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- Bruenner, Y. F., et al.
(author)
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Targeting the brain through the nose. Effects of intranasally administered insulin
- 2013
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In: Nervenarzt. - : Springer Science and Business Media LLC. - 0028-2804 .- 1433-0407. ; 84:8, s. 949-954
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Research review (peer-reviewed)abstract
- The assumption that the human brain is an insulin-independent organ was disproved with the discovery of insulin receptors in the central nervous system in the year 1978. Evidence has been provided for a high density of insulin receptors in brain regions responsible for cognitive memory processes (hippocampus) and for the regulation of appetite (hypothalamus). Accordingly, in animal studies an increased insulin level in the central nervous system leads to an improvement of hippocampal memory function and a decrease of food intake. Similar results were obtained in humans using the method of intranasal administration of insulin. Intranasal insulin reaches the brain and the cerebrospinal fluid via the olfactory epithelium and olfactory nerve fiber bundles leading through the lamina cribrosa to the olfactory bulb. Thus, this method renders the investigation of specific insulin effects in humans possible. The therapeutic potential of an intranasal insulin administration for the treatment of diseases for which an imbalance of the central nervous insulin metabolism is discussed (e.g. Alzheimer's disease, diabetes mellitus and obesity) can only be estimated with the help of further clinical studies.
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- Düzel, Emrah, et al.
(author)
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Innovation in der Diagnostik – mobile Technologien
- 2019
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In: Nervenarzt. - : Springer Science and Business Media LLC. - 0028-2804. ; 90:9, s. 914-920
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Research review (peer-reviewed)abstract
- Background: Progressive cognitive deficits are the main clinical symptom of Alzheimer’s disease; however, the precise recording of cognitive deficits and assessment of their progression pose major problems in patient care and early interventions. Objective: Which problems for care and early intervention result from the current practice of cognitive assessment of patients with memory problems and which opportunities arise from the use of mobile apps? Material and methods: Evaluation of current care structures, discussion of basic work, expert recommendations and current developments. Results: The current practice of the pencil and paper-based diagnostics of cognitive deficits, which is temporally and spatially bound to a clinical environment, constrains the feasibility, validity and reliability of cognitive assessment and the quantification of progression. This limits the meaningful use of further diagnostic measures, such as magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analyses. Recent progress in mobile app-based technologies, illustrated here with the example of the neotiv app, can help to overcome these problems. Conclusion: Mobile app-based technologies can help to improve the cognitive assessment of patients with the main symptom of memory complaints. They can reduce overuse and underuse of diagnostic and therapeutic pathways and enable a targeted and meaningful use of advanced diagnostics. In addition, they can structure risk-modifying preventive measures, identify iatrogenic impairment of cognition and in this respect also strengthen patient competence.
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- Gertz, HJ, et al.
(author)
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[Vascular dementia]
- 2002
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In: Der Nervenarzt. - : Springer Science and Business Media LLC. - 0028-2804. ; 73:5, s. 393-403
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Journal article (peer-reviewed)
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- Jost, W. H., et al.
(author)
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King’s Parkinson’s Disease Pain Scale : Interkulturelle Adaption in deutscher Sprache
- 2018
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In: Nervenarzt. - : Springer Science and Business Media LLC. - 0028-2804. ; 89:2, s. 178-183
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Journal article (peer-reviewed)abstract
- Background: Pain is a frequent symptom of idiopathic Parkinson’s disease and has a substantial impact on quality of life. The King’s Parkinson’s disease pain scale (KPPS) has become internationally established and is an English-language, standardized, reliable and valid scale for evaluation of pain in idiopathic Parkinson’s disease. This article presents a validated version in German. Method: The German translation was adapted interculturally and developed using an internationally recognized procedure in consultation with the authors of the original publication. The primary text was first translated by two bilingual neuroscientists independently of one another. Thereafter, the two versions were collated to generate a consensus version, which was accepted by the translators and preliminarily trialled with 10 patients. Hereafter, the German version was re-translated back into English by two other neurologists, again independently of one another, and a final consensus was agreed on using these versions. This English version was then compared with the original text by all of the translators, a process which entailed as many linguistic modifications to the German version as the translators considered necessary to generate a linguistically acceptable German version that was as similar as possible to the original English version. After this test text had been subsequently approved by the authors, the German text was applied to 50 patients in two hospitals, and reviewed as to its practicability and comprehensibility. Results: This work led to the successful creation of an inter-culturally adapted and linguistically validated German version of the KPPS. Discussion: The German version presented here is a useful scare for recording and quantifying pain in empirical studies, as well as in clinical practice.
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- Klingelhoefer, L., et al.
(author)
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Dystonia Non-Motor Symptoms Questionnaire (DNMSQuest) zur Erhebung nichtmotorischer Symptome bei Dystonie : Interkulturelle Adaptation in deutscher Sprache
- 2020
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In: Nervenarzt. - : Springer Science and Business Media LLC. - 0028-2804. ; 91, s. 337-342
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Journal article (peer-reviewed)abstract
- Background: Non-motor symptoms (NMS) in patients with dystonia have a relevant impact on health-related quality of life; however, a comprehensive easy to use NMS assessment tool for clinical bedside use is currently not available. Objective: The validated German version of the dystonia non-motor symptoms questionnaire (DNMSQuest) for assessing NMS in craniocervical dystonia is presented. Methods: The DNMSQuest in the German language was developed based on internationally recognized standards for intercultural adaptation of self-completed patient questionnaires. Translation of the original English questionnaire into the German language as well as back translation to English was carried out independently by four bilingual specialists in neurological movement disorders. In each case a consensus version accepted by each translator was created by another neurologist. The back translated English version was compared with the original English questionnaire for relevant linguistic and content discrepancies by a neurologist who was significantly involved in the development of the original questionnaire. The final German version was used in 130 patients with cervical dystonia and 48 healthy controls in an international, multicenter validation study. Results: An interculturally adapted validated version of the DNMSQuest in the German and English languages was developed for rapid bedside assessment and evaluation of NMS in cervical dystonia. Conclusion: The DNMSQuest successfully bridges the current gap of a validated disease-specific, patient self-administered, short, comprehensive questionnaire for NMS assessment in routine clinical practice in craniocervical dystonia. It is envisaged that this tool will be useful for the clinical practice and trials.
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- Storch, A., et al.
(author)
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Non-motor Symptoms Questionnaire and Scale for Parkinson's disease
- 2010
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In: Nervenarzt. - : Springer Science and Business Media LLC. - 0028-2804. ; 81:8, s. 980-985
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Journal article (peer-reviewed)abstract
- Idiopathic Parkinson's disease (PD) is a multisytem degenerative disorder. In addition to motor symptoms such as akinesia, rigidity and tremor, various non-motor symptoms occur, which are still insufficiently diagnosed. Moreover, the frequently used scales and scores do not adequately detect these non-motor symptoms. The Non-motor Symptoms Questionnaire (NMSQuest) is an established self-completed patient questionnaire with 30 qualitative questions covering all important non-motor symptoms of PD. The Non-motor Symptoms Scale (NMSScale) is a grade rating scale for estimating the frequency and severity of non-motor symptoms in PD. Since there are only original English versions of both questionnaires available, self-translated versions were frequently used or the questionnaires were not used at all in native German patients. We used international guidelines for cross-cultural adaptation of questionnaires to provide standard versions of both non-motor symptoms questionnaires in the German language.
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