Neurocognitive functioning and health-related quality of life in adult medulloblastoma patients: long-term outcomes of the NOA-07 study.

Background: Combined radiochemotherapy followed by maintenance chemotherapy with cisplatin, lomustine and vincristine within the NOA-07 study resulted in considerable short-term toxicity in adult medulloblastoma patients. Here we investigated the long-term impact of this treatment, focusing on neurocognitive functioning and health-related quality of life (HRQoL).

Methods: Neurocognitive functioning and HRQoL scores over time were determined, and differences between the post-treatment and follow-up assessments were calculated up to 18 months for neurocognition and 60 months for HRQoL.

Multicenter pilot study of radiochemotherapy as first-line treatment for adults with medulloblastoma (NOA-07).

Background: Medulloblastoma in adult patients is rare, with 0.6 cases per million. Prognosis depends on clinical factors and medulloblastoma entity.

Dynamic changes of resting state connectivity related to the acquisition of a lexico-semantic skill.

The brain undergoes adaptive changes during learning. Spontaneous neural activity has been proposed to play an important role in acquiring new information and/or improve the interaction of task related brain regions. A promising approach is the investigation of resting state functional connectivity (rs-fc) and resting state networks, which rely on the detection of interregional correlations of spontaneous BOLD fluctuations.

Influence of Formal Education on Cognitive Reserve in Patients with Multiple Sclerosis.

The concept of cognitive reserve (CR) and its influence on cognitive impairment has attracted increasing interest. One hundred twenty-eight patients with multiple sclerosis (MS) from Southern Germany were evaluated during the years 2000 to 2012. Twenty-seven neuropsychological (NP) tests were applied regarding basic cognitive functions, attention, executive functions, visual perception and construction, memory and learning, problem solving, and language.

The impact of sedation on brain mapping: a prospective, interdisciplinary, clinical trial.

Background: During awake craniotomies, patients may either be awake for the entire duration of the surgical intervention (awake-awake-awake craniotomy, AAA) or initially sedated (asleep-awake-asleep craniotomy, SAS).

Objective: To examine whether prior sedation in SAS may restrict brain mapping, we conducted neuropsychological tests in patients by means of a standardized anesthetic regimen comparable to an SAS.

Methods: We prospectively examined patients undergoing surgery either under total intravenous anesthesia (TIVA) or under regional anesthesia with slight sedation (RAS).

Awake craniotomies without any sedation: the awake-awake-awake technique.

Background: Temporary anaesthesia or analgosedation used for awake craniotomies carry substantial risks like hemodynamic instabilities, airway obstruction, hypoventilation, nausea and vomiting, agitation, and interference with test performances. We tested the actual need for sedatives and opioids in 50 patients undergoing awake craniotomy for brain tumour resection in eloquent or motoric brain areas when cranial nerve blocks, permanent presence of a contact person, and therapeutic communication are provided.

Methods: Therapeutic communication was based on the assumption that patients in such an extreme medical situation enter a natural trance-like state with elevated suggestibility.

Aggressiveness in different presentations of cluster headache: results from a controlled multicentric study.

Background: The hypothalamus has been discussed as a pivotal structure for both cluster headache (CH) and aggressiveness, but little is known about the extent of self-reported aggressiveness in patients with CH.

Patients And Methods: Twenty-six patients with chronic, 25 with active episodic and 22 with episodic CH outside the active period were examined interictally with a validated questionnaire quantifying factors of aggression and compared with 24 migraine patients and 31 headache-free volunteers.

Results: The ANOVA was significant for the subscale 'self-aggression/depression' (F(4, 123) = 5.

Mobilisation of hematopoietic CD34+ precursor cells in patients with acute stroke is safe--results of an open-labeled non randomized phase I/II trial.

Background: Regenerative strategies in the treatment of acute stroke may have great potential. Hematopoietic growth factors mobilize hematopoietic stem cells and may convey neuroprotective effects. We examined the safety, potential functional and structural changes, and CD34(+) cell-mobilization characteristics of G-CSF treatment in patients with acute ischemic stroke.

Distinct patterns of functional and structural neuroplasticity associated with learning Morse code.

Learning is based on neuroplasticity, i.e. on the capability of the brain to adapt to new experiences.

A lightning strike to the head causing a visual cortex defect with simple and complex visual hallucinations.

The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was sent into a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise largely recovered.

Working memory performance is correlated with local brain morphology in the medial frontal and anterior cingulate cortex in fibromyalgia patients: structural correlates of pain-cognition interaction.

Fibromyalgia (FM) is a disorder of unknown aetiology, characterized by chronic widespread pain, stiffness and sleep disturbances. In addition, patients frequently complain of memory and attention deficits. Accumulating evidence suggests that FM is associated with CNS dysfunction and with an altered brain morphology.

Striatal grey matter increase in patients suffering from fibromyalgia--a voxel-based morphometry study.

Fibromyalgia (FM), among other chronic pain syndromes, such as chronic tension type headache and atypical face pain, is classified as a so-called dysfunctional pain syndrome. Patients with fibromyalgia suffer from widespread, "deep" muscle pain and often report concomitant depressive episodes, fatigue and cognitive deficits. Clear evidence for structural abnormalities within the muscles or soft tissue of fibromyalgia patients is lacking.

Impaired working-memory after cerebellar infarcts paralleled by changes in BOLD signal of a cortico-cerebellar circuit.

A considerable body of evidence supports the notion that cerebellar lesions lead to neuropsychological deficits, including impairments in working-memory, executive tasks and verbal fluency. Studies employing functional magnetic resonance imaging (fMRI) and anatomical tracing in primates provide evidence for a cortico-cerebellar circuitry as the functional substrate of working-memory. The present fMRI study explores the activation pattern during an n-back working-memory task in patients with an isolated cerebellar infarct.

Differences in cortical activation during smooth pursuit and saccadic eye movements following cerebellar lesions.

Current evidence supports the proposal that the cerebellum mediates the activity of other brain areas involved in the control of eye movements. Most of the evidence so far has concentrated on the vermis and flocculi as the cerebellar agents of oculomotor control. But there is also evidence for an involvement of the cerebellar hemispheres in eye movement control.

A lightning strike to the head causing a visual cortex defect with simple and complex visual hallucinations.

The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was set to a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise recovered largely.

Long-term outcome after hemicraniectomy for space occupying right hemispheric MCA infarction.

Objective: To examine the long-term prognosis in patients with 'malignant' supratentorial ischemia of the right hemisphere treated with hemicraniectomy, especially in respect to depression, with a focus on age as a possible predictor of outcome.

Methods: We performed a prospective, long-term, follow-up examination in 23 survivors of 32 patients (mortality 28.1%) treated with hemicraniectomy for malignant middle cerebral artery (MCA) infarction of the right hemisphere, who were identified in our data bank since 1993.

Cognitive changes after epilepsy surgery in the posterior cortex.

Objective: The relationship between the posterior cortex and cognitive functions is still a relatively open field. There are no studies on populations in which functions of posterior structures were examined by a standardised neuropsychological examination before and after posterior resections. Changes in cognitive performance are regularly observed after epilepsy surgery in the temporal lobe.

Language lateralization by Wada test and fMRI in 100 patients with epilepsy.

Comparing the determination of language dominance using fMRI with results of the Wada test in 100 patients with different localization-related epilepsies, the authors found 91% concordance between both tests. The overall rate of false categorization by fMRI was 9%, ranging from 3% in left-sided temporal lobe epilepsy (TLE) to 25% in left-sided extratemporal epilepsy. Language fMRI might reduce the necessity of the Wada test for language lateralization, especially in TLE.