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Jünemann K, Engels A, Marie D, Worschech F, Scholz DS, Grouiller F, Kliegel M, Van De Ville D, Altenmüller E, Krüger THC, James CE, Sinke C. Increased functional connectivity in the right dorsal auditory stream after a full year of piano training in healthy older adults. Sci Rep 2023; 13:19993. [PMID: 37968500 PMCID: PMC10652022 DOI: 10.1038/s41598-023-46513-1] [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: 06/03/2022] [Accepted: 11/02/2023] [Indexed: 11/17/2023] Open
Abstract
Learning to play an instrument at an advanced age may help to counteract or slow down age-related cognitive decline. However, studies investigating the neural underpinnings of these effects are still scarce. One way to investigate the effects of brain plasticity is using resting-state functional connectivity (FC). The current study compared the effects of learning to play the piano (PP) against participating in music listening/musical culture (MC) lessons on FC in 109 healthy older adults. Participants underwent resting-state functional magnetic resonance imaging at three time points: at baseline, and after 6 and 12 months of interventions. Analyses revealed piano training-specific FC changes after 12 months of training. These include FC increase between right Heschl's gyrus (HG), and other right dorsal auditory stream regions. In addition, PP showed an increased anticorrelation between right HG and dorsal posterior cingulate cortex and FC increase between the right motor hand area and a bilateral network of predominantly motor-related brain regions, which positively correlated with fine motor dexterity improvements. We suggest to interpret those results as increased network efficiency for auditory-motor integration. The fact that functional neuroplasticity can be induced by piano training in healthy older adults opens new pathways to countervail age related decline.
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Affiliation(s)
- Kristin Jünemann
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Anna Engels
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Damien Marie
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- CIBM Center for Biomedical Imaging, MRI UNIGE, University of Geneva, Geneva, Switzerland
| | - Florian Worschech
- Center for Systems Neuroscience, Hannover, Germany
- Institute of Music Physiology and Musicians' Medicine, Hannover University of Music, Drama and Media, Hannover, Germany
| | - Daniel S Scholz
- Institute of Medical Psychology, University of Lübeck, Lübeck, Germany
- Department of Musicians' Health, University of Music Lübeck, Lübeck, Germany
| | - Frédéric Grouiller
- CIBM Center for Biomedical Imaging, MRI UNIGE, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Dimitri Van De Ville
- Neuro-X Institute, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Eckart Altenmüller
- Center for Systems Neuroscience, Hannover, Germany
- Institute of Music Physiology and Musicians' Medicine, Hannover University of Music, Drama and Media, Hannover, Germany
| | - Tillmann H C Krüger
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Clara E James
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Christopher Sinke
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
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Marie D, Müller CA, Altenmüller E, Van De Ville D, Jünemann K, Scholz DS, Krüger TH, Worschech F, Kliegel M, Sinke C, James CE. Music interventions in 132 healthy older adults enhance cerebellar grey matter and auditory working memory, despite general brain atrophy. Neuroimage: Reports 2023. [DOI: 10.1016/j.ynirp.2023.100166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Worschech F, James CE, Jünemann K, Sinke C, Krüger THC, Scholz DS, Kliegel M, Marie D, Altenmüller E. Fine motor control improves in older adults after one year of piano lessons: Analysis of individual development and its coupling with cognition and brain structure. Eur J Neurosci 2023. [PMID: 37143214 DOI: 10.1111/ejn.16031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 05/06/2023]
Abstract
Musical training can improve fine motor skills, cognitive abilities and induce macrostructural brain changes. However, it is not clear whether the changes in motor skills occur simultaneously with changes in cognitive and neurophysiological parameters. In this study, 156 healthy, musically naïve, and right-handed older adults were recruited and randomly assigned to a piano training or a music listening group. Before, after six and twelve months participants were scanned using MRI and assessed for fine motor skills, auditory working memory and processing speed. A Bayesian multilevel modeling approach was used to examine behavioral and neurophysiological group differences. The relationships between motor and cognitive and between motor and neurophysiological parameters were determined using latent change score models. Compared to music listening, practicing piano resulted in greater improvement in fine motor skills and probably working memory. Only in the piano group, unimanual fine motor skills and gray matter volume of the contralateral M1 changed together during the 6-12-month period. Additionally, M1 co-developed with ipsilateral putamen and thalamus. Playing piano induced more prevalent coupling between the motor and cognitive domain. However, there is little evidence that fine motor control develops concurrently with cognitive functions. Playing an instrument promotes motor, cognitive and neural development into older age. During the learning process, the consolidation of piano skills appears to take place in sensorimotor networks, enabling musicians to perform untrained motor tasks with higher acuity. Relationships between the development of motor acuity and cognition were bidirectional and can be explained by a common cause as well as by shared resources with compensatory mechanisms.
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Affiliation(s)
- Florian Worschech
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
- Center for Systems Neuroscience, Hanover, Germany
| | - Clara E James
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland HES- SO, Geneva, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
| | - Kristin Jünemann
- Center for Systems Neuroscience, Hanover, Germany
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Christopher Sinke
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Tillmann H C Krüger
- Center for Systems Neuroscience, Hanover, Germany
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Daniel S Scholz
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
- Center for Systems Neuroscience, Hanover, Germany
| | - Matthias Kliegel
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Damien Marie
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland HES- SO, Geneva, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
| | - Eckart Altenmüller
- Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
- Center for Systems Neuroscience, Hanover, Germany
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Osmonov D, Ragheb A, Romero-Otero JR, Bettocchi CB, van Renterghem K, Jünemann K, Wilson S. To drain or not to drain an inflatable penile prosthesis implantation? A multi-institutional experience tracking scrotal hematoma and infection occurrence. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Worschech F, Altenmüller E, Jünemann K, Sinke C, Krüger THC, Scholz DS, Müller CAH, Kliegel M, James CE, Marie D. Evidence of cortical thickness increases in bilateral auditory brain structures following piano learning in older adults. Ann N Y Acad Sci 2022; 1513:21-30. [PMID: 35292982 DOI: 10.1111/nyas.14762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/03/2022] [Indexed: 12/25/2022]
Abstract
Morphological differences in the auditory brain of musicians compared to nonmusicians are often associated with life-long musical activity. Cross-sectional studies, however, do not allow for any causal inferences, and most experimental studies testing music-driven adaptations investigated children. Although the importance of the age at which musical training begins is widely recognized to impact neuroplasticity, there have been few longitudinal studies examining music-related changes in the brains of older adults. Using magnetic resonance imaging, we measured cortical thickness (CT) of 12 auditory-related regions of interest before and after 6 months of musical instruction in 134 healthy, right-handed, normal-hearing, musically-naive older adults (64-76 years old). Prior to the study, all participants were randomly assigned to either piano training or to a musical culture/music listening group. In five regions-left Heschl's gyrus, left planum polare, bilateral superior temporal sulcus, and right Heschl's sulcus-we found an increase in CT in the piano training group compared with the musical culture group. Furthermore, CT of the right Heschl's gyrus could be identified as a morphological substrate supporting speech in noise perception. The results support the conclusion that playing an instrument is an effective stimulator for cortical plasticity, even in older adults.
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Affiliation(s)
- Florian Worschech
- Institute for Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany.,Center for Systems Neuroscience, Hanover, Germany
| | - Eckart Altenmüller
- Institute for Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany.,Center for Systems Neuroscience, Hanover, Germany
| | - Kristin Jünemann
- Center for Systems Neuroscience, Hanover, Germany.,Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Christopher Sinke
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Tillmann H C Krüger
- Center for Systems Neuroscience, Hanover, Germany.,Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Daniel S Scholz
- Institute for Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany.,Center for Systems Neuroscience, Hanover, Germany
| | - Cécile A H Müller
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland HES-SO, Geneva, Switzerland
| | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Clara E James
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland HES-SO, Geneva, Switzerland.,Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Damien Marie
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland HES-SO, Geneva, Switzerland.,Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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Jünemann K, Marie D, Worschech F, Scholz DS, Grouiller F, Kliegel M, Van De Ville D, James CE, Krüger THC, Altenmüller E, Sinke C. Six Months of Piano Training in Healthy Elderly Stabilizes White Matter Microstructure in the Fornix, Compared to an Active Control Group. Front Aging Neurosci 2022; 14:817889. [PMID: 35242025 PMCID: PMC8886041 DOI: 10.3389/fnagi.2022.817889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/06/2022] [Indexed: 12/31/2022] Open
Abstract
While aging is characterized by neurodegeneration, musical training is associated with experience-driven brain plasticity and protection against age-related cognitive decline. However, evidence for the positive effects of musical training mostly comes from cross-sectional studies while randomized controlled trials with larger sample sizes are rare. The current study compares the influence of six months of piano training with music listening/musical culture lessons in 121 musically naïve healthy elderly individuals with regard to white matter properties using fixel-based analysis. Analyses revealed a significant fiber density decline in the music listening/musical culture group (but not in the piano group), after six months, in the fornix, which is a white matter tract that naturally declines with age. In addition, these changes in fiber density positively correlated to episodic memory task performances and the amount of weekly piano training. These findings not only provide further evidence for the involvement of the fornix in episodic memory encoding but also more importantly show that learning to play the piano at an advanced age may stabilize white matter microstructure of the fornix.
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Affiliation(s)
- Kristin Jünemann
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany.,Center for Systems Neuroscience, Hanover, Germany
| | - Damien Marie
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland.,Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Florian Worschech
- Center for Systems Neuroscience, Hanover, Germany.,Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Daniel S Scholz
- Center for Systems Neuroscience, Hanover, Germany.,Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Frédéric Grouiller
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Dimitri Van De Ville
- Ecole Polytechnique Fédérale de Lausanne, Campus Biotech, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Campus Biotech, Geneva, Switzerland
| | - Clara E James
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland.,Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Tillmann H C Krüger
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany.,Center for Systems Neuroscience, Hanover, Germany
| | - Eckart Altenmüller
- Center for Systems Neuroscience, Hanover, Germany.,Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Christopher Sinke
- Division of Clinical Psychology & Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
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Ajina S, Jünemann K, Sahraie A, Bridge H. Increased Visual Sensitivity and Occipital Activity in Patients With Hemianopia Following Vision Rehabilitation. J Neurosci 2021; 41:5994-6005. [PMID: 34035137 PMCID: PMC8276743 DOI: 10.1523/jneurosci.2790-20.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/22/2021] [Accepted: 03/26/2021] [Indexed: 11/21/2022] Open
Abstract
Hemianopia, loss of vision in half of the visual field, results from damage to the visual pathway posterior to the optic chiasm. Despite negative effects on quality of life, few rehabilitation options are currently available. Recently, several long-term training programs have been developed that show visual improvement within the blind field, although little is known of the underlying neural changes. Here, we have investigated functional and structural changes in the brain associated with visual rehabilitation. Seven human participants with occipital lobe damage enrolled in a visual training program to distinguish which of two intervals contained a drifting Gabor patch presented within the blind field. Participants performed ∼25 min of training each day for 3-6 months and undertook psychophysical tests and a magnetic resonance imaging scan before and after training. A control group undertook psychophysical tests before and after an equivalent period without training. Participants who were not at ceiling on baseline tests showed on average 9.6% improvement in Gabor detection, 8.3% in detection of moving dots, and 9.9% improvement in direction discrimination after training. Importantly, psychophysical improvement only correlated with improvement in Humphrey perimetry in the trained region of the visual field. Whole-brain analysis showed an increased neural response to moving stimuli in the blind visual field in motion area V5/hMT. Using a region-of-interest approach, training had a significant effect on the blood oxygenation level-dependent signal compared with baseline. Moreover, baseline V5/hMT activity was correlated to the amount of improvement in visual sensitivity using psychophysical and perimetry tests. This study, identifying a critical role for V5/hMT in boosting visual function, may allow us to determine which patients may benefit most from training and design adjunct interventions to increase training effects.SIGNIFICANCE STATEMENT Homonymous visual field loss is a common consequence of brain injury and is estimated to affect more than 230,000 people in the United Kingdom. Despite its high prevalence and well-described impact on quality of life, treatments to improve visual sensitivity remain experimental, and deficits are considered permanent after 6 months. Our study shows that behavioral changes following vision rehabilitation are associated with enhanced visually-evoked occipital activity to stimuli in the blind visual field. Unlike previous behavioral studies, we observe clinical changes that are specific to the trained region of vision. This lends significant weight to such training paradigms and offers a mechanism by which visual function can be improved despite damage to the primary visual pathway.
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Affiliation(s)
- Sara Ajina
- Department of Neurorehabilitation and Therapy Services, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom
- Wellcome Centre for Integrative Neuroimaging, Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Kristin Jünemann
- Wellcome Centre for Integrative Neuroimaging, Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, United Kingdom
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30635 Hannover, Germany
| | - Arash Sahraie
- School of Psychology, University of Aberdeen, Kings College, Old Aberdeen AB24 3FX, United Kingdom
| | - Holly Bridge
- Wellcome Centre for Integrative Neuroimaging, Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, United Kingdom
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Worschech F, Marie D, Jünemann K, Sinke C, Krüger THC, Großbach M, Scholz DS, Abdili L, Kliegel M, James CE, Altenmüller E. Improved Speech in Noise Perception in the Elderly After 6 Months of Musical Instruction. Front Neurosci 2021; 15:696240. [PMID: 34305522 PMCID: PMC8299120 DOI: 10.3389/fnins.2021.696240] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/14/2021] [Indexed: 01/19/2023] Open
Abstract
Understanding speech in background noise poses a challenge in daily communication, which is a particular problem among the elderly. Although musical expertise has often been suggested to be a contributor to speech intelligibility, the associations are mostly correlative. In the present multisite study conducted in Germany and Switzerland, 156 healthy, normal-hearing elderly were randomly assigned to either piano playing or music listening/musical culture groups. The speech reception threshold was assessed using the International Matrix Test before and after a 6 month intervention. Bayesian multilevel modeling revealed an improvement of both groups over time under binaural conditions. Additionally, the speech reception threshold of the piano group decreased during stimuli presentation to the left ear. A right ear improvement only occurred in the German piano group. Furthermore, improvements were predominantly found in women. These findings are discussed in the light of current neuroscientific theories on hemispheric lateralization and biological sex differences. The study indicates a positive transfer from musical training to speech processing, probably supported by the enhancement of auditory processing and improvement of general cognitive functions.
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Affiliation(s)
- Florian Worschech
- Institute for Music Physiology and Musicians’ Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
- Center for Systems Neuroscience, Hanover, Germany
| | - Damien Marie
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Kristin Jünemann
- Center for Systems Neuroscience, Hanover, Germany
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Christopher Sinke
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Tillmann H. C. Krüger
- Center for Systems Neuroscience, Hanover, Germany
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Hanover, Germany
| | - Michael Großbach
- Institute for Music Physiology and Musicians’ Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Daniel S. Scholz
- Institute for Music Physiology and Musicians’ Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
- Center for Systems Neuroscience, Hanover, Germany
| | - Laura Abdili
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Clara E. James
- Geneva Musical Minds Lab, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Eckart Altenmüller
- Institute for Music Physiology and Musicians’ Medicine, Hanover University of Music, Drama and Media, Hanover, Germany
- Center for Systems Neuroscience, Hanover, Germany
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James CE, Altenmüller E, Kliegel M, Krüger THC, Van De Ville D, Worschech F, Abdili L, Scholz DS, Jünemann K, Hering A, Grouiller F, Sinke C, Marie D. Train the brain with music (TBM): brain plasticity and cognitive benefits induced by musical training in elderly people in Germany and Switzerland, a study protocol for an RCT comparing musical instrumental practice to sensitization to music. BMC Geriatr 2020; 20:418. [PMID: 33087078 PMCID: PMC7576734 DOI: 10.1186/s12877-020-01761-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 09/08/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Recent data suggest that musical practice prevents age-related cognitive decline. But experimental evidence remains sparse and no concise information on the neurophysiological bases exists, although cognitive decline represents a major impediment to healthy aging. A challenge in the field of aging is developing training regimens that stimulate neuroplasticity and delay or reverse symptoms of cognitive and cerebral decline. To be successful, these regimens should be easily integrated in daily life and intrinsically motivating. This study combines for the first-time protocolled music practice in elderly with cutting-edge neuroimaging and behavioral approaches, comparing two types of musical education. METHODS We conduct a two-site Hannover-Geneva randomized intervention study in altogether 155 retired healthy elderly (64-78) years, (63 in Geneva, 92 in Hannover), offering either piano instruction (experimental group) or musical listening awareness (control group). Over 12 months all participants receive weekly training for 1 hour, and exercise at home for ~ 30 min daily. Both groups study different music styles. Participants are tested at 4 time points (0, 6, and 12 months & post-training (18 months)) on cognitive and perceptual-motor aptitudes as well as via wide-ranging functional and structural neuroimaging and blood sampling. DISCUSSION We aim to demonstrate positive transfer effects for faculties traditionally described to decline with age, particularly in the piano group: executive functions, working memory, processing speed, abstract thinking and fine motor skills. Benefits in both groups may show for verbal memory, hearing in noise and subjective well-being. In association with these behavioral benefits we anticipate functional and structural brain plasticity in temporal (medial and lateral), prefrontal and parietal areas and the basal ganglia. We intend exhibiting for the first time that musical activities can provoke important societal impacts by diminishing cognitive and perceptual-motor decline supported by functional and structural brain plasticity. TRIAL REGISTRATION The Ethikkomission of the Leibniz Universität Hannover approved the protocol on 14.08.17 (no. 3604-2017), the neuroimaging part and blood sampling was approved by the Hannover Medical School on 07.03.18. The full protocol was approved by the Commission cantonale d'éthique de la recherche de Genève (no. 2016-02224) on 27.02.18 and registered at clinicaltrials.gov on 17.09.18 ( NCT03674931 , no. 81185).
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Affiliation(s)
- Clara E James
- Geneva School of Health Sciences, Geneva Musical Minds Lab (GEMMI Lab), University of Applied Sciences and Arts Western Switzerland HES-SO, Avenue de Champel 47, 1206, Geneva, Switzerland. .,Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont-d'Arve 40, 1205, Geneva, Switzerland.
| | - Eckart Altenmüller
- Institute for Music Physiology and Musicians' Medecine, Hannover University of Music, Drama and Media, Neues Haus 1, 30175, Hannover, Germany.,Center for Systems Neuroscience, Bünteweg 2, 30559, Hannover, Germany
| | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont-d'Arve 40, 1205, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland, Boulevard du Pont d'Arve 28, 1205, Genève, Switzerland
| | - Tillmann H C Krüger
- Center for Systems Neuroscience, Bünteweg 2, 30559, Hannover, Germany.,Department of Psychiatry, Social Psychiatry and Psychotherapy, Section of Clinical Psychology & Sexual Medicine, Hannover Medical School, Centre of Mental Health, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Dimitri Van De Ville
- Swiss Federal Institute of Technology Lausanne (EPFL), Route Cantonale, 1015, Lausanne, Switzerland.,Faculty of Medecine of the University of Geneva, Switzerland, Campus Biotech, Chemin des Mines 9, 1211, Geneva, Switzerland
| | - Florian Worschech
- Institute for Music Physiology and Musicians' Medecine, Hannover University of Music, Drama and Media, Neues Haus 1, 30175, Hannover, Germany.,Center for Systems Neuroscience, Bünteweg 2, 30559, Hannover, Germany
| | - Laura Abdili
- Geneva School of Health Sciences, Geneva Musical Minds Lab (GEMMI Lab), University of Applied Sciences and Arts Western Switzerland HES-SO, Avenue de Champel 47, 1206, Geneva, Switzerland
| | - Daniel S Scholz
- Institute for Music Physiology and Musicians' Medecine, Hannover University of Music, Drama and Media, Neues Haus 1, 30175, Hannover, Germany.,Center for Systems Neuroscience, Bünteweg 2, 30559, Hannover, Germany
| | - Kristin Jünemann
- Center for Systems Neuroscience, Bünteweg 2, 30559, Hannover, Germany.,Department of Psychiatry, Social Psychiatry and Psychotherapy, Section of Clinical Psychology & Sexual Medicine, Hannover Medical School, Centre of Mental Health, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Alexandra Hering
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont-d'Arve 40, 1205, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland, Boulevard du Pont d'Arve 28, 1205, Genève, Switzerland
| | - Frédéric Grouiller
- Swiss Center for Affective Sciences, University of Geneva, 1205 Geneva, Switzerland. Campus Biotech, Chemin des Mines 9, 1202, Geneva, Switzerland
| | - Christopher Sinke
- Center for Systems Neuroscience, Bünteweg 2, 30559, Hannover, Germany.,Department of Psychiatry, Social Psychiatry and Psychotherapy, Section of Clinical Psychology & Sexual Medicine, Hannover Medical School, Centre of Mental Health, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Damien Marie
- Geneva School of Health Sciences, Geneva Musical Minds Lab (GEMMI Lab), University of Applied Sciences and Arts Western Switzerland HES-SO, Avenue de Champel 47, 1206, Geneva, Switzerland
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10
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Gameiro RR, Jünemann K, Herbik A, Wolff A, König P, Hoffmann MB. Natural visual behavior in individuals with peripheral visual-field loss. J Vis 2018; 18:10. [PMID: 30458515 DOI: 10.1167/18.12.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Retinitis pigmentosa (RP) is an inherited disease that causes progressive peripheral visual-field loss. In this study, we investigated how such loss affects visual exploration of natural images. Individuals with varying degrees of visual-field loss and healthy control participants freely observed images of different sizes while eye movements were recorded. We examined whether visual behavior differed when the scene content was shown in various extents of the visual field, and investigated the spatial bias, saccade amplitudes, and number and duration of fixations. We found that the healthy control group showed a central spatial bias during image viewing. The RP group showed similar biases on the group level, but with reproducible individual exploration patterns. For saccade amplitudes, the healthy control group and the RP group showed similar behavior throughout all image sizes. The RP group with severe loss of peripheral vision thus tended to target saccades toward blind areas of their visual field. The number of fixations did not change between the two groups, although fixation durations decreased in the RP group. In conclusion, the RP group scanned the images surprisingly similarly to the healthy control group; however, they showed individual idiosyncratic explorative strategies when the observed scene exceeded their visible field. Thus, although RP leads to a severe loss of the visual field, there is no general adaptive mechanism to change visual exploration. Instead, individuals rely on individual strategies, leading to high heterogeneity in the RP group.
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Affiliation(s)
| | - Kristin Jünemann
- Institute of Cognitive Science, University of Osnabrück, Osnabrück, Germany
| | - Anne Herbik
- Visual Processing Lab, Ophthalmic Department, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Anika Wolff
- Visual Processing Lab, Ophthalmic Department, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Peter König
- Institute of Cognitive Science, University of Osnabrück, Osnabrück, Germany.,Institute of Neurophysiology und Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael B Hoffmann
- Visual Processing Lab, Ophthalmic Department, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
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11
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Brüwer G, Naumann C, v. Petersdorff M, Jünemann K, Osmonov D. [Mixed epithelial and stromal tumour of the kidney: a case report]. Aktuelle Urol 2018; 49:429-432. [PMID: 28905347 DOI: 10.1055/s-0043-107757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Mixed epithelial and stromal tumours of the kidney are rare. Histologically, they are characterised by a complex of epithelium and stroma with cystic and solid areas. They usually occur in perimenopausal women receiving hormone replacement with oestrogen. Typical symptoms are haematuria, flank pain and a palpable mass, with more and more authors reporting incidentally diagnosed tumours. This also applies to our case report. We are reporting the first published case in Germany: a 60-year-old female with a mixed epithelial and stromal tumour of the right kidney. The tumour was removed through complete nephrectomy.
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Affiliation(s)
- G. Brüwer
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - C. Naumann
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - M. v. Petersdorff
- Institut für Pathologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - K. Jünemann
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - D. Osmonov
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
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12
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Abstract
People with sequence-space synesthesia (SSS) report stable visuo-spatial forms corresponding to numbers, days, and months (amongst others). This type of synesthesia has intrigued scientists for over 130 years but the lack of an agreed upon tool for assessing it has held back research on this phenomenon. The present study builds on previous tests by measuring the consistency of spatial locations that is known to discriminate controls from synesthetes. We document, for the first time, the sensitivity and specificity of such a test and suggest a diagnostic cut-off point for discriminating between the groups based on the area bounded by different placement attempts with the same item.
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Affiliation(s)
- Nicolas Rothen
- School of Psychology and Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
| | - Kristin Jünemann
- School of Psychology and Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
| | - Andy D Mealor
- School of Psychology and Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
| | - Vera Burckhardt
- School of Psychology and Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
| | - Jamie Ward
- School of Psychology and Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK.
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13
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Janßen I, Naumann C, Hamann M, Knüpfer S, Jünemann K, Osmonov D. [Significance and Importance of Pelvic Lymphadenectomy in Low-Risk Prostate Cancer Patients]. Aktuelle Urol 2016; 47:402-7. [PMID: 27680192 DOI: 10.1055/s-0042-104788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The most frequent carcinoma in male patients is prostate cancer. D'Amico and colleagues (1998) set up a classification to assess the aggressiveness of prostate cancer growth and the risk of metastatic spread, taking into account the following parameters: PSA, Gleason Score (GS), and tumour spread (T). The combination of these parameters results in a classification of low-, intermediate- and high-risk patients.In the context of a larger heuristic study entitled "Low-Risk Prostate Cancer Patients: Significance And Importance Of Pelvic Lymphadenectomy in Localized Prostate Carcinomas", we observed the correlation of the parameters PSA, GS and T stage with the occurrence of lymph node metastases in low-risk-patients who underwent lymphadenectomy during radical prostatectomy. PATIENTS/MATERIALS AND METHODS Due to a lack of evidence - none of the confirmed LR (low-risk=LR) patients was diagnosed with metastases - we set up a subclassification for LR patients for the following corridor transition zone between low-risk and high-risk patients (based on the D'Amico classification):PSA≤10 ng/ml and GS≤7a (c: 7a) and clinical stage T1a-T2c (c: T2b, T2c): The population consists of 288 prostate cancer patients (60 low-risk (LR) patients, 228 corridor (c) patients). We analysed the number and frequency of removed lymph nodes and lymph node metastases. Moreover, we analysed the population with a view to a postoperative GS upgrade. The results are based on heuristic methods. RESULTS The situation regarding the data in the transition zone, i. e. in the corridor area, and in the verified low-risk range is very complicated:In total, 3 743 lymph nodes were removed in 288 patients (mean: 13 lymph nodes). Of these only 7 lymph nodes in 5 patients from the corridor group were metastatic. The overall number of removed lymph nodes in these 5 patients lies within a small interval [23,32]; 26 lymph nodes were removed on average. A postoperative Gleason Score upgrade was found in 20.14% of the whole patient population. CONCLUSION A postoperative Gleason Score upgrade in every fifth patient shows a highly relevant preoperative undergrading in these patients, which may lead to inadequate treatment. An opening of the D'Amico classification to include a corridor category of patients could be an opportunity to minimise preoperative undergrading. In this context, pelvic lymphadenectomy must be considered, at least for corridor patients.
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Affiliation(s)
- I. Janßen
- Klinik für Anästhesiologie und Intensivmedizin Bonn
| | - C. Naumann
- Klinik für Urologie und Kinderurologie Kiel
| | - M. Hamann
- Klinik für Urologie und Kinderurologie Kiel
| | - S. Knüpfer
- Klinik für Urologie und Kinderurologie Kiel
| | | | - D. Osmonov
- Klinik für Urologie und Kinderurologie Kiel
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14
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Bannowsky A, Osmonov D, Ückert S, Jünemann K. 097 Preservation of Nocturnal Penile Tumescense with Daily Low-Dose Sildenafil 6 Weeks after Nerve-Sparing Radical Prostatectomy is Correlated with Erectile Function Rehabilitation. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.100] [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]
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Abstract
Urachal carcinoma is a rare form of cancer. It often is diagnosed incidentally, like in our case report, because its cardinal symptom also occurs in a number of other urological diseases. We report the case of a 26-year-old man with a mucinous adenocarcinoma of the urachus. The carcinoma was removed via partial cystectomy with umbilical tumour excision.
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Affiliation(s)
- W. Köhler
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - C. Naumann
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - M. Hamann
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - K. Bothe
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - C. Röcken
- Institut für Pathologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - K. Jünemann
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
| | - D. Osmonov
- Klinik für Urologie und Kinderurologie Universitätsklinikum Schleswig-Holstein Campus Kiel
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16
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Ward J, Mensah A, Jünemann K. The rubber hand illusion depends on the tactile congruency of the observed and felt touch. ACTA ACUST UNITED AC 2015; 41:1203-8. [DOI: 10.1037/xhp0000088] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Osmonov D, Jüttner E, Leuschner I, Melchior D, van der Horst C, Jünemann K. Die Manifestation eines Nierenzellkarzinoms an der Nasenspitze. Akt Dermatol 2009. [DOI: 10.1055/s-0029-1214901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Bührle C, Jünemann K, Schmidt P, Berle B, Persson-Jünemann u. P. Alken C. Elektromyographie des Corpus cavernosum beim Hund: Probleme der Signalaufnahme, Verarbeitung und Analyse. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1058304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Löbelenz M, Jünemann K, Siegsmund M, Rassweiler J, Alken P. Penisrevaskularisation bei SKAT-non-respondern in einer modifizierten mikrochirurgischen Technik. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1060494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Bross S, Schumacher S, Scheepe J, Seif C, Weiß J, Zendler S, Jünemann K, Alken P. Der Einfluß des intravesikalen Volumens auf die Blasenantwort unter sakraler Vorderwurzelstimulation vor und nach Blasenüberdehnung. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1054308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Munk AK, Seif C, Renders L, Jünemann K, Braun P. [Percutaneous nephrolithotomy of an upper pole calix stone in a transplanted kidney]. Aktuelle Urol 2007; 38:479-82. [PMID: 17987538 DOI: 10.1055/s-2006-944307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Nephrolithiasis in a transplanted kidney is an uncommon complication and may lead to an acute deterioration in renal function. Different techniques for stone treatment are known. In this case, we were successful by using percutaneous nephrolithotomy for the removal of the stone. CASE REPORT A 65-year-old male patient was found with urinary retention II degrees two months after renal transplantation. A stone in the upper pole calix was found as the probable cause. Percutaneous nephrolithotomy with a 15-Charr Storz mininephroscope was used successfully to disintegrate and remove the stone. CONCLUSION In comparison to other techniques for the removal of stones, percutaneous nephrolithotomy is a secure method in the treatment of nephrolithiasis in a transplanted kidney. This technique treats the renal stone in one session. We used a 15-Charr Storz mininephroscope which is less invasive than the usually used nephroscopes with a bigger lumen.
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Abstract
OBJECTIVE The article deals with the complex conceptual history and current concepts on the relationship between personality, personality disorders and affective disorders. It is discussed whether these concepts represent distinct clinical entities or whether they lie on a continuum. METHOD We reviewed the classical literature from the 19th and the first half of the 20th centuries as well as analysed recent empirical data in order to summarize the current knowledge on this topic with respect to its historical origin. As a particular example, the position of the depressive personality disorder is evaluated. RESULTS Considerable heterogeneity can be seen, both theoretically and empirically. The two major concepts are based either on a continuum model or favour distinct clinical entities, corresponding to a more dimensional or category-orientated recording method. CONCLUSION The relationship between personality disorders and affective disorders is still unclear and is a highly debated issue. There is as yet no consensus, but a certain shift to dimensional models can be recognized.
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Affiliation(s)
- H Sass
- Institution Aachen University Hospital, Aachen, Germany
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23
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Berthold G, Wanzar I, Jünemann K. [Therapeutic strategy of transgastral stenting in retrogastral abscesses]. Zentralbl Chir 2002; 127:457-9. [PMID: 12058310 DOI: 10.1055/s-2002-31978] [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: 10/16/2022]
Abstract
We report on two patients with postinterventional retrogastric abscesses, one as a postoperative complication after partial pancreatectomy, one as a complication of biliary pancreatitis. In both cases, the abscess cavity could be completely drained by EUS-guided endoscopic application of a short "Amsterdam" stent, length 4 cm, 11.5 Fr. The stents could be removed by endoscopy after an interval of several weeks. In suitable cases EUS-guided endoscopic transgastral stenting appears to be the therapy of choice for retrogastral abscesses.
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Affiliation(s)
- G Berthold
- Medizinische Klinik 1, Wald-Klinikum, Gera, Germany
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24
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Sass H, Jünemann K. [Etiological and therapeutic aspects of schizoid and schizotypal personality disorder]. Fortschr Neurol Psychiatr 2001; 69 Suppl 2:S120-6. [PMID: 11533862 DOI: 10.1055/s-2001-16542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Following the introduction to the history of the concepts of abnormal personality, with regard to the schizoid and schizotypal forms, we present their systematic assessment in the modern classification systems.Both, the schizoid and schizotypal forms, are usually considered as schizophrenia-spectrum disorders. Biological and clinical data indicate relations to other axis-I disorders as well. However there are few systematic and strictly controlled studies on the psychotherapeutic and pharmacological treatment of schizotypal and schizoid personality disorders. Basic theoretic assumptions concerning both treatment concepts - for personality disorders in general, and especially in schizoid and schizotypal personality disorder - are given. Finally the role of neuroleptics and antidepressants for schizophrenia-spectrum disorders is discussed. New possibilities may emerge from the use of the recently developed atypical drugs, but further research in randomised studies is needed. Current prospective studies on early detected schizophrenia-spectrum disorders will broaden our knowledge about prevention and therapy.
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Affiliation(s)
- H Sass
- Psychiatrische Klinik der RWTH, Aachen
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25
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Abstract
Monopolar electrosurgery is querried because of the availability of new preparation-techniques in laparoscopic cholecystectomy. The advantage of simple handling, cheap application and high efficiency has to be set against the danger of tissue lesions e. g. the damage of the bile duct as demonstrated by four own cases. Especially the bipolar preparation-method and ultrasonic dissection are safer, but expensive and not as fast and effective as monopolar technique. Laser-heated instruments exist but are not in wide clinical use. The danger of tissue-lesions can be reduced by accurate preparation-principles and caution in dissection of the Calot-triangle.
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Affiliation(s)
- M Berger
- Abteilung für Allgemeine, Viszerale und Kinderchirurgie, Wald-Klinikum Gera gGmbH, Germany
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26
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Martínez Portillo F, Hoang-Boehm J, Weiss J, Alken P, Jünemann K. Methylene blue as a successful treatment alternative for pharmacologically induced priapism. Eur Urol 2001; 39:20-3. [PMID: 11173934 DOI: 10.1159/000052407] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [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: 11/19/2022]
Abstract
OBJECTIVE Priapism is defined as prolonged and persistent erection of the penis without sexual stimulation. Etiologies of this condition are numerous. Treatment of priapism varies from a conservative medical to a drastic surgical approach. Recent findings indicate methylene blue (MB), a guanylate cyclase inhibitor, to be a potential inhibitor of endothelial-mediated cavernous relaxation. This prompted us to assess the feasibility, use and effectiveness of MB in the treatment of priapism. METHODS 12 patients were treated for priapism. Etiologies were: 10 drug-mediated (PGE(1) or papaverine/phentolamine mixture) after corpus cavernosum injection therapy (CCIT); 1 leukemia-induced, and 1 idiopathic high-flow priapism. The age range for all patients was 13-67 years, the average duration of priapism was 5.5 h after CCIT. MB was administered after blood aspiration of the corpora cavernosa. 5 ml of MB was injected intracavernously (i.c.) and left for 5 min. MB was then aspirated and the penis compressed for an additional 5 min. RESULTS All patients with CCIT-induced priapism were cured with MB alone. The 2 patients who did not respond to MB underwent i.c. phenylephrine administration and embolization of the pudendal artery, respectively. The etiology and duration of priapism were the strongest predictors for success with i.c. administered MB. The primary side effects were a transient burning sensation and blue discoloration of the penis on injection of MB. The initial baseline erectile status was restored in all patients cured by MB. CONCLUSION These results confirm that MB is a safe and highly effective treatment agent for short-term pharmacologically induced priapism. The application of MB shows virtually no significant side effects compared to the systemic and local complications induced by alpha-adrenergic agonists.
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Affiliation(s)
- F Martínez Portillo
- Department of Urology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany
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27
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Bross S, Schumacher S, Scheepe JR, Zendler S, Braun PM, Alken P, Jünemann K. Effects of acute urinary bladder overdistension on bladder response during sacral neurostimulation. Eur Urol 1999; 36:354-9. [PMID: 10473998 DOI: 10.1159/000019999] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [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: 11/19/2022]
Abstract
OBJECTIVE Urinary retention and micturition disorders after overdistension are clinically well-known complications of subvesical obstruction. We attempted to evaluate whether bladder overdistension influences bladder response and whether overdistension supports detrusor decompensation. METHODS Following lumbal laminectomy in 9 male foxhounds, the sacral anterior roots S2 and S3 were placed into a modified Brindley electrode for reproducible and controlled detrusor activation. The bladder was filled in stages of 50 ml from 0 to 700 ml, corresponding to an overdistension. At each volume, the bladder response during sacral anterior root stimulation was registered. After overdistension, the bladder was refilled stepwise from 0 to 300 ml and stimulated. RESULTS In all dogs, the bladder response was influenced by the intravesical volume. The maximum pressure (mean 69.1 cm H(2)O) was observed at mean volume of 100 ml. During overdistension, a significant reduction in bladder response of more than 80% was seen. After overdistension, a significant reduction in intravesical pressure of 19.0% was observed. In 2 cases, reduction in bladder response was more than 50% after a single overdistension. CONCLUSIONS We conclude that motoric bladder function is influenced during and after overdistension. A single bladder overdistension can support acute and long-lasting detrusor decompensation. In order to protect motoric bladder function, bladder overdistension must be prevented.
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Affiliation(s)
- S Bross
- Neuro-Urological Laboratory, Department of Urology, University Hospital Mannheim of the University of Heidelberg, Mannheim, Germany
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28
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Schramm H, Büttner K, Jünemann K, Hohmann U. [Preoperative diagnosis in laparoscopic cholecystectomy: is intravenous cholangiography currently still justified?]. Zentralbl Chir 1998; 123 Suppl 2:34-6. [PMID: 9622864] [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: 02/07/2023]
Abstract
Laparocopic cholecystectomy requires essentially the safe exclusion of choledocholithias. The aim of this study was to compare the intravenous cholangiography and ERCP in addition to a basic program (case history, laboratory results ultrasound) with references to the diagnostic ability and therapeutic consequences in patients with choledocholithiasis. The results show, that the intravenous cholangiography not provides extra important informations after the case history, ultrasound and laboratory findings and therefore its general use is not justified. Instead of the intravenous cholangiography the preoperative ERCP should be performed generously if choledocholithiasis is suspected, especially because the ERCP offers the possibility to extract the stone.
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Affiliation(s)
- H Schramm
- Chirurgische Klinik I, Klinikums Gera
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29
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Reisser C, Mielenz H, Jünemann K. [Initial clinical experience with taurolidin instillation into the area of the middle area]. HNO 1994; 42:643-6. [PMID: 8002372] [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: 01/28/2023]
Abstract
In this pilot study 2% taurolidin solution was used for irrigation of infected ears and instillation topically in 10 patients with severe purulent otitis media. The main purpose of the study was to find out whether the application of the taurolidin solution into the middle ear would cause significant pain or not. A slight increase in local pain was found sporadically but was not reason for withdrawing the drug. Twelve of 13 bacterial species isolated prior to treatment were eliminated during the trial, with the otorrhea of most patients stopping after just the first instillation. Audiometric evaluations during and 30 months after therapy did not reveal any ototoxic side effects. Tinnitus was not experienced by any patient during therapy. Overall findings demonstrated that local therapy with taurolidin for patients with severe purulent otitis media was very well tolerated and effective bacteriologically. There were also no therapy-related complications or ototoxic side effects.
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Abstract
A case of a severe Candida sepsis is reported, which was treated successfully by a combination therapy of flucytosine with fluconazole. After an extensive abdominal operation, a 70-year-old man developed a syndrome of fulminant sepsis due to Candida albicans with the beginnings of renal failure. The latter fact forced us to search for a therapeutic alternative to the classical amphotericin B plus flucytosine combination therapy.
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Affiliation(s)
- M Scheven
- Medizinal-, Lebensmittel- und Veterinäruntersuchungsamt Thüringen, Hygiene-Institut Medizinaluntersuchung Gera, Germany
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