21 results on '"Münger M"'
Search Results
2. Real Time Video Projection in an MRI for the Characterization of the Neural Correlates Associated with Mirror Therapy treatment for Phantom Limb Pain
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Saleh Velez, FG, Pinto, CB, Bailin, ES, Münger, M, Ellison, A, Costa, BT, Crandell, D, Bolognini, N, Merabet, LB, Fregni, F., Saleh Velez, F, Pinto, C, Bailin, E, Münger, M, Ellison, A, Costa, B, Crandell, D, Bolognini, N, Merabet, L, and Fregni, F
- Subjects
Phantom limb pain, fMRI, brain imaging, mirror therapy, amputation, neuroplasticity, sensorimotor cortex - Abstract
Mirror therapy (MT) has been proposed as an effective rehabilitative strategy to alleviate pain symptoms in amputees with phantom limb pain (PLP). However, establishing the neural correlates associated with MT therapy have been challenging given that it is difficult to administer the therapy effectively within a magnetic resonance imaging (MRI) scanner environment. To characterize the functional organization of cortical regions associated with this rehabilitative strategy, we have developed a combined behavioral and functional neuroimaging protocol that can be applied in participants with a leg amputation. This novel approach allows participants to undergo MT within the MRI scanner environment by viewing real-time video images captured by a camera. The images are viewed by the participant through a system of mirrors and a monitor that the participant views while lying on the scanner bed. In this manner, functional changes in cortical areas of interest (e.g., sensorimotor cortex) can be characterized in response to the direct application of MT.
- Published
- 2019
3. Real Time Video Projection in an MRI for the Characterization of the Neural Correlates Associated with Mirror Therapy treatment for Phantom Limb Pain.
- Author
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Saleh Velez, F, Pinto, C, Bailin, E, Münger, M, Ellison, A, Costa, B, Crandell, D, Bolognini, N, Merabet, L, Fregni, F, Saleh Velez, FG, Pinto, CB, Bailin, ES, Costa, BT, Merabet, LB, Fregni, F., Saleh Velez, F, Pinto, C, Bailin, E, Münger, M, Ellison, A, Costa, B, Crandell, D, Bolognini, N, Merabet, L, Fregni, F, Saleh Velez, FG, Pinto, CB, Bailin, ES, Costa, BT, Merabet, LB, and Fregni, F.
- Abstract
Mirror therapy (MT) has been proposed as an effective rehabilitative strategy to alleviate pain symptoms in amputees with phantom limb pain (PLP). However, establishing the neural correlates associated with MT therapy have been challenging given that it is difficult to administer the therapy effectively within a magnetic resonance imaging (MRI) scanner environment. To characterize the functional organization of cortical regions associated with this rehabilitative strategy, we have developed a combined behavioral and functional neuroimaging protocol that can be applied in participants with a leg amputation. This novel approach allows participants to undergo MT within the MRI scanner environment by viewing real-time video images captured by a camera. The images are viewed by the participant through a system of mirrors and a monitor that the participant views while lying on the scanner bed. In this manner, functional changes in cortical areas of interest (e.g., sensorimotor cortex) can be characterized in response to the direct application of MT.
- Published
- 2019
4. Surrounding Photovoltaic Façade Sihlweid – First Yield Results and Analysis
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Joss, D., Muntwyler, U., and Münger, M.
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PV and Architecture ,PV SYSTEMS - Abstract
28th European Photovoltaic Solar Energy Conference and Exhibition; 4392-4397, As part of a core refurbishment of two 60 meter high tower blocks in Zurich Leimbach, all four façades of each building were covered with standard microcrystalline and amorphous thin film tandem modules. As in January 2012 the renovating process of the first tower block was completed, its photovoltaic plant started energy generation. More than one year later, first results of the energy production and operating data of the system can be presented. The production data has been analyzed and evaluated for all four façade sides as well as for the overall system. Module circuitry considering partial shading, inverter configurations as well as energy yields and plant efficiencies had been calculated by students as part of their bachelor thesis at the Laboratory for Photovoltaics of Bern University of Applied Sciences BUAS. These calculations were used as a basis for planning and implementation of the refurbishment. Thanks to the yield data of the first year of operation, it is now possible to relate the calculations and evaluate the utility of the selected configurations.
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- 2013
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5. Comparison of PV Evaluation Programs Based on the Long-Term PV-Measurement Campaign of the Berne University of Applied Sciences
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Muntwyler, U., Schärf, P., Münger, M., Hauser, M., and Heiniger, T.
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Large PV Power Plants and Distributed PV: System Aspects and Grid Connection ,PV Systems - Abstract
27th European Photovoltaic Solar Energy Conference and Exhibition; 4158-4160, Based on these data of the PV long term measurement campaign of the Berne University of Applied Sciences (BUAS) in Burgdorf (Switzerland) we compared seven PV calculation programs with two different studies. We used different sites on different climatic situations to evaluate the accuracy of the programs. The Berne University of Applied Sciences in the town of Burgdorf near Berne in Switzerland is measuring PV-installations in a long term test campaign since more than 20 years with high precision. Actually more than 70 installations are measured. For the study we used two installations in Burgdorf and the football stadium in Bern with more than 1,3 MWp as a typical sites for the Swiss Basin. Another installation was the 500 kWp site on the mountain range of the Jura. For the alpine climatic situation we used the PV installation on the Jungfraujoch on 3’454 m asli. In this first BSc-studyii done by Marc Hauser he used the PV program PVSyst from the University of Geneva to calculate the accuracy of the simulations against the result from the existing plants. In the second BSc-study done by Thomas Heinigeriii four freeware and 3 professional PV-simulation programs were compared with the results of the first study.
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- 2012
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6. Further Expansion to the Long-Term PV-Measurement Campaign over the 25 Year Guarantee of PV-Modules
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Muntwyler, U., Häberlin, H., Schärf, P., and Münger, M.
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Large PV Power Plants and Distributed PV: System Aspects and Grid Connection ,PV Systems - Abstract
26th European Photovoltaic Solar Energy Conference and Exhibition; 4233-4236, One of the features of grid connected PV-installations is their stable production of electricity over 20-40 years. Guarantees up to 25 years mislead many users to the assumption, that this is possible without problems. If serious problems occur, the user will have financial problems and the PV-industry has an image problem. The PVmarket must learn that a low price also could lead to a lower quality. In such a young business the aspect of long term quality is very important. This is a focus of the PV-Laboratory of the Berne University of Applied Sciences in the town of Burgdorf near Berne in Switzerland. PV-systemtechnology is a main field of the applied research activities. At the moment more than 70 installations are measured. The first installations are now over 20 years old. The range goes from 3 kWp roof installation to a 20 year old 555 kWp free standing PV-plant in the mountain range of the Jura. The biggest installation is the football stadium in Bern (1,347 MWp) and the highest is fixed in the alps on the Jungfraujoch on 3’454 m asl. In Burgdorf more than 20 years ago the “feed in-tariff” was developed. This is the reason why Burgdorf has many old PV-installations. That give us a good base for further research. For the next 10-15 years we are planning a selected expansion of the measured PVinstallations. The results can be seen on www.pvtest.ch.
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- 2011
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7. New PV Array Simulator of 100kW: Results of First Tests at a PV Inverter of 100kW
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Häberlin, H., Borgna, L., Gfeller, D., Münger, M., and Schärf, P.
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Components for PV Systems ,Balance of System Components - Abstract
24th European Photovoltaic Solar Energy Conference, 21-25 September 2009, Hamburg, Germany; 3625-3630, The PV laboratory of BFH-TI in Burgdorf has developed two linear PV generator simulators up to 25 kW with high stability and fast transient response between 2000 and 2004. With these devices, which are controlled by computers, it is possible to perform semi-automated tests of PV inverters including the measurement of MPP-tracking efficiency [3]. From these measurements, the total or overall efficiency can be calculated [4]. So far many inverter tests have been performed with this equipment (see www.pvtest.ch). As 100 kW is an important power limit in many countries, in a research project funded by the Swiss Federal Office of Energy, the PV laboratory was mandated to develop a corresponding PV array simulator of 100 kW (VOC ≤ 810 V / ISC ≤ 156 A). A first presentation of the state of this project was given at Valencia in 2008 [5]. In January 2009 this new PV array simulator was fully operational and it is now possible to perform automated tests under computer control (like those performed at low power devices) at much more powerful inverters up to 100 kW. In this paper, the results of first successful tests at a 100 kW-inverter Solarmax 100C are described.
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- 2009
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8. A descriptive study of antithrombotic medication patterns in adult patients with recent venous thromboembolism
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Allahwerdy F, Pan S, Feehan M, Jones AE, Munger MA, and Witt DM
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Anticoagulants ,Thrombolytic Therapy ,Venous Thromboembolism ,Drug Utilization ,Practice Patterns ,Physicians' ,Cohort Studies ,Utah ,Therapeutics. Pharmacology ,RM1-950 ,Pharmacy and materia medica ,RS1-441 - Abstract
Objectives: The objective of this study is to describe the most common self-reported antithrombotic therapy utilization patterns in a national cohort of patients with recent venous thromboembolism (VTE). Methods: Extant data from a national online survey administered to 907 patients 18 years of age or older with VTE in the last two years were analyzed. Patients’ self-reported antithrombotic usage patterns used during three phases of treatment for the most recent VTE episode were summarized using descriptive statistics. Results: The following overall antithrombotic usage patterns were identified: warfarin (38.7%), direct oral anticoagulants (DOACs) (26.1%), switching between warfarin and DOACs (13.3%), aspirin only (8.7%), switching between different DOACs (4.5%), injectable anticoagulants only (3.9%), and no treatment (4.7%). Extended antithrombotic therapy beyond 90 days was reported by 65.7% of patients. Aspirin coadministration with anticoagulant therapy occurred for 33.7%. Conclusions: In this national sample of recent VTE sufferers warfarin therapy remains the most used anticoagulant followed closely by DOAC therapy. Switching between warfarin and DOACs and between different DOACs was common which could indicate adverse events or affordability issues. Aspirin coadministration with anticoagulant therapy was present in 1 of 3 patients and is a potential medication safety intervention for anticoagulation providers.
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- 2019
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9. Clinical outcomes of a balloon-expandable stent for symptomatic obstructions of the subclavian or innominate arteries.
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Fumagalli RM, Schürch K, Grigorean A, Holy EW, Münger M, Pleming W, Kucher N, and Barco S
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- Male, Humans, Aged, Female, Brachiocephalic Trunk diagnostic imaging, Vascular Patency, Stents, Treatment Outcome, Angioplasty, Balloon adverse effects, Peripheral Arterial Disease diagnostic imaging, Peripheral Arterial Disease therapy
- Abstract
Background: Upper-extremity peripheral arterial disease (PAD) may present with a broad spectrum of signs and symptoms. If an endovascular treatment is planned, percutaneous angioplasty and stent placement may lead to a better patency compared to percutaneous angioplasty alone. We assessed the characteristics and clinical course of patients with upper-extremity PAD who received angioplasty and a balloon-expandable stent. Patients and methods: We analyzed data from consecutive patients treated with angioplasty and placement of a balloon-expandable BeSmooth Peripheral Stent System
® (Bentley, Germany) at the Angiology Department (University Hospital Zurich) between 2018 and 2022. The primary outcome was re-intervention at the target lesion within 6 months from index angioplasty and during available follow-up. The study was approved by the local ethical commission. Results: A total of 27 patients were treated. The median age was 70 (Q1-Q3: 60-74) years and 59% were men. The subclavian artery (74%) represented the most frequently treated target lesion, followed by the innominate artery (26%). The mean improvement in blood pressure in the treated arm was 21 (95%CI 7 to 35) mmHg at 24 hours and 29 (95%CI 15 to 43) mmHg at 6 months. At 6 months, 2 (8%) patients required a target lesion re-intervention. During the remaining follow-up period up to 24 months, one of these two patients required additional intervention and a total of 3 (11%) patients died due to sepsis, cancer, and unknown causes, respectively. Conclusions: Percutaneous catheter-based treatment with a balloon-expandable stent for symptomatic upper extremity PAD appeared to be effective and safe.- Published
- 2023
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10. Detangling the Structural Neural Correlates Associated with Resting versus Dynamic Phantom Limb Pain Intensity Using a Voxel-based Morphometry Analysis.
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Pinto CB, Pacheco-Barrios K, Saleh Velez FG, Gunduz ME, Münger M, and Fregni F
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- Humans, Brain, Gray Matter, Magnetic Resonance Imaging methods, Phantom Limb therapy, Transcranial Direct Current Stimulation methods, Motor Cortex
- Abstract
The management of phantom limb pain (PLP) is still challenging due to a partial understanding of its neurophysiological mechanisms. Structural neuroimaging features are potential biomarkers. However, only a few studies assessed their correlations with clinical severity and treatment response. This study aims to explore the association between brain gray matter volume (GMV) with phantom limb manifestations severity and PLP improvement after neuromodulatory treatments (transcranial direct current stimulation and mirror therapy). Voxel-based morphometry analyses and functional decoding using a reverse inference term-based meta-analytic approach were used. We included 24 lower limb traumatic amputees with moderate to severe PLP. We found that alterations of cortical GMV were correlated with PLP severity but not with other clinical manifestations. Less PLP severity was associated with larger brain clusters GMV in the non-affected prefrontal, insula (non-affected mid-anterior region), and bilateral thalamus. However, only the insula cluster survived adjustments. Moreover, the reverse inference meta-analytic approach revealed that the found insula cluster is highly functionally connected to the contralateral insula and premotor cortices, and the decoded psychological processes related to this cluster were "rating," "sustained attention," "impulsivity, " and "suffering." Moreover, we found that responders to neuromodulatory treatment have higher GMV in somatosensory areas (total volume of S1 and S2) in the affected hemisphere at baseline, compared to non-responders, even after adjustments., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2023
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11. Clinical outcomes of ultrasound-assisted coagulation monitoring-adjusted catheter-directed thrombolysis for acute pulmonary embolism.
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Zbinden S, Voci D, Grigorean A, Holy EW, Kaufmann PA, Münger M, Pleming W, Kucher N, and Barco S
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- Male, Humans, Aged, Female, Thrombolytic Therapy methods, Treatment Outcome, Retrospective Studies, Tissue Plasminogen Activator therapeutic use, Heparin therapeutic use, Hemorrhage chemically induced, Catheters, Fibrinolytic Agents therapeutic use, Pulmonary Embolism etiology
- Abstract
Background: Ultrasound-assisted catheter-directed thrombolysis (USAT) may reverse right ventricular dysfunction due to acute pulmonary embolism (PE) with a favorable safety profile., Methods: We studied intermediate-high- and high-risk acute PE patients who underwent USAT at the University Hospital Zurich, 2018-2022. The USAT regimen included alteplase 10 mg per catheter over 15 h, therapeutic-dosed heparin, and dosage adaptations based on routinely monitored coagulation parameters, notably anti-factor Xa activity and fibrinogen. We focused on the mean pulmonary arterial pressure (mPAP) and the National Early Warning Score (NEWS) before and after USAT, and reported the incidence of hemodynamic decompensation, PE recurrence, major bleeding, and death over 30 days., Results: We included 161 patients: 96 (59.6 %) were men and the mean age was 67.8 (SD 14.6) years. Mean PAP decreased from a mean of 35.6 (SD 9.8) to 25.6 (SD 8.2) mmHg, whereas the NEWS decreased from a median of 5 (Q1-Q3 4-6) to 3 (Q1-Q3 2-4) points. No cases of hemodynamic decompensation occurred. One (0.6 %) patient had an episode of recurrent PE. Two (1.2 %) major bleeding events occurred, including one (0.6 %) intracranial, fatal hemorrhage in a patient with high-risk PE, severe heparin overdosing, and a recent head trauma (with negative CT scan of the brain performed at baseline). No other deaths occurred., Conclusions: USAT resulted in a rapid improvement of hemodynamic parameters among patients with intermediate-high risk acute PE and selected ones with high-risk acute PE, without any recorded deaths related to PE itself. A strategy including USAT, therapeutic-dosed heparin, and routinely monitored coagulation parameters may partly explain the overall very low rate of major bleeding., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The study was conducted at the Department of Angiology of the University Hospital Zurich and was supported by an unrestricted grant from Boston Scientific., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2023
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12. Percutaneous large-bore aspiration embolectomy with veno-arterial extracorporal membrane oxygenation support or standby in patients with high-risk pulmonary embolism and contraindications to thrombolysis: a preliminary single centre experience.
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Kucher N, Ouda A, Voci D, Barco S, Micieli E, Münger M, Pleming W, Grigorean A, Sromicki J, Schmiady MO, and Holy EW
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- Male, Humans, Middle Aged, Female, Retrospective Studies, Contraindications, Embolectomy, Thrombolytic Therapy, Extracorporeal Membrane Oxygenation methods, Pulmonary Embolism therapy, Heart Failure, Heart Arrest
- Abstract
Aims: Large-bore catheter aspiration embolectomy reduces thrombus burden and right ventricle strain and improves haemodynamics after pulmonary embolism (PE). Sparse data are available for patients with high-risk PE and contraindications to thrombolysis or thrombolysis failure, particularly if veno-arterial extracorporal membrane oxygenation (VA-ECMO) is required., Methods and Results: All patients with acute high-risk PE and contraindications to thrombolysis undergoing FlowTriever® percutaneous embolectomy and VA-ECMO circulatory support (or standby) at the University Hospital Zurich between April 2021 and August 2022 were retrospectively analysed. The primary outcome was the combination of recurrent PE, heart failure hospitalization, and all-cause death at 30 days. The analysis included 15 patients: mean age was 63.1 years and 14 (93%) were men. Overall, four (27%) patients presented with cardiac arrest, eight (53%) with ongoing obstructive shock, and three (20%) with persistent arterial hypotension. Veno-arterial extracorporal membrane oxygenation was implanted prior to aspiration embolectomy in eight (53%) patients. Three of seven patients without initial VA-ECMO support experienced periprocedural cardiac arrest, of whom two received ECMO support before completion of embolectomy. Veno-arterial extracorporal membrane oxygenation weaning was successful in all patients after a mean of 5.4 days. There was one periprocedural death in a patient who did not receive VA-ECMO support following a periprocedural cardiac arrest. The primary outcome at 30 days occurred in five (33.3%; 95% confidence interval 13.0-61.3%) patients., Conclusion: This study provides preliminary evidence for the feasibility of percutaneous large-bore aspiration embolectomy in combination with VA-ECMO support (or standby) in patients with high-risk PE and contraindications to thrombolysis., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2023
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13. Vigilance described by the time-on-task effect in EEG activity during a cued Go/NoGo task.
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Pershin I, Candrian G, Münger M, Baschera GM, Rostami M, Eich D, and Müller A
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- Adult, Humans, Reaction Time physiology, Cues, Electroencephalography, Attention physiology, Wakefulness
- Abstract
Vigilance refers to the ability to maintain attention and to remain alert to stimuli in prolonged and monotonous tasks. Vigilance decrement describes the decline in performance in the course of such sustained attention tasks. Time-related alterations in attention have been found to be associated with changes in EEG. We investigated these time-on-task effects on the basis of changes in the conventional EEG spectral bands with the aim of finding a compound measure of vigilance. 148 healthy adults performed a cued Go/NoGo task that lasted approximately 21 min. Behavioural performance was examined by comparing the number of errors in the first and last quarters of the task using paired t-test. EEG data were epoched per trial, and time-on-task effects were modelled by using multiple linear regression, with frequency spectra band power values as independent variables and trial number as the dependent variable. Behavioural performance decreased in terms of omission errors only. Performance of the models, expressed by predicted R-squared, was between 0.10 and 0.27, depending on the particular task condition. The time-on-task EEG spectral changes were characterized by broad changes in the alpha and frontal changes in the beta and gamma bands. We were able to identify a set of EEG spectral features that predict time-on-task. Our output is considered to be a measure of vigilance, reflecting the allocation of mental resources for the maintenance of attention., Competing Interests: Declaration of competing interest AM holds stocks of HBImed AG. The other authors have no interests to declare., (Copyright © 2022 Elsevier B.V. All rights reserved.)
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- 2023
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14. Longitudinal investigation in children and adolescents with ADHD and healthy controls: A 2-year ERP study.
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Münger M, Sele S, Candrian G, Müller A, and Jäncke L
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- Humans, Adolescent, Child, Electroencephalography, Cross-Sectional Studies, Evoked Potentials physiology, Reaction Time physiology, Attention Deficit Disorder with Hyperactivity
- Abstract
Cross-sectional group comparisons have shown altered neurocognitive and neurophysiological profiles in individuals with attention-deficit/hyperactivity disorder (ADHD). We report a two-year longitudinal observational study of ADHD children and adolescents (N = 239) regarding ADHD symptoms, behavioral metrics, and event-related potentials (ERP) and compared them to healthy controls (N = 91). The participants were assessed up to five times with a cued Go/NoGo task while ERPs were recorded. We fitted the trajectories of our variables of interest with univariate and bivariate latent growth curve models. At baseline, the ADHD group had increased reaction time variability, higher number of omission and commission errors, and attenuated CNV and P3d amplitudes compared to controls. The task performance in terms of behavioral metrics improved in both groups over two years; however, with differential patterns: the decrease in reaction time and omission errors were stronger in the control group, and the reduction of commission errors was more substantial in the ADHD group. The cueP3, CNV, and N2d amplitudes changed slightly over two years, with negligible differences between both groups. Furthermore, the parent-rated symptom burden in the ADHD group decreased by 22 % (DSM-5-based questionnaire). We did not identify any associations between the changes in symptoms and the changes in the behavioral or neurophysiological metrics. The lack of association between the changes in symptoms and the behavioral or ERP metrics supports the trait liability hypothesis, which claims that the neurocognitive deficits are independent of symptom alleviation. Furthermore, the change in symptom burden was substantial, questioning the stability of the reported ADHD symptoms., (Copyright © 2022 Elsevier B.V. All rights reserved.)
- Published
- 2023
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15. Major adverse limb events in patients with femoro-popliteal and below-the-knee peripheral arterial disease treated with either sirolimus-coated balloon or standard uncoated balloon angioplasty: a structured protocol summary of the "SirPAD" randomized controlled trial.
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Barco S, Sebastian T, Voci D, Engelberger RP, Grigorean A, Holy E, Leeger C, Münger M, Périard D, Probst E, Spescha R, Held U, and Kucher N
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- Clinical Trials, Phase III as Topic, Coated Materials, Biocompatible, Constriction, Pathologic, Femoral Artery, Humans, Popliteal Artery, Randomized Controlled Trials as Topic, Treatment Outcome, Vascular Patency, Angioplasty, Balloon adverse effects, Angioplasty, Balloon methods, Paclitaxel adverse effects, Peripheral Arterial Disease therapy, Sirolimus adverse effects
- Abstract
Background: Peripheral arterial disease is a progressive atherosclerotic disease with symptoms ranging from an intermittent claudication to acute critical limb ischemia and amputations. Drug-coated balloons and stents were developed to prevent neo-intimal proliferation and restenosis after percutaneous transluminal angioplasty. Randomized controlled trials showed that drug-coated, notably paclitaxel-coated, devices reduce restenosis, late lumen loss, and the need for target lesion re-vascularization compared with uncoated ones. However, the size of these trials was too small to prove superiority for "hard" clinical outcomes. Moreover, available studies were characterized by too restrictive eligibility criteria. Finally, it remains unclear whether paclitaxel-coated balloons may impair long-term survival. Alternative drug-coated balloons, the so-called limus-based analogs, have been approved for clinical use in patients with peripheral arterial disease. By encapsulating sirolimus in phospholipid drug nanocarriers, they optimize adhesion properties of sirolimus and provide better bioavailability., Methods: In this investigator-initiated all-comer open-label phase III randomized controlled trial, we will evaluate whether sirolimus-coated balloon angioplasty is non-inferior and eventually superior, according to a predefined hierarchical analysis, to uncoated balloon angioplasty in adults with infra-inguinal peripheral arterial disease requiring endovascular angioplasty. Key exclusion criteria are pregnancy or breastfeeding, known intolerance or allergy to sirolimus, and participation in a clinical trial during the previous 3 months. The primary efficacy outcome is the composite of two clinically relevant non-subjective "hard" outcomes: unplanned major amputation of the target limb and endovascular or surgical target lesion re-vascularization for critical limb ischemia occurring within 1 year of randomization. The primary safety outcome includes death from all causes., Discussion: By focusing on clinically relevant outcomes, this study will provide useful information on the efficacy and safety of sirolimus-coated balloon catheters for infra-inguinal peripheral arterial disease in a representative ("all-comer") population of unselected patients. As regulatory agencies had raised safety concerns in patients exposed to paclitaxel-coated devices (versus uncoated ones), collect mortality data up to 5 years after randomization will be collected., Trial Registration: ClinicalTrials.gov NCT04238546., (© 2022. The Author(s).)
- Published
- 2022
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16. Longitudinal Analysis of Self-Reported Symptoms, Behavioral Measures, and Event-Related Potential Components of a Cued Go/NoGo Task in Adults With Attention-Deficit/Hyperactivity Disorder and Controls.
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Münger M, Sele S, Candrian G, Kasper J, Abdel-Rehim H, Eich-Höchli D, Müller A, and Jäncke L
- Abstract
This study characterizes a large sample of adults with attention-deficit/hyperactivity disorder (ADHD) and healthy controls regarding their task performance and neurophysiology; cross-sectionally and longitudinally. Self-reported symptoms, behavioral measures, and event-related potentials from a classical cued Go/NoGo task were used to outline the symptom burden, executive function deficits and neurophysiological features, and the associations between these domains. The study participants ( N = 210 ADHD, N = 158 controls, age: 18-62 years) were assessed five (ADHD) or three (controls) times over two years. We describe cross-sectional and longitudinal group differences, and associations between symptom burden, and behavioral and event-related potential (ERP) components variables by latent growth curve models, including random slopes and intercepts. The ADHD group showed increased reaction time variability, increased commission and omission errors, and attenuated cueP3, CNV, N2d, and P3d amplitudes. We observed a decrease in self-reported symptoms in the ADHD group over the two years. The behavioral measures (reaction time variability, number of omission, and commission errors) did not change over time, whereas the cueP3, P3d, and N2d amplitude attenuated in both groups. There was no evidence for a robust association between symptom burden and behavioral or ERP measures. The changes in the ERP components with stable task performance, potentially indicate more efficient neuronal processing over the two years. Whether the lack of association between symptom burden and behavioral or ERP measures might be due to the low reliability of the ADHD assessment criteria, or the inappropriateness of the objective measures cannot be inferred., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Münger, Sele, Candrian, Kasper, Abdel-Rehim, Eich-Höchli, Müller and Jäncke.)
- Published
- 2022
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17. Behavioral and Neurophysiological Markers of ADHD in Children, Adolescents, and Adults: A Large-Scale Clinical Study.
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Münger M, Candrian G, Kasper J, Abdel-Rehim H, Eich D, Müller A, and Jäncke L
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- Adolescent, Adult, Biomarkers, Child, Electroencephalography, Evoked Potentials, Humans, Reaction Time, Reproducibility of Results, Attention Deficit Disorder with Hyperactivity diagnosis
- Abstract
This study aimed to re-evaluate the possible differences between attention-deficit/hyperactivity disorder (ADHD) subjects and healthy controls in the context of a standard Go/NoGo task (visual continuous performance test [VCPT]), frequently used to measure executive functions. In contrast to many previous studies, our sample comprises children, adolescents, and adults. We analyzed data from 447 ADHD patients and 227 healthy controls. By applying multivariate linear regression analyses, we controlled the group differences between ADHD patients and controls for age and sex. As dependent variables we used behavioral (number of omission and commission errors, reaction time, and reaction time variability) and neurophysiological measures (event-related potentials [ERPs]). In summary, we successfully replicated the deviations of ADHD subjects from healthy controls. The differences are small to moderate when expressed as effect size measures (number of omission errors: d = 0.60, reaction time variability: d = 0.56, contingent negative variation (CNV) and P3 amplitudes: -0.35 < d < -0.47, ERP latencies: 0.21 < d < 0.29). Further analyses revealed no substantial differences between ADHD subtypes (combined, inattentive, and hyperactive/impulsive presentation), subgroups according to high- and low-symptomatic burden or methylphenidate intake for their daily routine. We successfully replicated known differences between ADHD subjects and controls for the behavioral and neurophysiological variables. However, the small-to-moderate effect sizes limit their utility as biomarkers in the diagnostic procedure. The incongruence of self-reported symptomatic burden and clinical diagnosis emphasizes the challenges of the present clinical diagnosis with low reliability, which partially accounts for the low degree of discrimination between ADHD subjects and controls.
- Published
- 2021
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18. EEG modulation by different transcranial direct current stimulation (tDCS) montages: a randomized double-blind sham-control mechanistic pilot trial in healthy participants.
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El-Hagrassy M, Duarte D, Lu J, Uygur-Kucukseymen E, Münger M, Thibaut A, Lv P, Morales-Quezada L, and Fregni F
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- Adult, Double-Blind Method, Electrodes, Female, Humans, Male, Pilot Projects, Prefrontal Cortex diagnostic imaging, Young Adult, Electroencephalography, Healthy Volunteers, Transcranial Direct Current Stimulation adverse effects
- Abstract
Background : Based on our Phantom study on transcranial direct current stimulation (tDCS), we hypothesized that EEG band power and field confinement would be greater following left dorsolateral prefrontal cortex (DLPFC - F3) tDCS using circular vs. rectangular electrodes. Methods : Double-blind-randomized trial comparing tDCS with anode over left DLPFC (groups: rectangular electrodes, circular electrodes, sham) and 2 active subgroup references (right shoulder vs. right DLPFC). Results : Twenty-four randomized participants were assessed. We indeed found higher average EEG power spectral density (PSD) across bands for circular vs. rectangular electrodes, largely confined to F3 and there was a significant increase at AF3 for low alpha (p = 0.037). Significant differences included: increased PSD in low beta (p = 0.024) and theta bands (p = 0.021) at F3, and in theta (p = 0.036) at FC5 for the right DLPFC vs. shoulder with no coherence changes. We found PSD differences between active vs. sham tDCS at Fz for alpha (p = 0.043), delta (p = 0.036), high delta (p = 0.030); and at FC1 for alpha (p = 0.031), with coherence differences for F3-Fz in beta (p = 0.044), theta (p = 0.044), delta (p = 0.037) and high delta (p = 0.009). Conclusion : This pilot study despite low statistical power given its small sample size shows that active left DLPFC tDCS modulates EEG frontocentrally and suggests that electrode shapes/reference locations affect its neurophysiological effects, such as increased low alpha power at AF3 using circular vs. rectangular electrodes. Further research with more participants is warranted.
- Published
- 2021
- Full Text
- View/download PDF
19. Protective and Risk Factors for Phantom Limb Pain and Residual Limb Pain Severity.
- Author
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Münger M, Pinto CB, Pacheco-Barrios K, Duarte D, Enes Gunduz M, Simis M, Battistella LR, and Fregni F
- Subjects
- Adult, Aged, Amputation, Surgical adverse effects, Amputees, Cross-Sectional Studies, Female, Humans, Lower Extremity, Male, Middle Aged, Risk Factors, Young Adult, Neuralgia etiology, Phantom Limb etiology
- Abstract
Introduction: The exact mechanisms underlying the development and maintenance of phantom limb pain (PLP) are still unclear. This study aimed to identify the factors affecting pain intensity in patients with chronic, lower limb, traumatic PLP., Methods: This is a cross-sectional analysis of patients with PLP. We assessed amputation-related and pain-related clinical and demographic variables. We used univariate and multivariate models to evaluate the associated factors modulating PLP and residual limb pain (RLP) intensity., Results: We included 71 unilateral traumatic lower limb amputees. Results showed that (1) amputation-related perceptions were experienced by a large majority of the patients with chronic PLP (sensations: 90.1%, n = 64; residual pain: 81.7%, n = 58); (2) PLP intensity has 2 significant protective factors (phantom limb movement and having effective treatment for PLP previously) and 2 significant risk factors (phantom limb sensation intensity and age); and (3) on the other hand, for RLP, risk factors are different: presence of pain before amputation and level of amputation (in addition to the same protective factors)., Conclusion: These results suggest different neurobiological mechanisms to explain PLP and RLP intensity. While PLP risk factors seem to be related to maladaptive plasticity, since phantom sensation and older age are associated with more pain, RLP risk factors seem to have components leading to neuropathic pain, such as the amount of neural lesion and previous history of chronic pain. Interestingly, the phantom movement appears to be protective for both phenomena., (© 2020 World Institute of Pain.)
- Published
- 2020
- Full Text
- View/download PDF
20. Reperfusion treatment for high-risk pulmonary embolism associated with COVID-19.
- Author
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Barco S, Münger M, Sebastian T, and Kucher N
- Subjects
- Betacoronavirus, COVID-19, Humans, Pandemics, SARS-CoV-2, Coronavirus Infections, Pneumonia, Viral, Pulmonary Embolism
- Published
- 2020
- Full Text
- View/download PDF
21. Real-time Video Projection in an MRI for Characterization of Neural Correlates Associated with Mirror Therapy for Phantom Limb Pain.
- Author
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Saleh Velez FG, Pinto CB, Bailin ES, Münger M, Ellison A, Costa BT, Crandell D, Bolognini N, Merabet LB, and Fregni F
- Subjects
- Amputees, Humans, Male, Middle Aged, Video Recording, Magnetic Resonance Imaging, Phantom Limb diagnostic imaging, Phantom Limb therapy
- Abstract
Mirror therapy (MT) has been proposed as an effective rehabilitative strategy to alleviate pain symptoms in amputees with phantom limb pain (PLP). However, establishing the neural correlates associated with MT therapy have been challenging given that it is difficult to administer the therapy effectively within a magnetic resonance imaging (MRI) scanner environment. To characterize the functional organization of cortical regions associated with this rehabilitative strategy, we have developed a combined behavioral and functional neuroimaging protocol that can be applied in participants with a leg amputation. This novel approach allows participants to undergo MT within the MRI scanner environment by viewing real-time video images captured by a camera. The images are viewed by the participant through a system of mirrors and a monitor that the participant views while lying on the scanner bed. In this manner, functional changes in cortical areas of interest (e.g., sensorimotor cortex) can be characterized in response to the direct application of MT.
- Published
- 2019
- Full Text
- View/download PDF
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