@phdthesis{EttlingergebHaberstumpf2023,
  author    = {Ettlinger [geb. Haberstumpf], Sophia},
  title     = {Pathological cognitive decline in the elderly participants of the Vogel Study},
  doi       = {10.25972/OPUS-26558},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265582},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Due to the global aging society and the enormous global incidence and prevalence rates that will result in the coming years, Alzheimer's Dementia (AD) represents a growing challenge for the health care system. The pathogenesis, which is unclear in parts, the chronic progression of AD, which often lasts for years, as well as insufficient diagnostic and therapeutic options complicate an adequate psychotherapeutic and medical approach to the disease. To date, AD is also considered an incurable disease. Therefore, it is essential to gain deeper insights into the early detection or even prevention of AD. Consideration of prodromal syndromes such as Mild Cognitive Impairment (MCI) can provide significant evidence about high-risk groups for AD progression and differentiate cognitively "normal" aging individuals from those with pathological cognitive decline. Thus, for example, functional Near-Infrared Spectroscopy (fNIRS) imaging helps identify early neurodegenerative processes. In contrast, potential risk factors and predictors of later-onset clinical symptoms of MCI and AD can most often be revealed and quantified via the use of neuropsychiatric test batteries. The present thesis consists of four studies and aimed to assess and describe the pathological cognitive decline in a sample of elderly study participants (age: ≥ 70 years; N = 604 at baseline) of the longitudinal, observational, and prospective "Vogel Study" from W{\"u}rzburg, Germany, who were primarily healthy at baseline, over two measurement time points approximately 3 years apart, to differentiate between healthy and diseased study participants and to define predictors of MCI/AD and longitudinal study dropout. Studies 1 and 2 differentiated healthy study participants from MCI patients based on the baseline hemodynamic response of the parietal cortex recorded by fNIRS during the processing of a paradigm (here: Angle Discrimination Task [ADT]) for visual-spatial processing performance. Neuronal hypoactivity was found in the MCI patients, with both healthy study participants and MCI patients showing higher superior and right hemispheric activation. MCI patients had more difficulty resolving the paradigm. Thus, no evidence of possible compensatory mechanisms was uncovered in the MCI patients. Study 3 first defined the four latent factors declarative memory, working memory, attention, and visual-spatial processing based on structural equation model (SEM) calculations of the sample using adequate measurement (in-)variant confirmatory factor models from the baseline assessment to the first of a total of two follow-up assessments after approximately 3 years. This allowed a dimensional assessment of pathological cognitive decline versus classificatory-categorical assignment (healthy/diseased) of the sample. In addition, the superiority of the latent factor approach over a composite approach was demonstrated. Next, using a mixed-model approach, predictive analyses were calculated for the prediction of latent factors at first follow-up by baseline risk factors. The sex of study participants proved to be the best predictor of cognitive change in all the cognitive domains, with females performing better than men in the memory domains. Specifically, for declarative memory, older age predicted lower performance regardless of sex. Additional predictive evidence emerged for low serum levels of Brain-Derived Neurotrophic Factor (BDNF) on lower attention performance and higher depression symptoms on lower visual-spatial processing performance. Study 4 further reported baseline predictors of study dropout at first follow-up. Cognitive performance, as defined in Study 3 using the four latent cognitive factors, was a predictor of study dropout for cognitive decline in the domains of declarative memory, attention, and visual-spatial processing. Conspicuous dementia screening on the Mini-Mental Status Examination (MMSE) also predicted dropout. Overall, both the use of fNIRS imaging to detect visual-spatial processing performance in the parietal cortex during applying ADT and the dimensional perspective of the neuropsychiatric test battery in the context of prediction and dropout analyses were found to be suitable for early detection research of MCI and AD. Finally, the results will be interpreted in the overall context and implications, limitations, and perspectives will be discussed.},
  language  = {en}
}
@article{MetzenmacherVaraljaiHegeduesetal.2020,
  author    = {Metzenmacher, Martin and V{\´a}raljai, Ren{\´a}ta and Heged{\"u}s, Balazs and Cima, Igor and Forster, Jan and Schramm, Alexander and Scheffler, Bj{\"o}rn and Horn, Peter A. and Klein, Christoph A. and Szarvas, Tibor and Reis, Hennig and Bielefeld, Nicola and Roesch, Alexander and Aigner, Clemens and Kunzmann, Volker and Wiesweg, Marcel and Siveke, Jens T. and Schuler, Martin and Lueong, Smiths S.},
  title     = {Plasma Next Generation Sequencing and Droplet Digital-qPCR-Based Quantification of Circulating Cell-Free RNA for Noninvasive Early Detection of Cancer},
  series = {Cancers},
  volume    = {12},
  journal   = {Cancers},
  number    = {2},
  issn      = {2072-6694},
  doi       = {10.3390/cancers12020353},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200553},
  year      = {2020},
  abstract  = {Early detection of cancer holds high promise for reducing cancer-related mortality. Detection of circulating tumor-specific nucleic acids holds promise, but sensitivity and specificity issues remain with current technology. We studied cell-free RNA (cfRNA) in patients with non-small cell lung cancer (NSCLC; n = 56 stage IV, n = 39 stages I-III), pancreatic cancer (PDAC, n = 20 stage III), malignant melanoma (MM, n = 12 stage III-IV), urothelial bladder cancer (UBC, n = 22 stage II and IV), and 65 healthy controls by means of next generation sequencing (NGS) and real-time droplet digital PCR (RT-ddPCR). We identified 192 overlapping upregulated transcripts in NSCLC and PDAC by NGS, more than 90\% of which were noncoding. Previously reported transcripts (e.g., HOTAIRM1) were identified. Plasma cfRNA transcript levels of POU6F2-AS2 discriminated NSCLC from healthy donors (AUC = 0.82 and 0.76 for stages IV and I-III, respectively) and significantly associated (p = 0.017) with the established tumor marker Cyfra 21-1. cfRNA yield and POU6F2-AS transcript abundance discriminated PDAC patients from healthy donors (AUC = 1.0). POU6F2-AS2 transcript was significantly higher in MM (p = 0.044). In summary, our findings support further validation of cfRNA detection by RT-ddPCR as a biomarker for early detection of solid cancers.},
  language  = {en}
}
@phdthesis{Wess2008,
  author    = {Wess, Christian},
  title     = {Wertigkeit der simultanen intraoperativen Ableitung von subduralem EEG und SSEP w{\"a}hrend vaskul{\"a}rer neurochirurgischer Operationen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-34855},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2008},
  abstract  = {Einleitung: SSEP sind etabliert, um Patienten intraoperativ zu {\"u}berwachen, wenn sie sich Operationen im zerebrovaskul{\"a}ren System unterziehen. Das EEG ist eine weitere Methode zur neurophysiologischen {\"U}berwachung. In dieser Studie wurde die Wertigkeit des simultanen Ableitens von SSEP und EEG Signalen untersucht. Methode: Dreizehn Patienten (7 Frauen, 6 M{\"a}nner, mittleres Alter 53.5 Jahre), welche sich dem Clipping eines intrakraniellen Aneurysma unterzogen, wurden eingeschlossen. Die SSEP Latenz 1 (Lat1), Latenz 2 (Lat2) und Amplitude (Amp) wurden kontinuierlich gemessen. Verminderung der Amplitude > 50\% oder Verl{\"a}ngerungen der Latenzen > 10\% gegen{\"u}ber den Ausgangswerten wurden als signifikante Ereignisse bewertet. Das EEG wurde mittels einer subduralen Grid-Elektrode gemessen. Alpha \% (Al\%), Alpha-Delta-Ratio (ADR) und Total Power (TP) wurden ausgewertet. Resultate: Circa 9000 Einzelwerte wurden analysiert. Statistisch signifikante Korrelationen traten zwischen Al\% und Amp (K=0.5) auf. Dabei zeigten sich die Ver{\"a}nderungen im EEG (Al\%) 6 Minuten vor Ereignissen im SSEP (Amp). Statistisch signifikante Korrelationen traten ebenfalls zwischen Al\% und Amp-Ereignissen (K=-0.4) auf. In 6/7 Patienten traten die Al\%-{\"A}nderungen 7 Minuten vor den Amp-{\"A}nderungen auf. Noch st{\"a}rkere Beziehungen ergaben sich zwischen Lat2 und allen EEG Modalit{\"a}ten, jedoch reichte die Gesamtzahl der Datenpunkte nicht aus, um statistische Signifikanzen herzuleiten. Schlussfolgerung: Dies ist die erste Beschreibung von signifikanten Beziehungen zwischen quantitativem SSEP und EEG w{\"a}hrend zerebrovaskul{\"a}ren Operationen. Das quantitative EEG hat das Potenzial, fr{\"u}he isch{\"a}mische Ereignisse eher zu detektieren als dies mit SSEP m{\"o}glich ist.},
  subject      = {intraoperatives Monitoring},
  language  = {de}
}