Articles

PIMIDES I: a pilot study to assess the feasibility of patient-controlled neurostimulation with the EASEE® system to treat medically refractory focal epilepsy

The study design of PIMIDES, a trial based on patient-individualized transcranial electric neurostimulation of epileptic foci, is reported. Inclusion criteria include a predominant epileptic focus and pharmaco...

Authors: Kristina Kravalis and Andreas Schulze-Bonhage

How to use and assess qualitative research methods

This paper aims to provide an overview of the use and assessment of qualitative research methods in the health sciences. Qualitative research can be defined as the study of the nature of phenomena and is especial...

Authors: Loraine Busetto, Wolfgang Wick and Christoph Gumbinger

Optical coherence tomography-based assessment of retinal vascular pathology in cerebral small vessel disease

Cerebral small vessel disease (CSVD) is a disorder of brain vasculature that causes various structural changes in the brain parenchyma, and is associated with various clinical symptoms such as cognitive impair...

Authors: A. Abdelhak, A. Huss, A. Brück, U. Sebert, B. Mayer, H. P. Müller, H. Tumani, M. Otto, D. Yilmazer-Hanke, A. C. Ludolph, J. Kassubek, E. Pinkhardt and H. Neugebauer

Changed functional connectivity at rest in functional illiterates after extensive literacy training

About 6.2 million adults in Germany cannot read and write properly despite attending school for several years. They are considered to be functional illiterates (FI). Since the ability to read and write is cruc...

Authors: Bahram Mohammadi, Thomas F. Münte, David M. Cole, Amir Sami, Melanie Boltzmann and Jascha Rüsseler

Prevention of migraine with monoclonal antibodies against CGRP or the CGRP receptor

Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor (Erenumab) or against CGRP (Eptinezumab, Fremanezumab, Galcanezumab) are new substances for the preventive treatment of migrain...

Authors: Hans-Christoph Diener, Stefanie Förderreuther, Charly Gaul, Florian Giese, Till Hamann, Dagny Holle-Lee, Tim P. Jürgens, Katharina Kamm, Torsten Kraya, Christian Lampl, Arne May, Uwe Reuter, Armin Scheffler and Peer Tfelt-Hansen

Protocol for a multicenter observational prospective study of functional recovery from stroke beyond inpatient rehabilitation - The Interdisciplinary Platform for Rehabilitation Research and Innovative Care of Stroke Patients (IMPROVE)

Stroke and its long-term consequences pose major challenges for the lives of those affected and healthcare systems. Neurological rehabilitation therefore primarily attempts to improve function in order to incr...

Authors: Gunnar Birke, Silke Wolf, Thies Ingwersen, Christian Bartling, Gabriele Bender, Alfons Meyer, Achim Nolte, Katharina Ottes, Oliver Pade, Martin Peller, Jochen Steinmetz, Christian Gerloff and Götz Thomalla

Inter-rater and test-retest reliability of the “standardized endoscopic swallowing evaluation for tracheostomy decannulation in critically ill neurologic patients”

Removal of a tracheostomy tube in critically ill neurologic patients is a difficult issue, particularly due to the high incidence of oropharyngeal dysphagia. For an objective evaluation of decannulation readin...

Authors: Tobias Warnecke, Paul Muhle, Inga Claus, Jens B. Schröder, Bendix Labeit, Sriramya Lapa, Sonja Suntrup-Krueger and Rainer Dziewas

S1 guidelines “lumbar puncture and cerebrospinal fluid analysis” (abridged and translated version)

Cerebrospinal fluid (CSF) analysis is important for detecting inflammation of the nervous system and the meninges, bleeding in the area of the subarachnoid space that may not be visualized by imaging, and the ...

Authors: H. Tumani, H. F. Petereit, A. Gerritzen, C. C. Gross, A. Huss, S. Isenmann, S. Jesse, M. Khalil, P. Lewczuk, J. Lewerenz, F. Leypoldt, N. Melzer, S. G. Meuth, M. Otto, K. Ruprecht, E. Sindern…

Verum versus sham tDCS in the treatment of stroke-induced apraxia: study protocol of the randomized controlled trial RAdiCS -“Rehabilitating (stroke-induced) Apraxia with direct Current Stimulation”

Stroke is the leading cause of acquired disability in western societies. (Motor) cognitive deficits like apraxia significantly contribute to disability after stroke, harming activities of daily living and reha...

Authors: Nina N. Kleineberg, Monika K. Richter, Ingrid Becker, Peter H. Weiss and Gereon R. Fink

Neurological research and practice: the first year

Authors: Werner Hacke

Antibody-related movement disorders – a comprehensive review of phenotype-autoantibody correlations and a guide to testing

Over the past decade increasing scientific progress in the field of autoantibody–mediated neurological diseases was achieved. Movement disorders are a frequent and often prominent feature in such diseases whic...

Authors: Felix Gövert, Frank Leypoldt, Ralf Junker, Klaus-Peter Wandinger, Günther Deuschl, Kailash P. Bhatia and Bettina Balint

Remarkable improvement of primary orthostatic tremor using perampanel

Management of primary orthostatic tremor (POT) remains challenging, and medication is often ineffective.

Authors: Marcus Grobe-Einsler and Oliver Kaut

Acute intermittent porphyria (AIP) in a patient with celiac disease

We present the case of an 18 year old Caucasian with known celiac disease, who suffered a severe first attack of acute intermittent porphyria (AIP) with neuropsychiatric symptoms, severe tetraparesis and respi...

Authors: Sebastian Nunnemann, Christoph Uibel, Petra Budig and Mathias Mäurer

SOP: antibody-associated autoimmune encephalitis

Antibody-mediated and paraneoplastic autoimmune encephalitides (AE) present with a broad spectrum of clinical symptoms. They often lead to progressing inflammatory changes of the central nervous system with su...

Authors: Rosa Rössling and Harald Prüss

Autoimmune encephalitis in children and adolescents

Autoimmune encephalitides with neural and glial antibodies have become an attractive field in neurology because the antibodies are syndrome-specific, explain the pathogenesis, indicate the likelihood of an und...

Authors: C. G. Bien and C. I. Bien

Second look Holter ECG in neurorehabilitation

Many stroke survivors suffer recurrent stroke because paroxysmal atrial fibrillation (AF) was missed and no preventive anticoagulation initiated. This prospective cohort study determined the added diagnostic y...

Authors: Stefan Knecht, Sebastian Petsch, Paulus Kirchhof and Bettina Studer

Signatures of immune reprogramming in anti-CD52 therapy of MS: markers for risk stratification and treatment response

Multiple sclerosis is one of the most prevalent neurological diseases in young adults affecting over 2 million people worldwide. Alemtuzumab is a highly effective therapy in relapsing remitting MS. Alemtuzumab...

Authors: Laura Bierhansl, Tobias Ruck, Steffen Pfeuffer, Catharina C. Gross, Heinz Wiendl and Sven G. Meuth

Inpatient TIA and stroke care in adult patients in Germany - retrospective analysis of nationwide administrative data sets of 2011 to 2017

Comprehensive administrative data on TIA and stroke cases and treatment modalities are fundamental for improving structural conditions and adjusting future strategies of stroke care.

Authors: Jens Eyding, Dirk Bartig, Ralph Weber, Aristeidis H. Katsanos, Christian Weimar, Werner Hacke and Christos Krogias

Anodal tDCS over left parietal cortex expedites recovery from stroke-induced apraxic imitation deficits: a pilot study

To date, specific therapeutic approaches to expedite recovery from apraxic deficits after left hemisphere (LH) stroke remain sparse. Thus, in this pilot study we evaluated the effect of anodal transcranial dir...

Authors: Jana M. Ant, Eva Niessen, Elisabeth I. S. Achilles, Jochen Saliger, Hans Karbe, Peter H. Weiss and Gereon R. Fink

Neuro-Sweet syndrome - a rare differential diagnosis in aseptic meningoencephalitis

Acute febrile neutrophilic dermatosis (Sweet‘s syndrome) is a dermatological entity, which may be associated with malignancies, drugs, and infections and which is characterized by high fever, elevated neutroph...

Authors: Elgin Hoffmann, Christian Boßelmann, Stephan Forchhammer, Holger Lerche and Tobias Freilinger

Genotypes and phenotypes of patients with Lafora disease living in Germany

Lafora progressive myoclonus epilepsy (Lafora disease) is a rare, usually childhood-onset, fatal neurodegenerative disease caused by biallelic mutations in EPM2A (Laforin) or EPM2B (NHLRC1; Malin). The epidemiolo...

Authors: David Brenner, Tobias Baumgartner, Sarah von Spiczak, Jan Lewerenz, Roger Weis, Anja Grimmer, Petra Gaspirova, Claudia D. Wurster, Wolfram S. Kunz, Jan Wagner, Berge A. Minassian, Christian E. Elger, Albert C. Ludolph, Saskia Biskup and Dennis Döcker

Outcome evaluation by patient reported outcome measures in stroke clinical practice (EPOS) protocol for a prospective observation and implementation study

The impact of stroke-related impairment on activities of daily living may vary between patients, and can only be estimated by applying patient-reported outcome measures. The International Consortium for Health...

Authors: D. Leander Rimmele, Lisa Lebherz, Marc Frese, Hannes Appelbohm, Hans-Jürgen Bartz, Levente Kriston, Christian Gerloff, Martin Härter and Götz Thomalla

The use of a dedicated neurological triage system improves process times and resource utilization: a prospective observational study from an interdisciplinary emergency department

Patients with neurological symptoms have been contributing to the increasing rates of emergency department (ED) utilization in recent years. Existing triage systems represent neurological symptoms rather crude...

Authors: Carolin Hoyer, Patrick Stein, Hans-Werner Rausch, Angelika Alonso, Simon Nagel, Michael Platten and Kristina Szabo

Position paper: ability to drive in cerebrovascular diseases

The regulations for fitness to drive after a cerebrovascular accident in the German Driving License Regulations (FeV) and the German Evaluation Guidelines for Driving Ability (BGL). are not up to date with the...

Authors: Peter Marx, Gerhard Hamann, Otto Busse, Thomas Mokrusch, Hendrik Niemann, Hartmut Vatter and Bernhard Widder

Protocol of a randomized, double-blind, placebo-controlled, parallel-group, multicentre study of the efficacy and safety of nicotinamide in patients with Friedreich ataxia (NICOFA)

Currently, no treatment that delays with the progression of Friedreich ataxia is available. In the majority of patients Friedreich ataxia is caused by homozygous pathological expansion of GAA repeats in the fi...

Authors: Kathrin Reetz, Ralf-Dieter Hilgers, Susanne Isfort, Marc Dohmen, Claire Didszun, Kathrin Fedosov, Jennifer Kistermann, Caterina Mariotti, Alexandra Durr, Sylvia Boesch, Thomas Klopstock, Francisco Javier Rodríguez de Rivera Garrido, Ludger Schöls, Thomas Klockgether, Massimo Pandolfo, Rudolf Korinthenberg…

General principles and escalation options of immunotherapy in autoantibody-associated disorders of the CNS

Autoimmune diseases associated with antineuronal and antiglial autoantibodies (Abs) is one of the most rapidly expanding research fields in clinical neuroimmunology, with more than 30 autoantibodies described ...

Authors: Ilya Ayzenberg, Simon Faissner, Laura Tomaske, Daniel Richter, Volker Behrendt and Ralf Gold

Evaluation of a programming algorithm for deep brain stimulation in dystonia used in a double-blind, sham-controlled multicenter study

Programming deep brain stimulation in dystonia is difficult because of the delayed benefits and absence of evidence-based guidelines. Therefore, we evaluated the efficacy of a programming algorithm applied in ...

Authors: Frank Steigerwald, Anna Dalal Kirsch, Andrea A. Kühn, Andreas Kupsch, Joerg Mueller, Wilhelm Eisner, Günther Deuschl, Daniela Falk, Alfons Schnitzler, Inger Marie Skogseid, Juliane Vollmer-Haase, Chi W. Ip, Volker Tronnier, Jan Vesper, Markus Naumann and Jens Volkmann

Prevalence of hereditary transthyretin amyloid polyneuropathy in idiopathic progressive neuropathy in conurban areas

Hereditary transthyretin amyloidosis (ATTR amyloidosis) is a rare, genetically heterogenous, and clinically variable autosomal dominant disease that severely reduces life expectancy. As treatment options grow,...

Authors: Andreas Thimm, Saskia Bolz, Michael Fleischer, Benjamin Stolte, Sebastian Wurthmann, Andreas Totzeck, Alexander Carpinteiro, Peter Luedike, Maria Papathanasiou, Christoph Rischpler, Ken Herrmann, Tienush Rassaf, Lars Steinmüller-Magin, Christoph Kleinschnitz and Tim Hagenacker

Molecular mechanisms of proteinopathies across neurodegenerative disease: a review

Although there is a range of different symptoms across neurodegenerative diseases, they have been noted to have common pathogenic features. An archetypal feature shared between these diseases is protein misfol...

Authors: Alexander P. Marsh

The German trial on Aciclovir and Corticosteroids in Herpes-simplex-virus-Encephalitis (GACHE): a multicenter, randomized, double-blind, placebo-controlled trial

Comprehensive treatment of Herpes-simplex-virus-encephalitis (HSVE) remains a major clinical challenge. The current therapy gold standard is aciclovir, a drug that inhibits viral replication. Despite antiviral...

Authors: U. Meyding-Lamadé, C. Jacobi, F. Martinez-Torres, T. Lenhard, B. Kress, M. Kieser, C. Klose, K. Einhäupl, J. Bösel, M-B Mackert, V. Homberg, C. Koennecke, G. Weißheit, D. Claus, B. Kieseier, J. Bardutzky…

Conditioned pain modulation in drug-naïve patients with de novo Parkinson’s disease

Pain is highly prevalent in patients with Parkinson’s disease (PD), but underlying pathophysiological mechanisms are largely unclear. In many chronic pain syndromes deficits in endogenous pain inhibition have ...

Authors: Wiebke Grashorn, Odette Fründt, Carsten Buhmann, Nathalie Wrobel, Katharina Schmidt and Ulrike Bingel

An omics-based strategy using coenzyme Q10 in patients with Parkinson’s disease: concept evaluation in a double-blind randomized placebo-controlled parallel group trial

This study focuses on genetically stratified subgroups of Parkinson’s disease patients (PD) with an enrichment of risk variants in mitochondrial genes,who might benefit from treatment with the “mitochondrial e...

Authors: Jannik Prasuhn, Norbert Brüggemann, Nicole Hessler, Daniela Berg, Thomas Gasser, Kathrin Brockmann, Denise Olbrich, Andreas Ziegler, Inke R. König, Christine Klein and Meike Kasten

Human immunodeficiency virus and multiple sclerosis: a review of the literature

Multiple sclerosis (MS) and human immunodeficiency virus (HIV) infection are frequent and well-studied nosological entities. Yet, comorbidity of MS and HIV has only been rarely reported in the medical literatu...

Authors: Maria-Ioanna Stefanou, Markus Krumbholz, Ulf Ziemann and Markus C. Kowarik

Computer-aided imaging analysis in acute ischemic stroke – background and clinical applications

Tools for medical image analysis have been developed to reduce the time needed to detect abnormalities and to provide more accurate results. Particularly, tools based on artificial intelligence and machine lea...

Authors: Yahia Mokli, Johannes Pfaff, Daniel Pinto dos Santos, Christian Herweh and Simon Nagel

SOP myasthenic crisis

The overall prevalence of myasthenic crisis is quite low at 30/1 million inhabitants because myasthenia gravis is a rare disease per se. But it should be noted that 15–20% of patients with myasthenia gravis ex...

Authors: Henning Stetefeld and Michael Schroeter

An unmet clinical need: roads to remyelination in MS

In the central nervous system (CNS) myelin sheaths stabilize, protect, and electrically insulate axons. However, in demyelinating autoimmune CNS diseases such as multiple sclerosis (MS) these sheaths are destr...

Authors: Peter Göttle, Moritz Förster, Vivien Weyers, Patrick Küry, Konrad Rejdak, Hans-Peter Hartung and David Kremer

New alternative splicing variants of the ATXN2 transcript

Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant disorder with progressive degeneration of cerebellar Purkinje cells and selective loss of neurons in the brainstem. This neurodegenerative disorder...

Authors: Isabel Lastres-Becker, David Nonis, Joachim Nowock and Georg Auburger

HDMTX-based induction therapy followed by consolidation with conventional systemic chemotherapy and intraventricular therapy (modified Bonn protocol) in primary CNS lymphoma: a monocentric retrospective analysis

To evaluate outcome and toxicity of High-dose methotrexate (HDMTX)-based induction therapy followed by consolidation with conventional systemic chemotherapy and facultative intraventricular therapy (modified B...

Authors: Sabine Seidel, Agnieszka Korfel, Thomas Kowalski, Michelle Margold, Fatme Ismail, Roland Schroers, Alexander Baraniskin, Hendrik Pels, Peter Martus and Uwe Schlegel

Emerging and re-emerging viruses affecting the nervous system

Emerging and re-emerging viruses may cause meningitis, encephalitis, meningoencephalomyelitis, encephalitis, Guillian-Barré-like-syndromes as well as strokes. Most important viruses belong to the family of Adenov...

Authors: Uta Meyding-Lamadé, Eva Craemer and Paul Schnitzler

Functional stroke outcomes after mobile stroke unit deployment – the revised protocol for the Berlin Prehospital Or Usual Delivery of acute stroke care (B_PROUD) part 2 study

Studies investigating the Mobile Stroke Unit (MSU) concept have shown increased thrombolysis rates, reduced alarm-to-treatment times and improved prehospital triage. Yet, so far, there is no definite scientifi...

Authors: Peter Harmel, Martin Ebinger, Erik Freitag, Ulrike Grittner, Irina Lorenz-Meyer, Ira Napierkowski, Christian H. Nolte, Bob Siegerink and Heinrich J. Audebert

Ulnar nerve integrity predicts 1-year outcome in cervical spinal cord injury

Accurate predictors of neurological recovery after cervical spinal cord injury are needed. Particularly, to tailor adequate rehabilitation plans. However, objective and quantifiable predictors are sparse.

Authors: Andreas Hug, Christian Schuld, Bettina Mürle, Markus Böttinger, Norbert Weidner and Rüdiger Rupp

Cerebral involvement in systemic vasculitides

Cerebral vasculitis is a rare disorder but plays a major role in the differential diagnosis of stroke, encephalopathy and headache. This guideline was developed in order to support clinicians in the diagnosis ...

Authors: Peter Berlit and Markus Krämer

Resumption of oral anticoagulation after spontaneous intracerebral hemorrhage

Given an ageing population the incidence of both patients suffering from intracerebral hemorrhage (ICH) and those requiring oral anticoagulation will increase. Up to now there are no results from randomized tr...

Authors: Jochen A. Sembill, Joji B. Kuramatsu, Stefan Schwab and Hagen B. Huttner

Aneurysmatic subarachnoid haemorrhage

Aneurysmatic Subarachnoid Haemorrhage (aSAH) is typically caused by extravasated blood in the subarachnoid space due to a ruptured aneurysm. aSAH is often life-threatening in the acute stage, but may also caus...

Authors: Oezguer A. Onur, Gereon R. Fink, Joji B. Kuramatsu and Stefan Schwab

Historical review: a short history of German neurology – from its origins to the 1940s

This paper aims at reconstructing the development and role of German neurology between 1840 and 1940. Therefore a couple of original sources as well as selected material form the scattered secondary literature...

Authors: A. Karenberg, H. Fangerau, H. Steinmetz, P. Berlit and M. Grond

Safety and clinical impact of FEES – results of the FEES-registry

At present, the flexible endoscopic evaluation of swallowing (FEES) is one of the most commonly used methods for the objective assessment of swallowing. This multicenter trial prospectively collected data on t...

Authors: Rainer Dziewas, Matthias auf dem Brinke, Ulrich Birkmann, Götz Bräuer, Kolja Busch, Franziska Cerra, Renate Damm-Lunau, Juliane Dunkel, Amelie Fellgiebel, Elisabeth Garms, Jörg Glahn, Sandra Hagen, Sophie Held, Christine Helfer, Mirko Hiller, Christina Horn-Schenk…

Primary angiitis of the CNS (PACNS) and Behçet disease

Cerebral vasculitis is a rare disorder but plays a major role in the differential diagnosis of stroke, encephalopathy and headache. This guideline was developed in order to support clinicians in the diagnosis ...

Authors: Peter Berlit and Markus Krämer

Neurobiology and clinical features of impulse control failure in Parkinson’s disease

Impulse control disorders (ICDs) and other impulsive-compulsive related behaviours are frequent and still under recognized non-motor complications of Parkinson’s disease (PD). They result from sensitization of...

Authors: Matthieu Béreau, Paul Krack, Norbert Brüggemann and Thomas F. Münte

Socioeconomic decline and advancement within and between generations and the risk of stroke - a case-control study

Disadvantageous socioeconomic conditions (SEC) in both childhood and adulthood increase the risk of stroke. We investigated whether intergenerational and lifetime social advancement decreases and/or social des...

Authors: Armin J. Grau, Annette Aigner, Christian Urbanek, Frederik Palm, Florian Buggle, Anton Safer and Heiko Becher

GCS 15: when mild TBI isn’t so mild

The present study characterizes patients with the mildest of mild traumatic brain injury (TBI), as defined by a Glasgow coma score (GCS) of 15.

Authors: Latha Ganti, Tej Stead, Yasamin Daneshvar, Aakash N. Bodhit, Christa Pulvino, Sarah W. Ayala and Keith R. Peters