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Article ; Online: Permanent deterioration of fine motor skills after the resection of tumors in the supplementary motor area.

Maurer, Stefanie / Butenschoen, Vicki M / Kelm, Anna / Schramm, Severin / Schröder, Axel / Meyer, Bernhard / Krieg, Sandro M

Neurosurgical review

2024 Volume 47, Issue 1, Page(s) 114

Abstract: Supplementary motor area syndrome (SMAS) represents a common neurosurgical sequela. The incidence and time frame of its occurrence have yet to be characterized after surgery for brain tumors. We examined patients suffering from a brain tumor ... ...

Abstract	Supplementary motor area syndrome (SMAS) represents a common neurosurgical sequela. The incidence and time frame of its occurrence have yet to be characterized after surgery for brain tumors. We examined patients suffering from a brain tumor preoperatively, postoperatively, and during follow-up examinations after three months, including fine motor skills testing and transcranial magnetic stimulation (TMS). 13 patients suffering from a tumor in the dorsal part of the superior frontal gyrus underwent preoperative, early postoperative, and 3-month follow-up testing of fine motor skills using the Jebsen-Taylor Hand Function Test (JHFT) and the Nine-Hole Peg Test (NHPT) consisting of 8 subtests for both upper extremities. They completed TMS for cortical motor function mapping. Test completion times (TCTs) were recorded and compared. No patient suffered from neurological deficits before surgery. On postoperative day one, we detected motor deficits in two patients, which remained clinically stable at a 3-month follow-up. Except for page-turning, every subtest indicated a significant worsening of function, reflected by longer TCTs (p < 0.05) in the postoperative examinations for the contralateral upper extremity (contralateral to the tumor manifestation). At 3-month follow-up examinations for the contralateral upper extremity, each subtest indicated significant worsening compared to the preoperative status despite improvement to the immediate postoperative level. We also detected significantly longer TCTs (p < 0.05) postoperatively in the ipsilateral upper extremity. This study suggests a long-term worsening of fine motor skills even three months after SMA tumor resection, indicating the necessity of targeted physical therapy for these patients.
MeSH term(s)	Humans ; Motor Cortex/surgery ; Motor Skills ; Brain Neoplasms/etiology ; Transcranial Magnetic Stimulation ; Neurosurgical Procedures/adverse effects
Language	English
Publishing date	2024-03-14
Publishing country	Germany
Document type	Journal Article
ZDB-ID	6907-3
ISSN	1437-2320 ; 0344-5607
ISSN (online)	1437-2320
ISSN	0344-5607
DOI	10.1007/s10143-024-02330-2
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Article ; Online: Navigated transcranial magnetic stimulation mapping of the motor cortex for preoperative diagnostics in pediatric epilepsy.

Schramm, Severin / Mehta, Aashna / Auguste, Kurtis I / Tarapore, Phiroz E

Journal of neurosurgery. Pediatrics

2021 Volume 28, Issue 3, Page(s) 287–294

Abstract: Objective: Navigated transcranial magnetic stimulation (nTMS) is a noninvasive technique often used for localization of the functional motor cortex via induction of motor evoked potentials (MEPs) in neurosurgical patients. There has, however, been no ... ...

Abstract	Objective: Navigated transcranial magnetic stimulation (nTMS) is a noninvasive technique often used for localization of the functional motor cortex via induction of motor evoked potentials (MEPs) in neurosurgical patients. There has, however, been no published record of its application in pediatric epilepsy surgery. In this study, the authors aimed to investigate the feasibility of nTMS-based motor mapping in the preoperative diagnostic workup within a population of children with medically refractory epilepsy. Methods: A single-institution database was screened for preoperative nTMS motor mappings obtained in pediatric patients (aged 0 to 18 years, 2012 to present) with medically refractory epilepsy. Patient clinical data, demographic information, and mapping results were extracted and used in statistical analyses. Results: Sixteen patients met the inclusion criteria, 15 of whom underwent resection. The median age was 9 years (range 0-17 years). No adverse effects were recorded during mapping. Specifically, no epileptic seizures were provoked via nTMS. Recordings of valid MEPs induced by nTMS were obtained in 10 patients. In the remaining patients, no MEPs could be elicited. Failure to generate MEPs was associated significantly with younger patient age (r = 0.8020, p = 0.0001863). The most frequent seizure control outcome was Engel Epilepsy Surgery Outcome Scale class I (9 patients). Conclusions: Navigated TMS is a feasible, effective, and well-tolerated method for mapping the motor cortex of the upper and lower extremities in pediatric patients with epilepsy. Patient age modulates elicitability of MEPs, potentially reflecting various stages of myelination. Successful motor mapping has the potential to add to the existing presurgical diagnostic workup in this population, and further research is warranted.
Language	English
Publishing date	2021-06-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2021.2.PEDS20901
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Article: Implementation of GAN-Based, Synthetic T2-Weighted Fat Saturated Images in the Routine Radiological Workflow Improves Spinal Pathology Detection.

Schlaeger, Sarah / Drummer, Katharina / Husseini, Malek El / Kofler, Florian / Sollmann, Nico / Schramm, Severin / Zimmer, Claus / Kirschke, Jan S / Wiestler, Benedikt

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 5

Abstract: 1) Background and Purpose: In magnetic resonance imaging (MRI) of the spine, T2-weighted (T2-w) fat-saturated (fs) images improve the diagnostic assessment of pathologies. However, in the daily clinical setting, additional T2-w fs images are frequently ... ...

Abstract	(1) Background and Purpose: In magnetic resonance imaging (MRI) of the spine, T2-weighted (T2-w) fat-saturated (fs) images improve the diagnostic assessment of pathologies. However, in the daily clinical setting, additional T2-w fs images are frequently missing due to time constraints or motion artifacts. Generative adversarial networks (GANs) can generate synthetic T2-w fs images in a clinically feasible time. Therefore, by simulating the radiological workflow with a heterogenous dataset, this study's purpose was to evaluate the diagnostic value of additional synthetic, GAN-based T2-w fs images in the clinical routine. (2) Methods: 174 patients with MRI of the spine were retrospectively identified. A GAN was trained to synthesize T2-w fs images from T1-w, and non-fs T2-w images of 73 patients scanned in our institution. Subsequently, the GAN was used to create synthetic T2-w fs images for the previously unseen 101 patients from multiple institutions. In this test dataset, the additional diagnostic value of synthetic T2-w fs images was assessed in six pathologies by two neuroradiologists. Pathologies were first graded on T1-w and non-fs T2-w images only, then synthetic T2-w fs images were added, and pathologies were graded again. Evaluation of the additional diagnostic value of the synthetic protocol was performed by calculation of Cohen's ĸ and accuracy in comparison to a ground truth (GT) grading based on real T2-w fs images, pre- or follow-up scans, other imaging modalities, and clinical information. (3) Results: The addition of the synthetic T2-w fs to the imaging protocol led to a more precise grading of abnormalities than when grading was based on T1-w and non-fs T2-w images only (mean ĸ GT versus synthetic protocol = 0.65; mean ĸ GT versus T1/T2 = 0.56;
Language	English
Publishing date	2023-03-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13050974
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Article ; Online: Synthetic T2-weighted fat sat based on a generative adversarial network shows potential for scan time reduction in spine imaging in a multicenter test dataset.

Schlaeger, Sarah / Drummer, Katharina / El Husseini, Malek / Kofler, Florian / Sollmann, Nico / Schramm, Severin / Zimmer, Claus / Wiestler, Benedikt / Kirschke, Jan S

European radiology

2023 Volume 33, Issue 8, Page(s) 5882–5893

Abstract: Objectives: T2-weighted (w) fat sat (fs) sequences, which are important in spine MRI, require a significant amount of scan time. Generative adversarial networks (GANs) can generate synthetic T2-w fs images. We evaluated the potential of synthetic T2-w ... ...

Abstract	Objectives: T2-weighted (w) fat sat (fs) sequences, which are important in spine MRI, require a significant amount of scan time. Generative adversarial networks (GANs) can generate synthetic T2-w fs images. We evaluated the potential of synthetic T2-w fs images by comparing them to their true counterpart regarding image and fat saturation quality, and diagnostic agreement in a heterogenous, multicenter dataset. Methods: A GAN was used to synthesize T2-w fs from T1- and non-fs T2-w. The training dataset comprised scans of 73 patients from two scanners, and the test dataset, scans of 101 patients from 38 multicenter scanners. Apparent signal- and contrast-to-noise ratios (aSNR/aCNR) were measured in true and synthetic T2-w fs. Two neuroradiologists graded image (5-point scale) and fat saturation quality (3-point scale). To evaluate whether the T2-w fs images are indistinguishable, a Turing test was performed by eleven neuroradiologists. Six pathologies were graded on the synthetic protocol (with synthetic T2-w fs) and the original protocol (with true T2-w fs) by the two neuroradiologists. Results: aSNR and aCNR were not significantly different between the synthetic and true T2-w fs images. Subjective image quality was graded higher for synthetic T2-w fs (p = 0.023). In the Turing test, synthetic and true T2-w fs could not be distinguished from each other. The intermethod agreement between synthetic and original protocol ranged from substantial to almost perfect agreement for the evaluated pathologies. Discussion: The synthetic T2-w fs might replace a physical T2-w fs. Our approach validated on a challenging, multicenter dataset is highly generalizable and allows for shorter scan protocols. Key points: • Generative adversarial networks can be used to generate synthetic T2-weighted fat sat images from T1- and non-fat sat T2-weighted images of the spine. • The synthetic T2-weighted fat sat images might replace a physically acquired T2-weighted fat sat showing a better image quality and excellent diagnostic agreement with the true T2-weighted fat images. • The present approach validated on a challenging, multicenter dataset is highly generalizable and allows for significantly shorter scan protocols.
MeSH term(s)	Humans ; Spine/diagnostic imaging ; Magnetic Resonance Imaging/methods ; Radionuclide Imaging
Language	English
Publishing date	2023-03-16
Publishing country	Germany
Document type	Multicenter Study ; Journal Article
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-023-09512-4
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Article ; Online: Functional magnetic resonance imaging in migraine: A systematic review.

Schramm, Severin / Börner, Corinna / Reichert, Miriam / Baum, Thomas / Zimmer, Claus / Heinen, Florian / Bonfert, Michaela V / Sollmann, Nico

Cephalalgia : an international journal of headache

2023 Volume 43, Issue 2, Page(s) 3331024221128278

Abstract: Background: Migraine is a highly prevalent primary headache disorder. Despite a high burden of disease, key disease mechanisms are not entirely understood. Functional magnetic resonance imaging is an imaging method using the blood-oxygen-level-dependent ...

Abstract	Background: Migraine is a highly prevalent primary headache disorder. Despite a high burden of disease, key disease mechanisms are not entirely understood. Functional magnetic resonance imaging is an imaging method using the blood-oxygen-level-dependent signal, which has been increasingly used in migraine research over recent years. This systematic review summarizes recent findings employing functional magnetic resonance imaging for the investigation of migraine. Methods: We conducted a systematic search and selection of functional magnetic resonance imaging applications in migraine from April 2014 to December 2021 (PubMed and references of identified articles according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines). Methodological details and main findings were extracted and synthesized. Results: Out of 224 articles identified, 114 were included after selection. Repeatedly emerging structures of interest included the insula, brainstem, limbic system, hypothalamus, thalamus, and functional networks. Assessment of functional brain changes in response to treatment is emerging, and machine learning has been used to investigate potential functional magnetic resonance imaging-based markers of migraine. Conclusions: A wide variety of functional magnetic resonance imaging-based metrics were found altered across the brain for heterogeneous migraine cohorts, partially correlating with clinical parameters and supporting the concept to conceive migraine as a brain state. However, a majority of findings from previous studies have not been replicated, and studies varied considerably regarding image acquisition and analyses techniques. Thus, while functional magnetic resonance imaging appears to have the potential to advance our understanding of migraine pathophysiology, replication of findings in large representative datasets and precise, standardized reporting of clinical data would likely benefit the field and further increase the value of observations.
MeSH term(s)	Humans ; Migraine Disorders ; Brain ; Magnetic Resonance Imaging/methods ; Brain Mapping/methods ; Hypothalamus
Language	English
Publishing date	2023-01-25
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	604567-4
ISSN	1468-2982 ; 0333-1024
ISSN (online)	1468-2982
ISSN	0333-1024
DOI	10.1177/03331024221128278
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Book ; Online ; Thesis: Using navigated transcranial magnetic stimulation to map the supplementary motor area

Schramm, Severin Verfasser] / [Krieg, Sandro [Akademischer Betreuer] / Krieg, Sandro [Gutachter] / Yakushev, Igor Gutachter] / [Kirschke, Jan [Gutachter]

2023

Author's details	Severin Schramm ; Gutachter: Sandro M. Krieg, Igor Yakushev, Jan St. Kirschke ; Betreuer: Sandro M. Krieg
Keywords	Medizin, Gesundheit ; Medicine, Health
Subject code	sg610
Language	English
Publisher	Universitätsbibliothek der TU München
Publishing place	München
Document type	Book ; Online ; Thesis
Database	Digital theses on the web

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Article ; Online: Perfusion imaging by arterial spin labeling in migraine: A literature review.

Schramm, Severin / Börner, Corinna / Reichert, Miriam / Hoffmann, Gabriel / Kaczmarz, Stephan / Griessmair, Michael / Jung, Kirsten / Berndt, Maria T / Zimmer, Claus / Baum, Thomas / Heinen, Florian / Bonfert, Michaela V / Sollmann, Nico

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism

2024 , Page(s) 271678X241237733

Abstract: Arterial spin labeling (ASL) is a non-invasive magnetic resonance imaging (MRI) method for the assessment of cerebral blood flow (CBF). This review summarizes recent ASL-based investigations in adult and pediatric patients with migraine with aura, ... ...

Abstract	Arterial spin labeling (ASL) is a non-invasive magnetic resonance imaging (MRI) method for the assessment of cerebral blood flow (CBF). This review summarizes recent ASL-based investigations in adult and pediatric patients with migraine with aura, migraine without aura, and chronic migraine. A systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted within PubMed and reference sections of articles identified from April 2014 to November 2022. Out of 236 initial articles, 20 remained after filtering, encompassing data from 1155 subjects in total. Cross-sectional studies in adults showed inconsistent results, while longitudinal studies demonstrated that cerebral perfusion changes over the migraine cycle can be tracked using ASL. The most consistent findings were observed in ictal states among pediatric migraine patients, where studies showed hypoperfusion matching aura symptoms during early imaging followed by hyperperfusion. Overall, ASL is a useful but currently underutilized modality for evaluating cerebral perfusion in patients with migraine. The generalizability of results is currently limited by heterogeneities regarding study design and documentation of clinical variables (e.g., relation of attacks to scanning timepoint, migraine subtypes). Future MRI studies should consider augmenting imaging protocols with ASL to further elucidate perfusion dynamics in migraine.
Language	English
Publishing date	2024-03-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604628-9
ISSN	1559-7016 ; 0271-678X
ISSN (online)	1559-7016
ISSN	0271-678X
DOI	10.1177/0271678X241237733
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Article: Navigated TMS in the ICU: Introducing Motor Mapping to the Critical Care Setting.

Schramm, Severin / Haddad, Alexander F / Chyall, Lawrence / Krieg, Sandro M / Sollmann, Nico / Tarapore, Phiroz E

Brain sciences

2020 Volume 10, Issue 12

Abstract: Navigated transcranial magnetic stimulation (nTMS) is a modality for noninvasive cortical mapping. Specifically, nTMS motor mapping is an objective measure of motor function, offering quantitative diagnostic information regardless of subject cooperation ... ...

Abstract	Navigated transcranial magnetic stimulation (nTMS) is a modality for noninvasive cortical mapping. Specifically, nTMS motor mapping is an objective measure of motor function, offering quantitative diagnostic information regardless of subject cooperation or consciousness. Thus far, it has mostly been restricted to the outpatient setting. This study evaluates the feasibility of nTMS motor mapping in the intensive care unit (ICU) setting and solves the challenges encountered in this special environment. We compared neuronavigation based on computed tomography (CT) and magnetic resonance imaging (MRI). We performed motor mappings in neurocritical patients under varying conditions (e.g., sedation or hemicraniectomy). Furthermore, we identified ways of minimizing electromyography (EMG) noise in the interference-rich ICU environment. Motor mapping was performed in 21 patients (six females, median age: 69 years). In 18 patients, motor evoked potentials (MEPs) were obtained. In three patients, MEPs could not be evoked. No adverse reactions occurred. We found CT to offer a comparable neuronavigation to MRI (CT maximum e-field 52 ± 14 V/m vs. MRI maximum e-field 52 ± 11 V/m;
Language	English
Publishing date	2020-12-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci10121005
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Article ; Online: Capturing multiple interaction effects in L1 and L2 object-naming reaction times in healthy bilinguals: a mixed-effects multiple regression analysis.

Schramm, Severin / Tanigawa, Noriko / Tussis, Lorena / Meyer, Bernhard / Sollmann, Nico / Krieg, Sandro M

BMC neuroscience

2020 Volume 21, Issue 1, Page(s) 3

Abstract: Background: It is difficult to set up a balanced higher-order full-factorial experiment that can capture multiple intricate interactions between cognitive and psycholinguistic factors underlying bilingual speech production. To capture interactions more ... ...

Abstract	Background: It is difficult to set up a balanced higher-order full-factorial experiment that can capture multiple intricate interactions between cognitive and psycholinguistic factors underlying bilingual speech production. To capture interactions more fully in one study, we analyzed object-naming reaction times (RTs) by using mixed-effects multiple regression. Methods: Ten healthy bilinguals (median age: 23 years, seven females) were asked to name 131 colored pictures of common objects in each of their languages. RTs were analyzed based on language status, proficiency, word choice, word frequency, word duration, initial phoneme, time series, and participant's gender. Results: Among five significant interactions, new findings include a facilitating effect of a cross-language shared initial phoneme (mean RT for shared phoneme: 974 ms vs. mean RT for different phoneme: 1020 ms), which profited males less (mean profit: 10 ms) than females (mean profit: 47 ms). Conclusions: Our data support language-independent phonological activation and a gender difference in inhibitory cognitive language control. Single word production process in healthy adult bilinguals is affected by interactions among cognitive, phonological, and semantic factors.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Multilingualism ; Pattern Recognition, Visual ; Phonetics ; Psycholinguistics ; Psychomotor Performance ; Reaction Time ; Regression Analysis ; Semantics ; Speech ; Young Adult
Language	English
Publishing date	2020-01-17
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1471-2202
ISSN (online)	1471-2202
DOI	10.1186/s12868-020-0549-x
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Article ; Online: Headache frequency and neck pain are associated with trapezius muscle T2 in tension-type headache among young adults.

Sollmann, Nico / Schandelmaier, Paul / Weidlich, Dominik / Stelter, Jonathan / Joseph, Gabby B / Börner, Corinna / Schramm, Severin / Beer, Meinrad / Zimmer, Claus / Landgraf, Mirjam N / Heinen, Florian / Karampinos, Dimitrios C / Baum, Thomas / Bonfert, Michaela V

The journal of headache and pain

2023 Volume 24, Issue 1, Page(s) 84

Abstract: Background: Tension-type headache (TTH) is the most prevalent primary headache disorder. Neck pain is commonly associated with primary headaches and the trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto ...

Abstract	Background: Tension-type headache (TTH) is the most prevalent primary headache disorder. Neck pain is commonly associated with primary headaches and the trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto neurons of the brainstem, thus conceptualizes the emergence of headache in relation to neck pain. However, no objective biomarkers exist for the myofascial involvement in primary headaches. This study aimed to investigate the involvement of the trapezius muscles in primary headache disorders by quantitative magnetic resonance imaging (MRI), and to explore associations between muscle T2 values and headache frequency and neck pain. Methods: This cohort study prospectively enrolled fifty participants (41 females, age range 20-31 years): 16 subjects with TTH only (TTH-), 12 with mixed-type TTH plus migraine (TTH+), and 22 healthy controls (HC). The participants completed fat-suppressed T2-prepared three-dimensional turbo spin-echo MRI, a headache diary (over 30 days prior to MRI), manual palpation (two weeks before MRI), and evaluation of neck pain (on the day of MRI). The bilateral trapezius muscles were manually segmented, followed by muscle T2 extraction. Associations between muscle T2 and the presence of neck pain as well as the number of days with headache (considering the 30 days prior to imaging using the headache calendar) were analyzed using regression models (adjusting for age, sex, and body mass index). Results: The TTH+ group demonstrated the highest muscle T2 values (right side: 31.4 ± 1.2 ms, left side: 31.4 ± 0.8 ms) as compared to the TTH- group or HC group (p < 0.001). Muscle T2 was significantly associated with the number of headache days (β-coefficient: 2.04, p = 0.04) and the presence of neck pain (odds ratio: 2.26, p = 0.04). With muscle T2 as the predictor, the area under the curve for differentiating between HC and the TTH+ group was 0.82. Conclusions: Increased T2 of trapezius muscles may represent an objective imaging biomarker for myofascial involvement in primary headache disorders, which could help to improve patient phenotyping and therapy evaluation. Pathophysiologically, the increased muscle T2 values could be interpreted as a surrogate of neurogenic inflammation and peripheral sensitization within myofascial tissues.
MeSH term(s)	Female ; Young Adult ; Humans ; Adult ; Tension-Type Headache/diagnostic imaging ; Neck Pain/diagnostic imaging ; Cohort Studies ; Superficial Back Muscles/diagnostic imaging ; Headache
Language	English
Publishing date	2023-07-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2036768-5
ISSN	1129-2377 ; 1129-2369
ISSN (online)	1129-2377
ISSN	1129-2369
DOI	10.1186/s10194-023-01626-w
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