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Papers by Maja Tippmann-peikert

Neurology, Jan 11, 2014

To describe the detection frequency and clinical associations of immunoglobulin G (IgG) targeting... more To describe the detection frequency and clinical associations of immunoglobulin G (IgG) targeting dipeptidyl-peptidase-like protein-6 (DPPX), a regulatory subunit of neuronal Kv4.2 potassium channels. Specimens from 20 patients evaluated on a service basis by tissue-based immunofluorescence yielded a synaptic immunostaining pattern consistent with DPPX-IgG (serum, 20; CSF, all 7 available). Transfected HEK293 cell-based assay confirmed DPPX specificity in all specimens. Sixty-nine patients with stiff-person syndrome and related disorders were also evaluated by DPPX-IgG cell-based assay. Of 20 seropositive patients, 12 were men; median symptom onset age was 53 years (range, 13-75). Symptom onset was insidious in 15 and subacute in 5. Twelve patients reported prodromal weight loss. Neurologic disorders were multifocal. All had one or more brain or brainstem manifestations: amnesia (16), delirium (8), psychosis (4), depression (4), seizures (2), and brainstem disorders (15; eye movemen...

Sleep medicine, 2014

As factors associated with injury in rapid eye movement (REM) sleep behavior disorder (RBD) remai... more As factors associated with injury in rapid eye movement (REM) sleep behavior disorder (RBD) remain largely unknown, we aimed to identify such factors. We surveyed consecutive idiopathic (iRBD) or symptomatic RBD patients seen between 2008 and 2010 regarding RBD-related injuries. Associations between injuries and clinical variables were determined with odds ratios (OR) and multiple logistic regression analyses. The primary outcome variables were injury and injury severity. Fifty-three patients (40%) responded. Median age was 69 years, and 35 (73.5%) were men. Twenty-eight (55%) had iRBD. Twenty-nine (55%) reported injury, with 37.8% to self and 16.7% to the bed partner. 11.3% had marked injuries requiring medical intervention or hospitalization, including two (4%) subdural hematomas. iRBD diagnosis (OR = 6.8, p = 0.016) and dream recall (OR = 7.5, p = 0.03) were associated with injury; and iRBD diagnosis was independently associated with injury and injury severity adjusting for age, ...

Lee-Chiong/Sleep: A Comprehensive Handbook, 2005

... MAJA TIPPMANN-PEIKERT, TIMOTHY I. MORGENTHALER, BRADLEY F. BOEVE, AND MICHAEL H. SILBER Mayo ... more ... MAJA TIPPMANN-PEIKERT, TIMOTHY I. MORGENTHALER, BRADLEY F. BOEVE, AND MICHAEL H. SILBER Mayo Clinic College of Medicine, Rochester ... or bedpartner [3]. Even though the earliest descriptions of RBD date back to around 1600 (Miguel de Cervantes in Don ...

Sleep Medicine, 2011

Objective-To validate a questionnaire focused on REM sleep behavior disorder (RBD) among particip... more Objective-To validate a questionnaire focused on REM sleep behavior disorder (RBD) among participants in an aging and dementia cohort.

Sleep and Breathing, 2012

Descriptions of nocturnal vocalizations, including catathrenia, are few. We undertook a study at ... more Descriptions of nocturnal vocalizations, including catathrenia, are few. We undertook a study at our center on patients diagnosed with catathrenia, to evaluate the characteristic features of these events and their response to continuous positive airway pressure (CPAP) treatment. Retrospective study of patients with a diagnosis of catathrenia who had an overnight polysomnogram (PSG) and available synchronized audio video recordings (to confirm the presence of moaning and groaning), at our center between January 2007 and May 2010. Ten patients were included in the analysis. Three (30%) patients presented with the chief complaint of expiratory noises during sleep. The other moaning/groaning sounds were incidental findings noted by the sleep technologist and/or the sleep physician. The number of moaning/groaning events during PSG varied between 2 and 343 per patient with sound duration ranging from 0.4 to 21.4 s. Moaning/groaning events during exhalation (1,026 episodes) were separated into typical catathrenia events (as per the International Classification of Sleep Disorders, 2nd edition [ICSD-2] definition) and atypical/nocturnal vocalization events (moaning/groaning events that did not meet the ICSD-2 criteria). Typical catathrenia events (5% or 52/1,026) were experienced by five of the ten patients and had mean exhalation duration of 14.97 ± 5.13 s (range 5.8-24 s) with a mean sound duration of 8.47 ± 5.97 s (range 2-21.4 s). The typical and atypical events occurred predominantly in NREM sleep. Six of the ten patients had associated sleep-disordered breathing and four underwent CPAP titration. All four patients had significantly fewer events of moaning/groaning (mean reduction was 75.8 ± 26.2%) with CPAP. New and unique features were identified in our series of patients diagnosed with catathrenia. Though all events had the characteristic moaning and groaning sound during exhalation, only a small percentage (5%) met the catathrenia definition as outlined in ICSD-2. Do we label the atypical events as part of the spectrum of nocturnal vocalizations or consider them as catathrenia by redefining the criteria? CPAP appeared to be a reasonable treatment option.

Neurology, 2006

... Maja Tippmann-Peikert, MD,; Bradley F. Boeve, MD and; B. Mark Keegan, MD. From the Department... more ... Maja Tippmann-Peikert, MD,; Bradley F. Boeve, MD and; B. Mark Keegan, MD. From the Department of Neurology (MT-P., BFB ... Additional nonenhancing T2 lesions highly characteristic of MS were present in the posterior fossa, periventricular white matter, and corpus callosum. ...

Journal of Hypertension, 2010

Archives of Neurology, 2011

To identify the spectrum of sleep disorders associated with autoantibodies reactive with voltage-... more To identify the spectrum of sleep disorders associated with autoantibodies reactive with voltage-gated potassium channel (VGKC) complexes. Case series of all patients with neurologic disorders of VGKC autoimmunity evaluated in the Mayo Clinic Center for Sleep Medicine (Rochester, Minnesota) between January 1, 1994, and February 1, 2010. Academic referral center. Fifteen consecutive patients were identified with limbic encephalitis (n = 5), Morvan syndrome (n = 4), and overlapping features (n = 6). Ten patients received immunotherapy (corticosteroids, cyclophosphamide, or mycophenolate mofetil). Response to immunotherapy. The median VGKC autoantibody value at presentation was 1.51 nmol/L (range, 0.09-4.86 nmol/L). Neoplasms were discovered in 5 patients (33%) (thymoma [n = 2], prostate adenocarcinoma, colon adenocarcinoma, and melanoma). In 14 patients (93%), serious sleep disturbances were identified (insomnia, dream enactment behavior, suspected nocturnal epilepsy, and hypersomnia). Severe insomnia occurred in 9 patients (60%), regardless of neurologic presentation. Polysomnography at presentation (7 patients) revealed a mean sleep efficiency of 19% (4 patients had complete absence of sleep). Dream enactment behavior occurred in 8 patients (53%), including 3 of 5 with limbic encephalitis and all 4 with Morvan syndrome. Two of 7 polysomnograms demonstrated loss of rapid eye movement sleep muscle atonia; absent or minimal rapid eye movement sleep precluded interpretation in 4 patients. Sleep disorders resolved completely or almost completely in 8 of 10 patients who received immunotherapy. Sleep disorders are cardinal manifestations of VGKC complex autoimmunity in association with a spectrum of neurologic presentations. They may respond favorably to immunotherapy.

Alzheimer's & Dementia, 2011

Characteristics are shown in . Results: Caregivers reported that memory impairment was the most c... more Characteristics are shown in . Results: Caregivers reported that memory impairment was the most common presenting symptom in DLB (57%), followed by visual hallucinations (VH) (44%), depression (34%), problemsolving difficulties (33%), gait problems (28%) and tremor/stiffness (25%). In contrast, 99 % of AD carers reported impaired memory as the first symptom, whereas visual hallucinations were the presenting symtoms in only 3% of the AD cases. Prior to diagnosis, visual hallucinations (77%), gait/balance problems or falling (66%), tremor/stiffness (59%) and delirium/fluctuations of counsiousness (43%) were reported in DLB patients. There were no significant differences in symptom profile in the DLB subgroups according to dementia severity, age and gender. There was a trend towards REM-sleep behaviour disturbance (RBD) (p ¼ 0.071) and parkinsonism (p ¼ 0.157) being more common in male DLB patients, and RBD was numerically more common in the younger group (p < 0.094). Conclusions: Memory impairment and visual hallucinations were the most commonly reported presenting symptoms in DLB. The suggested sequence of symptoms in DLB patients, with cognitive and VH occuring before parkinsonism, suggest that cortical or forebrain changes often occur before involvement of the brain stem.

Alzheimer's & Dementia, 2008

Journal of Clinical Sleep Medicine, 2000

Study Objective: To describe our experience regarding the clinical and polysomnographic features ... more Study Objective: To describe our experience regarding the clinical and polysomnographic features of REM sleep behavior disorder (RBD) in childhood. Methods: This was a retrospective chart review of children and adolescents with RBD and REM sleep without atonia. Demographics, and clinical and polysomnographic information were tabulated. Our fi ndings were compared with those in the existing literature.