TY - JOUR A1 - Odin, Per A1 - Chaudhuri, K. Ray A1 - Volkmann, Jens A1 - Antonini, Angelo A1 - Storch, Alexander A1 - Dietrichs, Espen A1 - Pirtošek, Zvezdan A1 - Henriksen, Tove A1 - Horne, Malcolm A1 - Devos, David A1 - Bergquist, Filip T1 - Viewpoint and practical recommendations from a movement disorder specialist panel on objective measurement in the clinical management of Parkinson’s disease JF - npj Parkinson's Disease N2 - Motor aspects of Parkinson’s disease, such as fluctuations and dyskinesia, can be reliably evaluated using a variety of “wearable” technologies, but practical guidance on objective measurement (OM) and the optimum use of these devices is lacking. Therefore, as a first step, a panel of movement disorder specialists met to provide guidance on how OM could be assessed and incorporated into clinical guidelines. A key aspect of the incorporation of OM into the management of Parkinson’s disease (PD) is defining cutoff values that separate “controlled” from “uncontrolled” symptoms that can be modified by therapy and that relate to an outcome that is relevant to the person with PD (such as quality of life). Defining cutoffs by consensus, which can be subsequently tested and refined, is the first step to optimizing OM in the management of PD. OM should be used by all clinicians that treat people with PD but the least experienced may find the most value, but this requires guidance from experts to allow non-experts to apply guidelines. While evidence is gained for devices that produce OM, expert opinion is needed to supplement the evidence base. KW - Parkinson's disease Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234435 VL - 4 ER - TY - JOUR A1 - Kirsch, Anna Dalal A1 - Hassin-Baer, Sharon A1 - Matthies, Cordula A1 - Volkmann, Jens A1 - Steigerwald, Frank T1 - Anodic versus cathodic neurostimulation of the subthalamic nucleus: A randomized-controlled study of acute clinical effects JF - Parkinsonism and Related Disorders N2 - Introduction Stimulation settings of deep brain stimulation (DBS) have evolved empirically within a limited parameter space dictated by first generation devices. There is a need for controlled clinical studies, which evaluate efficacy and safety of established programming practice against novel programming options provided by modern neurostimulation devices. Methods Here, we tested a polarity reversal from conventional monopolar cathodic to anodic stimulation in an acute double-blind, randomized, cross-over study in patients with PD implanted with bilateral STN DBS. The primary outcome measure was the difference between efficacy and side-effect thresholds (current amplitude, mA) in a monopolar review and the severity of motor symptoms (as assessed by MDS-UPDRS III ratings) after 30 min of continuous stimulation in the medication off-state. Results Effect and side effect thresholds were significantly higher with anodic compared to cathodic stimulation (3.36 ± 1.58 mA vs. 1.99 ± 1.37 mA; 6.05 ± 1.52 mA vs. 4.15 ± 1.13 mA; both p < 0.0001). However, using a predefined amplitude of 0.5 mA below the respective adverse effect threshold, blinded MDS-UPDRS-III-ratings were significantly lower with anodic stimulation (anodic: median 17 [min: 12, max: 25]; cathodic: 23 [12, 37]; p < 0.005). Conclusion Effective anodic stimulation requires a higher charge injection into the tissue, but may provide a better reduction of off-period motor symptoms within the individual therapeutic window. Therefore, a programming change to anodic stimulation may be considered in patients suffering from residual off-period motor symptoms of PD despite reaching the adverse effect threshold of cathodic stimulation in the subthalamic nucleus. KW - deep brain stimulation KW - subthalamic nucleus KW - Parkinson's disease KW - anodic stimulation Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-325820 VL - 55 ER - TY - JOUR A1 - Li, Ru-Jin A1 - Han, Muxin A1 - Tessarolo, Jacopo A1 - Holstein, Julian J. A1 - Lübben, Jens A1 - Dittrich, Birger A1 - Volkmann, Christian A1 - Finze, Maik A1 - Jenne, Carsten A1 - Clever, Guido H. T1 - Successive Photoswitching and Derivatization Effects in Photochromic Dithienylethene-Based Coordination Cages JF - ChemPhotoChem N2 - A new series of [Pd2(L)4] cages based on photochromic dithienylethene (DTE) ligands allowed us to gain insight into the successive photoswitching of multiple DTE moieties in a confined metallo-supramolecular assembly. Three new X-ray structures of [Pd2(o-L4)4], [Pd2(o-L1)2(c-L1)2] and [Pd2(c-L1)4] (o-L and c-L = open and closed forms of DTE ligands, respectively) were obtained. The structures deliver snapshots of three different combinations of DTE photoisomeric states within the cage, facilitating a comparison of the all-open with the all-closed, and most notably, an intermediate form where open and closed switches co-exist in the same cage. Moreover, a series of spherical anionic borate clusters was introduced in order to study their roles in the light-controllable host–guest chemistry. The binding guests show higher affinities with the flexible open cage [Pd2(o-L1)4] than with the rigid closed cage [Pd2(c-L1)4]. For the [B12F12]2− guest, thermodynamic data obtained from NMR experiments was compared to results from isothermal titration calorimetry (ITC). KW - coordination cages KW - dithienylethene KW - host-guest systems KW - photoswitches KW - supramolecular chemistry Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236815 VL - 3 ER - TY - JOUR A1 - Steigerwald, Frank A1 - Timmermann, Lars A1 - Kühn, Andrea A1 - Schnitzler, Alfons A1 - Reich, Martin M. A1 - Kirsch, Anna Dalal A1 - Barbe, Michael Thomas A1 - Visser-Vandewalle, Veerle A1 - Hübl, Julius A1 - van Riesen, Christoph A1 - Groiss, Stefan Jun A1 - Moldovan, Alexia-Sabine A1 - Lin, Sherry A1 - Carcieri, Stephen A1 - Manola, Ljubomir A1 - Volkmann, Jens T1 - Pulse duration settings in subthalamic stimulation for Parkinson's disease JF - Movement Disorders N2 - Background Stimulation parameters in deep brain stimulation (DBS) of the subthalamic nucleus for Parkinson's disease (PD) are rarely tested in double-blind conditions. Evidence-based recommendations on optimal stimulator settings are needed. Results from the CUSTOM-DBS study are reported, comparing 2 pulse durations. Methods A total of 15 patients were programmed using a pulse width of 30 µs (test) or 60 µs (control). Efficacy and side-effect thresholds and unified PD rating scale (UPDRS) III were measured in meds-off (primary outcome). The therapeutic window was the difference between patients’ efficacy and side effect thresholds. Results The therapeutic window was significantly larger at 30 µs than 60 µs (P = ·0009) and the efficacy (UPDRS III score) was noninferior (P = .00008). Interpretation Subthalamic neurostimulation at 30 µs versus 60 µs pulse width is equally effective on PD motor signs, is more energy efficient, and has less likelihood of stimulation-related side effects. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society. KW - deep brain stimulation KW - Parkinson's disease; KW - pulse width KW - stimulation parameters KW - subthalamic Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239402 VL - 33 ER - TY - JOUR A1 - Arlotti, Mattia A1 - Palmisano, Chiara A1 - Minafra, Brigida A1 - Todisco, Massimiliano A1 - Pacchetti, Claudio A1 - Canessa, Andrea A1 - Pozzi, Nicoló G. A1 - Cilia, Roberto A1 - Prenassi, Marco A1 - Marceglia, Sara A1 - Priori, Alberto A1 - Rampini, Paolo A1 - Barbieri, Sergio A1 - Servello, Domenico A1 - Volkmann, Jens A1 - Pezzoli, Gianni A1 - Isaias, Ioannis U. T1 - Monitoring subthalamic oscillations for 24 hours in a freely moving Parkinson's disease patient JF - Movement Disorders N2 - No abstract available Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-221249 VL - 34 ER -