124 results on '"Waldthaler, A."'
Search Results
2. The Swedish National Facility for Magnetoencephalography Parkinson’s disease dataset
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Vinding, Mikkel C., Eriksson, Allison, Comarovschii, Igori, Waldthaler, Josefine, Manting, Cassia Low, Oostenveld, Robert, Ingvar, Martin, Svenningsson, Per, and Lundqvist, Daniel
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- 2024
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3. Oscillatory and non-oscillatory features of the magnetoencephalic sensorimotor rhythm in Parkinson’s disease
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Mikkel C. Vinding, Josefine Waldthaler, Allison Eriksson, Cassia Low Manting, Daniel Ferreira, Martin Ingvar, Per Svenningsson, and Daniel Lundqvist
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Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Parkinson’s disease (PD) is associated with changes in neural activity in the sensorimotor alpha and beta bands. Using magnetoencephalography (MEG), we investigated the role of spontaneous neuronal activity within the somatosensory cortex in a large cohort of early- to mid-stage PD patients (N = 78) on Parkinsonian medication and age- and sex-matched healthy controls (N = 60) using source reconstructed resting-state MEG. We quantified features of the time series data in terms of oscillatory alpha power and central alpha frequency, beta power and central beta frequency, and 1/f broadband characteristics using power spectral density. Furthermore, we characterised transient oscillatory burst events in the mu-beta band time-domain signals. We examined the relationship between these signal features and the patients’ disease state, symptom severity, age, sex, and cortical thickness. PD patients and healthy controls differed on PSD broadband characteristics, with PD patients showing a steeper 1/f exponential slope and higher 1/f offset. PD patients further showed a steeper age-related decrease in the burst rate. Out of all the signal features of the sensorimotor activity, the burst rate was associated with increased severity of bradykinesia, whereas the burst duration was associated with axial symptoms. Our study shows that general non-oscillatory features (broadband 1/f exponent and offset) of the sensorimotor signals are related to disease state and oscillatory burst rate scales with symptom severity in PD.
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- 2024
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4. The Swedish National Facility for Magnetoencephalography Parkinson’s disease dataset
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Mikkel C. Vinding, Allison Eriksson, Igori Comarovschii, Josefine Waldthaler, Cassia Low Manting, Robert Oostenveld, Martin Ingvar, Per Svenningsson, and Daniel Lundqvist
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Science - Abstract
Abstract Parkinson’s disease (PD) is characterised by a loss of dopamine and dopaminergic cells. The consequences hereof are widespread network disturbances in brain function. It is an ongoing topic of investigation how the disease-related changes in brain function manifest in PD relate to clinical symptoms. We present The Swedish National Facility for Magnetoencephalography Parkinson’s Disease Dataset (NatMEG-PD) as an Open Science contribution to identify the functional neural signatures of Parkinson’s disease and contribute to diagnosis and treatment. The dataset contains whole-head magnetoencephalographic (MEG) recordings from 66 well-characterised PD patients on their regular dose of dopamine replacement therapy and 68 age- and sex-matched healthy controls. NatMEG-PD contains three-minute eyes-closed resting-state MEG, MEG during an active movement task, and MEG during passive movements. The data includes anonymised MRI for source analysis and clinical scores. MEG data is rich in nature and can be used to explore numerous functional features. By sharing these data, we hope other researchers will contribute to advancing our understanding of the relationship between brain activity and disease state or symptoms.
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- 2024
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5. Pupil light reflex dynamics in Parkinson’s disease
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Panagiota Tsitsi, Mattias Nilsson, Josefine Waldthaler, Gustaf Öqvist Seimyr, Olof Larsson, Per Svenningsson, and Ioanna Markaki
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pupil reflex ,Parkinson’s disease ,eye movements ,eye tracking ,dysautonomia ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
IntroductionVisual disturbance is common symptom in Parkinson’s disease (PD), and defective pupil light reflex (PLR) is an anticipated contributing factor that may be associated to the presence of autonomic dysfunction, which is a common non-motor feature of PD. Studies investigating the intercorrelation between PLR and dysautonomia in PD are limited.MethodsThe aim of this study was to investigate differences of PLR parameters, measured by eye-tracker, between patients with PD, with and without signs of dysautonomia, and healthy controls (HC). In total, 43 HC and 50 patients with PD were recruited and PLR parameters were measured with Tobii Pro Spectrum, during a long (1,000 ms) and a short (100 ms) light stimulus. Presence of orthostatic hypotension (OH) was used as proxy marker of dysautonomia. Linear mixed-effects model and non-parametric comparative statistics were applied to investigate differences among groups.ResultsPeak constriction velocity was slower in PD compared with HC, after adjustment for age and sex in the mixed model, and the difference was greater in the subgroup of PD with OH (unadjusted). Dilation amplitude and velocity were also gradually slower in HC vs. PD without OH vs. PD with OH (unadjusted for confounders). In the mixed model, age was significant predictor of dilation response.DiscussionOur results support previous observations on defective PLR in PD, evaluated with eye-tracker, and show a possible association with autonomic dysfunction. Further studies with more patients and rigorous evaluation of autonomic dysfunction are needed to validate these findings.
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- 2023
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6. High (130 Hz)- and mid (60 Hz)-frequency deep brain stimulation in the subthalamic nucleus differentially modulate response inhibition: A preliminary combined EEG and eye tracking study
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Waldthaler, Josefine, Sperlich, Alexander, König, Aylin, Stüssel, Charlotte, Bremmer, Frank, Timmermann, Lars, and Pedrosa, David
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- 2023
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7. Neurocognitive profile of adults with the Norrbottnian type of Gaucher disease
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Panagiota Tsitsi, Ioanna Markaki, Josefine Waldthaler, Maciej Machaczka, and Per Svenningsson
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attention ,cognition ,glucocerebrosidase ,memory ,neuronopathic Gaucher disease ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 ,Genetics ,QH426-470 - Abstract
Abstract Introduction Gaucher disease (GD) is a monogenic, lysosomal storage disorder, classified according to the presence of acute (type 2), chronic (type 3), or no (type 1) neurological manifestations. The Norrbottnian subtype of neuronopathic GD type 3 (GD3) is relatively frequent in the northern part of Sweden. It exhibits a wide range of neurological symptoms but is characterized by extended life expectancy compared to GD3 in other countries. The aim of our study was to describe the cognitive profile of adult patients with Norrbottnian GD3. Materials and Methods Ten patients with GD3 (five males and five females) underwent neurocognitive testing with the Repeatable Battery for Assessment of Neuropsychological Status (RBANS). RBANS consists of different short tests that assess Immediate Memory, Visuospatial and Constructional function, Language, Attention, and Delayed Memory. General neurological symptoms of the patients were assessed with the modified severity scoring tool. Results Patients (median age 41.5 range 24–57) performed lower than average in all cognitive domains. The overall index score was low (median 58.5, Interquartile range [IQR] 25.5), with the most profound deficit in attention (median 57, IQR 32.5) and immediate memory (median 76.5, IQR 13). Higher scores were found in language (median 83, IQR 21.5), delayed memory (median 81, IQR 41), and visuospatial/constructional function (median 86, IQR 32.35). Conclusion Norrbottnian GD3 patients showed a unique neurocognitive profile with low overall performance, mostly derived from low scores in attention and memory domains whereas language and visuospatial/constructional ability were relatively spared.
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- 2022
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8. High (130 Hz)- and mid (60 Hz)-frequency deep brain stimulation in the subthalamic nucleus differentially modulate response inhibition: A preliminary combined EEG and eye tracking study
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Josefine Waldthaler, Alexander Sperlich, Aylin König, Charlotte Stüssel, Frank Bremmer, Lars Timmermann, and David Pedrosa
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Antisaccade ,Response inhibition ,Parkinson’s disease ,Executive functions ,Eye tracking ,Movement disorders ,Computer applications to medicine. Medical informatics ,R858-859.7 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
While deep brain stimulation (DBS) in the subthalamic nucleus (STN) improves motor functions in Parkinson’s disease (PD), it may also increase impulsivity by interfering with the inhibition of reflexive responses. The aim of this study was to investigate if varying the pulse frequency of STN-DBS has a modulating effect on response inhibition and its neural correlates.For this purpose, 14 persons with PD repeated an antisaccade task in three stimulation settings (DBS off, high-frequency DBS (130 Hz), mid-frequency DBS (60 Hz)) in a randomized order, while eye movements and brain activity via high-density EEG were recorded.On a behavioral level, 130 Hz DBS stimulation had no effect on response inhibition measured as antisaccade error rate, while 60 Hz DBS induced a slight but significant reduction of directional errors compared with the DBS-off state and 130 Hz DBS. Further, stimulation with both frequencies decreased the onset latency of correct antisaccades, while increasing the latency of directional errors.Time-frequency domain analysis of the EEG data revealed that 60 Hz DBS was associated with an increase in preparatory theta power over a midfrontal region of interest compared with the off-DBS state which is generally regarded as a marker of increased cognitive control. While no significant differences in brain activity over mid- and lateral prefrontal regions of interest emerged between the 60 Hz and 130 Hz conditions, both stimulation frequencies were associated with a stronger midfrontal beta desynchronization during the mental preparation for correct antisaccades compared with DBS off-state which is discussed in the context of potentially enhanced proactive recruitment of the oculomotor network.Our preliminary findings suggest that mid-frequency STN-DBS may provide beneficial effects on response inhibition, while both 130 Hz- and 60 Hz STN-DBS may promote voluntary actions at the expense of slower reflexive responses.
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- 2023
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9. Imaging-based programming of subthalamic nucleus deep brain stimulation in Parkinson's disease
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Josefine Waldthaler, Miriam Bopp, Nele Kühn, Bugrahan Bacara, Merle Keuler, Marko Gjorgjevski, Barbara Carl, Lars Timmermann, Christopher Nimsky, and David J. Pedrosa
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Idiopathic Parkinson's disease ,Deep brain stimulation ,Subthalamic nucleus ,Programming ,Directional leads ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Background: The need for imaging-guided optimization of Deep Brain Stimulation (DBS) parameters is increasing with recent developments of sophisticated lead designs offering highly individualized, but time-consuming and complex programming. Objective: The objective of this study was to compare changes in motor symptoms of Parkinson's Disease (PD) and the corresponding volume of the electrostatic field (VEsF) achieved by DBS programming using GUIDE XT™, a commercially available software for visualization of DBS leads within the patient-specific anatomy from fusions of preoperative magnetic resonance imaging (MRI) and postoperative computed tomography (CT) scans, versus standard-of-care clinical programming. Methods: Clinical evaluation was performed to identify the optimal set of parameters based on clinical effects in 29 patients with PD and bilateral directional leads for Subthalamic Nucleus (STN) DBS. A second DBS program was generated in GUIDE XT™ based on a VEsF optimally located within the dorsolateral STN. Reduction of motor symptoms (Movement Disorders Society Unified Parkinson's Disease Rating Scale, MDS-UPDRS) and the overlap of the corresponding VEsF of both programs were compared. Results: Clinical and imaging-guided programming resulted in a significant reduction in the MDS-UPDRS scores compared to off-state. Motor symptom control with GUIDE XT™-derived DBS program was non-inferior to standard clinical programming. The overlap of the two VEsF did not correlate with the difference in motor symptom reduction by the programs. Conclusions: Imaging-guided programming of directional DBS leads using GUIDE XT™ is possible without computational background and leads to non-inferior motor symptom control compared with clinical programming. DBS programs based on patient-specific imaging data may thus serve as starting point for clinical testing and may promote more efficient DBS programming.
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- 2021
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10. Present and future role of endoscopic retrograde cholangiography in primary sclerosing cholangitis
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Waldthaler, A., Schramm, C., and Bergquist, A.
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- 2021
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11. Visual Perturbation Suggests Increased Effort to Maintain Balance in Early Stages of Parkinson’s to be an Effect of Age Rather Than Disease
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Justus Student, David Engel, Lars Timmermann, Frank Bremmer, and Josefine Waldthaler
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Parkinson’s disease ,body sway ,virtual reality ,center of mass (CoM) ,center of pressure (CoP) ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Postural instability marks a prevalent symptom of Parkinson’s disease (PD). It often manifests in increased body sway, which is commonly assessed by tracking the Center of Pressure (CoP). Yet, in terms of postural control, the body’s Center of Mass (CoM), and not CoP is what is regulated in a gravitational field. The aim of this study was to explore the effect of early- to mid-stage PD on these measures of postural control in response to unpredictable visual perturbations. We investigated three cohorts: (i) 18 patients with early to mid-stage PD [Hoehn & Yahr stage (1–3); 1.94 ± 0.70]; (ii) a group of 15 age-matched controls (ECT); and (iii) a group of 12 young healthy adults (YCT). Participants stood on a force plate to track their CoP, while the movement of their entire body was recorded with a video-based motion tracking system to monitor their CoM. A moving room paradigm was applied through a head-mounted virtual reality headset. The stimulus consisted of a virtual tunnel that stretched in the anterior-posterior direction which either remained static or moved back and forth in an unpredictable fashion.We found differences in mean sway amplitude (MSA) and mean velocities of CoP and CoM between the groups under both conditions, with higher MSA of CoP and CoM for PD and higher mean velocities of both variables for PD and ECT when compared with YCT. Visual perturbation increased mean CoP velocity in all groups but did not have effects on mean CoM velocity or MSA. While being significantly lower for the young adults, the net effect of visual perturbation on mean CoP velocity was similar between patients with PD and age-matched controls. There was no effect of the visual perturbation on mean CoM velocity for any of the groups.Our simultaneous assessment of CoP and CoM revealed that postural control is reflected differently in CoM and CoP. As the motion of CoM remained mostly unaffected, all groups successfully counteracted the perturbation and maintained their balance. Higher CoP velocity for PD and ECT revealed increased corrective motion needed to achieve this, which however was similar in both groups. Thus, our results suggest increased effort, expressed in CoP velocity, to be an effect of age rather than disease in earlier stages of PD.
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- 2022
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12. New insights into facial emotion recognition in Parkinson's disease with and without mild cognitive impairment from visual scanning patterns
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Waldthaler, Josefine, Krüger-Zechlin, Charlotte, Stock, Lena, Deeb, Zain, and Timmermann, Lars
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- 2019
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13. Pupil light reflex dynamics in Parkinson’s disease
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Tsitsi, Panagiota, primary, Nilsson, Mattias, additional, Waldthaler, Josefine, additional, Öqvist Seimyr, Gustaf, additional, Larsson, Olof, additional, Svenningsson, Per, additional, and Markaki, Ioanna, additional
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- 2023
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14. New insights into facial emotion recognition in Parkinson's disease with and without mild cognitive impairment from visual scanning patterns
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Josefine Waldthaler, Charlotte Krüger-Zechlin, Lena Stock, Zain Deeb, and Lars Timmermann
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Parkinson's disease ,Facial emotion recognition ,Eye movements ,Eye tracking ,Cognition ,Mild cognitive impairment ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Background: Recognizing emotional facial expressions is crucial for social interactions. Cognitive impairment and oculomotor abnormalities are common features of Parkinson's disease (PD) which may contribute to the performance in facial emotion recognition (FER) in PD. Objective: The aim of this study was to analyze eye movement behavior during a facial emotion recognition (FER) task with respect to cognitive state in PD patients and healthy controls. Methods: Eye movements of 24 non-demented, non-depressed PD patients (12 with intact cognitive functions and 12 with Mild Cognitive Impairment (MCI) according to MDS task force criteria level 2), and 12 age-, sex and education-matched healthy controls were recorded during visual exploration of 28 emotional (happiness, surprise, disgust, anger, fear and sadness) and neutral faces. Participants were asked to identify the displayed emotion out of a sevenfold multiple choice question. Results: PD-MCI patients showed reduced FER with specific impairment of anger recognition. Although the scanned area of PD patients with intact cognition was significantly restricted, they did not differ in FER from healthy subjects. While healthy subjects and cognitively intact PD patients scanned faces with preference for mouth and eyes, patients with PD-MCI tended to look at the center of the face and spent significantly less time fixating the mouth. Conclusions: Ineffective visual exploration may contribute to impaired emotion recognition in PD. Visual scanning of emotional faces is altered in PD even in the absence of cognitive impairment. The progression to PD-MCI may result in further deterioration of scanning behavior and FER impairment.
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- 2019
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15. Natural Reading in Parkinson’s Disease With and Without Mild Cognitive Impairment
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Lena Stock, Charlotte Krüger-Zechlin, Zain Deeb, Lars Timmermann, and Josefine Waldthaler
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Parkinson’s disease ,reading ,eye movements ,eye tracking ,cognition ,mild cognitive impairment ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Background: Patients with Parkinson’s disease (PD) show eye movement abnormalities and frequently complain about difficulties in reading. So far, it is unclear whether basal ganglia dysfunction or cognitive impairment has a greater impact on eye movements during reading.Objective: To analyze eye movement behavior during a natural reading task with respect to cognitive state and dopaminergic therapy in PD and healthy controls.Methods: Eye movements of 59 PD patients and 29 age- and education-matched healthy controls were recorded during mute, self-paced reading of a text. 25 cognitively normal PD patients performed the task additionally in off medication state. Clinical assessment included a comprehensive neuropsychological test battery and the motor section of MDS—Unified Parkinson’s Disease Rating Scale (MDS-UPDRS).Results: PD-mild cognitive impairment (MCI) was diagnosed in 21 patients. Reading speed was significantly reduced in PD-MCI compared to healthy controls and PD patients without MCI due to higher numbers of progressive saccades. Cognitively intact PD patients showed no significant alterations of reading speed or eye movement pattern during reading. The fixation duration tended to be prolonged in PD compared to healthy controls and decreased significantly after levodopa intake. Scores for executive functions, attention, and language correlated with reading speed in the PD group.Conclusion: The present study is the first to reveal (1) reduced reading speed with altered reading pattern in PD with MCI and (2) a relevant impact of levodopa on fixation duration during reading in PD. Further research is needed to determine whether therapeutic interventions, e.g., levodopa or neuropsychological training, improve the subjective reading experience for patients with PD.
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- 2020
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16. Bimodal ERCP, a new way of seeing things
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Marcus Reuterwall, Alexander Waldthaler, Jeanne Lubbe, Nils Kadesjö, Raffaella Pozzi Mucelli, Marco Del Chiaro, Matthias Lohr, and Urban Arnelo
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and study aims Conventional endoscopic retrograde cholangiopancreatography (ERCP) is hampered by two-dimensional visualization, post-procedural adverse events (AEs), and exposure to ionizing radiation. Bimodal ERCP might mitigate these challenges, but no reports of its use are available to date. The aim of this study was to explore the feasibility of bimodal ERCP, while investigating its potential clinical yield. Patients and methods This was a retrospective observational study of patients that underwent bimodal ERCP in a single tertiary academic referral center. Thirteen patients undergoing conventional ERCP had a previously T2-weighted isotropic 3 D TSE MRCP sequence aligned and fused with the two-dimensional image generated from the fluoroscopy c-arm unit in real time. Results Over a 2-month period, 13 patients with a mean age of 54 underwent bimodal ERCP for bile duct stricture (61.5 %), complex cholelithiasis (7.7 %) and ductal leakage (30.1 %). Bimodal ERCP was feasible in all 13 cases, and image quality was assessed as “good” in 11 patients (84.6 %). Bimodal ERCP aided in visualizing the lesion of interest (76.9 %), assisted in understanding the 3 D anatomy of the biliopancreatic ductal system (61.5 %), and aided in finding a favorable position for the c-arm (38.4 %) for subsequent therapeutic intervention. Conclusions This first report on bimodal ERCP proves its feasibility and suggests that it may assist in increasing both the diagnostic and therapeutic yield of ERCP, while at the same time decreasing AEs during and after ERCP. Its main application might lie in treatment of complex intrahepatic disease.
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- 2020
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17. Stimulation of non-motor subthalamic nucleus impairs selective response inhibition via prefrontal connectivity
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Waldthaler, Josefine, primary, Sperlich, Alexander, additional, Stüssel, Charlotte, additional, Steidel, Kenan, additional, Timmermann, Lars, additional, and Pedrosa, David J, additional
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- 2023
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18. Le ver est dans le fruit: une maladie tropicale dans le pays de Glaris?
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Henzi, Anna, primary, Hakanovic, Amir, additional, Wiedenmann, Margarethe, additional, Waldthaler, Christian, additional, and Brack, Thomas, additional
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- 2023
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19. Da ist der Wurm drin: Tropenkrankheit im Glarnerland?
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Henzi, Anna, primary, Hakanovic, Amir, additional, Wiedenmann, Margarethe, additional, Waldthaler, Christian, additional, and Brack, Thomas, additional
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- 2023
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20. Deep Learning for Time Series Classification of Parkinson's Disease Eye Tracking Data
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Uribarri, Gonzalo, von Huth, Simon Ekman, Waldthaler, Josefine, Svenningsson, Per, Fransén, Erik, Uribarri, Gonzalo, von Huth, Simon Ekman, Waldthaler, Josefine, Svenningsson, Per, and Fransén, Erik
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Eye-tracking is an accessible and non-invasive technology that provides information about a subject's motor and cognitive abilities. As such, it has proven to be a valuable resource in the study of neurodegenerative diseases such as Parkinson's disease. Saccade experiments, in particular, have proven useful in the diagnosis and staging of Parkinson's disease. However, to date, no single eye-movement biomarker has been found to conclusively differentiate patients from healthy controls. In the present work, we investigate the use of state-of-the-art deep learning algorithms to perform Parkinson's disease classification using eye-tracking data from saccade experiments. In contrast to previous work, instead of using hand-crafted features from the saccades, we use raw $\sim1.5\,s$ long fixation intervals recorded during the preparatory phase before each trial. Using these short time series as input we implement two different classification models, InceptionTime and ROCKET. We find that the models are able to learn the classification task and generalize to unseen subjects. InceptionTime achieves $78\%$ accuracy, while ROCKET achieves $88\%$ accuracy. We also employ a novel method for pruning the ROCKET model to improve interpretability and generalizability, achieving an accuracy of $96\%$. Our results suggest that fixation data has low inter-subject variability and potentially carries useful information about brain cognitive and motor conditions, making it suitable for use with machine learning in the discovery of disease-relevant biomarkers., Comment: Extended Abstract presented at Machine Learning for Health (ML4H) symposium 2023, December 10th, 2023, New Orleans, United States, 12 pages
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- 2023
21. Stimulation of non-motor subthalamic nucleus impairs selective response inhibition via prefrontal connectivity
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Josefine Waldthaler, Alexander Sperlich, Charlotte Stüssel, Kenan Steidel, Lars Timmermann, and David J Pedrosa
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Cellular and Molecular Neuroscience ,Psychiatry and Mental health ,Neurology ,Biological Psychiatry - Abstract
Given the inconsistent results in the past, there is an ongoing debate whether and how deep brain stimulation in the subthalamic nucleus modifies cognitive control processes like response inhibition in persons with Parkinson’s disease. In this study, we examined how the location of the stimulation volume within the subthalamic nucleus affects the performance in an antisaccade task but also how its structural connectivity is related to response inhibition. Antisaccade error rates and latencies were collected in 14 participants on and off deep brain stimulation in a randomized order. Stimulation volumes were computed based on patient-specific lead localizations using preoperative MRI and postoperative CT scans. Structural connectivity of the stimulation volumes with pre-defined cortical oculomotor control regions as well as whole-brain connectivity was estimated using a normative connectome. We showed that the detrimental effect of deep brain stimulation on response inhibition, measured as antisaccade error rate, depended upon the magnitude of the intersection of volumes of activated tissue with the non-motor subregion of the subthalamic nucleus and on its structural connectivity with regions of the prefrontal oculomotor network including bilateral frontal eye fields and right anterior cingulate cortex. Our results corroborate previous recommendations for avoidance of stimulation in the ventromedial non-motor subregion of the subthalamic nucleus which connects to the prefrontal cortex to prevent stimulation-induced impulsivity. Furthermore, antisaccades were initiated faster with deep brain stimulation when the stimulation volume was connected to fibres passing the subthalamic nucleus laterally and projecting onto the prefrontal cortex, indicating that improvement of voluntary saccade generation with deep brain stimulation may be an off-target effect driven by stimulation of corticotectal fibres directly projecting from the frontal and supplementary eye fields onto brainstem gaze control areas. Taken together, these findings could help implement individualized circuit-based deep brain stimulation strategies that avoid impulsive side effects while improving voluntary oculomotor control.
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- 2023
22. Le ver est dans le fruit: une maladie tropicale dans le pays de Glaris?
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Anna Henzi, Amir Hakanovic, Margarethe Wiedenmann, Christian Waldthaler, and Thomas Brack
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General Medicine - Published
- 2023
23. Da ist der Wurm drin: Tropenkrankheit im Glarnerland?
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Anna Henzi, Amir Hakanovic, Margarethe Wiedenmann, Christian Waldthaler, and Thomas Brack
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General Medicine - Published
- 2023
24. GLRA1 mutation and long-term follow-up of the first hyperekplexia family
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Paucar, Martin, Waldthaler, Josefine, and Svenningsson, Per
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- 2018
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25. Vertical saccades and antisaccades: complementary markers for motor and cognitive impairment in Parkinson’s disease
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Waldthaler, Josefine, Tsitsi, Panagiota, and Svenningsson, Per
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- 2019
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26. Attenuated beta rebound to proprioceptive afferent feedback in Parkinson’s disease
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Vinding, Mikkel C., Tsitsi, Panagiota, Piitulainen, Harri, Waldthaler, Josefine, Jousmäki, Veikko, Ingvar, Martin, Svenningsson, Per, and Lundqvist, Daniel
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- 2019
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27. Diagnosis and treatment of exocrine pancreatic insufficiency in chronic pancreatitis: An international expert survey and case vignette study
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Florence E.M. de Rijk, Charlotte L. van Veldhuisen, Marc G. Besselink, Jeanin E. van Hooft, Hjalmar C. van Santvoort, Erwin J.M. van Geenen, Peter Hegyi, J-Matthias Löhr, Juan E. Dominguez-Munoz, Pieter Jan F. de Jonge, Marco J. Bruno, Robert C. Verdonk, Massimo Falconi, Wen-Bin Zou, Trond Engjom, Chee Y. Ooi, Robert Sutton, Luca Frulloni, John Neoptolemos, Charles Wilcox, Vujasinovic Miroslav, Guru Trikudanathan, Zhuan Liao, Truls Hauge, Joachim Mössner, Chantal Hoge, Paul Fockens, Sven Mieog, Gabriele Capurso, Yunfeng Cui, Enrique de Madaria, Marius Distler, Ali Aghdassi, David C. Whitcomb, Kylie Russell, Georg Beyer, Lumír Kunovsky, Wilhelmus Kwanten, Andrea Kazemi Nava, Kevin Conlon, A.K. Siriwardena, Salvatore Paiella, Felipe Alconchel, Marco Vito Marino, Vincent E. de Meijer, Carlos Domingo, Jorg Kleeff, Aarti Lakshmanan, Michael Jen Lie Chu, Stefan Bouwense, Pueya Rashid Nashidengo, Perivoliotis Konstantinos, Edoardo Maria Muttillo, Garzali Ibrahim Umar, Maria Jesus Castro Santiago, Victor Lopez-Lopez, Francesco Torri, Moritz Schmelzle, Povilas Ignatavicius, Dennis Wicherts, Antonio Gomes, Nikolaos A. Machairas, Panagiotis I. Dorovinis, Alejandro Serrablo, Kjetil Soreide, Mohammad Rahbari, Michael Jen Jie Chu, Margarita Ptasnuka, Marius Petrulionis, Colin Byron Noel, Ernest Castro, Marcello Di Martino, Alfonso Recordare, Stefan Stättner, Fabio Ausania, Vera Hartman, Geert Roeyen, Viacheslav Egorov, Tomas Vanagas, Mohamed Ebrahim, Elena Arabadzhieva, Giuseppe Malleo, Liang Li, David Adams, Grzegorz Oracz, Reddy D. Nageshwar, Alexander Waldthaler, Atsushi Masamune, Asbjorn Mohr Drewes, Antonio Amodio, Temel Tirkes, Anshu Srivastava, Gregory J. Beilman, Zoltan Berger, Bjorn Lindkvist, Giulia Martina Cavestro, Cheryl Gariepy, Laszlo Czakó, Milena Di Leo, Vishal Sharma, Sundeep Lakhtakia, Surinder Singh Rana, Sinaed N. Duggan, Chang-Il Kwon, Anna Evans Phillips, Christopher E. Forsmark, Ferga C. Gleeson, Glen A. Lehman, William Greenhalf, Guido Costamagna, Christopher M. Halloran, Helmut Friess, Henrik Hojgaard Rasmussen, Tsukasa Ikeura, Ingfrid S. Haldorsen, Takao Itoi, Jacob R. Izbicki, John Windsor, Jakob Lykke Poulsen, Jens Brondum Frokjaer, Jose Larino-Noia, Dan Wang, Julio Iglesias Garcia, Evangelos Kalaitzakis, Kararzyna Wertheim-Tysarowska, Kensuke Kubota, Jessica Larusch, Markus M. Lerch, Liang-Hao Hu, Mert Erkan, Jorg D. Machicado, Marianna Arvanitakis, Markus W. Buchler, Marlon F. Levy, Melvin B. Heyman, Camilla Nojgaard, Mouen A. Khashab, Myriam Delhaye, Takeshi Ogura, Kazuichi Okazaki, Paula Ghaneh, Peter A. Banks, Pankaj Gupta, Georgios I. Papachristou, Patrick Michl, Philippe Levy, Aldis Pukitis, Raffaele Pezzilli, Ryan D. Baron, Stephen T. Amann, Sarah Jane Schwarzenberg, Shuiji Isaji, Soren Schou Olesen, Srdan Novovic, Steven J. Hughes, Steven L. Werlin, Tanja Gonska, Timothy B. Gardner, Mark D. Topazian, Frank Ulrich Weiss, Venakata S. Akshintala, Veronique D. Morinville, Vinciane Rebours, Aron Vincze, Vikesh K. Singh, Naiqiang Cui, Hong Zhang, Zhao-shen Li, Integrated Research on Energy, Environment & Socie, Molecular Active Systems, Gastroenterology and hepatology, Gastroenterology & Hepatology, Graduate School, Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and Gastroenterology and Hepatology
- Subjects
Pancreatic enzyme replacement therapy ,Hepatology ,Endocrinology, Diabetes and Metabolism ,Clinical Decision-Making ,Exocrine pancreatic insufficiency ,Gastroenterology ,Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0] ,Steatorrhea ,SDG 3 - Good Health and Well-being ,Expert opinion ,Pancreatitis, Chronic ,Humans ,HaPanEU-guidelines ,Pancreas ,Chronic pancreatitis - Abstract
IntroductionDespite evidence-based guidelines, exocrine pancreatic insufficiency is frequently underdiagnosed and undertreated in patients with chronic pancreatitis. Therefore, the aim of this study is to provide insight into the current opinion and clinical decision-making of international pancreatologists regarding the management of exocrine pancreatic insufficiency.MethodsAn online survey and case vignette study was sent to experts in chronic pancreatitis and members of various pancreatic associations: EPC, E-AHPBA and DPSG. Experts were selected based on publication record from the past 5 years.ResultsOverall, 252 pancreatologists participated of whom 44% had ≥ 15 years of experience and 35% treated ≥ 50 patients with chronic pancreatitis per year. Screening for exocrine pancreatic insufficiency as part of the diagnostic work-up for chronic pancreatitis is performed by 69% and repeated annually by 21%. About 74% considers nutritional assessment to be part of the standard work-up. Patients are most frequently screened for deficiencies of calcium (47%), iron (42%), vitamin D (61%) and albumin (59%). In case of clinically steatorrhea, 71% prescribes enzyme supplementation. Of all pancreatologists, 40% refers more than half of their patients to a dietician. Despite existing guidelines, 97% supports the need for more specific and tailored instructions regarding the management of exocrine pancreatic insufficiency.ConclusionThis survey identified a lack of consensus and substantial practice variation among international pancreatologists regarding guidelines pertaining the management of exocrine pancreatic insufficiency. These results highlight the need for further adaptation of these guidelines according to current expert opinion and the level of available scientific evidence. Introduction: Despite evidence-based guidelines, exocrine pancreatic insufficiency is frequently underdiagnosed and undertreated in patients with chronic pancreatitis. Therefore, the aim of this study is to provide insight into the current opinion and clinical decision-making of international pancreatologists regarding the management of exocrine pancreatic insufficiency. Methods: An online survey and case vignette study was sent to experts in chronic pancreatitis and members of various pancreatic associations: EPC, E-AHPBA and DPSG. Experts were selected based on publication record from the past 5 years. Results: Overall, 252 pancreatologists participated of whom 44% had ≥ 15 years of experience and 35% treated ≥ 50 patients with chronic pancreatitis per year. Screening for exocrine pancreatic insufficiency as part of the diagnostic work-up for chronic pancreatitis is performed by 69% and repeated annually by 21%. About 74% considers nutritional assessment to be part of the standard work-up. Patients are most frequently screened for deficiencies of calcium (47%), iron (42%), vitamin D (61%) and albumin (59%). In case of clinically steatorrhea, 71% prescribes enzyme supplementation. Of all pancreatologists, 40% refers more than half of their patients to a dietician. Despite existing guidelines, 97% supports the need for more specific and tailored instructions regarding the management of exocrine pancreatic insufficiency. Conclusion: This survey identified a lack of consensus and substantial practice variation among international pancreatologists regarding guidelines pertaining the management of exocrine pancreatic insufficiency. These results highlight the need for further adaptation of these guidelines according to current expert opinion and the level of available scientific evidence.
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- 2022
28. Neurocognitive profile of adults with the Norrbottnian type of Gaucher disease
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Panagiota Tsitsi, Per Svenningsson, Josefine Waldthaler, Maciej Machaczka, and Ioanna Markaki
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Research Report ,cognition ,Pediatrics ,medicine.medical_specialty ,business.industry ,glucocerebrosidase ,Endocrinology, Diabetes and Metabolism ,Research Reports ,Disease ,QH426-470 ,RC648-665 ,Biochemistry, Genetics and Molecular Biology (miscellaneous) ,Diseases of the endocrine glands. Clinical endocrinology ,attention ,memory ,Internal Medicine ,medicine ,Genetics ,neuronopathic Gaucher disease ,business ,Neurocognitive - Abstract
Introduction Gaucher disease (GD) is a monogenic, lysosomal storage disorder, classified according to the presence of acute (type 2), chronic (type 3), or no (type 1) neurological manifestations. The Norrbottnian subtype of neuronopathic GD type 3 (GD3) is relatively frequent in the northern part of Sweden. It exhibits a wide range of neurological symptoms but is characterized by extended life expectancy compared to GD3 in other countries. The aim of our study was to describe the cognitive profile of adult patients with Norrbottnian GD3. Materials and Methods Ten patients with GD3 (five males and five females) underwent neurocognitive testing with the Repeatable Battery for Assessment of Neuropsychological Status (RBANS). RBANS consists of different short tests that assess Immediate Memory, Visuospatial and Constructional function, Language, Attention, and Delayed Memory. General neurological symptoms of the patients were assessed with the modified severity scoring tool. Results Patients (median age 41.5 range 24–57) performed lower than average in all cognitive domains. The overall index score was low (median 58.5, Interquartile range [IQR] 25.5), with the most profound deficit in attention (median 57, IQR 32.5) and immediate memory (median 76.5, IQR 13). Higher scores were found in language (median 83, IQR 21.5), delayed memory (median 81, IQR 41), and visuospatial/constructional function (median 86, IQR 32.35). Conclusion Norrbottnian GD3 patients showed a unique neurocognitive profile with low overall performance, mostly derived from low scores in attention and memory domains whereas language and visuospatial/constructional ability were relatively spared.
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- 2021
29. Cluster analysis reveals distinct patterns of saccade impairment and their relation to cognitive profiles in Parkinson's disease
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Josefine Waldthaler, Lena Stock, Charlotte Krüger‐Zechlin, Zain Deeb, and Lars Timmermann
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Behavioral Neuroscience ,Neuropsychology and Physiological Psychology ,Cognitive Neuroscience - Abstract
Saccade performance has been reported to be altered in Parkinson's disease (PD), however, with a large variability between studies as both motor and cognitive impairment interfere with oculomotor control. The aim of this study was to identify different patterns in saccade alterations in PD using a data-driven approach and to explore their relationship with cognitive phenotypes. Sixty-one participants with PD and 25 controls performed eye-tracking (horizontal and vertical prosaccades, antisaccades) and neuropsychological testing. Hierarchical cluster analysis was applied to the eye-tracking data to subsequently compare the clusters based on demographical, clinical and cognitive characteristics. The three identified clusters of saccade alterations differed in cognitive profiles from healthy controls, but not in PD-related motor symptoms or demographics. The rate of directive errors in the antisaccade task was increased in clusters 1 and 2. Further, cluster 1 was defined by a general disinhibition of reflexive saccades and executive dysfunction in the neuropsychological evaluation. In cluster 2, prolonged saccade latencies and hypometria were accompanied by multidomain cognitive impairment. The cluster 3 showed increased antisaccade latency and vertical hypometria despite lack of evidence for cognitive impairment. Our results suggest that there may be at least two opposing patterns of saccade alterations associated with cognitive impairment in PD, which may explain some of the contradictory results of previous studies.
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- 2022
30. Visual perturbation of balance suggests impaired motor control but intact visuomotor processing in Parkinson’s disease
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David W. Engel, Frank Bremmer, Adam P. Morris, Justus Student, Lars Timmermann, Josefine Waldthaler, and Jakob C. B. Schwenk
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Adult ,Male ,Parkinson's disease ,genetic structures ,Physiology ,Disease ,050105 experimental psychology ,Phase locking ,Postural control ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,0501 psychology and cognitive sciences ,Postural Balance ,Aged ,Balance (ability) ,business.industry ,General Neuroscience ,05 social sciences ,Motor control ,Parkinson Disease ,Middle Aged ,medicine.disease ,Body sway ,Visual Perception ,Female ,business ,Neuroscience ,Psychomotor Performance ,030217 neurology & neurosurgery - Abstract
Postural instability marks one of the most disabling features of Parkinson's disease (PD), but it only reveals itself after affected brain areas have already been significantly damaged. Thus there is a need to detect deviations in balance and postural control before visible symptoms occur. In this study, we visually perturbed balance in the anterior-posterior direction using sinusoidal oscillations of a moving room in virtual reality at different frequencies. We tested three groups: individuals with PD under dopaminergic medication, an age-matched control group, and a group of young healthy adults. We tracked their center of pressure and their full-body motion, from which we also extracted the center of mass. We investigated sway amplitudes and applied newly introduced phase-locking analyses to investigate responses across participants' bodies. Patients exhibited significantly higher sway amplitudes as compared with the control subjects. However, their sway was phase locked to the visual motion like that of age-matched and young healthy adults. Furthermore, all groups successfully compensated for the visual perturbation by phase locking their sway to the stimulus. As frequency of the perturbation increased, distribution of phase locking (PL) across the body revealed a shift of the highest PL values from the upper body toward the hip region for young healthy adults, which could not be observed in patients and elderly healthy adults. Our findings suggest an impaired motor control, but intact visuomotor processing in early stages of PD, while less flexibility to adapt postural strategy to different perturbations revealed to be an effect of age rather than disease.
- Published
- 2021
31. Vitamins D and K as Factors Associated with Osteopathy in Chronic Pancreatitis: A Prospective Multicentre Study (P-BONE Study)
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Stigliano, Serena, Waldthaler, Alexander, Martinez-Moneo, Emma, Lionetto, Luana, Robinson, Stuart, Malvik, Marko, Hedstrom, Aleksandra, Kaczka, Aleksandra, Scholdei, Marius, Haas, Stephan, Simmaco, Maurizio, Delle Fave, Gianfranco, Lohr, Matthias, Simon, Peter, and Capurso, Gabriele
- Published
- 2018
- Full Text
- View/download PDF
32. Antisaccades in Parkinson’s Disease: A Meta-Analysis
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Josefine Waldthaler, Justus Student, Lars Timmermann, Stefan Dowiasch, Johanna Sommerkorn, and Lena Stock
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medicine.medical_specialty ,Levodopa ,Antisaccade ,Eye movement ,Deep brain stimulation ,Neurology ,Parkinson's disease ,medicine.medical_treatment ,Deep Brain Stimulation ,Review ,050105 experimental psychology ,Executive functions ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Subthalamic Nucleus ,medicine ,Humans ,0501 psychology and cognitive sciences ,05 social sciences ,Neuropsychology ,Parkinson Disease ,medicine.disease ,Subthalamic nucleus ,Neuropsychology and Physiological Psychology ,Saccade ,Parkinson’s disease ,Eye-tracking ,Antisaccade task ,Psychology ,Cognition Disorders ,030217 neurology & neurosurgery ,Executive dysfunction ,medicine.drug - Abstract
The usefulness of eye-tracking tasks as potential biomarkers for motor or cognitive disease burden in Parkinson’s disease (PD) has been subject of debate for many years. Several studies suggest that the performance in the antisaccade task may be altered in patients with PD and associated with motor disease severity or executive dysfunction. In this meta-analysis, random effects models were used to synthesize the existing evidence on antisaccade error rates and latency in PD. Furthermore, meta-regressions were performed to assess the role of motor and cognitive disease severity, dopaminergic medication and methodological factors. Additionally, the impact of acute levodopa administration and activation of deep brain stimulation was evaluated in two separate sub-analyses. This meta-analysis confirms that antisaccade latency and error rate are significantly increased in PD. Disease duration, Unified Parkinson’s disease rating scale score and Hoehn and Yahr stage mediate the effect of PD on antisaccade latency with higher motor burden being associated with increased antisaccade latency. Acute administration of levodopa had no significant effects on antisaccade performance in a small number of eligible studies. Deep brain stimulation in the subthalamic nucleus, on the other hand, may alter the speed accuracy trade-off supporting an increase of impulsivity following deep brain stimulation in PD. According to the results of the meta-analysis, antisaccade latency may provide a potential marker for disease severity and progression in PD which needs further confirmation in longitudinal studies. Supplementary Information The online version contains supplementary material available at 10.1007/s11065-021-09489-1.
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- 2021
33. Paraduodenal pancreatitis - problem in the groove
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Miroslav Vujasinovic, Raffaella Pozzi Mucelli, Aristeidis Grigoriadis, Isabella Palmér, Ebba Asplund, Wiktor Rutkowski, Francisco Baldaque-Silva, Alexander Waldthaler, Poya Ghorbani, Caroline S. Verbeke, and J. Matthias Löhr
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Gastroenterology - Abstract
Background Paraduodenal pancreatitis (PDP) is a particular form of chronic pancreatitis (CP) occurring in and around the duodenal wall. Despite its low prevalence, this rare condition presents a significant challenge in clinical practice. Methods We retrospectively analysed the electronic medical charts of all patients with a diagnosis of chronic pancreatitis and identified those with PDP, between January 1999 and December 2020. Results There were 35 patients diagnosed with PDP (86% males and 14% females); median age of 56 ± 11 (range 38–80). Alcohol overconsumption was reported in 81% and smoking in 90% of patients. Abdominal pain was the leading symptom (71%), followed by weight loss, nausea and vomiting, jaundice, and diarrhoea. In 23 patients (66%), recurrent acute pancreatitis attacks were noted. Focal duodenal wall thickening was present in 34 patients (97%), cystic lesions in 80%, pancreatic duct dilatation in 54% and common bile duct dilatation in 46%. Endoscopic treatment was performed on nine patients (26%) and five patients (14%) underwent surgery. Complete symptom relief was reported in 12 patients (34%), partial symptom relief in three (9%), there was no improvement in five (14%), data were not available in three (9%) and 12 (34%) patients died before data analysis. Conclusions PDP is a rare form of pancreatitis, most commonly occurring in the 5th or 6th decade of life, with a predominance in males and patients with a history of smoking and high alcohol consumption. Focal thickening and cystic lesions of the duodenal wall are the most common imaging findings, followed by pancreatic duct and common bile duct dilatation. A minority of patients requires surgery.
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- 2022
34. Paraduodenal pancreatitis - problem in the groove
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Vujasinovic, Miroslav, Mucelli, Raffaella Pozzi, Grigoriadis, Aristeidis, Palmer, Isabella, Asplund, Ebba, Rutkowski, Wiktor, Baldaque-Silva, Francisco, Waldthaler, Alexander, Ghorbani, Poya, Verbeke, Caroline S., Lohr, J. Matthias, Vujasinovic, Miroslav, Mucelli, Raffaella Pozzi, Grigoriadis, Aristeidis, Palmer, Isabella, Asplund, Ebba, Rutkowski, Wiktor, Baldaque-Silva, Francisco, Waldthaler, Alexander, Ghorbani, Poya, Verbeke, Caroline S., and Lohr, J. Matthias
- Abstract
Background Paraduodenal pancreatitis (PDP) is a particular form of chronic pancreatitis (CP) occurring in and around the duodenal wall. Despite its low prevalence, this rare condition presents a significant challenge in clinical practice. Methods We retrospectively analysed the electronic medical charts of all patients with a diagnosis of chronic pancreatitis and identified those with PDP, between January 1999 and December 2020. Results There were 35 patients diagnosed with PDP (86% males and 14% females); median age of 56 +/- 11 (range 38-80). Alcohol overconsumption was reported in 81% and smoking in 90% of patients. Abdominal pain was the leading symptom (71%), followed by weight loss, nausea and vomiting, jaundice, and diarrhoea. In 23 patients (66%), recurrent acute pancreatitis attacks were noted. Focal duodenal wall thickening was present in 34 patients (97%), cystic lesions in 80%, pancreatic duct dilatation in 54% and common bile duct dilatation in 46%. Endoscopic treatment was performed on nine patients (26%) and five patients (14%) underwent surgery. Complete symptom relief was reported in 12 patients (34%), partial symptom relief in three (9%), there was no improvement in five (14%), data were not available in three (9%) and 12 (34%) patients died before data analysis. Conclusions PDP is a rare form of pancreatitis, most commonly occurring in the 5th or 6th decade of life, with a predominance in males and patients with a history of smoking and high alcohol consumption. Focal thickening and cystic lesions of the duodenal wall are the most common imaging findings, followed by pancreatic duct and common bile duct dilatation. A minority of patients requires surgery.
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- 2022
- Full Text
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35. Visual Perturbation Suggests Increased Effort to Maintain Balance in Early Stages of Parkinson’s to be an Effect of Age Rather Than Disease
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Student, Justus, primary, Engel, David, additional, Timmermann, Lars, additional, Bremmer, Frank, additional, and Waldthaler, Josefine, additional
- Published
- 2022
- Full Text
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36. Neurocognitive profile of adults with the Norrbottnian type of Gaucher disease
- Author
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Tsitsi, Panagiota, primary, Markaki, Ioanna, additional, Waldthaler, Josefine, additional, Machaczka, Maciej, additional, and Svenningsson, Per, additional
- Published
- 2021
- Full Text
- View/download PDF
37. Antisaccade Latency Is Sensitive to Longitudinal Change of Motor and Cognitive Symptoms in Parkinson's Disease
- Author
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Charlotte Krüger-Zechlin, Lars Timmermann, Lena Stock, Johanna Sommerkorn, and Josefine Waldthaler
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medicine.medical_specialty ,Cognitive Symptoms ,Parkinson's disease ,business.industry ,MEDLINE ,Parkinson Disease ,medicine.disease ,Cognition ,Text mining ,Physical medicine and rehabilitation ,Neurology ,medicine ,Humans ,Neurology (clinical) ,Latency (engineering) ,business - Published
- 2020
38. Visual perturbation of balance suggests impaired neuromuscular stability but intact visuo-motor control in Parkinson’s disease
- Author
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David W. Engel, Frank Bremmer, Jakob C. B. Schwenk, Adam P. Morris, Justus Student, Lars Timmermann, and Josefine Waldthaler
- Subjects
medicine.medical_specialty ,Parkinson's disease ,Flexibility (anatomy) ,business.industry ,Dopaminergic ,Postural instability ,Motor control ,Stimulus (physiology) ,medicine.disease ,Control subjects ,medicine.anatomical_structure ,Physical medicine and rehabilitation ,medicine ,business ,Balance (ability) - Abstract
Postural instability marks one of the most disabling features of Parkinson’s disease (PD), but only reveals itself after affected brain areas have already been significantly damaged. Thus, there is a need to detect deviations in balance and postural control before visible symptoms occur. In this study, we visually perturbed balance in the anterior-posterior direction using sinusoidal oscillations of a moving room in virtual reality at different frequencies. We tested three groups: individuals with PD under dopaminergic medication, an age-matched control group, and a group of young healthy adults. We tracked their centre of pressure and their full-body motion. We investigated sway amplitudes and applied newly introduced phase-locking analyses to investigate responses across participants’ bodies. Patients exhibited significantly higher sway amplitudes as compared to the control subjects. However, their sway was phase-locked to the visual motion like that of age-matched and young healthy adults. Furthermore, all groups successfully compensated for the visual perturbation by – most likely reflexively - phase-locking their sway to the stimulus. As frequency of the perturbation increased, distribution of phase-locking (PL) across the body revealed a shift of the highest PL-values from the upper body towards the hip-region for young healthy adults, which could not be observed in patients and elderly healthy adults. Our findings suggest an impaired neuromuscular stability, but intact visuomotor processing in early stages of PD, while less flexibility to adapt postural strategy to different perturbations revealed to be an effect of age rather than disease.New & NoteworthyA better understanding of visuomotor control in Parkinson’s disease (PD) potentially serves as a tool for earlier diagnosis, which is crucial for improving patient’s quality of life. In our study, we assess body sway responses to visual perturbations of the balance control system in patients with early-to-mid stage PD, using motion tracking along with recently established phase-locking techniques. Our findings suggest patients at this stage to have an impaired muscular stability but intact visuomotor control.
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- 2021
39. Changes in non-oscillatory features of the cortical sensorimotor rhythm in Parkinson’s disease across age
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Josefine Waldthaler, C. L. Man Ting, Per Svenningsson, Mikkel C. Vinding, Daniel Lundqvist, Daniel Ferreira, Martin Ingvar, and A. Eriksson
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Electrophysiology ,Parkinson's disease ,medicine.diagnostic_test ,medicine ,Alpha (ethology) ,Premovement neuronal activity ,Beta Rhythm ,Magnetoencephalography ,Biology ,medicine.disease ,Somatosensory system ,Beta (finance) ,Neuroscience - Abstract
Parkinsons disease (PD) is associated with functional changes in the neural activity within the brains sensorimotor network, which in turn are related to the characteristic motor symptoms in PD. The functional changes in PD are particularly prominent in terms of oscillatory neuronal activity in the characteristic sensorimotor alpha and beta rhythms. However, summaries in terms of alpha or beta power do not capture the full range of the complex dynamic nature of the signals from the somatosensory cortex. This raises the question of how to quantify and summarise the functional changes in such oscillatory features in a manner that captures the relevant disease- and symptom-related neural activity. We investigated the role of spontaneous cortical somatosensory activity in the electrophysiological alpha and beta bands among a cohort of early- to mid-stage PD patients (N=78) and age- and gender-matched healthy controls (N=60) using source reconstructed resting-state magnetoencephalography (MEG) recordings. We quantified the oscillatory features of the neural time series by its oscillatory alpha power, beta power, and 1/f broadband characteristics using power spectral density, and additionally by characterising "burst" properties in the signals. We examined the relationship between the signal features and disease state, age, sex, and cortical thickness. Using multiple regression, we examined the relative contribution of the oscillatory features on the clinical manifestation of motor symptoms in the PD group. Our results show that PD patients differ from healthy controls on several of the oscillatory features, showing higher beta-band power, higher burst amplitude, and steeper 1/f broadband characteristics compared to healthy controls, as well as a steeper age-related decrease in the bursts rate. While there was a high degree of correlation between some of the oscillatory features, several features also appeared functionally separated, showing independent feature-to-symptom relationships. For instance, oscillatory beta power increased with the severity of midline function symptoms, while burst rate decreased with the severity of bradykinesia. Our study shows that quantification of distinct features within the oscillatory sensorimotor neural time series in PD captures different underlying mechanisms related to disease progression and symptom severity, which in turn has a potential for a more individualised and precision-based approach to assessing functional neural changes in PD.
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- 2021
40. Visual perturbation of balance suggests impaired motor control but intact visuo-motor processing in Parkinson's disease
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Engel, David, primary, Student, Justus, additional, Schwenk, Jakob Christian Benjamin, additional, Morris, Adam, additional, Waldthaler, Josefine, additional, Timmermann, Lars, additional, and Bremmer, Frank, additional
- Published
- 2021
- Full Text
- View/download PDF
41. Imaging-based programming of subthalamic nucleus deep brain stimulation in Parkinson's disease
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Waldthaler, Josefine, primary, Bopp, Miriam, additional, Kühn, Nele, additional, Bacara, Bugrahan, additional, Keuler, Merle, additional, Gjorgjevski, Marko, additional, Carl, Barbara, additional, Timmermann, Lars, additional, Nimsky, Christopher, additional, and Pedrosa, David J., additional
- Published
- 2021
- Full Text
- View/download PDF
42. Neues zu Diagnostik und Therapie des idiopathischen Parkinson-Syndroms
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Josefine Waldthaler and Lars Timmermann
- Subjects
Gynecology ,03 medical and health sciences ,Psychiatry and Mental health ,medicine.medical_specialty ,0302 clinical medicine ,Neurology ,business.industry ,medicine ,Neurology (clinical) ,business ,Idiopathic parkinson's disease ,030217 neurology & neurosurgery ,030227 psychiatry - Abstract
In Deutschland leben mindestens 300000 Menschen mit einem idiopathischen Parkinson-Syndrom. Aufgrund des demografischen Wandels ist mit einer stetig steigenden Zahl Betroffener zu rechnen. In diesem Beitrag werden die evidenzbasierte Diagnostik und Therapie des idiopathischen Parkinson-Syndroms dargestellt. Insbesondere soll ein Überblick über die neuen Erkenntnisse und Entwicklungen der letzten Jahre gegeben werden.
- Published
- 2019
43. Vertical saccades and antisaccades: complementary markers for motor and cognitive impairment in Parkinson’s disease
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Per Svenningsson, Josefine Waldthaler, and Panagiota Tsitsi
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Levodopa ,Parkinson's disease ,Article ,lcsh:RC346-429 ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Physical medicine and rehabilitation ,medicine ,Effects of sleep deprivation on cognitive performance ,lcsh:Neurology. Diseases of the nervous system ,business.industry ,Impaired Balance ,Montreal Cognitive Assessment ,Diagnostic markers ,Cognition ,medicine.disease ,Saccadic masking ,030104 developmental biology ,Neurology ,Saccade ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Previous studies provide partly contradictory results about the characteristics of saccades in PD and the possible effects of levodopa, which may be attributed to different study design regarding disease stages, medication state or cognitive functioning. We studied horizontal and vertical visually guided saccades (VGS) and antisaccades (AS) in 40 patients with PD with and without postural instability in On and Off medication state as well as in 20 healthy controls (HC). Motor and cognitive performance were assessed using UPDRS, Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). The PD group showed decreased VGS amplitudes and increased vertical VGS and AS latencies. Only relatively few studies had assessed vertical saccades in PD so far. However, our results indicate that vertical saccadic amplitude may be a supportive marker in diagnosing PD since upwards gain demonstrated an AUC of 0.85 for the discrimination of PD and HC. Only more advanced patients in Hoehn & Yahr stage 3 executed higher numbers of AS errors than HC. Since the AS error rate correlated with FAB and MoCA scores, AS performance seems to reflect cognitive ability in PD. Furthermore, the correlation of AS latency with the UPDRS axial subscore promotes the recently highlighted connection between postural control and executive function in PD. Levodopa did not alter saccade amplitudes and had opposing effects on the initiation of VGS and AS: Levodopa intake prolonged VGS latency, but decreased AS latency. Possible mechanisms by which levodopa may be capable of partially reversing the impaired balance between voluntary and reflexive cortical saccade initiation of PD are discussed.
- Published
- 2019
44. Endoscopic and Conservative Management of Chronic Pancreatitis and Its Complications
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Roberto Valente, J-Matthias Löhr, Urban Arnelo, and Alexander Waldthaler
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medicine.medical_specialty ,Conservative management ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,General surgery ,Gastroenterology ,Review Article ,Disease ,Lithotripsy ,medicine.disease ,Endoscopy ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,Pancreatitis ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
Chronic pancreatitis is a progressive inflammatory disease of the pancreas potentially giving rise to several complications. For this reason, patients need long-term care and treatment by medical, interventional, and sometimes surgical measures. This article reviews current state-of-the-art strategies and guidelines for treating chronic pancreatitis with conventional and endoscopic measures.
- Published
- 2019
45. Correction to: Palliative Endoscopic Therapy in Pancreatic Cancer
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Wiktor Rutkowski, Alexander Waldthaler, and J.-Matthias Löhr
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Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,Pancreatic cancer ,medicine ,business ,medicine.disease - Published
- 2021
46. Risk of Developing Pancreatic Cancer in Patients with Chronic Pancreatitis
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Alexander Waldthaler, Hannes Hagström, Amer Aljic, Ana Dugic, Roberto Valente, Raffaella Pozzi Mucelli, Maximilian Kordes, Robin Berggren, Nikola Panic, Patrick Maisonneuve, Miroslav Vujasinovic, P. Ghorbani, and Johannes-Matthias Löhr
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medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,lcsh:Medicine ,Gastroenterology ,Article ,chronic pancreatitis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Diabetes mellitus ,Pancreatic cancer ,medicine ,cancer ,risk factors ,pancreas ,Family history ,Hepatology ,business.industry ,lcsh:R ,Cancer ,General Medicine ,medicine.disease ,digestive system diseases ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Pancreatitis ,Acute pancreatitis ,030211 gastroenterology & hepatology ,Pancreas ,business ,Cohort study - Abstract
Background: Patients with chronic pancreatitis (CP) have an increased risk of developing pancreatic ductal adenocarcinoma (PDAC). We present data on PDAC in one of the most extensive European single-centre cohort studies of patients with CP. Methods: Retrospective analysis of prospectively collected data of patients with CP was performed. Aetiology of CP was determined according to the M-ANNHEIM classification system and only patients with definite CP >, 18 years at data analysis were included. The final dataset included 581 patients with definite CP diagnosed between 2003 and 2018. Results: At CP diagnosis, there were 371 (63.9%) males and 210 (36.1%) females (median age 57 years, range 2&ndash, 86). During 3423 person-years of observation, six pancreatic cancers were diagnosed (0.2% year). The mean time between diagnosis of CP and the occurrence of PDAC was 5.0 years (range 2.7&ndash, 8.6). None of the cancer patients had a family history of PDAC. Diabetes mellitus (DM) was present in five of six (83.3%) patients with PDAC: in three patients before and in two after CP diagnosis. Clinical/laboratory signs of pancreatic exocrine insufficiency (PEI) were present in five of six (83.3%) patients with PDAC: in two at diagnosis of CP and in three after diagnosis. The mean survival time was 4 months after the diagnosis of PDAC (range 0.5&ndash, 13). PDAC occurred significantly more often (p <, 0.001) in two groups of patients without previous acute pancreatitis (AP): 2 of 20 patients (10%) with low body mass index (BMI) and PEI and in 3 of 10 (30%) patients with high BMI and DM at diagnosis of CP. Conclusions: Patients with CP have a high risk of developing PDAC, although risk is low in absolute terms. Our data suggest the possibility of defining subgroups of patients with a particularly elevated risk of PDAC. Such a possibility would open a path to personalised decision making on initiation of PDAC surveillance of patients with no previous episode of AP, (i) with low BMI and PEI, or (ii) elevated BMI and DM.
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- 2020
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47. Neural correlates of impaired response inhibition in the antisaccade task in Parkinson’s disease
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Josefine Waldthaler, Mikkel C. Vinding, Allison Eriksson, Per Svenningsson, and Daniel Lundqvist
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Male ,Magnetoencephalography ,Prefrontal Cortex ,Parkinson Disease ,Middle Aged ,Brain Waves ,Executive Function ,Inhibition, Psychological ,Behavioral Neuroscience ,Saccades ,Humans ,Cognitive Dysfunction ,Female ,Cortical Synchronization ,Aged - Abstract
Deficits in response inhibition are a central feature of the highly prevalent dysexecutive syndrome found in Parkinson's disease (PD). Such deficits are related to a range of common clinically relevant symptoms including cognitive impairment as well as impulsive and compulsive behaviors. In this study, we explored the cortical dynamics underlying response inhibition during the mental preparation for the antisaccade task by recording magnetoencephalography (MEG) and eye-movements in 21 non-demented patients with early to mid-stage Parkinson's disease and 21 age-matched healthy control participants (HC). During the pre-stimulus preparatory period for antisaccades we observed: Taken together, the results indicate that alterations in pre-stimulus prefrontal alpha and beta activity hinder proactive response inhibition and in turn result in higher error rates and prolonged response latencies in PD.
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- 2022
48. Conservative Treatment of Chronic Pancreatitis: A Practical Approach
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Roberto Valente, Chiara Scandavini, Johannes-Matthias Löhr, M Del Chiaro, Alexander Waldthaler, Urban Arnelo, and Miroslav Vujasinovic
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Pancreatic parenchyma ,medicine.medical_specialty ,Comorbidity ,Endoscopic management ,Conservative Treatment ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,Pancreatitis, Chronic ,Medicine ,Humans ,Patient Care Team ,business.industry ,Pancreatic exocrine insufficiency ,Pain management ,medicine.disease ,Conservative treatment ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Pancreatitis ,030211 gastroenterology & hepatology ,Surgery ,business ,Pancreas - Abstract
Background: Chronic pancreatitis is a long-standing, inflammatory condition of the pancreas that leads to the progressive damage and loss of function of pancreatic parenchyma and to the development of possible locoregional and systemic medical complications. Materials and methods: In this review, we tried to summarize the current evidence on non-surgical treatment trying to suggest a practical approach to the management of chronic pancreatitis. Results: Besides the unclear pathophysiological mechanism and a poorly unknown epidemiology, chronic pancreatitis is a complex syndrome that displays different possible challenges for physicians. Despite being traditionally considered as a benign disease, chronic pancreatitis encompasses 10-year mortality rates which are superior to the ones reported for some of the most common cancers. Conclusions: Chronic pancreatitis encompasses the management of multiple and complex medical co-morbidities that needs to be understood and addressed in a multidisciplinary specialist context.
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- 2020
49. Bimodal ERCP, a new way of seeing things
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Nils Kadesjö, Jeanne Lubbe, Alexander Waldthaler, Marcus Reuterwall, Matthias Löhr, Raffaella Pozzi Mucelli, Marco Del Chiaro, and Urban Arnelo
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medicine.medical_specialty ,Original article ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,business.industry ,Bile duct ,Mean age ,Retrospective cohort study ,digestive system ,digestive system diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,surgical procedures, operative ,030220 oncology & carcinogenesis ,Medicine ,Fluoroscopy ,Referral center ,030211 gastroenterology & hepatology ,Pharmacology (medical) ,lcsh:Diseases of the digestive system. Gastroenterology ,Radiology ,lcsh:RC799-869 ,business ,Adverse effect - Abstract
Background and study aims Conventional endoscopic retrograde cholangiopancreatography (ERCP) is hampered by two-dimensional visualization, post-procedural adverse events (AEs), and exposure to ionizing radiation. Bimodal ERCP might mitigate these challenges, but no reports of its use are available to date. The aim of this study was to explore the feasibility of bimodal ERCP, while investigating its potential clinical yield. Patients and methods This was a retrospective observational study of patients that underwent bimodal ERCP in a single tertiary academic referral center. Thirteen patients undergoing conventional ERCP had a previously T2-weighted isotropic 3 D TSE MRCP sequence aligned and fused with the two-dimensional image generated from the fluoroscopy c-arm unit in real time. Results Over a 2-month period, 13 patients with a mean age of 54 underwent bimodal ERCP for bile duct stricture (61.5 %), complex cholelithiasis (7.7 %) and ductal leakage (30.1 %). Bimodal ERCP was feasible in all 13 cases, and image quality was assessed as “good” in 11 patients (84.6 %). Bimodal ERCP aided in visualizing the lesion of interest (76.9 %), assisted in understanding the 3 D anatomy of the biliopancreatic ductal system (61.5 %), and aided in finding a favorable position for the c-arm (38.4 %) for subsequent therapeutic intervention. Conclusions This first report on bimodal ERCP proves its feasibility and suggests that it may assist in increasing both the diagnostic and therapeutic yield of ERCP, while at the same time decreasing AEs during and after ERCP. Its main application might lie in treatment of complex intrahepatic disease.
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- 2020
50. Reduction of spontaneous cortical beta bursts in Parkinson's disease is linked to symptom severity
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Vinding, M.C., Tsitsi, Panagiota, Waldthaler, Josefine, Oostenveld, R., Ingvar, M., Svenningsson, P., and Lundqvist, Daniel
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150 000 MR Techniques in Brain Function - Abstract
Contains fulltext : 225578.pdf (Publisher’s version ) (Open Access)
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- 2020
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