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Kellett S, Petrushkin H, Ashworth J, Connor A, McLoone E, Schmoll C, Sharma S, Agorogiannis E, Williams J, Choi J, Injarie A, Puvanachandra N, Watts P, Shafi A, Millar E, Long V, Kumar A, Hughes E, Ritchie A, Gonzalez-Martin J, Pradeep A, Anwar S, Warrior K, Muthusamy B, Pilling R, Benzimra J, Reddy A, Bush K, Pharoah D, Falzon K, O'Colmain U, Knowles R, Tadic V, Dick A, Rahi J, Solebo AL. 2 Pathways to detection of non-infectious childhood uveitis in the UK: findings from the UNICORN cohort study. BMJ Open Ophthalmol 2023; 8:A1. [PMID: 37797997 DOI: 10.1136/bmjophth-2023-biposa.2] [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: 10/07/2023] Open
Abstract
INTRODUCTION Prompt detection of childhood uveitis is key to minimising negative impact. From an internationally unique inception cohort, we report pathways to disease detection.UNICORNS is a national childhood non-infectious uveitis study with longitudinal collection of a standardised clinical dataset and patient reported outcomes. Descriptive analysis of baseline characteristics are reported.Amongst 150 recruited children (51% female, 31% non-white ethnicity) age at detection ranged from 2-18yrs (median 10). In 69%, uveitis was diagnosed following onset of symptoms: time from first symptoms to uveitis detection ranged from 0-739days (median 7days), with longer time to detection for those presenting initially to their general practitioner. Non symptomatic children were detected through JIA/other disease surveillance (16%), routine optometry review (5%) or child visual health screening (1%). Commonest underlying diagnoses at uveitis detection were JIA (17%), TINU (9%, higher than pre-pandemic reported UK disease frequency) and sarcoid (1%). 60% had no known systemic disease at uveitis detection. At disease detection, in at least one eye: 34% had structural complications (associated with greater time to detection - 17 days versus 4 days for uncomplicated presentation).The larger relative proportions of children with non-JIA uveitis reported here increase the importance of improving awareness of childhood uveitis amongst the wider clinical communities. There is scope for improvement of pathways to detection. Forthcoming analysis on the full cohort (251 recruited to date across 33 hospitals and 4 nations) will provide nationally representative data on management and the determinants of visual and broader developmental/well-being outcomes.
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Affiliation(s)
- S Kellett
- University College London, Institute of Child Health, UK
| | - H Petrushkin
- University College London, Institute of Child Health, UK
| | - J Ashworth
- University College London, Institute of Child Health, UK
| | - A Connor
- University College London, Institute of Child Health, UK
| | - E McLoone
- University College London, Institute of Child Health, UK
| | - C Schmoll
- University College London, Institute of Child Health, UK
| | - S Sharma
- University College London, Institute of Child Health, UK
| | - E Agorogiannis
- University College London, Institute of Child Health, UK
| | - J Williams
- University College London, Institute of Child Health, UK
| | - J Choi
- University College London, Institute of Child Health, UK
| | - A Injarie
- University College London, Institute of Child Health, UK
| | | | - P Watts
- University College London, Institute of Child Health, UK
| | - A Shafi
- University College London, Institute of Child Health, UK
| | - E Millar
- University College London, Institute of Child Health, UK
| | - V Long
- University College London, Institute of Child Health, UK
| | - A Kumar
- University College London, Institute of Child Health, UK
| | - E Hughes
- University College London, Institute of Child Health, UK
| | - A Ritchie
- University College London, Institute of Child Health, UK
| | | | - A Pradeep
- University College London, Institute of Child Health, UK
| | - S Anwar
- University College London, Institute of Child Health, UK
| | - K Warrior
- University College London, Institute of Child Health, UK
| | - B Muthusamy
- University College London, Institute of Child Health, UK
| | - R Pilling
- University College London, Institute of Child Health, UK
| | - J Benzimra
- University College London, Institute of Child Health, UK
| | - A Reddy
- University College London, Institute of Child Health, UK
| | - K Bush
- University College London, Institute of Child Health, UK
| | - D Pharoah
- University College London, Institute of Child Health, UK
| | - K Falzon
- University College London, Institute of Child Health, UK
| | - U O'Colmain
- University College London, Institute of Child Health, UK
| | - R Knowles
- University College London, Institute of Child Health, UK
| | - V Tadic
- University College London, Institute of Child Health, UK
| | - A Dick
- University College London, Institute of Child Health, UK
| | - J Rahi
- University College London, Institute of Child Health, UK
| | - A L Solebo
- University College London, Institute of Child Health, UK
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Gyorfi N, Gal AR, Fincsur A, Kalmar-Nagy K, Mintal K, Hormay E, Miseta A, Tornoczky T, Nemeth AK, Bogner P, Kiss T, Helyes Z, Sari Z, Klincsik M, Tadic V, Lenard L, Vereczkei A, Karadi Z, Vizvari Z, Toth A. Novel Noninvasive Paraclinical Study Method for Investigation of Liver Diseases. Biomedicines 2023; 11:2449. [PMID: 37760890 PMCID: PMC10525796 DOI: 10.3390/biomedicines11092449] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Based on a prior university patent, the authors developed a novel type of bioimpedance-based test method to noninvasively detect nonalcoholic fatty liver disease (NAFLD). The development of a new potential NAFLD diagnostic procedure may help to understand the underlying mechanisms between NAFLD and severe liver diseases with a painless and easy-to-use paraclinical examination method, including the additional function to detect even the earlier stages of liver disease. The aim of this study is to present new results and the experiences gathered in relation to NAFLD progress during animal model and human clinical trials.
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Affiliation(s)
- Nina Gyorfi
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Institute of Physiology, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Adrian Robert Gal
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Department of Medical Biology and Central Electron Microscopic Laboratory, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Andras Fincsur
- Department of Pathology, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Karoly Kalmar-Nagy
- Department of Surgery, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Kitti Mintal
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Institute of Physiology, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Edina Hormay
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Institute of Physiology, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Attila Miseta
- Department of Laboratory Medicine, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Tamas Tornoczky
- Department of Pathology, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Anita Katalin Nemeth
- Department of Medical Imaging, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Peter Bogner
- Department of Medical Imaging, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Tamas Kiss
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
- Eötvös Loránd Research Network, Chronic Pain Research Group, University of Pecs, H-7624 Pecs, Hungary
- National Laboratory for Drug Research and Development, Magyar Tudósok Krt. 2, H-1117 Budapest, Hungary
| | - Zoltan Sari
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Symbolic Methods in Material Analysis and Tomography Research Group, Faculty of Engineering and Information Technology, University of Pecs, Boszorkany Str. 6, H-7624 Pecs, Hungary
- Department of Technical Informatics, Faculty of Engineering and Information Technology, University of Pecs, Boszorkany Str. 2, H-7624 Pecs, Hungary
| | - Mihaly Klincsik
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Symbolic Methods in Material Analysis and Tomography Research Group, Faculty of Engineering and Information Technology, University of Pecs, Boszorkany Str. 6, H-7624 Pecs, Hungary
- Department of Technical Informatics, Faculty of Engineering and Information Technology, University of Pecs, Boszorkany Str. 2, H-7624 Pecs, Hungary
| | - Vladimir Tadic
- Symbolic Methods in Material Analysis and Tomography Research Group, Faculty of Engineering and Information Technology, University of Pecs, Boszorkany Str. 6, H-7624 Pecs, Hungary
- Institute of Information Technology, University of Dunaujvaros, Tancsics M. Str. 1/A, H-2401 Dunaujvaros, Hungary
- John von Neumann Faculty of Informatics, University of Obuda, Becsi Str. 96/B, H-1034 Budapest, Hungary
| | - Laszlo Lenard
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Institute of Physiology, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Andras Vereczkei
- Department of Surgery, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Zoltan Karadi
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Institute of Physiology, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
| | - Zoltan Vizvari
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Symbolic Methods in Material Analysis and Tomography Research Group, Faculty of Engineering and Information Technology, University of Pecs, Boszorkany Str. 6, H-7624 Pecs, Hungary
- John von Neumann Faculty of Informatics, University of Obuda, Becsi Str. 96/B, H-1034 Budapest, Hungary
- Department of Environmental Engineering, Faculty of Engineering and Information Technology, University of Pecs, Boszorkany Str. 2, H-7624 Pecs, Hungary
| | - Attila Toth
- Medical and Engineering Multidisciplinary Cellular Bioimpedance Research Group, Szentagothai Research Centre, University of Pecs, Ifjusag Str. 20, H-7624 Pecs, Hungary
- Institute of Physiology, Medical School, University of Pecs, Szigeti Str. 12, H-7624 Pecs, Hungary
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Koy A, Bockhorn N, Kühn A, Schneider GH, Krause P, Lauritsch K, Witt K, Paschen S, Deuschl G, Krauss J, Saryyeva A, Runge J, Borggraefe I, Mehrkens J, Horn A, Vesper J, Schnitzler A, Siegert S, Freilinger M, Eckenweiler M, Coenen V, Tadic V, Voges J, Pauls K, Wirths J, Timmermann L, Hellmich M, Abdallat M, Ascencao LC, Grünwald S, Wloch A, Schrader C, Groiss SJ, Wojtecki L. Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia. Brain Stimul 2019; 12:1111-1120. [DOI: 10.1016/j.brs.2019.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/15/2019] [Accepted: 04/02/2019] [Indexed: 11/29/2022] Open
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Zittel S, Tadic V, Moll CKE, Bäumer T, Fellbrich A, Gulberti A, Rasche D, Brüggemann N, Tronnier V, Münchau A. Prospective evaluation of Globus pallidus internus deep brain stimulation in Huntington's disease. Parkinsonism Relat Disord 2018; 51:96-100. [PMID: 29486999 DOI: 10.1016/j.parkreldis.2018.02.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 11/14/2017] [Revised: 02/05/2018] [Accepted: 02/18/2018] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Pharmacological treatment of chorea in Huntington's disease (HD) is often limited by poor efficacy or side effects. Pallidal deep brain stimulation (DBS) has been considered in these patients but experience is so far limited. METHODS We prospectively evaluated the effects of bilateral DBS of the Globus pallidus internus (GPi) over one year in six severely affected HD patients with treatment refractory chorea in an advanced stage of the disease. Primary endpoint of the study was improvement in chorea. Additionally, we evaluated the effects of GPi DBS on the motor part of the Unified Huntington's Disease Rating Scale (UHDRS), bradykinesia, dystonia, functional impairment, psychiatric and cognitive symptoms. Side effects were systematically assessed. RESULTS The chorea subscore was significantly reduced postoperatively (-47% six months, -40% twelve months postoperatively). The UHDRS total motor score was significantly reduced at six months postoperatively (- 17%) but the effect was not sustained twelve months after the operation (- 5%). Pallidal DBS did not improve other motor symptoms or functional impairment. There was no effect on psychiatric symptoms or cognition. A number of side effects were noted, especially spasticity in three of the patients. CONCLUSIONS Pallidal DBS is a treatment option for HD patients with severe pharmacologically refractory chorea. Further studies are needed to define optimal candidates for this procedure.
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Affiliation(s)
- S Zittel
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - V Tadic
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany; Department of Neurology, University of Lübeck, Lübeck, Germany
| | - C K E Moll
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Germany
| | - T Bäumer
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - A Fellbrich
- Department of Neurology, University of Lübeck, Lübeck, Germany; Institute of Psychology II, University of Lübeck, Lübeck, Germany
| | - A Gulberti
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Germany
| | - D Rasche
- Department of Neurosurgery, University of Lübeck, Lübeck, Germany
| | - N Brüggemann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany; Department of Neurology, University of Lübeck, Lübeck, Germany
| | - V Tronnier
- Department of Neurosurgery, University of Lübeck, Lübeck, Germany
| | - A Münchau
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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Prasuhn J, Piskol L, Vollstedt EJ, Graf J, Schmidt A, Tadic V, Tunc S, Hampf J, Warrlich E, Bibergeil C, Hagenah J, Klein C, Kasten M, Brüggemann N. Non-motor symptoms and quality of life in subjects with mild parkinsonian signs. Acta Neurol Scand 2017; 136:495-500. [PMID: 28345787 DOI: 10.1111/ane.12760] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mild parkinsonian signs (MPS) are frequent in the elderly population and associated with the presence of risk markers for Parkinson's disease (PD). Both MPS and non-motor signs may be present in prodromal PD and may significantly impair quality of life (QoL). OBJECTIVE To disentangle the contribution of motor impairment and extra-motor manifestations to QoL in subjects with MPS (n=63), manifest PD (n=69), disorders with motor symptoms due to non-neurodegenerative diseases (n=213) and healthy controls (n=258). METHODS Subjects with MPS, healthy controls, disease controls (patients with motor impairment due to, eg, arthrosis and spondylosis), and PD patients (total n=603) were selected from a large epidemiological longitudinal study, the EPIPARK cohort. Motor function was determined using the UPDRSIII protocol, and information on depressive symptoms, anxiety, sleep, and QoL was assessed via rating scales and data were analyzed. RESULTS Depressive symptoms, anxiety, and sleep problems were equally frequent in the MPS group and controls. Health-related QoL was slightly reduced in the MPS group. Motor impairment and its extent was comparable between the MPS group and disease controls (UPDRSIII 5-6 points). Higher motor dysfunction was associated with lower QoL. Depressive symptoms, but not anxiety and daytime sleepiness, was significant predictors of general QoL, independent of motor function. CONCLUSIONS Quality of life is slightly decreased in an elderly population with MPS. QoL is associated with severity of motor impairment but also with non-motor aspects, ie, depressive symptoms. Follow-up studies in large cohorts are warranted to determine the natural course of MPS and its impact on QoL.
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Affiliation(s)
- J. Prasuhn
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - L. Piskol
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - E.-J. Vollstedt
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Psychiatry and Psychotherapy; University of Lübeck; Lübeck Germany
| | - J. Graf
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Neurology; University of Lübeck; Lübeck Germany
| | - A. Schmidt
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Kurt Singer Institute for Music Physiology and Musicians’ Health; Hanns Eisler School of Music Berlin; Berlin Germany
- Berlin Center for Musicians’ Medicine; Charité - University Medicine Berlin; Berlin Germany
| | - V. Tadic
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Neurology; University of Lübeck; Lübeck Germany
| | - S. Tunc
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Neurology; University of Lübeck; Lübeck Germany
| | - J. Hampf
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - E. Warrlich
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - C. Bibergeil
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - J. Hagenah
- Department of Neurology; Westküstenklinikum Heide; Heide Germany
| | - C. Klein
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - M. Kasten
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Psychiatry and Psychotherapy; University of Lübeck; Lübeck Germany
| | - N. Brüggemann
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Neurology; University of Lübeck; Lübeck Germany
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Werner E, Weißbach A, Timmann D, Brüggemann N, Tadic V, Klein C, Münchau A, Bäumer T. EP 56. Cerebellar learning and its modifiability by alcohol in myoclonus-dystonia. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rasche D, Zittel S, Tadic V, Moll C, Fellbrich A, Brüggemann N, Bäumer T, Tronnier V, Münchau A. EP 39. Clinical experience with deep brain stimulation in Huntington’s disease. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.232] [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: 11/27/2022]
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Tadic V, T. Le T, Goldhammer N, Grosskreutz J. Der ER – Mitochondrien – Kalzium – Zyklus und Organellfehlfunktion in der Pathophysiologie der Amyotrophen Lateralsklerose. KLIN NEUROPHYSIOL 2015. [DOI: 10.1055/s-0041-107640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- V. Tadic
- Hans Berger Klinik für Neurologie, Universitätsklinikum Jena, Jena, Deutschland
| | - T. T. Le
- Hans Berger Klinik für Neurologie, Universitätsklinikum Jena, Jena, Deutschland
| | - N. Goldhammer
- Hans Berger Klinik für Neurologie, Universitätsklinikum Jena, Jena, Deutschland
| | - J. Grosskreutz
- Hans Berger Klinik für Neurologie, Universitätsklinikum Jena, Jena, Deutschland
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Steinlechner S, Wenzel L, Kasten M, Tadic V, Brüggemann N, Hagenah J, Rumpf H, Klein C, Lencer R. Evaluation psychiatrischer Störungen anhand eines erweiterten SKID-Screenings. Fortschr Neurol Psychiatr 2015; 83:499-505. [DOI: 10.1055/s-0035-1553670] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- S. Steinlechner
- Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck
| | - L. Wenzel
- Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck
| | - M. Kasten
- Institut für Neurogenetik, Universität zu Lübeck
| | - V. Tadic
- Institut für Neurogenetik, Universität zu Lübeck
| | | | - J. Hagenah
- Klinik für Neurologie, Westküstenklinikum Heide
| | - H. Rumpf
- Psychiatrie und Psychotherapie, Universität zu Lübeck
| | - C. Klein
- Institut für Neurogenetik, Universität zu Lübeck
| | - R. Lencer
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinik Münster
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Tronnier VM, Domingo A, Moll CK, Rasche D, Mohr C, Rosales R, Capetian P, Jamora RD, Lee LV, Münchau A, Diesta CC, Tadic V, Klein C, Brüggemann N, Moser A. Biochemical mechanisms of pallidal deep brain stimulation in X-linked dystonia parkinsonism. Parkinsonism Relat Disord 2015; 21:954-9. [PMID: 26093890 DOI: 10.1016/j.parkreldis.2015.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 02/27/2015] [Revised: 05/17/2015] [Accepted: 06/08/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Invasive techniques such as in-vivo microdialysis provide the opportunity to directly assess neurotransmitter levels in subcortical brain areas. METHODS Five male Filipino patients (mean age 42.4, range 34-52 years) with severe X-linked dystonia-parkinsonism underwent bilateral implantation of deep brain leads into the internal part of the globus pallidus (GPi). Intraoperative microdialysis and measurement of gamma aminobutyric acid and glutamate was performed in the GPi in three patients and globus pallidus externus (GPe) in two patients at baseline for 25/30 min and during 25/30 min of high-frequency GPi stimulation. RESULTS While the gamma-aminobutyric acid concentration increased in the GPi during high frequency stimulation (231 ± 102% in comparison to baseline values), a decrease was observed in the GPe (22 ± 10%). Extracellular glutamate levels largely remained unchanged. CONCLUSIONS Pallidal microdialysis is a promising intraoperative monitoring tool to better understand pathophysiological implications in movement disorders and therapeutic mechanisms of high frequency stimulation. The increased inhibitory tone of GPi neurons and the subsequent thalamic inhibition could be one of the key mechanisms of GPi deep brain stimulation in dystonia. Such a mechanism may explain how competing (dystonic) movements can be suppressed in GPi/thalamic circuits in favour of desired motor programs.
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Affiliation(s)
- V M Tronnier
- Department of Neurosurgery, University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - A Domingo
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany
| | - C K Moll
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
| | - D Rasche
- Department of Neurosurgery, University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - C Mohr
- Department of Neuroradiology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - R Rosales
- XDP Study Group, Philippine Children's Medical Center, Quezon City, Philippines; Department of Neurology and Psychiatry, Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
| | - P Capetian
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany; Department of Neurology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - R D Jamora
- XDP Study Group, Philippine Children's Medical Center, Quezon City, Philippines; Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - L V Lee
- XDP Study Group, Philippine Children's Medical Center, Quezon City, Philippines
| | - A Münchau
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany
| | - C C Diesta
- XDP Study Group, Philippine Children's Medical Center, Quezon City, Philippines
| | - V Tadic
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany
| | - C Klein
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany
| | - N Brüggemann
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, D-23562 Lübeck, Germany; Department of Neurology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - A Moser
- Department of Neurology, University Hospital Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
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Jeremic I, Petrovic D, Zivkovic M, Petricevic S, Tadic V, Petronijevic M, Stanojevic Z, Trajkovic V, Sefik-Bukilica M, Gosic K, Isakovic A. AB0092 Sideritis Scardica Extract Prevents Bone Loss in Ovariectomized Rats. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6184] [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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Brüggemann N, Külper W, Hagenah J, Bauer P, Pattaro C, Tadic V, Lohnau T, Winkler S, Tönnies H, Sprenger A, Pramstaller P, Rolfs A, Siebert R, Riess O, Vieregge P, Lohmann K, Klein C. Autosomal dominant Parkinson's disease in a large German pedigree. Acta Neurol Scand 2012; 126:129-37. [PMID: 22107061 DOI: 10.1111/j.1600-0404.2011.01621.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE While several genes have been identified to cause Parkinson's disease (PD), monogenic forms explain only a small proportion of cases. We report clinical and genetic results in a large family with late-onset autosomal dominant PD. METHODS Thirty-eight family members of a five-generation Northern German PD family underwent a detailed neurologic examination, and transcranial sonography was performed in fifteen of them. Comprehensive mutation analysis of known PD-causing genes and a genome-wide linkage analysis were performed. RESULTS Late-onset definite PD was found in five subjects with a mean age at onset of 63 years. Another six individuals presented either with probable/possible PD or with subtle parkinsonian signs. Six members with a mean age of 79 years had an essential tremor phenotype. Mode of PD inheritance was compatible with autosomal dominant transmission. One of three examined patients with definite PD demonstrated an increased area of substantia nigra hyperechogenicity upon transcranial sonography. Comprehensive linkage and mutational analysis excluded mutations in known PD-causing genes. Genome-wide linkage analysis suggested a putative disease gene in an 11.3-Mb region on chromosome 7p15-21.1 with a multipoint LOD score of 2.0. CONCLUSIONS The findings in this family further demonstrate genetic heterogeneity in familial autosomal dominant late-onset PD.
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Affiliation(s)
- N Brüggemann
- Division of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
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Eggers C, Schmidt A, Hagenah J, Brüggemann N, Klein JC, Tadic V, Kertelge L, Kasten M, Binkofski F, Siebner H, Neumaier B, Fink GR, Hilker R, Klein C. Progression of subtle motor signs in PINK1 mutation carriers with mild dopaminergic deficit. Neurology 2010; 74:1798-805. [PMID: 20513816 DOI: 10.1212/wnl.0b013e3181e0f79c] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND While homozygous mutations in the PINK1 gene cause recessively inherited early-onset Parkinson disease (PD), heterozygous mutations have been suggested as a susceptibility factor. METHODS To evaluate this hypothesis, 4 homozygous PINK1 patients with PD and 10 asymptomatic carriers of a single heterozygous mutation from a large German family (family W) were included in this study. Clinical follow-up of the heterozygous mutation carriers 3 years after the initial visit included a detailed videotaped neurologic examination using the Unified Parkinson's Disease Rating Scale III protocol and smell and color discrimination testing. At follow-up, PET with 18-fluorodopa (FDOPA) of 13 family members was obtained in order to evaluate the clinical phenotype in light of nigostriatal dopaminergic functioning. The clinical and PET data were compared to those of healthy controls. RESULTS While there was mild worsening of clinical signs in previously affected heterozygous mutation carriers upon follow-up, 3 additional individuals had newly developed signs of possible PD. Hyposmia was found in 7 of the heterozygous mutation carriers, diminished color discrimination in 4. The homozygous mutation carriers who were all definitely affected with PD showed a severe, 60% decrease of caudate and putaminal FDOPA uptake; heterozygous offspring also had a significant 20% putaminal FDOPA uptake reduction compared to controls. CONCLUSIONS Our findings strengthen the hypothesis that heterozygous PINK1 mutations act as a susceptibility factor to develop at least subtle Parkinson disease motor and nonmotor signs, as supported by the finding of a reduced striatal dopaminergic FDOPA uptake not only in homozygous but also, albeit to a lesser extent, in heterozygous mutation carriers.
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Affiliation(s)
- C Eggers
- Department of Neurology, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
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Kasten M, Kertelge L, Brüggemann N, Schmidt A, Tadic V, Wisse C, Drude L, Lencer R, Steinlechner S, Schneider S, van der Vegt J, Siebner H, Lohmann K, Buhmann C, Hagenah J, Klein C. P1.044 Characteristics of depression in Parkinson disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70166-x] [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: 10/20/2022]
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Kertelge L, Brueggemann N, Schmidt A, Tadic V, Wisse C, Drude L, Schneider S, van der Vegt J, Siebner H, Lohmann K, Buhmann C, Hagenah J, Klein C, Kasten M. P1.139 Determinants of quality of life in Parkinson disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70261-5] [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: 11/25/2022]
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Tadic V, Kertelge L, Brüggemann N, Schmidt A, Wisse C, Drude L, van der Vegt J, Schneider SA, Siebner HR, Lohmann K, Buhmann C, Hagenah J, Klein C, Kasten M. Beeinträchtigung der Geruchs- und Farbwahrnehmung bei genetischen und nicht genetischen Parkinson-Syndromen. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238865] [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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Brueggemann N, Odin P, Gruenewald A, Tadic V, Hagenah J, Seidel G, Lohmann K, Klein C, Djarmati A. Re: Alpha-synuclein gene duplication is present in sporadic Parkinson disease. Neurology 2008; 71:1294; author reply 1294. [PMID: 18852448 DOI: 10.1212/01.wnl.0000338439.00992.c7] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Tadic V, Brüggemann N, Steinlechner S, Schmidt A, Kertelge L, Lohmann K, Pawlack H, Djarmati A, Klein C, Hagenah J. Eine Familie mit LRRK2-Mutation – Genotyp nicht gleich Phänotyp. Akt Neurol 2008. [DOI: 10.1055/s-0028-1087001] [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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Schmidt A, Hagenah J, Tadic V, Brüggemann N, Kertelge L, Djarmati A, Klein C. Klinische Verlaufsuntersuchung heterozygoter Mutationsträger einer PINK1-Mutation. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086790] [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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Stojiljkovic MP, Zeljkovic J, Tadic V. [From the history of the Academy of Military Medicine: II--the admissions and surgery department]. VOJNOSANIT PREGL 2002; 59:437-41. [PMID: 12240645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Tadic V. [Who is he to review me...!]. VOJNOSANIT PREGL 2002; 59:349-50. [PMID: 12235738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Stojiljkovic MP, Zeljkovic J, Tadic V. [From the history of the Academy of Military Medicine: The 1st Military Hospital in Belgrade from 1836 to 1938]. VOJNOSANIT PREGL 2002; 59:329-33. [PMID: 12132250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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Knezevic DL, Tadic V, Cetkovic S. The efficacy of different decontaminants in rats and pigs percutaneously poisoned with organophosphates. Vet Hum Toxicol 1993; 35:403-405. [PMID: 8249260] [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: 05/22/2023]
Abstract
The efficacies of clay or alcoholate as decontaminants and a polyethylene glycol + oxime N-octylpyridium-4-aldoxime bromide (OPAB) protective ointment were evaluated in rats and pigs percutaneously poisoned with O-ethyl S-2-diisopropylaminoethyl methylphosphonothioate (VX) and soman (GD) nerve gases. The use of protective ointment per se or combined with the decontaminants protected all rats poisoned with GD, regardless of the experimental procedure. No poisoning or fatalities were observed in pigs decontaminated 2 min later with clay or alcoholate, while the protective ointment delayed the onset of poisoning and even prevented death. The application of protective ointment, with or without the use of decontaminants, significantly postponed the onset of poisoning in animals contaminated with VX. There was no significant difference between procedures. Decontamination was very satisfactory and dependent on the duration of exposure, being somewhat more efficient if performed by 30 min after exposure.
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Affiliation(s)
- D L Knezevic
- Army Institute of Military Technology, Department of Medicine, Belgrade, Yugoslavia
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Knezevic DL, Tadic V, Cetkovic S, Kicic Z. The efficacy of different formulations of protective-decontaminating ointments based on polyethylene glycol in rats percutaneously poisoned with highly toxic organophosphates. Vet Hum Toxicol 1993; 35:418-20. [PMID: 8249264] [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: 01/29/2023]
Abstract
Protective-decontaminating ointments based on polyethylene glycols (PEG) of different molecular weights were tested alone or with oxime N-octylpyridinium-4-aldoxime bromide, against percutaneous poisoning by the nerve gases 0-ethyl S-2-diisopropyl methylphosphorothiolate and soman in rats after 60 min exposure. PEG-based ointments consisting of higher PEG combined with the oxime proved the most efficient for both poisons. The combination of lower and medium PEG was somewhat less efficient, while the formulation consisting of mostly lower PEG exerted protective effects only in soman poisoning.
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Affiliation(s)
- D L Knezevic
- Army Institute of Military Technology, Department of Medicine, Belgrade, Yugoslavia
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Teodosijevic M, Tadic V, Sokic G. [Pathological changes in the tongue coating]. Stomatol Glas Srb 1972; 19:87-95. [PMID: 4509952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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