Eduard Auff | Medical University of Vienna (original) (raw)
Papers by Eduard Auff
Annals of Neurology, Apr 1, 1997
tial treatment with double-dose sulfamethoxazoletrimethoprim (ST), given twice daily for 1 year, ... more tial treatment with double-dose sulfamethoxazoletrimethoprim (ST), given twice daily for 1 year, might be the best approach. Because folate deficiency is a potential complication of such treatment, supplementation is recommended [5]. In many studies, there was no improvement in CNS involvement during treatment with tetracycline alone, or in combination with other antibiotics [2]. Gaze palsies and nystagmus were most responsive to treatment, and dementia was arrested in patients with WD confined to the nervous system (for review, see Reference 2). Remarkable improvement in the organic psychosyndrome was noted when using ST and slight improvement when using ceftriaxone 121. The optimum duration of antibiotic treatment is unknown. In the initial stage of WD, it appears wise to prescribe ST for a period of about 1 year [3]. Several of the CNS relapse patients had been undergoing treatment for about a year or more [2], although Fleming and co-workers 131 stated that the duration of treatment did not have any substantial effect on the outcome. We prefer long-term treatment [2]; our patient has now been treated for 32 months without having a relapse.
European Neuropsychopharmacology, 2009
Botulinumtoxin (BTX) wurde bis vor wenigen Jahren hauptsachlich als Verursacher des gefurchteten ... more Botulinumtoxin (BTX) wurde bis vor wenigen Jahren hauptsachlich als Verursacher des gefurchteten Nahrungsmittelbotulismus und als potentieller biologischer Kampfstoff erwahnt. Trotz dieser ungunstigen Voraussetzungen nimmt diese Substanz heute einen nicht mehr weg zudenkenden Stellenwert in der Behandlung neurologischer Erkrankungen ein, insbesondere solcher, die mit einem lokal erhohten Muskeltonus oder einer hyperkinetischen Bewegungsstorung einhergehen. Die lokale intramuskulare Injektion von Botulinumtoxin stellt heute die Behandlung der Wahl fur Patienten mit Torticollis spasmodicus und Blinzelkrampf dar. Auch der Einsatz von BTX-A in der Behandlung von Patienten mit fokalen spastischen Syndromen im Erwachsenen- und Kindesalter ist aus dem klinischen Alltag nicht mehr wegzudenken.
Acta chirurgica Austriaca, Apr 1, 1985
PubMed, Feb 7, 1986
An initial loss of consciousness is of grave prognostic significance in patients with acute ischa... more An initial loss of consciousness is of grave prognostic significance in patients with acute ischaemic cerebrovascular disorders, both as regards the early course as well as the long-term prognosis. The aim of this study was to assess the prognostic importance of an initial loss of consciousness in patients who had survived the acute stage. Thus, 133 out of 139 patients suffering from ischaemic cerebrovascular disorders who survived the first 3 weeks after a stroke were clinically re-examined after a mean follow-up period of more than two years. The other 6 patients had died as a result of a second stroke in the post-acute period. Patients with an initial loss of consciousness suffered cerebrovascular disturbances or fatal strokes in the follow-up period slightly more frequently than patients without an initial loss of consciousness. However, there were no convincing differences between the two groups. Indeed, on follow up, patients with an initial loss of consciousness were slightly less socially disabled than patients without an initial loss of consciousness. The results suggest that an initial loss of consciousness is no longer a factor of prognostic importance in patients who have survived the initial stage.
Journal of the Neurological Sciences, Oct 1, 2013
Background and purpose: The goal of this study was to establish the prevalence of subjective memo... more Background and purpose: The goal of this study was to establish the prevalence of subjective memory complaints (SMCs) and depressive symptoms (DS)s and their relation to cognitive functioning in patients with Parkinson's disease (PD). Methods: In all, 248 controls and 104 PD patients were included in the study. The PD group was subdivided into three PD subtypes with mild cognitive impairment (MCI) according to the Petersen criteria and three PD subtypes with MCI according to the Litvan criteria. Results: Substantial SMCs were reported by 7.7% of controls and 16.3% of the PD patients (P < 0.001). A clinically relevant degree of DSs was evident in 16.6% of controls compared with 40.4% in the PD group (P < 0.001). An analysis of variance revealed a statistically significant difference for SMCs across all Petersen groups as well across all Litvan groups. Two-factor analyses of variance with the factors cognitive status (MCI subtype) and depressive state (depressed versus not depressed) and SMCs as dependent variable revealed significant results. Conclusions: Approximately 15% of PD patients seeking help in a movement disorder clinic report significant SMCs, with an increasing degree from cognitively healthy PD to PD-MCI. Significant DSs increase SMCs across all cognitive status groups.
<b><i>Purpose:</i></b> To investigate the spatiotemporal evolution of cor... more <b><i>Purpose:</i></b> To investigate the spatiotemporal evolution of cortical activation during the initiation of optokinetic nystagmus using magnetoencephalography. <b><i>Background:</i></b> Previous imaging studies of optokinetic nystagmus in humans using positron emission tomography and functional magnetic resonance imaging discovered activation of a large set of cortical and subcortical structures during steady-state optokinetic stimulation, but did not provide information on the temporal dynamics of the initial response. Imaging studies have shown that cortical areas responsible for vision in occipital and temporo-occipital areas are involved, i.e. cortical areas control optokinetic stimulation in humans. Magnetoencephalography provides measures that reflect neural ensemble activity in the millisecond time scale, allowing the identification of early cortical components of visuomotor integration. <b><i>Design/Methods:</i></b> We studied neuromagnetic cortical responses during the initiation of optokinetic nystagmus in 6 right-handed healthy subjects. Neuromagnetic activity was recorded with a whole-head magnetoencephalograph, consisting of 143 planar gradiometers. <b><i>Results:</i></b> The mean (±SD) latency between stimulus onset and initiation of optokinetic nystagmus was 177.7 ± 59 ms. Initiation of optokinetic nystagmus evoked an early component in the primary visual cortex starting at 40-90 ms prior to the onset of the slow phase of nystagmus. Almost simultaneously an overlapping second component occurred bilaterally in the temporo-occipital area (visual motion areas), pronounced in the right hemisphere, starting at 10-60 ms prior to the slow-phase onset. Both components showed long-duration activity lasting for up to 100 ms after slow-phase onset. <b><i>Conclusions:</i></b> Our findings suggest that the initiation of optokinetic nystagmus induces early cortical activation in the occipital cortex and almost simultaneously bilaterally in the temporo-occipital cortex. These c [...]
PubMed, Apr 24, 1998
Parkinson's disease is not only a disorder affecting locomotion, but often also causes speech pro... more Parkinson's disease is not only a disorder affecting locomotion, but often also causes speech problems. Functional impairment of articulation, phonation, prosody and also respiration may occur. Speech disorder is frequent in Parkinson's disease and often has an impact on the quality of life. Speech therapy is by no means offered as a matter of course to these patients. This article outlines the different approaches of speech therapy regarding respiration, loudness, articulation, prosody, and intonation. Speech therapy seems to be useful in patients with Parkinson's disease only if there is no cognitive impairment; success also depends on motivation and eventual frequent repetition of therapy series.
International Psychogeriatrics, Sep 17, 2015
Background: Deficits in facial emotion recognition (FER) have been shown to substantially impair ... more Background: Deficits in facial emotion recognition (FER) have been shown to substantially impair several aspects in everyday life of affected individuals (e.g. social functioning). Presently, we aim at assessing differences in emotion recognition performance in three patient groups suffering from mild forms of cognitive impairment compared to healthy controls. Methods: Performance on a concise emotion recognition test battery (VERT-K) of 68 patients with subjective cognitive decline (SCD), 44 non-amnestic (non-aMCI), and 25 amnestic patients (aMCI) with mild cognitive impairment (MCI) was compared with an age-equivalent sample of 138 healthy controls all of which were recruited within the framework of the Vienna Conversion to Dementia Study. Additionally, patients and controls underwent individual assessment using a comprehensive neuropsychological test battery examining attention, executive functioning, language, and memory (NTBV), the Beck Depression Inventory (BDI), and a measure of premorbid IQ (WST). Results: Type of diagnosis showed a significant effect on emotion recognition performance, indicating progressively deteriorating results as severity of diagnosis increased. Between-groups effect sizes were substantial, showing non-trivial effects in all comparisons (Cohen's ds from −0.30 to −0.83) except for SCD versus controls. Moreover, emotion recognition performance was higher in women and positively associated with premorbid IQ. Conclusions: Our findings indicate substantial effects of progressive neurological damage on emotion recognition in patients. Importantly, emotion recognition deficits were observable in non-amnestic patients as well, thus conceivably suggesting associations between decreased recognition performance and global cognitive decline. Premorbid IQ appears to act as protective factor yielding lesser deficits in patients showing higher IQs.
Electromagnetic Tomography (EMT) is a novel imaging modality with clinically viable potentials, b... more Electromagnetic Tomography (EMT) is a novel imaging modality with clinically viable potentials, being capable for fast functional imaging. The technology, when matured, might present an effective supplement to current imaging technologies for an assessment of functionality of brain tissue with unique time resolution in a range of dozens of msec together with decent spatial resolution. We have re-designed EMT imaging technology towards brain imaging and developed novel EMT scanner for human brain imaging. The scanner was used in initial clinical studies for diagnostic of stroke. First EMT tomographic human brain imaging results are presented here.
British Journal of Dermatology, Jun 1, 1996
European Journal of Neurology, Jun 9, 2014
Background and purpose: The goal of this study was to establish the prevalence of subjective memo... more Background and purpose: The goal of this study was to establish the prevalence of subjective memory complaints (SMCs) and depressive symptoms (DS)s and their relation to cognitive functioning in patients with Parkinson's disease (PD). Methods: In all, 248 controls and 104 PD patients were included in the study. The PD group was subdivided into three PD subtypes with mild cognitive impairment (MCI) according to the Petersen criteria and three PD subtypes with MCI according to the Litvan criteria. Results: Substantial SMCs were reported by 7.7% of controls and 16.3% of the PD patients (P < 0.001). A clinically relevant degree of DSs was evident in 16.6% of controls compared with 40.4% in the PD group (P < 0.001). An analysis of variance revealed a statistically significant difference for SMCs across all Petersen groups as well across all Litvan groups. Two-factor analyses of variance with the factors cognitive status (MCI subtype) and depressive state (depressed versus not depressed) and SMCs as dependent variable revealed significant results. Conclusions: Approximately 15% of PD patients seeking help in a movement disorder clinic report significant SMCs, with an increasing degree from cognitively healthy PD to PD-MCI. Significant DSs increase SMCs across all cognitive status groups.
British Journal of Dermatology, Apr 1, 1997
Minimally Invasive Neurosurgery, 1981
ABSTRACT
Neuropsychiatrie, Jun 11, 2008
RöFo, Sep 28, 2011
Phantom pain in upper limb amputees is associated with the extent of reorganization in the primar... more Phantom pain in upper limb amputees is associated with the extent of reorganization in the primary sensorimotor cortex. Mirror visual feedback therapy has been shown to improve phantom pain. We investigated the extent of cortical reorganization in lower limb amputees and changes in neural activity induced by mirror therapy. Eight lower limb amputees underwent 12 sessions of MVFT and functional magnetic resonance imaging (fMRI) of the brain before the first and after the last MVFT session. FMRI sessions consisted of two runs in which subjects were instructed to perform repetitive movement of the healthy and phantom ankle. Before MVFT, the mean phantom pain intensity was 4.6 ± 3.1 on a visual analog scale and decreased to 1.8 ± 1.7 (p = 0.04). We did not observe a consistent pattern of cortical activation in primary sensorimotor areas during phantom limb movements. Following MVFT, increased activity was obtained in the right orbitofrontal cortex during phantom ankle movements. Comparison of cortical activity during movements of the phantom ankle and the intact ankle showed significantly higher activity in the left inferior frontal cortex (pars triangularis). These results question the known association between phantom pain and primary sensorimotor reorganization and propose reorganizational changes involving multiple cortical areas in lower limb amputees. Finally, reduction of phantom pain after mirror visual feedback therapy was associated with increased prefrontal cortical activity during phantom ankle movements.
PubMed, 2009
Background and objectives: The aim of this review was to evaluate the evidence for the treatment ... more Background and objectives: The aim of this review was to evaluate the evidence for the treatment of phantom limb pain with mirror therapy. Material and methods: Randomised controlled studies were identified by a systematic search strategy in the databases "Medline" and "The Cochrane Library". The studies were evaluated using the quality criteria of the JADAD-scale. Results: Three small-sized randomised controlled studies were identified. Unfortunately, these studies lacked methodological quality. One of them found a significant decrease of phantom pain after four weeks of daily mirror therapy sessions. Two other studies could not find a significant difference in the reduction of phantom limb pain between intervention- and control-groups. To date, there is only circumstantial evidence for mirror therapy in phantom pain. Hence, no firm recommendations regarding this treatment option are possible. Conclusion: More sufficiently powered randomised controlled studies with high methodological quality are mandatory to investigate the analgesic effect of mirror therapy in phantom limb pain.
Journal of the Neurological Sciences, Oct 1, 2013
Toxicon, Dec 1, 2016
Introduction and objectives: Cerebral palsy (CP) is the most common cause of chronic disability i... more Introduction and objectives: Cerebral palsy (CP) is the most common cause of chronic disability in childhood and may lead to cognitive delay and difficulty in walking. Botulinum toxin type A is a well-established treatment for spasticity in patients with CP. In this retrospective case series, we report our experience of incobotulinumtoxinA (Xeomin) treatment for children with CP. Methods: Sixty-nine patients with CP (63.8% male) received 191 incobo-tulinumtoxinA injections, frequently under sedation or anesthesia. Doses, treatment intervals, muscles injected, and tolerability were recorded. Results: Children's mean (standard deviation; SD) age was 8.3 (4.0) years; mean weight was 25.5 (SD, 13.5) kg; and mean time since starting treatment was 10.6 (SD, 9.4) months. The Gross Motor Function Classification System level was I for 15% of patients, II for 41%, III for 7%, IV for 15%, and V for 22%; 39.1% of patients were hemiplegic, 23.2% diplegic, and 37.3% tetraplegic. Patients received a mean (SD) of 2.8 (1.5) incobotulinumtoxinA treatments at mean (SD) intervals of 6.0 (1.7) months. From the first to the sixth treatment, the mean (SD) total dose increased from 191.7 (126.2) U (8.5 [5.4] U/kg weight) to 368.0 (170.1) U (9.9 [5.5] U/kg weight), and the mean (SD) number of muscles injected increased from 2.4 (1.2) to 4.2 (1.9). The most frequently injected muscles were gastrocnemius (68.1% of patients), hamstrings (47.8%), adductor longus (42.0%), finger flexors (18.8%), adductor magnus (18.8%), and biceps brachii (13.0%). Five adverse effects were reported (7.2% of patients, 2.6% of injections); 3 of these occurred during the first treatment. Adverse events assessed as treatment related were muscle weakness, generalized weakness, and fever. Conclusions: IncobotulinumtoxinA is well tolerated in the treatment of focal spasticity in children with CP.
Annals of Neurology, Apr 1, 1997
tial treatment with double-dose sulfamethoxazoletrimethoprim (ST), given twice daily for 1 year, ... more tial treatment with double-dose sulfamethoxazoletrimethoprim (ST), given twice daily for 1 year, might be the best approach. Because folate deficiency is a potential complication of such treatment, supplementation is recommended [5]. In many studies, there was no improvement in CNS involvement during treatment with tetracycline alone, or in combination with other antibiotics [2]. Gaze palsies and nystagmus were most responsive to treatment, and dementia was arrested in patients with WD confined to the nervous system (for review, see Reference 2). Remarkable improvement in the organic psychosyndrome was noted when using ST and slight improvement when using ceftriaxone 121. The optimum duration of antibiotic treatment is unknown. In the initial stage of WD, it appears wise to prescribe ST for a period of about 1 year [3]. Several of the CNS relapse patients had been undergoing treatment for about a year or more [2], although Fleming and co-workers 131 stated that the duration of treatment did not have any substantial effect on the outcome. We prefer long-term treatment [2]; our patient has now been treated for 32 months without having a relapse.
European Neuropsychopharmacology, 2009
Botulinumtoxin (BTX) wurde bis vor wenigen Jahren hauptsachlich als Verursacher des gefurchteten ... more Botulinumtoxin (BTX) wurde bis vor wenigen Jahren hauptsachlich als Verursacher des gefurchteten Nahrungsmittelbotulismus und als potentieller biologischer Kampfstoff erwahnt. Trotz dieser ungunstigen Voraussetzungen nimmt diese Substanz heute einen nicht mehr weg zudenkenden Stellenwert in der Behandlung neurologischer Erkrankungen ein, insbesondere solcher, die mit einem lokal erhohten Muskeltonus oder einer hyperkinetischen Bewegungsstorung einhergehen. Die lokale intramuskulare Injektion von Botulinumtoxin stellt heute die Behandlung der Wahl fur Patienten mit Torticollis spasmodicus und Blinzelkrampf dar. Auch der Einsatz von BTX-A in der Behandlung von Patienten mit fokalen spastischen Syndromen im Erwachsenen- und Kindesalter ist aus dem klinischen Alltag nicht mehr wegzudenken.
Acta chirurgica Austriaca, Apr 1, 1985
PubMed, Feb 7, 1986
An initial loss of consciousness is of grave prognostic significance in patients with acute ischa... more An initial loss of consciousness is of grave prognostic significance in patients with acute ischaemic cerebrovascular disorders, both as regards the early course as well as the long-term prognosis. The aim of this study was to assess the prognostic importance of an initial loss of consciousness in patients who had survived the acute stage. Thus, 133 out of 139 patients suffering from ischaemic cerebrovascular disorders who survived the first 3 weeks after a stroke were clinically re-examined after a mean follow-up period of more than two years. The other 6 patients had died as a result of a second stroke in the post-acute period. Patients with an initial loss of consciousness suffered cerebrovascular disturbances or fatal strokes in the follow-up period slightly more frequently than patients without an initial loss of consciousness. However, there were no convincing differences between the two groups. Indeed, on follow up, patients with an initial loss of consciousness were slightly less socially disabled than patients without an initial loss of consciousness. The results suggest that an initial loss of consciousness is no longer a factor of prognostic importance in patients who have survived the initial stage.
Journal of the Neurological Sciences, Oct 1, 2013
Background and purpose: The goal of this study was to establish the prevalence of subjective memo... more Background and purpose: The goal of this study was to establish the prevalence of subjective memory complaints (SMCs) and depressive symptoms (DS)s and their relation to cognitive functioning in patients with Parkinson's disease (PD). Methods: In all, 248 controls and 104 PD patients were included in the study. The PD group was subdivided into three PD subtypes with mild cognitive impairment (MCI) according to the Petersen criteria and three PD subtypes with MCI according to the Litvan criteria. Results: Substantial SMCs were reported by 7.7% of controls and 16.3% of the PD patients (P < 0.001). A clinically relevant degree of DSs was evident in 16.6% of controls compared with 40.4% in the PD group (P < 0.001). An analysis of variance revealed a statistically significant difference for SMCs across all Petersen groups as well across all Litvan groups. Two-factor analyses of variance with the factors cognitive status (MCI subtype) and depressive state (depressed versus not depressed) and SMCs as dependent variable revealed significant results. Conclusions: Approximately 15% of PD patients seeking help in a movement disorder clinic report significant SMCs, with an increasing degree from cognitively healthy PD to PD-MCI. Significant DSs increase SMCs across all cognitive status groups.
<b><i>Purpose:</i></b> To investigate the spatiotemporal evolution of cor... more <b><i>Purpose:</i></b> To investigate the spatiotemporal evolution of cortical activation during the initiation of optokinetic nystagmus using magnetoencephalography. <b><i>Background:</i></b> Previous imaging studies of optokinetic nystagmus in humans using positron emission tomography and functional magnetic resonance imaging discovered activation of a large set of cortical and subcortical structures during steady-state optokinetic stimulation, but did not provide information on the temporal dynamics of the initial response. Imaging studies have shown that cortical areas responsible for vision in occipital and temporo-occipital areas are involved, i.e. cortical areas control optokinetic stimulation in humans. Magnetoencephalography provides measures that reflect neural ensemble activity in the millisecond time scale, allowing the identification of early cortical components of visuomotor integration. <b><i>Design/Methods:</i></b> We studied neuromagnetic cortical responses during the initiation of optokinetic nystagmus in 6 right-handed healthy subjects. Neuromagnetic activity was recorded with a whole-head magnetoencephalograph, consisting of 143 planar gradiometers. <b><i>Results:</i></b> The mean (±SD) latency between stimulus onset and initiation of optokinetic nystagmus was 177.7 ± 59 ms. Initiation of optokinetic nystagmus evoked an early component in the primary visual cortex starting at 40-90 ms prior to the onset of the slow phase of nystagmus. Almost simultaneously an overlapping second component occurred bilaterally in the temporo-occipital area (visual motion areas), pronounced in the right hemisphere, starting at 10-60 ms prior to the slow-phase onset. Both components showed long-duration activity lasting for up to 100 ms after slow-phase onset. <b><i>Conclusions:</i></b> Our findings suggest that the initiation of optokinetic nystagmus induces early cortical activation in the occipital cortex and almost simultaneously bilaterally in the temporo-occipital cortex. These c [...]
PubMed, Apr 24, 1998
Parkinson's disease is not only a disorder affecting locomotion, but often also causes speech pro... more Parkinson's disease is not only a disorder affecting locomotion, but often also causes speech problems. Functional impairment of articulation, phonation, prosody and also respiration may occur. Speech disorder is frequent in Parkinson's disease and often has an impact on the quality of life. Speech therapy is by no means offered as a matter of course to these patients. This article outlines the different approaches of speech therapy regarding respiration, loudness, articulation, prosody, and intonation. Speech therapy seems to be useful in patients with Parkinson's disease only if there is no cognitive impairment; success also depends on motivation and eventual frequent repetition of therapy series.
International Psychogeriatrics, Sep 17, 2015
Background: Deficits in facial emotion recognition (FER) have been shown to substantially impair ... more Background: Deficits in facial emotion recognition (FER) have been shown to substantially impair several aspects in everyday life of affected individuals (e.g. social functioning). Presently, we aim at assessing differences in emotion recognition performance in three patient groups suffering from mild forms of cognitive impairment compared to healthy controls. Methods: Performance on a concise emotion recognition test battery (VERT-K) of 68 patients with subjective cognitive decline (SCD), 44 non-amnestic (non-aMCI), and 25 amnestic patients (aMCI) with mild cognitive impairment (MCI) was compared with an age-equivalent sample of 138 healthy controls all of which were recruited within the framework of the Vienna Conversion to Dementia Study. Additionally, patients and controls underwent individual assessment using a comprehensive neuropsychological test battery examining attention, executive functioning, language, and memory (NTBV), the Beck Depression Inventory (BDI), and a measure of premorbid IQ (WST). Results: Type of diagnosis showed a significant effect on emotion recognition performance, indicating progressively deteriorating results as severity of diagnosis increased. Between-groups effect sizes were substantial, showing non-trivial effects in all comparisons (Cohen's ds from −0.30 to −0.83) except for SCD versus controls. Moreover, emotion recognition performance was higher in women and positively associated with premorbid IQ. Conclusions: Our findings indicate substantial effects of progressive neurological damage on emotion recognition in patients. Importantly, emotion recognition deficits were observable in non-amnestic patients as well, thus conceivably suggesting associations between decreased recognition performance and global cognitive decline. Premorbid IQ appears to act as protective factor yielding lesser deficits in patients showing higher IQs.
Electromagnetic Tomography (EMT) is a novel imaging modality with clinically viable potentials, b... more Electromagnetic Tomography (EMT) is a novel imaging modality with clinically viable potentials, being capable for fast functional imaging. The technology, when matured, might present an effective supplement to current imaging technologies for an assessment of functionality of brain tissue with unique time resolution in a range of dozens of msec together with decent spatial resolution. We have re-designed EMT imaging technology towards brain imaging and developed novel EMT scanner for human brain imaging. The scanner was used in initial clinical studies for diagnostic of stroke. First EMT tomographic human brain imaging results are presented here.
British Journal of Dermatology, Jun 1, 1996
European Journal of Neurology, Jun 9, 2014
Background and purpose: The goal of this study was to establish the prevalence of subjective memo... more Background and purpose: The goal of this study was to establish the prevalence of subjective memory complaints (SMCs) and depressive symptoms (DS)s and their relation to cognitive functioning in patients with Parkinson's disease (PD). Methods: In all, 248 controls and 104 PD patients were included in the study. The PD group was subdivided into three PD subtypes with mild cognitive impairment (MCI) according to the Petersen criteria and three PD subtypes with MCI according to the Litvan criteria. Results: Substantial SMCs were reported by 7.7% of controls and 16.3% of the PD patients (P < 0.001). A clinically relevant degree of DSs was evident in 16.6% of controls compared with 40.4% in the PD group (P < 0.001). An analysis of variance revealed a statistically significant difference for SMCs across all Petersen groups as well across all Litvan groups. Two-factor analyses of variance with the factors cognitive status (MCI subtype) and depressive state (depressed versus not depressed) and SMCs as dependent variable revealed significant results. Conclusions: Approximately 15% of PD patients seeking help in a movement disorder clinic report significant SMCs, with an increasing degree from cognitively healthy PD to PD-MCI. Significant DSs increase SMCs across all cognitive status groups.
British Journal of Dermatology, Apr 1, 1997
Minimally Invasive Neurosurgery, 1981
ABSTRACT
Neuropsychiatrie, Jun 11, 2008
RöFo, Sep 28, 2011
Phantom pain in upper limb amputees is associated with the extent of reorganization in the primar... more Phantom pain in upper limb amputees is associated with the extent of reorganization in the primary sensorimotor cortex. Mirror visual feedback therapy has been shown to improve phantom pain. We investigated the extent of cortical reorganization in lower limb amputees and changes in neural activity induced by mirror therapy. Eight lower limb amputees underwent 12 sessions of MVFT and functional magnetic resonance imaging (fMRI) of the brain before the first and after the last MVFT session. FMRI sessions consisted of two runs in which subjects were instructed to perform repetitive movement of the healthy and phantom ankle. Before MVFT, the mean phantom pain intensity was 4.6 ± 3.1 on a visual analog scale and decreased to 1.8 ± 1.7 (p = 0.04). We did not observe a consistent pattern of cortical activation in primary sensorimotor areas during phantom limb movements. Following MVFT, increased activity was obtained in the right orbitofrontal cortex during phantom ankle movements. Comparison of cortical activity during movements of the phantom ankle and the intact ankle showed significantly higher activity in the left inferior frontal cortex (pars triangularis). These results question the known association between phantom pain and primary sensorimotor reorganization and propose reorganizational changes involving multiple cortical areas in lower limb amputees. Finally, reduction of phantom pain after mirror visual feedback therapy was associated with increased prefrontal cortical activity during phantom ankle movements.
PubMed, 2009
Background and objectives: The aim of this review was to evaluate the evidence for the treatment ... more Background and objectives: The aim of this review was to evaluate the evidence for the treatment of phantom limb pain with mirror therapy. Material and methods: Randomised controlled studies were identified by a systematic search strategy in the databases "Medline" and "The Cochrane Library". The studies were evaluated using the quality criteria of the JADAD-scale. Results: Three small-sized randomised controlled studies were identified. Unfortunately, these studies lacked methodological quality. One of them found a significant decrease of phantom pain after four weeks of daily mirror therapy sessions. Two other studies could not find a significant difference in the reduction of phantom limb pain between intervention- and control-groups. To date, there is only circumstantial evidence for mirror therapy in phantom pain. Hence, no firm recommendations regarding this treatment option are possible. Conclusion: More sufficiently powered randomised controlled studies with high methodological quality are mandatory to investigate the analgesic effect of mirror therapy in phantom limb pain.
Journal of the Neurological Sciences, Oct 1, 2013
Toxicon, Dec 1, 2016
Introduction and objectives: Cerebral palsy (CP) is the most common cause of chronic disability i... more Introduction and objectives: Cerebral palsy (CP) is the most common cause of chronic disability in childhood and may lead to cognitive delay and difficulty in walking. Botulinum toxin type A is a well-established treatment for spasticity in patients with CP. In this retrospective case series, we report our experience of incobotulinumtoxinA (Xeomin) treatment for children with CP. Methods: Sixty-nine patients with CP (63.8% male) received 191 incobo-tulinumtoxinA injections, frequently under sedation or anesthesia. Doses, treatment intervals, muscles injected, and tolerability were recorded. Results: Children's mean (standard deviation; SD) age was 8.3 (4.0) years; mean weight was 25.5 (SD, 13.5) kg; and mean time since starting treatment was 10.6 (SD, 9.4) months. The Gross Motor Function Classification System level was I for 15% of patients, II for 41%, III for 7%, IV for 15%, and V for 22%; 39.1% of patients were hemiplegic, 23.2% diplegic, and 37.3% tetraplegic. Patients received a mean (SD) of 2.8 (1.5) incobotulinumtoxinA treatments at mean (SD) intervals of 6.0 (1.7) months. From the first to the sixth treatment, the mean (SD) total dose increased from 191.7 (126.2) U (8.5 [5.4] U/kg weight) to 368.0 (170.1) U (9.9 [5.5] U/kg weight), and the mean (SD) number of muscles injected increased from 2.4 (1.2) to 4.2 (1.9). The most frequently injected muscles were gastrocnemius (68.1% of patients), hamstrings (47.8%), adductor longus (42.0%), finger flexors (18.8%), adductor magnus (18.8%), and biceps brachii (13.0%). Five adverse effects were reported (7.2% of patients, 2.6% of injections); 3 of these occurred during the first treatment. Adverse events assessed as treatment related were muscle weakness, generalized weakness, and fever. Conclusions: IncobotulinumtoxinA is well tolerated in the treatment of focal spasticity in children with CP.