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Bauer M, Hollenstein C, Lieb JM, Grassegger S, Haas T, Egloff L, Berger C, Scheurer E, Lenz C. Longitudinal visibility of MRI findings in living victims of strangulation. Int J Legal Med 2024:10.1007/s00414-024-03207-1. [PMID: 38561435 DOI: 10.1007/s00414-024-03207-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
Initial experiences with magnetic resonance imaging (MRI) of living strangulation victims demonstrated additional findings of internal injuries compared to the standard clinical forensic examination. However, existing studies on the use of MRI for this purpose mostly focused on the first 48 h after the incident. The aims of this study were (a) to evaluate the longitudinal visibility of MRI findings after violence against the neck by performing two MRI examinations within 12 days and a minimum of four days between both MRI scans and (b) to assess which MRI sequences were most helpful for the detection of injuries. Twenty strangulation victims participated in this study and underwent one (n = 8) or two (n = 12) MRI scans. The first MRI examination was conducted during the first five days, the second five to 12 days after the incident. Two blinded radiologists assessed the MRI data and looked for lesions in the structures of the neck. In total, 140 findings were reported in the 32 MRI examinations. Most of the findings were detected in the thyroid and the muscles of the neck. T2-weighted SPACE with fat suppression, T1-weighted TSE and T1-weighted MPRAGE were rated as the most helpful MRI sequences. Subjects who showed findings in the initial scan also demonstrated comparable results in the second scan, which was performed on average 8.4 days after the incident. Our results show that even up to 12 days after the incident, the criminal proceeding of strangulation cases may greatly profit from the information provided by an MRI examination of the neck in addition to the standard clinical forensic examination.
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Affiliation(s)
- Melanie Bauer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Pestalozzistrasse 22, Basel, 4056, Switzerland
- Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Christina Hollenstein
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Pestalozzistrasse 22, Basel, 4056, Switzerland
- Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Johanna Maria Lieb
- Division of Neuroradiology, Clinic of Radiology and Nuclear Medicine, Department of Theragnostics, University of Basel Hospital, Basel, Switzerland
| | - Sabine Grassegger
- Österreichische Gesundheitskasse im Gesundheitszentrum für Physikalische Medizin Liezen, Liezen, Austria
| | - Tanja Haas
- Division of Radiological Physics, Department of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland
| | - Laura Egloff
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Pestalozzistrasse 22, Basel, 4056, Switzerland
- Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Celine Berger
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Pestalozzistrasse 22, Basel, 4056, Switzerland
- Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Eva Scheurer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Pestalozzistrasse 22, Basel, 4056, Switzerland
- Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Claudia Lenz
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Pestalozzistrasse 22, Basel, 4056, Switzerland.
- Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland.
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2
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Zirn A, Scheurer E, Lenz C. Automated detection of fatal cerebral haemorrhage in postmortem CT data. Int J Legal Med 2024:10.1007/s00414-024-03183-6. [PMID: 38329584 DOI: 10.1007/s00414-024-03183-6] [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: 08/08/2023] [Accepted: 02/01/2024] [Indexed: 02/09/2024]
Abstract
During the last years, the detection of different causes of death based on postmortem imaging findings became more and more relevant. Especially postmortem computed tomography (PMCT) as a non-invasive, relatively cheap, and fast technique is progressively used as an important imaging tool for supporting autopsies. Additionally, previous works showed that deep learning applications yielded robust results for in vivo medical imaging interpretation. In this work, we propose a pipeline to identify fatal cerebral haemorrhage on three-dimensional PMCT data. We retrospectively selected 81 PMCT cases from the database of our institute, whereby 36 cases suffered from a fatal cerebral haemorrhage as confirmed by autopsy. The remaining 45 cases were considered as neurologically healthy. Based on these datasets, six machine learning classifiers (k-nearest neighbour, Gaussian naive Bayes, logistic regression, decision tree, linear discriminant analysis, and support vector machine) were executed and two deep learning models, namely a convolutional neural network (CNN) and a densely connected convolutional network (DenseNet), were trained. For all algorithms, 80% of the data was randomly selected for training and 20% for validation purposes and a five-fold cross-validation was executed. The best-performing classification algorithm for fatal cerebral haemorrhage was the artificial neural network CNN, which resulted in an accuracy of 0.94 for all folds. In the future, artificial neural network algorithms may be applied by forensic pathologists as a helpful computer-assisted diagnostics tool supporting PMCT-based evaluation of cause of death.
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Affiliation(s)
- Andrea Zirn
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Pestalozzistrasse 22, 4056, Basel, Switzerland
- Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Eva Scheurer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Pestalozzistrasse 22, 4056, Basel, Switzerland
- Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Claudia Lenz
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Pestalozzistrasse 22, 4056, Basel, Switzerland.
- Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland.
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Nolte S, Krüger K, Lenz C, Zentgraf K. Optimizing the Gut Microbiota for Individualized Performance Development in Elite Athletes. Biology (Basel) 2023; 12:1491. [PMID: 38132317 PMCID: PMC10740793 DOI: 10.3390/biology12121491] [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] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/23/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
The human gut microbiota can be compared to a fingerprint due to its uniqueness, hosting trillions of living organisms. Taking a sport-centric perspective, the gut microbiota might represent a physiological system that relates to health aspects as well as individualized performance in athletes. The athletes' physiology has adapted to their exceptional lifestyle over the years, including the diversity and taxonomy of the microbiota. The gut microbiota is influenced by several physiological parameters and requires a highly individual and complex approach to unravel the linkage between performance and the microbial community. This approach has been taken in this review, highlighting the functions that the microbial community performs in sports, naming gut-centered targets, and aiming for both a healthy and sustainable athlete and performance development. With this article, we try to consider whether initiating a microbiota analysis is practicable and could add value in elite sport, and what possibilities it holds when influenced through a variety of interventions. The aim is to support enabling a well-rounded and sustainable athlete and establish a new methodology in elite sport.
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Affiliation(s)
- Svenja Nolte
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, University of Giessen, 35394 Giessen, Germany; (K.K.); (C.L.)
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, University of Giessen, 35394 Giessen, Germany; (K.K.); (C.L.)
| | - Claudia Lenz
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, University of Giessen, 35394 Giessen, Germany; (K.K.); (C.L.)
| | - Karen Zentgraf
- Department 5: Psychology & Sports Sciences, Institute for Sports Sciences, Goethe University Frankfurt, 60323 Frankfurt am Main, Germany;
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4
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Berger C, Bauer M, Wittig H, Gerlach K, Scheurer E, Lenz C. Investigation of post mortem brain, rectal and forehead temperature relations. J Therm Biol 2023; 115:103615. [PMID: 37390676 DOI: 10.1016/j.jtherbio.2023.103615] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 07/02/2023]
Abstract
It is well known that magnetic resonance (MR) imaging is temperature sensitive, which is highly relevant for post mortem examinations. Therefore, the determination of the exact temperature of the investigated body site, e.g. the brain, is crucial. However, direct temperature measurements are invasive and inconvenient. Thus, in view of post mortem MR imaging of the brain, this study aims at investigating the relation between the brain and the forehead temperature for modelling the brain temperature based on the non-invasive forehead temperature. In addition, the brain temperature will be compared to the rectal temperature. Brain temperature profiles measured in the longitudinal fissure between the brain hemispheres, as well as rectal and forehead temperature profiles of 16 deceased were acquired continuously. Linear mixed, linear, quadratic and cubic models were fitted to the relation between the longitudinal fissure and the forehead and between the longitudinal fissure and the rectal temperature, respectively. Highest adjusted R2 values were found between the longitudinal fissure and the forehead temperature, as well as between the longitudinal fissure and the rectal temperature using a linear mixed model including the sex, environmental temperature and humidity as fixed effects. The results indicate that the forehead, as well as the rectal temperature, can be used to model the brain temperature measured in the longitudinal fissure. Comparable fit results were observed for the longitudinal fissure-forehead temperature relation and for the longitudinal fissure-rectal temperature relation. Combined with the fact that the forehead temperature overcomes the problem of measurement invasiveness, the results suggest using the forehead temperature for modelling the brain temperature in the longitudinal fissure.
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Affiliation(s)
- Celine Berger
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Melanie Bauer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Holger Wittig
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Kathrin Gerlach
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Eva Scheurer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Claudia Lenz
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland.
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Berger C, Bauer M, Scheurer E, Lenz C. Temperature correction of post mortem quantitative magnetic resonance imaging using real-time forehead temperature acquisitions. Forensic Sci Int 2023; 348:111738. [PMID: 37263059 DOI: 10.1016/j.forsciint.2023.111738] [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: 12/22/2022] [Revised: 04/24/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
Performing magnetic resonance imaging (MRI) of deceased is challenging due to altered body temperatures compared to in vivo temperatures and, hence, requires a temperature correction. This study investigates the possibility to correct brain MRI parameters real-time and non invasively based on the forehead temperature. 17 post mortem cases were included and their forehead temperatures were measured continuously during the in situ brain MRI protocol consisting of a diffusion tensor imaging, multi-contrast spin echo, multi-echo gradient echo and inversion recovery spin echo sequence. Linear models were fitted to the quantitative MRI parameters in a forensically interesting temperature range for white matter, cerebral cortex and deep gray matter, separately, and the influence of the forehead temperature on the MRI parameters was determined. A statistically significant temperature sensitivity was found for T2 and mean diffusivity in white matter, for T1 in cerebral cortex, as well as for T1 and mean diffusivity in deep gray matter. Linear models were computed to temperature correct these MRI parameters in in situ post mortem scans to allow their comparison regardless of temperature. The here presented real-time and non invasive temperature correction method for the brain presents a crucial precondition for quantitative in situ post mortem MRI.
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Affiliation(s)
- Celine Berger
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Melanie Bauer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Eva Scheurer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Claudia Lenz
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland.
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6
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Neuhaus D, Wittig H, Scheurer E, Lenz C. Fully automated radiologic identification focusing on the sternal bone. Forensic Sci Int 2023; 346:111648. [PMID: 36996581 DOI: 10.1016/j.forsciint.2023.111648] [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] [Received: 12/20/2022] [Revised: 02/24/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
A crucial task in forensic investigations is the identification of unknown deceased. In general, secure identification methods rely on a comparison of ante mortem (AM) with post mortem (PM) data. However, available morphologic approaches are often dependent on the expertise and experience of the examiner, and often lack standardisation and statistical evidence. The objective of this study was therefore to overcome the current challenges via developing a fully automated radiologic identification (autoRADid) method based on the sternal bone. An anonymised AM data set consisting of 91 chest computed tomography (CT) scans, as well as an anonymised PM data set of 42 chest CT scans were included in this work. Out of the 91 available AM CT data sets, 42 AM scans corresponded to the 42 PM CT scans. For the fully automated identification analysis, a custom-made python pipeline was developed, which automatically registers AM data to the PM data in question using a two-step registration method. To evaluate the registration procedure and subsequent identification success, the image similarity measures Jaccard Coefficient, Dice Coefficient, and Mutual Information were computed. The highest value for each metric was retrieved in order to analyse the correspondence between AM and PM data. For all three similarity measures, 38 out of the 42 cases were matched correctly. This corresponds to an accuracy of 91.2%. The four unsuccessful cases incorporated surgical interventions taking place between the AM and the PM CT acquisition or poor CT scan quality preventing robust registration results. To conclude, the presented autoRADid method seems to be a promising fully automated tool for a reliable and facile identification of unknown deceased. A final pipeline combining all three similarity measures is open source and publicly available for efficient future identifications of unknown deceased.
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Berger C, Birkl C, Bauer M, Scheurer E, Lenz C. Technical note: Quantitative optimization of the FLAIR sequence in post mortem magnetic resonance imaging. Forensic Sci Int 2022; 341:111494. [DOI: 10.1016/j.forsciint.2022.111494] [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] [Received: 07/11/2022] [Revised: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 11/29/2022]
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8
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Bauer M, Berger C, Gerlach K, Scheurer E, Lenz C. Post mortem evaluation of brain edema using quantitative MRI. Forensic Sci Int 2022; 337:111376. [DOI: 10.1016/j.forsciint.2022.111376] [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] [Received: 01/18/2022] [Revised: 05/30/2022] [Accepted: 06/26/2022] [Indexed: 11/30/2022]
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9
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Lackermair K, Fischer F, Manhart J, Scheurer E, Graw M, Boy D, Lenz C, Hartrampf B, Kellnar A, Sams L, Estner H, Fichtner S. Determination of time of death by blinded post-mortem interrogation of cardiac implantable electrical devices. Sci Rep 2022; 12:8199. [PMID: 35581374 PMCID: PMC9112646 DOI: 10.1038/s41598-022-12390-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 04/29/2022] [Indexed: 12/02/2022] Open
Abstract
Postmortal interrogation of cardiac implantable electrical devices (CIED) may contribute to the determination of time of death in forensic medicine. Recent studies aimed to improve estimation of time of death by combining findings from autopsy, CIED interrogation and patients´ medical history. CIED from deceased undergoing forensic autopsy were included, if time of death remained unclear after forensic assessment. CIED explanted from deceased with known time of death were analysed as a control cohort. CIED were sent to our device interrogation lab and underwent analysis blinded for autopsy findings, medical history and police reports. The accuracy of time of death determination and the accuracy of time of death in the control cohort served as primary outcome. A total of 87 CIED were analysed. The determination of time of death was possible in 54 CIED (62%, CI 52–72%). The accuracy of the estimated time of death was 92.3% in the control cohort. Certain CIED type and manufacturers were associated with more successful determination. Blinded postmortal analysis enables a valid determination of the time of death in the majority of CIED. Analysis of explanted CIED in a cardiological core lab is feasible and should be implemented in forensic medicine.
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Affiliation(s)
- Korbinian Lackermair
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Marchioninistr. 15, 81377, Munich, Germany.
| | - Florian Fischer
- Institute of Legal Medicine, Ludwig-Maximilian University, Munich, Germany
| | - Johannes Manhart
- Institute of Legal Medicine, Rostock University Medical Center, Rostock, Germany
| | - Eva Scheurer
- Department of Biomedical Engineering, Institute of Forensic Medicine, University of Basel, Basel, Switzerland.,Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Matthias Graw
- Institute of Legal Medicine, Ludwig-Maximilian University, Munich, Germany
| | - Diana Boy
- Institute of Legal Medicine, Rostock University Medical Center, Rostock, Germany
| | - Claudia Lenz
- Department of Biomedical Engineering, Institute of Forensic Medicine, University of Basel, Basel, Switzerland.,Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Bonnie Hartrampf
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Marchioninistr. 15, 81377, Munich, Germany
| | - Antonia Kellnar
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Marchioninistr. 15, 81377, Munich, Germany
| | - Lauren Sams
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Marchioninistr. 15, 81377, Munich, Germany
| | - Heidi Estner
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Marchioninistr. 15, 81377, Munich, Germany
| | - Stephanie Fichtner
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Marchioninistr. 15, 81377, Munich, Germany
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Penzel N, Sanfelici R, Antonucci LA, Betz LT, Dwyer D, Ruef A, Cho KIK, Cumming P, Pogarell O, Howes O, Falkai P, Upthegrove R, Borgwardt S, Brambilla P, Lencer R, Meisenzahl E, Schultze-Lutter F, Rosen M, Lichtenstein T, Kambeitz-Ilankovic L, Ruhrmann S, Salokangas RKR, Pantelis C, Wood SJ, Quednow BB, Pergola G, Bertolino A, Koutsouleris N, Kambeitz J, Dwyer D, Ruef A, Kambeitz-Ilankovic L, Sen Dong M, Erkens A, Gussmann E, Haas S, Hasan A, Hoff C, Khanyaree I, Melo A, Muckenhuber-Sternbauer S, Kohler J, Ozturk OF, Popovic D, Rangnick A, von Saldern S, Sanfelici R, Spangemacher M, Tupac A, Urquijo MF, Weiske J, Wosgien A, Kambeitz J, Ruhrmann S, Rosen M, Betz L, Lichtenstein T, Blume K, Seves M, Kaiser N, Penzel N, Pilgram T, Lichtenstein T, Wenzel J, Woopen C, Borgwardt S, Andreou C, Egloff L, Harrisberger F, Lenz C, Leanza L, Mackintosh A, Smieskova R, Studerus E, Walter A, Widmayer S, Upthegrove R, Wood SJ, Chisholm K, Day C, Griffiths SL, Lalousis PA, Iqbal M, Pelton M, Mallikarjun P, Stainton A, Lin A, Salokangas RKR, Denissoff A, Ellila A, From T, Heinimaa M, Ilonen T, Jalo P, Laurikainen H, Lehtinen M, Luutonen A, Makela A, Paju J, Pesonen H, Armio Säilä RL, Sormunen E, Toivonen A, Turtonen O, Solana AB, Abraham M, Hehn N, Schirmer T, Brambilla P, Altamura C, Belleri M, Bottinelli F, Ferro A, Re M, Monzani E, Percudani M, Sberna M, D’Agostino A, Del Fabro L, Perna G, Nobile M, Alciati A, Balestrieri M, Bonivento C, Cabras G, Fabbro F, Garzitto M, PiCCuin S, Bertolino A, Blasi G, Antonucci LA, Pergola G, Caforio G, Faio L, Quarto T, Gelao B, Romano R, Andriola I, Falsetti A, Barone M, Passatiore R, Sangiuliano M, Lencer R, Surman M, Bienek O, Romer G, Dannlowski U, Meisenzahl E, Schultze-Lutter F, Schmidt-Kraepelin C, Neufang S, Korda A, Rohner H. Pattern of predictive features of continued cannabis use in patients with recent-onset psychosis and clinical high-risk for psychosis. Schizophrenia (Heidelb) 2022; 8:19. [PMID: 35264631 PMCID: PMC8907166 DOI: 10.1038/s41537-022-00218-y] [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] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/31/2022] [Indexed: 11/09/2022]
Abstract
Continued cannabis use (CCu) is an important predictor for poor long-term outcomes in psychosis and clinically high-risk patients, but no generalizable model has hitherto been tested for its ability to predict CCu in these vulnerable patient groups. In the current study, we investigated how structured clinical and cognitive assessments and structural magnetic resonance imaging (sMRI) contributed to the prediction of CCu in a group of 109 patients with recent-onset psychosis (ROP). We tested the generalizability of our predictors in 73 patients at clinical high-risk for psychosis (CHR). Here, CCu was defined as any cannabis consumption between baseline and 9-month follow-up, as assessed in structured interviews. All patients reported lifetime cannabis use at baseline. Data from clinical assessment alone correctly classified 73% (p < 0.001) of ROP and 59 % of CHR patients. The classifications of CCu based on sMRI and cognition were non-significant (ps > 0.093), and their addition to the interview-based predictor via stacking did not improve prediction significantly, either in the ROP or CHR groups (ps > 0.065). Lower functioning, specific substance use patterns, urbanicity and a lack of other coping strategies contributed reliably to the prediction of CCu and might thus represent important factors for guiding preventative efforts. Our results suggest that it may be possible to identify by clinical measures those psychosis-spectrum patients at high risk for CCu, potentially allowing to improve clinical care through targeted interventions. However, our model needs further testing in larger samples including more diverse clinical populations before being transferred into clinical practice.
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Affiliation(s)
- Nora Penzel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Rachele Sanfelici
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany
| | - Linda A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Department of Education, Psychology, Communication, University of Bari, Bari, Italy
| | - Linda T Betz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Kang Ik K Cho
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul Cumming
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland.,School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.,International Research Lab in Neuropsychiatry, Neuroscience Research Institute, Samara State Medical University, Samara, Russia
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.,MRC London Institute of Medical Sciences, Hammersmith Hospital, London, W12 0NN, UK.,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK.,South London and Maudsley NHS Foundation Trust, London, SE5 8AF, UK
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK.,Early Intervention Service, Birmingham Womens and Childrens NHS Foundation Trust, Birmingham, UK
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCUS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.,Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.,Otto Creutzfeldt Center for Behavioral and Cognitive Neuroscience, University of Münster, Münster, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marlene Rosen
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
| | - Theresa Lichtenstein
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Stephan Ruhrmann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Stephen J Wood
- Institute for Mental Health, University of Birmingham, Birmingham, UK.,Orygen, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstr. 31, 8032, Zurich, Switzerland
| | - Giulio Pergola
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Alessandro Bertolino
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany.,Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - Joseph Kambeitz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany.
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11
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Lenz C, Berger C, Bauer M, Scheurer E, Birkl C. Sensitivity of fiber orientation dependent R 2 ∗ to temperature and post mortem interval. Magn Reson Med 2021; 86:2703-2715. [PMID: 34086354 DOI: 10.1002/mrm.28874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/27/2020] [Revised: 04/23/2021] [Accepted: 05/10/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE R 2 ∗ imaging of brain white matter is well known for being sensitive to the orientation of nerve fibers with respect to the B0 field of the MRI scanner. The goal of this study was to evaluate whether and to which extent fiber orientation dependent R 2 ∗ differs between in vivo and post mortem in situ examinations, and to investigate the influence of varying temperatures and post mortem intervals (PMI). METHODS Post mortem in situ and in vivo MRI scans were conducted at 3T. R 2 ∗ was acquired with a multi-echo gradient-echo sequence, and the orientation of white matter fibers was computed using diffusion tensor imaging (DTI). Fitting of the measured fiber orientation dependent R 2 ∗ was performed using three different formulations of a previously proposed model. RESULTS R 2 ∗ increased with increasing fiber angle for in vivo and post mortem in situ examinations, whereby the orientation dependency was lower post mortem. The different formulations of the fiber orientation model resulted in an identical fit, but showed large variations of the estimated parameters. The higher order orientation dependent R 2 ∗ components significantly decreased with decreasing temperature, while the orientation independent R 2 ∗ components showed no significant correlation with either temperature or PMI. CONCLUSION Although the mean diffusivity is strongly reduced post mortem, we could successfully estimate the fiber angle using DTI. Due to the strong correlation of the higher order orientation dependent R 2 ∗ components with temperature, the decreased R 2 ∗ fiber orientation dependency post mortem in situ might primarily be attributed to the lower brain temperature.
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Affiliation(s)
- Claudia Lenz
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Celine Berger
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Melanie Bauer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Eva Scheurer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland.,Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Christoph Birkl
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria
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12
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Sommer P, Spitzer S, Brachmann J, Janssen G, Lenz C, Luik A, Sarver A, Szili-Torok T. Final results from the EU focal impulse and rotor modulation (E-FIRM) registry. Europace 2021. [DOI: 10.1093/europace/euab116.089] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Abbott
Background
The exact pathophysiology of how pulmonary vein (PV) triggers initiate or maintain episodes of atrial fibrillation (AF) has been elusive. Catheter ablation at relatively circumscribed areas of rapidly spinning rotors or very rapid focal impulse formation can significantly affect AF. Targeted ablation of these sources using Focal Impulse and Rotor Modulation (FIRM™) shows promise.
Purpose
To assess the safety and effectiveness of FIRM-guided procedures for the treatment of any type of symptomatic atrial fibrillation (AF).
Methods
Two hundred and ninety-nine subjects were enrolled in the E-FIRM Registry at 9 clinical sites in Germany and the Netherlands. Subjects were eligible if they had reported incidence of at least 2 documented episodes of symptomatic AF during the preceding 3 months and had failed at least Class I or III anti-arrhythmia drug. Data was collected at enrollment/baseline, procedure, and at 3-, 6-, and 12-month follow-up visits.
Results
A majority (59.5%, 178/299) had a history of previous ablation, 81.1% (133/164) in the left side, with an average of 1.5 ± 0.8 [range 0, 5] prior ablations. The primary safety endpoint was defined as freedom from procedure related Serious Adverse Events (SAEs) through 7-days and at 12-months. At 7-days, freedom from procedure related SAEs was 94.8% (257/271). At 12-months, freedom from procedure related SAEs was 84.4% (184/218). There were no deaths. Acute effectiveness success, defined as the elimination of all identified rotors, occurred in 64.0% (165/258) of treated patients. All patients for which data was reported had at least 1 rotor identified. The most common regions to find rotors were the lateral wall of the right atrium, the anterior/septal wall of the left atrium, and the posterior inferior region of the left atrium. 75.2% (194/258) of patients had at least one rotor identified in the right atrium, and 84.1% (217/258) of patients had at least one rotor identified in the left atrium. Success was defined as two sequential endpoints: single procedure freedom from AF recurrence at 3-months and single procedure freedom from AF recurrence. At 12-months, success was achieved in 46.4% (13/28) Paroxysmal, 42.9% (87/203) Persistent, and 0% (0/9) Long Standing AF subjects. Conclusions: Since acute success was reported as being achieved in only ∼2/3 of the treated subjects, it is possible that the full potential benefit of the FIRM-guided ablation was hidden in this evaluation of the full cohort. Considering the previous ablation and disease history of subjects, a single-procedure success rate at 12-months over 40% was considered a positive result. Based on these results, FIRM-guided RF ablation in conjunction with conventional RF ablation practices is both a safe and effective treatment strategy for patients with symptomatic AF.
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Affiliation(s)
- P Sommer
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - S Spitzer
- Praxis Klinik-Dresden, Dresden, Germany
| | | | - G Janssen
- Kardiologische Gemeinschaftspraxis am Park Sanssouci, Potsdam, Germany
| | - C Lenz
- UKB Berlin, Berlin, Germany
| | - A Luik
- Stadtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - A Sarver
- Abbott Laboratories, Plymouth, United States of America
| | - T Szili-Torok
- Erasmus University Medical Centre, Rotterdam, Netherlands (The)
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Proff J, Merkely B, Papp R, Lenz C, Nordbeck P, Butter CH, Meyerhoefer J, Doering M, Maccarter DJ, Ingel K, Thouet TH, Roser M. Closed loop stimulation in heart failure patients with severe chronotropic incompetence: responder versus non-responders. Europace 2021. [DOI: 10.1093/europace/euab116.442] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Biotronik SE & Co. KG Woermannkehre 1 12359 Berlin
Background
The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. Rate-adaptive pacing (RAP) is an important treatment option for CI. However, only a proportion of HF patients treated with cardiac resynchronisation therapy (CRT) devices benefit from accelerometer-based RAP in terms of exercise tolerance, functional capacity, and quality of life (QoL). Further research is needed to identify patient characteristics predicting positive response to RAP, and to evaluate performance of alternative sensors such as closed loop stimulation (CLS) driven by cardiac impedance measurements. An optimal outcome measure is represented by ventilatory efficiency (VE) slope during cardio-pulmonary exercise test (CPX) because of superior prognostic value.
Purpose
The purpose of the BIO|Create pilot study was to assess the benefit of CLS in CRT patients with CI. In this predefined subanalysis, we identify predictors of positive response to CLS (reduction of VE slope by ≥5%) and compare study outcomes in responders vs non-responders.
Methods
The study enrolled CRT patients with NYHA class II or III and severe CI (<75% of age-predicted maximum heart rate [HR] or <50% of HR reserve utilised at end-exercise). Patients were randomised to DDD-CLS mode or to DDD pacing at 40 beats/min for 1 month, followed by crossover for another month. At 1- and 2-month follow-ups, exercise tolerance was assessed by treadmill CPX, functional capacity by 6-min walk test, and QoL by the EQ-5D-5L and Minnesota Living with HF (MLHFQ) questionnaires.
Results
Among 17 patients with full follow-up datasets, 8 (47%) were responders to CLS. Compared to non-responders, responders had larger left ventricular (LV) ejection fraction at baseline (46 ± 3 vs 36 ± 9 %; p = 0.0070), smaller end-diastolic (121 ± 34 vs 181 ± 41 ml; p = 0.0085) and end-systolic (65 ± 23 vs 114 ± 39 ml; p = 0.0076) LV volumes, and were predominantly in NYHA class II (p = 0.0498). For study outcomes, the mean difference between DDD-CLS and DDD-40 modes in responders vs non-responders was - 6.1 (-16.4%) vs +2.7 (+6.8%) for VE slope (both p < 0.05), +0.5 vs -0.2 ml/min (O2 uptake efficiency slope), +1.3 vs -0.3 ml/kg/min (peak O2 uptake), +1.4 vs -0.75 mmHg (end-exercise end-tidal CO2), 16 vs 7 m (6-min walk distance), 0.08 vs 0.06 (EQ-5D-5L index), 1.9 vs 0 (EQ-5D-5L scale), and -2.5 vs +1.75 (MLHFQ).
Conclusions
For the first time, predictors for positive outcome of RAP in CRT patients have been identified. Patients with less advanced HF were responders to RAP driven by CLS principle. In addition, a consistent increase in exercise and functional capacity and QoL in these patients could be achieved. In contrast, patients with advanced HF experienced worse exercise capacity and QoL during RAP, suggesting caution if RAP is desirable due to CI. Further clinical research is needed to evaluate if positive response to RAP can improve hard clinical outcomes.
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Affiliation(s)
- J Proff
- Charite Universitatsmedizin Berlin, Berlin, Germany
| | - B Merkely
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - R Papp
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - C Lenz
- UKB Berlin, Berlin, Germany
| | - P Nordbeck
- University Hospital Wuerzburg, Wuerzburg, Germany
| | - CH Butter
- Brandenburg Heart Center, Bernau bei Berlin, Germany
| | - J Meyerhoefer
- Maria Heimsuchung Caritas-Clinic Pankow, Berlin, Germany
| | - M Doering
- Heart Center of Leipzig, Leipzig, Germany
| | - DJ Maccarter
- Castle Pines , Castle Point Circle, United States of America
| | - K Ingel
- Biotronik SE & Co. KG, Berlin, Germany
| | - TH Thouet
- Charite Universitatsmedizin Berlin, Berlin, Germany
| | - M Roser
- Charite Universitatsmedizin Berlin, Berlin, Germany
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14
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Bauer M, Deigendesch N, Wittig H, Scheurer E, Lenz C. Tissue sample analysis for post mortem determination of brain edema. Forensic Sci Int 2021; 323:110808. [PMID: 33971505 DOI: 10.1016/j.forsciint.2021.110808] [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: 01/11/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
The post mortem evaluation of a brain edema is routinely performed by pathologists based on the macroscopic signs during autopsy. This method represents the current gold standard, but is subjective and observer dependent. Therefore, three post mortem evaluation methods of brain samples were analyzed in this work: histology, wet-dry weight and normalized cerebral weight, which was described in 2020 by Bauer et al. Tissue samples from six different regions of 34 brains were collected and examined both by rating of histological slides and by measuring the water content by using a drying oven. The rating of the histological slides, stained with hematoxylin and eosin, was performed by two pathologists independently. For the water content, the wet weight and the dry weight of each sample were set in relation. The normalized cerebral weight was calculated by dividing the brain weight by the brain volume, which were both determined during autopsy and in computed tomography images, respectively. A fair to moderate interrater agreement was obtained for the histologic evaluation and a significant correlation was present between one rater and the wet-dry weight and the normalized cerebral weight method. When classifying according to the gold standard, a significant difference was detected between the edematous and nonedematous cases by using the wet-dry weight method in the cerebral cortex and by using the normalized cerebral weight method. However, the significant correlations and group differences were limited to the aforementioned results. In conclusion, both the histological and the wet-dry weight method show limited benefits for the classification of brain edema and the histology analysis is highly observer dependent. The normalized cerebral weight method, however, reveals a significant effect between the edematous and nonedematous cases when classifying according to the gold standard. Therefore, we suggest to apply this method for the assessment of brain edema since it is objective and rater independent. Nevertheless, the exact evaluation of brain edema remains a challenging task, especially due to the continuous transition between no edema and edema.
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Affiliation(s)
- Melanie Bauer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland.
| | - Nikolaus Deigendesch
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Holger Wittig
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Eva Scheurer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Claudia Lenz
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
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15
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Proff J, Merkely B, Papp R, Lenz C, Nordbeck P, Butter C, Meyerhoefer J, MacCarter D, Thouet T, Roser M. Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0803] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI.
Purpose
This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients.
Methods
A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL.
Results
Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13).
Conclusion
First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG
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Affiliation(s)
- J Proff
- Charite Universitatsmedizin Berlin, Berlin, Germany
| | - B Merkely
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - R Papp
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - C Lenz
- UKB Berlin, Berlin, Germany
| | - P.J Nordbeck
- University Hospital Wuerzburg, Wuerzburg, Germany
| | - C.H Butter
- Brandenburg Heart Center, Bernau bei Berlin, Germany
| | - J Meyerhoefer
- Maria Heimsuchung Caritas-Clinic Pankow, Berlin, Germany
| | - D MacCarter
- Shape Medical System Inc., Denver, United States of America
| | - T.H Thouet
- Charite Universitatsmedizin Berlin, Berlin, Germany
| | - M Roser
- Charite Universitatsmedizin Berlin, Berlin, Germany
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16
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Schenk S, Terne A, Keweloh B, Lenz C, Zacharzowsky U, Fritzsche D. Combination of cryothermy with radiofrequency energy sources during hybrid atrial fibrillation ablation- impact on lesion quality and outcomes. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0628] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Whereas pulmonary vein isolation lays the groundwork of endocardial atrial fibrillation (AF) ablation, it leaves patients undertreated. Additional substrate modification of the left atrium is often required, but lesion gaps and non-transmurality limit restoration of sinus rhythm. Moreover, some low voltage areas and conduction abnormalities are located exclusively on the epicardial aspect, and endocardial ablation alone does not address these issues. Our hybrid endo-/epicardial ablation strategy overcomes all these shortcomings.
Purpose
To test if the combination of epicardial cryo and radiofrequency (RF) ablation (dual) further improves the quality of ablation lines, and if the combined endo-/epicardial ablation can treat intractable cases of AF.
Methods
Twenty-six patients (13 paroxysmal, 13 long-persistent; 20 patients with 1–5 prior endocardial AF ablations) first underwent epicardial, total thoracoscopic beating heart ablation (TTA). Lesion sets included bilateral PVI, left atrial appendage closure, as well as superior (roof) and inferior (floor) interpulmonary vein lines. Roof and floor lines were alternatingly ablated by dual energy or RF only. Three months post TTA, endocardial mapping with optional gap closure completed this two-stage hybrid concept.
Results
Intraoperatively, 24 of 40 (60%) previous left or right endocardial PVIs were found incomplete. Apart from two post-TTA pacemaker insertions and one mini-thoracotomy for bleeding, respectively, no major morbidity was observed during follow up. The full protocol of the hybrid concept was applied in 24 patients. Forty-five of 47 (96%) epicardial PVIs were found gap-less during endocardial mapping, and the remaining 2 PVIs were readily re-ablated. In contrast, only 32 of 46 (70%) roof and floor lines were complete, and endocardial touch up was required in one of three patients. Of note, dual energy lines were more likely to be complete than RF only lines (17 of 22, 77%, vs. 15 of 24, 62%; p NS). Among 19 patients with continuous monitoring, only 4 (21%) had any AF burden including two patients within blanking period and before endocardial gap closure. The remaining 7 patients without continuous monitoring never experienced any symptoms related to recurrent AF, and serial Holter EKG were without pathology.
Conclusions
Hybrid ablation and dual energy provides a strong armamentarium for extra-pulmonary venous triggers of AF. Linear ablation lines were more likely to be gap-less and transmural, if dual energy sources were used. Dual energy TTA is highly efficient to restore sinus rhythm in patients with prior failed endocardial AF ablation. However, one of three patients will require endocardial gap closure to realize the full benefit of our two-stage hybrid concept. Further study will evaluate if dual energy lines outside the box can improve outcome in these challenging cases of intractable AF.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Schenk
- Sana-Heart Centre Cottbus, Cottbus, Germany
| | - A Terne
- Sana-Heart Centre Cottbus, Cottbus, Germany
| | - B Keweloh
- Hirslanden-Klinik im Park, Cardiology, Zurich, Switzerland
| | - C Lenz
- UKB Berlin, Cardiology, Berlin, Germany
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Bauer M, Gerlach K, Scheurer E, Lenz C. Analysis of different post mortem assessment methods for cerebral edema. Forensic Sci Int 2020; 308:110164. [PMID: 32014814 DOI: 10.1016/j.forsciint.2020.110164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/09/2019] [Accepted: 01/21/2020] [Indexed: 11/18/2022]
Abstract
While cerebral edema is a live-threatening condition in living persons, also an edema-like fluid redistribution can occur post mortem. In deceased, usually macroscopic signs are evaluated during autopsy in order to determine the presence or absence of cerebral edema. As a quantitative and objective classification is beneficial, an already existing method (Radojevic et al., 2017), which is based on a mathematical formula using the intracranial dimensions and the cerebral weight, was compared to the evaluation of macroscopic signs in 31 cases. The results showed an excellent agreement for the comparison between the raters as well as the measurement methods (at opened skull or in CT images). However, both measurement methods only poorly agree with the macroscopic edema evaluation. In order to find a more concordant method, the normalized cerebral weight, which puts the cerebral weight in relation to the intracranial volume, was calculated for 115 cases. This method resulted in an excellent agreement with the macroscopic rating and showed a clear numerical difference between the edematous and nonedematous group. While the influence of the post mortem time and the cooling time was found to be negligible, the age at death might confound the edema classification due to pre-existing cerebral atrophy leading to lower cerebral weights. In summary, the present study compared different assessment methods to classify cerebral edema and developed a rater independent, objective and quantitative classification method, which was as reliable as the rating of the forensic pathologists.
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Affiliation(s)
- Melanie Bauer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland.
| | - Kathrin Gerlach
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Eva Scheurer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Claudia Lenz
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
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18
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Barbarics B, Eildermann K, Kaderali L, Cyganek L, Paul T, Ströbel P, Urlaub H, Tirilomis T, Lenz C, Bohnenberger H. Proteomic Mapping of Atrial and Ventricular Protein Abundance in Patients with Aortic Valve Stenosis. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705541] [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: 10/24/2022]
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19
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Egloff L, Lenz C, Studerus E, Heitz U, Harrisberger F, Smieskova R, Schmidt A, Leanza L, Andreou C, Borgwardt S, Riecher‐Rössler A. No associations between medial temporal lobe volumes and verbal learning/memory in emerging psychosis. Eur J Neurosci 2019; 50:3060-3071. [DOI: 10.1111/ejn.14427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 03/26/2019] [Accepted: 04/07/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Laura Egloff
- Department of Psychiatry University of Basel Psychiatric Hospital Basel Switzerland
- Division of Clinical Psychology and Epidemiology Department of Psychology University of Basel Basel Switzerland
- Center for Gender Research and Early Detection University of Basel Psychiatric Hospital Basel Switzerland
| | - Claudia Lenz
- Institute of Forensic Medicine University of Basel Basel Switzerland
| | - Erich Studerus
- Center for Gender Research and Early Detection University of Basel Psychiatric Hospital Basel Switzerland
| | - Ulrike Heitz
- Center for Gender Research and Early Detection University of Basel Psychiatric Hospital Basel Switzerland
| | | | - Renata Smieskova
- Department of Psychiatry University of Basel Psychiatric Hospital Basel Switzerland
| | - André Schmidt
- Department of Psychiatry University of Basel Psychiatric Hospital Basel Switzerland
| | - Letizia Leanza
- Division of Clinical Psychology and Epidemiology Department of Psychology University of Basel Basel Switzerland
- Center for Gender Research and Early Detection University of Basel Psychiatric Hospital Basel Switzerland
| | - Christina Andreou
- Department of Psychiatry University of Basel Psychiatric Hospital Basel Switzerland
- Center for Gender Research and Early Detection University of Basel Psychiatric Hospital Basel Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry University of Basel Psychiatric Hospital Basel Switzerland
| | - Anita Riecher‐Rössler
- Center for Gender Research and Early Detection University of Basel Psychiatric Hospital Basel Switzerland
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20
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Egloff L, Lenz C, Studerus E, Harrisberger F, Smieskova R, Schmidt A, Huber C, Simon A, Lang UE, Riecher-Rössler A, Borgwardt S. Sexually dimorphic subcortical brain volumes in emerging psychosis. Schizophr Res 2018; 199:257-265. [PMID: 29605160 DOI: 10.1016/j.schres.2018.03.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/27/2018] [Accepted: 03/18/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND In schizophrenic psychoses, the normal sexual dimorphism of the brain has been shown to be disrupted or even reversed. Little is known, however, at what time point in emerging psychosis this occurs. We have therefore examined, if these alterations are already present in the at-risk mental state (ARMS) for psychosis and in first episode psychosis (FEP) patients. METHODS Data from 65 ARMS (48 (73.8%) male; age=25.1±6.32) and 50 FEP (37 (74%) male; age=27±6.56) patients were compared to those of 70 healthy controls (HC; 27 (38.6%) male; age=26±4.97). Structural T1-weighted images were acquired using a 3 Tesla magnetic resonance imaging (MRI) scanner. Linear mixed effects models were used to investigate whether subcortical brain volumes are dependent on sex. RESULTS We found men to have larger total brain volumes (p<0.001), and smaller bilateral caudate (p=0.008) and hippocampus volume (p<0.001) than women across all three groups. Older subjects had more GM and WM volume than younger subjects. No significant sex×group interaction was found. CONCLUSIONS In emerging psychosis there still seem to exist patterns of normal sexual dimorphism in total brain and caudate volume. The only structure affected by reversed sexual dimorphism was the hippocampus, with women showing larger volumes than men even in HC. Thus, we conclude that subcortical volumes may not be primarily affected by disrupted sexual dimorphism in emerging psychosis.
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Affiliation(s)
- Laura Egloff
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland; University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland
| | - Claudia Lenz
- University of Basel, Institute of Forensic Medicine, Basel, Switzerland
| | - Erich Studerus
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Fabienne Harrisberger
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Renata Smieskova
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - André Schmidt
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Christian Huber
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Andor Simon
- University Hospital of Bern, University Hospital of Psychiatry, Bern, Switzerland; Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, Bruderholz, Switzerland
| | - Undine E Lang
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Anita Riecher-Rössler
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Stefan Borgwardt
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland.
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Abstract
BACKGROUND Recent evidence shows that the serotonin 2A receptor (5-hydroxytryptamine2A receptor, 5-HT2AR) is critically involved in the formation of visual hallucinations and cognitive impairments in lysergic acid diethylamide (LSD)-induced states and neuropsychiatric diseases. However, the interaction between 5-HT2AR activation, cognitive impairments and visual hallucinations is still poorly understood. This study explored the effect of 5-HT2AR activation on response inhibition neural networks in healthy subjects by using LSD and further tested whether brain activation during response inhibition under LSD exposure was related to LSD-induced visual hallucinations. METHODS In a double-blind, randomized, placebo-controlled, cross-over study, LSD (100 µg) and placebo were administered to 18 healthy subjects. Response inhibition was assessed using a functional magnetic resonance imaging Go/No-Go task. LSD-induced visual hallucinations were measured using the 5 Dimensions of Altered States of Consciousness (5D-ASC) questionnaire. RESULTS Relative to placebo, LSD administration impaired inhibitory performance and reduced brain activation in the right middle temporal gyrus, superior/middle/inferior frontal gyrus and anterior cingulate cortex and in the left superior frontal and postcentral gyrus and cerebellum. Parahippocampal activation during response inhibition was differently related to inhibitory performance after placebo and LSD administration. Finally, activation in the left superior frontal gyrus under LSD exposure was negatively related to LSD-induced cognitive impairments and visual imagery. CONCLUSION Our findings show that 5-HT2AR activation by LSD leads to a hippocampal-prefrontal cortex-mediated breakdown of inhibitory processing, which might subsequently promote the formation of LSD-induced visual imageries. These findings help to better understand the neuropsychopharmacological mechanisms of visual hallucinations in LSD-induced states and neuropsychiatric disorders.
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Affiliation(s)
- A Schmidt
- Department of Psychiatry (UPK),University of Basel,Basel,Switzerland
| | - F Müller
- Department of Psychiatry (UPK),University of Basel,Basel,Switzerland
| | - C Lenz
- Department of Psychiatry (UPK),University of Basel,Basel,Switzerland
| | - P C Dolder
- Division of Clinical Pharmacology and Toxicology,Department of Biomedicine and Department of Clinical Research,University of Basel, University Hospital Basel,Basel,Switzerland
| | - Y Schmid
- Division of Clinical Pharmacology and Toxicology,Department of Biomedicine and Department of Clinical Research,University of Basel, University Hospital Basel,Basel,Switzerland
| | - D Zanchi
- Department of Psychiatry (UPK),University of Basel,Basel,Switzerland
| | - U E Lang
- Department of Psychiatry (UPK),University of Basel,Basel,Switzerland
| | - M E Liechti
- Division of Clinical Pharmacology and Toxicology,Department of Biomedicine and Department of Clinical Research,University of Basel, University Hospital Basel,Basel,Switzerland
| | - S Borgwardt
- Department of Psychiatry (UPK),University of Basel,Basel,Switzerland
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Ruprecht R, Scheurer E, Lenz C. Systematic review on the characterization of chronic traumatic encephalopathy by MRI and MRS. J Magn Reson Imaging 2018; 49:212-228. [PMID: 29717792 DOI: 10.1002/jmri.26162] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 11/14/2017] [Accepted: 04/10/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that is found in people who have suffered from chronic traumatic brain injury (TBI). Up to now, diagnosis of CTE could only be made based on postmortem histopathological examinations. The application of MR techniques might offer a promising possibility for in vivo diagnoses. PURPOSE/HYPOTHESIS To provide a critical systematic review of the characterization of chronic TBI and CTE by considering the range of MR techniques. STUDY TYPE This was a systematic review for which the electronic databases PubMed and Embase were searched using the terms ("chronic traumatic encephalopathy" OR "punch drunk syndrome" OR "chronic traumatic brain injury" OR "dementia pugilistica" OR "chronic head trauma") AND ("magnetic resonance imaging" OR mri OR imaging OR mrs OR "magnetic resonance spectroscopy" OR spectroscopy). POPULATION/SUBJECTS/PHANTOM/SPECIMEN/ANIMAL MODEL Of the 432 studies identified by the database search, 25 were included in this review. FIELD STRENGTH/SEQUENCE Diffusion, structural, and functional MRI sequences and MR spectroscopy were evaluated at 1.5T or 3T and at 11.74T for the ex vivo studies. ASSESSMENT Data were extracted by two reviewers independently. Specific inclusion and exclusion criteria like the study design, publication type, and applied MR techniques were used to select studies for review. STATISTICAL TESTS Results of the original research articles were stated in this review as significant if P ≤ 0.05. RESULTS Of the included articles, two were ex vivo studies focusing on the coregistration of histology and MRI. All other studies were based on in vivo data. DATA CONCLUSION The included studies varied considerably regarding study setup, MR techniques, and results. Nevertheless, this work aims to establish links between the studies and discusses the results and limitations associated with the characterization of chronic TBI and CTE based on MR. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:212-228.
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Affiliation(s)
- Rahel Ruprecht
- Institute of Forensic Medicine, University of Basel, Basel, Switzerland
| | - Eva Scheurer
- Institute of Forensic Medicine, University of Basel, Basel, Switzerland
| | - Claudia Lenz
- Institute of Forensic Medicine, University of Basel, Basel, Switzerland
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23
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Weiss G, Wittig H, Scheurer E, Ruprecht R, Lenz C. Identification of deceased based on sternal bone computed tomography features. Forensic Sci Int 2018; 286:233-238. [DOI: 10.1016/j.forsciint.2018.03.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/08/2018] [Accepted: 03/09/2018] [Indexed: 11/24/2022]
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Müller F, Lenz C, Dolder P, Lang U, Schmidt A, Liechti M, Borgwardt S. Increased thalamic resting-state connectivity as a core driver of LSD-induced hallucinations. Acta Psychiatr Scand 2017; 136:648-657. [PMID: 28940312 PMCID: PMC5698745 DOI: 10.1111/acps.12818] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE It has been proposed that the thalamocortical system is an important site of action of hallucinogenic drugs and an essential component of the neural correlates of consciousness. Hallucinogenic drugs such as LSD can be used to induce profoundly altered states of consciousness, and it is thus of interest to test the effects of these drugs on this system. METHOD 100 μg LSD was administrated orally to 20 healthy participants prior to fMRI assessment. Whole brain thalamic functional connectivity was measured using ROI-to-ROI and ROI-to-voxel approaches. Correlation analyses were used to explore relationships between thalamic connectivity to regions involved in auditory and visual hallucinations and subjective ratings on auditory and visual drug effects. RESULTS LSD caused significant alterations in all dimensions of the 5D-ASC scale and significantly increased thalamic functional connectivity to various cortical regions. Furthermore, LSD-induced functional connectivity measures between the thalamus and the right fusiform gyrus and insula correlated significantly with subjective auditory and visual drug effects. CONCLUSION Hallucinogenic drug effects might be provoked by facilitations of cortical excitability via thalamocortical interactions. Our findings have implications for the understanding of the mechanism of action of hallucinogenic drugs and provide further insight into the role of the 5-HT2A -receptor in altered states of consciousness.
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Affiliation(s)
- F. Müller
- Department of Psychiatry (UPK)University of BaselBaselSwitzerland
| | - C. Lenz
- Department of Psychiatry (UPK)University of BaselBaselSwitzerland
| | - P. Dolder
- Division of Clinical Pharmacology and ToxicologyDepartment of Biomedicine and Department of Clinical ResearchUniversity Hospital BaselUniversity of BaselBaselSwitzerland
| | - U. Lang
- Department of Psychiatry (UPK)University of BaselBaselSwitzerland
| | - A. Schmidt
- Department of Psychiatry (UPK)University of BaselBaselSwitzerland
| | - M. Liechti
- Division of Clinical Pharmacology and ToxicologyDepartment of Biomedicine and Department of Clinical ResearchUniversity Hospital BaselUniversity of BaselBaselSwitzerland
| | - S. Borgwardt
- Department of Psychiatry (UPK)University of BaselBaselSwitzerland
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25
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Wottawa M, Naas S, Böttger J, van Belle GJ, Möbius W, Revelo NH, Heidenreich D, von Ahlen M, Zieseniss A, Kröhnert K, Lutz S, Lenz C, Urlaub H, Rizzoli SO, Katschinski DM. Hypoxia-stimulated membrane trafficking requires T-plastin. Acta Physiol (Oxf) 2017; 221:59-73. [PMID: 28218996 DOI: 10.1111/apha.12859] [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] [Received: 01/09/2017] [Revised: 01/25/2017] [Accepted: 02/15/2017] [Indexed: 12/30/2022]
Abstract
AIM Traffic between the plasma membrane and the endomembrane compartments is an essential feature of eukaryotic cells. The secretory pathway sends cargoes from biosynthetic compartments to the plasma membrane. This is counterbalanced by a retrograde endocytic route and is essential for cell homoeostasis. Cells need to adapt rapidly to environmental challenges such as the reduction of pO2 which, however, has not been analysed in relation to membrane trafficking in detail. Therefore, we determined changes in the plasma membrane trafficking in normoxia, hypoxia, and after reoxygenation. METHODS Membrane trafficking was analysed by using the bulk membrane endocytosis marker FM 1-43, the newly developed membrane probe mCLING, wheat germ agglutinin as well as fluorescently labelled cholera toxin subunit B. Additionally, the uptake of specific membrane proteins was determined. In parallel, a non-biased SILAC screen was performed to analyse the abundance of membrane proteins in normoxia and hypoxia. RESULTS Membrane trafficking was increased in hypoxia and quickly reversed upon reoxygenation. This effect was independent of the hypoxia-inducible factor (HIF) system. Using SILAC technology, we identified that the actin-bundling protein T-plastin is recruited to the plasma membrane in hypoxia. By the use of T-plastin knockdown cells, we could show that T-plastin mediates the hypoxia-induced membrane trafficking, which was associated with an increased actin density in the cells as determined by electron microscopy. CONCLUSION Membrane trafficking is highly dynamic upon hypoxia. This phenotype is quickly reversible upon reoxygenation, which suggests that this mechanism participates in the cellular adaptation to hypoxia.
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Affiliation(s)
- M. Wottawa
- Institute of Cardiovascular Physiology; University Medical Center Göttingen (UMG); Göttingen Germany
| | - S. Naas
- Institute of Cardiovascular Physiology; University Medical Center Göttingen (UMG); Göttingen Germany
| | - J. Böttger
- Institute of Cardiovascular Physiology; University Medical Center Göttingen (UMG); Göttingen Germany
| | - G. J. van Belle
- Institute of Cardiovascular Physiology; University Medical Center Göttingen (UMG); Göttingen Germany
| | - W. Möbius
- Department of Neurogenetics; Max Planck Institute of Experimental Medicine; Göttingen Germany
- Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB); Göttingen Germany
| | - N. H. Revelo
- Institute of Neuro- and Sensory Physiology; UMG, CNMPB; Göttingen Germany
| | - D. Heidenreich
- Institute of Cardiovascular Physiology; University Medical Center Göttingen (UMG); Göttingen Germany
| | - M. von Ahlen
- Institute of Cardiovascular Physiology; University Medical Center Göttingen (UMG); Göttingen Germany
| | - A. Zieseniss
- Institute of Cardiovascular Physiology; University Medical Center Göttingen (UMG); Göttingen Germany
| | - K. Kröhnert
- Institute of Neuro- and Sensory Physiology; UMG, CNMPB; Göttingen Germany
| | - S. Lutz
- Institute of Pharmacology; UMG; Göttingen Germany
| | - C. Lenz
- Bioanalytical Mass Spectrometry; Max Planck Institute for Biophysical Chemistry; Göttingen Germany
- Bioanalytics Research Group; Institute of Clinical Chemistry; UMG; Göttingen Germany
| | - H. Urlaub
- Bioanalytical Mass Spectrometry; Max Planck Institute for Biophysical Chemistry; Göttingen Germany
- Bioanalytics Research Group; Institute of Clinical Chemistry; UMG; Göttingen Germany
| | - S. O. Rizzoli
- Institute of Neuro- and Sensory Physiology; UMG, CNMPB; Göttingen Germany
| | - D. M. Katschinski
- Institute of Cardiovascular Physiology; University Medical Center Göttingen (UMG); Göttingen Germany
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26
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Dukart J, Smieskova R, Harrisberger F, Lenz C, Schmidt A, Walter A, Huber C, Riecher-Rössler A, Simon A, Lang UE, Fusar-Poli P, Borgwardt S. Age-related brain structural alterations as an intermediate phenotype of psychosis. J Psychiatry Neurosci 2017; 42:307-319. [PMID: 28459416 PMCID: PMC5573573 DOI: 10.1503/jpn.160179] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There is only limited agreement with respect to location, directionality and functional implications of brain structural alterations observed in patients with schizophrenia. Additionally, their link to occurrence of psychotic symptoms remains unclear. A viable way of addressing these questions is to examine populations in an at-risk mental state (ARMS) before the transition to psychosis. METHODS We tested for structural brain alterations in individuals in an ARMS compared with healthy controls and patients with first-episode psychosis (FEP) using voxel-based morphometry and measures of cortical thickness. Furthermore, we evaluated if these alterations were modified by age and whether they were linked to the observed clinical symptoms. RESULTS Our sample included 59 individuals with ARMS, 26 healthy controls and 59 patients with FEP. We found increased grey matter volume and cortical thickness in individuals with ARMS and a similar pattern of structural alterations in patients with FEP. We further found stronger age-related reductions in grey matter volume and cortical thickness in both patients with FEP and individuals with ARMS, linking these alterations to observed clinical symptoms. LIMITATIONS The ARMS group comprised subgroups with heterogeneous levels of psychosis risk and medication status. Furthermore, the cross-sectional nature of our study and the reduced number of older patients limit conclusions with respect to observed interactions with age. CONCLUSION Our findings on consistent structural alterations in individuals with ARMS and patients with FEP and their link to clinical symptoms have major implications for understanding their time of occurrence and relevance to psychotic symptoms. Interactions with age found for these alterations may explain the heterogeneity of findings reported in the literature.
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Affiliation(s)
- Juergen Dukart
- Correspondence to: J. Dukart, Biomarkers & Clinical Imaging, NORD DTA, F. Hoffmann-La Roche, Grenzacherstrasse 170, 4070 Basel, Switzerland;
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27
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Schmidt A, Crossley NA, Harrisberger F, Smieskova R, Lenz C, Riecher-Rössler A, Lang UE, McGuire P, Fusar-Poli P, Borgwardt S. Structural Network Disorganization in Subjects at Clinical High Risk for Psychosis. Schizophr Bull 2017; 43:583-591. [PMID: 27481826 PMCID: PMC5464048 DOI: 10.1093/schbul/sbw110] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Previous network studies in chronic schizophrenia patients revealed impaired structural organization of the brain's rich-club members, a set of highly interconnected hub regions that play an important integrative role for global brain communication. Moreover, impaired rich-club connectivity has also been found in unaffected siblings of schizophrenia patients, suggesting that abnormal rich-club connectivity is related to familiar, possibly reflecting genetic, vulnerability for schizophrenia. However, no study has yet investigated whether structural rich-club organization is also impaired in individuals with a clinical risk syndrome for psychosis. Diffusion tensor imaging and probabilistic tractography was used to construct structural whole-brain networks in 24 healthy controls and 24 subjects with an at-risk mental state (ARMS). Graph theory was applied to quantify the structural rich-club organization and global network properties. ARMS subjects revealed a significantly altered structural rich-club organization compared with the control group. The disruption of rich-club organization was associated with the severity of negative psychotic symptoms and led to an elevated level of modularity in ARMS subjects. This study shows that abnormal structural rich-club organization is already evident in clinical high-risk subjects for psychosis and further demonstrates the impact of rich-club disorganization on global network communication. Together with previous evidence in chronic schizophrenia patients and unaffected siblings, our findings suggest that abnormal structural rich-club organization may reflect an endophenotypic marker of psychosis.
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Affiliation(s)
- André Schmidt
- Department of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, PO63 De Crespigny Park, London SE5 8AF, UK
| | - Nicolas A. Crossley
- Department of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, PO63 De Crespigny Park, London SE5 8AF, UK
| | | | - Renata Smieskova
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Claudia Lenz
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - Undine E. Lang
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Philip McGuire
- Department of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, PO63 De Crespigny Park, London SE5 8AF, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, PO63 De Crespigny Park, London SE5 8AF, UK
| | - Stefan Borgwardt
- Department of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, PO63 De Crespigny Park, London SE5 8AF, UK;,Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
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28
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Davis K, Lenz C, Houghton K, Kaye J. Clinical Outcomes of Crizotinib in Real-World Practice Settings for Patients with Advanced ALK-Positive Non–Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.01.168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Davis K, Lenz C, Houghton K, Kaye J. Real-World Clinical Outcomes of Crizotinib Treatment in ALK-Positive Non–Small Cell Lung Cancer Patients with Brain Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.01.169] [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: 11/25/2022]
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30
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Walter A, Suenderhauf C, Harrisberger F, Lenz C, Smieskova R, Chung Y, Cannon TD, Bearden CE, Rapp C, Bendfeldt K, Borgwardt S, Vogel T. Hippocampal volume in subjects at clinical high-risk for psychosis: A systematic review and meta-analysis. Neurosci Biobehav Rev 2016; 71:680-690. [DOI: 10.1016/j.neubiorev.2016.10.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/09/2016] [Accepted: 10/11/2016] [Indexed: 01/16/2023]
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31
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Walter A, Suenderhauf C, Smieskova R, Lenz C, Harrisberger F, Schmidt A, Vogel T, Lang UE, Riecher-Rössler A, Eckert A, Borgwardt S. Altered Insular Function during Aberrant Salience Processing in Relation to the Severity of Psychotic Symptoms. Front Psychiatry 2016; 7:189. [PMID: 27933003 PMCID: PMC5120113 DOI: 10.3389/fpsyt.2016.00189] [Citation(s) in RCA: 14] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 11/09/2016] [Indexed: 12/31/2022] Open
Abstract
There is strong evidence for abnormal salience processing in patients with psychotic experiences. In particular, there are indications that the degree of aberrant salience processing increases with the severity of positive symptoms. The aim of the present study was to elucidate this relationship by means of brain imaging. Functional magnetic resonance imaging was acquired to assess hemodynamic responses during the Salience Attribution Test, a paradigm for reaction time that measures aberrant salience to irrelevant stimulus features. We included 42 patients who were diagnosed as having a psychotic disorder and divided them into two groups according to the severity of their positive symptoms. Whole brain analysis was performed using Statistical Parametric Mapping. We found no significant behavioral differences with respect to task performance. Patients with more positive symptoms showed increased hemodynamic responses in the left insula corresponding to aberrant salience than in patients with less positive symptoms. In addition, left insula activation correlated negatively with cumulative antipsychotic medication. Aberrant salience processing in the insula may be increased in psychosis, depending on the severity of positive symptoms. This study indicates that clinically similar psychosis manifestations share the same functional characteristics. In addition, our results suggest that antipsychotic medication can modulate insular function.
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Affiliation(s)
- Anna Walter
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - Renata Smieskova
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Claudia Lenz
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - André Schmidt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Tobias Vogel
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Undine E. Lang
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - Anne Eckert
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
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32
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Harrisberger F, Buechler R, Smieskova R, Lenz C, Walter A, Egloff L, Bendfeldt K, Simon AE, Wotruba D, Theodoridou A, Rössler W, Riecher-Rössler A, Lang UE, Heekeren K, Borgwardt S. Alterations in the hippocampus and thalamus in individuals at high risk for psychosis. NPJ Schizophr 2016; 2:16033. [PMID: 27738647 PMCID: PMC5040554 DOI: 10.1038/npjschz.2016.33] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/08/2016] [Accepted: 08/10/2016] [Indexed: 02/04/2023]
Abstract
Reduction in hippocampal volume is a hallmark of schizophrenia and already present in the
clinical high-risk state. Nevertheless, other subcortical structures, such as the
thalamus, amygdala and pallidum can differentiate schizophrenia patients from controls. We
studied the role of hippocampal and subcortical structures in clinical high-risk
individuals from two cohorts. High-resolution T1-weighted structural MRI brain
scans of a total of 91 clinical high-risk individuals and 64 healthy controls were
collected in two centers. The bilateral volume of the hippocampus, the thalamus, the
caudate, the putamen, the pallidum, the amygdala, and the accumbens were automatically
segmented using FSL-FIRST. A linear mixed-effects model and a prospective meta-analysis
were applied to assess group-related volumetric differences. We report reduced hippocampal
and thalamic volumes in clinical high-risk individuals compared to healthy controls. No
volumetric alterations were detected for the caudate, the putamen, the pallidum, the
amygdala, or the accumbens. Moreover, we found comparable medium effect sizes for
group-related comparison of the thalamus in the two analytical methods. These findings
underline the relevance of specific alterations in the hippocampal and subcortical volumes
in the high-risk state. Further analyses may allow hippocampal and thalamic volumes to be
used as biomarkers to predict psychosis.
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Affiliation(s)
| | - Roman Buechler
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | - Renata Smieskova
- Department of Psychiatry, University of Basel, Basel, Switzerland; Medical Image Analysis Centre, University of Basel, Basel, Switzerland
| | - Claudia Lenz
- Department of Psychiatry, University of Basel , Basel, Switzerland
| | - Anna Walter
- Department of Psychiatry, University of Basel , Basel, Switzerland
| | - Laura Egloff
- Department of Psychiatry, University of Basel , Basel, Switzerland
| | - Kerstin Bendfeldt
- Medical Image Analysis Centre, University of Basel , Basel, Switzerland
| | - Andor E Simon
- Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry , Bruderholz, Switzerland
| | - Diana Wotruba
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | - Anastasia Theodoridou
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | - Wulf Rössler
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | | | - Undine E Lang
- Department of Psychiatry, University of Basel , Basel, Switzerland
| | - Karsten Heekeren
- The Zurich Program for Sustainable Development of Mental Health Services, Psychiatric Hospital, University of Zurich , Zurich, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland; Medical Image Analysis Centre, University of Basel, Basel, Switzerland; Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK
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Harrisberger F, Smieskova R, Vogler C, Egli T, Schmidt A, Lenz C, Simon AE, Riecher-Rössler A, Papassotiropoulos A, Borgwardt S. Impact of polygenic schizophrenia-related risk and hippocampal volumes on the onset of psychosis. Transl Psychiatry 2016; 6:e868. [PMID: 27505231 PMCID: PMC5022088 DOI: 10.1038/tp.2016.143] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 04/25/2016] [Accepted: 06/05/2016] [Indexed: 12/12/2022] Open
Abstract
Alterations in hippocampal volume are a known marker for first-episode psychosis (FEP) as well as for the clinical high-risk state. The Polygenic Schizophrenia-related Risk Score (PSRS), derived from a large case-control study, indicates the polygenic predisposition for schizophrenia in our clinical sample. A total of 65 at-risk mental state (ARMS) and FEP patients underwent structural magnetic resonance imaging. We used automatic segmentation of hippocampal volumes using the FSL-FIRST software and an odds-ratio-weighted PSRS based on the publicly available top single-nucleotide polymorphisms from the Psychiatric Genomics Consortium genome-wide association study (GWAS). We observed a negative association between the PSRS and hippocampal volumes (β=-0.42, P=0.01, 95% confidence interval (CI)=(-0.72 to -0.12)) across FEP and ARMS patients. Moreover, a higher PSRS was significantly associated with a higher probability of an individual being assigned to the FEP group relative to the ARMS group (β=0.64, P=0.03, 95% CI=(0.08-1.29)). These findings provide evidence that a subset of schizophrenia risk variants is negatively associated with hippocampal volumes, and higher values of this PSRS are significantly associated with FEP compared with the ARMS. This implies that FEP patients have a higher genetic risk for schizophrenia than the total cohort of ARMS patients. The identification of associations between genetic risk variants and structural brain alterations will increase our understanding of the neurobiology underlying the transition to psychosis.
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Affiliation(s)
- F Harrisberger
- Division of Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Psychiatric University Clinics, University of Basel, Basel, Switzerland,Division of Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), Psychiatric University Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, Basel 4012, Switzerland. E-mail:
| | - R Smieskova
- Division of Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Psychiatric University Clinics, University of Basel, Basel, Switzerland,Medical Image Analysis Centre, University Hospital Basel, Basel, Switzerland
| | - C Vogler
- Psychiatric University Clinics, University of Basel, Basel, Switzerland,Division of Molecular Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - T Egli
- Division of Molecular Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - A Schmidt
- King's College London, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - C Lenz
- Division of Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - A E Simon
- Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, Bruderholz, Switzerland
| | - A Riecher-Rössler
- Division of Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - A Papassotiropoulos
- Psychiatric University Clinics, University of Basel, Basel, Switzerland,Division of Molecular Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland,Transfaculty Research Platform, University of Basel, Basel, Switzerland,Department Biozentrum, Life Sciences Training Facility, University of Basel, Basel, Switzerland
| | - S Borgwardt
- Division of Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland,Psychiatric University Clinics, University of Basel, Basel, Switzerland,Medical Image Analysis Centre, University Hospital Basel, Basel, Switzerland,King's College London, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, London, UK
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Suenderhauf C, Walter A, Lenz C, Lang UE, Borgwardt S. Counter striking psychosis: Commercial video games as potential treatment in schizophrenia? A systematic review of neuroimaging studies. Neurosci Biobehav Rev 2016; 68:20-36. [PMID: 27090742 DOI: 10.1016/j.neubiorev.2016.03.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 10/19/2015] [Revised: 02/19/2016] [Accepted: 03/16/2016] [Indexed: 01/01/2023]
Abstract
Schizophrenia is a severe, chronic, and strongly disabling neuropsychiatric disorder, characterized by cognitive decline, positive and negative symptoms. Positive symptoms respond well to antipsychotic medication and psycho-social interventions, in contrast to negative symptoms and neurocognitive impairments. Cognitive deficits have been linked to a poorer outcome and hence specific cognitive remediation therapies have been proposed. Their effectiveness is nowadays approved and neurobiological correlates have been reconfirmed by brain imaging studies. Interestingly, recent MRI work showed that commercial video games modified similar brain areas as these specialized training programs. If gray matter increases and functional brain modulations would translate in better cognitive and every day functioning, commercial video game training could be an enjoyable and economically interesting treatment option for patients with neuropsychiatric disorders. This systematic review summarizes advances in the area with emphasis on imaging studies dealing with brain changes upon video game training and contrasts them to conventional cognitive remediation. Moreover, we discuss potential challenges therapeutic video game development and research would have to face in future treatment of schizophrenia.
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Affiliation(s)
- Claudia Suenderhauf
- Neuropsychiatry and Brain Imaging Group, Department of Psychiatry (UPK), Department of Clinical Research (DKF), Wilhelm Klein-Strasse 27, 4012 Basel, Switzerland.
| | - Anna Walter
- Neuropsychiatry and Brain Imaging Group, Department of Psychiatry (UPK), Department of Clinical Research (DKF), Wilhelm Klein-Strasse 27, 4012 Basel, Switzerland
| | - Claudia Lenz
- Neuropsychiatry and Brain Imaging Group, Department of Psychiatry (UPK), Department of Clinical Research (DKF), Wilhelm Klein-Strasse 27, 4012 Basel, Switzerland
| | - Undine E Lang
- Neuropsychiatry and Brain Imaging Group, Department of Psychiatry (UPK), Department of Clinical Research (DKF), Wilhelm Klein-Strasse 27, 4012 Basel, Switzerland
| | - Stefan Borgwardt
- Neuropsychiatry and Brain Imaging Group, Department of Psychiatry (UPK), Department of Clinical Research (DKF), Wilhelm Klein-Strasse 27, 4012 Basel, Switzerland
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Schmidt A, Lenz C, Smieskova R, Harrisberger F, Walter A, Riecher-Rössler A, Simon A, Lang UE, McGuire P, Fusar-Poli P, Borgwardt SJ. Brain Diffusion Changes in Emerging Psychosis and the Impact of State-Dependent Psychopathology. Neurosignals 2015; 23:71-83. [PMID: 26682550 DOI: 10.1159/000442605] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Previous diffusion tensor imaging (DTI) studies have shown microstructural changes in the brain white matter of at-risk mental state (ARMS) subjects for psychosis and patients with first-episode psychosis (FEP). However, only a few studies have been conducted in clinical high-risk samples and findings in both groups are inconsistent, in particular along the superior longitudinal fasciculus (SLF). METHODS This DTI study used tract-based spatial statistics (TBSS) to compare fractional anisotropy (FA) and mean diffusivity (MD) between ARMS subjects, untreated and antipsychotic-treated FEP patients and healthy controls (HC) across the whole brain and the SLF. RESULTS Compared to HC, ARMS and FEP patients showed increased FA and decreased MD in diverse regions across the whole brain including the SLF. FA in the SLF was positively correlated with positive psychotic symptoms in ARMS and FEP individuals. Furthermore, untreated but not treated FEP patients showed increased FA in the left inferior longitudinal fasciculus and right SLF. CONCLUSION This study revealed increased FA and decreased MD in early stages of psychosis in widespread white matter tracts including the SLF. Our findings further suggest that microstructural changes in the SLF are probably related to state-dependent psychopathology.
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Affiliation(s)
- André Schmidt
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
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Harrisberger F, Smieskova R, Schmidt A, Lenz C, Walter A, Wittfeld K, Grabe HJ, Lang UE, Fusar-Poli P, Borgwardt S. BDNF Val66Met polymorphism and hippocampal volume in neuropsychiatric disorders: A systematic review and meta-analysis. Neurosci Biobehav Rev 2015; 55:107-18. [PMID: 25956254 DOI: 10.1016/j.neubiorev.2015.04.017] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [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: 12/06/2014] [Revised: 04/15/2015] [Accepted: 04/25/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is a neurotrophin involved in neurogenesis and synaptic plasticity in the central nervous system, especially in the hippocampus, and has been implicated in the pathophysiology of several neuropsychiatric disorders. Its Val66Met polymorphism (refSNP Cluster Report: rs6265) is a functionally relevant single nucleotide polymorphism affecting the secretion of BDNF and is implicated in differences in hippocampal volumes. METHODS This is a systematic meta-analytical review of findings from imaging genetic studies on the impact of the rs6265 SNP on hippocampal volumes in neuropsychiatric patients with major depressive disorder, anxiety, bipolar disorder or schizophrenia. RESULTS The overall sample size of 18 independent clinical cohorts comprised 1695 patients. Our results indicated no significant association of left (Hedge's g=0.08, p=0.12), right (g=0.07, p=0.22) or bilateral (g=0.07, p=0.16) hippocampal volumes with BDNF rs6265 in neuropsychiatric patients. There was no evidence for a publication bias or any demographic, clinical, or methodological moderating effects. Both Val/Val homozygotes (g=0.32, p=0.004) and Met-carriers (g=0.20, p=0.004) from the patient sample had significantly smaller hippocampal volumes than the healthy control sample with the same allele. The magnitude of these effects did not differ between the two genotypes. CONCLUSION This meta-analysis suggests that there is no association between this BDNF polymorphism and hippocampal volumes. For each BDNF genotype, the hippocampal volumes were significantly lower in neuropsychiatric patients than in healthy controls.
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Affiliation(s)
- F Harrisberger
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - R Smieskova
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - A Schmidt
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - C Lenz
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - A Walter
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - K Wittfeld
- German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - H J Grabe
- German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Helios Hospital Stralsund, Stralsund, Germany
| | - U E Lang
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - P Fusar-Poli
- King's College London, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, De Crespigny Park 16, SE58AF London, UK; OASIS Prodromal Team SLaM NHS Foundation Trust, London, UK
| | - S Borgwardt
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland; King's College London, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, De Crespigny Park 16, SE58AF London, UK.
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Bernasconi R, Smieskova R, Schmidt A, Harrisberger F, Raschle NM, Lenz C, Walter A, Simon A, Riecher-Rössler A, Radue EW, Lang UE, Fusar-Poli P, Borgwardt SJ. Hippocampal volume correlates with attenuated negative psychotic symptoms irrespective of antidepressant medication. Neuroimage Clin 2015; 8:230-7. [PMID: 26110110 PMCID: PMC4473852 DOI: 10.1016/j.nicl.2015.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 04/23/2015] [Accepted: 04/25/2015] [Indexed: 12/18/2022]
Abstract
Background Individuals with at-risk mental state for psychosis (ARMS) often suffer from depressive and anxiety symptoms, which are clinically similar to the negative symptomatology described for psychosis. Thus, many ARMS individuals are already being treated with antidepressant medication. Objectives To investigate clinical and structural differences between psychosis high-risk individuals with or without antidepressants. Methods We compared ARMS individuals currently receiving antidepressants (ARMS-AD; n = 18), ARMS individuals not receiving antidepressants (ARMS-nonAD; n = 31) and healthy subjects (HC; n = 24), in terms of brain structure abnormalities, using voxel-based morphometry. We also performed region of interest analysis for the hippocampus, anterior cingulate cortex, amygdala and precuneus. Results The ARMS-AD had higher ‘depression’ and lower ‘motor hyperactivity’ scores than the ARMS-nonAD. Compared to HC, there was significantly less GMV in the middle frontal gyrus in the whole ARMS cohort and in the superior frontal gyrus in the ARMS-AD subgroup. Compared to ARMS-nonAD, the ARMS-AD group showed more gray matter volume (GMV) in the left superior parietal lobe, but less GMV in the left hippocampus and the right precuneus. We found a significant negative correlation between attenuated negative symptoms and hippocampal volume in the whole ARMS cohort. Conclusion Reduced GMV in the hippocampus and precuneus is associated with short-term antidepressant medication and more severe depressive symptoms. Hippocampal volume is further negatively correlated with attenuated negative psychotic symptoms. Longitudinal studies are needed to distinguish whether hippocampal volume deficits in the ARMS are related to attenuated negative psychotic symptoms or to antidepressant action. We compared brain structure in high-risk patients with/without antidepressants (AD). We found attenuated negative psychotic symptoms (ANS) irrespective of AD. We found a significant correlation between ANS and hippocampal volume. Results indicate relevance of ANS for clinical high-risk studies.
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Affiliation(s)
- Raffaele Bernasconi
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
| | - Renata Smieskova
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
| | - André Schmidt
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Nora Maria Raschle
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
| | - Claudia Lenz
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
| | - Anna Walter
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
| | - Andor Simon
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
| | | | | | - Undine E. Lang
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
| | - Paolo Fusar-Poli
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stefan J. Borgwardt
- Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, Basel, Switzerland
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Medical Image Analysis Centre, University Hospital, Basel, Switzerland
- Correspondence to: Department of Psychiatry (UPK), University of Basel, Wilhelm Klein-strasse 27, Basel 4056, Switzerland. Tel.: +41 (0)61 325 81 87; fax: +41 (0)61 325 81 80.
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McGuire A, Martin M, Lenz C, Sollano JA. Treatment cost of non-small cell lung cancer in three European countries: comparisons across France, Germany, and England using administrative databases. J Med Econ 2015; 18:525-32. [PMID: 25802950 DOI: 10.3111/13696998.2015.1032974] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Lung cancer is a highly prevalent condition with non-small cell lung cancer (NSCLC), representing ∼ 80%. Given its high prevalence and poor survival rates, it is important to understand costs associated with NSCLC treatment. OBJECTIVES To carry out an incidence-based study in three European countries: France, Germany, and the UK, to estimate the cost of NSCLC treatment. METHODS Three similar administrative databases were accessed; Hospital Episode Statistics (England), Gesundheitsforen Leipzig (Germany), French Hospital Discharge system (France), using ICD-9/10 codes and treatment/surgery algorithms to identify NSCLC patients. An incidence population of NSCLC patients was obtained using an index year (ranging from 2007-2008), ensuring the absence of prior lung cancer (12-months). Data were extracted on treatment information, patient characteristics, and disease staging. Average NSCLC treatment costs were estimated by age and severity. For England, 20,081 patients were identified, for France, 15,061, and for Germany, 1038. RESULTS In-patient length of stay was 8.9, 8.7, and 10.1 days for France, England, and Germany, respectively, for the first year. Average total costs for the 2-year follow-up period for France, England, and Germany were €25,063, €17,777, and €32,500, respectively. Sub-group analyses showed higher costs for younger patients and those with metastatic disease. CONCLUSION Considerable differences in average treatment costs were observed. In-patient costs dominate in the first year of treatment in all countries. The study highlights the costly nature of NSCLC.
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Affiliation(s)
- A McGuire
- LSE, London, UK, and Mapi , Uxbridge , UK
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Mcguire A, Martin M, Lenz C, Sollano J. The Cost of NSCLC Treatment in Three Countries: France, Germany and UK. Value Health 2014; 17:A628-A629. [PMID: 27202224 DOI: 10.1016/j.jval.2014.08.2243] [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: 06/05/2023]
Affiliation(s)
- A Mcguire
- London School of Economics, London, UK
| | - M Martin
- OptumInsight, Uxbridge, Middlesex, UK
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Smieskova R, Fusar-Poli P, Aston J, Simon A, Bendfeldt K, Lenz C, Stieglitz RD, McGuire P, Riecher-Rössler A, Borgwardt SJ. Insular volume abnormalities associated with different transition probabilities to psychosis. Psychol Med 2012; 42:1613-1625. [PMID: 22126702 PMCID: PMC3413195 DOI: 10.1017/s0033291711002716] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [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: 08/02/2011] [Revised: 10/25/2011] [Accepted: 10/26/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although individuals vulnerable to psychosis show brain volumetric abnormalities, structural alterations underlying different probabilities for later transition are unknown. The present study addresses this issue by means of voxel-based morphometry (VBM). METHOD We investigated grey matter volume (GMV) abnormalities by comparing four neuroleptic-free groups: individuals with first episode of psychosis (FEP) and with at-risk mental state (ARMS), with either long-term (ARMS-LT) or short-term ARMS (ARMS-ST), compared to the healthy control (HC) group. Using three-dimensional (3D) magnetic resonance imaging (MRI), we examined 16 FEP, 31 ARMS, clinically followed up for on average 3 months (ARMS-ST, n=18) and 4.5 years (ARMS-LT, n=13), and 19 HC. RESULTS The ARMS-ST group showed less GMV in the right and left insula compared to the ARMS-LT (Cohen's d 1.67) and FEP groups (Cohen's d 1.81) respectively. These GMV differences were correlated positively with global functioning in the whole ARMS group. Insular alterations were associated with negative symptomatology in the whole ARMS group, and also with hallucinations in the ARMS-ST and ARMS-LT subgroups. We found a significant effect of previous antipsychotic medication use on GMV abnormalities in the FEP group. CONCLUSIONS GMV abnormalities in subjects at high clinical risk for psychosis are associated with negative and positive psychotic symptoms, and global functioning. Alterations in the right insula are associated with a higher risk for transition to psychosis, and thus may be related to different transition probabilities.
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Affiliation(s)
- R. Smieskova
- Department of Psychiatry, University of Basel, Switzerland
- Medical Image Analysis Centre, University of Basel, Switzerland
| | - P. Fusar-Poli
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK
| | - J. Aston
- Department of Psychiatry, University of Basel, Switzerland
| | - A. Simon
- Specialized Out-patient Service for Early Psychosis, Department of Psychiatry, Bruderholz, Switzerland
- University Hospital of Psychiatry, University of Bern, Switzerland
| | - K. Bendfeldt
- Medical Image Analysis Centre, University of Basel, Switzerland
| | - C. Lenz
- Radiological Physics, University Hospital Basel, Switzerland
| | | | - P. McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK
| | | | - S. J. Borgwardt
- Department of Psychiatry, University of Basel, Switzerland
- Medical Image Analysis Centre, University of Basel, Switzerland
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK
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Jones KB, Su L, Jin H, Lenz C, Randall RL, Underhill TM, Nielsen TO, Sharma S, Capecchi MR. SS18-SSX2 and the mitochondrial apoptosis pathway in mouse and human synovial sarcomas. Oncogene 2012; 32:2365-71, 2375.e1-5. [PMID: 22797074 DOI: 10.1038/onc.2012.247] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Synovial sarcoma is a deadly malignancy with limited sensitivity to traditional cytotoxic chemotherapy. SS18-SSX fusion oncogene expression characterizes human synovial sarcomas and drives oncogenesis in a mouse model. Elevated expression of BCL2 is considered a consistent feature of the synovial sarcoma expression profile. Our objective was to evaluate the expression of apoptotic pathway members in synovial sarcomas and interrogate the impact of modulating SS18-SSX expression on this pathway. We show in human and murine synovial sarcoma cells that SS18-SSX increases BCL2 expression, but represses other anti-apoptotic genes, including MCL1 and BCL2A1. This repression is achieved by directly suppressing expression via binding through activating transcription factor 2 (ATF2) to the cyclic adenosine monophosphate (AMP) response element (CRE) in the promoters of these genes and recruiting TLE1/Groucho. The suppression of these two anti-apoptotic pathways silences the typical routes by which other tumors evade BH3-domain peptidomimetic pharmacotherapy. We show that mouse and human synovial sarcoma cells are sensitive in vitro to ABT-263, a BH3-peptidomimetic, much more than the other tested cancer cell lines. ABT-263 also enhances the sensitivity of these cells to doxorubicin, a traditional cytotoxic chemotherapy used for synovial sarcoma. We also demonstrate the capacity of ABT-263 to stunt synovial sarcomagenesis in vivo in a genetic mouse model. These data recommend pursuit of BH3-peptidomimetic pharmacotherapy in human synovial sarcomas.
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Affiliation(s)
- K B Jones
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112-5331, USA
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Vogt H, Ehmann I, Kremer M, Lenz C, Grab D. Kongenitale zystische adenomatoide Lungenmalformation (CCAML). Z Geburtshilfe Neonatol 2012. [DOI: 10.1055/s-0032-1309101] [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: 10/28/2022]
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Finan M, Boudreaux C, Donnell R, Gates T, Klein M, Lenz C, Rocconi R. Capillary lymphatic space (CLS) invasion in robotic vs abdominal hysterectomy for endometrial cancer. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.398] [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]
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Lenz C, Klarhöfer M, Scheffler K. Feasibility of in vivo myelin water imaging using 3D multigradient-echo pulse sequences. Magn Reson Med 2011; 68:523-8. [PMID: 22213038 DOI: 10.1002/mrm.23241] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 08/10/2011] [Accepted: 09/08/2011] [Indexed: 11/12/2022]
Abstract
Quantitative myelin water imaging is able to show demyelinating processes and, therefore, provides insight into the pathology of white matter diseases such as multiple sclerosis. So far, mapping of the myelin water fraction most often was performed using single-slice multiecho spin-echo sequences. Recently, a different approach using two-dimensional multigradient-echo pulse sequences was suggested. In this work, a solution to three-dimensional in vivo myelin water fraction imaging is presented that applies multigradient-echo pulse sequences and uses non-negative least squares algorithms to analyze the multicomponent T*(2) decay. The suggested method offers not only whole brain coverage but also clinically practicable acquisition times. The obtained myelin water fraction values are low (6.9% for white matter) but are able to detect demyelination in multiple sclerosis lesions. However, the clinical application of the proposed method remains questionable, because further measurements that clarify the possibility of detecting ongoing processes in lesions are needed.
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Affiliation(s)
- C Lenz
- Department of Radiological Physics, University of Basel Hospital, Basel, Switzerland.
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Smieskova R, Allen P, Simon A, Aston J, Bendfeldt K, Drewe J, Gruber K, Gschwandtner U, Klarhoefer M, Lenz C, Scheffler K, Stieglitz RD, Radue EW, McGuire P, Riecher-Rössler A, Borgwardt SJ. Different duration of at-risk mental state associated with neurofunctional abnormalities. A multimodal imaging study. Hum Brain Mapp 2011; 33:2281-94. [PMID: 21922599 DOI: 10.1002/hbm.21360] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 03/22/2011] [Accepted: 04/26/2011] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Neurofunctional alterations are correlates of vulnerability to psychosis, as well as of the disorder itself. How these abnormalities relate to different probabilities for later transition to psychosis is unclear. We investigated vulnerability- versus disease-related versus resilience biomarkers of psychosis during working memory (WM) processing in individuals with an at-risk mental state (ARMS). EXPERIMENTAL DESIGN Patients with "first-episode psychosis" (FEP, n = 21), short-term ARMS (ARMS-ST, n = 17), long-term ARMS (ARMS-LT, n = 16), and healthy controls (HC, n = 20) were investigated with an n-back WM task. We examined functional magnetic resonance imaging (fMRI) and structural magnetic resonance imaging (sMRI) data in conjunction using biological parametric mapping (BPM) toolbox. PRINCIPAL OBSERVATIONS There were no differences in accuracy, but the FEP and the ARMS-ST group had longer reaction times compared with the HC and the ARMS-LT group. With the 2-back > 0-back contrast, we found reduced functional activation in ARMS-ST and FEP compared with the HC group in parietal and middle frontal regions. Relative to ARMS-LT individuals, FEP patients showed decreased activation in the bilateral inferior frontal gyrus and insula, and in the left prefrontal cortex. Compared with the ARMS-LT, the ARMS-ST subjects showed reduced activation in the right inferior frontal gyrus and insula. Reduced insular and prefrontal activation was associated with gray matter volume reduction in the same area in the ARMS-LT group. CONCLUSIONS These findings suggest that vulnerability to psychosis was associated with neurofunctional alterations in fronto-temporo-parietal networks in a WM task. Neurofunctional differences within the ARMS were related to different duration of the prodromal state and resilience factors.
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Affiliation(s)
- Renata Smieskova
- Department of Psychiatry, University of Basel, c/o University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland
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Lenz C, Klarhöfer M, Scheffler K, Winter L, Sommer G. Assessing extracranial tumors using diffusion-weighted whole-body MRI. Z Med Phys 2011; 21:79-90. [DOI: 10.1016/j.zemedi.2010.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 04/29/2010] [Accepted: 06/01/2010] [Indexed: 01/20/2023]
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Sommer G, Klarhöfer M, Lenz C, Scheffler K, Bongartz G, Winter L. Signal characteristics of focal bone marrow lesions in patients with multiple myeloma using whole body T1w-TSE, T2w-STIR and diffusion-weighted imaging with background suppression. Eur Radiol 2010; 21:857-62. [DOI: 10.1007/s00330-010-1950-0] [Citation(s) in RCA: 37] [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: 07/19/2010] [Accepted: 08/13/2010] [Indexed: 11/29/2022]
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48
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Abstract
BACKGROUND Body image distortion is a key symptom of anorexia nervosa. In behavioral research two components of body image have been defined: attitudes towards the body and body size experience. Neuroimaging studies concerning own body image distortions in anorexia nervosa have revealed an inconsistent pattern of results and are constrained by the fact that no direct distinction between the different parts of body image has been made. METHOD The present study therefore set out to investigate the neural correlates of two parts of the own body image using functional magnetic resonance imaging (fMRI): satisfaction rating and size estimation for distorted own body photographs in patients with anorexia nervosa and controls. RESULTS Anorectic patients were less satisfied with their current body shape than controls. Patients further demonstrated stronger activation of the insula and lateral prefrontal cortex during the satisfaction rating of thin self-images. This indicates a stronger emotional involvement when patients are presented with distorted images close to their own ideal body size. Patients also overestimated their own body size. We were able to show complex differential modulations in activation of the precuneus during body size estimation in control and anorectic subjects. It could be speculated that a deficit in the retrieval of a multimodal coded body schema in precuneus/posterior parietal cortex is related to body size overestimation. CONCLUSIONS We were able to find specific behavioral responses and neural activation patterns for two parts of body image in anorexia nervosa and healthy controls. Thus, the present results underline the importance of developing research and therapeutic strategies that target the two different aspects of body image separately.
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Affiliation(s)
- H M Mohr
- Department of Biological Psychology, Institute of Psychology, Johann Wolfgang Goethe University, Frankfurt, Germany.
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Fortin T, Salvador A, Charrier JP, Lenz C, Bettsworth F, Lacoux X, Choquet-Kastylevsky G, Lemoine J. Multiple Reaction Monitoring Cubed for Protein Quantification at the Low Nanogram/Milliliter Level in Nondepleted Human Serum. Anal Chem 2009; 81:9343-52. [DOI: 10.1021/ac901447h] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- T. Fortin
- R&D Proteomique, bioMérieux SA, Marcy l’Etoile, France, UMR 5180 Sciences Analytiques, Université de Lyon, Lyon1, France, and PSM Support, Applied Biosystems, Darmstadt, Germany
| | - A. Salvador
- R&D Proteomique, bioMérieux SA, Marcy l’Etoile, France, UMR 5180 Sciences Analytiques, Université de Lyon, Lyon1, France, and PSM Support, Applied Biosystems, Darmstadt, Germany
| | - J. P. Charrier
- R&D Proteomique, bioMérieux SA, Marcy l’Etoile, France, UMR 5180 Sciences Analytiques, Université de Lyon, Lyon1, France, and PSM Support, Applied Biosystems, Darmstadt, Germany
| | - C. Lenz
- R&D Proteomique, bioMérieux SA, Marcy l’Etoile, France, UMR 5180 Sciences Analytiques, Université de Lyon, Lyon1, France, and PSM Support, Applied Biosystems, Darmstadt, Germany
| | - F. Bettsworth
- R&D Proteomique, bioMérieux SA, Marcy l’Etoile, France, UMR 5180 Sciences Analytiques, Université de Lyon, Lyon1, France, and PSM Support, Applied Biosystems, Darmstadt, Germany
| | - X. Lacoux
- R&D Proteomique, bioMérieux SA, Marcy l’Etoile, France, UMR 5180 Sciences Analytiques, Université de Lyon, Lyon1, France, and PSM Support, Applied Biosystems, Darmstadt, Germany
| | - G. Choquet-Kastylevsky
- R&D Proteomique, bioMérieux SA, Marcy l’Etoile, France, UMR 5180 Sciences Analytiques, Université de Lyon, Lyon1, France, and PSM Support, Applied Biosystems, Darmstadt, Germany
| | - J. Lemoine
- R&D Proteomique, bioMérieux SA, Marcy l’Etoile, France, UMR 5180 Sciences Analytiques, Université de Lyon, Lyon1, France, and PSM Support, Applied Biosystems, Darmstadt, Germany
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Abdrakhmanova A, Schlichting R, Hunter CL, Glueckmann M, Lenz C, Echeverri CJ, Soennichsen B, Jung A, Weiss-Haljiti C. RNAi and iTRAQ reagents united: targeted quantitation of siRNA-mediated protein silencing in human cells. Anal Bioanal Chem 2009; 395:773-85. [PMID: 19711061 DOI: 10.1007/s00216-009-3028-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 07/21/2009] [Accepted: 07/24/2009] [Indexed: 10/20/2022]
Abstract
Bridging the gap between functional genomics and traditional molecular cell biology is a challenge of the next decade. Here, we are aiming to find routines for targeted quantitation of protein silencing in response to RNAi based on complex cellular lysates. A workflow was established adapting siRNA treatment, processing the sample, generating isobaric iTRAQ-reagent-labeled peptides, and analyzing the sample applying MRM-based peptide quantitation to verify protein silencing on a 4000 QTRAP LC/MS/MS mass spectrometer. Subsequently, eight targets were analyzed, mostly with two siRNA designs. Although transcript and protein silencing correlated, the downregulation on the protein level was less pronounced. A time-course analysis of the chaperon HSPA9/mortalin indicated a delayed kinetic of protein versus transcript silencing. Further, the analysis of the functional response on the example of HSD17B4, a multifunctional enzyme essential to generate precursors for cholesterol biosynthesis, confirmed that strong silencing on the transcript level accompanied by moderate reduction of protein is sufficient to generate a physiological significant response. Fifty percent protein silencing resulted in a 3.5-fold induction of low-density lipoprotein and therefore cholesterol uptake in human liver cells. The established routines pave the way for the development of targeted protein quantitation assays suitable for target and biomarker validation.
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Affiliation(s)
- A Abdrakhmanova
- Applied Biosystems, Life Technologies, Frankfurter Strasse 129B, 64293, Darmstadt, Germany
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