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Introduction: In Germany, stroke is the third leading cause of death, with more than 60,000 fatalities out of approximately 260,000 cases (first-ever and recurrent strokes) each year. So far, there are only a few long-term studies investigating determinants of the natural course of the disease, especially in the era of mechanical thrombectomy. Materials and Methods: The prospective single-center stroke cohort Augsburg (SCHANA) study will include about 1000 patients treated for stroke in the University Hospital of Augsburg. Patients aged 18 years or older with a confirmed diagnosis of ischemic or hemorrhagic stroke are included in the study. Information on demographic characteristics, onset of symptoms, etiologic factors, comorbidities, quality of life, invasive and non-invasive treatment, complications, and laboratory parameters are collected during a personal interview conducted during the patients’ hospital stay and via a medical chart review. About 30 mL of blood is collected from each patient, and after processing and aliquoting, all blood specimens are frozen at −80° C. The study participants will be followed-up via postal questionnaires at three and 12 months after discharge from the hospital. Furthermore, mortality follow-ups will be conducted. Cox-regression analysis will be used to estimate relative risks. Conclusion: The SCHANA study will generate comprehensive data on the long-term course of the disease. In addition to the main outcomes, recurrent events and survival, patient-oriented outcomes such as health-related quality of life and depression are the focus of the study.
Michael Ertl; Christa Meisinger; Jakob Linseisen; Sebastian-Edgar Baumeister; Philipp Zickler; Markus Naumann. Long-Term Outcomes in Patients with Stroke after in-Hospital Treatment—Study Protocol of the Prospective Stroke Cohort Augsburg (SCHANA Study). Medicina 2020, 56, 280 .
AMA StyleMichael Ertl, Christa Meisinger, Jakob Linseisen, Sebastian-Edgar Baumeister, Philipp Zickler, Markus Naumann. Long-Term Outcomes in Patients with Stroke after in-Hospital Treatment—Study Protocol of the Prospective Stroke Cohort Augsburg (SCHANA Study). Medicina. 2020; 56 (6):280.
Chicago/Turabian StyleMichael Ertl; Christa Meisinger; Jakob Linseisen; Sebastian-Edgar Baumeister; Philipp Zickler; Markus Naumann. 2020. "Long-Term Outcomes in Patients with Stroke after in-Hospital Treatment—Study Protocol of the Prospective Stroke Cohort Augsburg (SCHANA Study)." Medicina 56, no. 6: 280.
Background Programming deep brain stimulation in dystonia is difficult because of the delayed benefits and absence of evidence-based guidelines. Therefore, we evaluated the efficacy of a programming algorithm applied in a double-blind, sham-controlled multicenter study of pallidal deep brain stimulation in dystonia. Methods A standardized monopolar review to identify the contact with the best acute antidystonic effect was applied in 40 patients, who were then programmed 0.5 V below the adverse effect threshold and maintained on these settings for at least 3 months, if tolerated. If no acute effects were observed, contact selection was based on adverse effects or anatomical criteria. Three-year follow-up data was available for 31 patients, and five-year data for 32 patients. The efficacy of the algorithm was based on changes in motor scores, adverse events, and the need for reprogramming. Results The mean (±standard deviation) dystonia motor score decreased by 73 ± 24% at 3 years and 63 ± 38% at 5 years for contacts that exhibited acute improvement of dystonia (n = 17) during the monopolar review. Contacts without acute benefit improved by 58 ± 30% at 3 years (n = 63) and 53 ± 31% at 5 years (n = 59). Interestingly, acute worsening or induction of dystonia/dyskinesia (n = 9) correlated significantly with improvement after 3 years, but not 5 years. Conclusions Monopolar review helped to detect the best therapeutic contact in approximately 30% of patients exhibiting acute modulation of dystonic symptoms. Acute improvement, as well as worsening of dystonia, predicted a good long-term outcome, while induction of phosphenes did not correlate with outcome. Trial registration ClinicalTrials.gov NCT00142259.
Frank Steigerwald; for the DBS study group for dystonia; Anna Dalal Kirsch; Andrea A. Kühn; Andreas Kupsch; Joerg Mueller; Wilhelm Eisner; Günther Deuschl; Daniela Falk; Alfons Schnitzler; Inger Marie Skogseid; Juliane Vollmer-Haase; Chi W. Ip; Volker Tronnier; Jan Vesper; Markus Naumann; Jens Volkmann. Evaluation of a programming algorithm for deep brain stimulation in dystonia used in a double-blind, sham-controlled multicenter study. Neurological Research and Practice 2019, 1, 1 -6.
AMA StyleFrank Steigerwald, for the DBS study group for dystonia, Anna Dalal Kirsch, Andrea A. Kühn, Andreas Kupsch, Joerg Mueller, Wilhelm Eisner, Günther Deuschl, Daniela Falk, Alfons Schnitzler, Inger Marie Skogseid, Juliane Vollmer-Haase, Chi W. Ip, Volker Tronnier, Jan Vesper, Markus Naumann, Jens Volkmann. Evaluation of a programming algorithm for deep brain stimulation in dystonia used in a double-blind, sham-controlled multicenter study. Neurological Research and Practice. 2019; 1 (1):1-6.
Chicago/Turabian StyleFrank Steigerwald; for the DBS study group for dystonia; Anna Dalal Kirsch; Andrea A. Kühn; Andreas Kupsch; Joerg Mueller; Wilhelm Eisner; Günther Deuschl; Daniela Falk; Alfons Schnitzler; Inger Marie Skogseid; Juliane Vollmer-Haase; Chi W. Ip; Volker Tronnier; Jan Vesper; Markus Naumann; Jens Volkmann. 2019. "Evaluation of a programming algorithm for deep brain stimulation in dystonia used in a double-blind, sham-controlled multicenter study." Neurological Research and Practice 1, no. 1: 1-6.
For more than three decades, Botulinum neurotoxin (BoNT) has been used to treat a variety of clinical conditions such as spastic or dystonic disorders by inducing a temporary paralysis of the injected muscle as the desired clinical effect. BoNT is known to primarily act at the neuromuscular junction resulting in a biochemical denervation of the treated muscle. However, recent evidence suggests that BoNT’s pharmacological properties may not only be limited to local muscular denervation at the injection site but may also include additional central effects. In this review, we report and discuss the current evidence for BoNT’s central effects based on clinical observations, neurophysiological investigations and neuroimaging studies in humans. Collectively, these data strongly point to indirect mechanisms via changes to sensory afferents that may be primarily responsible for the marked plastic effects of BoNT on the central nervous system. Importantly, BoNT-related central effects and consecutive modulation and/or reorganization of the brain may not solely be considered “side-effects” but rather an additional therapeutic impact responsible for a number of clinical observations that cannot be explained by merely peripheral actions.
David Weise; Christopher M. Weise; Markus Naumann. Central Effects of Botulinum Neurotoxin—Evidence from Human Studies. Toxins 2019, 11, 21 .
AMA StyleDavid Weise, Christopher M. Weise, Markus Naumann. Central Effects of Botulinum Neurotoxin—Evidence from Human Studies. Toxins. 2019; 11 (1):21.
Chicago/Turabian StyleDavid Weise; Christopher M. Weise; Markus Naumann. 2019. "Central Effects of Botulinum Neurotoxin—Evidence from Human Studies." Toxins 11, no. 1: 21.
Die heterogene Erkrankungsgruppe der Dystonien wird anhand ihrer klinischen Charakteristika und Ätiologie unterschieden, selten sind dyston anmutende Bewegungsstörungen psychogener Natur. Pathophysiologisch wird von einer Funktionsstörung im Basalganglienbereich ausgegangen. Die drei Säulen der Therapie bilden nach den aktuellen Leitlinien die Injektion von Botulinumtoxin, die systemische medikamentöse Behandlung und die tiefe Hirnstimulation [1]. Bei der Auswahl der spezifischen Therapie ist die Unterteilung der Dystonien in generalisierte oder fokal/segmentale Formen entscheidend.
Med. Peter Ratzka; Dr. Med. Markus Naumann. Gezielte Diagnose und leitliniengerechte Therapie von Dystonien. InFo Neurologie + Psychiatrie 2016, 18, 38 -46.
AMA StyleMed. Peter Ratzka, Dr. Med. Markus Naumann. Gezielte Diagnose und leitliniengerechte Therapie von Dystonien. InFo Neurologie + Psychiatrie. 2016; 18 (4):38-46.
Chicago/Turabian StyleMed. Peter Ratzka; Dr. Med. Markus Naumann. 2016. "Gezielte Diagnose und leitliniengerechte Therapie von Dystonien." InFo Neurologie + Psychiatrie 18, no. 4: 38-46.
Botulinum toxin is a well established, highly effective and safe treatment option for movement disorders and autonomic diseases with excellent long term results. There is increasing evidence that the beneficial effect in both motor and autonomic indication is based on a complex mode of botulinum toxin action modulating efferent as well as afferent nerve fiber activity. In particular, this has been shown for the treatment of dystonia, spasticity and overactive bladder. A unique observation is that botulinum toxin has a markedly longer duration of action in autonomic than in motor disorders for which the reason remains unclear. Although botulinum toxin type B seems to have an initially higher affinity to autonomic nerve endings there is currently no clear evidence that type B is superior to type A in autonomic disorders. The risk of antibody formation probably does not depend on the target tissue injected and seems to be similar for movement disorders and autonomic indications. More research is needed to better understand similarities and differences of treatment outcome in motor and autonomic disorders.
M. Naumann. Clinical comparison of botulinum toxin in motor and autonomic disorders: Similarities and differences. Toxicon 2015, 107, 68 -71.
AMA StyleM. Naumann. Clinical comparison of botulinum toxin in motor and autonomic disorders: Similarities and differences. Toxicon. 2015; 107 ():68-71.
Chicago/Turabian StyleM. Naumann. 2015. "Clinical comparison of botulinum toxin in motor and autonomic disorders: Similarities and differences." Toxicon 107, no. : 68-71.
Alemtuzumab, a humanized monoclonal antibody targeting the surface molecule CD52, leads to a rapid depletion of immune cells in the innate and adaptive immune system. In phase 2 and 3 trials in multiple sclerosis (MS), infections have been reported more frequently in alemtuzumab than in interferon beta treated patients. Here we report two patients treated with alemtuzumab for MS developing Listeria meningitis few days after the first infusion cycle. Both patients recovered completely after prompt diagnosis and adequate treatment. Physicians and patients should be aware of this serious, but treatable complication.
Daniela Rau; Michael Lang; Andreas Harth; Markus K Naumann; Frank Weber; Hayrettin Tumani; Antonios Bayas. Listeria Meningitis Complicating Alemtuzumab Treatment in Multiple Sclerosis—Report of Two Cases. International Journal of Molecular Sciences 2015, 16, 14669 -14676.
AMA StyleDaniela Rau, Michael Lang, Andreas Harth, Markus K Naumann, Frank Weber, Hayrettin Tumani, Antonios Bayas. Listeria Meningitis Complicating Alemtuzumab Treatment in Multiple Sclerosis—Report of Two Cases. International Journal of Molecular Sciences. 2015; 16 (12):14669-14676.
Chicago/Turabian StyleDaniela Rau; Michael Lang; Andreas Harth; Markus K Naumann; Frank Weber; Hayrettin Tumani; Antonios Bayas. 2015. "Listeria Meningitis Complicating Alemtuzumab Treatment in Multiple Sclerosis—Report of Two Cases." International Journal of Molecular Sciences 16, no. 12: 14669-14676.
Markus Naumann. 149. Clinical comparison of botulinum neurotoxin effects at the neuromuscular junction and autonomic nerves: similarities and differences. Toxicon 2014, 93, S46 .
AMA StyleMarkus Naumann. 149. Clinical comparison of botulinum neurotoxin effects at the neuromuscular junction and autonomic nerves: similarities and differences. Toxicon. 2014; 93 ():S46.
Chicago/Turabian StyleMarkus Naumann. 2014. "149. Clinical comparison of botulinum neurotoxin effects at the neuromuscular junction and autonomic nerves: similarities and differences." Toxicon 93, no. : S46.
M. Naumann. Mechanism of action of botulinum neurotoxin in hyperhidrosis. Toxicon 2013, 68, 71 .
AMA StyleM. Naumann. Mechanism of action of botulinum neurotoxin in hyperhidrosis. Toxicon. 2013; 68 ():71.
Chicago/Turabian StyleM. Naumann. 2013. "Mechanism of action of botulinum neurotoxin in hyperhidrosis." Toxicon 68, no. : 71.
Lewis–Sumner syndrome (LSS, synonymous multifocal acquired demyelinating sensory and motor neuropathy, MADSAM) is a dysimmune peripheral neuropathy responding to corticosteroids and intravenous immunoglobulins (IVIG) in the majority of patients. We report on the long term treatment (37 and 46 months respectively) of two LSS patients, who had initially responded to IVIG, with subcutaneous immunoglobulins (SCIg). Both were switched to SCIg since stabilization by IVIG could only be achieved with short treatment intervals, and one of them also suffered from recurrent transient ischemic attacks (TIAs) following IVIG related increased blood viscosity. Long-term use of SCIg was safe and well tolerated. Both patients were clinically stable with only mild to moderate fluctuations requiring SCIg dosage adaptions. No further ischemic events occurred, when the patient was switched to SCIg.
Antonios Bayas; Ralf Gold; Markus Naumann. Long-term treatment of Lewis–Sumner syndrome with subcutaneous immunoglobulin infusions. Journal of the Neurological Sciences 2013, 324, 53 -56.
AMA StyleAntonios Bayas, Ralf Gold, Markus Naumann. Long-term treatment of Lewis–Sumner syndrome with subcutaneous immunoglobulin infusions. Journal of the Neurological Sciences. 2013; 324 (1):53-56.
Chicago/Turabian StyleAntonios Bayas; Ralf Gold; Markus Naumann. 2013. "Long-term treatment of Lewis–Sumner syndrome with subcutaneous immunoglobulin infusions." Journal of the Neurological Sciences 324, no. 1: 53-56.
Botulinum neurotoxin (BoNT) can be injected to achieve therapeutic benefit across a large range of clinical conditions. To assess the efficacy and safety of BoNT injections for the treatment of certain hypersecretory disorders, including hyperhidrosis, sialorrhea, and chronic rhinorrhea, an expert panel reviewed evidence from the published literature. Data sources included English-language studies identified via MEDLINE, EMBASE, CINAHL, Current Contents, and the Cochrane Central Register of Controlled Trials. Evidence tables generated in the 2008 Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology (AAN) review of the use of BoNT for autonomic disorders were also reviewed and updated. The panel evaluated evidence at several levels, supporting BoNT as a class, the serotypes BoNT-A and BoNT-B, as well as the four individual commercially available formulations: abobotulinumtoxinA (A/Abo), onabotulinumtoxinA (A/Ona), incobotulinumtoxinA (A/Inco), and rimabotulinumtoxinB (B/Rima). The panel ultimately made recommendations for each therapeutic indication, based upon the strength of clinical evidence and following the AAN classification scale. For the treatment of axillary hyperhidrosis in a total of 923 patients, the evidence supported a Level A recommendation for BoNT-A, with a Level B recommendation for A/Abo and A/Ona and a Level U recommendation (insufficient data) for A/Inco and B/Rima. Five trials in 82 patients supported the use of BoNT in palmar hyperhidrosis, with a Level B recommendation for BoNT-A and a Level C recommendation for BoNT-B; individual formulations received a Level U rating due to insufficient data. BoNT (and all individual formulations) received a Level U recommendation for the treatment of gustatory sweating. Support for use of BoNT in sialorrhea was derived from eight trials in a total of 222 adults and children. Evidence supported a Level B recommendation for A/Abo, A/Ona, and B/Rima and a Level U recommendation for A/Inco. Evidence supported a Level B recommendation for A/Ona for the treatment of allergic rhinitis, based on two Class II studies in 73 patients. A lack of published studies for A/Abo, A/Inco, or B/Rima supported a Level U recommendation for those formulations. Further clarity on the optimal mode of administration and additional studies using other BoNT formulations are needed to fill current evidence gaps.
Markus Naumann; Dirk Dressler; Mark Hallett; Joseph Jankovic; Giampietro Schiavo; Karen R. Segal; Daniel Truong. Evidence-based review and assessment of botulinum neurotoxin for the treatment of secretory disorders. Toxicon 2012, 67, 141 -152.
AMA StyleMarkus Naumann, Dirk Dressler, Mark Hallett, Joseph Jankovic, Giampietro Schiavo, Karen R. Segal, Daniel Truong. Evidence-based review and assessment of botulinum neurotoxin for the treatment of secretory disorders. Toxicon. 2012; 67 ():141-152.
Chicago/Turabian StyleMarkus Naumann; Dirk Dressler; Mark Hallett; Joseph Jankovic; Giampietro Schiavo; Karen R. Segal; Daniel Truong. 2012. "Evidence-based review and assessment of botulinum neurotoxin for the treatment of secretory disorders." Toxicon 67, no. : 141-152.
This meta‐analysis evaluated the frequency of neutralizing antibody (nAb) conversion with onabotulinumtoxinA (BOTOX®; Allergan) across five studied indications. The analysis was based on large, controlled or prospective, open‐label trials (durations 4 months to ≥2 years). Serum samples were analyzed for nAbs using the Mouse Protection Assay. Subjects who were antibody negative at baseline and had at least one analyzable postbaseline antibody assay result were included. The 16 clinical studies included 3,006 subjects; of these, 2,240 met the inclusion criteria for this analysis. Subjects received 1–15 treatments (mean 3.8 treatments) with onabotulinumtoxinA. Total doses per treatment cycle ranged from 10 or 20 units in glabellar lines to 20–500 units in cervical dystonia. The numbers of subjects who converted from an antibody‐negative status at baseline to antibody‐positive status at any post‐treatment time point were: cervical dystonia 4/312 (1.28%), glabellar lines 2/718 (0.28%), overactive bladder 0/22 (0%), post‐stroke spasticity 1/317 (0.32%), and primary axillary hyperhidrosis 4/871 (0.46%). Across all indications, 11/2,240 subjects (0.49%) converted from antibody negative at baseline to positive at one or more post‐treatment time points, but only three subjects became clinically unresponsive to onabotulinumtoxinA at some point following a positive assay. Based on these large trials, the frequency of antibody conversion after onabotulinumtoxinA treatment is very low, and infrequently leads to loss of efficacy. © 2010 Movement Disorder Society
Markus Naumann; Alastair Carruthers; Jean Carruthers; Sheena K. Aurora; Ross Zafonte; Susan Abu-Shakra; Terry Boodhoo; Mary Ann Miller‐Messana Rn; George Demos; Lynn James; Frederick Beddingfield Md; Amanda VanDenburgh; Mary Ann Chapman; Mitchell F. Brin. Meta-analysis of neutralizing antibody conversion with onabotulinumtoxinA (BOTOX®) across multiple indications. Movement Disorders 2010, 25, 2211 -2218.
AMA StyleMarkus Naumann, Alastair Carruthers, Jean Carruthers, Sheena K. Aurora, Ross Zafonte, Susan Abu-Shakra, Terry Boodhoo, Mary Ann Miller‐Messana Rn, George Demos, Lynn James, Frederick Beddingfield Md, Amanda VanDenburgh, Mary Ann Chapman, Mitchell F. Brin. Meta-analysis of neutralizing antibody conversion with onabotulinumtoxinA (BOTOX®) across multiple indications. Movement Disorders. 2010; 25 (13):2211-2218.
Chicago/Turabian StyleMarkus Naumann; Alastair Carruthers; Jean Carruthers; Sheena K. Aurora; Ross Zafonte; Susan Abu-Shakra; Terry Boodhoo; Mary Ann Miller‐Messana Rn; George Demos; Lynn James; Frederick Beddingfield Md; Amanda VanDenburgh; Mary Ann Chapman; Mitchell F. Brin. 2010. "Meta-analysis of neutralizing antibody conversion with onabotulinumtoxinA (BOTOX®) across multiple indications." Movement Disorders 25, no. 13: 2211-2218.
Myokymie und Neuromyotonie sind klinische Phänomene, denen eine charakteristische elektromyographische Aktivität zu Grunde liegt. Die Kenntnis dieser Merkmale ist von diagnostischem und differentialdiagnostischem Wert, da sie nur bei einem eingeschränkten, wenn auch heterogenen Spektrum von Erkrankungen des peripheren Nervensystems vorkommen. Myokymia and neuromyotonia are clinical phenomena associated with characteristic electromyographic findings. The typical clinical and electrophysiological features are important for the differential diagnosis of neurological diseases as they can be observed in only a selected although heterogeneous spectrum of disorders of the peripheral nervous system.
Markus Naumann; Antonios Bayas. Myokymie und Neuromyotonie. Das Neurophysiologie-Labor 2008, 30, 23 -28.
AMA StyleMarkus Naumann, Antonios Bayas. Myokymie und Neuromyotonie. Das Neurophysiologie-Labor. 2008; 30 (1):23-28.
Chicago/Turabian StyleMarkus Naumann; Antonios Bayas. 2008. "Myokymie und Neuromyotonie." Das Neurophysiologie-Labor 30, no. 1: 23-28.
M Naumann. [Long-term safety of therapeutic botulinum toxin A]. Der Nervenarzt 2008, 79, 1 .
AMA StyleM Naumann. [Long-term safety of therapeutic botulinum toxin A]. Der Nervenarzt. 2008; 79 ():1.
Chicago/Turabian StyleM Naumann. 2008. "[Long-term safety of therapeutic botulinum toxin A]." Der Nervenarzt 79, no. : 1.