1
|
Bahia MS, Kaspi O, Touitou M, Binayev I, Dhail S, Spiegel J, Khazanov N, Yosipof A, Senderowitz H. A comparison between 2D and 3D descriptors in QSAR modeling based on bio-active conformations. Mol Inform 2023; 42:e2200186. [PMID: 36617991 DOI: 10.1002/minf.202200186] [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: 01/03/2023] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/10/2023]
Abstract
QSAR models are widely and successfully used in many research areas. The success of such models highly depends on molecular descriptors typically classified as 1D, 2D, 3D, or 4D. While 3D information is likely important, e. g., for modeling ligand-protein binding, previous comparisons between the performances of 2D and 3D descriptors were inconclusive. Yet in such comparisons the modeled ligands were not necessarily represented by their bioactive conformations. With this in mind, we mined the PDB for sets of protein-ligand complexes sharing the same protein for which uniform activity data were reported. The results, totaling 461 structures spread across six series were compiled into a carefully curated, first of its kind dataset in which each ligand is represented by its bioactive conformation. Next, each set was characterized by 2D, 3D and 2D + 3D descriptors and modeled using three machine learning algorithms, namely, k-Nearest Neighbors, Random Forest and Lasso Regression. Models' performances were evaluated on external test sets derived from the parent datasets either randomly or in a rational manner. We found that many more significant models were obtained when combining 2D and 3D descriptors. We attribute these improvements to the ability of 2D and 3D descriptors to code for different, yet complementary molecular properties.
Collapse
Affiliation(s)
| | - Omer Kaspi
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, 5290002, Israel
| | - Meir Touitou
- School of Cancer and Pharmaceutical Sciences, King's College London, London, 150 Stamford Street, SE1 9NH, United Kingdom
| | - Idan Binayev
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, 5290002, Israel
| | - Seema Dhail
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, 5290002, Israel
| | - Jacob Spiegel
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, 5290002, Israel
| | - Netaly Khazanov
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, 5290002, Israel
| | - Abraham Yosipof
- Department of Information Systems, College of Law & Business, Ramat-Gan, P.O. Box 852, Bnei Brak, 5110801, Israel
| | - Hanoch Senderowitz
- Department of Chemistry, Bar-Ilan University, Ramat-Gan, 5290002, Israel
| |
Collapse
|
2
|
Spiegel J, Senderowitz H. Towards an Enrichment Optimization Algorithm (EOA)-based Target Specific Docking Functions for Virtual Screening. Mol Inform 2022; 41:e2200034. [PMID: 35790469 PMCID: PMC9786651 DOI: 10.1002/minf.202200034] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
Docking-based virtual screening (VS) is a common starting point in many drug discovery projects. While ligand-based approaches may sometimes provide better results, the advantage of docking lies in its ability to provide reliable ligand binding modes and approximated binding free energies, two factors that are important for hit selection and optimization. Most docking programs were developed to be as general as possible and consequently their performances on specific targets may be sub-optimal. With this in mind, in this work we present a method for the development of target-specific scoring functions using our recently reported Enrichment Optimization Algorithm (EOA). EOA derives QSAR models in the form of multiple linear regression (MLR) equations by optimizing an enrichment-like metric. Since EOA requires target-specific active and inactive (or decoy) compounds, we retrieved such data for six targets from the DUD-E database, and used them to re-derive the weights associated with the components that make up GOLD's ChemPLP scoring function yielding target-specific, modified functions. We then used the original ChemPLP function in small-scale VS experiments on the six targets and subsequently rescored the resulting poses with the modified functions. In addition, we used the modified functions for compounds re-docking. We found that in many although not all cases, either rescoring the original ChemPLP poses or repeating the entire docking process with the modified functions, yielded better results in terms of AUC and EF1% , two metrics, common for the evaluation of VS performances. While work on additional datasets and docking tools is clearly required, we propose that the results obtained thus far hint to the potential benefits in using EOA-based optimization for the derivation of target-specific functions in the context of virtual screening. To this end, we discuss the downsides of the methods and how it could be improved.
Collapse
Affiliation(s)
- Jacob Spiegel
- Department of ChemistryBar-Ilan UniversityRamat-Gan5290002Israel
| | | |
Collapse
|
3
|
Spiegel J, Arnold S, Salbach H, Gotti EG, Pfeiffer E, Lehmkuhl U, Correll CU, Jaite C. Emotional abuse interacts with borderline personality in adolescent inpatients with binge-purging eating disorders. Eat Weight Disord 2022; 27:131-138. [PMID: 33677816 PMCID: PMC8860808 DOI: 10.1007/s40519-021-01142-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/01/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Childhood abuse is associated with an increased risk of developing eating disorders (EDs) as well as personality disorders (PDs). However, their interaction is still uncertain, particularly in adolescents. This study investigates the correlations between childhood emotional neglect (CEN), childhood emotional abuse (CEA), and obsessive-compulsive and borderline personality styles in female adolescent inpatients with eating disorders (EDs). METHODS One hundred and twenty-eight inpatients (ages 14-18) were assessed, 54 were diagnosed with restricting-type anorexia nervosa (AN-R) and 33 with a binge-purging ED [BP-ED; comprising patients with binge-purging type anorexia nervosa (AN-BP), n = 15, and bulimia nervosa (BN), n = 18]. Fifty healthy participants made up the control group (CG). CEN and CEA were assessed with the Childhood Trauma Questionnaire, while the Personality Style and Disorder Inventory was implemented to determine personality styles. RESULTS A MANOVA revealed a significant main effect of CEA on spontaneous-borderline personality style [F(8,119) = 17.1, p < 0.001, η2 = 0.126], as well as a main effect of ED group on spontaneous-borderline [F(2,119) = 3.1, p = 0.048, η2 = 0.050]. A significant interaction between ED group, CEA, and spontaneous-borderline was found [F(2,119) = 3.5, p = 0.034, η2 = 0.055] with BP-ED showing significantly higher scores in CEA (9.3 ± 4.0) and in spontaneous-borderline (14.2 ± 6.2). CONCLUSIONS Considering CEA and borderline personality style in adolescent inpatients with BN or AN-BP may help improve the understanding of the etiology and maintenance of BP-ED and provide more effective treatment targets. LEVEL OF EVIDENCE Level III, case-control analytic study.
Collapse
Affiliation(s)
- J Spiegel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Hospital Urban, Berlin, Germany
| | - S Arnold
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - H Salbach
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - E G Gotti
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - E Pfeiffer
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - U Lehmkuhl
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - C U Correll
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA
| | - C Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
| |
Collapse
|
4
|
Spiegel J, Senderowitz H. A Comparison between Enrichment Optimization Algorithm (EOA)-Based and Docking-Based Virtual Screening. Int J Mol Sci 2021; 23:43. [PMID: 35008467 PMCID: PMC8744642 DOI: 10.3390/ijms23010043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/18/2021] [Accepted: 12/19/2021] [Indexed: 12/30/2022] Open
Abstract
Virtual screening (VS) is a well-established method in the initial stages of many drug and material design projects. VS is typically performed using structure-based approaches such as molecular docking, or various ligand-based approaches. Most docking tools were designed to be as global as possible, and consequently only require knowledge on the 3D structure of the biotarget. In contrast, many ligand-based approaches (e.g., 3D-QSAR and pharmacophore) require prior development of project-specific predictive models. Depending on the type of model (e.g., classification or regression), predictive ability is typically evaluated using metrics of performance on either the training set (e.g.,QCV2) or the test set (e.g., specificity, selectivity or QF1/F2/F32). However, none of these metrics were developed with VS in mind, and consequently, their ability to reliably assess the performances of a model in the context of VS is at best limited. With this in mind we have recently reported the development of the enrichment optimization algorithm (EOA). EOA derives QSAR models in the form of multiple linear regression (MLR) equations for VS by optimizing an enrichment-based metric in the space of the descriptors. Here we present an improved version of the algorithm which better handles active compounds and which also takes into account information on inactive (either known inactive or decoy) compounds. We compared the improved EOA in small-scale VS experiments with three common docking tools, namely, Glide-SP, GOLD and AutoDock Vina, employing five molecular targets (acetylcholinesterase, human immunodeficiency virus type 1 protease, MAP kinase p38 alpha, urokinase-type plasminogen activator, and trypsin I). We found that EOA consistently outperformed all docking tools in terms of the area under the ROC curve (AUC) and EF1% metrics that measured the overall and initial success of the VS process, respectively. This was the case when the docking metrics were calculated based on a consensus approach and when they were calculated based on two different sets of single crystal structures. Finally, we propose that EOA could be combined with molecular docking to derive target-specific scoring functions.
Collapse
Affiliation(s)
| | - Hanoch Senderowitz
- Department of Chemistry, Bar-Ilan University, Ramat-Gan 5290002, Israel;
| |
Collapse
|
5
|
Ehrlich R, Spiegel J, Yassi A. Diverse approaches to preventing occupational tuberculosis in health workers: cross-disciplinary or cross purposes? Public Health Action 2019; 9:11-14. [PMID: 30963037 DOI: 10.5588/pha.18.0086] [Citation(s) in RCA: 5] [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: 10/18/2018] [Accepted: 12/19/2018] [Indexed: 12/29/2022] Open
Affiliation(s)
- R Ehrlich
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - J Spiegel
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - A Yassi
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
6
|
Kalampokini S, Lyros E, Luley M, Schöpe J, Spiegel J, Bürmann J, Dillmann U, Fassbender K, Unger MM. Facial emotion recognition in Parkinson's disease: Association with age and olfaction. J Clin Exp Neuropsychol 2017. [PMID: 28637374 DOI: 10.1080/13803395.2017.1341470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 12/31/2022]
Abstract
OBJECTIVE The ability to recognize facial emotion expressions has been reported to be impaired in Parkinson's disease (PD), yet previous studies showed inconsistent findings. The aim of this study was to further investigate facial emotion recognition (FER) in PD patients and its association with demographic and clinical parameters (including motor and nonmotor symptoms). METHOD Thirty-four nondemented PD patients and 24 age- and sex-matched healthy controls (HC) underwent clinical neurological and neuropsychological assessment, standardized olfactory testing with Sniffin' Sticks, and the Ekman 60 Faces Emotion Recognition Test. RESULTS PD patients had a significantly lower score on the total FER task than HC (p = .006), even after controlling for the potential confounding factors depression and apathy. The PD group had a specific impairment in the recognition of surprise (p = .007). The recognition of anger approached statistical significance (p = .07). Increasing chronological age and age at disease onset were associated with worse performance on the FER task in PD patients. Olfactory function along with PD diagnosis predicted worse FER performance within all study participants. CONCLUSION Facial emotion recognition and especially the recognition of surprise are significantly impaired in PD patients compared with age- and sex-matched HC. The association of FER with age and olfactory function is endorsed by common structures that undergo neurodegeneration in PD. The relevance of FER in social interaction stresses the clinical relevance and the need for further investigation in this field. Future studies should also determine whether impaired FER is already present in premotor stages of PD.
Collapse
Affiliation(s)
- S Kalampokini
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - E Lyros
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - M Luley
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - J Schöpe
- b Institute for Medical Biometry, Epidemiology and Medical Informatics , Saarland University , Homburg , Germany
| | - J Spiegel
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - J Bürmann
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - U Dillmann
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - K Fassbender
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| | - M M Unger
- a Department of Neurology , University Hospital of Saarland , Homburg , Germany
| |
Collapse
|
7
|
Spiegel J, Ishimori ML, Wallace DJ, Weisman MH. The lowest surviving birth weight reported in a systemic lupus erythematosus patient: a review of the literature. Lupus 2016; 16:52-5. [PMID: 17283586 DOI: 10.1177/0961203306072382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The success rates for pregnancies in women with systemic lupus erythematosus(SLE) have improved over the years: however, pregnancy for women with active, serious, organ-threatening lupus continues to be a challenge. Preeclampsia and HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome may complicate pregnancy especially in the setting of advanced maternal age, underlying SLE and chronic renal disease. We report the pregnancy course and outcome for a 35-year old woman with active lupus nephritis at the time of conception who developed severe preeclampsia and HELLP syndrome. The infant was delivered at 26-5/7 weeks gestation, which, associated with intrauterine growth retardation, led to a birth weight of only 470 g. We have reviewed the relevant literature for similar cases of prematurity, very low birth weight, and preeclampsia in the setting of underlying lupus in Medline between 1986 and 2006. This report represents the lowest birth weight pregnancy survival in a lupus patient and the first case of a survival in the second trimester with preeclampsia and HELLP syndrome.
Collapse
Affiliation(s)
- J Spiegel
- Division of Rheumatology, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | | | | |
Collapse
|
8
|
Wu J, Ye J, Chen F, Hill G, Spiegel J, Mehta V. Duty Cycle Selection of Gating in Lung SBRT With Flatting Filter–Free Beams. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
9
|
Ye J, Wu J, Chen F, Hill G, Spiegel J, Mehta V. Does MLC With Finer Leaf Width Improve the Treatment Plan Quality in Stereotactic Body Radiation Therapy of Lung Cancers. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
Rao M, Ye J, Spiegel J, Takamiya R, Mehta V, Wu J. Interplay Effect During Lung SBRT With VMAT Delivered by Flattening Filter–Free Beams. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
11
|
Lorenz R, Samnick S, Dillmann U, Schiller M, Ong MF, Faßbender K, Buck A, Spiegel J. Nicotinic α4β2 acetylcholine receptors and cognitive function in Parkinson's disease. Acta Neurol Scand 2014; 130:164-71. [PMID: 24762290 DOI: 10.1111/ane.12259] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Idiopathic Parkinson's disease (IPD) is characterized by the clinical motor symptoms of hypokinesia, rigidity, and tremor. Apart from these motor symptoms, cognitive deficits often occur in IPD. The positive effect of cholinesterase inhibitors on cognitive deficits in IPD and findings of earlier molecular imaging studies suggest that the cholinergic system plays an important role in the origin of cognitive decline in IPD. METHODS Twenty-five non-demented patients with IPD underwent a 5-[123I]iodo-3-[2(S)-2-azetidinylmethoxy]pyridine (5-I-A-85380) SPECT to visualize α4β2 nicotinic acetylcholine receptors (nAchR) and cognitive testing with the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) battery to identify domains of cognitive dysfunction. RESULTS In the CERAD, the IPD patients exhibited deficits in non-verbal memory, attention, psychomotor velocity, visuoconstructive ability, and executive functions. After Bonferroni correction for multiple comparisons, we found significant correlations between performance of the CERAD subtests Boston Naming Test (a specific test for visual perception and for detection of word-finding difficulties) and Word List Intrusions (a specific test for learning capacity and memory for language information) vs binding of α4β2 nAchR in cortical (the right superior parietal lobule) and subcortical areas (the left thalamus, the left posterior subcortical region, and the right posterior subcortical region). CONCLUSIONS These significant correlations between the results of the CERAD subtests and the cerebral α4β2 nAchR density, as assessed by 5-I-A-85380 SPECT, indicate that cerebral cholinergic pathways are relevant to cognitive processing in IPD.
Collapse
Affiliation(s)
- R. Lorenz
- Department of Nuclear Medicine; University of Würzburg; Würzburg Germany
| | - S. Samnick
- Department of Nuclear Medicine; University of Würzburg; Würzburg Germany
| | - U. Dillmann
- Department of Neurology; Saarland University; Homburg/Saar Germany
| | - M. Schiller
- Department of Nuclear Medicine; University of Würzburg; Würzburg Germany
| | - M. F. Ong
- Department of Biometry; Epidemiology and Medical Informatics; Saarland University; Homburg/Saar Germany
| | - K. Faßbender
- Department of Neurology; Saarland University; Homburg/Saar Germany
| | - A. Buck
- Department of Nuclear Medicine; University of Würzburg; Würzburg Germany
| | - J. Spiegel
- Department of Neurology; Saarland University; Homburg/Saar Germany
| |
Collapse
|
12
|
Wu J, Ye J, Hill G, Spiegel J, Mehta V. SU-E-T-361: Clinical Benefit of Automatic Beam Gating Mixed with Breath Hold in Radiation Therapy of Left Breast. Med Phys 2014. [DOI: 10.1118/1.4888694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
13
|
Wu J, Chen F, Ye J, Mehta V, Loiselle C, Spiegel J. SU-E-J-06: Necessity of 4D Cone-Beam CT Imaging in Patient Setup for Gated Stereotactic Body Radiation Therapy of Lung Cancer. Med Phys 2013. [DOI: 10.1118/1.4814218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
14
|
Fousse M, Becker C, Faßbender K, Reith W, Körner H, Alexandrou M, Spiegel J. [First occurrence of an organic manic schizophreniform syndrome followed by catatonia induced by anti-NMDA-receptor encephalitis]. Fortschr Neurol Psychiatr 2013; 81:206-9. [PMID: 23504517 DOI: 10.1055/s-0033-1335044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We report on a 39-year-old female patient who developed catatonia after there had been schizomanic symptoms in the six months before. At admission the patient exhibited catatonia, a tetraspastic syndrome and focal epileptic seizures. The cranial MRI revealed bilateral subcortical hyperintense lesions which took up contrast agent. Examination of the cerebrospinal fluid disclosed a lymphocytic pleocytosis and autochthone oligoclonal bands. In the serum autoantibodies against the NMDA-NR-1 receptor were reproducibly detected. A detailed search for a tumour was negative. In detail, we could exclude a neoplasm of the ovaries which is often present in the paraneoplastic type of anti-NMDA-receptor encephalitis. Therefore we assume an autoimmune, not paraneoplastic, encephalitis in our patient. The symptoms improved significantly after an immunosuppressive therapy - initially with glucocorticoids followed by rituximab - had been initiated. This case illustrates that an autoimmune encephalitis should be looked for when first psychotic symptoms occur.
Collapse
Affiliation(s)
- M Fousse
- Klinik für Neurologie, Universitätsklinikum des Saarlands, 66421 Homburg
| | | | | | | | | | | | | |
Collapse
|
15
|
Yilmaz U, Papanagiotou P, Roth C, Spiegel J, Kalampokini S, Reith W. Peri-ictal restricted diffusion in heterotopic gray matter assessed by MRI. Neurology 2012; 79:1300. [DOI: 10.1212/wnl.0b013e31826aad0b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
16
|
Pehlke JR, Geipel U, von Müller L, Spiegel J. [Meningoencephalitis and ventricular arrhythmia caused by yersiniosis]. Fortschr Neurol Psychiatr 2012; 80:527-9. [PMID: 22951772 DOI: 10.1055/s-0032-1312786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We report on a 19-year-old patient without any immunodeficiency and without a history of significant diseases in whom two seizure attacks as symptoms of meningoencephalitis occurred after he had suffered from abdominal symptoms for a week. Later, we could observe frequent polymorphic ventricular extrasystoles. A massive production of anti-Yersinia IgM, IgG and IgA as a sign of an acute infection could be found, although we were not able to detect the microbe itself with culturing methods. After targetted antibiotic treatment, the patient fully recovered within two weeks and could be discharged from hospital without clinical abnormalities and an almost normalised cell count in the cerebrospinal fluid. Possible ways of infection are mice which the patient kept as pets and his work in the sewer system. The present case reminds us to think of uncommon infectious agents even in young patients without a predisposition but unusual symptoms and/or potentially relevant anamnestic data.
Collapse
Affiliation(s)
- J R Pehlke
- Klinik für Neurologie, Universitätsklinikum des Saarlands, Homburg, Saar
| | | | | | | |
Collapse
|
17
|
Devenney-Cakir B, Dunfee B, Subramaniam R, Sundararajan D, Mehra P, Spiegel J, Sakai O. Ameloblastic carcinoma of the mandible with metastasis to the skull and lung: advanced imaging appearance including computed tomography, magnetic resonance imaging and positron emission tomography computed tomography. Dentomaxillofac Radiol 2010; 39:449-53. [PMID: 20841465 DOI: 10.1259/dmfr/29356719] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Ameloblastic carcinoma is a very rare malignant odontogenic tumour with characteristic histopathological and clinical features, which requires aggressive surgical treatment and surveillance and, therefore, differs from ameloblastoma. Metastasis typically occurs in the lung. Only one patient with metastasis to the skull has previously been described and no prior case reports have presented MRI and positron emission tomography-CT (PET-CT) imaging findings. We describe a case of ameloblastic carcinoma with metastasis to the skull and lung with emphasis on imaging features including MRI and PET-CT.
Collapse
Affiliation(s)
- B Devenney-Cakir
- Department of Radiology, Boston Medical Center, Boston, MA 02118, USA.
| | | | | | | | | | | | | |
Collapse
|
18
|
Abstract
The aim was to describe a tried approach to endoscopic Zenker's diverticulostomy, especially in those patients with unfavorable anatomy or smaller pouches who may otherwise be relegated to open repair. The study design was a retrospective case series The setting was an urban, tertiary care university medical center There were seven patients, both inpatient and outpatient, with chief complaints of dysphagia. All had a documented Zenker's diverticulum (ZD) on barium swallow. All of the patients were deemed by the primary surgeon to have some anatomic factor that limited exposure of the diverticulum. The patients underwent Endostitch-assisted endoscopic Zenker's diverticulostomy. Records were retrospectively reviewed, including preoperative and postoperative swallowing status, radiographic findings, operative findings, and follow-up results. Seven patients were reviewed, each of whom had successful endoscopic treatment of ZD. Notably, in each case, an anatomical factor precluded the seating of the gastrointestinal anastomosis (GIA) stapler on the cricopharyngeal bar without the use of endoscopic retention sutures. The majority of the patients were discharged on postoperative day one. All but one patient noted a marked improvement in swallowing function immediately following the procedure and at their outpatient follow-up visit. Endoscopic Zenker's diverticulostomy has been well-described and established as a reliable technique in a majority of cases. We report on our experience using a previously described technique specifically for difficult, unfavorable, or contraindicated cases and suggest the employment of this technique as an alternative method to facilitate endoscopic repair and possibly limit the need for an open approach.
Collapse
Affiliation(s)
- B D Nicholas
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
| | | | | | | | | |
Collapse
|
19
|
Becker C, Roth C, Reith W, Fassbender K, Spiegel J. [Multiple aneurysms of intracranial arteries in neurofibromatosis Recklinghausen type 1]. Fortschr Neurol Psychiatr 2010; 78:294-5. [PMID: 20229451 DOI: 10.1055/s-0029-1245294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report on a 58 year old female patient with neurofibromatosis Recklinghausen type 1 (NF-1) in whom multiple intracranial aneurysms could be proven. Vascular changes in patients with NF-1 are frequent and concern primarily the aorta, the kidney arteries, the coronary and gastrointestinal arteries. Our case shows that in patients with NF-1 intracranial artery changes like aneurysms, maybe in need of treatment, are possible.
Collapse
Affiliation(s)
- C Becker
- Neurologische Klinik, Universität des Saarlandes, Kirrberger Strasse, Homburg/Saar
| | | | | | | | | |
Collapse
|
20
|
Becker C, Roth C, Reith W, Fassbender K, Spiegel J. [Bilateral spontaneous carotid artery dissection in osteogenesis imperfecta (type I)]. Nervenarzt 2009; 80:1222-5. [PMID: 19768444 DOI: 10.1007/s00115-009-2860-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We report on a 36-year-old patient with an acute cerebral infarction due to a spontaneous dissection of both internal carotid arteries in conjunction with type I osteogenesis imperfecta. Spontaneous dissections of cerebral arteries (DCA) represent a common cause of cerebral infarctions in younger patients. Our case shows that a hereditary connective tissue disorder should be considered in all patients with "spontaneous" DCA. The identification of an - initially unknown - hereditary connective tissue disorder may con-tribute to primary and secondary prophylaxis of cerebral ischemia.
Collapse
Affiliation(s)
- C Becker
- Neurologische Klinik, Universitätsklinikum des Saarlandes, Homburg/Saar.
| | | | | | | | | |
Collapse
|
21
|
Abstract
Ageing patients reveal an increasing coincidence of orthopaedic disorders and Parkinson's disease (PD). In addition, parkinsonian motor symptoms predispose individuals for orthopaedic diseases. PD patients have a higher risk of perioperative complications than patients without PD; this higher risk is based on motor and autonomous deficits in PD as well as on interactions between antiparkinsonian and anaesthesia medications. The elevated perioperative risk in PD can be reduced by appropriate perioperative management and no longer represents a contraindication to surgery in PD patients.
Collapse
Affiliation(s)
- J Spiegel
- Neurologische Klinik, Universitätsklinikum des Saarlandes, Kirrberger Strasse, 66421, Homburg/Saar, Deutschland.
| |
Collapse
|
22
|
Fehringer C, Spiegel J, Dillmann U, Fassbender K. Epstein-Barr-Virus-Infektion als Ursache einer prolongierten Meningitis. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
23
|
Becker C, Fassbender K, Spiegel J. Beidseitige spontane Carotisdissektion bei Osteogenesis imperfecta (Typ I). Akt Neurol 2009. [DOI: 10.1055/s-0029-1238594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
24
|
Spiegel J, Hellwig D, Jost WH, Farmakis G, Kirsch CM, Dillmann U, Fassbender K. Kranielle und extrakranielle sympathische Lewykörperchen-Degeneration beim Morbus Parkinson entwickeln sich zueinander synchron. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
25
|
Bürmann J, Spiegel J, Messner I, Kostopoulos P, Feiden S, Fassbender K. Status epilepticus mit tödlichem Verlauf bei einem 30-jährigen Patienten mit einer mitochondrialen Erkrankung. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
26
|
Sühs KW, Fassbender K, Spiegel J. Hirnorganisches Psychosyndrom mit Wahnsymptomatik bei Hashimoto Enzephalopathie. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
27
|
Taranu D, Fassbender K, Spiegel J. Multifokale motorische Neuropathie – eine Differenzialdiagnose zum Sulcus-ulnaris-Syndrom. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
28
|
Spiegel J, Hellwig D, Jost W, Farmakis G, Samnick S, Fassbender K, Kirsch C, Dillmann U. 122. Cerebral and extracranial neurodegeneration are strongly coupled in Parkinson’s disease. Clin Neurophysiol 2009. [DOI: 10.1016/j.clinph.2008.07.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
29
|
Spiegel J, Hellwig D, Jost WH, Farmakis G, Samnick S, Fassbender K, Kirsch CM, Dillmann U. Cerebral and extracranial neurodegeneration are strongly coupled in Parkinson's disease. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
30
|
Dillmann U, Spiegel J, Marziniak M, Koenig J, Chelius C, Heide G, Krick C, Fassbender K. Transcranial magnetic stimulation of the facial nerve in acute isolated peripheral facial palsy. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
31
|
Spiegel J, Dillmann U, Moringlane JR. Quantification of temporal and spatial accuracy of alternating arm movements in multiple sclerosis patients treated with deep brain stimulation of the thalamic ventralis intermedius nucleus (VIM). Zentralbl Neurochir 2007; 68:67-72. [PMID: 17614086 DOI: 10.1055/s-2007-977739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE In patients with multiple sclerosis (MS) ataxia is a common symptom, which is barely influenced by pharmacological treatment. We studied whether stimulation of the thalamic ventralis intermedius nucleus (VIM) improves the performance of alternating forearm movements in MS patients. METHODS We investigated 6 patients with primary (n=1) or secondary (n=5) chronic progressive MS (age 36-66 years, median 41.5 years, median EDSS [expanded disability status scale] 6.5). Patients were seated in a chair with one arm abduced at right angles to the body. This arm was strapped into a splint with one fixed section for the upper arm and one movable section for the forearm. The latter allowed horizontal movements in the elbow joint. The patients had to perform rhythmic alternating flexion and extension movements in the elbow joint. The rhythm and spatial extent of movements were indicated acoustically by a click tone stimulator and by marks respectively. Six manoeuvres (spatial extents of 48 degrees , 83 degrees at frequencies of 0.9 Hz, 1.5 Hz, and 2.5 Hz each) had to be performed. A potentiometer converted the horizontal movements of the forearm into a variable voltage. Forearm movements were measured with and without contralateral VIM stimulation. RESULTS In all patients, spatial accuracy of the alternating forearm movements improved significantly after the stimulation had been switched on. Temporal accuracy increased during VIM stimulation in 5 of 6 patients. In 1 of 6 patients the spatial but not the temporal movement accuracy improved during stimulation. CONCLUSIONS During VIM stimulation, performance of alternating forearm movements improved significantly. This might indicate that VIM stimulation could be a therapeutic alternative in the treatment of upper limb ataxia in MS.
Collapse
Affiliation(s)
- J Spiegel
- Department of Neurology, Saarland University, Homburg, Saar, Germany.
| | | | | |
Collapse
|
32
|
Spiegel J, Krick C, Fuss G, Becker G, Dillmann U. Orthostatic tremor during modification of standing. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
33
|
Spiegel J, Hellwig D, Samnick S, Jost W, Möllers MO, Fassbender K, Kirsch CM, Dillmann U. Striatal FP-CIT uptake differs in the subtypes of early Parkinson's disease. J Neural Transm (Vienna) 2006; 114:331-5. [PMID: 16715205 DOI: 10.1007/s00702-006-0518-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2006] [Accepted: 04/19/2006] [Indexed: 10/24/2022]
Abstract
In idiopathic Parkinson's disease (PD), a tremor-dominant type (TDT), an akinetic-rigid type (ART), and a mixed type (MT) are distinguished. We compared cerebral [I-123]FP-CIT SPECT in the PD subtypes (67 patients Hoehn and Yahr stage 1:26 with ART, 19 with MT, 22 with TDT). We measured the ratios putamen/occipital lobe binding and caudate nucleus/occipital lobe binding. Parkinsonian motor symptoms were quantified by UPDRS motor scale. In both putamen and caudate nucleus contralateral to the clinically affected body side TDT patients showed a significantly higher FP-CIT uptake than ART or MT patients (ANOVA; p<0.01). Contralateral putamen and caudate nucleus FP-CIT uptake correlated significantly with severity of rigidity (p<0.01) and hypokinesia (p<0.01) but not with severity of resting or postural tremor (p>0.05). The missing correlation between striatal FP-CIT uptake and tremor suggests, that further systems besides the nigrostriatal dopaminergic system may contribute to generation of parkinsonian tremor.
Collapse
Affiliation(s)
- J Spiegel
- Department of Neurology, Saarland University, Homburg/Saar, Germany
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Spiegel J, Krick C, Fuss G, Becker G, Dillmann U. Orthostatic tremor during modification of standing. KLIN NEUROPHYSIOL 2006. [DOI: 10.1055/s-2006-939294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
35
|
Storch A, Jost W, Vieregge P, Spiegel J, Greulich W, Durner J, Müller T, Kupsch A, Henningsen H, Oertel W, Fuchs G, Kuhn W, Niklowitz P, Herting B, Reichmann H. Multizentrische, plazebokontrollierte, randomisierte Doppelblindstudie: Coenzym Q10-Nanodispersion versus Plazebo zur symptomatischen Therapie von Patienten mit Morbus Parkinson. Akt Neurol 2005. [DOI: 10.1055/s-2005-919517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
36
|
Hochstrasser H, Bauer P, Walter U, Behnke S, Spiegel J, Csoti I, Zeiler B, Bornemann A, Pahnke J, Becker G, Riess O, Berg D. Ceruloplasmin gene variations and substantia nigra hyperechogenicity in Parkinson disease. Neurology 2005; 63:1912-7. [PMID: 15557511 DOI: 10.1212/01.wnl.0000144276.29988.c3] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Transcranial ultrasound may be used to detect increased iron levels of the substantia nigra (SN) in patients with Parkinson disease (PD) and in control subjects. It is not known whether iron accumulation in PD is a primary or secondary phenomenon. However, sequence variations in genes involved in iron metabolism have been linked to basal ganglia disorders. One of these is ceruloplasmin (Cp), which is vitally involved in iron transport across the cell membrane. METHODS One hundred seventy-six patients with PD according to the UK Brain Bank criteria and 180 ethnically matched control subjects, who were previously examined for SN iron signal changes by transcranial ultrasound, were examined for mutations in the Cp gene using denaturing high-performance liquid chromatography and subsequent sequencing for verification of unequivocal signals. Immunohistochemistry of PD midbrains was performed to examine the presence of Cp in Lewy bodies. RESULTS Five novel missense variations were detected. One of these (I63T) was found in a single PD patient. A known variation (D554E) was significantly associated with PD and the ultrasound marker for increased SN iron levels. Moreover, a third sequence variation (R793H) was found to segregate with the ultrasound marker for increased iron levels in patients and control subjects. Immunohistochemistry demonstrated that Cp co-localizes with Lewy bodies in PD. CONCLUSIONS Detection of sequence variations in a single Parkinson disease (PD) patient or associated with the ultrasound marker for increased substantia nigra iron levels and the presence of ceruloplasmin (Cp) immunoreactivity in Lewy bodies underline a suspected role for Cp in the pathogenesis of PD. Further functional analyses are warranted to investigate whether these variations are causally linked to the complex pathogenesis of PD in a subset of cases.
Collapse
Affiliation(s)
- H Hochstrasser
- Institute for Medical Genetics, University of Tuebingen, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Dillmann U, Spiegel J. [The 10-minute office visit. Differential diagnosis of tremor. The hands shake -- Parkinson?]. MMW Fortschr Med 2005; 147:59-60. [PMID: 15934595] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- U Dillmann
- Neurologische Klinik, Universitätsklinikum des Saarlandes, Homburg, Saar
| | | |
Collapse
|
38
|
Hochstrasser H, Tomiuk J, Walter U, Behnke S, Spiegel J, Krüger R, Becker G, Rieß O, Berg D. Funktionelle Relevanz von Ceruloplasmin-Mutationen für das idiopathische Parkinson-Syndrom. Akt Neurol 2005. [DOI: 10.1055/s-2005-866621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
39
|
Reichmann H, Storch A, Jost W, Vieregge P, Spiegel J, Greulich W, Durner J, Müller T, Kupsch A, Henningsen H, Oertel W, Fuchs G, Kuhn W. Coenzym Q10-Nanodispersion versus Plazebo zur symptomatischen Therapie von Patienten mit Morbus Parkinson. Eine multizentrische, plazebokontrollierte, randomisierte Doppelblindstudie. Akt Neurol 2005. [DOI: 10.1055/s-2005-866699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
40
|
Spiegel J, Möllers M, Jost W, Fuss G, Samnick S, Dillmann U, Becker G, Kirsch C. FP-CIT-SPECT und MIBG-Szintigraphie im Anfangsstadium des idiopathischen Parkinson-Syndroms. Akt Neurol 2005. [DOI: 10.1055/s-2005-866703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
41
|
Spiegel J, Behnke S, Fuss G, Becker G, Dillmann U. Echogenic substantia nigra in patients with orthostatic tremor. J Neural Transm (Vienna) 2004; 112:915-20. [PMID: 15526141 DOI: 10.1007/s00702-004-0236-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2004] [Accepted: 09/11/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Previous studies suggest that the nigrostriatal dopaminergic transmission is impaired in patients with primary orthostatic tremor. METHODS We used transcranial sonography (TCS) to examine the morphology of the substantia nigra (SN) in four patients with primary orthostatic tremor (OT). RESULTS TCS revealed an SN echogenicity in all patients, in three patients unilaterally, in one patient bilaterally. CONCLUSIONS Our data suggest nigrostriatal dopaminergic deficits in OT patients. The exact impact of these dopaminergic deficits on OT generation is unclear.
Collapse
Affiliation(s)
- J Spiegel
- Department of Neurology, University of the Saarland, Homburg, Saar, Germany.
| | | | | | | | | |
Collapse
|
42
|
Abstract
Dementia induced by Hashimoto's encephalopathy (HE) seems to be a rare condition. We report on two patients, who revealed a syndrome consisting of a rapid progressive dementia with myocloni. In both patients, the detection of antithyroid antibodies enabled the diagnosis of HE. The symptoms receded completely during a high-dose glucocorticoid therapy. In patients with rapidly progressive dementia or with dementia of unknown origin, HE should be considered.
Collapse
Affiliation(s)
- J Spiegel
- Department of Neurology, University of the Saarland, Homburg/Saar, Germany.
| | | | | | | |
Collapse
|
43
|
Spiegel J, Fuss G, Becker G, Dillmann U. Orthostatic Tremor during Modification of Stance. KLIN NEUROPHYSIOL 2004. [DOI: 10.1055/s-2004-832179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
44
|
Abstract
OBJECTIVE Primary orthostatic tremor (OT) is thought to be generated by a unique supraspinal tremor generator. Here we studied the effect of ipsi- and contralateral stimulation of the central and peripheral nervous system on OT. METHODS In 7 patients with primary OT, surface EMG was recorded from both tibialis anterior muscles. We performed transcranial magnetic stimulation (TMS) over the vertex, and lumbar magnetic stimulation (LMS) over the lumbar spine. Supramaximal electrical nerve stimuli were applied to the tibial or peroneal nerve at the knee. Proprioceptive input was evoked by rhythmical submaximal stimulation of the tibial, peroneal or sural nerve at the ankle. RESULTS TMS reset OT significantly in the contralateral as well as the ipsilateral tibialis anterior muscle. The resetting in both muscles was identical. In contrast, peripheral input by means of LMS, supra- or submaximal nerve stimulation had no impact on OT. CONCLUSIONS Transcranial magnetic stimulation of one cortical leg area resets OT in both legs whereas OT is not modified by any peripheral stimuli applied in this study. SIGNIFICANCE Our results support the hypothesis of n unique supraspinal OT generator. This generator receives a modulating input from the motor cortex.
Collapse
Affiliation(s)
- J Spiegel
- Department of Neurology, University of the Saarland, Homburg/Saar, D-66421 Germany.
| | | | | | | |
Collapse
|
45
|
Deplazes J, Schöbel K, Hochstrasser H, Bauer P, Walter U, Behnke S, Spiegel J, Becker G, Riess O, Berg D. Screening for mutations of the IRP2 gene in Parkinson?s disease patients with hyperechogenicity of the substantia nigra. J Neural Transm (Vienna) 2004; 111:515-21. [PMID: 15057521 DOI: 10.1007/s00702-004-0125-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2003] [Accepted: 01/26/2004] [Indexed: 11/24/2022]
Abstract
IRP2 plays an important role in brain iron metabolism. We recently identified an increased amount of iron in patients with Parkinson's disease (PD) and hyperchogenicity of the substantia nigra (SN). Therefore, the IRP2 gene was screened for mutations in 176 PD patients with increased echogenicity of the SN. We identified one non-synonymous polymorphism (I888V) in exon 21 and a -88C > T polymorphism in the promoter region of IRP2 at similar frequencies in patients and controls without increased SN iron levels. In one patient a -74C > T variation was found which was not present in the control group. Our data indicate that mutations in the IRP2 gene are not a common cause of PD associated with SN iron accumulation.
Collapse
Affiliation(s)
- J Deplazes
- Institute for Human Genetics, University of Tübingen, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Fuss G, Spiegel J, Magnus T, Moringlane JR, Becker G, Dillmann U. Improvement of Apraxia of Lid Opening by STN-Stimulation in a 70-Year-Old Patient with Parkinson's Disease. ACTA ACUST UNITED AC 2004; 47:58-60. [PMID: 15100935 DOI: 10.1055/s-2003-812466] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report on a 70-year-old female patient with Parkinson's disease, who showed an improvement of a preexisting apraxia of lid opening on electrical impulses, so-called deep brain stimulation (DBS) delivered to the subthalamic nucleus (STN). This was not described by any other authors before. Up to now, the appearance of apraxia of lid opening was observed only as a side effect after deep brain stimulation in the nucleus subthalamicus. We suggest that these differences may be due to the region of the nucleus subthalamicus that is influenced by the stimulation.
Collapse
Affiliation(s)
- G Fuss
- Department of Neurology, Saarland University, Homburg/Saar, Germany.
| | | | | | | | | | | |
Collapse
|
47
|
Spiegel J, Uhrig I, Fuß G, Krick C, Dillmann U. Ist die zeitliche Bewegungskoordination beim Morbus Parkinson beeinträchtigt? KLIN NEUROPHYSIOL 2003. [DOI: 10.1055/s-2003-816540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
48
|
Abstract
Neuropathological studies show frequent and extensive effects on the visual system in Creutzfeldt-Jakob disease (CJD), but deterioration of vision is not reported by all patients. We examined the function of the visual system by means of visual evoked potentials (VEP). We recorded monocular pattern-reversal VEP in six patients with sporadic CJD 1-13 months after first symptoms occurred. Three patients had normal vision, and in a further three, vision was impaired. All patients had pathological VEP with a delayed P100 component (six eyes) or loss of cortical response (five eyes). The patients with visual impairment vs those without were not different concerning VEP findings. The VEP are already pathological in initial CJD stages and point to an early effect on the visual system in CJD, irrespective of clinical visual deficits.
Collapse
Affiliation(s)
- J Spiegel
- Neurologische Klinik, Universitätskliniken des Saarlandes, Homburg/Saar, Germany
| | | | | |
Collapse
|
49
|
Abstract
It is increasingly well documented that a collaborative problem-solving approach is more effective in addressing workplace health concerns than an adversarial approach. Combining this with strategies based on good evidence is key to success. On this premise, a trial was conducted in British Columbia, beginning in July 1999, based on a collaborative approach in which healthcare workers and managers work together to identify and implement evidence-based initiatives to improve the health and working conditions of healthcare workers.
Collapse
Affiliation(s)
- Annalee Yassi
- Institute of Health Promotion Research, University of British Columbia
| | | | | | | | | |
Collapse
|
50
|
Sylvester J, Grimm P, Blasco J, Meier R, Spiegel J, Heaney C, Cavanagh W. The role of androgen ablation in patients with biochemical or local failure after definitive radiation therapy: a survey of practice patterns of urologists and radiation oncologists in the United States. Urology 2001; 58:65-70. [PMID: 11502452 DOI: 10.1016/s0090-4295(01)01244-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To identify therapeutic patterns for putative prostate cancer treatment failures and the role played by androgen ablation therapy in these patients, a questionnaire study was undertaken with urologists and radiation oncologists who had attended a brachytherapy forum at the Seattle Prostate Institute (SPI). Hypothetical questions were asked about recommendations the physicians would give to a patient demonstrating biochemical or local failure after external-beam radiation therapy. Most of the physicians queried were in private practice; 53% were radiation oncologists and 47% were urologists. The respondents' recommendations for a hypothetical patient, who was 45 to 65 years of age, with a biopsy-proven local recurrence was treatment with androgen ablation (35% of respondents), radical prostatectomy (25%), interstitial brachytherapy (20%), and observation (19%). In the 65- to 75-year-old patient with a local recurrence, the respondents recommended observation (43%), androgen ablation (35%), interstitial brachytherapy (17%), and radical prostatectomy (4%). In patients receiving androgen ablation for a biochemical failure alone, there was no consensus on whether to use luteinizing hormone-releasing hormone agonist alone, total androgen ablation, orchiectomy, or intermittent androgen ablation. Criteria that prompted physicians to initiate androgen ablation were based on the rate of prostate-specific antigen (PSA) increase (67%), an absolute PSA number (24%), or clinical failure (9%). In the younger patient with a local recurrence, local intervention with radical prostatectomy or interstitial brachytherapy was recommended most often, followed by androgen ablation, then by observation. In the older patient, observation was recommended most often, followed closely by androgen ablation. Overall, there was a lack of consensus on how to deliver androgen ablation. However, there was remarkable agreement between urologists and radiation oncologists on virtually all issues queried.
Collapse
Affiliation(s)
- J Sylvester
- Seattle Prostate Institute, Seattle, Washington 98104, USA
| | | | | | | | | | | | | |
Collapse
|