TY - THES A1 - Rott, Evelyn T1 - Experimentelle autoimmune Enzephalomyelitis in beta2 Mikroglobulin knock-out Mäusen : axonaler Schaden entsteht unabhängig von MHC-I Expression T1 - EAE in beta-2 microglobulin-deficient mice: axonal damage is not dependent on MHC-I restricted immune responses N2 - CD4 T-Zellen wurden lange als die vor allem pathogen wirkenden Immunzellen bei chronisch entzündlichen ZNS-Erkrankungen angesehen. Wir untersuchten die Wirkung von CD8 T-Zellen in der EAE (exp. autoimmunen Enzephalomyelitis = Tiermodell der Multiplen Sklerose) anhand von beta2-Mikroglobulin knock-out Mäusen (fehlende CD8 T-Zellen). Ergebnis: im Vergleich zu den Wildtyptieren zeigten die Knock-outs eine signifikant stärker ausgeprägte Erkrankung bei der mit verschiedenen Antigenen (MOG, MBP) induzierten EAE mit erhöhter Mortalität. Histologisch fnad sich eine vermehrte Infiltration von Makrophagen und Mikroglia. Die Demyelinisierung war bei den Knock-outs stärker ausgeprägt, ebenso auch der axonale Schaden. Das Fehlen von funktionellen CD8 T-Zellen führte demnach zu einer Verstärkung der autoimmunen Gewebsschädigung im ZNS. N2 - There is accumulating evidence that CD8-positive (CD8+) T-cells and MHC-I expression may also play a role in neurodegeneration associated with multiple sclerosis (MS). We investigated the role of MHC-I and CD8+ T-cells by studying experimental autoimmune encephalomyelitis (EAE) in beta-2 microglobulin knockout mice induced by myelin oligodendrocyte glycoprotein (MOG) peptide 35-55 or whole rat myelin basic protein (rMBP). For both encephalitogens and even after reconstitution of the immune system with MHC-I-positive bone marrow and transfer of mature CD8+ T-cells (iMHC-I+ CD8+ beta2m-/- mice), the disease course in beta2m-/- mice was significantly more severe with a 10-fold increased mortality in the beta2m-/- mice as compared to wild-type C57BL/6 mice. EAE in beta2m-/- mice caused more severe demyelination after immunization with MOG than with rMBP and axonal damage was more marked with rMBP as well as MOG even in iMHC-I+ CD8+ beta2m-/- mice. Immunocytochemical analysis of spinal cord tissue revealed a significant increase in macrophage and microglia infiltration in beta2m-/- and iMHC-I+ CD8+ beta2m-/- mice. The different pattern of T-cell infiltration was underscored by a 2.5-fold increase in CD4-positive (CD4+) T-cells in beta2m-/- mice after induction of MOG 35-55 EAE. We conclude that lack of functional MHC-I molecules and CD8+ T-cells aggravates autoimmune tissue destruction in the CNS. Enhanced axonal damage speaks for pathways of tissue damage independent of CD8+ T-cells and neuronal MHC-I expression. KW - EAE KW - beta2 Mikroglobulin knock-out Mäuse KW - axonaler Schaden KW - axonal damage KW - beta2 microglobulin knock-out mice Y1 - 2005 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-19500 ER - TY - JOUR A1 - Jírů-Hillmann, Steffi A1 - Gabriel, Katharina M. A. A1 - Schuler, Michael A1 - Wiedmann, Silke A1 - Mühler, Johannes A1 - Dötter, Klaus A1 - Soda, Hassan A1 - Rascher, Alexandra A1 - Benesch, Sonka A1 - Kraft, Peter A1 - Pfau, Mathias A1 - Stenzel, Joachim A1 - von Nippold, Karin A1 - Benghebrid, Mohamed A1 - Schulte, Kerstin A1 - Meinck, Ralf A1 - Volkmann, Jens A1 - Haeusler, Karl Georg A1 - Heuschmann, Peter U. T1 - Experiences of family caregivers 3-months after stroke: results of the prospective trans-regional network for stroke intervention with telemedicine registry (TRANSIT-Stroke) JF - BMC Geriatrics N2 - Background Long-term support of stroke patients living at home is often delivered by family caregivers (FC). We identified characteristics of stroke patients being associated with receiving care by a FC 3-months (3 M) after stroke, assessed positive and negative experiences and individual burden of FC caring for stroke patients and determined factors associated with caregiving experiences and burden of FC 3 M after stroke. Methods Data were collected within TRANSIT-Stroke, a regional telemedical stroke-network comprising 12 hospitals in Germany. Patients with stroke/TIA providing informed consent were followed up 3 M after the index event. The postal patient-questionnaire was accompanied by an anonymous questionnaire for FC comprising information on positive and negative experiences of FC as well as on burden of caregiving operationalized by the Caregiver Reaction Assessment and a self-rated burden-scale, respectively. Multivariable logistic and linear regression analyses were performed. Results Between 01/2016 and 06/2019, 3532 patients provided baseline and 3 M-follow-up- data and 1044 FC responded to questionnaires regarding positive and negative caregiving experiences and caregiving burden. 74.4% of FC were older than 55 years, 70.1% were women and 67.5% were spouses. Older age, diabetes and lower Barthel-Index in patients were significantly associated with a higher probability of receiving care by a FC at 3 M. Positive experiences of FC comprised the importance (81.5%) and the privilege (70.0%) of caring for their relative; negative experiences of FC included financial difficulties associated with caregiving (20.4%). Median overall self-rated burden was 30 (IQR: 0–50; range 0–100). Older age of stroke patients was associated with a lower caregiver burden, whereas younger age of FC led to higher burden. More than half of the stroke patients in whom a FC questionnaire was completed did self-report that they are not being cared by a FC. This stroke patient group tended to be younger, more often male with less severe stroke and less comorbidities who lived more often with a partner. Conclusions The majority of caregivers wanted to care for their relatives but experienced burden at the same time. Elderly patients, patients with a lower Barthel Index at discharge and diabetes are at higher risk of needing care by a family caregiver. Trial registration The study was registered at “German Clinical Trial Register”: DRKS00011696. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011696 KW - family caregiver KW - informal care KW - stroke KW - stroke care KW - telemedicine network Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-313330 VL - 22 ER - TY - JOUR A1 - Badr, Mohammad A1 - McFleder, Rhonda L. A1 - Wu, Jingjing A1 - Knorr, Susanne A1 - Koprich, James B. A1 - Hünig, Thomas A1 - Brotchie, Jonathan M. A1 - Volkmann, Jens A1 - Lutz, Manfred B. A1 - Ip, Chi Wang T1 - Expansion of regulatory T cells by CD28 superagonistic antibodies attenuates neurodegeneration in A53T-α-synuclein Parkinson’s disease mice JF - Journal of Neuroinflammation N2 - Background Regulatory CD4\(^+\)CD25\(^+\)FoxP3\(^+\) T cells (Treg) are a subgroup of T lymphocytes involved in maintaining immune balance. Disturbance of Treg number and impaired suppressive function of Treg correlate with Parkinson’s disease severity. Superagonistic anti-CD28 monoclonal antibodies (CD28SA) activate Treg and cause their expansion to create an anti-inflammatory environment. Methods Using the AAV1/2-A53T-α-synuclein Parkinson’s disease mouse model that overexpresses the pathogenic human A53T-α-synuclein (hαSyn) variant in dopaminergic neurons of the substantia nigra, we assessed the neuroprotective and disease-modifying efficacy of a single intraperitoneal dose of CD28SA given at an early disease stage. Results CD28SA led to Treg expansion 3 days after delivery in hαSyn Parkinson’s disease mice. At this timepoint, an early pro-inflammation was observed in vehicle-treated hαSyn Parkinson’s disease mice with elevated percentages of CD8\(^+\)CD69\(^+\) T cells in brain and increased levels of interleukin-2 (IL-2) in the cervical lymph nodes and spleen. These immune responses were suppressed in CD28SA-treated hαSyn Parkinson’s disease mice. Early treatment with CD28SA attenuated dopaminergic neurodegeneration in the SN of hαSyn Parkinson’s disease mice accompanied with reduced brain numbers of activated CD4\(^+\), CD8\(^+\) T cells and CD11b\(^+\) microglia observed at the late disease-stage 10 weeks after AAV injection. In contrast, a later treatment 4 weeks after AAV delivery failed to reduce dopaminergic neurodegeneration. Conclusions Our data indicate that immune modulation by Treg expansion at a timepoint of overt inflammation is effective for treatment of hαSyn Parkinson’s disease mice and suggest that the concept of early immune therapy could pose a disease-modifying option for Parkinson’s disease patients. KW - Parkinson’s disease KW - neuroinflammation KW - T cells KW - regulatory T cells KW - neuroprotection Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-300580 VL - 19 ER - TY - JOUR A1 - Zeller, Daniel A1 - Dang, Su-Yin A1 - Weise, David A1 - Rieckmann, Peter A1 - Toyka, Klaus V. A1 - Classen, Joseph T1 - Excitability decreasing central motor plasticity is retained in multiple sclerosis patients N2 - Background: Compensation of brain injury in multiple sclerosis (MS) may in part work through mechanisms involving neuronal plasticity on local and interregional scales. Mechanisms limiting excessive neuronal activity may have special significance for retention and (re-)acquisition of lost motor skills in brain injury. However, previous neurophysiological studies of plasticity in MS have investigated only excitability enhancing plasticity and results from neuroimaging are ambiguous. Thus, the aim of this study was to probe long-term depression-like central motor plasticity utilizing continuous theta-burst stimulation (cTBS), a non-invasive brain stimulation protocol. Because cTBS also may trigger behavioral effects through local interference with neuronal circuits, this approach also permitted investigating the functional role of the primary motor cortex (M1) in force control in patients with MS. Methods: We used cTBS and force recordings to examine long-term depression-like central motor plasticity and behavioral consequences of a M1 lesion in 14 patients with stable mild-to-moderate MS (median EDSS 1.5, range 0 to 3.5) and 14 age-matched healthy controls. cTBS consisted of bursts (50 Hz) of three subthreshold biphasic magnetic stimuli repeated at 5 Hz for 40 s over the hand area of the left M1. Corticospinal excitability was probed via motor-evoked potentials (MEP) in the abductor pollicis brevis muscle over M1 before and after cTBS. Force production performance was assessed in an isometric right thumb abduction task by recording the number of hits into a predefined force window. Results: cTBS reduced MEP amplitudes in the contralateral abductor pollicis brevis muscle to a comparable extent in control subjects (69 ± 22% of baseline amplitude, p < 0.001) and in MS patients (69 ± 18%, p < 0.001). In contrast, postcTBS force production performance was only impaired in controls (2.2 ± 2.8, p = 0.011), but not in MS patients (2.0 ± 4.4, p = 0.108). The decline in force production performance following cTBS correlated with corticomuscular latencies (CML) in MS patients, but did not correlate with MEP amplitude reduction in patients or controls. Conclusions: Long-term depression-like plasticity remains largely intact in mild-to-moderate MS. Increasing brain injury may render the neuronal networks less responsive toward lesion-induction by cTBS. KW - Medizin KW - Multiple sclerosis KW - LTD KW - Motor plasticity KW - TMS KW - Motor cortex Y1 - 2012 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-76333 ER - TY - THES A1 - Hähnel, Luzia Maria T1 - Evaluation von Beta-2-Mikroglobulin, Laktat und Angiotensin-Converting Enzyme im Liquor als Biomarker der Multiplen Sklerose T1 - Evaluation of beta-2-microglobulin, lactate and angiotensin-converting enzyme in CSF as biomarkers in multiple sclerosis N2 - This study investigates the suitability of beta-2-microglobulin (β2-microglobulin), lactate and angiotensin-converting enzyme (ACE) as biomarkers, given the good availability of these parameters in routine diagnostics but lack of data in this regard. For this purpose, 6,310 CSF samples obtained at the Neurological Clinic of the University Hospital of Würzburg were analyzed. Closer analysis was carried out of 276 cases with non-inflammatory neurological diseases (NIND; control group) and 438 MS cases not taking an immunotherapy treatment (study group). In the MS cases, the form of progression of the disease and the disease activity (clinical relapses, progression index) were recorded. A clear correlation could be seen between age and CSF levels of β2-microglobulin, lactate and ACE in both the MS and control groups, whereby a correction was required for the subsequent comparison studies; this could also at least partly explain the contradictory data obtained in other studies to date. The MS cases showed elevated β2-microglobulin and lactate levels and decreased ACE levels in CSF compared to the controls. In both groups, there was a positive correlation between β2-microglobulin and ACE levels. In the separate analysis of the forms of progression of MS, cases with clinically-isolated syndrome (CIS) and relapsing-remitting MS (RRMS) revealed elevated β2-microglobulin levels, whilst cases with secondary-progressive or primary-progressive MS (SPMS or PPMS) did not. Lactate levels were only increased in cases of CIS. Cases with a relapsing course showed reduced ACE levels. The disease activity could not reliably be mapped by the parameters. Lactate levels tended to be elevated during a relapse, but this result was no longer significant after correction. Lactate levels also showed a positive correlation with the progression index. Our findings in this study provide evidence that the examined analysis parameters cannot be used in isolation to assess progression, disease activity and duration of disease. However, the significant differences between relapsing and chronic-progressive courses support the hypothesis of different underlying mechanisms of pathogenesis, and could serve as a starting basis for further studies. N2 - In der vorliegenden Arbeit wurde die Eignung der im Rahmen der Routinediagnostik verfügbaren, aber unzu¬reichend charakterisierten Analyten Beta-2-Mikroglobulin (β2-Mikroglobulin), Laktat und Angiotensin-Converting Enzyme (ACE) als Biomarker untersucht. Dazu wurden 6.310 an der Neurologischen Klinik des Universitätsklinikums Würzburg gewonnene Liquorproben analysiert. Näher analysiert wurden 276 Fälle mit nicht entzünd¬lichen neurologischen Erkrankungen (NIND; Kontrollgruppe) und 438 nicht immuntherapeutisch behandelte MS-Fälle (Untersuchugsgruppe). Bei den MS-Fällen wurde die Verlaufs¬form und Krankheitsaktivität (klinische Schübe, Progressionsindex) dokumentiert. Es zeigte sich eine deutliche Altersabhängigkeit der Liquorspiegel von β2-Mikroglobulin, Laktat und ACE in der MS- und Kontrollgruppe, was für die sich anschließenden weiteren Vergleichsuntersuchungen eine Korrektur erforderte und zumindest teilweise die wider¬sprüchliche Datenlage bisheriger Studien erklären könnte. MS-Fälle zeigten im Liquor im Vergleich zu Kontrollen erhöhte β2-Mikroglobulin- und Laktat- sowie er¬niedrigte ACE-Spiegel. In beiden Gruppen korrelierten die β2-Mikroglobulin- und ACE-Spiegel positiv miteinander. Bei der getrennten Analyse der MS-Verlaufsformen zeigten Fälle mit klinisch isoliertem Syndrom (CIS) und schubförmig remittierender MS (RRMS) erhöhte β2-Mikroglobulin-Spiegel, Fälle mit sekundär bzw. primär pro¬gredienter MS (SPMS bzw. PPMS) dagegen nicht. Die Laktat-Spiegel waren lediglich bei CIS-Fällen erhöht. Fälle mit schubförmigen Verläufen zeigten reduzierte ACE-Spiegel. Die Krankheitsaktivität wurde durch die Parameter nicht zuverlässig abgebildet. Die Laktat-Spiegel waren tendenziell bei einem Schub erhöht, das Ergebnis war nach Korrektur aber nicht mehr signifikant. Die Laktat-Spiegel korrelierten zudem positiv mit dem Progressionsindex. Die vorliegenden Befunde belegen, dass die untersuchten Analyten alleine nicht in der Lage sind, die Verlaufsform, Krankheitsaktivität und -dauer zu beurteilen. Die deutlichen Unterschiede zwischen schubförmigen und chronisch progredienten Verläufen unterstützen jedoch die Hypothese unterschiedlicher zugrundeliegender Pathomechanismen und könnten als Ausgangspunkt für weitere Untersuchungen dienen. KW - Multiple Sklerose KW - Biomarker KW - Liquor cerebrospinalis KW - Mikroglobulin KW - ACE KW - Laktat Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-258503 ER - TY - JOUR A1 - Haarmann, Axel A1 - Deiss, Annika A1 - Prochaska, Juergen A1 - Foerch, Christian A1 - Weksler, Babette A1 - Romero, Ignacio A1 - Couraud, Pierre-Olivier A1 - Stoll, Guido A1 - Rieckmann, Peter A1 - Buttmann, Mathias T1 - Evaluation of Soluble Junctional Adhesion Molecule-A as a Biomarker of Human Brain Endothelial Barrier Breakdown N2 - Background: An inducible release of soluble junctional adhesion molecule-A (sJAM-A) under pro-inflammatory conditions was described in cultured non-CNS endothelial cells (EC) and increased sJAM-A serum levels were found to indicate inflammation in non-CNS vascular beds. Here we studied the regulation of JAM-A expression in cultured brain EC and evaluated sJAM-A as a serum biomarker of blood-brain barrier (BBB) function. Methodology/Principal Findings: As previously reported in non-CNS EC types, pro-inflammatory stimulation of primary or immortalized (hCMEC/D3) human brain microvascular EC (HBMEC) induced a redistribution of cell-bound JAM-A on the cell surface away from tight junctions, along with a dissociation from the cytoskeleton. This was paralleled by reduced immunocytochemical staining of occludin and zonula occludens-1 as well as by increased paracellular permeability for dextran 3000. Both a self-developed ELISA test and Western blot analysis detected a constitutive sJAM-A release by HBMEC into culture supernatants, which importantly was unaffected by pro-inflammatory or hypoxia/reoxygenation challenge. Accordingly, serum levels of sJAM-A were unaltered in 14 patients with clinically active multiple sclerosis compared to 45 stable patients and remained unchanged in 13 patients with acute ischemic non-small vessel stroke over time. Conclusion: Soluble JAM-A was not suited as a biomarker of BBB breakdown in our hands. The unexpected non-inducibility of sJAM-A release at the human BBB might contribute to a particular resistance of brain EC to inflammatory stimuli, protecting the CNS compartment. KW - Biomarker KW - Gehirn Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68468 ER - TY - THES A1 - Bischofs, Stefan T1 - Evaluation der antihyperalgetischen und neuroregenerativen Wirkung von Topiramat nach tierexperimenteller peripherer Nervenläsion T1 - Evaluation of topiramate as an antihyperalgesic and/or neuroregenerative agent after peripheral nerve injury N2 - Evaluation der antihyperalgetischen wie neuroregenerativen Potenz von Topiramat nach peripherer Nervenläsion. Untersuchung im Tiermodell nach CCI / Crush-Nervenläsion. Verhaltenstestungen, morphometrisch histologische Analysen, Immunhistochemische Färbungen, elektrophysiologische Studien sowie RT-PCR. Topiramat zeigte hierbei - modulierende Wirkung auf die Entwicklung einer mechanischen Hyperalgesie wie Kälteallodynie nach CCI, auf Hitzehyperalgesie wie Kälteallodynia nach Crush - keine neuroprotektive oder pro-regenerative Wirkung in den von uns verwendeten Läsionsmodellen - eine ausgeprägte Modulation des zellulären Zytokinmilieus distal der Nervenläsion im Sinne einer Hochregulation proinflammatorischer Zytokine. N2 - Evaluation of Topiramate as an antihyperalgesic and/or neuroregenerative agent after peripheral nerve injury. Behavioral testing, morphometric analysis, immunohistochemistry, electrophysiological study and RT-PCR. Topiramate showed - a modulation of the development of mechanical hyperalgesia and cold allodynia post CCI, further on heat hyperalgesia and cold allodynia after crush lesion of the peripheral nerve. - no neuroprotective or pro-regenerative effect in the lesion models applied - a marked alteration of the cellular cytokine-mileu, elevation of pro-inflammatory cytokines. KW - Topiramat KW - CCI KW - Crush KW - Neuroregeneration KW - neuropathischer Schmerz KW - Topiramate KW - CCI KW - crush KW - neuroregeneration KW - neuropathic pain Y1 - 2005 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-18352 ER - TY - THES A1 - Magg, Barbara T1 - Etablierung und Validierung des Würzburger Fabry Schmerzfragebogens für erwachsene Patienten T1 - A comprehensive Fabry-related pain questionnaire for adult patients N2 - Der M. Fabry ist eine X-chromosomal vererbte lysosomale Speicherkankheit, die zu einem Multiorganversagen führt. Ein frühes Symptom sind Schmerzen, die meist schon in der frühen Kindheit einsetzen. Das Besondere an diesen Schmerzen ist, dass sie sich sehr unterschiedlich u.a. bezüglich ihres Verlaufs, ihrer Dauer und ihrer Lokalisation präsentieren können. Diese Fabry-assoziierten Schmerzen sind meist brennend und akral betont, können aber auch andere Qualitäten aufweisen und sehr variable Körperpartien erfassen, was ihre diagnostische Einordnung erschwert. Bisher verfügbare validierte Schmerzfragebögen können das Spektrum der Fabry-assoziierten Schmerzen nicht erfassen. In dieser Arbeit wird der erste M. Fabry spezifische Schmerzfragebogen für Erwachsene in zwei Versionen präsentiert. Die erste Version ist eine Interview Version (iFPQ), bei der der Arzt in einem persönlichen Gespräch mit dem Patienten mit Hilfe des Fragbogens alle wesentlichen Aspekte der Fabry-assoziierten Schmerzen erfragen kann. Die zweite Version kann eigenständig vom Patienten ausgefüllt werden (saFPQ). Zur Etablierung der Fragebögen wurde in einer Pilotstudie zunächst mit 20 Patienten eine erste Version des iFPQ entwickelt. Nach Verbesserungen wurde die Interview Version mit Hilfe von 42 Studienteilnehmern validiert, die jeweils an einem Erst- und Zweitgespräch im Abstand von zwei Wochen teilnahmen. Hierbei wurde auch der NPSI als vergleichender Fragebogen ausgefüllt. Bei der ersten statistischen Analyse ergab sich eine gute Reliabilität mit ICC-Werten von 0,896 bis 0,999 aber eine unzureichende Validität zwischen iFPQ und NPSI mit K-Werten von 0,257 bis 0,566. Nach der ersten statistischen Analyse wurde der Fragebogen erneut überarbeitet und mit Hilfe von 20 Studienteilnehmern erneut validiert. Anschließend zeigte sich eine gute Validität mit K-Werten von 0,634 bis 1,0. Der saFPQ wurde im Anschluss an die finale iFPQ Version entwickelt. Bei 40 Patienten erfolgte ein Erstgespräch, bei dem die Patienten die valide Version des iFPQ ausfüllten. Im Abstand von zwei Wochen schickten die Patienten dann die selbständig ausgefüllte Version des saFPQ postalisch zurück. Die postalische Version erweitert die Flexibilität dieses Fragebogens. Sie ist für den klinischen Alltag sehr relevant. Die Resonanz der Patienten hinsichtlich beider Fragebögen war sehr positiv. Perspektivisch ist die Entwicklung einer englischen Version geplant. N2 - Pain may be the earliest symptom in Fabry disease and presents with a distinct phenotype including triggerable pain attacks, evoked pain, pain crises, and chronic pain. Current pain questionnaires do not reflect the special phenotype of Fabry disease–associated pain, which hampers its systematic evaluation as the basis of correct diagnosis and effective treatment. A questionnaire specifically designed to assess Fabry disease–associated pain is thus urgently needed. At the Würzburg Fabry Center for Interdisciplinary Therapy (FAZIT), Germany, we developed and validated the first face-to-face Fabry Pain Questionnaire (FPQ) for adult patients. The initial version of the FPQ was tested in a pilot study with 20 consecutive Fabry disease patients. The performance of the revised FPQ was assessed in a first (n = 56) and second (n = 20) validation phase in consecutive Fabry disease patients. For this, patients were interviewed at baseline and 2 weeks later. We determined the test-retest reliability and validity of the FPQ in comparison to data obtained with the Neuropathic Pain Symptom Inventory. The FPQ contains 15 questions on the 4 pain phenotypes of Fabry disease (pain attacks, pain crises, evoked pain, chronic pain) in childhood and adulthood, on pain development during life with and without enzyme replacement therapy, and on everyday life impairment due to pain. a self-administered Version of the face-to-face Version was validated accordingly to the face-to-face 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). 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. This first disease-specific questionnaire is a valuable tool for baseline and follow-up assessment of pain in Fabry disease patients and may guide treatment in this distinct pain phenotype. The self-administered version allows a more flexible usage. In the future an english version is anticipated. KW - M.Fabry KW - neuropathischer Schmerz KW - Schmerzfragebogen KW - M. Fabry KW - neuropathischer Schmerz KW - Schmerzfragebogen Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-154928 ER - TY - JOUR A1 - Schanbacher, Constanze A1 - Bieber, Michael A1 - Reinders, Yvonne A1 - Cherpokova, Deya A1 - Teichert, Christina A1 - Nieswandt, Bernhard A1 - Sickmann, Albert A1 - Kleinschnitz, Christoph A1 - Langhauser, Friederike A1 - Lorenz, Kristina T1 - ERK1/2 activity is critical for the outcome of ischemic stroke JF - International Journal of Molecular Sciences N2 - Ischemic disorders are the leading cause of death worldwide. The extracellular signal-regulated kinases 1 and 2 (ERK1/2) are thought to affect the outcome of ischemic stroke. However, it is under debate whether activation or inhibition of ERK1/2 is beneficial. In this study, we report that the ubiquitous overexpression of wild-type ERK2 in mice (ERK2\(^{wt}\)) is detrimental after transient occlusion of the middle cerebral artery (tMCAO), as it led to a massive increase in infarct volume and neurological deficits by increasing blood–brain barrier (BBB) leakiness, inflammation, and the number of apoptotic neurons. To compare ERK1/2 activation and inhibition side-by-side, we also used mice with ubiquitous overexpression of the Raf-kinase inhibitor protein (RKIP\(^{wt}\)) and its phosphorylation-deficient mutant RKIP\(^{S153A}\), known inhibitors of the ERK1/2 signaling cascade. RKIP\(^{wt}\) and RKIP\(^{S153A}\) attenuated ischemia-induced damages, in particular via anti-inflammatory signaling. Taken together, our data suggest that stimulation of the Raf/MEK/ERK1/2-cascade is severely detrimental and its inhibition is rather protective. Thus, a tight control of the ERK1/2 signaling is essential for the outcome in response to ischemic stroke. KW - ERK1/2 KW - tMCAO KW - ischemic stroke KW - RKIP Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-283991 SN - 1422-0067 VL - 23 IS - 2 ER - TY - THES A1 - Mötzing, Sandra T1 - Entwicklung von Merkelzellen in der Haut von P0-defizienten Mäusen T1 - Development of Merkel cells in P0-deficient mice N2 - Hereditäre periphere Neuropathien sind chronische Erkrankungen des peripheren Nervensystems, einhergehend mit Muskelschwäche und sensorischer Dysfunktion. Die Merkelzelle als Mechanorezeptor der Haut wird von einer myelinisierten langsam adaptierenden Afferenz (Aß) innerviert. Deshalb wurde in der vorliegenden Arbeit als sekundärer Indikator für die distale Innervation in P0-defizienten Mäusen, ein Tiermodell der hereditären motorisch-sensorischen Déjérine-Sottas-Neuropathie, die Merkelzellzahl in der Haut dieser Tiere untersucht. Zusätzlich wurde untersucht, ob durch den Gendefekt das unmyelinisierte Nervenfasersystem der Haut und das Vorkommen von Neurotrophinen (NT-3, NGF) in den P0-defizienten Mäusen beeinflußt wird. Zur Anwendung kamen 6 Wochen, 4 Monate und 6 Monate alte Wildtyp- und P0-defiziente Mäuse. Unter Zuhilfenahme immunhistochemischer Färbemethoden, computergestützter und lichtmikroskopischer Auswerteverfahren konnte ein Verlust von Merkelzellen in behaarter als auch in unbehaarter Haut mit fortschreitenden Alter der Tiere gezeigt werden. Die Bestimmung des NT-3- und NGF-Gehaltes mittels enzymgekoppelten Assays ergab keine signifikante Reduktion des Vorkommens dieser Neurotrophine. Neben dem beträchtlichen Verlust an Merkelzellen konnte man keinen Effekt auf unmyelinisierte intraepidermale Nervenfasern nachweisen. Im Gegensatz dazu stellte eine parallel durchgeführte Studie an Nervus femoralis und Nervus ischiadicus in 6 Monate alten P0-defizienten Tieren eine 70 Prozent Reduktion myelinisierter Axone fest, so daß wir daraus eine Abhängigkeit der Merkelzelle von ihrer assoziierten myelinisierten SAI-Afferenz sowohl in behaarter als auch in unbehaarter Haut in den P0-defizienten Tieren schlußfolgerten. Der Verlust an Merkelzellen und die Beeinträchtigung von myelinisierten Nervenfasern in den P0-defizienten Tieren kann nicht als sekundäre Wirkung eines veränderten trophischen Gehaltes an NT-3 oder NGF angesehen werden, sondern ist vielmehr durch den axonalen Verlust erklärbar. Die intraepidermalen unmyelinisierten Nervenfasern bleiben durch den Gendefekt unbeeinflußt, so daß die Mutation im P0-Gen eine Spezifität für das myelinisierte Nervenfasersystem zeigt. Wichtige Ergebnisse dieser Arbeit wurden bereits veröffentlicht. N2 - Inherited peripheral neuropathies are chronical diseases of the peripheral nervous system, associated with muscular weakness and sensory dysfunction. Merkel cells, which are specialized epidermal cells are innervated by slowly adapting mechanosensitive afferent fibres with large myelinated (Aß) axons. In P0-deficient mice, an animal modell of the inherited Charcot-Marie-Tooth Neuropathy, we examined the population of Merkel cells as an indirect indicator of the distal innervation. Additionally, we observed the intraepidermal nerve fibre system and the amount of neurotrophin-3 and nerve growth factor, if they are affected by the mutation in the P0-Gen. We used 6 weeks, 4 months and 6 months old mice, homozygot mutation of the P0-Gen and age-matched Wildtyp-Control-mice. By using immunhistochemical staining methods, computer-guided and light microscopical techniques, we find a profound loss of Merkel cells in both hairy and glabrous skin, increased with age of the animals. Despite of these loss, we could not obtain a corresponding reduction of neurotrophin-3 or nerve growth factor nor an effect of the number of intraepidermal umyelinated nerve fibres. A parallel study on the Femoral and Ischiatic nerve in 6 months old P0-deficient mice shows a reduction of 70 percent of myelinated axons. This finding indicates that the contact with the assosiated myelinated nerve fibre is crucial for the development and maintenance of the Merkel cells in both hairy and against previous studies in glabrous skin. The loss of Merkel cells and the reduction of myelinated nerve fibres are unlikely the cause of a changed amount of neurotrophins. The intraepidermal unmyelinated nerve fibre system are not affected by the mutation, suggests that the mutation of the P0-Gen is specific to myelinated nerve fibres. Important results are published in the Journal of Neuroscience 1999. KW - Hereditäre Neuropathien KW - Myelinprotein KW - Merkelzelle KW - Neurotrophine KW - Nervenfaser KW - Inherited neuropathies KW - myelin protein zero KW - Merkel cells KW - neurotrophins KW - nerve fibres Y1 - 2002 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-578 ER - TY - THES A1 - Kusche-Tekin, Burak Baris T1 - Entwicklung einer fokalen Dystonie durch periphere Nervenschädigung bei \(Tor1a\) +/- Mäusen T1 - Focal dystonia manifests in \(Tor1a\) +/- mice via a striatal dopaminergic dysregulation triggered by peripheral nerve injury N2 - Focal dystonia manifests in Tor1a+/- mice via a striatal dopaminergic dysregulation triggered by peripheral nerve injury Chi Wang Ip, Ioannis U. Isaias, Burak B. Kusche - Tekin, Dennis Klein, Janos Groh, Aet O’Leary, Susanne Knorr, Takahiro Higuchi, James B. Koprich, Jonathan M. Brotchie, Klaus V. Toyka, Andreas Reif, Jens Volkmann 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. N2 - Hintergrund dieser Doktorarbeit ist die ungeklärte Pathophysiologie der idiopathischen Dystonie. Die DYT1 Dystonie ist die häufigste hereditäre Dystonie und weist eine Mutation im Tor1a-Gen auf, welches das Protein TorsinA kodiert. Diese DYT1 Dystonie besitzt interessanterweise lediglich eine Penetranz von 30%. Ein gutes Nagermodell mit einem klinisch dystonen Phänotyp existiert bislang nicht. Diese Dissertation adressiert die Frage, ob sich eine Dystonie bei DYT1 relevanter genetischer Prädisposition durch peripheren Stress („second-hit“) manifestiert. Bei Tor1a +/- Mäusen (50% TorsinA Expression, Tor1a +/-), die im naiven Zustand keinen dystonen Phänotyp haben, sowie bei Wildtyp (wt) Kontrolltieren im Alter von vier Monaten wurde eine rechtsseitige reversible N. ischiadicus Quetschläsion durchgeführt. Die Tiere wurden daraufhin in einem Beobachtungszeitraum von acht Wochen nach dem Trauma verhaltensanalytisch und morphologisch untersucht. Folgende Ergebnisse wurden hierbei erzielt: Im „Tail-suspension-Test“ zeigte sich bereits ein Tag nach der Quetschläsion des N. ischiadicus eine passagere Parese des betroffenen rechten Hinterbeins bei wt und Tor1a +/- Mäusen. Die fokale Dystonie entwickelte sich ab der vierten Woche bei Tor1a +/- Mäusen stärker als bei den wt Kontrolltieren. Durch das computergestützte Ganganalysesystem (Catwalk™ XT 10.0) konnte bei wt und Tor1a +/- Tieren eine Woche nach der Quetschläsion eine Veränderung der Schrittfolgemuster mit einer Reduktion des Schrittfolge-Regularitäts-Index festgestellt werden. Die abnormale Schrittfolge beim Laufen führte bei Tor1a +/- Mäusen zu einer progredienten Abnahme des Schrittfolge-Regularitäts-Index, während sich wt Mäuse nach fünf Wochen aber wieder erholten. Bei der Überprüfung der Koordinationsfähigkeit beider Genotypen durch den Rotarod Test konnten keine signifikanten Unterschiede festgestellt werden. Immunhistochemische Färbungen des N. ischiadicus auf den Myelinmarker Myelinprotein Zero MPZ, den axonalen Marker Neurofilament und Makrophagen Marker F4/80+ vor der Nervenläsion und acht Wochen nach der Nervenläsion zeigten ebenso keine signifikanten Unterschiede zwischen wt und Tor1a +/- Tieren. Die Anzahl Nissl+ Neurone im lumbalen Rückenmark (L2-4), Striatum und zerebralen Kortex und zudem die Anzahl CD11b positiver Mikroglia im lumbalen Rückenmark (L2-4) wiesen ebenfalls keine signifikanten Unterschiede im Vergleich der beiden Genotypen nach Nervenläsion auf. Abschließend wurden noch verschiedene Behandlungsexperimente durchgeführt, um zu klären, ob die gefundenen Unterschiede zwischen Tor1a +/- und Tor1a +/+ Mäusen dopaminerg verursacht sind. Hierfür wurden sowohl genetisch mutierte Tor1a +/- Mäuse als auch wt Mäuse nach der Quetschläsion entweder mit einem Kombinationspräparat aus L-Dopa und Benserazid oder mit AMPT acht Wochen lang behandelt. Folgende Ergebnisse wurden hierbei ermittelt: Die Schrittfolgeregularität beim Catwalk™ XT 10.0 zeigte bei genetisch mutierten Mäusen eine deutliche Auswirkung der Medikation. Tor1a +/- AMPT Mäuse wiesen nach der Läsion eine progrediente Zunahme der Schrittfolgeregularität auf das Ausgangsniveau auf, Tor1a + /- L-Dopa Mäuse hingegen entwickelten auf die Läsion hin eine kontinuierliche Abnahme der Schrittfolgeregularität und konnten sich nicht auf ihr Ausgangsniveau erholen. Die Ergebnisse beim „Tail-suspension-Test“ zeigten ähnliche Resultate: Tor1a +/- Mäuse wiesen nach der Quetschläsion auf die Verabreichung von AMPT hin eine Reduktion der fokalen Dystonie auf, wohingegen die Behandlung mit L-Dopa bei Mutanten zu einer Verschlechterung der Dystonie führte. Schlussfolgernd zeigt die vorliegende Dissertation, dass ein peripheres Trauma bei genetisch prädispositionierten Mäusen im Sinne eines „second-hits“ zur klinischen Ausprägung einer DYT1 Dystonie führt. Die verstärkte fokale Dystonie in Tor1a +/- Mäusen ist nicht durch ein unterschiedliches Ausmaß an Nervenschädigung nach N. ischiadicus Quetschläsion oder durch morphologische Veränderungen der Tor1a +/- Mäuse im Bereich des N. ischiadicus, Rückenmarks, Striatums oder des Kortex zu begründen. KW - Focal dystonie KW - DYT1 KW - Tor1a KW - peripheral nerve injury KW - striatal dopaminergic dysregulation Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-175161 N1 - siehe auch: Acta Neuropathologica Communications, Biomed Central London, Jahrgang 4 Ausgabe 108, 14 Seiten ER - TY - JOUR A1 - Jovanovic, Ana A1 - Klassen, Philipp A1 - Heuschmann, Peter A1 - Sommer, Claudia A1 - Roberts, Mark A1 - Üçeyler, Nurcan T1 - English version of the self-administered Fabry Pain Questionnaire for adult patients JF - Orphanet Journal of Rare Diseases N2 - Background Pain is an early symptom of Fabry disease (FD) and is characterized by a unique phenotype with mainly episodic acral and triggerable burning pain. Recently, we designed and validated the first pain questionnaire for adult FD patients in an interview and a self-administered version in German: the Wurzburg Fabry Pain Questionnaire (FPQ). We now report the validation of the English version of the self-administered FPQ (enFPQ). Methods After two forward-backward translations of the FPQ by native German and native English speakers, the enFPQ was applied at The Mark Holland Metabolic Unit, Manchester, UK for validation. Consecutive patients with genetically ascertained FD and current or previous FD pain underwent a face-to-face interview using the enFPQ. Two weeks later, patients filled in the self-administered enFPQ at home. The agreement between entries collected by supervised administration and self-administration of the enFPQ was assessed via Gwet's AC1-statistics (AC1) for nominal-scaled scores and intraclass correlation coefficient (ICC) for interval-scaled elements. Results Eighty-three FD patients underwent the face-to-face interview and 54 patients sent back a completed self-administered version of the enFPQ 2 weeks later. We found high agreement with a mean AC1-statistics of 0.725 for 55 items, and very high agreement with a mean ICC of 0.811 for 9 items. Conclusions We provide the validated English version of the FPQ for self-administration in adult FD patients. The enFPQ collects detailed information on the individual FD pain phenotype and thus builds a solid basis for better pain classification and treatment in patients with FD. KW - Fabry disease KW - Fabry-associated pain KW - Pain questionnaire KW - English version Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-230298 VL - 15 ER - TY - JOUR A1 - Klein, Dennis A1 - Groh, Janos A1 - Weishaupt, Andreas A1 - Martini, Rudolf T1 - Endogenous antibodies contribute to macrophage-mediated demyelination in a mouse model for CMT1B JF - Journal of Neuroinflammation N2 - Background We could previously identify components of both the innate and the adaptive immune system as disease modifiers in the pathogenesis of models for Charcot-Marie-Tooth (CMT) neuropathies type 1B and 1X. As part of the adaptive immune system, here we investigated the role of antibodies in a model for CMT1B. Methods Antibodies were localized and characterized in peripheral nerves of the CMT1B model by immunohistochemistry and Western blot analysis. Experimental ablation of antibodies was performed by cross breeding the CMT1B models with mutants deficient in B-lymphocytes (JHD−/− mutants). Ameliorated demyelination by antibody deficiency was reverted by intravenous injection of mouse IgG fractions. Histopathological analysis was performed by immunocytochemistry and light and quantitative electron microscopy. Results We demonstrate that in peripheral nerves of a mouse model for CMT1B, endogenous antibodies strongly decorate endoneurial tubes of peripheral nerves. These antibodies comprise IgG and IgM subtypes and are preferentially, but not exclusively, associated with nerve fiber aspects nearby the nodes of Ranvier. In the absence of antibodies, the early demyelinating phenotype is substantially ameliorated. Reverting the neuropathy by reconstitution with murine IgG fractions identified accumulating antibodies as potentially pathogenic at this early stage of disease. Conclusions Our study demonstrates that in a mouse model for CMT1B, endogenous antibodies contribute to early macrophage-mediated demyelination and disease progression. Thus, both the innate and adaptive immune system are mutually interconnected in a genetic model for demyelination. Since in Wallerian degeneration antibodies have also been shown to be involved in myelin phagocytosis, our study supports our view that inherited demyelination and Wallerian degeneration share common mechanisms, which are detrimental when activated under nonlesion conditions. KW - adaptive immune system KW - macrophages KW - antibodies KW - demyelination KW - Charcot-Marie-Tooth KW - B-lymphocytes KW - Fc-receptor KW - complement Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-125036 VL - 12 IS - 49 ER - TY - THES A1 - Siedler, Gabriela Anja T1 - Elektrisch evozierte Schmerz-assoziierte Potentiale bei Patienten mit small – und large fiber Neuropathien T1 - Pain related evoked potentials in patients with small - and large fiber neuropathies N2 - In dieser Studie wurden 108 Patienten mit PNP, 60 Patienten mit M. Fabry und 58 gesunde Kontrollpersonen mittels PREP auf eine small fiber-Pathologie untersucht. Zudem erfolgte eine PREP-Untersuchung bei 5 gesunden Probanden und 3 Patienten nach Anwendung von lokalem Capsaicin. Zur Charakterisierung der small fibers erfolgten zudem Anamnese, klinische Untersuchung, die Fragebögen NPSI, GCPS und ADS, QST und eine Hautbiopsie. In der Gruppe der Patienten mit PNP waren sowohl Patienten mit LFN, MFN und SFN unterschiedlicher Ätiologie vertreten. Patienten mit einer MFN und Patienten mit einer zu einer Mitbeteiligung der small fibers passenden Anamnese (MFN und SFN) wiesen eine verlängerte N1-Latenz nach Stimulation am Fuß auf. Bei einer reduzierten IENFD in der proximalen Hautbiopsie zeigte sich die PPA nach Stimulation im Gesicht reduziert, beide Werte korrelierten positiv miteinander. Bei Patienten mit einer demyelinisierenden PNP war die N1-Latenz nach Stimulation an der Hand verlängert, zudem war bei Patienten mit CIDP die PPA nach Stimulation an Gesicht und Hand reduziert. M. Fabry ist eine X-chromosomal vererbte lysosomale Speicherkrankheit, welche mit einer SFN einhergehen kann. Weibliche Patienten mit M. Fabry und einer subjektiven Hypohidrose als klinische Präsentation einer small fiber Pathologie wiesen eine reduzierte PPA nach Stimulation an Gesicht, Hand und Fuß auf. Über die gesamte Patientengruppe hinweg zeigte sich eine negative Korrelation der PPA nach Stimulation am Fuß mit der klinischen Schmerzpräsentation im NPSI (Summenscore, Subscores evozierte Schmerzen und Schmerzattacken), sowie bei weiblichen Patienten mit der CDT, WDT und TSL in der QST als Marker für die small fiber Funktion. Patienten mit einer längenunabhängigen Reduktion der IENFD wiesen eine niedrigere PPA nach Stimulation am Fuß auf. Ein nicht-auswertbares PREP-Potential spricht nach Ausschluss messtechnischer Artefakte für eine fortgeschrittene Nervenfaserschädigung. Probanden und Patienten zeigten nach Applikation von topischem Capsaicin eine Reduktion der PPA. PREP ist eine einfache, komplikationslos durchzuführende und objektive Methode zur Untersuchung der small fibers. Sie stellt eine sinnvolle Ergänzung zu den bereits etablierten Methoden QST und Hautbiopsie dar und bietet insbesondere für die Evaluation von Medikamenteneffekten wie z.B. von topischem Capsaicin eine vielversprechende Untersuchungsmöglichkeit. N2 - In this study, 108 patients with polyneuropathy, 60 patients with M. Fabry and 58 healthy controls underwent PREP for diagnoses of small fiber pathology. Furthermore, PREP was performed on 5 healthy controls and 3 patients after treatment with local Capsaicin. For characterization of small fibers, anamnesis, clinical examination, NPSI, GCPS, ADS, QST and skin biopsy were performed. In patients with polyneuropathy, patients with LFN, MFN and SFN of different etiology were included. Patients with MFN and patients with clinical symptoms of small fiber pathology had prolonged N1-latency after stimulation at the foot. In case of a reduced IENFD in the proximal skin biopsy, PPA after stimulation at the face was reduced, both parameters correlated. In patients with demyelinating polyneuropathy, N1-latency after stimulation at the hand was prolonged, and in patients with CIDP PPA after stimulation at face and hand was reduced. M. Fabry is an x-chromosomal inherited lysosomal storage disorder, which can induce SFN. Female patients with M. Fabry and subjective hypohidrosis as clinical presentation of small fiber pathology had a reduced PPA after stimulation at face, hand, and foot. Regarding all patients, PPA after stimulation at the foot did show a correlation to clinical symptoms in NPSI (sumscore and subscores for evoked pain and pain attacks), and in female patients with CDT, WDT, and TSL in QST as parameters of small fiber function. Patients with a non-length-dependent reduction of IENFD did show a reduced amplitude after stimulation at the foot. A non-evaluable PREP-potential gives hint on advanced nerve fiber damage after exclusion of examination errors. Patients and controls show a reduction of PPA after application of topical Capsaicin. PREP is an easy, complicationfree and objective method for examination of small fibers. It is a useful additional method alongside established methods, like QST and skin biopsy, and does provide promising possibilities, especially for examination of medication effects, like topical capsaicin. KW - Fabry-Krankheit KW - Evoziertes Potenzial KW - Polyneuropathie KW - Small fiber Neuropathie KW - A delta-Faser Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-167186 ER - TY - JOUR A1 - Karle, Kathrin N. A1 - Schüle, Rebecca A1 - Klebe, Stephan A1 - Otto, Susanne A1 - Frischholz, Christian A1 - Liepelt-Scarfone, Inga A1 - Schöls, Ludger T1 - Electrophysiological characterisation of motor and sensory tracts in patients with hereditary spastic paraplegia (HSP) JF - Orphanet Journal of Rare Diseases N2 - Background: Hereditary spastic paraplegias (HSPs) are characterised by lower limb spasticity due to degeneration of the corticospinal tract. We set out for an electrophysiological characterisation of motor and sensory tracts in patients with HSP. Methods: We clinically and electrophysiologically examined a cohort of 128 patients with genetically confirmed or clinically probable HSP. Motor evoked potentials (MEPs) to arms and legs, somato-sensory evoked potentials of median and tibial nerves, and nerve conduction studies of tibial, ulnar, sural, and radial nerves were assessed. Results: Whereas all patients showed clinical signs of spastic paraparesis, MEPs were normal in 27% of patients and revealed a broad spectrum with axonal or demyelinating features in the others. This heterogeneity can at least in part be explained by different underlying genotypes, hinting for distinct pathomechanisms in HSP subtypes. In the largest subgroup, SPG4, an axonal type of damage was evident. Comprehensive electrophysiological testing disclosed a more widespread affection of long fibre tracts involving peripheral nerves and the sensory system in 40%, respectively. Electrophysiological abnormalities correlated with the severity of clinical symptoms. Conclusions: Whereas HSP is primarily considered as an upper motoneuron disorder, our data suggest a more widespread affection of motor and sensory tracts in the central and peripheral nervous system as a common finding in HSP. The distribution patterns of electrophysiological abnormalities were associated with distinct HSP genotypes and could reflect different underlying pathomechanisms. Electrophysiological measures are independent of symptomatic treatment and may therefore serve as a reliable biomarker in upcoming HSP trials. KW - motor evoked potential (MEP) KW - amyotrophic-lateral-sclerosis KW - somatosensory-evoked-potentials KW - Silver-syndrome KW - gene mutations KW - SPG4 KW - mouse model KW - ALSIN gene KW - neuropathy KW - paraparesis KW - protein KW - electrophysiology KW - hereditary spastic paraplegia (HSP) Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-124763 SN - 1750-1172 VL - 8 IS - 158 ER - TY - JOUR A1 - Schuhmann, Michael K. A1 - Stoll, Guido A1 - Papp, Lena A1 - Bohr, Arne A1 - Volkmann, Jens A1 - Fluri, Felix T1 - Electrical stimulation of the mesencephalic locomotor region has no impact on blood–brain barrier alterations after cerebral photothrombosis in rats JF - International Journal of Molecular Science N2 - Blood–brain barrier (BBB) disruption is a critical event after ischemic stroke, which results in edema formation and hemorrhagic transformation of infarcted tissue. BBB dysfunction following stroke is partly mediated by proinflammatory agents. We recently have shown that high frequency stimulation of the mesencephalic locomotor region (MLR-HFS) exerts an antiapoptotic and anti-inflammatory effect in the border zone of cerebral photothrombotic stroke in rats. Whether MLR-HFS also has an impact on BBB dysfunction in the early stage of stroke is unknown. In this study, rats were subjected to photothrombotic stroke of the sensorimotor cortex and implantation of a stimulating microelectrode into the ipsilesional MLR. Thereafter, either HFS or sham stimulation of the MLR was applied for 24 h. After scarifying the rats, BBB disruption was assessed by determining albumin extravasation and tight junction integrity (claudin 3, claudin 5, and occludin) using Western blot analyses and immunohistochemistry. In addition, by applying zymography, expression of pro-metalloproteinase-9 (pro-MMP-9) was analyzed. No differences were found regarding infarct size and BBB dysfunction between stimulated and unstimulated animals 24 h after induction of stroke. Our results indicate that MLR-HFS neither improves nor worsens the damaged BBB after stroke. Attenuating cytokines/chemokines in the perilesional area, as mediated by MLR-HFS, tend to play a less significant role in preventing the BBB integrity. KW - photothrombotic stroke KW - deep brain stimulation KW - mesencephalic locomotor region KW - blood-brain barrier KW - tight junctions Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201284 SN - 1422-0067 VL - 20 IS - 16 ER - TY - JOUR A1 - Schuhmann, Michael K. A1 - Stoll, Guido A1 - Bohr, Arne A1 - Volkmann, Jens A1 - Fluri, Felix T1 - Electrical stimulation of the mesencephalic locomotor region attenuates neuronal loss and cytokine expression in the perifocal region of photothrombotic stroke in rats JF - International Journal of Molecular Science N2 - Deep brain stimulation of the mesencephalic locomotor region (MLR) improves the motor symptoms in Parkinson’s disease and experimental stroke by intervening in the motor cerebral network. Whether high-frequency stimulation (HFS) of the MLR is involved in non-motor processes, such as neuroprotection and inflammation in the area surrounding the photothrombotic lesion, has not been elucidated. This study evaluates whether MLR-HFS exerts an anti-apoptotic and anti-inflammatory effect on the border zone of cerebral photothrombotic stroke. Rats underwent photothrombotic stroke of the right sensorimotor cortex and the implantation of a microelectrode into the ipsilesional MLR. After intervention, either HFS or sham stimulation of the MLR was applied for 24 h. The infarct volumes were calculated from consecutive brain sections. Neuronal apoptosis was analyzed by TUNEL staining. Flow cytometry and immunohistochemistry determined the perilesional inflammatory response. Neuronal apoptosis was significantly reduced in the ischemic penumbra after MLR-HFS, whereas the infarct volumes did not differ between the groups. MLR-HFS significantly reduced the release of cytokines and chemokines within the ischemic penumbra. MLR-HFS is neuroprotective and it reduces pro-inflammatory mediators in the area that surrounds the photothrombotic stroke without changing the number of immune cells, which indicates that MLR-HFS enables the function of inflammatory cells to be altered on a molecular level. KW - photothrombotic stroke KW - deep brain stimulation KW - mesencephalic locomotor region KW - neuroprotection KW - neuronal apoptosis KW - neuroinflammation Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201355 SN - 1422-0067 VL - 20 IS - 9 ER - TY - THES A1 - Sturn, Anja T1 - Einfluss von niedrigdosierter Heparinbehandlung auf den Verlauf von Stammganglienblutungen T1 - Influence of low-dose heparin therapy on the course of spontaneous basal ganglia hemorrhage N2 - ZIEL: An möglichst großer Fallzahl und vergleichbarem Patientenkollektiv zu überprüfen, ob eine niedrigdosierte Heparintherapie für Patienten mit intracerebralen Blutungen schädliche oder nützliche Auswirkungen hat. METHODEN: retrospektive Analyse von 238 Patienten mit Stammganglienblutungen hinsichtlich Heparinbehandlung sowie operativer vs. konservativer Behandlung und folgende Auswirkung auf Blutungskomplikation, thrombembolische Ereignisse, Mortalität und funktionellem Outcome nach dem GOS. ERGEBNIS: kein Nachblutungsrisiko, durchweg günstigere Prognose für heparinbehandelte Patienten (86% im Kollektiv), bei tendenziell positiver Patientenselektion, weitere prospektive Studien gerechtfertigt und wünschenswert; operative Therapieindikation streng zu stellen N2 - AIM: Investigate on a homogeneous representiv number of patients with ICH the influence of low-dose hepatin treatment on complications/prognosis. METHODS: retrospective analysis of 238 patients (10 year period) with spontaneous basal ganglia hemorrhage with regard to bleeding, threomembolic complications, death, functional outcome (GOS) comparing heparin therapie vs. no prophylactic anticoagulation and distinguishing between operated and conservatively treated patients. RESULT: 86% of patients with low-dose heparin therapy, no risk vor further intracerebral found, better outcome for these patients but positive patient selection, further prospective studies justified and planned; no advantages for operated patients KW - Heparin KW - Antikoagulation KW - Stammganglienblutung KW - ICB KW - heparin KW - anticoagulation KW - basal ganglia hemorrhage KW - ICH Y1 - 2006 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-19113 ER - TY - THES A1 - Weiß, Eva Maria T1 - Einfluss von Makrophagen auf autophagische Vorgänge in Schwann´schen Zellen unter den Bedingungen von Nervenläsion und genetisch bedingter Neuropathie T1 - Influence of macrophages on Schwann cell autophagy under the conditions of nerve lesion and genetic neuropathy N2 - Charcot-Marie-Tooth (CMT) Neuropathien stellen als häufigste erblich bedingte neurologische Erkrankungen eine Gruppe genetisch heterogener, chronisch progredienter peripherer Polyneuropathien dar. Die Lebensqualität der Patienten ist bei fehlender kurativer Therapieoption vor allem durch motorische und sensorische Defizite deutlich eingeschränkt. In verschiedenen Studien konnte die pathophysiologische Relevanz einer sekundären Entzündungsreaktion, insbesondere durch Makrophagen und Lymphozyten vermittelt, in Mausmodellen dreier CMT1 Subtypen (CMT1A, CMT1B, CMT1X) aufgezeigt werden. Auch in Folge einer Läsion peripherer Nerven ist eine akute Entzündungsreaktion von entscheidender Bedeutung, wobei sich bereits Gemeinsamkeiten zwischen der postläsionalen Waller´schen Degeneration (WD) und CMT1 Neuropathien identifizieren ließen. Während die aktive Beteiligung der Autophagie Schwann´scher Zellen (hier kurz SZ Autophagie genannt) an der Myelindegradation im Falle einer WD jedoch vielfach beschrieben wurde, ist Ähnliches in CMT1 Neuropathien bisher nur unzureichend untersucht. Da in einer Studie in Cx32def Mausmodellen der CMT1X Erkrankung auch nach Reduktion endoneuraler Makrophagen anhaltende Demyelinisierung beobachtet werden konnte, sollte das Vorkommen von SZ Autophagie sowie deren mögliche Beeinflussung durch Makrophagen in diesen Myelinmutanten untersucht werden. In der vorliegenden Arbeit wurden sowohl Wildtyp (Wt) Mäuse in ex vivo und in vivo Modellen einer WD als auch Cx32def Myelinmutanten zweier Altersstufen (4 und 12 Monate) mit einem niedermolekularen CSF1-Rezeptor-Inhibitor (CSF1RI) zur Reduktion endoneuraler Makrophagen behandelt, wobei sich vergleichende histochemische bzw. immunhistochemische Analysen peripherer Nerven behandelter und unbehandelter Tiere anschlossen. Im Rahmen der Etablierung immunhistochemischer Methodik zeigte sich hierbei unter den kontrollierten Bedingungen einer ex vivo Ischiasnervenkultur eine vermehrte Aktivierung der SZ Autophagie in behandelten Wt Mäusen. Auch 4 Monate alte behandelte Cx32def Tiere wiesen, verglichen mit unbehandelten Myelinmutanten bzw. Wt Mäusen derselben Altersstufe, eine vermehrte autophagische Aktivität in SZ auf. Diese scheint sich jedoch im weiteren Verlauf der Erkrankung zu reduzieren, da im Falle der 12 Monate alten Cx32def Modelltiere weniger autophagisch aktive SZ Profile bzw. kaum Unterschiede zwischen behandelten und unbehandelten Tieren beobachtet werden konnten. Die Ergebnisse lassen somit eine mögliche aktive Beteiligung von SZ Autophagie insbesondere in der Pathophysiologie der frühen Phase einer CMT1X Erkrankung sowie deren Beeinflussung durch endoneurale Makrophagen vermuten. Dies sollte vornehmlich in der Entwicklung von Therapiestrategien der CMT1X bedacht werden, da sich eine frühe Reduktion pathophysiologisch relevanter endoneuraler Makrophagen somit auch nachteilig auf die Myelinintegrität auswirken könnte. N2 - Charcot-Marie-Tooth (CMT) neuropathies are the most common hereditary neurological diseases and represent a group of genetically heterogeneous, chronically progressive peripheral polyneuropathies. In the absence of curative treatment options, patients' quality of life is significantly impaired, primarily due to motor and sensory deficits. Various studies have demonstrated the pathophysiological relevance of a secondary inflammatory reaction, in particular mediated by macrophages and lymphocytes, in mouse models of three CMT1 subtypes (CMT1A, CMT1B, CMT1X). An acute inflammatory reaction is also of crucial importance following a lesion of peripheral nerves, whereby similarities between postlesional Wallerian degeneration (WD) and CMT1 neuropathies have already been identified. However, while the active involvement of Schwann cell autophagy (here referred to as SC autophagy) in myelin degradation in WD has been widely described, a similar involvement in CMT1 neuropathies has been insufficiently studied. Since in a study in Cx32def mouse models of CMT1X disease persistent demyelination could be observed even after reduction of endoneural macrophages, the occurrence of SC autophagy and its possible influence by macrophages in these myelin mutants should be investigated. In the present study, both wild-type (Wt) mice in ex vivo and in vivo models of WD and Cx32def myelin mutants of two ages (4 and 12 months) were treated with a small molecule CSF1 receptor inhibitor (CSF1RI) to reduce endoneural macrophages, followed by comparative histochemical and immunohistochemical analyses of peripheral nerves of treated and untreated animals, respectively. During the establishment of immunohistochemical methods, an increased activation of SC autophagy was shown in treated Wt mice under the controlled conditions of ex vivo sciatic nerve culture. Even 4-month-old treated Cx32def animals showed increased autophagic activity in SC compared to untreated myelin mutants or Wt mice of the same age. However, this appears to be reduced as the disease progresses, since in the case of the 12-month-old Cx32def model animals fewer autophagically active SC profiles or hardly any differences between treated and untreated animals could be observed. The results thus suggest a possible active involvement of SC autophagy, particularly in the pathophysiology of the early phase of CMT1X disease and its influence by endoneural macrophages. This should primarily be considered in the development of therapeutic strategies for CMT1X, as an early reduction of pathophysiologically relevant endoneural macrophages could therefore also have a detrimental effect on myelin integrity. KW - Schwann-Zelle KW - M-CSF KW - Autophagie KW - Charcot-Marie-Syndrom KW - Makrophage KW - Schwann´sche Zelle KW - Autophagie KW - hereditäre sensomotorische Neuropathie KW - Makrophagen KW - CSF-1 KW - Immunsystem Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-369674 ER - TY - THES A1 - Wind, Teresa Elisabeth T1 - Einfluss von Alter und Polyneuropathie auf zeitliche Wahrnehmungsschwellen somatosensorischer und kinästhetischer Stimuli und propriozeptive Leistungsfähigkeit T1 - Temporal Discrimination Thresholds and Proprioceptive Performance: Impact of Age and Nerve Conduction N2 - Zeitliche Diskrimination somatosensorischer und kinästhetischer Stimuli wurde als neurophysiologisches Korrelat für propriozeptive Präzision postuliert und bei verschiedenen Bewegungsstörungen als pathologisch beschrieben. Ziel der Untersuchung war es, den Einfluss von Alter und Polyneuropathie auf die kinästhetische (TDMT) und taktile (STDT) zeitliche Wahrnehmungsschwelle sowie die propriozeptive Genauigkeit bei Zeigeversuchen systematisch zu untersuchen. Hierfür wurden 54 gesunde Probanden und 25 Polyneuropathie-Patienten im Alter zwischen 30 und 76 Jahren untersucht. Die STDT-Messung erfolgte mit Oberflächenelektroden, die an der Zeigefingerspitze bzw. am Großzehengrundgelenk angebracht wurden. Die TDMT-Werte wurden mit Hilfe einer sterilen Nadelelektrode erfasst, welche in den Musculus flexor carpi radialis bzw. Musculus tibialis anterior inseriert wurde. Die Daten zur Propriozeption wurden mit Hilfe eines Goniometers erhoben und beinhalteten dabei aktive Zeigeaufgaben (Zeigen auf eine LED, Nachahmung einer Bewegung anhand einer auf einem Computerbildschirm dargebotenen PFEIL-Darstellung unterschiedlicher Länge) und die Einschätzung der Position der jeweiligen Extremität nach passiver Bewegung (PASSIV). Die Messungen erfolgten jeweils ohne visuelle Rückmeldung. Die Zeigefehler (Abweichung von der Zielposition) bzw. Schätzfehler (Abweichung der geschätzten von der tatsächlichen Position nach passiver Auslenkung) wurden als Maß der propriozeptiven Präzision verwendet. Die Ergebnisse der gesunden Probandengruppe zeigten, dass höheres Alter mit höheren STDT- und TDMT-Werten korrelierte. Die Polyneuropathie-Patienten erzielten in allen Bereichen (Diskriminationsschwellen und Propriozeptionsaufgaben) signifikant schlechtere Ergebnisse als die gesunde Kontrollgruppe. Zusätzlich konnte eine statistisch signifikante positive Korrelation zwischen der propriozeptiven Präzision bei den aktiven Zeige-Aufgaben (LED und PFEIL) und den zeitlichen Diskriminationsschwellen (STDT und TDMT) gezeigt werden. In Anbetracht dieser Ergebnisse sollten das Patienten-Alter und mögliche Störungen der peripheren Nervenleitung berücksichtigt werden, wenn STDT-und TDMT-Bestimmungen bei Patienten mit Bewegungsstörungen angewendet werden. Die Korrelation zwischen den Diskriminationsschwellen und der Performance bei aktiven Zeigeversuchen (PFEIL- und LED-Aufgabe) legt nahe, dass STDT und TDMT Indikatoren der propriozeptiven Funktion sein könnten. Es ist weitere Forschungsarbeit notwendig, um diese Beziehung exakt zu beleuchten. Im Falle einer Bestätigung der Befunde auch bei Patienten mit Bewegungsstörungen erscheint denkbar, dass sich STDT und TDMT als vergleichsweise leicht messbare und gut quantifizierbare Parameter der Propriozeption herausstellen mit Potenzial zur differenzialdiagnostischen Anwendung, möglicherweise aber auch als Surrogatparameter einer gezielten rehabilitativen Behandlung. N2 - Objective: To assess the association of somatosensorytemporal discriminationthreshold (STDT) and temporal movement discrimination threshold (TDMT) with age and proprioception. Methods: STDT and TDMT were assessed in 54 healthy subjects aged 30 to 76 yearsand 25 patients with PNP. STDT was tested with surface electrodes placed over the thenar or dorsal foot region. TDMT was probed with needle electrodes in flexor carpiradialis and tibialis anterior muscle. Limb proprioception was assessed by active pointing tasks and by limb position estimation with goniometer-based devices.Pointing (or estimation) error was taken as a measure of proprioceptive performance. Results: Higher age was associated with higher STDT and TDMT, while age did not correlate with proprioceptive performance. In PNP patients,STDT, TDMT and active proprioceptive Peformance were worse at all sites as compared to controls. In Addition,proprioceptive performance in the active pointing task correlated with STDT and TDMT of upper extremities. Conclusions: Temporal discrimination thresholds may prove useful as surrogatemarkers of proprioceptive function. PNP-related impairment of afferent conduction shows high impact on STDT and TDMT. Significance: Comparable modulation of STDT and TDMT by age and peripheral neuropathy may support the notion that their differential changes in movement disorders may result from disease-specific modifications of central networks. KW - Propriozeption KW - Alter KW - Polyneuropathie KW - zeitliche Wahrnehmungsschwellen KW - STDT KW - TDMT KW - Temporal Discrimination Threshold KW - Proprioception KW - Polyneuropathy KW - Age Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-208047 ER - TY - JOUR A1 - Hiew, Shawn A1 - Nguemeni, Carine A1 - Zeller, Daniel T1 - Efficacy of transcranial direct current stimulation in people with multiple sclerosis: a review JF - European Journal of Neurology N2 - Background and purpose Multiple sclerosis (MS) is a chronic inflammatory disease causing a wide range of symptoms including motor and cognitive impairment, fatigue and pain. Over the last two decades, non-invasive brain stimulation, especially transcranial direct current stimulation (tDCS), has increasingly been used to modulate brain function in various physiological and pathological conditions. However, its experimental applications for people with MS were noted only as recently as 2010 and have been growing since then. The efficacy for use in people with MS remains questionable with the results of existing studies being largely conflicting. Hence, the aim of this review is to paint a picture of the current state of tDCS in MS research grounded on studies applying tDCS that have been done to date. Methods A keyword search was performed to retrieve articles from the earliest article identified until 14 February 2021 using a combination of the groups (1) ‘multiple sclerosis’, ‘MS’ and ‘encephalomyelitis’ and (2) ‘tDCS’ and ‘transcranial direct current stimulation’. Results The analysis of the 30 articles included in this review underlined inconsistent effects of tDCS on the motor symptoms of MS based on small sample sizes. However, tDCS showed promising benefits in ameliorating fatigue, pain and cognitive symptoms. Conclusion Transcranial direct current stimulation is attractive as a non-drug approach in ameliorating MS symptoms, where other treatment options remain limited. The development of protocols tailored to the individual's own neuroanatomy using high definition tDCS and the introduction of network mapping in the experimental designs might help to overcome the variability between studies. KW - transcranial direct current stimulation KW - cognitive KW - effects KW - motor KW - multiple sclerosis Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259424 VL - 29 IS - 2 ER - TY - JOUR A1 - Grünewald, Benedikt A1 - Bennett, Jeffrey L. A1 - Toyka, Klaus V. A1 - Sommer, Claudia A1 - Geis, Christian T1 - Efficacy of Polyvalent Human Immunoglobulins in an Animal Model of Neuromyelitis Optica Evoked by Intrathecal Anti-Aquaporin 4 Antibodies JF - International Journal of Molecular Sciences N2 - Neuromyelitis Optica Spectrum Disorders (NMOSD) are associated with autoantibodies (ABs) targeting the astrocytic aquaporin-4 water channels (AQP4-ABs). These ABs have a direct pathogenic role by initiating a variety of immunological and inflammatory processes in the course of disease. In a recently-established animal model, chronic intrathecal passive-transfer of immunoglobulin G from NMOSD patients (NMO-IgG), or of recombinant human AQP4-ABs (rAB-AQP4), provided evidence for complementary and immune-cell independent effects of AQP4-ABs. Utilizing this animal model, we here tested the effects of systemically and intrathecally applied pooled human immunoglobulins (IVIg) using a preventive and a therapeutic paradigm. In NMO-IgG animals, prophylactic application of systemic IVIg led to a reduced median disease score of 2.4 on a 0–10 scale, in comparison to 4.1 with sham treatment. Therapeutic IVIg, applied systemically after the 10th intrathecal NMO-IgG injection, significantly reduced the disease score by 0.8. Intrathecal IVIg application induced a beneficial effect in animals with NMO-IgG (median score IVIg 1.6 vs. sham 3.7) or with rAB-AQP4 (median score IVIg 2.0 vs. sham 3.7). We here provide evidence that treatment with IVIg ameliorates disease symptoms in this passive-transfer model, in analogy to former studies investigating passive-transfer animal models of other antibody-mediated disorders. KW - intrathecal application KW - NMOSD KW - aquaporin 4 KW - autoantibody KW - IVIg Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-166000 VL - 17 IS - 9 ER - TY - JOUR A1 - Flachenecker, Peter A1 - Bures, Anna Karoline A1 - Gawlik, Angeli A1 - Weiland, Ann-Christin A1 - Kuld, Sarah A1 - Gusowski, Klaus A1 - Streber, René A1 - Pfeifer, Klaus A1 - Tallner, Alexander T1 - Efficacy of an internet-based program to promote physical activity and exercise after inpatient rehabilitation in persons with multiple sclerosis: a randomized, single-blind, controlled study JF - International Journal of Environmental Research and Public Health N2 - Background: Multimodal rehabilitation improves fatigue and mobility in persons with multiple sclerosis (PwMS). Effects are transient and may be conserved by internet-based physical activity promotion programs. Objective: Evaluate the effects of internet-based physical activity and exercise promotion on fatigue, quality of life, and gait in PwMS after inpatient rehabilitation. Methods: PwMS (Expanded Disability Status Scale (EDSS) ≤ 6.0, fatigue: Würzburg Fatigue Inventory for Multiple Sclerosis (WEIMuS) ≥ 32) were randomized into an intervention group (IG) or a control group (CG). After rehabilitation, IG received 3 months of internet-based physical activity promotion, while CG received no intervention. Primary outcome: self-reported fatigue (WEIMuS). Secondary outcomes: quality of life (Multiple Sclerosis Impact Scale 29, MSIS-29), gait (2min/10m walking test, Tinetti score). Measurements: beginning (T0) and end (T1) of inpatient rehabilitation, 3 (T2) and 6 (T3) months afterwards. Results: 64 of 84 PwMS were analyzed (IG: 34, CG: 30). After rehabilitation, fatigue decreased in both groups. At T2 and T3, fatigue increased again in CG but was improved in IG (p < 0.001). MSIS-29 improved in both groups at T1 but remained improved at T2 and T3 only in IG. Gait improvements were more pronounced in IG at T2. Conclusions: The study provides Class II evidence that the effects of rehabilitation on fatigue, quality of life, and gait can be maintained for 3–6 months with an internet-based physical activity and exercise promotion program. KW - multiple sclerosis KW - rehabilitation KW - fatigue KW - quality of life KW - walking KW - physical activity KW - exercise KW - online systems KW - internet-based intervention KW - health behavior Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-207863 SN - 1660-4601 VL - 17 IS - 12 ER - TY - JOUR A1 - Schuhmann, Michael K. A1 - Fluri, Felix T1 - Effects of fullerenols on mouse brain microvascular endothelial cells JF - International Journal of Molecular Sciences N2 - Fullerenols, water-soluble C60-fullerene derivatives, have been shown to exert neuroprotective effects in vitro and in vivo, most likely due to their capability to scavenge free radicals. However, little is known about the effects of fullerenols on the blood–brain barrier (BBB), especially on cerebral endothelial cells under inflammatory conditions. Here, we investigated whether the treatment of primary mouse brain microvascular endothelial cells with fullerenols impacts basal and inflammatory blood–brain barrier (BBB) properties in vitro. While fullerenols (1, 10, and 100 µg/mL) did not change transendothelial electrical resistance under basal and inflammatory conditions, 100 µg/mL of fullerenol significantly reduced erk1/2 activation and resulted in an activation of NFκB in an inflammatory milieu. Our findings suggest that fullerenols might counteract oxidative stress via the erk1/2 and NFκB pathways, and thus are able to protect microvascular endothelial cells under inflammatory conditions. KW - mouse brain microvascular endothelial cell cultur KW - adhesion molecules KW - fullerenes KW - blood-brain barrier KW - inflammation KW - tight junctions Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158072 SN - 1422-0067 VL - 18 IS - 8 ER - TY - THES A1 - Andreska, Thomas T1 - Effects of dopamine on BDNF / TrkB mediated signaling and plasticity on cortico-striatal synapses T1 - Effekte von Dopamin auf BDNF / TrkB vermittelte Signalwege und Plastizität an cortico-striatalen Synapsen N2 - Progressive loss of voluntary movement control is the central symptom of Parkinson's disease (PD). Even today, we are not yet able to cure PD. This is mainly due to a lack of understanding the mechanisms of movement control, network activity and plasticity in motor circuits, in particular between the cerebral cortex and the striatum. Brain-derived neurotrophic factor (BDNF) has emerged as one of the most important factors for the development and survival of neurons, as well as for synaptic plasticity. It is thus an important target for the development of new therapeutic strategies against neurodegenerative diseases. Together with its receptor, the Tropomyosin receptor kinase B (TrkB), it is critically involved in development and function of the striatum. Nevertheless, little is known about the localization of BDNF within presynaptic terminals in the striatum, as well as the types of neurons that produce BDNF in the cerebral cortex. Furthermore, the influence of midbrain derived dopamine on the control of BDNF / TrkB interaction in striatal medium spiny neurons (MSNs) remains elusive so far. Dopamine, however, appears to play an important role, as its absence leads to drastic changes in striatal synaptic plasticity. This suggests that dopamine could regulate synaptic activity in the striatum via modulation of BDNF / TrkB function. To answer these questions, we have developed a sensitive and reliable protocol for the immunohistochemical detection of endogenous BDNF. We find that the majority of striatal BDNF is provided by glutamatergic, cortex derived afferents and not dopaminergic inputs from the midbrain. In fact, we found BDNF in cell bodies of neurons in layers II-III and V of the primary and secondary motor cortex as well as layer V of the somatosensory cortex. These are the brain areas that send dense projections to the dorsolateral striatum for control of voluntary movement. Furthermore, we could show that these projection neurons significantly downregulate the expression of BDNF during the juvenile development of mice between 3 and 12 weeks. In parallel, we found a modulatory effect of dopamine on the translocation of TrkB to the cell surface in postsynaptic striatal Medium Spiny Neurons (MSNs). In MSNs of the direct pathway (dMSNs), which express dopamine receptor 1 (DRD1), we observed the formation of TrkB aggregates in the 6-hydroxydopamine (6-OHDA) model of PD. This suggests that DRD1 activity controls TrkB surface expression in these neurons. In contrast, we found that DRD2 activation has opposite effects in MSNs of the indirect pathway (iMSNs). Activation of DRD2 promotes a rapid decrease in TrkB surface expression which was reversible and depended on cAMP. In parallel, stimulation of DRD2 led to induction of phospho-TrkB (pTrkB). This effect was significantly slower than the effect on TrkB surface expression and indicates that TrkB is transactivated by DRD2. Together, our data provide evidence that dopamine triggers dual modes of plasticity on striatal MSNs by acting on TrkB surface expression in DRD1 and DRD2 expressing MSNs. This surface expression of the receptor is crucial for the binding of BDNF, which is released from corticostriatal afferents. This leads to the induction of TrkB-mediated downstream signal transduction cascades and long-term potentiation (LTP). Therefore, the dopamine-mediated translocation of TrkB could be a mediator that modulates the balance between dopaminergic and glutamatergic signaling to allow synaptic plasticity in a spatiotemporal manner. This information and the fact that TrkB is segregated to persistent aggregates in PD could help to improve our understanding of voluntary movement control and to develop new therapeutic strategies beyond those focusing on dopaminergic supply. N2 - Der fortschreitende Verlust der willkürlichen Bewegungskontrolle ist ein zentrales Symptom der Parkinson-Krankheit (PD). Auch heute sind wir noch nicht in der Lage, PD zu heilen. Dafür verantwortlich ist hauptsächlich ein mangelndes Verständnis von Mechanismen der Bewegungskontrolle, Netzwerkaktivität und Plastizität in motorischen Schaltkreisen, insbesondere zwischen Hirnrinde und Striatum. Der neurotrophe Faktor BDNF ist einer der wichtigsten Faktoren für die Entwicklung und das Überleben von Neuronen sowie für synaptische Plastizität im zentralen Nervensystem. BDNF ist daher ein Target für die Entwicklung neuer therapeutischer Strategien gegen neurodegenerative Erkrankungen. Zusammen mit seinem Rezeptor, der Tropomyosin-Rezeptorkinase B (TrkB), ist BDNF maßgeblich an der Entwicklung und Funktion des Striatums beteiligt. Dennoch ist nur wenig bekannt, wo BDNF an Synapsen im Striatum lokalisiert ist, und wo BDNF in Neuronen der Hirnrinde synthetisiert wird. Außerdem ist der Einfluss von Dopamin aus dem Mittelhirn auf die Kontrolle der BDNF / TrkB-Interaktion in striatalen Medium-Spiny-Neuronen (MSNs) bisher unklar. Dopamin scheint jedoch eine wichtige Rolle zu spielen, da dessen Abwesenheit zu drastischen Veränderungen der striatalen Plastizität führt. Dopamin könnte synaptische Plastizität im Striatum über eine Modulation der BDNF / TrkB-Interaktion regulieren. Um diese Fragen beantworten zu können, haben wir ein sensitives und zuverlässiges Protokoll für den immunhistochemischen Nachweis von endogenem BDNF entwickelt. Wir fanden heraus, dass BDNF im Striatum vor allem in glutamatergen Synapsen von Projektion aus dem Kortex lokalisiert ist und nicht in Terminalen dopaminerger Neurone aus dem Mittelhirn. Tatsächlich fanden wir BDNF in den Zellkörpern von Neuronen in den Schichten II-III und V des primären und sekundären motorischen Kortex sowie Schicht V des somatosensorischen Kortex. Es sind jene Hirnareale, welche dichte Projektionen zum dorsolateralen Striatum senden und entscheidend an der Steuerung von willkürlichen Bewegungen beteiligt sind. Weiterhin konnten wir zeigen, dass eben jene Projektionsneurone die Bildung von BDNF während der juvenilen Entwicklung von Mäusen zwischen 3 und 12 Wochen signifikant herunter regulieren. In striatalen MSN fanden wir zudem einen modulatorischen Effekt von Dopamin auf die Translokation von TrkB zur Zelloberfläche. In MSNs des direkten Signalweges (dMSNs), welche Dopaminrezeptor 1 (DRD1) exprimieren, konnten wir die Bildung von TrkB-Aggregaten im 6-Hydroxydopamin (6-OHDA) - Rattenmodell der Parkinson Erkankung beobachten. Dies deutet darauf hin, dass die DRD1-Aktivität die TrkB-Oberflächenexpression in diesen Neuronen steuert. Im Gegensatz dazu fanden wir heraus, dass die DRD2-Aktivierung in MSNs des indirekten Signalweges (iMSNs) eine gegensätzliche Wirkung hat. Die Aktivierung von DRD2 führt zu einer schnellen Reduktion der TrkB-Oberflächenexpression, die reversibel und von cAMP abhängig ist. Außerdem führte die Stimulation von DRD2 zu einer Induktion von Phospho-TrkB (pTrkB). Dieser Effekt war deutlich langsamer als die Wirkung auf die TrkB-Oberflächenexpression und deutet auf eine Transaktivierung von TrkB über DRD2 hin. Insgesamt scheint Dopamin entgegengesetzte Plastizitätsmodi in striatalen MSNs auszulösen, indem es auf die TrkB-Oberflächenexpression in DRD1- und DRD2-exprimierenden MSNs einwirkt. Diese Oberflächenexpression des Rezeptors ist entscheidend für die Bindung von BDNF, welches aus kortiko-striatalen Afferenzen freigesetzt wird. Dies führt zur Induktion von TrkB-vermittelten-Signaltransduktionskaskaden und Langzeitpotenzierung (LTP). Daher könnte die dopamin-vermittelte Translokalisation von TrkB das Gleichgewicht zwischen dopaminergen und glutamatergen Signalen modulieren, um die synaptische Plastizität in einer räumlich-zeitlich abgestimmten Weise zu ermöglichen. Diese Information und die Tatsache, dass TrkB bei PD stabile Aggregate bildet, könnte dazu beitragen, unser Verständnis der willkürlichen Bewegungskontrolle zu verbessern und neue therapeutische Strategien zu entwickeln, die über jene hinausgehen, welche sich auf die dopaminerge Versorgung konzentrieren. KW - Brain-derived neurotrophic factor KW - Parkinson Krankheit KW - Plastizität KW - Motorisches Lernen KW - Basalganglien KW - Brain-derived neurotrophic factor KW - TrkB KW - Basal Ganglia KW - Motor learning KW - Parkinson's disease KW - Synaptic plasticity KW - Striatum KW - Medium spiny neurons KW - Cortico-striatal projection neurons Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-174317 ER - TY - JOUR A1 - Klein, Dennis A1 - Groh, Janos A1 - Yuan, Xidi A1 - Berve, Kristina A1 - Stassart, Ruth A1 - Fledrich, Robert A1 - Martini, Rudolf T1 - Early targeting of endoneurial macrophages alleviates the neuropathy and affects abnormal Schwann cell differentiation in a mouse model of Charcot-Marie-Tooth 1A JF - Glia N2 - We have previously shown that targeting endoneurial macrophages with the orally applied CSF-1 receptor specific kinase (c-FMS) inhibitor PLX5622 from the age of 3 months onwards led to a substantial alleviation of the neuropathy in mouse models of Charcot-Marie-Tooth (CMT) 1X and 1B disease, which are genetically-mediated nerve disorders not treatable in humans. The same approach failed in a model of CMT1A (PMP22-overexpressing mice, line C61), representing the most frequent form of CMT. This was unexpected since previous studies identified macrophages contributing to disease severity in the same CMT1A model. Here we re-approached the possibility of alleviating the neuropathy in a model of CMT1A by targeting macrophages at earlier time points. As a proof-of-principle experiment, we genetically inactivated colony-stimulating factor-1 (CSF-1) in CMT1A mice, which resulted in lower endoneurial macrophage numbers and alleviated the neuropathy. Based on these observations, we pharmacologically ablated macrophages in newborn CMT1A mice by feeding their lactating mothers with chow containing PLX5622, followed by treatment of the respective progenies after weaning until the age of 6 months. We found that peripheral neuropathy was substantially alleviated after early postnatal treatment, leading to preserved motor function in CMT1A mice. Moreover, macrophage depletion affected the altered Schwann cell differentiation phenotype. These findings underscore the targetable role of macrophage-mediated inflammation in peripheral nerves of inherited neuropathies, but also emphasize the need for an early treatment start confined to a narrow therapeutic time window in CMT1A models and potentially in respective patients. KW - colony stimulating factor 1 KW - Schwann cell differentiation KW - neuroinflammation KW - macrophage KW - inherited peripheral neuropathy Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-318714 VL - 70 IS - 6 SP - 1100 EP - 1116 ER - TY - JOUR A1 - Kleinschnitz, Christoph A1 - Mencl, Stine A1 - Garz, Cornelia A1 - Niklass, Solveig A1 - Braun, Holger A1 - Göb, Eva A1 - Homola, György A1 - Heinze, Hans-Jochen A1 - Reymann, Klaus G. A1 - Schreiber, Stefanie T1 - Early microvascular dysfunction in cerebral small vessel disease is not detectable on 3.0 Tesla magnetic resonance imaging: a longitudinal study in spontaneously hypertensive stroke-prone rats JF - Experimental & Translational Stroke Medicine N2 - Background Human cerebral small vessel disease (CSVD) has distinct histopathologic and imaging findings in its advanced stages. In spontaneously hypertensive stroke-prone rats (SHRSP), a well-established animal model of CSVD, we recently demonstrated that cerebral microangiopathy is initiated by early microvascular dysfunction leading to the breakdown of the blood–brain barrier and an activated coagulatory state resulting in capillary and arteriolar erythrocyte accumulations (stases). In the present study, we investigated whether initial microvascular dysfunction and other stages of the pathologic CSVD cascade can be detected by serial magnetic resonance imaging (MRI). Findings Fourteen SHRSP and three control (Wistar) rats (aged 26–44 weeks) were investigated biweekly by 3.0 Tesla (3 T) MRI. After perfusion, brains were stained with hematoxylin–eosin and histology was correlated with MRI data. Three SHRSP developed terminal CSVD stages including cortical, hippocampal, and striatal infarcts and macrohemorrhages, which could be detected consistently by MRI. Corresponding histology showed small vessel thromboses and increased numbers of small perivascular bleeds in the infarcted areas. However, 3 T MRI failed to visualize intravascular erythrocyte accumulations, even in those brain regions with the highest densities of affected vessels and the largest vessels affected by stases, as well as failing to detect small perivascular bleeds. Conclusion Serial MRI at a field strength of 3 T failed to detect the initial microvascular dysfunction and subsequent small perivascular bleeds in SHRSP; only terminal stages of cerebral microangiopathy were reliably detected. Further investigations at higher magnetic field strengths (7 T) using blood- and flow-sensitive sequences are currently underway. KW - Cerebral small vessel disease KW - SHRSP KW - MRI Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-97056 UR - http://www.etsmjournal.com/content/5/1/8 ER - TY - JOUR A1 - Burlina, Alessandro P. A1 - Sims, Katherine B. A1 - Politei, Juan M. A1 - Bennett, Gary J. A1 - Baron, Ralf A1 - Sommer, Claudia A1 - Moller, Anette Torvin A1 - Hilz, Max J. T1 - Early diagnosis of peripheral nervous system involvement in Fabry disease and treatment of neuropathic pain: the report of an expert panel JF - BMC Neurology N2 - Background: Fabry disease is an inherited metabolic disorder characterized by progressive lysosomal accumulation of lipids in a variety of cell types, including neural cells. Small, unmyelinated nerve fibers are particularly affected and small fiber peripheral neuropathy often clinically manifests at young age. Peripheral pain can be chronic and/or occur as provoked attacks of excruciating pain. Manifestations of dysfunction of small autonomic fibers may include, among others, impaired sweating, gastrointestinal dysmotility, and abnormal pain perception. Patients with Fabry disease often remain undiagnosed until severe complications involving the kidney, heart, peripheral nerves and/or brain have arisen. Methods: An international expert panel convened with the goal to provide guidance to clinicians who may encounter unrecognized patients with Fabry disease on how to diagnose these patients early using simple diagnostic tests. A further aim was to offer recommendations to control neuropathic pain. Results: We describe the neuropathy in Fabry disease, focusing on peripheral small fiber dysfunction - the hallmark of early neurologic involvement in this disorder. The clinical course of peripheral pain is summarized, and the importance of medical history-taking, including family history, is highlighted. A thorough physical examination (e. g., angiokeratoma, corneal opacities) and simple non-invasive sensory perception tests could provide clues to the diagnosis of Fabry disease. Reported early clinical benefits of enzyme replacement therapy include reduction of neuropathic pain, and adequate management of residual pain to a tolerable and functional level can substantially improve the quality of life for patients. Conclusions: Our recommendations can assist in diagnosing Fabry small fiber neuropathy early, and offer clinicians guidance in controlling peripheral pain. This is particularly important since management of pain in young patients with Fabry disease appears to be inadequate. KW - Enzyme replacement therapy KW - Quality of life KW - Small-fiber neuropathy KW - Rochester diabetic neuropathy KW - Randomized controlled trial KW - Agalsidase beta therapy KW - Outcome survey KW - Pharmacological management KW - Clinical manifestations KW - Alpha galactosidase KW - Diagnosis KW - Fabry KW - Disease KW - Neuropathy KW - Pain KW - Treatment Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-135309 VL - 11 IS - 61 ER - TY - JOUR A1 - Spitzel, Marlene A1 - Wagner, Elise A1 - Breyer, Maximilian A1 - Henniger, Dorothea A1 - Bayin, Mehtap A1 - Hofmann, Lukas A1 - Mauceri, Daniela A1 - Sommer, Claudia A1 - Üçeyler, Nurcan T1 - Dysregulation of immune response mediators and pain-related ion channels is associated with pain-like behavior in the GLA KO mouse model of Fabry disease JF - Cells N2 - Fabry disease (FD) is a rare life-threatening disorder caused by deficiency of the alpha-galactosidase A (GLA) enzyme with a characteristic pain phenotype. Impaired GLA production or function leads to the accumulation of the cell membrane compound globotriaosylceramide (Gb3) in the neurons of the dorsal root ganglia (DRG) of FD patients. Applying immunohistochemistry (IHC) and quantitative real-time polymerase chain reaction (qRT PCR) analysis on DRG tissue of the GLA knockout (KO) mouse model of FD, we address the question of how Gb3 accumulation may contribute to FD pain and focus on the immune system and pain-associated ion channel gene expression. We show a higher Gb3 load in the DRG of young (<6 months) (p < 0.01) and old (≥12 months) (p < 0.001) GLA KO mice compared to old wildtype (WT) littermates, and an overall suppressed immune response in the DRG of old GLA KO mice, represented by a reduced number of CD206\(^+\) macrophages (p < 0.01) and lower gene expression levels of the inflammation-associated targets interleukin(IL)1b (p < 0.05), IL10 (p < 0.001), glial fibrillary acidic protein (GFAP) (p < 0.05), and leucine rich alpha-2-glycoprotein 1 (LRG1) (p < 0.01) in the DRG of old GLA KO mice compared to old WT. Dysregulation of immune-related genes may be linked to lower gene expression levels of the pain-associated ion channels calcium-activated potassium channel 3.1 (KCa3.1) and transient receptor potential ankyrin 1 channel (TRPA1). Ion channel expression might further be disturbed by impaired sphingolipid recruitment mediated via the lipid raft marker flotillin-1 (FLOT1). This impairment is represented by an increased number of FLOT1\(^+\) DRG neurons with a membranous expression pattern in old GLA KO mice compared to young GLA KO, young WT, and old WT mice (p < 0.001 each). Further, we provide evidence for aberrant behavior of GLA KO mice, which might be linked to dysregulated ion channel gene expression levels and disturbed FLOT1 distribution patterns. Behavioral testing revealed mechanical hypersensitivity in young (p < 0.01) and old (p < 0.001) GLA KO mice compared to WT, heat hypersensitivity in young GLA KO mice (p < 0.001) compared to WT, age-dependent heat hyposensitivity in old GLA KO mice (p < 0.001) compared to young GLA KO mice, and cold hyposensitivity in young (p < 0.001) and old (p < 0.001) GLA KO mice compared to WT, which well reflects the clinical phenotype observed in FD patients. KW - Fabry disease KW - globotriaosylceramide KW - inflammation KW - macrophages KW - cytokines KW - ion channels KW - flotillin-1 lipid rafts KW - pain-associated behavior KW - mouse model Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-275186 SN - 2073-4409 VL - 11 IS - 11 ER - TY - JOUR A1 - Simon, Christian M. A1 - Rauskolb, Stefanie A1 - Gunnersen, Jennifer M. A1 - Holtmann, Bettina A1 - Drepper, Carsten A1 - Dombert, Benjamin A1 - Braga, Massimiliano A1 - Wiese, Stefan A1 - Jablonka, Sibylle A1 - Pühringer, Dirk A1 - Zielasek, Jürgen A1 - Hoeflich, Andreas A1 - Silani, Vincenzo A1 - Wolf, Eckhard A1 - Kneitz, Susanne A1 - Sommer, Claudia A1 - Toyka, Klaus V. A1 - Sendtner, Michael T1 - Dysregulated IGFBP5 expression causes axon degeneration and motoneuron loss in diabetic neuropathy JF - Acta Neuropathologica N2 - Diabetic neuropathy (DNP), afflicting sensory and motor nerve fibers, is a major complication in diabetes.The underlying cellular mechanisms of axon degeneration are poorly understood. IGFBP5, an inhibitory binding protein for insulin-like growth factor 1 (IGF1) is highly up-regulated in nerve biopsies of patients with DNP. We investigated the pathogenic relevance of this finding in transgenic mice overexpressing IGFBP5 in motor axons and sensory nerve fibers. These mice develop motor axonopathy and sensory deficits similar to those seen in DNP. Motor axon degeneration was also observed in mice in which the IGF1 receptor(IGF1R) was conditionally depleted in motoneurons, indicating that reduced activity of IGF1 on IGF1R in motoneurons is responsible for the observed effect. These data provide evidence that elevated expression of IGFBP5 in diabetic nerves reduces the availability of IGF1 for IGF1R on motor axons, thus leading to progressive neurodegeneration. Inhibition of IGFBP5 could thus offer novel treatment strategies for DNP. KW - Motor nerve biopsy KW - Diabetic polyneuropathy KW - Neuropathy KW - Neurotrophic factors KW - Axonal degeneration Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-154569 VL - 130 SP - 373 EP - 387 ER - TY - JOUR A1 - Andreska, Thomas A1 - Lüningschrör, Patrick A1 - Wolf, Daniel A1 - McFleder, Rhonda L. A1 - Ayon-Olivas, Maurilyn A1 - Rattka, Marta A1 - Drechsler, Christine A1 - Perschin, Veronika A1 - Blum, Robert A1 - Aufmkolk, Sarah A1 - Granado, Noelia A1 - Moratalla, Rosario A1 - Sauer, Markus A1 - Monoranu, Camelia A1 - Volkmann, Jens A1 - Ip, Chi Wang A1 - Stigloher, Christian A1 - Sendtner, Michael T1 - DRD1 signaling modulates TrkB turnover and BDNF sensitivity in direct pathway striatal medium spiny neurons JF - Cell Reports N2 - Highlights • Dopamine receptor-1 activation induces TrkB cell-surface expression in striatal neurons • Dopaminergic deficits cause TrkB accumulation and clustering in the ER • TrkB clusters colocalize with cargo receptor SORCS-2 in direct pathway striatal neurons • Intracellular TrkB clusters fail to fuse with lysosomes after dopamine depletion Summary Disturbed motor control is a hallmark of Parkinson’s disease (PD). Cortico-striatal synapses play a central role in motor learning and adaption, and brain-derived neurotrophic factor (BDNF) from cortico-striatal afferents modulates their plasticity via TrkB in striatal medium spiny projection neurons (SPNs). We studied the role of dopamine in modulating the sensitivity of direct pathway SPNs (dSPNs) to BDNF in cultures of fluorescence-activated cell sorting (FACS)-enriched D1-expressing SPNs and 6-hydroxydopamine (6-OHDA)-treated rats. DRD1 activation causes enhanced TrkB translocation to the cell surface and increased sensitivity for BDNF. In contrast, dopamine depletion in cultured dSPN neurons, 6-OHDA-treated rats, and postmortem brain of patients with PD reduces BDNF responsiveness and causes formation of intracellular TrkB clusters. These clusters associate with sortilin related VPS10 domain containing receptor 2 (SORCS-2) in multivesicular-like structures, which apparently protects them from lysosomal degradation. Thus, impaired TrkB processing might contribute to disturbed motor function in PD. KW - motor learning KW - cortico-striatal synapse KW - basal ganglia KW - direct pathway KW - DRD1 KW - dSPN KW - BDNF KW - TrkB KW - synaptic plasticity KW - GPCR Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-349932 VL - 42 IS - 6 ER - TY - JOUR A1 - Jänsch, Sarah A1 - Evdokimov, Dimitar A1 - Egenolf, Nadine A1 - Meyer zu Altenschildesche, Caren A1 - Kreß, Luisa A1 - Üçeyler, Nurcan T1 - Distinguishing fibromyalgia syndrome from small fiber neuropathy: a clinical guide JF - Pain Reports N2 - Introduction: Fibromyalgia syndrome (FMS) and small fiber neuropathy (SFN) are distinct pain conditions that share commonalities and may be challenging as for differential diagnosis. Objective: To comprehensively investigate clinical characteristics of women with FMS and SFN to determine clinically applicable parameters for differentiation. Methods: We retrospectively analyzed medical records of 158 women with FMS and 53 with SFN focusing on pain-specific medical and family history, accompanying symptoms, additional diseases, and treatment. We investigated data obtained using standardized pain, depression, and anxiety questionnaires. We further analyzed test results and findings obtained in standardized small fiber tests. Results: FMS patients were on average ten years younger at symptom onset, described higher pain intensities requiring frequent change of pharmaceutics, and reported generalized pain compared to SFN. Pain in FMS was accompanied by irritable bowel or sleep disturbances, and in SFN by paresthesias, numbness, and impaired glucose metabolism (P < 0.01 each). Family history was informative for chronic pain and affective disorders in FMS (P < 0.001) and for neurological disorders in SFN patients (P < 0.001). Small fiber pathology in terms of skin denervation and/or thermal sensory threshold elevation was present in 110/158 (69.7 %) FMS patients and 39/53 (73.6 %) SFN patients. FMS patients mainly showed proximally reduced skin innervation and higher corneal nerve branch densities (p<0.001) whereas SFN patients were characterized by reduced cold detection and prolonged electrical A-delta conduction latencies (P < 0.05). Conclusions: Our data show that FMS and SFN differ substantially. Detailed pain, drug and family history, investigating blood glucose metabolism, and applying differential small fiber tests may help to improve diagnostic differentiation and targeted therapy. KW - fibromyalgia syndrome KW - small fiber neuropathy KW - clinical phenotype KW - pain pattern KW - differential diagnosis Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-350306 VL - 9 IS - 1 ER - TY - JOUR A1 - Erbacher, Christoph A1 - Vaknine, Shani A1 - Moshitzky, Gilli A1 - Lobentanzer, Sebastian A1 - Eisenberg, Lina A1 - Evdokimov, Dimitar A1 - Sommer, Claudia A1 - Greenberg, David S. A1 - Soreq, Hermona A1 - Üçeyler, Nurcan T1 - Distinct CholinomiR blood cell signature as a potential modulator of the cholinergic system in women with fibromyalgia syndrome JF - Cells N2 - Fibromyalgia syndrome (FMS) is a heterogeneous chronic pain syndrome characterized by musculoskeletal pain and other key co-morbidities including fatigue and a depressed mood. FMS involves altered functioning of the central and peripheral nervous system (CNS, PNS) and immune system, but the specific molecular pathophysiology remains unclear. Anti-cholinergic treatment is effective in FMS patient subgroups, and cholinergic signaling is a strong modulator of CNS and PNS immune processes. Therefore, we used whole blood small RNA-sequencing of female FMS patients and healthy controls to profile microRNA regulators of cholinergic transcripts (CholinomiRs). We compared microRNA profiles with those from Parkinson's disease (PD) patients with pain as disease controls. We validated the sequencing results with quantitative real-time PCR (qRT-PCR) and identified cholinergic targets. Further, we measured serum cholinesterase activity in FMS patients and healthy controls. Small RNA-sequencing revealed FMS-specific changes in 19 CholinomiRs compared to healthy controls and PD patients. qRT-PCR validated miR-182-5p upregulation, distinguishing FMS patients from healthy controls. mRNA targets of CholinomiRs bone morphogenic protein receptor 2 and interleukin 6 signal transducer were downregulated. Serum acetylcholinesterase levels and cholinesterase activity in FMS patients were unchanged. Our findings identified an FMS-specific CholinomiR signature in whole blood, modulating immune-related gene expression. KW - fibromyalgia syndrome KW - cholinergic system KW - CholinomiRs KW - microRNA KW - miR-182-5p KW - Parkinson's disease Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-270686 SN - 2073-4409 VL - 11 IS - 8 ER - TY - JOUR A1 - Bolzoni, Francesco A1 - Esposti, Roberto A1 - Marchese, Silvia M. A1 - Pozzi, Nicoló G. A1 - Ramirez-Pasos, Uri E. A1 - Isaias, Ioannis U. A1 - Cavallari, Paolo T1 - Disrupt of intra-limb APA pattern in parkinsonian patients performing index-finger flexion JF - Frontiers in Physiology N2 - Voluntary movements induce postural perturbations which are counteracted by anticipatory postural adjustments (APAs). These actions are known to build up long fixation chains toward available support points (inter-limb APAs), so as to grant whole body equilibrium. Moreover, recent studies highlighted that APAs also build-up short fixation chains, within the same limb where a distal segment is moved (intra-limb APAs), aimed at stabilizing the proximal segments. The neural structures generating intra-limb APAs still need investigations; the present study aims to compare focal movement kinematics and intra-limb APA latencies and pattern between healthy subjects and parkinsonian patients, assuming the latter as a model of basal ganglia dysfunction. Intra-limb APAs that stabilize the arm when the index-finger is briskly flexed were recorded in 13 parkinsonian patients and in 10 age-matched healthy subjects. Index-finger movement was smaller in parkinsonian patients vs. healthy subjects (p = 0.01) and more delayed with respect to the onset of the prime mover flexor digitorum superficialis (FDS, p < 0.0001). In agreement with the literature, in all healthy subjects the FDS activation was preceded by an inhibitory intra-limb APA in biceps brachii (BB) and anterior deltoid (AD), and almost simultaneous to an excitatory intra-limb APA in triceps brachii (TB). In parkinsonian patients, no significant differences were found for TB and AD intra-limb APA timings, however only four patients showed an inhibitory intra-limb APA in BB, while other four did not show any BB intra-limb APAs and five actually developed a BB excitation. The frequency of occurrence of normal sign, lacking, and inverted BB APAs was different in healthy vs. parkinsonian participants (p = 0.0016). The observed alterations in index-finger kinematics and intra-limb APA pattern in parkinsonian patients suggest that basal ganglia, in addition to shaping the focal movement, may also contribute to intra-limb APA control. KW - intra-limb anticipatory postural adjustments KW - Parkinson disease KW - basal ganglia KW - motor control KW - human Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-369245 SN - 1664-042X VL - 9 ER - TY - JOUR A1 - Steigerwald, Frank A1 - Müller, Lorenz A1 - Johannes, Silvia A1 - Matthies, Cordula A1 - Volkmann, Jens T1 - Directional deep brain stimulation of the subthalamic nucleus: a pilot study using a novel neurostimulation device JF - Movement Disorders N2 - Introduction A novel neurostimulation system allows steering current in horizontal directions by combining segmented leads and multiple independent current control. The aim of this study was to evaluate directional DBS effects on parkinsonian motor features and adverse effects of subthalamic neurostimulation. Methods Seven PD patients implanted with the novel directional DBS system for bilateral subthalamic DBS underwent an extended monopolar review session during the first postoperative week, in which current thresholds were determined for rigidity control and stimulation-induced adverse effects using either directional or ring-mode settings. Results Effect or adverse effect thresholds were modified by directional settings for each of the 14 STN leads. Magnitude of change varied markedly between leads, as did orientation of optimal horizontal current steering. Conclusion Directional current steering through chronically implanted segmented electrodes is feasible, alters adverse effect and efficacy thresholds in a highly individual manner, and expands the therapeutic window in a monopolar review as compared to ring-mode DBS. KW - deep brain stimulation KW - Parkinson's disease Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-187683 VL - 31 IS - 8 ER - TY - JOUR A1 - Schuhmann, Michael K. A1 - Langhauser, Friederike A1 - Zimmermann, Lena A1 - Bellut, Maximilian A1 - Kleinschnitz, Christoph A1 - Fluri, Felix T1 - Dimethyl fumarate attenuates lymphocyte infiltration and reduces infarct size in experimental stroke JF - International journal of molecular sciences N2 - Ischemic stroke is associated with exacerbated tissue damage caused by the activation of immune cells and the initiation of other inflammatory processes. Dimethyl fumarate (DMF) is known to modulate the immune response, activate antioxidative pathways, and improve the blood–brain barrier (BBB) after stroke. However, the specific impact of DMF on immune cells after cerebral ischemia remains unclear. In our study, male mice underwent transient middle cerebral artery occlusion (tMCAO) for 30 min and received oral DMF (15 mg/kg) or a vehicle immediately after tMCAO, followed by twice-daily administrations for 7 days. Infarct volume was assessed on T2-weighted magnetic resonance images on days 1 and 7 after tMCAO. Brain-infiltrating immune cells (lymphocytes, monocytes) and microglia were quantified using fluorescence-activated cell sorting. DMF treatment significantly reduced infarct volumes and brain edema. On day 1 after tMCAO, DMF-treated mice showed reduced lymphocyte infiltration compared to controls, which was not observed on day 7. Monocyte and microglial cell counts did not differ between groups on either day. In the acute phase of stroke, DMF administration attenuated lymphocyte infiltration, probably due to its stabilizing effect on the BBB. This highlights the potential of DMF as a therapeutic candidate for mitigating immune cell-driven damage in stroke. KW - experimental stroke KW - transient middle cerebral artery occlusion model KW - dimethyl fumarate KW - cerebral inflammation Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357731 VL - 24 IS - 21 ER - TY - JOUR A1 - Karl, Franziska A1 - Grießhammer, Anne A1 - Üçeyler, Nurcan A1 - Sommer, Claudia T1 - Differential Impact of miR-21 on Pain and Associated Affective and Cognitive Behavior after Spared Nerve Injury in B7-H1 ko Mouse JF - Frontiers in Molecular Neuroscience N2 - MicroRNAs (miRNAs) are increasingly recognized as regulators of immune and neuronal gene expression and are potential master switches in neuropathic pain pathophysiology. miR-21 is a promising candidate that may link the immune and the pain system. To investigate the pathophysiological role of miR-21 in neuropathic pain, we assessed mice deficient of B7 homolog 1 (B7-H1), a major inhibitor of inflammatory responses. In previous studies, an upregulation of miR-21 had been shown in mouse lymphocytes. Young (8 weeks), middle-aged (6 months), and old (12 months) B7-H1 ko mice and wildtype littermates (WT) received a spared nerve injury (SNI). We assessed thermal withdrawal latencies and mechanical withdrawal thresholds. Further, we performed tests for anxiety-like and cognitive behavior. Quantitative real time PCR was used to determine miR-21 relative expression in peripheral nerves, and dorsal root ganglia (DRG) at distinct time points after SNI. We found mechanical hyposensitivity with increasing age of naïve B7-H1 ko mice. Young and middle-aged B7-H1 ko mice were more sensitive to mechanical stimuli compared to WT mice (young: p < 0.01, middle-aged: p < 0.05). Both genotypes developed mechanical and heat hypersensitivity (p < 0.05) after SNI, without intergroup differences. No relevant differences were found after SNI in three tests for anxiety like behavior in B7-H1 ko and WT mice. Also, SNI had no effect on cognition. B7-H1 ko and WT mice showed a higher miR-21 expression (p < 0.05) and invasion of macrophages and T cells in the injured nerve 7 days after SNI without intergroup differences. Our study reveals that increased miR-21 expression in peripheral nerves after SNI is associated with reduced mechanical and heat withdrawal thresholds. These results point to a role of miR-21 in the pathophysiology of neuropathic pain, while affective behavior and cognition seem to be spared. Contrary to expectations, B7-H1 ko mice did not show higher miR-21 expression than WT mice, thus, a B7-H1 knockout may be of limited relevance for the study of miR-21 related pain. KW - B7-H1 KW - PD-L1 KW - immune system KW - neuropathic pain KW - SNI KW - miRNA KW - miR-21 Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-170722 VL - 10 IS - 219 ER - TY - JOUR A1 - Bail, Kathrin A1 - Notz, Quirin A1 - Rovituso, Damiano M. A1 - Schampel, Andrea A1 - Wunsch, Marie A1 - Koeniger, Tobias A1 - Schropp, Verena A1 - Bharti, Richa A1 - Scholz, Claus-Juergen A1 - Foerstner, Konrad U. A1 - Kleinschnitz, Christoph A1 - Kuerten, Stefanie T1 - Differential effects of FTY720 on the B cell compartment in a mouse model of multiple sclerosis. JF - Journal of Neuroinflammation N2 - Background: MP4-induced experimental autoimmune encephalomyelitis (EAE) is a mouse model of multiple sclerosis (MS), which enables targeted research on B cells, currently much discussed protagonists in MS pathogenesis. Here, we used this model to study the impact of the S1P1 receptor modulator FTY720 (fingolimod) on the autoreactive B cell and antibody response both in the periphery and the central nervous system (CNS). Methods: MP4-immunized mice were treated orally with FTY720 for 30 days at the peak of disease or 50 days after EAE onset. The subsequent disease course was monitored and the MP4-specific B cell/antibody response was measured by ELISPOT and ELISA. RNA sequencing was performed to determine any effects on B cell-relevant gene expression. S1P\(_{1}\) receptor expression by peripheral T and B cells, B cell subset distribution in the spleen and B cell infiltration into the CNS were studied by flow cytometry. The formation of B cell aggregates and of tertiary lymphoid organs (TLOs) was evaluated by histology and immunohistochemistry. Potential direct effects of FTY720 on B cell aggregation were studied in vitro. Results: FTY720 significantly attenuated clinical EAE when treatment was initiated at the peak of EAE. While there was a significant reduction in the number of T cells in the blood after FTY720 treatment, B cells were only slightly diminished. Yet, there was evidence for the modulation of B cell receptor-mediated signaling upon FTY720 treatment. In addition, we detected a significant increase in the percentage of B220\(^{+}\) B cells in the spleen both in acute and chronic EAE. Whereas acute treatment completely abrogated B cell aggregate formation in the CNS, the numbers of infiltrating B cells and plasma cells were comparable between vehicle- and FTY720-treated mice. In addition, there was no effect on already developed aggregates in chronic EAE. In vitro B cell aggregation assays suggested the absence of a direct effect of FTY720 on B cell aggregation. However, FTY720 impacted the evolution of B cell aggregates into TLOs. Conclusions: The data suggest differential effects of FTY720 on the B cell compartment in MP4-induced EAE. KW - B cells KW - EAE KW - FTY720 KW - fingolimod KW - multiple sclerosis KW - TLO Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-157869 VL - 14 IS - 148 ER - TY - JOUR A1 - Brumberg, Joachim A1 - Schröter, Nils A1 - Blazhenets, Ganna A1 - Frings, Lars A1 - Volkmann, Jens A1 - Lapa, Constantin A1 - Jost, Wolfgang H. A1 - Isaias, Ioannis U. A1 - Meyer, Philipp T. T1 - Differential diagnosis of parkinsonism: a head-to-head comparison of FDG PET and MIBG scintigraphy JF - NPJ Parkinsons Disease N2 - [\(^{18}\)F]fluorodeoxyglucose (FDG) PET and [\(^{123}\)I]metaiodobenzylguanidine (MIBG) scintigraphy may contribute to the differential diagnosis of neurodegenerative parkinsonism. To identify the superior method, we retrospectively evaluated 54 patients with suspected neurodegenerative parkinsonism, who were referred for FDG PET and MIBG scintigraphy. Two investigators visually assessed FDG PET scans using an ordinal 6-step score for disease-specific patterns of Lewy body diseases (LBD) or atypical parkinsonism (APS) and assigned the latter to the subgroups multiple system atrophy (MSA), progressive supranuclear palsy (PSP), or corticobasal syndrome. Regions-of-interest analysis on anterior planar MIBG images served to calculate the heart-to-mediastinum ratio. Movement disorder specialists blinded to imaging results established clinical follow-up diagnosis by means of guideline-derived case vignettes. Clinical follow-up (1.7 +/- 2.3 years) revealed the following diagnoses: n = 19 LBD (n = 17 Parkinson's disease [PD], n = 1 PD dementia, and n = 1 dementia with Lewy bodies), n = 31 APS (n = 28 MSA, n = 3 PSP), n = 3 non-neurodegenerative parkinsonism; n = 1 patient could not be diagnosed and was excluded. Receiver operating characteristic analyses for discriminating LBD vs. non-LBD revealed a larger area under the curve for FDG PET than for MIBG scintigraphy at statistical trend level for consensus rating (0.82 vs. 0.69, p = 0.06; significant for investigator #1: 0.83 vs. 0.69, p = 0.04). The analysis of PD vs. MSA showed a similar difference (0.82 vs. 0.69, p = 0.11; rater #1: 0.83 vs. 0.69, p = 0.07). Albeit the notable differences in diagnostic performance did not attain statistical significance, the authors consider this finding clinically relevant and suggest that FDG PET, which also allows for subgrouping of APS, should be preferred. KW - clinical diagnosis KW - F-18-FDG PET KW - disease KW - dementia KW - accuracy KW - stimulation KW - guidelines KW - criteria KW - brain KW - risk Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-230675 VL - 6 ER - TY - JOUR A1 - Pritchard, Rory A. A1 - Falk, Lovissa A1 - Larsson, Mathilda A1 - Leinders, Mathias A1 - Sorkin, Linda S. T1 - Different phosphoinositide 3-kinase isoforms mediate carrageenan nociception and inflammation JF - Pain N2 - Phosphoinositide 3-kinases (PI3Ks) participate in signal transduction cascades that can directly activate and sensitize nociceptors and enhance pain transmission. They also play essential roles in chemotaxis and immune cell infiltration leading to inflammation. We wished to determine which PI3K isoforms were involved in each of these processes. Lightly anesthetized rats (isoflurane) were injected subcutaneously with carrageenan in their hind paws. This was preceded by a local injection of 1% DMSO vehicle or an isoform-specific antagonist to PI3K-α (compound 15-e), -β (TGX221), -δ (Cal-101), or -γ (AS252424). We measured changes in the mechanical pain threshold and spinal c-Fos expression (4 hours after injection) as indices of nociception. Paw volume, plasma extravasation (Evans blue, 0.3 hours after injection), and neutrophil (myeloperoxidase; 1 hour after injection) and macrophage (CD11b+; 4 hour after injection) infiltration into paw tissue were the measured inflammation endpoints. Only PI3K-γ antagonist before treatment reduced the carrageenan-induced pain behavior and spinal expression of c-Fos (P ≤ 0.01). In contrast, pretreatment with PI3K-α, -δ, and-γ antagonists reduced early indices of inflammation. Plasma extravasation PI3K-α (P ≤ 0.05), -δ (P ≤ 0.05), and -γ (P ≤ 0.01), early (0-2 hour) edema -α (P ≤ 0.05), -δ (P ≤ 0.001), and -γ (P ≤ 0.05), and neutrophil infiltration (all P ≤ 0.001) were all reduced compared to vehicle pretreatment. Later (2-4 hour), edema and macrophage infiltration (P ≤ 0.05) were reduced by only the PI3K-δ and -γ isoform antagonists, with the PI3K-δ antagonist having a greater effect on edema. PI3K-β antagonism was ineffective in all paradigms. These data indicate that pain and clinical inflammation are pharmacologically separable and may help to explain clinical conditions in which inflammation naturally wanes or goes into remission, but pain continues unabated. KW - c-Fos KW - macrophage KW - neutrophil KW - plasma extravasation KW - pain KW - edema Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-150248 VL - 157 IS - 1 ER - TY - JOUR A1 - Pritchard, Rory A. A1 - Falk, Lovissa A1 - Larsson, Mathilda A1 - Leinders, Mathias A1 - Sorkin, Linda S. T1 - Different phosphoinositide 3-kinase isoforms mediate carrageenan nociception and inflammation JF - Pain N2 - Phosphoinositide 3-kinases (PI3Ks) participate in signal transduction cascades that can directly activate and sensitize nociceptors and enhance pain transmission. They also play essential roles in chemotaxis and immune cell infiltration leading to inflammation. We wished to determine which PI3K isoforms were involved in each of these processes. Lightly anesthetized rats (isoflurane) were injected subcutaneously with carrageenan in their hind paws. This was preceded by a local injection of 1% DMSO vehicle or an isoform-specific antagonist to PI3K-α (compound 15-e), -β (TGX221), -δ (Cal-101), or -γ (AS252424). We measured changes in the mechanical pain threshold and spinal c-Fos expression (4 hours after injection) as indices of nociception. Paw volume, plasma extravasation (Evans blue, 0.3 hours after injection), and neutrophil (myeloperoxidase; 1 hour after injection) and macrophage (CD11b+; 4 hour after injection) infiltration into paw tissue were the measured inflammation endpoints. Only PI3K-γ antagonist before treatment reduced the carrageenan-induced pain behavior and spinal expression of c-Fos (P <= 0.01). In contrast, pretreatment with PI3K-α, -δ, and -γ antagonists reduced early indices of inflammation. Plasma extravasation PI3K-α (P <= 0.05), -δ (P <= 0.05), and -γ (P <= 0.01), early (0-2 hour) edema -α (P <= 0.05), -δ (P <= 0.001), and -γ (P <= 0.05), and neutrophil infiltration (all P <= 0.001) were all reduced compared to vehicle pretreatment. Later (2-4 hour), edema and macrophage infiltration (P <= 0.05) were reduced by only the PI3K-δ and -γ isoform antagonists, with the PI3K-δ antagonist having a greater effect on edema. PI3K-β antagonism was ineffective in all paradigms. These data indicate that pain and clinical inflammation are pharmacologically separable and may help to explain clinical conditions in which inflammation naturally wanes or goes into remission, but pain continues unabated. KW - c-Fos KW - Edema KW - Macrophage KW - Neutrophil KW - Plasma extravasation KW - Pain KW - PI3K isoforms Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-191312 VL - 157 IS - 1 ER - TY - JOUR A1 - Hecker, Katharina A1 - Grüner, Julia A1 - Hartmannsberger, Beate A1 - Appeltshauser, Luise A1 - Villmann, Carmen A1 - Sommer, Claudia A1 - Doppler, Kathrin T1 - Different binding and pathogenic effect of neurofascin and contactin–1 autoantibodies in autoimmune nodopathies JF - Frontiers in Immunology N2 - Introduction IgG4 autoantibodies against paranodal proteins are known to induce acute-onset and often severe sensorimotor autoimmune neuropathies. How autoantibodies reach their antigens at the paranode in spite of the myelin barrier is still unclear. Methods We performed in vitro incubation experiments with patient sera on unfixed and unpermeabilized nerve fibers and in vivo intraneural and intrathecal passive transfer of patient IgG to rats, to explore the access of IgG autoantibodies directed against neurofascin-155 and contactin-1 to the paranodes and their pathogenic effect. Results We found that in vitro incubation resulted in weak paranodal binding of anti-contactin-1 autoantibodies whereas anti-neurofascin-155 autoantibodies bound to the nodes more than to the paranodes. After short-term intraneural injection, no nodal or paranodal binding was detectable when using anti-neurofascin-155 antibodies. After repeated intrathecal injections, nodal more than paranodal binding could be detected in animals treated with anti-neurofascin-155, accompanied by sensorimotor neuropathy. In contrast, no paranodal binding was visible in rats intrathecally injected with anti-contactin-1 antibodies, and animals remained unaffected. Conclusion These data support the notion of different pathogenic mechanisms of anti-neurofascin-155 and anti-contactin-1 autoantibodies and different accessibility of paranodal and nodal structures. KW - autoimmune nodopathy KW - IgG4 KW - neurofascin KW - contactin KW - node of ranvier KW - inflammatory neuropathy KW - passive transfer Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-320395 VL - 14 ER - TY - JOUR A1 - Polat, Bülent A1 - Wohlleben, Gisela A1 - Kosmala, Rebekka A1 - Lisowski, Dominik A1 - Mantel, Frederick A1 - Lewitzki, Victor A1 - Löhr, Mario A1 - Blum, Robert A1 - Herud, Petra A1 - Flentje, Michael A1 - Monoranu, Camelia-Maria T1 - Differences in stem cell marker and osteopontin expression in primary and recurrent glioblastoma JF - Cancer Cell International N2 - Background Despite of a multimodal approach, recurrences can hardly be prevented in glioblastoma. This may be in part due to so called glioma stem cells. However, there is no established marker to identify these stem cells. Methods Paired samples from glioma patients were analyzed by immunohistochemistry for expression of the following stem cell markers: CD133, Musashi, Nanog, Nestin, octamer-binding transcription factor 4 (Oct4), and sex determining region Y-box 2 (Sox2). In addition, the expression of osteopontin (OPN) was investigated. The relative number of positively stained cells was determined. By means of Kaplan–Meier analysis, a possible association with overall survival by marker expression was investigated. Results Sixty tissue samples from 30 patients (17 male, 13 female) were available for analysis. For Nestin, Musashi and OPN a significant increase was seen. There was also an increase (not significant) for CD133 and Oct4. Patients with mutated Isocitrate Dehydrogenase-1/2 (IDH-1/2) status had a reduced expression for CD133 and Nestin in their recurrent tumors. Significant correlations were seen for CD133 and Nanog between OPN in the primary and recurrent tumor and between CD133 and Nestin in recurrent tumors. By confocal imaging we could demonstrate a co-expression of CD133 and Nestin within recurrent glioma cells. Patients with high CD133 expression had a worse prognosis (22.6 vs 41.1 months, p = 0.013). A similar trend was seen for elevated Nestin levels (24.9 vs 41.1 months, p = 0.08). Conclusions Most of the evaluated markers showed an increased expression in their recurrent tumor. CD133 and Nestin were associated with survival and are candidate markers for further clinical investigation. KW - Glioblastoma KW - Glioma stem cells KW - Osteopontin KW - CD133 KW - Nestin Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-301240 SN - 1475-2867 VL - 22 ER - TY - THES A1 - Schmid, Harriet T1 - Die Wirkung des Phosphodiesterase-IV-Inhibitors Mesopram auf Faktoren der Blut-Hirn-Schranke T1 - Effects of the Phosphodiesterase-IV-Inhibitor Mesopram on factors of the blood-brain-barrier N2 - Multiple Sklerose ist eine chronisch degenerative Erkrankung des ZNS, deren Therapie-möglichkeiten noch immer begrenzt sind. In der vorliegenden Arbeit wurde in vitro der selektive PDE-IV-Inhibitor Mesopram untersucht, welcher bereits in einer Phase II Studie bei Patienten mit klinisch gesicherter MS zum Einsatz kommt. Anhand von HBMEC’s, die als ein Model der menschlichen BHS gelten, konnten TJ’s (ZO-1, Claudin-3, Occludin), Adhäsionsmoleküle (ICAM, VCAM, MCAM), Zytokine und Chemokine (AR, Il-6, MCP-1, Il-8) und MMP-2 nachgewiesen werden. Diese Faktoren sind bei der Zerstörung der BHS in der Pathologie der MS beteiligt. Die Idee dieser Arbeit war es, durch die spezifische PDE-IV-Inhibition mit Mesopram die untersuchten Faktoren der BHS so zu beeinflussen, dass eine weitere Permeabilitätserhöhung verhindert werden könnte. Da es sich bei MS um eine inflammatorische Erkrankung handelt und TNFα in MS-Läsionen gefunden wird, wurde in dieser Arbeit TNFα als inflammatorischer Stimulus verwendet. Unter TNFα-Stimulation wurden die meisten der genannten Faktoren vermehrt exprimiert. Keine Veränderung unter TNFα zeigten Occludin, ZO-1, VCAM und MMP-2. Die HBMEC’s wurden über 24 und 48 h mit TNFα und Mesopram stimuliert. Es konnte in den unterschiedlichen Auswertungen (ELISA, FACS, Western Blot, Zymographie) keine regulatorische Modulation der verschiedenen Faktoren unter Mesopram-induzierter cAMP-Erhöhung nachgewiesen werden. N2 - Multiple Sklerose ist eine chronisch degenerative Erkrankung des ZNS, deren Therapie-möglichkeiten noch immer begrenzt sind. In der vorliegenden Arbeit wurde in vitro der selektive PDE-IV-Inhibitor Mesopram untersucht, welcher bereits in einer Phase II Studie bei Patienten mit klinisch gesicherter MS zum Einsatz kommt. Anhand von HBMEC’s, die als ein Model der menschlichen BHS gelten, konnten TJ’s (ZO-1, Claudin-3, Occludin), Adhäsionsmoleküle (ICAM, VCAM, MCAM), Zytokine und Chemokine (AR, Il-6, MCP-1, Il-8) und MMP-2 nachgewiesen werden. Diese Faktoren sind bei der Zerstörung der BHS in der Pathologie der MS beteiligt. Die Idee dieser Arbeit war es, durch die spezifische PDE-IV-Inhibition mit Mesopram die untersuchten Faktoren der BHS so zu beeinflussen, dass eine weitere Permeabilitätserhöhung verhindert werden könnte. Da es sich bei MS um eine inflammatorische Erkrankung handelt und TNFα in MS-Läsionen gefunden wird, wurde in dieser Arbeit TNFα als inflammatorischer Stimulus verwendet. Unter TNFα-Stimulation wurden die meisten der genannten Faktoren vermehrt exprimiert. Keine Veränderung unter TNFα zeigten Occludin, ZO-1, VCAM und MMP-2. Die HBMEC’s wurden über 24 und 48 h mit TNFα und Mesopram stimuliert. Es konnte in den unterschiedlichen Auswertungen (ELISA, FACS, Western Blot, Zymographie) keine regulatorische Modulation der verschiedenen Faktoren unter Mesopram-induzierter cAMP-Erhöhung nachgewiesen werden. KW - Blut-Hirn-Schranke KW - Phosphodiesterasehemmer KW - Multiple Sklerose KW - blood-brain-barrier KW - multiple sclerosis KW - phosphodiesterase inhibitor Y1 - 2007 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-26345 ER - TY - THES A1 - Lintner, Hannes T1 - Die Wertigkeit des Liquorbiomarkers CXCL-13 in der Diagnostik der Neuroborreliose und anderer neuroinflammatorischer Erkrankungen T1 - Sensitivity and specificity of cerebrospinal fluid CXCL13 for diagnosing Lyme neuroborreliosis : A study on 1410 patients and review of the literature N2 - Zu den häufigsten Symptomen der Neuroborreliose zählen Meningopolyradikulitis, lymphozytäre Meningitis und eine Beteiligung von Hirnnerven. Die Diagnosestellung erfolgt anhand klinischer Symptomatik, Liquoranalyse und Antikörperuntersuchungen von Liquor und Serum. Besonders in der Frühphase der Infektion gestaltet sich die Diagnosesicherung aufgrund der noch fehlenden Antikörperreaktion jedoch oftmals sehr schwierig. Die Ergebnisse mehrerer Studien legen nahe, dass CXCL-13 einen wertvollen Beitrag leisten könnte, um diese diagnostische Lücke zu schließen. Ziel der Studie war es, die Wertigkeit des Liquorbiomarkers CXCL-13 in der Diagnostik der Neuroborreliose und anderer neuroinflammatorischer Erkrankungen anhand eines großen unselektierten Kollektivs zu ermitteln, einen cut-off Wert für die Verwendung im klinischen Alltag zu definieren und die Ergebnisse mit der bestehenden Literatur zu vergleichen. Dafür wurden am Klinikum Wels-Grieskirchen über einen Zeitraum von 3 Jahren alle Patienten analysiert, bei denen im Rahmen einer Liquorpunktion die CXCL-13 Konzentration bestimmt wurde. Die Patienten wurden anhand der Hauptdiagnose bei Entlassung in 12 Diagnosegruppen aufgeteilt, für die Einteilung der Neuroborreliose Patienten wurden die Diagnoseleitlinien der DGN herangezogen. Alle Liquorproben wurden routinemäßig auf Zellzahl, Gesamteiweiß und Laktat untersucht, die CXCL-13 Konzentration wurde anhand eines enzyme-linked immunsorbent assay (CXCL-13 ELISA, Euroimmun) bestimmt. Unter den 1410 augewerteten Patienten fanden sich 29 Fälle mit gesicherter Neuroborreliose sowie 9 Fälle mit wahrscheinlicher/möglicher Neuroborreliose. Beide Neuroborreliosegruppen zeigten eine deutlich erhöhte mediane CXCL-13 Konzentration (554pg/ml bzw. 649pg/ml), in der Gruppe der bakteriellen und Pilzinfektionen (n=6) fand sich ebenfalls ein deutlich erhöhter Median von 410pg/ml. Alle anderen Gruppen wiesen signifikant niedrigere CXCL-13 Konzentrationen auf (p<0,001), lediglich bei sechs Patienten aus der Gruppe der soliden Tumore, darunter ein kutanes Lymphom und fünf hirneigene Tumore, wurden Werte über 500pg/ml gefunden. Anhand einer ROC-Kurve wurde der ideale cut-off für die Diagnose der gesicherten Neuroborreliose errechnet. Dieser lag bei 55,5pg/ml mit einer Sensitivität von 96,6% (95% KI 80,4-99,8%) und einer Spezifität von 94,9% (95% KI 93,5-95,9%). Bei 28 der 29 gesicherten Neuroborreliosefälle konnte ein positiver Antikörperindex nachgewiesen werden, dies entspricht einer Sensitivität von 96,6%. Der direkte Erregernachweis mittels PCR wurde bei neun Patienten durchgeführt, er war lediglich in zwei Fällen positiv, die Sensitivität lag bei 22,2%. Bei den Patienten mit wahrscheinlicher Neuroborreliose (n=5) war eine Bestimmung des Antikörper-Index nicht möglich, da entweder nur im Serum oder im Liquor borrelienspezifische Antikörper vorlagen. Alle Patienten zeigten eine typische klinische Symptomatik, eine lymphozytäre Pleozytose und deutlich erhöhte CXCL-13 Konzentrationen. Es erfolgte eine antibiotische Therapie mit Ceftriaxon, worauf die Symptomatik rasch rückläufig war. Die Ergebnisse der Studie bestätigen die hohe Wertigkeit von CXCL-13 für die Diagnose der Neuroborreliose und belegen die Übertragbarkeit der bisherigen Funde auf ein unselektiertes Patientenkollektiv. Die CXCL-13 Bestimmung ist dem direkten Erregernachweis deutlich überlegen, dieser ist aufgrund der niedrigen Sensitivität lediglich als Bestätigungstest geeignet. Im Vergleich zum borrelienspezifischen Antikörper-Index ist CXCL-13 als in etwa ebenbürtig anzusehen. Besonders in der Frühphase der Infektion bietet die CXCL-13 Bestimmung aufgrund der Latenzzeit bis zur Nachweisbarkeit von Antikörpern jedoch einen deutlichen Vorteil. Zusätzlich fällt die CXCL-13 Konzentration nach erfolgter Therapie rasch wieder ab, wodurch es sich auch als Verlaufsparameter eignet. Ein positiver Antikörper-Index kann über viele Jahre persistieren, weshalb eine Unterscheidung zwischen akuter und abgelaufener Infektion unmöglich ist. Am sinnvollsten erscheint eine Kombination von CXCL-13 und Antikörper-Index, in Verbindung mit der klinischen Präsentation ergibt sich so eine sehr hohe diagnostische Sicherheit in allen Stadien der Erkrankung. N2 - Introduction: The B-cell chemoattractant CXCL13 has been suggested as a cerebrospinal fluid (CSF) biomarker for Lyme neuroborreliosis (LNB). Our aim was to substantiate the value of CXCL13 in a large unselected cohort and determine a practical cut-off value to diagnose LNB. Methods: We retrospectively studied clinical and CSF data of consecutive patients who underwent CSF CXCL13 testing over a period of three years (February 2015 to January 2018) at our academic teaching hospital. Patients were classified into 12 groups according to their final diagnosis. To diagnose LNB (definite or probable/possible), definitions of the respective guideline of the German Neurological Society were applied. Results: Of 1410 patients, 29 were diagnosed with definite LNB and 9 with probable/possible LNB. Median CXCL13 levels were highly elevated in both LNB groups (exceeding the test limit of 500 pg/mL) and the group with bacterial/fungal CNS infections (410 pg/mL; n= 6), while the other nine disease groups had markedly lower median CXCL13 levels (p < 0.001). For definite LNB, the best CXCL13 test cut-off was 55.5 pg/mL with a sensitivity of 96.6% (95% confidence interval, CI, 80.4%-99.8%) and a specificity of 94.9% (95% CI 93.5%- 95.9%). All patients diagnosed with LNB showed improvement of clinical symptoms after antibiotic treatment. Conclusion: In this large monocentric cohort, CSF CXCL13 was found to be a highly sensitive and useful marker for LNB. A review of the literature on the sensitivity and specificity of CSF CXCL13 in the differential of LNB is provided. KW - Borreliose KW - Neuroborreliose Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-260471 ER - TY - THES A1 - Seager, Anna T1 - Die urämische Neuropathie - ein Vitamin-B\(_{12}\)-Mangel? T1 - Uremic Neuropathy - a Vitamin B\(_{12}\) Deficiency? N2 - Eine Vielzahl von Patienten mit fortgeschrittener, beziehungsweise dialysepflichtiger Niereninsuffizienz entwickeln eine Polyneuropathie. Die Pathogenese der urämischen Neuropathie (UN) ist nicht geklärt, sodass auf der Suche nach dem Pathomechanismus auch ein Vitamin-B12-Mangel diskutiert werden muss, da dieser ähnliche Symptome wie die UN hervorrufen kann. Ziel dieser Studie war es, den Zusammenhang zwischen den Parametern des Vitamin-B12-Stoffwechsels und der UN darzustellen. In einer prospektiven Studie mit insgesamt 54 teilnehmenden Patienten wurden diese vor und nach einer Vitamin-B12-Substitution laborchemisch untersucht. Zudem erhielten die Patienten neben einer klinischen Untersuchung eine elektroneurographische Diagnostik des N. suralis und des N. tibialis, sowie eine QST-Untersuchung. N2 - Uremic neuropathy (UN) is the most common neurological disorder in end-stage renal disease. The pathophysiology of uremic neuropathy is complex and is not yet fully understood. Vitamin B12 deficiency can cause severe neurological disorders and symptoms are similar to UN. To investigate whether UN is due to Vitamin B12 deficiency, we conducted a study measuring Vitamin B12 Biomarkers on 54 dialysis patients before and after administering Vitamin B12. In addition a full neurological clinical exam, as well as electroneurography and QST were conducted before and after Vitamin B12 supplementation. KW - Urämie KW - Polyneuropathie KW - Chronische Niereninsuffizienz KW - Vitamin-B12-Mangel KW - Dialyse KW - Methylmalonsäure Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-291094 ER - TY - THES A1 - Kerscher, Susanne Regina T1 - Die Rolle von Makrophagen an der motorischen Endplatte bei der Pathogenese neuromuskulärer Erkrankungen am Beispiel von Tiermodellen peripherer Neuropathien vom Charcot-Marie-Tooth-Typ T1 - The role of macrophages at neuromuscular junctions in the pathogenesis of Charcot-Marie-Tooth neuropathies N2 - Bei den Charcot-Marie-Tooth (CMT) Neuropathien handelt es sich um erbliche Erkrankungen des peripheren Nervensystems, die progredient zu motorischen und sensorischen Defiziten führen und für die bislang keine kausalen Therapieoptionen existieren. In verschiedenen Studien konnte gezeigt werden, dass Entzündungsreaktionen, insbesondere durch Lymphozyten und Makrophagen vermittelt, eine bedeutende Rolle bei der Pathogenese dieser Erkrankung spielen. Neben neuronaler und axonaler Schädigung, sowie Demyelinisierung ist in untersuchten Myelin Mutanten auch eine erhöhte Anzahl an denervierten neuromuskulärer Endplatten zu erkennen. Eine genetische Blockade der Makrophagen-Aktivierung konnte in den Studien eine Verbesserung sämtlicher neuropathologischer Merkmale bei gleichzeitig reduzierter Makrophagenanzahl zeigen. Ob und welche Rolle Makrophagen bei der Denervation neuromuskulärer Endplatten spielen, blieb bislang ungeklärt. In dieser Studie konnte in allen untersuchten Myelin Mutanten im Vergleich zum Wildtyp eine Zunahme an neuromuskulären Synapsen beobachtet werden, die mit Makrophagen räumlich assoziiert waren. Daneben zeigten entsprechende Myelin Mutanten eine Zunahme denervierter und partiell denervierter Endplatten und zwar interessanterweise direkt proportional zur Anzahl an Synapsen in Assoziation mit Makrophagen. Das bedeutet, dass die Anzahl an Endplatten in Assoziation mit Makrophagen verhältnismäßig parallel zur Anzahl an denervierten Endplatten zunahm, während die Anzahl an Makrophagen im gesamten Muskel nahezu unverändert blieb. Dies deutet eine mögliche Rolle der räumlich mit Endplatten assoziierten Makrophagen an deren Denervation an. Dabei waren alle Synapsen in Assoziation mit Makrophagen innerviert und damit morphologisch intakt. Bei doppel-mutanten Mäusen mit genetischer Blockade der Makrophagen-Aktivierung waren die beschriebenen pathologischen Merkmale an der neuromuskulären Synapse deutlich reduziert bei gleichzeitig signifikanter Abnahme an Makrophagen in Assoziation mit Endplatten. Ähnliche pathologische Auffälligkeiten wie bei Myelin Mutanten fanden sich in geringerer Ausprägung auch im Wildtyp im Rahmen des Alterungsprozesses sowie auch bei Mäusen mit Defizienz des neurotrophen Faktors CNTF. Zusammenfassend deuten die Ergebnisse darauf hin, dass sowohl in der Pathogenese der CMT Neuropathie wie auch im Rahmen altersbedingter Neurodegeneration ein Makrophagen-vermittelter Schaden an der neuromuskulären Endplatte entsteht. Wesentliche Mediatoren scheinen hierbei das von Fibroblasten und vermutlich auch perisynaptischen Fibroblasten exprimierte CSF-1 zu sein, sowie MCP-1, das durch Schwann Zellen und möglicherweise auch von terminalen Schwann Zellen freigesetzt wird. Auch eine Defizienz des neurotrophen Faktors CNTF bewirkt zumindest in geringem Ausmaß eine Zunahme der pathologischen Merkmale Denervation und Makrophagen-Endplatten-Assoziation im Vergleich zum Wildtyp. Diese Ergebnisse erweitern insbesondere das Wissen um Pathomechanismen an der neuromuskulären Endplatte und eröffnen neue Möglichkeiten der Behandlung für CMT und weitere neuromuskuläre Erkrankungen. N2 - Charcot-Marie-Tooth (CMT) neuropathies are a group of hereditary diseases of the peripheral nervous system that progressively lead to motor and sensory deficits and for which currently no causal therapeutic options exist. Various studies revealed that inflammatory reactions, especially mediated by lymphocytes and macrophages, play a significant role in the pathogenesis of this disease. In addition to demyelination, neuronal and axonal damage, an increased number of denervated neuromuscular junctions were detected in myelin mutant mice. In these studies, a genetic blockade of macrophage activation induced an improvement in all neuropathological features with a simultaneous reduction in the number of macrophages. Whether and which role macrophages play in the denervation of neuromuscular endplates remained unclear by now. In this presented study, an increase in neuromuscular synapses spatially associated with macrophages was observed in all investigated myelin mutant mice compared to wild type mice. In addition, corresponding myelin mutants showed an increase in denervated and partially denervated endplates directly proportional to the number of synapses associated with macrophages. This means that the number of endplates in association with macrophages increased relatively in parallel with the number of denervated endplates, while the number of macrophages remained nearly unchanged throughout the skeletal muscle. This suggests a possible pathogenetic role of spatially endplate-associated macrophages in their denervation. All synapses in association with macrophages were innervated and thus morphologically intact. In dual mutant mice with a genetic blockade of macrophage activation, the described pathological features at the neuromuscular junction were significantly reduced with concomitant significant decrease in macrophages associated with endplates. Similar pathological abnormalities as in myelin mutants were found to a lesser extent also in the wild type in the context of the aging process as well as in mice with deficiency of the neurotrophic factor CNTF. In summary, these results suggest that macrophage-related damage of neuromuscular junctions occurs in both the pathogenesis of CMT neuropathy and in the context of age-related neurodegeneration. Important mediators seem to be CSF-1 expressed by fibroblasts and probably also perisynaptic fibroblasts, as well as MCP-1, which is released by Schwann cells and possibly also by terminal Schwann cells. Furthermore, a deficiency of the neurotrophic factor CNTF causes, at least to a small extent, an increase in the pathological features of denervation and macrophage-endplate association compared to the wild-type. In particular, these findings expand knowledge of pathomechanisms at the neuromuscular endplate and open up new treatment options for CMT and other neuromuscular diseases. KW - CMT KW - Charcot-Marie-Tooth KW - hereditäre Neuropathien KW - neuromuskuläre Endplatte KW - Makrophagen Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-169412 ER - TY - THES A1 - Kobsar, Igor V. T1 - Die Rolle von Immunzellen bei der primär genetisch-vermittelten Demyelinisierung in einem Mausmodell für die Charcot-Marie-Tooth-Neuropathie, Typ 1X T1 - The role of immune cells in genetic-mediated demyelination in a mouse model of Charcot-Marie-Tooth neuropathy, type 1X N2 - Ziel der vorliegenden Arbeit war, zu untersuchen, ob Immunzellen den Schweregrad einer peripheren Neuropathie im Mausmodell von CMT1X (Cx32def (Cx32-defiziente) Maus) beeinflussen können. Mit Hilfe von immunhistochemischen Färbemethoden, lichtmikroskopischen, immunelektronenmikroskopischen und computergestützen konventionellen elektronenmikroskopischen Auswertungsverfahren wurde die Anzahl von endoneuralen Makrophagen und CD8+ T-Zellen, sowie die Morphologie von Quadricepsnerven und ventralen Spinalwurzeln analysiert.. Aufgrund der vorliegenden Ergebnissen können dabei folgende Aussagen getroffen werden: 1. Makrophagen und CD8+ T-Zellen sind in Quadricepsnerven von Cx32-defizienten Mäusen hochreguliert, wobei die Anzahl der endoneuralen Makrophagen die Anzahl der CD8+ T-Zellen wesentlich übersteigt. Die Anzahl war altersabhängig und korrelierte mit dem Schweregrad des pathomorphologischen Bildes der peripheren Neuropathie. 2. Mit Immunelektronenmikroskopie haben wir eindeutig identifizierbare endoneurale Makrophagen innerhalb der endoneuralen Röhren in engem Kontakt zu demyelinisierten oder in Demyelinisierung begriffenen Axonen nachgewiesen. Endoneurale Makrophagen enthielten häufig Reste von phagozytiertem Myelin. 3. Bei Immun- und konventioneller Elektronenmikroskopie haben wir häufig ausgeprägte Kontakte zwischen Makrophagen und Fibroblasten beobachtet. 4. In Cx32def/RAG-1-/- Doppelmutanten, die zusätzlich zu der Myelinmutation auch keine reifen Lymphozyten beinhalten, ist eine signifikant geringere Hochregulation der Anzahl von endoneuralen Makrophagen nachweisbar, ebenso eine wesentliche Abmilderung der pathologischen Veränderungen von Quadricepsnerven und ventralen Spinalwurzeln im Vergleich zu Cx32def/ RAG-1+/? Geschwistertieren. Diese Ergebnisse lassen die Schlußfolgerung zu, daß Makrophagen und CD8+ T-Zellen die primär genetisch-bedingte Demyelinisierung im Mausmodell für CMT1X wesentlich verstärkend beeinflussen. Aufgrund der ähnlichen Literaturdaten über das Mausmodell von CMT1B (P0+/- Mutante) können wir vermuten, daß die Interaktion zwischen Schwann- und Immunzellen eine wichtige Komponente der peripheren Demyelinisierung in Mausmodellen für CMT1 ist. N2 - An aim of the presented work was to investigate whether immune cells could influence upon the severity of a peripheral neuropathy in a mouse model of CMT1X (Cx32def (Cx32-deficient mouse). Using immunohistochemical methods of staining, light-, immunelectron microscopy and computerised conventional electron microscopy we analysed a number of endoneurial macrophages and CD8+ T-cells as well as morphology of N. Quadriceps and ventral spinal roots. Taking into account our results, we could make such a conclusion: 1. Macrophages and CD8+ T-cells are upregulated in the N. Quadriceps and the number of endoneurial macrophages is significantly higher in comparison with the number of endoneurial CD8+ T-cells. These numbers are correlated with the age of the mice and with the severity of patholomorphological signs of peripheral neuropathy. 2. With the help of immunelectronmicroscopy we could definitely identify endoneurial macrophages inside of endoneurial tubes in close contact with axons during or after the process of demyelination. The endoneurial macrophages included rather often the rest of phagocyted myelin. 3. By means of immun- and conventional electron microscopy we have also observed close contacts between macrophages and fibroblasts inside of investigated nerves. 4. In Cx32def/RAG-1-/- double mutants, which in addition to myelin mutation contained no mature lymphocytes, we observed significantly lower upregulation of endoneurial macrophages as well as amelioration of pathological changes of N. Quadriceps and ventral spinal roots in comparison with Cx32def/ RAG-1+/? littermates. These results lead us to conclusion that macrophages and CD8+ T-cells could significantly aggravate genetically-mediated demyelination in a mouse model of CMT1X. Taking into account similar literature data concerning a mouse model of CMT1B (P0+/- mutants), we could assume, that interaction between Schwann- and immune cells is an important component of the pathogenesis of peripheral demyelination in mouse models of CMT1. KW - CMT KW - HMSN KW - immunzellen KW - RAG-1 KW - makrophagen KW - CMT KW - HMSN immune cells KW - RAG-1 KW - macrophages Y1 - 2005 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-17047 ER - TY - THES A1 - Hornburger, Hannah T1 - Die Rolle des primären somatosensiblen Kortex für die multisensorische Integration bei der Puppenhandillusion – eine tDCS-Studie T1 - The role of the primary somatosensory cortex for multisensory integration during rubber hand illusion - a tDCS study N2 - In der Puppenhandillusion (PHI) wird durch die synchrone Berührung der nicht-sichtbaren Hand des Probanden und einer sichtbaren Puppenhand ein illusio-näres Körperzugehörigkeitsgefühl induziert. Dieses Paradigma erlaubt es zu untersuchen, wie das Gehirn widersprüchliche multisensorische Informationen während einer perzeptiven Inferenz auflöst. Vorausgehende Studien weisen darauf hin, dass der Konflikt zwischen visueller und propriozeptiver Information vor der PHI durch eine Abschwächung des so-matosensiblen Inputs behoben wird. Um herauszufinden, ob eine Exzitabilitäts-Minderung des primären somatosensiblen Kortex die PHI verstärken kann, kam die kathodale transkranielle Gleichstromstimulation (c-tDCS) zum Einsatz. An dreißig gesunden Probanden wurde die PHI ohne (=baseline) und während tDCS untersucht. Jeder Proband erhielt kathodale, anodale und sham-Stimulation an drei unterschiedlichen Tagen im Abstand von je einer Woche. Das PHI-Paradigma wurde in sechs Distanzen (von 17,5 bis 67,5 cm) zwischen der eigenen Hand und der Puppenhand durchgeführt. Das Auftreten der PHI wurde anhand eines Fragebogens (Illusionsscore, IS) und der Abweichung der gefühlten Handposition in Bezug zur realen Position (relativer Drift, RD) evalu-iert. Die kathodale Stimulation war mit einem signifikanten Anstieg des IS im Vergleich zur anodalen Stimulation assoziiert, wohingegen die RD-Werte über alle Stimulationsarten hinweg vergleichbar waren. Die fehlende Signifikanz zwischen Verum und Sham-Stimulation wurde auf die geringe Effektstärke bei vergleichsweise kleinem Probandenkollektiv bezogen. Die Ergebnisse dieser Studie zeigen jedoch eine verstärkte Wahrnehmung der PHI unabhängig von demographischen Faktoren, wenn kathodale tDCS über dem kontralateralen primären somatosensiblen Kortex appliziert wurde. Dies unterstützt unsere Hypothese, dass eine Abschwächung der somatosensiblen Präzision den Weg für eine erleichterte Integration eines fremden Körperteils in das eigene Körperschema ebnet. N2 - In the rubber hand illusion (RHI), illusory bodily ownership is induced by synchronous touch of a participant's hidden hand and a visible surrogate. This paradigm allows investigating how the brain resolves conflicting multisensory evidence during perceptual inference. Previous studies suggest that the conflict between visual and proprioceptive information preceding the RHI is solved by attenuation of the somatosensory input. To investigate whether excitability-decreasing transcranial direct current stimulation (cathodal tDCS) over the primary somatosensory cortex may enhance the RHI, thirty healthy subjects underwent RHI without (baseline) and during tDCS. Each subject received cathodal, anodal, and sham stimulation at independent sessions on three separate days. The RHI paradigm was applied at six interval distances between the real and artificial hand. Occurrence of the RHI was evaluated by a questionnaire (illusion score) and the perceived hand misplacement (relative drift). Compared to sham, neither cathodal, nor anodal tDCS induced significant changes of the illusion score. However, cathodal tDCS was associated with significantly higher illusion scores compared to anodal stimulation. The relative drift was comparable between stimulation modes. Our findings point to a differential impact of cathodal vs. anodal tDCS over the somatosensory region on RHI perception. This may indicate that an attenuation - in contrast to an enhancement - of somatosensory precision might pave the way for the integration of an artificial limb into one's body schema. KW - tDCS KW - Puppenhandillusion KW - Propriozeption KW - multisensorische Integration KW - predictive coding Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-232323 ER - TY - THES A1 - Emmerich, Christoph T1 - Die Rolle der clathrin- und dynaminabhängigen Endozytose bei der Internalisation von anti-Amphiphysin-Autoantikörpern im Falle des Stiff-Person-Syndroms, untersucht am Zellkulturmodell hippocampaler Neurone T1 - The role of clathrin- and dynamin dependent endocytosis in internalisation of anti-amphiphysin-autoantibodies in case of Stiff-Person-Syndrom N2 - In dieser Arbeit wurde mit Hilfe von small-molecule Inhibitoren die Rolle von clathrin- und dynaminabhängigen Endozytosemechanismen bei der Aufnahme von anti-Amphiphysin-Autoantikörpern am Zellkulturmodell primärer hippocampaler Neurone untersucht. Hierbei konnte eine Beeinflussung der Autoaantikörperaufnahme durch die Intervention gezeigt werden. Außerdem erfolgte der Versuch der Etablierung eines siRNA knockdowns unter Zuhilfenahme unterschiedlicher Traansfektionsreaaagenzien. N2 - This thesis investigated the role of clathrin and dynamin dependent endocytosis in internalisation of anti-amphiphysin-autoantibodies in primary mouse hippocampal neurons by using small molecule inhibitors. An influence in the uptake due to small molecule treatment can be shown. Furthermore an attempt of siRNA knockdown establishment was performed using different transfection reagents. KW - siRNA KW - small molecule KW - Stiff-Person-Syndrom KW - anti-Amphiphysin Antikörper KW - siRNA KW - small-molecule Inhibitoren KW - Stiff-Person-Syndrom KW - anti-amphiphysin antibodies KW - small-molecule inhibitors Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-209360 ER -