@article{GutknechtPoppWaideretal.2015, author = {Gutknecht, Lise and Popp, Sandy and Waider, Jonas and Sommerlandt, Frank M. J. and G{\"o}ppner, Corinna and Post, Antonia and Reif, Andreas and van den Hove, Daniel and Strekalova, Tatyana and Schmitt, Angelika and Colaςo, Maria B. N. and Sommer, Claudia and Palme, Rupert and Lesch, Klaus-Peter}, title = {Interaction of brain 5-HT synthesis deficiency, chronic stress and sex differentially impact emotional behavior in Tph2 knockout mice}, series = {Psychopharmacology}, volume = {232}, journal = {Psychopharmacology}, doi = {10.1007/s00213-015-3879-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-154586}, pages = {2429 -- 2441}, year = {2015}, abstract = {Rationale While brain serotonin (5-HT) function is implicated in gene-by-environment interaction (GxE) impacting the vulnerability-resilience continuum in neuropsychiatric disorders, it remains elusive how the interplay of altered 5-HT synthesis and environmental stressors is linked to failure in emotion regulation. Objective Here, we investigated the effect of constitutively impaired 5-HT synthesis on behavioral and neuroendocrine responses to unpredictable chronic mild stress (CMS) using a mouse model of brain 5-HT deficiency resulting from targeted inactivation of the tryptophan hydroxylase-2 (Tph2) gene. Results Locomotor activity and anxiety- and depression-like behavior as well as conditioned fear responses were differentially affected by Tph2 genotype, sex, and CMS. Tph2 null mutants (Tph2\(^{-/-}\)) displayed increased general metabolism, marginally reduced anxiety- and depression-like behavior but strikingly increased conditioned fear responses. Behavioral modifications were associated with sex-specific hypothalamic-pituitary-adrenocortical (HPA) system alterations as indicated by plasma corticosterone and fecal corticosterone metabolite concentrations. Tph2\(^{-/-}\) males displayed increased impulsivity and high aggressiveness. Tph2\(^{-/-}\) females displayed greater emotional reactivity to aversive conditions as reflected by changes in behaviors at baseline including increased freezing and decreased locomotion in novel environments. However, both Tph2\(^{-/-}\) male and female mice were resilient to CMS-induced hyperlocomotion, while CMS intensified conditioned fear responses in a GxE-dependent manner. Conclusions Our results indicate that 5-HT mediates behavioral responses to environmental adversity by facilitating the encoding of stress effects leading to increased vulnerability for negative emotionality.}, language = {en} } @article{KressHuettenhoferLandryetal.2013, author = {Kress, Michaela and H{\"u}ttenhofer, Alexander and Landry, Marc and Kuner, Rohini and Favereaux, Alexandre and Greenberg, David and Bednarik, Josef and Heppenstall, Paul and Kronenberg, Florian and Malcangio, Marzia and Rittner, Heike and {\"U}{\c{c}}eyler, Nurcan and Trajanoski, Zlatko and Mouritzen, Peter and Birklein, Frank and Sommer, Claudia and Soreq, Hermona}, title = {microRNAs in nociceptive circuits as predictors of future clinical applications}, series = {Frontiers in Molecular Neuroscience}, volume = {6}, journal = {Frontiers in Molecular Neuroscience}, number = {33}, doi = {10.3389/fnmol.2013.00033}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-154597}, year = {2013}, abstract = {Neuro-immune alterations in the peripheral and central nervous system play a role in the pathophysiology of chronic pain, and non-coding RNAs - and microRNAs (miRNAs) in particular - regulate both immune and neuronal processes. Specifically, miRNAs control macromolecular complexes in neurons, glia and immune cells and regulate signals used for neuro-immune communication in the pain pathway. Therefore, miRNAs may be hypothesized as critically important master switches modulating chronic pain. In particular, understanding the concerted function of miRNA in the regulation of nociception and endogenous analgesia and defining the importance of miRNAs in the circuitries and cognitive, emotional and behavioral components involved in pain is expected to shed new light on the enigmatic pathophysiology of neuropathic pain, migraine and complex regional pain syndrome. Specific miRNAs may evolve as new druggable molecular targets for pain prevention and relief. Furthermore, predisposing miRNA expression patterns and inter-individual variations and polymorphisms in miRNAs and/or their binding sites may serve as biomarkers for pain and help to predict individual risks for certain types of pain and responsiveness to analgesic drugs. miRNA-based diagnostics are expected to develop into hands-on tools that allow better patient stratification, improved mechanism-based treatment, and targeted prevention strategies for high risk individuals.}, language = {en} } @phdthesis{Karl2017, author = {Karl, Franziska}, title = {The role of miR-21 in the pathophysiology of neuropathic pain using the model of B7-H1 knockout mice}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-156004}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {The impact of microRNA (miRNA) as key players in the regulation of immune and neuronal gene expression and their role as master switches in the pathophysiology of neuropathic pain is increasingly recognized. miR-21 is a promising candidate that could be linked to the immune and the nociceptive system. To further investigate the pathophysiological role of miR-21 in neuropathic pain, we assesed mice deficient of B7 homolog 1 (B7-H1 ko), a protein with suppressive effect on inflammatory responses. B7-H1 ko mice and wildtype littermates (WT) of three different age-groups, young (8 weeks), middle-aged (6 months), and old (12 months) received a spared nerve injury (SNI). Thermal withdrawal latencies and mechanical withdrawal thresholds were determined. Further, we investigated anxiety-, depression-like and cognitive behavior. Quantitative real time PCR was used to determine miR-21 relative expression in peripheral nerves, dorsal root ganglia and white blood cells (WBC) at distinct time points after SNI. Na{\"i}ve B7-H1 ko mice showed mechanical hyposensitivity with increasing age. Young and middle-aged B7-H1 ko mice displayed lower mechanical withdrawal thresholds compared to WT mice. From day three after SNI both genotypes developed mechanical and heat hypersensitivity, without intergroup differences. As supported by the results of three behavioral tests, no relevant differences were found for anxiety-like behavior after SNI in B7-H1 ko and WT mice. Also, there was no indication of depression-like behavior after SNI or any effect of SNI on cognition in both genotypes. The injured nerves of B7-H1 ko and WT mice showed higher miR-21 expression and invasion of macrophages and T cells 7 days after SNI without intergroup differences. Perineurial miR-21 inhibitor injection reversed SNI-induced mechanical and heat hypersensitivity in old B7-H1 ko and WT mice. This study reveals that reduced mechanical thresholds and heat withdrawal latencies are associated with miR-21 induction in the tibial and common peroneal nerve after SNI, which can be reversed by perineurial injection of a miR-21 inhibitor. Contrary to expectations, miR-21 expression levels were not higher in B7-H1 ko compared to WT mice. Thus, the B7-H1 ko mouse may be of minor importance for the study of miR-21 related pain. However, these results spot the contribution of miR-21 in the pathophysiology of neuropathic pain and emphasize the crucial role of miRNA in the regulation of neuronal and immune circuits that contribute to neuropathic pain.}, subject = {neuropathic pain}, language = {en} } @phdthesis{KissnergebStenger2018, author = {Kißner [geb. Stenger], Stefanie Martina}, title = {Morphologische Untersuchungen an Myoblasten von Patienten, die an facioscapulohumeraler Muskeldystrophie (FSHD) leiden}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-156676}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {Die autosomal-dominant vererbte facioscapulohumerale Muskeldystrophie (FSHD) ist mit einer Pr{\"a}valenz von etwa 1:20.000 die dritth{\"a}ufigste Form der heredit{\"a}ren Myopathien. Erste Beschwerden werden meist in der zweiten Lebensdekade beobachtet. Betroffen sind vor allem die Muskulatur von Gesicht, Schultern, Oberarmen, die Fußhebermuskulatur und die Muskeln des H{\"u}ftg{\"u}rtels. FSHD wird durch einen Gendefekt ausgel{\"o}st, der den langen Arm des Chromosoms vier (4q35) betrifft, wobei es zur teilweisen Deletion des polymorphen Abschnitts D4Z4, der f{\"u}r das Protein DUX4 codiert, kommt. Dabei treten unter anderem St{\"o}rungen in der DUX4-Expression, Ver{\"a}nderungen der myogenen Genexpression, eine Unterdr{\"u}ckung der Muskelzelldifferenzierung und eine Inhibition der Muskelbildung auf. FSHD und eine andere Form der Muskeldystrophie, die Emery-Dreifuss-Muskeldystrophie (EDMD), zeigen trotz unterschiedlicher genetischer Ursachen ph{\"a}notypisch {\"A}hnlichkeiten in der Auspr{\"a}gung der Erkrankungen. In fr{\"u}heren Studien zeigte die Kernh{\"u}lle von EDMD-Myoblasten morphologische Auff{\"a}lligkeiten. In anderen Untersuchungen waren morphologische Ver{\"a}nderungen der Mitochondrien von FSHD-Patienten festzustellen. Daher wurden elektronenmikroskopische Untersuchungen der Kernh{\"u}lle und der Mitochondrien von FSHD-Myoblasten durchgef{\"u}hrt und mit der entsprechenden Kontrolle verglichen. Hierf{\"u}r wurden drei verschiedene Zelllinien-Paare in unterschiedlichen Passagen, das heißt unterschiedlicher Anzahl an Subkultivierungen, eingesetzt, wobei in den h{\"o}heren Passagen vermehrt morphologische Atypien beobachtet werden konnten. Die eingesetzten Zelllinien differenzieren sich durch verschiedene Parameter wie beispielsweise Alter und Geschlecht der Patienten. Dabei zeigten sich sowohl zwischen den Kontrollzellen als auch zwischen den FSHD-Myoblasten Unterschiede. Im Rahmen der Probenvorbereitung f{\"u}r die Elektronenmikroskopie kamen zwei verschiedene Fixierungsmethoden zum Einsatz: die konventionelle chemische Fixierung, Entw{\"a}sserung und Flacheinbettung von Kulturzellen und die Hochdruckgefrierung mit anschließender Gefriersubstitution. In Bezug auf die Qualit{\"a}t des Strukturerhalts, die beim Hochdruckgefrieren erreicht wird, wird dieser Art der Fixierung eine {\"U}berlegenheit gegen{\"u}ber allen anderen Verfahren zugeschrieben. Diese allgemeine Aussage kann nicht vollst{\"a}ndig auf die Untersuchungen an den Myoblasten {\"u}bertragen werden. F{\"u}r die Untersuchung der Kernmembranen sind beide Methoden geeignet, wobei der Abstand zwischen innerer und {\"a}ußerer Kernmembran nach der HPF-Fixierung sch{\"a}rfer abgebildet wurde. Bei der Darstellung der Mitochondrien zeigten die elektronenmikroskopischen Aufnahmen nach dem Hochdruckgefrieren bessere und sch{\"a}rfere Ergebnisse. Die Kernporen waren bei beiden Fixierungsmethoden gut erkennbar. Beim Vergleich der gesunden und erkrankten Myoblasten wiesen die Kontrollzellen deutlich weniger Auff{\"a}lligkeiten auf als die Myoblasten von FSHD-Patienten. Innere und {\"a}ußere Kernmembran verliefen bei den Kontrollzellen meist parallel und die Mitochondrien zeigten in den meisten F{\"a}llen eine typische wurmartige, l{\"a}ngliche Form mit Cristae. Dies traf sowohl f{\"u}r die konventionelle Fixierung als auch f{\"u}r das Hochdruckgefrieren zu. Die erkrankten Myoblasten wiesen im Vergleich zur Kontrolle bei beiden Fixierungsmethoden deutliche Auff{\"a}lligkeiten in der Mitochondrien-Morphologie auf. Neben einer oft großen Variationsbreite hinsichtlich Form und L{\"a}nge war auch das teilweise Fehlen der Cristae festzustellen. Bei Betrachtung der Kernh{\"u}lle fielen jedoch deutliche Unterschiede zwischen konventioneller und HPF-Fixierung auf. Die {\"a}ußere Kernmembran der konventionell fixierten FSHD-Myoblasten verlief unregelm{\"a}ßig und gewellt. Im Gegensatz dazu wies die Kernh{\"u}lle der HPF-fixierten erkrankten Myoblasten einen erstaunlich parallelen Verlauf auf. Da bei EDMD in vorangegangenen Untersuchungen auch fluoreszenzmikroskopisch Ver{\"a}nderungen der erkrankten Zellen auff{\"a}llig waren, wurde neben den Methoden der Elektronenmikroskopie das Vorliegen und die Verteilung verschiedener Proteine in FSHD-Myoblasten mittels indirekter Immunfluoreszenz untersucht und mit den Kontrollzellen verglichen. Zur Beurteilung der Kernh{\"u}lle wurden Antik{\"o}rper gegen Lamin A/C und Nukleoporine eingesetzt. Die Mitochondrien wurden mithilfe des Antik{\"o}rpers ANT1/2, der an den Adenin-Nukleotid-Translokator der inneren Mitochondrienmembran bindet, untersucht. Im Gegensatz zu den Untersuchungen an EDMD-Myoblasten waren die Lamine A und C sowie die Kernporen sowohl bei den Myoblasten der FSHD-Patienten als auch bei den Kontrollzellen nachweisbar und gleichm{\"a}ßig verteilt. Bei der indirekten Immunfluoreszenz mit ANT1/2 zeigten sich Unterschiede zwischen den untersuchten Myoblasten-Paaren. Durch die vorliegenden Ergebnisse ist darauf zu schließen, dass die Myoblasten von FSHD-Patienten Ver{\"a}nderungen Mitochondrien aufweisen. Die Untersuchungen der Kernh{\"u}lle liefern abh{\"a}ngig von der Fixierungsmethode unterschiedliche Ergebnisse.}, subject = {Landouzy-D{\´e}jerine-Atrophie}, language = {de} } @phdthesis{Hose2018, author = {Hose, Dorothea Anna Elisabeth}, title = {Charakterisierung von Spinalganglienneuronen im alpha-Galaktosidase A-defizienten Maus-Modell des M. Fabry}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-163233}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {M. Fabry ist eine X-chromosomale, lysosomale Speicherkrankheit, die aufgrund einer Mutation im f{\"u}r das Enzym αGalaktosidase A (αGalA)-kodierenden Gen GLA, zu einer vollst{\"a}ndig fehlenden oder verminderten Expression von αGalA f{\"u}hrt. Aufgrund ubiquit{\"a}rer Ablagerungen von Globotriaosylceramid 3 (Gb3) kommt es zu einer progressiven Multiorganerkrankung sowie der Entwicklung einer small-fiber Neuropathie (SFN). Der Pathomechanismus des Fabry-assoziierten Schmerzes blieb trotz Entwicklung eines αGalA-defizienten Mausmodells (Fabry-ko-Maus) durch Ohshima et al. bisher weitgehend ungekl{\"a}rt. Ziel der vorliegenden Arbeit war die systematische Charakterisierung des Fabry-ko-Mausmodells hinsichtlich Schmerz-assoziierten Verhaltens und Expression Schmerz-assoziierter Ionenkan{\"a}le in Spinalganglienneuronen. Hierzu wurden insgesamt 42 drei Monate und 41 12 Monate alte m{\"a}nnliche und weibliche Fabry-ko-M{\"a}use und ihre gleichaltrigen Wurfgeschwister untersucht. Die Verhaltenstestungen beinhalteten einen von Frey-, einen Hargreaves- sowie einen „Cold"-Test zur Evaluation der mechanischen und thermischen R{\"u}ckzugslatenz. Weiterhin erfolgten die Analyse der intraepidermalen Nervenfaserdichte (IENFD) in Fußsohlen der M{\"a}use sowie eine H.E.-F{\"a}rbung von Spinalganglien zur Untersuchung morphologischer Ver{\"a}nderungen der Neurone. Zus{\"a}tzlich folgten immunhistochemische und molekulargenetische Untersuchungen des Gb3-Rezeptors (CD77), des transient receptor potential vanilloid 1 (TRPV1)-Kanals, des spannungsgesteuerten Natrium-Kanals 1.8 (Nav1.8), des Calcitonin Gene related peptide (CGRP), des Neurofilaments 200 (NF200) sowie von Isolectin B4 (IB4) an kryokonservierten und kultivierten Spinalganglienneuronen. In Verhaltenstestungen konnten eine {\"U}berempfindlichkeit gegen{\"u}ber mechanischen und Hitze-Stimuli sowie ein vermindertes K{\"a}lteempfinden festgestellt werden. Es zeigte sich eine reduzierte IENFD in Fußsohlen sowie eine Vergr{\"o}ßerung der neuronalen Fl{\"a}che in Spinalganglien von Fabry-ko-M{\"a}usen. Die immunhistochemischen Untersuchungen ergaben eine erh{\"o}hte CD77- und TRPV1-Immunreaktivit{\"a}t sowie eine erniedrigte NF200-Immunreaktivit{\"a}t in Fabry-ko-M{\"a}usen; Untersuchungen hinsichtlich der Immunreaktivit{\"a}t von Nav1.8 ergaben keine Unterschiede. Molekulargenetisch konnte neben einer verminderten Nav1.8-Expression in jungen Fabry-ko-M{\"a}usen keine Unterschiede festgestellt werden. Die Ergebnisse der Verhaltenstestungen sowie die verminderte IENFD bei Fabry-ko-M{\"a}usen entsprechen klinischen Befunden bei Fabry-Patienten. Erstmals konnte in dieser Arbeit eine Vergr{\"o}ßerung der Neuronenfl{\"a}che in Fabry-ko-M{\"a}usen quantitativ nachgewiesen und eine vermehrte Immunreaktivit{\"a}t von TRPV1 und CD77 festgestellt werden. Bei fehlendem Nachweis eines geschlechtsspezifischen Unterschieds der Ergebnisse, konnte ein Einfluss des weiblichen Geschlechts auf den Ph{\"a}notyp des M. Fabry ausgeschlossen werden.
Die Ergebnisse der vorliegenden Arbeit zeigen, dass die von Oshima et al. entwickelte Fabry-ko-Maus ein suffizientes Model zur Erforschung des M. Fabry darstellt. Weiterhin r{\"u}cken sie TRPV1 und spannungsgesteuerte Natriumkan{\"a}le weiter in den Fokus der Untersuchung Fabry-assoziierten Schmerzes und k{\"o}nnen aufgrund der hohen Anzahl an Versuchstieren und dem Vergleich mit Wurfgeschwistern als Grundlage f{\"u}r weitere Studien dienen.}, subject = {Fabry-Krankheit}, language = {de} } @phdthesis{Weis2018, author = {Weis, Jessica}, title = {Innervation von Schweißdr{\"u}sen bei Patienten mit Morbus Parkinson}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-161505}, school = {Universit{\"a}t W{\"u}rzburg}, pages = {97}, year = {2018}, abstract = {Die Forschung auf dem Gebiet der Parkinson-Erkrankung erlebt einen großen Wandel. Eindeutig ist mittlerweile, dass es zu kurz gefasst w{\"a}re diese Erkrankung auf die motorischen Symptome zu beschr{\"a}nken. In den letzten Jahren wurde durch intensive Forschung bewiesen, dass der idiopathische M. Parkinson eine multisystemische Erkrankung ist, welche verschiedene Teile des Nervensystems betreffen kann. Um die zugrundeliegende Pathophysiologie und die Beteiligung des autonomen Nervensystems bei M. Parkinson n{\"a}her zu untersuchen, wurden f{\"u}r diese Studie 30 Patienten mit idiopathischem M. Parkinson, 19 Patienten mit atypischem Parkinsonsyndrom und 30 gesunde Probanden am Universit{\"a}tsklinikum W{\"u}rzburg und an der Paracelsus-Elena-Klinik Kassel rekrutiert. Um Beeintr{\"a}chtigungen von groß-und kleinkalibrigen Nervenfasern einsch{\"a}tzen zu k{\"o}nnen, wurden eine Neurografie des N. suralis sowie eine quantitativ sensorische Testung durchgef{\"u}hrt. Zur Bewertung einer m{\"o}glichen toxischen Komponente von Levodopa gegen{\"u}ber einer direkten Sch{\"a}digung peripherer Nerven durch p-α-Synuclein wurden am Vitamin B12 Stoffwechsel beteiligte Proteine im Blut bestimmt. Alle Patienten und Probanden erhielten Hautbiopsien an Unterschenkel, Oberschenkel, R{\"u}cken und Finger, um anschließend eine immunhistochemische Aufarbeitung der Pr{\"a}parate durchf{\"u}hren zu k{\"o}nnen. Einerseits wurde die Beteiligung somatosensibler Nervenfasern mithilfe der Ausz{\"a}hlung intraepidermaler Nervenfasern (PGP 9.5) bewertet. Andererseits wurden die Schweißdr{\"u}sen auf Pathologien der sympathischen Nervenfasern (VIP, TH, SP, CGRP) und der sudomotorischen Synapsen (SNCA, Synaptophysin, SNAP 25) untersucht. Weiterhin wurde versucht p-α-Synuclein, als Biomarker der Parkinson-Erkrankung, in der Haut nachzuweisen. Positive Ergebnisse konnten hinsichtlich pathologischer Prozesse an den Synapsen erzielt werden. Es zeigte sich sowohl eine Reduktion von nativem α-Synuclein (Unterschenkel, p=0,009 und R{\"u}cken, p=0,013), Synaptophysin (Unterschenkel, p=0,007) als auch SNAP 25 (Unterschenkel, p=0,023) an den untersuchten Schweißdr{\"u}sen der Patientengruppe. Bei der Untersuchung von SNAP 25 zeigte sich des Weiteren eine negative Korrelation zwischen der SNAP 25 Dichte im Unterschenkel und p-α-Synuclein (p=0,007). Bei der Suche nach p-α-Synuclein wurden beinahe 72\% der Parkinson-Patienten positiv getestet, wohingegen keiner der gesunden Probanden p-α-Synuclein in der Haut zeigte. Weiterhin konnte bei 75\% der positiv getesteten Patienten mit Multisystematrophie p-α-Synuclein an somatosensiblen Nervenfasern des subepidermalen Plexus nachgewiesen werden, wohingegen es bei den M. Parkinson Patienten nur 13\% waren. Die Ergebnisse der zugrundeliegenden Arbeit zeigen, dass die Hautbiopsie als fr{\"u}hdiagnostisches Mittel und in der Differentialdiagnose ein hohes Potenzial hat. Die Erforschung von Pathologien an Synapsen wird in der Zukunft an großer Bedeutung gewinnen und scheint ein wichtiger Ansatz, um die Pathophysiologie des M. Parkinson genauer zu verstehen. Die Hautbiopsie k{\"o}nnte dabei von Vorteil sein, da sich Pathologien in vivo untersuchen lassen und man nicht auf Ergebnisse von Autopsien angewiesen ist.}, subject = {Parkinson-Krankheit}, language = {de} } @article{IsaiasTrujilloSummersetal.2016, author = {Isaias, Ioannis U. and Trujillo, Paula and Summers, Paul and Marotta, Giorgio and Mainardi, Luca and Pezzoli, Gianni and Zecca, Luigi and Costa, Antonella}, title = {Neuromelanin Imaging and Dopaminergic Loss in Parkinson's Disease}, series = {Frontiers in Aging Neuroscience}, volume = {8}, journal = {Frontiers in Aging Neuroscience}, number = {196}, doi = {10.3389/fnagi.2016.00196}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-164046}, year = {2016}, abstract = {Parkinson's disease (PD) is a progressive neurodegenerative disorder in which the major pathologic substrate is a loss of dopaminergic neurons from the substantia nigra. Our main objective was to determine the correspondence between changes in the substantia nigra, evident in neuromelanin and iron sensitive magnetic resonance imaging (MRI), and dopaminergic striatal innervation loss in patients with PD. Eighteen patients and 18 healthy control subjects were included in the study. Using neuromelanin-MRI, we measured the volume of the substantia nigra and the contrast-to-noise-ratio between substantia nigra and a background region. The apparent transverse relaxation rate and magnetic susceptibility of the substantia nigra were calculated from dual-echo MRI. Striatal dopaminergic innervation was measured as density of dopamine transporter (DAT) by means of single-photon emission computed tomography and [123I] N-ω-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl) tropane. Patients showed a reduced volume of the substantia nigra and contrast-to-noise-ratio and both positively correlated with the corresponding striatal DAT density. The apparent transverse relaxation rate and magnetic susceptibility values of the substantia nigra did not differ between patients and healthy controls. The best predictor of DAT reduction was the volume of the substantia nigra. Clinical and imaging correlations were also investigated for the locus coeruleus. Our results suggest that neuromelanin-MRI can be used for quantifying substantia nigra pathology in PD where it closely correlates with dopaminergic striatal innervation loss. Longitudinal studies should further explore the role of Neuromelanin-MRI as an imaging biomarker of PD, especially for subjects at risk of developing the disease.}, language = {en} } @phdthesis{Musacchio2017, author = {Musacchio, Thomas Giuseppe}, title = {ALS und MMN mimics bei Patienten mit BSCL2 Mutationen - eine Erweiterung des klinischen Spektrums der heredit{\"a}ren Spinalparalyse SPG17}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-154224}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {Die heredit{\"a}re Spinalparalyse SPG17 ist eine autosomal-dominant vererbte Motoneuronerkrankung, welche durch Mutationen im BSCL2 (Seipin) Gen verursacht wird. Klassischerweise {\"a}ußert sich die Krankheit durch eine spastische Paraparese der Beine und Amyotrophie der H{\"a}nde (Silver-Syndrom) oder eine vorwiegend periphere (senso-)motorische Neuropathie. F{\"u}r die vorliegende Arbeit wurden insgesamt sieben Patienten aus vier verschiedenen Familien, bei denen heterozygote Mutationen im BSCL2 Gen nachgewiesen werden konnten, klinisch sowie elektrophysiologisch und molekulargenetisch untersucht. Es gelang hierbei zwei bisher unbekannte ph{\"a}notypische Auspr{\"a}gungen zu beschreiben, welche die Symptomatik und den Verlauf einer Multifokalen Motorischen Neuropathie (MMN) bzw. einer Amyotrophen Lateralsklerose (ALS) imitieren und hiervon nur durch den genetischen Befund zu unterscheiden sind. Anhand dieser Ergebnisse erfolgte dann nach extensiver Literaturrecherche eine Zusammenfassung aller bisher publizierten F{\"a}lle der SPG17 und eine Einordnung der hier erstbeschriebenen Ph{\"a}notypen in einen Vorschlag zur Erweiterung des bisher verwendeten Klassifikationssystems von BSCL 2 Mutationen.}, subject = {Heredit{\"a}re spastische Spinalparalyse}, language = {de} } @phdthesis{Schubert2017, author = {Schubert, Anna-Lena}, title = {Untersuchung potenzieller Biomarker in Haut- und Nervenbiopsaten von Patienten mit schmerzhaften und schmerzlosen Polyneuropathien}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-153254}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {Polyneuropathien sind eine {\"a}tiologisch heterogene Erkrankung des peripheren Nervensystems. In bis zu 30\% der F{\"a}lle ist eine Zuordnung zu einem bestimmten PNP Subtyp auch nach aufw{\"a}ndiger und zum Teil invasiver Diagnostik nicht m{\"o}glich. Bislang fehlt ein diagnostischer Biomarker bei PNP, der z.B. bei der Unterscheidung zwischen einzelnen diagnostischen Subgruppen oder entz{\"u}ndlichen und nicht-entz{\"u}ndlichen Erkrankungsformen helfen k{\"o}nnte. In einer prospektiven Studie mit insgesamt 97 Patienten mit Neuropathien verschiedenster {\"A}tiologie und 17 gesunden Kontrollpersonen erstellten wir Genexpressionsprofile von inflammatorischen Markern und Markern der Regeneration peripherer Nerven in Haut- und N. suralis-Biopsaten. Es wurden Inflammationsmarker (TAC1, CRMP2, AIF1, IL-6) und Marker, die in die Regeneration peripherer Nerven involviert sind (SCD, Netrin-1, DCC, UNC5H2, NEO1, Netrin-G1, Netrin-G2), mittels qRT-PCR untersucht. Alle Patienten erhielten eine N. suralis-Biopsie und/oder eine Hautbiopsie von Ober- beziehungsweise Unterschenkel. Weder in den Haut- noch in den N. suralis-Biopsaten konnten Unterschiede in der Genexpression dieser Marker zwischen einzelnen diagnostischen Subgruppen gefunden werden. Der Inflammationsmarker AIF1 war jedoch in Patienten-Hautproben sowohl proximal als auch distal h{\"o}her exprimiert als bei gesunden Kontrollpersonen (p < 0,05 bzw. p < 0,01). Zudem fand sich in den Hautproben von PNP-Patienten eine deutlich reduzierte Genexpression von Regenerationsmarkern aus der Netrin-Familie verglichen mit den Hautproben gesunder Probanden (Netrin-1, DCC, UNC5H2, NEO1 sowie Netrin-G1 und G2; p < 0,05 bis p < 0,001). Ferner wies Netrin-1 in distalen Hautproben bei Patienten mit einer entz{\"u}ndlichen PNP eine niedrigere Genexpression auf, als bei Patienten mit einer nicht-entz{\"u}ndlichen Erkrankungsform (p < 0,05). Die Genexpression von NEO1 in distalen Hautproben war bei schmerzloser PNP und gesunden Kontrollpersonen h{\"o}her als bei schmerzhafter PNP (p < 0,05). Sowohl eine Erh{\"o}hung bestimmter Inflammationsmarker als auch eine Verminderung von Regenerationsmarkern peripherer Nerven k{\"o}nnen bei der Pathophysiologie von Polyneuropathien involviert sein. Insbesondere Mitglieder der Netrin-Familie scheinen eine komplexe Rolle f{\"u}r das Axonwachstum, jedoch auch f{\"u}r entz{\"u}ndliche Prozesse zu spielen.}, subject = {Biomarker}, language = {de} } @phdthesis{Cheong2018, author = {Cheong, David}, title = {Stereologische Untersuchung der Gesamtanzahl dopaminerger Neurone in der Substantia Nigra von C57BL/6 M{\"a}usen unter Benutzung des „optical fractionator" und einer Standard-Mikroskopieausr{\"u}stung}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-162753}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {In pre-clinical Parkinson's disease research, analysis of the nigrostriatal tract, including quantification of dopaminergic neuron loss within the substantia nigra, is essential. To estimate the total dopaminergic neuron number, unbiased stereology using the optical fractionator method is currently considered the gold standard. Because the theory behind the optical fractionator method is complex and because stereology is difficult to achieve without specialized equipment, several commercially available complete stereology systems that include the necessary software do exist, purely for cell counting reasons. Since purchasing a specialized stereology setup is not always feasible, for many reasons, this report describes a method for the stereological estimation of dopaminergic neuronal cell counts using standard microscopy equipment, including a light microscope, a motorized object table (x, y, z plane) with imaging software, and a computer for analysis. A step-by-step explanation is given on how to perform stereological quantification using the optical fractionator method, and pre-programmed files for the calculation of estimated cell counts are provided. To assess the accuracy of this method, a comparison to data obtained from a commercially available stereology apparatus was performed. Comparable cell numbers were found using this protocol and the stereology device, thus demonstrating the precision of this protocol for unbiased stereology. Source: Ip, C. W., Cheong, D., Volkmann, J. Stereological Estimation of Dopaminergic Neuron Number in the Mouse Substantia Nigra Using the Optical Fractionator and Standard Microscopy Equipment. J. Vis. Exp. (127), e56103, doi:10.3791/56103 (2017)}, subject = {Stereologie}, language = {de} } @phdthesis{Papagianni2018, author = {Papagianni, Aikaterini}, title = {Schmerz-assoziierte elektrisch evozierte Potentiale (PREP) bei Patienten mit neuropathischen Schmerzsyndromen}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159728}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {In der vorliegenden Studie wurden 32 Patienten (19 Frauen, 13 M{\"a}nner, medianes Alter 50 Jahren, Spanne: 26-83 Jahre) mit einem klinisch akralen neuropathischen Schmerzsyndrom unterschiedlicher Genese mittels QST, PREP und Hautbiopsie untersucht. Unser Patientenkollektiv bestand aus drei Subgruppen: sechsen Patienten erf{\"u}llten die Kriterien einer SFN, acht Patienten hatten eine Neuropathie der großkalibrigen Nervenfasern mit zus{\"a}tzlicher Beeintr{\"a}chtigung der kleinkalibrigen Nervenfasern und weitere acht Patienten hatten ein akrales Schmerzsyndrom mit neuropathischen Charakteristika, ohne vorbekannte Diagnose einer Neuropathie der groß- oder kleinkalibrigen Nervenfasern. Die Patienten wurden mittels klinischer neurologischer Untersuchung, elektrophysiologischer Tests, QST, PREP und Hautbiopsie untersucht. Die Patientendaten wurden jeweils mit Daten großer Kontrollgruppen verglichen, die wir in unserer Klinik unter Angeh{\"o}rigen und Freunden unserer Patienten mit deren Einwilligung rekrutiert hatten. QST und die Hautbiopsie waren bei Patienten mit SFN und PNP jeweils auff{\"a}llig, bei akralem Schmerzsyndrom unklarer {\"A}tiologie hingegen unauff{\"a}llig. Nach elektrischer kutaner Stimulation aller drei K{\"o}rperregionen zeigte sich eine Amplitudenminderung der PREP-Reizantwort in allen Patientensubgruppen (7,5 µV in der SFN-Gruppe, 3,8 µV in der PNP-Gruppe, und 11,3 µV bei den Patienten mit akralem Schmerzsyndrom). Somit konnten wir zeigen, dass eine Kleinfaserpathologie in der Studienpopulation von Patienten mit neuropathischem Schmerzsyndrom besteht. Nur die Amplitudenminderung der PREP bildet diese Pathologie ab. Diese Daten erlauben uns die eingangs aufgestellte Hypothese, dass PREP zur Diagnostik bei Frage nach Kleinfaserbeteiligung geeignet ist, positiv zu belegen. PREP ist eine nicht-invasive Methode f{\"u}r die Evaluation der Funktion v.a. der Aδ-Faser mit standardisiertem Ablaufprotokoll zur Erhebung von reproduzierbaren Daten. Sie kann bei Patienten mit der Anamnese eines akralen neuropathischen Schmerzsyndroms einen objektiven Hinweis auf eine Dysfunktion der kleinkalibrigen Nervenfasern, auch wenn bereits etablierte Methoden (QST und Hautbiopsie) unauff{\"a}llig bleiben, erbringen. Entsprechend k{\"o}nnen die PREP eine wertvolle Erg{\"a}nzung der klinischen Untersuchungsbatterie f{\"u}r die Evaluation der Funktion der kleinkalibrigen Nervenfasern sein.}, subject = {PREP}, language = {de} } @phdthesis{Schroeter2018, author = {Schr{\"o}ter, Nils}, title = {Diagnostische Wertigkeit von Gb3-Ablagerungen in der Haut von Patienten mit M. Fabry}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-160552}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {In der vorliegenden Arbeit wurde gepr{\"u}ft, ob Gb3 in Hautstanzbiopsien von Patienten mit M. Fabry nachweisbar ist, die Ablagerungen quantifizierbar sind, mit der Krankheitsschwere korrelieren, und ob eine Unterscheidung von Patienten und gesunden Kontrollen anhand der dermalen Gb3-Ablagerungen m{\"o}glich ist. Es wurden 84 Patienten mit M. Fabry {\"u}ber das FAZiT sowie 27 gesunde Kontrollen zwischen 2008 und 2013 prospektiv rekrutiert und jeweils eine proximale und eine distale Hautbiopsie entnommen. Zus{\"a}tzlich erfolgten eine Anamnese, eine klinische Untersuchung, eine QST, das Ausf{\"u}llen von Frageb{\"o}gen mit der Fragestellung nach Schmerz und Depression sowie eine Blutentnahme und kardiale Diagnostik. Die Immunfluoreszenz erfolgte mit Antik{\"o}rpern gegen CD77, einem Marker f{\"u}r Gb3. Es erfolgte die verblindete, semiautomatische Quantifizierung der Gb3 Ablagerungen. Hierzu wurden pro Biopsie drei ROI ausgew{\"a}hlt und die Fl{\"a}che der ROIs mit Gb3-Ablagerungen in Relation zu der Gesamtfl{\"a}che der ROIs gesetzt. F{\"u}r die Auswertung wurden die Patienten sowohl nach Geschlecht als auch nach Krankheitsschwere und einzelnen Symptomen stratifiziert Die Gb3 Ablagerungen ließen sich bevorzugt in Schweißdr{\"u}sen und Endothel nachweisen. Es fanden sich jedoch auch gr{\"o}ßere Mengen an Gb3-Ablagerungen ohne ersichtliches anatomischer Korrelat. Die Gb3-Ablagerungen wurden semiautomatisch quantifiziert. Es konnte nachgewiesen werden, dass m{\"a}nnliche Fabry-Patienten eine deutlich gr{\"o}ßere Menge an Gb3 in den distalen Hautbiopsien zeigen als gesunde Kontrollen, Patienten mit einer eingeschr{\"a}nkten Nierenfunktion hatten eine gr{\"o}ßere Menge an Gb3-Ablagerungen in der Haut als Patienten mit einer uneingeschr{\"a}nkten Nierenfunktion. Bei Patienten mit einer SFN waren erh{\"o}hte dermale Gb3 Mengen vorhanden im Vergleich zu gesunden Kontrollen, bei Patienten ohne eine SFN fand sich dieser Unterschied nicht. Patienten mit einem niedrigen SNAP zeigten im Vergleich zu gesunden Kontrollen eine gr{\"o}ßere Menge an Gb3 in ihrer distalen Haut, bei Patienten mit einem h{\"o}heren SNAP fand sich dies nicht. Aus diesen Ergebnissen ergeben sich ein m{\"o}gliches weiteres Werkzeug sowohl f{\"u}r die Diagnosestellung als auch f{\"u}r das Monitoring der Erkrankung, sowie weiterf{\"u}hrend auch ein m{\"o}glicher Indikator f{\"u}r den Therapieerfolg der ERT.}, subject = {Fabry-Krankheit}, language = {de} } @article{JariusRuprechtKleiteretal.2016, author = {Jarius, Sven and Ruprecht, Klemens and Kleiter, Ingo and Borisow, Nadja and Asgari, Nasrin and Pitarokoili, Kalliopi and Pache, Florence and Stich, Oliver and Beume, Lena-Alexandra and H{\"u}mmert, Martin W. and Ringelstein, Marius and Trebst, Corinna and Winkelmann, Alexander and Schwarz, Alexander and Buttmann, Mathias and Zimmermann, Hanna and Kuchling, Joseph and Franciotta, Diego and Capobianco, Marco and Siebert, Eberhard and Lukas, Carsten and Korporal-Kuhnke, Mirjam and Haas, J{\"u}rgen and Fechner, Kai and Brandt, Alexander U. and Schanda, Kathrin and Aktas, Orhan and Paul, Friedemann and Reindl, Markus and Wildemann, Brigitte}, title = {MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome}, series = {Journal of Neuroinflammation}, volume = {13}, journal = {Journal of Neuroinflammation}, number = {280}, doi = {10.1186/s12974-016-0718-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-165570}, year = {2016}, abstract = {Background A subset of patients with neuromyelitis optica spectrum disorders (NMOSD) has been shown to be seropositive for myelin oligodendrocyte glycoprotein antibodies (MOG-IgG). Objective To describe the epidemiological, clinical, radiological, cerebrospinal fluid (CSF), and electrophysiological features of a large cohort of MOG-IgG-positive patients with optic neuritis (ON) and/or myelitis (n = 50) as well as attack and long-term treatment outcomes. Methods Retrospective multicenter study. Results The sex ratio was 1:2.8 (m:f). Median age at onset was 31 years (range 6-70). The disease followed a multiphasic course in 80\% (median time-to-first-relapse 5 months; annualized relapse rate 0.92) and resulted in significant disability in 40\% (mean follow-up 75 ± 46.5 months), with severe visual impairment or functional blindness (36\%) and markedly impaired ambulation due to paresis or ataxia (25\%) as the most common long-term sequelae. Functional blindness in one or both eyes was noted during at least one ON attack in around 70\%. Perioptic enhancement was present in several patients. Besides acute tetra-/paraparesis, dysesthesia and pain were common in acute myelitis (70\%). Longitudinally extensive spinal cord lesions were frequent, but short lesions occurred at least once in 44\%. Fourty-one percent had a history of simultaneous ON and myelitis. Clinical or radiological involvement of the brain, brainstem, or cerebellum was present in 50\%; extra-opticospinal symptoms included intractable nausea and vomiting and respiratory insufficiency (fatal in one). CSF pleocytosis (partly neutrophilic) was present in 70\%, oligoclonal bands in only 13\%, and blood-CSF-barrier dysfunction in 32\%. Intravenous methylprednisolone (IVMP) and long-term immunosuppression were often effective; however, treatment failure leading to rapid accumulation of disability was noted in many patients as well as flare-ups after steroid withdrawal. Full recovery was achieved by plasma exchange in some cases, including after IVMP failure. Breakthrough attacks under azathioprine were linked to the drug-specific latency period and a lack of cotreatment with oral steroids. Methotrexate was effective in 5/6 patients. Interferon-beta was associated with ongoing or increasing disease activity. Rituximab and ofatumumab were effective in some patients. However, treatment with rituximab was followed by early relapses in several cases; end-of-dose relapses occurred 9-12 months after the first infusion. Coexisting autoimmunity was rare (9\%). Wingerchuk's 2006 and 2015 criteria for NMO(SD) and Barkhof and McDonald criteria for multiple sclerosis (MS) were met by 28\%, 32\%, 15\%, 33\%, respectively; MS had been suspected in 36\%. Disease onset or relapses were preceded by infection, vaccination, or pregnancy/delivery in several cases. Conclusion Our findings from a predominantly Caucasian cohort strongly argue against the concept of MOG-IgG denoting a mild and usually monophasic variant of NMOSD. The predominantly relapsing and often severe disease course and the short median time to second attack support the use of prophylactic long-term treatments in patients with MOG-IgG-positive ON and/or myelitis.}, language = {en} } @article{JariusRuprechtKleiteretal.2016, author = {Jarius, Sven and Ruprecht, Klemens and Kleiter, Ingo and Borisow, Nadja and Asgari, Nasrin and Pitarokoili, Kalliopi and Pache, Florence and Stich, Oliver and Beume, Lena-Alexandra and H{\"u}mmert, Martin W. and Trebst, Corinna and Ringelstein, Marius and Aktas, Orhan and Winkelmann, Alexander and Buttmann, Mathias and Schwarz, Alexander and Zimmermann, Hanna and Brandt, Alexander U. and Franciotta, Diego and Capobianco, Marco and Kuchling, Joseph and Haas, J{\"u}rgen and Korporal-Kuhnke, Mirjam and Lillevang, Soeren Thue and Fechner, Kai and Schanda, Kathrin and Paul, Friedemann and Wildemann, Brigitte and Reindl, Markus}, title = {MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 1: Frequency, syndrome specificity, influence of disease activity, long-term course, association with AQP4-IgG, and origin}, series = {Journal of Neuroinflammation}, volume = {13}, journal = {Journal of Neuroinflammation}, number = {279}, doi = {10.1186/s12974-016-0717-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-165659}, pages = {1-16}, year = {2016}, abstract = {Background Antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) have been suggested to play a role in a subset of patients with neuromyelitis optica and related disorders. Objective To assess (i) the frequency of MOG-IgG in a large and predominantly Caucasian cohort of patients with optic neuritis (ON) and/or myelitis; (ii) the frequency of MOG-IgG among AQP4-IgG-positive patients and vice versa; (iii) the origin and frequency of MOG-IgG in the cerebrospinal fluid (CSF); (iv) the presence of MOG-IgG at disease onset; and (v) the influence of disease activity and treatment status on MOG-IgG titers. Methods 614 serum samples from patients with ON and/or myelitis and from controls, including 92 follow-up samples from 55 subjects, and 18 CSF samples were tested for MOG-IgG using a live cell-based assay (CBA) employing full-length human MOG-transfected HEK293A cells. Results MOG-IgG was detected in 95 sera from 50 patients with ON and/or myelitis, including 22/54 (40.7\%) patients with a history of both ON and myelitis, 22/103 (21.4\%) with a history of ON but no myelitis and 6/45 (13.3\%) with a history of longitudinally extensive transverse myelitis but no ON, and in 1 control patient with encephalitis and a connective tissue disorder, all of whom were negative for AQP4-IgG. MOG-IgG was absent in 221 further controls, including 83 patients with AQP4-IgG-seropositive neuromyelitis optica spectrum disorders and 85 with multiple sclerosis (MS). MOG-IgG was found in 12/18 (67\%) CSF samples from MOG-IgG-seropositive patients; the MOG-IgG-specific antibody index was negative in all cases, indicating a predominantly peripheral origin of CSF MOG-IgG. Serum and CSF MOG-IgG belonged to the complement-activating IgG1 subclass. MOG-IgG was present already at disease onset. The antibodies remained detectable in 40/45 (89\%) follow-up samples obtained over a median period of 16.5 months (range 0-123). Serum titers were higher during attacks than during remission (p < 0.0001), highest during attacks of simultaneous myelitis and ON, lowest during acute isolated ON, and declined following treatment. Conclusions To date, this is the largest cohort studied for IgG to human full-length MOG by means of an up-to-date CBA. MOG-IgG is present in a substantial subset of patients with ON and/or myelitis, but not in classical MS. Co-existence of MOG-IgG and AQP4-IgG is highly uncommon. CSF MOG-IgG is of extrathecal origin. Serum MOG-IgG is present already at disease onset and remains detectable in the long-term course. Serum titers depend on disease activity and treatment status.}, language = {en} } @article{ContarinoSmitvandenDooletal.2016, author = {Contarino, Maria Fiorella and Smit, Marenka and van den Dool, Joost and Volkmann, Jens and Tijssen, Marina A. J.}, title = {Unmet Needs in the Management of Cervical Dystonia}, series = {Frontiers in Neurology}, volume = {7}, journal = {Frontiers in Neurology}, number = {165}, doi = {10.3389/fneur.2016.00165}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-165225}, year = {2016}, abstract = {Cervical dystonia (CD) is a movement disorder which affects daily living of many patients. In clinical practice, several unmet treatment needs remain open. This article focuses on the four main aspects of treatment. We describe existing and emerging treatment approaches for CD, including botulinum toxin injections, surgical therapy, management of non-motor symptoms, and rehabilitation strategies. The unsolved issues regarding each of these treatments are identified and discussed, and possible future approaches and research lines are proposed.}, language = {en} } @article{UeceylerBikoHoseetal.2016, author = {{\"U}{\c{c}}eyler, Nurcan and Biko, Lydia and Hose, Dorothea and Hoffmann, Lukas and Sommer, Claudia}, title = {Comprehensive and differential long-term characterization of the alpha-galactosidase A deficient mouse model of Fabry disease focusing on the sensory system and pain development}, series = {Molecular Pain}, volume = {12}, journal = {Molecular Pain}, number = {1744806916646370}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-147562}, year = {2016}, abstract = {Fabry disease is an X-linked lysosomal storage disorder due to impaired activity of alpha-galactosidase A with intracellular accumulation of globotriaosylceramide. Associated small fiber pathology leads to characteristic pain in Fabry disease. We systematically assessed sensory system, physical activity, metabolic parameters, and morphology of male and female mice with alpha-galactosidase A deficiency (Fabry ko) from 2 to 27 months of age and compared results with those of age- and gender-matched wild-type littermates of C57Bl/6J background. Results From the age of two months, male and female Fabry mice showed mechanical hypersensitivity (p < 0.001 each) compared to wild-type littermates. Young Fabry ko mice of both genders were hypersensitive to heat stimulation (p < 0.01) and developed heat hyposensitivity with aging (p < 0.05), while cold hyposensitivity was present constantly in young (p < 0.01) and old (p < 0.05) Fabry ko mice compared to wild-type littermates. Stride angle increased only in male Fabry ko mice with aging (p < 0.01) in comparison to wild-type littermates. Except for young female mice, male (p < 0.05) and female (p < 0.01) Fabry ko mice had a higher body weight than wild-type littermates. Old male Fabry ko mice were physically less active than their wild-type littermates (p < 0.05), had lower chow intake (p < 0.001), and lost more weight (p < 0.001) in a one-week treadmill experiment than wild-type littermates. Also, Fabry ko mice showed spontaneous pain protective behavior and developed orofacial dysmorphism resembling patients with Fabry disease. Conclusions. Mice with alpha-galactosidase A deficiency show age-dependent and distinct deficits of the sensory system. alpha-galactosidase A-deficient mice seem to model human Fabry disease and may be helpful when studying the pathophysiology of Fabry-associated pain.}, language = {en} } @article{WestermaierLinsenmannHomolaetal.2016, author = {Westermaier, Thomas and Linsenmann, Thomas and Homola, Gy{\"o}rgy A. and Loehr, Mario and Stetter, Christian and Willner, Nadine and Ernestus, Ralf-Ingo and Soymosi, Laszlo and Vince, Giles H.}, title = {3D rotational fluoroscopy for intraoperative clip control in patients with intracranial aneurysms - assessment of feasibility and image quality}, series = {BMC Medical Imaging}, volume = {16}, journal = {BMC Medical Imaging}, number = {30}, doi = {10.1186/s12880-016-0133-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-146381}, year = {2016}, abstract = {Background Mobile 3D fluoroscopes have become increasingly available in neurosurgical operating rooms. In this series, the image quality and value of intraoperative 3D fluoroscopy with intravenous contrast agent for the evaluation of aneurysm occlusion and vessel patency after clip placement was assessed in patients who underwent surgery for intracranial aneurysms. Materials and methods Twelve patients were included in this retrospective analysis. Prior to surgery, a 360° rotational fluoroscopy scan was performed without contrast agent followed by another scan with 50 ml of intravenous iodine contrast agent. The image files of both scans were transferred to an Apple PowerMac® workstation, subtracted and reconstructed using OsiriX® free software. The procedure was repeated after clip placement. Both image sets were compared for assessment of aneurysm occlusion and vessel patency. Results Image acquisition and contrast administration caused no adverse effects. Image quality was sufficient to follow the patency of the vessels distal to the clip. Metal artifacts reduce the assessability of the immediate vicinity of the clip. Precise image subtraction and post-processing can reduce metal artifacts and make the clip-site assessable and depict larger neck-remnants. Conclusion This technique quickly supplies images at adequate quality to evaluate distal vessel patency after aneurysm clipping. Significant aneurysm remnants may be depicted as well. As it does not require visual control of all vessels that are supposed to be evaluated intraoperatively, this technique may be complementary to other intraoperative tools like indocyanine green videoangiography and micro-Doppler, especially for the assessment of larger aneurysms. At the momentary state of this technology, it cannot replace postoperative conventional angiography. However, 3D fluoroscopy and image post-processing are young technologies. Further technical developments are likely to result in improved image quality.}, language = {en} } @article{WolfBraunHainingetal.2016, author = {Wolf, Karen and Braun, Attila and Haining, Elizabeth J. and Tseng, Yu-Lun and Kraft, Peter and Schuhmann, Michael K. and Gotru, Sanjeev K. and Chen, Wenchun and Hermanns, Heike M. and Stoll, Guido and Lesch, Klaus-Peter and Nieswandt, Bernhard}, title = {Partially Defective Store Operated Calcium Entry and Hem(ITAM) Signaling in Platelets of Serotonin Transporter Deficient Mice}, series = {PLoS One}, volume = {11}, journal = {PLoS One}, number = {1}, doi = {10.1371/journal.pone.0147664}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-146399}, pages = {e0147664}, year = {2016}, abstract = {Background Serotonin (5-hydroxytryptamin, 5-HT) is an indolamine platelet agonist, biochemically derived from tryptophan. 5-HT is secreted from the enterochromaffin cells into the gastrointestinal tract and blood. Blood 5-HT has been proposed to regulate hemostasis by acting as a vasoconstrictor and by triggering platelet signaling through 5-HT receptor 2A (5HTR2A). Although platelets do not synthetize 5-HT, they take 5-HT up from the blood and store it in their dense granules which are secreted upon platelet activation. Objective To identify the molecular composite of the 5-HT uptake system in platelets and elucidate the role of platelet released 5-HT in thrombosis and ischemic stroke. Methods: 5-HT transporter knockout mice (5Htt\(^{-/-}\)) were analyzed in different in vitro and in vivo assays and in a model of ischemic stroke. Results In 5Htt\(^{-/-}\) platelets, 5-HT uptake from the blood was completely abolished and agonist-induced Ca2+ influx through store operated Ca\(^{2+}\) entry (SOCE), integrin activation, degranulation and aggregation responses to glycoprotein VI (GPVI) and C-type lectin-like receptor 2 (CLEC-2) were reduced. These observed in vitro defects in 5Htt\(^{-/-}\) platelets could be normalized by the addition of exogenous 5-HT. Moreover, reduced 5-HT levels in the plasma, an increased bleeding time and the formation of unstable thrombi were observed ex vivo under flow and in vivo in the abdominal aorta and carotid artery of 5Htt\(^{-/-}\) mice. Surprisingly, in the transient middle cerebral artery occlusion (tMCAO) model of ischemic stroke 5Htt\(^{-/-}\) mice showed nearly normal infarct volume and the neurological outcome was comparable to control mice. Conclusion Although secreted platelet 5-HT does not appear to play a crucial role in the development of reperfusion injury after stroke, it is essential to amplify the second phase of platelet activation through SOCE and plays an important role in thrombus stabilization.}, language = {en} } @article{PhamHelluyKleinschnitzetal.2011, author = {Pham, Mirko and Helluy, Xavier and Kleinschnitz, Christoph and Kraft, Peter and Bartsch, Andreas J. and Jakob, Peter and Nieswandt, Bernhard and Bendszus, Martin and Guido, Stoll}, title = {Sustained Reperfusion after Blockade of Glycoprotein-Receptor-Ib in Focal Cerebral Ischemia: An MRI Study at 17.6 Tesla}, series = {PLoS ONE}, volume = {6}, journal = {PLoS ONE}, number = {4}, doi = {10.1371/journal.pone.0018386}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-142608}, pages = {e18386}, year = {2011}, abstract = {Background: Inhibition of early platelet adhesion by blockade of glycoprotein-IB (GPIb) protects mice from ischemic stroke. To elucidate underlying mechanisms in-vivo, infarct development was followed by ultra-high field MRI at 17.6 Tesla. Methods: Cerebral infarction was induced by transient-middle-cerebral-artery-occlusion (tMCAO) for 1 hour in C57/BL6 control mice (N = 10) and mice treated with 100 mg Fab-fragments of the GPIb blocking antibody p0p/B 1 h after tMCAO (N = 10). To control for the effect of reperfusion, additional mice underwent permanent occlusion and received anti-GPIb treatment (N = 6; pMCAO) or remained without treatment (N = 3; pMCAO). MRI 2 h and 24 h after MCAO measured cerebral-blood-flow (CBF) by continuous arterial-spin labelling, the apparent-diffusion-coefficient (ADC), quantitative-T2 and T2-weighted imaging. All images were registered to a standard mouse brain MRI atlas and statistically analysed voxel-wise, and by cortico-subcortical ROI analysis. Results: Anti-GPIb treatment led to a relative increase of postischemic CBF vs. controls in the cortical territory of the MCA (2 h: 44.2 +/- 6.9 ml/100g/min versus 24 h: 60.5 +/- 8.4; p = 0.0012, F((1,18)) = 14.63) after tMCAO. Subcortical CBF 2 h after tMCAO was higher in anti-GPIb treated animals (45.3 +/- 5.9 vs. controls: 33.6 +/- 4.3; p = 0.04). In both regions, CBF findings were clearly related to a lower probability of infarction (Cortex/Subcortex of treated group: 35\%/65\% vs. controls: 95\%/100\%) and improved quantitative-T2 and ADC. After pMCAO, anti-GPIb treated mice developed similar infarcts preceded by severe irreversible hypoperfusion as controls after tMCAO indicating dependency of stroke protection on reperfusion. Conclusion: Blockade of platelet adhesion by anti-GPIb-Fab-fragments results in substantially improved CBF early during reperfusion. This finding was in exact spatial correspondence with the prevention of cerebral infarction and indicates in-vivo an increased patency of the microcirculation. Thus, progression of infarction during early ischemia and reperfusion can be mitigated by anti-platelet treatment.}, language = {en} } @article{KleinschnitzNiemczykRehbergWeberetal.2015, author = {Kleinschnitz, Christoph and Niemczyk, Gabriele and Rehberg-Weber, Karin and Wernsd{\"o}rfer, Colin}, title = {Interferon Beta-1a (AVONEX®) as a treatment option for untreated patients with multiple sclerosis (AXIOM): a prospective, observational study}, series = {International Journal of Molecular Sciences}, volume = {16}, journal = {International Journal of Molecular Sciences}, doi = {10.3390/ijms160715271}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-148487}, pages = {15271-15286}, year = {2015}, abstract = {The efficacy and safety of first-line disease-modifying therapies (DMT) for relapsing-remitting multiple sclerosis (RRMS) has been demonstrated in pivotal, randomized trials, but these studies do not reflect the routine care setting where treatment gaps or switches are common. The Avonex as Treatment Option for Untreated MS Patients (AXIOM) trial assessed the efficacy of newly-initiated intramuscular interferon beta-1a (IM IFNb-1a) after a treatment-free interval, with particular consideration of the previous course of disease and therapy. The AXIOM trial was an open, 12-month, observational, non-interventional study with a retrospective and a prospective part conducted in Germany. RRMS patients with a treatment-free interval of at least three months were included and treated with IFNb-1a for up to 12 months. Relapse rate, disability progression, injection-related parameters and quality of life observed during the prospective part were compared with retrospectively-collected data. Two hundred and thirty five RRMS patients participated in AXIOM. The mean relapse rate decreased from 1.1 in the three months before baseline to 0.2 per quarter during the twelve-month observational period; the Multiple Sclerosis Functional Composite score improved during twelve months of IM IFNb-1a treatment, while the Expanded Disability Status Scale score did not change over the course of this study. Compared to previous DMTs (IM IFNb-1a, subcutaneous IFNb-1a (SC IFNb-1a), SC IFNb-1b, glatiramer acetate), the patients experienced less injection site reactions and flu-like symptoms, with a stated improved quality of life. IM IFNb-1a was effective and well accepted in RRMS patients with no or discontinued previous therapy. These results from the routine care setting may inform optimization of DMT treatment in RRMS, but need confirmation in further studies.}, language = {en} } @phdthesis{Nuth2017, author = {Nuth, Linda}, title = {Niederfrequente, Tiefe Hirnstimulation bei Parkinson-Patienten mit ON-Freezing. Identifikation von Respondern anhand kinematischer Gangparameter}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-150317}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {Das ON-Freezing ist ein seltenes, aber generell extrem schwer zu therapierendes Ph{\"a}nomen. Es betrifft Parkinson-Patienten mit und ohne THS. Die derzeitige Literaturlage spiegelt wider, dass es unterschiedliche Strategien gibt, diesem Ph{\"a}nomen zu begegnen. Ein allgemeing{\"u}ltiges Therapiekonzept existiert dabei nicht. F{\"u}r einige Patienten mit STN-THS konnte durch eine Reduktion der Stimulationsfrequenz eine Besserung der Gangst{\"o}rung erzielt werden. Andere profitierten vom Einsatz sogenannter Interleaving-Protokolle mit gleichzeitiger Stimulation der Substantia nigra (Sn). Im Vergleich zu anderen Arbeiten, die keine vorhersagbaren Parameter gefunden oder sich auf Symptome, Auspr{\"a}gung der Subtypen und Erkrankungsdauer oder den Zeitpunkt der Erkrankung konzentriert haben, verfolgten wir die Absicht, die Effekte der LF-Stim des STN auf Parkinson-Patienten mit Gangst{\"o}rung und Freezing-Ph{\"a}nomen zu untersuchen und herauszufinden, ob man Gangparameter identifizieren kann, an Hand derer man das Ansprechen auf eine LF-Stim vorhersagen kann. Unter der Einschr{\"a}nkung, dass die Zahl der Probanden unserer Studie sehr gering ist, haben wir herausgefunden, dass diejenigen Patienten besser auf eine LF-Stim ansprechen, die unter der Standard-HF-Stim eine signifikant h{\"o}here Ganggeschwindigkeit und eine gr{\"o}ßere Schrittl{\"a}nge aufzeigen und nur ein intermittierendes Freezing haben. Dar{\"u}ber hinaus zeigte sich ein besseres Ansprechen der LF-Stim bei Parkinson-Patienten mit akinetisch-rigidem Parkinson-Ph{\"a}notyp. Unsere Ergebnisse best{\"a}tigen die Annahme, dass sich L-Dopa additiv zur Stimulationstherapie bei manchen Parkinson-Patienten zus{\"a}tzlich positiv auf die motorischen PD-Symptome auswirken kann. In Bezug auf die Verbesserung der Gangparameter zeigte sich in unseren Ergebnissen allerdings, dass L-Dopa eher eine untergeordnete Rolle spielt. Aufgrund der niedrigen Anzahl von Respondern in unserer Studie l{\"a}sst sich daher sicherlich noch keine allgemeing{\"u}ltige Regel ableiten. Es bedarf letztlich weiterer Studien mit gr{\"o}ßeren Untersuchungszahlen, um unsere Thesen zu st{\"u}tzen und abzusichern. In jedem Fall wird aber das ON-Freezing auch weiterhin eine therapeutische Herausforderung bleiben.}, subject = {Parkinson}, language = {de} } @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} } @article{QuartaVoglConstantinetal.2011, author = {Quarta, Serena and Vogl, Christian and Constantin, Cristina E. and {\"U}{\c{c}}eyler, Nurcan and Sommer, Claudia and Kress, Michaela}, title = {Genetic evidence for an essential role of neuronally expressed IL-6 signal transducer gp130 in the induction and maintenance of experimentally induced mechanical hypersensitivity \(in\) \(vivo\) and \(in\) \(vitro\)}, series = {Molecular Pain}, volume = {7,73}, journal = {Molecular Pain}, doi = {10.1186/1744-8069-7-73}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-140380}, pages = {1-9}, year = {2011}, abstract = {Tenderness and mechanical allodynia are key symptoms of malignant tumor, inflammation and neuropathy. The proinflammatory cytokine interleukin-6 (IL-6) is causally involved in all three pathologies. IL-6 not only regulates innate immunity and inflammation but also causes nociceptor sensitization and hyperalgesia. In general and in most cell types including immune cells and sensory neurons, IL-6 binds soluble mu receptor subunits which heteromerizes with membrane bound IL-6 signal transducer gp130. In the present study, we used a conditional knock-out strategy to investigate the importance of signal transducer gp130 expressed in C nociceptors for the generation and maintenance of mechanical hypersensitivity. Nociceptors were sensitized to mechanical stimuli by experimental tumor and this nociceptor sensitization was preserved at later stages of the pathology in control mice. However, in mice with a conditional deletion of gp130 in Nav1.8 expressing nociceptors mechanical hypersensitivity by experimental tumor, nerve injury or inflammation recovery was not preserved in the maintenance phase and nociceptors exhibited normal mechanical thresholds comparable to untreated mice. Together, the results argue for IL-6 signal transducer gp130 as an essential prerequisite in nociceptors for long-term mechanical hypersensitivity associated with cancer, inflammation and nerve injury.}, language = {en} } @article{HopfnerSchormairKnaufetal.2011, author = {Hopfner, Franziska and Schormair, Barbara and Knauf, Franziska and Berthele, Achim and T{\"o}lle, Thomas R. and Baron, Ralf and Maier, Christoph and Treede, Rolf-Detlef and Binder, Andreas and Sommer, Claudia and Maih{\"o}fner, Christian and Kunz, Wolfram and Zimprich, Friedrich and Heemann, Uwe and Pfeufer, Arne and N{\"a}bauer, Michael and K{\"a}{\"a}b, Stefan and Nowak, Barbara and Gieger, Christian and Lichtner, Peter and Trenkwalder, Claudia and Oexle, Konrad and Winkelmann, Juliane}, title = {Novel SCARB2 mutation in Action Myoclonus-Renal Failure syndrome and evaluation of SCARB2 mutations in isolated AMRF features}, series = {BMC Neurology}, volume = {11}, journal = {BMC Neurology}, number = {134}, doi = {10.1186/1471-2377-11-134}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-141209}, pages = {1-8}, year = {2011}, abstract = {Background: Action myoclonus-renal failure syndrome is a hereditary form of progressive myoclonus epilepsy associated with renal failure. It is considered to be an autosomal-recessive disease related to loss-of-function mutations in SCARB2. We studied a German AMRF family, additionally showing signs of demyelinating polyneuropathy and dilated cardiomyopathy. To test the hypothesis whether isolated appearance of individual AMRF syndrome features could be related to heterozygote SCARB2 mutations, we screened for SCARB2 mutations in unrelated patients showing isolated AMRF features. Methods: In the AMRF family all exons of SCARB2 were analyzed by Sanger sequencing. The mutation screening of unrelated patients with isolated AMRF features affected by either epilepsy (n = 103, progressive myoclonus epilepsy or generalized epilepsy), demyelinating polyneuropathy (n = 103), renal failure (n = 192) or dilated cardiomyopathy (n = 85) was performed as high resolution melting curve analysis of the SCARB2 exons. Results: A novel homozygous 1 bp deletion (c.111delC) in SCARB2 was found by sequencing three affected homozygous siblings of the affected family. A heterozygous sister showed generalized seizures and reduction of nerve conduction velocity in her legs. No mutations were found in the epilepsy, renal failure or dilated cardiomyopathy samples. In the polyneuropathy sample two individuals with demyelinating disease were found to be carriers of a SCARB2 frameshift mutation (c.666delCCTTA). Conclusions: Our findings indicate that demyelinating polyneuropathy and dilated cardiomyopathy are part of the action myoclonus-renal failure syndrome. Moreover, they raise the possibility that in rare cases heterozygous SCARB2 mutations may be associated with PNP features.}, language = {en} } @article{HoppAlbertWeissenberger2015, author = {Hopp, Sarah and Albert-Weissenberger, Christiane}, title = {The kallikrein-kinin system: a promising therapeutic target for traumatic brain injury}, series = {Neural Regeneration Research}, volume = {10}, journal = {Neural Regeneration Research}, number = {6}, doi = {10.4103/1673-5374.158339}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-149416}, pages = {885-886}, year = {2015}, 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{Pausch2017, author = {Pausch, Jonas Franz}, title = {Pr{\"a}ferentielle Lokalisation von Makrophagen im r{\"a}umlichen Umfeld von Ranvier'schen Schn{\"u}rringen - Morphologische Analysen zur r{\"a}umlichen Verteilung von Makrophagen in Mausmodellen f{\"u}r erbliche Neuropathien}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-143801}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2017}, abstract = {Die Charcot-Marie-Tooth Typ 1 Erkrankungen sind eine genetisch heterogene Gruppe, aktuell nicht kurativ therapierbarer, erblicher Neuropathien des Peripheren Nervensystems. Klinische Manifestationen reichen von Sensibilit{\"a}ts-st{\"o}rungen, verminderten Muskeleigenreflexen, sowie fortschreitenden L{\"a}hmungen, bis hin zu Muskelatrophie und bedeuten f{\"u}r die betroffenen Patienten eine starke Einschr{\"a}nkung der Lebensqualit{\"a}t. Anhand fr{\"u}herer Studien wurde Makrophagen, als Teil des angeborenen Immunsystems, eine entscheidende Rolle in der Pathogenese dreier CMT1-Unterformen zugeschrieben. Abgesehen von den morphologischen Manifestationen der demyelinisierenden CMT1-Erkrankungen, wie simultanes Auftreten von Dedifferenzierung, sowie Hypo-, und Demyelinisierung erkrankter Schwann-Zellen, sind pathologische Ver{\"a}nderungen der Dom{\"a}nengliederung der Ranvier'schen Schn{\"u}rringe betroffener Nervenfasern ebenfalls von der Aktivierung pathogener Makrophagen abh{\"a}ngig. Auf der Basis verschiedener ver{\"o}ffentlichter Studien, welche sowohl demyelinisierende Erkrankungen des ZNS, aber auch prim{\"a}r durch axonale Sch{\"a}den gekennzeichnete Erkrankungen des PNS beinhalten, besteht ein m{\"o}glicher r{\"a}umlicher Zusammenhang zwischen Architekturst{\"o}rungen der RS und aktivierten pathogenen Mikrogliazellen bzw. Makrophagen. In dieser Studie konnte, anhand morphologischer Analysen von peripherem Nervengewebe, in Wt-M{\"a}usen erstmals eine unerwartete pr{\"a}ferentielle Lokalisation von Makrophagen im r{\"a}umlichen Umfeld von RS beobachtet werden. Hierbei scheint, trotz des Fehlens einer direkten Zell-Zell-Interaktion zwischen Makrophagen und RS, vor allem im Hinblick auf die ebenfalls im r{\"a}umlichen Umfeld von RS nachweisbare EZM und Fibroblasten, eine funktionelle Relevanz der assoziierten Makrophagen f{\"u}r die Aufrechterhaltung der Dom{\"a}nengliederung bzw. elektrophysiologischen Eigenschaften myelinisierter peripherer Nervenfasern denkbar. Im Gegensatz dazu wurde trotz der signifikanten Zunahme der Makrophagenanzahlen in den drei untersuchten CMT1-Mausmodellen keine erh{\"o}hte r{\"a}umliche Assoziation mit den RS der mutierten Schwann-Zellen beobachtet. Vielmehr konnten anhand des Vergleiches mit wildtypischen Kontrollm{\"a}usen signifikant erniedrigte Assoziationsraten beider Strukturen in den CMT1-Modelltieren festgestellt werden. Folglich scheint die von der Einwanderung und Aktivierung pathogener Makrophagen abh{\"a}ngige St{\"o}rung der Dom{\"a}nengliederung der RS der mutierten Schwann-Zellen, nicht durch eine direkte Interaktion bzw. r{\"a}umliche Assoziation von Makrophagen mit RS ausgel{\"o}st zu werden.}, subject = {Makrophagen}, language = {de} } @article{BinderMayBaronetal.2011, author = {Binder, Andreas and May, Denisa and Baron, Ralf and Maier, Christoph and T{\"o}lle, Thomas R. and Treede, Rolf-Detlef and Berthele, Achim and Faltraco, Frank and Flor, Herta and Gierthm{\"u}hlen, Janne and Haenisch, Sierk and Huge, Volker and Magerl, Walter and Maih{\"o}fner, Christian and Richter, Helmut and Rolke, Roman and Scherens, Andrea and {\"U}{\c{c}}eyler, Nurcan and Ufer, Mike and Wasner, Gunnar and Zhu, Jihong and Cascorbi, Ingolf}, title = {Transient Receptor Potential Channel Polymorphisms Are Associated with the Somatosensory Function in Neuropathic Pain Patients}, series = {PLoS ONE}, volume = {6}, journal = {PLoS ONE}, number = {3}, doi = {10.1371/journal.pone.0017387}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-142782}, pages = {e17387}, year = {2011}, abstract = {Transient receptor potential channels are important mediators of thermal and mechanical stimuli and play an important role in neuropathic pain. The contribution of hereditary variants in the genes of transient receptor potential channels to neuropathic pain is unknown. We investigated the frequency of transient receptor potential ankyrin 1, transient receptor potential melastin 8 and transient receptor potential vanilloid 1 single nucleotide polymorphisms and their impact on somatosensory abnormalities in neuropathic pain patients. Within the German Research Network on Neuropathic Pain (Deutscher Forscbungsverbund Neuropathischer Schmerz) 371 neuropathic pain patients were phenotypically characterized using standardized quantitative sensory testing. Pyrosequencing was employed to determine a total of eleven single nucleotide polymorphisms in transient receptor potential channel genes of the neuropathic pain patients and a cohort of 253 German healthy volunteers. Associations of quantitative sensory testing parameters and single nucleotide polymorphisms between and within groups and subgroups, based on sensory phenotypes, were analyzed. Single nucleotide polymorphisms frequencies did not differ between both the cohorts. However, in neuropathic pain patients transient receptor potential ankyrin 1 710G>A (rs920829, E179K) was associated with the presence of paradoxical heat sensation (p=0.03), and transient receptor potential vanilloid 1 1911A>G (rs8065080, I585V) with cold hypoalgesia (p=0.0035). Two main subgroups characterized by preserved (1) and impaired (2) sensory function were identified. In subgroup 1 transient receptor potential vanilloid 1 1911A>G led to significantly less heat hyperalgesia, pinprick hyperalgesia and mechanical hypaesthesia (p=0.006, p=0.005 and p<0.001) and transient receptor potential vanilloid 1 1103C>G (rs222747, M315I) to cold hypaesthesia (p=0.002), but there was absence of associations in subgroup 2. In this study we found no evidence that genetic variants of transient receptor potential channels are involved in the expression of neuropathic pain, but transient receptor potential channel polymorphisms contributed significantly to the somatosensory abnormalities of neuropathic pain patients.}, language = {en} } @article{TonyBurmesterSchulzeKoopsetal.2011, author = {Tony, Hans-Peter and Burmester, Gerd and Schulze-Koops, Hendrik and Grunke, Mathias and Henes, Joerg and K{\"o}tter, Ina and Haas, Judith and Unger, Leonore and Lovric, Svjetlana and Haubitz, Marion and Fischer-Betz, Rebecca and Chehab, Gamal and Rubbert-Roth, Andrea and Specker, Christof and Weinerth, Jutta and Holle, Julia and M{\"u}ller-Ladner, Ulf and K{\"o}nig, Ramona and Fiehn, Christoph and Burgwinkel, Philip and Budde, Klemens and S{\"o}rensen, Helmut and Meurer, Michael and Aringer, Martin and Kieseier, Bernd and Erfurt-Berge, Cornelia and Sticherling, Michael and Veelken, Roland and Ziemann, Ulf and Strutz, Frank and von Wussow, Praxis and Meier, Florian MP and Hunzelmann, Nico and Schmidt, Enno and Bergner, Raoul and Schwarting, Andreas and Eming, R{\"u}diger and Schwarz-Eywill, Michael and Wassenberg, Siegfried and Fleck, Martin and Metzler, Claudia and Zettl, Uwe and Westphal, Jens and Heitmann, Stefan and Herzog, Anna L. and Wiendl, Heinz and Jakob, Waltraud and Schmidt, Elvira and Freivogel, Klaus and D{\"o}rner, Thomas and Hertl, Michael and Stadler, Rudolf}, title = {Safety and clinical outcomes of rituximab therapy in patients with different autoimmune diseases: experience from a national registry (GRAID)}, series = {Arthritis Research \& Therapy}, volume = {13}, journal = {Arthritis Research \& Therapy}, number = {R75}, doi = {10.1186/ar3337}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-142856}, pages = {1-14}, year = {2011}, abstract = {Introduction: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin's lymphoma in a real-life clinical setting. Methods: Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases. The main outcome measures were safety and clinical response, as judged at the discretion of the investigators. Results: A total of 370 patients (299 patient-years) with various autoimmune diseases (23.0\% with systemic lupus erythematosus, 15.7\% antineutrophil cytoplasmic antibody-associated granulomatous vasculitides, 15.1\% multiple sclerosis and 10.0\% pemphigus) from 42 centres received a mean dose of 2,440 mg of rituximab over a median (range) of 194 (180 to 1,407) days. The overall rate of serious infections was 5.3 per 100 patient-years during rituximab therapy. Opportunistic infections were infrequent across the whole study population, and mostly occurred in patients with systemic lupus erythematosus. There were 11 deaths (3.0\% of patients) after rituximab treatment (mean 11.6 months after first infusion, range 0.8 to 31.3 months), with most of the deaths caused by infections. Overall (n = 293), 13.3\% of patients showed no response, 45.1\% showed a partial response and 41.6\% showed a complete response. Responses were also reflected by reduced use of glucocorticoids and various immunosuppressives during rituximab therapy and follow-up compared with before rituximab. Rituximab generally had a positive effect on patient well-being (physician's visual analogue scale; mean improvement from baseline of 12.1 mm)}, language = {en} } @article{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} } @phdthesis{Purrer2020, author = {Purrer, Veronika}, title = {Nicht-motorische Begleitsymptome bei Patienten mit Essentiellen Tremor}, doi = {10.25972/OPUS-19366}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-193665}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Der essentielle Tremor (ET) ist eine der h{\"a}ufigsten Bewegungsst{\"o}rungen, welcher lange Zeit als rein motorische St{\"o}rung angesehen wurde. Aufgrund zunehmender Belege {\"u}ber nicht-motorisch Begleitsymptome wandelte sich dieses Bild jedoch in den letzten Jahren zunehmend. In der vorliegenden Arbeit untersuchten wir 113 Probanden aus der Allgemeinbev{\"o}lkerung mit klinisch definitiven oder wahrscheinlichen ET anhand einer breiten Batterie neuro-psychologischer Testverfahren. Es gelang hierbei signifikante Unterschiede im Vergleich zu gesunden Eichstichproben im Hinblick auf neuro-psychologische Charakteristika, wie Apathie, {\"A}ngstlichkeit und exekutive Dysfunktion, sowie deren negativen Einfluss auf die Lebensqualit{\"a}t der Probanden darzustellen. Bisher werden im klinischen Alltag nicht-motorische Begleitph{\"a}nomene beim ET nicht regelhaft erfasst; aufgrund unserer Ergebnisse und der Relevanz vor allem im Hinblick auf die Lebensqualit{\"a}t des Einzelnen halten wir jedoch die Erfassung und gegebenenfalls Behandlung dieser Symptome f{\"u}r ebenso relevant.}, subject = {Essentieller Tremor}, language = {de} } @article{HoppAlbertWeissenbergerMencletal.2016, author = {Hopp, Sarah and Albert-Weissenberger, Christiane and Mencl, Stine and Bieber, Michael and Schuhmann, Michael K. and Stetter, Christian and Nieswandt, Bernhard and Schmidt, Peter M. and Monoranu, Camelia-Maria and Alafuzoff, Irina and Marklund, Niklas and Nolte, Marc W. and Sir{\´e}n, Anna-Leena and Kleinschnitz, Christoph}, title = {Targeting coagulation factor XII as a novel therapeutic option in brain trauma}, series = {Annals of Neurology}, volume = {79}, journal = {Annals of Neurology}, number = {6}, doi = {10.1002/ana.24655}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-188800}, pages = {970-982}, year = {2016}, abstract = {Objective: Traumatic brain injury is a major global public health problem for which specific therapeutic interventions are lacking. There is, therefore, a pressing need to identify innovative pathomechanism-based effective therapies for this condition. Thrombus formation in the cerebral microcirculation has been proposed to contribute to secondary brain damage by causing pericontusional ischemia, but previous studies have failed to harness this finding for therapeutic use. The aim of this study was to obtain preclinical evidence supporting the hypothesis that targeting factor XII prevents thrombus formation and has a beneficial effect on outcome after traumatic brain injury. Methods: We investigated the impact of genetic deficiency of factor XII and acute inhibition of activated factor XII with a single bolus injection of recombinant human albumin-fused infestin-4 (rHA-Infestin-4) on trauma-induced microvascular thrombus formation and the subsequent outcome in 2 mouse models of traumatic brain injury. Results: Our study showed that both genetic deficiency of factor XII and an inhibition of activated factor XII in mice minimize trauma-induced microvascular thrombus formation and improve outcome, as reflected by better motor function, reduced brain lesion volume, and diminished neurodegeneration. Administration of human factor XII in factor XII-deficient mice fully restored injury-induced microvascular thrombus formation and brain damage. Interpretation: The robust protective effect of rHA-Infestin-4 points to a novel treatment option that can decrease ischemic injury after traumatic brain injury without increasing bleeding tendencies.}, language = {en} } @phdthesis{Schneider2018, author = {Schneider, Katharina}, title = {Nachweis und Analyse von Phospho-Alpha-Synuclein-Ablagerungen in Hautnerven von Patienten mit Morbus Parkinson oder Multisystematrophie}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-169694}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2018}, abstract = {Zielsetzung der Studie war es, Ablagerungen des phosphorylierten Alpha-Synucleins in der Haut von Patienten mit Morbus Parkinson und atypischen Parkinson-Syndromen zu untersuchen und deren Auswirkungen auf das periphere Nervensystem zu erforschen. Dazu wurden Hautbiopsien von 92 Patienten mit Morbus Parkinson, 12 Patienten mit MSA und 13 Patienten mit einer Tauopathie sowie 83 gesunden Kontrollpersonen immunhisto-chemisch gef{\"a}rbt und unter dem Mikroskop untersucht. Mit einer Sensitivit{\"a}t von 52 \% f{\"u}r den Morbus Parkinson und 67 \% f{\"u}r die MSA bei hoher Spezifit{\"a}t stellt der Nachweis von Phospho-Alpha-Synuclein in den kleinen Nervenfasern der Haut einen geeigneten Biomarker dar. W{\"a}hrend die Ablagerungen des phosphorylierten Alpha-Synucleins bei Patienten mit Morbus Parkinson eher in autonomen Strukturen nachweisbar waren, fanden sie sich bei Patienten mit MSA eher in sub- und intraepidermal gelegenen Nervenfasern. Phospho-Alpha-Synuclein konnte in allen untersuchten Nervenfasersubtypen nachgewiesen werden, also in CGRP-, SP-, TH- und VIP-positiven Fasern. Bei den in der vorliegenden Studie untersuchten Parkinson-Patienten waren keine Ver{\"a}nderungen in der sensiblen Neurographie des Nervus suralis erkennbar. Die intraepidermale Nervenfaserdichte sowie die Innervation der Schweißdr{\"u}sen waren jedoch teilweise vermindert und auch in der QST zeigten sich Auff{\"a}lligkeiten. Ein Zusammenhang zu dem Vorhandensein von Phospho-Alpha-Synuclein-Ablagerungen konnte jedoch nur f{\"u}r die Innervation der Musculi arrectores pilorum hergestellt werden. Bei der Untersuchung der pathophysiologischen Hintergr{\"u}nde, durch die Phospho-Alpha-Synuclein-Ablagerungen zu Nervenfasersch{\"a}digungen f{\"u}hren, konnten die Hinweise auf eine Beteiligung von axonalen Transportproteinen, Mikrotubuli oder Mitochondrien nicht erh{\"a}rtet werden.}, subject = {Synuclein }, language = {de} } @article{CoenenAmtageVolkmannetal.2015, author = {Coenen, Volker A. and Amtage, Florian and Volkmann, Jens and Schl{\"a}pfer, Thomas E.}, title = {Deep Brain Stimulation in Neurological and Psychiatric Disorders}, series = {Deutsches {\"A}rzteblatt International}, volume = {112}, journal = {Deutsches {\"A}rzteblatt International}, doi = {10.3238/arztebl.2015.0519}, pages = {519 -- 526}, year = {2015}, abstract = {Background: Deep brain stimulation (DBS) is the chronic electrical stimulation of selected target sites in the brain through stereotactically implanted electrodes. More than 150 000 patients around the world have been treated to date with DBS for medically intractable conditions. The indications for DBS include movement disorders, epilepsy, and some types of mental illness. Methods: This review is based on relevant publications retrieved by a selective search in PubMed and the Cochrane Library, and on the current guidelines of the German Neurological Society (Deutsche Gesellschaft fur Neurologie, DGN). Results: DBS is usually performed to treat neurological diseases, most often movement disorders and, in particular, Parkinson's disease. Multiple randomized controlled trials (RCTs) have shown that DBS improves tremor, dyskinesia, and quality of life in patients with Parkinson's disease by 25\% to 50\%, depending on the rating scales used. DBS for tremor usually involves stimulation in the cerebello-thalamo-cortical regulatory loop. In an RCT of DBS for the treatment of primary generalized dystonia, the patients who underwent DBS experienced a 39.3\% improvement of dystonia, compared to only 4.9\% in the control group. Two multicenter trials of DBS for depression were terminated early because of a lack of efficacy. Conclusion: DBS is an established treatment for various neurological and psychiatric diseases. It has been incorporated in the DGN guidelines and is now considered a standard treatment for advanced Parkinson's disease. The safety and efficacy of DBS can be expected to improve with the application of new technical developments in electrode geometry and new imaging techniques. Controlled trials would be helpful so that DBS could be extended to further indications, particularly psychiatric ones.}, language = {en} } @article{HaarmannNehenDeissetal.2015, author = {Haarmann, Axel and Nehen, Mathias and Deiß, Annika and Buttmann, Mathias}, title = {Fumaric acid esters do not reduce inflammatory NF-\(\kappa\)B/p65 nuclear translocation, ICAM-1 expression and T-cell adhesiveness of human brain microvascular endothelial cells}, series = {International Journal of Molecular Sciences}, volume = {16}, journal = {International Journal of Molecular Sciences}, doi = {10.3390/ijms160819086}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-148295}, pages = {19086-19095}, year = {2015}, abstract = {Dimethyl fumarate (DMF) is approved for disease-modifying treatment of patients with relapsing-remitting multiple sclerosis. Animal experiments suggested that part of its therapeutic effect is due to a reduction of T-cell infiltration of the central nervous system (CNS) by uncertain mechanisms. Here we evaluated whether DMF and its primary metabolite monomethyl fumarate (MMF) modulate pro-inflammatory intracellular signaling and T-cell adhesiveness of nonimmortalized single donor human brain microvascular endothelial cells at low passages. Neither DMF nor MMF at concentrations of 10 or 50 \(\mu\)M blocked the IL-1\(\beta\)-induced nuclear translocation of NF-\(\kappa\)B/p65, whereas the higher concentration of DMF inhibited the nuclear entry of p65 in human umbilical vein endothelium cultured in parallel. DMF and MMF also did not alter the IL-1\(\beta\)-stimulated activation of p38 MAPK in brain endothelium. Furthermore, neither DMF nor MMF reduced the basal or IL-1\(\beta\)-inducible expression of ICAM-1. In accordance, both fumaric acid esters did not reduce the adhesion of activated Jurkat T cells to brain endothelium under basal or inflammatory conditions. Therefore, brain endothelial cells probably do not directly mediate a potential blocking effect of fumaric acid esters on the inflammatory infiltration of the CNS by T cells.}, language = {en} } @article{IpIsaiasKuscheTekinetal.2016, author = {Ip, Chi Wang and Isaias, Ioannis U. and Kusche-Tekin, Burak B. and Klein, Dennis and Groh, Janos and O´Leary, Aet and Knorr, Susanne and Higuchi, Takahiro and Koprich, James B. and Brotchie, Jonathan M. and Toyka, Klaus V. and Reif, Andreas and Volkmann, Jens}, title = {Tor1a+/- mice develop dystonia-like movements via a striatal dopaminergic dysregulation triggered by peripheral nerve injury}, series = {Acta Neuropathologica Communications}, volume = {4}, journal = {Acta Neuropathologica Communications}, number = {108}, doi = {10.1186/s40478-016-0375-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-147839}, year = {2016}, abstract = {Isolated generalized dystonia is a central motor network disorder characterized by twisted movements or postures. The most frequent genetic cause is a GAG deletion in the Tor1a (DYT1) gene encoding torsinA with a reduced penetrance of 30-40 \% suggesting additional genetic or environmental modifiers. Development of dystonia-like movements after a standardized peripheral nerve crush lesion in wild type (wt) and Tor1a+/- mice, that express 50 \% torsinA only, was assessed by scoring of hindlimb movements during tail suspension, by rotarod testing and by computer-assisted gait analysis. Western blot analysis was performed for dopamine transporter (DAT), D1 and D2 receptors from striatal and quantitative RT-PCR analysis for DAT from midbrain dissections. Autoradiography was used to assess the functional DAT binding in striatum. Striatal dopamine and its metabolites were analyzed by high performance liquid chromatography. After nerve crush injury, we found abnormal posturing in the lesioned hindlimb of both mutant and wt mice indicating the profound influence of the nerve lesion (15x vs. 12x relative to control) resembling human peripheral pseudodystonia. In mutant mice the phenotypic abnormalities were increased by about 40 \% (p < 0.05). This was accompanied by complex alterations of striatal dopamine homeostasis. Pharmacological blockade of dopamine synthesis reduced severity of dystonia-like movements, whereas treatment with L-Dopa aggravated these but only in mutant mice suggesting a DYT1 related central component relevant to the development of abnormal involuntary movements. Our findings suggest that upon peripheral nerve injury reduced torsinA concentration and environmental stressors may act in concert in causing the central motor network dysfunction of DYT1 dystonia.}, language = {en} } @article{KornKleinschnitzMagnusetal.2016, author = {Korn, Thomas and Kleinschnitz, Christoph and Magnus, Tim and Meuth, Sven G. and Linker, Ralf A.}, title = {Report on the 7th scientific meeting of the Association for the Advancement of Young Academics in Neurology (NEUROWIND e.V.) held in Motzen, Germany, October 30-November 1, 2015}, series = {Experimental and Translational Stroke Medicine}, volume = {8}, journal = {Experimental and Translational Stroke Medicine}, number = {3}, organization = {7th NEUROWIND e.V. scientific meeting}, doi = {10.1186/s13231-016-0017-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-146595}, year = {2016}, abstract = {From October 30-November 1, 2015, the 7th NEUROWIND e.V. meeting was held in Motzen, Brandenburg, Germany. Seventy doctoral students and postdocs from over 25 different groups working in German and Swiss University Hospitals or Research Institutes attended the meeting to discuss their latest experiments and findings in the fields of neuroimmunology, neurodegeneration and neurovascular research. This meeting report summarizes the many diverse presentations and the new preclinical to clinical neurology research data that were shared by the participants at the meeting.}, language = {en} } @article{IsraelOhsiekAlMomanietal.2016, author = {Israel, Ina and Ohsiek, Andrea and Al-Momani, Ehab and Albert-Weissenberger, Christiane and Stetter, Christian and Mencl, Stine and Buck, Andreas K. and Kleinschnitz, Christoph and Samnick, Samuel and Sir{\´e}n, Anna-Leena}, title = {Combined [\(^{18}\)F]DPA-714 micro-positron emission tomography and autoradiography imaging of microglia activation after closed head injury in mice}, series = {Journal of Neuroinflammation}, volume = {13}, journal = {Journal of Neuroinflammation}, number = {140}, doi = {10.1186/s12974-016-0604-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-146606}, year = {2016}, abstract = {Background Traumatic brain injury (TBI) is a major cause of death and disability. Neuroinflammation contributes to acute damage after TBI and modulates long-term evolution of degenerative and regenerative responses to injury. The aim of the present study was to evaluate the relationship of microglia activation to trauma severity, brain energy metabolism, and cellular reactions to injury in a mouse closed head injury model using combined in vivo PET imaging, ex vivo autoradiography, and immunohistochemistry. Methods A weight-drop closed head injury model was used to produce a mixed diffuse and focal TBI or a purely diffuse mild TBI (mTBI) in C57BL6 mice. Lesion severity was determined by evaluating histological damage and functional outcome using a standardized neuroscore (NSS), gliosis, and axonal injury by immunohistochemistry. Repeated intra-individual in vivo μPET imaging with the specific 18-kDa translocator protein (TSPO) radioligand [\(^{18}\)F]DPA-714 was performed on day 1, 7, and 16 and [\(^{18}\)F]FDG-μPET imaging for energy metabolism on days 2-5 after trauma using freshly synthesized radiotracers. Immediately after [\(^{18}\)F]DPA-714-μPET imaging on days 7 and 16, cellular identity of the [\(^{18}\)F]DPA-714 uptake was confirmed by exposing freshly cut cryosections to film autoradiography and successive immunostaining with antibodies against the microglia/macrophage marker IBA-1. Results Functional outcome correlated with focal brain lesions, gliosis, and axonal injury. [\(^{18}\)F]DPA-714-μPET showed increased radiotracer uptake in focal brain lesions on days 7 and 16 after TBI and correlated with reduced cerebral [\(^{18}\)F]FDG uptake on days 2-5, with functional outcome and number of IBA-1 positive cells on day 7. In autoradiography, [\(^{18}\)F]DPA-714 uptake co-localized with areas of IBA1-positive staining and correlated strongly with both NSS and the number of IBA1-positive cells, gliosis, and axonal injury. After mTBI, numbers of IBA-1 positive cells with microglial morphology increased in both brain hemispheres; however, uptake of [\(^{18}\)F]DPA-714 was not increased in autoradiography or in μPET imaging. Conclusions [\(^{18}\)F]DPA-714 uptake in μPET/autoradiography correlates with trauma severity, brain metabolic deficits, and microglia activation after closed head TBI.}, language = {en} } @phdthesis{Kuesters2019, author = {K{\"u}sters, Sebastian}, title = {Darstellung des nikotinergen Acetylcholinrezeptors bei Patienten mit idiopathischem Parkinson-Syndrom und Levodopa-induzierter Dyskinesie}, doi = {10.25972/OPUS-17874}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-178740}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2019}, abstract = {Ziel der Studie war ein Zusammenhang zwischen cholinerger Innervation in den Basalganglien mit Levodopa-induzierter Dyskinesie darzustellen. 26 Patienten mit idiopatischem Parkinson-Syndrom ohne Demenz und Depression wurden in zwei Gruppen mit und ohne Dyskinesie eingeteilt. Es wurde nach klinischer Untersuchung eine SPECT-Bildgebung mit 5-[123I]iodo-3-[2(S)-2-azetidinylmethoxy]pyridine (5IA) durchgef{\"u}hrt und anschließend die Ergebnisse in Zusammenschau mit den klinischen Daten und mit den Ergebnissen der SPECT mit [123I]N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (FP-CIT) bewertet. Dyskinetische Patienten hatten eine h{\"o}here Dichte an nikotinergen Acetylcholinrezeptoren im Nucleus caudatus, haupts{\"a}chlich der Halbseite mit st{\"a}rkerer dopaminerger Degeneration. Dies st{\"u}tzt die Hypothese, dass sich die Dyskinesie nach Levodopa-Therapie aufgrund einer verst{\"a}rkten cholinergen Modulation im st{\"a}rker degenerierten Striatum entwickelt.}, subject = {Parkinson-Krankheit}, 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} } @article{MaggRieglerWiedmannetal.2015, author = {Magg, Barbara and Riegler, Christoph and Wiedmann, Silke and Heuschmann, Peter and Sommer, Claudia and {\"U}{\c{c}}eyler, Nurcan}, title = {Self-administered version of the Fabry-associated pain questionnaire for adult patients}, series = {Orphanet Journal of Rare Diseases}, volume = {10}, journal = {Orphanet Journal of Rare Diseases}, number = {113}, doi = {10.1186/s13023-015-0325-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-145294}, year = {2015}, abstract = {Background Fabry-associated pain may be the first symptom of Fabry disease (FD) and presents with a unique phenotype including mostly acral burning triggerable pain attacks, evoked pain, pain crises, and permanent pain. We recently developed and validated the first Fabry Pain Questionnaire (FPQ) for adult patients. Here we report on the validation of the self-administered version of the FPQ that no longer requires a face-to-face interview but can be filled in by the patients themselves allowing more flexible data collection. Methods At our W{\"u}rzburg Fabry Center for Interdisciplinary Treatment, Germany, we have developed the self-administered version of the FPQ by adapting the questionnaire to a self-report version. To do this, consecutive Fabry patients with current or past pain history (n = 56) were first interviewed face-to-face. Two weeks later patients' self-reported questionnaire results were collected by mail (n = 55). We validated the self-administered version of the FPQ by assessing the inter-rater reliability agreement of scores obtained by supervised administration and self-administration of the FPQ. Results The FPQ contains 15 questions on the different pain phenotypes, on pain development during life with and without therapy, and on impairment due to pain. Statistical analysis showed that the majority of questions were answered in high agreement in both sessions with a mean AC1-statistic of 0.857 for 55 nominal-scaled items and a mean ICC of 0.587 for 9 scores. Conclusions This self-administered version of the first pain questionnaire for adult Fabry patients is a useful tool to assess Fabry-associated pain without a time-consuming face-to-face interview but via a self-reporting survey allowing more flexible usage.}, language = {en} } @phdthesis{Leinders2016, author = {Leinders, Mathias}, title = {microRNAs in chronic pain}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-144395}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2016}, abstract = {Chronic pain is a common problem in clinical practice, not well understood clinically, and frequently tough to satisfactorily diagnose. Because the pathophysiology is so complex, finding effective treatments for people with chronic pain has been overall less than successful and typically reduced to an unsatisfactory trial-and-error process, all of which translates into a significant burden to society. Knowledge of the mechanisms underlying the development of chronic pain, and moreover why some patients experience pain and others not, may aid in developing specific treatment regimens. Although nerve injuries are major contributors to pain chronification, they cannot explain the entire phenomenon. Considerable research has underscored the importance of the immune system for the development and maintenance of chronic pain, albeit the exact factors regulating inflammatory reactions remain unclear. Understanding the putative molecular and cellular regulator switches of inflammatory reactions will open novel opportunities for immune modulatory analgesics with putatively higher specificity and less adverse effects. It has become clear that small, non- coding RNA molecules known as microRNAs are in fact potent regulators of many thousands of genes and possibly cross-communicate between cellular pathways in multiple systems acting as so-called "master-switches". Aberrant expression of miRNAs is now implicated in numerous disorders, including nerve injuries as well as in inflammatory processes. Moreover, compelling evidence supports the idea that miRNAs also regulate pain, and in analogy to the oncology field aid in the differential diagnosis of disease subtypes. In fact, first reports describing characteristic miRNA expression profiles in blood or cerebrospinal fluid of patients with distinct pain conditions are starting to emerge, however evidence linking specific miRNA expression profiles to specific pain disorders is still insufficient. The present thesis aimed at first, identifying specific miRNA signatures in two distinct chronic pain conditions, namely peripheral neuropathies of different etiologies and fibromyalgia syndrome. Second, it aimed at identifying miRNA profiles to better understand potential factors that differentiate painful from painless neuropathies and third, study the mechanistic role of miRNAs in the pathophysiology of pain, to pave the way for new druggable targets. Three studies were conducted in order to identify miRNA expression signatures that are characteristic for the given chronic pain disorder. The first study measured expression of miR-21, miR-146a and miR-155 in white blood cells, skin and nerve biopsies of patients with peripheral neuropathies. It shows that peripheral neuropathies of different etiologies are associated with increased peripheral miR-21 and miR-146a, but decreased miR-155 expression. More importantly, it was shown that painful neuropathies have increased sural nerve miR-21 and miR-155 expression, but reduced miR-146a and miR-155 expression in distal skin of painful neuropathies. These results point towards the potential use of miRNAs profiles to stratify painful neuropathies. The seconds study extends these findings and first analyzed the role of miR-132-3p in patients and subsequently in an animal model of neuropathic pain. Interestingly, miR-132-3p was upregulated in white blood cells and sural nerve biopsies of patients with painful neuropathies and in animals after spared nerve injury. Pharmacologically modulating the expression of miR-132-3p dose-dependently reversed pain behavior and pain aversion, indicating the pro-nociceptive effect of miR-132-3p in chronic pain. This study thus demonstrates the potential analgesic impact by modulating miRNA expression. Fibromyalgia is associated with chronic widespread pain and, at least in a subgroup, impairment in small nerve fiber morphology and function. Interestingly, the disease probably comprises subgroups with different underlying pathomechanisms. In accordance with this notion, the third study shows that fibromyalgia is associated with both aberrant white blood cell and cutaneous miRNA expression. Being the first of its kind, this study identified miR-let-7d and its downstream target IGF-1R as potential culprit for impaired small nerve fiber homeostasis in a subset of patients with decreased intra-epidermal nerve fiber density. The work presented in this thesis is a substantial contribution towards the goal of better characterizing chronic pain based on miRNA expression signatures and thus pave the way for new druggable targets.}, subject = {miRNS}, language = {en} } @phdthesis{HoppKraemer2016, author = {Hopp-Kr{\"a}mer, Sarah}, title = {Untersuchungen zur Pathophysiologie und therapeutischer Relevanz des Blutgerinnungsfaktors XII nach experimentellem Sch{\"a}del-Hirn-Trauma}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-144421}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2016}, abstract = {Das Sch{\"a}del-Hirn-Trauma (SHT) entsteht durch {\"a}ußere Gewalteinwirkung auf den Kopf und verursacht mechanisch eine Sch{\"a}digung des Hirngewebes. Zus{\"a}tzlich tragen sekund{\"a}re Pathomechanismen, wie Entz{\"u}ndungsprozesse und die Sch{\"a}digung der Blut-Hirn-Schranke (BHS), dazu bei, dass sich das initial gesch{\"a}digte L{\"a}sionsareal im Laufe der Zeit vergr{\"o}ßert. Vor allem bei jungen Erwachsenen ist das SHT eine der h{\"a}ufigsten Ursachen f{\"u}r bleibende Behinderungen und Todesf{\"a}lle. Aufgrund der schweren Auswirkungen des SHT und der bislang fehlenden Therapieoptionen ist die Identifizierung neuer Zielstrukturen f{\"u}r eine kausale Therapie von gr{\"o}ßter Bedeutung. Ausgehend von tierexperimentellen Studien ist das Kallikrein-Kinin-System (KKS) ein besonders erfolgversprechender Angriffspunkt zur Behandlung des SHT. Die Aktivierung des KKS {\"u}ber den Gerinnungsfaktor XII (FXII) und die darauf folgende Bildung von Bradykinin sind mit dem Entstehen von Hirn{\"o}demen und Entz{\"u}ndungsreaktionen assoziiert. Vorangegangene Studien haben weiterhin die Frage aufgeworfen, ob und in welchem Maße thrombotische Prozesse einen Einfluss auf die Pathophysiologie und die sekund{\"a}ren Hirnsch{\"a}digungen nach SHT haben. Da FXII sowohl das KKS als auch die intrinsische plasmatische Gerinnungskaskade initiiert und somit zur Fibrinbildung beitr{\"a}gt, stand FXII im Mittelpunkt der Untersuchungen dieser Dissertation. Die vorliegende Arbeit besch{\"a}ftigt sich mit den Fragen, (I) inwiefern FXII eine Rolle bei der sekund{\"a}ren Hirnsch{\"a}digung nach Trauma spielt und (II) ob thrombotische Prozesse ein pathophysiologisches Merkmal nach Trauma darstellen. In zwei unterschiedlichen Trauma-Modellen wurden FXII-defiziente Tiere und mit einem spezifischen Inhibitor des aktivierten FXII (FXIIa) behandelte Tiere gegen Kontrolltiere nach SHT verglichen. Die Analyse der funktionellen Ausfallerscheinungen und des Ausmaßes an neuronaler Degeneration zeigte, dass FXII-Defizienz und FXIIa-Inhibition vor den Auswirkungen eines SHT sch{\"u}tzen. Als zugrundeliegende Mechanismen wurden die Reduktion von thrombotisch verschlossenen Gef{\"a}ßen in der Mikrovaskulatur des Gehirns sowie der Schutz vor BHS-St{\"o}rungen und verringerte inflammatorische Prozesse identifiziert. Weiterhin wurde festgestellt, dass eine Blockade der intrinsischen Gerinnungskaskade {\"u}ber FXII keine intrazerebralen Blutungen ausl{\"o}st. In Gewebeproben von Patienten mit SHT wurde gezeigt, dass Thrombozytenaggregate auch im klinischen Verlauf auftreten und sich somit die tierexperimentellen Befunde auf die humane Situation {\"u}bertragen lassen. Insgesamt tragen die Ergebnisse dazu bei, die komplexen und vielf{\"a}ltigen Pathomechanismen nach SHT besser zu verstehen und vor allem die Relevanz thrombo-inflammatorischer Prozesse nach SHT aufzuzeigen. Die gezielte Blockade des FXII(a) k{\"o}nnte als therapeutisches Prinzip zur Abschw{\"a}chung der Sekund{\"a}rschaden nach SHT geeignet sein.}, subject = {Sch{\"a}del-Hirn-Trauma}, language = {de} } @phdthesis{RamirezPasos2019, author = {Ramirez Pasos, Uri Eduardo}, title = {Subthalamic Nucleus Neural Synchronization and Connectivity during Limbic Processing of Emotional Pictures: Evidence from Invasive Recordings in Patients with Parkinson's Disease}, doi = {10.25972/OPUS-16985}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-169850}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2019}, abstract = {In addition to bradykinesia and tremor, patients with Parkinson's disease (PD) are known to exhibit non-motor symptoms such as apathy and hypomimia but also impulsivity in response to dopaminergic replacement therapy. Moreover, a plethora of studies observe differences in electrocortical and autonomic responses to both visual and acoustic affective stimuli in PD subjects compared to healthy controls. This suggests that the basal ganglia (BG), as well as the hyperdirect pathway and BG thalamocortical circuits, are involved in affective processing. Recent studies have shown valence and dopamine-dependent changes in synchronization in the subthalamic nucleus (STN) in PD patients during affective tasks. This thesis investigates the role of dopamine, valence, and laterality in STN electrophysiology by analyzing event-related potentials (ERP), synchronization, and inter-hemispheric STN connectivity. STN recordings were obtained from PD patients with chronically implanted electrodes for deep brain stimulation during a passive affective picture presentation task. The STN exhibited valence-dependent ERP latencies and lateralized 'high beta' (28-40 Hz) event-related desynchronization. This thesis also examines the role of dopamine, valence, and laterality on STN functional connectivity with the anterior cingulate cortex (ACC) and the amygdala. The activity of these limbic structures was reconstructed using simultaneously recorded electroencephalographic signals. While the STN was found to establish early coupling with both structures, STN-ACC coupling in the 'alpha' range (7-11 Hz) and uncoupling in the 'low beta' range (14-21 Hz) were lateralized. Lateralization was also observed at the level of synchrony in both reconstructed sources and for ACC ERP amplitude, whereas dopamine modulated ERP latency in the amygdala. These results may deepen our current understanding of the STN as a limbic node within larger emotional-motor networks in the brain.
}, subject = {Nucleus subthalamicus}, language = {en} } @article{UeceylerBikoSommer2010, author = {Ueceyler, Nurcan and Biko, Lydia and Sommer, Claudia}, title = {MDL-28170 Has No Analgesic Effect on CCI Induced Neuropathic Pain in Mice}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-68359}, year = {2010}, abstract = {The calpain inhibitor MDL-28710 blocks the early local pro-inflammatory cytokine gene expression in mice after chronic constriction nerve injury (CCI). Onehundred- thirteen wild type mice of C57Bl/6J background received CCI of the right sciatic nerve. Mechanical paw withdrawal thresholds and thermal withdrawal latencies were investigated at baseline and at 1, 3, and 7 days after CCI. Three application regimens were used for MDL-28170: a) single injection 40 min before CCI; b) serial injections of MDL- 28170 40 min before and up to day three after CCI; c) sustained application via intraperitoneal osmotic pumps. The control animals received the vehicle DMSO/PEG 400. The tolerable dose of MDL-28170 for mice was 30 mg/kg body weight, higher doses were lethal within the first hours after application. Mechanical withdrawal thresholds and thermal withdrawal latencies were reduced after CCI and did not normalize after single or serial injections, nor with application of MDL-28170 via osmotic pumps. Although the calpain inhibitor MDL-28170 inhibits the early local cytokine upregulation in the sciatic nerve after CCI, pain behavior is not altered. This finding implies that local cytokine upregulation after nerve injury alone is only one factor in the induction and maintenance of neuropathic pain.}, 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 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} } @phdthesis{Pizon2010, author = {Pizon, Dorothea}, title = {Prognose des raumfordernden Mediainfarktes bei konservativer vs. operativer Therapie am Universit{\"a}tsklinikum W{\"u}rzburg 1993-2005}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-70232}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2010}, abstract = {In dieser Studie wurden Schlaganfallpatienten untersucht, die einen ausgedehnten Infarkt im Versorgungsgebiet der A.cerebri media erlitten und wegen Bewusstseinstr{\"u}bung (sog. Maligner Mediainfarkt) auf der Neurologischen Intensivstation des Universit{\"a}tsklinikums W{\"u}rzburg im Zeitraum von 1991 bis 2005 behandelt wurde, um herauszufinden, welchen Einfluss eine operative Behandlung auf den kritisch erh{\"o}hten Hirnsdrucks zus{\"a}tzlich zur konservativen Intensivtherapie auf Mortalit{\"a}t sowie langfristige Lebensqualit{\"a}t hatte. Insgesamt konnten die Daten von 292 Patienten ausgewertet werden, wovon 259 konservativ und 33 operativ behandelt worden waren. Es zeigte sich insgesamt, dass eine stillschweigende g{\"u}nstige Selektion f{\"u}r eine Trepanation sprach (j{\"u}nger, eher keine Aphasie, weniger Komorbidit{\"a}ten). Die Hemikraniektomie senkte die Mortalit{\"a}t in der Akutphase hochsignifikant (K: 22, 4\%, T: 3,0\%; p=0,009). Sie hatte erwartungsgem{\"a}ß auch einen positiven Einfluss auf das Vigilanzniveau: die Quote von wachen Patienten war bei Entlassung der Trepanierten um 66\% h{\"o}her als bei Aufnahme, bei den konservativ Behandelten war sie nur um 33,3 \% gestiegen. Das vorherrschende Symptom bei Aufnahme und Entlassung war eine motorische bzw. sensomotorische Hemiparese. Der Anteil der Aphasiker bei den 201 konservativ therapierten Patienten, die den station{\"a}ren Aufenthalt {\"u}berlebt haben, ist von bei Aufnahme 56,2\% auf bei Entlassung 48,6\% gesunken. Bei den 32 trepanierten Patienten ist er dagegen mit 50\% gleich geblieben, obwohl 2/3 aller Patienten an der nicht-dominanten Hemisph{\"a}re operiert worden waren. Es war und ist auch nicht zu erwarten, dass eine Entlastung von Hirndruck qualitativ die hirninfarktbedingten Symptome beseitigt. Die Nachbefragung der Patienten fand im Schnitt 64,7 Monate nach erlittenem Mediainfarkt statt. Inzwischen waren von den 259 konservativ Behandelten 47,1\% verstorben, von den 33 Hemikraniektomierten nur 24,2\%. Die poststation{\"a}re Mortalit{\"a}t im weiteren Verlauf war anteilsm{\"a}ßig gering (K: 24\%, T: 21,2\%). Die {\"U}berlebensdauer der Trepanierten war dreimal so lang wie die der nicht operierten (K: 11,6 Monate, T: 34,4 Monate). Diese Unterschiede im Langzeit{\"u}berleben sind wahrscheinlicher auf die geringeren Komorbidit{\"a}ten der Trepanierten zur{\"u}ckzuf{\"u}hren, als auf die stattgehabte Operation an sich. Allerdings ist nicht auszuschließen, dass die durch Trepanation fr{\"u}hzeitiger verbesserte Wachheit sich auch g{\"u}nstig auf lebensverk{\"u}rzende Folgekomplikationen ausgewirkt haben k{\"o}nnte. In der Nachbefragung zeigte sich, dass bez{\"u}glich der erworbenen k{\"o}rperlichen Funktionsdefizite, gemessen am Barthel Index, zwischen den beiden Kollektiven kein signifikanter Unterschied bestand. Die ehemals konservativ behandelten Patienten kamen auf durchschnittlich 75, die trepanierten Patienten auf 60 von 100 Punkten. Im Lebensalltag schl{\"a}gt sich dieser Unterschied von 15 Punkten relevant nieder, aber insgesamt liegen beide Patientenkollektive im Bereich einer leichten bis nicht vorhandenen Abh{\"a}ngigkeit. Die vergleichbaren Langzeitdaten von Patienten mit Mediainfarkt liegen in einem {\"a}hnlichen Bereich. Erstmalig werden hier Langzeitdaten solcher Patienten {\"u}ber die Lebensqualit{\"a}t vorgelegt, gemessen mit dem SF-36. Nachvollziehbar zeigte sich ein deutlicher Unterschied zur Lebensqualit{\"a}t der Durchschnittsbev{\"o}lkerung, insbesondere im Bereich der k{\"o}rperlichen Belastbarkeit. F{\"u}r uns unerwartet g{\"u}nstig fielen die Antworten auf der eher psychologischen Ebene aus. Es zeigten sich bei allen Punkten des SF-36 keine signifikanten Unterschiede zwischen dem konservativ behandelten und den hemikraniektomierten Patienten, so dass die Operation als solche keinen eigenst{\"a}ndigen Einfluss auf die langfristige Lebensqualit{\"a}t nahm. Zusammengefasst verbesserte die osteoklastische Trepanation des raumfordernden malignen Mediainfarkts die {\"U}berlebenschance in der Akutphase signifikant, was mit inzwischen publizierten kontrollierten Studienergebnissen {\"u}bereinstimmt. Der Langzeitverlauf nach {\"u}berlebter Akutkrankheit gestaltet sich unabh{\"a}ngig von der Trepanation. Es gibt aufgrund der erworbenen Behinderung eine weiterhin relativ hohe l{\"a}ngerfristige Sterblichkeit. Bemerkenswert ist, dass die Selbsteinsch{\"a}tzung der Lebensqualit{\"a}t von Patienten mit einer erheblichen infarktbedingen k{\"o}rperlichen Behinderung psychologisch-emotional nur geringf{\"u}gig von der Selbstwahrnehmung in der nicht- behinderten Durchschnittsbev{\"o}lkerung. Dass bedeutet, dass Spekulationen {\"u}ber die zuk{\"u}nftige Lebensqualit{\"a}t keinen Einfluss auf die Operationsindikation nehmen sollten.}, subject = {Arteria cerebri media}, language = {de} } @phdthesis{Kafke2011, author = {Kafke, Waldemar}, title = {Bestimmung von Zytokinexpressionsprofilen aus humanen Blut- und Hautproben bei Patienten mit small fiber Neuropathie}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-71132}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2011}, abstract = {Zusammenfassend konnte durch unsere Daten die eingangs gestellte Hypothese, dass Patienten mit SFN eine lokal und systemisch erh{\"o}hte Expression pro-inflammatorischer und algetischer Zytokine haben, auf lokaler Ebene bei der Untergruppe mit LD-SFN best{\"a}tigt werden. Bei der Untergruppe mit NLD-SFN waren keine Unterschiede bei den Zytokinexpressionen zwischen proximalen und distalen Hautbiopsien im Vergleich zu Kontrollprobanden nachweisbar. Zudem zeigten sich deutliche Unterschiede bei den Quotienten der IENFD zwischen beiden Untergruppen. Dies legt die Vermutung nahe, dass die Unterteilung in LD-SFN und NLD-SFN klinisch bedeutsam und ein m{\"o}glicher Grundstein f{\"u}r das Verst{\"a}ndnis der pathophysiologischen Mechanismen der SFN sein k{\"o}nnte. Hieraus k{\"o}nnten sich Fortschritte in der Diagnostik ergeben und gezielte symptomatische und vielleicht sogar kausale Therapien auf lokaler Ebene bei der SFN entwickeln.}, subject = {Small fiber Neuropathie}, language = {de} } @article{UeceylerHaeuserSommer2011, author = {{\"U}ceyler, Nurcan and H{\"a}user, Winfried and Sommer, Claudia}, title = {Systematic review with meta-analysis: Cytokines in fibromyalgia syndrome}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-69189}, year = {2011}, abstract = {Background: To perform a systematic review and meta-analysis on cytokine levels in patients with fibromyalgia syndrome (FMS). Methods: Through December 2010 we systematically reviewed the databases PubMed, MEDLINE, and PsycINFO and screened the reference lists of 22 review articles for suitable original articles. Original articles investigating cytokines in patients with FMS were included. Data were extracted by two independent authors. Differences of the cytokine levels of FMS patients and controls were summarized by standardized mean differences (SMD) using a random effects model. Study quality was assessed applying methodological scores: modified Center of Evidence Based Medicine, Newcastle-Ottawa-Scale, and W{\"u}rzburg Methodological Quality Score. Results: Twenty-five articles were included investigating 1255 FMS patients and 800 healthy controls. Data of 13/25 studies entered meta-analysis. The overall methodological quality of studies was low. The results of the majority of studies were not comparable because methods, investigated material, and investigated target cytokines differed. Systematic review of the selected 25 articles revealed that FMS patients had higher serum levels of interleukin (IL)-1 receptor antagonist, IL-6, and IL-8, and higher plasma levels of IL-8. Meta-analysis of eligible studies showed that FMS patients had higher plasma IL-6 levels compared to controls (SMD = -0.34 [-0.64, -0.03] 95\% CI; p = 0.03). The majority of investigated cytokines were not different between patients and controls. Conclusions: The pathophysiological role of cytokines in FMS is still unclear. Studies of higher quality and with higher numbers of subjects are needed.}, subject = {Fibromyalgie}, language = {en} } @article{BraeuningerKleinschnitzStoll2010, author = {Braeuninger, Stefan and Kleinschnitz, C. and Stoll, G.}, title = {Interleukin-18 does not influence infarct volume or functional outcome in the early stage after transient focal brain ischemia in mice}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-68141}, year = {2010}, abstract = {Interleukin-18 (IL-18) is a proinflammatory cytokine of the interleukin-1 family which is upregulated after cerebral ischemia. The functional role of IL-18 in cerebral ischemia is unknown. In the present study, we compared infarct size in IL-18 knock-out and wild-type mice 24 hours and 48 hours after 1-hour transient middle cerebral artery occlusion (tMCAO). Moreover, the functional outcome was evaluated in a modified Bederson score, foot fault test and grip test. There were no significant differences in infarct size or functional outcome tests between wild-type and IL-18 knock-out mice. These data indicate that the early inflammatory response to cerebral ischemia does not involve IL-18, in contrast to other interleukin-1 family members such as interleukin-1.}, subject = {Interleukin-18}, language = {en} }