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  • 1
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    Online Resource
    Peripapillary retinal nerve fibre layer as measured by optical coherence tomography is a prognostic biomarker not only for physical but also for cognitive disability progression in multiple sclerosis
    SAGE Publications ; 2019
    In:  Multiple Sclerosis Journal Vol. 25, No. 2 ( 2019-02), p. 196-203
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 25, No. 2 ( 2019-02), p. 196-203
    Abstract: Peripapillary retinal nerve fibre layer (pRNFL) thickness is emerging as a marker of axonal degeneration in multiple sclerosis (MS). Objective: We aimed to prospectively assess the predictive value of pRNFL for progression of physical and cognitive disability in relapsing-remitting MS (RRMS). Methods: In this 3-year longitudinal study on 151 RRMS patients, pRNFL was measured by spectral-domain optical coherence tomography (OCT). We used proportional hazard models, correcting for age, sex, disease duration, Expanded Disability Status Scale (EDSS) and Symbol Digit Modalities Test (SDMT) at baseline, to test a pRNFL thickness ≤88 µm at baseline for prediction of EDSS progression and cognitive decline. We also evaluated the decrease in pRNFL thickness from baseline to year 3 in a multivariate linear regression model. Results: pRNFL thickness ≤88 µm was independently associated with a threefold increased risk of EDSS progression ( p  〈  0.001) and a 2.7-fold increased risk of cognitive decline within the subsequent 3 years ( p  〈  0.001). Mean pRNFL delta was −5.3 µm (SD, 4.2). It was significantly negatively impacted by EDSS progression, cognitive decline, higher age and disease duration, while positively impacted by disease-modifying therapy (DMT). Conclusion: Cross-sectional and longitudinal monitoring of pRNFL is useful as a biomarker for prediction of physical and cognitive disability progression in patients with RRMS in everyday clinical practice.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458517740216
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2008225-3
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  • 2
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    Online Resource
    Retinal layer thinning as a biomarker of long-term disability progression in multiple sclerosis
    SAGE Publications ; 2022
    In:  Multiple Sclerosis Journal Vol. 28, No. 12 ( 2022-10), p. 1871-1880
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 28, No. 12 ( 2022-10), p. 1871-1880
    Abstract: Peripapillary retinal nerve fibre layer and macular ganglion cell plus inner plexiform layer thinning are markers of neuroaxonal degeneration in multiple sclerosis. Objective: We aimed to investigate the value of peripapillary retinal nerve fibre layer and ganglion cell plus inner plexiform layer thinning for prediction of long-term disability. Methods: This is a 6-year prospective longitudinal study on 93 multiple sclerosis patients. Optical coherence tomography scans were performed at baseline, after 1, 2 and 6 years. Primary endpoint was disability progression after 6 years, defined as expanded disability status scale worsening and/or cognitive deterioration. Univariate and multivariate analysis was used to investigate the value of peripapillary retinal nerve fibre layer and ganglion cell plus inner plexiform layer to predict the primary endpoint. Results: A total of 57 (61.3%) patients had disability worsening, 40 (43.0%) expanded disability status scale worsening and 34 (36.6%) cognitive deterioration. Mean peripapillary retinal nerve fibre layer and ganglion cell plus inner plexiform layer baseline thickness were 93.0 and 75.2 µm, and mean annualised peripapillary retinal nerve fibre layer and ganglion cell plus inner plexiform layer thinning rates over 6 years were 1.3 and 1.6 µm, respectively. Univariate and multivariate analysis revealed lower peripapillary retinal nerve fibre layer and ganglion cell plus inner plexiform layer baseline thickness and higher annualised thinning rates in patients with disability progression after 6 years. Effects were more pronounced for ganglion cell plus inner plexiform layer and expanded disability status scale worsening than for peripapillary retinal nerve fibre layer models and cognitive deterioration. Conclusion: Ganglion cell plus inner plexiform layer and peripapillary retinal nerve fibre layer measurements depict neurodegeneration and predict disability progression in multiple sclerosis.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/13524585221097566
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 3
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    Smelling multiple sclerosis: Different qualities of olfactory function reflect either inflammatory activity or neurodegeneration
    SAGE Publications ; 2020
    In:  Multiple Sclerosis Journal Vol. 26, No. 1 ( 2020-01), p. 57-68
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 26, No. 1 ( 2020-01), p. 57-68
    Abstract: Peripapillary retinal nerve fiber layer (pRNFL) thickness and olfactory function are both emerging biomarkers in multiple sclerosis (MS). Impairment of odor identification and discrimination is an irreversible feature of more advanced MS suggested to be associated with neurodegeneration, while olfactory threshold is a transient feature of early, active MS possibly associated with short-term inflammatory disease activity. Objective: The aim of this study was to validate the association of olfactory (dys)function and parameters of MS disease course in a large cohort of MS patients and to correlate olfactory function with pRNFL thickness as a surrogate biomarker of neurodegeneration. Methods: In a cross-sectional design, olfactory function was assessed using the Sniffin’ Sticks test, which quantifies three different qualities of olfactory function (threshold, discrimination, and identification). pRNFL thickness was measured by spectral-domain optical coherence tomography (OCT). Results were correlated with age, sex, disease duration, relapses, Expanded Disability Status Scale (EDSS), cognitive function, depression, smoking, and pRNFL thickness by multivariable linear regression models. Results: We included 260 MS patients (mean age of 35.9 years, 68.7% female). Olfactory threshold correlated significantly with number of relapses in the year prior to assessment and shorter disease duration. Odor discrimination, identification, and their sum score were significantly correlated with longer disease duration, higher EDSS, and reduced cognitive function. pRNFL thickness was associated with identification and discrimination, but not with threshold. Conclusion: Olfactory threshold is a marker of short-term inflammatory relapse activity unrelated to parameters of neurodegeneration, while odor identification and discrimination are markers of neurodegeneration mostly independent of relapse activity. Assessment of olfactory function provides an opportunity to stratify MS patients with regard to inflammation and neurodegeneration.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458518814113
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 4
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    Online Resource
    Incidence of migraine and tension-type headache in three different populations at risk within the German DMKG headache study
    SAGE Publications ; 2012
    In:  Cephalalgia Vol. 32, No. 4 ( 2012-03), p. 328-336
    Details
    In: Cephalalgia, SAGE Publications, Vol. 32, No. 4 ( 2012-03), p. 328-336
    Abstract: Background: Unlike the prevalence, the incidence of headache disorders has attracted only little attention in epidemiological research. Different definitions of the ‘population at risk’ among the few published migraine and tension-type headache incidence studies limit their comparability and warrant further research. Therefore, we analysed data from the German Migraine and Headache Society (DMKG). Methods: Incidences were assessed in the general population in Germany via standardized headache questions using the International Classification of Headache Disorders, 2nd Edition (ICHD-2). The population was drawn from a 5-year age-group- stratified and gender-stratified random sample from the population register. Results: Of the 1312 baseline participants examined between 2003 and 2004, 1122 (85.5%) participated in the follow-up in 2006 and were the basis for three different populations at risk. We found that the three populations differed in size, age, gender and incidence estimate. The total sample incidence of migraine ranged between 0% and 3.3% and of tension-type headache between 5.3% and 9.2% depending on the definition of ‘at risk’. Conclusion: We concluded that one significant problem in headache incidence estimation is the definition of ‘at risk’, limiting comparability. Thus, this study supports the need for a common definition for prospective headache incidence estimations.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/0333102411428953
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
    detail.hit.zdb_id: 2019999-5
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  • 5
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    Change in intraindividual ICHD-II headache diagnosis over time: A follow-up of the DMKG headache study
    SAGE Publications ; 2013
    In:  Cephalalgia Vol. 33, No. 1 ( 2013-01), p. 25-33
    Details
    In: Cephalalgia, SAGE Publications, Vol. 33, No. 1 ( 2013-01), p. 25-33
    Abstract: Change in headache diagnoses over time within the same individual is not well studied in the adult population. In this study, we prospectively examined the individual variation of migraine and tension-type headache (TTH) diagnoses over time. Methods As part of the epidemiological Deutsche Migräne und Kopfschmerzgesellschaft (DMKG) headache study, 1312 participants were personally interviewed and 1122 responded to a second mailed questionnaire 2.2 years later. Headaches were assigned to migraine or TTH at two different points in time using the International Headache Classification, ICHD-II. We used broad (definite and probable subtypes) and strict (only definite type) definitions of migraine and TTH. Results Using the broad definition increased the reproducibility of migraine diagnosis from 48.0% to 62.0% and of TTH from 59.0% to 65.0%. A constant TTH diagnosis was related to a higher social status (OR 2.81; 95% CI 1.43–5.53) a higher level of education (OR 1.96; 95% CI 1.00–3.85) and physical inactivity (OR 2.28; 95% CI 1.16–4.49). A constant diagnosis of definite migraine was associated with severe headache (OR 2.64; 95% CI 0.97–7.21) and frequent use of headache medication (OR 4.73; 95% CI 0.95–23.60). The result that coexisting TTH decreased the likelihood of a constant migraine (OR 0.29; 95% CI 0.10–0.85) is assumed to indicate response variability. Conclusions In epidemiological studies, definite and probable subtypes should be included in the diagnosis to increase the diagnostic accuracy.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/0333102412465203
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
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  • 6
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    Associations of socioeconomic status with migraine and non-migraine headache
    SAGE Publications ; 2012
    In:  Cephalalgia Vol. 32, No. 2 ( 2012-01), p. 159-170
    Details
    In: Cephalalgia, SAGE Publications, Vol. 32, No. 2 ( 2012-01), p. 159-170
    Abstract: Background: Migraine has been linked with several measures of socioeconomic status (SES). However, results are inconsistent and data on the association between SES and non-migraine headache, migraine subtypes and migraine frequency are sparse. Methods: We conducted a cross-sectional study among 36,858 participants in the Women’s Health Study. As proxy for SES, we calculated an SES index using annual household income and education. Migraine, migraine aura, and non-migraine headache were self-reported with good validation rates. Multinomial logistic regression models were used to evaluate the association between the SES index and the various headache forms. Results: Of the women participating in the study, 12,140 (32.9%) reported any history of headache, 6801 (18.4%) reported any history of migraine and 5339 (14.5%) reported non-migraine headache. Women with low SES had an increased risk for all headache forms. The multivariable-adjusted odds ratios (ORs; 95% CI) were 1.22 (1.10–1.36) for non-migraine headache, 1.40 (1.28–1.54) for any migraine, 1.44 (1.23–1.69) for migraine with aura, and 1.38 (1.21–1.58) for migraine without aura. Among active migraineurs, low SES was associated with an increased OR for ≥weekly attack frequency (1.77, 1.26–2.49). Conclusions: In this large cohort of female health professionals, low SES was associated with an increased prevalence for all headache forms and an increased migraine attack frequency.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/0333102411430854
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
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  • 7
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    Vigilance Scoring in Children With Acquired Brain Injury: Vienna Vigilance Score in Comparison With Usual Coma Scales
    SAGE Publications ; 2001
    In:  Journal Of Child Neurology Vol. 16, No. 04 ( 2001), p. 236-
    Details
    In: Journal Of Child Neurology, SAGE Publications, Vol. 16, No. 04 ( 2001), p. 236-
    Type of Medium: Online Resource
    ISSN: 0883-0738
    URL: Article
    DOI: 10.2310/7010.2001.17372
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2001
    detail.hit.zdb_id: 2068710-2
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  • 8
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    Stroke admission outside daytime working hours delays mechanical thrombectomy and worsens short-term outcome
    SAGE Publications ; 2019
    In:  International Journal of Stroke Vol. 14, No. 5 ( 2019-07), p. 517-521
    Details
    In: International Journal of Stroke, SAGE Publications, Vol. 14, No. 5 ( 2019-07), p. 517-521
    Abstract: Rapid therapeutic decisions in acute stroke patients leading to earlier initiation of revascularization therapies are associated with better outcome. An association between regular working hours and reduced time to initiation of intravenous thrombolysis has been reported. However, its influence on mechanical thrombectomy (MT) remains uncertain. We aimed to analyze the effects of admission time on door-to-groin time and stroke outcome in a large prospective stroke registry of the Neurovascular Net Ruhr in Germany. Methods Procedural times of a total of 512 patients treated with MT were analyzed. Admission to hospital during regular working days and hours (Monday to Friday, 8 am to 4 pm) was compared with admission outside these times. Door-to-groin time and the difference in NIH Stroke Scale between admission and discharge served as primary outcome parameters. Long-term functional outcome was centrally assessed with modified Rankin scale. Results MT outside regular working hours was associated with a significant mean initiation delay of 20 min. By multivariate regression analysis, every 20 min delay of MT reduced the difference in NIHSS score between admission and discharge by 0.76 points (95% CI −1.24 to −0.28, p = 0.002). Favorable long-term outcome did not differ between both treatment groups. Conclusions Treatment outside regular working hours caused a significant delay in the initiation of MT, which was associated with a decreased short-term clinical efficacy of thrombectomy. Strategies like compulsory attendance of the interventional neuroradiologist at the hospital 24/7 might result in shorter door-to-groin times and consecutive in better stroke outcome.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/1747493018790079
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2211666-7
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  • 9
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    Online Resource
    Inner nuclear layer and olfactory threshold are interlinked and reflect inflammatory activity in multiple sclerosis
    SAGE Publications ; 2020
    In:  Multiple Sclerosis Journal - Experimental, Translational and Clinical Vol. 6, No. 3 ( 2020-07), p. 205521732094573-
    Details
    In: Multiple Sclerosis Journal - Experimental, Translational and Clinical, SAGE Publications, Vol. 6, No. 3 ( 2020-07), p. 205521732094573-
    Abstract: Retinal inner nuclear layer (INL) and olfactory threshold (OT) are associated with inflammatory activity in multiple sclerosis (MS). Objective The study aims to investigate (a) whether there is an association of INL and OT in MS and (b) if changes in INL and OT follow a time pattern in relation to MS relapse. Methods We assessed INL by optical coherence tomography and OT by Sniffin’ Sticks in three different cohorts: a cross-sectional MS cohort ( n = 260), a longitudinal, 3-year cohort of MS ( n = 141) and healthy controls ( n = 30), and a longitudinal, 24-weeks cohort with acute MS relapse ( n = 28) and stable MS controls ( n = 27). Results Cross-sectionally, INL and OT were strongly correlated with number but not localization of relapse in the previous 12 months and INL correlated with OT. Longitudinally, INL was thicker and OT score was lower short term in times of relapse activity, but not long term and independent of relapse localization. In acute MS relapse, INL and OT were altered compared with stable MS, again, independent of relapse localization resolving over 12–24 weeks with faster approximation to stable MS after escalation of disease-modifying treatment. Conclusions INL and OT are interlinked markers of short-term inflammatory activity, following a nearly congruent time pattern and independent of relapse localization, possibly reflecting a proinflammatory state within the central nervous system.
    Type of Medium: Online Resource
    ISSN: 2055-2173 , 2055-2173
    URL: Article
    DOI: 10.1177/2055217320945738
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2841884-0
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  • 10
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    Migraine and restless legs syndrome: A systematic review
    SAGE Publications ; 2014
    In:  Cephalalgia Vol. 34, No. 10 ( 2014-09), p. 777-794
    Details
    In: Cephalalgia, SAGE Publications, Vol. 34, No. 10 ( 2014-09), p. 777-794
    Abstract: Restless legs syndrome (RLS) is increasingly being reported as a comorbidity of migraine. Methods We conducted a systematic review and meta-analysis of studies investigating RLS in headache/migraine and vice versa. We calculated the prevalence and 95% confidence intervals (CI) of RLS in headache/migraine, of headache/migraine in RLS and controls, and odds ratios (ORs) of the association between the conditions. We then determined pooled effect estimates for the associations. Results We identified 24 studies. RLS prevalence in migraine ranged from 8.7% to 39.0% with no apparent differences based on gender and aura status. Prevalence among controls was compatible with the literature. Migraine prevalence in RLS ranged from 15.1% to 62.6%. We did not pool prevalence data because of high unexplained heterogeneity. High heterogeneity with respect to the association between any migraine and RLS could be explained by study design. Pooled analyses showed substantially higher effect estimates in case-control studies (pooled OR = 4.19, 95% CI 3.07–5.71; I 2  = 0.0%) than in cohort studies (pooled OR = 1.22, 95% CI 1.14–1.30; I 2  = 0.0%). Conclusion Our results support the concept of RLS as an important comorbidity of migraine. However, the degree of association appears to be strongly determined by study design. Potential effects by gender and aura status and the role of RLS in other headache disorders remain unclear.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/0333102414537725
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
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