9 results on '"Kneiphof J"'
Search Results
2. Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis
- Author
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Safouris, A. Krogias, C. Sharma, V.K. Katsanos, A.H. Faissner, S. Roussopoulou, A. Zompola, C. Kneiphof, J. Kargiotis, O. Deftereos, S. Giannopoulos, G. Triantafyllou, N. Voumvourakis, K. Vadikolias, K. Tsivgoulis, G.
- Abstract
Objective - Although statin pretreatment (SP) is associated with better outcomes in patients with acute cerebral ischemia after an ischemic stroke/transient ischemic attack, data on the underlying mechanism of this beneficial effect are limited. Approach and Results - We sought to evaluate the potential association between SP and microembolic signal (MES) burden in acute cerebral ischemia because of large artery atherosclerosis (LAA). We prospectively evaluated consecutive patients with first-ever acute cerebral ischemia because of LAA in 3 tertiary stroke centers over a 2-year period. All patients underwent continuous 1-hour transcranial Doppler monitoring of the relevant vessel at baseline (≤24 hours). SP was recorded and dichotomized as high dose or low-to-moderate dose. SP was documented in 43 (41%) of 106 LAA patients (mean age, 65.4±10.3 years; 72% men; low-to-moderate dose, 32%; high dose, 8%). There was a significant (P=0.022) dose-dependent effect between SP and MES prevalence: no SP (37%), SP with low-to-moderate dose (18%), and SP with high dose (0%). Similarly, a significant (P=0.045) dose-dependent effect was documented between SP and MES burden: no SP (1.1±1.8), SP with low-to-moderate dose (0.7±1.6), and SP with high dose (0±0). In multivariable logistic regression analysis adjusting for demographics, vascular risk factors, location of LAA, stroke severity, and other prevention therapies, SP was associated with lower likelihood of MES presence (odds ratio, 0.29; 95% confidence interval, 0.09-0.92; P=0.036). In addition, SP was found also to be independently related to higher odds of functional improvement (common odds ratio, 3.33; 95% confidence interval, 1.07-10.0; P=0.037). Conclusions - We found that SP in patients with acute LAA is related with reduced MES presence and lower MES burden with an apparently dose-dependent association. © 2017 American Heart Association, Inc.
- Published
- 2017
3. Hereditary defect of cobalamin metabolism with adolescence onset resembling multiple sclerosis: 41-year follow up in two cases.
- Author
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Motte J, Kneiphof J, Straßburger-Krogias K, Pitarokoili K, Fisse AL, Kappos L, and Gold R
- Abstract
The cblC defect is the most common inborn error of cobalamin (Cbl) metabolism. Clinical severity and presentation of the cblC defect ranges from death to mild disability. Only 71 cases of late-onset cblC defect have been described in the literature. We provide the 41-year follow up of two siblings with a late-onset cblC defect, first described after initial diagnosis in 1996. While one of the siblings showed initial symptoms resembling multiple sclerosis with a good response to corticosteroids, the other sister showed only subclinical signs of the disease. The course of the first case was characterized by a severe deterioration and intensive-care therapy after respiratory failure. After diagnoses and Cbl treatment, the patient survived and showed a pronounced improvement of the symptoms. Both sisters have an active life and gave birth to healthy children. The reason for the initial improvement after corticosteroids could not be explained by the classical metabolic pathways of Cbl. Recent studies have suggested that Cbl plays an important role as a regulator of the balance between neurotrophic and neurotoxic factors in the central and peripheral nervous system (CNS and PNS). This first long-term follow up revealed that ultra-high-dose intramuscular Hydroxocobalamin (OH-Cbl) treatment can effectively protect patients from disease progression. It underlines the importance of diagnostic vigilance and laboratory work up even in cases without typical hematologic signs of Cbl deficiency. Cbl-related diseases are often a chameleon and must always be considered in the differential of demyelinating diseases of the PNS and CNS. The case supports the theory that it is not only the classical biochemical pathways that play a key role in Cbl deficiency, especially with regard to neurological symptoms., Competing Interests: Conflict of interest statement: JM received travel grants from Biogen, his research is funded by the Klaus Tschira Foundation and Ruhr-University Bochum (FoRUM-Program); none related to this work. KS-K received travels grants for scientific meetings from Bayer Vital. KP received travel grants and speaker’s honoraria from Biogen, Bayer Schering, and Novartis. LK has received in the last 3 years and used exclusively for research support steering committee, advisory board, and consultancy fees (Actelion, Addex, Bayer HealthCare, Biogen, Biotica, Genzyme, Lilly, Merck, Mitsubishi, Novartis, Ono Pharma, Pfizer, Receptos, Sanofi, Santhera, Siemens, Teva, UCB, and XenoPort); speaker fees (Bayer HealthCare, Biogen, Merck, Novartis, Sanofi, Teva); support for educational activities (Bayer HealthCare, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi, Teva); royalties (Neurostatus); grants (Bayer HealthCare, Biogen, EU, Merck, Novartis, Roche Research Foundation, Swiss MS Society, Swiss National Research Foundation). RG serves on scientific advisory boards for Teva, Biogen, Bayer Schering Pharma, and Novartis; has received speaker honoraria from Biogen, Teva, Bayer Schering Pharma, and Novartis; serves as editor for Therapeutic Advances in Neurological Diseases and on the editorial boards of Experimental Neurology and the Journal of Neuroimmunology; receives research support from Teva, Biogen, Bayer Schering Pharma, Genzyme, Merck Serono, and Novartis; none related to this manuscript.
- Published
- 2019
- Full Text
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4. Successful therapy with rituximab in three patients with probable neurosarcoidosis.
- Author
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Zella S, Kneiphof J, Haghikia A, Gold R, Woitalla D, and Thöne J
- Abstract
Background: Neurosarcoidosis occurs in about 5-15% of patients with sarcoidosis. Therapy with corticosteroids is generally accepted as the first-line medication, followed by various immunomodulating and cytotoxic agents or combined therapy. However, some patients show an unsatisfactory outcome or have adverse events and require novel treatment strategies., Methods: We describe three patients with systemic sarcoidosis and central nervous system involvement who received CD20-targeted B-cell depletion with rituximab., Results: Treatment with rituximab was well tolerated and followed by marked remission in patients nonresponsive to other immunosuppressive agents., Conclusion: Rituximab may be used for patients with neurosarcoidosis who are nonresponsive to established treatment regimes., Competing Interests: Conflict of interest statement: The authors declare that there is no conflict of interest.
- Published
- 2018
- Full Text
- View/download PDF
5. Flaccid paralysis in neuromyelitis optica: An atypical presentation with possible involvement of the peripheral nervous system.
- Author
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Grüter T, Ayzenberg I, Gahlen A, Kneiphof J, Gold R, and Kleiter I
- Subjects
- Aged, Antibodies blood, Aquaporin 4 immunology, Female, Humans, Magnetic Resonance Imaging, Neural Conduction physiology, Neuromyelitis Optica diagnostic imaging, Peripheral Nervous System diagnostic imaging, Spinal Cord diagnostic imaging, Neuromyelitis Optica complications, Neuromyelitis Optica pathology, Paraplegia etiology, Peripheral Nervous System physiopathology
- Abstract
Background: Neuromyelitis optica spectrum disorders (NMOSD) typically lead to spastic paraparesis and spare the peripheral nervous system (PNS)., Case Report: Here, we describe an anti-aquaporin-4-seropositive NMOSD patient suffering from acute transverse myelitis with painful, flaccid paralysis and incontinence of urine and feces. Due to the involvement of the PNS as indicated by electrodiagnostic examination, we verified the expression of aquaporin-4-channels on the proximal dorsal spinal radix of rats by staining rat tissue with human NMOSD serum., Conclusion: This case suggests a manifestation of the proximal PNS in NMOSD. Thus, NMOSD should be considered as a differential diagnosis for patients presenting with signs of spinal cord disease and additional radicular involvement., (Copyright © 2018. Published by Elsevier B.V.)
- Published
- 2018
- Full Text
- View/download PDF
6. Detection of JC virus archetype in cerebrospinal fluid in a MS patient with dimethylfumarate treatment without lymphopenia or signs of PML.
- Author
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Motte J, Kneiphof J, Straßburger-Krogias K, Klasing A, Adams O, Haghikia A, and Gold R
- Subjects
- Aged, Antibodies, Viral blood, Antibodies, Viral cerebrospinal fluid, DNA, Viral blood, DNA, Viral cerebrospinal fluid, Female, Humans, Multiple Sclerosis, Relapsing-Remitting complications, Polyomavirus Infections complications, Polyomavirus Infections drug therapy, Polyomavirus Infections immunology, Tumor Virus Infections complications, Tumor Virus Infections drug therapy, Tumor Virus Infections immunology, Dimethyl Fumarate therapeutic use, Immunosuppressive Agents therapeutic use, JC Virus genetics, JC Virus immunology, Multiple Sclerosis, Relapsing-Remitting drug therapy, Multiple Sclerosis, Relapsing-Remitting immunology
- Abstract
We report a 76-year-old MS patient, treated with DMF for 3 years. Lymphocytes never showed values below 1240/µl. CSF analysis revealed 1,988,880 copies/ml of JCV-DNA, JCV-DNA was detectable in serum and anti-JCV-antibody in CSF and serum were highly positive. Stratify®-JCV-test was positive. CD8-positive T-lymphocytes were reduced. Therapy with mefloquine, mirtazapine and cidofovir resulted in complete elimination of the virus in serum and 90% reduction of viral load in CSF. This case shows that despite careful monitoring for lymphopenia JCV spreading to the CSF may occur during treatment with DMF.
- Published
- 2018
- Full Text
- View/download PDF
7. Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis.
- Author
-
Safouris A, Krogias C, Sharma VK, Katsanos AH, Faissner S, Roussopoulou A, Zompola C, Kneiphof J, Kargiotis O, Deftereos S, Giannopoulos G, Triantafyllou N, Voumvourakis K, Vadikolias K, and Tsivgoulis G
- Subjects
- Aged, Brain Ischemia diagnostic imaging, Brain Ischemia epidemiology, Cerebral Angiography methods, Chi-Square Distribution, Computed Tomography Angiography, Dose-Response Relationship, Drug, Female, Germany epidemiology, Greece epidemiology, Humans, Intracranial Arteriosclerosis diagnostic imaging, Intracranial Arteriosclerosis epidemiology, Intracranial Embolism diagnostic imaging, Intracranial Embolism epidemiology, Ischemic Attack, Transient diagnostic imaging, Ischemic Attack, Transient epidemiology, Logistic Models, Magnetic Resonance Angiography, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Prevalence, Prospective Studies, Risk Factors, Singapore epidemiology, Tertiary Care Centers, Time Factors, Treatment Outcome, Ultrasonography, Doppler, Transcranial, Brain Ischemia prevention & control, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Intracranial Arteriosclerosis drug therapy, Intracranial Embolism prevention & control, Ischemic Attack, Transient prevention & control
- Abstract
Objective: Although statin pretreatment (SP) is associated with better outcomes in patients with acute cerebral ischemia after an ischemic stroke/transient ischemic attack, data on the underlying mechanism of this beneficial effect are limited., Approach and Results: We sought to evaluate the potential association between SP and microembolic signal (MES) burden in acute cerebral ischemia because of large artery atherosclerosis (LAA). We prospectively evaluated consecutive patients with first-ever acute cerebral ischemia because of LAA in 3 tertiary stroke centers over a 2-year period. All patients underwent continuous 1-hour transcranial Doppler monitoring of the relevant vessel at baseline (≤24 hours). SP was recorded and dichotomized as high dose or low-to-moderate dose. SP was documented in 43 (41%) of 106 LAA patients (mean age, 65.4±10.3 years; 72% men; low-to-moderate dose, 32%; high dose, 8%). There was a significant ( P =0.022) dose-dependent effect between SP and MES prevalence: no SP (37%), SP with low-to-moderate dose (18%), and SP with high dose (0%). Similarly, a significant ( P =0.045) dose-dependent effect was documented between SP and MES burden: no SP (1.1±1.8), SP with low-to-moderate dose (0.7±1.6), and SP with high dose (0±0). In multivariable logistic regression analysis adjusting for demographics, vascular risk factors, location of LAA, stroke severity, and other prevention therapies, SP was associated with lower likelihood of MES presence (odds ratio, 0.29; 95% confidence interval, 0.09-0.92; P =0.036). In addition, SP was found also to be independently related to higher odds of functional improvement (common odds ratio, 3.33; 95% confidence interval, 1.07-10.0; P =0.037)., Conclusions: We found that SP in patients with acute LAA is related with reduced MES presence and lower MES burden with an apparently dose-dependent association., (© 2017 American Heart Association, Inc.)
- Published
- 2017
- Full Text
- View/download PDF
8. Effects of fatigue on cognitive control in neurosarcoidosis.
- Author
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Beste C, Kneiphof J, and Woitalla D
- Subjects
- Adult, Aged, Analysis of Variance, Brain Mapping, Electroencephalography, Evoked Potentials physiology, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Reaction Time physiology, Receptors, Interleukin-2 blood, Regression Analysis, Sarcoidosis blood, Tumor Necrosis Factor-alpha blood, Young Adult, Cognition Disorders etiology, Fatigue etiology, Sarcoidosis complications
- Abstract
Fatigue is a usual reaction to prolonged performance but also a major symptom in various neuroimmunological diseases. In neurosarcoidosis fatigue is a core symptom, but little is known about the relevance of fatigue on cognitive functions in this disease. Previous results in healthy subjects suggest that fatigue strongly affects cognitive control processes. However, fatigue is not a uni-dimensional construct but consists of different facets. It is unknown which of these facets are most important for mechanisms of cognitive control. In the current study we investigate conflict monitoring and response selection processes in neurosarcoidosis patients as a 'model disease' of fatigue and healthy controls in relation to the impact of 'cognitive' and 'motor fatigue' on these processes using event-related potentials (ERPs). We focus on ERPs reflecting attentional selection (P1, N1) and conflict monitoring/response selection processes (N2). ERPs reflecting attentional selection processes were unchanged. The N2 on incompatible trials was reduced in neurosarcoidosis suggesting that response selection and conflict monitoring functions are dysfunctional. Of note, fatigue strongly modulates responses selection processes in conflicting situations (N2) in controls and neurosarcoidosis, but the effect of fatigue on these processes was stronger in neurosarcoidosis. Neuroimmunological parameters like TNF-α and soluble interleukin-2 receptor serum concentrations do not seem to modulate the pattern of results. Concerning fatigue it seems to be the 'cognitive' dimension and not the 'motor' dimension that is of relevance for the modulation of response selection in conflicting situations., (Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.)
- Published
- 2015
- Full Text
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9. Modulatory effects of proinflammatory cytokines for action cascading processes - evidence from neurosarcoidosis.
- Author
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Beste C, Kneiphof J, and Woitalla D
- Subjects
- Acoustic Stimulation, Adult, Aged, Attention, Biomarkers, Case-Control Studies, Central Nervous System Diseases diagnosis, Central Nervous System Diseases immunology, Central Nervous System Diseases psychology, Cognition Disorders immunology, Cognition Disorders metabolism, Cognition Disorders psychology, Decision Making physiology, Electroencephalography, Female, Humans, Judgment physiology, Male, Middle Aged, Neuropsychological Tests, Photic Stimulation, Sarcoidosis diagnosis, Sarcoidosis immunology, Sarcoidosis psychology, Central Nervous System Diseases metabolism, Cognition Disorders etiology, Cytokines physiology, Executive Function physiology, Psychomotor Performance physiology, Receptors, Interleukin-2 blood, Sarcoidosis metabolism
- Abstract
Neurosarcoidosis is a rare central nervous system manifestation of sarcoidosis. T cell, T-helper cell and macrophage activation via the major histocompatibility complex (MHC) II-mediated pathway causes this disease. Little is known about the possible cognitive disturbances in this disease as most reported instances are case studies. Here, we provide the first in-depth analysis of psychomotor functions in a sample of 30 neurosarcoidosis patients. We investigated action control processes using a paradigm that is able to examine how different tasks are cascaded to achieve the task goal. We integrated electrophysiological (EEG) data with behavioural and neuroimmunological data. Our results show that there was no general cognitive decline in patients with neurosarcoidosis. Patients only presented deficits when two response options have to be prioritized. Patients apply an inefficient processing strategy where they try to processes different response options in parallel. The electrophysiological data show that the deficits are due to dysfunctions at the response selection stage. Behavioural and neurophysiological changes are predictable on the basis of soluble interleukin 2 receptor serum concentrations. The results show that neurosarcoidosis is not associated with nonspecific changes in cognitive functions but does lead to specific alterations in cognitive control that are strongly dependent on immunological parameters., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
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