1
|
Girod K, Schlüter S, Hennig T, Lohmann H, Kaluza S. Methanol synthesis with real steel mill gases: Performance investigations in a new on‐site technical center. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- K. Girod
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
| | - S. Schlüter
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
| | - T. Hennig
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
| | - H. Lohmann
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
| | - S. Kaluza
- Fraunhofer UMSICHT Osterfelder Str. 3 46047 Oberhausen Germany
- Hochschule Düsseldorf, University of Applied Sciences Faculty of Mechanical and Process Engineering Münsterstr. 156 40476 Düsseldorf Germany
| |
Collapse
|
2
|
Johnen A, Räthe S, Lohmann H, Philipp K, Minnerup J, Wiendl H, Meuth SG, Duning T. [Frequency and risk factors associated with post-stroke dementia-an observational study on stroke patients without premorbid cognitive impairment]. Nervenarzt 2019; 91:131-140. [PMID: 31712835 DOI: 10.1007/s00115-019-00830-x] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Longitudinal studies on cognitive outcomes after stroke revealed heterogeneous results and the underlying pathology and risk factors for so-called post-stroke dementia are unclear. OBJECTIVE To assess long-term cognitive performance changes in patients after the first ischemic stroke and to evaluate possible risk factors for post-stroke dementia. MATERIAL AND METHODS In this study 66 clinically mildly affected patients aged 54-87 years without a history of dementia underwent extensive neuropsychological assessment after first ever ischemic stroke and again 6 months after the event (follow-up assessment). Demographic, clinical and paraclinical parameters were assessed as potential predictors for long-term cognitive outcome. RESULTS At the group level significant performance improvements were found for most of the neurocognitive domains at the follow-up assessment. The greatest cognitive improvement was found in visuospatial processing. Immediately after stroke 54.5% of patients were considered cognitively impaired (z-scores < -2 in at least 2 neurocognitive domains). At follow-up only 16.7% were considered cognitively impaired according to this criterion and among these only 2 patients (3%) had developed a new, clinically relevant cognitive impairment (i.e. post-stroke dementia). Patients with inferior cognitive performance improvements at follow-up had on average larger brain lesions caused by the stroke as well as a prediabetic metabolic status. DISCUSSION The probability of developing a post-stroke dementia syndrome is lower than previously assumed in patients with first ever stroke, with only mild clinical disability and without premorbid cognitive impairment. Long-term cognitive impairment could primarily be determined by the size of the lesioned brain area as well as the premorbid (pre)diabetic status.
Collapse
Affiliation(s)
- A Johnen
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
| | - S Räthe
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - H Lohmann
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - K Philipp
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - J Minnerup
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - H Wiendl
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - S G Meuth
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - T Duning
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| |
Collapse
|
3
|
Storm Van's Gravesande K, Calabrese P, Blaschek A, Rostásy K, Huppke P, Rothe L, Mall V, Kessler J, Kalbe E, Dornfeld E, Elpers C, Lohmann H, Weddige A, Hagspiel S, Kirschner J, Brehm M, Blank C, Schubert J, Schimmel M, Pacheè S, Mohrbach M, Karenfort M, Kamp G, Lücke T, Neumann H, Lutz S, Gierse A, Sievers S, Schiffmann H, de Soye I, Trollmann R, Candova A, Rosner M, Neu A, Romer G, Seidel U, John R, Hofmann C, Schulz, Kinder S, Bertolatus A, Scheidtmann K, Lasogga R, Leiz S, Alber M, Kranz J, Bajer-Kornek B, Seidl R, Novak A. The Multiple Sclerosis Inventory of Cognition for Adolescents (MUSICADO): A brief screening instrument to assess cognitive dysfunction, fatigue and loss of health-related quality of life in pediatric-onset multiple sclerosis. Eur J Paediatr Neurol 2019; 23:792-800. [PMID: 31551133 DOI: 10.1016/j.ejpn.2019.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/23/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Screening for cognitive impairment (CI), fatigue and also Health-related quality of life (HRQoL) in patients with pediatric-onset multiple sclerosis (POMS) is of utmost importance in clinical practice. The aim of this study was to establish a new and validated pediatric screening tool "MUSICADO" that is easy to use and time economical. METHODS 106 patients with POMS aged 12-18 years and 210 healthy controls (HCs) stratified for age and education underwent neuropsychological testing including a screening test "Multiple Sclerosis Inventory of Cognition" for adults and 8 standardized cognitive tests and established scales to assess fatigue and HRQoL. RESULTS The phonemic verbal fluency task (RWT "s-words"), the Trail Making Test A (TMT-A), and the Digit Span Forward discriminated significantly between patients and HCs (p = 0.000, respectively) and showed the highest proportion of test failure in patients (24.5%, 17.9%; 15.1%, respectively). Therefore, they were put together to form the cognitive part of the "MUSICADO". After applying a scoring algorithm with balanced weighting of the subtests and age and education correction and a cut-off score for impairment, 35.8% of patients were categorized to be cognitively impaired (specificity: 88.6%). Fatigue was detected in 37.1% of the patients (specificity: 94.0%) and loss of HRQoL in 41.8% (specificity 95.7%) with the screening version, respectively. CONCLUSION The MUSICADO is a newly designed brief and easy to use screening test to help to early identify CI, fatigue, and loss of HRQoL in patients with POMS as cut scores are provided for all three items. Further studies will have to show its usability in independent samples of patients with POMS.
Collapse
Affiliation(s)
- K Storm Van's Gravesande
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany.
| | - P Calabrese
- Neuropsychology and Behavioral Neurology Unit, Division of Molecular and Cognitive Neuroscience, Department of Psychology, University of Basel, Birmannsgasse 8, 4055 Basel, Switzerland
| | - A Blaschek
- Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Lindwurmstrasse 4, 80337 Munich, Germany
| | - K Rostásy
- Pediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, Dr. Friedrich Steiner Str. 5, 5711 Datteln, Germany
| | - P Huppke
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, University Medical Center Göttingen, Robert-Koch Strasse 40, 37075 Göttingen, Germany
| | - L Rothe
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - V Mall
- Department of Pediatrics, Child and Adolescent Psychosomatics, Technische Universität München, Munich, Heigelhofstr. 63, 81377 München, Germany
| | - J Kessler
- Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | - E Kalbe
- Department of Medical Psychology ǀ, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Kerpenerstr. 62, 50937 Cologne, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Johnen A, Elpers C, Riepl E, Landmeyer NC, Krämer J, Polzer P, Lohmann H, Omran H, Wiendl H, Göbel K, Meuth SG. Early effective treatment may protect from cognitive decline in paediatric multiple sclerosis. Eur J Paediatr Neurol 2019; 23:783-791. [PMID: 31540711 DOI: 10.1016/j.ejpn.2019.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/01/2019] [Accepted: 08/28/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cognitive impairment (CI) is a critical feature for patients with childhood or juvenile multiple sclerosis (MS). OBJECTIVE To promote the understanding of CI and to address the impact of different pharmacological treatment strategies on cognitive performance in this patient group. METHODS A cohort of 19 patients with therapy-naïve or ß-Interferon-treated juvenile MS completed a comprehensive neuropsychological assessment at initial presentation (baseline) and on average 2.5 years later (follow-up). The assessments were complemented with a neuropaediatric examination and conventional cerebral magnetic resonance imaging (MRI). RESULTS 9 patients (47%) were impaired in at least one test at baseline (z-score <-1.645 compared with age-adjusted normative data), with the highest impairment frequency in the domains processing speed and attention & executive functions. At follow-up a higher impairment frequency was prominent in those patients whose therapy had not been escalated (N = 13, 69% impaired in at least one test), while cognition was preserved or ameliorated in patients whose treatment had been escalated to highly effective drugs (N = 6, 0% impaired) during the observational period. These group differences at follow-up were not attributable to differences regarding demographics, MRI metrics or cognitive performance at baseline. CONCLUSION Our findings confirm that paediatric MS is associated with considerable CI already in early disease stages. Early administration of highly effective treatment may protect from cognitive decline or alleviate CI in juvenile MS, but larger controlled trials are warranted to confirm these preliminary results.
Collapse
Affiliation(s)
- A Johnen
- University of Münster, Department of Neurology with Institute of Translational Neurology, Germany.
| | - C Elpers
- University of Münster, University Children's Hospital Münster, General Pediatrics - Neuropediatric Department, Germany
| | - E Riepl
- University of Münster, Department of Neurology with Institute of Translational Neurology, Germany
| | - N C Landmeyer
- University of Münster, Department of Neurology with Institute of Translational Neurology, Germany
| | - J Krämer
- University of Münster, Department of Neurology with Institute of Translational Neurology, Germany
| | - P Polzer
- University of Münster, Institute of Clinical Radiology, Germany
| | - H Lohmann
- Herz-Jesu-Hospital, Münster-Hiltrup, Germany
| | - H Omran
- University of Münster, University Children's Hospital Münster, General Pediatrics - Neuropediatric Department, Germany
| | - H Wiendl
- University of Münster, Department of Neurology with Institute of Translational Neurology, Germany
| | - K Göbel
- University of Münster, Department of Neurology with Institute of Translational Neurology, Germany
| | - S G Meuth
- University of Münster, Department of Neurology with Institute of Translational Neurology, Germany
| |
Collapse
|
5
|
Helmstaedter C, Winter B, Melzer N, Lohmann H, Witt JA. Accelerated long-term forgetting in focal epilepsies with special consideration given to patients with diagnosed and suspected limbic encephalitis. Cortex 2019; 110:58-68. [DOI: 10.1016/j.cortex.2018.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 07/13/2017] [Accepted: 01/05/2018] [Indexed: 02/04/2023]
|
6
|
Lohmann H, Kulessa F, Holling H, Johnen A, Reul S, Lueg G, Duning T. [Implementation of the German S3 guidelines on dementia in clinical practice: wish or reality?]. Nervenarzt 2018; 88:895-904. [PMID: 28429077 DOI: 10.1007/s00115-017-0325-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Published in 2009, the German S3 guidelines on dementia define a milestone in quality improvement of the diagnostics and treatment of dementia. In clinical practice patients suffering from dementia are primarily treated by physicians in private practice; therefore, this study examined how the guidelines are implemented in outpatient clinical settings. Furthermore, it aimed at the identification of behavioral determinants that govern the actual diagnostic and therapeutic approach in clinical practice. METHODS Physicians involved in the primary care of dementia patients were asked to participate in a nationwide internet survey. The questionnaire covered aspects on the diagnostic and therapeutic care of dementia patients as recommended by the S3 guidelines. Behavioral determinants of the implementation of the guidelines (e. g. treatment decisions) were derived from an established psychological prediction model. RESULTS Out of a total of 2755 physicians contacted, the data of 225 participants could be used in this study. The diagnostic recommendations of the S3 guidelines were implemented in satisfactory measures (e.g. combined cognitive screening in at least 68%, cerebral neuroimaging in at least 93% and specific laboratory diagnostics in at least 27% of cases); however, only two thirds of the patients with indications for a guideline-conform therapy were treated in accordance with the S3 guidelines. There was a substantial prescription of non-recommended drugs and a notable long-term use of antipsychotic drugs (prescription by at least 14% of non-neurological medical specialists and by 8% of neurologists and psychiatrists). When considering the behavioral determinants in the implementation of the guidelines, normative assumptions ("my colleagues and patients expect me to comply with the guidelines") surprisingly had the highest impact, which was then followed by attitudes towards the behavior ("utilization of the guidelines improves diagnostics and therapy"). CONCLUSION The German S3 guidelines on dementia were satisfactorily implemented in outpatient clinical practice; however, deficits existed in the frequency of the pharmaceutical treatment of patients with indications for therapy, the prescription of non-recommended drugs and the relatively common use of permanent neuroleptic medications. Interestingly, the motivation for implementation of the guidelines was not primarily influenced by the physicians' personal convictions but mainly stimulated by the expectations of others.
Collapse
Affiliation(s)
- H Lohmann
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
| | - F Kulessa
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
- Institut für Psychologie, Westfälische Wilhelms-Universität Münster, Münster, Deutschland
| | - H Holling
- Institut für Psychologie, Westfälische Wilhelms-Universität Münster, Münster, Deutschland
| | - A Johnen
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - S Reul
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - G Lueg
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - T Duning
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| |
Collapse
|
7
|
Riepl E, Pfeuffer S, Ruck T, Lohmann H, Wiendl H, Meuth SG, Johnen A. Alemtuzumab Improves Cognitive Processing Speed in Active Multiple Sclerosis-A Longitudinal Observational Study. Front Neurol 2018; 8:730. [PMID: 29387035 PMCID: PMC5775967 DOI: 10.3389/fneur.2017.00730] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/18/2017] [Indexed: 12/15/2022] Open
Abstract
Background Several disease-modifying drugs have shown promising effects on cognitive impairment in multiple sclerosis (MS). Alemtuzumab, a humanized monoclonal antibody, is effective in controlling disease activity, however, has not been evaluated for its effects on cognition in detail so far. Objective To explore the influence of alemtuzumab on cognitive impairment in active relapsing–remitting MS (RRMS) as well as possible clinical and neuroimaging predictors of cognitive changes during the first year of therapy. Methods Extensive neuropsychological assessment was administered to 21 patients with active RRMS at baseline and again after the second treatment with alemtuzumab (mean time span: 15.05 months). Clinical and routine structural neuroimaging markers were explored for their capacity to predict individual courses of cognitive change. Results Overall cognitive functioning remained stable or improved during the observational period of alemtuzumab treatment on average. Scores on two neuropsychological tests of processing speed significantly improved and clinically relevant individual gains of processing speed were seen in the majority of patients. Linear regression models showed that clinical and routine neuroimaging measures of disease activity could not fully account for these cognitive changes. Conclusion Results suggest that alemtuzumab treatment in active RRMS stabilizes overall cognitive functioning and furthermore positively affects cognitive processing speed. Changes in processing speed were independent from clinical and structural neuroimaging parameters of disease activity and may thus represent an underrated and independent outcome measure to evaluate treatment effects.
Collapse
Affiliation(s)
- Ester Riepl
- Department of Neurology, University Hospital Muenster, Muenster, Germany
| | - Steffen Pfeuffer
- Department of Neurology, University Hospital Muenster, Muenster, Germany
| | - Tobias Ruck
- Department of Neurology, University Hospital Muenster, Muenster, Germany
| | - Hubertus Lohmann
- Department of Neurology, University Hospital Muenster, Muenster, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital Muenster, Muenster, Germany
| | - Sven G Meuth
- Department of Neurology, University Hospital Muenster, Muenster, Germany
| | - Andreas Johnen
- Department of Neurology, University Hospital Muenster, Muenster, Germany
| |
Collapse
|
8
|
Reul S, Lohmann H, Wiendl H, Duning T, Johnen A. Can cognitive assessment really discriminate early stages of Alzheimer's and behavioural variant frontotemporal dementia at initial clinical presentation? Alzheimers Res Ther 2017; 9:61. [PMID: 28793933 PMCID: PMC5550986 DOI: 10.1186/s13195-017-0287-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 07/17/2017] [Indexed: 12/13/2022]
Abstract
Background Neuropsychological testing is considered crucial for differential diagnosis of Alzheimer’s disease (AD) and behavioural variant frontotemporal dementia (bvFTD). In-depth neuropsychological assessment revealed specific dysfunctions in the two dementia syndromes. However, a significant overlap of cognitive impairments exists in early disease stages. We questioned whether a standard neuropsychological assessment at initial clinical presentation can delineate patients with AD versus bvFTD. Methods In a retrospective approach, we evaluated and compared how cognitive profiles assessed at initial clinical presentation predicted the diagnosis of later verified AD (n = 43) and bvFTD (n = 26). Additionally, the neuropsychological standard domains memory, language, visuospatial skills, executive functions, praxis and social cognition were subjected to stepwise discriminant analysis to compare their differential contribution to diagnosis. Results Regardless of diagnosis, a percentage of patients presented with major deterioration in a wide range of cognitive domains when compared with age-matched normative data. Only few significant differences were detected on the group level: Patients with AD were relatively more impaired in the verbal recall, verbal recognition, figure copy, and surprisingly in the executive subdomains, set shifting and processing speed whereas bvFTD was characterised by more deficits in imitation of face postures. A combination of tests for verbal recall, imitation of limb and face postures, and figure copy showed the greatest discriminatory power. Conclusions Our results imply that the contribution of a standard neuropsychological assessment is limited for differential diagnosis of AD and bvFTD at initial presentation. In contrast to current clinical guidelines, executive functions are neither particularly nor exclusively impaired in patients with bvFTD when assessed within a standard clinical neuropsychological test battery. The significant overlap of bvFTD and AD concerning the profile of cognitive impairments questions current neuropsychological diagnostic criteria and calls for revision, regarding both the degree and the profile of cognitive deficits.
Collapse
Affiliation(s)
- Sophia Reul
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
| | - Hubertus Lohmann
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Thomas Duning
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Andreas Johnen
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| |
Collapse
|
9
|
Miske R, Gross CC, Scharf M, Golombeck KS, Hartwig M, Bhatia U, Schulte-Mecklenbeck A, Bönte K, Strippel C, Schöls L, Synofzik M, Lohmann H, Dettmann IM, Deppe M, Mindorf S, Warnecke T, Denno Y, Teegen B, Probst C, Brakopp S, Wandinger KP, Wiendl H, Stöcker W, Meuth SG, Komorowski L, Melzer N. Neurochondrin is a neuronal target antigen in autoimmune cerebellar degeneration. Neurol Neuroimmunol Neuroinflamm 2016; 4:e307. [PMID: 27957508 PMCID: PMC5141526 DOI: 10.1212/nxi.0000000000000307] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/10/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To report on a novel neuronal target antigen in 3 patients with autoimmune cerebellar degeneration. METHODS Three patients with subacute to chronic cerebellar ataxia and controls underwent detailed clinical and neuropsychological assessment together with quantitative high-resolution structural MRI. Sera and CSF were subjected to comprehensive autoantibody screening by indirect immunofluorescence assay (IFA) and immunoblot. Immunoprecipitation with lysates of hippocampus and cerebellum combined with mass spectrometric analysis was used to identify the autoantigen, which was verified by recombinant expression in HEK293 cells and use in several immunoassays. Multiparameter flow cytometry was performed on peripheral blood and CSF, and peripheral blood was subjected to T-cell receptor spectratyping. RESULTS Patients presented with a subacute to chronic cerebellar and brainstem syndrome. MRI was consistent with cortical and cerebellar gray matter atrophy associated with subsequent neuroaxonal degeneration. IFA screening revealed strong immunoglobulin G1 reactivity in sera and CSF with hippocampal and cerebellar molecular and granular layers, but not with a panel of 30 recombinantly expressed established neural autoantigens. Neurochondrin was subsequently identified as the target antigen, verified by IFA and immunoblot with HEK293 cells expressing human neurochondrin as well as the ability of recombinant neurochondrin to neutralize the autoantibodies' tissue reaction. Immune phenotyping revealed intrathecal accumulation and activation of B and T cells during the acute but not chronic phase of the disease. T-cell receptor spectratyping suggested an antigen-specific T-cell response accompanying the formation of antineurochondrin autoantibodies. No such neurochondrin reactivity was found in control cohorts of various neural autoantibody-associated neurologic syndromes, relapsing-remitting multiple sclerosis, cerebellar type of multiple system atrophy, hereditary cerebellar ataxias, other neurologic disorders, or healthy donors. CONCLUSION Neurochondrin is a neuronal target antigen in autoimmune cerebellar degeneration.
Collapse
Affiliation(s)
- Ramona Miske
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Catharina C Gross
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Madeleine Scharf
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Kristin S Golombeck
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Marvin Hartwig
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Urvashi Bhatia
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Andreas Schulte-Mecklenbeck
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Kathrin Bönte
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Christine Strippel
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Ludger Schöls
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Matthis Synofzik
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Hubertus Lohmann
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Inga Madeleine Dettmann
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Michael Deppe
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Swantje Mindorf
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Tobias Warnecke
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Yvonne Denno
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Bianca Teegen
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Christian Probst
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Stefanie Brakopp
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Klaus-Peter Wandinger
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Heinz Wiendl
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Winfried Stöcker
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Sven G Meuth
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Lars Komorowski
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Nico Melzer
- Institute of Experimental Immunology (R.M., M. Scharf, I.M.D., S.M., Y.D., B.T., C.P., S.B., W.S., L.K.), Euroimmun AG, Lübeck; Department of Neurology (C.C.G., K.S.G., M.H., U.B., A.S.-M., K.B., C.S., H.L., M.D., T.W., H.W., S.G.M., N.M.), University of Münster; Centre for Neurology and Hertie-Institute for Clinical Brain Research (L.S., M. Synofzik), Tübingen; German Center for Neurodegenerative Diseases (DZNE) (L.S., M. Synofzik), Tübingen; and Institute of Clinical Chemistry and Department of Neurology (K.-P.W.), University Hospital of Schleswig-Holstein, Lübeck, Germany
| |
Collapse
|
10
|
Kleffner I, Dörr J, Ringelstein M, Gross CC, Böckenfeld Y, Schwindt W, Sundermann B, Lohmann H, Wersching H, Promesberger J, von Königsmarck N, Alex A, Guthoff R, Frijns CJM, Kappelle LJ, Jarius S, Wildemann B, Aktas O, Paul F, Wiendl H, Duning T. Diagnostic criteria for Susac syndrome. J Neurol Neurosurg Psychiatry 2016; 87:1287-1295. [PMID: 28103199 DOI: 10.1136/jnnp-2016-314295] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [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] [Received: 06/27/2016] [Revised: 08/19/2016] [Accepted: 09/20/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Susac syndrome is characterised by the triad of encephalopathy with or without focal neurological signs, branch retinal artery occlusions and hearing loss. Establishment of the diagnosis is often delayed because the triad is complete only in a minority of patients at disease onset. This leads to a critical delay in the initiation of appropriate treatment. Our objective was to establish criteria for diagnosis of either definite or probable Susac syndrome. METHOD The establishment of diagnostic criteria was based on the following three steps: (1) Definition of a reference group of 32 patients with an unambiguous diagnosis of Susac syndrome as assessed by all interdisciplinary experts of the European Susac Consortium (EuSaC) team (EuSaC cohort); (2) selection of diagnostic criteria, based on common clinical and paraclinical findings in the EuSaC cohort and on a review of the literature; and (3) validation of the proposed criteria in the previously published cohort of all Susac cases reported until 2012. RESULTS Integrating the clinical presentation and paraclinical findings, we propose formal criteria and recommend a diagnostic workup to facilitate the diagnosis of Susac syndrome. More than 90% of the cases in the literature fulfilled the proposed criteria for probable or definite Susac syndrome. We surmise that more patients could have been diagnosed with the recommended diagnostic workup. CONCLUSIONS We propose diagnostic criteria for Susac syndrome that may help both experts and physicians not familiar with Susac syndrome to make a correct diagnosis and to prevent delayed treatment initiation.
Collapse
Affiliation(s)
- Ilka Kleffner
- Department of Neurology, University Hospital of Münster, Münster, Germany
| | - Jan Dörr
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Marius Ringelstein
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Catharina C Gross
- Department of Neurology, University Hospital of Münster, Münster, Germany
| | - Yvonne Böckenfeld
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Münster, Münster, Germany
| | - Wolfram Schwindt
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | | | - Hubertus Lohmann
- Department of Neurology, University Hospital of Münster, Münster, Germany
| | - Heike Wersching
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | | | | | - Anne Alex
- Department of Ophthalmology, University of Münster, Münster, Germany
| | - Rainer Guthoff
- Department of Ophthalmology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Catharina J M Frijns
- Department of Neurology, Brain Centre Rudolph Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - L Jaap Kappelle
- Department of Neurology, Brain Centre Rudolph Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sven Jarius
- Molecular Neuroimmunology Working Group, Department of Neurology, University of Heidelberg, Germany
| | - Brigitte Wildemann
- Molecular Neuroimmunology Working Group, Department of Neurology, University of Heidelberg, Germany
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Department of Neurology, Clinical and Experimental Multiple Sclerosis Research Center, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital of Münster, Münster, Germany
| | - Thomas Duning
- Department of Neurology, University Hospital of Münster, Münster, Germany
| | | |
Collapse
|
11
|
Reul S, Johnen A, Duning T, Lohmann H. EP 122. The effectiveness of standard neuropsychological testing to differentiate behavioral variant of frontotemporal dementia (bvFTD) from Alzheimer’s Dementia (AD) – A retrospective clinical approach. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.164] [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]
|
12
|
Salazar Gómez JI, Lohmann H, Krassowski J. Determination of volatile organic compounds from biowaste and co-fermentation biogas plants by single-sorbent adsorption. Chemosphere 2016; 153:48-57. [PMID: 27010166 DOI: 10.1016/j.chemosphere.2016.02.128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 01/12/2016] [Accepted: 02/29/2016] [Indexed: 06/05/2023]
Abstract
Characterisation of biogases is normally dedicated to the online monitoring of the major components methane and carbon dioxide and, to a lesser extent, to the determination of ammonia and hydrogen sulphide. For the case of Volatile Organic Compounds (VOCs), much less attention is usually paid, since such compounds are normally removed during gas conditioning and with exception of sulphur compounds and siloxanes represent a rather low risk to conventional downstream devices but could be a hindrance for fuel cells. However, there is very little information in the literature about the type of substances found in biogases generated from biowaste or co-fermentation plants and their concentration fluctuations. The main aim of this study was to provide information about the time dependencies of the VOCs in three biogas plants spread out through Germany from autumn until summer, which have different process control, in order to assess their potential as biofuels. Additionally, this study was an attempt to establish a correlation between the nature of the substrates used in the biogas plants and the composition of the VOCs present in the gas phase. Significant time-dependent variations in concentration were observed for most VOCs but only small changes in composition were observed. In general, terpenes and ketones appeared as the predominant VOCs in biogas. Although for substances such as esters, sulphur-organic compounds and siloxanes the average concentrations observed were rather low, they exhibited significant concentration peaks. The second biogas plant which operates with dry fermentation was found to contain the highest levels of VOCs. The amount of total volatile organic compounds (TVOCs) for the first, second and third biogas plants ranged from 35 to 259 mg Nm(-3), 291-1731 mg Nm(-3) and 84-528 mg Nm(-3), respectively.
Collapse
Affiliation(s)
- J I Salazar Gómez
- Fraunhofer Institute for Environmental, Safety, and Energy Technology (UMSICHT), Osterfelder Strasse 3, 46047 Oberhausen, Germany.
| | - H Lohmann
- Fraunhofer Institute for Environmental, Safety, and Energy Technology (UMSICHT), Osterfelder Strasse 3, 46047 Oberhausen, Germany.
| | - J Krassowski
- Fraunhofer Institute for Environmental, Safety, and Energy Technology (UMSICHT), Osterfelder Strasse 3, 46047 Oberhausen, Germany.
| |
Collapse
|
13
|
Golombeck KS, Bönte K, Mönig C, van Loo KM, Hartwig M, Schwindt W, Widman G, Lindenau M, Becker AJ, Glatzel M, Elger CE, Wiendl H, Meuth SG, Lohmann H, Gross CC, Melzer N. Evidence of a pathogenic role for CD8(+) T cells in anti-GABAB receptor limbic encephalitis. Neurol Neuroimmunol Neuroinflamm 2016; 3:e232. [PMID: 27213174 PMCID: PMC4853055 DOI: 10.1212/nxi.0000000000000232] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 03/17/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To characterize the cellular autoimmune response in patients with γ-aminobutyric acid (GABA)B receptor antibody-associated limbic encephalitis (GABAB-R LE). METHODS Patients underwent MRI, extensive neuropsychological assessment, and multiparameter flow cytometry of peripheral blood and CSF. RESULTS We identified a series of 3 cases of nonparaneoplastic GABAB-R LE and one case of paraneoplastic GABAB-R LE associated with small cell lung cancer. All patients exhibited temporal lobe epilepsy, neuropsychological deficits, and MRI findings typical of LE. Absolute numbers of CD19(+) B cells, CD138(+) CD19(+) plasma cells, CD4(+) T cells, activated HLADR(+) CD4(+) T cells, as well as CD8(+) T cells and HLADR(+) CD8(+) T cells did not differ in peripheral blood but were elevated in CSF of patients with GABAB-R LE compared to controls. Augmented absolute numbers of CD138(+) CD19(+) plasma cells and activated HLADR(+) CD8(+) T cells in CSF corresponded to higher overall neuropsychological and memory deficits in patients with GABAB-R LE. A histologic specimen of one patient following selective amygdalohippocampectomy revealed perivascular infiltrates of CD138(+) plasma cells and CD4(+) T cells, whereas cytotoxic CD8(+) T cells were detected within the brain parenchyma in close contact to neurons. CONCLUSION Our data suggest a pathogenic role for CD8(+) T cells in addition to the established role of plasma cell-derived autoantibodies in GABAB-R LE.
Collapse
Affiliation(s)
- Kristin S Golombeck
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Kathrin Bönte
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Constanze Mönig
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Karen M van Loo
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Marvin Hartwig
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Wolfram Schwindt
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Guido Widman
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Matthias Lindenau
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Albert J Becker
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Markus Glatzel
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Christian E Elger
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Heinz Wiendl
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Sven G Meuth
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Hubertus Lohmann
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Catharina C Gross
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| | - Nico Melzer
- Departments of Neurology (K.S.G., K.B., C.M., M.H., H.W., S.G.M., H.L., C.C.G., N.M.) and Clinical Radiology (W.S.), and Institute of Physiology I-Neuropathophysiology (S.G.M.), University of Münster; Departments of Epileptology (G.W., C.E.E.) and Neuropathology (K.M.v.L., A.J.B.), University of Bonn; Epilepsy Center Hamburg (M.L.), Evangelisches Krankenhaus Alsterdorf, Hamburg; and Department of Neuropathology (M.G.), University of Hamburg, Germany
| |
Collapse
|
14
|
Dogan Onugoren M, Golombeck KS, Bien C, Abu-Tair M, Brand M, Bulla-Hellwig M, Lohmann H, Münstermann D, Pavenstädt H, Thölking G, Valentin R, Wiendl H, Melzer N, Bien CG. Immunoadsorption therapy in autoimmune encephalitides. Neurol Neuroimmunol Neuroinflamm 2016; 3:e207. [PMID: 26977423 PMCID: PMC4772911 DOI: 10.1212/nxi.0000000000000207] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/15/2015] [Indexed: 12/19/2022]
Abstract
Objective: It was hypothesized that in encephalitides with autoantibodies directed to CNS surface antigens an antibody-removing intervention might speed up recovery. Methods: The outcome of autoimmune encephalitis in 19 patients with antibodies against surface antigens (leucine-rich, glioma inactivated 1 [LGI1], n = 3; contactin-associated protein-2 [CASPR2], n = 4; NMDA receptor [NMDAR], n = 7) and intracellular antigens (glutamic acid decarboxylase [GAD], n = 5) after immunoadsorption in addition to corticosteroid therapy was evaluated retrospectively. Modified Rankin scale (mRS) scores and data on seizures, memory, and antibody titers directly after immunoadsorption (early follow-up) and after a median of 4 months (late follow-up) were compiled. Results: Immediately after immunoadsorption, 9 of 14 patients with antibodies against LGI1, CASPR2, or NMDAR (64%), but none with GAD antibodies, had improved by at least one mRS point. Five of the 7 patients with LGI1 or CASRP2 antibodies had become seizure-free, and 2 patients with NMDAR antibodies had a memory improvement of more than 1 SD of a normal control population. At late follow-up, 12 of 14 patients with surface antibodies had improved (86%), and none of the patients with GAD antibodies. Conclusions: It is suggested that addition of immunoadsorption to immunosuppression therapy in patients with surface antibodies may accelerate recovery. This supports the pathogenic role of surface antibodies. Classification of evidence: This study provides Class IV evidence that immunoadsorption combined with immunosuppression therapy is effective in patients with autoimmune encephalitis with surface antibodies.
Collapse
Affiliation(s)
- Müjgan Dogan Onugoren
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Kristin S Golombeck
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Corinna Bien
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Mariam Abu-Tair
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Marcus Brand
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Michael Bulla-Hellwig
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Hubertus Lohmann
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Dieter Münstermann
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Hermann Pavenstädt
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Gerold Thölking
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Rainer Valentin
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Heinz Wiendl
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Nico Melzer
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| | - Christian G Bien
- Epilepsy Center Bethel (M.D.O., C.B., M.B.-H., C.G.B.), Krankenhaus Mara, Bielefeld; Department of Neurology (M.D.O.), University Hospital Erlangen; Department of Neurology (K.S.G., H.L., H.W., N.M.), University of Münster; Department of Nephrology (M.A.-T., R.V.), Bethel-EvKB, Bielefeld; Department of Medicine D (M.B., H.P., G.T.), Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Münster; and Laboratory Krone (D.M.), Bad Salzuflen, Germany
| |
Collapse
|
15
|
Schröder O, Schriewer E, Golombeck KS, Kürten J, Lohmann H, Schwindt W, Wiendl H, Bruchmann M, Melzer N, Straube T. Impaired Autonomic Responses to Emotional Stimuli in Autoimmune Limbic Encephalitis. Front Neurol 2015; 6:250. [PMID: 26648907 PMCID: PMC4663278 DOI: 10.3389/fneur.2015.00250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 09/07/2015] [Accepted: 11/13/2015] [Indexed: 12/19/2022] Open
Abstract
Limbic encephalitis (LE) is an autoimmune-mediated disorder that affects structures of the limbic system, in particular, the amygdala. The amygdala constitutes a brain area substantial for processing of emotional, especially fear-related signals. The amygdala is also involved in neuroendocrine and autonomic functions, including skin conductance responses (SCRs) to emotionally arousing stimuli. This study investigates behavioral and autonomic responses to discrete emotion evoking and neutral film clips in a patient suffering from LE associated with contactin-associated protein-2 (CASPR2) antibodies as compared to a healthy control group. Results show a lack of SCRs in the patient while watching the film clips, with significant differences compared to healthy controls in the case of fear-inducing videos. There was no comparable impairment in behavioral data (emotion report, valence, and arousal ratings). The results point to a defective modulation of sympathetic responses during emotional stimulation in patients with LE, probably due to impaired functioning of the amygdala.
Collapse
Affiliation(s)
- Olga Schröder
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster , Muenster , Germany
| | - Elisabeth Schriewer
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster , Muenster , Germany
| | | | - Julia Kürten
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster , Muenster , Germany
| | - Hubertus Lohmann
- Department of Neurology, University of Muenster , Muenster , Germany
| | - Wolfram Schwindt
- Department of Clinical Radiology, University of Muenster , Muenster , Germany
| | - Heinz Wiendl
- Department of Neurology, University of Muenster , Muenster , Germany
| | - Maximilian Bruchmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster , Muenster , Germany
| | - Nico Melzer
- Department of Neurology, University of Muenster , Muenster , Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster , Muenster , Germany
| |
Collapse
|
16
|
Johnen A, Frommeyer J, Modes F, Wiendl H, Duning T, Lohmann H. Dementia Apraxia Test (DATE): A Brief Tool to Differentiate Behavioral Variant Frontotemporal Dementia from Alzheimer’s Dementia Based on Apraxia Profiles. J Alzheimers Dis 2015; 49:593-605. [DOI: 10.3233/jad-150447] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
17
|
Grauer OM, Reichelt D, Grüneberg U, Lohmann H, Schneider-Hohendorf T, Schulte-Mecklenbeck A, Gross CC, Meuth SG, Wiendl H, Husstedt IW. Neurocognitive decline in HIV patients is associated with ongoing T-cell activation in the cerebrospinal fluid. Ann Clin Transl Neurol 2015; 2:906-19. [PMID: 26401512 PMCID: PMC4574808 DOI: 10.1002/acn3.227] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/10/2015] [Accepted: 06/11/2015] [Indexed: 01/30/2023] Open
Abstract
Objective HIV-associated neurocognitive disorders (HAND) remain a challenge despite combination antiretroviral therapy (cART). Immune cell activation has been implicated to play a major role in the development of HAND. Methods In this study, we used multicolor flow cytometry on peripheral blood (PB) and cerebrospinal fluid (CSF) samples to determine the expression of HLA-DR and programmed death-1 (PD-1) on CD4+ and CD8+ T cells in patients with chronic HIV infection. Expression levels were correlated with HI virus load in PB and CSF, classification of HAND and severity of magnetic resonance imaging (MRI) signal abnormalities. Results In a cohort of 86 HIV patients we found that the grade of neurocognitive impairment and the severity of MRI signal abnormalities correlated with decreasing CD4/CD8-ratios and increased frequencies of HLA-DR expressing CD4+ and CD8+ T cells reaching the highest values in the CSF samples. Importantly, HLA-DR upregulation was still detectable in virologically suppressed HIV patients. Further, T-cell subpopulation analysis of 40 HIV patients showed a significant shift from naïve to effector memory (EM) T cells that was negatively correlated with the grade of neurocognitive impairment in the PB samples. Moreover, PD-1 was significantly increased on CD4+ memory T cells with highest levels on EM T cells in HIV patients with mild or severe neurocognitive alterations. Interpretation The CD4/CD8 ratio, the proportion of EM to naïve T cells and the immune activation profile of CD4+ and CD8+ T cells in PB and CSF might be useful parameters to monitor the efficacy of cART and to identify HIV patients at risk of further neurocognitive deterioration.
Collapse
Affiliation(s)
- Oliver M Grauer
- Department of Neurology, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| | - Doris Reichelt
- Department of Internal Medicine D, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| | - Ute Grüneberg
- Department of Internal Medicine D, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| | - Hubertus Lohmann
- Department of Neurology, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| | - Tilman Schneider-Hohendorf
- Department of Neurology, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| | - Andreas Schulte-Mecklenbeck
- Department of Neurology, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| | - Catharina C Gross
- Department of Neurology, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| | - Sven G Meuth
- Department of Neurology, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| | - Ingo W Husstedt
- Department of Neurology, University Hospital of Muenster Albert-Schweitzer-Campus 1, D-48149, Muenster, Germany
| |
Collapse
|
18
|
Johnen A, Brandstetter L, Lohmann H, Duning T. P12. Neural correlates of apraxia in mild dementia of Alzheimer’s disease – A voxel-based morphometry study. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
19
|
Johnen A, Tokaj A, Kirschner A, Wiendl H, Lueg G, Duning T, Lohmann H. Apraxia profile differentiates behavioural variant frontotemporal from Alzheimer's dementia in mild disease stages. J Neurol Neurosurg Psychiatry 2015; 86:809-15. [PMID: 25248366 DOI: 10.1136/jnnp-2014-308773] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 06/17/2014] [Accepted: 08/27/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Despite refined criteria for behavioural variant frontotemporal dementia (bvFTD), its differentiation from Alzheimer's dementia (AD) remains difficult at early clinical presentation. Apraxia is not considered as a supportive feature for the diagnosis of bvFTD, but for AD. However, only few studies have quantified praxis disturbances in mild disease stages and their specificity for AD compared with bvFTD remains indistinct. We explore apraxia in bvFTD and investigate the differential validity of apraxia screening tests to distinguish between AD, bvFTD and healthy controls (HC). METHODS We compared composite apraxia scores assessed with standardised neuropsychological screening tests as well as performance in praxis subdomains in patients who fulfil current clinical criteria for AD (N=20), bvFTD (N=20), and in HC (N=20). RESULTS Composite scores of apraxia screening tests provided high diagnostic accuracy for detecting mild stages of both neurodegenerative disorders compared with HC (sensitivity: 75-95%; specificity: 70-90%). Both patient groups showed pronounced impairments in limb praxis, especially in imitation of hand and finger postures (bvFTD: 71.7%; AD: 55.5%; HC: 86.7%) and pantomime of object use (bvFTD: 88.6%; AD: 81.4%; HC: 97.5%). Beyond that, patients with bvFTD displayed a unique profile of deficits for imitating face postures (bvFTD: 69%; AD: 88%; HC: 95.5%). CONCLUSIONS Praxis disturbances are important but under-represented diagnostic features in mild stages of AD and bvFTD. Apraxia screening tests are easily applicable diagnostic tools, which may support clinical diagnoses of both neurodegenerative diseases. The analysis of individual apraxia profiles can effectively facilitate differential diagnosis of AD and bvFTD.
Collapse
Affiliation(s)
- Andreas Johnen
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Amelie Tokaj
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Anne Kirschner
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Gero Lueg
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Thomas Duning
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Hubertus Lohmann
- Department of Neurology, University Hospital Münster, Münster, Germany
| |
Collapse
|
20
|
Lueg G, Gross CC, Lohmann H, Johnen A, Kemmling A, Deppe M, Groger J, Minnerup J, Wiendl H, Meuth SG, Duning T. Clinical relevance of specific T-cell activation in the blood and cerebrospinal fluid of patients with mild Alzheimer's disease. Neurobiol Aging 2015; 36:81-9. [DOI: 10.1016/j.neurobiolaging.2014.08.008] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/23/2014] [Accepted: 08/07/2014] [Indexed: 11/26/2022]
|
21
|
Buschmeier F, Niederstadt T, Lohmann H, Wiendl H, Duning T. Rasch progrediente demenzielle Entwicklung als initiales Symptom einer Neuromyelitis optica (NMO). KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1370052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- F. Buschmeier
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster
| | - T. Niederstadt
- Institut für Klinische Radiologie, Universitätsklinikum Münster
| | - H. Lohmann
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster
| | - H. Wiendl
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster
| | - T. Duning
- Klinik für Allgemeine Neurologie, Universitätsklinikum Münster
| |
Collapse
|
22
|
Speer P, Wersching H, Bruchmann S, Bracht D, Stehling C, Thielsch M, Knecht S, Lohmann H. Age- and gender-adjusted normative data for the German version of Rey's Auditory Verbal Learning Test from healthy subjects aged between 50 and 70 years. J Clin Exp Neuropsychol 2013; 36:32-42. [PMID: 24341534 DOI: 10.1080/13803395.2013.863834] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Rey's Auditory Verbal Learning Test (AVLT) is widely used to evaluate dysfunctional episodic memory. The current study aimed to provide extended age- and gender-specific norms for the German AVLT for individuals older than 50 years. In 690 subjects, a comprehensive medical examination including a structural 3.0-tesla magnetic resonance imaging scan was administered, as well as extensive neuropsychological tests. After controlling for exclusion criteria, 407 subjects were included in the analysis. AVLT performance decreased with age, and women outperformed men. We present age- and gender-specific normative data for the German AVLT from subjects aged between 50 and 70 years.
Collapse
Affiliation(s)
- Paula Speer
- a Department of Neurology , University Hospital Münster , Münster , Germany
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Duning K, Wennmann DO, Bokemeyer A, Reissner C, Wersching H, Thomas C, Buschert J, Guske K, Franzke V, Flöel A, Lohmann H, Knecht S, Brand SM, Pöter M, Rescher U, Missler M, Seelheim P, Pröpper C, Boeckers TM, Makuch L, Huganir R, Weide T, Brand E, Pavenstädt H, Kremerskothen J. Common exonic missense variants in the C2 domain of the human KIBRA protein modify lipid binding and cognitive performance. Transl Psychiatry 2013; 3:e272. [PMID: 23778582 PMCID: PMC3693407 DOI: 10.1038/tp.2013.49] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The human KIBRA gene has been linked to human cognition through a lead intronic single-nucleotide polymorphism (SNP; rs17070145) that is associated with episodic memory performance and the risk to develop Alzheimer's disease. However, it remains unknown how this relates to the function of the KIBRA protein. Here, we identified two common missense SNPs (rs3822660G/T [M734I], rs3822659T/G [S735A]) in exon 15 of the human KIBRA gene to affect cognitive performance, and to be in almost complete linkage disequilibrium with rs17070145. The identified SNPs encode variants of the KIBRA C2 domain with distinct Ca(2+) dependent binding preferences for monophosphorylated phosphatidylinositols likely due to differences in the dynamics and folding of the lipid-binding pocket. Our results further implicate the KIBRA protein in higher brain function and provide direction to the cellular pathways involved.
Collapse
Affiliation(s)
- K Duning
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - D O Wennmann
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - A Bokemeyer
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - C Reissner
- Department of Anatomy and Molecular Neurobiology, University Münster, Münster, Germany
| | - H Wersching
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - C Thomas
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - J Buschert
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - K Guske
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - V Franzke
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - A Flöel
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - H Lohmann
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - S Knecht
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - S-M Brand
- Institute of Sports Medicine, University of Münster, Münster, Germany
| | - M Pöter
- Institute of Medical Biochemistry, Center for Molecular Biology of Inflammation, Münster, Germany
| | - U Rescher
- Institute of Medical Biochemistry, Center for Molecular Biology of Inflammation, Münster, Germany
| | - M Missler
- Department of Anatomy and Molecular Neurobiology, University Münster, Münster, Germany
| | - P Seelheim
- Institute of Biochemistry, University of Münster, Münster, Germany
| | - C Pröpper
- Institute of Anatomy and Cell Biology, University Ulm, Ulm, Germany
| | - T M Boeckers
- Institute of Anatomy and Cell Biology, University Ulm, Ulm, Germany
| | - L Makuch
- Howard Hughes Medical Center, John Hopkins University, Baltimore, MD, USA
| | - R Huganir
- Howard Hughes Medical Center, John Hopkins University, Baltimore, MD, USA
| | - T Weide
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - E Brand
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - H Pavenstädt
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - J Kremerskothen
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany,Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany. E-mail:
| |
Collapse
|
24
|
Steinbrink F, Evers S, Buerke B, Young P, Arendt G, Koutsilieri E, Reichelt D, Lohmann H, Husstedt IW. Cognitive impairment in HIV infection is associated with MRI and CSF pattern of neurodegeneration. Eur J Neurol 2012; 20:420-428. [PMID: 23095123 DOI: 10.1111/ene.12006] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 09/10/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Biomarkers as indicators for the progression of human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) remain still elusive. We performed a cross-sectional study to analyze the correlation between cognitive impairment, abnormalities in magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) markers of neurodegeneration in HIV-infected patients. METHODS We enrolled 94 patients (82 men and 12 women; mean age 45 ± 10 years) with HIV infection, but without opportunistic infections of the CNS. All patients underwent MRI and CSF analysis. The global pattern of white matter signal intensity abnormalities, the index of atrophy, the severity of periventricular white matter abnormalities, and the severity of basal ganglia signal changes were analyzed. We measured CSF markers of neurodegeneration (total tau, phospho-tau, beta-amyloid). The findings of this evaluation were correlated with demographic and infection parameters of the patients in blood and CSF. RESULTS We found a highly significant correlation between the severity of global brain atrophy, basal ganglia signal changes, and cognitive impairment in HIV-infected patients. Furthermore, cognitive impairment was significantly correlated with total tau, but not with phospho-tau or A-beta-amyloid in CSF analysis. CONCLUSIONS Our results confirm the significant correlation between MRI changes and cognitive impairment in HIV infection. Furthermore, we could show that global brain atrophy and signal changes in basal ganglia are the typical MRI pattern in HAND. The correlation between cognitive impairment and total tau, but not phospho-tau, supports the hypothesis that HAND are not a subtype of Alzheimer's dementia.
Collapse
Affiliation(s)
- F Steinbrink
- Department of Neurology, University of Münster, Münster, Germany
| | - S Evers
- Department of Neurology, University of Münster, Münster, Germany
| | - B Buerke
- Institute of Radiology, University of Münster, Münster, Germany
| | - P Young
- Department of Neurology, University of Münster, Münster, Germany
| | - G Arendt
- Department of Neurology, University of Düsseldorf, Düsseldorf, Germany
| | - E Koutsilieri
- Clinical Neurochemistry, Department of Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - D Reichelt
- Department of Internal Medicine D, University of Münster, Münster, Germany
| | - H Lohmann
- Department of Neurology, University of Münster, Münster, Germany
| | - I-W Husstedt
- Department of Neurology, University of Münster, Münster, Germany
| | | |
Collapse
|
25
|
Ruscheweyh R, Deppe M, Lohmann H, Wersching H, Korsukewitz C, Duning T, Bluhm S, Stehling C, Keller SS, Knecht S. Executive performance is related to regional gray matter volume in healthy older individuals. Hum Brain Mapp 2012; 34:3333-46. [PMID: 22815223 DOI: 10.1002/hbm.22146] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [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: 09/30/2011] [Revised: 12/23/2012] [Accepted: 05/20/2012] [Indexed: 11/07/2022] Open
Abstract
Individual differences in executive functioning and brain morphology are considerable. In this study, we investigated their interrelation in a large sample of healthy older individuals. Digit span, trail-making, and Stroop tasks were used to assess different executive subfunctions in 367 nondemented community-dwelling individuals (50-81 years). Task performance was analyzed relative to brain structure using voxel-based morphometry, corrected for age and sex. Improved task performance was associated with increased local gray matter volume in task-specific patterns that showed partial, but not complete overlap with known task-specific functional imaging patterns. While all three tasks showed associations with prefrontal gray matter volume as expected for executive functioning, the strongest overlap between the three tasks was found in insular cortex, suggesting that it has a previously underestimated role for executive functions. The association between the insular cortex and executive functioning was corroborated using stereological region-of-interest measurement of insular volume in a subgroup of 93 subjects. Quantitatively, the volume of the single most strongly related region explained 2.4 ± 1.1% of the variance in executive performance over and above the variance explained by age, which amounted to 7.4 ± 4.1%. The age-independent peak associations between executive performance and gray matter described here occurred in regions that were also strongly affected by age-related gray matter atrophy, consistent with the hypothesis that age-related regional brain volume loss and age-related cognitive changes are linked.
Collapse
Affiliation(s)
- Ruth Ruscheweyh
- Department of Neurology, University Hospital of Münster, Münster, Germany; Department of Neurology, University of München, München, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Kleffner I, Duning T, Lohmann H, Deppe M, Basel T, Promesberger J, Dörr J, Schwindt W, Ringelstein EB. A brief review of Susac syndrome. J Neurol Sci 2012; 322:35-40. [PMID: 22640902 DOI: 10.1016/j.jns.2012.05.021] [Citation(s) in RCA: 54] [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] [Received: 01/31/2012] [Revised: 04/29/2012] [Accepted: 05/05/2012] [Indexed: 10/28/2022]
Abstract
Susac syndrome was named after J.O. Susac who first described the syndrome in 1979. It is characterized by the clinical triad of encephalopathy, branch retinal artery occlusion, and sensorineural hearing loss. It mainly occurs in young women. This underdiagnosed disease needs to be considered in the differential diagnosis of a broad variety of disorders. In Susac syndrome, autoimmune processes leading to damage and inflammation-related occlusion of the microvessels in brain, retina, and inner ear are thought to play a causal role. The diagnosis is based primarily on the clinical presentation, the documentation of branch retinal artery occlusion by fluorescence angiography, and characteristic findings on cerebral MRI, that help in distinguishing Susac syndrome from other inflammatory entities, like multiple sclerosis. Antiendothelial cell antibodies could be detected in some patients. Patients are successfully treated with immunosuppression, however, the best regimen still needs to be defined. As a result of the rarity of the disease, controlled therapeutic trials are missing so far. In this review, we want to demonstrate the clinical features, natural history, treatment, and clinical course of Susac syndrome, illustrated by a typical case history.
Collapse
Affiliation(s)
- I Kleffner
- Department of Neurology, University of Muenster, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Flöel A, Suttorp W, Kohl O, Kürten J, Lohmann H, Breitenstein C, Knecht S. Non-invasive brain stimulation improves object-location learning in the elderly. Neurobiol Aging 2011; 33:1682-9. [PMID: 21684040 DOI: 10.1016/j.neurobiolaging.2011.05.007] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/14/2011] [Accepted: 05/13/2011] [Indexed: 12/01/2022]
Abstract
Remembering the location of objects, an integral part of everyday life, is known to decline with advancing age and early in the course of neurodegenerative dementia. Here, we aimed to test if object-location learning and its retention could be modified by noninvasive brain stimulation. In a group of 20 elderly (mean age 62.1 years) right-handed individuals, we applied transcranial direct current stimulation (tDCS; 20 minutes, 1 mA) over the right temporoparietal cortex, while subjects acquired the correct position of buildings on a street map using an associative learning paradigm. Each subject participated in a randomized and balanced order in 1 session of anodal tDCS and 1 session of sham stimulation, in a double-blind design with 2 parallel versions of the task. Outcome measures were learning success at the end of each session, and immediate as well as delayed (1 week) free recall. We found that subjects performed comparably in the learning task in the 2 conditions, but showed improved recall 1 week after learning with anodal tDCS compared with learning with sham stimulation. In conclusion, retention of object-location learning in the elderly may be modulated by noninvasive brain stimulation, a finding of potential relevance not only for normal aging but also for memory deficits in pathological aging.
Collapse
Affiliation(s)
- Agnes Flöel
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | | | | | | | | | | | | |
Collapse
|
28
|
Konrad C, Geburek AJ, Rist F, Blumenroth H, Fischer B, Husstedt I, Arolt V, Schiffbauer H, Lohmann H. Long-term cognitive and emotional consequences of mild traumatic brain injury. Psychol Med 2011; 41:1197-1211. [PMID: 20860865 DOI: 10.1017/s0033291710001728] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The objective of this study was to investigate long-term cognitive and emotional sequelae of mild traumatic brain injury (mTBI), as previous research has remained inconclusive with respect to their prevalence and extent. METHOD Thirty-three individuals who had sustained mTBI on average 6 years prior to the study and 33 healthy control subjects were matched according to age, gender and education. Structural brain damage at time of testing was excluded by magnetic resonance imaging (MRI). A comprehensive neuropsychological test battery was conducted to assess learning, recall, working memory, attention and executive function. Psychiatric symptoms were assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Beck Depression Inventory (BDI). Possible negative response bias was ruled out by implementing the Word Memory Test (WMT). RESULTS The mTBI individuals had significant impairments in all cognitive domains compared to the healthy control subjects. Effect sizes of cognitive deficits were medium to large, and could not be accounted for by self-perceived deficits, depression, compensation claims or negative response bias. BDI scores were significantly higher in the patient group, and three patients fulfilled DSM-IV criteria for a mild episode of major depression. CONCLUSIONS Primarily, well-recovered individuals who had sustained a minor trauma more than half a decade ago continue to have long-term cognitive and emotional sequelae relevant for everyday social and professional life. mTBI may lead to a lasting disruption of neurofunctional circuits not detectable by standard structural MRI and needs to be taken seriously in clinical and forensic evaluations.
Collapse
Affiliation(s)
- C Konrad
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Dirks C, Jansen A, Deppe M, Lohmann H. - Interaktion von Sprache und Gedächtnis bei Probanden mit typischer und atypischer Sprachdominanz. KLIN NEUROPHYSIOL 2011. [DOI: 10.1055/s-0031-1272792] [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]
|
30
|
Ruscheweyh R, Deppe M, Lohmann H, Stehling C, Flöel A, Ringelstein BE, Knecht S. Pain is associated with regional grey matter reduction in the general population. Pain 2011; 152:904-911. [PMID: 21296501 DOI: 10.1016/j.pain.2011.01.013] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 11/29/2010] [Accepted: 01/07/2011] [Indexed: 11/19/2022]
Abstract
Regional decreases in grey matter volume as detected by magnetic resonance imaging-based volumetry have been reported in several clinical chronic pain cohorts. Here, we used voxel-based morphometry in a nonclinical cohort to investigate whether grey matter alterations also occur in older individuals (aged 40-85 years) from the general population. Based on self-report of pain, we identified 31 pain-free controls, 45 subjects with ongoing pain (low back pain, headache, or lower extremity joint pain) who had at least moderate pain on more than 3 days/month, and 29 individuals with past pain (stopped for >12 months). Relative to controls, the ongoing pain group showed regional grey matter volume decreases, predominantly in cingulate, prefrontal, and motor/premotor regions. No grey matter volume decreases were found in the group with pain that had stopped for >12 months. These results show that pain-related grey matter volume decreases are present in individuals from the general population. The lack of morphometric anomalies in subjects with past pain supports recent evidence suggesting that pain-related grey matter changes are reversible after cessation of pain.
Collapse
Affiliation(s)
- Ruth Ruscheweyh
- Department of Neurology, University of Münster, Münster, Germany Institute of Clinical Radiology, University of Münster, Münster, Germany Department of Neurology, Charité Universitätsmedizin, Berlin, Germany
| | | | | | | | | | | | | |
Collapse
|
31
|
Duning T, Warnecke T, Schirmacher A, Schiffbauer H, Lohmann H, Mohammadi S, Young P, Deppe M. Specific pattern of early white-matter changes in pure hereditary spastic paraplegia. Mov Disord 2010; 25:1986-92. [PMID: 20669295 DOI: 10.1002/mds.23211] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Hereditary spastic paraplegias (HSP) are genetically and clinically heterogeneous neurodegenerative disorders. Most MR studies on HSP include very heterogeneous samples of patients, and findings were inconsistent. Here, we examined six patients with pure HSP and SPG4 mutations by clinical evaluation, detailed neuropsychological testing, and neuroimaging analyses, including conventional MRI, diffusion tensor imaging (DTI), and brain volumetry. Differences of voxel-wise statistics and ROI-based analysis of DTI data between patients and 32 healthy volunteers were evaluated. Although conventional MRI and brain volumetry were normal, DTI revealed widespread disturbance of white matter (WM) integrity (P < 0.001), mainly affecting the corticospinal tract. With longer disease duration, frontal regions were also involved. The WM changes were also present in subclinical subjects harbouring the pathogenic mutation. These subtle WM abnormalities have functional relevance because they correlated with clinical symptoms. Thus, early alterations of nerve fibres, which can be detected by DTI, might serve as a biological marker in HSP, in particular with respect to future longitudinal studies.
Collapse
Affiliation(s)
- Thomas Duning
- Department of Neurology, University Hospital of Münster, Münster, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Warnecke T, Oelenberg S, Teismann I, Hamacher C, Lohmann H, Ringelstein EB, Dziewas R. Endoscopic characteristics and levodopa responsiveness of swallowing function in progressive supranuclear palsy. Mov Disord 2010; 25:1239-45. [PMID: 20629130 DOI: 10.1002/mds.23060] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Dysphagia is a frequent and early symptom in progressive supranuclear palsy (PSP) predisposing patients to aspiration pneumonia. Fiberoptic endoscopic evaluation of swallowing (FEES) has emerged as a valuable apparative tool for objective evaluation of neurogenic dysphagia. This is the first study using FEES to investigate the nature of swallowing impairment in PSP. Eighteen consecutive PSP patients (mean age 69.7 +/- 9.0 years) were included. The salient findings of FEES in PSP patients were compared with those of 15 patients with Parkinson's disease (PD). In 7 PSP patients, a standardized FEES protocol was performed to explore levodopa (L-dopa) responsiveness of dysphagia. Most frequent abnormalities detected by FEES were bolus leakage, delayed swallowing reflex, and residues in valleculae and piriformes. Aspiration events with at least one food consistency occurred in nearly 30% of PSP patients. Significant pharyngeal saliva pooling was observed in 4 PSP patients. We found no difference of salient endoscopic findings between PSP and PD patients. Endoscopic dysphagia severity in PSP correlated positively with disease duration, clinical disability, and cognitive impairment. No correlation was found with dysarthria severity. In early PSP patients, swallowing dysfunction was solely characterized by liquid leakage with the risk of predeglutitive aspiration during the oral phase of swallowing. Two PSP patients showed relevant improvement of swallowing function after L-dopa challenge. Chin tuck-maneuver, hard swallow, and modification of food consistency were identified as the most effective therapeutic interventions. In conclusion, FEES assessment can deliver important findings for the diagnosis and refined therapy of dysphagia in PSP patients.
Collapse
Affiliation(s)
- Tobias Warnecke
- Department of Neurology, University Hospital of Münster, Münster, Germany.
| | | | | | | | | | | | | |
Collapse
|
33
|
Warnecke T, Duning T, Schirmacher A, Mohammadi S, Schwindt W, Lohmann H, Dziewas R, Deppe M, Ringelstein EB, Young P. A novel splice site mutation in the SPG7 gene causing widespread fiber damage in homozygous and heterozygous subjects. Mov Disord 2010; 25:413-20. [PMID: 20108356 DOI: 10.1002/mds.22949] [Citation(s) in RCA: 22] [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] [Indexed: 11/08/2022] Open
Abstract
Hereditary spastic paraplegias (HSP) are genetically and clinically heterogeneous neurodegenerative disorders. The purpose of this study was to assess the genotype and phenotype in a family with a complicated form of autosomal recessive hereditary spastic paraplegia (ARHSP). Neurological and neuropsychological evaluation, neurophysiologic studies, fiberoptic endoscopic evaluation of swallowing (FEES), neuroimaging analysis including diffusion tensor imaging (DTI), and mutation analysis of SPG4 and SPG7 gene were performed. The index case (mother) was affected by an adult-onset form of complicated ARHSP due to the homozygous splice site mutation c.1552+1 G>T in the SPG7 gene. This mutation leads to an abnormally spliced mRNA lacking exon 11. Additional clinical features were bilateral ptosis and subtle deficits in executive function. All three asymptomatic daughters carried the sequence variation c.1552+1 G>T in heterozygous state. DTI of the mother revealed disturbance of white matter (WM) integrity in the left frontal lobe, the left corticospinal tract and both sides of the brainstem. DTI of the daughters showed subtle WM alteration in the frontal corpus callosum. The novel mutation is the first splice site mutation found in the SPG7 gene. It removes part of the AAA domain of paraplegin protein, probably leading to a loss-of-function of the paraplegin-AFG3L2 complex in the mitochondrial inner membrane. The pattern of WM damage in the homozygote index case may be specific for SPG7-HSP. The detection of cerebral WM alterations in the corpus callosum of asymptomatic heterozygote carriers confirms this brain region as the most prominent and early location of fiber damage in ARHSP.
Collapse
Affiliation(s)
- Tobias Warnecke
- Department of Neurology, University Hospital of Münster, Münster, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Dimova I, Hlushchuk R, Makanya A, Djonov V, Theurl M, Schgoer W, Albrecht K, Beer A, Patsch JR, Schratzberger P, Mahata S, Kirchmair R, Didie M, Christalla P, Rau T, Eschenhagen T, Schumacher U, Lin Q, Zenke M, Zimmmermann W, Hoch M, Fischer P, Stapel B, Missol-Kolka E, Erschow S, Scherr M, Drexler H, Hilfiker-Kleiner D, Diebold I, Petry A, Kennel P, Djordjevic T, Hess J, Goerlach A, Castellano J, Aledo R, Sendra J, Costales P, Badimon L, Llorente-Cortes V, Dworatzek E, Mahmoodzadeh S, Regitz-Zagrosek V, Posa A, Varga C, Berko A, Veszelka M, Szablics P, Vari B, Pavo I, Laszlo F, Brandenburger M, Wenzel J, Bogdan R, Richardt D, Reppel M, Hescheler J, Terlau H, Dendorfer A, Heijman J, Rudy Y, Westra R, Volders P, Rasmusson R, Bondarenko V, Ertas Gokhan MD, Ural Ertan MD, Karaoz Erdal PHD, Aksoy Ayca PHD, Kilic Teoman MD, Kozdag Guliz MD, Vural Ahmet MD, Ural Dilek MD, Poulet C, Christ T, Wettwer E, Ravens U, Van Der Pouw Kraan C, Schirmer S, Fledderus J, Moerland P, Leyen T, Piek J, Van Royen N, Horrevoets A, Fleissner F, Jazbutyte V, Fiedler J, Galuppo P, Mayr M, Ertl G, Bauersachs J, Thum T, Protze S, Bussek A, Ravens U, Li F, Hoo R, Lam K, Xu A, Westenbrink B, Maass A, Sillje H, Van Veldhuisen D, Van Gilst W, De Boer R, Biesmans L, Bito V, Driessen R, Holemans P, Subramanian P, Lenaerts I, Huysmans C, Sipido K, Mourouzis I, Pantos C, Galanopoulos G, Gavra M, Perimenis P, Spanou D, Cokkinos D, Karshovska E, Berezin A, Panasenko T, Euler G, Partsch S, Harjung C, Heger J, Bogdanova A, Mihov D, Mocharla P, Yakushev S, Megens R, Vogel J, Gassmann M, Tavakoli R, Johansen D, Sanden E, Xi C, Sundset R, Ytrehus K, Bliksoen M, Rutkovskiy A, Akhtar S, Mariero L, Vaage I, Stenslokken K, Pisarenko O, Shulzhenko V, Studneva I, Serebryakova L, Tskitishvili O, Pelogeykina Y, Timoshin A, Heyll K, Vanin A, Ziberna L, Lunder M, Drevensek G, Passamonti S, Gorza L, Ravara B, Scapin C, Vitadello M, Zigrino F, Jansen Y, Gerosa G, Gwathmey J, Del Monte F, Vilahur G, Juan-Babot O, Onate B, Casani L, Badimon L, Lemoine S, Calmettes G, Weber C, Jaspard-Vinassa B, Duplaa C, Couffinhal T, Diolez P, Dos Santos P, Fusco A, Santulli G, Cipolletta E, Sorriento D, Cervero P, Schober A, Trimarco B, Feliciello A, Iaccarino G, Loganathan S, Barnucz E, Korkmaz S, Hirschberg K, Karck M, Szabo G, Kozichova K, Zafeiriou M, Hlavackova M, Neckar J, Kolar F, Novakova O, Novak F, Kusmic C, Matteucci M, Pelosi G, Vesentini N, Barsanti C, Noack C, Trivella M, Abraham N, L'abbate A, Muntean D, Mirica S, Duicu O, Raducan A, Hancu M, Fira-Mladinescu O, Ordodi V, Renger A, Voelkl J, Haubner B, Neely G, Moriell C, Seidl S, Pachinger O, Penninger J, Metzler B, Dietz R, Zelarayan L, Bergmann M, Meln I, Malashicheva A, Anisimov S, Kalinina N, Sysoeva V, Zaritskey A, Barbuti A, Scavone A, Mazzocchi N, Crespi A, Capilupo D, Difrancesco D, Qian L, Shim W, Gu Y, Mohammed S, Wong P, Noack C, Renger A, Zafiriou M, Dietz R, Schaeffer H, Bergmann M, Zelarayan L, Kovacs P, Simon J, Christ T, Wettwer E, Varro A, Ravens U, Athias P, Wolf J, Bouchot O, Vandroux D, Mathe A, De Carvalho A, Laurent G, Rainer P, Huber M, Edelmann F, Stojakovic T, Trantina-Yates A, Trauner M, Pieske B, Von Lewinski D, De Jong A, Maass A, Oberdorf-Maass S, Van Gelder I, Lin Y, Li J, Wang F, He Y, Li X, Xu H, Yang X, Coppini R, Ferrantini C, Ferrara C, Rossi A, Mugelli A, Poggesi C, Cerbai E, Rozmaritsa N, Voigt N, Christ T, Wettwer E, Dobrev D, Ravens U, Kienitz MC, Zoidl G, Bender K, Pott L, Kohajda Z, Kristof A, Kovacs P, Virag L, Varro A, Jost N, Voigt N, Trafford A, Ravens U, Dobrev D, Prnjavorac B, Mujaric E, Jukic J, Abduzaimovic K, Brack K, Patel V, Coote J, Ng G, Wilders R, Van Ginneken A, Verkerk A, Brack K, Coote J, Ng G, Xaplanteris P, Vlachopoulos C, Baou K, Vassiliadou C, Dima I, Ioakeimidis N, Stefanadis C, Ruifrok W, Qian C, Sillje H, Van Goor H, Van Veldhuisen D, Van Gilst W, De Boer R, Schmidt K, Kaiser F, Erdmann J, De Wit C, Barnett O, Kyyak Y, Cesana F, Boffi L, Mauri T, Alloni M, Betelli M, Nava S, Giannattasio C, Mancia G, Vilskersts R, Kuka J, Svalbe B, Liepinsh E, Dambrova M, Zakrzewicz A, Maroski J, Vorderwuelbecke B, Fiedorowicz K, Da Silva-Azevedo L, Pries A, Gryglewska B, Necki M, Zelawski M, Grodzicki T, Scoditti E, Massaro M, Carluccio M, Distante A, Storelli C, De Caterina R, Kocgirli O, Valcaccia S, Dao V, Suvorava T, Kumpf S, Floeren M, Oppermann M, Kojda G, Leo C, Ziogas J, Favaloro J, Woodman O, Goettsch W, Marton A, Goettsch C, Morawietz H, Khalifa E, Ashour Z, Dao V, Floeren M, Kumpf S, Suvorava T, Kojda G, Rupprecht V, Scalera F, Martens-Lobenhoffer J, Bode-Boeger S, Li W, Kwan Y, Leung G, Patella F, Mercatanti A, Pitto L, Rainaldi G, Tsimafeyeu I, Tishova Y, Wynn N, Kalinchenko S, Clemente Lorenzo M, Grande M, Barriocanal F, Aparicio M, Martin A, Hernandez J, Lopez Novoa J, Martin Luengo C, Kurlianskaya A, Denisevich T, Leo C, Ziogas J, Favaloro J, Woodman O, Barth N, Loot A, Fleming I, Wang Y, Gabrielsen A, Ripa R, Jorgensen E, Kastrup J, Arderiu G, Pena E, Badimon L, Kobus K, Czyszek J, Kozlowska-Wiechowska A, Milkiewicz P, Milkiewicz M, Madonna R, Montebello E, Geng Y, De Caterina R, Chin-Dusting J, Michell D, Skilton M, Dixon J, Dart A, Moore X, Hlushchuk R, Ehrbar M, Reichmuth P, Heinimann N, Djonov V, Hewing B, Stangl V, Stangl K, Laule M, Baumann G, Ludwig A, Widmer-Teske R, Mueller A, Stieger P, Tillmanns H, Braun-Dullaeus R, Sedding D, Troidl K, Eller L, Benli I, Apfelbeck H, Schierling W, Troidl C, Schaper W, Schmitz-Rixen T, Hinkel R, Trenkwalder T, Pfosser A, Globisch F, Stachel G, Lebherz C, Bock-Marquette I, Kupatt C, Seyler C, Duthil-Straub E, Zitron E, Scholz E, Thomas D, Gierten J, Karle C, Fink R, Padro T, Lugano R, Garcia-Arguinzonis M, Badimon L, Schuchardt M, Pruefer J, Toelle M, Pruefer N, Jankowski V, Jankowski J, Zidek W, Van Der Giet M, Pena E, Arderiu G, Badimon L, Fransen P, Van Hove C, Michiels C, Van Langen J, Bult H, Quarck R, Wynants M, Alfaro-Moreno E, Rosario Sepulveda M, Wuytack F, Van Raemdonck D, Meyns B, Delcroix M, Christofi F, Wijetunge S, Sever P, Hughes A, Ohanian J, Forman S, Ohanian V, Wijetunge S, Hughes A, Gibbons C, Ohanian J, Ohanian V, Costales P, Aledo R, Vernia S, Das A, Shah V, Casado M, Badimon L, Llorente-Cortes V, Fransen P, Van Hove C, Van Langen J, Bult H, Bielenberg W, Daniel J, Tillmanns H, Sedding D, Daniel JM, Hersemeyer K, Schmidt-Woell T, Kaetzel D, Tillmans H, Sedding D, Kanse S, Tuncay E, Kandilci H, Zeydanli E, Sozmen N, Akman D, Yildirim S, Turan B, Nagy N, Acsai K, Farkas A, Papp J, Varro A, Toth A, Viero C, Mason S, Williams A, Marston S, Stuckey D, Dyer E, Song W, El Kadri M, Hart G, Hussain M, Faltinova A, Gaburjakova J, Urbanikova L, Hajduk M, Tomaskova B, Antalik M, Zahradnikova A, Steinwascher P, Jaquet K, Muegge A, Ferrantini C, Coppini R, Wang G, Zhang M, Cerbai E, Tesi C, Poggesi C, Ter Keurs H, Kettlewell S, Smith G, Workman A, Acsai K, Lenaerts I, Holemans P, Sokolow S, Schurmans S, Herchuelz A, Sipido K, Antoons G, Wehrens X, Li N, Respress JR, De Almeida A, Van Oort R, Bussek A, Lohmann H, Christ T, Wettwer E, Ravens U, Saes M, Muegge A, Jaquet K, Messer A, Copeland O, Leung M, Marston S, Matthes F, Steinbrecher J, Salinas-Riester G, Opitz L, Hasenfuss G, Lehnart S, Caracciolo G, Eleid M, Carerj S, Chandrasekaran K, Khandheria B, Sengupta P, Riaz I, Tyng L, Dou Y, Seymour A, Dyer C, Griffin S, Haswell S, Greenman J, Yasushige S, Amorim P, Nguyen T, Schwarzer M, Mohr F, Doenst T, Popin Sanja S, Lalosevic D, Capo I, Momcilov Popin T, Astvatsatryan A, Senan M, Astvatsatryan A, Senan M, Shafieian G, Goncalves N, Falcao-Pires I, Henriques-Coelho T, Moreira-Goncalves D, Leite-Moreira A, Bronze Carvalho L, Azevedo J, Andrade M, Arroja I, Relvas M, Morais G, Seabra M, Aleixo A, Winter J, Brack K, Ng G, Zabunova M, Mintale I, Lurina D, Narbute I, Zakke I, Erglis A, Astvatsatryan A, Senan M, Marcinkevics Z, Kusnere S, Abolins A, Aivars J, Rubins U, Nassar Y, Monsef D, Hamed G, Abdelshafy S, Chen L, Wu Y, Wang J, Cheng C, Sternak M, Khomich T, Jakubowski A, Szafarz M, Szczepanski W, Mateuszuk L, Szymura-Oleksiak J, Chlopicki S, Sulicka J, Strach M, Kierzkowska I, Surdacki A, Mikolajczyk T, Balwierz W, Guzik T, Grodzicki T, Dmitriev V, Oschepkova E, Polovitkina O, Titov V, Rogoza A, Shakur R, Metcalfe S, Bradley J, Demyanets S, Kaun C, Kastl S, Pfaffenberger S, Huk I, Maurer G, Huber K, Wojta J, Eriksson O, Aberg M, Siegbahn A, Prnjavorac B, Niccoli G, Sgueglia G, Conte M, Giubilato S, Cosentino N, Ferrante G, Crea F, Dmitriev V, Oschepkova E, Polovitkina O, Titov V, Ilisei D, Leon M, Mitu F, Kyriakakis E, Philippova M, Cavallari M, Bochkov V, Biedermann B, De Libero G, Erne P, Resink T, Titov V, Bakogiannis C, Antoniades C, Tousoulis D, Demosthenous M, Psarros C, Sfyras N, Channon K, Stefanadis C, Del Turco S, Navarra T, Basta G, De Caterina R, Carnicelli V, Frascarelli S, Zucchi R, Kostareva A, Malashicheva A, Sjoberg G, Gudkova A, Semernin E, Shlyakhto E, Sejersen T, Cucu N, Anton M, Stambuli D, Botezatu A, Arsene C, Lupeanu E, Anton G, Beer A, Theurl M, Schgoer W, Albrecht K, Patsch J, Huber E, Schratzberger P, Kirchmair R, Lande C, Cecchettini A, Tedeschi L, Trivella M, Citti L, Chen B, Ma Y, Yang Y, Ma X, Liu F, Hasanzad M, Rejali L, Fathi M, Minassian A, Mohammad Hassani R, Najafi A, Sarzaeem M, Sezavar S, Akhmedov A, Klingenberg R, Yonekawa K, Lohmann C, Gay S, Maier W, Neithard M, Luescher T, Xie X, Ma Y, Yang Y, Fu Z, Li X, Ma X, Liu F, Chen B, Kevorkov A, Verduci L, Mercatanti A, Cremisi F, Pitto L, Wonnerth A, Katsaros K, Zorn G, Kaun C, Weiss T, Huber K, Maurer G, Wojta J, De Rosa R, Galasso G, Piscione F, Santulli G, Iaccarino G, Piccolo R, Luciano R, Chiariello M, Szymanski M, Schoemaker R, Van Veldhuisen D, Van Gilst W, Hillege H, Rizzo S, Basso C, Thiene G, Valente M, Rickelt S, Franke W, Bartoloni G, Bianca S, Giurato E, Barone C, Ettore G, Bianca I, Eftekhari P, Wallukat G, Bekel A, Heinrich F, Fu M, Briedert M, Briand J, Roegel J, Rizzo S, Pilichou K, Basso C, Thiene G, Korkmaz S, Radovits T, Pali S, Hirschberg K, Zoellner S, Loganathan S, Karck M, Szabo G, Bartoloni G, Pucci A, Pantaleo J, Martino S, Pelosi G, Matteucci M, Kusmic C, Vesentini N, Piccolomini F, Viglione F, Trivella M, L'abbate A, Slavikova J, Chottova Dvorakova M, Kummer W, Campanile A, Spinelli L, Santulli G, Ciccarelli M, De Gennaro S, Assante Di Panzillo E, Trimarco B, Iaccarino G, Akbarzadeh Najar R, Ghaderian S, Tabatabaei Panah A, Vakili H, Rezaei Farimani A, Rezaie G, Beigi Harchegani A, Falcao-Pires I, Hamdani N, Gavina C, Van Der Velden J, Niessen H, Stienen G, Leite-Moreira A, Paulus W, Goncalves N, Falcao-Pires I, Moura C, Lamego I, Eloy C, Niessen H, Areias J, Leite-Moreira A, Bonda T, Dziemidowicz M, Hirnle T, Dmitruk I, Kaminski K, Musial W, Winnicka M, Villar A, Merino D, Ares M, Pilar F, Valdizan E, Hurle M, Nistal J, Vera V, Toelle M, Van Der Giet M, Zidek W, Jankowski J, Astvatsatryan A, Senan M, Karuppasamy P, Chaubey S, Dew T, Sherwood R, Desai J, John L, Marber M, Kunst G, Cipolletta E, Santulli G, Attanasio A, Del Giudice C, Campiglia P, Illario M, Iaccarino G, Berezin A, Koretskaya E, Bishop E, Fearon I, Heger J, Warga B, Abdallah Y, Meyering B, Schlueter K, Piper H, Euler G, Lavorgna A, Cecchetti S, Rio T, Coluzzi G, Carrozza C, Conti E, Crea F, Andreotti F, Berezin A, Glavatskiy A, Uz O, Kardesoglu E, Yiginer O, Bas S, Ipcioglu O, Ozmen N, Aparci M, Cingozbay B, Ivanes F, Hillaert M, Susen S, Mouquet F, Doevendans P, Jude B, Montalescot G, Van Belle E, Leon M, Ilisei D, Mitu F, Castellani C, Angelini A, De Boer O, Van Der Loos C, Gerosa G, Thiene G, Van Der Wal A, Dumitriu I, Baruah P, Kaski J, Maytham O, D Smith J, Rose M, Cappelletti A, Pessina A, Mazzavillani M, Calori G, Margonato A, De Rosa R, Galasso G, Piscione F, Cassese S, Piccolo R, Luciano R, D'anna C, Chiariello M, Niccoli G, Ferrante G, Leo A, Giubilato S, Silenzi A, Baca' M, Biasucci L, Crea F, Baller D, Gleichmann U, Holzinger J, Bitter T, Horstkotte D, Bakogiannis C, Antoniades C, Antonopoulos A, Tousoulis D, Miliou A, Triantafyllou C, Channon K, Stefanadis C, Masson W, Siniawski D, Sorroche P, Casanas L, Scordo W, Krauss J, Cagide A, Schuchardt M, Toelle M, Huang T, Wiedon A, Van Der Giet M, Chin-Dusting J, Lee S, Walker K, Dart A, O'dea K, Skilton M, Perez Berbel P, Arrarte Esteban V, Garcia Valentin M, Sola Villalpando M, Lopez Vaquero C, Caballero L, Quintanilla Tello M, Sogorb Garri F, Duerr G, Elhafi N, Bostani T, Swieny L, Kolobara E, Welz A, Roell W, Dewald O, Kaludercic N, Takimoto E, Nagayama T, Chen K, Shih J, Kass D, Di Lisa F, Paolocci N, Vinet L, Pezet M, Briec F, Previlon M, Rouet-Benzineb P, Hivonnait A, Charpentier F, Mercadier J, Villar A, Cobo M, Llano M, Montalvo C, Exposito V, Nistal J, Hurle M, Ruifrok W, Meems L. Saturday, 17 July 2010. Cardiovasc Res 2010. [DOI: 10.1093/cvr/cvq174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
35
|
Wersching H, Duning T, Lohmann H, Mohammadi S, Stehling C, Fobker M, Conty M, Minnerup J, Ringelstein EB, Berger K, Deppe M, Knecht S. Serum C-reactive protein is linked to cerebral microstructural integrity and cognitive function. Neurology 2010; 74:1022-9. [PMID: 20350977 DOI: 10.1212/wnl.0b013e3181d7b45b] [Citation(s) in RCA: 159] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE C-reactive protein is a marker of inflammation and vascular disease. It also seems to be associated with an increased risk of dementia. To better understand potential underlying mechanisms, we assessed microstructural brain integrity and cognitive performance relative to serum levels of high-sensitivity C-reactive protein (hs-CRP). METHODS We cross-sectionally examined 447 community-dwelling and stroke-free individuals from the Systematic Evaluation and Alteration of Risk Factors for Cognitive Health (SEARCH) Health Study (mean age 63 years, 248 female). High-field MRI was performed in 321 of these subjects. Imaging measures included fluid-attenuated inversion recovery sequences for assessment of white matter hyperintensities, automated quantification of brain parenchyma volumes, and diffusion tensor imaging for calculation of global and regional white matter integrity, quantified by fractional anisotropy (FA). Psychometric analyses covered verbal memory, word fluency, and executive functions. RESULTS Higher levels of hs-CRP were associated with worse performance in executive function after adjustment for age, gender, education, and cardiovascular risk factors in multiple regression analysis (beta = -0.095, p = 0.02). Moreover, higher hs-CRP was related to reduced global fractional anisotropy (beta = -0.237, p < 0.001), as well as regional FA scores of the frontal lobes (beta = -0.246, p < 0.001), the corona radiata (beta = -0.222, p < 0.001), and the corpus callosum (beta = -0.141, p = 0.016), in particular the genu (beta = -0.174, p = 0.004). We did not observe a significant association of hs-CRP with measures of white matter hyperintensities or brain atrophy. CONCLUSION These data suggest that low-grade inflammation as assessed by high-sensitivity C-reactive protein is associated with cerebral microstructural disintegration that predominantly affects frontal pathways and corresponding executive function.
Collapse
Affiliation(s)
- H Wersching
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstrasse 3, 48149 Münster, Germany.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Duning T, van den Heuvel I, Dickmann A, Volkert T, Wempe C, Reinholz J, Lohmann H, Freise H, Ellger B. Hypoglycemia aggravates critical illness-induced neurocognitive dysfunction. Diabetes Care 2010; 33:639-44. [PMID: 20032274 PMCID: PMC2827523 DOI: 10.2337/dc09-1740] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Tight glycemic control (TGC) in critically ill patients is associated with an increased risk of hypoglycemia. Whether those short episodes of hypoglycemia are associated with adverse morbidity and mortality is a matter of discussion. Using a case-control study design, we investigated whether hypoglycemia under TGC causes permanent neurocognitive dysfunction in patients surviving critical illness. RESEARCH DESIGN AND METHODS From our patient data management system, we identified adult survivors treated for >72 h in our surgical intensive care unit (ICU) between 2004 and 2007 (n = 4,635) without a history of neurocognitive dysfunction or structural brain abnormalities who experienced at least one episode of hypoglycemia during treatment (hypo group) (n = 37). For each hypo group patient, one patient stringently matched for demographic- and disease-related data were identified as a control subject. We performed a battery of neuropsychological tests investigating five areas of cognitive functioning in both groups at least 1 year after ICU discharge. Test results were compared with data from healthy control subjects and between groups. RESULTS Critical illness caused neurocognitive dysfunction in all tested domains in both groups. The dysfunction was aggravated in hypo group patients in one domain, namely that of visuospatial skills (P < 0.01). Besides hypoglycemia, both hyperglycemia (r = -0.322; P = 0.005) and fluctuations of blood glucose (r = -0.309; P = 0.008) were associated with worse test results in this domain. CONCLUSIONS Hypoglycemia was found to aggravate critical illness-induced neurocognitive dysfunction to a limited, but significant, extent; however, an impact of hyperglycemia and fluctuations of blood glucose on neurocognitive function cannot be excluded.
Collapse
Affiliation(s)
- Thomas Duning
- Department of Neurology, University Hospital of Muenster, Muenster, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Flöel A, Ruscheweyh R, Krüger K, Willemer C, Winter B, Völker K, Lohmann H, Zitzmann M, Mooren F, Breitenstein C, Knecht S. Physical activity and memory functions: Are neurotrophins and cerebral gray matter volume the missing link? Neuroimage 2010; 49:2756-63. [PMID: 19853041 DOI: 10.1016/j.neuroimage.2009.10.043] [Citation(s) in RCA: 153] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2009] [Revised: 10/01/2009] [Accepted: 10/14/2009] [Indexed: 12/11/2022] Open
|
38
|
Menke R, Meinzer M, Kugel H, Deppe M, Baumgärtner A, Schiffbauer H, Thomas M, Kramer K, Lohmann H, Flöel A, Knecht S, Breitenstein C. Imaging short- and long-term training success in chronic aphasia. BMC Neurosci 2009; 10:118. [PMID: 19772660 PMCID: PMC2754483 DOI: 10.1186/1471-2202-10-118] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Accepted: 09/22/2009] [Indexed: 11/14/2022] Open
Abstract
Background To date, functional imaging studies of treatment-induced recovery from chronic aphasia only assessed short-term treatment effects after intensive language training. In the present study, we show with functional magnetic resonance imaging (fMRI), that different brain regions may be involved in immediate versus long-term success of intensive language training in chronic post-stroke aphasia patients. Results Eight patients were trained daily for three hours over a period of two weeks in naming of concrete objects. Prior to, immediately after, and eight months after training, patients overtly named trained and untrained objects during event-related fMRI. On average the patients improved from zero (at baseline) to 64.4% correct naming responses immediately after training, and treatment success remained highly stable at follow-up. Regression analyses showed that the degree of short-term treatment success was predicted by increased activity (compared to the pretraining scan) bilaterally in the hippocampal formation, the right precuneus and cingulate gyrus, and bilaterally in the fusiform gyri. A different picture emerged for long-term training success, which was best predicted by activity increases in the right-sided Wernicke's homologue and to a lesser degree in perilesional temporal areas. Conclusion The results show for the first time that treatment-induced language recovery in the chronic stage after stroke is a dynamic process. Initially, brain regions involved in memory encoding, attention, and multimodal integration mediated treatment success. In contrast, long-term treatment success was predicted mainly by activity increases in the so-called 'classical' language regions. The results suggest that besides perilesional and homologue language-associated regions, functional integrity of domain-unspecific memory structures may be a prerequisite for successful (intensive) language interventions.
Collapse
Affiliation(s)
- Ricarda Menke
- Department of Neurology, University of Münster, Münster, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Kleffner I, Deppe M, Mohammadi S, Schiffbauer H, Stupp N, Lohmann H, Young P, Ringelstein E. Diffusion tensor imaging demonstrates fiber impairment in Susac's syndrome. J Neurol Sci 2009. [DOI: 10.1016/j.jns.2009.02.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
40
|
Duning T, Wersching H, Lohmann H, Stehling C, Knecht S, Deppe M. C-Reactive Protein in healthy individuals is associated with executive dysfunction and white matter alterations. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71952-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
41
|
Duning T, Warnecke T, Mohammadi S, Lohmann H, Schiffbauer H, Kugel H, Knecht S, Ringelstein EB, Deppe M. Pattern and progression of white-matter changes in a case of posterior cortical atrophy using diffusion tensor imaging. J Neurol Neurosurg Psychiatry 2009; 80:432-6. [PMID: 19289480 DOI: 10.1136/jnnp.2008.153148] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [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: 11/04/2022]
Abstract
BACKGROUND The progression of white-matter changes in a case of posterior cortical atrophy (PCA) was examined over a period of 15 months using diffusion tensor imaging (DTI) and the association with neuropsychological variables was studied. PATIENT AND METHODS A PCA patient was observed over a period of 15 months. DTI and volumetric magnetic resonance imaging were obtained at visit 1 and 15 months later. Fractional anisotropy (FA) and volumetric changes were compared with findings in a typical case of Alzheimer disease (AD) and in 65 healthy volunteers, and the association of neuropsychological deficits with these changes was studied. RESULTS Reduction in FA was focused on the occipital lobe in the early stages of PCA. During the 15-month period, the FA values of the PCA patient tended to align with the FA ratios of the AD patient, with a more pronounced FA reduction in the parietal lobes, as opposed to a stable FA level in the occipital lobe. In addition to the DTI changes, clinical and neuropsychological symptoms deteriorated further. Brain volumes (grey matter, white matter and total normalised brain volume) of the PCA patient were substantially decreased compared with the control group, but loss of tissue volumes showed only marginal progression between visit 1 and 2. CONCLUSIONS The findings suggest that PCA starts as distinct clinical syndrome but in its later course might turn into a final pathway shared with AD. DTI might be helpful in detecting changes in cerebral white matter during disease progression in PCA patients.
Collapse
Affiliation(s)
- T Duning
- Department of Neurology, University Hospital of Münster, Münster, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Lohmann H, Esenwein S, Geier B, Vogel T, Kleinert H. Aneurysma spurium der A. profunda femoris – Komplikation nach pertrochantärer Femurfraktur mit Dislokation des Trochanter minor. Z Orthop Unfall 2009; 147:23-5. [DOI: 10.1055/s-2008-1039115] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
43
|
Kraus J, Lohmann H, Evers S. [Cognitive dysfunction as a hidden multiple sclerosis related symptom relevant for an expert appraisal]. Fortschr Neurol Psychiatr 2009; 77:38-43. [PMID: 19101878 DOI: 10.1055/s-0028-1100835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We report on a patient with multiple sclerosis (MS), who had severe cognitive dysfunction despite only mild changes in cerebral magnetic resonance imaging (cMRI). The severe MS-related cognitive deficits were disclosed only in a comprehensive neuropsychological evaluation. A previous appraiser was not able to detect these neuropsychological deficits as he did not conduct an appropriate neuropsychological assessment. The expert appraisal had been performed to decide whether the MS-related deficits would make the patient eligible to receive pension payments from a private pension insurance. Only after a subsequent neuropsychological expert appraisal the insurance company had to pay several ten thousands of Euro as decided by judicial decree. The presented case impressingly demonstrates that the so called hidden symptoms of MS such as fatigue or cognitive dysfunction are often not identified by treating physicians and in medico-legal evaluations. We therefore postulate that comprehensive neuropsychological evaluation is mandatory to perform expert appraisals to assess occupational disability in MS patients.
Collapse
Affiliation(s)
- J Kraus
- Neurologische Universitätsklinik, Christian-Doppler-Klinik, Salzburger Landeskliniken, Paracelsus Medizinische Privatuniversität, Salzburg, Osterreich.
| | | | | |
Collapse
|
44
|
Lohmann H, Evers S, Bruchmann S, Husstedt I. Beschwerdenvalidierung in neuropsychologischen Begutachtungen bei fraglichen hirnorganischen Schädigungen: Kreuzvalidierung des Word Memory Test mit ereigniskorrelierten Potentialen (P 300). Akt Neurol 2008. [DOI: 10.1055/s-0028-1086749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
45
|
Rösser N, Witte A, Willemer C, Lohmann H, Knecht S, Breitenstein C, Flöel A. Stroke impairs associative learning independent of lesion side. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
46
|
Sakellaridou E, Reinholz J, Lohmann H, Wersching H, de Vries M, Knecht S. Sprache im Alter: Eignung als Prädemenz-Marker? Akt Neurol 2008. [DOI: 10.1055/s-0028-1086744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
47
|
Knecht S, Oelschläger C, Duning T, Lohmann H, Albers J, Stehling C, Heindel W, Breithardt G, Berger K, Ringelstein EB, Kirchhof P, Wersching H. Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. Eur Heart J 2008; 29:2125-32. [PMID: 18667399 DOI: 10.1093/eurheartj/ehn341] [Citation(s) in RCA: 222] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Stefan Knecht
- Department of Neurology, University of Münster, A. Schweitzer Street 33, 48129 Münster, Germany.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Flöel A, Witte AV, Lohmann H, Wersching H, Ringelstein EB, Berger K, Knecht S. Lifestyle and memory in the elderly. Neuroepidemiology 2008; 31:39-47. [PMID: 18535399 DOI: 10.1159/000137378] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Accepted: 03/22/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Healthy lifestyle has been associated with a decreased risk of developing cardiovascular disease, but its relationship with memory functions is still inconclusive. This study aims to analyze the association between a composite lifestyle index and memory performance. METHODS In this cross-sectional survey, 198 healthy individuals (aged 65-84 years) underwent tests of verbal episodic memory. A composite lifestyle index was calculated that included the following lifestyle dimensions: physical exercise, dietary habits, BMI, smoking and alcohol consumption. The healthiest behavior was defined as: a BMI <22; a diet high in fruits, vegetables, wholemeal/low-fat foods and unsaturated fatty acids; energy expenditure through physical activity >13,000 kcal/week; a history of never smoking; an alcohol consumption of 4-10 drinks per week. RESULTS Linear regression analysis revealed that a high lifestyle index score was associated with a better memory score (after adjusting for age, sex, education and blood pressure). The composite index had a stronger relationship with memory scores than single factors. CONCLUSIONS This cross-sectional study revealed that a healthy lifestyle, assessed by a simple composite index, is related to better memory performance in healthy elderly individuals. Our findings point to the importance of a comprehensive modulation of lifestyle factors when finding ways to preserve memory functions in the elderly.
Collapse
Affiliation(s)
- Agnes Flöel
- Department of Neurology, University of Münster, Münster, Germany.
| | | | | | | | | | | | | |
Collapse
|
49
|
Knecht S, Wersching H, Lohmann H, Bruchmann M, Duning T, Dziewas R, Berger K, Ringelstein EB. High-Normal Blood Pressure Is Associated With Poor Cognitive Performance. Hypertension 2008; 51:663-8. [DOI: 10.1161/hypertensionaha.107.105577] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While the relation between systolic blood pressure (SBP) and vascular events is linear down to the high-normal range, the relation between SBP and cognition is less clear. We cross-sectionally assessed the relation between SBP and cognition in a cohort extending from mid- to late-life. From a total of 2200 community-dwelling individuals we recruited 377 aged 44 to 82 years (median: 64 years, 171 male) in the SEARCH-Health study (Systematic evaluation and alteration of risk factors for cognitive health). Participants were studied with a comprehensive neuropsychological test battery that provided, based on principal component analysis, 5 composite scores for cognition (learning and memory, attention and executive function, spatial skills, working memory, and verbal skills). Global cognition was calculated from the sum of the composite scores. SBP (corrected
R
2
=0.007), education (corrected
R
2
=0.203), age (corrected
R
2
=0.102), and gender (corrected
R
2
=0.011) explained one third of variance in global cognitive performance (
P
<0.001) on multivariate analyses. Moreover, the relation between SBP (based on 10 mm Hg-categories from <120 mm Hg to >170 mm Hg) and global cognitive performance was linear in this range of SBP-values, ie, even in the normotensive range (β=−0.110,
P
<0.05). Subgroup analysis showed that the association of SBP and cognition was driven by results in midlife (<60 years) individuals (β=−0.291,
P
<0.005). Thus, even in the normotensive range increasing systolic blood pressure is inversely related to cognition.
Collapse
Affiliation(s)
- Stefan Knecht
- From the Departments of Neurology (S.K., H.W., H.L., T.D., R.D., E.B.R.), Psychology (M.B.), and Epidemiology (K.B.), University of Münster, Germany
| | - Heike Wersching
- From the Departments of Neurology (S.K., H.W., H.L., T.D., R.D., E.B.R.), Psychology (M.B.), and Epidemiology (K.B.), University of Münster, Germany
| | - Hubertus Lohmann
- From the Departments of Neurology (S.K., H.W., H.L., T.D., R.D., E.B.R.), Psychology (M.B.), and Epidemiology (K.B.), University of Münster, Germany
| | - Maximilian Bruchmann
- From the Departments of Neurology (S.K., H.W., H.L., T.D., R.D., E.B.R.), Psychology (M.B.), and Epidemiology (K.B.), University of Münster, Germany
| | - Thomas Duning
- From the Departments of Neurology (S.K., H.W., H.L., T.D., R.D., E.B.R.), Psychology (M.B.), and Epidemiology (K.B.), University of Münster, Germany
| | - Rainer Dziewas
- From the Departments of Neurology (S.K., H.W., H.L., T.D., R.D., E.B.R.), Psychology (M.B.), and Epidemiology (K.B.), University of Münster, Germany
| | - Klaus Berger
- From the Departments of Neurology (S.K., H.W., H.L., T.D., R.D., E.B.R.), Psychology (M.B.), and Epidemiology (K.B.), University of Münster, Germany
| | - E. Bernd Ringelstein
- From the Departments of Neurology (S.K., H.W., H.L., T.D., R.D., E.B.R.), Psychology (M.B.), and Epidemiology (K.B.), University of Münster, Germany
| |
Collapse
|
50
|
Kleffner I, Deppe M, Mohammadi S, Schiffbauer H, Stupp N, Lohmann H, Young P, Ringelstein EB. DIFFUSION TENSOR IMAGING DEMONSTRATES FIBER IMPAIRMENT IN SUSAC SYNDROME. Neurology 2007; 70:1867-9. [DOI: 10.1212/01.wnl.0000280580.95671.01] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|