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Article ; Online: Central Bradypnea and Ataxic Breathing in Myotonic Dystrophy Type 1 - A Clinical Case Report.

Summ, Oliver / Mathys, Christian / Grimm, Teresa / Groß, Martin

Journal of neuromuscular diseases

2023 Volume 10, Issue 3, Page(s) 465–471

Abstract: Background: The occurrence of obstructive and central sleep apnea syndromes, ventilator pump failure and reduced hypercapnic ventilatory drive in myotonic dystrophy type 1 (DM1) is well established, and there are indications for an impairment of the ... ...

Abstract	Background: The occurrence of obstructive and central sleep apnea syndromes, ventilator pump failure and reduced hypercapnic ventilatory drive in myotonic dystrophy type 1 (DM1) is well established, and there are indications for an impairment of the hypoxic ventilator drive, too. Yet, it is still unknown, to which extent the respiratory rhythm is affected by DM1, thus if a central bradypnea, cluster breathing or ataxic ("Biot's") breathing can occur. Additionally, the causes of the impairment of the central respiratory drive in DM1 are not known. Case presentation: We present the case of a tracheotomized female patient with DM1 with central bradypnea and ataxic breathing. A 57-year-old woman with DM1 was admitted to our Neurointensive Care Unit (NICU) due to refractory tracheobronchial retention of secretions resulting from aspiration of saliva. Due to a combination of chronic hypercapnic respiratory failure, severe central bradypnea with a minimal breathing frequency of 3 per minute and ataxic breathing a pressure-controlled home ventilation was initiated. Conclusions: In our patient central bradypnea and ataxic breathing possibly were respiratory sequale of DM1, that may have been caused by pontine white matter lesions affecting the pontine respiratory nuclei. From a clinical viewpoint, polygraphy is a suitable tool to objectify disorders of the respiratory rhythm in DM1 even in tracheotomized patients. Clinical studies combining respiratory diagnostics as polygraphy, transcutaneous capnometry and blood gas analysis with brain magnetic resonance imaging (MRI) are required to better understand disorders of respiratory regulation in DM1, and to identify their anatomical correlates.
MeSH term(s)	Humans ; Female ; Middle Aged ; Myotonic Dystrophy/complications ; Myotonic Dystrophy/diagnosis ; Myotonic Dystrophy/epidemiology ; Respiration ; Respiration Disorders ; Hypercapnia/etiology ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy
Language	English
Publishing date	2023-03-11
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ISSN	2214-3602
ISSN (online)	2214-3602
DOI	10.3233/JND-221652
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Neurostimulation Treatment in Chronic Cluster Headache-a Narrative Review.

Evers, Stefan / Summ, Oliver

Current pain and headache reports

2021 Volume 25, Issue 12, Page(s) 81

Abstract: Purpose of review: In this narrative review, the current literature on neurostimulation methods in the treatment of chronic cluster headache is evaluated. These neurostimulation methods include deep brain stimulation, vagus nerve stimulation, greater ... ...

Abstract	Purpose of review: In this narrative review, the current literature on neurostimulation methods in the treatment of chronic cluster headache is evaluated. These neurostimulation methods include deep brain stimulation, vagus nerve stimulation, greater occipital nerve stimulation, sphenopalatine ganglion stimulation, transcranial magnetic stimulation, transcranial direct current stimulation, supraorbital nerve stimulation, and cervical spinal cord stimulation. Recent findings: Altogether, only nVNS and SPG stimulation are supported by at least one positive sham-controlled clinical trial for preventive and acute attack (only SPG stimulation) treatment. Other clinical trials either did not control at all or controlled by differences in the stimulation technique itself but not by a sham-control. Case series report higher responder rates. The evidence for these neurostimulation methods in the treatment of chronic cluster headache is poor and in part contradictive. However, except deep brain stimulation, tolerability and safety of these methods are good so that in refractory situations application might be justified in individual cases.
MeSH term(s)	Cluster Headache/therapy ; Ganglia, Parasympathetic ; Humans ; Transcranial Direct Current Stimulation ; Transcranial Magnetic Stimulation ; Vagus Nerve Stimulation
Language	English
Publishing date	2021-12-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2055062-5
ISSN	1534-3081 ; 1531-3433
ISSN (online)	1534-3081
ISSN	1531-3433
DOI	10.1007/s11916-021-00989-6
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Zs.A 5477: Show issues

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Article ; Online: Disordered breathing in severe cerebral illness - Towards a conceptual framework.

Summ, Oliver / Hassanpour, Nahid / Mathys, Christian / Groß, Martin

Respiratory physiology & neurobiology

2022 Volume 300, Page(s) 103869

Abstract: Despite potentially life-threatening symptoms of disordered breathing in severe cerebral illness, there are no clear recommendations on diagnostic and therapeutic strategies for these patients. To identify types of breathing disorders observed in ... ...

Abstract	Despite potentially life-threatening symptoms of disordered breathing in severe cerebral illness, there are no clear recommendations on diagnostic and therapeutic strategies for these patients. To identify types of breathing disorders observed in severely neurological comprised patients, to direct further research on classification, pathophysiology, diagnosis and treatment for disordered breathing in cerebral disease. Data including polygraphy, transcutaneous capnometry, blood gas analysis and radiological examinations of patients with severe cerebral illness and disordered breathing admitted to the neurological intensive care were analyzed. Patients (15) presented with acquired central hypoventilation syndrome (ACHS), central bradypnea, central tachypnea, obstructive, mixed and central apneas and hypopneas, Cheyne Stokes respiration, ataxic (Biot's) breathing, cluster breathing and respiration alternans. Severe cerebral illness may result in an ACHS and in a variety of disorders of the respiratory rhythm. Two of these, abrupt switches between breathing patterns and respiration alternans, suggest the existence of a rhythmogenic respiratory network. Polygraphy, transcutaneous capnometry, blood gas analysis and MRI are promising tools for diagnosis and research alike.
MeSH term(s)	Blood Gas Monitoring, Transcutaneous ; Cheyne-Stokes Respiration/therapy ; Humans ; Respiration ; Sleep Apnea, Central/therapy
Language	English
Publishing date	2022-02-15
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2077867-3
ISSN	1878-1519 ; 1569-9048
ISSN (online)	1878-1519
ISSN	1569-9048
DOI	10.1016/j.resp.2022.103869
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Article ; Online: CGRP release in an experimental human trigeminal pain model.

Frese, Achim / Summ, Oliver / Evers, Stefan

Cephalalgia : an international journal of headache

2021 Volume 41, Issue 11-12, Page(s) 1268–1271

Abstract: Background: Migraine and trigemino-autonomic cephalalgia attacks are associated with an increase of α-calcitonin-gene related peptide levels in the ipsilateral jugular vein. It is however unknown whether trigeminal pain stimulation in healthy subjects ... ...

Abstract	Background: Migraine and trigemino-autonomic cephalalgia attacks are associated with an increase of α-calcitonin-gene related peptide levels in the ipsilateral jugular vein. It is however unknown whether trigeminal pain stimulation in healthy subjects without headache disorders also induces increase of calcitonin-gene related peptide levels. Findings: We measured α-calcitonin-gene related peptide levels in eight healthy subjects after subcutaneous injection of capsaicin in the forehead and in the mandibular region and after injection of sodium chloride in the forehead. We observed a significant increase of α-calcitonin-gene related peptide level only after injection of capsaicin in the forehead (i.e. first trigeminal branch). We also observed trigemino-autonomic activation (lacrimation, rhinorrhea etc.) only after injection of capsaicin in the forehead. Conclusion: Increase of α-calcitonin-gene related peptide levels do not only occur in primary headache attacks but also after experimental trigeminal pain of the first branch. This finding suggests that α-calcitonin-gene related peptide elevation is, at least an additional, unspecific effect of first trigeminal branch stimulation following pain activation and not a specific mechanism of idiopathic headache disorders.
MeSH term(s)	Calcitonin Gene-Related Peptide ; Capsaicin/toxicity ; Headache Disorders ; Humans ; Migraine Disorders ; Pain ; Trigeminal Ganglion
Chemical Substances	Calcitonin Gene-Related Peptide (JHB2QIZ69Z) ; Capsaicin (S07O44R1ZM)
Language	English
Publishing date	2021-06-20
Publishing country	England
Document type	Journal Article
ZDB-ID	604567-4
ISSN	1468-2982 ; 0333-1024
ISSN (online)	1468-2982
ISSN	0333-1024
DOI	10.1177/03331024211017250
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Zs.A 1645: Show issues

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Article ; Online: Very young age of onset in trigemino-autonomic cephalalgias - case report and review of the literature.

Evers, Stefan / Summ, Oliver / Frese, Achim

Cephalalgia : an international journal of headache

2020 Volume 40, Issue 12, Page(s) 1385–1388

Abstract: Background: Trigemino-autonomic cephalalgias are very rare disorders and even rarer in children and adolescents. We report the onset of paroxysmal hemicrania in a very young girl and reviewed the scientific literature for similar cases.: Findings: We ...

Abstract	Background: Trigemino-autonomic cephalalgias are very rare disorders and even rarer in children and adolescents. We report the onset of paroxysmal hemicrania in a very young girl and reviewed the scientific literature for similar cases. Findings: We describe the case of a 1.6-year-old girl with left-sided headache attacks fulfilling the criteria of paroxysmal hemicrania including prompt responsiveness to indomethacin. In addition, we detected at least two children for every trigemino-autonomic cephalalgias subtype with an age of under 7 years at the onset of the trigemino-autonomic cephalalgias. Remarkable features were a vast majority of chronic course from onset on and left-sided attacks. Conclusion: Although very rare, trigemino-autonomic cephalalgias can occur even in very young children under the age of 6 years. This should be known in neuropaediatrics.
MeSH term(s)	Age of Onset ; Female ; Humans ; Infant ; Trigeminal Autonomic Cephalalgias
Language	English
Publishing date	2020-07-14
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	604567-4
ISSN	1468-2982 ; 0333-1024
ISSN (online)	1468-2982
ISSN	0333-1024
DOI	10.1177/0333102420942220
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Article: Psychophysiological Effects of Biographical Interventions in People With Unresponsive Wakefulness Syndrome and Minimally Conscious State.

Grimm, Teresa / Groß, Martin / Nater, Urs M / Summ, Oliver / Kreutz, Gunter

Frontiers in neurology

2022 Volume 13, Page(s) 788588

Abstract: Background: Various music interventions can evoke favorable behavioral responses or physiological reactions in people with disorders of consciousness (DOC), such as coma, unresponsive wakefulness syndrome (UWS), and minimally conscious state (MCS). ... ...

Abstract	Background: Various music interventions can evoke favorable behavioral responses or physiological reactions in people with disorders of consciousness (DOC), such as coma, unresponsive wakefulness syndrome (UWS), and minimally conscious state (MCS). However, it appears that no study thus far has investigated the effects of music on the endocrine system of people with DOC. Objective: This explorative study aimed to investigate the effects of biographical music and biographical language on the physiological and endocrine systems of people with UWS and MCS. Method: A cohort of 20 people with DOC (10 women, 10 men; age range 19-77) received 20 min of biographical music and biographical language. Before and afterward, they were exposed to silence. Physiological and hormonal measurements were conducted before, during, and after the interventions. Results: Paired Conclusion: Biographical interventions can modulate reactions in the endocrine system in people with DOC. Further studies are needed to establish whether and how individuals living with DOC show psychoneuroendocrine responses to music and other arts-based interventions.
Language	English
Publishing date	2022-05-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2022.788588
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Article ; Online: Levetiracetam in the prophylactic treatment of episodic migraine: A prospective open label study.

Evers, Stefan / Frese, Achim / Summ, Oliver / Husstedt, Ingo W / Marziniak, Martin

Cephalalgia : an international journal of headache

2022 Volume 42, Issue 11-12, Page(s) 1218–1224

Abstract: Background: The prophylactic treatment of migraine includes anticonvulsant drugs such as valproic acid and topiramate. However, these substances are often poorly tolerated by migraine patients. So far levetiracetam has hardly been studied as an episodic ...

Abstract	Background: The prophylactic treatment of migraine includes anticonvulsant drugs such as valproic acid and topiramate. However, these substances are often poorly tolerated by migraine patients. So far levetiracetam has hardly been studied as an episodic migraine prophylactic agent in adults. Objective: To perform a prospective pilot study for the evaluation of the efficacy and tolerability of levetiracetam in the prophylactic treatment of episodic migraine. Methods: Fifty patients with episodic migraine were enrolled in this prospective, open label study. After a baseline period of four weeks, patients received 1,000 mg (starting dose 500 mg) bid levetiracetam for 12 weeks. Migraine frequency and accompanying symptoms were recorded in a headache diary. The primary endpoint was the comparison of attack frequency during the baseline with attack frequency during the last four weeks of treatment (treatment period 3). Results: In the Intent-To-Treat analysis, 46% of the patients had a migraine reduction of more than 50% in the third period as compared to the baseline period. The mean number of migraine attacks decreased from 5.2 +/- 2.1 (baseline) to 3.4 +/- 2.7 (period 3). The most frequently reported side effects were somnolence, nausea, and weight gain; all were mild and transient. In a post-hoc comparison, responders to levetiracetam had significantly less migraine attacks at baseline and had significantly more often migraine with aura. Conclusion: The data suggest that levetiracetam has some potential in the prophylactic treatment of episodic migraine which seems, however, to be not superior to that of other anticonvulsant drugs. Levetiracetam was well tolerated and showed better efficacy in patients with migraine with aura and in less affected migraine patients. A larger placebo-controlled, double-blind study in adults seems justified on the basis of these data.
MeSH term(s)	Adult ; Anticonvulsants/therapeutic use ; Double-Blind Method ; Humans ; Levetiracetam/therapeutic use ; Migraine Disorders/drug therapy ; Migraine Disorders/prevention & control ; Migraine with Aura/drug therapy ; Pilot Projects ; Prospective Studies ; Topiramate/therapeutic use ; Treatment Outcome ; Valproic Acid/therapeutic use
Chemical Substances	Anticonvulsants ; Topiramate (0H73WJJ391) ; Levetiracetam (44YRR34555) ; Valproic Acid (614OI1Z5WI)
Language	English
Publishing date	2022-05-27
Publishing country	England
Document type	Journal Article
ZDB-ID	604567-4
ISSN	1468-2982 ; 0333-1024
ISSN (online)	1468-2982
ISSN	0333-1024
DOI	10.1177/03331024221103815
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Article ; Online: Effect of mechanical insufflation-exsufflation for ineffective cough on weaning duration in diseases of the peripheral or central nervous system (MEDINE): study protocol for a randomised controlled trial in a neurological weaning centre.

Seipp, Alexander / Klausen, Andreas / Timmer, Antje / Grimm, Teresa / Groß, Martin / Summ, Oliver / Otto-Sobotka, Fabian

BMJ open

2023 Volume 13, Issue 7, Page(s) e071273

Abstract: Introduction: Patients with neurological or neurosurgical disease can suffer from impaired cough, which may result in life-threatening retention of tracheobronchial secretions, atelectasis, pneumonia and finally death. Due to a lack of alternatives and ... ...

Abstract	Introduction: Patients with neurological or neurosurgical disease can suffer from impaired cough, which may result in life-threatening retention of tracheobronchial secretions, atelectasis, pneumonia and finally death. Due to a lack of alternatives and pathophysiological plausibility, the application of mechanical insufflation-exsufflation (MI-E) has already become international standard care in neuromuscular disease and spinal cord injury although a lack of evidence for efficacy. High-quality studies to support the use of MI-E in neurological and neurosurgical patients during weaning from mechanical ventilation are missing. The goal of this exploratory study is to display the effect size of MI-E intervention on the duration of mechanical ventilation and additional outcomes. Methods and analysis: One hundred adult patients with a cough deficiency or retention of secretion admitted to a neurological intensive care unit (ICU) are planned to be recruited for this randomised controlled trial. Patients are randomised 1:1 to receive either MI-E or best standard care. Observation will take place until discharge from the hospital, death or end of the study period. The primary endpoint of this trial is the duration of mechanical ventilation from randomisation until successful weaning. The outcome will be analysed with Kaplan-Meier estimation and competing risks analyses. Secondary endpoint is the proportion of patients with successful weaning. Further outcomes will include the incidence of hospital-acquired pneumonia, mortality, decannulation rate, length of stay on the ICU and the total score of the Glasgow Coma Scale. Ethics and dissemination: The study was approved by the Medical Ethics Committee of the University of Oldenburg. The findings of this study will be submitted for publication in a peer-reviewed journal. Trial registration number: DRKS00020981.
MeSH term(s)	Adult ; Humans ; Respiration, Artificial ; COVID-19 ; SARS-CoV-2 ; Cough/therapy ; Insufflation/methods ; Ventilator Weaning/methods ; Central Nervous System ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-07-17
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-071273
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Rehabilitation bei Amyotropher Lateralsklerose

Groß, Martin / Summ, Oliver

Nervenheilkunde

2019 Volume 38, Issue 05, Page(s) 249–256

Abstract: In der stationären neurologischen Rehabilitation in Deutschland werden vorwiegend akute neurologische Erkrankungen, aber nur selten schwere, fortschreitende neuromuskuläre Erkrankungen wie die Amyotrophe Lateralsklerose behandelt. Mittlerweile liegt ... ...

Abstract	In der stationären neurologischen Rehabilitation in Deutschland werden vorwiegend akute neurologische Erkrankungen, aber nur selten schwere, fortschreitende neuromuskuläre Erkrankungen wie die Amyotrophe Lateralsklerose behandelt. Mittlerweile liegt jedoch in Bezug auf die Amyotrophe Lateralsklerose eine umfangreiche Evidenz für den positiven Nutzen in der Rehabilitation angewandter Methoden und den Einsatz von in der Rehabilitation tätigen Fachbereichen vor: Physiotherapie, Übungsbehandlung, Atmungstherapie, Logopädie, Ernährungstherapie, Ergotherapie, der Einsatz von Hilfsmitteln, assistive Technologien, Elektrorollstühlen und Unterstützter Kommunikation sowie multidisziplinäre Zusammenarbeit und Palliative Care können das Leben der Patienten verlängern, Teilhabe und Lebensqualität verbessern und ein würdevolles Sterben ermöglichen. Essenziell sind die Integration der Angehörigen und beatmungsmedizinischer Expertise in die Behandlung. Ambulante und stationäre neurologische sollten daher fester Bestandteil der Behandlung der Amyotrophen Lateralsklerose sein.
Keywords	Amyotrophe Lateralsklerose ; außerklinische Beatmung ; Rehabilitation ; Unterstützte Kommunikation ; Elektromobilität ; Amyotrophic lateral sclerosis ; motoneuron disease ; rehabilitation ; palliative care ; assistive technologies ; assistive and augmentative communication ; multidisciplinary
Language	German
Publishing date	2019-05-01
Publisher	© Georg Thieme Verlag KG Stuttgart · New York
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2223503-6
ISSN	2567-5788 ; 0722-1541
ISSN (online)	2567-5788
ISSN	0722-1541
DOI	10.1055/a-0876-2651
Database	Thieme publisher's database

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Article: Schwerpunkt. Rehabilitation bei Amyotropher Lateralsklerose

Groß, Martin / Summ, Oliver

Nervenheilkunde

2019 Volume 38, Issue 5, Page(s) 249

Language	German
Document type	Article
ZDB-ID	604504-2
ISSN	0722-1541
Database	Current Contents Medicine

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