@article{EvdokimovDinkelFranketal.2020, author = {Evdokimov, Dimitar and Dinkel, Philine and Frank, Johanna and Sommer, Claudia and {\"U}{\c{c}}eyler, Nurcan}, title = {Characterization of dermal skin innervation in fibromyalgia syndrome}, series = {PLoS One}, volume = {15}, journal = {PLoS One}, number = {1}, doi = {10.1371/journal.pone.0227674}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229299}, year = {2020}, abstract = {Introduction We characterized dermal innervation in patients with fibromyalgia syndrome (FMS) as potential contribution to small fiber pathology. Methods Skin biopsies of the calf were collected (86 FMS patients, 35 healthy controls). Skin was immunoreacted with antibodies against protein gene product 9.5, calcitonine gene-related peptide, substance P, CD31, and neurofilament 200 for small fiber subtypes. We assessed two skin sections per patient; on each skin section, two dermal areas (150 x 700 mu m each) were investigated for dermal nerve fiber length (DNFL). Results In FMS patients we found reduced DNFL of fibers with vessel contact compared to healthy controls (p<0.05). There were no differences for the other nerve fiber subtypes. Discussion We found less dermal nerve fibers in contact with blood vessels in FMS patients than in controls. The pathophysiological relevance of this finding is unclear, but we suggest the possibility of a relationship with impaired thermal tolerance commonly reported by FMS patients.}, language = {en} } @article{EvdokimovFrankKlitschetal.2019, author = {Evdokimov, Dimitar and Frank, Johanna and Klitsch, Alexander and Unterecker, Stefan and Warrings, Bodo and Serra, Jordi and Papagianni, Aikaterini and Saffer, Nadine and Meyer zu Altenschildesche, Caren and Kampik, Daniel and Malik, Rayaz A. and Sommer, Claudia and {\"U}ceyler, Nurcan}, title = {Reduction of skin innervation is associated with a severe fibromyalgia phenotype}, series = {Annals of Neurology}, volume = {86}, journal = {Annals of Neurology}, number = {4}, doi = {10.1002/ana.25565}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-206168}, pages = {504-516}, year = {2019}, abstract = {Objective: To assess patterns and impact of small nerve fiber dysfunction and pathology in patients with fibromyalgia syndrome (FMS). Methods: One hundred seventeen women with FMS underwent neurological examination, questionnaire assessment, neurophysiology assessment, and small fiber tests: skin punch biopsy, corneal confocal microscopy, microneurography, quantitative sensory testing including C-tactile afferents, and pain-related evoked potentials. Data were compared with those of women with major depressive disorder and chronic widespread pain (MD-P) and healthy women. Results: Intraepidermal nerve fiber density (IENFD) was reduced at different biopsy sites in 63\% of FMS patients (MDP: 10\%, controls: 18\%; p < 0.001 for each). We found 4 patterns of skin innervation in FMS: normal, distally reduced, proximally reduced, and both distally and proximally reduced (p < 0.01 for each compared to controls). Microneurography revealed initial activity-dependent acceleration of conduction velocity upon low frequencies of stimulation in 1A fibers, besides 1B fiber spontaneous activity and mechanical sensitization in FMS patients. FMS patients had elevated warm detection thresholds (p < 0.01), impaired C-tactile afferents (p < 0.05), and reduced amplitudes (p < 0.001) of pain-related evoked potentials compared to controls. Compared to FMS patients with normal skin innervation, those with generalized IENFD reduction had higher pain intensity and impairment due to pain, higher disease burden, more stabbing pain and paresthesias, and more anxiety (p < 0.05 for each). FMS patients with generalized IENFD reduction also had lower corneal nerve fiber density (p < 0.01) and length (p < 0.05). Interpretation: The extent of small fiber pathology is related to symptom severity in FMS. This knowledge may have implications for the diagnostic classification and treatment of patients with FMS.}, language = {en} } @phdthesis{Fackelmann2011, author = {Fackelmann, Stefanie}, title = {Langzeitkorrelation evozierter Potentialparameter mit dem klinischen Verlauf bei Patienten mit Multipler Sklerose}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-64840}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2011}, abstract = {Evozierte Potenziale werden bereits als Hilfsmittel zur Diagnosestellung der Multiplen Sklerose herangezogen. Das Spektrum der Verl{\"a}ufe der Erkrankung ist sehr unterschiedlich. Ziel der Studie war es, zu pr{\"u}fen, ob visuell (VEP), somatosensibel (SEP) und Magnet- (MEP) evozierte Potentiale durch das Aufdecken klinisch noch stummer L{\"a}sionen eine prognostische Bedeutung haben. Es wurden 94 Patienten bei Erstvorstellung sowie zum 5-Jahres- und 10-Jahresverlaufszeitpunkt untersucht. Es wurde ein Zusammenhang von MEP- und SEP-Scores mit dem sp{\"a}teren Behinderungsgrad, gemessen in Form der EDSS nach f{\"u}nf und zehn jahren gefunden, sofern die elektrophysiologischen Untersuchungen in den ersten beiden Jahren nach Erstmanifestation klinischer Symptome durchgef{\"u}hrt worden waren (Gruppe 1, 44 Patienten). F{\"u}r Gruppe 2 (50 Patienten), deren Erstuntersuchung sp{\"a}ter im Verlauf stattgefunden hatte (im Mittel 9,6a) konnte keine prognostische Bedeutung gesehen werden. Die Durchf{\"u}hrung multimodaler evozierter Potenziale ist kann somit eine Hilfestellung zur fr{\"u}hzeitigen Therapieentscheidung geben.}, subject = {Multiple Sklerose}, language = {de} } @article{FarinelliPalmisanoMarcheseetal.2020, author = {Farinelli, Veronica and Palmisano, Chiara and Marchese, Silvia Maria and Strano, Camilla Mirella Maria and D'Arrigo, Stefano and Pantaleoni, Chiara and Ardissone, Anna and Nardocci, Nardo and Esposti, Roberto and Cavallari, Paolo}, title = {Postural control in children with cerebellar ataxia}, series = {Applied Sciences}, volume = {10}, journal = {Applied Sciences}, number = {5}, issn = {2076-3417}, doi = {10.3390/app10051606}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200692}, year = {2020}, abstract = {Controlling posture, i.e., governing the ensemble of involuntary muscular activities that manage body equilibrium, represents a demanding function in which the cerebellum plays a key role. Postural activities are particularly important during gait initiation when passing from quiet standing to locomotion. Indeed, several studies used such motor task for evaluating pathological conditions, including cerebellar disorders. The linkage between cerebellum maturation and the development of postural control has received less attention. Therefore, we evaluated postural control during quiet standing and gait initiation in children affected by a slow progressive generalized cerebellar atrophy (SlowP) or non-progressive vermian hypoplasia (Joubert syndrome, NonP), compared to that of healthy children (H). Despite the similar clinical evaluation of motor impairments in NonP and SlowP, only SlowP showed a less stable quiet standing and a shorter and slower first step than H. Moreover, a descriptive analysis of lower limb and back muscle activities suggested a more severe timing disruption in SlowP. Such differences might stem from the extent of cerebellar damage. However, literature reports that during childhood, neural plasticity of intact brain areas could compensate for cerebellar agenesis. We thus proposed that the difference might stem from disease progression, which contrasts the consolidation of compensatory strategies.}, language = {en} } @phdthesis{Feierabend2006, author = {Feierabend, Stefanie}, title = {Informationsgehalt und Akzeptanz zweier K{\"o}rperschemata bei Patienten mit orofazialen Schmerzen}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-20970}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2006}, abstract = {Ziel dieser prospektiven multizentrischen Studie war der Vergleich 2 verschiedener Schemata zur Schmerzzeichnung bei Patienten mit orofazialen Schmerzen. 204 Patienten, die wegen orofazialer Schmerzen einen (Zahn)arzt aufsuchten, erhielten randomisiert 2 unterschiedliche K{\"o}rperschemata zur Schmerzzeichnung und einen Fragebogen zu deren Beurteilung. Ein Schema war dem Deutschen Schmerzfragebogen entnommen (Bogen A), das andere war mit der Intention entwickelt worden, den K{\"o}rper symmetrisch darzustellen und eine computergest{\"u}tzte Auswertung zu erm{\"o}glichen (Bogen B). Diese Zeichnung war großformatiger und enthielt ein vergr{\"o}ßertes Kopfschema. Die Antworten wurden bzgl. Pr{\"a}ferenz, Anzahl und Verteilung der Schmerzgebiete und {\"U}bereinstimmung zwischen den Schemata ausgewertet sowie mit Patientendaten korreliert. Die Daten von 183 Patienten waren auswertbar. Von 100/183 Patienten wurde Bogen B bevorzugt, von 57/183 Bogen A, unabh{\"a}ngig von Geschlecht, Alter und Erkrankungsdauer. Fast alle Patienten gaben mehr als ein Schmerzgebiet an, nur 43/183 Patienten Schmerzen ausschließlich in der Gesichts- und Kopfregion. Anzahl und Lokalisation der Schmerzgebiete waren zwischen den Schemata nicht unterschiedlich. Detaillierte Kopf- und K{\"o}rperschemata k{\"o}nnen ohne {\"U}berforderung der Patienten sinnvoll in die Diagnostik orofazialer Schmerzen eingesetzt werden und sind n{\"u}tzlich, um Komorbidit{\"a}ten zu erkennen.}, language = {de} } @article{FeldheimKesslerSchmittetal.2018, author = {Feldheim, Jonas and Kessler, Almuth F and Schmitt, Dominik and Wilczek, Lara and Linsenmann, Thomas and Dahlmann, Mathias and Monoranu, Camelia M and Ernestus, Ralf-Ingo and Hagemann, Carsten and L{\"o}hr, Mario}, title = {Expression of activating transcription factor 5 (ATF5) is increased in astrocytomas of different WHO grades and correlates with survival of glioblastoma patients}, series = {OncoTargets and Therapy}, volume = {11}, journal = {OncoTargets and Therapy}, doi = {10.2147/OTT.S176549}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-177541}, pages = {8673-8684}, year = {2018}, abstract = {Background: ATF5 suppresses differentiation of neuroprogenitor cells and is overexpressed in glioblastoma (GBM). A reduction of its expression leads to apoptotic GBM cell death. Data on ATF5 expression in astrocytoma WHO grade II (low-grade astrocytoma [LGA]) are scarce and lacking on recurrent GBM. Patients and methods: ATF5 mRNA was extracted from frozen samples of patients' GBM (n=79), LGA (n=40), and normal brain (NB, n=10), quantified by duplex qPCR and correlated with retrospectively collected clinical data. ATF5 protein expression was evaluated by measuring staining intensity on immunohistochemistry. Results: ATF5 mRNA was overexpressed in LGA (sevenfold, P<0.001) and GBM (tenfold, P<0.001) compared to NB, which was confirmed on protein level. Although ATF5 mRNA expression in GBM showed a considerable fluctuation range, groups of varying biological behavior, that is, local/multifocal growth or primary tumor/relapse and the tumor localization at diagnosis, were not significantly different. ATF5 mRNA correlated with the patients' age (r=0.339, P=0.028) and inversely with Ki67-staining (r=-0.421, P=0.007). GBM patients were allocated to a low and a high ATF5 expression group by the median ATF5 overexpression compared to NB. Kaplan-Meier analysis and Cox regression indicated that ATF5 mRNA expression significantly correlated with short-term survival (t<12 months, median survival 18 vs 13 months, P=0.022, HR 2.827) and progression-free survival (PFS) (12 vs 6 months, P=0.024). This advantage vanished after 24 months (P=0.084). Conclusion: ATF5 mRNA expression could be identified as an additional, though not independent factor correlating with overall survival and PFS. Since its inhibition might lead to the selective death of glioma cells, it might serve as a potential ubiquitous therapeutic target in astrocytic tumors.}, language = {en} } @phdthesis{Fischer2009, author = {Fischer, Cindy Erika Elisabeth}, title = {Expression des fetalen Acetylcholinrezeptors im Muskel bei experimenteller Nervenl{\"a}sion der Ratte und bei Neuropathien des Menschen}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-36619}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2009}, abstract = {No abstract available}, subject = {Acetylcholinrezeptor}, language = {de} } @phdthesis{Fischer2004, author = {Fischer, Matthias}, title = {Lokalisierung eines Ged{\"a}chtnisses bei Drosophila melanogaster}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-8050}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2004}, abstract = {Es konnte in dieser Arbeit gezeigt werden, daß das olfaktorische Kurzzeitged{\"a}chtnis von Drosophila melanogaster in den Pilzk{\"o}rpern lokalisiert ist. Zu Beginn dieser Doktorarbeit war bekannt, daß die Pilzk{\"o}rper notwendig f{\"u}r das Geruchsged{\"a}chtnis sind. Drei unabh{\"a}ngige Methoden der Ablation bzw. Ver{\"a}nderung der biochemischen Eigenschaften der Pilzk{\"o}rper hatten zu dem selben Ergebnis gef{\"u}hrt, daß funktionierende Pilzk{\"o}rper unentbehrlich f{\"u}r den Aufbau eines Geruchsged{\"a}chtnisses sind. Noch informativer als ein Experiment, in dem durch Zerst{\"o}rung einer Struktur eine Leistung unm{\"o}glich gemacht wird ist der umgekehrte Weg, der durch einen gewebespezifischen „rescue" die Leistung wiederherstellt. Dazu wurde in dieser Arbeit das wildtypische Allel des Gens rutabaga in rut-mutanten Fliegen mit Hilfe des Gal4/UAS-Systems ausschließlich in den Pilzk{\"o}rpern, bzw., im Gegenexperiment, nur außerhalb der Pilzk{\"o}rper zur Expression gebracht. rut kodiert f{\"u}r die Adenylatcyclase I, die mit synaptischer Plastizit{\"a}t bei Drosophila, Aplysia und M{\"a}usen in Verbindung gebracht wird. Man geht davon aus, daß synaptische Plastizit{\"a}t die molekulare Grundlage f{\"u}r Lernen und Ged{\"a}chtnis ist. Die AC I stellt cAMP her, dessen Menge und pr{\"a}zise Regulation die {\"U}bertragungsst{\"a}rke an Neuronen beeinflußt. Eine St{\"o}rung dieses Signalweges z. B. durch die rut-Mutation f{\"u}hrt zu einer Beeintr{\"a}chtigung des Ged{\"a}chtnisses bei Drosophila. rut wurde mit Hilfe des in Drosophila etablierten Gal4/UAS-Systems exprimiert: Der gewebespezifisch aktive Hefe-Transkriptionsfaktor Gal4 f{\"u}hrt dazu, daß das hinter einen Gal4-spezifischen UAS-Promotor klonierte wildtypische rut-Gen in denjenigen Zellen transkribiert wird, in denen der Transkriptionsfaktor vorhanden ist. Dies wurde in einer rut-Mutante durchgef{\"u}hrt, so daß in allen anderen Zellen keine funktionierende AC I vorhanden war. Die rut-abh{\"a}ngige synaptische Plastizit{\"a}t wurde damit ausschließlich auf die gew{\"u}nschten Regionen beschr{\"a}nkt. Das Expressionsmuster der Gal4-Linien wurde durch Immuncytochemie (Anti-Tau) sichtbar gemacht. Diese Fliegen wurden in einem klassischen Konditionierungsexperiment auf ihr Geruchs-Ged{\"a}chtnis untersucht. Dazu wurden einer Gruppe von Fliegen nacheinander 2 Ger{\"u}che pr{\"a}sentiert, von denen einer mit Elektroschocks gepaart war. Nach ca. 2 min konnten diese Fliegen sich f{\"u}r einen der beiden Ger{\"u}che entscheiden, die nun gleichzeitig aus 2 unterschiedlichen Richtungen dargeboten wurden. Je nach Lernleistung entschieden sich mehr oder weniger Fliegen f{\"u}r den vorher unbestraften Geruch. Es ergab sich, daß der Ort im Gehirn, an dem die wildtypische AC I exprimiert wurde, {\"u}ber die H{\"o}he des Ged{\"a}chtniswertes entschied: Die AC I ausschließlich in den Pilzk{\"o}rpern gew{\"a}hrte ein v{\"o}llig normales Ged{\"a}chtnis, wogegen die AC I außerhalb der Pilzk{\"o}rper das Ged{\"a}chtnis nicht gegen{\"u}ber der rut-Mutante verbessern konnte. Die Analyse der Expressionsverteilung von insgesamt 9 getesteten Fliegenlinien mißt {\"u}berdies dem \&\#61543;-Lobus des Pilzk{\"o}rpers eine besondere Bedeutung bei und l{\"a}ßt den Schluß zu, daß das hier untersuchte Ged{\"a}chtnis ausschließlich in den \&\#61543;-Loben lokalisiert ist. Dieses erfolgreiche rut-„rescue" - Experiment zeigt, daß rut-abh{\"a}ngige synaptische Plastizit{\"a}t ausschließlich in den Pilzk{\"o}rpern ausreichend f{\"u}r ein wildtypisches Ged{\"a}chtnis ist. Dieses Ergebnis vervollst{\"a}ndigt die Erkenntnisse von den Pilzk{\"o}rper-Ablationsexperimenten insofern, als nun die Aussage zutrifft, daß die Pilzk{\"o}rper notwendig und hinreichend f{\"u}r das olfaktorische Kurzzeitged{\"a}chtnis sind.}, language = {de} } @phdthesis{Fischer2008, author = {Fischer, Stefan Martin}, title = {Regulation and functional consequences of MCP-1 expression in a model of Charcot-Marie-Tooth 1B disease}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-29189}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2008}, abstract = {Charcot-Marie-Tooth 1B (CMT1B) is a progressive inherited demyelinating disease of human peripheral nervous system leading to sensory and/or motor function disability and is caused by mutations in the P0 gene. Mice heterozygously deficient for P0 (P0+/-) are an adequate model of this human disorder showing myelin degeneration, formation of onion bulbs, remyelination and a reduced motor conduction velocity of around 30m/s similar to patients. Previously, it had been shown that T-lymphocytes and macrophages play a crucial role during pathogenesis in peripheral nerves of P0+/- mice. Both, T-lymphocytes and macrophages increase in number in the endoneurium and deletion of T-lymphocytes or deletion of a macrophage-directed cytokine ameliorates the disease. In this study the monocyte chemoattractant protein-1 (MCP-1) was identified as an early regulated cytokine before onset of disease is visible at the age of six months. MCP-1 mRNA and protein expression could be detected in femoral quadriceps and sciatic nerves of P0+/- mice already at the age of one month but not in cutaneous saphenous nerves which are never affected by the disease. MCP-1 was shown to be expressed by Schwann cells and to mediate the immigration of immune cells into peripheral nerves. Deletion of MCP-1 in P0+/- mice accomplished by crossbreeding P0 and MCP-1 deficient mice revealed a substantial reduction of immune cells in peripheral nerves of P0+/-/MCP-1+/- and P0+/-/MCP-1-/- mice at the age of six months. In twelve months old mice reduction of immune cells in peripheral nerves is accompanied by amelioration of demyelinating disease in P0+/-/MCP-1+/- and aggravation of demyelinating disease in lumbar ventral roots of P0+/ /MCP-1-/- mice in comparison to P0+/ /MCP 1+/+ mice. Furthermore, activation of the MEK1/2-ERK1/2 signalling cascade could be demonstrated to take place in Schwann cells of affected peripheral nerves of P0+/- mice overlapping temporarily and spatially with MCP-1 expression. An animal experiment using a MEK1/2-inhibitor in vivo, CI-1040, revealed that upon reduction of ERK1/2 phosphorylation MCP-1 mRNA expression is diminished suggesting that the activation of the MEK1/2-ERK1/2 signalling cascade is necessary for MCP-1 expression. Additionally, peripheral nerves of P0+/- mice showing reduced ERK1/2 phosphorylation and MCP-1 mRNA expression also show reduced numbers of macrophages in the endoneurium. This study shows a molecular link between a Schwann cell based mutation and immune cell function. Inhibition of the identified signalling cascade might be a putative target for therapeutic approaches.}, subject = {Schwann-Zelle}, language = {en} } @article{FlacheneckerBuresGawliketal.2020, author = {Flachenecker, Peter and Bures, Anna Karoline and Gawlik, Angeli and Weiland, Ann-Christin and Kuld, Sarah and Gusowski, Klaus and Streber, Ren{\´e} and Pfeifer, Klaus and Tallner, Alexander}, title = {Efficacy of an internet-based program to promote physical activity and exercise after inpatient rehabilitation in persons with multiple sclerosis: a randomized, single-blind, controlled study}, series = {International Journal of Environmental Research and Public Health}, volume = {17}, journal = {International Journal of Environmental Research and Public Health}, number = {12}, issn = {1660-4601}, doi = {10.3390/ijerph17124544}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-207863}, year = {2020}, abstract = {Background: Multimodal rehabilitation improves fatigue and mobility in persons with multiple sclerosis (PwMS). Effects are transient and may be conserved by internet-based physical activity promotion programs. Objective: Evaluate the effects of internet-based physical activity and exercise promotion on fatigue, quality of life, and gait in PwMS after inpatient rehabilitation. Methods: PwMS (Expanded Disability Status Scale (EDSS) ≤ 6.0, fatigue: W{\"u}rzburg Fatigue Inventory for Multiple Sclerosis (WEIMuS) ≥ 32) were randomized into an intervention group (IG) or a control group (CG). After rehabilitation, IG received 3 months of internet-based physical activity promotion, while CG received no intervention. Primary outcome: self-reported fatigue (WEIMuS). Secondary outcomes: quality of life (Multiple Sclerosis Impact Scale 29, MSIS-29), gait (2min/10m walking test, Tinetti score). Measurements: beginning (T0) and end (T1) of inpatient rehabilitation, 3 (T2) and 6 (T3) months afterwards. Results: 64 of 84 PwMS were analyzed (IG: 34, CG: 30). After rehabilitation, fatigue decreased in both groups. At T2 and T3, fatigue increased again in CG but was improved in IG (p < 0.001). MSIS-29 improved in both groups at T1 but remained improved at T2 and T3 only in IG. Gait improvements were more pronounced in IG at T2. Conclusions: The study provides Class II evidence that the effects of rehabilitation on fatigue, quality of life, and gait can be maintained for 3-6 months with an internet-based physical activity and exercise promotion program.}, language = {en} } @article{FluriFleischerKleinschnitz2015, author = {Fluri, Felix and Fleischer, Michael and Kleinschnitz, Christoph}, title = {Accidental Thrombolysis in a Stroke Patient Receiving Apixaban}, series = {Cerebrovascular Diseases Extra}, volume = {5}, journal = {Cerebrovascular Diseases Extra}, doi = {10.1159/000375181}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126326}, pages = {55-56}, year = {2015}, abstract = {No abstract available.}, language = {en} } @article{FluriHeinenKleinschnitz2013, author = {Fluri, Felix and Heinen, Florian and Kleinschnitz, Christoph}, title = {Intravenous Thrombolysis in a Stroke Patient Receiving Rivaroxaban}, series = {Cerebrovascular Disease Extra}, volume = {2013}, journal = {Cerebrovascular Disease Extra}, number = {3}, doi = {10.1159/000355839}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-128816}, pages = {153-155}, year = {2013}, abstract = {No abstract available.}, language = {en} } @article{FluriSchuhmannKleinschnitz2015, author = {Fluri, Felix and Schuhmann, Michael K and Kleinschnitz, Christoph}, title = {Animal models of ischemic stroke and their application in clinical research}, series = {Drug Design, Development and Therapy}, volume = {9}, journal = {Drug Design, Development and Therapy}, doi = {10.2147/DDDT.S56071}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-149157}, pages = {3445-3454}, year = {2015}, abstract = {This review outlines the most frequently used rodent stroke models and discusses their strengths and shortcomings. Mimicking all aspects of human stroke in one animal model is not feasible because ischemic stroke in humans is a heterogeneous disorder with a complex pathophysiology. The transient or permanent middle cerebral artery occlusion (MCAo) model is one of the models that most closely simulate human ischemic stroke. Furthermore, this model is characterized by reliable and well-reproducible infarcts. Therefore, the MCAo model has been involved in the majority of studies that address pathophysiological processes or neuroprotective agents. Another model uses thromboembolic clots and thus is more convenient for investigating thrombolytic agents and pathophysiological processes after thrombolysis. However, for many reasons, preclinical stroke research has a low translational success rate. One factor might be the choice of stroke model. Whereas the therapeutic responsiveness of permanent focal stroke in humans declines significantly within 3 hours after stroke onset, the therapeutic window in animal models with prompt reperfusion is up to 12 hours, resulting in a much longer action time of the investigated agent. Another major problem of animal stroke models is that studies are mostly conducted in young animals without any comorbidity. These models differ from human stroke, which particularly affects elderly people who have various cerebrovascular risk factors. Choosing the most appropriate stroke model and optimizing the study design of preclinical trials might increase the translational potential of animal stroke models.}, language = {en} } @phdthesis{Frank2021, author = {Frank, Franziska}, title = {Ver{\"a}nderung der Ranvier'schen Schn{\"u}rringarchitektur bei Patienten mit diabetischer Neuropathie}, doi = {10.25972/OPUS-21966}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219668}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {In der Krankheitsentstehung der diabetischen Neuropathie wird die paranodale Demyelinisierung als ein m{\"o}glicher Pathomechanismus diskutiert, wobei Studien mit Gewebeproben von Patienten aufgrund der Invasivit{\"a}t limitiert sind. In der vorliegenden Studie wurden periphere Nervenfasern in Hautbiopsien von Patienten mit diabetischer Neuropathie und in Patienten mit Diabetes mellitus ohne Neuropathie untersucht. Ziel war es, nodale und paranodale Ver{\"a}nderungen, wie eine Dispersion der paranodalen Proteine Caspr und Neurofascin oder der nodalen Na-Kan{\"a}le, zu detektieren und die Proben auf verl{\"a}ngerte Ranvier`sche Schn{\"u}rringe zu untersuchen. Es wurde die Hypothese {\"u}berpr{\"u}ft, dass paranodale Demyelinisierungen bei Patienten mit diabetischer Neuropathie in Hautbiopsien, als minimal-invasive Methode, nachweisbar sind. Hautproben von Patienten mit Diabetes mellitus ohne Neuropathie sollten zudem in einem fr{\"u}hen Krankheitsstadium untersucht werden. F{\"u}r die Untersuchung konnten 35 Patienten mit einer diabetischen Neuropathie, 17 Patienten mit Diabetes mellitus und 31 Kontrollen eingeschlossen werden. Immunfluoreszenzf{\"a}rbungen mit Antik{\"o}rpern gegen Caspr, Neurofascin und Natrium-Kan{\"a}len wurden zur Analyse der Ranvier`schen Schn{\"u}rringarchitektur durchgef{\"u}hrt und ausgewertet. Eine erh{\"o}hte Anzahl an verl{\"a}ngerten Schn{\"u}rringen, als Zeichen einer segmentalen Demyelinisierung, konnte in den Patienten mit diabetischer Neuropathie aber auch in Patienten mit Diabetes mellitus nachgewiesen werden. Weiterhin waren vermehrt Ver{\"a}nderungen der paranodalen Proteine, wie eine Dispersion von Caspr und Neurofascin in den Proben des Fingers der Patienten mit diabetischer Neuropathie sowie eine Dispersion von Neurofascin im Unterschenkel in beiden Patientengruppen nachweisbar. Interessanterweise waren einzelne Ver{\"a}nderungen auch in den gesunden Kontrollen auffindbar. Ver{\"a}nderungen der Schn{\"u}rringarchitektur lassen sich mithilfe der Hautbiopsie nachweisen und quantifizieren. Nodale und paranodale Ver{\"a}nderungen weisen auf demyelinisierende Prozesse in Patienten mit diabetischer Neuropathie hin und finden sich auch bereits in einem fr{\"u}hen Krankheitsstadium.}, subject = {Ranvier-Schn{\"u}rring}, language = {de} } @phdthesis{Frank2019, author = {Frank, Johanna}, title = {Untersuchung der Kleinfaserpathologie beim Fibromyalgie-Syndrom}, publisher = {Annals of Neurology, The Journal of Rheumatology}, doi = {10.25972/OPUS-19265}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-192653}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2019}, abstract = {Die Studienergebnisse st{\"u}tzen das Konzept, dass das periphere Nervensystem zu Schmerzen beim Fibromyalgie-Syndrom (FMS) beitr{\"a}gt. An der Neurologischen Universit{\"a}tsklinik W{\"u}rzburg wurden 53 FMS Patientinnen und 35 gesunde Kontrollen rekrutiert, ausf{\"u}hrlich anamnestiziert inklusive spezieller Schmerzfrageb{\"o}gen, neurologisch und mittels spezieller Tests auf eine St{\"o}rung der kleinkalibrigen A-delta- und C-Nervenfasern untersucht. Hierzu geh{\"o}rte eine quantitative sensorische Testung mit Pleasant touch Untersuchung und die schmerz-assoziierten elektrisch-evoziierten Potentiale f{\"u}r die Kleinfaserfunktion und die corneale confocale Mikroskopie, sowie die Analyse von Hautstanbiopsien f{\"u}r die Kleinfasermorphologie. Im Unterschied zu gesunden Kontrollen wiesen die FMS Patientinnen eine Reduktion, als auch eine Funktions{\"a}nderung der kleinkalibrigen Nervenfasern auf. Des Weiteren konnten wir aus der heterogenen Patientenpopulation anhand von unterschiedlichen Nervenfaserdichten der Haut eine Subgruppe mit generalisierter Reduktion der Hautinnervation identifizieren, die besonders schwer betroffen ist. Diese Subgruppenanalysen k{\"o}nnen k{\"u}nftig von großer Bedeutung f{\"u}r die Therapiewahl sein.}, subject = {Fibromyalgie}, language = {de} } @article{FrankeBieberStolletal.2021, author = {Franke, Maximilian and Bieber, Michael and Stoll, Guido and Schuhmann, Michael Klaus}, title = {Validity and Efficacy of Methods to Define Blood Brain Barrier Integrity in Experimental Ischemic Strokes: A Comparison of Albumin Western Blot, IgG Western Blot and Albumin Immunofluorescence}, series = {Methods and Protocols}, volume = {4}, journal = {Methods and Protocols}, number = {1}, issn = {2409-9279}, doi = {10.3390/mps4010023}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234214}, year = {2021}, abstract = {The clinical and preclinical research of ischemic strokes (IS) is becoming increasingly comprehensive, especially with the emerging evidence of complex thrombotic and inflammatory interactions. Within these, the blood brain barrier (BBB) plays an important role in regulating the cellular interactions at the vascular interface and is therefore the object of many IS-related questions. Consequently, valid, economic and responsible methods to define BBB integrity are necessary. Therefore, we compared the three ex-vivo setups albumin Western blot (WB), IgG WB and albumin intensity measurement (AIM) with regard to validity as well as temporal and economic efficacy. While the informative value of the three methods correlated significantly, the efficacy of the IgG WB dominated.}, language = {en} } @article{FrerichsSirenFeuersteinetal.1992, author = {Frerichs, K. and Sir{\`e}n, Anna-Leena and Feuerstein, G. and Hallenbeck, JM}, title = {The onset of postischemic hypoperfusion in rats is precipitous and may be controlled by local neurons}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-47980}, year = {1992}, abstract = {Background and Purpose: Reperfusion following transient global cerebral ischemia is characterized by an initial hyperemic phase, which precedes hypo perfusion. The pathogenesis of these flow derangements remains obscure. Our study investigates the dynamics of postischemic cerebral blood flow changes, with particular attention to the role of local neurons. Metho(Js: We assessed local cortical blood flow continuously by laser Doppler flowmetry to permit observation of any rapid flow changes after forebrain ischemia induced by four-vessel occlusion for 20 minutes in rats. To investigate the role of local cortical neurons in the regulation of any blood flow fluctuations, five rats received intracortical microinjections of a neurotoxin (10 p,g ibotenic acid in 1 p,1; 1.5-mm-depth parietal cortex) 24 hours before ischemia to induce selective and localized neuronal depletion in an area corresponding to the sampie volume of the laser Doppler probe (1 mm3 ). Local cerebral blood flow was measured within the injection site and at an adjacent control site. Results: Ischemia was followed by marked hyperemia (235 ±23\% of control, n =7), followed by secondary hypoperfusion (45±3\% of control, n=7). The transition from hyperemia to hypoperfusioo occurred not gradually but precipitously (maximal slope of flow decay: 66±6\%/min; n=7). In ibotenic acid-injected rats, hyperemia was preserved at the injection site, but the sudden decline of blood flow was abolished (maximal slope of flow decay: 5±3\%/min compared with 53±8\%/min at the control site; n=5, p 550 annotated frames: ConVNG. In a cross-sectional approach, slow-phase velocity of optokinetic nystagmus was calculated in 10 subjects using ConVNG and VOG. Equivalence of accuracy and precision was assessed using the "two one-sample t-test" (TOST) and Bayesian interval-null approaches. ConVNG was systematically compared to OpenFace and MediaPipe as computer vision (CV) benchmarks for gaze estimation. Results ConVNG tracking accuracy reached 9-15\% of an average pupil diameter. In a fully independent clinical video dataset, ConVNG robustly detected pupil keypoints (median prediction confidence 0.85). SPV measurement accuracy was equivalent to VOG (TOST p < 0.017; Bayes factors (BF) > 24). ConVNG, but not MediaPipe, achieved equivalence to VOG in all SPV calculations. Median precision was 0.30°/s for ConVNG, 0.7°/s for MediaPipe and 0.12°/s for VOG. ConVNG precision was significantly higher than MediaPipe in vertical planes, but both algorithms' precision was inferior to VOG. Conclusions ConVNG enables offline smartphone video nystagmography with an accuracy comparable to VOG and significantly higher precision than MediaPipe, a benchmark computer vision application for gaze estimation. This serves as a blueprint for highly accessible tools with potential to accelerate progress toward precise and personalized Medicine.}, language = {en} } @article{GabrielJirůHillmannKraftetal.2020, author = {Gabriel, Katharina M. A. and J{\´i}rů-Hillmann, Steffi and Kraft, Peter and Selig, Udo and R{\"u}cker, Victoria and M{\"u}hler, Johannes and D{\"o}tter, Klaus and Keidel, Matthias and Soda, Hassan and Rascher, Alexandra and Schneider, Rolf and Pfau, Mathias and Hoffmann, Roy and Stenzel, Joachim and Benghebrid, Mohamed and Goebel, Tobias and Doerck, Sebastian and Kramer, Daniela and Haeusler, Karl Georg and Volkmann, Jens and Heuschmann, Peter U. and Fluri, Felix}, title = {Two years' experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)}, series = {BMC Neurology}, volume = {20}, journal = {BMC Neurology}, doi = {10.1186/s12883-020-01676-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229214}, year = {2020}, abstract = {Background Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years' experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region. Methods The TRANSIT-Stroke network covers a mainly rural region in north-western Bavaria (Germany). All hospitals providing acute stroke care in this region participate in TRANSIT-Stroke, including four hospitals with a supra-regional certified stroke unit (SU) care (level III), three of those providing teleconsultation to two hospitals with a regional certified SU (level II) and five hospitals without specialized SU care (level I). For a two-year-period (01/2015 to 12/2016), data of eight of these hospitals were available; 13 evidence-based quality indicators (QIs) related to processes during hospitalisation were evaluated quarterly and compared according to predefined target values between level-I- and level-II/III-hospitals. Results Overall, 7881 patients were included (mean age 74.6 years +/- 12.8; 48.4\% female). In level-II/III-hospitals adherence of all QIs to predefined targets was high ab initio. In level-I-hospitals, three patterns of QI-development were observed: a) high adherence ab initio (31\%), mainly in secondary stroke prevention; b) improvement over time (44\%), predominantly related to stroke specific diagnosis and in-hospital organization; c) no clear time trends (25\%). Overall, 10 out of 13 QIs reached predefined target values of quality of care at the end of the observation period. Conclusion The implementation of the comprehensive TRANSIT-Stroke network resulted in an improvement of quality of care in level-I-hospitals.}, language = {en} } @article{GarciaFernandezHoefflinRauschetal.2023, author = {Garc{\´i}a-Fern{\´a}ndez, Patricia and H{\"o}fflin, Klemens and Rausch, Antonia and Strommer, Katharina and Neumann, Astrid and Cebulla, Nadine and Reinhold, Ann-Kristin and Rittner, Heike and {\"U}{\c{c}}eyler, Nurcan and Sommer, Claudia}, title = {Systemic inflammatory markers in patients with polyneuropathies}, series = {Frontiers in Immunology}, volume = {14}, journal = {Frontiers in Immunology}, doi = {10.3389/fimmu.2023.1067714}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304217}, year = {2023}, abstract = {Introduction In patients with peripheral neuropathies (PNP), neuropathic pain is present in 50\% of the cases, independent of the etiology. The pathophysiology of pain is poorly understood, and inflammatory processes have been found to be involved in neuro-degeneration, -regeneration and pain. While previous studies have found a local upregulation of inflammatory mediators in patients with PNP, there is a high variability described in the cytokines present systemically in sera and cerebrospinal fluid (CSF). We hypothesized that the development of PNP and neuropathic pain is associated with enhanced systemic inflammation. Methods To test our hypothesis, we performed a comprehensive analysis of the protein, lipid and gene expression of different pro- and anti-inflammatory markers in blood and CSF from patients with PNP and controls. Results While we found differences between PNP and controls in specific cytokines or lipids, such as CCL2 or oleoylcarnitine, PNP patients and controls did not present major differences in systemic inflammatory markers in general. IL-10 and CCL2 levels were related to measures of axonal damage and neuropathic pain. Lastly, we describe a strong interaction between inflammation and neurodegeneration at the nerve roots in a specific subgroup of PNP patients with blood-CSF barrier dysfunction. Conclusion In patients with PNP systemic inflammatory, markers in blood or CSF do not differ from controls in general, but specific cytokines or lipids do. Our findings further highlight the importance of CSF analysis in patients with peripheral neuropathies.}, language = {en} } @article{GarciaFernandezReinholdUeceyleretal.2023, author = {Garc{\´i}a-Fern{\´a}ndez, Patricia and Reinhold, Colette and {\"U}{\c{c}}eyler, Nurcan and Sommer, Claudia}, title = {Local inflammatory mediators involved in neuropathic pain}, series = {International Journal of Molecular Sciences}, volume = {24}, journal = {International Journal of Molecular Sciences}, number = {9}, issn = {1422-0067}, doi = {10.3390/ijms24097814}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-313613}, year = {2023}, abstract = {Polyneuropathy (PNP) is a term to describe diseases of the peripheral nervous system, 50\% of which present with neuropathic pain. In some types of PNP, pain is restricted to the skin distally in the leg, suggesting a local regulatory process leading to pain. In this study, we proposed a pro-inflammatory pathway mediated by NF-κB that might be involved in the development of pain in patients with painful PNP. To test this hypothesis, we have collected nerve and skin samples from patients with different etiologies and levels of pain. We performed RT-qPCR to analyze the gene expression of the proposed inflammatory pathway components in sural nerve and in distal and proximal skin samples. In sural nerve, we showed a correlation of TLR4 and TNFα to neuropathic pain, and an upregulation of TNFα in patients with severe pain. Patients with an inflammatory PNP also presented a lower expression of TRPV1 and SIRT1. In distal skin, we found a reduced expression of TLR4 and miR-146-5p, in comparison to proximal skin. Our findings thus support our hypothesis of local inflammatory processes involved in pain in PNP, and further show disturbed anti-inflammatory pathways involving TRPV1 and SIRT1 in inflammatory PNP.}, language = {en} } @phdthesis{Geis2004, author = {Geis, Christian}, title = {Charakterisierung von Spinalganglienneuronen intakter und l{\"a}dierter Afferenzen}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-13926}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2004}, abstract = {Am Tiermodell einer experimentellen Mononeuropathie (chronic constriction injury, CCI) wurde bei Ratten die Expression von Zytokinen (TNF-\&\#945;, IL-10), Vanilloidrezeptor 1 (VR1) und Neuropeptiden in Spinalganglienneuronen immunhistochemisch analy-siert. Durch retrograde Anf{\"a}rbung mit den Tracern Fluorogold (FG) und Fluoruby (FR) konnten intakte von gesch{\"a}digten Neuronen unterschieden und Muskel- und Hautaffe-renzen getrennt untersucht werden. Nach CCI fand sich ein selektiver Anstieg der TNF-\&\#945; Immunreaktivit{\"a}t in mittelgroßen und großen Spinalganglienneuronen, welche durch Vergleich mit anderen neuronalen Markern als A-Faser Neurone identifiziert werden konnten. Nicht nur gesch{\"a}digte, sondern auch intakte Spinalganglienneurone wiesen eine erh{\"o}hte TNF-\&\#945; Immunreaktivit{\"a}t auf und sowohl Muskel- als auch Hautafferenzen trugen zur vermehrten TNF-\&\#945; Expression bei. IL-10, VR1 und IB4 Immunreaktivit{\"a}t fand sich vor allem in kleinen Neuronen und war nach CCI deutlich reduziert, w{\"a}hrend die Expression von CGRP in kleinen und mittel-großen Spinalganglienneuronen nachzuweisen war und keine Ver{\"a}nderung zeigte. Die Ergebnisse zeigen, dass intakt gebliebene A-Faser Neurone pathophysiologische Ver{\"a}nderungen im Sinne einer vermehrten Expression des pro-inflammatorischen Zyto-kins TNF-\&\#945; erfahren. Dieser ph{\"a}notypische Switch ist m{\"o}glicherweise mit einer neuen Funktion dieser Neurone im nozizeptiven System verbunden. Die verminderte Expression des anti-inflammatorischen Zytokins IL-10 vier Tage nach CCI korrespondiert mit der fr{\"u}hen Schmerzentstehung nach peripherer Nervenl{\"a}sion und der noch fehlenden Suppression der pro-inflammatorischen Zytokine zu diesem Zeitpunkt. Dagegen ist der R{\"u}ckgang der VR1 und IB4 Konzentrationen im Spinal-ganglion am ehesten durch einen l{\"a}sionsbedingten Mangel an neurotrophen Faktoren zu erkl{\"a}ren. Die in dieser Arbeit gewonnenen Erkenntnisse unterst{\"u}tzen die These, dass pro-inflammatorischen Zytokinen, insbesondere TNF-\&\#945;, eine besondere Bedeutung bei der Entstehung neuropathischer Schmerzen zukommt. Dies k{\"o}nnte ein Ansatzpunkt f{\"u}r wei-tere Studien sein, die Wirksamkeit TNF-\&\#945; hemmender Medikamente bei neuropathi-schen Schmerzmodellen im Tierversuch und eventuell sp{\"a}ter klinisch zu untersuchen.}, language = {de} } @article{GeisWeishauptGruenewaldetal.2011, author = {Geis, Christian and Weishaupt, Andreas and Gr{\"u}newald, Benedikt and Wultsch, Thomas and Reif, Andreas and Gerlach, Manfred and Dirkx, Ron and Solimena, Michele and Perani, Daniela and Heckmann, Manfred and Toyka, Klaus V. and Folli, Franco and Sommer, Claudia}, title = {Human Stiff-Person Syndrome IgG Induces Anxious Behavior in Rats}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-74757}, year = {2011}, abstract = {Background: Anxiety is a heterogeneous behavioral domain playing a role in a variety of neuropsychiatric diseases. While anxiety is the cardinal symptom in disorders such as panic disorder, co-morbid anxious behavior can occur in a variety of diseases. Stiff person syndrome (SPS) is a CNS disorder characterized by increased muscle tone and prominent agoraphobia and anxiety. Most patients have high-titer antibodies against glutamate decarboxylase (GAD) 65. The pathogenic role of these autoantibodies is unclear. Methodology/Principal Findings: We re-investigated a 53 year old woman with SPS and profound anxiety for GABA-A receptor binding in the amygdala with (11)C-flumazenil PET scan and studied the potential pathogenic role of purified IgG from her plasma filtrates containing high-titer antibodies against GAD 65. We passively transferred the IgG fraction intrathecally into rats and analyzed the effects using behavioral and in vivo electrophysiological methods. In cell culture, we measured the effect of patient IgG on GABA release from hippocampal neurons. Repetitive intrathecal application of purified patient IgG in rats resulted in an anxious phenotype resembling the core symptoms of the patient. Patient IgG selectively bound to rat amygdala, hippocampus, and frontal cortical areas. In cultured rat hippocampal neurons, patient IgG inhibited GABA release. In line with these experimental results, the GABA-A receptor binding potential was reduced in the patient's amygdala/hippocampus complex. No motor abnormalities were found in recipient rats. Conclusion/Significance: The observations in rats after passive transfer lead us to propose that anxiety-like behavior can be induced in rats by passive transfer of IgG from a SPS patient positive for anti-GAD 65 antibodies. Anxiety, in this case, thus may be an antibody-mediated phenomenon with consecutive disturbance of GABAergic signaling in the amygdala region.}, subject = {Medizin}, language = {en} } @article{GeisWeishauptGruenewaldetal.2011, author = {Geis, Christian and Weishaupt, Andreas and Gr{\"u}newald, Benedikt and Wultsch, Thomas and Reif, Andreas and Gerlach, Manfred and Dirkx, Ron and Solimena, Michele and Toyka, Klaus V and Folli, Franco and Perani, Daniela and Heckmann, Manfred and Sommer, Claudia}, title = {Human Stiff-Person Syndrome IgG Induces Anxious Behavior in Rats}, series = {Plos One}, volume = {6}, journal = {Plos One}, number = {2}, doi = {10.1371/journal.pone.0016775}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-140506}, pages = {e16775}, year = {2011}, abstract = {Background: Anxiety is a heterogeneous behavioral domain playing a role in a variety of neuropsychiatric diseases. While anxiety is the cardinal symptom in disorders such as panic disorder, co-morbid anxious behavior can occur in a variety of diseases. Stiff person syndrome (SPS) is a CNS disorder characterized by increased muscle tone and prominent agoraphobia and anxiety. Most patients have high-titer antibodies against glutamate decarboxylase (GAD) 65. The pathogenic role of these autoantibodies is unclear. Methodology/Principal Findings: We re-investigated a 53 year old woman with SPS and profound anxiety for GABA-A receptor binding in the amygdala with (11) C-flumazenil PET scan and studied the potential pathogenic role of purified IgG from her plasma filtrates containing high-titer antibodies against GAD 65. We passively transferred the IgG fraction intrathecally into rats and analyzed the effects using behavioral and in vivo electrophysiological methods. In cell culture, we measured the effect of patient IgG on GABA release from hippocampal neurons. Repetitive intrathecal application of purified patient IgG in rats resulted in an anxious phenotype resembling the core symptoms of the patient. Patient IgG selectively bound to rat amygdala, hippocampus, and frontal cortical areas. In cultured rat hippocampal neurons, patient IgG inhibited GABA release. In line with these experimental results, the GABA-A receptor binding potential was reduced in the patient's amygdala/hippocampus complex. No motor abnormalities were found in recipient rats. Conclusion/Significance: The observations in rats after passive transfer lead us to propose that anxiety-like behavior can be induced in rats by passive transfer of IgG from a SPS patient positive for anti-GAD 65 antibodies. Anxiety, in this case, thus may be an antibody-mediated phenomenon with consecutive disturbance of GABAergic signaling in the amygdala region.}, language = {en} } @article{GeranUeckerPruessetal.2019, author = {Geran, Rohat and Uecker, Florian C. and Pr{\"u}ss, Harald and Haeusler, Karl Georg and Paul, Friedemann and Ruprecht, Klemens and Harms, Lutz and Schmidt, Felix A.}, title = {Olfactory and Gustatory Dysfunction in Patients With Autoimmune Encephalitis}, series = {Frontiers in Neurology}, volume = {10}, journal = {Frontiers in Neurology}, doi = {10.3389/fneur.2019.00480}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232921}, year = {2019}, abstract = {Objective: To test the hypothesis that olfactory (OF) and gustatory function (GF) is disturbed in patients with autoimmune encephalitides (AE). Methods: The orthonasal OF was tested in 32 patients with AE and 32 age- and sex-matched healthy controls (HC) with the standardized Threshold Discrimination Identification (TDI) score. This validated olfactory testing method yields individual scores for olfactory threshold (T), odor discrimination (D), and identification (I), along with a composite TDI score. The GF was determined by the Taste Strip Test (TST). Results: Overall, 24/32 (75\%) of patients with AE, but none of 32 HC (p < 0.001) had olfactory dysfunction in TDI testing. The results of the threshold, discrimination and identification subtests were significantly reduced in patients with AE compared to HC (all p < 0.001). Assessed by TST, 5/19 (26.3\%) of patients with AE, but none of 19 HC presented a significant limitation in GF (p < 0.001). The TDI score was correlated with the subjective estimation of the olfactory capacity on a visual analog scale (VAS; rs = 0.475, p = 0.008). Neither age, sex, modified Rankin Scale nor disease duration were associated with the composite TDI score. Conclusions: This is the first study investigating OF and GF in AE patients. According to unblinded assessment, patients with AE have a reduced olfactory and gustatory capacity compared to HC, suggesting that olfactory and gustatory dysfunction are hitherto unrecognized symptoms in AE. Further studies with larger number of AE patients would be of interest to verify our results.}, language = {en} } @article{GesslerLehmannBoeseletal.2021, author = {Gessler, Florian and Lehmann, Felix and B{\"o}sel, Julian and Fuhrer, Hannah and Neugebauer, Hermann and Wartenberg, Katja E. and Wolf, Stefan and Bernstock, Joshua D. and Niesen, Wolf-Dirk and Schuss, Patrick}, title = {Triage and Allocation of Neurocritical Care Resources During the COVID 19 Pandemic - A National Survey}, series = {Frontiers in Neurology}, volume = {11}, journal = {Frontiers in Neurology}, issn = {1664-2295}, doi = {10.3389/fneur.2020.609227}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-221593}, year = {2021}, abstract = {Objective: In light of the ongoing COVID-19 pandemic and the associated hospitalization of an overwhelming number of ventilator-dependent patients, medical and/or ethical patient triage paradigms have become essential. While guidelines on the allocation of scarce resources do exist, such work within the subdisciplines of intensive care (e.g., neurocritical care) remains limited. Methods: A 16-item questionnaire was developed that sought to explore/quantify the expert opinions of German neurointensivists with regard to triage decisions. The anonymous survey was conducted via a web-based platform and in total, 96 members of the Initiative of German Neurointensive Trial Engagement (IGNITE)-study group were contacted via e-mail. The IGNITE consortium consists of an interdisciplinary panel of specialists with expertise in neuro-critical care (i.e., anesthetists, neurologists and neurosurgeons). Results: Fifty members of the IGNITE consortium responded to the questionnaire; in total the respondents were in charge of more than 500 Neuro ICU beds throughout Germany. Common determinants reported which affected triage decisions included known patient wishes (98\%), the state of health before admission (96\%), SOFA-score (85\%) and patient age (69\%). Interestingly, other principles of allocation, such as a treatment of "youngest first" (61\%) and members of the healthcare sector (50\%) were also noted. While these were the most accepted parameters affecting the triage of patients, a "first-come, first-served" principle appeared to be more accepted than a lottery for the allocation of ICU beds which contradicts much of what has been reported within the literature. The respondents also felt that at least one neurointensivist should serve on any interdisciplinary triage team. Conclusions: The data gathered in the context of this survey reveal the estimation/perception of triage algorithms among neurointensive care specialists facing COVID-19. Further, it is apparent that German neurointensivists strongly feel that they should be involved in any triage decisions at an institutional level given the unique resources needed to treat patients within the Neuro ICU.}, language = {en} } @article{GiordanoCanesiIsalbertietal.2014, author = {Giordano, Rosaria and Canesi, Margherita and Isalberti, Maurizio and Isaias, Ioannis Ugo and Montemurro, Tiziana and Vigan{\`o}, Mariele and Montelatici, Elisa and Boldrin, Valentina and Benti, Riccardo and Cortelezzi, Agostino and Fracchiolla, Nicola and Lazzari, Lorenza and Pezzoli, Gianni}, title = {Autologous mesenchymal stem cell therapy for progressive supranuclear palsy: translation into a phase I controlled, randomized clinical study}, series = {Journal of Translational Medicine}, volume = {12}, journal = {Journal of Translational Medicine}, number = {14}, doi = {10.1186/1479-5876-12-14}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-117594}, year = {2014}, abstract = {Background: Progressive Supranuclear Palsy (PSP) is a sporadic and progressive neurodegenerative disease which belongs to the family of tauopathies and involves both cortical and subcortical structures. No effective therapy is to date available. Methods/design: Autologous bone marrow (BM) mesenchymal stem cells (MSC) from patients affected by different type of parkinsonisms have shown their ability to improve the dopaminergic function in preclinical and clinical models. It is also possible to isolate and expand MSC from the BM of PSP patients with the same proliferation rate and immuphenotypic profile as MSC from healthy donors. BM MSC can be efficiently delivered to the affected brain regions of PSP patients where they can exert their beneficial effects through different mechanisms including the secretion of neurotrophic factors. Here we propose a randomized, placebo-controlled, double-blind phase I clinical trial in patients affected by PSP with MSC delivered via intra-arterial injection. Discussion: To our knowledge, this is the first clinical trial to be applied in a no-option parkinsonism that aims to test the safety and to exploit the properties of autologous mesenchymal stem cells in reducing disease progression. The study has been designed to test the safety of this " first-in-man" approach and to preliminarily explore its efficacy by excluding the placebo effect. Trial registration: NCT01824121}, language = {en} } @article{GolombeckWessigMonoranuetal.2013, author = {Golombeck, Stefanie Kristin and Wessig, Carsten and Monoranu, Camelia-Maria and Sch{\"u}tz, Ansgar and Solymosi, Laszlo and Melzer, Nico and Kleinschnitz, Christoph}, title = {Fatal atypical reversible posterior leukoencephalopathy syndrome: a case report}, series = {Journal of Medical Case Reports}, volume = {7}, journal = {Journal of Medical Case Reports}, number = {14}, doi = {10.1186/1752-1947-7-14}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-135517}, year = {2013}, abstract = {Introduction: Reversible posterior leukoencephalopathy syndrome - a reversible subacute global encephalopathy clinically presenting with headache, altered mental status, visual symptoms such as hemianopsia or cortical blindness, motor symptoms, and focal or generalized seizures - is characterized by a subcortical vasogenic edema symmetrically affecting posterior brain regions. Complete reversibility of both clinical signs and magnetic resonance imaging lesions is regarded as a defining feature of reversible posterior leukoencephalopathy syndrome. Reversible posterior leukoencephalopathy syndrome is almost exclusively seen in the setting of a predisposing clinical condition, such as pre-eclampsia, systemic infections, sepsis and shock, certain autoimmune diseases, various malignancies and cytotoxic chemotherapy, transplantation and concomitant immunosuppression (especially with calcineurin inhibitors) as well as episodes of abrupt hypertension. We describe for the first time clinical, radiological and histological findings in a case of reversible posterior leukoencephalopathy syndrome with an irreversible and fatal outcome occurring in the absence of any of the known predisposing clinical conditions except for a hypertensive episode. Case presentation: A 58-year-old Caucasian woman presented with a two-week history of subacute and progressive occipital headache, blurred vision and imbalance of gait and with no evidence for raised arterial blood pressure during the two weeks previous to admission. Her past medical history was unremarkable except for controlled arterial hypertension. Cerebral magnetic resonance imaging demonstrated cortical and subcortical lesions with combined vasogenic and cytotoxic edema atypical for both venous congestion and arterial infarction. Routine laboratory and cerebrospinal fluid parameters were normal. The diagnosis of reversible posterior leukoencephalopathy syndrome was established. Within hours after admission the patient showed a rapidly decreasing level of consciousness, extension and flexion synergisms, bilaterally extensor plantar responses and rapid cardiopulmonary decompensation requiring ventilatory and cardiocirculatory support. Follow-up cerebral imaging demonstrated widespread and confluent cytotoxic edematous lesions in different arterial territories, global cerebral swelling, and subsequent upper and lower brainstem herniation. Four days after admission, the patient was declared dead because of brain death. Conclusion: This case demonstrates that fulminant and fatal reversible posterior leukoencephalopathy syndrome may occur spontaneously, that is, in the absence of any of the known predisposing systemic conditions.}, language = {en} } @article{GolombeckWessigMonoranuetal.2013, author = {Golombeck, Stefanie Kristin and Wessig, Carsten and Monoranu, Camelia-Maria and Sch{\"u}tz, Ansgar and Solymosi, Laszlo and Melzer, Niko and Kleinschnitz, Christoph}, title = {Fatal atypical reversible posterior leukoencephalopathy syndrome: a case report}, series = {Journal of Medical Case Reports}, volume = {7}, journal = {Journal of Medical Case Reports}, number = {14}, doi = {10.1186/1752-1947-7-14}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-129456}, year = {2013}, abstract = {Introduction: Reversible posterior leukoencephalopathy syndrome - a reversible subacute global encephalopathy clinically presenting with headache, altered mental status, visual symptoms such as hemianopsia or cortical blindness, motor symptoms, and focal or generalized seizures - is characterized by a subcortical vasogenic edema symmetrically affecting posterior brain regions. Complete reversibility of both clinical signs and magnetic resonance imaging lesions is regarded as a defining feature of reversible posterior leukoencephalopathy syndrome. Reversible posterior leukoencephalopathy syndrome is almost exclusively seen in the setting of a predisposing clinical condition, such as pre-eclampsia, systemic infections, sepsis and shock, certain autoimmune diseases, various malignancies and cytotoxic chemotherapy, transplantation and concomitant immunosuppression (especially with calcineurin inhibitors) as well as episodes of abrupt hypertension. We describe for the first time clinical, radiological and histological findings in a case of reversible posterior leukoencephalopathy syndrome with an irreversible and fatal outcome occurring in the absence of any of the known predisposing clinical conditions except for a hypertensive episode. Case presentation: A 58-year-old Caucasian woman presented with a two-week history of subacute and progressive occipital headache, blurred vision and imbalance of gait and with no evidence for raised arterial blood pressure during the two weeks previous to admission. Her past medical history was unremarkable except for controlled arterial hypertension. Cerebral magnetic resonance imaging demonstrated cortical and subcortical lesions with combined vasogenic and cytotoxic edema atypical for both venous congestion and arterial infarction. Routine laboratory and cerebrospinal fluid parameters were normal. The diagnosis of reversible posterior leukoencephalopathy syndrome was established. Within hours after admission the patient showed a rapidly decreasing level of consciousness, extension and flexion synergisms, bilaterally extensor plantar responses and rapid cardiopulmonary decompensation requiring ventilatory and cardiocirculatory support. Follow-up cerebral imaging demonstrated widespread and confluent cytotoxic edematous lesions in different arterial territories, global cerebral swelling, and subsequent upper and lower brainstem herniation. Four days after admission, the patient was declared dead because of brain death. Conclusion: This case demonstrates that fulminant and fatal reversible posterior leukoencephalopathy syndrome may occur spontaneously, that is, in the absence of any of the known predisposing systemic conditions.}, language = {en} } @article{Gonzalez‐EscamillaMuthuramanReichetal.2019, author = {Gonzalez-Escamilla, Gabriel and Muthuraman, Muthuraman and Reich, Martin M. and Koirala, Nabin and Riedel, Christian and Glaser, Martin and Lange, Florian and Deuschl, G{\"u}nther and Volkmann, Jens and Groppa, Sergiu}, title = {Cortical network fingerprints predict deep brain stimulation outcome in dystonia}, series = {Movement Disorders}, volume = {34}, journal = {Movement Disorders}, number = {10}, doi = {10.1002/mds.27808}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-213532}, pages = {1536 -- 1545}, year = {2019}, abstract = {Background Deep brain stimulation (DBS) is an effective evidence-based therapy for dystonia. However, no unequivocal predictors of therapy responses exist. We investigated whether patients optimally responding to DBS present distinct brain network organization and structural patterns. Methods From a German multicenter cohort of 82 dystonia patients with segmental and generalized dystonia who received DBS implantation in the globus pallidus internus, we classified patients based on the clinical response 3 years after DBS. Patients were assigned to the superior-outcome group or moderate-outcome group, depending on whether they had above or below 70\% motor improvement, respectively. Fifty-one patients met MRI-quality and treatment response requirements (mean age, 51.3 ± 13.2 years; 25 female) and were included in further analysis. From preoperative MRI we assessed cortical thickness and structural covariance, which were then fed into network analysis using graph theory. We designed a support vector machine to classify subjects for the clinical response based on individual gray-matter fingerprints. Results The moderate-outcome group showed cortical atrophy mainly in the sensorimotor and visuomotor areas and disturbed network topology in these regions. The structural integrity of the cortical mantle explained about 45\% of the DBS stimulation amplitude for optimal response in individual subjects. Classification analyses achieved up to 88\% of accuracy using individual gray-matter atrophy patterns to predict DBS outcomes. Conclusions The analysis of cortical integrity, informed by group-level network properties, could be developed into independent predictors to identify dystonia patients who benefit from DBS.}, language = {en} } @phdthesis{Gossger2005, author = {Gossger, Nicoletta Philippine}, title = {Bildgebende Verfahren in der Diagnostik von Myopathien}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-14712}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2005}, abstract = {Ziel dieser Arbeit war es, die Aussagef{\"a}higkeit der Kernspintomographie mit der der Histologie und der Sonographie im Hinblick auf Umbauvorg{\"a}nge im Muskel in einem Patientenkollektiv mit Myopathien verschiedener {\"A}tiologie zu vergleichen. Weiterhin sollte {\"u}berpr{\"u}ft werden, ob die MRT-Untersuchung mittels fettsupprimierter TIRM-Sequenz und T1-gewichteter Sequenz nach Kontrastmittelgabe eine zus{\"a}tzliche Hilfe bei der Diagnosefindung darstellt. Hierzu wurden {\"u}ber den Zeitraum von zwei Jahren 26 Patienten, die in der Neurologischen Universit{\"a}tsklinik W{\"u}rzburg mit einer Myopathie aufgenommen wurden, nach einem standardisierten Protokoll klinisch, laborchemisch, sonographisch (n=16) sowie kernspintomographisch untersucht. Außerdem erfolgte zur histologischen Diagnostik nach Aufkl{\"a}rung des Patienten eine Muskelbiopsie. Die kernspintomographische Untersuchung umfasste eine konventionelle T1-gewichtete Sequenz, eine fettunterdr{\"u}ckte TIRM-Sequenz und eine T1-gewichtete Sequenz nach der Gabe von Gadolinium-DTPA. Das Patientenkollektiv wurde f{\"u}r die statistische Auswertung in drei klinische Diagnosegruppen aufgeteilt: nicht-entz{\"u}ndliche, degenerative Myopathien (Gruppe A1), nicht-entz{\"u}ndliche, nicht-degenerative Myopathien (Gruppe A2) und entz{\"u}ndliche Myopathien (Gruppe B). Die T1-gewichtete Spinechosequenz zeigte sich in diesen Untersuchungen wie in vorangegangenen Arbeiten im Bezug auf fett- und bindegewebigen Umbauvorg{\"a}nge des Muskelparenchyms am sensitivsten. Muskul{\"a}re Ver{\"a}nderungen in der T1-gewichteten Sequenz korrelieren mit der Schwere des Muskelumbaus in der Histologie und dem MRC-Kraftgrad als funktionellen Parameter. Pathologische Befunde in der {\"o}demsensitiven TIRM-Sequenz fanden sich bei entz{\"u}ndlichen und nicht-entz{\"u}ndlichen Myopathien etwa gleich h{\"a}ufig. Unsere Ergebnisse legen also nahe, dass eine {\"O}dementstehung nicht zwangsl{\"a}ufig an eine entz{\"u}ndliche Genese gebunden ist. Eine Korrelation des histologischen Entz{\"u}ndungsscores mit der TIRM-Sequenz konnte in keiner der Diagnosegruppen nachgewiesen werden. Hieraus ist abzuleiten, dass zur genauen Lokalisation der Muskelbiopsie eine MRT-Diagnostik vor allem bei entz{\"u}ndlichen Myopathien sehr zu empfehlen ist. In dieser Arbeit fanden sich in der Patientengruppe mit einer degenerativen Myopathie h{\"a}ufiger als bisher beschrieben pathologische Auff{\"a}lligkeiten (46 \% der Patienten) in der T1-Sequenz nach Kontrastmittelgabe. Die Kontrastmittelanreicherung entspricht nicht in jedem Fall einer in der TIRM-Sequenz festgestellten {\"O}demausbreitung. Bei den entz{\"u}ndlichen Myopathien zeigte sich eine Korrelation der CK-Aktivit{\"a}t mit der T1-gewichteten Sequenz nach Kontrastmittelgabe, jedoch nicht mit den beiden anderen MRT-Sequenzen. An Hand der vorliegenden Befunde l{\"a}sst sich vermuten, dass Kontrastmittelanreicherung ein Ausdruck aktiver muskul{\"a}rer Umbauprozesse im Rahmen entz{\"u}ndlicher und degenerativer Myopathien ist. Damit scheint unter dem Aspekt der Erfassung der Aktivit{\"a}t einer Myopathie eine Kontrastmittelgabe bei der MRT-Diagnostik auch bei degenerativen neuromuskul{\"a}ren Erkrankungen sinnvoll. Die Befunde der Sonographie korrelieren mit den Befunden aus der T1-gewichteten MRT- Sequenz, mit der Schwere des Muskelumbaus in der Histologie und dem MRC-Kraftgrad. Diese Ergebnisse zeigen die gute Nachweisrate von muskul{\"a}ren Ver{\"a}nderungen durch die Sonographie. Alle drei zu vergleichenden Untersuchungsmethoden eignen sich f{\"u}r die Diagnostik von Myopathien. Eine spezifische Diagnose der Muskelerkrankungen auf Grund der MRT allein, ist, auch bei der hier untersuchten Anwendung von zus{\"a}tzlicher Kontrastmittelgabe, noch nicht m{\"o}glich. Die Diagnosestellung erfolgt letztendlich aus der Anamnese und der Gesamtheit aller Befunde. Welche apparativen und bildgebenden Verfahren hierbei zum Einsatz kommen, muss individuell entschieden werden, da die Untersuchungsverfahren unterschiedliche Aspekte der Erkrankung beleuchten. Die vorliegenden Ergebnisse k{\"o}nnten hierbei eine Entscheidungshilfe sein.}, language = {de} } @phdthesis{Graulich2011, author = {Graulich, Michael}, title = {Spinale Effekte von TNF-α am Modell des tumorinduzierten Knochenschmerzes der Maus}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-54439}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2011}, abstract = {Am Modell des tumorinduzierten Schmerzes der Maus wurden sowohl das Schmerzverhalten der Tiere als auch spezifische morphologische Ver{\"a}nderungen im Hinterhorn des R{\"u}ckenmarks (Aktivierung von Astrozyten) und im tumorbefallenen Knochen analysiert. Durch Analyse von M{\"a}usen mit Defizienz f{\"u}r TNF-Rezeptor 1, TNF-Rezeptor 2 oder f{\"u}r beide Rezeptoren konnte die Rolle von TNF-α seiner Rezeptoren bei der Entstehung von tumorinduziertem Schmerz untersucht werden. Im Unterschied zu neuropathischen Schmerzmodellen konnte gezeigt werden, dass beide TNF-Rezeptoren ausgeschaltet werden m{\"u}ssen, um eine signifikante Schmerzreduktion zu erzielen. Die systemische Behandlung mit dem TNF-neutralisierenden Fusionsprotein Etanercept konnte die im genetischen Modell gezeigte Reduktion der mechanischen Allodynie teilweise, aber nicht vollst{\"a}ndig reproduzieren. Eine Hemmung der Mikrogliaaktivierung mittels Minocyclin erbrachte im Tumor-schmerzmodell keinen Effekt auf das Schmerzverhalten der Tiere. Die histologische Analyse der tumoraffizierten Knochen zeigte eine signifikante Zunahme der Osteoklastenaktivit{\"a}t in tumortragenden Tieren. Die Behandlung mit Minocyclin war ohne erkennbaren Effekt auf die Differenzierung und die Aktivit{\"a}t der Osteoklasten. Es ergaben sich jedoch Hinweise, dass TNF-α einen hemmenden Einfluss auf die Osteoklastenaktivit{\"a}t im Knochentumormodell hat, da sowohl in den TNFR-KO-Tieren als auch unter Gabe von Etanercept eine Steigerung der Osteoklastenaktivit{\"a}t nachgewiesen werden konnte. Die Ergebnisse dieser Arbeit zeigen, dass TNF-α eine wichtige Rolle, sowohl in der Entstehung, als auch in der Aufrechterhaltung von tumorinduziertem Schmerz spielt. Hier liegt der Ansatzpunkt f{\"u}r weitere Studien mit dem Ziel, eine spezifische Pharmakotherapie zu entwickeln mit wirksamer TNF-α Blockade auch bei Patienten mit Tumorschmerzen. Nach den Erkenntnissen dieser Arbeit mit Etanercept sollte ein spezielles Augenmerk auf die ZNS-G{\"a}ngigkeit dieser Substanzen gelegt werden und die Gefahr der M{\"o}glichkeit eines vermehrten Tumorwachstum bedacht werden.}, subject = {Neuralgie}, language = {de} } @phdthesis{Greeske2008, author = {Greeske, Juliane}, title = {Mechanismen der Makrophagen-Aktivierung in Connexin32-defizienten M{\"a}usen}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-27491}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2008}, abstract = {Connexin32- defiziente M{\"a}use stellen ein Mausmodell f{\"u}r eine Form der heredit{\"a}ren peripheren Neuropahtie dar. Es konnte gezeigt werden, dass Makrophagen, m{\"o}glicherweise aktiviert durch MCP-1, die Demyelinisierung in Connexin32-defizienten M{\"a}usen vermitteln. Diese Arbeit untersucht m{\"o}gliche Signaltransduktionswege, die in den peripheren Nerven Connexin32- defizienter M{\"a}use aktiviert sein k{\"o}nnten und damit in Zusammenhang mit der Genexpression von MCP-1 und/oder Makrophagen-Aktivierung stehen k{\"o}nnten.}, subject = {Makrophage}, language = {de} } @article{GriebelSegebarthSteinetal.2023, author = {Griebel, Matthias and Segebarth, Dennis and Stein, Nikolai and Schukraft, Nina and Tovote, Philip and Blum, Robert and Flath, Christoph M.}, title = {Deep learning-enabled segmentation of ambiguous bioimages with deepflash2}, series = {Nature Communications}, volume = {14}, journal = {Nature Communications}, doi = {10.1038/s41467-023-36960-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357286}, year = {2023}, abstract = {Bioimages frequently exhibit low signal-to-noise ratios due to experimental conditions, specimen characteristics, and imaging trade-offs. Reliable segmentation of such ambiguous images is difficult and laborious. Here we introduce deepflash2, a deep learning-enabled segmentation tool for bioimage analysis. The tool addresses typical challenges that may arise during the training, evaluation, and application of deep learning models on ambiguous data. The tool's training and evaluation pipeline uses multiple expert annotations and deep model ensembles to achieve accurate results. The application pipeline supports various use-cases for expert annotations and includes a quality assurance mechanism in the form of uncertainty measures. Benchmarked against other tools, deepflash2 offers both high predictive accuracy and efficient computational resource usage. The tool is built upon established deep learning libraries and enables sharing of trained model ensembles with the research community. deepflash2 aims to simplify the integration of deep learning into bioimage analysis projects while improving accuracy and reliability.}, language = {en} } @article{GrohAbdelwahabKattimanietal.2023, author = {Groh, Janos and Abdelwahab, Tassnim and Kattimani, Yogita and H{\"o}rner, Michaela and Loserth, Silke and Gudi, Viktoria and Adalbert, Robert and Imdahl, Fabian and Saliba, Antoine-Emmanuel and Coleman, Michael and Stangel, Martin and Simons, Mikael and Martini, Rudolf}, title = {Microglia-mediated demyelination protects against CD8\(^+\) T cell-driven axon degeneration in mice carrying PLP defects}, series = {Nature Communications}, volume = {14}, journal = {Nature Communications}, doi = {10.1038/s41467-023-42570-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357641}, year = {2023}, abstract = {Axon degeneration and functional decline in myelin diseases are often attributed to loss of myelin but their relation is not fully understood. Perturbed myelinating glia can instigate chronic neuroinflammation and contribute to demyelination and axonal damage. Here we study mice with distinct defects in the proteolipid protein 1 gene that develop axonal damage which is driven by cytotoxic T cells targeting myelinating oligodendrocytes. We show that persistent ensheathment with perturbed myelin poses a risk for axon degeneration, neuron loss, and behavioral decline. We demonstrate that CD8\(^+\) T cell-driven axonal damage is less likely to progress towards degeneration when axons are efficiently demyelinated by activated microglia. Mechanistically, we show that cytotoxic T cell effector molecules induce cytoskeletal alterations within myelinating glia and aberrant actomyosin constriction of axons at paranodal domains. Our study identifies detrimental axon-glia-immune interactions which promote neurodegeneration and possible therapeutic targets for disorders associated with myelin defects and neuroinflammation.}, language = {en} } @article{GrohBerveMartini2021, author = {Groh, Janos and Berve, Kristina and Martini, Rudolf}, title = {Immune modulation attenuates infantile neuronal ceroid lipofuscinosis in mice before and after disease onset}, series = {Brain Communications}, volume = {3}, journal = {Brain Communications}, number = {2}, doi = {10.1093/braincomms/fcab047}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260167}, year = {2021}, abstract = {Targeting neuroinflammation in models for infantile and juvenile forms of neuronal ceroid lipofuscinosis (NCL, CLN disease) with the clinically established immunomodulators fingolimod and teriflunomide significantly attenuates the neurodegenerative phenotype when applied preventively, i.e. before the development of substantial neural damage and clinical symptoms. Here, we show that in a mouse model for the early onset and rapidly progressing CLN1 form, more complex clinical phenotypes like disturbed motor coordination and impaired visual acuity are also ameliorated by immunomodulation. Moreover, we show that the disease outcome can be attenuated even when fingolimod and teriflunomide treatment starts after disease onset, i.e. when neurodegeneration is ongoing and clinical symptoms are detectable. In detail, treatment with either drug led to a reduction in T-cell numbers and microgliosis in the CNS, although not to the same extent as upon preventive treatment. Pharmacological immunomodulation was accompanied by a reduction of axonal damage, neuron loss and astrogliosis in the retinotectal system and by reduced brain atrophy. Accordingly, the frequency of myoclonic jerks and disturbed motor coordination were attenuated. Overall, disease alleviation was remarkably substantial upon therapeutic treatment with both drugs, although less robust than upon preventive treatment. To test the relevance of putative immune-independent mechanisms of action in this model, we treated CLN1 mice lacking mature T- and B-lymphocytes. Immunodeficient CLN1 mice showed, as previously reported, an improved neurological phenotype in comparison with genuine CLN1 mice which could not be further alleviated by either of the drugs, reflecting a predominantly immune-related therapeutic mechanism of action. The present study supports and strengthens our previous view that repurposing clinically approved immunomodulators may alleviate the course of CLN1 disease in human patients, even though diagnosis usually occurs when symptoms have already emerged.}, language = {en} } @article{GrohHoernerMartini2018, author = {Groh, Janos and H{\"o}rner, Michaela and Martini, Rudolf}, title = {Teriflunomide attenuates neuroinflammation-related neural damage in mice carrying human PLP1 mutations}, series = {Journal of Neuroinflammation}, volume = {15}, journal = {Journal of Neuroinflammation}, number = {194}, doi = {10.1186/s12974-018-1228-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-176524}, year = {2018}, abstract = {Background: Genetically caused neurological disorders of the central nervous system (CNS) are mostly characterized by poor or even fatal clinical outcome and few or no causative treatments are available. Often, these disorders are associated with low-grade, disease-promoting inflammation, another feature shared by progressive forms of multiple sclerosis (PMS). We previously generated two mouse lines carrying distinct mutations in the oligodendrocytic PLP1 gene that have initially been identified in patients diagnosed with MS. These mutations cause a loss of PLP function leading to a histopathological and clinical phenotype common to both PMS and genetic CNS disorders, like hereditary spastic paraplegias. Importantly, neuroinflammation promotes disease progression in these models, suggesting that pharmacological modulation of inflammation might ameliorate disease outcome. Methods: We applied teriflunomide, an approved medication for relapsing-remitting MS targeting activated T-lymphocytes, in the drinking water (10 mg/kg body weight/day). Experimental long-term treatment of PLP mutant mice was non-invasively monitored by longitudinal optical coherence tomography and by rotarod analysis. Immunomodulatory effects were subsequently analyzed by flow cytometry and immunohistochemistry and treatment effects regarding neural damage, and neurodegeneration were assessed by histology and immunohistochemistry. Results: Preventive treatment with teriflunomide attenuated the increase in number of CD8+ cytotoxic effector T cells and fostered the proliferation of CD8+ CD122+ PD-1+ regulatory T cells in the CNS. This led to an amelioration of axonopathic features and neuron loss in the retinotectal system, also reflected by reduced thinning of the innermost retinal composite layer in longitudinal studies and ameliorated clinical outcome upon preventive long-term treatment. Treatment of immune-incompetent PLP mutants did not provide evidence for a direct, neuroprotective effect of the medication. When treatment was terminated, no rebound of neuroinflammation occurred and histopathological improvement was preserved for at least 75 days without treatment. After disease onset, teriflunomide halted ongoing axonal perturbation and enabled a recovery of dendritic arborization by surviving ganglion cells. However, neither neuron loss nor clinical features were ameliorated, likely due to already advanced neurodegeneration before treatment onset. Conclusions: We identify teriflunomide as a possible medication not only for PMS but also for inflammation-related genetic diseases of the nervous system for which causal treatment options are presently lacking.}, language = {en} } @phdthesis{Groh2013, author = {Groh, Janos Michael}, title = {Pathogenic impact of immune cells in mouse models of neuronal ceroid lipofuscinosis}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-77684}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2013}, abstract = {The neuronal ceroid lipofuscinoses (NCLs) are fatal neurodegenerative disorders in which the visual system is affected in early stages of disease. A typical accompanying feature is neuroinflammation, the pathogenic impact of which is presently unknown. In this study, the role of inflammatory cells in the pathogenesis was investigated in Palmitoyl-protein thioesterase 1-deficient (Ppt1-/-) and Ceroidlipofuscinosis, neuronal 3-deficient (Cln3-/-) mice, models of the infantile and juvenile forms of NCL, respectively. Focusing predominantly on the visual system, an infiltration of CD8+ cytotoxic Tlymphocytes and an activation of microglia/macrophage-like cells was observed early in disease. To analyze the pathogenic impact of lymphocytes, Ppt1-/- mice were crossbred with mice lacking lymphocytes (Rag1-/-) and axonal transport, perturbation and neuronal survival were scored. Lack of lymphocytes led to a significant amelioration of neuronal disease and reconstitution experiments revealed a crucial role of CD8+ cytotoxic T-lymphocytes. Lack of lymphocytes also caused an improved clinical phenotype and extended longevity. To investigate the impact of microglia/macrophage-like cells, Ppt1-/- and Cln3-/- mice were crossbred with mice lacking sialoadhesin (Sn-/-), a monocyte lineage-restricted cell adhesion molecule important for interactions between macrophage-like cells and lymphocytes. Similar to the lack of lymphocytes, absence of sialoadhesin significantly ameliorated the disease in Ppt1-/- and Cln3-/- mice. Taken together, both T-lymphocytes and microglia/macrophage-like cells were identified as pathogenic mediators in two distinct forms of fatal inherited neurodegenerative storage disorders. These studies expand the concept of secondary inflammation as a common pathomechanistic feature in some neurological diseases and provide novel insights that may be crucial for developing treatment strategies for different forms of NCL.}, subject = {Nervendegeneration}, language = {en} } @article{GrohStadlerButtmannetal.2014, author = {Groh, Janos and Stadler, David and Buttmann, Mathias and Martini, Rudolf}, title = {Non-invasive assessment of retinal alterations in mouse models of infantile and juvenile neuronal ceroid lipofuscinosis by spectral domain optical coherence tomography}, doi = {10.1186/2051-5960-2-54}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-110566}, year = {2014}, abstract = {Introduction The neuronal ceroid lipofuscinoses constitute a group of fatal inherited lysosomal storage diseases that manifest in profound neurodegeneration in the CNS. Visual impairment usually is an early symptom and selective degeneration of retinal neurons has been described in patients suffering from distinct disease subtypes. We have previously demonstrated that palmitoyl protein thioesterase 1 deficient (Ppt1-/-) mice, a model of the infantile disease subtype, exhibit progressive axonal degeneration in the optic nerve and loss of retinal ganglion cells, faithfully reflecting disease severity in the CNS. Here we performed spectral domain optical coherence tomography (OCT) in Ppt1-/- and ceroid lipofuscinosis neuronal 3 deficient (Cln3-/-) mice, which are models of infantile and juvenile neuronal ceroid lipofuscinosis, respectively, in order to establish a non-invasive method to assess retinal alterations and monitor disease severity in vivo. Results Blue laser autofluorescence imaging revealed increased accumulation of autofluorescent storage material in the inner retinae of 7-month-old Ppt1-/- and of 16-month-old Cln3-/- mice in comparison with age-matched control littermates. Additionally, optical coherence tomography demonstrated reduced thickness of retinae in knockout mice in comparison with age-matched control littermates. High resolution scans and manual measurements allowed for separation of different retinal composite layers and revealed a thinning of layers in the inner retinae of both mouse models at distinct ages. OCT measurements correlated well with subsequent histological analysis of the same retinae. Conclusions These results demonstrate the feasibility of OCT to assess neurodegenerative disease severity in mouse models of neuronal ceroid lipofuscinosis and might have important implications for diagnostic evaluation of disease progression and therapeutic efficacy in patients. Moreover, the non-invasive method allows for longitudinal studies in experimental models, reducing the number of animals used for research.}, language = {en} } @phdthesis{Grohmann2023, author = {Grohmann, Christoph}, title = {Kognitive Leistungsf{\"a}higkeit und Lebensqualit{\"a}t bei minimaler hepatischer Enzephalopathie - eine Pilotstudie zum Patient Reported Outcome in der Verlaufsdiagnostik}, doi = {10.25972/OPUS-30537}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-305375}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2023}, abstract = {Die WHO definiert Gesundheit als v{\"o}lliges k{\"o}rperliches, geistiges und soziales Wohlbefinden. W{\"a}hrend diese ganzheitliche Betrachtungsweise seit Menschengedenken nahezu weltweit das Gesundheitswesen pr{\"a}gt, hat die Medizin in Europa mit der naturwissenschaftlichen Erkenntnisrevolution einen Sonderweg eingeschlagen. Hier wird der kranke Organismus in erster Linie als defekter Apparat gesehen, der mit ausgekl{\"u}gelter Technik zu reparieren ist. Aber auch pr{\"a}ziseste Qualit{\"a}tsarbeit st{\"o}ßt dabei oft an Leistungsgrenzen, weil sie als seelenlos erlebt wird. Daher sehen heute viele Fachgebiete die Notwendigkeit, ihre Behandlungskonzepte zu beseelen und ihre Behandlungserfolge auch anhand der subjektiv von Patienten empfundenen Lebensqualit{\"a}t zu beurteilen. F{\"u}r die Ermittlung dieses PRO kommen etablierte psychometrische Testverfahren in Frage, die sich auch f{\"u}r routinem{\"a}ßige Verlaufskontrollen eignen. In der vorliegenden Arbeit wurde am Beispiel der mHE gepr{\"u}ft, welchen Nutzen eine PRO-Bestimmung bei der Verlaufskontrolle haben kann. Dazu wurde eine prospektive Studie mit anf{\"a}nglich 75 Patienten durchgef{\"u}hrt. Alle hatten eine mHE und waren entweder alkoholbedingt oder aus anderen Gr{\"u}nden schwer leberkrank. An vier Terminen im Abstand von sechs Monaten wurden die kognitive Leistungsf{\"a}higkeit und der emotionale Status {\"u}berpr{\"u}ft. Die Patienten zeigten anf{\"a}nglich kognitive Einschr{\"a}nkungen, die sich im Verlauf der individuell abgestimmten Behandlung deutlich verbesserten oder ganz verschwanden. Die globale Testung mit dem MoCA ergab eine hochsignifikante Normalisierung im ersten Behandlungsjahr. Die MoCA-Werte am Studienanfang und -ende waren von der Erkrankungsursache unabh{\"a}ngig. Dieser Befund differenzierte sich in den Spezialtests TMT, PHES und NHPT. Hier zeigten die alkoholbedingt Erkrankten durchweg schlechtere Leistungen als die nicht-alkoholbedingt Erkrankten, erholten sich aber in der Regel auch deutlicher. Die seelische Gestimmtheit gem{\"a}ß BDI-II und die mit dem SF-36 MCS ermittelte psychosoziale Befindlichkeit waren in beiden Patientengruppen von Anfang an vergleichsweise g{\"u}nstig. Dabei hatten die alkoholbedingt Erkrankten die besseren Werte, speziell der BDI-II zeigte bei ihnen nach einem halben Jahr eine zus{\"a}tzliche und bleibende Stimmungsaufhellung an. Der SF-36 PCS zum K{\"o}rpererleben zeigte hingegen, dass sich die alkoholbedingt Erkrankten zu Studienbeginn in einer deutlich schlechteren Verfassung befanden. Diese verbesserte sich aber kontinuierlich, sodass nach 1,5 Jahren kein Unterschied mehr zu den nicht-alkoholbedingt Erkrankten bestand. Aus diesen Befunden und dem reichhaltigen Erfahrungsgut zur Alkoholkrankheit wird geschlossen, dass der Genesungsprozess bei alkoholbedingtem Leberversagen viel komplexer ist als bei nicht-alkoholbedingtem Leberversagen. Er k{\"o}nnte wesentlich mehr Zeit erfordern und wird offensichtlich anders erlebt. Dieser Patientengruppe k{\"o}nnten besondere physio- und gespr{\"a}chstherapeutische Angebote eine große Hilfe sein. Die Arbeit zeigt, dass es m{\"o}glich ist, mit wenig Aufwand komplement{\"a}r zu den klinischen Verlaufsbefunden einen informativen PRO-Bericht zu erhalten. Er hilft Angeh{\"o}rigen und medizinischem Personal, die pers{\"o}nlichen N{\"o}te und Hoffnungen der Patienten besser zu verstehen und gegebenenfalls einen Korrekturbedarf im Umgang zu erkennen. Hinzu kam im vorliegenden Fall die Erkenntnis, dass die alkoholbedingt Erkrankten in ihrem Kranksein anders betroffen waren. Die Gr{\"u}nde daf{\"u}r sind im Nachhinein plausibel, der Sachverhalt als solcher w{\"a}re aber ohne diese Spezialuntersuchung wohl nicht erkannt worden. Das Beispiel der PRO-Ermittlung bei der mHE macht den praktischen Wert einer Ber{\"u}cksichtigung des gesamtheitlichen Gesundheitskonzepts der WHO auch in der technikzentrierten „westlichen Medizin" deutlich.}, subject = {Encephalopathia hepatica}, language = {de} } @article{GrotemeyerFischerKoprichetal.2023, author = {Grotemeyer, Alexander and Fischer, Judith F. and Koprich, James B. and Brotchie, Jonathan M. and Blum, Robert and Volkmann, Jens and Ip, Chi Wang}, title = {Inflammasome inhibition protects dopaminergic neurons from α-synuclein pathology in a model of progressive Parkinson's disease}, series = {Journal of Neuroinflammation}, volume = {20}, journal = {Journal of Neuroinflammation}, doi = {10.1186/s12974-023-02759-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357652}, year = {2023}, abstract = {Neuroinflammation has been suggested as a pathogenetic mechanism contributing to Parkinson's disease (PD). However, anti-inflammatory treatment strategies have not yet been established as a therapeutic option for PD patients. We have used a human α-synuclein mouse model of progressive PD to examine the anti-inflammatory and neuroprotective effects of inflammasome inhibition on dopaminergic (DA) neurons in the substantia nigra (SN). As the NLRP3 (NOD-, LRR- and pyrin domain-containing 3)-inflammasome is a core interface for both adaptive and innate inflammation and is also highly druggable, we investigated the implications of its inhibition. Repeat administration of MCC950, an inhibitor of NLRP3, in a PD model with ongoing pathology reduced CD4\(^+\) and CD8\(^+\) T cell infiltration into the SN. Furthermore, the anti-inflammasome treatment mitigated microglial activation and modified the aggregation of α-synuclein protein in DA neurons. MCC950-treated mice showed significantly less neurodegeneration of DA neurons and a reduction in PD-related motor behavior. In summary, early inflammasome inhibition can reduce neuroinflammation and prevent DA cell death in an α-synuclein mouse model for progressive PD.}, language = {en} } @article{GrotemeyerMcFlederWuetal.2022, author = {Grotemeyer, Alexander and McFleder, Rhonda Leah and Wu, Jingjing and Wischhusen, J{\"o}rg and Ip, Chi Wang}, title = {Neuroinflammation in Parkinson's disease - putative pathomechanisms and targets for disease-modification}, series = {Frontiers in Immunology}, volume = {13}, journal = {Frontiers in Immunology}, issn = {1664-3224}, doi = {10.3389/fimmu.2022.878771}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-274665}, year = {2022}, abstract = {Parkinson's disease (PD) is a progressive and debilitating chronic disease that affects more than six million people worldwide, with rising prevalence. The hallmarks of PD are motor deficits, the spreading of pathological α-synuclein clusters in the central nervous system, and neuroinflammatory processes. PD is treated symptomatically, as no causally-acting drug or procedure has been successfully established for clinical use. Various pathways contributing to dopaminergic neuron loss in PD have been investigated and described to interact with the innate and adaptive immune system. We discuss the possible contribution of interconnected pathways related to the immune response, focusing on the pathophysiology and neurodegeneration of PD. In addition, we provide an overview of clinical trials targeting neuroinflammation in PD.}, language = {en} } @phdthesis{Gross2010, author = {Groß, Catharina Luise}, title = {Die funktionelle Beteiligung verschiedener Hirnregionen in einer das K{\"o}rperselbstgef{\"u}hl t{\"a}uschenden Illusion: Eine L{\"a}sionsstudie}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-51319}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2010}, abstract = {Das K{\"o}rperselbstgef{\"u}hl stellt einen elementaren, jedoch selten beachteten Bestandteil unserer Wahrnehmung dar, ohne dass wir den Alltag nicht bew{\"a}ltigen k{\"o}nnten. Umso gravierender ist es, wenn dieses Selbstverst{\"a}ndnis f{\"u}r den eigenen K{\"o}rper oder f{\"u}r einen K{\"o}rperteil durch z.B. einen Schlaganfall verloren geht. Die Grundlagen der Entstehung und der St{\"o}rung des K{\"o}rperselbstgef{\"u}hles sind bisher nur teilweise bekannt. Diese Studie hat zwei Aspekte des K{\"o}rperselbstgef{\"u}hles bei Schlaganfallpatienten un-tersucht: die St{\"o}rung der Puppenhandillusion als eine Unf{\"a}higkeit, eine Illusion der Zu-geh{\"o}rigkeit einer Puppenhand zum eigenen K{\"o}rper zu empfinden und Asomatognosie als eine spontane St{\"o}rung des Zugeh{\"o}rigkeitsgef{\"u}hles zur eigenen Hand. Mit der so genannten Puppenhandillusion (PHI) kann auf einfache Weise die Basis der Selbstidentifikation untersucht werden. Innerhalb kurzer Zeit entsteht bei dem Proban-den der Eindruck, eine vor ihm liegende Puppenhand geh{\"o}re zu ihm. Die PHI entsteht, wenn die eigene, f{\"u}r den Probanden verdeckte Hand und eine f{\"u}r den Probanden sicht-bare, direkt {\"u}ber der eigenen Hand platzierte, lebensgroße Puppenhand zeit- und orts-synchron an den Fingern mit Pinseln ber{\"u}hrt und bestrichen werden. Es wurden 120 gesunde Probanden und 70 Schlaganfallpatienten an beiden H{\"a}nden mit der PHI untersucht und das Vorhandensein der PHI durch einen anschließend beantworteten Fragebogen festgestellt. Zus{\"a}tzlich wurden 64 Schlaganfallpatienten auf das Vorhandensein einer Asomatognosie hin untersucht. Eine Analyse der isch{\"a}mischen L{\"a}sionen der Schlaganfallpatienten wurde mit den dif-fusionsgewichteten MRT-Bildern und frei im Internet erh{\"a}ltlicher Software durchge-f{\"u}hrt. Die Isch{\"a}mien wurden manuell als regions of interest (ROI) markiert und in den Standardraum des MNI152-Gehirns transformiert. Rechtshemisph{\"a}rische L{\"a}sionen wurden {\"u}ber die Mittellinie gespiegelt. Es wurden Subtraktionsanalysen und ein voxel-based lesion-symptom mapping (VLSM) zur Feststellung der f{\"u}r die PHI und eine nor-male Somatognosie essentiellen Hirnregionen angewandt. Repetitive transkranielle Magnetstimulation (rTMS) als reversible L{\"a}sionstechnik wurde {\"u}ber dem ventralen pr{\"a}motorischen Kortex bei 8 Probanden durchgef{\"u}hrt. Erstmals wurde eine große Gruppe gesunder Probanden mit der PHI untersucht. Es zeigten sich keine signifikanten Unterschiede im Auftreten der PHI in Bezug auf Alter, Geschlecht, K{\"o}rperseite und H{\"a}ndigkeit. Die PHI konnte bei 86\% der Probanden an beiden H{\"a}nden induziert werden. Bei der rTMS-Untersuchung konnte nach Stimulation des pr{\"a}motorischen Kortex keine signifikante {\"A}nderung des Illusionserlebnisses beobachtet werden. Eine kontral{\"a}sional gest{\"o}rte PHI fand sich bei 11 (16\%), eine bilateral gest{\"o}rte PHI bei zus{\"a}tzlich 7 (10\%) der 70 Schlaganfallpatienten. Wir fanden L{\"a}sionsvoxel innerhalb der subkortikalen weißen Substanz in direkter struk-tureller N{\"a}he zum pr{\"a}motorischen, pr{\"a}frontalen und parietalen Kortex sowie zur Insel-region, welche eine signifikante Assoziation mit kontral{\"a}sionaler bzw. beidseitiger PHI-St{\"o}rung aufweisen. Eine kontral{\"a}sionale Asomatognosie wurde bei 18 (28\%) von 64 Schlaganfallpatienten gefunden. Asomatognosie korrelierte nicht mit einer gest{\"o}rten PHI- weder in der klini-schen Untersuchung noch hinsichtlich der L{\"a}sionslokalisation. Unsere Resultate sind vereinbar mit einer Rolle des pr{\"a}motorischen Kortex und dessen subkortikalen Verbindungen, sowie parietaler Hirnregionen und der Inselregion bei der Entstehung der PHI. Bei Schlaganfallpatienten korrelierte eine St{\"o}rung der PHI und eine Asomatognosie nicht miteinander, folglich gehen wir von zwei unabh{\"a}ngig voneinander bestehenden Mechanismen aus, denen verschiedene neuronale Netzwerke zugrunde liegen.}, subject = {Anosognosie}, language = {de} } @article{GruendahlWackerEinseleetal.2020, author = {Gr{\"u}ndahl, Marie and Wacker, Beate and Einsele, Hermann and Heinz, Werner J.}, title = {Invasive fungal diseases in patients with new diagnosed acute lymphoblastic leukaemia}, series = {Mycoses}, volume = {63}, journal = {Mycoses}, number = {10}, doi = {10.1111/myc.13151}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-217844}, pages = {1101 -- 1106}, year = {2020}, abstract = {Background Patients with acute leukaemia have a high incidence of fungal infections. This has primarily been shown in acute myeloid leukaemia and is different for acute lymphoblastic leukaemia. Until now no benefit of mould active prophylaxis has been demonstrated in the latter population. Methods In this retrospective single-centre study, we analysed the incidence, clinical relevance, and outcome of invasive fungal diseases (IFD) as well as the impact of antifungal prophylaxis for the first 100 days following the primary diagnosis of acute lymphoblastic leukaemia. Results In 58 patients a high rate of proven, probable, and possible fungal infections could be demonstrated with a 3.4\%, 8.6\%, and 17.2\% likelihood, respectively. The incidence might be even higher, as nearly 40\% of all patients had no prolonged neutropenia for more than 10 days, excluding those from the European Organization of Research and Treatment of cancer and the Mycoses Study Group criteria for probable invasive fungal disease. The diagnosed fungal diseases had an impact on the duration of hospitalisation, which was 13 days longer for patients with proven/probable IFD compared to patients with no signs of fungal infection. Use of antifungal prophylaxis did not significantly affect the risk of fungal infection. Conclusion Patients with acute lymphoblastic leukaemia are at high risk of acquiring an invasive fungal disease. Appropriate criteria to define fungal infections, especially in this population, and strategies to reduce the risk of infection, including antifungal prophylaxis, need to be further evaluated.}, language = {en} } @article{GruenewaldBennettToykaetal.2016, author = {Gr{\"u}newald, Benedikt and Bennett, Jeffrey L. and Toyka, Klaus V. and Sommer, Claudia and Geis, Christian}, title = {Efficacy of Polyvalent Human Immunoglobulins in an Animal Model of Neuromyelitis Optica Evoked by Intrathecal Anti-Aquaporin 4 Antibodies}, series = {International Journal of Molecular Sciences}, volume = {17}, journal = {International Journal of Molecular Sciences}, number = {9}, doi = {10.3390/ijms17091407}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-166000}, pages = {1407}, year = {2016}, abstract = {Neuromyelitis Optica Spectrum Disorders (NMOSD) are associated with autoantibodies (ABs) targeting the astrocytic aquaporin-4 water channels (AQP4-ABs). These ABs have a direct pathogenic role by initiating a variety of immunological and inflammatory processes in the course of disease. In a recently-established animal model, chronic intrathecal passive-transfer of immunoglobulin G from NMOSD patients (NMO-IgG), or of recombinant human AQP4-ABs (rAB-AQP4), provided evidence for complementary and immune-cell independent effects of AQP4-ABs. Utilizing this animal model, we here tested the effects of systemically and intrathecally applied pooled human immunoglobulins (IVIg) using a preventive and a therapeutic paradigm. In NMO-IgG animals, prophylactic application of systemic IVIg led to a reduced median disease score of 2.4 on a 0-10 scale, in comparison to 4.1 with sham treatment. Therapeutic IVIg, applied systemically after the 10th intrathecal NMO-IgG injection, significantly reduced the disease score by 0.8. Intrathecal IVIg application induced a beneficial effect in animals with NMO-IgG (median score IVIg 1.6 vs. sham 3.7) or with rAB-AQP4 (median score IVIg 2.0 vs. sham 3.7). We here provide evidence that treatment with IVIg ameliorates disease symptoms in this passive-transfer model, in analogy to former studies investigating passive-transfer animal models of other antibody-mediated disorders.}, language = {en} } @article{GruenewaldLangeWerneretal.2017, author = {Gr{\"u}newald, Benedikt and Lange, Maren D and Werner, Christian and O'Leary, Aet and Weishaupt, Andreas and Popp, Sandy and Pearce, David A and Wiendl, Heinz and Reif, Andreas and Pape, Hans C and Toyka, Klaus V and Sommer, Claudia and Geis, Christian}, title = {Defective synaptic transmission causes disease signs in a mouse model of juvenile neuronal ceroid lipofuscinosis}, series = {eLife}, volume = {6}, journal = {eLife}, number = {e28685}, doi = {10.7554/eLife.28685}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-170004}, year = {2017}, abstract = {Juvenile neuronal ceroid lipofuscinosis (JNCL or Batten disease) caused by mutations in the CLN3 gene is the most prevalent inherited neurodegenerative disease in childhood resulting in widespread central nervous system dysfunction and premature death. The consequences of CLN3 mutation on the progression of the disease, on neuronal transmission, and on central nervous network dysfunction are poorly understood. We used Cln3 knockout (Cln3\(^{Δex1-6}\)) mice and found increased anxiety-related behavior and impaired aversive learning as well as markedly affected motor function including disordered coordination. Patch-clamp and loose-patch recordings revealed severely affected inhibitory and excitatory synaptic transmission in the amygdala, hippocampus, and cerebellar networks. Changes in presynaptic release properties may result from dysfunction of CLN3 protein. Furthermore, loss of calbindin, neuropeptide Y, parvalbumin, and GAD65-positive interneurons in central networks collectively support the hypothesis that degeneration of GABAergic interneurons may be the cause of supraspinal GABAergic disinhibition.}, language = {en} } @article{GschmackMonoranuMaroufetal.2022, author = {Gschmack, Eva and Monoranu, Camelia-Maria and Marouf, Hecham and Meyer, Sarah and Lessel, Lena and Idris, Raja and Berg, Daniela and Maetzler, Walter and Steigerwald, Frank and Volkmann, Jens and Gerlach, Manfred and Riederer, Peter and Koutsilieri, Eleni and Scheller, Carsten}, title = {Plasma autoantibodies to glial fibrillary acidic protein (GFAP) react with brain areas according to Braak staging of Parkinson's disease}, series = {Journal of Neural Transmission}, volume = {129}, journal = {Journal of Neural Transmission}, number = {5-6}, doi = {10.1007/s00702-022-02495-4}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-325161}, pages = {545-555}, year = {2022}, abstract = {Idiopathic Parkinson's disease (PD) is characterized by a progredient degeneration of the brain, starting at deep subcortical areas such as the dorsal motor nucleus of the glossopharyngeal and vagal nerves (DM) (stage 1), followed by the coeruleus-subcoeruleus complex; (stage 2), the substantia nigra (SN) (stage 3), the anteromedial temporal mesocortex (MC) (stage 4), high-order sensory association areas and prefrontal fields (HC) (stage 5) and finally first-order sensory association areas, premotor areas, as well as primary sensory and motor field (FC) (stage 6). Autoimmunity might play a role in PD pathogenesis. Here we analyzed whether anti-brain autoantibodies differentially recognize different human brain areas and identified autoantigens that correlate with the above-described dissemination of PD pathology in the brain. Brain tissue was obtained from deceased individuals with no history of neurological or psychiatric disease and no neuropathological abnormalities. Tissue homogenates from different brain regions (DM, SN, MC, HC, FC) were subjected to SDS-PAGE and Western blot. Blots were incubated with plasma samples from 30 PD patients and 30 control subjects and stained with anti-IgG antibodies to detect anti-brain autoantibodies. Signals were quantified. Prominent autoantigens were identified by 2D-gel-coupled mass spectrometry sequencing. Anti-brain autoantibodies are frequent and occur both in healthy controls and individuals with PD. Glial fibrillary acidic protein (GFAP) was identified as a prominent autoantigen recognized in all plasma samples. GFAP immunoreactivity was highest in DM areas and lowest in FC areas with no significant differences in anti-GFAP autoantibody titers between healthy controls and individuals with PD. The anti-GFAP autoimmunoreactivity of different brain areas correlates with the dissemination of histopathological neurodegeneration in PD. We hypothesize that GFAP autoantibodies are physiological but might be involved as a cofactor in PD pathogenesis secondary to a leakage of the blood-brain barrier.}, language = {en} } @article{GulbertiMollHameletal.2015, author = {Gulberti, A. and Moll, C.K.E. and Hamel, W. and Buhmann, C. and Koeppen, J.A. and Boelmans, K. and Zittel, S. and Gerloff, C. and Westphal, M. and Schneider, T.R. and Engel, A.K.}, title = {Predictive timing functions of cortical beta oscillations are impaired in Parkinson's disease and influenced by L-DOPA and deep brain stimulation of the subthalamic nucleus Impaired beta-band timing functions in PD}, series = {NeuroImage: Clinical}, volume = {9}, journal = {NeuroImage: Clinical}, doi = {10.1016/j.nicl.2015.09.013}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-150049}, pages = {436-449}, year = {2015}, abstract = {Cortex-basal ganglia circuits participate in motor timing and temporal perception, and are important for the dynamic configuration of sensorimotor networks in response to exogenous demands. In Parkinson's disease (PD) patients, rhythmic auditory stimulation (RAS) induces motor performance benefits. Hitherto, little is known concerning contributions of the basal ganglia to sensory facilitation and cortical responses to RAS in PD. Therefore, we conducted an EEG study in 12 PD patients before and after surgery for subthalamic nucleus deep brain stimulation (STN-DBS) and in 12 age-matched controls. Here we investigated the effects of levodopa and STN-DBS on resting-state EEG and on the cortical-response profile to slow and fast RAS in a passive-listening paradigm focusing on beta-band oscillations, which are important for auditory-motor coupling. The beta-modulation profile to RAS in healthy participants was characterized by local peaks preceding and following auditory stimuli. In PD patients RAS failed to induce pre-stimulus beta increases. The absence of pre-stimulus beta-band modulation may contribute to impaired rhythm perception in PD. Moreover, post-stimulus beta-band responses were highly abnormal during fast RAS in PD patients. Treatment with levodopa and STN-DBS reinstated a post-stimulus beta-modulation profile similar to controls, while STN-DBS reduced beta-band power in the resting-state. The treatment-sensitivity of beta oscillations suggests that STN-DBS may specifically improve timekeeping functions of cortical beta oscillations during fast auditory pacing.}, language = {en} }