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Linka L, Nephuth S, Gorny I, Krause K, Michael Mross P, Tsalouchidou PE, Zahnert F, Fuest S, Menzler K, Knake S, Habermehl L. First epileptic seizure and quality of life - A prospective study. Epilepsy Behav 2024; 153:109704. [PMID: 38401415 DOI: 10.1016/j.yebeh.2024.109704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/19/2024] [Accepted: 02/15/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Impaired QoL and depression are common in patients with chronic epilepsies; however, data on the impact of a first seizure on QoL are sparse. According to the current ILAE-definition of epilepsy, patients may be diagnosed with epilepsy immediately after the first seizure, if EEG and/or imaging findings are abnormal. Patients with normal findings in imaging and EEG are not diagnosed as having epilepsy. We investigated QoL in patients after a first seizure with and without a consecutive diagnosis of epilepsy to detect differences between groups within the first year after seizure. METHODS We examined patients (n = 152) after a first epileptic seizure and six and 12 months thereafter using demographic, clinical and QoL-related questionnaire data (Short Form-36 Health Survey (SF-36), Quality of Life in Epilepsy Inventory-31 (QOLIE-31), Beck's depression inventory II (BDI-II)). RESULTS Patients diagnosed with epilepsy after the first seizure showed a tendency of reduced mental health-related QoL six (p =.098) and 12 months (p =.092) after the first seizure compared to patients who were not diagnosed with epilepsy, but were diagnosed as having had a single first seizure. There were no significant differences between the two groups in physical health-related QoL. Multiple regression analyses showed that especially depressive symptoms explained 22.0 - 48.7 % of the variance in mental health-related QoL six (p <.001) and 12 months (p <.001) after the first seizure. Physical health-related QoL was especially predicted by age (p <.001), group (p =.002) and recurrent seizures (p = < 0.001). In PWE, there was a statistical trend with improving QOLIE-31 overall scores from six to 12 months (p =.086). CONCLUSION Our results suggest that QoL may be impaired in patients diagnosed with epilepsy early, immediately after the onset of disease. Early follow-up monitoring from the beginning of patient career is important for possible interventions and to improve patients' daily life in the long term.
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Affiliation(s)
- Louise Linka
- Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany.
| | - Selina Nephuth
- Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Iris Gorny
- Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Kristina Krause
- Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | | | | | - Felix Zahnert
- Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Sven Fuest
- Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Katja Menzler
- Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Germany
| | - Lena Habermehl
- Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany
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Guertler D, Krause K, Moehring A, Bischof G, Batra A, Freyer-Adam J, Ulbricht S, Rumpf HJ, Wurm S, Cuijpers P, Lucht M, John U, Meyer C. E-Health intervention for subthreshold depression: Reach and two-year effects of a randomized controlled trial. J Affect Disord 2023; 339:33-42. [PMID: 37392942 DOI: 10.1016/j.jad.2023.06.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND There is evidence for e-Health interventions for full-blown depression. Little is known regarding commonly untreated subthreshold depression in primary care. This randomized controlled multi-centre trial assessed reach and two-year-effects of a proactive e-Health intervention (ActiLife) for patients with subthreshold depression. METHODS Primary care and hospital patients were screened for subthreshold depression. Over 6 months, ActiLife participants received three individualized feedback letters and weekly messages promoting self-help strategies against depression, e.g., dealing with unhelpful thoughts or behavioural activation. The primary outcome depressive symptom severity (Patient Health Questionnaire;PHQ-8) and secondary outcomes were assessed 6, 12 and 24 months. RESULTS Of those invited, n = 618(49.2 %) agreed to participate. Of them, 456 completed the baseline interview and were randomized to ActiLife (n = 227) or assessment only (n = 226). Generalised estimation equation analyses adjusting for site, setting and baseline depression revealed that depressive symptom severity declined over time, with no significant group differences at 6 (mean difference = 0.47 points; d = 0.12) and 24 months (mean difference = -0.05 points; d = -0.01). Potential adverse effects were observed at 12 months, with higher depressive symptom severity for ActiLife than control participants (mean difference = 1.33 points; d = 0.35). No significant differences in rates of reliable deterioration or reliable improvement of depressive symptoms were observed. ActiLife increased applied self-help strategies at 6 (mean difference = 0.32; d = 0.27) and 24 months (mean difference = 0.22; d = 0.19), but not at 12 months (mean difference = 0.18; d = 0.15). LIMITATIONS Self-report measures and lack of information on patients' mental health treatment. DISCUSSION ActiLife yielded satisfactory reach and increased the use of self-help strategies. Data were inconclusive in terms of depressive symptom changes.
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Affiliation(s)
- D Guertler
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany.
| | - K Krause
- Evangelic Hospital Bethania, Greifswald, Germany
| | - A Moehring
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany; Institute for Community Medicine, Department of Methods in Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - G Bischof
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - A Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
| | - J Freyer-Adam
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany; Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
| | - S Ulbricht
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany
| | - H J Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - S Wurm
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany
| | - P Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Institute, and WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - M Lucht
- Department of Psychiatry and Psychotherapy at Helios Hanseklinikum Stralsund, Stralsund, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - U John
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany
| | - C Meyer
- Institute for Community Medicine, Department of Prevention Research and Social Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Germany
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Boeing A, Mavrommatis L, Daya NM, Zhuge H, Volke L, Kocabas A, Kneifel M, Athamneh M, Krause K, Südkamp N, Döring K, Theiss C, Roos A, Zaehres H, Güttsches AK, Vorgerd M. Generation of two human iPSC lines (HIMRi002-A and HIMRi003-A) derived from Caveolinopathy patients with rippling muscle disease. Stem Cell Res 2023; 72:103220. [PMID: 37839261 DOI: 10.1016/j.scr.2023.103220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023] Open
Abstract
Here we introduce the human induced pluripotent stem cell lines (hiPSCs), HIMRi002-A and HIMRi003-A, generated from cultured dermal fibroblasts of 61-year-old (HIMRi002-A) and 38-year-old (HIMRi003-A) female patients, carrying a known heterozygous pathogenic variant (p.A46T) in the Caveolin 3 (CAV3) gene, via lentiviral expression of OCT4, SOX2, KLF4 and c-MYC. HIMRi002-A and HIMRi003-A display typical embryonic stem cell-like morphology, carry the p.A46T CAV3 gene mutation, express several pluripotent stem cell markers, retain normal karyotype (46, XX) and can differentiate in all three germ layers. We postulate that the HIMRi002-A and HIMRi003-A iPSC lines can be used for the characterization of CAV3-associated pathomechanisms and for developing new therapeutic options.
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Affiliation(s)
- A Boeing
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - L Mavrommatis
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - N M Daya
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - H Zhuge
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - L Volke
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - A Kocabas
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - M Kneifel
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - M Athamneh
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - K Krause
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - N Südkamp
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - K Döring
- Department of Human Genetics, Ruhr-University Bochum, 44801 Bochum, Germany
| | - C Theiss
- Department of Cytology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - A Roos
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - H Zaehres
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Ruhr-University Bochum, 44801 Bochum, Germany
| | - A K Güttsches
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - M Vorgerd
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany.
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Doerr JM, Juenemann M, Hakel L, Schmidt L, Menzler K, Krause K, Linka L, Skoluda N, Nater UM, Knake S. Effect of transcutaneous vagus nerve stimulation on stress-reactive neuroendocrine measures in a sample of persons with temporal lobe epilepsy. Epilepsia Open 2023; 8:1013-1020. [PMID: 37310988 PMCID: PMC10472404 DOI: 10.1002/epi4.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE Dysregulation of stress-reactive neuroendocrine measures, as well as subjective stress, have been found to worsen epilepsy. Transcutaneous vagus nerve stimulation (tVNS) is a relatively new treatment option for epilepsy. We were interested in its effect on the activity of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) as well as subjective stress and tiredness in patients with temporal lobe epilepsy (TLE). METHODS Twenty patients (age 44 ± 11 years, 13 women) were enrolled in the study. They were free of seizures for more than 1 year. All took part in two sessions with 4 h of stimulation (tVNS vs. sham) in a randomized order. Saliva samples and subjective stress and tiredness levels were measured at five time points each session (before and after stimulation and three time points every hour in between). Data were analyzed using repeated measures analysis of variance as well as paired t-tests. RESULTS There was a dampened salivary cortisol (sCort) decrease during tVNS (time × condition effect: F[2.38, 38.15] = 6.50, P = 0.002, partial η2 = 0.29). Furthermore, we detected a dampened increase in salivary flow rate during tVNS (time × condition effect: F[3.28, 55.67] = 2.82, P = 0.043, partial η2 = 0.14). There was neither a difference in overall sCort or salivary alpha-amylase (sAA) levels nor in subjective stress or tiredness levels between conditions. sAA levels at the last measurement point were slightly higher during tVNS (t(19) = 2.26, P = 0.035, d = 0.51), but this effect failed to reach significance when controlled for multiple comparisons. SIGNIFICANCE Our results partially support that tVNS influences the regulation of stress-reactive neuroendocrine systems (namely the HPA axis and ANS) in epilepsy. More research with larger samples is needed on the difference between short-term and repeated long-term stimulation.
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Affiliation(s)
- Johanna M. Doerr
- Department of NeurologyUniversity Hospital Gießen and MarburgGießenGermany
| | - Martin Juenemann
- Department of NeurologyUniversity Hospital Gießen and MarburgGießenGermany
| | - Lukas Hakel
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Laura Schmidt
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Katja Menzler
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Kristina Krause
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Louise Linka
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Nadine Skoluda
- Department of Clinical and Health Psychology, Faculty of PsychologyUniversity of ViennaViennaAustria
| | - Urs M. Nater
- Department of Clinical and Health Psychology, Faculty of PsychologyUniversity of ViennaViennaAustria
| | - Susanne Knake
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
- Center for Mind, Brain and Behavior (CMBB)Philipps‐University MarburgMarburgGermany
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Linka L, Magnus B, Habermehl L, Tsalouchidou PE, Zahnert F, Moeller L, Krause K, Knake S, Menzler K. Effect of the revised definition of epilepsy on treatment decisions and seizure recurrence after a first epileptic seizure. Eur J Neurol 2023; 30:1557-1564. [PMID: 36883241 DOI: 10.1111/ene.15769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Studies on risk factors for epilepsy and seizure recurrence after a first seizure are usually based on the old definition of epilepsy with the need for two unprovoked seizures. The current definition of epilepsy allows diagnosis and treatment of epilepsy after a first seizure if the recurrence risk is >60%. We evaluate treatment decisions, seizure recurrence and risk factors for epilepsy related to the application of the new definition of epilepsy. METHODS Data of 629 patients with a first seizure were analyzed to investigate changes of treatment decisions and seizure recurrence after the revised definition of epilepsy. We used binary logistic regression to investigate the impact of multiple factors influencing seizure recurrence like EEG and MRI results and administration of ASM. RESULTS The proportion of patients receiving ASM significantly increased from 70.4% to 80.5% (p = .015) following the new epilepsy definition, without any significant changes in the recurrence rate (40.8% vs. 45.5% after two years, p > 0.05). The presence of interictal epileptiform discharges (IED) in the EEG increased (OR = 1.98) and administration of ASM decreased (OR = 0.43) recurrence rates significantly. CONCLUSIONS The new definition of epilepsy was associated with increased application of ASM, but not with reduced recurrence rates. The study confirms the presence of IED as a strong risk factor for seizure recurrence and the protective effect of ASM. The influence of imaging findings, which have a strong impact on the new definition of epilepsy, could not be confirmed.
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Affiliation(s)
- Louise Linka
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
| | - Benedikt Magnus
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany
| | - Lena Habermehl
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
| | - Panagiota-Eleni Tsalouchidou
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
| | - Felix Zahnert
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
| | - Leona Moeller
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
| | - Kristina Krause
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
| | - Katja Menzler
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
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Brembilla N, Modarressi A, André-Lévigne D, Vuagnat H, Durual S, Marger L, Boehncke W, Krause K, Preynat-Seauve O. LB1027 An adipose-derived stem cell-engineered patch represents a promising treatment for chronic wounds. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.1056] [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: 10/17/2022]
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Krause K, Goschzik T, Dörner E, Pietsch T. Genetic landscape of large cell/anaplastic medulloblastoma
– more than one disease. KLINISCHE PADIATRIE 2022. [DOI: 10.1055/s-0042-1748732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- K Krause
- University of Bonn Medical Center, Dept. of Neuropathology, Bonn,
Germany
| | - T Goschzik
- University of Bonn Medical Center, Dept. of Neuropathology, Bonn,
Germany
| | - E Dörner
- University of Bonn Medical Center, Dept. of Neuropathology, Bonn,
Germany
| | - T Pietsch
- University of Bonn Medical Center, Dept. of Neuropathology, Bonn,
Germany
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8
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Preynat-Seauve O, Lanza F, Brioudes E, Modarressi A, Vuagnat H, Boehncke W, Krause K, Brembilla N. 369 An Adipose-derived Stem Cell-engineered matrix represents a promising treatment for chronic wounds. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.378] [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: 11/25/2022]
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Gorny I, Wenn W, Biermann L, Habermehl L, Mross PM, Krause K, Möller L, Fuest S, Menzler K, Knake S. Perception of memory performance after first seizure in patients with and without an epilepsy diagnosis. Epilepsy Behav 2021; 122:108195. [PMID: 34256337 DOI: 10.1016/j.yebeh.2021.108195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Memory complaints in patients with epilepsy have been well-studied. Although memory complaints are commonly reported by patients with chronic epilepsy, to date, few studies exist on memory complaints at the onset of epilepsy. The present study investigated the presence of memory complaints and their relation to mood and memory performance in patients after their first seizure. Thereby, we examined differences between individuals who received a diagnosis of epilepsy immediately with the occurrence of their first seizure and those who were diagnosed as having the first epileptic seizure, without fulfilling the ILAE criteria for the diagnosis of epilepsy. METHODS Sixty-one patients participated in the study and completed, among others, a memory task and questionnaires on memory complaints and depression after their first epileptic seizure. We investigated the level of memory complaints and their correlation and accuracy in classification with a memory measure. We compared patients who received an epilepsy diagnosis after the first seizure with those who did not. RESULTS Memory complaints did not correlate with objective memory performance. Classification into impaired/unimpaired showed low concordance between memory complaints and neuropsychological memory measures. After their first epileptic seizure, patients reported few memory complaints overall (10%), and there were no differences in memory complaints between patients with and without an epilepsy diagnosis. CONCLUSION At epilepsy onset, in contrast to established epilepsies, memory complaints are rare. Although influences of anticonvulsant drugs and seizures are not present at the beginning of epilepsy, this substantial absence of memory complaints at epilepsy onset emphasizes the need for comprehensive neurological and psychological treatment early with the given diagnosis. Treatment should focus on anticonvulsant drug regimens, patients' concerns and convey realistic expectations.
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Affiliation(s)
- Iris Gorny
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg.
| | - Wiebke Wenn
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Louise Biermann
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Lena Habermehl
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Peter Michael Mross
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Kristina Krause
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Leona Möller
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Sven Fuest
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Katja Menzler
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Susanne Knake
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
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Meyer C, Gürtler D, Krause K, Möhring A, Freyer-Adam J, Baumann S, Ulbricht S, Batra A, Bischof G, Rumpf RJ, Wurm S, John U. Computer-based interventions targeting hazardous alcohol consumption and depressiveness among medical care patients: Preliminary findings from a randomized controlled proof of concept trial. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732736] [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: 10/20/2022]
Affiliation(s)
- C Meyer
- Abteilung für Sozialmedizin und Prävention, Institut für Community Medicine, Universitätsmedizin Greifswald
- DZHK, Standort Greifswald
| | - D Gürtler
- Abteilung für Sozialmedizin und Prävention, Institut für Community Medicine, Universitätsmedizin Greifswald
- DZHK, Standort Greifswald
| | - K Krause
- Institut für Medizinische Psychologie, Universitätsmedizin Greifswald
| | - A Möhring
- Abteilung für Sozialmedizin und Prävention, Institut für Community Medicine, Universitätsmedizin Greifswald
- DZHK, Standort Greifswald
| | - J Freyer-Adam
- DZHK, Standort Greifswald
- Institut für Medizinische Psychologie, Universitätsmedizin Greifswald
| | - S Baumann
- Abteilung für Sozialmedizin und Prävention, Institut für Community Medicine, Universitätsmedizin Greifswald
- DZHK, Standort Greifswald
- Institut und Poliklinik für Arbeits und Sozialmedizin
| | - S Ulbricht
- Abteilung für Sozialmedizin und Prävention, Institut für Community Medicine, Universitätsmedizin Greifswald
- DZHK, Standort Greifswald
| | - A Batra
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen
| | - G Bischof
- Klinik für Psychiatrie und Psychotherapie, Universität Lübeck
| | - RJ Rumpf
- Klinik für Psychiatrie und Psychotherapie, Universität Lübeck
| | - S Wurm
- Abteilung für Sozialmedizin und Prävention, Institut für Community Medicine, Universitätsmedizin Greifswald
| | - U John
- Abteilung für Sozialmedizin und Prävention, Institut für Community Medicine, Universitätsmedizin Greifswald
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Krause K, Gürtler D, Möhring A, Bischof G, Batra A, Rumpf HJ, Wurm S, John U, Meyer C. An individualized proactive e-health intervention promoting a lifestyle against depression: Results of a randomized controlled trial over 24 months. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732148] [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: 10/20/2022]
Affiliation(s)
- K Krause
- Institute for Medical Psychology, University Medicine Greifswald
| | - D Gürtler
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
| | - A Möhring
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
| | - G Bischof
- Department of Psychiatry, University of Lübeck
| | - A Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen
| | - H-J Rumpf
- Department of Psychiatry, University of Lübeck
| | - S Wurm
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
| | - U John
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
| | - C Meyer
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
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Gürtler D, Möhring A, Krause K, Tomczyk S, Freyer-Adam J, Baumann S, Bischof G, Rumpf HJ, Batra A, Wurm S, John U, Meyer C. Latent alcohol use patterns and their link to depressive symptomatology in medical care patients. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732121] [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: 10/20/2022]
Affiliation(s)
- D Gürtler
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
| | - A Möhring
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
| | - K Krause
- Institute for Medical Psychology, University Medicine Greifswald
| | - S Tomczyk
- Institute of Psychology, Department of Health and Prevention, University of Greifswald
| | - J Freyer-Adam
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
- Institute for Medical Psychology, University Medicine Greifswald
| | - S Baumann
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
- Institute and Policlinic for Occupational and Social Medicine, Technische Universität Dresden
| | - G Bischof
- Department of Psychiatry and Psychotherapy, Research Group S:TEP, University of Lübeck
| | - H-J Rumpf
- Department of Psychiatry and Psychotherapy, Research Group S:TEP, University of Lübeck
| | - A Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen
| | - S Wurm
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
| | - U John
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
| | - C Meyer
- Institute for Community Medicine, Department of Social Medicine and Prevention, University Medicine Greifswald
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald
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13
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Steidel K, Krause K, Menzler K, Strzelczyk A, Immisch I, Fuest S, Gorny I, Mross P, Hakel L, Schmidt L, Timmermann L, Rosenow F, Bauer S, Knake S. Transcutaneous auricular vagus nerve stimulation influences gastric motility: A randomized, double-blind trial in healthy individuals. Brain Stimul 2021; 14:1126-1132. [PMID: 34187756 DOI: 10.1016/j.brs.2021.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/01/2021] [Accepted: 06/13/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Transcutaneous auricular vagus nerve stimulation (taVNS) has been investigated regarding its therapeutic properties in several several conditions such as epilepsy, migraine and major depressive disorder and was shown to access similar neural pathways as invasive vagus nerve stimulation. While the vagus nerve's role in gut motility is physiologically established, the effect of taVNS has scarcely been investigated in humans and yielded conflicting results. Real-time gastric magnetic resonance imaging (rtMRI) is an established reproducible method to investigate gastric motility non-invasively. OBJECTIVE To investigate the influence of taVNS on gastric motility of healthy participants using rtMRI. METHODS We conducted a randomized, double-blind study using high-frequency (HF) stimulation at 25Hz or low-frequency (LF) taVNS at 1Hz after ingestions of a standardized meal in 57 healthy participants. The gastric motility index (GMI) was determined by measuring the amplitude and velocity of the peristaltic waves using rtMRI. RESULTS After HF taVNS, GMI was significantly higher than after LF stimulation (p = 0.005), which was mainly attributable to a higher amplitude of the peristaltic waves (p = 0.003). CONCLUSION We provide evidence that 4-h of taVNS influences gastric motility in healthy human participants for the first time using rtMRI. HF stimulation is associated with higher amplitudes of peristaltic waves in the gastric antrum compared to LF stimulation. Further studies are needed to investigate the effect of different frequencies of taVNS and its therapeutic properties in conditions with impaired gastric motility.
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Affiliation(s)
- Kenan Steidel
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Kristina Krause
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Germany
| | - Katja Menzler
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Germany; Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Ilka Immisch
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Sven Fuest
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Iris Gorny
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Peter Mross
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Lukas Hakel
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Laura Schmidt
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Lars Timmermann
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany
| | - Felix Rosenow
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany; Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Germany
| | - Sebastian Bauer
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany; Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Germany
| | - Susanne Knake
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Germany.
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14
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Tsalouchidou PE, Mintziras I, Biermann L, Krause K, Bergmann MP, Belke M, Nimsky C, Schulze M, Strzelczyk A, Rosenow F, Menzler K, Knake S. Temporal encephaloceles in epilepsy patients and asymptomatic cases: Size may indicate epileptogenicity. Epilepsia 2021; 62:1354-1361. [PMID: 33939185 DOI: 10.1111/epi.16900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/22/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study was undertaken to identify temporal encephaloceles (TEs) and examine their characteristics in patients with temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE), as well as in asymptomatic cases. METHODS Four hundred fifty-eight magnetic resonance imaging scans were examined retrospectively to identify TE in 157 patients with TLE, 150 patients with ETLE, and 151 healthy controls (HCs). RESULTS At least one TE was identified in 9.6% of the TLE patients (n = 15, 95% confidence interval [CI] = 5.3%-15.3%), in 3.3% of patients with ETLE (n = 5, 95% CI = 1.1%-7.6%), and in 2.0% of the HCs (n = 3, 95% CI = .4%-5.7%), indicating a significantly higher frequency in patients with TLE compared to ETLE and HC subjects (p = .027, p = .005). Examining the characteristics of TEs in both asymptomatic and epilepsy patients, we found that TEs with a diameter of less than 6.25 mm were more likely to be asymptomatic, with a sensitivity of 91.7% and a specificity of 73.3% (area under the curve = .867, 95% CI = .723-1.00, p = .001). SIGNIFICANCE Temporal encephaloceles may occur without presenting any clinical symptoms. Patients with TLE show a higher frequency of TEs compared to the ETLE and HC groups. According to our study, TE size could be used to suggest potential epileptogenicity.
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Affiliation(s)
| | - Ioannis Mintziras
- Department of Visceral, Thoracic, and Vascular Surgery, Philipps University Marburg, Marburg, Germany
| | - Louise Biermann
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Kristina Krause
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Marc-Philipp Bergmann
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Marcus Belke
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Christopher Nimsky
- Department of Neurosurgery, Philipps University Marburg, Marburg, Germany
| | - Maximilian Schulze
- Division of Neuroradiology, Philipps University Marburg, Marburg, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Katja Menzler
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
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15
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Roussel-Gervais A, Sakic A, Cherpin O, Ilmjärv S, Salmon P, Krause K, Alessandrini M. Multiplex gene silencing as a promising tool for development of next generation immune effector cell therapies. Cytotherapy 2021. [DOI: 10.1016/s1465324921003996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Mlambo T, Roussel-Gervais A, Ilmjärv S, Sakic A, Myburgh R, Bredl S, Salmon P, Pepper M, Krause K, Speck R, Alessandrini M. Development of an off-the-shelf CAR T-cell therapy for HIV: a step towards a universally accessible advanced therapy. Cytotherapy 2021. [DOI: 10.1016/s1465324921004357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Habermehl L, Mross PM, Krause K, Immisch I, Chiru D, Zahnert F, Gorny I, Strzelczyk A, Rosenow F, Möller L, Menzler K, Knake S. Stiripentol in the treatment of adults with focal epilepsy- a retrospective analysis. Seizure 2021; 88:7-11. [PMID: 33774499 DOI: 10.1016/j.seizure.2021.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/10/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES The aim of the present study was to evaluate the safety and efficacy of the add-on treatment of stiripentol (STP) in adult patients with severely pharmacoresistant focal or multifocal epilepsy. METHODS Data on adult patients treated with STP from March 2007 to July 2020 and with at least one clinical follow-up (FU) were retrospectively reviewed. Data on tolerability, efficacy and concomitant medication were evaluated at baseline, 6 months (5.5 ± 1.6 months (mean ± SD)) and 12 months (13.1 ± 3.9 months (mean ± SD)). RESULTS Data of 22 patients (54.5% male, mean age 34.4 ± 17.79 years (mean ± SD), including mean duration of epilepsy 17.6 ± 25.5 years (mean ± SD), median seizure frequency 30 ± 20 (median ± MAD) per month, and 63.6% being severely intellectually disabled, with 3 to 18 previous anti-seizure-drugs (ASD), were collected. After 6 months, 72.7% of the patients were still taking STP, and 31% of the patients were responders, including 13% who were seizure-free. The 12-month retention rate was 54.4 %, the response rate was 36.4% and 13.6% of patients were seizure-free at the 12-month FU. Reasons for discontinuation were increased seizure frequency, hyperammonaemia and encephalopathy. CONCLUSION STP seems to be a useful option in the treatment of patients with severely pharmacoresistant epilepsy. Prospective trials are necessary to examine the efficacy of STP in adult patients with pharmacoresistant focal epilepsy.
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Affiliation(s)
- L Habermehl
- Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany
| | - P M Mross
- Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany
| | - K Krause
- Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany
| | - I Immisch
- Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany
| | - D Chiru
- Department of Acute Medicine, Schweizer Paraplegiker Zentrum, Notwill, Switzerland
| | - F Zahnert
- Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany
| | - I Gorny
- Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany
| | - A Strzelczyk
- Department of Neurology, Epilepsy Centre Frankfurt Rhine-Main, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - F Rosenow
- Department of Neurology, Epilepsy Centre Frankfurt Rhine-Main, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - L Möller
- Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany
| | - K Menzler
- Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany
| | - S Knake
- Department of Neurology, Epilepsy Centre Hessen, Philipps-University Marburg, Marburg, Germany.
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18
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Weber I, Niehaus H, Krause K, Molitor L, Peper M, Schmidt L, Hakel L, Timmermann L, Menzler K, Knake S, Oehrn CR. Trust your gut: vagal nerve stimulation in humans improves reinforcement learning. Brain Commun 2021; 3:fcab039. [PMID: 33928247 PMCID: PMC8066886 DOI: 10.1093/braincomms/fcab039] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 08/24/2020] [Revised: 12/01/2020] [Accepted: 01/20/2021] [Indexed: 11/26/2022] Open
Abstract
Whereas the effect of vagal nerve stimulation on emotional states is well established, its effect on cognitive functions is still unclear. Recent rodent studies show that vagal activation enhances reinforcement learning and neuronal dopamine release. The influence of vagal nerve stimulation on reinforcement learning in humans is still unknown. Here, we studied the effect of transcutaneous vagal nerve stimulation on reinforcement learning in eight long-standing seizure-free epilepsy patients, using a well-established forced-choice reward-based paradigm in a cross-sectional, within-subject study design. We investigated vagal nerve stimulation effects on overall accuracy using non-parametric cluster-based permutation tests. Furthermore, we modelled sub-components of the decision process using drift-diffusion modelling. We found higher accuracies in the vagal nerve stimulation condition compared to sham stimulation. Modelling suggests a stimulation-dependent increase in reward sensitivity and shift of accuracy-speed trade-offs towards maximizing rewards. Moreover, vagal nerve stimulation was associated with increased non-decision times suggesting enhanced sensory or attentional processes. No differences of starting bias were detected for both conditions. Accuracies in the extinction phase were higher in later trials of the vagal nerve stimulation condition, suggesting a perseverative effect compared to sham. Together, our results provide first evidence of causal vagal influence on human reinforcement learning and might have clinical implications for the usage of vagal stimulation in learning deficiency.
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Affiliation(s)
- Immo Weber
- Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany
| | - Hauke Niehaus
- Faculty of Psychology, Neuropsychology Section, Philipps-University Marburg, 35032 Marburg, Germany.,Faculty of Psychology, Theoretical Neuroscience Section, Philipps-University Marburg, 35032 Marburg, Germany
| | - Kristina Krause
- Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany.,Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, 35032 Marburg, Germany.,Department of Neurology, Epilepsy Center Hessen, Philipps University, 35043 Marburg, Germany
| | - Lena Molitor
- Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany
| | - Martin Peper
- Faculty of Psychology, Neuropsychology Section, Philipps-University Marburg, 35032 Marburg, Germany.,Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, 35032 Marburg, Germany
| | - Laura Schmidt
- Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany
| | - Lukas Hakel
- Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany
| | - Lars Timmermann
- Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany.,Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, 35032 Marburg, Germany
| | - Katja Menzler
- Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany.,Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, 35032 Marburg, Germany.,Department of Neurology, Epilepsy Center Hessen, Philipps University, 35043 Marburg, Germany
| | - Susanne Knake
- Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany.,Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, 35032 Marburg, Germany.,Department of Neurology, Epilepsy Center Hessen, Philipps University, 35043 Marburg, Germany
| | - Carina R Oehrn
- Department of Neurology, Philipps-University Marburg, 35043 Marburg, Germany.,Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, 35032 Marburg, Germany.,Department of Neurology, Epilepsy Center Hessen, Philipps University, 35043 Marburg, Germany
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19
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Kim P, Lee J, Lee CH, Fahy K, Shrestha P, Krause K, Shafaque H, Bazylak A. Tailoring catalyst layer interface with titanium mesh porous transport layers. Electrochim Acta 2021. [DOI: 10.1016/j.electacta.2021.137879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Abstract
Schwere Arzneimittelnebenwirkungen stellen mit 5–7 % einen häufigen Grund für eine Krankenhauseinweisung dar. Die Prävalenz von unerwünschten Arzneimittelwirkungen (UAW) während eines stationären Aufenthaltes liegt sogar bei etwa 11,5 %. Die Ursache sind oftmals Medikamentenwechselwirkungen, bedingt durch die Polypharmazie der multimorbiden älteren Patienten. So nimmt ein 65-jähriger Patient im Durchschnitt 5 Medikamente gleichzeitig ein. Aufgrund des zunehmenden Einsatzes von Systemtherapeutika in der Dermatologie und der gleichzeitig zunehmenden Polypharmazie ist das Wissen um Medikamenteninteraktionen für den Dermatologen zur Vermeidung schwerer Arzneimittelnebenwirkungen wesentlich. Dieser Beitrag soll eine Hilfestellung bieten, Patienten und Medikamente mit einem hohen Risiko für schwerwiegende Interaktionen zu identifizieren und dadurch das Auftreten unerwünschter Wirkungen oder auch die Verminderung des therapeutischen Effektes von Wirkstoffen zu vermeiden. Wir möchten darauf hinweisen, dass die folgende Arbeit einzelne Aspekte behandelt und nicht von der Überprüfung einzelner Arzneimittelinteraktionen mittels Interaktionsprogrammen entbindet. Nicht außer Acht gelassen werden sollte, dass neben verschreibungspflichtigen Medikamenten auch Nahrungsmittel, Nahrungsergänzungsmittel und Kräuter zu Interaktionen mit Medikamenten führen können.
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Affiliation(s)
- Kristina Krause
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - Katharina Jahn
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - Bernhard Homey
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
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21
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Mross PM, Gorny I, Krause K, Biermann L, Habermehl L, Möller L, Bergmann MP, Tsalouchidou PE, Laakmann JD, Weyand AM, Menzler K, Knake S. Examination of the Flynn effect in German patients with epilepsy assessed with the Wechsler Adult Intelligence Scale (WAIS) III and IV. Epilepsy Behav 2020; 112:107337. [PMID: 32919198 DOI: 10.1016/j.yebeh.2020.107337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/03/2020] [Accepted: 07/12/2020] [Indexed: 10/23/2022]
Abstract
The Flynn effect describes an increase in intelligence quotient (IQ) in the general population of about 3 points per decade. While this effect is well established in healthy individuals, research exploring the link to brain pathologies is scarce. We investigated the Flynn effect in a German sample of 203 patients with epilepsy with left, right, and bilateral lesions. Intelligence quotient values were obtained using the Wechsler Adult Intelligence Scales (WAIS) III and IV. Our results showed a stable Flynn effect with nearly no difference in adjusted full scale IQ (FSIQ) scores (0.02 IQ points) between the WAIS-III and WAIS-IV samples. There were no significant interactions between the side of pathology and corrected IQ values. Our sample showed a tendency towards performing worse in the WAIS-IV in three out of four subscales independently of the Flynn effect, pointing out methodological differences between the newer Wechsler editions. However, although patients with bilateral lesions performed worst across all subscales, they exhibited a similar pattern as patients with lesions in the left or right hemisphere, indicating that also more severe forms of brain pathologies can profit from the mechanisms behind the Flynn effect.
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22
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Menting T, Krause K, Benz-Tettey F, Boehringer R, Laufer D, Gruber B, Crump M, Schieferdecker R, Reuhl S, Kaeferstein A, Engelhart S, Streeck H, Marx B, Aldabbagh S, Eis-Hübinger A, Rockstroh JK, Schwarze-Zander C. Low-threshold SARS-CoV-2 testing facility for hospital staff: Prevention of COVID-19 outbreaks? Int J Hyg Environ Health 2020; 231:113653. [PMID: 33137564 PMCID: PMC7580697 DOI: 10.1016/j.ijheh.2020.113653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The ongoing global SARS-CoV-2 pandemic has caused over 4.7 million infections greatly challenging healthcare workers (HCW) and medical institutions worldwide. The SARS-CoV-2 pandemic has shown to significantly impact mental and physical health of HCW. Thus, implementation of testing facilities supporting HCW are urgently needed. METHODS A low-threshold SARS-CoV-2 testing facility was introduced at the University Hospital Bonn, Germany, in March 2020. Irrespective of clinical symptoms employees were offered a voluntary and free SARS-CoV-2 test. Furthermore, employees returning from SARS-CoV-2 risk regions and employees after risk contact with SARS-CoV-2 infected patients or employees were tested for SARS-CoV-2 infection. Pharyngeal swabs were taken and reverse transcription polymerase chain reaction for detection of SARS-CoV-2 was performed, test results being available within 24 h. Profession, symptoms and reason for SARS-CoV-2 testing of employees were recorded. RESULTS Between 9th March and April 30, 2020, a total of 1510 employees were tested for SARS-CoV-2 infection. 1185 employees took advantage of the low-threshold testing facility. One percent (n = 11) were tested positive for SARS-CoV-2 infection, 18% being asymptomatic, 36% showing mild and 36% moderate/severe symptoms (missing 10%). Furthermore, of 56 employees returning from SARS-CoV-2 risk regions, 18% (10/56) were tested SARS-CoV-2 positive. After risk contact tracking by the hospital hygiene 6 patient-to-employee transmissions were identified in 163 employees with contact to 55 SARS-CoV-2 positive patients. CONCLUSION In the absence of easily accessible public SARS-CoV-2 testing facilities low-threshold SARS-CoV-2 testing facilities in hospitals with rapid testing resources help to identify SARS-CoV-2 infected employees with absent or mild symptoms, thus stopping the spread of infection in vulnerable hospital environments. High levels of professional infection prevention training and implementation of specialized wards as well as a perfectly working hospital hygiene network identifying and tracking risk contacts are of great importance in a pandemic setting.
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Affiliation(s)
- T Menting
- Occupational Health Service, University Hospital Bonn, Germany
| | - K Krause
- Occupational Health Service, University Hospital Bonn, Germany
| | - F Benz-Tettey
- Occupational Health Service, University Hospital Bonn, Germany
| | - R Boehringer
- Occupational Health Service, University Hospital Bonn, Germany
| | - D Laufer
- Medical Controlling, University Hospital Bonn, Germany
| | - B Gruber
- Medical Controlling, University Hospital Bonn, Germany
| | - M Crump
- Occupational Health Service, University Hospital Bonn, Germany
| | | | - S Reuhl
- Occupational Health Service, University Hospital Bonn, Germany
| | - A Kaeferstein
- Occupational Health Service, University Hospital Bonn, Germany
| | - S Engelhart
- Institute for Hygiene and Public Health, University Hospital Bonn, Germany
| | - H Streeck
- Institute of Virology, University of Bonn, Germany
| | - B Marx
- Institute of Virology, University of Bonn, Germany
| | - S Aldabbagh
- Institute of Virology, University of Bonn, Germany
| | | | - J K Rockstroh
- Department of Infectious Diseases, Internal Medicine I, University Hospital Bonn, Germany; German Center of Infection Research (DZIF), Partner Site Bonn-Cologne, Germany
| | - C Schwarze-Zander
- Department of Infectious Diseases, Internal Medicine I, University Hospital Bonn, Germany; German Center of Infection Research (DZIF), Partner Site Bonn-Cologne, Germany.
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Lubig S, Krause K, Erices-Leclercq M, Tenckhoff D, Rudlowski C. Prospektive monozentrische Kohorten-Studie zum Einsatz des Misoprostol Vaginal-Insert (Misodel®) zur Geburtseinleitung bei Terminüberschreitung: Finale Ergebnisse von 304 Schwangeren. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717163] [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: 10/23/2022] Open
Affiliation(s)
- S Lubig
- Evangelisches Krankenhaus, Frauenklinik
| | - K Krause
- Evangelisches Krankenhaus, Frauenklinik
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Schargus M, Langhorst CA, Joachim S, Frings A, Krause K, Reifenberger J, Geerling G, Frings VG. Hidradenitis Suppurativa is Associated with Symptoms of Keratoconjunctivitis Sicca. Curr Eye Res 2020; 46:23-30. [PMID: 32506959 DOI: 10.1080/02713683.2020.1775259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM OF THE STUDY Hidradenitis suppurativa (HS) and psoriasis vulgaris (PSO) are chronic inflammatory dermatoses in which proinflammatory cytokines, such as IL-17, play a central role. The prevalence of keratoconjunctivitis sicca (KCS) is commonly higher in PSO than in healthy individuals. This study was thus set up to investigate the prevalence of KCS among patients with HS. MATERIALS AND METHODS In a cross-sectional study standardized tear film parameters and symptom-oriented questionnaires (OSDI, SPEED) were analyzed in a total of 71 subjects (HS n = 20, PSO n = 20, healthy controls n = 31). Additionally, IL-17 and MMP-9 in the tear film were analyzed. These parameters were correlated to the clinical severity of the skin disease. PSO patients served as inflammatory control group. RESULTS There were statistically significant differences in OSDI (p = .003) and SPEED (p ≤ 0.001) between HS and the control group, but not between PSO and controls. For HS, there was a statistically significant correlation between symptoms (OSDI) and the severity of HS according to Hurley stage (p = .023). Tear film concentrations showed significantly increased levels of IL-17 (p = .018), but not MMP-9, in PSO alone compared to the control group. CONCLUSION Data show that subjective complaints of KCS may be associated with HS and correlate with the severity of the respective Hurley stage, but do not involve alterations of tear film MMP-9 and IL-17. Clinicians should remain mindful that ocular complications in HS are often more vague than in psoriatic patients, but dry eye symptoms might be detrimental for the patients' quality of life.
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Affiliation(s)
- Marc Schargus
- Department of Ophthalmology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany.,Department of Ophthalmology, Asklepios Hospital Nord-Heidberg , Hamburg, Germany
| | | | - Stephanie Joachim
- Department of Ophthalmology, Experimental Eye Research Institute, Ruhr-University Bochum , Bochum, Germany
| | - Andreas Frings
- Department of Ophthalmology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany.,UCL Institute of Ophthalmology , London, UK
| | - Kristina Krause
- Department of Dermatology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany
| | - Julia Reifenberger
- Department of Dermatology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany
| | - Gerd Geerling
- Department of Ophthalmology, Heinrich-Heine-University Düsseldorf , Düsseldorf, Germany
| | - Verena Gerlinde Frings
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg , Würzburg, Germany
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25
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Martin S, Strzelczyk A, Lindlar S, Krause K, Reif PS, Menzler K, Chiocchetti AG, Rosenow F, Knake S, Klein KM. Drug-Resistant Juvenile Myoclonic Epilepsy: Misdiagnosis of Progressive Myoclonus Epilepsy. Front Neurol 2019; 10:946. [PMID: 31551911 PMCID: PMC6746890 DOI: 10.3389/fneur.2019.00946] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/15/2019] [Indexed: 12/30/2022] Open
Abstract
Juvenile myoclonic epilepsy (JME) is a common epilepsy syndrome characterized by bilateral myoclonic and tonic-clonic seizures typically starting in adolescence and responding well to medication. Misdiagnosis of a more severe progressive myoclonus epilepsy (PME) as JME has been suggested as a cause of drug-resistance. Medical records of the Epilepsy Center Hessen-Marburg between 2005 and 2014 were automatically selected using keywords and manually reviewed regarding the presence of a JME diagnosis at any timepoint. The identified patients were evaluated regarding seizure outcome and drug resistance according to ILAE criteria. 87/168 identified JME patients were seizure-free at last follow-up including 61 drug-responsive patients (group NDR). Seventy-eight patients were not seizure-free including 26 drug-resistant patients (group DR). Valproate was the most efficacious AED. The JME diagnosis was revised in 7 patients of group DR including 6 in whom the diagnosis had already been questioned or revised during clinical follow-up. One of these was finally diagnosed with PME (genetically confirmed Lafora disease) based on genetic testing. She was initially reviewed at age 29 yrs and considered to be inconsistent with PME. Intellectual disability (p = 0.025), cognitive impairment (p < 0.001), febrile seizures in first-degree relatives (p = 0.023) and prominent dialeptic seizures (p = 0.009) where significantly more frequent in group DR. Individuals with PME are rarely found among drug-resistant alleged JME patients in a tertiary epilepsy center. Even a very detailed review by experienced epileptologists may not identify the presence of PME before the typical features evolve underpinning the need for early genetic testing in drug-resistant JME patients.
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Affiliation(s)
- Sarah Martin
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Adam Strzelczyk
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany.,Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Silvia Lindlar
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Frankfurt am Main, Germany
| | - Kristina Krause
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Philipp S Reif
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Katja Menzler
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Andreas G Chiocchetti
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Frankfurt am Main, Germany
| | - Felix Rosenow
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany.,Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Susanne Knake
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Karl Martin Klein
- Center for Personalized Translational Epilepsy Research (CePTER), Frankfurt am Main, Germany.,Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany.,Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany.,Departments of Clinical Neurosciences, Medical Genetics and Community Health Sciences, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Krause K, Sabat R, Witte‐Händel E, Schulze A, Puhl V, Maurer M, Wolk K. Schnitzler 综合征与 CCL2. Br J Dermatol 2019. [DOI: 10.1111/bjd.17670] [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: 11/30/2022]
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Krause K, Sabat R, Witte‐Händel E, Schulze A, Puhl V, Maurer M, Wolk K. CCL2 in Schnitzler syndrome. Br J Dermatol 2019. [DOI: 10.1111/bjd.17654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Conradi N, Hermsen A, Krause K, Gorny I, Strzelczyk A, Knake S, Rosenow F. Hemispheric language lateralization in presurgical patients with temporal lobe epilepsy: Improving the retest reliability of functional transcranial Doppler sonography. Epilepsy Behav 2019; 91:48-52. [PMID: 30217756 DOI: 10.1016/j.yebeh.2018.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 04/09/2018] [Revised: 08/09/2018] [Accepted: 08/12/2018] [Indexed: 11/16/2022]
Abstract
Since its introduction, functional transcranial Doppler sonography (fTCD) has been extensively applied in research and clinical settings and has now become part of the routine presurgical work-up of patients with epilepsy. Because of its importance in planning neurosurgical interventions and predicting possible cognitive risks, the reproducibility of fTCD in determining hemispheric language lateralization (HLL) has to be ensured. In the present study, fTCD was performed twice in 33 initially lateralized patients with temporal lobe epilepsy (TLE) as part of their presurgical work-up, using a standard word generation paradigm. Initially, the standard analysis, including only the statistical examination of fTCD data, was applied, and a rather poor retest reliability of r = 0.41 was obtained (p = 0.017). Because of doubts concerning appropriate task performance in some patients, subsequently, a two-step data analysis was introduced, including an additional qualitative evaluation of fTCD data regarding (1) instruction-compliant task performance, (2) sufficient quality of the baseline phase, and (3) adequate increase in cerebral blood flow velocity (CBFV) during the activation phase. Attributable to a more valid interpretation of fTCD data after the application of the qualitative step, the reproducibility of HLL significantly improved (p = 0.007) to a high retest reliability of r = 0.84 (p < 0.000). In clinical settings, psychological and situational factors seem to strongly influence the reproducibility of fTCD determining HLL. Accordingly, we highly recommend the complementation of the standard statistical examination of fTCD data by an additional qualitative evaluation (two-step data analysis), as this extra security is particularly desirable because of its direct implications for the further evaluation of neurosurgical interventions. This article is part of the Special Issue "Individualized Epilepsy Management: Medicines, Surgery and Beyond".
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Affiliation(s)
- Nadine Conradi
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany.
| | - Anke Hermsen
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Kristina Krause
- Epilepsy Center Hessen, Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Iris Gorny
- Epilepsy Center Hessen, Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany
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Krause K, Sabat R, Witte-Händel E, Schulze A, Puhl V, Maurer M, Wolk K. Association of CCL2 with systemic inflammation in Schnitzler syndrome. Br J Dermatol 2018; 180:859-868. [PMID: 30339714 DOI: 10.1111/bjd.17334] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Schnitzler syndrome (SchS) is a rare autoinflammatory disease characterized by urticarial exanthema, bone and joint alterations, fever and monoclonal gammopathy, which manifest mostly in the second half of life. It involves overactivation of the interleukin (IL)-1 system, but the exact pathophysiological pathways remain largely unknown. OBJECTIVES To identify and characterize the pathogenetic players in SchS. METHODS Blood parameters were quantified in patients with SchS compared with healthy controls and patients with psoriasis and hidradenitis suppurativa using enzyme-linked immunosorbent assay (ELISA). CCL2 expression in cultured primary cells was analysed by quantitative reverse-transcriptase polymerase chain reaction and ELISA. RESULTS CCL2, a chemoattractant for monocytic and further mononuclear immune cells, was found to be significantly elevated in patients with SchS. CCL2 levels showed a positive association with global disease activity, especially with bone pain, but not disease duration, gammopathy, neutrophilia or skin disease. In vitro stimulation assays demonstrated a strong CCL2 production capacity of mononuclear immune cells and fibroblasts, but not epithelial or endothelial cells. Among a range of inflammatory mediators, only IL-1β (immune cells, fibroblasts) and tumour necrosis factor (TNF)-α (fibroblasts) were important CCL2 inducers. TNF-α, but not IL-17, strengthened the CCL2-inducing effect of IL-1β in fibroblasts. Accordingly, CCL2 levels positively correlated with both TNF-α and IL-1β serum levels in patients with SchS. Therapeutic IL-1β blockade decreased CCL2 blood levels in these patients as early as 1 week after the initiation of treatment. CONCLUSIONS CCL2 may be an important component of the pathogenetic cascade leading to bone alterations, and a suitable marker of disease activity in patients with SchS.
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Affiliation(s)
- K Krause
- Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Autoinflammation Reference Centre Charité, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - R Sabat
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology and, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - E Witte-Händel
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology and, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - A Schulze
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology and, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - V Puhl
- Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Autoinflammation Reference Centre Charité, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - M Maurer
- Dermatological Allergology, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Autoinflammation Reference Centre Charité, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - K Wolk
- Interdisciplinary Group of Molecular Immunopathology, Dermatology/Medical Immunology and, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,Berlin-Brandenburg Centre for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Kessler AF, Krause K, Al-Shameri B, Weiland J, Linsenmann T, Ernestus R, Hagemann C, Löhr M, Jentschke E. OS4.3 The BReMen trial: Patients with benign meningioma - is rehabilitation really necessary? Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.028] [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: 11/13/2022] Open
Affiliation(s)
- A F Kessler
- University of Würzburg, Department of Neurosurgery, Laboratory of Tumorbiology, Würzburg, Germany
| | - K Krause
- University of Würzburg, Department of Neurosurgery, Neuropsychology, Würzburg, Germany
| | - B Al-Shameri
- University of Würzburg, Department of Neurosurgery, Laboratory of Tumorbiology, Würzburg, Germany
| | - J Weiland
- University of Würzburg, Department of Neurosurgery, Laboratory of Tumorbiology, Würzburg, Germany
| | - T Linsenmann
- University of Würzburg, Department of Neurosurgery, Laboratory of Tumorbiology, Würzburg, Germany
| | - R Ernestus
- University of Würzburg, Department of Neurosurgery, Laboratory of Tumorbiology, Würzburg, Germany
| | - C Hagemann
- University of Würzburg, Department of Neurosurgery, Laboratory of Tumorbiology, Würzburg, Germany
| | - M Löhr
- University of Würzburg, Department of Neurosurgery, Laboratory of Tumorbiology, Würzburg, Germany
| | - E Jentschke
- University of Würzburg, Department of Neurosurgery, Neuropsychology, Würzburg, Germany
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Gürtler D, Krause K, Möhring A, Bischof G, John U, Meyer C. Activating primary medical care patients for a depression-preventive lifestyle with individualized e-health interventions (ActiLife). Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667635] [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: 10/28/2022]
Affiliation(s)
- D Gürtler
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
| | - K Krause
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
| | - A Möhring
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
| | - G Bischof
- Universität zu Lübeck, Klinik für Psychiatrie und Psychotherapie, Lübeck, Deutschland
| | - U John
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
| | - C Meyer
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
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Gürtler D, Möhring A, Krause K, Rumpf HJ, John U, Meyer C. Proactive health risk screening for multiple motivational interventions in primary care patients: Methods, design and reach. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667701] [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: 10/28/2022]
Affiliation(s)
- D Gürtler
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
| | - A Möhring
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
| | - K Krause
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
| | - HJ Rumpf
- Universität zu Lübeck, Klinik für Psychiatrie und Psychotherapie, Lübeck, Deutschland
| | - U John
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
| | - C Meyer
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
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33
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Krause K, Gürtler D, Möhring A, Bischof G, John U, Meyer C. Proaktive computergestützte Depressionsprävention in der primärmedizinischen Versorgung: Wer wird erreicht? Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667784] [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: 10/28/2022]
Affiliation(s)
- K Krause
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
| | - D Gürtler
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
| | - A Möhring
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
| | - G Bischof
- Universität zu Lübeck, Klinik für Psychiatrie und Psychotherapie, Lübeck, Deutschland
| | - U John
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
| | - C Meyer
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Greifswald, Greifswald, Deutschland
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Liu F, Krause K, Amer A, Hall-Stoodley L, Reilly J, Nichols A. EPS1.05 CAT-5571 restores autophagy, a fundamental defect in cystic fibrosis, and is a potential new treatment for people with cystic fibrosis. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30236-4] [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: 12/01/2022]
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Keszthelyi D, Aziz Q, Ruffle JK, O'Daly O, Sanders D, Krause K, Williams SCR, Howard MA. Delineation between different components of chronic pain using dimension reduction - an ASL fMRI study in hand osteoarthritis. Eur J Pain 2018. [PMID: 29520913 PMCID: PMC6055802 DOI: 10.1002/ejp.1212] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Traditional psychometric measures aimed at characterizing the pain experience often show considerable overlap, due to interlinked affective and modulatory processes under central nervous system control. Neuroimaging studies have been employed to investigate this complexity of pain processing, in an attempt to provide a quantifiable, adjunctive description of pain perception. In this exploratory study, we examine psychometric and neuroimaging data from 38 patients with painful osteoarthritis of the carpometacarpal joint. We had two aims: first, to utilize principal component analysis (PCA) as a dimension reduction strategy across multiple self‐reported endpoints of pain, cognitive and affective functioning; second, to investigate the relationship between identified dimensions and regional cerebral blood flow (rCBF) as an indirect measure of brain activity underpinning their ongoing pain experiences. Methods Psychometric data were collected using validated questionnaires. Quantitative estimates of rCBF were acquired using pseudo‐continuous arterial spin‐labelled functional magnetic resonance imaging. Results Two principal components were identified that accounted for 73% of data variance; one related to pain scores and a second to psychological traits. Voxel‐wise multiple regression analysis revealed a significant negative association between the ‘pain score’ component and rCBF to a right temporal lobe cluster, including the amygdala and the parahippocampal cortex. Conclusion We suggest this association may represent a coping mechanism that aims to reduce fear‐related pain‐anxiety. Further investigation of central brain processing mechanisms in osteoarthritis‐related pain may offer insights into more effective therapeutic strategies. Significance This study demonstrates that dimension reduction using PCA allows insight into pain perception and its affective components in relation to brain activation patterns in patients with painful hand osteoarthritis.
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Affiliation(s)
- D Keszthelyi
- Division of Gastroenterology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.,Centre for Neuroscience and Trauma, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.,Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
| | - Q Aziz
- Centre for Neuroscience and Trauma, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - J K Ruffle
- Centre for Neuroscience and Trauma, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.,Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
| | - O O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
| | - D Sanders
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK.,Pain Management Research Institute, The University of Sydney at Royal North Shore Hospital, St Leonards, NSW, Australia
| | - K Krause
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK.,Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - S C R Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
| | - M A Howard
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience at King's College London, UK
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Gorny I, Krause K, Albert A, Schneider S, Möller L, Habermehl L, Strzelczyk A, Rosenow F, Hermsen A, Knake S, Menzler K. Limitations of a Short Demographic Questionnaire for Bedside Estimation of Patients’ Global Cognitive Functioning in Epilepsy Patients. Front Neurol 2018; 9:85. [PMID: 29545768 PMCID: PMC5838021 DOI: 10.3389/fneur.2018.00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/06/2018] [Indexed: 12/02/2022] Open
Abstract
Objectives The German socio-demographic estimation scale was developed by Jahn et al. (1) to quickly predict premorbid global cognitive functioning in patients. So far, it has been validated in healthy adults and has shown a good correlation with the full and verbal IQ of the Wechsler Adult Intelligence Scale (WAIS) in this group. However, there are no data regarding its use as a bedside test in epilepsy patients. Methods Forty native German speaking adult patients with refractory epilepsy were included. They completed a neuropsychological assessment, including a nine scale short form of the German version of the WAIS-III and the German socio-demographic estimation scale by Jahn et al. (1) during their presurgical diagnostic stay in our center. We calculated means, correlations, and the rate of concordance (range ±5 and ±7.5 IQ score points) between these two measures for the whole group, and a subsample of 19 patients with a global cognitive functioning level within 1 SD of the mean (IQ score range 85–115) and who had completed their formal education before epilepsy onset. Results The German demographic estimation scale by Jahn et al. (1) showed a significant mean overestimation of the global cognitive functioning level of eight points in the epilepsy patient sample compared with the short form WAIS-III score. The accuracy within a range of ±5 or ±7.5 IQ score points for each patient was similar to that of the healthy controls reported by Jahn et al. (1) in our subsample, but not in our whole sample. Conclusion Our results show that the socio-demographic scale by Jahn et al. (1) is not sufficiently reliable as an estimation tool of global cognitive functioning in epilepsy patients. It can be used to estimate global cognitive functioning in a subset of patients with a normal global cognitive functioning level who have completed their formal education before epilepsy onset, but it does not reliably predict global cognitive functioning in epilepsy patients in general, who often do not fulfill these criteria. It is therefore not a useful tool to be applied in the general neuropsychological presurgical evaluation of epilepsy patients.
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Affiliation(s)
- Iris Gorny
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
- *Correspondence: Iris Gorny,
| | - Kristina Krause
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | - Anita Albert
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | | | - Leona Möller
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | - Lena Habermehl
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | - Adam Strzelczyk
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
- Epilepsy Center Frankfurt Rhine-Main, Goethe University, Frankfurt, Germany
| | - Felix Rosenow
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
- Epilepsy Center Frankfurt Rhine-Main, Goethe University, Frankfurt, Germany
| | - Anke Hermsen
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
- Epilepsy Center Frankfurt Rhine-Main, Goethe University, Frankfurt, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
| | - Katja Menzler
- Epilepsy Center Hessen, Philipps-University, Marburg, Germany
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Zahnert F, Krause K, Immisch I, Habermehl L, Gorny I, Chmielewska I, Möller L, Weyand AM, Mross PM, Wagner J, Menzler K, Knake S. Brivaracetam in the Treatment of Patients with Epilepsy-First Clinical Experiences. Front Neurol 2018; 9:38. [PMID: 29467714 PMCID: PMC5808159 DOI: 10.3389/fneur.2018.00038] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 10/17/2017] [Accepted: 01/16/2018] [Indexed: 01/15/2023] Open
Abstract
Objectives To assess first clinical experiences with brivaracetam (BRV) in the treatment of epilepsies. Methods Data on patients treated with BRV from February to December 2016 and with at least one clinical follow-up were collected from electronic patient records. Data on safety and efficacy were evaluated retrospectively. Results In total, 93 patients were analyzed; 12 (12.9%) received BRV in monotherapy. The mean duration to follow-up was 4.85 months (MD = 4 months; SD = 3.63). Fifty-seven patients had more than one seizure per month at baseline and had a follow-up of more than 4 weeks; the rate of ≥50% responders was 35.1% (n = 20) in this group, of which five (8.8%) patients were newly seizure-free. In 50.5% (47/93), patients were switched from levetiracetam (LEV) to BRV, of which 43 (46.2%) were switched immediately. Adverse events (AE) occurred in 39.8%, with 22.6% experiencing behavioral and 25.8% experiencing non-behavioral AE. LEV-related AE (LEV-AE) were significantly reduced by switching to BRV. The discontinuation of BRV was reported in 26/93 patients (28%); 10 of those were switched back to LEV with an observed reduction of AE in 70%. For clinical reasons, 12 patients received BRV in monotherapy, 75% were seizure–free, and previous LEV-AE improved in 6/9 patients. BRV-related AE occurred in 5/12 cases, and five patients discontinued BRV. Conclusion BRV seems to be a safe, easy, and effective option in the treatment of patients with epilepsy, especially in the treatment of patients who have psychiatric comorbidities and might not be good candidates for LEV treatment. BRV broadens the therapeutic spectrum and facilitates personalized treatment.
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Affiliation(s)
- Felix Zahnert
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Kristina Krause
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Ilka Immisch
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Lena Habermehl
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Iris Gorny
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Izabella Chmielewska
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Leona Möller
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Anna M Weyand
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Peter M Mross
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Jan Wagner
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Katja Menzler
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
| | - Susanne Knake
- Department of Neurology, Universitätsklinikum Gießen und Marburg, Philipps University of Marburg, Marburg, Germany
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Bonnekoh H, Scheffel J, Maurer M, Krause K. Use of skin biomarker profiles to distinguish Schnitzler syndrome from chronic spontaneous urticaria: results of a pilot study. Br J Dermatol 2017; 178:561-562. [DOI: 10.1111/bjd.15705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- H. Bonnekoh
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
- Autoinflammation Reference Center Charité (ARC ); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - J. Scheffel
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
- Autoinflammation Reference Center Charité (ARC ); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. Maurer
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
- Autoinflammation Reference Center Charité (ARC ); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - K. Krause
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
- Autoinflammation Reference Center Charité (ARC ); Charité - Universitätsmedizin Berlin; Berlin Germany
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Krause K, Möllers M, Hammer K, Falkenberg MK, Möllmann U, Görlich D, Klockenbusch W, Schmitz R. Quantification of mechanical dyssynchrony in growth restricted fetuses and normal controls using speckle tracking echocardiography (STE). J Perinat Med 2017; 45:821-827. [PMID: 28063262 DOI: 10.1515/jpm-2016-0280] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 11/30/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE To evaluate longitudinal mechanical dyssynchrony in normally grown fetuses by speckle tracking echocardiography (STE) and to compare longitudinal mechanical dyssynchrony in fetal growth restriction (FGR) with normal controls. MATERIALS AND METHODS A prospective study was performed on 30 FGR and 62 normally grown fetuses, including 30 controls matched by gestational age, using STE and a transversal four-chamber view. Data analysis was carried out with a high frame rate of about 175 frames/s. Dyssynchrony was analyzed offline with QLab 9 (Philips Medical Systems, Andover, MA, USA) as time differences between peaks in strain of both ventricles and the septum. Inter- and intraventricular and intraseptal dyssynchrony were obtained and inter- and intraobserver reliability was analyzed. RESULTS Longitudinal mechanical dyssynchrony was feasible in all cases, with high inter- and intraobserver reliability. Levels of inter- and intraventricular dyssynchrony were higher in the FGR than in the control group. CONCLUSION Speckle tracking echocardiography (STE) is a reliable technique for cardiac function assessment in the fetal heart. Interventricular dyssynchrony could be a potential parameter for early detection of subclinical myocardial dysfunction before other parameters demand intervention. The future clinical role of longitudinal mechanical dyssynchrony needs to be verified in larger studies and with a technique customized for prenatal echocardiography.
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Terhorst D, Koti I, Krause K, Metz M, Maurer M. In chronic spontaneous urticaria, high numbers of dermal endothelial cells, but not mast cells, are linked to recurrent angio-oedema. Clin Exp Dermatol 2017; 43:131-136. [PMID: 29064119 DOI: 10.1111/ced.13254] [Citation(s) in RCA: 11] [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] [Accepted: 02/23/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Chronic spontaneous urticaria (CSU) is an inflammatory skin disorder characterized by recurrent weals, angio-oedema or both. Recent studies have shown that the number of endothelial cells is increased in the skin of patients with CSU, but the underlying mechanisms and clinical implications of this are unclear. AIM To evaluate whether mast cell (MC) or endothelial cell (EC) numbers correlate with CSU and whether they are relevant for disease duration, disease activity or the presence of clinical features. METHODS We determined the numbers of CD31+ ECs and MCs in nonlesional skin of 30 patients with CSU using quantitative histomorphometry, and assessed their correlation with each other and with clinical features such as disease duration, disease activity and occurrence of angio-oedema. RESULTS The numbers of MCs and ECs were high in the nonlesional skin of patients with CSU, but did not correlate with each other. Neither MC number nor EC number correlated with disease duration or disease activity. Interestingly, patients with high numbers of cutaneous CD31+ ECs had higher rates of recurrent angio-oedema and vice versa. CONCLUSIONS Based on these findings, we speculate that vascular remodelling and MC hyperplasia in patients with CSU occurs independently and via different mechanisms. Targeting of the mechanisms that drive neoangiogenesis in CSU may result in novel therapeutic strategies for the management of patients with angio-oedema.
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Affiliation(s)
- D Terhorst
- Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - I Koti
- Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - K Krause
- Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M Metz
- Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - M Maurer
- Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Bonnekoh H, Ohanyan T, Lenze D, Krause K, Maurer M, Zuberbier T, Siebenhaar F. Development of tripe palms and soles in a patient with long pre-existing systemic mastocytosis and newly developed non-small cell lung cancer. J Eur Acad Dermatol Venereol 2017; 32:e151-e153. [PMID: 29055165 DOI: 10.1111/jdv.14648] [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: 11/27/2022]
Affiliation(s)
- H Bonnekoh
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T Ohanyan
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - D Lenze
- Department of Pathology, Laboratory of Molecular Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K Krause
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Maurer
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T Zuberbier
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - F Siebenhaar
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Kuemmerle-Deschner JB, Verma D, Endres T, Broderick L, de Jesus AA, Hofer F, Blank N, Krause K, Rietschel C, Horneff G, Aksentijevich I, Lohse P, Goldbach-Mansky R, Hoffman HM, Benseler SM. Clinical and Molecular Phenotypes of Low-Penetrance Variants of NLRP3: Diagnostic and Therapeutic Challenges. Arthritis Rheumatol 2017; 69:2233-2240. [PMID: 28692792 DOI: 10.1002/art.40208] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 07/06/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Cryopyrin-associated periodic syndromes (CAPS) result from gain-of-function mutations in the NLRP3 gene, which causes excessive release of interleukin-1β (IL-1β) and systemic inflammation. While pathogenetic NLRP3 variant phenotypes are well-characterized, low-penetrance NLRP3 variants represent a significant clinical challenge. The aims of this study were to determine the clinical phenotype, the in vitro biologic phenotype, and the effect of anti-IL-1 treatment in patients with low-penetrance NLRP3 variants. METHODS A multicenter study of consecutive symptomatic patients with low-penetrance NLRP3 variants recruited from 7 centers between May 2012 and May 2013 was performed. The observed findings were transferred into a study database, from which they were extracted for analysis. Controls were patients with a known pathogenetic NLRP3 variant. Clinical presentation and CAPS markers of inflammation were captured. Functional assays of inflammasome activation, including caspase 1 activity, NF-κB release, cell death, and IL-1β release, were performed. Treatment effects of IL-1 were determined. Comparisons between low-penetrance and pathogenetic NLRP3 variants were performed. RESULTS The study included 45 patients, 21 of which were female (47%); 26 of the patients (58%) were children. NLRP3 low-penetrance variants identified in the patients were Q703K (n = 19), R488K (n = 6), and V198M (n = 20). In the controls, 28 had pathogenetic NLRP3 variants. Patients with low-penetrance NLRP3 variants had significantly more fever (76%) and gastrointestinal symptoms (73%); eye disease, hearing loss, and renal involvement were less common. Functional inflammasome testing identified an intermediate phenotype in low-penetrance NLRP3 variants as compared to wild-type and pathogenetic NLRP3 variants. All treated patients responded to IL-1 inhibition, with complete response documented in 50% of patients. CONCLUSION Patients with low-penetrance NLRP3 variants display a distinct clinical phenotype and an intermediate biologic phenotype, including IL-1β and non-IL-1β-mediated inflammatory pathway activation.
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Affiliation(s)
| | - D Verma
- Rady Children's Hospital and University of California at San Diego, San Diego, California
| | - T Endres
- University Hospital Tuebingen, Tuebingen, Germany
| | - L Broderick
- Rady Children's Hospital and University of California at San Diego, San Diego, California
| | - A A de Jesus
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland
| | - F Hofer
- University Hospital Tuebingen, Tuebingen, Germany
| | - N Blank
- Universitaetsklinikum Heidelberg, Heidelberg, Germany
| | - K Krause
- Charité Medical University, Berlin, Germany
| | - C Rietschel
- Clementine-Kinderhospital, Frankfurt, Germany
| | - G Horneff
- Asklepios-Klinik Sankt Augustin, Sankt Augustin, Germany
| | - I Aksentijevich
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - P Lohse
- Institute of Laboratory Medicine and Human Genetics, Singen, Germany
| | | | - H M Hoffman
- Rady Children's Hospital and University of California at San Diego, San Diego, California
| | - S M Benseler
- University Hospital Tuebingen, Tuebingen, Germany, and Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
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Krause K, Gürtler D, Bischof G, Batra A, John U, Meyer C. Computergestützte Beratung bei gesundheitsriskantem Alkoholkonsum und Depressivität: Ergebnisse einer multizentrischen Pilotstudie. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605835] [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: 10/18/2022]
Affiliation(s)
- K Krause
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald
| | - D Gürtler
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V., Greifswald
| | - G Bischof
- Universität zu Lübeck, Klinik für Psychiatrie und Psychotherapie, Lübeck
| | - A Batra
- Universität Tübingen, Klinik für Psychiatrie und Psychiatrie, Tübingen
| | - U John
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V., Greifswald
| | - C Meyer
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V., Greifswald
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Meyer C, Poser J, Krause K, Rumpf HJ, Batra A, John U. Muster von gesundheitsriskanten Verhaltensweisen und Depressivität bei Patienten der primärmedizinischen Versorgung. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605735] [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: 10/18/2022]
Affiliation(s)
- C Meyer
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V., Greifswald
| | - J Poser
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald
| | - K Krause
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald
| | - HJ Rumpf
- Universität zu Lübeck, Klinik für Psychiatrie und Psychotherapie, Lübeck
| | - A Batra
- Universität Tübingen, Klinik für Psychiatrie und Psychotherapie, Tübingen
| | - U John
- Universitätsmedizin Greifswald, Institut für Sozialmedizin und Prävention, Greifswald
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V., Greifswald
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Krause K, Laier-Groeneveld G, Abazed Y. Struktur und Outcome einer respiratorischen Intensivstation RICU. Pneumologie 2017. [DOI: 10.1055/s-0037-1598317] [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: 10/20/2022]
Affiliation(s)
- K Krause
- Med Klinik II, Ev. Klinikum Niederrhein, Ejk Oberhausen
| | | | - Y Abazed
- Med Klinik II, Ev. Klinikum Niederrhein, Ejk Oberhausen
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Laier-Groeneveld G, Krause K, Abazed Y. Welches Beatmungsziel: Atmungsentlastung oder Lungenprotektion? Eine Kasuistik. Pneumologie 2017. [DOI: 10.1055/s-0037-1598325] [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: 10/20/2022]
Affiliation(s)
| | - K Krause
- Med Klinik II, Klinikum Niederrhein, Ejk Oberhausen
| | - Y Abazed
- Med Klinik II, Klinikum Niederrhein, Ejk Oberhausen
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Gorczyza M, Schoepke N, Krause K, Hawro T, Maurer M. Patients with chronic cold urticaria may benefit from doxycycline therapy. Br J Dermatol 2016; 176:259-261. [DOI: 10.1111/bjd.14820] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- M. Gorczyza
- Department of Dermatology and Allergy Allergie‐Centrum Charité/ECARF Charité‐Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany
| | - N. Schoepke
- Department of Dermatology and Allergy Allergie‐Centrum Charité/ECARF Charité‐Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany
| | - K. Krause
- Department of Dermatology and Allergy Allergie‐Centrum Charité/ECARF Charité‐Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany
| | - T. Hawro
- Department of Dermatology and Allergy Allergie‐Centrum Charité/ECARF Charité‐Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany
| | - M. Maurer
- Department of Dermatology and Allergy Allergie‐Centrum Charité/ECARF Charité‐Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany
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Abstract
FOXO transcription factors are key regulators of DNA damage repair, proliferation and apoptosis in thyrocytes. Thyroid malignancies show impaired FOXO function. In this study, we investigated the transcriptional regulation of FOXO isoforms in thyroid epithelial cells. mRNA expression of FOXO isoforms (FOXO1, 3 and 4) was determined in FRTL-5 cells stimulated with different growth factors and H2O2. Furthermore, the impact of PI3K/AKT signalling on FOXO transcription was investigated in PI3K p110α mutant FRTL-5 cells and regulatory dependence of FOXO transcription on FOXO was studied in FRTL-5 cells with hFOXO3 overexpression. Finally, mRNA expression levels of FOXO isoforms were determined in human epithelial thyroid tumours. Growth factor deprivation induced transcription of FOXO1, 3 and 4, whereas insulin stimulation decreased FOXO1 and FOXO4 transcription in FRTL-5 cells. Inhibition of the PI3K/AKT cascade amplified FOXO1 and FOXO4 expression. In contrast, H2O2 and TSH did not influence FOXO transcription in thyrocytes. Overexpression of PI3K p110α inhibited FOXO3 and induced FOXO4 transcription. In human thyroid tumours, FOXO1 and FOXO3 mRNA levels were significantly downregulated in papillary thyroid carcinoma when compared to normal tissues. In contrast, follicular thyroid carcinomas showed significant upregulation of FOXO4 mRNA.In this paper, we demonstrate an influence of PI3K signalling on FOXO transcription in thyrocytes. Moreover, we show that thyroid cancers exhibit alterations in FOXO transcription besides the previously reported alterations in posttranslational FOXO3 regulation. These findings may add to the concept of targeting the PI3K pathway in advanced thyroid cancers.
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Affiliation(s)
- F Franz
- Clinic of Endocrinology and Nephrology, Department of Internal Medicine, Neurology and Dermatology, University of Leipzig, Leipzig, Germany
| | - C Weidinger
- Clinic of Endocrinology and Nephrology, Department of Internal Medicine, Neurology and Dermatology, University of Leipzig, Leipzig, Germany
| | - K Krause
- Clinic of Endocrinology and Nephrology, Department of Internal Medicine, Neurology and Dermatology, University of Leipzig, Leipzig, Germany
| | - O Gimm
- Department of General, Visceral, and Vascular Surgery, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany
| | - H Dralle
- Department of General, Visceral, and Vascular Surgery, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany
| | - D Führer
- Department of Endocrinology & Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany
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Krüger J, Scholz M, Gross A, Krause K, Marzi C, Grallert H, Ladenvall C, Schleinitz D, Kirsten H, Heyne H, Laurila E, Kriebel J, Thorand B, Rathmann W, Groop L, Prokopenko I, Isomaa B, Beutner F, Kratzsch J, Thiery J, Klöting N, Fischer-Rosinský A, Pfeiffer A, Spranger J, Gieger C, Blüher M, Stumvoll M, Kovacs P, Tönjes A. Genome wide meta-analysis identifies novel regulators of circulating serum progranulin. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bonnekoh H, Maurer M, Krause K. Interleukin-1-related cytokines as potential biomarkers in autoinflammatory skin diseases. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599984 DOI: 10.1186/1546-0096-13-s1-p197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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