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Koy A, Kühn AA, Schiller P, Huebl J, Schneider GH, Eckenweiler M, Rensing-Zimmermann C, Coenen VA, Krauss JK, Saryyeva A, Hartmann H, Lorenz D, Volkmann J, Matthies C, Schnitzler A, Vesper J, Gharabaghi A, Weiss D, Bevot A, Marks W, Howser A, Monbaliu E, Mueller J, Prinz-Langenohl R, Visser-Vandewalle V, Timmermann L. Long-Term Follow-Up of Pediatric Patients with Dyskinetic Cerebral Palsy and Deep Brain Stimulation. Mov Disord 2023; 38:1736-1742. [PMID: 37358761 DOI: 10.1002/mds.29516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/16/2023] [Accepted: 06/05/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) has been increasingly used in the management of dyskinetic cerebral palsy (DCP). Data on long-term effects and the safety profile are rare. OBJECTIVES We assessed the efficacy and safety of pallidal DBS in pediatric patients with DCP. METHODS The STIM-CP trial was a prospective, single-arm, multicenter study in which patients from the parental trial agreed to be followed-up for up to 36 months. Assessments included motor and non-motor domains. RESULTS Of the 16 patients included initially, 14 (mean inclusion age 14 years) were assessed. There was a significant change in the (blinded) ratings of the total Dyskinesia Impairment Scale at 36 months. Twelve serious adverse events (possibly) related to treatment were documented. CONCLUSION DBS significantly improved dyskinesia, but other outcome parameters did not change significantly. Investigations of larger homogeneous cohorts are needed to further ascertain the impact of DBS and guide treatment decisions in DCP. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Anne Koy
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Petra Schiller
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julius Huebl
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
- Department of Neurology, Munich Municipal Hospital Bogenhausen, Munich, Germany
| | | | - Matthias Eckenweiler
- Department of Neuropediatrics and Muscle Disorders, University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Cornelia Rensing-Zimmermann
- Department of Neuropediatrics and Muscle Disorders, University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Volker Arnd Coenen
- Department of Stereotactic and Functional Neurosurgery, University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Deep Brain Stimulation, University Medical Center, Freiburg, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Assel Saryyeva
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Hans Hartmann
- Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Delia Lorenz
- Department of Pediatrics, University Children's Hospital, Wuerzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Cordula Matthies
- Department of Stereotactic and Functional Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Jan Vesper
- Department of Functional Neurosurgery and Stereotaxy, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alireza Gharabaghi
- Institute for Neuromodulation and Neurotechnology, Department of Neurosurgery and Neurotechnology, University Hospital and University of Tübingen, Tübingen, Germany
| | - Daniel Weiss
- Department of Neurology, Medical Faculty, University of Tübingen, Tübingen, Germany
| | - Andrea Bevot
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital Tübingen, Tübingen, Germany
| | - Warren Marks
- Department of Neurology, Cook Children's Medical Center, Fort Worth, Texas, USA
- Department of Pediatrics, University of North Texas Health Sciences Center, Fort Worth, Texas, USA
| | - Angela Howser
- Department of Pediatrics, University of North Texas Health Sciences Center, Fort Worth, Texas, USA
| | - Elegast Monbaliu
- Department of Rehabilitation Sciences, KU Leuven Campus Bruges, Brugge, Belgium
| | - Joerg Mueller
- Department of Neurology, Vivantes Klinikum Spandau, Berlin, Germany
| | | | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
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Lorenz D, Musacchio T, Kunstmann E, Grauer E, Pluta N, Stock A, Speer CP, Hebestreit H. A case report of Sanfilippo syndrome - the long way to diagnosis. BMC Neurol 2022; 22:93. [PMID: 35291973 PMCID: PMC8922843 DOI: 10.1186/s12883-022-02611-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 03/01/2022] [Indexed: 12/03/2022] Open
Abstract
Background Mucopolysaccharidosis type III (Sanfilippo syndrome) is a lysosomal storage disorder, caused by a deficiency in the heparan-N-sulfatase enzyme involved in the catabolism of the glycosaminoglycan heparan sulfate. It is characterized by early nonspecific neuropsychiatric symptoms, followed by progressive neurocognitive impairment in combination with only mild somatic features. In this patient group with a broad clinical spectrum a significant genotype-phenotype correlation with some mutations leading to a slower progressive, attenuated course has been demonstrated. Case presentation Our patient had complications in the neonatal period and was diagnosed with Mucopolysaccharidosis IIIa only at the age of 28 years. He was compound heterozygous for the variants p.R245H and p.S298P, the latter having been shown to lead to a significantly milder phenotype. Conclusions The diagnostic delay is even more prolonged in this patient population with comorbidities and a slowly progressive course of the disease.
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Affiliation(s)
- Delia Lorenz
- Center for Rare Diseases, University Hospital of Wuerzburg, Josef-Schneider-Strasse 2, 97080, Wuerzburg, Germany.,University Children's Hospital Wuerzburg, University Hospital of Wuerzburg, Josef-Schneider- Strasse 2, 97080, Wuerzburg, Germany
| | - Thomas Musacchio
- Center for Rare Diseases, University Hospital of Wuerzburg, Josef-Schneider-Strasse 2, 97080, Wuerzburg, Germany.,Department of Neurology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 2, 97080, Wuerzburg, Germany
| | - Erdmute Kunstmann
- Department of Human Genetics, University of Wuerzburg, Am Hubland, 97074, Wuerzburg, Germany
| | - Eva Grauer
- Department of Human Genetics, University of Wuerzburg, Am Hubland, 97074, Wuerzburg, Germany
| | - Natalie Pluta
- Department of Human Genetics, University of Wuerzburg, Am Hubland, 97074, Wuerzburg, Germany
| | - Annika Stock
- Department of Neuroradiology, University Hospital Wuerzburg, Josef-Schneider-Strasse 2, 97080, Wuerzburg, Germany
| | - Christian P Speer
- University Children's Hospital Wuerzburg, University Hospital of Wuerzburg, Josef-Schneider- Strasse 2, 97080, Wuerzburg, Germany
| | - Helge Hebestreit
- Center for Rare Diseases, University Hospital of Wuerzburg, Josef-Schneider-Strasse 2, 97080, Wuerzburg, Germany. .,University Children's Hospital Wuerzburg, University Hospital of Wuerzburg, Josef-Schneider- Strasse 2, 97080, Wuerzburg, Germany.
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Hebestreit H, Zeidler C, Schippers C, de Zwaan M, Deckert J, Heuschmann P, Krauth C, Bullinger M, Berger A, Berneburg M, Brandstetter L, Deibele A, Dieris-Hirche J, Graessner H, Gündel H, Herpertz S, Heuft G, Lapstich AM, Lücke T, Maisch T, Mundlos C, Petermann-Meyer A, Müller S, Ott S, Pfister L, Quitmann J, Romanos M, Rutsch F, Schaubert K, Schubert K, Schulz JB, Schweiger S, Tüscher O, Ungethüm K, Wagner TOF, Haas K, Akkaya F, Babka C, Bârlescu L, Bärsch-Michelmann A, Bergbreiter A, Blömeke J, Böhm L, Böttger B, Braun B, Brinkmann F, Britz V, Cario H, Celiker M, de Greck M, Debatin KM, Dillmann-Jehn K, Ertl M, Ettinger M, Eymann J, Frommer J, Gabrian M, Glode A, Gödecke V, Grasemann C, Grauer E, Greger H, Haas A, Haase M, Haisch L, Heinrich I, Held M, Hennermann J, Herrmann-Werner A, Hett J, Hilbig B, Holthöfer L, Imhof C, Jacob T, Junne F, Karl S, Kassubek J, Kick L, Koschitzki KT, Krassort H, Kratz C, Kristensen K, Kropff B, Kuhn J, Latzko P, Loew T, Lorenz D, Ludolph AC, dos Santos IM, Meyer T, Mohnike K, Monninger M, Musacchio T, Nanciu AN, Nießen M, Nöhre M, Papagianni A, Pfeifer-Duck C, Piduhn LS, Rampp C, Richter A, Rieß O, Schmidt A, Schneider S, Schoels L, Schwalba M, Selig U, Spangenberger A, Sroka A, Steinbüchel T, Stösser S, Suchant S, Vogel M, Volk D, Vollmuth C, Volnov S, Walter S, Warrings B, Weiler C, Witt S, Zajt KK, Zeltner L, Zenker K, Zhang KD, Zipfel S. Dual guidance structure for evaluation of patients with unclear diagnosis in centers for rare diseases (ZSE-DUO): study protocol for a controlled multi-center cohort study. Orphanet J Rare Dis 2022; 17:47. [PMID: 35164804 PMCID: PMC8842899 DOI: 10.1186/s13023-022-02176-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/16/2022] [Indexed: 11/12/2022] Open
Abstract
Background In individuals suffering from a rare disease the diagnostic process and the confirmation of a final diagnosis often extends over many years. Factors contributing to delayed diagnosis include health care professionals' limited knowledge of rare diseases and frequent (co-)occurrence of mental disorders that may complicate and delay the diagnostic process. The ZSE-DUO study aims to assess the benefits of a combination of a physician focusing on somatic aspects with a mental health expert working side by side as a tandem in the diagnostic process. Study design This multi-center, prospective controlled study has a two-phase cohort design. Methods Two cohorts of 682 patients each are sequentially recruited from 11 university-based German Centers for Rare Diseases (CRD): the standard care cohort (control, somatic expertise only) and the innovative care cohort (experimental, combined somatic and mental health expertise). Individuals aged 12 years and older presenting with symptoms and signs which are not explained by current diagnoses will be included. Data will be collected prior to the first visit to the CRD’s outpatient clinic (T0), at the first visit (T1) and 12 months thereafter (T2). Outcomes Primary outcome is the percentage of patients with one or more confirmed diagnoses covering the symptomatic spectrum presented. Sample size is calculated to detect a 10 percent increase from 30% in standard care to 40% in the innovative dual expert cohort. Secondary outcomes are (a) time to diagnosis/diagnoses explaining the symptomatology; (b) proportion of patients successfully referred from CRD to standard care; (c) costs of diagnosis including incremental cost effectiveness ratios; (d) predictive value of screening instruments administered at T0 to identify patients with mental disorders; (e) patients’ quality of life and evaluation of care; and f) physicians’ satisfaction with the innovative care approach. Conclusions This is the first multi-center study to investigate the effects of a mental health specialist working in tandem with a somatic expert physician in CRDs. If this innovative approach proves successful, it will be made available on a larger scale nationally and promoted internationally. In the best case, ZSE-DUO can significantly shorten the time to diagnosis for a suspected rare disease. Trial registration ClinicalTrials.gov; Identifier: NCT03563677; First posted: June 20, 2018, https://clinicaltrials.gov/ct2/show/NCT03563677.
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4
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Liao C, Castonguay CE, Heilbron K, Vuokila V, Medeiros M, Houle G, Akçimen F, Ross JP, Catoire H, Diez-Fairen M, Kang J, Mueller SH, Girard SL, Hopfner F, Lorenz D, Clark LN, Soto-Beasley AI, Klebe S, Hallett M, Wszolek ZK, Pendziwiat M, Lorenzo-Betancor O, Seppi K, Berg D, Vilariño-Güell C, Postuma RB, Bernard G, Dupré N, Jankovic J, Testa CM, Ross OA, Arzberger T, Chouinard S, Louis ED, Mandich P, Vitale C, Barone P, García-Martín E, Alonso-Navarro H, Agúndez JAG, Jiménez-Jiménez FJ, Pastor P, Rajput A, Deuschl G, Kuhlenbaümer G, Meijer IA, Dion PA, Rouleau GA. Association of Essential Tremor With Novel Risk Loci: A Genome-Wide Association Study and Meta-analysis. JAMA Neurol 2022; 79:185-193. [PMID: 34982113 PMCID: PMC8728658 DOI: 10.1001/jamaneurol.2021.4781] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Question Can common genetic variants associated with essential tremor (ET) be identified? Findings In this genome-wide association study and meta-analysis including genetic data on 483 054 individuals, 5 genome-wide significant loci were associated with risk of ET and common variants were associated with approximately 18% of ET heritability. Meaning Findings of this study may help identify new genes and inform ET biology. Importance Essential tremor (ET) is one of the most common movement disorders, affecting 5% of the general population older than 65 years. Common variants are thought to contribute toward susceptibility to ET, but no variants have been robustly identified. Objective To identify common genetic factors associated with risk of ET. Design, Setting, and Participants Case-control genome-wide association study. Inverse-variance meta-analysis was used to combine cohorts. Multicenter samples collected from European populations were collected from January 2010 to September 2019 as part of an ongoing study. Included patients were clinically diagnosed with or reported having ET. Control individuals were not diagnosed with or reported to have ET. Of 485 250 individuals, data for 483 054 passed data quality control and were used. Main Outcomes and Measures Genotypes of common variants associated with risk of ET. Results Of the 483 054 individuals included, there were 7177 with ET (3693 [51.46%] female; mean [SD] age, 62.66 [15.12] years), and 475 877 control individuals (253 785 [53.33%] female; mean [SD] age, 56.40 [17.6] years). Five independent genome-wide significant loci and were identified and were associated with approximately 18% of ET heritability. Functional analyses found significant enrichment in the cerebellar hemisphere, cerebellum, and axonogenesis pathways. Genetic correlation (r), which measures the degree of genetic overlap, revealed significant common variant overlap with Parkinson disease (r, 0.28; P = 2.38 × 10−8) and depression (r, 0.12; P = 9.78 × 10−4). A separate fine-mapping of transcriptome-wide association hits identified genes such as BACE2, LRRN2, DHRS13, and LINC00323 in disease-relevant brain regions, such as the cerebellum. Conclusions and Relevance The results of this genome-wide association study suggest that a portion of ET heritability can be explained by common genetic variation and can help identify new common genetic risk factors for ET.
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Affiliation(s)
- Calwing Liao
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Charles-Etienne Castonguay
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | | | - Veikko Vuokila
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Miranda Medeiros
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Gabrielle Houle
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Fulya Akçimen
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Jay P Ross
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Helene Catoire
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Monica Diez-Fairen
- Fundació Docència i Recerca Mútua Terrassa, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain.,Movement Disorders Unit, Department of Neurology, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Jooeun Kang
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stefanie H Mueller
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Simon L Girard
- Département des Sciences Fondamentales, Université du Québec à Chicoutimi, Saguenay, Quebec, Canada.,Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | | | - Delia Lorenz
- University Children's Hospital, University of Würzburg, Wurzburg, Germany
| | - Lorraine N Clark
- Department of Pathology and Cell Biology, Taub Institute, Columbia University, New York, New York
| | | | - Stephan Klebe
- Department of Neurology, University Hospital Würzburg, Wurzburg, Germany.,Department of Neurology, University Hospital Essen, Essen, Germany
| | - Mark Hallett
- National Institute of Neurological Disorders and Stroke Intramural Research Program, National Institutes of Health, Bethesda, Maryland
| | | | - Manuela Pendziwiat
- Institute of Clinical Molecular Biology, University of Kiel, Kiel, Germany.,Department of Neuropediatrics, University Medical Center Schleswig-Holstein, University of Kiel, Kiel, Germany
| | - Oswaldo Lorenzo-Betancor
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington.,Department of Neurology, University of Washington School of Medicine, Seattle
| | - Klaus Seppi
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Daniela Berg
- Department of Neurology, University Hospital Schleswig-Holstein, University of Kiel, Kiel, Germany
| | - Carles Vilariño-Güell
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ronald B Postuma
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Geneviève Bernard
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.,Division of Pediatric Neurology, Departments of Pediatrics, Neurology and Neurosurgery, Montreal Children's Hospital, Montreal, Quebec, Canada.,Child Health and Human Development Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Division of Medical Genetics, Department of Specialized Medicine, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Nicolas Dupré
- Faculté de Médecine, Université Laval, Centre Hospitalier Universitaire de Québec (l'Enfant-Jésus), Quebec, Canada
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas
| | - Claudia M Testa
- Parkinson's and Movement Disorders Center, Department of Neurology, Virginia Commonwealth University, Richmond
| | - Owen A Ross
- Departments of Neuroscience and Clinical Genomics, Mayo Clinic Florida, Jacksonville
| | - Thomas Arzberger
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.,Center for Neuropathology and Prion Research, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sylvain Chouinard
- Unité des troubles du mouvement André Barbeau, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Elan D Louis
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas
| | - Paola Mandich
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico Policlinico, San Martino, Genova, Italy
| | - Carmine Vitale
- Department of Motor Sciences and Wellness, University Parthenope, Naples, Italy
| | - Paolo Barone
- Center for Neurodegenerative Disease (CEMAND), Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Salerno, Italy
| | - Elena García-Martín
- University Institute of Molecular Pathology Biomarkers, UNEx, ARADyAL Instituto de Salud Carlos III, Caceres, Spain
| | | | - José A G Agúndez
- University Institute of Molecular Pathology Biomarkers, UNEx, ARADyAL Instituto de Salud Carlos III, Caceres, Spain
| | | | - Pau Pastor
- Fundació Docència i Recerca Mútua Terrassa, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Alex Rajput
- University of Saskatchewan, Saskatoon Health Authority, Saskatoon, Saskatchewan, Canada
| | - Günther Deuschl
- Department of Neurology, University Medical Center Schleswig Holstein, University of Kiel, Kiel, Germany
| | - Gregor Kuhlenbaümer
- Department of Neurology, University Hospital Schleswig-Holstein, University of Kiel, Kiel, Germany
| | - Inge A Meijer
- Department of Neuroscience and Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Patrick A Dion
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Guy A Rouleau
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
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Smith A, Pierce M, Loftus K, Lorenz D, Kaczor K. 272 Fractures in Young Children: Abuse or Accident? There’s An App For That. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lorenz D, Kress W, Zaum AK, Speer CP, Hebestreit H. Report of two siblings with spondylodysplastic Ehlers-Danlos syndrome and B4GALT7 deficiency. BMC Pediatr 2021; 21:293. [PMID: 34193099 PMCID: PMC8243911 DOI: 10.1186/s12887-021-02767-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/07/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The spondylodysplastic Ehlers-Danlos subtype (OMIM #130070) is a rare connective tissue disorder characterized by a combination of connective tissue symptoms, skeletal features and short stature. It is caused by variants in genes encoding for enzymes involved in the proteoglycan biosynthesis or for a zinc transporter. PRESENTATION OF CASES We report two brothers with a similar phenotype of short stature, joint hypermobility, distinct craniofacial features, developmental delay and severe hypermetropia indicative for a spondylodysplastic Ehlers-Danlos subtype. One also suffered from a recurrent pneumothorax. Gene panel analysis identified two compound heterozygous variants in the B4GALT7 gene: c.641G > A and c.723 + 4A > G. B4GALT7 encodes for galactosyltransferase I, which is required for the initiation of glycosaminoglycan side chain synthesis of proteoglycans. CONCLUSIONS This is a first full report on two cases with spondylodysplastic Ehlers-Danlos syndrome and the c.723 + 4A > G variant of B4GALT7. The recurrent pneumothoraces observed in one case expand the variable phenotype of the syndrome.
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Affiliation(s)
- Delia Lorenz
- Center for Rare Diseases, University Hospital Würzburg, University of Würzburg, Josef-Schneider-Strasse 2, 97080, Würzburg, Germany
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Strasse 2, 97080, Würzburg, Germany
| | - Wolfram Kress
- Department of Human Genetics, University of Würzburg, Biozentrum, Am Hubland, 97074, Würzburg, Germany
| | - Ann-Kathrin Zaum
- Department of Human Genetics, University of Würzburg, Biozentrum, Am Hubland, 97074, Würzburg, Germany
| | - Christian P Speer
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Strasse 2, 97080, Würzburg, Germany
| | - Helge Hebestreit
- Center for Rare Diseases, University Hospital Würzburg, University of Würzburg, Josef-Schneider-Strasse 2, 97080, Würzburg, Germany.
- University Children's Hospital Würzburg, University of Würzburg, Josef-Schneider-Strasse 2, 97080, Würzburg, Germany.
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Oetzmann von Sochaczewski C, Haist T, Pauthner M, Mann M, Fisseler-Eckhoff A, Braun S, Ell C, Lorenz D. The overall metastatic rate in early esophageal adenocarcinoma: long-time follow-up of surgically treated patients. Dis Esophagus 2019; 32:5267101. [PMID: 30596900 DOI: 10.1093/dote/doy127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/04/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022]
Abstract
The overall metastatic potential of surgically treated early esophageal adenocarcinoma has not been studied in detail. This paper therefore assessed lymph node metastases at surgery, loco regional and distant metastases, in order to assess the metastatic potential of early esophageal adenocarcinoma. Two hundred and seventeen patients (53 T1a, 164 T1b; median follow-ups 87 and 75 months, 187 males) diagnosed with early esophageal adenocarcinoma and treated with esophagectomy in our tertiary center's database between July 2000 and December 2015 were included. All metastatic events were retrospectively analyzed, their topographic distribution was assessed, and the overall metastatic rate was calculated. Lymph node metastases occurred in 39 patients (18%) and 29 (13.4%) developed recurrences. Lymph node metastases were absent in m1 and m2 tumors and rare in m3 (1/18), m4 (5/21), and sm1 (4/42), but more frequent in sm2 (11/44) and sm3 tumors (18/78). Locoregional recurrences were exceedingly rare in m3 (2/18), m4 (1/21), sm1 (1/42), and sm2 (2/44), but frequent in sm3 (12/78). In contrast, distant metastases were more frequent with 2/18 in m3, 1/21 in m4, 4/42 in sm1, 4/44 in sm2, and 13/78 in sm3. Overall metastatic rates of 11.9% in sm1 (submucosal layer divided into equal thirds), 27.3% in sm2, and 32.1% in sm3 tumors were calculated. This first report of the metastatic potential of early esophageal adenocarcinoma provides a meticulous assessment of the overall metastatic risk. Metastatic events pose a relevant risk in surgically treated patients with esophageal adenocarcinoma with distant metastases being more frequent than locoregional recurrences.
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Affiliation(s)
| | - T Haist
- Department of Surgery I, Sana Klinikum Offenbach, Germany
| | - M Pauthner
- Department of Surgery I, Sana Klinikum Offenbach, Germany
| | - M Mann
- Department of Surgery I, Sana Klinikum Offenbach, Germany
| | - A Fisseler-Eckhoff
- Institute of Pathology, Helios Dr. Horst-Schmidt-Kliniken, Wiesbaden, Germany
| | - S Braun
- Institute of Pathology, Sana Klinikum Offenbach, Germany
| | - C Ell
- Department of Internal Medicine II, Sana Klinikum Offenbach, Offenbach, Germany
| | - D Lorenz
- Department of Surgery I, Klinikum Darmstadt, Darmstadt, Germany
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Buhr HJ, Hardt J, Klinger C, Seyfried F, Wiegering A, Dietrich A, Bartsch DK, Lorenz D, Post S, Germer CT, Keck T, Wellner U. [Quality indicators with reference values and threshold limits in general and visceral surgery : For obesity and metabolic, pancreatic, colon carcinoma and rectal carcinoma surgery]. Chirurg 2019; 89:1-3. [PMID: 29330678 DOI: 10.1007/s00104-017-0562-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H J Buhr
- Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, Haus der Bundespressekonferenz, Schiffbauerdamm 40, 10117, Berlin, Deutschland.
| | - J Hardt
- Chirurgische Klinik, Universitätsmedizin Mannheim, Mannheim, Deutschland
| | - C Klinger
- Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, Haus der Bundespressekonferenz, Schiffbauerdamm 40, 10117, Berlin, Deutschland
| | - F Seyfried
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - A Wiegering
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - A Dietrich
- Klinik und Poliklinik für Viszeral‑, Transplantations‑, Thorax- und Gefäßchirurgie Bereich Bariatrische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - D K Bartsch
- Klinik für Visceral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Marburg, Marburg, Deutschland
| | - D Lorenz
- Klinik für Allgemein- und Viszeralchirurgie bzw. der Medizinischen Klinik II Gastroenterologie, Hepatologie, Endokrinologie, Infektiologie, Sana Klinikum Offenbach, Offenbach, Deutschland
| | - S Post
- Chirurgische Klinik, Universitätsmedizin Mannheim, Mannheim, Deutschland
| | - C T Germer
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - T Keck
- Klinik für Allgemeine Chirurgie, Universitätsklinikum S.-H. Campus Lübeck, Lübeck, Deutschland
| | - U Wellner
- Klinik für Allgemeine Chirurgie, Universitätsklinikum S.-H. Campus Lübeck, Lübeck, Deutschland
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Haffez F, Haist T, Stolte M, Wiebols A, Lorenz D. Eine seltene Ursache eines Dünndarmileus. Chirurg 2018; 89:1002-1004. [DOI: 10.1007/s00104-018-0674-6] [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: 11/27/2022]
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11
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Hopfner F, Ahlf A, Lorenz D, Klebe S, Zeuner KE, Kuhlenbäumer G, Deuschl G. Early- and late-onset essential tremor patients represent clinically distinct subgroups. Mov Disord 2017; 31:1560-1566. [PMID: 27384030 DOI: 10.1002/mds.26708] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 05/14/2016] [Accepted: 05/30/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Essential tremor is a very common disease defined by sparse clinical criteria. It is unlikely that essential tremor is an etiologically homogeneous disease. Stratifying broadly defined diseases using clinical characteristics has often aided the etiopathological understanding. Most studies of essential tremor show 2 distinct age at onset peaks: early and late. This study investigates phenotypical differences between early- and late-onset essential tremor patients. METHODS We studied a sample of 1137 tremor patients. Of these patients, 978 suffered from definite or probable essential tremor. All of the patients underwent the same standardized examination encompassing, among other items, drawing of the Archimedes spiral and assessment of the Fahn-Tolosa-Marin scale. RESULTS Two subgroups of early-onset (≤ 24 years of age, n = 317) and late-onset (≥ 46 years of age, n = 356) patients were selected based on the visual and mathematical analysis of the age-at-onset distribution. Tremor severity in both groups was comparable. Tremor progression measured as Archimedes spiral score and the Fahn-Tolosa-Marin subscales divided by the disease duration in 10-year bins was significantly faster in late-onset patients when compared with early-onset patients. Early-onset patients more frequently reported a positive family history and alcohol sensitivity of the tremor. CONCLUSIONS The age-at-onset distribution suggests a distinction between early- and late-onset tremor. Early-onset and late-onset essential tremor differ in the progression rates and the frequencies of a positive family history and history of a positive effect of alcohol on tremor. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Franziska Hopfner
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Anjuli Ahlf
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Delia Lorenz
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Stephan Klebe
- Department of Neurology, University Hospital of Freiburg, Freiburg, Germany
| | - Kirsten E Zeuner
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany.
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12
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Haist T, Knabe M, May A, Lorenz D. [Endoscopic and surgical treatment of early gastric and esophageal carcinoma]. Chirurg 2017; 88:997-1004. [PMID: 29110039 DOI: 10.1007/s00104-017-0543-8] [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] [Indexed: 11/30/2022]
Abstract
BACKGROUND The treatment of early gastric (EGC) and esophageal carcinomas (EEC) is an interdisciplinary challenge. The risk of lymph node metastasis (LNM) is the crucial point in choosing the correct treatment option. OBJECTIVE This article gives an overview of the current treatment options and provides help in choosing the correct therapy. METHOD Current concepts and therapy algorithms are presented on the basis of a literature review and data from our own center. RESULTS Endoscopic submucosal dissection (ESD) is recommended for mucosal gastric cancer with good or moderate differentiation (G1,2) without macroscopic ulceration, in elevated type lesions smaller than 2 cm in size or depressed lesions smaller than 1 cm in size. In additional chromoendoscopy should be carried out. The extent of surgical resection is defined by the location of the tumor. A safety margin of at least 3 cm should be applied in distal gastric resections whereas the first line goal in gastrectomy is to achieve an R0 resection. In cN0 tumors a D1 lymphadenectomy (LA) seems to be sufficient. Minimally invasive techniques currently show promising results especially for a subtotal resection. The treatment strategy in EEC differs depending on the tumor entity. Mucosal squamous cell carcinoma with high risk factors (L1,V1) and all cN0 submucosal tumors without the detection of LNM should be referred to primary surgical resection. Early stage cN+ squamous cell carcinomas should be preoperatively treated with chemoradiotherapy. Adenocarcinoma with infiltration of the deeper submucosa (sm2,3) and high-risk sm1 tumors require surgical treatment. The standard operating procedure for EEC is an Ivor Lewis esophagectomy with 2‑field LA preferably performed as a hybrid or by a completely minimally invasive procedure. The procedure of choice in endoscopic resection of EEC is resection with the suck and cut technique.
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Affiliation(s)
- T Haist
- Abteilung Allgemein- und Viszeralchirurgie, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach, Deutschland
| | - M Knabe
- Medizinische Klinik II/IV, Sana Klinikum Offenbach, Offenbach, Deutschland
| | - A May
- Medizinische Klinik II/IV, Sana Klinikum Offenbach, Offenbach, Deutschland
| | - D Lorenz
- Abteilung Allgemein- und Viszeralchirurgie, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach, Deutschland.
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13
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Manner H, Wetzka J, May A, Pauthner M, Pech O, Fisseler-Eckhoff A, Stolte M, Vieth M, Lorenz D, Ell C. Early-stage adenocarcinoma of the esophagus with mid to deep submucosal invasion (pT1b sm2-3): the frequency of lymph-node metastasis depends on macroscopic and histological risk patterns. Dis Esophagus 2017; 30:1-11. [PMID: 26952572 DOI: 10.1111/dote.12462] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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] [Indexed: 02/06/2023]
Abstract
The rate of lymph-node (LN) metastasis in early adenocarcinoma (EAC) of the esophagus with mid to deep submucosal invasion (pT1b sm2/3) has not yet been precisely defined. The aim of the this study was to evaluate the rate of LN metastasis in pT1b sm2/3 EAC depending on macroscopic and histological risk patterns to find out whether there may also be options for endoscopic therapy as in cancers limited to the mucosa and the upper third of the submucosa. A total of 1.718 pt with suspicion of EAC were referred for endoscopic treatment (ET) to the Dept. of Internal Medicine II at HSK Wiesbaden 1996-2010. In 230/1.718 pt, the suspicion (endoscopic ultrasound, EUS) or definitive diagnosis of pT1b EAC (ER/surgery) was made. Of these, 38 pt had sm2 lesions, and 69 sm3. Rate of LN metastasis was analyzed depending on risk patterns: histologically low-risk (hisLR): G1-2, L0, V0; histologically high-risk (hisHR): ≥1 criterion not fulfilled; macroscopically low-risk (macLR): gross tumor type I-II, tumor size ≤2 cm; macroscopically high-risk (macHR): ≥1 criterion not fulfilled; combined low-risk (combLR): hisLR+macLR; combined high-risk (combHR): at least 1 risk factor. LN rate was only evaluated in pt who had proven maximum invasion depth of sm2/sm3, and who in case of ET had a follow-up (FU) by EUS of at least 24 months. 23/38 pt with pT1b sm2 lesions and 39/69 pt with sm3 lesions fulfilled our inclusion criteria. In the pT1b sm2 group, rate of LN metastasis in the hisLR, hisHR, combLR, and combHR groups were 8.3% (1/12), 36.3% (4/11), 0% (0/5), and 27.8% (5/18). In the pT1b sm3 group, rate of LN metastasis in the hisLR, hisHR, combLR and combHR groups were 28.6% (2/7), 37.5% (12/32), 25% (1/4), and 37.1% (13/35). 30-day mortality of surgery was 1.7% (1/58 pt). In EAC with pT1b sm2/3 invasion, the frequency of LN metastasis depends on macroscopic and histological risk patterns. Surgery remains the standard treatment, because the rate of LN metastasis appears to be higher than the mortality risk of surgery. Whether a highly selected group of pT1b sm2 patients with a favourable risk pattern may be candidates for endoscopic therapy cannot be decided until the results of larger case volumes are available.
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Affiliation(s)
- H Manner
- Department of Internal Medicine II, HSK Hospital, Teaching Hospital of the University Medicine of Mainz, Wiesbaden, Germany
| | - J Wetzka
- Department of Internal Medicine II/IV, Sana Klinikum Offenbach, Teaching Hospital of the University Medicine of Frankfurt, Germany
| | - A May
- Department of Internal Medicine II/IV, Sana Klinikum Offenbach, Teaching Hospital of the University Medicine of Frankfurt, Germany
| | - M Pauthner
- Department of General and Visceral Surgery, Sana Klinikum Offenbach, Teaching Hospital of the University Medicine of Frankfurt, Germany
| | - O Pech
- Department of Gastroenterology and Interventional Endoscopy, St. John of God Hospital, Regensburg, Germany
| | | | - M Stolte
- Institute of Pathology, Kulmbach Hospital, Germany
| | - M Vieth
- Institute of Pathology, Bayreuth Hospital, Germany
| | - D Lorenz
- Department of General and Visceral Surgery, Sana Klinikum Offenbach, Teaching Hospital of the University Medicine of Frankfurt, Germany
| | - C Ell
- Department of Internal Medicine II/IV, Sana Klinikum Offenbach, Teaching Hospital of the University Medicine of Frankfurt, Germany
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Abstract
Minimally invasive resections are increasingly employed in oncologic surgery for esophageal carcinoma. The new German S3 guideline states that esophagectomy, as well as reconstruction of the esophagus, can be performed minimally invasively or in combination with open techniques (hybrid). However, the current value of different techniques - ranging from complete minimally invasive esophagectomy over hybrid to robotic surgery - remains unregarded.This review provides a critical comparison of these techniques based on current evidence. Minimally invasive procedures of oncologic esophageal resection are safe in experienced hands and show numerous advantages with regard to postoperative reconvalescence. Laparoscopic gastrolysis with intra-abdominal lymphadenectomy and muscle sparing as well as anterolateral mini-thoracotomy (also via VATS as single-port technique) as a hybrid method also result in a relevant reduction of postoperative mortality and offer the possibility of extended mediastinal lymphadenectomy, which requires a high level of expertise when performed thoracoscopically. At present, robotic esophagectomy is applied in only a few clinics in Germany. A lack of evidence based on studies for esophageal surgery, as well as high acquisition and operating costs of the robotic system, have to be taken into account.
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Affiliation(s)
- I Gockel
- Klinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
| | - D Lorenz
- Klinik für Allgemein- und Viszeralchirurgie, Sana Klinikum Offenbach GmbH, Offenbach, Deutschland
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15
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Koy A, Kühn AA, van Riesen A, Huebl J, Korinthenberg R, Coenen VA, Krauss JK, Wloch A, Lorenz D, Haussler M, Schnitzler A, Vesper J, Alesch F, Lehmacher W, Mueller J, Borck G, Witt K, Baumer T, Berweck S, Schroder S, Voges J, Langenohl RP, Vandewalle VV, Hellmich M, Timmermann L, investigators STIMCP. Effect of Deep Brain Stimulation of the Globus Pallidus Internus on Quality of Life in Young Patients with Dyskinetic Cerebral Palsy (STIM-CP): a Prospective Single-Arm Multicenter Trial with a Double-Blind Cross-Over at 12-Months Follow-up. ACTA ACUST UNITED AC 2017. [DOI: 10.4172/2167-0870.1000317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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17
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Müller SH, Girard SL, Hopfner F, Merner ND, Bourassa CV, Lorenz D, Clark LN, Tittmann L, Soto-Ortolaza AI, Klebe S, Hallett M, Schneider SA, Hodgkinson CA, Lieb W, Wszolek ZK, Pendziwiat M, Lorenzo-Betancor O, Poewe W, Ortega-Cubero S, Seppi K, Rajput A, Hussl A, Rajput AH, Berg D, Dion PA, Wurster I, Shulman JM, Srulijes K, Haubenberger D, Pastor P, Vilariño-Güell C, Postuma RB, Bernard G, Ladwig KH, Dupré N, Jankovic J, Strauch K, Panisset M, Winkelmann J, Testa CM, Reischl E, Zeuner KE, Ross OA, Arzberger T, Chouinard S, Deuschl G, Louis ED, Kuhlenbäumer G, Rouleau GA. Genome-wide association study in essential tremor identifies three new loci. Brain 2016; 139:3163-3169. [PMID: 27797806 PMCID: PMC5382938 DOI: 10.1093/brain/aww242] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/10/2016] [Accepted: 08/06/2016] [Indexed: 11/13/2022] Open
Abstract
We conducted a genome-wide association study of essential tremor, a common movement disorder characterized mainly by a postural and kinetic tremor of the upper extremities. Twin and family history studies show a high heritability for essential tremor. The molecular genetic determinants of essential tremor are unknown. We included 2807 patients and 6441 controls of European descent in our two-stage genome-wide association study. The 59 most significantly disease-associated markers of the discovery stage were genotyped in the replication stage. After Bonferroni correction two markers, one (rs10937625) located in the serine/threonine kinase STK32B and one (rs17590046) in the transcriptional coactivator PPARGC1A were associated with essential tremor. Three markers (rs12764057, rs10822974, rs7903491) in the cell-adhesion molecule CTNNA3 were significant in the combined analysis of both stages. The expression of STK32B was increased in the cerebellar cortex of patients and expression quantitative trait loci database mining showed association between the protective minor allele of rs10937625 and reduced expression in cerebellar cortex. We found no expression differences related to disease status or marker genotype for the other two genes. Replication of two lead single nucleotide polymorphisms of previous small genome-wide association studies (rs3794087 in SLC1A2, rs9652490 in LINGO1) did not confirm the association with essential tremor.
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Affiliation(s)
- Stefanie H Müller
- 1 Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts University Kiel, Germany
| | - Simon L Girard
- 2 Département des Sciences Fondamentales, Université du Québec à Chicoutimi, Saguenay, Canada.,3 Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
| | - Franziska Hopfner
- 1 Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts University Kiel, Germany
| | - Nancy D Merner
- 3 Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Canada.,4 Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - Cynthia V Bourassa
- 3 Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
| | - Delia Lorenz
- 5 University Children's Hospital, University of Würzburg, Würzburg, Germany
| | - Lorraine N Clark
- 6 Department of Pathology and Cell Biology, Taub Institute, Columbia University, New York City, NY, USA
| | - Lukas Tittmann
- 7 Institute of Epidemiology, Christian-Albrechts University Kiel and Biobank POPGEN, Kiel, Germany
| | | | - Stephan Klebe
- 9 Department of Neurology, University Hospital Würzburg, Würzburg, Germany.,10 Department of Neurology, University Hospital Freiburg, Freiburg im Breisgau, Germany
| | - Mark Hallett
- 11 NINDS Intramural Research Program, National Institutes of Health, Bethesda, MD, USA
| | - Susanne A Schneider
- 1 Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts University Kiel, Germany.,12 Department of Neurology, Ludwig-Maximilians-Universität München, Munich Germany
| | | | - Wolfgang Lieb
- 7 Institute of Epidemiology, Christian-Albrechts University Kiel and Biobank POPGEN, Kiel, Germany
| | | | - Manuela Pendziwiat
- 14 Department of Paediatric Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts University Kiel, Germany
| | - Oswaldo Lorenzo-Betancor
- 15 Neurogenetics, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, CIBERNED, Centro de Investigacion Biomedica en Red en Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Spain.,16 Department of Neurology, Hospital Universitari Mutua de Terrassa, University of Barcelona, Barcelona, Spain
| | - Werner Poewe
- 17 Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Sara Ortega-Cubero
- 15 Neurogenetics, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, CIBERNED, Centro de Investigacion Biomedica en Red en Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Spain.,16 Department of Neurology, Hospital Universitari Mutua de Terrassa, University of Barcelona, Barcelona, Spain
| | - Klaus Seppi
- 17 Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Alex Rajput
- 18 University of Saskatchewan and Saskatoon Health Region, Saskatoon, SK, Canada
| | - Anna Hussl
- 17 Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Ali H Rajput
- 18 University of Saskatchewan and Saskatoon Health Region, Saskatoon, SK, Canada
| | - Daniela Berg
- 1 Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts University Kiel, Germany
| | - Patrick A Dion
- 3 Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
| | - Isabel Wurster
- 19 Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, and German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Joshua M Shulman
- 20 Department of Neurology, Baylor College of Medicine, Houston, TX, USA.,21 Departments of Molecular and Human Genetics and Neuroscience, and Program in Developmental Biology, Baylor College of Medicine and Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA
| | - Karin Srulijes
- 19 Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, and German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Dietrich Haubenberger
- 11 NINDS Intramural Research Program, National Institutes of Health, Bethesda, MD, USA
| | - Pau Pastor
- 15 Neurogenetics, Division of Neurosciences, Center for Applied Medical Research (CIMA), University of Navarra, CIBERNED, Centro de Investigacion Biomedica en Red en Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Spain.,16 Department of Neurology, Hospital Universitari Mutua de Terrassa, University of Barcelona, Barcelona, Spain
| | - Carles Vilariño-Güell
- 22 Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Ronald B Postuma
- 3 Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Canada.,23 Department of Neurology, Montreal General Hospital, Montréal, QC, Canada
| | - Geneviève Bernard
- 3 Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Canada.,24 Departments of Pediatrics, Neurology and Neurosurgery, division of Pediatric Neurology, Montreal Children's Hospital, Montreal, Canada
| | - Karl-Heinz Ladwig
- 25 Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,26 Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität, Munich, Germany
| | - Nicolas Dupré
- 27 Faculté de Médecine, Université Laval, CHU de Québec (Enfant-Jésus), Québec, QC, Canada
| | - Joseph Jankovic
- 20 Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Konstantin Strauch
- 28 Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,29 Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Michel Panisset
- 30 Unité des troubles du mouvement André Barbeau, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Juliane Winkelmann
- 31 Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany.,32 Neurologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, and Munich Cluster for Systems Neurology (Synergy), Munich, Germany
| | - Claudia M Testa
- 33 Department of Neurology and Parkinson's and Movement Disorders Center, Virginia Commonwealth University, Richmond VA, USA
| | - Eva Reischl
- 25 Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,34 Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Kirsten E Zeuner
- 1 Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts University Kiel, Germany
| | - Owen A Ross
- 8 Department of Neuroscience and Neurology, Mayo Clinic, Florida, USA
| | - Thomas Arzberger
- 35 Center for Neuropathology and Prion Research, University of Munich, 80539 München, Germany.,36 Centre for Neuropathology and Prion Research, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sylvain Chouinard
- 30 Unité des troubles du mouvement André Barbeau, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Günther Deuschl
- 1 Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts University Kiel, Germany
| | - Elan D Louis
- 37 Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Gregor Kuhlenbäumer
- 1 Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts University Kiel, Germany
| | - Guy A Rouleau
- 3 Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
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Lorenz D, Armbruster W, Vogelgesang C, Hoffmann H, Pattar A, Schmidt D, Volk T, Kubulus D. Erratum zu: Eine neue Ära der MANV-Ausbildung? Anaesthesist 2016; 65:709. [DOI: 10.1007/s00101-016-0211-2] [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: 12/01/2022]
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Lorenz D, Armbruster W, Vogelgesang C, Hoffmann H, Pattar A, Schmidt D, Volk T, Kubulus D. [A new age of mass casuality education? : The InSitu project: realistic training in virtual reality environments]. Anaesthesist 2016; 65:703-9. [PMID: 27411523 DOI: 10.1007/s00101-016-0196-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Chief emergency physicians are regarded as an important element in the care of the injured and sick following mass casualty accidents. Their education is very theoretical; practical content in contrast often falls short. Limitations are usually the very high costs of realistic (large-scale) exercises, poor reproducibility of the scenarios, and poor corresponding results. OBJECTIVES To substantially improve the educational level because of the complexity of mass casualty accidents, modified training concepts are required that teach the not only the theoretical but above all the practical skills considerably more intensively than at present. Modern training concepts should make it possible for the learner to realistically simulate decision processes. This article examines how interactive virtual environments are applicable for the education of emergency personnel and how they could be designed. MATERIALS AND METHODS Virtual simulation and training environments offer the possibility of simulating complex situations in an adequately realistic manner. The so-called virtual reality (VR) used in this context is an interface technology that enables free interaction in addition to a stereoscopic and spatial representation of virtual large-scale emergencies in a virtual environment. Variables in scenarios such as the weather, the number wounded, and the availability of resources, can be changed at any time. The trainees are able to practice the procedures in many virtual accident scenes and act them out repeatedly, thereby testing the different variants. RESULTS With the aid of the "InSitu" project, it is possible to train in a virtual reality with realistically reproduced accident situations. These integrated, interactive training environments can depict very complex situations on a scale of 1:1. Because of the highly developed interactivity, the trainees can feel as if they are a direct part of the accident scene and therefore identify much more with the virtual world than is possible with desktop systems. CONCLUSION Interactive, identifiable, and realistic training environments based on projector systems could in future enable a repetitive exercise with changes within a decision tree, in reproducibility, and within different occupational groups. With a hard- and software environment numerous accident situations can be depicted and practiced. The main expense is the creation of the virtual accident scenes. As the appropriate city models and other three-dimensional geographical data are already available, this expenditure is very low compared with the planning costs of a large-scale exercise.
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Affiliation(s)
- D Lorenz
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, 66421, Kirrberger Straße, Geb. 57, Homburg/Saar, Deutschland.
| | - W Armbruster
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, 66421, Kirrberger Straße, Geb. 57, Homburg/Saar, Deutschland.,Notfalltrainings- und Simulationszentrum der Universität des Saarlandes an der Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Homburg, Homburg/Saar, Deutschland
| | - C Vogelgesang
- Deutsches Forschungszentrum für Künstliche Intelligenz (DFKI) GmbH, Saarbrücken, Deutschland
| | - H Hoffmann
- Deutsches Forschungszentrum für Künstliche Intelligenz (DFKI) GmbH, Saarbrücken, Deutschland
| | - A Pattar
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, 66421, Kirrberger Straße, Geb. 57, Homburg/Saar, Deutschland
| | - D Schmidt
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, 66421, Kirrberger Straße, Geb. 57, Homburg/Saar, Deutschland.,Notfalltrainings- und Simulationszentrum der Universität des Saarlandes an der Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Homburg, Homburg/Saar, Deutschland
| | - T Volk
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, 66421, Kirrberger Straße, Geb. 57, Homburg/Saar, Deutschland
| | - D Kubulus
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, 66421, Kirrberger Straße, Geb. 57, Homburg/Saar, Deutschland
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Lesage S, Drouet V, Majounie E, Deramecourt V, Jacoupy M, Nicolas A, Cormier-Dequaire F, Hassoun S, Pujol C, Ciura S, Erpapazoglou Z, Usenko T, Maurage CA, Sahbatou M, Liebau S, Ding J, Bilgic B, Emre M, Erginel-Unaltuna N, Guven G, Tison F, Tranchant C, Vidailhet M, Corvol JC, Krack P, Leutenegger AL, Nalls M, Hernandez D, Heutink P, Gibbs J, Hardy J, Wood N, Gasser T, Durr A, Deleuze JF, Tazir M, Destée A, Lohmann E, Kabashi E, Singleton A, Corti O, Brice A, Lesage S, Tison F, Vidailhet M, Corvol JC, Agid Y, Anheim M, Bonnet AM, Borg M, Broussolle E, Damier P, Destée A, Dürr A, Durif F, Krack P, Klebe S, Lohmann E, Martinez M, Pollak P, Rascol O, Tranchant C, Vérin M, Viallet F, Brice A, Lesage S, Majounie E, Tison F, Vidailhet M, Corvol J, Nalls M, Hernandez D, Gibbs J, Dürr A, Arepalli S, Barker R, Ben-Shlomo Y, Berg D, Bettella F, Bhatia K, de Bie R, Biffi A, Bloem B, Bochdanovits Z, Bonin M, Lesage S, Tison F, Vidailhet M, Corvol JC, Agid Y, Anheim M, Bonnet AM, Borg M, Broussolle E, Damier P, Destée A, Dürr A, Durif F, Krack P, Klebe S, Lohmann E, Martinez M, Pollak P, Rascol O, Tranchant C, Vérin M, Bras J, Brockmann K, Brooks J, Burn D, Charlesworth G, Chen H, Chinnery P, Chong S, Clarke C, Cookson M, Counsell C, Damier P, Dartigues JF, Deloukas P, Deuschl G, Dexter D, van Dijk K, Dillman A, Dong J, Durif F, Edkins S, Escott-Price V, Evans J, Foltynie T, Gao J, Gardner M, Goate A, Gray E, Guerreiro R, Harris C, van Hilten J, Hofman A, Hollenbeck A, Holmans P, Holton J, Hu M, Huang X, Huber H, Hudson G, Hunt S, Huttenlocher J, Illig T, Jónsson P, Kilarski L, Jansen I, Lambert JC, Langford C, Lees A, Lichtner P, Limousin P, Lopez G, Lorenz D, Lubbe S, Lungu C, Martinez M, Mätzler W, McNeill A, Moorby C, Moore M, Morrison K, Mudanohwo E, O’Sullivan S, Owen M, Pearson J, Perlmutter J, Pétursson H, Plagnol V, Pollak P, Post B, Potter S, Ravina B, Revesz T, Riess O, Rivadeneira F, Rizzu P, Ryten M, Saad M, Simón-Sánchez J, Sawcer S, Schapira A, Scheffer H, Schulte C, Sharma M, Shaw K, Sheerin UM, Shoulson I, Shulman J, Sidransky E, Spencer C, Stefánsson H, Stefánsson K, Stockton J, Strange A, Talbot K, Tanner C, Tashakkori-Ghanbaria A, Trabzuni D, Traynor B, Uitterlinden A, Velseboer D, Walker R, van de Warrenburg B, Wickremaratchi M, Williams-Gray C, Winder-Rhodes S, Wurster I, Williams N, Morris H, Heutink P, Hardy J, Wood N, Gasser T, Singleton A, Brice A. Loss of VPS13C Function in Autosomal-Recessive Parkinsonism Causes Mitochondrial Dysfunction and Increases PINK1/Parkin-Dependent Mitophagy. Am J Hum Genet 2016; 98:500-513. [PMID: 26942284 DOI: 10.1016/j.ajhg.2016.01.014] [Citation(s) in RCA: 271] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/20/2016] [Indexed: 11/29/2022] Open
Abstract
Autosomal-recessive early-onset parkinsonism is clinically and genetically heterogeneous. The genetic causes of approximately 50% of autosomal-recessive early-onset forms of Parkinson disease (PD) remain to be elucidated. Homozygozity mapping and exome sequencing in 62 isolated individuals with early-onset parkinsonism and confirmed consanguinity followed by data mining in the exomes of 1,348 PD-affected individuals identified, in three isolated subjects, homozygous or compound heterozygous truncating mutations in vacuolar protein sorting 13C (VPS13C). VPS13C mutations are associated with a distinct form of early-onset parkinsonism characterized by rapid and severe disease progression and early cognitive decline; the pathological features were striking and reminiscent of diffuse Lewy body disease. In cell models, VPS13C partly localized to the outer membrane of mitochondria. Silencing of VPS13C was associated with lower mitochondrial membrane potential, mitochondrial fragmentation, increased respiration rates, exacerbated PINK1/Parkin-dependent mitophagy, and transcriptional upregulation of PARK2 in response to mitochondrial damage. This work suggests that loss of function of VPS13C is a cause of autosomal-recessive early-onset parkinsonism with a distinctive phenotype of rapid and severe progression.
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Deuschl G, Petersen I, Lorenz D, Christensen K. Tremor in the elderly: Essential and aging-related tremor. Mov Disord 2015; 30:1327-34. [PMID: 26095699 DOI: 10.1002/mds.26265] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [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: 04/21/2014] [Revised: 04/11/2015] [Accepted: 04/13/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Isolated tremor in the elderly is commonly diagnosed as essential tremor (ET). The prevalence of tremor increases steeply with increasing age, whereas hereditary tremor is becoming less common. Moreover, late-manifesting tremor seems to be associated with dementia and earlier mortality. We hypothesize that different entities underlie tremor in the elderly. METHODS Two thousand four hundred forty-eight subjects from the Longitudinal Study of Aging Danish Twins older than 70 y answered screening questions for ET in 2001. Two thousand fifty-six (84%) participants drew Archimedes spirals to measure their tremor severity, and classical aging phenotypes were assessed. A subgroup of 276 individuals fulfilling either screening criteria for ET or being controls were personally assessed. Medications and mortality data are available. RESULTS The spiral score increased with age. The spiral score correlated with tremor severity. For the whole cohort, mortality was significantly correlated with the spiral score, and higher spiral scores were associated with lower physical and cognitive functioning. Multivariate analysis identified higher spiral scores as an independent risk factor for mortality. In contrast, the ET patients did not show an increased but rather a lower mortality rate although it was not statistically significant. Consistent with a slower than normal aging, they were also physically and cognitively better functioning than controls. CONCLUSIONS Because incident tremors beyond 70 y of age show worse aging parameters and mortality than controls and ET, we propose to label it 'aging-related tremor' (ART). This tremor starts later in life and is accompanied by subtle signs of aging both cognitively and physically. More detailed clinical features and pathogenesis warrant further assessment.
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Affiliation(s)
- Günther Deuschl
- Department of Neurology, Universitätsklinikum Schleswig-Holstein, Kiel Campus, Christian-Albrechts-University, Kiel, Germany
| | - Inge Petersen
- Institute of Public Health, The Danish Twin Registry and the Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Delia Lorenz
- Department of Neurology, Universitätsklinikum Schleswig-Holstein, Kiel Campus, Christian-Albrechts-University, Kiel, Germany
| | - Kaare Christensen
- Institute of Public Health, The Danish Twin Registry and the Danish Aging Research Center, University of Southern Denmark, Odense, Denmark.,Department of Clinical Genetics, Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
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Hopfner F, Erhart T, Knudsen K, Lorenz D, Schneider SA, Zeuner KE, Deuschl G, Kuhlenbäumer G. Testing for alcohol sensitivity of tremor amplitude in a large cohort with essential tremor. Parkinsonism Relat Disord 2015. [PMID: 26002382 DOI: 10.1016/j.parkreldis.2015.05.005.] [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] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
BACKGROUND Improvement of essential tremor (ET) amplitude after alcohol ingestion is usually based on patient reports but a quantitative test for large numbers of patients is lacking and the percentage of ET patients with a detectable alcohol effect is therefore unknown. METHODS A validated and published alcohol home test was used in 104 ET patients. The Archimedes spiral was drawn before alcohol ingestion and at 4 time points after alcohol consumption and rated on a 10-point rating scale according to Bain and Findley. A second identical test without alcohol ingestion was performed by the same patients and evaluated by the same two raters to analyze the total variability of the spiral ratings. RESULTS Alcohol reduces tremor in ET patients as a group and a rebound effect with an increase in tremor intensity was found the next morning. Sex, family history of ET, diagnosis (definite vs. probable) and medical history of alcohol responsiveness do not predict the alcohol response. The minimal detectable difference in the spiral score was 2 due to spontaneous tremor fluctuations and inter-rater differences. The test demonstrated alcohol sensitivity of the tremor in 46% of the patients. Responsivity to alcohol could only be seen in patients with spiral scores above 3. CONCLUSIONS Alcohol sensitivity is a feature of ET in at least 46% of the patients. We could not find predictors for alcohol sensitivity. The minimal detectable change is 2 scores and alcohol responsivity was only detected in patients with baseline Archimedes spiral rating of ≥3.
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Affiliation(s)
- Franziska Hopfner
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Tatjana Erhart
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Karina Knudsen
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Delia Lorenz
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Susanne A Schneider
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Kirsten E Zeuner
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| | - Gregor Kuhlenbäumer
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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23
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Hopfner F, Erhart T, Knudsen K, Lorenz D, Schneider SA, Zeuner KE, Deuschl G, Kuhlenbäumer G. Testing for alcohol sensitivity of tremor amplitude in a large cohort with essential tremor. Parkinsonism Relat Disord 2015; 21:848-51. [PMID: 26002382 DOI: 10.1016/j.parkreldis.2015.05.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/27/2015] [Accepted: 05/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Improvement of essential tremor (ET) amplitude after alcohol ingestion is usually based on patient reports but a quantitative test for large numbers of patients is lacking and the percentage of ET patients with a detectable alcohol effect is therefore unknown. METHODS A validated and published alcohol home test was used in 104 ET patients. The Archimedes spiral was drawn before alcohol ingestion and at 4 time points after alcohol consumption and rated on a 10-point rating scale according to Bain and Findley. A second identical test without alcohol ingestion was performed by the same patients and evaluated by the same two raters to analyze the total variability of the spiral ratings. RESULTS Alcohol reduces tremor in ET patients as a group and a rebound effect with an increase in tremor intensity was found the next morning. Sex, family history of ET, diagnosis (definite vs. probable) and medical history of alcohol responsiveness do not predict the alcohol response. The minimal detectable difference in the spiral score was 2 due to spontaneous tremor fluctuations and inter-rater differences. The test demonstrated alcohol sensitivity of the tremor in 46% of the patients. Responsivity to alcohol could only be seen in patients with spiral scores above 3. CONCLUSIONS Alcohol sensitivity is a feature of ET in at least 46% of the patients. We could not find predictors for alcohol sensitivity. The minimal detectable change is 2 scores and alcohol responsivity was only detected in patients with baseline Archimedes spiral rating of ≥3.
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Affiliation(s)
- Franziska Hopfner
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Tatjana Erhart
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Karina Knudsen
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Delia Lorenz
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Susanne A Schneider
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Kirsten E Zeuner
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| | - Gregor Kuhlenbäumer
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Hopfner F, Müller SH, Lorenz D, Appenzeller S, Klebe S, Deuschl G, Kuhlenbäumer G. Mutations in HTRA2 are not a common cause of familial classic ET. Mov Disord 2015; 30:1149-50. [PMID: 25970799 DOI: 10.1002/mds.26252] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 03/25/2015] [Accepted: 03/29/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
- Franziska Hopfner
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Stefanie H Müller
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Delia Lorenz
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | | | - Stephan Klebe
- Department of Neurology, University Hospital of Würzburg, Germany
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
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Hopfner F, Stevanin G, Müller SH, Mundwiller E, Bungeroth M, Durr A, Pendziwiat M, Anheim M, Schneider SA, Tittmann L, Klebe S, Lorenz D, Deuschl G, Brice A, Kuhlenbäumer G. The impact of rare variants in FUS in essential tremor. Mov Disord 2015; 30:721-4. [PMID: 25631824 DOI: 10.1002/mds.26145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 10/04/2014] [Revised: 12/02/2014] [Accepted: 12/21/2014] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE We analyzed the coding region of the Fused in Sarcoma (FUS) gene in familial essential tremor (ET) and reviewed previous studies assessing FUS variants in ET. BACKGROUND ET is often a familial disorder with an autosomal dominant inheritance pattern. A potentially causative variant in FUS has been identified in one ET family. Subsequent studies described further putatively causal variants. METHODS We performed DNA sequencing of FUS in 85 unrelated, familial German and French definite ET patients. RESULTS We did not find novel variants affecting the protein sequence. Seven previously published studies and data from the exome variant server (EVS) showed that rare exonic variants in FUS are not more frequent in ET than in the general population. CONCLUSIONS Our findings provide no evidence for a role of rare genetic variants in the pathogenesis of ET, apart from the initially published FUS mutation segregating in a large ET family.
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Affiliation(s)
- Franziska Hopfner
- Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
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Buxmann H, Eggermann T, Lorenz D, Sewell AC, Böhles H, Schlößer RL, Merz E. Cystinuria in a girl presenting with a hyperechogenic colon detected by prenatal ultrasonography and a new SLC3A1 gene mutation (p.Phe278Ser). Ultraschall Med 2014; 35:473-474. [PMID: 24824759 DOI: 10.1055/s-0034-1366442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Zwintz K, Fossati L, Ryabchikova T, Guenther D, Aerts C, Barnes TG, Themeßl N, Lorenz D, Cameron C, Kuschnig R, Pollack-Drs S, Moravveji E, Baglin A, Matthews JM, Moffat AFJ, Poretti E, Rainer M, Rucinski SM, Sasselov D, Weiss WW. Asteroseismology. Echography of young stars reveals their evolution. Science 2014; 345:550-3. [PMID: 24993346 DOI: 10.1126/science.1253645] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We demonstrate that a seismic analysis of stars in their earliest evolutionary phases is a powerful method with which to identify young stars and distinguish their evolutionary states. The early star that is born from the gravitational collapse of a molecular cloud reaches at some point sufficient temperature, mass, and luminosity to be detected. Accretion stops, and the pre-main sequence star that emerges is nearly fully convective and chemically homogeneous. It will continue to contract gravitationally until the density and temperature in the core are high enough to start nuclear burning of hydrogen. We show that there is a relationship for a sample of young stars between detected pulsation properties and their evolutionary status, illustrating the potential of asteroseismology for the early evolutionary phases.
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Affiliation(s)
- K Zwintz
- Instituut voor Sterrenkunde, Katholieke Universiteit (KU) Leuven, Celestijnenlaan 200D, 3001 Leuven, Belgium.
| | - L Fossati
- Argelander Institut für Astronomie der Universität Bonn, Auf dem Hügel 71, 53121 Bonn, Germany
| | - T Ryabchikova
- Institute of Astronomy, Russian Academy of Sciences (RAS), Pyatnitskaya 48, 109017 Moscow, Russia
| | - D Guenther
- Department of Astronomy and Physics, St. Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
| | - C Aerts
- Instituut voor Sterrenkunde, Katholieke Universiteit (KU) Leuven, Celestijnenlaan 200D, 3001 Leuven, Belgium. Department of Astrophysics, Institute for Mathematics, Astrophysics and Particle Physics, Radboud University Nijmegen, Post Office Box 9010, 6500 GL Nijmegen, Netherlands
| | - T G Barnes
- The University of Texas at Austin, McDonald Observatory, 82 Mt. Locke Road, McDonald Observatory, TX 79734, USA
| | - N Themeßl
- Universität Wien, Institut für Astrophysik, Türkenschanzstraße 17, 1180 Vienna, Austria
| | - D Lorenz
- Universität Wien, Institut für Astrophysik, Türkenschanzstraße 17, 1180 Vienna, Austria
| | - C Cameron
- Department of Mathematics, Physics and Geology, Cape Breton University, 1250 Grand Lake Road, Sydney, Nova Scotia B1P 6L2, Canada
| | - R Kuschnig
- Universität Wien, Institut für Astrophysik, Türkenschanzstraße 17, 1180 Vienna, Austria
| | - S Pollack-Drs
- Universität Wien, Institut für Astrophysik, Türkenschanzstraße 17, 1180 Vienna, Austria
| | - E Moravveji
- Instituut voor Sterrenkunde, Katholieke Universiteit (KU) Leuven, Celestijnenlaan 200D, 3001 Leuven, Belgium
| | - A Baglin
- Laboratoire d'Études Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris-Meudon, 5 place Jules Janssen, 92195, Meudon, France
| | - J M Matthews
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, British Columbia V6T 1Z1, Canada
| | - A F J Moffat
- Départment de Physique, Université de Montréal, C.P. 6128, Succ. Centre-Ville, Montréal, Quebec H3C 3J7, Canada
| | - E Poretti
- Istituto Nazionale di Astrofisica-Osservatorio Astronomico di Brera, Via E. Bianchi 46, 23807 Merate, Italy
| | - M Rainer
- Istituto Nazionale di Astrofisica-Osservatorio Astronomico di Brera, Via E. Bianchi 46, 23807 Merate, Italy
| | - S M Rucinski
- Department of Astronomy and Astrophysics, University of Toronto, 50 St. George Street, Toronto, Ontario M5S 3H4, Canada
| | - D Sasselov
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138, USA
| | - W W Weiss
- Universität Wien, Institut für Astrophysik, Türkenschanzstraße 17, 1180 Vienna, Austria
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Adamczyk Z, Belouschek P, Lorenz D. Electrostatic Interactions of Bodies Bearing Thin Double-Layers I. General Formulation. ACTA ACUST UNITED AC 2014. [DOI: 10.1002/bbpc.199000063] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Adamczyk Z, Belouschek P, Lorenz D. Electrostatic Interactions of Bodies Bearing Thin Double-Layers II. Exact Numerical Solutions. ACTA ACUST UNITED AC 2014. [DOI: 10.1002/bbpc.199000064] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Karakas E, Oetzmann von Sochaczewski C, Haist T, Pauthner M, Lorenz D. Grenzen der Chirurgie bei Karzinomen des oberen Intestinaltraktes. Chirurg 2014; 85:186-91. [DOI: 10.1007/s00104-013-2598-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Klebe S, Golmard JL, Nalls MA, Saad M, Singleton AB, Bras JM, Hardy J, Simon-Sanchez J, Heutink P, Kuhlenbäumer G, Charfi R, Klein C, Hagenah J, Gasser T, Wurster I, Lesage S, Lorenz D, Deuschl G, Durif F, Pollak P, Damier P, Tison F, Durr A, Amouyel P, Lambert JC, Tzourio C, Maubaret C, Charbonnier-Beaupel F, Tahiri K, Vidailhet M, Martinez M, Brice A, Corvol JC. The Val158Met COMT polymorphism is a modifier of the age at onset in Parkinson's disease with a sexual dimorphism. J Neurol Neurosurg Psychiatry 2013; 84:666-73. [PMID: 23408064 PMCID: PMC3646288 DOI: 10.1136/jnnp-2012-304475] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The catechol-O-methyltranferase (COMT) is one of the main enzymes that metabolise dopamine in the brain. The Val158Met polymorphism in the COMT gene (rs4680) causes a trimodal distribution of high (Val/Val), intermediate (Val/Met) and low (Met/Met) enzyme activity. We tested whether the Val158Met polymorphism is a modifier of the age at onset (AAO) in Parkinson's disease (PD). The rs4680 was genotyped in a total of 16 609 subjects from five independent cohorts of European and North American origin (5886 patients with PD and 10 723 healthy controls). The multivariate analysis for comparing PD and control groups was based on a stepwise logistic regression, with gender, age and cohort origin included in the initial model. The multivariate analysis of the AAO was a mixed linear model, with COMT genotype and gender considered as fixed effects and cohort and cohort-gender interaction as random effects. COMT genotype was coded as a quantitative variable, assuming a codominant genetic effect. The distribution of the COMT polymorphism was not significantly different in patients and controls (p=0.22). The Val allele had a significant effect on the AAO with a younger AAO in patients with the Val/Val (57.1±13.9, p=0.03) than the Val/Met (57.4±13.9) and the Met/Met genotypes (58.3±13.5). The difference was greater in men (1.9 years between Val/Val and Met/Met, p=0.007) than in women (0.2 years, p=0.81). Thus, the Val158Met COMT polymorphism is not associated with PD in the Caucasian population but acts as a modifier of the AAO in PD with a sexual dimorphism: the Val allele is associated with a younger AAO in men with idiopathic PD.
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Affiliation(s)
- Stephan Klebe
- Centre d'Investigation Clinique, Institut du Cerveau et de la Moelle épinière, Hôpital de la Pitié-Salpêtrière, 47 boulevard de l'Hôpital, Paris 75651 Cedex 13, France
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Raethjen J, Muthuraman M, Kostka A, Nahrwold M, Hellriegel H, Lorenz D, Deuschl G. Corticomuscular coherence in asymptomatic first-degree relatives of patients with essential tremor. Mov Disord 2013; 28:679-82. [PMID: 23677898 DOI: 10.1002/mds.25425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 01/09/2013] [Accepted: 02/07/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Essential tremor (ET) follows an autosomal dominant type of inheritance in the majority of patients, yet its genetic basis has not been identified. Its exact origin is still elusive, but coherence measurements between electromyography tremor bursts and electroencephalography unequivocally demonstrate a correlation. METHODS We tested these measurements in 37 healthy first-degree relatives (children) of patients with essential tremor (ET) and a group of 37 age-matched and sex-matched controls. Pooled coherence spectra of the maximally coherent electroencephalogram electrodes were computed for ET relatives and controls. RESULTS The maximal coherence and its frequency were significantly higher in ET relatives than in controls during the pinch grip task and during slow hand movements. Electromyography amplitude (root-mean-square) was slightly but significantly greater in ET relatives, whereas 2-Hz to 40-Hz power and spectral peak frequency were not different. CONCLUSIONS The presymptomatic alteration in corticomuscular interaction may reflect a role of genetic factors.
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Affiliation(s)
- Jan Raethjen
- Department of Neurology, University Hospital Schleswig, Holstein, Campus Kiel, Germany
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Wenger S, Ament M, Guthe S, Lorenz D, Tillmann A, Weiskopf D, Magnor M. Visualization of Astronomical Nebulae via Distributed Multi-GPU Compressed Sensing Tomography. IEEE Trans Vis Comput Graph 2012; 18:2188-2197. [PMID: 26357126 DOI: 10.1109/tvcg.2012.281] [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: 06/05/2023]
Abstract
The 3D visualization of astronomical nebulae is a challenging problem since only a single 2D projection is observable from our fixed vantage point on Earth. We attempt to generate plausible and realistic looking volumetric visualizations via a tomographic approach that exploits the spherical or axial symmetry prevalent in some relevant types of nebulae. Different types of symmetry can be implemented by using different randomized distributions of virtual cameras. Our approach is based on an iterative compressed sensing reconstruction algorithm that we extend with support for position-dependent volumetric regularization and linear equality constraints. We present a distributed multi-GPU implementation that is capable of reconstructing high-resolution datasets from arbitrary projections. Its robustness and scalability are demonstrated for astronomical imagery from the Hubble Space Telescope. The resulting volumetric data is visualized using direct volume rendering. Compared to previous approaches, our method preserves a much higher amount of detail and visual variety in the 3D visualization, especially for objects with only approximate symmetry.
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Affiliation(s)
- S Wenger
- Institut für Computergraphik, TU Braunschweig, Germany.
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Langbein J, Skarlatou S, Spielvogel A, Hein C, Herms K, Lorenz D, Stahl U, Oberschmidt D, Uhlmann E. Analysis and detection of microbial contamination and biofilms in technical fluids and its impact on fluid management. N Biotechnol 2012. [DOI: 10.1016/j.nbt.2012.08.289] [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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Herms K, Langbein J, Hein C, Spielvogel A, Lorenz D, Stahl U, Oberschmidt D, Uhlmann E. Production of E. coli lysate for in vitro Cell free protein Synthesis. N Biotechnol 2012. [DOI: 10.1016/j.nbt.2012.08.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Thier S, Lorenz D, Nothnagel M, Poremba C, Papengut F, Appenzeller S, Paschen S, Hofschulte F, Hussl AC, Hering S, Poewe W, Asmus F, Gasser T, Schöls L, Christensen K, Nebel A, Schreiber S, Klebe S, Deuschl G, Kuhlenbäumer G. Polymorphisms in the glial glutamate transporter SLC1A2 are associated with essential tremor. Neurology 2012; 79:243-8. [PMID: 22764253 DOI: 10.1212/wnl.0b013e31825fdeed] [Citation(s) in RCA: 88] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Sporadic, genetically complex essential tremor (ET) is one of the most common movement disorders and may lead to severe impairment of the quality of life. Despite high heritability, the genetic determinants of ET are largely unknown. We performed the second genome-wide association study (GWAS) for ET to elucidate genetic risk factors of ET. METHODS Using the Affymetrix Genome-Wide SNP Array 6.0 (1000K) we conducted a two-stage GWAS in a total of 990 subjects and 1,537 control subjects from Europe to identify genetic variants associated with ET. RESULTS We discovered association of an intronic variant of the main glial glutamate transporter (SLC1A2) gene with ET in the first-stage sample (rs3794087, p = 6.95 × 10(-5), odds ratio [OR] = 1.46). We verified the association of rs3794087 with ET in a second-stage sample (p = 1.25 × 10(-3), OR = 1.38). In the subgroup analysis of patients classified as definite ET, rs3794087 obtained genome-wide significance (p = 3.44 × 10(-10), OR = 1.59) in the combined first- and second-stage sample. Genetic fine mapping using nonsynonymous single nucleotide polymorphisms (SNPs) and SNPs in high linkage disequilibrium with rs3794087 did not reveal any SNP with a stronger association with ET than rs3794087. CONCLUSIONS We identified SLC1A2 encoding the major glial high-affinity glutamate reuptake transporter in the brain as a potential ET susceptibility gene. Acute and chronic glutamatergic overexcitation is implied in the pathogenesis of ET. SLC1A2 is therefore a good functional candidate gene for ET.
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Affiliation(s)
- Sandra Thier
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
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Haist T, Behrens A, Willenbrock K, Fisseler-Eckhoff A, Ell C, Lorenz D. [A rare cause of recurrent small bowel intussusception. Case report and review of the literature]. Chirurg 2012; 83:568-71. [PMID: 22695813 DOI: 10.1007/s00104-012-2313-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Small bowel intussusception is a rare cause of abdominal pain in adult patients. Due to varying symptoms and different underlying causes its diagnosis and treatment is challenging for physicians. This case report describes recurrent intussusception in an adult female patient and celiac disease could only be diagnosed as the cause of these symptoms after surgery. In addition a review of the literature regarding adult intussusception is presented.
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Affiliation(s)
- T Haist
- Abteilung für Allgemein- und Visceralchirurgie, Dr. Horst-Schmidt Klinik Wiesbaden, Ludwig Erhard Str. 100, 65199, Wiesbaden, Deutschland.
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Grabowski J, Harter P, Buhrmann C, Lorenz D, Hils R, Kommoss S, Traut A, du Bois A. Re-operation outcome in patients referred to a gynecologic oncology center with presumed ovarian cancer FIGO I-IIIA after sub-standard initial surgery. Surg Oncol 2012; 21:31-5. [DOI: 10.1016/j.suronc.2010.08.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 07/24/2010] [Accepted: 08/26/2010] [Indexed: 11/26/2022]
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Peters O, Lorenz D, Fesche A, Schmidtke K, Hüll M, Perneczky R, Rüther E, Möller HJ, Jessen F, Maier W, Kornhuber J, Jahn H, Luckhaus C, Gertz HJ, Schröder J, Pantel J, Teipel S, Wellek S, Frölich L, Heuser I. A combination of galantamine and memantine modifies cognitive function in subjects with amnestic MCI. J Nutr Health Aging 2012; 16:544-8. [PMID: 22659994 DOI: 10.1007/s12603-012-0062-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Mild cognitive impairment (MCI) is etiologically heterogeneous, and a substantial proportion of MCI subjects will develop different dementia disorders. One subtype of this syndrome, amnestic MCI, occurs preferentially but not exclusively in prodromal AD and is characterized by defined deficits of episodic memory. DESIGN, SETTING AND PARTICIPANTS For a 2-year, double-blinded, placebo-controlled study MCI patients, presenting with an amnestic syndrome but not necessarily based on presumed prodromal AD were randomized. INTERVENTION Patients received (a) a combination of 16 mg galantamine plus 20 mg memantine, or (b) 16 mg galantamine alone or (c) placebo. MEASUREMENTS The primary objective was to explore the differential impact of these interventions on the progression to dementia and on cognitive changes as measured by the ADAScog. RESULTS After recruitment of 232 subjects, the trial was halted before reaching the planned sample size, because safety concerns arose in other studies with galantamine in MCI. This resulted in a variable treatment duration of 2-52 weeks. The statistical analysis plan was amended for studying cognitive effects of discontinuing the study medication, which was done separately for galantamine and memantine, and under double-blind conditions. There was one death, no unexpected severe adverse events, and no differences of severe adverse events between the treatment arms. The cognitive changes on the ADAScog were not different among the groups. Only for the subgroup of amnestic MCI with presumed AD etiology, a significant improvement of ADAScog score over placebo before the discontinuation of medication was observed, while amnestic MCI presumably due to other etiologies showed no cognitive changes with broad variation. Cognitive improvement was numerically larger in the combination treatment group than under galantamine alone. Patients who received placebo declined as expected. Discontinuation of galantamine, either as part of the combination regimen or as mono treatment, resulted in a transient decline of the ADAScog score in amnestic MCI of presumed AD etiology, while discontinuation of Memantine did not change the cognitive status. CONCLUSION In an interrupted trial with amnestic MCI subjects the combination of galantamine plus memantine were generally well tolerated. In the subgroup of MCI subjects with presumed AD etiology, a cognitive benefit of a short-term combination treatment of galantamine plus memantine was observed, and cognitive decline occurred after discontinuation of galantamine.
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Affiliation(s)
- O Peters
- Department of Psychiatry, Charité - Campus Benjamin Franklin, Berlin, Germany.
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Borgulya M, Lorenz D, Vieth M, Ell C, Pohl J. Extensive Papillomatose des Ösophagus mit maligner Transformation des Plattenepithels. Z Gastroenterol 2011; 49:1475-8. [DOI: 10.1055/s-0031-1281751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Knudsen K, Lorenz D, Deuschl G. A clinical test for the alcohol sensitivity of essential tremor. Mov Disord 2011; 26:2291-5. [PMID: 22021159 DOI: 10.1002/mds.23846] [Citation(s) in RCA: 21] [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: 06/21/2010] [Revised: 05/13/2011] [Accepted: 05/23/2011] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The objective of the study was to develop a simple diagnostic test for alcohol sensitivity of essential tremor patients. Here we describe the controlled measurements of tremor severity after alcohol ingestion and the practicability of using it as a home test. METHODS Ten patients were tested for alcohol sensitivity under controlled conditions in the laboratory (blood alcohol, quantitative tremor recordings, modified Fahn scale, visual analog scale, Archimedes spirals), and 15 patients were instructed to perform an alcohol test at home (visual analog scale, Archimedes spirals) following an adapted dosage of alcohol. RESULTS The time course of the antitremor effect showed significant improvement of up to 50% in both groups for all the outcome parameters. Tremor deteriorated after 3 hours. A quarter of the patients noticed the alcohol effect for the first time during the test. CONCLUSIONS Alcohol is an effective drug for essential tremor. Its effect is only short-lived and exhibits a rebound after > 3 hours and the next morning. We propose this essential tremor home test as a diagnostic tool to confirm the alcohol sensitivity of essential tremor.
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Affiliation(s)
- Karina Knudsen
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
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Affiliation(s)
- L Brinkmann
- Klinik für Allgemein- und Viszeralchirurgie, HSK, Dr. Horst-Schmidt-Kliniken Wiesbaden, Deutschland
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Witzenrath M, Pache F, Lorenz D, Koppe U, Schönrock S, Meixenberger K, Dorhoi A, Ma J, Holmes A, Trendelenburg G, Heimesaat M, Bereswill S, van der Linden M, Tschopp J, Mitchell T, Suttorp N, Opitz B. Differenzial Activation of the NLRP3 Inflammasome by Pneumolysin Variants and Role of NLRP3 in Pneumococcal Pneumonia. Pneumologie 2011. [DOI: 10.1055/s-0031-1272062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Witzenrath M, Pache F, Lorenz D, Koppe U, Gutbier B, Meixenberger K, Tabeling C, Dorhoi A, Ma J, Holmes A, Trendelenburg G, Heimesaat MM, Bereswill S, van der Linden M, Tschopp J, Mitchell TJ, Suttorp N, Opitz B. The NLRP3 inflammasome is differentially activated by pneumolysin variants and contributes to host defense in pneumococcal pneumonia1. Pneumologie 2011. [DOI: 10.1055/s-0030-1270363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lorenz D, Poremba C, Papengut F, Schreiber S, Deuschl G. The psychosocial burden of essential tremor in an outpatient- and a community-based cohort. Eur J Neurol 2011; 18:972-9. [PMID: 21244579 DOI: 10.1111/j.1468-1331.2010.03295.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE To compare psychosocial burden in patients with essential tremor (ET) in an outpatient (OPC)- and a community-based cohort (CBC). METHODS A sample of outpatients of a tertiary referral center (n = 180) and a community-based sample (n = 100) with ET were asked for study participation. Psychosocial aspects were assessed by a questionnaire on psychosocial aspects of ET, neuropsychological scales, quality of life, personality traits, and coping strategies. RESULTS One hundred and seven patients of the OPC and 90 individuals of the CBC participated and their results are descriptively presented. Statistical analysis was restricted to 38 pairs of OPC and CBC individuals matched for age, sex, and tremor severity. One-third of these individuals reported a profound impairment in everyday or professional life. Neuropsychological scales showed a severe depression in 8% of the individuals and pathologic values for the general level of psychiatric symptoms in 26%. The main coping strategy was 'active problem-orientated coping'. Patients of the OPC perceived a more severe impact of ET on their life. Multivariate analysis revealed the Beck Depression Inventory score as the only predictive factor for the outcome variables, physical and mental component scores, of the SF-12 health survey. CONCLUSIONS ET causes a significant psychosocial impairment, which does depend on symptom severity but also on mood with depression as the main driving factor and other so far undetermined factors.
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Affiliation(s)
- D Lorenz
- Department of Neurology Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Thier S, Kuhlenbäumer G, Lorenz D, Nothnagel M, Nebel A, Christensen K, Schreiber S, Deuschl G, Klebe S. GABA(A) receptor- and GABA transporter polymorphisms and risk for essential tremor. Eur J Neurol 2010; 18:1098-100. [PMID: 21749575 DOI: 10.1111/j.1468-1331.2010.03308.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clinical features and animal models of essential tremor (ET) suggest gamma-aminobutyric acid A receptor (GABA(A) R) subunits and GABA transporters as putative candidate genes. METHODS A total of 503 ET cases and 818 controls were investigated for an association between polymorphisms in 15 GABA(A) R and four GABA transporter genes and ET. RESULTS Nine nominally significant tagging SNPs (P values from 4.9×10(-2) to 5.2×10(-4) ) were found in the hypothesis generation stage. Five SNPs were followed up in a second verification stage but failed to reach significance. (P values from 0.30 to 0.77). DISCUSSION In our samples, no evidence of association between GABA(A) R and GABA transporter genes with ET was detected. Further studies are necessary to clarify the role of these genes in ET.
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Affiliation(s)
- S Thier
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel
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Fenske W, Lorenz D, Haagen U, Papassotiriou J, Fassnacht M, Quinkler M, Störk S, Allolio B. Copeptin in the differential diagnosis of the polydipsia-polyuria syndrome – revisiting the direct and indirect water deprivation tests. Exp Clin Endocrinol Diabetes 2010. [DOI: 10.1055/s-0030-1267029] [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: 10/19/2022]
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Abstract
Management of esophageal anastomotic leaks is associated with high morbidity and mortality and remains an interdisciplinary challenge. We describe the first two cases of endoscopic closure of postoperative leaks following gastrectomy and primary repair after spontaneous acute esophageal perforation, using the over-the-scope clip (OTSC) system (Ovesco Endoscopy GmbH, Tübingen, Germany). Both leaks were successfully sealed with one clip. While one patient recovered without reintervention, in the other patient the postoperative leak reappeared following clip displacement 13 days later.
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Affiliation(s)
- J Pohl
- Department of Gastroenterology, Dr. Horst Schmitt Kliniken, Wiesbaden, Germany.
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Klebe S, Thier S, Lorenz D, Nothnagel M, Schreiber S, Klein C, Hagenah J, Kasten M, Berg D, Srulijes K, Gasser T, Deuschl G, Kuhlenbäumer G. LINGO1 is not associated with Parkinson's disease in German patients. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:1173-8. [PMID: 20468067 DOI: 10.1002/ajmg.b.31085] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 11/06/2022]
Abstract
Essential tremor (ET) and Parkinson's disease (PD) are the most common movement disorders and show clinical, genetic, and pathophysiological overlap. Single-nucleotide polymorphisms (SNPs) in the leucine-rich repeat (LRR) and immunoglobulin (Ig) domain-containing, Nogo receptor-interacting protein gene (LINGO1) are associated with ET. LINGO1 is overexpressed in the substantia nigra (SN) of PD patients and inhibition of LINGO1 confers neuroprotection in a rodent model of PD. In this study we test the hypothesis whether SNPs in the LINGO1 gene that are associated with ET are also associated with PD. Three large German case-control samples from Kiel, Lübeck, and Tübingen (total: 1,798 cases and 1,482 controls) were genotyped for the three LINGO1 SNPs associated with ET. Association was assessed using allele- and genotype-based tests in each of the three samples separately, in the combined sample, and in subsets of patients with early-onset PD (<50 years) and of patients with a positive family history of PD. Neither of the three samples alone nor the combined sample showed evidence for association between LINGO1 SNPs and PD. The allele-based test showed a trend toward nominal association for all three SNPs in the Kiel sample. The subsets with early-onset PD or a positive family history did also not reveal evidence for association. SNPs in the LINGO1 gene associated with ET could not be shown to be associated with PD in our study population, despite a postulated overlap between both diseases.
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Affiliation(s)
- Stephan Klebe
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, Kiel, Germany
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Abstract
Management of esophageal anastomotic leaks is associated with high morbidity and mortality and remains an interdisciplinary challenge. We describe the first two cases of endoscopic closure of postoperative leaks following gastrectomy and primary repair after spontaneous acute esophageal perforation, using the over-the-scope clip (OTSC) system (Ovesco Endoscopy GmbH, Tübingen, Germany). Both leaks were successfully sealed with one clip. While one patient recovered without reintervention, in the other patient the postoperative leak reappeared following clip displacement 13 days later.
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Affiliation(s)
- J Pohl
- Department of Gastroenterology, Dr. Horst Schmitt Kliniken, Wiesbaden, Germany.
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