@article{SchulteBlum2022, author = {Schulte, Annemarie and Blum, Robert}, title = {Shaped by leaky ER: Homeostatic Ca\(^{2+}\) fluxes}, series = {Frontiers in Physiology}, volume = {13}, journal = {Frontiers in Physiology}, issn = {1664-042X}, doi = {10.3389/fphys.2022.972104}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-287102}, year = {2022}, abstract = {At any moment in time, cells coordinate and balance their calcium ion (Ca\(^{2+}\)) fluxes. The term 'Ca\(^{2+}\) homeostasis' suggests that balancing resting Ca2+ levels is a rather static process. However, direct ER Ca\(^{2+}\) imaging shows that resting Ca\(^{2+}\) levels are maintained by surprisingly dynamic Ca\(^{2+}\) fluxes between the ER Ca\(^{2+}\) store, the cytosol, and the extracellular space. The data show that the ER Ca\(^{2+}\) leak, continuously fed by the high-energy consuming SERCA, is a fundamental driver of resting Ca\(^{2+}\) dynamics. Based on simplistic Ca\(^{2+}\) toolkit models, we discuss how the ER Ca\(^{2+}\) leak could contribute to evolutionarily conserved Ca\(^{2+}\) phenomena such as Ca\(^{2+}\) entry, ER Ca\(^{2+}\) release, and Ca\(^{2+}\) oscillations.}, language = {en} } @article{BerveWestMartinietal.2020, author = {Berve, Kristina and West, Brian L. and Martini, Rudolf and Groh, Janos}, title = {Sex- and region-biased depletion of microglia/macrophages attenuates CLN1 disease in mice}, series = {Journal of Neuroinflammation}, volume = {17}, journal = {Journal of Neuroinflammation}, doi = {10.1186/s12974-020-01996-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-230234}, year = {2020}, abstract = {Background The neuronal ceroid lipofuscinoses (CLN diseases) are fatal lysosomal storage diseases causing neurodegeneration in the CNS. We have previously shown that neuroinflammation comprising innate and adaptive immune reactions drives axonal damage and neuron loss in the CNS of palmitoyl protein thioesterase 1-deficient (Ppt1\(^{-/-}\)) mice, a model of the infantile form of the diseases (CLN1). Therefore, we here explore whether pharmacological targeting of innate immune cells modifies disease outcome in CLN1 mice. Methods We applied treatment with PLX3397 (150 ppm in the chow), a potent inhibitor of the colony stimulating factor-1 receptor (CSF-1R) to target innate immune cells in CLN1 mice. Experimental long-term treatment was non-invasively monitored by longitudinal optical coherence tomography and rotarod analysis, as well as analysis of visual acuity, myoclonic jerks, and survival. Treatment effects regarding neuroinflammation, neural damage, and neurodegeneration were subsequently analyzed by histology and immunohistochemistry. Results We show that PLX3397 treatment attenuates neuroinflammation in CLN1 mice by depleting pro-inflammatory microglia/macrophages. This leads to a reduction of T lymphocyte recruitment, an amelioration of axon damage and neuron loss in the retinotectal system, as well as reduced thinning of the inner retina and total brain atrophy. Accordingly, long-term treatment with the inhibitor also ameliorates clinical outcomes in CLN1 mice, such as impaired motor coordination, visual acuity, and myoclonic jerks. However, we detected a sex- and region-biased efficacy of CSF-1R inhibition, with male microglia/macrophages showing higher responsiveness toward depletion, especially in the gray matter of the CNS. This results in a better treatment outcome in male Ppt1\(^{-/-}\) mice regarding some histopathological and clinical readouts and reflects heterogeneity of innate immune reactions in the diseased CNS. Conclusions Our results demonstrate a detrimental impact of innate immune reactions in the CNS of CLN1 mice. These findings provide insights into CLN pathogenesis and may guide in the design of immunomodulatory treatment strategies.}, language = {en} } @article{NotzLotzHerrmannetal.2021, author = {Notz, Quirin and Lotz, Christopher and Herrmann, Johannes and Vogt, Marius and Schlesinger, Tobias and Kredel, Markus and Muellges, Wolfgang and Weismann, Dirk and Westermaier, Thomas and Meybohm, Patrick and Kranke, Peter}, title = {Severe neurological complications in critically ill COVID‑19 patients}, series = {Journal of Neurology}, journal = {Journal of Neurology}, issn = {0340-5354}, doi = {10.1007/s00415-020-10152-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232429}, pages = {1576-1579}, year = {2021}, abstract = {No abstract available.}, language = {en} } @article{TraubOttoSelletal.2022, author = {Traub, Jan and Otto, Markus and Sell, Roxane and G{\"o}pfert, Dennis and Homola, Gy{\"o}rgy and Steinacker, Petra and Oeckl, Patrick and Morbach, Caroline and Frantz, Stefan and Pham, Mirko and St{\"o}rk, Stefan and Stoll, Guido and Frey, Anna}, title = {Serum phosphorylated tau protein 181 and neurofilament light chain in cognitively impaired heart failure patients}, series = {Alzheimer's Research \& Therapy}, volume = {14}, journal = {Alzheimer's Research \& Therapy}, doi = {10.1186/s13195-022-01087-4}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300515}, year = {2022}, abstract = {Background Chronic heart failure (HF) is known to increase the risk of developing Alzheimer's dementia significantly. Thus, detecting and preventing mild cognitive impairment, which is common in patients with HF, is of great importance. Serum biomarkers are increasingly used in neurological disorders for diagnostics, monitoring, and prognostication of disease course. It remains unclear if neuronal biomarkers may help detect cognitive impairment in this high-risk population. Also, the influence of chronic HF and concomitant renal dysfunction on these biomarkers is not well understood. Methods Within the monocentric Cognition.Matters-HF study, we quantified the serum levels of phosphorylated tau protein 181 (pTau) and neurofilament light chain (NfL) of 146 extensively phenotyped chronic heart failure patients (aged 32 to 85 years; 15.1\% women) using ultrasensitive bead-based single-molecule immunoassays. The clinical work-up included advanced cognitive testing and cerebral magnetic resonance imaging (MRI). Results Serum concentrations of NfL ranged from 5.4 to 215.0 pg/ml (median 26.4 pg/ml) and of pTau from 0.51 to 9.22 pg/ml (median 1.57 pg/ml). We detected mild cognitive impairment (i.e., T-score < 40 in at least one cognitive domain) in 60\% of heart failure patients. pTau (p = 0.014), but not NfL, was elevated in this group. Both NfL (ρ = - 0.21; p = 0.013) and pTau (ρ = - 0.25; p = 0.002) related to the cognitive domain visual/verbal memory, as well as white matter hyperintensity volume and cerebral and hippocampal atrophy. In multivariable analysis, both biomarkers were independently influenced by age (T = 4.6 for pTau; T = 5.9 for NfL) and glomerular filtration rate (T = - 2.4 for pTau; T = - 3.4 for NfL). Markers of chronic heart failure, left atrial volume index (T = 4.6) and NT-proBNP (T = 2.8), were further cardiological determinants of pTau and NfL, respectively. In addition, pTau was also strongly affected by serum creatine kinase levels (T = 6.5) and ferritin (T = - 3.1). Conclusions pTau and NfL serum levels are strongly influenced by age-dependent renal and cardiac dysfunction. These findings point towards the need for longitudinal examinations and consideration of frequent comorbidities when using neuronal serum biomarkers.}, language = {en} } @article{TraubOttoSelletal.2022, author = {Traub, Jan and Otto, Markus and Sell, Roxane and Homola, Gy{\"o}rgy A. and Steinacker, Petra and Oeckl, Patrick and Morbach, Caroline and Frantz, Stefan and Pham, Mirko and St{\"o}rk, Stefan and Stoll, Guido and Frey, Anna}, title = {Serum glial fibrillary acidic protein indicates memory impairment in patients with chronic heart failure}, series = {ESC Heart Failure}, volume = {9}, journal = {ESC Heart Failure}, number = {4}, doi = {10.1002/ehf2.13986}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-312736}, pages = {2626-2634}, year = {2022}, abstract = {Aims Cognitive dysfunction occurs frequently in patients with heart failure (HF), but early detection remains challenging. Serum glial fibrillary acidic protein (GFAP) is an emerging biomarker of cognitive decline in disorders of primary neurodegeneration such as Alzheimer's disease. We evaluated the utility of serum GFAP as a biomarker for cognitive dysfunction and structural brain damage in patients with stable chronic HF. Methods and results Using bead-based single molecule immunoassays, we quantified serum levels of GFAP in patients with HF participating in the prospective Cognition.Matters-HF study. Participants were extensively phenotyped, including cognitive testing of five separate domains and magnetic resonance imaging (MRI) of the brain. Univariable and multivariable models, also accounting for multiple testing, were run. One hundred and forty-six chronic HF patients with a mean age of 63.8 ± 10.8 years were included (15.1\% women). Serum GFAP levels (median 246 pg/mL, quartiles 165, 384 pg/mL; range 66 to 1512 pg/mL) did not differ between sexes. In the multivariable adjusted model, independent predictors of GFAP levels were age (T = 5.5; P < 0.001), smoking (T = 3.2; P = 0.002), estimated glomerular filtration rate (T = -4.7; P < 0.001), alanine aminotransferase (T = -2.1; P = 0.036), and the left atrial end-systolic volume index (T = 3.4; P = 0.004). NT-proBNP but not serum GFAP explained global cerebral atrophy beyond ageing. However, serum GFAP levels were associated with the cognitive domain visual/verbal memory (T = -3.0; P = 0.003) along with focal hippocampal atrophy (T = 2.3; P = 0.025). Conclusions Serum GFAP levels are affected by age, smoking, and surrogates of the severity of HF. The association of GFAP with memory dysfunction suggests that astroglial pathologies, which evade detection by conventional MRI, may contribute to memory loss beyond ageing in patients with chronic HF.}, language = {en} } @phdthesis{Schramm2002, author = {Schramm, Axel}, title = {Sensomotorische Integration bei zervikalen Dystonien}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-4722}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2002}, abstract = {Zervikale Dystonien geh{\"o}ren zu den h{\"a}ufigsten Formen fokaler Dystonien. Diese sind durch anhaltende, unwillk{\"u}rliche Muskelkontraktionen gekennzeichnet, welche zu verdrehenden oder repetitiven Bewegungen oder abnormalen Haltungen des Kopfes f{\"u}hren. Ein seit {\"u}ber 100 Jahren beobachtetes Ph{\"a}nomen stellt hierbei die M{\"o}glichkeit dar, mittels sogenannter "sensibler Trickman{\"o}ver", welche meistens in einer leichten Ber{\"u}hrung von Arealen im Kopfbereich bestehen, die pathologische Muskelaktivit{\"a}t zu reduzieren und damit die Kopfposition zu normalisieren. Ziel der vorliegenden Arbeit war es, eine breite und vor allem erstmalig quantitative Charakterisierung von wirksamen Trickman{\"o}vern vorzunehmen und so verschiedene Einflußgr{\"o}ßen auf die Wirksamkeit solcher Tricks zu untersuchen. Hierzu wurden die Muskelaktivit{\"a}ten der vier wichtigsten den Kopf drehenden Muskeln mittels Oberfl{\"a}chen-EMG abgeleitet und die Ver{\"a}nderungen bei Trickapplikation unterschiedlicher Lokalisation, Modalit{\"a}t und bei verschiedenen Ausgangspositionen ermittelt. 1) Hinsichtlich der Lokalisation ergaben sich {\"u}ber alle Patienten gemittelt keine signifikante Seitendifferenz, und auch bei individuellem Vergleich zeigten sich bei rund 50\% der Patienten keine signifikanten Unterschiede zwischen kontralateraler und ipsilateraler Trickapplikation. Unter den getesteten Applikationsorten grenzte sich das Areal "Wange" mit durchschnittlich 33\%iger Reduktion der gesamten EMG-Aktivit{\"a}t signifikant gegen die Areale "Kinn" (-23\%) und "Hals" (-23\%) ab und war bei 79\% der Patienten am besten wirksam. 2) Bei weiterer Untersuchung verschiedener Trickmodalit{\"a}ten auf dem f{\"u}r jeden Patienten individuell wirksamsten Areal waren neben dem klassischen Trickman{\"o}ver (-42\%) auch die Verwendung eines Plastikstabes durch den Patienten (-43\%) oder Untersucher (-32\%), sowie nicht-sensible Man{\"o}ver wie das Heben des Armes ohne eigentliche Ber{\"u}hrung (-18\%) und die bloße Vorstellung einer Trickapplikation (-20\%) hochsignifikant wirksam. Allerdings korrelierten sensible und (wie die beiden letztgenannten) nicht-sensible Tricks nicht miteinander, was auf einen prinzipiell unterschiedlichen Wirkmechanismus hinweisen k{\"o}nnte. Visuelle R{\"u}ckkopplung {\"u}ber einen Spiegel hatte im Gegensatz dazu keine Wirkung. 3) Bez{\"u}glich der Bedeutung der Kopfposition f{\"u}r Muskelaktivit{\"a}t und Trickwirksamkeit zeigte sich bereits bei willk{\"u}rlicher Einnahme einer Neutralposition ohne Trickanwendung eine signifikante Reduktion agonistischer Muskelaktivit{\"a}t (-30\%), die allerdings von einer leichten antagonistischen Aktivierung begleitet war (+2,4\%). {\"U}berraschenderweise war die Applikation eines Tricks um so wirksamer, je weiter der Kopf zu Beginn auf die zur dystonen Drehrichtung kontralateralen Seite gedreht war. Demgegen{\"u}ber ließ sich bei Trickapplikation in dystoner Maximalposition kaum mehr eine Wirkung nachweisen (-12\%). Die vorliegenden Ergebnisse sprechen aufgrund der unspezifischen Wirkung verschiedenster Trickman{\"o}ver (2) und Lokalisationen (1) f{\"u}r die Einbeziehung h{\"o}herer sensomotorischer Integrationszentren wie z. B. des Parietalcortex in den Wirkmechanismus. Sensible Trickman{\"o}ver k{\"o}nnten bei auf die pathologische Kopfposition adaptierten sensiblen Afferenzen Zusatzinformationen {\"u}ber die Kopfposition im Vergleich zum Rumpf liefern. M{\"o}glicherweise sind diese umso wirksamer, je weiter sich der Kopf noch auf der kontralateralen Seite befindet (3), da in dieser Situation die dystone Muskelaktivit{\"a}t noch gering und das sensible Mismatch, {\"u}ber welches sensible Stimuli modulierend einwirken k{\"o}nnten, maximal ist. Nach den vorgelegten Ergebnissen l{\"a}ßt sich erstmals ein zweiphasiger Ablauf der Trickwirkung postulieren: Der in einer ersten Phase teils willk{\"u}rlich in eine g{\"u}nstige Ausgangsposition gebrachte Kopf kann durch die Anwendung sensibler Stimuli oder Imagination in einer zweiten Phase mit geringerer Anstrengung und unter Ausnutzung kortikaler sensomotorischer Servomechanismen stabilisiert werden. Im Rahmen der vorgelegten Studie konnte das Verst{\"a}ndnis f{\"u}r therapeutisch nutzbare sensible Trickman{\"o}ver verbessert und somit Patienten unterschiedliche Trickstrategien an die Hand gegeben werden. Die Identifikation der zentralen Rolle h{\"o}herer integrativer Zentren wie dem Parietalcortex im Rahmen des Wirkmechanismus, k{\"o}nnte dabei Ausgangspunkt f{\"u}r neue Therapieans{\"a}tze in Form einer gezielten Beeinflussung solcher Areale sein.}, language = {de} } @phdthesis{Nehring2003, author = {Nehring, Claudia}, title = {Sensitivit{\"a}t elektrophysiologischer Parameter bei der chronischen inflammatorischen demyelinisierenden Polyneuropathie (CIDP) in der Beurteilung des Langzeitverlaufes}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-7659}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2003}, abstract = {Die Chronische Inflammatorische Demyelinisierende Polyneuropathie (CIDP) ist eine seltene autoimmune Erkrankung des peripheren Nervensystems. In der vorliegenden Dissertation wurden die Akten von 23 CIDP - Patienten der Neurologischen Klinik der Universit{\"a}t W{\"u}rzburg aus dem Zeitraum von 1990 bis 1999 ausgewertet und die elektrophysiologischen Parameter sowohl mit den klinischen Befunden als auch mit den Biopsiebefunden in Beziehung gestellt. Folgende Schlussfolgerungen konnten gezogen werden : - In dem untersuchten Patientenkollektiv war die sensomotorische Form der CIDP mit {\"u}berwiegend motorischen Symptomen die h{\"a}ufigste Auspr{\"a}gungsform. Hingegen treten rein motorische und rein sensible Formen sehr selten auf. - Die Krankheit manifestierte sich {\"u}berwiegend an den distalen Extremit{\"a}ten. - Die oberen Extremit{\"a}ten waren selten und in keinem Fall isoliert betroffen. - Die systematische Auswertung des klinischen Schwergrades erfolgte anhand des Modifizierten Rankin Scores, der sowohl motorische als auch sensible Symptome ber{\"u}cksichtigt. Zus{\"a}tzlich erfolgte der Entwurf eines sensiblen Scores, bei dem die sensiblen Symptome der Patienten in Zahlenwerten ausgedr{\"u}ckt sind. - Der Vergleich des klinischen Schweregrades mit den neurophysiologischen Befunden ergab vier unterschiedliche Korrelationstypen, die von sehr enger Korrelation bis hin zu nur geringen {\"U}bereinstimmungen reichten. - Der Schwergrad der Beeintr{\"a}chtigung der Patienten war im Langzeitverlauf mit dem axonalen Verlust korreliert. Es fand sich eine gute Korrelation der Muskelsummenaktionspotentiale (CMAP) des Nervus medianus und des Nervus tibialis sowie der sensiblen Nervenaktionspotentiale (SNAP) des Nervus suralis mit dem Score. - Es ergab sich ein signifikanter Zusammenhang zwischen der Amplitude des Nervus suralis NAP`s und dem Ausmaß des Axonverlustes, wohingegen zwischen der Nervenleitungsgeschwindigkeit des Nervus suralis und dem Axonverlust nur eine geringe Abh{\"a}ngigkeit besteht. - Der Grad der Demyelinisierung korrelierte mit der Anzahl der endoneuralen Makrophagen. - Zwischen der Nervenleitgeschwindigkeit des Nervus suralis und dem Grad der Demyelinisierung im Biopsat konnte keine eindeutige Abh{\"a}ngigkeit nachgewiesen werden. - Es besteht ein Zusammenhang zwischen der Spontanaktivit{\"a}t im EMG und im Verlauf abnehmenden Nervenleitgeschwindigkeiten des Nervus medianus, der aber statistisch nicht signifikant ist. - Insbesondere ist die NLG- Abnahme in den ersten Wochen ein prognostisch ung{\"u}nstiges Zeichen. - Eine Analogie zwischen einer durch das EMG nachgewiesenen Spontanaktivit{\"a}t und der Amplitude des Nervus suralis besteht. - Zwischen den Amplituden der motorischen Summenaktionspotentiale des Nervus tibialis oder den Amplituden der sensiblen Nervenaktionspotentiale des Nervus suralis auf der einen Seite und dem Ausmaß der Spontanaktivit{\"a}t im EMG auf der anderen Seite bestehen erkennbare Korrelationen.}, language = {de} } @article{MaggRieglerWiedmannetal.2015, author = {Magg, Barbara and Riegler, Christoph and Wiedmann, Silke and Heuschmann, Peter and Sommer, Claudia and {\"U}{\c{c}}eyler, Nurcan}, title = {Self-administered version of the Fabry-associated pain questionnaire for adult patients}, series = {Orphanet Journal of Rare Diseases}, volume = {10}, journal = {Orphanet Journal of Rare Diseases}, number = {113}, doi = {10.1186/s13023-015-0325-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-145294}, year = {2015}, abstract = {Background Fabry-associated pain may be the first symptom of Fabry disease (FD) and presents with a unique phenotype including mostly acral burning triggerable pain attacks, evoked pain, pain crises, and permanent pain. We recently developed and validated the first Fabry Pain Questionnaire (FPQ) for adult patients. Here we report on the validation of the self-administered version of the FPQ that no longer requires a face-to-face interview but can be filled in by the patients themselves allowing more flexible data collection. Methods At our W{\"u}rzburg Fabry Center for Interdisciplinary Treatment, Germany, we have developed the self-administered version of the FPQ by adapting the questionnaire to a self-report version. To do this, consecutive Fabry patients with current or past pain history (n = 56) were first interviewed face-to-face. Two weeks later patients' self-reported questionnaire results were collected by mail (n = 55). We validated the self-administered version of the FPQ by assessing the inter-rater reliability agreement of scores obtained by supervised administration and self-administration of the FPQ. Results The FPQ contains 15 questions on the different pain phenotypes, on pain development during life with and without therapy, and on impairment due to pain. Statistical analysis showed that the majority of questions were answered in high agreement in both sessions with a mean AC1-statistic of 0.857 for 55 nominal-scaled items and a mean ICC of 0.587 for 9 scores. Conclusions This self-administered version of the first pain questionnaire for adult Fabry patients is a useful tool to assess Fabry-associated pain without a time-consuming face-to-face interview but via a self-reporting survey allowing more flexible usage.}, language = {en} } @article{BenKraiemSauerNorwigetal.2021, author = {Ben-Kraiem, Adel and Sauer, Reine-Solange and Norwig, Carla and Popp, Maria and Bettenhausen, Anna-Lena and Atalla, Mariam Sobhy and Brack, Alexander and Blum, Robert and Doppler, Kathrin and Rittner, Heike Lydia}, title = {Selective blood-nerve barrier leakiness with claudin-1 and vessel-associated macrophage loss in diabetic polyneuropathy}, series = {Journal of Molecular Medicine}, volume = {99}, journal = {Journal of Molecular Medicine}, number = {9}, doi = {10.1007/s00109-021-02091-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265237}, pages = {1237-1250}, year = {2021}, abstract = {Diabetic polyneuropathy (DPN) is the most common complication in diabetes and can be painful in up to 26\% of all diabetic patients. Peripheral nerves are shielded by the blood-nerve barrier (BNB) consisting of the perineurium and endoneurial vessels. So far, there are conflicting results regarding the role and function of the BNB in the pathophysiology of DPN. In this study, we analyzed the spatiotemporal tight junction protein profile, barrier permeability, and vessel-associated macrophages in Wistar rats with streptozotocin-induced DPN. In these rats, mechanical hypersensitivity developed after 2 weeks and loss of motor function after 8 weeks, while the BNB and the blood-DRG barrier were leakier for small, but not for large molecules after 8 weeks only. The blood-spinal cord barrier remained sealed throughout the observation period. No gross changes in tight junction protein or cytokine expression were observed in all barriers to blood. However, expression of Cldn1 mRNA in perineurium was specifically downregulated in conjunction with weaker vessel-associated macrophage shielding of the BNB. Our results underline the role of specific tight junction proteins and BNB breakdown in DPN maintenance and differentiate DPN from traumatic nerve injury. Targeting claudins and sealing the BNB could stabilize pain and prevent further nerve damage.}, language = {en} } @article{VolkmannAlbaneseAntoninietal.2013, author = {Volkmann, Jens and Albanese, Alberto and Antonini, Angelo and Chaudhuri, K. Ray and Clarke, Karl E. and de Bie, Rob M. A. and Deuschl, G{\"u}nther and Eggert, Karla and Houeto, Jean-Luc and Kulisevsky, Jaime and Nyholm, Dag and Odin, Per and Ostergaard, Karen and Poewe, Werner and Pollak, Pierre and Rabey, Jose Martin and Rascol, Olivier and Ruzicka, Evzen and Samuel, Michael and Speelman, Hans and Sydow, Olof and Valldeoriola, Francesc and van der Linden, Chris and Oertel, Wolfgang}, title = {Selecting deep brain stimulation or infusion therapies in advanced Parkinson's disease: an evidence-based review}, series = {Journal of Neurology}, volume = {260}, journal = {Journal of Neurology}, doi = {10.1007/s00415-012-6798-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-132373}, pages = {2701-2714}, year = {2013}, abstract = {Motor complications in Parkinson's disease (PD) result from the short half-life and irregular plasma fluctuations of oral levodopa. When strategies of providing more continuous dopaminergic stimulation by adjusting oral medication fail, patients may be candidates for one of three device-aided therapies: deep brain stimulation (DBS), continuous subcutaneous apomorphine infusion, or continuous duodenal/jejunal levodopa/carbidopa pump infusion (DLI). These therapies differ in their invasiveness, side-effect profile, and the need for nursing care. So far, very few comparative studies have evaluated the efficacy of the three device-aided therapies for specific motor problems in advanced PD. As a result, neurologists currently lack guidance as to which therapy could be most appropriate for a particular PD patient. A group of experts knowledgeable in all three therapies reviewed the currently available literature for each treatment and identified variables of clinical relevance for choosing one of the three options such as type of motor problems, age, and cognitive and psychiatric status. For each scenario, pragmatic and (if available) evidence-based recommendations are provided as to which patients could be candidates for either DBS, DLI, or subcutaneous apomorphine.}, language = {en} } @article{SamperAgreloSchiraHeinenBeyeretal.2020, author = {Samper Agrelo, Iria and Schira-Heinen, Jessica and Beyer, Felix and Groh, Janos and B{\"u}termann, Christine and Estrada, Veronica and Poschmann, Gereon and Bribian, Ana and Jadasz, Janusz J. and Lopez-Mascaraque, Laura and Kremer, David and Martini, Rudolf and M{\"u}ller, Hans Werner and Hartung, Hans Peter and Adjaye, James and St{\"u}hler, Kai and K{\"u}ry, Patrick}, title = {Secretome analysis of mesenchymal stem cell factors fostering oligodendroglial differentiation of neural stem cells in vivo}, series = {International Journal of Molecular Sciences}, volume = {21}, journal = {International Journal of Molecular Sciences}, number = {12}, issn = {1422-0067}, doi = {10.3390/ijms21124350}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-285465}, year = {2020}, abstract = {Mesenchymal stem cell (MSC)-secreted factors have been shown to significantly promote oligodendrogenesis from cultured primary adult neural stem cells (aNSCs) and oligodendroglial precursor cells (OPCs). Revealing underlying mechanisms of how aNSCs can be fostered to differentiate into a specific cell lineage could provide important insights for the establishment of novel neuroregenerative treatment approaches aiming at myelin repair. However, the nature of MSC-derived differentiation and maturation factors acting on the oligodendroglial lineage has not been identified thus far. In addition to missing information on active ingredients, the degree to which MSC-dependent lineage instruction is functional in vivo also remains to be established. We here demonstrate that MSC-derived factors can indeed stimulate oligodendrogenesis and myelin sheath generation of aNSCs transplanted into different rodent central nervous system (CNS) regions, and furthermore, we provide insights into the underlying mechanism on the basis of a comparative mass spectrometry secretome analysis. We identified a number of secreted proteins known to act on oligodendroglia lineage differentiation. Among them, the tissue inhibitor of metalloproteinase type 1 (TIMP-1) was revealed to be an active component of the MSC-conditioned medium, thus validating our chosen secretome approach.}, language = {en} } @article{RauschenbergerKnorrPisanietal.2021, author = {Rauschenberger, Lisa and Knorr, Susanne and Pisani, Antonio and Hallett, Mark and Volkmann, Jens and Ip, Chi Wang}, title = {Second hit hypothesis in dystonia: Dysfunctional cross talk between neuroplasticity and environment?}, series = {Neurobiology of Disease}, volume = {159}, journal = {Neurobiology of Disease}, doi = {10.1016/j.nbd.2021.105511}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265028}, year = {2021}, abstract = {One of the great mysteries in dystonia pathophysiology is the role of environmental factors in disease onset and development. Progress has been made in defining the genetic components of dystonic syndromes, still the mechanisms behind the discrepant relationship between dystonic genotype and phenotype remain largely unclear. Within this review, the preclinical and clinical evidence for environmental stressors as disease modifiers in dystonia pathogenesis are summarized and critically evaluated. The potential role of extragenetic factors is discussed in monogenic as well as adult-onset isolated dystonia. The available clinical evidence for a "second hit" is analyzed in light of the reduced penetrance of monogenic dystonic syndromes and put into context with evidence from animal and cellular models. The contradictory studies on adult-onset dystonia are discussed in detail and backed up by evidence from animal models. Taken together, there is clear evidence of a gene-environment interaction in dystonia, which should be considered in the continued quest to unravel dystonia pathophysiology.}, language = {en} } @phdthesis{Teuteberg2003, author = {Teuteberg, Philipp Wilhelm Friedemann}, title = {Schmerzhafte Mononeuropathie an C57BL/6 M{\"a}usen: Studien mit neutralisierenden Antik{\"o}rpern gegen Tumor-Nekrose-Faktor Alpha an zwei verschiedenen L{\"a}sionsmodellen}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-5346}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2003}, abstract = {Die vorliegende Arbeit befaßt sich mit zwei Modellen einer schmerzhaften Mononeuropathie an der C57BL/6-Maus sowie deren Beeinflussung durch neutralisierende AK gegen TNF. Daf{\"u}r wurden die Nn. ischiadici der M{\"a}use operativ manipuliert, zum einen in Form der CCI durch drei den Nerven einschn{\"u}rende Ligaturen und zum anderen in Form der PST durch Heraustrennen eines Drittels des Nervendurchmessers. Beide Operationsmodelle l{\"o}sten bei den M{\"a}usen eine schmerzhafte Neuropathie aus. Es wurde untersucht, inwieweit zum Zeitpunkt der jeweiligen Operation oder am 4. postoperativen Tag applizierte TNF-AK das Schmerz-assoziierte Verhalten beeinflussen konnten und ob diese Behandlung einen Einfluß auf die Zytokinexpression im Endoneurium, auf den Makrophageneinstrom und auf die Nervenregeneration hatte. Hierzu wurden Verhaltenstests sowie immunhistochemische und morphometrische Methoden verwendet. Aus den vorliegenden Ergebnissen kann geschlossen werden, daß der bei CCI vermutete Einfluß der epineuralen Entz{\"u}ndung auf das Schmerz-assoziierte Verhalten kleiner ist als urspr{\"u}nglich angenommen. Die Tatsache, daß zumindest auf einen Parameter (Hitzehyperalgesie) nicht nur die pr{\"a}ventive sondern auch die therapeutische TNF-Hemmung wirksam war, l{\"a}ßt auf einen Einsatz von TNF-Hemmern bei bestimmten Formen des neuropathischen Schmerzes zur Therapieerg{\"a}nzung hoffen. Obwohl die TNF-Hemmung in den hier verwendeten Dosen und Applikationsweisen keinen Einfluß auf die endoneurale Zytokinexpression, Makrophagendichte und Regeneration hatte, sollten zuk{\"u}nftige Studien diese Parameter unter variierten Applikationsbedingungen genauer untersuchen.}, language = {de} } @phdthesis{Papagianni2018, author = {Papagianni, Aikaterini}, title = {Schmerz-assoziierte elektrisch evozierte Potentiale (PREP) bei Patienten mit neuropathischen Schmerzsyndromen}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159728}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {In der vorliegenden Studie wurden 32 Patienten (19 Frauen, 13 M{\"a}nner, medianes Alter 50 Jahren, Spanne: 26-83 Jahre) mit einem klinisch akralen neuropathischen Schmerzsyndrom unterschiedlicher Genese mittels QST, PREP und Hautbiopsie untersucht. Unser Patientenkollektiv bestand aus drei Subgruppen: sechsen Patienten erf{\"u}llten die Kriterien einer SFN, acht Patienten hatten eine Neuropathie der großkalibrigen Nervenfasern mit zus{\"a}tzlicher Beeintr{\"a}chtigung der kleinkalibrigen Nervenfasern und weitere acht Patienten hatten ein akrales Schmerzsyndrom mit neuropathischen Charakteristika, ohne vorbekannte Diagnose einer Neuropathie der groß- oder kleinkalibrigen Nervenfasern. Die Patienten wurden mittels klinischer neurologischer Untersuchung, elektrophysiologischer Tests, QST, PREP und Hautbiopsie untersucht. Die Patientendaten wurden jeweils mit Daten großer Kontrollgruppen verglichen, die wir in unserer Klinik unter Angeh{\"o}rigen und Freunden unserer Patienten mit deren Einwilligung rekrutiert hatten. QST und die Hautbiopsie waren bei Patienten mit SFN und PNP jeweils auff{\"a}llig, bei akralem Schmerzsyndrom unklarer {\"A}tiologie hingegen unauff{\"a}llig. Nach elektrischer kutaner Stimulation aller drei K{\"o}rperregionen zeigte sich eine Amplitudenminderung der PREP-Reizantwort in allen Patientensubgruppen (7,5 µV in der SFN-Gruppe, 3,8 µV in der PNP-Gruppe, und 11,3 µV bei den Patienten mit akralem Schmerzsyndrom). Somit konnten wir zeigen, dass eine Kleinfaserpathologie in der Studienpopulation von Patienten mit neuropathischem Schmerzsyndrom besteht. Nur die Amplitudenminderung der PREP bildet diese Pathologie ab. Diese Daten erlauben uns die eingangs aufgestellte Hypothese, dass PREP zur Diagnostik bei Frage nach Kleinfaserbeteiligung geeignet ist, positiv zu belegen. PREP ist eine nicht-invasive Methode f{\"u}r die Evaluation der Funktion v.a. der Aδ-Faser mit standardisiertem Ablaufprotokoll zur Erhebung von reproduzierbaren Daten. Sie kann bei Patienten mit der Anamnese eines akralen neuropathischen Schmerzsyndroms einen objektiven Hinweis auf eine Dysfunktion der kleinkalibrigen Nervenfasern, auch wenn bereits etablierte Methoden (QST und Hautbiopsie) unauff{\"a}llig bleiben, erbringen. Entsprechend k{\"o}nnen die PREP eine wertvolle Erg{\"a}nzung der klinischen Untersuchungsbatterie f{\"u}r die Evaluation der Funktion der kleinkalibrigen Nervenfasern sein.}, subject = {PREP}, language = {de} } @phdthesis{Auchter2021, author = {Auchter, Antonia}, title = {Schlafassoziierte Ver{\"a}nderung der lokalen Feldpotential Aktivit{\"a}t im Nucleus subthalamicus bei Patienten mit Morbus Parkinson}, doi = {10.25972/OPUS-23782}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-237822}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Die tiefe Hirnstimulation ist eine etablierte und hocheffiziente operative Behandlungsmethode f{\"u}r Patienten mit idiopathischem Parkinson- Syndrom (IPS). Als Zielgebiet dient in den meisten F{\"a}llen der Nucleus subthalamicus. Die Indikationen zur Implantation einer tiefen Hirnstimulation (THS) sind medikament{\"o}s nicht behandelbare motorische Fluktuationen und Dyskinesien oder ein medikament{\"o}s nicht kontrollierbarer Tremor. Bislang erfolgt eine kontinuierliche Stimulation. Little et al. konnten jedoch bereits in ihrer 2013 ver{\"o}ffentlichen Studie zeigen, dass eine adaptive Stimulation, gemessen am UPDRS, um 27 \% effektiver war und entsprechend die Stimulationszeit um 56 \% gesenkt werden konnte. Voraussetzung f{\"u}r die Anwendbarkeit einer adaptiven Stimulation im klinischen Alltag ist der Nachweis eines oder mehrerer Physiomarker, welche als R{\"u}ckkopplungssignal f{\"u}r den Stimulationsbeginn dienen. Diese Marker m{\"u}ssen verl{\"a}sslich mit dem Auftreten und der Auspr{\"a}gung der Bewegungsst{\"o}rungen korrelieren. Die Systeme m{\"u}ssen die Signale auslesen und entsprechend darauf reagieren k{\"o}nnen, damit ein sogenanntes Closed- loop- Verfahren entstehen kann. Bei diesen Markern handelt es sich um sogenannte lokale Feldpotenzialaktivit{\"a}ten, das heißt niederfrequente Potential{\"a}nderungen von Zellen in subkortikalen Arealen des Gehirns, welche {\"u}ber Elektroden der THS abgeleitet werden k{\"o}nnen. Der Stimulator Activa PC+S (Medtronic) erm{\"o}glicht es erstmalig Aufzeichnungen von LFP- Daten, außerhalb eines experimentellen Laboraufbaus, mittels dauerhaft implantiertem Ger{\"a}t vorzunehmen und damit auch Langzeitanalysen durchzuf{\"u}hren. Erkenntnisse vergangener Studien ergaben, dass die synchronisierte, pathologisch gesteigerte oszillatorische Aktivit{\"a}t im Beta-Frequenzband (13- 35 Hz) eine bedeutende Rolle im Bezug auf die Pathophysiologie des IPS spielt und als krankheitsspezifische Aktivit{\"a}t gilt. Es konnte bereits belegt werden, dass die Verbesserung der motorischen Symptome (Bradykinese und Rigor) mit dem Ausmaß der Suppression der Betaband- Aktivit{\"a}t korreliert. Die Betabandaktivit{\"a}t als lokale Feldpotentialaktivit{\"a}t kann als Physiomarker einer adaptiven Stimulation dienen. Unser Hauptaugenmerk galt daher der Analyse der Betabandaktivit{\"a}t oder anderer Frequenzbereiche w{\"a}hrend des Schlafes um hier die THS bedarfsgerecht einzusetzen. Hierf{\"u}r wurden n{\"a}chtliche subkortikale LFP- Aufzeichnungen parallel zur Schlaf- Polysomnographie durchgef{\"u}hrt. Zudem erfolgte in der vorliegenden Arbeit sowohl in unserem Vorversuch als auch in unserem Hauptversuch die Anwendung des UPDRS Teil III zur Erfassung der motorischen Symptome, sowie die Durchf{\"u}hrung von Frageb{\"o}gen zur Erfassung der nicht- motorischen Symptome, insbesondere des Schlafes vor und nach Implantation der tiefen Hirnstimulation. Wir konnten belegen, dass es nach Implantation der THS zu einer Erh{\"o}hung der Schlafeffizienz und zu einer Erh{\"o}hung des Anteils der Schlafstadien II und III und damit einhergehend zu einer Steigerung der Schlafqualit{\"a}t kommt. {\"U}bereinstimmend mit anderen Studien konnten wir zeigen, dass sich die Motorik unter Stimulation deutlich verbessert. Im Vorversuch reduzierte sich der mittlere pr{\"a}operative MDS- UPDRS III im MedsOFF verglichen mit dem mittleren postoperativ MDS- UPDRS III im MedsOFF/StimON um 37 \%. In der PC+S- Studie imponierte eine Reduktion um 67\%. Zudem zeigte sich eine Reduktion der nicht- motorischen Symptome durch die THS, insbesondere in der Kategorie Schlaf. Die Ergebnisse der vorliegenden Arbeit ergaben außerdem, dass die Betabandaktivität im Schlafstadium II und vor allem im Schlafstadium III am geringsten ist. Im Schlafstadium I und REM ist die Betabandaktivit{\"a}t höher als im Schlafstadium II und III. Hierbei war entscheidend, dass die Patienten eine klar abgrenzbare Betabandaktivit{\"a}t im Wachstadium aufwiesen und die Elektrodenkontakte im dorsolateralen Kerngebiet des STN lokalisiert waren. Gegenl{\"a}ufig dazu verh{\"a}lt sich die Deltaaktivität. Sie ist im Schlafstadium II und besonders im Stadium III am h{\"o}chsten. Stadium I ist mit durchschnittlich um 7,3 \% niedriger als im Wachstadium. Am geringsten ist sie jedoch im REM-Schlafstadium. Indem wir mit der Betabandaktivit{\"a}t und Deltaaktivit{\"a}t in den einzelnen Schlafstadien einen stabilen und reproduzierbaren Physiomarker finden konnten, sind wir unserem Ziel der adaptiven THS ein St{\"u}ck n{\"a}her gekommen.}, subject = {Parkinson}, language = {de} } @article{SteinhardtCejkaChenetal.2024, author = {Steinhardt, Maximilian J. and Cejka, Vladimir and Chen, Mengmeng and B{\"a}uerlein, Sabrina and Sch{\"a}fer, Julia and Adrah, Ali and Ihne-Schubert, Sandra M. and Papagianni, Aikaterini and Kort{\"u}m, K. Martin and Morbach, Caroline and St{\"o}rk, Stefan}, title = {Safety and tolerability of SGLT2 inhibitors in cardiac amyloidosis — a clinical feasibility study}, series = {Journal of Clinical Medicine}, volume = {13}, journal = {Journal of Clinical Medicine}, number = {1}, issn = {2077-0383}, doi = {10.3390/jcm13010283}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-356024}, year = {2024}, abstract = {Sodium-glucose transport protein 2 inhibitors (SGLT2i) slow the progression of renal dysfunction and improve the prognosis of patients with heart failure. Amyloidosis constitutes an important subgroup for which evidence is lacking. Amyloidotic fibrils originating from misfolded transthyretin and light chains are the causal agents in ATTR and AL amyloidosis. In these most frequent subtypes, cardiac involvement is the most common organ manifestation. Because cardiac and renal function frequently deteriorate over time, even under best available treatment, SGLT2i emerge as a promising treatment option due to their reno- and cardioprotective properties. We retrospectively analyzed patients with cardiac amyloidosis, who received either dapagliflozin or empagliflozin. Out of 79 patients, 5.1\% had urinary tract infections; 2 stopped SGLT2i therapy; and 2.5\% died unrelated to the intake of SGLT2i. No genital mycotic infections were observed. As expected, a slight drop in the glomerular filtration rate was noted, while the NYHA functional status, cardiac and hepatic function, as well as the 6 min walk distance remained stable over time. These data provide a rationale for the use of SGLT2i in patients with amyloidosis and concomitant cardiac or renal dysfunction. Prospective randomized data are desired to confirm safety and to prove efficacy in this increasingly important group of patients.}, language = {en} } @article{VogtKollikowskiWeidneretal.2022, author = {Vogt, Marius L. and Kollikowski, Alexander M. and Weidner, Franziska and Strinitz, Marc and Feick, J{\"o}rn and Essig, Fabian and Neugebauer, Herrmann and Haeusler, Karl Georg and Pham, Mirko and Maerz, Alexander}, title = {Safety and Effectiveness of the New Generation APERIO® Hybrid Stent-retriever Device in Large Vessel Occlusion Stroke}, series = {Clinical Neuroradiology}, volume = {32}, journal = {Clinical Neuroradiology}, number = {1}, doi = {10.1007/s00062-021-01122-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-264817}, pages = {141-151}, year = {2022}, abstract = {Background It is unknown whether technological advancement of stent-retriever devices influences typical observational indicators of safety or effectiveness. Methods Observational retrospective study of APERIO® (AP) vs. new generation APERIO® Hybrid (APH) (Acandis®, Pforzheim, Germany) stent-retriever device (01/2019-09/2020) for mechanical thrombectomy (MT) in large vessel occlusion (LVO) stroke. Primary effectiveness endpoint was successful recanalization eTICI (expanded Thrombolysis In Cerebral Ischemia) ≥ 2b67, primary safety endpoint was occurrence of hemorrhagic complications after MT. Secondary outcome measures were time from groin puncture to first pass and successful reperfusion, and the total number of passes needed to achieve the final recanalization result. Results A total of 298 patients with LVO stroke who were treated by MT matched the inclusion criteria: 148 patients (49.7\%) treated with AP vs. 150 patients (50.3\%) treated with new generation APH. Successful recanalization was not statistically different between both groups: 75.7\% for AP vs. 79.3\% for APH; p = 0.450. Postinterventional hemorrhagic complications and particularly subarachnoid hemorrhage as the entity possibly associated with stent-retriever device type was significantly less frequent in the group treated with the APH: 29.7\% for AP and 16.0\% for APH; p = 0.005; however, rates of symptomatic hemorrhage with clinical deterioration and in domo mortality were not statistically different. Neither the median number of stent-retriever passages needed to achieve final recanalization, time from groin puncture to first pass, time from groin puncture to final recanalization nor the number of cases in which successful recanalization could only be achieved by using a different stent-retriever as bail-out device differed between both groups. Conclusion In the specific example of the APERIO® stent-retriever device, we observed that further technological developments of the new generation device were not associated with disadvantages with respect to typical observational indicators of safety or effectiveness.}, language = {en} } @article{TonyBurmesterSchulzeKoopsetal.2011, author = {Tony, Hans-Peter and Burmester, Gerd and Schulze-Koops, Hendrik and Grunke, Mathias and Henes, Joerg and K{\"o}tter, Ina and Haas, Judith and Unger, Leonore and Lovric, Svjetlana and Haubitz, Marion and Fischer-Betz, Rebecca and Chehab, Gamal and Rubbert-Roth, Andrea and Specker, Christof and Weinerth, Jutta and Holle, Julia and M{\"u}ller-Ladner, Ulf and K{\"o}nig, Ramona and Fiehn, Christoph and Burgwinkel, Philip and Budde, Klemens and S{\"o}rensen, Helmut and Meurer, Michael and Aringer, Martin and Kieseier, Bernd and Erfurt-Berge, Cornelia and Sticherling, Michael and Veelken, Roland and Ziemann, Ulf and Strutz, Frank and von Wussow, Praxis and Meier, Florian MP and Hunzelmann, Nico and Schmidt, Enno and Bergner, Raoul and Schwarting, Andreas and Eming, R{\"u}diger and Schwarz-Eywill, Michael and Wassenberg, Siegfried and Fleck, Martin and Metzler, Claudia and Zettl, Uwe and Westphal, Jens and Heitmann, Stefan and Herzog, Anna L. and Wiendl, Heinz and Jakob, Waltraud and Schmidt, Elvira and Freivogel, Klaus and D{\"o}rner, Thomas and Hertl, Michael and Stadler, Rudolf}, title = {Safety and clinical outcomes of rituximab therapy in patients with different autoimmune diseases: experience from a national registry (GRAID)}, series = {Arthritis Research \& Therapy}, volume = {13}, journal = {Arthritis Research \& Therapy}, number = {R75}, doi = {10.1186/ar3337}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-142856}, pages = {1-14}, year = {2011}, abstract = {Introduction: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin's lymphoma in a real-life clinical setting. Methods: Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases. The main outcome measures were safety and clinical response, as judged at the discretion of the investigators. Results: A total of 370 patients (299 patient-years) with various autoimmune diseases (23.0\% with systemic lupus erythematosus, 15.7\% antineutrophil cytoplasmic antibody-associated granulomatous vasculitides, 15.1\% multiple sclerosis and 10.0\% pemphigus) from 42 centres received a mean dose of 2,440 mg of rituximab over a median (range) of 194 (180 to 1,407) days. The overall rate of serious infections was 5.3 per 100 patient-years during rituximab therapy. Opportunistic infections were infrequent across the whole study population, and mostly occurred in patients with systemic lupus erythematosus. There were 11 deaths (3.0\% of patients) after rituximab treatment (mean 11.6 months after first infusion, range 0.8 to 31.3 months), with most of the deaths caused by infections. Overall (n = 293), 13.3\% of patients showed no response, 45.1\% showed a partial response and 41.6\% showed a complete response. Responses were also reflected by reduced use of glucocorticoids and various immunosuppressives during rituximab therapy and follow-up compared with before rituximab. Rituximab generally had a positive effect on patient well-being (physician's visual analogue scale; mean improvement from baseline of 12.1 mm)}, language = {en} } @article{WurmbSchlerethKredeletal.2014, author = {Wurmb, Thomas Erik and Schlereth, Stefan and Kredel, Markus and Muellenbach, Ralf M. and Wunder, Christian and Brederlau, J{\"o}rg and Roewer, Norbert and Kenn, Werner and Kunze, Ekkehard}, title = {Routine Follow-Up Cranial Computed Tomography for Deeply Sedated, Intubated, and Ventilated Multiple Trauma Patients with Suspected Severe Head Injury}, series = {BioMed Research International}, journal = {BioMed Research International}, number = {361949}, doi = {10.1155/2014/361949}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-120084}, year = {2014}, abstract = {Background. Missed or delayed detection of progressive neuronal damage after traumatic brain injury (TBI) may have negative impact on the outcome. We investigated whether routine follow-up CT is beneficial in sedated and mechanically ventilated trauma patients. Methods. The study design is a retrospective chart review. A routine follow-up cCT was performed 6 hours after the admission scan. We defined 2 groups of patients, group I: patients with equal or recurrent pathologies and group II: patients with new findings or progression of known pathologies. Results. A progression of intracranial injury was found in 63 patients (42\%) and 18 patients (12\%) had new findings in cCT 2 (group II). In group II a change in therapy was found in 44 out of 81 patients (54\%). 55 patients with progression or new findings on the second cCT had no clinical signs of neurological deterioration. Of those 24 patients (44\%) had therapeutic consequences due to the results of the follow-up cCT. Conclusion. We found new diagnosis or progression of intracranial pathology in 54\% of the patients. In 54\% of patients with new findings and progression of pathology, therapy was changed due to the results of follow-up cCT. In trauma patients who are sedated and ventilated for different reasons a routine follow-up CT is beneficial.}, language = {en} } @article{AlbertWeissenbergerMenclHoppetal.2014, author = {Albert-Weissenberger, Christiane and Mencl, Stine and Hopp, Sarah and Kleinschnitz, Christoph and Siren, Anna-Leena}, title = {Role of the kallikrein-kinin system in traumatic brain injury}, series = {Frontiers in Cellular Neuroscience}, volume = {8}, journal = {Frontiers in Cellular Neuroscience}, issn = {1662-5102}, doi = {10.3389/fncel.2014.00345}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-118226}, pages = {345}, year = {2014}, abstract = {Traumatic brain injury (TBI) is a major cause of mortality and morbidity worldwide. Despite improvements in acute intensive care, there are currently no specific therapies to ameliorate the effects of TBI. Successful therapeutic strategies for TBI should target multiple pathophysiologic mechanisms that occur at different stages of brain injury. The kallikrein-kinin system is a promising therapeutic target for TBI as it mediates key pathologic events of traumatic brain damage, such as edema formation, inflammation, and thrombosis. Selective and specific kinin receptor antagonists and inhibitors of plasma kallikrein and coagulation factor XII have been developed, and have already shown therapeutic efficacy in animal models of stroke and TBI. However, conflicting preclinical evaluation, as well as limited and inconclusive data from clinical trials in TBI, suggests that caution should be taken before transferring observations made in animals to humans. This review summarizes current evidence on the pathologic significance of the kallikrein-kinin system during TBI in animal models and, where available, the experimental findings are compared with human data.}, language = {en} }