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Kluge A, Schaeffer E, Bunk J, Sommerauer M, Röttgen S, Schulte C, Roeben B, von Thaler AK, Welzel J, Lucius R, Heinzel S, Xiang W, Eschweiler GW, Maetzler W, Suenkel U, Berg D. Detecting Misfolded α-Synuclein in Blood Years before the Diagnosis of Parkinson's Disease. Mov Disord 2024. [PMID: 38651526 DOI: 10.1002/mds.29766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Identifying individuals with Parkinson's disease (PD) already in the prodromal phase of the disease has become a priority objective for opening a window for early disease-modifying therapies. OBJECTIVE The aim was to evaluate a blood-based α-synuclein seed amplification assay (α-syn SAA) as a novel biomarker for diagnosing PD in the prodromal phase. METHODS In the TREND study (University of Tuebingen) biennial blood samples of n = 1201 individuals with/without increased risk for PD were taken prospectively over 4 to 10 years. We retrospectively analyzed blood samples of 12 participants later diagnosed with PD during the study to detect and amplify pathological α-syn conformers derived from neuronal extracellular vesicles using (1) immunoblot analyses with an antibody against these conformers and (2) an α-syn-SAA. Additionally, blood samples of n = 13 healthy individuals from the TREND cohort and n = 20 individuals with isolated rapid eye movement sleep behavior disorder (iRBD) from the University Hospital Cologne were analyzed. RESULTS All individuals with PD showed positive immunoblots and a positive α-syn SAA at the time of diagnosis. Moreover, all PD patients showed a positive α-syn SAA 1 to 10 years before clinical diagnosis. In the iRBD cohort, 30% showed a positive α-syn SAA. All healthy controls had a negative SAA. CONCLUSIONS We here demonstrate the possibility to detect and amplify pathological α-syn conformers in peripheral blood up to 10 years before the clinical diagnosis of PD in individuals with and without iRBD. The findings of this study indicate that this blood-based α-syn SAA assay has the potential to serve as a diagnostic biomarker for prodromal PD. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Annika Kluge
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Eva Schaeffer
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Josina Bunk
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Michael Sommerauer
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Sinah Röttgen
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Claudia Schulte
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Anna-Katharina von Thaler
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Julius Welzel
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Ralph Lucius
- Institute of Anatomy, Kiel University, Kiel, Germany
| | - Sebastian Heinzel
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Wei Xiang
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Gerhard W Eschweiler
- Geriatric Center, University Hospital Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Walter Maetzler
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Ulrike Suenkel
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany
| | - Daniela Berg
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
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Roeben B, Liepelt-Scarfone I, Lerche S, Zimmermann M, Wurster I, Sünkel U, Schulte C, Deuschle C, Eschweiler GW, Maetzler W, Gasser T, Berg D, Brockmann K. Longitudinal cognitive decline characterizes the profile of non-PD-manifest GBA1 mutation carriers. NPJ Parkinsons Dis 2024; 10:88. [PMID: 38649346 PMCID: PMC11035543 DOI: 10.1038/s41531-024-00706-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
With disease-modifying treatment for Parkinson's disease (PD) associated with variants in the glucocerebrosidase gene (GBA1) under way, the challenge to design clinical trials with non-PD-manifest GBA mutation carriers (GBA1NMC) comes within close reach. To delineate trajectories of motor and non-motor markers as well as serum neurofilament light (sNfL) levels and to evaluate clinical endpoints as outcomes for clinical trials in GBA1NMC, longitudinal data of 56 GBA1NMC carriers and 112 age- and sex-matched GBA1 wildtype participants (GBA1wildtype) with up to 9 years of follow-up was analyzed using linear mixed-effects models (LMEM) and Kaplan-Meier survival analysis of clinical endpoints for motor and cognitive function. GBA1NMC showed worse performance in Pegboard, 20 m fast walking, global cognition as well as in executive and memory function at baseline. Longitudinally, LMEM revealed a higher annual increase of the MDS-UPDRS III bradykinesia subscore in GBA1NMC compared to GBA1wildtype, but comparable trajectories of all other motor and non-motor markers as well as sNfL. Kaplan-Meier survival analysis showed a significantly earlier progression to clinical endpoints of cognitive decline in GBA1NMC. Incidence of PD was significantly higher in GBA1NMC. In conclusion, our study extends data on GBA1NMC indicating early cognitive decline as a potentially characteristic feature. Comprehensive longitudinal assessments of cognitive function are crucial to delineate the evolution of early changes in GBA1NMC enabling a more accurate stratification and allow for a more precise definition of trial design and sample size.
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Grants
- Dr. Roeben was supported by the Clinician Scientist program of the Medical Faculty of the University of Tübingen (grant #478-0-0).
- Janssen Research and Development (Janssen R&D)
- Michael J. Fox Foundation for Parkinson’s Research (Michael J. Fox Foundation)
- European Commission (EC)
- EC | Horizon 2020 Framework Programme (EU Framework Programme for Research and Innovation H2020)
- Novartis
- International Parkinson Fonds (Germany) GmbH (IPD) German Ministry for Education and Research (BMBF)
- Dr. Zimmermann was supported by the Clinician Scientist program of the Medical Faculty of the University of Tübingen (grant #481-0-0).
- Dr. Wurster received funding from the Michael J. Fox Foundation in form of the Edmond J. Safra Fellowship in Movement Disorders.
- German Ministry for Education and Research (BMBF), German Research Council (DFG), German Innovationsfonds
- Robert Bosch Stiftung (Robert Bosch Foundation)
- Dr. Maetzler receives or received funding from the European Union, the German Federal Ministry of Education of Research, German Research Council, Michael J. Fox Foundation, Robert Bosch Foundation, Neuroalliance, Lundbeck, Sivantos and Janssen.
- Dr. Gasser receives research support from Novartis, the European Union, BMBF (the Federal Ministry of Education and Research), and Helmholtz Association.
- Janssen Pharmaceuticals (Janssen Pharmaceuticals, Inc.)
- Teva Pharmaceutical Industries (Teva Pharmaceutical Industries Ltd.)
- Abbott | Abbott Pharmaceuticals
- Boehringer Ingelheim (Boehringer Ingelheim Pharmaceuticals)
- UCB | UCB US
- Deutsches Zentrum für Neurodegenerative Erkrankungen (German Center for Neurodegenerative Diseases)
- Dr. Berg has received funding for travel or speaker honoraria from Lundbeck Inc., Novartis, UCB/ SCHWARZ PHARMA, Merck Serono, Biogen, Zambon, AbbVie, and BIALLtd.; and has received research support from Janssen, Teva Pharmaceutical Industries Ltd., Solvay Pharmaceuticals, Inc./Abbott, Boehringer, UCB, Michael J Fox Foundation, BMBF, dPV (German Parkinson’s disease association), Neuroallianz, DZNE, Center of Integrative Neurosciences and the Damp Foundation.
- Dr. Brockmann has received research grants from the University of Tuebingen (Clinician Scientist), the German Society of Parkinson’s disease (dpv), the Michael J. Fox Foundation (MJFF), the German Centre for Neurodegenerative Diseases (DZNE, MIGAP) and the German Federal Ministry of Education and Research (BMBF) in the frame of ERACoSysMed2 (FKZ 031L0137B).
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Affiliation(s)
- Benjamin Roeben
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany.
| | - Inga Liepelt-Scarfone
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
- IB-Hochschule, Stuttgart, Germany
| | - Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Milan Zimmermann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Isabel Wurster
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Ulrike Sünkel
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwer Str. 14, 72076, Tübingen, Germany
| | - Claudia Schulte
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Christian Deuschle
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwer Str. 14, 72076, Tübingen, Germany
- Geriatric Center at the University Hospital of Tübingen, Calwer Str. 14, 72076, Tübingen, Germany
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, and Kiel University, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Thomas Gasser
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Daniela Berg
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, and Kiel University, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
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Brockmann K, Lerche S, Baiardi S, Rossi M, Wurster I, Quadalti C, Roeben B, Mammana A, Zimmermann M, Hauser AK, Deuschle C, Schulte C, Liepelt-Scarfone I, Gasser T, Parchi P. CSF α-synuclein seed amplification kinetic profiles are associated with cognitive decline in Parkinson's disease. NPJ Parkinsons Dis 2024; 10:24. [PMID: 38242875 PMCID: PMC10799016 DOI: 10.1038/s41531-023-00627-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/20/2023] [Indexed: 01/21/2024] Open
Abstract
Seed amplification assays have been implemented in Parkinson's disease to reveal disease-specific misfolded alpha-synuclein aggregates in biospecimens. While the assays' qualitative dichotomous seeding response is valuable to stratify and enrich cohorts for alpha-synuclein pathology in general, more quantitative parameters that are associated with clinical dynamics of disease progression and that might potentially serve as exploratory outcome measures in clinical trials targeting alpha-synuclein would add important information. To evaluate whether the seeding kinetic parameters time required to reach the seeding threshold (LAG phase), the peak of fluorescence response (Imax), and the area under the curve (AUC) are associated with clinical trajectories, we analyzed LAG, Imax, and AUC in relation to the development of cognitive decline in a longitudinal cohort of 199 people with Parkinson's disease with positive CSF alpha-synuclein seeding status. Patients were stratified into tertiles based on their individual CSF alpha-synuclein seeding kinetic properties. The effect of the kinetic parameters on longitudinal development of cognitive impairment defined by MoCA ≤25 was analyzed by Cox-Regression. Patients with a higher number of positive seeding replicates and tertile groups of shorter LAG, higher Imax, and higher AUC showed a higher prevalence of and a shorter duration until cognitive impairment longitudinally (3, 6, and 3 years earlier with p ≤ 0.001, respectively). Results remained similar in separate subgroup analyses of patients with and without GBA mutation. We conclude that a more prominent alpha-synuclein seeding kinetic profile translates into a more rapid development of cognitive decline.
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Affiliation(s)
- Kathrin Brockmann
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany.
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany.
- Department of Pharmacy and Biotechnology, University of Bologna, 40126, Bologna, Italy.
| | - Stefanie Lerche
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Simone Baiardi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy
| | - Marcello Rossi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
| | - Isabel Wurster
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
- Edmond J. Safra Fellow in Movement Disorders, Tuebingen, Germany
| | - Corinne Quadalti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
- Department of Pharmacy and Biotechnology, University of Bologna, 40126, Bologna, Italy
| | - Benjamin Roeben
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Angela Mammana
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
| | - Milan Zimmermann
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Ann-Kathrin Hauser
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Christian Deuschle
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Claudia Schulte
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Inga Liepelt-Scarfone
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Thomas Gasser
- Department of Neurodegeneration, Center of Neurology, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tuebingen, Hoppe Seyler‑Strasse 3, 72076, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Piero Parchi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Bologna, Italy
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Roeben B, Scharf M, Miske R, Teegen B, Traschütz A, Wilke C, Zimmermann M, Deuschle C, Schulte C, Brockmann K, Schöls L, Komorowski L, Synofzik M. Seroprevalence of autoimmune antibodies in degenerative ataxias: a broad, disease-controlled screening in 456 subjects. J Neurol 2023; 270:5649-5654. [PMID: 37507501 PMCID: PMC10576697 DOI: 10.1007/s00415-023-11900-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/22/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023]
Affiliation(s)
- Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
| | - Madeleine Scharf
- Institute for Experimental Immunology, affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - Ramona Miske
- Institute for Experimental Immunology, affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - Bianca Teegen
- Clinical Immunological Laboratory Prof. Dr. Med. Winfried Stöcker, Lübeck, Germany
| | - Andreas Traschütz
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
- Division Translational Genomics of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Carlo Wilke
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
- Division Translational Genomics of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Milan Zimmermann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
| | - Christian Deuschle
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
| | - Claudia Schulte
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
| | - Ludger Schöls
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
| | - Lars Komorowski
- Institute for Experimental Immunology, affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - Matthis Synofzik
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany.
- Division Translational Genomics of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
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Roeben B, Zeltner L, Hagberg GE, Scheffler K, Schöls L, Bender B. Reply to: "Susceptibility-Weighted Imaging Reveals Subcortical Iron Deposition in PLAN: The 'Double Cortex Sign'". Mov Disord 2023; 38:1973-1974. [PMID: 37885406 DOI: 10.1002/mds.29591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 10/28/2023] Open
Affiliation(s)
- Benjamin Roeben
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Research Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Lena Zeltner
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Center of Rare Diseases, University of Tübingen, Tübingen, Germany
| | - Gisela E Hagberg
- High Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Biomedical Magnetic Resonance, Eberhard Karl's University, Tübingen and University Hospital, Tübingen, Germany
| | - Klaus Scheffler
- High Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Biomedical Magnetic Resonance, Eberhard Karl's University, Tübingen and University Hospital, Tübingen, Germany
| | - Ludger Schöls
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Research Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
- Center of Rare Diseases, University of Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
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Roeben B, Zeltner L, Hagberg GE, Scheffler K, Schöls L, Bender B. Susceptibility-Weighted Imaging Reveals Subcortical Iron Deposition in PLA2G6-associated Neurodegeneration: The "Double Cortex Sign". Mov Disord 2023; 38:904-906. [PMID: 36853590 DOI: 10.1002/mds.29364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/24/2023] [Accepted: 02/07/2023] [Indexed: 03/01/2023] Open
Affiliation(s)
- Benjamin Roeben
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Research Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Lena Zeltner
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Center of Rare Diseases (ZSE), University of Tübingen, Tübingen, Germany
| | - Gisela E Hagberg
- High Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Biomedical Magnetic Resonance, Eberhard Karl's University, Tübingen and University Hospital, Tübingen, Germany
| | - Klaus Scheffler
- High Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Biomedical Magnetic Resonance, Eberhard Karl's University, Tübingen and University Hospital, Tübingen, Germany
| | - Ludger Schöls
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Research Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
- Center of Rare Diseases (ZSE), University of Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
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Jensen-Kondering U, Margraf NG, Weiler C, Maetzler W, Dargvainiene J, Falk K, Philippen S, Bartsch T, Flüh C, Röcken C, Möller B, Royl G, Neumann A, Brüggemann N, Roeben B, Schulte C, Bender B, Berg D, Kuhlenbäumer G. Characterizing mixed location hemorrhages/microbleeds with CSF markers. Int J Stroke 2023:17474930231152124. [PMID: 36622021 DOI: 10.1177/17474930231152124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Cerebral amyloid angiopathy (CAA) is a common cause of lobar and subarachnoid hemorrhages in the elderly. A diagnosis of CAA requires multiple lobar hemorrhagic lesions (intracerebral hemorrhage and/or cerebral microbleeds) and/or cortical superficial siderosis (cSS). In contrast, hemorrhagic lesions located in the deep structures are the hallmark of hypertensive arteriopathy (HTN-A). They are an exclusion criterion for CAA, and when present with lobar hemorrhagic lesions considered a separate entity: mixed location hemorrhages/microbleeds (MLHs). We compared clinical, radiological, and cerebrospinal fluid (CSF) marker data in patients with CAA, MLH, and Alzheimer's disease (AD), and healthy controls (HCs) and used it to position MLH in the disease spectrum. PATIENTS AND METHODS Retrospective cohort study of consecutive patients with CAA (n = 31), MLH (n = 31), AD (n = 28), and HC (n = 30). Analysis of clinical, radiological, CSF biomarker (Aß42, Aß40, t-tau, and p-tau), and histopathological data in patients each group. RESULTS cSS was significantly more common in CAA than MLH (45% vs 13%, p = 0.011), and cSS in MLH was associated with intracerebral hemorrhage (ICH) (p = 0.037). Aß42 levels and the Aß42/Aß40 ratio, diagnostic groups followed the order HC > MLH > CAA > AD and the opposite order for t-tau and p-tau. No clear order was apparent forAß40. Aß40 and Aß42 levels as well as the Aß42/Aß40 ratio were lower in both CAA and MLH patients with cSS than in patients without cSS. Aß40 and Aß42 levels were higher in CAA and MLH patients with lacunar infarcts than in those without. CONCLUSION Our data suggest that MLH and CAA are mutually not exclusive diagnoses, and are part of a spectrum with variable contributions of both CAA and HTN-A.
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Affiliation(s)
- Ulf Jensen-Kondering
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel, Germany.,Department of Neuroradiology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Nils G Margraf
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Caroline Weiler
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Walter Maetzler
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Justina Dargvainiene
- Institute of Clinical Chemistry, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Kim Falk
- Institute of Clinical Chemistry, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Sarah Philippen
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Thorsten Bartsch
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Charlotte Flüh
- Department of Neurosurgery, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Christoph Röcken
- Department of Pathology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Bettina Möller
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Georg Royl
- Department of Neurology, University Medical Center Schleswig Holstein, Lübeck, Germany
| | - Alexander Neumann
- Department of Neuroradiology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Norbert Brüggemann
- Department of Neurology, University Medical Center Schleswig Holstein, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Benjamin Roeben
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Claudia Schulte
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital of Tübingen, Tübingen, Germany
| | - Daniela Berg
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
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8
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Lerche S, Zimmermann M, Wurster I, Roeben B, Fries FL, Deuschle C, Waniek K, Lachmann I, Gasser T, Jakobi M, Joos TO, Schneiderhan-Marra N, Brockmann K. CSF and Serum Levels of Inflammatory Markers in PD: Sparse Correlation, Sex Differences and Association With Neurodegenerative Biomarkers. Front Neurol 2022; 13:834580. [PMID: 35280273 PMCID: PMC8914943 DOI: 10.3389/fneur.2022.834580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/13/2022] [Indexed: 01/06/2023] Open
Abstract
BackgroundAn involvement of the central-nervous and peripheral, innate and adaptive immune system in the pathogenesis of Parkinson's disease (PD) is nowadays well established.ObjectivesWe face several open questions in preparation of clinical trials aiming at disease-modification by targeting the immune system: Do peripheral (blood) inflammatory profiles reflect central (CSF) inflammatory processes? Are blood/CSF inflammatory markers associated with CSF levels of neurodegenerative/PD-specific biomarkers?MethodsUsing a multiplex assay we assessed 41 inflammatory markers in CSF/serum pairs in 453 sporadic PD patients. We analyzed CSF/serum correlation as well as associations of inflammatory markers with clinical outcome measures (UPDRS-III, H&Y, MoCA) and with CSF levels of α-synuclein, Aβ1−42, t-Tau, p181-Tau and NFL. All analyses were stratified by sex as the immune system shows relevant sex-specific differences.ResultsCorrelations between CSF and serum were sparse and detected in only 25% (9 out of 36) of the analysable inflammatory markers in male PD patients and in only 38% (12 out of 32) of female PD patients. The most important pro-inflammatory mediators associated with motor and cognitive decline as well as with neurodegenerative/PD-specific biomarkers were FABP, ICAM-1, IL-8, MCP-1, MIP-1-beta, and SCF. Results were more robust for CSF than for serum.InterpretationLevels of central-nervous and peripheral inflammatory markers might be regulated independently of each other with CSF inflammatory markers reflecting CNS pathology more accurately than peripheral markers. These findings along with sex-specific characteristics have to be considered when designing clinical trials aiming at disease-modification by targeting the immune system.
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Affiliation(s)
- Stefanie Lerche
- Department of Neurodegeneration, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Milan Zimmermann
- Department of Neurodegeneration, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Isabel Wurster
- Department of Neurodegeneration, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Franca Laura Fries
- Department of Neurodegeneration, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Christian Deuschle
- Department of Neurodegeneration, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | | | | | - Thomas Gasser
- Department of Neurodegeneration, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Meike Jakobi
- Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - Thomas O. Joos
- Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | | | - Kathrin Brockmann
- Department of Neurodegeneration, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
- *Correspondence: Kathrin Brockmann
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9
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Margraf NG, Jensen-Kondering U, Weiler C, Leypoldt F, Maetzler W, Philippen S, Bartsch T, Flüh C, Röcken C, Möller B, Royl G, Neumann A, Brüggemann N, Roeben B, Schulte C, Bender B, Berg D, Kuhlenbäumer G. Cerebrospinal Fluid Biomarkers in Cerebral Amyloid Angiopathy: New Data and Quantitative Meta-Analysis. Front Aging Neurosci 2022; 14:783996. [PMID: 35237145 PMCID: PMC8884145 DOI: 10.3389/fnagi.2022.783996] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/03/2022] [Indexed: 01/31/2023] Open
Abstract
Background To evaluate the diagnostic accuracy of cerebrospinal fluid (CSF) biomarkers in patients with probable cerebral amyloid angiopathy (CAA) according to the modified Boston criteria in a retrospective multicentric cohort. Methods Beta-amyloid 1-40 (Aβ40), beta-amyloid 1-42 (Aβ42), total tau (t-tau), and phosphorylated tau 181 (p-tau181) were measured in 31 patients with probable CAA, 28 patients with Alzheimer’s disease (AD), and 30 controls. Receiver-operating characteristics (ROC) analyses were performed for the measured parameters as well as the Aβ42/40 ratio to estimate diagnostic parameters. A meta-analysis of all amenable published studies was conducted. Results In our data Aβ42/40 (AUC 0.88) discriminated best between CAA and controls while Aβ40 did not perform well (AUC 0.63). Differentiating between CAA and AD, p-tau181 (AUC 0.75) discriminated best in this study while Aβ40 (AUC 0.58) and Aβ42 (AUC 0.54) provided no discrimination. In the meta-analysis, Aβ42/40 (AUC 0.90) showed the best discrimination between CAA and controls followed by t-tau (AUC 0.79), Aβ40 (AUC 0.76), and p-tau181 (AUC 0.71). P-tau181 (AUC 0.76), Aβ40 (AUC 0.73), and t-tau (AUC 0.71) differentiated comparably between AD and CAA while Aβ42 (AUC 0.54) did not. In agreement with studies examining AD biomarkers, Aβ42/40 discriminated excellently between AD and controls (AUC 0.92–0.96) in this study as well as the meta-analysis. Conclusion The analyzed parameters differentiate between controls and CAA with clinically useful accuracy (AUC > ∼0.85) but not between CAA and AD. Since there is a neuropathological, clinical and diagnostic continuum between CAA and AD, other diagnostic markers, e.g., novel CSF biomarkers or other parameters might be more successful.
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Affiliation(s)
- Nils G. Margraf
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
- *Correspondence: Nils G. Margraf,
| | - Ulf Jensen-Kondering
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
- Department of Neuroradiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Caroline Weiler
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
| | - Frank Leypoldt
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
- Institute of Clinical Chemistry, University Medical Center Schleswig-Holstein, Kiel/Lübeck, Germany
| | - Walter Maetzler
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
| | - Sarah Philippen
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
| | - Thorsten Bartsch
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
| | - Charlotte Flüh
- Department of Neurosurgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
| | - Christoph Röcken
- Department of Pathology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
| | - Bettina Möller
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
| | - Georg Royl
- Department of Neurology, University Medical Center Schleswig Holstein, Campus Lübeck, Lübeck, Germany
| | - Alexander Neumann
- Department of Neuroradiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Norbert Brüggemann
- Department of Neurology, University Medical Center Schleswig Holstein, Campus Lübeck, Lübeck, Germany
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Claudia Schulte
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Neuroradiology, Diagnostical and Interventional Neuroradiology, University Hospital of Tübingen, Tübingen, Germany
| | - Daniela Berg
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel University, Kiel, Germany
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10
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Schaeffer E, Roeben B, Granert O, Hanert A, Liepelt-Scarfone I, Leks E, Otterbein S, Saraykin P, Busch JH, Synofzik M, Stransky E, Bartsch T, Berg D. Effects of exergaming on hippocampal volume and brain-derived neurotrophic factor levels in Parkinson's disease. Eur J Neurol 2021; 29:441-449. [PMID: 34724287 DOI: 10.1111/ene.15165] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/17/2021] [Accepted: 10/27/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Cognitive impairment is among the most burdensome non-motor symptoms in Parkinson's disease (PD) and has been associated with hippocampal atrophy. Exercise has been reported to enhance neuroplasticity in the hippocampus in correlation with an improvement of cognitive function. We present data from the Training-PD study, which was designed to evaluate effects of an "" training protocol on neuronal plasticity in PD. METHODS We initiated a 6-week exergaming training program, combining visually stimulating computer games with physical exercise in 17 PD patients and 18 matched healthy controls. Volumetric segmentation of hippocampal subfields on T1- and T2-weighted magnetic resonance imaging and brain-derived neurotrophic factor (BDNF) serum levels were analyzed before and after the training protocol. RESULTS The PD group showed a group-dependent significant volume increase of the left hippocampal subfields CA1, CA4/dentate gyrus (DG) and subiculum after the 6-week training protocol. The effect was most pronounced in the left DG of PD patients, who showed a significantly smaller percentage volume compared to healthy controls at baseline, but not at follow-up. Both groups had a significant increase in serum BDNF levels after training. CONCLUSIONS The results of the present study indicate that exergaming might be a suitable approach to induce hippocampal volume changes in PD patients. Further and larger studies are needed to verify our findings.
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Affiliation(s)
- Eva Schaeffer
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Oliver Granert
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany
| | - Annika Hanert
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,IB Hochschule, Studienzentrum Stuttgart, Stuttgart, Germany
| | - Edyta Leks
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Sascha Otterbein
- Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Pavel Saraykin
- Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Jan-Hinrich Busch
- Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Matthis Synofzik
- Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Elke Stransky
- Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Thorsten Bartsch
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany
| | - Daniela Berg
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany.,Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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11
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Brockmann K, Quadalti C, Lerche S, Rossi M, Wurster I, Baiardi S, Roeben B, Mammana A, Zimmermann M, Hauser AK, Deuschle C, Schulte C, Waniek K, Lachmann I, Sjödin S, Brinkmalm A, Blennow K, Zetterberg H, Gasser T, Parchi P. Association between CSF alpha-synuclein seeding activity and genetic status in Parkinson's disease and dementia with Lewy bodies. Acta Neuropathol Commun 2021; 9:175. [PMID: 34717775 PMCID: PMC8556894 DOI: 10.1186/s40478-021-01276-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/13/2021] [Indexed: 12/25/2022] Open
Abstract
The clinicopathological heterogeneity in Lewy-body diseases (LBD) highlights the need for pathology-driven biomarkers in-vivo. Misfolded alpha-synuclein (α-Syn) is a lead candidate based on its crucial role in disease pathophysiology. Real-time quaking-induced conversion (RT-QuIC) analysis of CSF has recently shown high sensitivity and specificity for the detection of misfolded α-Syn in patients with Parkinson's disease (PD) and dementia with Lewy bodies (DLB). In this study we performed the CSF RT-QuIC assay in 236 PD and 49 DLB patients enriched for different genetic forms with mutations in GBA, parkin, PINK1, DJ1, and LRRK2. A subgroup of 100 PD patients was also analysed longitudinally. We correlated kinetic seeding parameters of RT-QuIC with genetic status and CSF protein levels of molecular pathways linked to α-Syn proteostasis. Overall, 85% of PD and 86% of DLB patients showed positive RT-QuIC α-Syn seeding activity. Seeding profiles were significantly associated with mutation status across the spectrum of genetic LBD. In PD patients, we detected positive α-Syn seeding in 93% of patients carrying severe GBA mutations, in 78% with LRRK2 mutations, in 59% carrying heterozygous mutations in recessive genes, and in none of those with bi-allelic mutations in recessive genes. Among PD patients, those with severe GBA mutations showed the highest seeding activity based on RT-QuIC kinetic parameters and the highest proportion of samples with 4 out of 4 positive replicates. In DLB patients, 100% with GBA mutations showed positive α-Syn seeding compared to 79% of wildtype DLB. Moreover, we found an association between α-Syn seeding activity and reduced CSF levels of proteins linked to α-Syn proteostasis, specifically lysosome-associated membrane glycoprotein 2 and neurosecretory protein VGF. These findings highlight the value of α-Syn seeding activity as an in-vivo marker of Lewy-body pathology and support its use for patient stratification in clinical trials targeting α-Syn.
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12
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Schaeffer E, Vaterrodt T, Zaunbrecher L, Liepelt-Scarfone I, Emmert K, Roeben B, Elshehabi M, Hansen C, Becker S, Nussbaum S, Busch JH, Synofzik M, Berg D, Maetzler W. Effects of Levodopa on quality of sleep and nocturnal movements in Parkinson's Disease. J Neurol 2021; 268:2506-2514. [PMID: 33544218 PMCID: PMC8216994 DOI: 10.1007/s00415-021-10419-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Sleep disturbances are common in Parkinson's Disease (PD), with nocturnal akinesia being one of the most burdensome. Levodopa is frequently used in clinical routine to improve nocturnal akinesia, although evidence is not well proven. METHODS We assessed associations of Levodopa intake with quality of sleep and perception of nocturnal akinesia in three PD cohorts, using the Parkinson's Disease Sleep Scale (PDSS-2) in two cohorts and a question on nocturnal immobility in one cohort. In one cohort also objective assessment of mobility during sleep was performed, using mobile health technology. RESULTS In an independent analysis of all three cohorts (in total n = 1124 PD patients), patients taking Levodopa CR reported a significantly higher burden by nocturnal akinesia than patients without Levodopa. Higher Levodopa intake and MDS-UPDRS part IV scores (indicating motor fluctuations) predicted worse PDSS-2 and higher subjective nocturnal immobility scores, while disease duration and severity were not predictive. Levodopa intake was not associated with objectively changed mobility during sleep. CONCLUSION Our results showed an association of higher Levodopa intake with perception of worse quality of sleep and nocturnal immobility in PD, indicating that Levodopa alone might not be suitable to improve subjective feeling of nocturnal akinesia in PD. In contrast, Levodopa intake was not relevantly associated with objectively measured mobility during sleep. PD patients with motor fluctuations may be particularly affected by subjective perception of nocturnal mobility. This study should motivate further pathophysiological and clinical investigations on the cause of perception of immobility during sleep in PD.
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Affiliation(s)
- Eva Schaeffer
- Department of Neurology, Christian-Albrecht-University Kiel, Arnold-Heller-Straße 3, Kiel, Germany.
| | - Thomas Vaterrodt
- Department for Neurology, SHG-Kliniken Sonnenberg, Saarbrücken, Germany
| | - Laura Zaunbrecher
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Studienzentrum Stuttgart, IB Hochschule für Gesundheit und Soziales, 70178, Stuttgart, Germany
| | - Kirsten Emmert
- Department of Neurology, Christian-Albrecht-University Kiel, Arnold-Heller-Straße 3, Kiel, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Morad Elshehabi
- Department of Neurology, Christian-Albrecht-University Kiel, Arnold-Heller-Straße 3, Kiel, Germany
| | - Clint Hansen
- Department of Neurology, Christian-Albrecht-University Kiel, Arnold-Heller-Straße 3, Kiel, Germany
| | - Sara Becker
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Susanne Nussbaum
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Jan-Hinrich Busch
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Matthis Synofzik
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Daniela Berg
- Department of Neurology, Christian-Albrecht-University Kiel, Arnold-Heller-Straße 3, Kiel, Germany
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Walter Maetzler
- Department of Neurology, Christian-Albrecht-University Kiel, Arnold-Heller-Straße 3, Kiel, Germany
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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13
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Lerche S, Sjödin S, Brinkmalm A, Blennow K, Wurster I, Roeben B, Zimmermann M, Hauser AK, Liepelt-Scarfone I, Waniek K, Lachmann I, Gasser T, Zetterberg H, Brockmann K. CSF Protein Level of Neurotransmitter Secretion, Synaptic Plasticity, and Autophagy in PD and DLB. Mov Disord 2021; 36:2595-2604. [PMID: 34180557 DOI: 10.1002/mds.28704] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/11/2021] [Accepted: 06/08/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Molecular pathways associated with α-synuclein proteostasis have been detected in genetic studies and in cell models and include autophagy, ubiquitin-proteasome system, mitochondrial homeostasis, and synaptic plasticity. However, we lack biomarkers that are representative for these pathways in human biofluids. OBJECTIVE The objective of this study was to evaluate CSF protein profiles of pathways related to α-synuclein proteostasis. METHODS We assessed CSF protein profiles associated with neurotransmitter secretion, synapse plasticity, and autophagy in 2 monocentric cohorts with α-synucleinopathy (385 PD patients and 67 DLB patients). We included 80 PD patients and 17 DLB patients with variants in the glucocerebrosidase gene to serve as proxy for accelerated α-synuclein pathology with pronounced clinical trajectories. RESULTS (1) Proteins associated with neurotransmitter secretion, synaptic plasticity, and endolysosomal autophagy were lower in PD and DLB patients compared with healthy controls. (2) These patterns were more pronounced in DLB than in PD patients, accentuated by GBA variant status in both entities. (3) CSF levels of these proteins were positively associated with CSF levels of total α-synuclein, with lower levels of proteostasis proteins related to lower levels of total α-synuclein. (4) These findings could be confirmed longitudinally. PD patients with low CSF profiles of proteostasis proteins showed lower CSF levels of α-synuclein longitudinally compared with PD patients with a normal proteostasis profile. CONCLUSION CSF proteins associated with neurotransmitter secretion, synaptic plasticity, and endolysosomal autophagy might serve as biomarkers related to α-synuclein proteostasis in PD and DLB. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Simon Sjödin
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Ann Brinkmalm
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Isabel Wurster
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Benjamin Roeben
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Milan Zimmermann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Ann-Kathrin Hauser
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Inga Liepelt-Scarfone
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | | | | | - Thomas Gasser
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom.,UK Dementia Research Institute at UCL, London, United Kingdom
| | - Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tuebingen, Tuebingen, Germany
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14
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Lerche S, Schulte C, Wurster I, Machetanz G, Roeben B, Zimmermann M, Deuschle C, Hauser AK, Böhringer J, Krägeloh-Mann I, Waniek K, Lachmann I, Petterson XMT, Chiang R, Park H, Wang B, Liepelt-Scarfone I, Maetzler W, Galasko D, Scherzer CR, Gasser T, Mielke MM, Hutten SJ, Mollenhauer B, Sardi SP, Berg D, Brockmann K. The Mutation Matters: CSF Profiles of GCase, Sphingolipids, α-Synuclein in PD GBA. Mov Disord 2021; 36:1216-1228. [PMID: 33547828 DOI: 10.1002/mds.28472] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/13/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND With pathway-specific trials in PD associated with variants in the glucocerebrosidase gene (PDGBA ) under way, we need markers that confirm the impact of genetic variants in patient-derived biofluids in order to allow patient stratification merely based on genetics and that might serve as biochemical read-out for target engagement. OBJECTIVE To explore GBA-pathway-specific biomarker profiles cross-sectionally (TUEPAC-MIGAP, PPMI) and longitudinally (PPMI). METHODS We measured enzyme activity of the lysosomal glucocerebrosidase, CSF levels of glucosylceramides (upstream substrate of glucocerebrosidase), CSF levels of ceramides (downstream product of glucocerebrosidase), lactosylceramides, sphingosines, sphingomyelin (by-products) and CSF levels of total α-synuclein in PDGBA patients compared to PDGBA_wildtype patients. RESULTS Cross-sectionally in both cohorts and longitudinally in PPMI: (1) glucocerebrosidase activity was significantly lower in PDGBA compared to PDGBA_wildtype . (2) CSF levels of upstream substrates (glucosylceramides species) were higher in PDGBA compared to PDGBA_wildtype . (3) CSF levels of total α-synuclein were lower in PDGBA compared to PDGBA_wildtype . All of these findings were most pronounced in PDGBA with severe mutations (PDGBA_severe ). Cross-sectionally in TUEPAC-MIGAP and longitudinally in PPMI, CSF levels of downstream-products (ceramides) were higher in PDGBA_severe . Cross-sectionally in TUEPAC-MIGAP by-products sphinganine and sphingosine-1-phosphate and longitudinally in PPMI species of by-products lactosylceramides and sphingomyelin were higher in PDGBA_severe . INTERPRETATION These findings confirm that GBA mutations have a relevant functional impact on biomarker profiles in patients. Bridging the gap between genetics and biochemical profiles now allows patient stratification for clinical trials merely based on mutation status. Importantly, all findings were most prominent in PDGBA with severe variants. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | - Claudia Schulte
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | - Isabel Wurster
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | - Gerrit Machetanz
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | - Benjamin Roeben
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | - Milan Zimmermann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | - Christian Deuschle
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | - Ann-Kathrin Hauser
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | | | | | | | | | - Xuan-Mai T Petterson
- Department of Health Sciences Research and Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Ruby Chiang
- Rare and Neurologic Diseases Therapeutic Area, Sanofi, Cambridge, Massachusetts, USA
| | - Hyejung Park
- Rare and Neurologic Diseases Therapeutic Area, Sanofi, Cambridge, Massachusetts, USA
| | - Bing Wang
- Rare and Neurologic Diseases Therapeutic Area, Sanofi, Cambridge, Massachusetts, USA
| | - Inga Liepelt-Scarfone
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts University, Kiel, Germany
| | - Douglas Galasko
- Department of Neurology, University of California at San Diego, San Diego, California, USA
| | - Clemens R Scherzer
- Center for Advanced Parkinson Research, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Thomas Gasser
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
| | - Michelle M Mielke
- Department of Health Sciences Research and Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Samantha J Hutten
- Michel J. Fox Foundation for Parkinson's Research (MJFF), New York, New York, USA
| | - Brit Mollenhauer
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Paracelsus-Elena Klinik Kassel, Kassel, Germany.,Department of Neurology, University Medical Center Goettingen, Göttingen, Germany
| | - S Pablo Sardi
- Rare and Neurologic Diseases Therapeutic Area, Sanofi, Cambridge, Massachusetts, USA
| | - Daniela Berg
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Neurology, Christian-Albrechts University, Kiel, Germany
| | - Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, University of Tübingen, Tuebingen, Germany
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15
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Becker S, Granert O, Timmers M, Pilotto A, Van Nueten L, Roeben B, Salvadore G, Galpern WR, Streffer J, Scheffler K, Maetzler W, Berg D, Liepelt-Scarfone I. Association of Hippocampal Subfields, CSF Biomarkers, and Cognition in Patients With Parkinson Disease Without Dementia. Neurology 2020; 96:e904-e915. [PMID: 33219138 DOI: 10.1212/wnl.0000000000011224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 10/02/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To examine whether hippocampal volume loss is primarily associated with cognitive status or pathologic β-amyloid 1-42 (Aβ42) levels, this study compared hippocampal subfield volumes between patients with Parkinson disease (PD) with mild cognitive impairment (PD-MCI) and without cognitive impairment (PD-CN) and between patients with low and high Aβ42 levels, in addition exploring the relationship among hippocampal subfield volumes, CSF biomarkers (Aβ42, phosphorylated and total tau), neuropsychological tests, and activities of daily living. METHODS Forty-five patients with PD without dementia underwent CSF analyses and MRI as well as comprehensive motor and neuropsychological examinations. Hippocampal segmentation was conducted using FreeSurfer image analysis suite 6.0. Regression models were used to compare hippocampal subfield volumes between groups, and partial correlations defined the association between variables while controlling for intracranial volume (ICV). RESULTS Linear regressions revealed cognitive group as a statistically significant predictor of both the hippocampal-amygdaloid transition area (HATA; β = -0.23, 95% CI -0.44 to -0.02) and the cornu ammonis 1 region (CA1; β = -0.28, 95% confidence interval [CI] -0.56 to -0.02), independent of disease duration and ICV, with patients with PD-MCI showing significantly smaller volumes than PD-CN. In contrast, no subfields were predicted by Aβ42 levels. Smaller hippocampal volumes were associated with worse performance on memory, language, spatial working memory, and executive functioning tests. The subiculum was negatively correlated with total tau levels (r = -0.37, 95% CI -0.60 to -0.09). CONCLUSION Cognitive status, but not CSF Aβ42, predicted hippocampal volumes, specifically the CA1 and HATA. Hippocampal subfields were associated with various cognitive domains, as well as with tau pathology.
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Affiliation(s)
- Sara Becker
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany.
| | - Oliver Granert
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Maarten Timmers
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Andrea Pilotto
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Luc Van Nueten
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Benjamin Roeben
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Giacomo Salvadore
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Wendy R Galpern
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Johannes Streffer
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Klaus Scheffler
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Walter Maetzler
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Daniela Berg
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Inga Liepelt-Scarfone
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
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16
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Roeben B, Just J, Hengel H, Bender F, Pöschl P, Synofzik M, Schöls L, Grimm A. Multifocal, hypoechogenic nerve thickening in Cerebrotendinous Xanthomatosis. Clin Neurophysiol 2020; 131:1798-1803. [PMID: 32531740 DOI: 10.1016/j.clinph.2020.04.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 04/01/2020] [Accepted: 04/16/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To characterize peripheral nerve morphology in cerebrotendinous xanthomatosis (CTX) patients using high-resolution ultrasound (HRUS) in vivo. We hypothesized that nerve enlargements might be present in CTX as a result of accumulation of abnormal lipids with deposition also in peripheral nerves. METHODS Four CTX patients were examined using HRUS to assess morphological abnormalities of peripheral nerves as well as cervical nerve roots 5 and 6. RESULTS HRUS revealed mild to moderate, hypoechogenic thickening of sensorimotor nerves (ulnar nerve in 1/4, tibial nerve in 3/4, median nerve 4/4 patients) as well as mild enlargement of pure sensory nerves (sural nerve in 2/3, superficial FN in 2/4 patients). The vagal nerve was moderately enlarged in one patient, cervical roots showed moderate enlargements of C5 in two patients, one of which also showing thickening of C6 as well as in another patient. UPSS score was slightly to moderately abnormal in all patients. The Homogeneity score was not increased suggesting regional to inhomogeneous nerve enlargement. CONCLUSIONS HRUS shows multifocal, hypoechogenic nerve thickening of peripheral nerves and nerve roots in CTX. SIGNIFICANCE HRUS might serve as a valuable, additive and non-invasive bedside tool to assess peripheral nerve morphology in future clinical studies on CTX patients.
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Affiliation(s)
- Benjamin Roeben
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Jennifer Just
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Holger Hengel
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Friedemann Bender
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Peter Pöschl
- Department of Neurology, Hospital Barmherzige Brüder, Regensburg, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Ludger Schöls
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.
| | - Alexander Grimm
- Center of Neurology and Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany
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17
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Wilke C, Santos MCT, Schulte C, Deuschle C, Scheller D, Verbelen M, Brockmann K, Thaler A, Sünkel U, Roeben B, Bujac S, Metzger FG, Maetzler W, Costa AN, Synofzik M, Berg D. Intraindividual Neurofilament Dynamics in Serum Mark the Conversion to Sporadic Parkinson's Disease. Mov Disord 2020; 35:1233-1238. [DOI: 10.1002/mds.28026] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/23/2020] [Accepted: 03/03/2020] [Indexed: 01/02/2023] Open
Affiliation(s)
- Carlo Wilke
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tübingen Tübingen Germany
| | | | - Claudia Schulte
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tübingen Tübingen Germany
| | - Christian Deuschle
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tübingen Tübingen Germany
| | | | - Moira Verbelen
- Exploratory StatisticsGlobal Exploratory Development, UCB Pharma Slough United Kingdom
| | - Kathrin Brockmann
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tübingen Tübingen Germany
| | - Anna‐Katharina Thaler
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tübingen Tübingen Germany
| | - Ulrike Sünkel
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tübingen Tübingen Germany
| | - Benjamin Roeben
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tübingen Tübingen Germany
| | - Sarah Bujac
- Exploratory StatisticsGlobal Exploratory Development, UCB Pharma Slough United Kingdom
| | - Florian G. Metzger
- Department of Psychiatry and PsychotherapyUniversity Hospital Tübingen Tübingen Germany
- Geriatric CenterUniversity Hospital Tübingen Tübingen Germany
- Vitos Hospital for Psychiatry and Psychotherapy Haina Germany
| | - Walter Maetzler
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- Department of NeurologyUniversity Hospital Schleswig‐Holstein, Kiel University Kiel Germany
| | - Andre Nogueira Costa
- Experimental Medicine and DiagnosticsGlobal Exploratory Development, UCB Biopharma Braine‐L'Alleud Belgium
- Precision MedicineOncology R&D Organisation AstraZeneca, Molndal Sweden
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tübingen Tübingen Germany
| | - Daniela Berg
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of NeurologyUniversity of Tübingen Tübingen Germany
- Department of NeurologyUniversity Hospital Schleswig‐Holstein, Kiel University Kiel Germany
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18
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Roeben B, Wilke C, Bender B, Ziemann U, Synofzik M. The motor band sign in ALS: presentations and frequencies in a consecutive series of ALS patients. J Neurol Sci 2019; 406:116440. [DOI: 10.1016/j.jns.2019.116440] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 11/30/2022]
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19
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Lerche S, Wurster I, Roeben B, Zimmermann M, Riebenbauer B, Deuschle C, Hauser A, Schulte C, Berg D, Maetzler W, Waniek K, Lachmann I, Liepelt‐Scarfone I, Gasser T, Brockmann K. Parkinson's Disease:
Glucocerebrosidase 1
Mutation Severity Is Associated with CSF Alpha‐Synuclein Profiles. Mov Disord 2019; 35:495-499. [DOI: 10.1002/mds.27884] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/21/2019] [Accepted: 09/03/2019] [Indexed: 12/25/2022] Open
Affiliation(s)
- Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Isabel Wurster
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Benjamin Roeben
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Milan Zimmermann
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Benjamin Riebenbauer
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Christian Deuschle
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Ann‐Kathrin Hauser
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Claudia Schulte
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Daniela Berg
- Department of NeurologyChristian‐Albrechts University Kiel Germany
| | - Walter Maetzler
- Department of NeurologyChristian‐Albrechts University Kiel Germany
| | | | | | - Inga Liepelt‐Scarfone
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Thomas Gasser
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
| | - Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative Diseases, University of Tuebingen Tuebingen Germany
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20
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Zimmermann M, Wurster I, Lerche S, Roeben B, Machetanz G, Sünkel U, von Thaler A, Eschweiler G, Fallgatter AJ, Maetzler W, Berg D, Brockmann K. Orthostatic hypotension as a risk factor for longitudinal deterioration of cognitive function in the elderly. Eur J Neurol 2019; 27:160-167. [DOI: 10.1111/ene.14050] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 07/22/2019] [Indexed: 01/08/2023]
Affiliation(s)
- M. Zimmermann
- Center of Neurology Department of Neurodegeneration and Hertie‐Institute for Clinical Brain Research University of Tübingen TübingenGermany
- German Center for Neurodegenerative Diseases (DZNE) University of Tübingen TübingenGermany
| | - I. Wurster
- Center of Neurology Department of Neurodegeneration and Hertie‐Institute for Clinical Brain Research University of Tübingen TübingenGermany
- German Center for Neurodegenerative Diseases (DZNE) University of Tübingen TübingenGermany
| | - S. Lerche
- Center of Neurology Department of Neurodegeneration and Hertie‐Institute for Clinical Brain Research University of Tübingen TübingenGermany
- German Center for Neurodegenerative Diseases (DZNE) University of Tübingen TübingenGermany
| | - B. Roeben
- Center of Neurology Department of Neurodegeneration and Hertie‐Institute for Clinical Brain Research University of Tübingen TübingenGermany
- German Center for Neurodegenerative Diseases (DZNE) University of Tübingen TübingenGermany
| | - G. Machetanz
- Center of Neurology Department of Neurodegeneration and Hertie‐Institute for Clinical Brain Research University of Tübingen TübingenGermany
- German Center for Neurodegenerative Diseases (DZNE) University of Tübingen TübingenGermany
| | - U. Sünkel
- Center of Neurology Department of Neurodegeneration and Hertie‐Institute for Clinical Brain Research University of Tübingen TübingenGermany
| | - A.‐K. von Thaler
- Center of Neurology Department of Neurodegeneration and Hertie‐Institute for Clinical Brain Research University of Tübingen TübingenGermany
| | - G. Eschweiler
- German Center for Neurodegenerative Diseases (DZNE) University of Tübingen TübingenGermany
- Department of Psychiatry University of Tübingen TübingenGermany
| | - A. J. Fallgatter
- German Center for Neurodegenerative Diseases (DZNE) University of Tübingen TübingenGermany
- Department of Psychiatry University of Tübingen TübingenGermany
| | - W. Maetzler
- Department of Neurology Christian‐Albrechts‐University of Kiel Kiel Germany
| | - D. Berg
- Department of Neurology Christian‐Albrechts‐University of Kiel Kiel Germany
| | - K. Brockmann
- Center of Neurology Department of Neurodegeneration and Hertie‐Institute for Clinical Brain Research University of Tübingen TübingenGermany
- German Center for Neurodegenerative Diseases (DZNE) University of Tübingen TübingenGermany
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21
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Schaeffer E, Busch JH, Roeben B, Otterbein S, Saraykin P, Leks E, Liepelt-Scarfone I, Synofzik M, Elshehabi M, Maetzler W, Hansen C, Andris S, Berg D. Effects of Exergaming on Attentional Deficits and Dual-Tasking in Parkinson's Disease. Front Neurol 2019; 10:646. [PMID: 31275234 PMCID: PMC6593241 DOI: 10.3389/fneur.2019.00646] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/31/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction: Impairment of dual-tasking, as an attention-based primary cognitive dysfunction, is frequently observed in Parkinson's Disease (PD). The Training-PD study investigated the efficiency of exergaming, as a novel cognitive-motor training approach, to improve attention-based deficits and dual-tasking in PD when compared to healthy controls. Methods: Eighteen PD patients and 17 matched healthy controls received a 6-week home-based training period of exergaming. Treatment effects were monitored using quantitative motor assessment of gait and cognitive testing as baseline and after 6 weeks of training. Results: At baseline PD patients showed a significantly worse performance in several quantitative motor assessment parameters and in two items of cognitive testing. After 6 weeks of exergames training, the comparison of normal gait vs. dual-tasking in general showed an improvement of stride length in the PD group, without a gait-condition specific improvement. In the direct comparison of three different gait conditions (normal gait vs. dual-tasking calculating while walking vs. dual-tasking crossing while walking) PD patients showed a significant improvement of stride length under the dual-tasking calculating condition. This corresponded to a significant improvement in one parameter of the D2 attention test. Conclusions: We conclude, that exergaming, as an easy to apply, safe technique, can improve deficits in cognitive-motor dual-tasking and attention in PD.
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Affiliation(s)
- Eva Schaeffer
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany
| | - Jan-Hinrich Busch
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Sascha Otterbein
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Pavel Saraykin
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Edyta Leks
- Department of Biomedical Magnetic Resonance, University of Tüebingen, Tüebingen, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Matthis Synofzik
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Morad Elshehabi
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany.,Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Walter Maetzler
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany.,Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Clint Hansen
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany
| | - Sarah Andris
- Mathematical Image Analysis Group, Faculty of Mathematics and Computer Science, Saarland University, Saarbrücken, Germany
| | - Daniela Berg
- Department of Neurology, Christian-Albrecht-University Kiel, Kiel, Germany.,Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
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22
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Lerche S, Machetanz G, Wurster I, Roeben B, Zimmermann M, Pilotto A, Preische O, Stransky E, Deuschle C, Hauser A, Schulte C, Lachmann I, Waniek K, Gasser T, Berg D, Maetzler W, Brockmann K. Dementia with lewy bodies:
GBA1
mutations are associated with cerebrospinal fluid alpha‐synuclein profile. Mov Disord 2019; 34:1069-1073. [DOI: 10.1002/mds.27731] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/02/2019] [Accepted: 05/13/2019] [Indexed: 01/07/2023] Open
Affiliation(s)
- Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
| | - Gerrit Machetanz
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
| | - Isabel Wurster
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
| | - Benjamin Roeben
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
| | - Milan Zimmermann
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental SciencesUniversity of Brescia Brescia Italy
- Parkinson's Disease Rehabilitation CentreFERB ONLUS–S. Isidoro Hospital Trescore Balneario (BG) Italy
| | - Oliver Preische
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
- Department of Psychiatry and PsychotherapyUniversity of Tübingen Tübingen Germany
| | - Elke Stransky
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
| | - Christian Deuschle
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
| | - Ann‐Kathrin Hauser
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
| | - Claudia Schulte
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
| | | | | | - Thomas Gasser
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
| | - Daniela Berg
- Department of NeurologyChristian‐Albrechts University Kiel Germany
| | - Walter Maetzler
- Department of NeurologyChristian‐Albrechts University Kiel Germany
| | - Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie‐Institute for Clinical Brain ResearchUniversity of Tuebingen Tuebingen Germany
- German Center for Neurodegenerative DiseasesUniversity of Tuebingen Tuebingen Germany
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23
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Roeben B, Blum D, Gabriel H, Synofzik M. Atypical parkinsonism with severely reduced striatal dopamine uptake associated with a 16p11.2 duplication syndrome. J Neurol 2019; 266:775-776. [PMID: 30617906 DOI: 10.1007/s00415-019-09182-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/02/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Benjamin Roeben
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Dominik Blum
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,Department of Nuclear Medicine and Clinical Molecular Imaging, University of Tübingen, Tübingen, Germany
| | - Heinz Gabriel
- CeGaT GmbH/Praxis für Humangenetik Tübingen, Paul-Ehrlich-Str. 23, 72076, Tübingen, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.
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24
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Dahms R, Eicher C, Dankbar R, Roeben B, Vetter T, Schröder M. NURMUT—EVALUATION OF A MUSIC PLAYER AND A VITAL SENSOR FOR PEOPLE WITH DEMENTIA. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Dahms
- Geriatrics Research Group of Charite - Universitaetsmedizin Berlin, Germany
| | - C Eicher
- Geriatrics Research Group, Charite - Universitaetsmedizin Berlin, Germany
| | - R Dankbar
- Wohlfahrtswerk for Baden-Wuerttemberg, Stuttgart, Germany
| | - B Roeben
- Wohlfahrtswerk for Baden-Wuerttemberg, Stuttgart, Germany
| | - T Vetter
- Wohlfahrtswerk for Baden-Wuerttemberg, Stuttgart, Germany
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25
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Becker S, Bäumer A, Maetzler W, Nussbaum S, Timmers M, Van Nueten L, Salvadore G, Zaunbrecher D, Roeben B, Brockmann K, Streffer J, Berg D, Liepelt-Scarfone I. Assessment of cognitive-driven activity of daily living impairment in non-demented Parkinson's patients. J Neuropsychol 2018; 14:69-84. [PMID: 30320954 DOI: 10.1111/jnp.12173] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 09/10/2018] [Indexed: 01/15/2023]
Abstract
The core criterion for Parkinson's disease dementia (PDD) is the impairment in activities of daily living (ADL) function primarily caused by cognitive, not motor symptoms. There is evidence to assume that mild ADL impairments in mild cognitive impairment (PD-MCI) characterize those patients at high risk for dementia. Data of 216 Parkinson's disease (PD) patients assessed with comprehensive motor and neuropsychological assessments were analysed. Based on linear regression models, subscores of the Functional Activities Questionnaire (FAQ) primarily reflecting patients' global cognitive status (FAQC ) or PD-related motor severity (FAQM ) were developed. A quotient (FAQQ ) of both scores was calculated, with values >1 indicating more cognitive- compared to motor-driven ADL impairment. Both FAQC and FAQM scores were higher in PD-MCI than cognitively normal (PD-CN) patients, indicating more severe cognitive- and motor-driven ADL impairments in this group. One third (31.6%) of the PD-MCI group had a FAQQ score >1, which was significantly different from patients with PD-CN (p = .02). PD-MCI patients with an FAQQ score >1 were more impaired on tests assessing attention (p = .019) and language (p = .033) compared to PD-MCI patients with lower FAQQ values. The differentiation between cognitive- and motor-driven ADL is important, as the loss of functional capacity is the defining factor for a diagnosis of PDD. We were able to differentiate the cognitive-driven from the motor-driven ADL impairments for the FAQ. PD-MCI patients with more cognitive- compared to motor-driven ADL impairments may pose a risk group for conversion to PDD and can be targeted for early treatments.
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Affiliation(s)
- Sara Becker
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Germany
| | - Alena Bäumer
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Germany
| | - Walter Maetzler
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Susanne Nussbaum
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Germany
| | - Maarten Timmers
- Janssen Research and Development, Janssen - Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium.,Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Belgium
| | - Luc Van Nueten
- Janssen Research and Development, Janssen - Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium
| | - Giacomo Salvadore
- Janssen Research and Development LLC, Janssen - Pharmaceutical Companies of Johnson & Johnson, Raritan, New Jersey, USA
| | - Detlev Zaunbrecher
- Private Practice for Neurology, Psychiatry, and Psychotherapy, Mössingen, Germany
| | - Benjamin Roeben
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Germany
| | - Kathrin Brockmann
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Germany
| | - Johannes Streffer
- Janssen Research and Development, Janssen - Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium.,Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Belgium
| | - Daniela Berg
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Germany
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Lerche S, Machetanz G, Roeben B, Wurster I, Zimmermann M, von Thaler AK, Liepelt-Scarfone I, Eschweiler GW, Fallgatter A, Metzger F, Maetzler W, Berg D, Brockmann K. Deterioration of executive dysfunction in elderly with REM sleep behavior disorder (RBD). Neurobiol Aging 2018; 70:242-246. [DOI: 10.1016/j.neurobiolaging.2018.06.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/19/2018] [Accepted: 06/23/2018] [Indexed: 11/26/2022]
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Roeben B, Zieschang T, Maetzler W. [Therapy of Dementia: State of the Art]. Dtsch Med Wochenschr 2018; 143:741-747. [PMID: 29727890 DOI: 10.1055/s-0043-113619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Due to the aging population, dementias represent a growing challenge for the health systems and for the society. This overview summarizes the current state of already practice-relevant therapies and management of dementias. Non-pharmacological approaches have a greater impact than pharmacological treatment. Increasing evidence underlines that consistent management of cardiovascular risk factors has beneficial effects on the progression of at least some, possibly almost all types of dementias. The main pharmacological agents for symptomatic treatment of cognitive deficits in Alzheimer's and Parkinson's disease-associated dementias are cholinesterase inhibitors and memantine. In most other dementias, no specific pharmacological treatment is currently available. There is an urgent need for further research on the effective management of dementias.
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Maas RR, Iwanicka‐Pronicka K, Kalkan Ucar S, Alhaddad B, AlSayed M, Al‐Owain MA, Al‐Zaidan HI, Balasubramaniam S, Barić I, Bubshait DK, Burlina A, Christodoulou J, Chung WK, Colombo R, Darin N, Freisinger P, Garcia Silva MT, Grunewald S, Haack TB, van Hasselt PM, Hikmat O, Hörster F, Isohanni P, Ramzan K, Kovacs‐Nagy R, Krumina Z, Martin‐Hernandez E, Mayr JA, McClean P, De Meirleir L, Naess K, Ngu LH, Pajdowska M, Rahman S, Riordan G, Riley L, Roeben B, Rutsch F, Santer R, Schiff M, Seders M, Sequeira S, Sperl W, Staufner C, Synofzik M, Taylor RW, Trubicka J, Tsiakas K, Unal O, Wassmer E, Wedatilake Y, Wolff T, Prokisch H, Morava E, Pronicka E, Wevers RA, de Brouwer AP, Wortmann SB. Progressive deafness-dystonia due to SERAC1 mutations: A study of 67 cases. Ann Neurol 2017; 82:1004-1015. [PMID: 29205472 PMCID: PMC5847115 DOI: 10.1002/ana.25110] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 11/13/2017] [Accepted: 11/26/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE 3-Methylglutaconic aciduria, dystonia-deafness, hepatopathy, encephalopathy, Leigh-like syndrome (MEGDHEL) syndrome is caused by biallelic variants in SERAC1. METHODS This multicenter study addressed the course of disease for each organ system. Metabolic, neuroradiological, and genetic findings are reported. RESULTS Sixty-seven individuals (39 previously unreported) from 59 families were included (age range = 5 days-33.4 years, median age = 9 years). A total of 41 different SERAC1 variants were identified, including 20 that have not been reported before. With the exception of 2 families with a milder phenotype, all affected individuals showed a strikingly homogeneous phenotype and time course. Severe, reversible neonatal liver dysfunction and hypoglycemia were seen in >40% of all cases. Starting at a median age of 6 months, muscular hypotonia (91%) was seen, followed by progressive spasticity (82%, median onset = 15 months) and dystonia (82%, 18 months). The majority of affected individuals never learned to walk (68%). Seventy-nine percent suffered hearing loss, 58% never learned to speak, and nearly all had significant intellectual disability (88%). Magnetic resonance imaging features were accordingly homogenous, with bilateral basal ganglia involvement (98%); the characteristic "putaminal eye" was seen in 53%. The urinary marker 3-methylglutaconic aciduria was present in virtually all patients (98%). Supportive treatment focused on spasticity and drooling, and was effective in the individuals treated; hearing aids or cochlear implants did not improve communication skills. INTERPRETATION MEGDHEL syndrome is a progressive deafness-dystonia syndrome with frequent and reversible neonatal liver involvement and a strikingly homogenous course of disease. Ann Neurol 2017;82:1004-1015.
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Affiliation(s)
- Roeltje R. Maas
- Translational Metabolic Laboratory, Department of Laboratory MedicineRadboud University Medical CenterNijmegenthe Netherlands
| | | | - Sema Kalkan Ucar
- Division of Metabolic Disease, Ege University Medical Faculty, Department of PediatricsIzmirTurkey
| | - Bader Alhaddad
- Institute of Human GeneticsTechnische UniversitätMünchenMunichGermany
| | - Moeenaldeen AlSayed
- Department of GeneticsKing Faisal Specialist Hospital and Research CenterRiyadhSaudi Arabia
- Department of Anatomy and Cell BiologyCollege of Medicine, Alfaisal UniversityRiyadhSaudi Arabia
| | - Mohammed A. Al‐Owain
- Department of GeneticsKing Faisal Specialist Hospital and Research CenterRiyadhSaudi Arabia
- Department of Anatomy and Cell BiologyCollege of Medicine, Alfaisal UniversityRiyadhSaudi Arabia
| | - Hamad I. Al‐Zaidan
- Department of GeneticsKing Faisal Specialist Hospital and Research CenterRiyadhSaudi Arabia
- Department of Anatomy and Cell BiologyCollege of Medicine, Alfaisal UniversityRiyadhSaudi Arabia
| | - Shanti Balasubramaniam
- Western Sydney Genetics Program, Children's Hospital at Westmead, SydneyNew South WalesAustralia
- Discipline of Genetic Medicine & Paediatrics and Child Health, University of SydneySydneyNew South WalesAustralia
| | - Ivo Barić
- Department of PediatricsUniversity Hospital CenterZagrebCroatia
- School of Medicine, University of ZagrebZagrebCroatia
| | - Dalal K. Bubshait
- Department of Pediatrics, College of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Alberto Burlina
- Division of Inherited Metabolic Diseases, Department of PediatricsUniversity Hospital of PaduaPaduaItaly
| | - John Christodoulou
- Neurodevelopmental Genomics Research Group, Murdoch Children's Research Institute, and Department of PaediatricsMelbourne Medical School, University of MelbourneMelbourneVictoriaAustralia
- Genetic Metabolic Disorders Research Unit and Western Sydney Genetics Program, Children's Hospital at WestmeadSydneyNew South WalesAustralia
- Discipline of Child and Adolescent Health and Genetic Medicine, Sydney Medical School, University of SydneySydneyNew South WalesAustralia
| | - Wendy K. Chung
- Departments of Pediatrics and MedicineColumbia UniversityNew YorkNY
| | - Roberto Colombo
- Institute of Clinical Biochemistry, Faculty of Medicine, Catholic University of the Sacred HeartRomeItaly
- Center for the Study of Rare Hereditary Diseases, Niguarda Ca' Granda Metropolitan HospitalMilanItaly
| | - Niklas Darin
- Department of PediatricsInstitute of Clinical Sciences, University of Gothenburg, Queen Silvia's Children's HospitalGothenburgSweden
| | | | - Maria Teresa Garcia Silva
- Inborn Errors of Metabolism and Mitochondrial Disease Unit“12 de Octubre” University Hospital, Avenida de Cordoba sn, 28041 Madrid, Spain. Rare Diseases Biomedical Research Centre (CIBERER)MadridSpain
- Complutense UniversityMadridSpain
| | - Stephanie Grunewald
- Metabolic Medicine DepartmentGreat Ormond Street Hospital for Children National Health Service Foundation Trust, University College London Institute of Child HealthLondonUnited Kingdom
| | - Tobias B. Haack
- Institute of Human GeneticsTechnische UniversitätMünchenMunichGermany
- Institute of Medical Genetics and Applied GenomicsTübingenGermany
| | - Peter M. van Hasselt
- Wilhelmina Children's Hospital Utrecht, University Medical Center UtrechtUtrechtthe Netherlands
| | - Omar Hikmat
- Department of PediatricsHaukeland University HospitalBergenNorway
- Department of Clinical Medicine (K1)University of BergenBergenNorway
| | - Friederike Hörster
- Department of General Pediatrics, Division of Neuropediatrics and Pediatric Metabolic MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Pirjo Isohanni
- Children's Hospital, University of Helsinki and Helsinki University HospitalHelsinkiFinland
- Research Programs Unit, Molecular Neurology, Biomedicum Helsinki, University of HelsinkiHelsinkiFinland
| | - Khushnooda Ramzan
- Department of GeneticsKing Faisal Specialist Hospital and Research CenterRiyadhSaudi Arabia
- Department of Anatomy and Cell BiologyCollege of Medicine, Alfaisal UniversityRiyadhSaudi Arabia
| | - Reka Kovacs‐Nagy
- Institute of Human GeneticsTechnische UniversitätMünchenMunichGermany
| | - Zita Krumina
- Department of Biology and MicrobiologyRiga Stradin's UniversityRigaLatvia
| | - Elena Martin‐Hernandez
- Inborn Errors of Metabolism and Mitochondrial Disease Unit“12 de Octubre” University Hospital, Avenida de Cordoba sn, 28041 Madrid, Spain. Rare Diseases Biomedical Research Centre (CIBERER)MadridSpain
- Complutense UniversityMadridSpain
| | - Johannes A. Mayr
- Department of PediatricsSalzburg State Hospitals and Paracelsus Medical UniversitySalzburgAustria
| | - Patricia McClean
- Leeds Teaching Hospitals National Health Service TrustLeedsUnited Kingdom
| | | | - Karin Naess
- Department of Pediatric NeurologyKarolinska University HospitalStockholmSweden
| | - Lock H. Ngu
- Division of Clinical Genetics, Department of GeneticsKuala Lumpur HospitalKuala LumpurMalaysia
| | - Magdalena Pajdowska
- Department of Clinical Biochemistry, Radioimmunology, and Experimental MedicineChildren's Memorial Health InstituteWarsawPoland
| | - Shamima Rahman
- University College London Great Ormond Street Institute of Child HealthLondonUnited Kingdom
| | - Gillian Riordan
- Department of Pediatric NeurologyRed Cross War Memorial Children's HospitalCape TownSouth Africa
| | - Lisa Riley
- Genetic Metabolic Disorders Research Unit and Western Sydney Genetics Program, Children's Hospital at WestmeadSydneyNew South WalesAustralia
- Discipline of Child and Adolescent Health and Genetic Medicine, Sydney Medical School, University of SydneySydneyNew South WalesAustralia
| | - Benjamin Roeben
- Department of NeurodegenerationHertie Institute for Clinical Brain Research, University of TübingenTübingenGermany
- German Center for Neurodegenerative Diseases (DZNE)TübingenGermany
| | - Frank Rutsch
- Department of General PediatricsMünster University Children's HospitalMünsterGermany
| | - Rene Santer
- Department of PediatricsUniversity Medical Center EppendorfHamburgGermany
| | - Manuel Schiff
- Reference Center for Inherited Metabolic Diseases, AP‐HP, Robert Debré Hospital, University Paris Diderot‐Sorbonne Paris Cité, Paris, France AND INSERM U1141ParisFrance
| | - Martine Seders
- Department of Human GeneticsRadboud University Medical CenterNijmegenthe Netherlands
| | | | - Wolfgang Sperl
- Department of PediatricsSalzburg State Hospitals and Paracelsus Medical UniversitySalzburgAustria
| | - Christian Staufner
- Department of General Pediatrics, Division of Neuropediatrics and Pediatric Metabolic MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Matthis Synofzik
- Department of NeurodegenerationHertie Institute for Clinical Brain Research, University of TübingenTübingenGermany
- German Center for Neurodegenerative Diseases (DZNE)TübingenGermany
| | - Robert W. Taylor
- Wellcome Centre for Mitochondrial ResearchInstitute of Neuroscience, The Medical School, Newcastle UniversityNewcastle upon TyneUnited Kingdom
| | - Joanna Trubicka
- Department of Medical GeneticsChildren's Memorial Health InstituteWarsawPoland
| | | | - Ozlem Unal
- Division of Metabolic DiseasesHacettepe University Children's HospitalAnkaraTurkey
| | | | - Yehani Wedatilake
- University College London Great Ormond Street Institute of Child HealthLondonUnited Kingdom
| | - Toni Wolff
- Nottingham University Hospitals National Health Service Trust, Nottingham Children's HospitalNottinghamUnited Kingdom
| | - Holger Prokisch
- Institute of Human GeneticsTechnische UniversitätMünchenMunichGermany
- Institute of Human Genetics, Helmholtz Center MunichNeuherbergGermany
| | - Eva Morava
- Hayward Genetics Center and Department of PediatricsTulane University Medical SchoolNew OrleansLA
| | - Ewa Pronicka
- Department of Pediatrics, Nutrition and Metabolic DiseasesChildren's Memorial Health InstituteWarsawPoland
| | - Ron A. Wevers
- Translational Metabolic Laboratory, Department of Laboratory MedicineRadboud University Medical CenterNijmegenthe Netherlands
| | - Arjan P. de Brouwer
- Department of Human GeneticsRadboud University Medical CenterNijmegenthe Netherlands
- Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical CenterNijmegenthe Netherlands
| | - Saskia B. Wortmann
- Institute of Human GeneticsTechnische UniversitätMünchenMunichGermany
- Department of PediatricsSalzburg State Hospitals and Paracelsus Medical UniversitySalzburgAustria
- Institute of Human Genetics, Helmholtz Center MunichNeuherbergGermany
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Roeben B, Schüle R, Ruf S, Bender B, Alhaddad B, Benkert T, Meitinger T, Reich S, Böhringer J, Langhans CD, Vaz FM, Wortmann SB, Marquardt T, Haack TB, Krägeloh-Mann I, Schöls L, Synofzik M. SERAC1 deficiency causes complicated HSP: evidence from a novel splice mutation in a large family. J Med Genet 2017; 55:39-47. [DOI: 10.1136/jmedgenet-2017-104622] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 08/24/2017] [Accepted: 08/31/2017] [Indexed: 12/21/2022]
Abstract
ObjectiveTo demonstrate that mutations in the phosphatidylglycerol remodelling enzyme SERAC1 can cause juvenile-onset complicated hereditary spastic paraplegia (cHSP) clusters, thus adding SERAC1 to the increasing number of complex lipid cHSP genes.MethodsCombined genomic and functional validation studies (whole-exome sequencing, mRNA, cDNA and protein), biomarker investigations (3-methyl-glutaconic acid, filipin staining and phosphatidylglycerols PG34:1/PG36:1), and clinical and imaging phenotyping were performed in six affected subjects from two different branches of a large consanguineous family.Results5 of 6 affected subjects shared cHSP as a common disease phenotype. Three subjects presented with juvenile-onset oligosystemic cHSP, still able to walk several miles at age >10–20 years. This benign phenotypic cluster and disease progression is strikingly divergent to the severe infantile phenotype of all SERAC1 cases reported so far. Two family members showed a more multisystemic juvenile-onset cHSP, indicating an intermediate phenotype between the benign oligosystemic cHSP and the classic infantile SERAC1 cluster. The homozygous splice mutation led to loss of the full-length SERAC1 protein and impaired phosphatidylglycerol PG34:1/PG36:1 remodelling. These phosphatidylglycerol changes, however, were milder than in classic infantile-onset SERAC1 cases, which might partially explain the milder SERAC1 phenotype.ConclusionsOur findings add SERAC1 to the increasing list of complex lipid cHSP genes. At the same time they redefine the phenotypic spectrum of SERAC1 deficiency. It is associated not only with the severe infantile-onset ‘Methylglutaconic aciduria, Deafness, Encephalopathy, Leigh-like’ syndrome (MEGDEL syndrome), but also with oligosystemic juvenile-onset cHSP as part of the now unfolding SERAC1 deficiency spectrum.
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Heinzel S, Bernhard FP, Roeben B, Nussbaum S, Heger T, Martus P, Hobert MA, Maetzler W, Berg D. Progression markers of motor deficits in Parkinson's disease: A biannual 4-year prospective study. Mov Disord 2017; 32:1254-1256. [PMID: 28681985 DOI: 10.1002/mds.27062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/18/2017] [Accepted: 05/01/2017] [Indexed: 11/09/2022] Open
Affiliation(s)
- Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Felix P Bernhard
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Susanne Nussbaum
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Tanja Heger
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, University Clinic of Tuebingen, Tuebingen, Germany
| | - Markus A Hobert
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
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Yilmaz R, Pilotto A, Roeben B, Preische O, Suenkel U, Heinzel S, Metzger FG, Laske C, Maetzler W, Berg D. Erratum: Structural Ultrasound of the Medial Temporal Lobe in Alzheimer's Disease. Ultraschall Med 2017; 38:e16. [PMID: 27459251 DOI: 10.1055/s-0035-1567111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- R Yilmaz
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - A Pilotto
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - B Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - O Preische
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - U Suenkel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - S Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - F G Metzger
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
- Geriatric Center at the University Hospital, University of Tuebingen, Tuebingen, Germany
| | - C Laske
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
- Geriatric Center at the University Hospital, University of Tuebingen, Tuebingen, Germany
- Section for Dementia Research, University of Tuebingen, Tuebingen, Germany
| | - W Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - D Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Department of Neurology, University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
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Yilmaz R, Pilotto A, Roeben B, Preische O, Suenkel U, Heinzel S, Metzger FG, Laske C, Maetzler W, Berg D. Structural Ultrasound of the Medial Temporal Lobe in Alzheimer's Disease. Ultraschall Med 2017; 38:294-300. [PMID: 27273178 DOI: 10.1055/s-0042-107150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Purpose One of the anatomical hallmarks of Alzheimer's disease (AD) is the atrophy of the medial temporal lobe (MTL), yet cost-effective and broadly available methodological alternatives to the current imaging tools for screening of this brain area are not currently available. Materials and Methods Using structural transcranial ultrasound (TCS), we attempted to visualize and measure the MTL, and compared the results of 32 AD patients and 84 healthy controls (HC). The MTL and the surrounding space were defined in the coronal plane on TCS. A ratio of the height of the MTL/height of the choroidal fissure (M/F) was calculated in order to obtain a regional proportion. Results An insufficient temporal bone window was identified in 22 % of the AD patients and 12 % of the HCs. The results showed that the ratio of M/F was significantly smaller in the AD group on both sides (p = 0.004 right, p = 0.007 left side). Furthermore, the M/F ratio made it possible to discriminate AD patients from HCs with a sensitivity of 83 % (right)/73 % (left) and a specificity of 76 % (right)/72 % (left) which is basically comparable to results published for magnetic resonance imaging. The measurements showed substantial intra/interrater reliability (ICC:0.79/0.69). Conclusion These results suggest that utilization of structural TCS may possibly constitute a cheap and easy-to-use supplement to other techniques for the diagnosis of AD. It may be especially useful as a screening tool in the large population of individuals with cognitive decline. Further studies are needed to validate this novel method.
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Affiliation(s)
- Rezzak Yilmaz
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Andrea Pilotto
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Oliver Preische
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Ulrike Suenkel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Florian G Metzger
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
- Geriatric Center at the University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Christoph Laske
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
- Geriatric Center at the University Hospital, University of Tuebingen, Tuebingen, Germany
- Section for Dementia Research, University of Tuebingen, Tuebingen, Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
- Department of Neurology, University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
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Pilotto A, Heinzel S, Suenkel U, Lerche S, Brockmann K, Roeben B, Schaeffer E, Wurster I, Yilmaz R, Liepelt-Scarfone I, von Thaler AK, Metzger FG, Eschweiler GW, Postuma RB, Maetzler W, Berg D. Application of the movement disorder society prodromal Parkinson's disease research criteria in 2 independent prospective cohorts. Mov Disord 2017; 32:1025-1034. [DOI: 10.1002/mds.27035] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/27/2017] [Accepted: 03/30/2017] [Indexed: 12/15/2022] Open
Affiliation(s)
- Andrea Pilotto
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- Neurology Unit, Department of Clinical and Experimental Sciences; University of Brescia, Brescia, Italy and Parkinson's Disease Rehabilitation Centre, FERB ONLUS S.Isidoro Hospital, Trescore Balneario (BG); Italy
| | - Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- Department of Neurology; Christian-Albrechts-University; Kiel Germany
| | - Ulrike Suenkel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Stefanie Lerche
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Eva Schaeffer
- Department of Neurology; Christian-Albrechts-University; Kiel Germany
| | - Isabel Wurster
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Rezzak Yilmaz
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- German Center for Neurodegenerative Diseases; Tuebingen Germany
| | - Anna-Katharina von Thaler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
| | - Florian G. Metzger
- Department of Psychiatry and Psychotherapy, Geriatric Center; Tuebingen University Hospital; Tuebingen Germany
| | - Gerhard W. Eschweiler
- Department of Psychiatry and Psychotherapy, Geriatric Center; Tuebingen University Hospital; Tuebingen Germany
| | - Ron B. Postuma
- Department of Neurology; Montreal General Hospital; Montreal Quebec Canada
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- Department of Neurology; Christian-Albrechts-University; Kiel Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research; University of Tuebingen; Tuebingen Germany
- Department of Neurology; Christian-Albrechts-University; Kiel Germany
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Roeben B, Maetzler W, Vanmechelen E, Schulte C, Heinzel S, Stellos K, Godau J, Huber H, Brockmann K, Wurster I, Gaenslen A, Grüner E, Niebler R, Eschweiler GW, Berg D. Association of Plasma Aβ40 Peptides, But Not Aβ42, with Coronary Artery Disease and Diabetes Mellitus. J Alzheimers Dis 2017; 52:161-9. [PMID: 27003209 DOI: 10.3233/jad-150575] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/OBJECTIVE Plasma levels of amyloid-beta (Aβ) 1-40 peptide have been proposed to be associated with cardiovascular mortality in patients with coronary artery disease (CAD). Therefore, we aimed to investigate the association of plasma Aβ levels with CAD, cardiovascular risk factors (CVRF), and APOE genotype in non-demented elderly individuals. METHODS Plasma Aβ1 - 40 and Aβ1 - 42 levels of 526 individuals (mean age of 63.0±7.3 years) were quantified with the INNO-BIA plasma Aβ forms assay based on multiplextrademark technique. APOE genotype was determined with an established protocol. Presence of CAD and CVRFs were ascertained using a questionnaire and/or medical records. RESULTS Plasma Aβ1 - 40 levels were significantly higher in individuals with CAD (p = 0.043) and, independently, in individuals with diabetes mellitus (DM) type 2 (p = 0.001) while accounting for age- and gender-effects. Plasma Aβ1 - 42 levels were higher in APOEɛ4 carriers (p = 0.004), but were neither relevantly associated with CAD nor with any CVRF. Plasma Aβ1 - 40 showed no association with APOE genotype. DISCUSSION Our findings argue for an association of circulating plasma Aβ1 - 40 peptides with incident CAD and DM. Further investigations are needed to entangle the role of Aβ1 - 40 role in the pathophysiology of cardiovascular disease independent of its known role in Alzheimer's disease.
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Affiliation(s)
- Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Geriatric Center, University of Tübingen, Tübingen, Germany
| | - Eugeen Vanmechelen
- Key4AD, Eke, Belgium.,Innogenetics N.V. (now Fujirebio Europe N.V.), Ghent, Belgium
| | - Claudia Schulte
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Konstantinos Stellos
- Institute of Cardiovascular Regeneration, Centre of Molecular Medicine, J.W. Goethe University Frankfurt, Frankfurt am Main, Germany.,Department of Cardiology, J.W. Goethe University Frankfurt, Frankfurt am Main, Germany.,German Center of Cardiovascular Research (DZHK), Frankfurt, Germany
| | - Jana Godau
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany
| | - Heiko Huber
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Isabel Wurster
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Alexandra Gaenslen
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Eva Grüner
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany
| | - Raphael Niebler
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Geriatric Center, University of Tübingen, Tübingen, Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Geriatric Center, University of Tübingen, Tübingen, Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
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Yilmaz R, Gräber S, Roeben B, Suenkel U, von Thaler AK, Heinzel S, Metzger FG, Eschweiler GW, Maetzler W, Berg D, Liepelt-Scarfone I. Cognitive Performance Patterns in Healthy Individuals with Substantia Nigra Hyperechogenicity and Early Parkinson's Disease. Front Aging Neurosci 2016; 8:271. [PMID: 27895578 PMCID: PMC5108760 DOI: 10.3389/fnagi.2016.00271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/28/2016] [Indexed: 12/17/2022] Open
Abstract
Introduction: Hyperechogenicity of the substantia nigra (SN+) is a risk marker for Parkinson’s disease (PD) which can be detected before the diagnosis. In healthy individuals, SN+ has been associated with slight deficits in specific cognitive functions, suggesting cognitive impairment as a possible pre-diagnostic marker for PD. However, the pattern of cognitive deficits associated with SN+ has not yet been compared with those present in PD. Methods: Data of 262 healthy individuals with normal echogenicity (SN-) and 48 healthy individuals with SN+ were compared with 82 early stage PD patients using the “Consortium to Establish a Registry for Alzheimer’s disease” test battery. First, the test clusters (factors) were identified using a principal component analysis (PCA). Mean group performance of cognitive tests belonging to distinct factors, according to the PCA, and single subtest performances were compared using analyses of variance. Second, the number of individuals with abnormal cognitive performances (z-score < -1.0) were compared between groups. Results: Verbal memory, semantic and executive function, and praxis were identified as components of cognitive performances. The SN+ group performed significantly worse than the SN- group in tests assessing semantic and executive function, with a non-significant decrease in verbal memory. On the subtest level, individuals of the SN+ group scored significantly lower than the SN- group on the Boston Naming Test (BNT; p = 0.008). In all subtests, the percentages of PD patients with values below the cut-off for abnormal performance were higher than in the SN- group. Moreover, more individuals from the SN+ group scored below the cut-off in the BNT (SN- = 8.4%, SN+ = 20.8%, p = 0.01) and TMT-B (SN- = 6.9%, SN+ = 16.7%, p = 0.02), compared to the SN- group. Conclusion: This study confirms poorer performance of healthy individuals with SN+ compared to SN- in specific cognitive domains. However, against the SN- group, the cognitive profile of the SN+ group was not fully consistent with the profile of early PD patients. Our data argues that cognitive impairment associated with SN+ might differ slightly from that seen in early PD. Compensational mechanisms in the early phases of neurodegeneration, and the fact that only a subgroup of SN+ will develop PD, may partly explain these differences.
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Affiliation(s)
- Rezzak Yilmaz
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen Tuebingen, Germany
| | - Susanne Gräber
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TuebingenTuebingen, Germany; German Center for Neurodegenerative DiseasesTuebingen, Germany
| | - Benjamin Roeben
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TuebingenTuebingen, Germany; German Center for Neurodegenerative DiseasesTuebingen, Germany
| | - Ulrike Suenkel
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen Tuebingen, Germany
| | - Anna-Katharina von Thaler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen Tuebingen, Germany
| | - Sebastian Heinzel
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TuebingenTuebingen, Germany; Department of Neurology, Christian-Albrechts-UniversityKiel, Germany
| | - Florian G Metzger
- Department of Psychiatry and Psychotherapy, University of TuebingenTuebingen, Germany; Geriatric Center at the University Hospital of TuebingenTuebingen, Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and Psychotherapy, University of TuebingenTuebingen, Germany; Geriatric Center at the University Hospital of TuebingenTuebingen, Germany
| | - Walter Maetzler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TuebingenTuebingen, Germany; Department of Neurology, Christian-Albrechts-UniversityKiel, Germany; Geriatric Center at the University Hospital of TuebingenTuebingen, Germany
| | - Daniela Berg
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TuebingenTuebingen, Germany; Department of Neurology, Christian-Albrechts-UniversityKiel, Germany
| | - Inga Liepelt-Scarfone
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of TuebingenTuebingen, Germany; German Center for Neurodegenerative DiseasesTuebingen, Germany
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Wilke C, Preische O, Deuschle C, Roeben B, Apel A, Barro C, Maia L, Maetzler W, Kuhle J, Synofzik M. Neurofilament light chain in FTD is elevated not only in cerebrospinal fluid, but also in serum. J Neurol Neurosurg Psychiatry 2016; 87:1270-1272. [PMID: 27188986 DOI: 10.1136/jnnp-2015-312972] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/18/2016] [Indexed: 11/03/2022]
Affiliation(s)
- Carlo Wilke
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Oliver Preische
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany Department of Psychiatry, University of Tübingen, Tübingen, Germany
| | - Christian Deuschle
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Benjamin Roeben
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Anja Apel
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Christian Barro
- Neurology, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Luis Maia
- Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany Department of Neurology, Hospital de Santo António-CHP, Porto, Portugal
| | - Walter Maetzler
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Jens Kuhle
- Neurology, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
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Heinzel S, Roeben B, Ben-Shlomo Y, Lerche S, Alves G, Barone P, Behnke S, Berendse HW, Bloem BR, Burn D, Dodel R, Grosset DG, Hu M, Kasten M, Krüger R, Moccia M, Mollenhauer B, Oertel W, Suenkel U, Walter U, Wirdefeldt K, Liepelt-Scarfone I, Maetzler W, Berg D. Prodromal Markers in Parkinson's Disease: Limitations in Longitudinal Studies and Lessons Learned. Front Aging Neurosci 2016; 8:147. [PMID: 27445791 PMCID: PMC4916171 DOI: 10.3389/fnagi.2016.00147] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/07/2016] [Indexed: 11/13/2022] Open
Abstract
A growing body of evidence supports a prodromal neurodegenerative process preceding the clinical onset of Parkinson's disease (PD). Studies have identified several different prodromal markers that may have the potential to predict the conversion from healthy to clinical PD but use considerably different approaches. We systematically reviewed 35 longitudinal studies reporting prodromal PD features and evaluated the methodological quality across 10 different predefined domains. We found limitations in the following domains: PD diagnosis (57% of studies), prodromal marker assessments (51%), temporal information on prodromal markers or PD diagnosis (34%), generalizability of results (17%), statistical methods (accounting for at least age as confounder; 17%), study design (14%), and sample size (9%). However, no limitations regarding drop-out (or bias investigation), or report of inclusion/exclusion criteria or prodromal marker associations were revealed. Lessons learned from these limitations and additional aspects of current prodromal marker studies in PD are discussed to provide a basis for the evaluation of findings and the improvement of future research in prodromal PD. The observed heterogeneity of studies, limitations and analyses might be addressed in future longitudinal studies using a, yet to be established, modular minimal set of assessments improving comparability of findings and enabling data sharing and combined analyses across studies.
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Affiliation(s)
- Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of TübingenTübingen, Germany; German Center for Neurodegenerative Diseases, University of TübingenTübingen, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of TübingenTübingen, Germany; German Center for Neurodegenerative Diseases, University of TübingenTübingen, Germany
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol Bristol, UK
| | - Stefanie Lerche
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of TübingenTübingen, Germany; German Center for Neurodegenerative Diseases, University of TübingenTübingen, Germany
| | - Guido Alves
- Norwegian Centre for Movement Disorders and Department of Neurology, Stavanger University Hospital Stavanger, Norway
| | - Paolo Barone
- Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, Department of Medicine, University of Salerno Salerno, Italy
| | - Stefanie Behnke
- Department of Neurology, University of Homburg Homburg, Germany
| | - Henk W Berendse
- Department of Neurology and Neuroscience Campus Amsterdam, VU University Medical Centre Amsterdam, Netherlands
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology Nijmegen, Netherlands
| | - David Burn
- Institute of Neuroscience, Newcastle University Newcastle Upon Tyne, UK
| | - Richard Dodel
- Department of Neurology, Philipps-University Marburg Marburg, Germany
| | - Donald G Grosset
- Institute of Neurological Sciences, Queen Elizabeth University Hospital Glasgow, UK
| | - Michele Hu
- Oxford Parkinson's Disease Centre and Nuffield Department of Clinical Neurosciences, University of Oxford Oxford, UK
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck Lübeck, Germany
| | - Rejko Krüger
- Clinical and Experimental Neuroscience, Luxembourg Center for Systems Biomedicine Belva, Luxembourg
| | - Marcello Moccia
- Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, Department of Medicine, University of Salerno Salerno, Italy
| | - Brit Mollenhauer
- Paracelsus-Elena-KlinikKassel, Germany; Department of Neuropathology, University Medical CenterGöttingen, Germany
| | - Wolfgang Oertel
- Department of Neurology, Philipps-University Marburg Marburg, Germany
| | - Ulrike Suenkel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of TübingenTübingen, Germany; German Center for Neurodegenerative Diseases, University of TübingenTübingen, Germany
| | - Uwe Walter
- Department of Neurology, University of Rostock Rostock, Germany
| | - Karin Wirdefeldt
- Department of Medical Epidemiology and Biostatistics and Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of TübingenTübingen, Germany; German Center for Neurodegenerative Diseases, University of TübingenTübingen, Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of TübingenTübingen, Germany; German Center for Neurodegenerative Diseases, University of TübingenTübingen, Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of TübingenTübingen, Germany; German Center for Neurodegenerative Diseases, University of TübingenTübingen, Germany; Department of Neurology, Christian-Albrechts-UniversityKiel, Germany
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Stirn SL, Freilinger C, Roeben B, Tünnerhoff J, Berg D, Freilinger T. Bilateral vertebral artery dissection in the setting of ADEM. J Neurol Sci 2016; 365:212-3. [PMID: 27206909 DOI: 10.1016/j.jns.2016.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 03/10/2016] [Accepted: 04/07/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Sören L Stirn
- Abteilung Neurologie mit Schwerpunkt Epileptologie, Hertie-Institut für Klinische Hirnforschung, Universitätsklinikum Tübingen, Germany; Arbeitsbereich Psychosen, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Germany
| | - Caroline Freilinger
- Abteilung Neurologie mit Schwerpunkt Epileptologie, Hertie-Institut für Klinische Hirnforschung, Universitätsklinikum Tübingen, Germany
| | - Benjamin Roeben
- Abteilung Neurologie mit Schwerpunkt Neurodegeneration, Hertie-Institut für Klinische Hirnforschung, Universitätsklinikum Tübingen, Germany
| | - Johannes Tünnerhoff
- Abteilung Neurologie mit Schwerpunkt vaskuläre Neurologie, Hertie-Institut für Klinische Hirnforschung, Universitätsklinikum Tübingen, Germany
| | - Daniela Berg
- Abteilung Neurologie mit Schwerpunkt Neurodegeneration, Hertie-Institut für Klinische Hirnforschung, Universitätsklinikum Tübingen, Germany
| | - Tobias Freilinger
- Abteilung Neurologie mit Schwerpunkt Epileptologie, Hertie-Institut für Klinische Hirnforschung, Universitätsklinikum Tübingen, Germany.
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Lerche S, Heinzel S, Alves GW, Barone P, Behnke S, Ben-Shlomo Y, Berendse H, Bloem BR, Burn D, Dodel R, Grosset DG, Hipp G, Hu MT, Kasten M, Krüger R, Liepelt-Scarfone I, Maetzler W, Moccia M, Mollenhauer B, Oertel W, Roeben B, Walter U, Wirdefeldt K, Berg D. Aiming for Study Comparability in Parkinson's Disease: Proposal for a Modular Set of Biomarker Assessments to be Used in Longitudinal Studies. Front Aging Neurosci 2016; 8:121. [PMID: 27303289 PMCID: PMC4882324 DOI: 10.3389/fnagi.2016.00121] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/12/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany; German Center for Neurodegenerative Diseases, University of TuebingenTuebingen, Germany
| | - Sebastian Heinzel
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany; German Center for Neurodegenerative Diseases, University of TuebingenTuebingen, Germany
| | - Guido W Alves
- Norwegian Centre for Movement Disorders, Stavanger University Hospital Stavanger, Norway
| | - Paolo Barone
- Neuroscience Section, Center for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, University of Salerno Salerno, Italy
| | - Stefanie Behnke
- Department of Neurology, Saarland University Hospital Homburg, Germany
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol Bristol, UK
| | - Henk Berendse
- Department of Neurology and Neuroscience Campus Amsterdam, VU University Hospital Amsterdam, Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior Nijmegen, Netherlands
| | - David Burn
- Institute of Neuroscience, Newcastle University Newcastle, UK
| | - Richard Dodel
- Department of Neurology, Philipps-Universität Marburg Marburg, Germany
| | - Donald G Grosset
- Institute of Neurological Sciences, Queen Elizabeth University Hospital Glasgow, UK
| | - Geraldine Hipp
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of LuxembourgBelval, Luxembourg; Centre Hospitalier LuxembourgLuxembourg, Luxembourg
| | - Michele T Hu
- Nuffield Department of Clinical Neurosciences, Oxford Parkinson's Disease Centre, University of Oxford Oxford, UK
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck Lübeck, Germany
| | - Rejko Krüger
- Clinical and Experimental Neuroscience, Luxembourg Centre for Systems Biomedicine, University of LuxembourgBelval, Luxembourg; Centre Hospitalier LuxembourgLuxembourg, Luxembourg
| | - Inga Liepelt-Scarfone
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany; German Center for Neurodegenerative Diseases, University of TuebingenTuebingen, Germany
| | - Walter Maetzler
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany; German Center for Neurodegenerative Diseases, University of TuebingenTuebingen, Germany
| | - Marcello Moccia
- Neuroscience Section, Center for Neurodegenerative Diseases (CEMAND), Department of Medicine and Surgery, University of Salerno Salerno, Italy
| | - Brit Mollenhauer
- Paracelsus-Elena-KlinikKassel, Germany; University Medical Center, Georg-August-Universität GöttingenGöttingen, Germany
| | - Wolfgang Oertel
- Department of Neurology, Philipps-Universität Marburg Marburg, Germany
| | - Benjamin Roeben
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany; German Center for Neurodegenerative Diseases, University of TuebingenTuebingen, Germany
| | - Uwe Walter
- Department of Neurology, University of Rostock Rostock, Germany
| | - Karin Wirdefeldt
- Department of Epidemiology and Biostatistics, Karolinska InstitutetStockholm, Sweden; Department of Clinical Neuroscience, Karolinska InstitutetStockholm, Sweden
| | - Daniela Berg
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of TuebingenTuebingen, Germany; German Center for Neurodegenerative Diseases, University of TuebingenTuebingen, Germany; Department of Neurology, Christian-Albrechts UniversityKiel, Germany
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Roeben B, Uhrig S, Bender B, Synofzik M. Teaching NeuroImages: When alopecia and disk herniations meet vascular leukoencephalopathy. Neurology 2016; 86:e166-e167. [DOI: 10.1212/wnl.0000000000002572] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Bernhard FP, Heinzel S, Binder G, Weber K, Apel A, Roeben B, Deuschle C, Maechtel M, Heger T, Nussbaum S, Gasser T, Maetzler W, Berg D. Insulin-Like Growth Factor 1 (IGF-1) in Parkinson's Disease: Potential as Trait-, Progression- and Prediction Marker and Confounding Factors. PLoS One 2016; 11:e0150552. [PMID: 26967642 PMCID: PMC4788352 DOI: 10.1371/journal.pone.0150552] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/15/2016] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Biomarkers indicating trait, progression and prediction of pathology and symptoms in Parkinson's disease (PD) often lack specificity or reliability. Investigating biomarker variance between individuals and over time and the effect of confounding factors is essential for the evaluation of biomarkers in PD, such as insulin-like growth factor 1 (IGF-1). MATERIALS AND METHODS IGF-1 serum levels were investigated in up to 8 biannual visits in 37 PD patients and 22 healthy controls (HC) in the longitudinal MODEP study. IGF-1 baseline levels and annual changes in IGF-1 were compared between PD patients and HC while accounting for baseline disease duration (19 early stage: ≤3.5 years; 18 moderate stage: >4 years), age, sex, body mass index (BMI) and common medical factors putatively modulating IGF-1. In addition, associations of baseline IGF-1 with annual changes of motor, cognitive and depressive symptoms and medication dose were investigated. RESULTS PD patients in moderate (130±26 ng/mL; p = .004), but not early stages (115±19, p>.1), showed significantly increased baseline IGF-1 levels compared with HC (106±24 ng/mL; p = .017). Age had a significant negative correlation with IGF-1 levels in HC (r = -.47, p = .028) and no correlation in PD patients (r = -.06, p>.1). BMI was negatively correlated in the overall group (r = -.28, p = .034). The annual changes in IGF-1 did not differ significantly between groups and were not correlated with disease duration. Baseline IGF-1 levels were not associated with annual changes of clinical parameters. DISCUSSION Elevated IGF-1 in serum might differentiate between patients in moderate PD stages and HC. However, the value of serum IGF-1 as a trait-, progression- and prediction marker in PD is limited as IGF-1 showed large inter- and intraindividual variability and may be modulated by several confounders.
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Affiliation(s)
- Felix P. Bernhard
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Gerhard Binder
- Department of Pediatric Endocrinology, University Children`s Hospital Tuebingen, Tuebingen, Germany
| | - Karin Weber
- Department of Pediatric Endocrinology, University Children`s Hospital Tuebingen, Tuebingen, Germany
| | - Anja Apel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Christian Deuschle
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Mirjam Maechtel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Tanja Heger
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Susanne Nussbaum
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
| | - Thomas Gasser
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany
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Yilmaz R, Behnke S, Liepelt-Scarfone I, Roeben B, Pausch C, Runkel A, Heinzel S, Niebler R, Suenkel U, Eschweiler GW, Maetzler W, Berg D. Substantia nigra hyperechogenicity is related to decline in verbal memory in healthy elderly adults. Eur J Neurol 2016; 23:973-8. [DOI: 10.1111/ene.12974] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 01/18/2016] [Indexed: 11/27/2022]
Affiliation(s)
- R. Yilmaz
- Department of Neurodegeneration; Hertie Institute for Clinical Brain Research (HIH); University of Tübingen; Tübingen Germany
| | - S. Behnke
- Department of Neurology; University of Homburg/Saar; Homburg Germany
| | - I. Liepelt-Scarfone
- Department of Neurodegeneration; Hertie Institute for Clinical Brain Research (HIH); University of Tübingen; Tübingen Germany
- German Center for Neurodegenerative Diseases (DZNE); Tübingen Germany
| | - B. Roeben
- Department of Neurodegeneration; Hertie Institute for Clinical Brain Research (HIH); University of Tübingen; Tübingen Germany
- German Center for Neurodegenerative Diseases (DZNE); Tübingen Germany
| | - C. Pausch
- Department of Neurology; University of Homburg/Saar; Homburg Germany
| | - A. Runkel
- Department of Neurology; University of Homburg/Saar; Homburg Germany
| | - S. Heinzel
- Department of Neurodegeneration; Hertie Institute for Clinical Brain Research (HIH); University of Tübingen; Tübingen Germany
| | - R. Niebler
- Department of Psychiatry and Psychotherapy; University of Tübingen; Tübingen Germany
- Geriatric Center at the University Hospital Tübingen; Tübingen Germany
| | - U. Suenkel
- Department of Neurodegeneration; Hertie Institute for Clinical Brain Research (HIH); University of Tübingen; Tübingen Germany
| | - G. W. Eschweiler
- Department of Psychiatry and Psychotherapy; University of Tübingen; Tübingen Germany
- Geriatric Center at the University Hospital Tübingen; Tübingen Germany
| | - W. Maetzler
- Department of Neurodegeneration; Hertie Institute for Clinical Brain Research (HIH); University of Tübingen; Tübingen Germany
- German Center for Neurodegenerative Diseases (DZNE); Tübingen Germany
| | - D. Berg
- Department of Neurodegeneration; Hertie Institute for Clinical Brain Research (HIH); University of Tübingen; Tübingen Germany
- German Center for Neurodegenerative Diseases (DZNE); Tübingen Germany
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Lerche S, Liepelt-Scarfone I, Alves G, Barone P, Behnke S, Ben-Shlomo Y, Berendse H, Burn D, Dodel R, Grosset D, Heinzel S, Hu M, Kasten M, Krüger R, Maetzler W, Moccia M, Mollenhauer B, Oertel W, Roeben B, Sünkel U, Walter U, Wirdefeldt K, Berg D. Methods in Neuroepidemiology Characterization of European Longitudinal Cohort Studies in Parkinson's Disease - Report of the JPND Working Group BioLoC-PD. Neuroepidemiology 2015; 45:282-97. [DOI: 10.1159/000439221] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 08/02/2015] [Indexed: 11/19/2022] Open
Abstract
Background: Enormous effort is being put into the identification and characterization of symptoms that may be used as predictive and progression markers in Parkinson's disease (PD). An impressive number of PD patients and individuals at risk for or in the prodromal stage of PD are currently followed in longitudinal studies; however, there does not exist an overview on the kind of markers evaluated and the assessments used. Methods: Information on the design, sample size, evaluated markers and assessments of 21 studies of the Joint Programme - Neurodegenerative Disease Research BioLoC-PD working group were collected by questionnaire. The studies were classified into at risk/prodromal or clinical PD cohorts. The assessments were grouped into quantitative assessments, investigator-rated assessments, investigator interviews, patient-rated questionnaires and caregiver-rated questionnaires. Results: Compilation of these data revealed an interesting consensus on evaluated markers, but there was an enormous variability of assessments. Furthermore, there is a remarkable similarity in the markers assessed and evaluation methods applied in the risk/prodromal and clinical PD cohorts. Conclusions: The inventory of the longitudinal cohorts that are part of the BioLoC-PD consortium reveals that there is a growing consensus on the markers that should be assessed in longitudinal cohort studies in PD. However, controversy still exists on the specific type of assessment. To allow comparison of data and common analyses it will be essential to harmonize scales and assessment outcomes.
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Roeben B, Stirn S, Freilinger T. Testen Sie Ihr Fachwissen. Akt Neurol 2015. [DOI: 10.1055/s-0034-1387555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- B. Roeben
- Neurologie mit Schwerpunkt Neurodegenerative Erkrankungen, Universitätsklinik Tübingen
| | - S. Stirn
- Neurologie mit Schwerpunkt Epileptologie, Universitätsklinik Tübingen
| | - T. Freilinger
- Neurologie mit Schwerpunkt Epileptologie, Universitätsklinik Tübingen
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Lerche S, Brockmann K, Wurster I, Gaenslen A, Roeben B, Holz D, Eschweiler GW, Maetzler W, Berg D. Reasons for mild parkinsonian signs - which constellation may indicate neurodegeneration? Parkinsonism Relat Disord 2014; 21:126-30. [PMID: 25511329 DOI: 10.1016/j.parkreldis.2014.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 11/20/2014] [Accepted: 11/24/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Mild parkinsonian signs (MPS) are common in the elderly population. Several factors including physical decline and comorbidities in addition to neurodegeneration may be possible sources for MPS. The objective was to examine whether MPS are associated with a history of orthopedic disturbances, vascular diseases or prodromal markers for neurodegeneration. METHODS The TREND study is a prospective longitudinal cohort study in individuals >50 years with biennial assessments designed to identify prodromal markers for neurodegeneration. In this substudy, 1091 elderly individuals were evaluated for a possible association of MPS with prodromal markers for neurodegeneration, orthopedic disturbances, vascular diseases, as well as cerebral abnormalities. These factors were assessed by self-administered questionnaires, with a structured health interview, a neurological examination and by transcranial sonography. RESULTS 82 participants showed MPS. They were found to have more often hyposmia and RBD, had a higher autonomic dysfunction score and they more frequently showed hyperechogenicity of the substantia nigra compared to controls. Neither orthopedic disturbances nor vascular diseases were significantly associated with the prevalence of MPS. CONCLUSION MPS might be a sign of early neurodegeneration rather than caused by other motor influencing diseases.
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Affiliation(s)
- Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
| | - Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany
| | - Isabel Wurster
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany
| | - Alexandra Gaenslen
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany
| | - Benjamin Roeben
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany
| | - Daniel Holz
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany
| | - Gerhard W Eschweiler
- Geriatric Center and Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Germany
| | - Walter Maetzler
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany
| | - Daniela Berg
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany
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Heinzel S, Liepelt-Scarfone I, Roeben B, Nasi-Kordhishti I, Suenkel U, Wurster I, Brockmann K, Fritsche A, Niebler R, Metzger FG, Eschweiler GW, Fallgatter AJ, Maetzler W, Berg D. A neurodegenerative vascular burden index and the impact on cognition. Front Aging Neurosci 2014; 6:161. [PMID: 25071568 PMCID: PMC4088338 DOI: 10.3389/fnagi.2014.00161] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 06/20/2014] [Indexed: 12/21/2022] Open
Abstract
A wide range of vascular burden factors has been identified to impact vascular function and structure as indicated by carotid intima–media thickness (IMT). On the basis of their impact on IMT, vascular factors may be selected and clustered in a vascular burden index (VBI). Since many vascular factors increase the risk of Alzheimer’s disease (AD), a multifactorial neurodegenerative VBI may be related to early pathological processes in AD and cognitive decline in its preclinical stages. We investigated an elderly cohort at risk for neurodegeneration (TREND study, n = 1102) for the multifactorial influence of vascular burden factors on IMT measured by ultrasound. To create a VBI for this cohort, vascular factors and their definitions (considering medical history, medication, and/or blood marker data) were selected based on their statistical effects on IMT in multiple regressions including age and sex. The impact of the VBI on cognitive performance was assessed using the Trail-Making Test (TMT) and the consortium to establish a registry for Alzheimer’s disease (CERAD) neuropsychological battery. IMT was significantly predicted by age (standardized β = 0.26), sex (0.09; males > females) and the factors included in the VBI: obesity (0.18), hypertension (0.14), smoking (0.08), diabetes (0.07), and atherosclerosis (0.05), whereas other cardiovascular diseases or hypercholesterolemia were not significant. Individuals with 2 or more VBI factors compared to individuals without had an odds ratio of 3.17 regarding overly increased IMT ( ≥ 1.0 mm). The VBI showed an impact on executive control [log(TMT B−A), p = 0.047] and a trend toward decreased global cognitive function (CERAD total score, p = 0.057) independent of age, sex, and education. A VBI established on the basis of IMT may help to identify individuals with overly increased vascular burden linked to decreased cognitive function indicating neurodegenerative processes. The longitudinal study of this risk cohort will reveal the value of the VBI as prodromal marker for cognitive decline and AD.
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Affiliation(s)
- Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Isabella Nasi-Kordhishti
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Ulrike Suenkel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Isabel Wurster
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Andreas Fritsche
- Department of Internal Medicine IV, University of Tübingen , Tübingen , Germany
| | - Raphael Niebler
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany ; Geriatric Center, University Hospital Tübingen , Tübingen , Germany
| | - Florian G Metzger
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany ; Geriatric Center, University Hospital Tübingen , Tübingen , Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany ; Geriatric Center, University Hospital Tübingen , Tübingen , Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
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