Publications by authors named "Benke T"

Background: White matter hyperintensities (WMH) have been implicated in the pathogenesis of neuropsychiatric symptoms of dementia but the functional significance of WMH in specific white matter (WM) tracts is unclear. We investigate whether WMH burden within major WM fibre classes and individual WM tracts are differentially associated with different neuropsychiatric syndromes in a large multicentre study.

Method: Neuroimaging and neuropsychiatric data of seven memory clinic cohorts through the Meta VCI Map consortium were harmonised.

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Introduction: The clinical, research and advocacy communities for Rett syndrome are striving to achieve clinical trial readiness, including having fit-for-purpose clinical outcome assessments. This study aimed to (1) describe psychometric properties of clinical outcome assessment for Rett syndrome and (2) identify what is needed to ensure that fit-for-purpose clinical outcome assessments are available for clinical trials.

Methods: Clinical outcome assessments for the top 10 priority domains identified in the Voice of the Patient Report for Rett syndrome were compiled and available psychometric data were extracted.

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Background: Unawareness or anosognosia of memory impairment is a common phenomenon in patients with Alzheimer's disease (AD). Different findings have been reported regarding its presentation, assessment procedure, and cognitive correlates.

Objective: To assess memory awareness of early AD patients predictively (before memory testing) and online (immediately after performing a memory test).

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Unlabelled: N-methyl-D-aspartate receptors (NMDARs) comprise a family of ligand-gated ionotropic glutamate receptors that mediate a slow, calcium-permeable component to excitatory neurotransmission. The GluN2D subunit is enriched in GABAergic inhibitory interneurons in cortical tissue. Diminished levels of GABAergic inhibition contribute to multiple neuropsychiatric conditions, suggesting that enhancing inhibition may have therapeutic utility, thus making GluN2D modulation an attractive drug target.

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  • The study aims to analyze the ages and genetic MECP2 variants of recently identified males, laying the groundwork for further investigation into their clinical characteristics.
  • Genetic data were collected from a parent group, focusing on whether MECP2 variants were newly developed or inherited, as well as the prevalence of mosaicism among those meeting Rett syndrome criteria.
  • Out of 59 males examined, the majority had de novo variants, and findings emphasize the necessity for improved diagnostic processes and equitable access to therapeutic options for those with MECP2 variants.
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  • White matter hyperintensities (WMH) are linked to cognitive impairment but solely measuring their volume doesn't fully explain the cognitive deficits.
  • Lesion network mapping (LNM) offers a new way to assess how WMH connects with brain networks, potentially improving our understanding of their impact on cognition.
  • In a study of 3,485 patients, LNM scores outperformed WMH volumes in predicting cognitive performance, especially in attention, processing speed, and verbal memory, but not for language functions.
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Objective: Early life seizures (ELS) are commonly associated with autism spectrum disorder (ASD); however, the exact role of ELS in the pathology is unknown. Prior studies have demonstrated social deficits, a core feature of ASD, following ELS; consequently, alterations in sensory modalities may contribute to the overall social deficits. Considering the speculated contribution of sensory deficit to social communication, we examined the developmental consequences of early postnatal kainic acid (KA)-induced seizures on olfactory preference and neural markers in the olfactory bulb in both male and female Sprague Dawley rats.

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Pathogenic variants in the cyclin-dependent kinase-like 5 (CDKL5) gene are associated with CDKL5 deficiency disorder (CDD), a severe X-linked developmental and epileptic encephalopathy. Deletions affecting the 5' untranslated region (UTR) of CDKL5, which involve the noncoding exon 1 and/or alternatively spliced first exons (exons 1a-e), are uncommonly reported. We describe genetic and phenotypic characteristics for 15 individuals with CDKL5 partial gene deletions affecting the 5' UTR.

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Although long-term survival in Rett syndrome (RTT) has been observed, limited information on older people with RTT exists. We hypothesized that increased longevity in RTT would be associated with genetic variants in associated with milder severity, and that clinical features would not be static in older individuals. To address these hypotheses, we compared the distribution of variants and clinical severity between younger individuals with Classic RTT (under 30 years old) and older individuals (over 30 years old).

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Objective: The CDKL5 Clinical Severity Assessment (CCSA) is a comprehensive, content-validated measurement tool capturing the diverse challenges of cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder (CDD), a genetically caused developmental epileptic encephalopathy (DEE). The CCSA is divided into clinician-reported (CCSA-Clinician) and caregiver-reported (CCSA-Caregiver) assessments. The aim of this study was to evaluate the factor structure of these measures through confirmatory factor analysis (CFA) and evaluate their validity and reliability.

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Alzheimer's disease (AD) imposes a major burden on affected individuals, their caregivers and health-care systems alike. Though quite many risk factors for disease progression have been identified, there is a lack of prospective studies investigating the interplay and predictive value of a wide variety of patient variables associated with cognitive deterioration (defined as key feature of AD progression). Study participants were patients with probable and possible AD, that were assessed at four time points over a period of two years (T1-T4).

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Background: Communication impairments are a leading concern for parent caregivers of individuals with rare neurodevelopmental disorders (RNDDs). Clinical trials of disease modifying therapies require valid and responsive outcome measures that are relevant to individuals with RNDDs. Identifying and evaluating current psychometric properties for communication measures is a critical step towards the selection and use of appropriate instruments.

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  • Trofinetide was shown to be effective for treating Rett syndrome in a long-term study called LILAC-2, following a shorter study, LAVENDER, confirming its benefits over 32 months.
  • The study included 77 female participants aged 5-22, examining safety through adverse events and efficacy using specific rating scales, with diarrhea and COVID-19 being the most commonly reported side effects.
  • Caregivers expressed high satisfaction with trofinetide, noting significant improvements in their children's symptoms without any new safety issues arising during the extended treatment.
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Study Objectives: Sleep difficulties are common in CDKL5 deficiency disorder, a developmental and epileptic encephalopathy. This study evaluated the factor structure of the Disorders of Initiating and Maintaining Sleep (DIMS), Disorders of Excessive Somnolence (DOES), and Sleep Breathing Disorders domains of the Sleep Disturbance Scale for Children for CDKL5 deficiency disorder.

Methods: A cross-sectional psychometric study design was used.

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CDKL5 deficiency disorder (CDD) is a rare developmental and epileptic encephalopathy. Ganaxolone, a neuroactive steroid, reduces the frequency of major motor seizures in children with CDD. This analysis explored the effect of ganaxolone on non-seizure outcomes.

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  • Trofinetide, approved for treating Rett syndrome, showed continued efficacy and safety in the 40-week LILAC extension study following the initial 12-week LAVENDER trial.
  • A total of 154 female participants aged 5-21 received trofinetide, with common side effects including diarrhea and vomiting; diarrhea was the leading cause for treatment withdrawal.
  • Symptoms of Rett syndrome improved over the 40-week period, with no significant difference in safety profiles between LILAC and the previous LAVENDER study.
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  • Mutations in the CDKL5 gene, associated with severe neurological disorders, lead to issues like early-onset epilepsy, autism, and intellectual disability, prompting this study to explore their impact on hippocampal function.
  • Using a rat model with a specific loss of function mutation, the researchers conducted various electrophysiological and biochemical assessments to understand how the absence of CDKL5 affects synaptic behavior in the brain.
  • The findings revealed enhanced long-term potentiation in juvenile Cdkl5 rats without altering NMDA receptor function or silent synapse formation, suggesting CDKL5 plays a crucial role in maintaining normal synaptic plasticity in the hippocampus.
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Nonketotic hyperglycinemia due to deficient glycine cleavage enzyme activity causes a severe neonatal epileptic encephalopathy. Current therapies based on mitigating glycine excess have only limited impact. An animal model with postnatal phenotyping is needed to explore new therapeutic approaches.

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  • Typical Rett syndrome (RTT) is a neurodevelopmental disorder primarily affecting females, causing loss of purposeful hand movements, speech, and impaired gait, often linked to mutations in the MECP2 gene.
  • A young woman with classic RTT had no genetic diagnosis for 20 years despite extensive testing, until recent advanced sequencing revealed a unique alteration involving the BCL11A gene affecting MECP2.
  • This case highlights the evolving nature of genetic testing and emphasizes the need for ongoing investigation into diagnoses as technology advances.
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  • The study aimed to identify specific EEG characteristics in individuals with Rett syndrome (RTT) to determine their potential as objective indicators of brain function.
  • EEG data were collected from 60 females with RTT and 26 neurotypical females, focusing on differences in brain activity and the correlation with clinical severity.
  • Findings showed that RTT participants exhibited greater amplitude variability and low-frequency brain activity, with consistent patterns in EEG power measures that correlated with clinical severity, supporting the use of EEG as an objective assessment tool for RTT.
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Introduction: White matter hyperintensities of presumed vascular origin (WMH) are associated with cognitive impairment and are a key imaging marker in evaluating cognitive health. However, WMH volume alone does not fully account for the extent of cognitive deficits and the mechanisms linking WMH to these deficits remain unclear. We propose that lesion network mapping (LNM), enables to infer if brain networks are connected to lesions, and could be a promising technique for enhancing our understanding of the role of WMH in cognitive disorders.

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Unlabelled: Nonketotic hyperglycinemia due to deficient glycine cleavage enzyme activity causes a severe neonatal epileptic encephalopathy. Current therapies based on mitigating glycine excess have only limited impact. An animal model with postnatal phenotyping is needed to explore new therapeutic approaches.

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Article Synopsis
  • * The study focuses on 48 de novo missense variants in GRIN1, GRIN2A, and GRIN2B that affect the M3 transmembrane helix, identified in children with conditions like epilepsy and developmental delays.
  • * Most of these variants lead to a gain-of-function effect, promoting NMDAR channel activity, reinforcing the importance of the M3 region in receptor function, and providing insights into how certain drugs may affect these variant receptors.
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  • - The study aimed to track changes in hand function skills over time in girls and young women with classic Rett Syndrome (RTT) and examine how these changes relate to genetic variants.
  • - Researchers analyzed data from 946 participants between ages 2 and 18, revealing that hand function generally declines over time, with sharper declines noted in individuals with milder genetic variants.
  • - The findings suggest that understanding these variations in hand use is crucial for designing effective clinical trials for RTT treatments, highlighting the need to consider specific genetic factors affecting hand function when planning interventions.
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