Publications by authors named "Julian GroSSkreutz"

Amyotrophic lateral sclerosis, a progressive neurodegenerative disease, presents challenges in predicting individual disease trajectories due to its heterogeneous nature. This study explores the application of texture analysis on T1-weighted MRI in patients with amyotrophic lateral sclerosis, stratified by the D50 disease progression model. The D50 model, which offers a more nuanced representation of disease progression than traditional linear metrics, calculates the sigmoidal curve of functional decline and provides independent quantifications of disease aggressiveness and accumulation.

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Background: Fasudil is a small molecule inhibitor of Rho-associated kinase (ROCK) and is approved for the treatment of subarachnoid haemorrhage. In preclinical studies, fasudil has been shown to attenuate neurodegeneration, modulate neuroinflammation, and foster axonal regeneration. We aimed to investigate the safety, tolerability, and efficacy of fasudil in patients with amyotrophic lateral sclerosis.

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  • The study investigates the effectiveness and safety of rozanolixizumab in treating patients with muscle-specific tyrosine kinase (MuSK) autoantibody-positive generalized myasthenia gravis (gMG), which is a severe form of the condition.
  • Conducted as a randomized, double-blind, placebo-controlled phase III trial, it involved participants aged 18 and older who were randomly assigned to receive either rozanolixizumab (at two different dosages) or a placebo over 6 weeks.
  • Results showed significant improvements in the Myasthenia Gravis Activities of Daily Living (MG-ADL) scores for both doses of rozanolixizumab compared to placebo, with manageable side effects reported;
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  • A study was conducted at 11 ALS centers in Germany from October 2021 to February 2024 to evaluate the frequency of pathogenic gene variants in ALS patients and their transition to an expanded access program for tofersen treatment.
  • Out of 1935 patients screened, 48.8% chose to be informed about genetic variants related to tofersen, revealing that 1.8% had (likely) pathogenic variants, 0.9% had other pathogenic variants, and 7.0% showed hexanucleotide repeat expansion.
  • The transition to tofersen treatment from genetic testing averaged 94 days, with a notable 74.0% of patients with certain variants opting for the therapy, highlighting the importance of comprehensive
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Objective: Robotic arms are innovative assistive devices for ALS patients with progressive motor deficits of arms and hands. The objective was to explore the patients´ expectations towards a robotic arm system and to assess the actual experiences after the provision of the device.

Methods: A prospective observational study was conducted at 9 ALS centers in Germany.

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Introduction: Amyotrophic lateral sclerosis (ALS) is an inevitably fatal condition that leads to a progressive loss of physical functioning, which results in a high psychosocial burden and organizational challenges related to medical care. Multidimensional and multiprofessional care is advised to meet the complex needs of patients and their families. Many healthcare systems, including Germany, may not be able to meet these needs because non-medical services such as psychological support or social counselling are not regularly included in the care of patients with ALS (pwALS).

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  • The study aimed to evaluate the relationship between serum neurofilament light chain (sNfL) levels and different clinical forms of amyotrophic lateral sclerosis (ALS) in nearly 3000 patients across Germany and Austria.
  • Results indicated that sNfL levels varied significantly across ALS phenotypes, with higher levels associated with faster disease progression and bulbar onset, while primary lateral sclerosis (PLS) and some other phenotypes showed lower levels.
  • The findings suggest that understanding these phenotypes is crucial for interpreting sNfL results and could influence clinical trials and practice in ALS management.
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Identifying upper motor neuron (UMN) dysfunction is fundamental to the diagnosis and understanding of disease pathogenesis in motor neuron disease (MND). The clinical assessment of UMN dysfunction may be difficult, particularly in the setting of severe muscle weakness. From a physiological perspective, transcranial magnetic stimulation (TMS) techniques provide objective biomarkers of UMN dysfunction in MND and may also be useful to interrogate cortical and network function.

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  • The ALSFRS, originally developed over 25 years ago, is used to track functional changes in ALS patients and has been adapted to create the ALSFRS-R for clinical trials, though it hasn't been fully re-validated.
  • A group of clinical trialists met to discuss ways to enhance the ALSFRS-R and consider alternative measures for clinical research.
  • The report emphasizes three key actions: standardizing ALSFRS-R usage worldwide, agreeing on clinical trial design and statistical analysis recommendations, and incorporating additional outcome measures.
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  • - In April 2023, tofersen, an antisense oligonucleotide, was FDA-approved for treating ALS after it significantly reduced levels of neurofilament light chain (NfL), a marker of neurodegeneration.
  • - A follow-up study involving 24 ALS patients in Germany showed that while ALS functional scores declined, there was a notable reduction in both serum NfL and phosphorylated neurofilament heavy chain (pNfH) levels in the cerebrospinal fluid (CSF).
  • - The therapy was considered safe, with no ongoing symptoms, despite some patients showing signs of immune response in the CSF, pointing to potential autoimmune reactions.
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  • A 2016 study tested the effectiveness of 1 mg rasagiline per day as an additional treatment for 252 ALS patients, aiming to identify which subgroups may benefit most from the drug.
  • New analyses revealed that ALS patients with very slow disease progression showed better survival rates without treatment, while those with intermediate to fast progression benefited from rasagiline, showing increased survival at 6 and 12 months.
  • The study found no clear link between genetic variations in the MAOB and DRD2 genes and rasagiline's treatment effects, emphasizing the importance of factoring in individual disease progression in future ALS research.
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Objective: Previous studies suggested that distinct phenotypes of eosinophilic granulomatosis with polyangiitis (EGPA; formerly known as Churg-Strauss syndrome) could be determined by the presence or absence of antineutrophil cytoplasmic antibodies (ANCA), reflecting predominant vasculitic or eosinophilic processes, respectively. This study explored whether ANCA-based clusters or other clusters can be identified in EGPA.

Methods: This study used standardized data of 15 European centers for patients with EGPA fulfilling widely accepted classification criteria.

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Amyotrophic lateral sclerosis (ALS) can result into an incomplete locked in state (iLIS), in which communication depends on eye tracking computer devices. Oculomotor function impairments in ALS have been reported, but there is little research, particularly with respect to patients in iLIS. In the present study, we compared reflexive and executive oculomotor function by means of an eye tracking test battery between three groups: advanced ALS patients in iLIS (n = 22), patients in early to middle ALS stages (n = 44) and healthy subjects (n = 32).

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The Topical Collection "Amyotrophic Lateral Sclerosis: Latest Advances and Prospects" started in 2020 and currently includes 11 publications reflecting a broad range of clinical research areas in the ALS field [...

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Introduction: In 2021, the Deutsche Gesellschaft für Neurology published a new guideline on diagnosis and therapy of motor neuron disorders. Motor neuron disorders affect upper motor neurons in the primary motor cortex and/or lower motor neurons in the brain stem and spinal cord. The most frequent motor neuron disease amyotrophic lateral sclerosis (ALS) is a rapidly progressive disease with an average life expectancy of 2-4 years with a yearly incidence of 3.

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  • New intrathecal antisense oligonucleotide therapies are being developed for motoneuron diseases like familial amyotrophic lateral sclerosis, prompting a study of sporadic cases to identify genetic mutations.
  • Researchers screened 2,340 patients for variants in 36 ALS-associated genes, completing genetic analysis on 2,267 patients and identifying 79 likely pathogenic and 10 pathogenic variants.
  • The study found that around 13% of the cohort could be genetically resolved, suggesting the presence of both known and novel variants and shedding light on the complexities of genetic factors contributing to ALS outcomes.
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  • Generalised myasthenia gravis is a serious autoimmune disease that currently lacks effective treatment options, leading researchers to explore rozanolixizumab as a new therapy.
  • The MycarinG study was a rigorous, randomized, double-blind trial involving 300 patients across multiple continents, assessing the safety and effectiveness of different doses of rozanolixizumab compared to a placebo.
  • The primary goal of the trial was to evaluate improvements in daily living activities, while also monitoring any adverse effects from the treatment over a 6-week period.
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  • The GGGGCC hexanucleotide expansion in a non-coding region is the leading genetic cause of familial amyotrophic lateral sclerosis (ALS), based on a study involving 248 patients over nearly a decade.
  • Clinical features analyzed included age of onset, family history, and progression rates, revealing that bulbar onset was more common in patients with this genetic mutation compared to sporadic cases.
  • Patients with the GGGGCC expansion had a later age of onset and shorter median survival compared to those with other mutations and sporadic ALS, with elevated levels of phosphorylated neurofilament heavy chains in their cerebrospinal fluid (CSF).
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: High-intensity physical activity and sports prone to repetitive injuries of the cervical spine and head (when associated with vigorous practice) have been suggested as possible risk factors for amyotrophic lateral sclerosis (ALS). Our objective was to evaluate the relationship between the practice of contact sports (boxing, hockey, football, rugby) and ALS. : The study included 2247 individuals, 1326 patients and 921 controls from several European countries.

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Background And Purpose: The objective was to assess the performance of serum neurofilament light chain (sNfL) in amyotrophic lateral sclerosis (ALS) in a wide range of disease courses, in terms of progression, duration and tracheostomy invasive ventilation (TIV).

Methods: A prospective cross-sectional study at 12 ALS centers in Germany was performed. sNfL concentrations were age adjusted using sNfL Z scores expressing the number of standard deviations from the mean of a control reference database and correlated to ALS duration and ALS progression rate (ALS-PR), defined by the decline of the ALS Functional Rating Scale.

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Capturing disease progression in amyotrophic lateral sclerosis (ALS) is challenging and refinement of progression markers is urgently needed. This study introduces new motor unit number index (MUNIX), motor unit size index (MUSIX) and compound muscle action potential (CMAP) parameters called M50, MUSIX200 and CMAP50. M50 and CMAP50 indicate the time in months from symptom onset an ALS patient needs to lose 50% of MUNIX or CMAP in relation to the mean values of controls.

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Background: Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease with a median survival of 2-5 years. An early diagnosis is essential for providing ALS patients the finest management possible. Studies from different countries report a similar median diagnostic delay of around 12 months, which is still far from desirable.

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Background: The ALS Functional Rating Scale in its revised version (ALSFRS-R) is a disease-specific severity score that reflects motor impairment and functional deterioration in people with amyotrophic lateral sclerosis (ALS). It has been widely applied in both clinical practice and ALS research. However, in Germany, several variants of the scale, each differing slightly from the others, have developed over time and are currently in circulation.

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Nonadherence to medication is a common issue that goes along with increased morbidity and mortality and immense health care costs. To improve medication adherence and outcome in ill people, their reasons of not taking their prescribed medication must be known. Here a dataset is presented based on the longitudinal observational NeuroGerAd study in adults with neurological disorders (N = 910).

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