Publications by authors named "Gereon Fink"

Background: Nitrous oxide (N₂O), commonly known as laughing gas, is widely recognized for its anesthetic and analgesic effects, and is frequently used in medical contexts. However, its misuse can lead to significant neurological complications, which are often under-recognized in clinical practice. Recent data on such cases in Germany are rare.

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Purpose: Especially in Europe, amino acid PET is increasingly integrated into multidisciplinary neuro-oncological tumor boards (MNTBs) to overcome diagnostic uncertainties such as treatment-related changes. We evaluated the accuracy of MNTB decisions that included the O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) PET information compared with FET PET results alone to differentiate tumor relapse from treatment-related changes.

Patients And Methods: In a single academic center, we retrospectively evaluated 180 MNTB decisions of 151 patients with CNS WHO grade 3 or 4 gliomas (n = 122) or brain metastases (n = 29) presenting equivocal MRI findings following anticancer treatment.

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The precise cognitive mechanisms underlying spatial neglect are not fully understood. Recent studies have provided the first evidence for aberrant behavioral and electrophysiological prediction and prediction error responses in patients with neglect, but also in right-hemispheric (RH) stroke patients without neglect. For prediction-dependent attention, as assessed with Posner-type cueing paradigms with volatile cue-target contingencies, studies in healthy volunteers point to a crucial role of the right temporo-parietal junction (rTPJ) - as part of a network commonly disrupted in neglect.

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Background: Apraxia is a motor-cognitive disorder that primary sensorimotor deficits cannot solely explain. Previous research in stroke patients has focused on damage to the fronto-parietal praxis networks in the left hemisphere (LH) as the cause of apraxic deficits. In contrast, the potential role of the (left) primary motor cortex (M1) has largely been neglected.

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Targeting of diseased cells is one of the most urgently needed prerequisites for a next generation of potent pharmaceuticals. Different approaches pursued fail mainly due to a lack of specific surface markers. Developing an RNA-based methodology, we can now ensure precise cell targeting combined with selective expression of effector proteins for therapy, diagnostics or cell steering.

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Gilles de la Tourette Syndrome (GTS) is a chronic tic disorder, characterized by unwanted motor actions and vocalizations. While brain stimulation techniques show promise in reducing tic severity, optimal target networks are not well-defined. Here, we leverage datasets from two independent deep brain stimulation (DBS) cohorts and a cohort of tic-inducing lesions to infer critical networks for treatment and occurrence of tics by mapping stimulation sites and lesions to a functional connectome derived from 1,000 healthy participants.

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Its angular representation on the retina does not solely determine the perceived size of an object. Instead, contextual information is interpreted. We investigated the levels of processing at which this interpretation occurs.

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Introduction: The REM Sleep Behavior Disorder (RBD) Screening Questionnaire (RBDSQ) is a widely established screening tool for detecting isolated RBD (iRBD). However, its accuracy may depend on its application context, e.g.

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Article Synopsis
  • Intragastric botulinum neurotoxin injections (IBNI) are being used as a weight-loss treatment, but an outbreak of severe iatrogenic botulism occurred in early 2023 in Europe after patients received this treatment in Turkey.
  • A retrospective analysis was conducted on ten patients in Austria and Germany who experienced severe symptoms like double vision, swallowing difficulties, and paralysis after IBNI.
  • Despite the severity of their conditions, all patients were hospitalized, many in intensive care, and ultimately recovered without lasting health issues, underscoring the need for awareness and risk mitigation in medical procedures involving botulinum neurotoxins.
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The effect of subthalamic stimulation (STN-DBS) on patients' personal satisfaction with life and their Parkinson's disease (PD) treatment is understudied, as is its correlation with quality of life (QoL). Therefore, we tested the hypothesis that STN-DBS for PD enhances satisfaction with life and treatment. In a prospective, multicenter study with a 6-month follow-up involving 121 patients, we measured the main outcomes using the Satisfaction with Life and Treatment Scale (SLTS-7).

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Background: Misfolding and aggregation of amyloid β (Aβ), along with neurofibrillary tangles consisting of aggregated Tau species, are pathological hallmarks of Alzheimer's disease (AD) onset and progression. In this study, we hypothesized the clearance of Aβ aggregates from the brain and body into the gut.

Methods: To investigate this, we used surface-based fluorescence intensity distribution analysis (sFIDA) to determine the Aβ aggregate concentrations in feces from 26 AD patients and 31 healthy controls (HC).

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Deep brain stimulation (DBS) for Parkinson's disease (PD) often necessitates frequent clinic visits for stimulation program optimization, with limited experience in remote patient management. Due to the resource-intensive nature of these procedures, we investigated a way to simplify stimulation optimization for these patients that allows for the continuous monitoring of symptoms while also reducing patient burden and travel distances. To this end, we prospectively recruited ten patients treated with DBS for PD to evaluate the feasibility of telemedicinal optimization in a home-based setting.

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Background: Stigma is a relevant aspect of Parkinson's disease (PD). Specific stigma tools are needed to address the complex construct of stigma in PD comprehensively.

Objective: To test the dimensionality and psychometric properties of the newly developed Parkinson's Disease Stigma Questionnaire (PDStigmaQuest).

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The flash-lag effect (FLE) occurs when a flash's position seems to be delayed relative to a continuously moving object, even though both are physically aligned. Although several studies have demonstrated that reduced attention increases FLE magnitude, the precise mechanism underlying these attention-dependent effects remains elusive. In this study, we investigated the influence of visual attention on the FLE by manipulating the level of attention allocated to multiple stimuli moving simultaneously in different locations.

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Efficient responses in dynamic environments rely on a combination of readiness and flexibility, regulated by anticipatory and online response control mechanisms. The latter are required when a motor response needs to be reprogrammed or when flanker stimuli induce response conflict and they are crucially modulated by anticipatory signals such as response and conflict expectations. The mutual influence and interplay of these control processes remain to be elucidated.

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The concept of structural reserve in stroke reorganization assumes that the relevance of the contralesional hemisphere strongly depends on the brain tissue spared by the lesion in the affected hemisphere. Recent studies, however, have indicated that the contralesional hemisphere's impact exhibits region-specific variability with concurrently existing maladaptive and supportive influences. This challenges traditional views, necessitating a nuanced investigation of contralesional motor areas and their interaction with ipsilesional networks.

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Importance: B-cell-targeting monoclonal antibodies have demonstrated safety and efficacy in multiple sclerosis or anti-aquaporin-4 IgG positive neuromyelitis optica spectrum disorder. However, these therapies do not facilitate drug-free remission, which may become possible with cell-based therapies, including chimeric antigen receptor (CAR) T cells. CAR T-cell therapy holds promise for addressing other antibody-mediated CNS disorders, e.

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Background/aims: Peripheral neuropathies perturbate the sensorimotor system, causing difficulties in walking-related motor tasks and, eventually, falls. Falls result in functional dependency and reliance on healthcare, especially in older persons. We investigated if peripheral neuropathy is a genuine risk factor for falls in the elderly and if quantification of postural control via posturography is helpful in identifying subjects at risk of falls.

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Background: Stimulation-induced dysarthria (SID) is a troublesome and potentially therapy-limiting side effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson's disease (PD). To date, the origin of SID, and especially whether there is an involvement of cerebellar pathways as well as the pyramidal tract, remains a matter of debate. Therefore, this study aims to shed light on structural networks associated with SID and to derive a data-driven model to predict SID in patients with PD and STN-DBS.

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Objective: The corticospinal tract (CST) is considered the most important motor output pathway comprising fibers from the primary motor cortex (M1) and various premotor areas. Damage to its descending fibers after stroke commonly leads to motor impairment. While premotor areas are thought to critically support motor recovery after stroke, the functional role of their corticospinal output for different aspects of post-stroke motor control remains poorly understood.

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Some people infected with SARS-CoV-2 report persisting symptoms following acute infection. If these persist for over three months, they are classified as post-COVID-19 syndrome (PCS). Although PCS is frequently reported, detailed longitudinal neuropsychological characterization remains scarce.

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Article Synopsis
  • After a stroke, the brain can start to heal and reorganize itself, but sometimes it doesn't work well, leading to problems with movement.
  • Researchers used special tests called TMS and EEG to study how the brains of 40 stroke patients changed over time and how it affected their movement.
  • They found that certain brainwave patterns early after a stroke could predict whether patients would have a good recovery or not, suggesting that treatments could help improve brain healing.
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In progressive supranuclear palsy (PSP), subcortical tau and cortical perfusion can be assessed using the tracer [18F]PI-2620. We investigated if subcortical tau (globus pallidus internus, dentate nucleus) and frontal/limbic perfusion correlate in a cohort of 32 PSP patients. Tau in subcortical regions showed significant negative correlation with perfusion in limbic cortex.

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Article Synopsis
  • PET imaging using amino acid tracers is increasingly utilized alongside MRI in managing glioma patients, with international guidelines being developed to standardize its use.
  • Health insurance agencies in Europe are starting to reimburse amino acid PET, indicating its growing relevance in clinical settings, while advancements in AI and radiomics may enhance tumor detection and treatment evaluation.
  • New technologies, including next-generation PET scanners and innovative PET tracers for targeted therapies, are expanding the applications of PET imaging in Neuro-Oncology, although further validation of these innovations is needed.
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Recent studies in Parkinson's disease (PD) patients reported disruptions in dynamic functional connectivity (dFC, i.e., a characterization of spontaneous fluctuations in functional connectivity over time).

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