 'expert' opinion. Questions continue regarding some fundamental issues of restraint, including the relative risks involved in alternative approaches, and anxieties have been expressed about the potential for injuries and death to result from restraint. This article outlines the results of a survey that sought to explore the incidence of deaths associated with restraint in health and social care settings in the UK. The outcome of an initial analysis of the cases identified is then discussed, with reference to the literature on restraint-related deaths, in order to identify the implications for practice.
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Affiliation(s)
- B Paterson
- Department of Nursing and Midwifery, University of Stirling, UK.
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Stark C. Book: Reckoning with Risk: Learning to Live with Uncertainty. West J Med 2002. [DOI: 10.1136/bmj.325.7377.1426] [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: 11/04/2022]
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Stark C. Book: Demon Doctors: Physicians as Serial Killers. West J Med 2002. [DOI: 10.1136/bmj.325.7367.781] [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: 11/03/2022]
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Stark C, Matthewson F, O'Neill N, Oates K, Hay A. Suicide in the Highlands of Scotland. Health Bull (Edinb) 2002; 60:27-32. [PMID: 12664765] [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: 03/01/2023]
Abstract
OBJECTIVE The Highlands have one of the highest suicide rates in Scotland. This paper describes suicide and deliberate self-harm in the Highlands in the last 20 years and explores possible reasons for the differences from the Scottish average. DESIGN Retrospective analysis of routine data from the SMRI/SMR01 scheme and information on deaths from the Registrar General. Suicide and undetermined deaths were combined in the analysis. SETTING Highland and Scotland 1978-98. RESULTS The high rates in Highland are caused by an excess of male deaths. Highland has had consistently high male suicide rates over the 20 year period compared to Scotland. These differences do not disappear when deaths of non-Highland residents are excluded. By comparison, deliberate self-harm admissions follow a similar pattern to Scotland as a whole. Causes of death differed from Scotland as a whole, with an over-representation of drowning, gases and firearm deaths. CONCLUSION Highland suicide rates are elevated compared to Scotland. This is mainly due to an excess of deaths in men up to the age of 74 years, and is not accounted for by deaths of non-residents. Female deaths are not elevated in comparison to the rest of Scotland. Male attempted suicide rates do not differ from Scotland. Lethality of method--drowning, car exhausts and firearms--may contribute to the elevated male death rates.
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Affiliation(s)
- C Stark
- Highland NHS Board, Assynt House, Beechwood Park, Inverness
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Abstract
Violence perpetrated by people experiencing mental illness poses a continuing challenge to practitioners and policy makers in the mental health field. It has been suggested, however, that policy developments in England during the period 1990--2000 became unduly dominated by the perceived need to prevent such violence and in particular that a 'moral panic' occurred following a series of high profile homicides perpetrated by people experiencing mental illness. This paper critically examines the ability of the moral panic theory to offer a cogent explanation of the relationship between media representations, public perceptions and developments in both social policy and legislation during the last decade. Its conclusions, however, suggest that the evidence does not support assertions of a moral panic and that of moral panic theory itself has serious flaws. Ultimately the paper suggests that we must look elsewhere, particularly to Foucault's conceptualization of discourse and to the work of Birkland, an American political theorist, in our search for an understanding of the relationship between events, ideas and social policy.
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Affiliation(s)
- B Paterson
- Department of Nursing and Midwifery, University of Stirling, UK
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