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  • 1
    Online Resource
    Online Resource
    Primäre ZNS-Vaskulitis : Eine Übersicht
    Hogrefe Publishing Group ; 2022
    In:  Therapeutische Umschau Vol. 79, No. 5 ( 2022-06), p. 247-253
    Details
    In: Therapeutische Umschau, Hogrefe Publishing Group, Vol. 79, No. 5 ( 2022-06), p. 247-253
    Abstract: Zusammenfassung. Die zerebralen Vaskulitiden, insbesondere die primäre Vaskulitis des Zentralnervensystems (primäre ZNS-Vaskulitis), sind seltene entzündliche Erkrankungen der kleinen und mittelgrossen Gefässe des ZNS. Klinisch präsentiert sich die primäre ZNS-Vaskulitis heterogen mit Leitsymptomen wie Kopfschmerzen, Gedächtnisstörungen und anderen neurologischen Defiziten. Die Pathogenese der primären ZNS-Vaskulitis ist unklar. Vermutet wird eine infektgetriggerte Aktivierung des Immunsystems mit daraus resultierender Inflammation der Blutgefässe des ZNS. Die breite differentialdiagnostische Abklärung vor Therapieeinleitung spielt eine entscheidende Rolle. Die Behandlung besteht aus einer Immuntherapie (Puls- und Erhaltungstherapie) und bedarf aufgrund des erhöhten Rezidivrisikos der Erkrankung einer langfristigen neurologischen Anbindung und Therapie.
    Type of Medium: Online Resource
    ISSN: 0040-5930 , 1664-2864
    URL: Article
    DOI: 10.1024/0040-5930/a001358
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2022
    detail.hit.zdb_id: 82044-1
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  • 2
    Online Resource
    Online Resource
    Negative SARS-CoV2-antibodies after positive COVID-19-PCR nasopharyngeal swab in patients treated with anti-CD20 therapies
    SAGE Publications ; 2021
    In:  Therapeutic Advances in Neurological Disorders Vol. 14 ( 2021-01), p. 175628642110166-
    Details
    In: Therapeutic Advances in Neurological Disorders, SAGE Publications, Vol. 14 ( 2021-01), p. 175628642110166-
    Type of Medium: Online Resource
    ISSN: 1756-2864 , 1756-2864
    URL: Article
    DOI: 10.1177/17562864211016641
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2442245-9
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  • 3
    Online Resource
    Online Resource
    Leptomeningeal enhancement under different MS immunotherapies: A monocentric retrospective cohort study of 214 patients
    SAGE Publications ; 2023
    In:  Multiple Sclerosis Journal Vol. 29, No. 1 ( 2023-01), p. 63-73
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 29, No. 1 ( 2023-01), p. 63-73
    Abstract: Leptomeningeal inflammation in patients with multiple sclerosis (MS) mainly affects meningeal B-cell follicle-like structures linked to cortical and subpial lesions and can be visualized as leptomeningeal enhancement (LME). Objective: To evaluate the evolution of LME under different MS immunotherapies. Methods: A total of 214 MS patients treated with anti-CD20 therapies or fingolimod at the university hospital Bern were screened for LME. Magnetic resonance imaging (MRI) and medical records were retrospectively evaluated, and comparative statistics were applied. Results: We compared MS patients treated with anti-CD20 therapies (128 patients (59.8%)) or fingolimod (86 patients (40.2%)). Of 128 anti-CD20-treated patients, 108 (84.4%) had no LME, 11 (8.6%) had persistent LME, and 9 (7.0%) showed resolution of LME. Of 86 fingolimod-treated MS patients, 81 (94.2%) had no LME and 5 (5.8%) persistent LME. Patients with LME persistence were older than those without or resolution of LME ( p = 0.039). Resolution of LME was more frequent during anti-CD20 compared with fingolimod treatment ( p = 0.019). Conclusion: We observed LME resolution under treatment with anti-CD20 therapies. As LME might play an important role in cerebral gray matter pathology in MS, further investigations including extensions to higher field strengths, correlation with clinical phenotypes, and comparison with other immunotherapies are needed.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/13524585221122210
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2008225-3
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  • 4
    Online Resource
    Online Resource
    Multidimensional phenotyping of the post‐COVID ‐19 syndrome: A Swiss survey study
    Wiley ; 2022
    In:  CNS Neuroscience & Therapeutics Vol. 28, No. 12 ( 2022-12), p. 1953-1963
    Details
    In: CNS Neuroscience & Therapeutics, Wiley, Vol. 28, No. 12 ( 2022-12), p. 1953-1963
    Abstract: Post‐COVID‐19 syndrome affects approximately 10–25% of people after a COVID‐19 infection, irrespective of initial COVID‐19 severity. The aim of this project was to assess the clinical characteristics, course, and prognosis of post‐COVID‐19 syndrome using a systematic multidimensional approach. Patients and Methods An online survey of people with suspected and confirmed COVID‐19 and post‐COVID‐19 syndrome, distributed via Swiss COVID‐19 support groups, social media, and our post‐COVID‐19 consultation, was performed. A total of 8 post‐infectious domains were assessed with 120 questions. Data were collected from October 15 to December 12, 2021, and 309 participants were included. Analysis of clinical phenomenology of post‐COVID‐19 syndrome was performed using comparative statistics. Results The three most prevalent post‐COVID‐19 symptoms in our survey cohort were fatigue (288/309, 93.2%), pain including headache (218/309, 70.6%), and sleep–wake disturbances (mainly insomnia and excessive daytime sleepiness, 145/309, 46.9%). Post‐COVID‐19 syndrome had an impact on work ability, as more than half of the respondents (168/268, 62.7%) reported an inability to work, which lasted on average 26.6 weeks (95% CI 23.5–29.6, range 1–94, n  = 168). Quality of life measured by WHO‐5 Well‐being Index was overall low in respondents with post‐COVID‐19 syndrome (mean, 95% CI 9.1 [8.5–9.8], range 1–25, n  = 239). Conclusion Fatigue, pain, and sleep–wake disturbances were the main symptoms of the post‐COVID‐19 syndrome in our cohort and had an impact on the quality of life and ability to work in a majority of patients. However, survey respondents reported a significant reduction in symptoms over 12 months. Post‐COVID‐19 syndrome remains a significant challenge. Further studies to characterize this syndrome and to explore therapeutic options are therefore urgently needed.
    Type of Medium: Online Resource
    ISSN: 1755-5930 , 1755-5949
    URL: Article
    DOI: 10.1111/cns.13938
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2423467-9
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  • 5
    Online Resource
    Online Resource
    Anti‐kelchlike protein 11 antibody‐associated encephalitis: Two case reports and review of the literature
    Wiley ; 2023
    In:  European Journal of Neurology Vol. 30, No. 6 ( 2023-06), p. 1801-1814
    Details
    In: European Journal of Neurology, Wiley, Vol. 30, No. 6 ( 2023-06), p. 1801-1814
    Abstract: Kelchlike protein 11 antibodies (KLHL11‐IgGs) were first described in 2019 as a marker of paraneoplastic neurological syndromes (PNSs). They have mostly been associated with testicular germ cell tumors (tGCTs). Methods Two patients with KLHL11‐IgG encephalitis are reported, and the literature is comprehensively reviewed. Results Patient 1 had been in remission from a tGCT 10 years prior. He developed episodic vertigo and diplopia progressing over a few days. Treatment with corticosteroids (CSs) was started a few days after symptom onset. Patient 2 had transient diplopia, which resolved spontaneously. Visual problems persisted for 7 months, when he additionally developed a progressive cerebellar syndrome. One year after onset, CS treatment was started. Initial magnetic resonance imaging was unremarkable in both patients, but analysis of cerebrospinal fluid (CSF) revealed chronic inflammation. KLHL11‐IgG was positive in both patients (Patient 1 only in CSF, Patient 2 in serum). Neoplastic screening has so far not revealed any signs of active underlying malignancy. We found 15 publications of 112 patients in total with KLHL11‐IgG encephalitis. Most patients ( n  = 82) had a cerebellar syndrome with or without signs of rhombencephalitis. The most common symptoms were ataxia ( n  = 82) and vertigo ( n  = 47), followed by oculomotor disturbances ( n  = 35) and hearing disorders ( n  = 31). Eighty of 84 patients had a GCT as an underlying tumor. Conclusions Our cases demonstrate classical symptoms of KLHL11‐IgG encephalitis. Early diagnosis and therapy are imperative. As with other PNSs, clinical awareness is needed and further studies are required especially in regard to therapeutic management.
    Type of Medium: Online Resource
    ISSN: 1351-5101 , 1468-1331
    URL: Issue
    URL: Article
    DOI: 10.1111/ene.v30.6
    DOI: 10.1111/ene.15758
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2020241-6
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  • 6
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    Online Resource
    Anti‐neurochondrin antibody as a biomarker in primary autoimmune cerebellar ataxia—a case report and review of the literature
    Wiley ; 2023
    In:  European Journal of Neurology Vol. 30, No. 4 ( 2023-04), p. 1135-1147
    Details
    In: European Journal of Neurology, Wiley, Vol. 30, No. 4 ( 2023-04), p. 1135-1147
    Abstract: Neuronal autoantibodies can support the diagnosis of primary autoimmune cerebellar ataxia (PACA). Knowledge of PACA is still sparce. This article aims to highlight the relevance of anti‐neurochondrin antibodies and possible therapeutical consequences in people with PACA. Methods This is a case presentation and literature review of PACA associated with anti‐neurochondrin antibodies. Results A 33‐year‐old man noticed reduced control of the right leg in May 2020. During his first clinic appointment at our institution in September 2021, he complained about gait imbalance, fine motor disorders, tremor, intermittent diplopia and slurred speech. He presented a pancerebellar syndrome with stance, gait and limb ataxia, scanning speech and oculomotor dysfunction. Within 3 months the symptoms progressed. An initial cerebral magnetic resonance imaging, June 2020, was normal, but follow‐up imaging in October 2021 and July 2022 revealed marked cerebellar atrophy (29% volume loss). Cerebrospinal fluid analysis showed lymphocytic pleocytosis of 11 x 10 3 /L (normal range 0–4) and oligoclonal bands type II. Anti‐neurochondrin antibodies (immunoglobulin G) were detected in serum (1:10,000) and cerebrospinal fluid (1:320, by cell‐based indirect immunofluorescence assay and immunoblot, analysed by the EUROIMMUN laboratory). After ruling out alternative causes and neoplasia, diagnosis of PACA was given and immunotherapy (steroids and cyclophosphamide) was started in January 2022. In March 2022 a stabilization of disease was observed. Conclusion Cerebellar ataxia associated with anti‐neurochondrin antibodies has only been described in 19 cases; however, the number of unrecognized PACAs may be higher. As anti‐neurochondrin antibodies target an intracellular antigen and exhibit a mainly cytotoxic T‐cell‐mediated pathogenesis, important therapeutic implications may result. Because of the severe and rapid clinical progression, aggressive immunotherapy was warranted. This case highlights the need for rapid diagnosis and therapy in PACA, as stabilization and even improvement of symptoms are attainable.
    Type of Medium: Online Resource
    ISSN: 1351-5101 , 1468-1331
    URL: Issue
    URL: Article
    DOI: 10.1111/ene.v30.4
    DOI: 10.1111/ene.15648
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2020241-6
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  • 7
    Online Resource
    Online Resource
    Fatigue in Post-COVID-19 Syndrome: Clinical Phenomenology, Comorbidities and Association With Initial Course of COVID-19
    SAGE Publications ; 2022
    In:  Journal of Central Nervous System Disease Vol. 14 ( 2022-01), p. 117957352211027-
    Details
    In: Journal of Central Nervous System Disease, SAGE Publications, Vol. 14 ( 2022-01), p. 117957352211027-
    Abstract: Post-COVID-19 syndrome affects approximately 10-25% of people suffering from COVID-19 infection, irrespective of initial COVID-19 severity. Fatigue is one of the major symptoms, occurring in 30-90% of people with post-COVID-19 syndrome. This study aims at describing factors associated with fatigue in people with Post-COVID-19 seen in our newly established Post-Covid clinic. Methods This retrospective single center study included 42 consecutive patients suffering from Post-COVID-19 syndrome treated at the Department of Neurology, University Hospital Bern, between 11/2020 and05/2021. Clinical phenomenology of Post-COVID-19 syndrome with a special focus on fatigue and risk factor identification was performed using Mann-Whitney U Test, Pearson Correlation, and Chi-Quadrat-Test. Results Fatigue (90.5%) was the most prevalent Post-COVID-19 symptom followed by depressive mood (52.4%) and sleep disturbance (47.6%). Fatigue was in mean severe (Fatigue severity scale (FSS) mean 5.5 points (95% Confidence interval (95CI) 5.1 - 5.9, range .9 - 6.9, n = 40), and it was unrelated to age, COVID-19 severity or sex. The only related factors with fatigue severity were daytime sleepiness and depressed mood. Conclusion Fatigue is the main symptom of the Post-COVID-19 syndrome in our cohort. Further studies describing this syndrome are needed to prepare the healthcare systems for the challenge of treating patients with Post-COVID-19 syndrome.
    Type of Medium: Online Resource
    ISSN: 1179-5735 , 1179-5735
    URL: Article
    DOI: 10.1177/11795735221102727
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2586873-1
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  • 8
    Online Resource
    Online Resource
    Primär- und Sekundärprävention des Hirnschlags: Gesunde Ernährung
    Hogrefe Publishing Group ; 2021
    In:  Therapeutische Umschau Vol. 78, No. 6 ( 2021-08), p. 259-268
    Details
    In: Therapeutische Umschau, Hogrefe Publishing Group, Vol. 78, No. 6 ( 2021-08), p. 259-268
    Abstract: Zusammenfassung. Ungesunde Ernährung ist einer der modifizierbaren Risikofaktoren für die Entstehung von Hirnschlägen. Dennoch zeigt sich weltweit eine suboptimale Ernährung. Ungesunde Lebensmittel wie Süssgetränke, verarbeitete Fleischprodukte und salzreiche Nahrungsmittel werden im Übermass konsumiert; gesunde Lebensmittel wie Vollkornprodukte und nährstoffreiche Nahrung wie Gemüse, Früchte und Fisch zu wenig. Dies trifft auch auf die Schweiz zu. Wir fassen hier in diesem Artikel die Erkenntnisse über den Einfluss der Ernährung auf das Hirnschlagrisiko zusammen. So wird für die Senkung des Hirnschlagrisikos eine salzarme und kaliumreiche Ernährung basierend auf hohen Anteilen an Gemüse, Früchten, Vollkornprodukten und ungesättigten Fettsäuren, mässigem Fischkonsum und niedrigem Fleischgehalt empfohlen. Die mediterrane Diät, welche alle diese Aspekte beinhaltet, konnte nachweislich das Hirnschlagrisiko reduzieren. Eine ausgewogene, abwechslungsreiche Ernährung ist wichtiger als die Zufuhr von Nahrungsergänzungsmitteln.
    Type of Medium: Online Resource
    ISSN: 0040-5930 , 1664-2864
    URL: Article
    DOI: 10.1024/0040-5930/a001270
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2021
    detail.hit.zdb_id: 82044-1
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  • 9
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    Online Resource
    Application of the “risk of ambulatory disability” (RoAD) score in a “real‐world” single‐center multiple sclerosis cohort
    Wiley ; 2022
    In:  CNS Neuroscience & Therapeutics Vol. 28, No. 5 ( 2022-05), p. 792-795
    Details
    In: CNS Neuroscience & Therapeutics, Wiley, Vol. 28, No. 5 ( 2022-05), p. 792-795
    Type of Medium: Online Resource
    ISSN: 1755-5930 , 1755-5949
    URL: Article
    DOI: 10.1111/cns.13806
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2423467-9
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  • 10
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    Online Resource
    Comparison of mRNA Vaccinations with BNT162b2 or mRNA-1273 in Anti-CD20-Treated Multiple Sclerosis Patients
    MDPI AG ; 2022
    In:  Vaccines Vol. 10, No. 6 ( 2022-06-09), p. 922-
    Details
    In: Vaccines, MDPI AG, Vol. 10, No. 6 ( 2022-06-09), p. 922-
    Abstract: Objective: Anti-CD20-treated patients are at risk of a reduced humoral immune response during the SARS-CoV-2 pandemic. Our aim was to compare the antibody response after two vaccinations with the mRNA vaccines BNT162b2 or mRNA-1273 in patients with multiple sclerosis. Methods: Data from the University Hospital of Bern and Cantonal Hospital of Lucerne were retrospectively collected from medical records and then analyzed. Anti-spike IgG serum titers were collected from both centers and were considered to be protective from a value of ≥100 AU/mL. Continuous variables were given as the mean and 95% confidence interval (95% CI); categorical variables were given as frequencies. A Mann–Whitney test and Fisher’s exact test as well as a multivariable linear regression analysis with anti-spike IgG (AU/mL) as the dependent variable were run using SPSS Statistic 25 (IBM Corp., Amonk, NY, USA). Results: A total of 74 patients were included; 41/74 (63.51%) were female patients and the mean age was 46.6 years (95% CI 43.4–49.9). Of these patients, 36/74 were vaccinated with BNT162b2 and 38/74 with mRNA-1273, following the national vaccination recommendation. In both vaccine groups, protective anti-spike IgG titers (≥100 AU/mL) were infrequently achieved (5/74: mRNA-1273 3/38; BNT162b2 2/36). Conclusions: In addition to a low rate of protective anti-spike IgG titers in both vaccine groups, we identified a drop in anti-spike IgG serum titers over time. This observation bears therapeutic consequences, as initial positive titers should be checked in case of an infection with the SARS-CoV-2 virus to identify patients who would benefit from an intravenous anti-spike IgG treatment against acute COVID-19.
    Type of Medium: Online Resource
    ISSN: 2076-393X
    URL: Article
    DOI: 10.3390/vaccines10060922
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2703319-3
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