TY  - JOUR
A1  - Semler, Elisa
A1  - Anderl-Straub, Sarah
A1  - Uttner, Ingo
A1  - Diehl-Schmid, Janine
A1  - Danek, Adrian
A1  - Einsiedler, Beate
A1  - Fassbender, Klaus
A1  - Fliessbach, Klaus
A1  - Huppertz, Hans-Jürgen
A1  - Jahn, Holger
A1  - Kornhuber, Johannes
A1  - Landwehrmeyer, Bernhard
A1  - Lauer, Martin
A1  - Muche, Rainer
A1  - Prudlo, Johannes
A1  - Schneider, Anja
A1  - Schroeter, Matthias L.
A1  - Ludolph, Albert C.
A1  - Otto, Markus
T1  - A language-based sum score for the course and therapeutic intervention in primary progressive aphasia
JF  - Alzheimer's Research & Therapy
N2  - Background
With upcoming therapeutic interventions for patients with primary progressive aphasia (PPA), instruments for the follow-up of patients are needed to describe disease progression and to evaluate potential therapeutic effects. So far, volumetric brain changes have been proposed as clinical endpoints in the literature, but cognitive scores are still lacking. This study followed disease progression predominantly in language-based performance within 1 year and defined a PPA sum score which can be used in therapeutic interventions.

Methods
We assessed 28 patients with nonfluent variant PPA, 17 with semantic variant PPA, 13 with logopenic variant PPA, and 28 healthy controls in detail for 1 year. The most informative neuropsychological assessments were combined to a sum score, and associations between brain atrophy were investigated followed by a sample size calculation for clinical trials.

Results
Significant absolute changes up to 20% in cognitive tests were found after 1 year. Semantic and phonemic word fluency, Boston Naming Test, Digit Span, Token Test, AAT Written language, and Cookie Test were identified as the best markers for disease progression. These tasks provide the basis of a new PPA sum score. Assuming a therapeutic effect of 50% reduction in cognitive decline for sample size calculations, a number of 56 cases is needed to find a significant treatment effect. Correlations between cognitive decline and atrophy showed a correlation up to r = 0.7 between the sum score and frontal structures, namely the superior and inferior frontal gyrus, as well as with left-sided subcortical structures.

Conclusion
Our findings support the high performance of the proposed sum score in the follow-up of PPA and recommend it as an outcome measure in intervention studies.
KW  - frontotemporal dementia
KW  - cognitive neuropsychology in dementia
KW  - assessment of cognitive disorders/dementia
KW  - volumetric MRI
KW  - aphasia
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236277
VL  - 10
ER  - 
TY  - JOUR
A1  - Huss, André M.
A1  - Halbgebauer, Steffen
A1  - Öckl, Patrick
A1  - Trebst, Corinna
A1  - Spreer, Annette
A1  - Borisow, Nadja
A1  - Harrer, Andrea
A1  - Brecht, Isabel
A1  - Balint, Bettina
A1  - Stich, Oliver
A1  - Schlegel, Sabine
A1  - Retzlaff, Nele
A1  - Winkelmann, Alexander
A1  - Roesler, Romy
A1  - Lauda, Florian
A1  - Yildiz, Özlem
A1  - Voß, Elke
A1  - Muche, Rainer
A1  - Rauer, Sebastian
A1  - Bergh, Florian Then
A1  - Otto, Markus
A1  - Paul, Friedemann
A1  - Wildemann, Brigitte
A1  - Kraus, Jörg
A1  - Ruprecht, Klemens
A1  - Stangel, Martin
A1  - Buttmann, Mathias
A1  - Zettl, Uwe K.
A1  - Tumani, Hayrettin
T1  - Importance of cerebrospinal fluid analysis in the era of McDonald 2010 criteria: a German-Austrian retrospective multicenter study in patients with a clinically isolated syndrome
JF  - Journal of Neurology
N2  - The majority of patients presenting with a first clinical symptom suggestive of multiple sclerosis (MS) do not fulfill the MRI criteria for dissemination in space and time according to the 2010 revision of the McDonald diagnostic criteria for MS and are thus classified as clinically isolated syndrome (CIS). To re-evaluate the utility of cerebrospinal fluid (CSF) analysis in the context of the revised McDonald criteria from 2010, we conducted a retrospective multicenter study aimed at determining the prevalence and predictive value of oligoclonal IgG bands (OCBs) in patients with CIS. Patients were recruited from ten specialized MS centers in Germany and Austria. We collected data from 406 patients; at disease onset, 44/406 (11 %) fulfilled the McDonald 2010 criteria for MS. Intrathecal IgG OCBs were detected in 310/362 (86 %) of CIS patients. Those patients were twice as likely to convert to MS according to McDonald 2010 criteria as OCB-negative individuals (hazard ratio = 2.1, p = 0.0014) and in a shorter time period of 25 months (95 % CI 21-34) compared to 47 months in OCB-negative individuals (95 % CI 36-85). In patients without brain lesions at first attack and presence of intrathecal OCBs (30/44), conversion rate to MS was 60 % (18/30), whereas it was only 21 % (3/14) in those without OCBs. Our data confirm that in patients with CIS the risk of conversion to MS substantially increases if OCBs are present at onset. CSF analysis definitely helps to evaluate the prognosis in patients who do not have MS according to the revised McDonald criteria.
KW  - multiple sklerosis
KW  - MRI criteria
KW  - conversion
KW  - MS
KW  - CSF
KW  - biomarker
KW  - OCB
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-186619
VL  - 263
IS  - 12
ER  -