1
|
Lövdal SS, Carli G, Orso B, Biehl M, Arnaldi D, Mattioli P, Janzen A, Sittig E, Morbelli S, Booij J, Oertel WH, Leenders KL, Meles SK. Investigating the aspect of asymmetry in brain-first versus body-first Parkinson's disease. NPJ Parkinsons Dis 2024; 10:74. [PMID: 38555343 PMCID: PMC10981719 DOI: 10.1038/s41531-024-00685-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/13/2024] [Indexed: 04/02/2024] Open
Abstract
Parkinson's disease (PD) is characterized by a progressive loss of dopaminergic neurons in the substantia nigra. Recent literature has proposed two subgroups of PD. The "body-first subtype" is associated with a prodrome of isolated REM-sleep Behavior Disorder (iRBD) and a relatively symmetric brain degeneration. The "brain-first subtype" is suggested to have a more asymmetric degeneration and a prodromal stage without RBD. This study aims to investigate the proposed difference in symmetry of the degeneration pattern in the presumed body and brain-first PD subtypes. We analyzed 123I-FP-CIT (DAT SPECT) and 18F-FDG PET brain imaging in three groups of patients (iRBD, n = 20, de novo PD with prodromal RBD, n = 22, and de novo PD without RBD, n = 16) and evaluated dopaminergic and glucose metabolic symmetry. The RBD status of all patients was confirmed with video-polysomnography. The PD groups did not differ from each other with regard to the relative or absolute asymmetry of DAT uptake in the putamen (p = 1.0 and p = 0.4, respectively). The patient groups also did not differ from each other with regard to the symmetry of expression of the PD-related metabolic pattern (PDRP) in each hemisphere. The PD groups had no difference in symmetry considering mean FDG uptake in left and right regions of interest and generally had the same degree of symmetry as controls, while the iRBD patients had nine regions with abnormal left-right differences (p < 0.001). Our findings do not support the asymmetry aspect of the "body-first" versus "brain-first" hypothesis.
Collapse
Affiliation(s)
- S S Lövdal
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, Netherlands.
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Groningen, Netherlands.
| | - G Carli
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, Netherlands
| | - B Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - M Biehl
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Groningen, Netherlands
- SMQB, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - D Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Neurophysiopathology Unit, IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - P Mattioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Neurophysiopathology Unit, IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - A Janzen
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - E Sittig
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - S Morbelli
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - J Booij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - W H Oertel
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - K L Leenders
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, Netherlands
| | - S K Meles
- Department of Neurology, University Medical Center Groningen, Groningen, Netherlands
| |
Collapse
|
2
|
Doppler K, Antelmi E, Kuzkina A, Donadio V, Incensi A, Plazzi G, Pizza F, Marelli S, Ferini-Strambi L, Tinazzi M, Mayer G, Sittig E, Booij J, Sedghi A, Oertel WH, Volkmann J, Sommer C, Janzen A, Liguori R. Consistent skin α-synuclein positivity in REM sleep behavior disorder - A two center two-to-four-year follow-up study. Parkinsonism Relat Disord 2021; 86:108-113. [PMID: 33895068 DOI: 10.1016/j.parkreldis.2021.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/11/2020] [Revised: 03/08/2021] [Accepted: 04/12/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE/METHODS Phosphorylated alpha-synuclein (p-syn) in dermal nerves of patients with isolated REM sleep behavior disorder (iRBD) is detectable by immunofluorescence-labeling. Skin-biopsy-p-syn-positivity was recently postulated to be a prodromal marker of Parkinson's disease (PD) or related synucleinopathies. Here, we provide two-to four-year clinical and skin biopsy follow-up data of 33 iRBD patients, whose skin biopsy findings at baseline were reported in 2017. RESULTS Follow-up biopsies were available from 25 patients (18 positive at baseline) and showed consistent findings over time in 24 patients. One patient converted from skin-biopsy-negativity to -positivity. P-syn-positivity was observed in iRBD patients who still had a normal FP-CIT-SPECT two years later. Clinically, five of the 23 at baseline skin-biopsy-positive patients (21.7%) had converted to PD or dementia with Lewy bodies at follow-up, but none of the skin-biopsy-negative patients. CONCLUSIONS Dermal p-syn in iRBD is most probably an early consistent marker of synucleinopathy and may support other indicators of conversion to manifest disease state.
Collapse
Affiliation(s)
- K Doppler
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany.
| | - E Antelmi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy
| | - A Kuzkina
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - V Donadio
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - A Incensi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - G Plazzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - F Pizza
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - S Marelli
- Vita-Salute San Raffaele University, Milan, Italy, IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Centre, Milan, Italy
| | - L Ferini-Strambi
- Vita-Salute San Raffaele University, Milan, Italy, IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Centre, Milan, Italy
| | - M Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - G Mayer
- Department of Neurology, Philipps University Marburg, Germany
| | - E Sittig
- Department of Neurology, Philipps University Marburg, Germany
| | - J Booij
- Department of Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, the Netherlands
| | - A Sedghi
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany; Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - W H Oertel
- Department of Neurology, Philipps University Marburg, Germany; Institute for Neurogenomics, Helmholtz Center for Health and Environment, München-Neuherberg, Germany
| | - J Volkmann
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - C Sommer
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - A Janzen
- Department of Neurology, Philipps University Marburg, Germany
| | - R Liguori
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| |
Collapse
|
3
|
Donadio V, Doppler K, Incensi A, Kuzkina A, Janzen A, Mayer G, Volkmann J, Rizzo G, Antelmi E, Plazzi G, Sommer C, Liguori R, Oertel WH. Abnormal α-synuclein deposits in skin nerves: intra- and inter-laboratory reproducibility. Eur J Neurol 2019; 26:1245-1251. [PMID: 30770596 DOI: 10.1111/ene.13939] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 02/07/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND PURPOSE Visualization of phosphorylated α-synuclein at serine 129 (p-syn) in skin nerves is a promising test for the in vivo diagnosis of synucleinopathies. Here the aim was to establish the intra- and inter-laboratory reproducibility of measurement of intraneural p-syn immunoreactivity in two laboratories with major expertise (Würzburg and Bologna). METHODS In total, 43 patients affected by Parkinson's disease (PD 21 patients), dementia with Lewy bodies (DLB 1), rapid eye movement sleep behaviour disorder (RBD 11), multiple system atrophy (MSA-P 4) and small fibre neuropathy (SFN 6) were enrolled. Skin biopsy was performed at the C7 paravertebral spine region and distal skin sites (thigh or leg). The analysis was standardized in both laboratories and carried out blinded on a single skin section double stained with antibodies to p-syn and the pan-axonal marker protein gene product 9.5. Fifty skin sections were randomly selected for the analysis: 25 from C7 and 25 from distal sites. Differently classified sections were re-evaluated to understand the reasons for the discrepancy. RESULTS The intra-laboratory analysis showed an excellent reproducibility both in Würzburg (concordance of classification 100% of sections; K = 1; P < 0.001) and Bologna (96% of sections; K = 0.92; P < 0.001). Inter-laboratory analysis showed reproducibility in 45 sections (90%; K = 0.8; P < 0.001) and a different classification in five sections, which was mainly due to fragmented skin samples or weak fluorescent signals. CONCLUSIONS Analysis of p-syn showed excellent inter- and intra-laboratory reproducibility supporting the reliability of this technique. The few ascertained discordances were important to further improve the standardization of this technique.
Collapse
Affiliation(s)
- V Donadio
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - K Doppler
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - A Incensi
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - A Kuzkina
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - A Janzen
- Philipps University, Marburg, Germany
| | - G Mayer
- Philipps University, Marburg, Germany
| | - J Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - G Rizzo
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - E Antelmi
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - G Plazzi
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - C Sommer
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - R Liguori
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | | |
Collapse
|
4
|
Guttowski D, Mayer G, Oertel WH, Kesper K, Rosenberg T. Validation of semiautomatic scoring of REM sleep without atonia in patients with RBD. Sleep Med 2018; 46:107-113. [PMID: 29773203 DOI: 10.1016/j.sleep.2018.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 01/09/2018] [Revised: 02/20/2018] [Accepted: 03/13/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE/BACKGROUND To evaluate REM sleep without atonia (RSWA) in REM sleep behavior disorder (RBD) several automatic algorithms have been developed. We aimed to validate our algorithm (Mayer et al., 2008) in order to assess the following: (1). capability of the algorithm to differentiate between RBD, night terror (NT), somnambulism (SW), Restless legs syndrome (RLS), and obstructive sleep apnea (OSA), (2). the cut-off values for short (SMI) and long muscle activity (LMI), (3). which muscles qualify best for differential diagnosis, and (4). the comparability of RSWA and registered movements between automatic and visual analysis of videometry. PATIENTS/METHODS RSWA was automatically scored according to Mayer et al., 2008 in polysomnographies of 20 RBD, 10 SW/NT, 10 RLS and 10 OSA patients. Receiver operating characteristic (ROC) curves were used to determine the sensitivity and specificity of SMI and LMI. Independent samples were calculated with t-tests. Boxplots were used for group comparison. The comparison between motor events by manual scoring and automatic analysis were performed with "Visual Basic for Applications" (VBA) for every hundredth second. RESULTS Our method discriminates RBD from SW/NT, OSA and RLS with a sensitivity of 72.5% and a specificity of 86.7%. Automatic scoring identifies more movements than visual video scoring. Mentalis muscle discriminates the sleep disorders best, followed by FDS, which was only recorded in SW/NT. Cut-off values for RSWA are comparable to those found by other groups. CONCLUSION The semi-automatic RSWA scoring method is capable to confirm RBD and to discriminate it with moderate sensitivity from other sleep disorders.
Collapse
Affiliation(s)
- D Guttowski
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, UKE, Martinistr. 52, 20246 Hamburg, Germany
| | - G Mayer
- Hephata Klinik 34613 Schwalmstadt Schimmelpfengstr. 6 Germany; Philipps University Marburg, Department of Neurology, Baldinger Str. 35043 Marburg, Germany.
| | - W H Oertel
- Philipps University Marburg, Department of Neurology, Baldinger Str. 35043 Marburg, Germany
| | - K Kesper
- Philipps Universität Marburg, Sleep Laboratory, Dept. of Pneumology, Baldinger Str. 35043 Marburg, Germany
| | - T Rosenberg
- Bosse Klinik, Department of Neurology/Psychiatry, Hans-Lufft-Str. 5, 06886 Lutherstadt Wittenberg, Germany
| |
Collapse
|
5
|
Müller-Rebstein S, Trenkwalder C, Oertel WH, Culmsee C, Eckermann G, Höglinger GU. Pharmakotherapie des Morbus Parkinson. Nervenarzt 2017; 88:888-894. [DOI: 10.1007/s00115-017-0345-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
6
|
Bauer M, Oertel WH. [Diagnostics and treatment of psychiatric and neurological disorders in the peripartum period]. Nervenarzt 2016; 87:923-5. [PMID: 27531203 DOI: 10.1007/s00115-016-0191-0] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- M Bauer
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - W H Oertel
- Klinik für Neurologie, AG Hertie Senior Forschungsprofessur, Universitätsklinikum Marburg, Marburg, Deutschland
| |
Collapse
|
7
|
Chahine LM, Xie SX, Simuni T, Tran B, Postuma R, Amara A, Oertel WH, Iranzo A, Scordia C, Fullard M, Linder C, Purri R, Darin A, Rennert L, Videnovic A, Del Riva P, Weintraub D. Longitudinal changes in cognition in early Parkinson's disease patients with REM sleep behavior disorder. Parkinsonism Relat Disord 2016; 27:102-6. [PMID: 27010070 PMCID: PMC5031362 DOI: 10.1016/j.parkreldis.2016.03.006] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 02/13/2016] [Accepted: 03/10/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Cognitive decline is common in Parkinson's disease (PD), and identifying patients at highest risk for it is essential. We aimed to examine the effect of possible REM sleep behavior disorder (pRBD) on rate of cognitive decline in early PD, for both global cognition and in specific cognitive domains. METHODS Parkinson's Progression Markers Initiative (PPMI) is a multi-site, international study of PD patients untreated at enrollment. pRBD was assessed with the REM sleep behavior disorder questionnaire (RBDSQ). Global cognition was assessed at baseline and annually using the Montreal Cognitive Assessment (MoCA) and a cognitive battery. Linear mixed effects models were used to examine the relationship between pRBD (RBDSQ≥6) and rate of change in cognitive variables. Age, sex, years of education, and baseline motor and cognitive scores were included as covariates. RESULTS The baseline sample consisted of 423 individuals with PD, mean age 61.7 years and 65.5% male. Data was available on 389, 366, and 196 participants at 1-year, 2-year, and 3-year follow-up respectively. Possible RBD occurred in 108 (25.5%) at baseline. In multivariate analyses, baseline RBD was associated with greater annual rate of decline in MoCA score (β = -0.34, 95%CI -0.54, -0.13, p < 0.001), Symbol Digit Modalities Test (β = -0.69, 95%CI -1.3, -0.09, p = 0.024), and Hopkins Verbal Learning Test-Revised, delayed free recall (β = -0.21, 95%CI -0.41, -0.013, p = 0.037). CONCLUSIONS Possible RBD is common in early PD and predicts future cognitive decline, particularly in attention and memory domains.
Collapse
Affiliation(s)
- L M Chahine
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - S X Xie
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - T Simuni
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - B Tran
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R Postuma
- McGill University, Montréal, Québec, Canada
| | - A Amara
- University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - W H Oertel
- Department of Neurology, Philipps University Marburg, Germany; Charitable Hertie Foundation, Frankfurt/Main, Germany
| | - A Iranzo
- Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - C Scordia
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M Fullard
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - C Linder
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R Purri
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - A Darin
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - L Rennert
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - A Videnovic
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - P Del Riva
- Department of Neurology, University Hospital Donostia, San Sebastián, Spain
| | - D Weintraub
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| |
Collapse
|
8
|
Stamelou M, Diehl-Schmid J, Hapfelmeier A, Kontaxopoulou D, Stefanis L, Oertel WH, Bhatia KP, Papageorgiou SG, Höglinger GU. The frontal assessment battery is not useful to discriminate progressive supranuclear palsy from frontotemporal dementias. Parkinsonism Relat Disord 2015; 21:1264-8. [PMID: 26324212 DOI: 10.1016/j.parkreldis.2015.08.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 01/13/2015] [Revised: 07/08/2015] [Accepted: 08/07/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The frontal assessment battery (FAB) has been suggested as a useful tool in the differential diagnosis of progressive supranuclear palsy (PSP) from Parkinson's disease (PD) and multiple system atrophy with parkinsonism (MSA-P). However, the utility of the FAB in the differential diagnosis of PSP from frontotemporal dementia (FTD) phenotypes is still under research. METHODS We performed the FAB, in a multi-centre cohort of 70 PSP, 103 FTD (N = 84 behavioral variant FTD, N = 10 semantic dementia, N = 9 progressive non-fluent aphasia), 26 PD and 11 MSA-P patients, diagnosed according to established criteria. Patients were also rated with the mini mental state examination and motor scales. RESULTS The FAB total score showed a poor discriminatory power between PSP and FTD as a group [area under the curve (AUC) = 0.523]. Moreover, the FAB score showed no correlation with disease duration in PSP (r = 0.05) or FTD group (r = 0.04). In contrast, we confirmed that the FAB is clinically useful to differentiate PSP from PD and MSA-P (AUC = 0.927). In fact, the sum of two FAB subscores together (verbal fluency and Luria motor series) were as good as the total score in differentiating PSP from PD and MSA-P (AUC = 0.957). CONCLUSIONS The FAB may not be a useful tool to differentiate PSP from FTDs, and shows no correlation with disease duration in these disorders. On the other hand, the essential information to differentiate PSP from PD and MSA-P is contained in the sum of only two FAB subscores. This should be taken into consideration in both clinical practice and the planning of clinical trials.
Collapse
Affiliation(s)
- M Stamelou
- Department of Neurology, Philipps Universität, Marburg, Germany; Second Department of Neurology, Attikon University Hospital, University of Athens, Greece; Movement Disorders Department, Hygeia Hospital, Athens, Greece.
| | - J Diehl-Schmid
- Department of Psychiatry, Technische Universität München, Munich, Germany
| | - A Hapfelmeier
- Department of Medical Statistics and Epidemiology, Technische Universität München, Munich, Germany
| | - D Kontaxopoulou
- Second Department of Neurology, Attikon University Hospital, University of Athens, Greece
| | - L Stefanis
- Second Department of Neurology, Attikon University Hospital, University of Athens, Greece
| | - W H Oertel
- Department of Neurology, Philipps Universität, Marburg, Germany
| | - K P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
| | - S G Papageorgiou
- Second Department of Neurology, Attikon University Hospital, University of Athens, Greece; First Department of Neurology, Eginition University General Hospital, University of Athens, Greece
| | - G U Höglinger
- Department of Neurology, Philipps Universität, Marburg, Germany; Department of Neurology, Technische Universität München, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), München, Germany
| |
Collapse
|
9
|
Antonini A, Bauer L, Dohin E, Oertel WH, Rascol O, Reichmann H, Schmid M, Singh P, Tolosa E, Chaudhuri KR. Effects of rotigotine transdermal patch in patients with Parkinson's disease presenting with non-motor symptoms - results of a double-blind, randomized, placebo-controlled trial. Eur J Neurol 2015; 22:1400-7. [DOI: 10.1111/ene.12757] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 04/27/2015] [Indexed: 12/25/2022]
Affiliation(s)
- A. Antonini
- Parkinson and Movement Disorders Unit; IRCCS Hospital San Camillo; Venice Italy
| | - L. Bauer
- UCB Pharma; Monheim am Rhein Germany
| | | | - W. H. Oertel
- Department of Neurology; Philipps University; Marburg Germany
| | - O. Rascol
- Clinical Investigation Centre CIC1436; and Departments of Clinical Pharmacology and Neurosciences; INSERM and Toulouse University Hospital; Toulouse France
| | - H. Reichmann
- Department of Neurology; University of Dresden; Dresden Germany
| | - M. Schmid
- UCB Pharma; Monheim am Rhein Germany
| | - P. Singh
- UCB Pharma; Monheim am Rhein Germany
| | - E. Tolosa
- Neurology Service; Hospital Clinic de Barcelona; Universitat de Barcelona; IDIBAPS; Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas (CIBERNED); Barcelona Catalonia Spain
| | - K. Ray Chaudhuri
- National Parkinson Foundation International Centre of Excellence; King's College Hospital; Kings College and Kings Health Partners; London UK
| |
Collapse
|
10
|
Keber U, Klietz M, Carlsson T, Oertel WH, Weihe E, Schäfer MKH, Höglinger GU, Depboylu C. Striatal tyrosine hydroxylase-positive neurons are associated with L-DOPA-induced dyskinesia in hemiparkinsonian mice. Neuroscience 2015; 298:302-17. [PMID: 25892702 DOI: 10.1016/j.neuroscience.2015.04.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 04/07/2015] [Accepted: 04/12/2015] [Indexed: 12/28/2022]
Abstract
L-3,4-Dihydroxyphenylalanine (L-DOPA) is the therapeutic gold standard in Parkinson's disease. However, long-term treatment is complicated by the induction of debilitating abnormal involuntary movements termed L-DOPA-induced dyskinesias (LIDs). Until today the underlying mechanisms of LID pathogenesis are not fully understood. The aim of this study was to reveal new factors, which may be involved in the induction of LID. We have focused on the expression of striatal tyrosine hydroxylase-positive (TH+) neurons, which are capable of producing either L-DOPA or dopamine (DA) in target areas of ventral midbrain DAergic neurons. To address this issue, a daily L-DOPA dose was administered over the course of 15 days to mice with unilateral 6-hydroxydopamine-induced lesions of the medial forebrain bundle and LIDs were evaluated. Remarkably, the number of striatal TH+ neurons strongly correlated with both induction and severity of LID as well as ΔFosB expression as an established molecular marker for LID. Furthermore, dyskinetic mice showed a marked augmentation of serotonergic fiber innervation in the striatum, enabling the decarboxylation of L-DOPA to DA. Axial, limb and orolingual dyskinesias were predominantly associated with TH+ neurons in the lateral striatum, whereas medially located TH+ neurons triggered locomotive rotations. In contrast, identified accumbal and cortical TH+ cells did not contribute to the generation of LID. Thus, striatal TH+ cells and serotonergic terminals may cooperatively synthesize DA and subsequently contribute to supraphysiological synaptic DA concentrations, an accepted cause in LID pathogenesis.
Collapse
Affiliation(s)
- U Keber
- Experimental Neurology, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - M Klietz
- Experimental Neurology, Department of Neurology, Philipps University Marburg, Marburg, Germany; Department of Molecular Neuroscience, Institute of Anatomy and Cell Biology, Philipps University Marburg, Marburg, Germany
| | - T Carlsson
- Experimental Neurology, Department of Neurology, Philipps University Marburg, Marburg, Germany; Section of Pharmacology, Institute for Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden(†)
| | - W H Oertel
- Experimental Neurology, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - E Weihe
- Department of Molecular Neuroscience, Institute of Anatomy and Cell Biology, Philipps University Marburg, Marburg, Germany
| | - M K-H Schäfer
- Department of Molecular Neuroscience, Institute of Anatomy and Cell Biology, Philipps University Marburg, Marburg, Germany
| | - G U Höglinger
- Experimental Neurology, Department of Neurology, Philipps University Marburg, Marburg, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany(†); Department of Neurology, Technical University, Munich, Germany
| | - C Depboylu
- Experimental Neurology, Department of Neurology, Philipps University Marburg, Marburg, Germany.
| |
Collapse
|
11
|
Stamelou M, Pilatus U, Reuss A, Respondek G, Knake S, Oertel WH, Höglinger GU. Brain energy metabolism in early MSA-P: A phosphorus and proton magnetic resonance spectroscopy study. Parkinsonism Relat Disord 2015; 21:533-5. [PMID: 25801909 DOI: 10.1016/j.parkreldis.2015.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 11/25/2014] [Revised: 02/26/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Recently, mutations in the COQ2 gene, encoding for an enzyme involved in coenzyme Q10 biosynthesis, have been suggested to confer susceptibility risk for multiple system atrophy (MSA). Thus, the possible role of mitochondrial dysfunction in the pathophysiology of MSA has emerged. Here, we studied brain energy metabolism in vivo in early MSA-parkinsonism (MSA-P) patients and compared to healthy controls. METHODS We have used combined phosphorus and proton magnetic resonance spectroscopy to measure high- and low-energy phosphates in the basal ganglia of early (Hoehn and Yahr stage I-III), probable MSA-P patients (N = 9) compared to healthy controls (N = 9). RESULTS No significant changes in the high energy phosphates and other parameters reflecting the energy status of the cells were found in the basal ganglia of MSA-P patients compared to healthy controls. N-acetylaspartate was significantly reduced in MSA-P compared to healthy controls and correlated with the Unified Multiple System Atrophy Rating Scale. CONCLUSION Brain energy metabolism in early MSA-P is not impaired, despite the presence of impaired neuronal integrity. This may imply that mitochondrial dysfunction may not play a primary role in the pathophysiology of MSA, at least in European populations.
Collapse
Affiliation(s)
- M Stamelou
- Department of Neurology, Philipps University Marburg, Germany; Second Department of Neurology, University of Athens, Greece; Movement Disorders Department, Hygeia Hospital, Athens, Greece.
| | - U Pilatus
- Institute of Neuroradiology, Goethe-University Frankfurt, Frankfurt, Germany
| | - A Reuss
- Center for Clinical Trials, Philipps University, Marburg, Germany
| | - G Respondek
- Department of Neurology, Philipps University Marburg, Germany; Department of Translational Neurodegeneration, German Centre for Neurodegenerative Diseases (DZNE), Munich, Germany; Department of Neurology, Technische Universität München, Munich, Germany
| | - S Knake
- Department of Neurology, Philipps University Marburg, Germany
| | - W H Oertel
- Department of Neurology, Philipps University Marburg, Germany
| | - G U Höglinger
- Department of Neurology, Philipps University Marburg, Germany; Department of Translational Neurodegeneration, German Centre for Neurodegenerative Diseases (DZNE), Munich, Germany; Department of Neurology, Technische Universität München, Munich, Germany
| |
Collapse
|
12
|
Eienbröker C, Seitz F, Spengler A, Kurz H, Seipelt M, Timmesfeld N, Sommer N, Oertel WH, Tackenberg B. IVIg-Erhaltungstherapie bei Myasthenia gravis – eine RCT-Fallzahlsimulation. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371264] [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: 10/25/2022]
|
13
|
Dams J, Bornschein B, Siebert U, Volkmann J, Deuschl G, Oertel WH, Reese JP, Dodel R. Die Kosten-Effektivität der Tiefen Hirnstimulation für Patienten mit Morbus Parkinson. Gesundheitswesen 2013. [DOI: 10.1055/s-0033-1354216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
14
|
Ferreira JJ, Katzenschlager R, Bloem BR, Bonuccelli U, Burn D, Deuschl G, Dietrichs E, Fabbrini G, Friedman A, Kanovsky P, Kostic V, Nieuwboer A, Odin P, Poewe W, Rascol O, Sampaio C, Schüpbach M, Tolosa E, Trenkwalder C, Schapira A, Berardelli A, Oertel WH. Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson's disease. Eur J Neurol 2013; 20:5-15. [PMID: 23279439 DOI: 10.1111/j.1468-1331.2012.03866.x] [Citation(s) in RCA: 216] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 08/06/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To summarize the 2010 EFNS/MDS-ES evidence-based treatment recommendations for the management of Parkinson's disease (PD). This summary includes the treatment recommendations for early and late PD. METHODS For the 2010 publication, a literature search was undertaken for articles published up to September 2009. For this summary, an additional literature search was undertaken up to December 2010. Classification of scientific evidence and the rating of recommendations were made according to the EFNS guidance. In cases where there was insufficient scientific evidence, a consensus statement ('good practice point') is made. RESULTS AND CONCLUSIONS For each clinical indication, a list of therapeutic interventions is provided, including classification of evidence.
Collapse
Affiliation(s)
- J J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics and Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Mylius V, Ayache SS, Ahdab R, Farhat WH, Zouari HG, Belke M, Brugières P, Wehrmann E, Krakow K, Timmesfeld N, Schmidt S, Oertel WH, Knake S, Lefaucheur JP. Definition of DLPFC and M1 according to anatomical landmarks for navigated brain stimulation: inter-rater reliability, accuracy, and influence of gender and age. Neuroimage 2013; 78:224-32. [PMID: 23567888 DOI: 10.1016/j.neuroimage.2013.03.061] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 03/06/2013] [Accepted: 03/25/2013] [Indexed: 11/29/2022] Open
Abstract
The optimization of the targeting of a defined cortical region is a challenge in the current practice of transcranial magnetic stimulation (TMS). The dorsolateral prefrontal cortex (DLPFC) and the primary motor cortex (M1) are among the most usual TMS targets, particularly in its "therapeutic" application. This study describes a practical algorithm to determine the anatomical location of the DLPFC and M1 using a three-dimensional (3D) brain reconstruction provided by a TMS-dedicated navigation system from individual magnetic resonance imaging (MRI) data. The coordinates of the right and left DLPFC and M1 were determined in 50 normal brains (100 hemispheres) by five different investigators using a standardized procedure. Inter-rater reliability was good, with 95% limits of agreement ranging between 7 and 16 mm for the different coordinates. As expressed in the Talairach space and compared with anatomical or imaging data from the literature, the coordinates of the DLPFC defined by our algorithm corresponded to the junction between BA9 and BA46, while M1 coordinates corresponded to the posterior border of hand representation. Finally, we found an influence of gender and possibly of age on some coordinates on both rostrocaudal and dorsoventral axes. Our algorithm only requires a short training and can be used to provide a reliable targeting of DLPFC and M1 between various TMS investigators. This method, based on an image-guided navigation system using individual MRI data, should be helpful to a variety of TMS studies, especially to standardize the procedure of stimulation in multicenter "therapeutic" studies.
Collapse
Affiliation(s)
- V Mylius
- EA 4391, Faculté de Médecine, Université Paris Est Créteil, and Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri-Mondor, AP-HP, Créteil, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Menzler K, Hermsen A, Balkenhol K, Duddek C, Bugiel H, Bauer S, Schorge S, Reif P, Klein KM, Haag A, Oertel WH, Hamer HM, Knake S, Trucks H, Sander T, Rosenow F. Ein Polymorphismus in der Spleiß-Region des SCN1A Gens beeinflusst den Effekt von Carbamazepin auf die kortikale Erregbarkeit – eine TMS Studie. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337127] [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: 10/27/2022]
|
17
|
Mengel D, Röskam S, Neff F, Balakrishnan K, Deuster O, Gold M, Oertel WH, Bacher M, Bach JP, Dodel R. Naturally occurring autoantibodies interfere with β-amyloid metabolism and improve cognition in a transgenic mouse model of Alzheimer's disease 24 h after single treatment. Transl Psychiatry 2013; 3:e236. [PMID: 23462987 PMCID: PMC3625912 DOI: 10.1038/tp.2012.151] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
There is evidence that naturally occurring antibodies directed against Aβ (nAbs-Aβ) have a role in Aβ-metabolism and Aβ-clearance. The presence of nAbs-Aβ leads to a reduction in amyloid fibrillation and thus a reduction in their toxicity. We investigated the effects of nAbs-Aβ in respect to oligomerization and used the Tg2576 transgenic mouse model in order to investigate the rapid effect with a single-dose (24 h) on oligomer breakdown and cytokine secretion along with immunohistochemical characterization of synaptic plasticity. nAbs-Aβ were able to reduce toxic oligomer concentration with an increase in Aβ-monomers. Cytokine secretion was significantly reduced. Synaptic plasticity was also improved after administration of nAbs. Finally, single treatment lead to a significant improvement in cognition. This study demonstrates the efficacy of nAbs-Aβ and presents evidence that several hallmarks of the disease are targeted by nAbs-Aβ.
Collapse
Affiliation(s)
- D Mengel
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - S Röskam
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,Department of Animal Physiology, Philipps-University, Marburg, Germany
| | - F Neff
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,Institute of Pathology, Helmholtz Zentrum, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), München, Germany
| | - K Balakrishnan
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - O Deuster
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,IZKS-Mainz, University Medical Center, Mainz, Germany
| | - M Gold
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - W H Oertel
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - M Bacher
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,Institute of Immunology, Philipps-University, Marburg, Germany
| | - J-P Bach
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - R Dodel
- Department of Neurology, Philipps-University Marburg, Marburg, Germany,Department of Neurology, Philipps-University Marburg, Baldingerstrasse, 35041 Marburg, Germany. E-mail:
| |
Collapse
|
18
|
Schuepbach WMM, Rau J, Knudsen K, Volkmann J, Krack P, Timmermann L, Hälbig TD, Hesekamp H, Navarro SM, Meier N, Falk D, Mehdorn M, Paschen S, Maarouf M, Barbe MT, Fink GR, Kupsch A, Gruber D, Schneider GH, Seigneuret E, Kistner A, Chaynes P, Ory-Magne F, Brefel Courbon C, Vesper J, Schnitzler A, Wojtecki L, Houeto JL, Bataille B, Maltête D, Damier P, Raoul S, Sixel-Doering F, Hellwig D, Gharabaghi A, Krüger R, Pinsker MO, Amtage F, Régis JM, Witjas T, Thobois S, Mertens P, Kloss M, Hartmann A, Oertel WH, Post B, Speelman H, Agid Y, Schade-Brittinger C, Deuschl G. Neurostimulation for Parkinson's disease with early motor complications. N Engl J Med 2013; 368:610-22. [PMID: 23406026 DOI: 10.1056/nejmoa1205158] [Citation(s) in RCA: 851] [Impact Index Per Article: 77.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Subthalamic stimulation reduces motor disability and improves quality of life in patients with advanced Parkinson's disease who have severe levodopa-induced motor complications. We hypothesized that neurostimulation would be beneficial at an earlier stage of Parkinson's disease. METHODS In this 2-year trial, we randomly assigned 251 patients with Parkinson's disease and early motor complications (mean age, 52 years; mean duration of disease, 7.5 years) to undergo neurostimulation plus medical therapy or medical therapy alone. The primary end point was quality of life, as assessed with the use of the Parkinson's Disease Questionnaire (PDQ-39) summary index (with scores ranging from 0 to 100 and higher scores indicating worse function). Major secondary outcomes included parkinsonian motor disability, activities of daily living, levodopa-induced motor complications (as assessed with the use of the Unified Parkinson's Disease Rating Scale, parts III, II, and IV, respectively), and time with good mobility and no dyskinesia. RESULTS For the primary outcome of quality of life, the mean score for the neurostimulation group improved by 7.8 points, and that for the medical-therapy group worsened by 0.2 points (between-group difference in mean change from baseline to 2 years, 8.0 points; P=0.002). Neurostimulation was superior to medical therapy with respect to motor disability (P<0.001), activities of daily living (P<0.001), levodopa-induced motor complications (P<0.001), and time with good mobility and no dyskinesia (P=0.01). Serious adverse events occurred in 54.8% of the patients in the neurostimulation group and in 44.1% of those in the medical-therapy group. Serious adverse events related to surgical implantation or the neurostimulation device occurred in 17.7% of patients. An expert panel confirmed that medical therapy was consistent with practice guidelines for 96.8% of the patients in the neurostimulation group and for 94.5% of those in the medical-therapy group. CONCLUSIONS Subthalamic stimulation was superior to medical therapy in patients with Parkinson's disease and early motor complications. (Funded by the German Ministry of Research and others; EARLYSTIM ClinicalTrials.gov number, NCT00354133.).
Collapse
Affiliation(s)
- W M M Schuepbach
- Assistance Publique–Hôpitaux de Paris, Centre d'Investigation Clinique (CIC) 9503, Institut du Cerveau et de la Moelle Épinière, Département de Neurologie, Université Pierre et Marie Curie–Paris 6 and INSERM, Centre Hospitalier Universitaire (CHU) Pitié–Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Besong-Agbo D, Wolf E, Jessen F, Oechsner M, Hametner E, Poewe W, Reindl M, Oertel WH, Noelker C, Bacher M, Dodel R. Naturally occurring -synuclein autoantibody levels are lower in patients with Parkinson disease. Neurology 2012; 80:169-75. [DOI: 10.1212/wnl.0b013e31827b90d1] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
20
|
Paterson RW, Waldermar G, Chaudhuri KR, Varga ET, Sztriha LK, Sellner J, Sauerbier A, Kondziella D, Macerollo A, Valkovic P, Oertel WH. Career mentorship for young neurologists in Europe. Neurology 2012; 79:381-3. [DOI: 10.1212/wnl.0b013e318260cdd7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
21
|
Menzler K, Belke M, Unger MM, Ohletz T, Keil B, Heverhagen JT, Rosenow F, Mayer G, Oertel WH, Möller JC, Knake S. DTI reveals hypothalamic and brainstem white matter lesions in patients with idiopathic narcolepsy. Sleep Med 2012; 13:736-42. [PMID: 22541810 DOI: 10.1016/j.sleep.2012.02.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 02/24/2012] [Accepted: 02/29/2012] [Indexed: 11/19/2022]
Affiliation(s)
- K Menzler
- Philipps-University Marburg, Department of Neurology, Marburg, Germany
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Politis M, Wu K, Loane C, Quinn NP, Brooks DJ, Oertel WH, Bjorklund A, Lindvall O, Piccini P. Serotonin Neuron Loss and Nonmotor Symptoms Continue in Parkinson's Patients Treated with Dopamine Grafts. Sci Transl Med 2012; 4:128ra41. [DOI: 10.1126/scitranslmed.3003391] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
23
|
Thum A, Haag A, Rösler J, Jacobs H, Hermsen A, Huber M, Knake S, Rosenow F, Oertel WH, Hamer HM. Verbal declarative memory and language lateralization in patients with major depression: A functional transcranial Doppler sonography (fTCD) study. Pharmacopsychiatry 2011. [DOI: 10.1055/s-0031-1292552] [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: 10/17/2022]
|
24
|
Fontanilla CV, Ma Z, Wei X, Klotsche J, Zhao L, Wisniowski P, Dodel RC, Farlow MR, Oertel WH, Du Y. Caffeic acid phenethyl ester prevents 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced neurodegeneration. Neuroscience 2011; 188:135-41. [PMID: 21571045 DOI: 10.1016/j.neuroscience.2011.04.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Revised: 03/30/2011] [Accepted: 04/06/2011] [Indexed: 01/23/2023]
Abstract
Parkinson's disease is associated with the loss of dopaminergic neurons in the substantia nigra and decreased striatal dopamine levels. We now report that caffeic acid phenethyl ester (CAPE), an active component of propolis, attenuated dopaminergic neurodegeneration and dopamine loss in the MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) mouse model of Parkinson's disease. The neuroprotective effect of CAPE was associated with marked reductions in inducible nitric oxide synthase (iNOS) and caspase 1 expression. Additionally, CAPE inhibited MPP+-induced neurotoxicity in vitro and directly inhibited MPP+-induced release of cytochrome c and apoptosis inducing factor (AIF) from mitochondria. Thus, CAPE may have beneficial effects in slowing or preventing the progression of Parkinson's disease and other neurodegenerative disorders.
Collapse
Affiliation(s)
- C V Fontanilla
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Reese JP, Winter Y, Rosa MM, Rodrigues E Silva AM, von Campenhausen S, Freire R, Mateus C, Balzer-Geldsetzer M, Botzel K, Oertel WH, Dodel R, Sampaio C. [Health-economic burden of Parkinson's disease in Portugal: a cohort study]. Rev Neurol 2011; 52:264-274. [PMID: 21341221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Parkinson's disease (PD) is a common neurodegenerative disorder with a considerable socioeconomic burden. Health-economic evaluations of PD in the Southern European countries are limited. AIM To evaluate the costs of PD in an outpatient cohort in Portugal. PATIENTS AND METHODS 49 consecutive PD patients were recruited at the neurological outpatient clinic of the University of Lisbon between October 2004 and December 2005. Clinical status was evaluated using the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr stages. Costs were assessed from the societal perspective using health-economic questionnaires. Human capital approach was used to estimate indirect costs. Health-related quality of life was evaluated by means of the EQ-5D. RESULTS Direct costs were 2,717 euros (95% CI = 1,147-3,351) per patient for a six-month period. Main contributors to the direct costs included drugs (544 euros; 95% CI = 426-6,940) and hospitalizations (690 euros; 95% CI = 229-1,944). Indirect costs amounted to 850 euros (95% CI = 397-1,529), whereas patient expenditures constituted 12% of direct costs. Assistance by family and other relatives played a major role. In general, costs were lower than in other Western countries. CONCLUSIONS The economic burden of PD in Portugal is considerable. Important cost components include medications and hospitalizations. More research is needed in order to describe a comprehensive health service patterns in Portugal and to guide health policy decisions more effectively.
Collapse
Affiliation(s)
- J P Reese
- Department of Neurology, Philipps, University Marburg, Marburg, Alemania
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Stamelou M, Knake S, Oertel WH, Höglinger GU. Magnetic resonance imaging in progressive supranuclear palsy. J Neurol 2010; 258:549-58. [PMID: 21181185 DOI: 10.1007/s00415-010-5865-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Revised: 11/20/2010] [Accepted: 11/29/2010] [Indexed: 10/18/2022]
Abstract
Progressive supranuclear palsy (PSP) is a tauopathy, presenting clinically most often with a symmetrical akinetic-rigid syndrome, postural instability, supranuclear gaze palsy and frontal dementia. In the absence of reliably validated biomarkers, the diagnosis of PSP in vivo is presently based on clinical criteria, which to date do not include supporting imaging findings, as is accepted for other neurodegenerative diseases. However, data from conventional magnetic resonance imaging (MRI) and various advanced MRI techniques including magnetic resonance volumetry, voxel-based morphometry, diffusion-weighted and diffusion-tensor imaging, magnetization transfer imaging and proton resonance spectroscopy suggest that MRI can contribute valuable information for the differential diagnosis of PSP. We review here the presently published literature concerning MRI in PSP and discuss the potential role of MRI in differentiating PSP from other parkinsonian syndromes.
Collapse
Affiliation(s)
- M Stamelou
- Department of Neurology, Philipps University, Rudolf-Bultmann Str. 8, 35033, Marburg, Germany.
| | | | | | | |
Collapse
|
27
|
Menzler K, Belke M, Wehrmann E, Krakow K, Lengler U, Jansen A, Hamer HM, Oertel WH, Rosenow F, Knake S. Men and women are different: diffusion tensor imaging reveals sexual dimorphism in the microstructure of the thalamus, corpus callosum and cingulum. Neuroimage 2010; 54:2557-62. [PMID: 21087671 DOI: 10.1016/j.neuroimage.2010.11.029] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 11/04/2010] [Accepted: 11/08/2010] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Numerous magnetic resonance imaging (MRI) studies have addressed the question of morphological differences of the brain of men and women, reporting conflicting results regarding brain size and the ratio of gray and white matter. In the present study, we used diffusion tensor imaging (DTI) to delineate sex differences of brain white matter. METHODS We investigated brain microstructure in 25 male and 25 female healthy subjects using a 3T MRI scanner. Whole-head DTI scans were analyzed without a-priori hypothesis using Tract-Based Spatial Statistics (TBSS) calculating maps of fractional anisotropy (FA), radial diffusivity (RD, a potential marker of glial alteration and changes in myelination) and axial diffusivity (AD, a potential marker of axonal changes). RESULTS DTI revealed regional microstructural differences between the brains of male and female subjects. Those were prominent in the thalamus, corpus callosum and cingulum. Men showed significantly (p<0.0001) higher values of fractional anisotropy and lower radial diffusivity in these areas, suggesting that the observed differences are mainly due to differences in myelination. DISCUSSION As a novel finding we showed widespread differences in thalamic microstructure that have not been described previously. Additionally, the present study confirmed earlier DTI studies focusing on sexual dimorphism in the corpus callosum and cingulum. All changes appear to be based on differences in myelination. The sex differences in thalamic microstructure call for further studies on the underlying cause and the behavioral correlates of this sexual dimorphism. Future DTI group studies may carefully control for gender to avoid confounding.
Collapse
Affiliation(s)
- K Menzler
- Philipps-University Marburg, Center of Brain Imaging, Department of Neurology, Marburg, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
Neurology and psychiatry deal with diseases of the (central) nervous system. Historically neurological disorders are related to a proven organic basis, whereas psychiatric disorders are mainly defined by the phenomenology and course of the symptoms. Neuroscientific research methods such as molecular genetics, neurochemistry, neurophysiology, neuropathology, functional (SPECT, PET, fMRI) or structural (MRI) imaging have dramatically increased our knowledge of psychiatric and neurological disorders in the last 20 years. Accordingly diagnostic and therapeutic procedures and the long-term prognosis of numerous diseases in both disciplines have substantially improved (i.e. pharmacotherapy, psychotherapy, functional neurosurgery). For major brain disorders - such as dementia of the Alzheimer type - close collaboration between both disciplines is developing in diagnosis, therapy and care. Due to common neurobiological research topics, educational programs, medical training and the challenges of assuring appropriate care to patients with brain disorders, further cooperation between neurology and psychiatry is expected and necessary.
Collapse
Affiliation(s)
- W H Oertel
- Klinik für Neurologie, Philipps-Universität, Rudolf-Bultmann-Strasse 8, 35039, Marburg, Deutschland.
| | | |
Collapse
|
29
|
Buob A, Winter H, Kindermann M, Becker G, Möller JC, Oertel WH, Böhm M. Parasympathetic but not sympathetic cardiac dysfunction at early stages of Parkinson's disease. Clin Res Cardiol 2010; 99:701-6. [PMID: 20443012 DOI: 10.1007/s00392-010-0170-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2010] [Accepted: 04/14/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Autonomic cardiovascular dysfunction is common in Parkinson's disease (PD). Imaging studies suggest loss of cardiac sympathetic nerves even in the absence of clinical signs of autonomic dysfunction. Aim of the study was to investigate the functional significance of autonomic cardiovascular denervation at early stages of PD. METHODS Seven PD patients (Hoehn and Yahr class 1 or 1.5) without clinical signs of autonomic dysfunction and seven age-matched healthy control subjects were studied. To evaluate the pre- and post-synaptic components of sympathetic innervation, dose-response curves of isoproterenol (no neuronal uptake) and epinephrine (neuronal uptake) on heart rate, contractility, cardiac output and systemic vascular resistance were determined echocardiographically. Additionally, measurements of baroreflex sensitivity and 24-h heart rate variability were done. RESULTS The chronotropic and inotropic responses during stimulation with isoproterenol and epinephrine were similar in PD patients and control subjects. Assessment of baroreflex sensitivity yielded no difference. Of the parameters of 24-h heart rate variability, only measures of high-frequency heart rate variation that more purely reflect parasympathetic activity were significantly depressed in PD patients as compared with control subjects. CONCLUSIONS The results of our study using direct determination of catecholamine-mediated chronotropic and contractile responses provide evidence against a functionally relevant sympathetic dysfunction. Possibly, sympathetic denervation is incomplete and the remaining fibers are sufficient for the maintenance of autonomic control. In contrast, the depression of several parameters of heart rate variability supports a significant change of parasympathetic activity at an early stage of PD with subclinical autonomic failure.
Collapse
Affiliation(s)
- Axel Buob
- Klinik für Innere Medizin III Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, 66421 Homburg/Saar, Germany.
| | | | | | | | | | | | | |
Collapse
|
30
|
Winter Y, Balzer‐Geldsetzer M, Spottke A, Reese JP, Baum E, Klotsche J, Rieke J, Simonow A, Eggert K, Oertel WH, Dodel R. Longitudinal study of the socioeconomic burden of Parkinson’s disease in Germany. Eur J Neurol 2010; 17:1156-1163. [DOI: 10.1111/j.1468-1331.2010.02984.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Y. Winter
- Department of Neurology, Philipps ‐ University, Marburg
| | | | - A. Spottke
- Department of Neurology, Friedrich‐Wilhelms‐University, Bonn
| | - J. P. Reese
- Department of Neurology, Philipps ‐ University, Marburg
| | - E. Baum
- Department of General Practice/Family Medicine, Philipps ‐ University, Marburg
| | - J. Klotsche
- Department of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden
| | - J. Rieke
- Neurological Practice, Giessen, Herborn
| | | | - K. Eggert
- Department of Neurology, Philipps ‐ University, Marburg
| | - W. H. Oertel
- Department of Neurology, Philipps ‐ University, Marburg
| | - R. Dodel
- Department of Neurology, Philipps ‐ University, Marburg
| |
Collapse
|
31
|
Respondek G, Decker S, Steinmeyer L, Oertel WH, Höglinger GU. [Differential diagnosis of Parkinson's disease: current consensus criteria and outlook]. Fortschr Neurol Psychiatr 2010; 78 Suppl 1:S8-15. [PMID: 20195943 DOI: 10.1055/s-0029-1245176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Parkinsonian-syndrome, clinically based on the combination of cardinal symptoms, could be the clinical manifestation of different, neuropathological defined entities. Because of the different prognostic, therapeutical and scientific implications a reliable differential diagnostic of the entities in early course of disease is desirable. For this purpose standardized clinical diagnostic criteria with sufficient validation against the gold standard of the neuropathological diagnostic are important. In this article, the clinical diagnostic criteria of atypical Parkinsonian-syndrome and their validity were discussed.
Collapse
Affiliation(s)
- G Respondek
- Klinik für Neurologie der Philipps-Universität Marburg, Marburg
| | | | | | | | | |
Collapse
|
32
|
Reese JP, Winter Y, Balzer-Geldsetzer M, Bötzel K, Eggert K, Oertel WH, Dodel R, Campenhausen SV. Morbus Parkinson: Krankheitskosten einer ambulanten Patientenkohorte. Gesundheitswesen 2010; 73:22-9. [DOI: 10.1055/s-0030-1247571] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
33
|
Menzler K, Belke M, Ohletz T, Keil B, Heverhagen J, Rosenow F, Mayer G, Oertel WH, Möller JC, Unger M, Knake S. MRI evidence of microstructural lesions in the mesencephalon and pons of patients with idiopathic narcolepsy. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
34
|
Menzler K, Welk A, Knake S, Oertel WH, Schepelmann K, Rosenow F, Mylius V. No modulation of experimentally-induced pain by navigation-guided rTMS of the right inferior frontal gyrus. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
35
|
Belke M, Unger MM, Hattemer K, Heverhagen JT, Keil B, Stiasny-Kolster K, Rosenow F, Diederich NJ, Mayer G, Möller JC, Oertel WH, Knake S. Diffusion Tensor Imaging (DTI) in idiopathic REM sleep behaviour disorder (iRBD). KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
36
|
Elzer J, Eienbröker C, Happel M, Schlegel K, Wellek AS, Hehenkamp A, Iwinska-Zelder J, Oertel WH, Tackenberg B. Dysregulation CD4+CD25+ T-Zellen (Treg) im Liquor korreliert mit T2-Läsionsvolumen beim frühen klinisch isolierten Syndrom verdächtig auf Multiple Sklerose. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238579] [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]
|
37
|
Haag A, Diezinger M, Hermsen A, Knake S, Rosenow F, Oertel WH, Hamer HM. Untersuchung der zerebrovaskulären Reserve und Sprachdominanz mittels funktioneller transkranieller Dopplersonografie bei gesunden älteren Probanden – Zusammenhang zum Verbalgedächtnis. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238708] [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]
|
38
|
Hülsmeier K, Wellek AS, Hagen BV, Himmel B, Eienbröker C, Jackl I, Esters J, Oertel WH, Hermsen A, Sommer N, Tackenberg B. Kontrollierte, prospektive Studie zur Stressverarbeitung und Copingstrategien bei Beginn einer immunmodulatorischen Therapie bei neu diagnostiziertem klinisch isolierten Syndrom und schubförmiger Multipler Sklerose. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238580] [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]
|
39
|
Wellek AS, Bach JP, Wellek S, Eienbröker C, Schock S, Korsukewitz C, Hagen BV, Dodel R, Oertel WH, Sommer N, Tackenberg B. Within-family associations and disease progression in familial multiple sclerosis. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238577] [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]
|
40
|
Schmittinger K, Unger M, Möller C, Eggert K, Heverhagen J, Keil B, Strauch K, Oertel WH, Hattemer K, Knake S. MR-tomographische Darstellung der verzögerten Magenmotilität bei Patienten mit idiopathischem Parkinson-Syndrom. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238348] [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]
|
41
|
Eienbröker C, Wellek AS, Hagen BV, Oertel WH, Tackenberg B. Steroidsparender Effekt der Langzeittherapie mit intravenösen Immunglobulinen bei Myasthenia gravis. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238816] [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]
|
42
|
Winter Y, Reese JP, Campenhausen SV, Eggert K, Balzer-Geldsetzer M, Klotsche J, Freire R, Brozova H, Longo K, Peter H, Gasser J, Seppi K, Popov G, Mateus C, Pfeiffer KP, Skoupa J, Boetzel K, Gusev E, Guekht A, Ruzicka E, Barone P, Sampaio C, Poewe W, Oertel WH, Dodel R. Health-related quality of life and pharmacotherapy in Parkinson's disease: results of a multi-country study of the EuroPA Study Group. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238343] [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]
|
43
|
Belke M, Stamelou M, Hattemer K, Pilatus U, Oertel WH, Höglinger GU, Knake S. Diffusion Tensor Imaging reveals microstructural brain changes in patients with Progressive supranuclear palsy. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238346] [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]
|
44
|
Stamelou M, Christ H, Oertel WH, Höglinger G. Hypodipsia discriminates PSP from Parkinson's disease and Multisystem Atrophy. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238875] [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]
|
45
|
Depboylu C, Chiu WH, Weihe E, Ries V, Oertel WH, Höglinger GU, Schäfer M. Striatal tyrosine hydroxylase expressing neurons in mouse models of Parkinson's disease. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238465] [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]
|
46
|
Plate A, Hattemer K, Iwinska-Zelder J, Shiratori K, Jäger RK, Oertel WH, Hamer HM, Rosenow F, Knake S. No evidence of hippocampal sclerosis in healthy subjects on magnetic resonance imaging. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238694] [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]
|
47
|
Teepker M, Hötzel J, Timmesfeld N, Reis J, Mylius V, Haag A, Oertel WH, Rosenow F, Schepelmann K. Low-frequency rTMS of the vertex in the prophylactic treatment of migraine. Cephalalgia 2009; 30:137-44. [DOI: 10.1111/j.1468-2982.2009.01911.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
High-frequency repetitive transcranial magnetic stimulation (rTMS) increases and low-frequency rTMS decreases neural excitability. Clinically, rTMS shows beneficial effects in the treatment of neurological and psychiatric disorders. Furthermore, chronic and neuropathic pain has been shown to respond to rTMS treatment. A small pilot study revealed prophylactic effects of high-frequency rTMS in migraine. As there is evidence of neuronal hyperexcitability in migraine, we conducted a placebo-controlled, blinded study to evaluate the therapeutic effects of low-frequency rTMS in migraine. The primary end-point was defined as a reduction of migraine attacks compared with placebo, secondary outcomes were a reduction in the total number of days with headache, hours with headache, pain intensity and a decrease of analgesic intake for migraine. Twenty-seven migraineurs completed the study and were treated with rTMS on five consecutive days. For the verum group, two trains of 500 pulses with a frequency of 1 Hz were applied over vertex with a round coil. For the treatment of the placebo group, a figure-of-eight sham coil was used. A significant decrease of migraine attacks could be observed in the verum group. However, when comparing these effects with placebo, no significance was evident. The same was true concerning secondary outcome measures with regard to days with migraine and total hours with migraine. No effects were evident for pain intensity and use of analgesics. The rTMS treatment was tolerated well. rTMS stimulation over vertex with 1 Hz was not effective in migraine prophylaxis when compared with placebo. The positive effects regarding migraine attacks, days and total hours with migraine in the verum group are encouraging and indicate that further research on this topic is warranted.
Collapse
Affiliation(s)
- M Teepker
- Department of Neurology, University of Marburg, Marburg, Germany
| | - J Hötzel
- Department of Neurology, University of Marburg, Marburg, Germany
| | - N Timmesfeld
- Institute of Medical Biometry and Epidemiology, University of Marburg, Marburg, Germany
| | - J Reis
- Department of Neurology, University of Marburg, Marburg, Germany
| | - V Mylius
- Department of Neurology, University of Marburg, Marburg, Germany
| | - A Haag
- Department of Neurology, University of Marburg, Marburg, Germany
| | - WH Oertel
- Department of Neurology, University of Marburg, Marburg, Germany
| | - F Rosenow
- Department of Neurology, University of Marburg, Marburg, Germany
| | - K Schepelmann
- Department of Neurology, University of Marburg, Marburg, Germany
- Schlei-Klinikum Schleswig MLK, Schleswig, Germany
| |
Collapse
|
48
|
Ehret R, Balzer-Geldsetzer M, Reese J, Dodel I, Becker E, Christopher A, Friedrich H, Kraemer S, Lüer W, Müngersdorf M, Puzich R, Rohr † A, Schultes-Platzek I, Siefjediers V, Tiel-Wilck K, Oertel WH, Dodel R. Direkte Kosten der Parkinson-Behandlung. Nervenarzt 2009; 80:452-8. [DOI: 10.1007/s00115-009-2671-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
49
|
Trenkwalder C, Paulus W, Krafczyk S, Hawken M, Oertel WH, Brandt T. Postural stability differentiates “lower body” from idiopathic parkinsonism. Acta Neurol Scand 2009. [DOI: 10.1111/j.1600-0404.1995.tb00444.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
50
|
Mylius V, Engau I, Teepker M, Stiasny-Kolster K, Schepelmann K, Oertel WH, Lautenbacher S, Möller JC. Pain sensitivity and descending inhibition of pain in Parkinson's disease. J Neurol Neurosurg Psychiatry 2009; 80:24-8. [PMID: 18653553 DOI: 10.1136/jnnp.2008.145995] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Patients suffering from Parkinson's disease (PD) often complain about painful sensations. Recent studies detected increased subjective pain sensitivity and increased spinal nociception, which appeared to be reversible by dopaminergic treatment. Possibly, reduced descending pain inhibition contributes to this finding. OBJECTIVE Subjective pain thresholds as well as nociceptive reflex thresholds were investigated to isolate potential loci of the pathophysiological changes within the pain pathway. In addition, the diffuse noxious inhibitory control (DNIC) system as one form of descending control was assessed. METHOD 15 patients with PD and 18 controls participated in the study. Electrical and heat pain thresholds as well as the nociceptive flexion reflex (NFR) thresholds were determined. Thereafter, the electrical pain thresholds were measured once during painful heat stimulation (conditioning stimulation) and twice during innocuous stimulation (control stimulation). RESULTS Patients with PD exhibited lower electrical and heat pain thresholds as well as lower NFR thresholds. Suppression of the electrical pain thresholds during painful heat stimulation (conditioning stimulation) compared with control stimulation did not differ significantly between the groups. No differences in the thresholds between patients with PD with and without clinical pain were seen. CONCLUSIONS Finding the NFR threshold to be decreased in addition to the decreased electrical and heat pain thresholds indicates that the pathophysiological changes either already reside at or reach down to the spinal level. Reduced activation of the DNIC system was apparently not associated with increased pain sensitivity, suggesting that DNIC-like mechanisms do not significantly contribute to clinical pain in PD.
Collapse
Affiliation(s)
- V Mylius
- Department of Neurology, Philipps University of Marburg, Rudolf-Bultmann-Str 8, 35033 Marburg, Germany.
| | | | | | | | | | | | | | | |
Collapse
|