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Article ; Online: Resolving dyskinesias at sustained anti-OCD efficacy by steering of DBS away from the anteromedial STN to the mesencephalic ventral tegmentum - case report.

Coenen, Volker A / Schlaepfer, Thomas E / Meyer, Dora / Kilian, Hannah / Spanier, Susanne / Sajonz, Bastian E A / Reinacher, Peter C / Reisert, Marco

Acta neurochirurgica

2022 Volume 164, Issue 9, Page(s) 2303–2307

Abstract: Here we describe therapeutic results in a female patient who underwent bilateral slMFB DBS for OCD. During a 35-month long course of stimulation, she suffered from stimulation-induced dyskinesia of her right leg which we interpreted as co-stimulation of ... ...

Abstract	Here we describe therapeutic results in a female patient who underwent bilateral slMFB DBS for OCD. During a 35-month long course of stimulation, she suffered from stimulation-induced dyskinesia of her right leg which we interpreted as co-stimulation of the adjacent anteromedial subthalamic nucleus (amSTN). After reprogramming to steer the stimulation away from the amSTN medial into the direction of the mesencephalic ventral tegmentum (MVT which contains the ventral tegmental area, VTA), the dyskinesias disappeared. Remarkably, anti-OCD efficacy in the presented patient was preserved and achieved with a bilateral stimulation which by our imaging study fully avoided the amSTN.
MeSH term(s)	Deep Brain Stimulation/methods ; Dyskinesias/etiology ; Dyskinesias/therapy ; Female ; Humans ; Obsessive-Compulsive Disorder/therapy ; Subthalamic Nucleus
Language	English
Publishing date	2022-05-02
Publishing country	Austria
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-022-05206-w
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Article ; Online: Treatment resistance in major depression is correlated with increased plasma levels of neurofilament light protein reflecting axonal damage.

Spanier, Susanne / Kilian, Hannah M / Meyer, Dora M / Schlaepfer, Thomas E

Medical hypotheses

2019 Volume 127, Page(s) 159–161

Abstract: Treatment resistant major depression is accompanied with a sizable impact on quality of life with severe consequences for social integrity, individual health and socioeconomic state. In- and outpatient care of patients with treatment resistant major ... ...

Abstract	Treatment resistant major depression is accompanied with a sizable impact on quality of life with severe consequences for social integrity, individual health and socioeconomic state. In- and outpatient care of patients with treatment resistant major depression remains very challenging for both patients and the health system. One reason is the limited knowledge on the etiology of treatment resistance in major depression resulting difficulties developing efficient treatment strategies for this group of severe depressed patients. Therefore, new focuses on research are needed. Biomarkers reliably reflecting neuropathological processes could help to understand the actual mechanisms in treatment resistance. Neurofilament light protein might be a reliable biomarker of axonal damage in the brain. Due to accumulating evidence that major depression is associated with axonal damage, it is our hypothesis that treatment resistant major depression is correlated with persistent axonal damage within circuits processing affective responses. Axonal damage is reflected by increased levels of neurofilament light protein in plasma. To evaluate our hypothesis, neurofilament light protein will be measured in a group of patients with homogeneous symptomatology of treatment resistant major depression.
MeSH term(s)	Axons/pathology ; Biomarkers/metabolism ; Brain/pathology ; Cytokines/metabolism ; Depressive Disorder, Major/blood ; Depressive Disorder, Major/therapy ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intermediate Filaments/metabolism ; Light ; Nervous System Diseases/pathology ; Neurofilament Proteins/blood ; Quality of Life ; Treatment Outcome
Chemical Substances	Biomarkers ; Cytokines ; Neurofilament Proteins ; neurofilament protein L
Language	English
Publishing date	2019-03-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	193145-3
ISSN	1532-2777 ; 0306-9877
ISSN (online)	1532-2777
ISSN	0306-9877
DOI	10.1016/j.mehy.2019.03.022
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Zs.A 1132: Show issues

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Article ; Online: Efficacy of superolateral medial forebrain bundle deep brain stimulation in obsessive-compulsive disorder.

Meyer, Dora M / Spanier, Susanne / Kilian, Hannah M / Reisert, Marco / Urbach, Horst / Sajonz, Bastian Ea / Reinacher, Peter C / Normann, Claus / Domschke, Katharina / Coenen, Volker A / Schlaepfer, Thomas E

Brain stimulation

2022 Volume 15, Issue 3, Page(s) 582–585

MeSH term(s)	Deep Brain Stimulation ; Humans ; Medial Forebrain Bundle ; Obsessive-Compulsive Disorder/therapy
Language	English
Publishing date	2022-03-26
Publishing country	United States
Document type	Letter
ZDB-ID	2394410-9
ISSN	1876-4754 ; 1935-861X
ISSN (online)	1876-4754
ISSN	1935-861X
DOI	10.1016/j.brs.2022.03.004
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Article ; Online: Discontinuation of Superolateral Medial Forebrain Bundle Deep Brain Stimulation for Treatment-Resistant Depression Leads to Critical Relapse.

Kilian, Hannah M / Meyer, Dora M / Bewernick, Bettina H / Spanier, Susanne / Coenen, Volker A / Schlaepfer, Thomas E

Biological psychiatry

2018 Volume 85, Issue 6, Page(s) e23–e24

MeSH term(s)	Adult ; Deep Brain Stimulation ; Depressive Disorder, Treatment-Resistant/therapy ; Female ; Humans ; Male ; Medial Forebrain Bundle/physiology ; Middle Aged ; Recurrence ; Withholding Treatment
Language	English
Publishing date	2018-09-22
Publishing country	United States
Document type	Case Reports ; Clinical Trial ; Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	209434-4
ISSN	1873-2402 ; 0006-3223
ISSN (online)	1873-2402
ISSN	0006-3223
DOI	10.1016/j.biopsych.2018.07.025
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Zs.A 720: Show issues

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Article ; Online: Superolateral medial forebrain bundle deep brain stimulation in major depression: a gateway trial.

Coenen, Volker A / Bewernick, Bettina H / Kayser, Sarah / Kilian, Hannah / Boström, Jan / Greschus, Susanne / Hurlemann, René / Klein, Margaretha Eva / Spanier, Susanne / Sajonz, Bastian / Urbach, Horst / Schlaepfer, Thomas E

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology

2019 Volume 44, Issue 7, Page(s) 1224–1232

Abstract: Short- and long-term antidepressant effects of deep brain stimulation (DBS) in treatment-resistant depression (TRD) have been demonstrated for several brain targets in open-label studies. For two stimulation targets, pivotal randomized trials have been ... ...

Abstract	Short- and long-term antidepressant effects of deep brain stimulation (DBS) in treatment-resistant depression (TRD) have been demonstrated for several brain targets in open-label studies. For two stimulation targets, pivotal randomized trials have been conducted; both failed a futility analysis. We assessed efficacy and safety of DBS of the supero-lateral branch of the medial forebrain bundle (slMFB) in a small Phase I clinical study with a randomized-controlled onset of stimulation in order to obtain data for the planning of a large RCT. Sixteen patients suffering from TRD received DBS of the slMFB and were randomized to sham or real stimulation for the duration of 2 months after implantation. Primary outcome measure was mean reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) during 12 months of DBS (timeline analysis). Secondary outcomes were the difference in several clinical measures between sham and real stimulation at 8 weeks and during stimulation phases. MADRS ratings decreased significantly from 29.6 (SD +/- 4) at baseline to 12.9 (SD +/- 9) during 12 months of DBS (mean MADRS, n = 16). All patients reached the response criterion, most patients (n = 10) responded within a week; 50% of patients were classified as remitters after 1 year of stimulation. The most frequent side effect was transient strabismus. Both groups (active/sham) demonstrated an antidepressant micro-lesioning effect but patients had an additional antidepressant effect after initiation of stimulation. Both rapid onset and stability of the antidepressant effects of slMFB-DBS were demonstrated as in our previous pilot study. Given recent experiences from pivotal trials in DBS for MDD, we believe that slow, careful, and adaptive study development is germane. After our exploratory study and a large-scale study, we conducted this gateway trial in order to better inform planning of the latter. Important aspects for the planning of RCTs in the field of DBS for severe and chronic diseases are discussed including meaningful phases of intra-individual and between-group comparisons and timeline instead of single endpoint analyses.
MeSH term(s)	Adult ; Aged ; Deep Brain Stimulation ; Depressive Disorder, Major/physiopathology ; Depressive Disorder, Major/therapy ; Depressive Disorder, Treatment-Resistant/physiopathology ; Depressive Disorder, Treatment-Resistant/therapy ; Female ; Humans ; Male ; Medial Forebrain Bundle/physiopathology ; Middle Aged ; Treatment Outcome
Language	English
Publishing date	2019-03-13
Publishing country	England
Document type	Clinical Trial, Phase I ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	639471-1
ISSN	1740-634X ; 0893-133X
ISSN (online)	1740-634X
ISSN	0893-133X
DOI	10.1038/s41386-019-0369-9
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Zs.A 2379: Show issues

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Article: Cytogenetic findings in a case of brown tumor associated with hyperparathyroidism.

Ganesan, J / Spanier, S / Bridge, J A

Cancer genetics and cytogenetics

2000 Volume 119, Issue 2, Page(s) 165–166

MeSH term(s)	Adenoma/complications ; Bone Cysts/complications ; Bone Cysts/genetics ; Bone Cysts/pathology ; Bone Resorption/etiology ; Chromosome Banding ; Hemosiderin/analysis ; Humans ; Hyperparathyroidism, Secondary/etiology ; Karyotyping ; Leg Injuries/complications ; Macrophages/chemistry ; Macrophages/pathology ; Male ; Middle Aged ; Mosaicism ; Neoplasms, Multiple Primary/complications ; Parathyroid Neoplasms/complications ; Sex Chromosomes ; Tibia/pathology ; Trisomy
Chemical Substances	Hemosiderin (9011-92-1)
Language	English
Publishing date	2000-06
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	800806-1
ISSN	1873-4456 ; 0165-4608
ISSN (online)	1873-4456
ISSN	0165-4608
DOI	10.1016/s0165-4608(99)00219-8
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Zs.A 1521: Show issues

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Book ; Thesis: Die Beobachtung einer isovektoriellen 0++-Resonanz mit einer Masse von 1470 MeV/c2 im [pi]0[pi]0[eta]-Endzustand der Proton-Antiproton-Vernichtung in Ruhe

Spanier, Stefan

1994

Title variant	pi
Author's details	vorgelegt von Stefan Spanier
Keywords	Pion ; Antiproton-Proton-Vernichtung ; Eta-Meson ; Skalares Meson
Language	German
Size	VI, 105 Bl, Ill., graph. Darst
Document type	Book ; Thesis
Thesis / German Habilitation thesis	@Mainz, Univ., Diss., 1994
Note	Mikrofiche-Ausg.: 1994. 2 Mikrofiches : 24x
Database	Library catalogue of the German National Library of Science and Technology (TIB), Hannover

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Book ; Thesis: Die Beobachtung einer isovektoriellen 0++-Resonanz mit einer Masse von 1470 MeV/c2 im [pi]0[pi]0[eta]-Endzustand der Proton-Antiproton-Vernichtung in Ruhe

Spanier, Stefan

1994

Title variant	pi
Author's details	vorgelegt von Stefan Spanier
Keywords	Pion ; Antiproton-Proton-Vernichtung ; Eta-Meson ; Skalares Meson
Language	German
Size	VI, 105 Bl, Ill., graph. Darst
Document type	Book ; Thesis
Thesis / German Habilitation thesis	@Mainz, Univ., Diss., 1994
Note	Mikrofiche-Ausg.: 1994. 2 Mikrofiches : 24x
Database	Former special subject collection: coastal and deep sea fishing

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Article: Revision surgery in dermatofibrosarcoma protuberans of the trunk and extremities.

Lindner, N J / Scarborough, M T / Powell, G J / Spanier, S / Enneking, W F

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

1999 Volume 25, Issue 4, Page(s) 392–397

Abstract: Aims: Dermatofibrosarcoma protuberans is a rare condition which is frequently misdiagnosed at presentation, resulting in a high incidence of local recurrence due to inadequate resection. The archives of the Department of Orthopaedics at the University ... ...

Abstract	Aims: Dermatofibrosarcoma protuberans is a rare condition which is frequently misdiagnosed at presentation, resulting in a high incidence of local recurrence due to inadequate resection. The archives of the Department of Orthopaedics at the University of Florida were analysed to investigate the natural history and results of treatment for this tumour. Methods: Between 1975 and 1996, 35 cases of DFSP were treated at the University of Florida. Of these, one was treated primarily, five were treated for local recurrence, 17 had tumour bed excisions following inadequate primary excisions elsewhere and 12 had tumour bed excisions following inadequate resection of local recurrences elsewhere. The data were analysed to assess the impact of age, gender, duration of symptoms, tumour site and size, surgical margin, number of operations and adjuvant treatments on survival and local recurrence outcomes. Results: Complete follow-up was available for 34 patients. Mean follow-up was 58 months (range 12-144 months). Thirty-three patients remain alive and disease-free. One patient died of unrelated causes. The margins obtained were wide in 28 patients, marginal in six and intralesional in one. Of the seven patients with inadequate surgical margins, four received adjuvant radiation therapy and remain disease-free. No patient with an adequate margin developed a local recurrence, but there were three local recurrences in the patients with an inadequate margin who did not receive adjuvant radiation therapy (local recurrence rate: 8%). No patient developed lymphatic or distant metastasis. Local recurrences were more likely to be classified Stage IB (17/17) than primary tumours (1/18) (P<0.001). Local recurrence was more likely where the surgical margin was less than 2.5 cm from the lesion. Conclusions: Dermatofibrosarcoma protuberans is a low-grade tumour that has a high potential for local recurrence unless it can be completely excised. The overall rate of local recurrence in referred patients in this series was 20/35 cases (57%). All occurred after inadequate margins at previous surgery in other institutions. Revision surgery in these patients showed a local recurrence rate of 8%. To avoid extensive surgery for recurrences, initial treatment should be by wide excision incorporating the underlying deep fascia and a cuff of 2.5-3 cm of normal skin tissue. Radiation therapy provides a useful adjunct where adequate margins cannot be obtained.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Dermatofibrosarcoma/radiotherapy ; Dermatofibrosarcoma/surgery ; Female ; Humans ; Infant ; Leg ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Reoperation ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	1999-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632519-1
ISSN	0748-7983
ISSN	0748-7983
DOI	10.1053/ejso.1999.0663
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Zs.A 1149: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 549: Show issues

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Article: Prevention of infection after total joint replacement. Experiments with a canine model.

Petty, W / Spanier, S / Shuster, J J

The Journal of bone and joint surgery. American volume

1988 Volume 70, Issue 4, Page(s) 536–539

Abstract: An experiment was done in dogs to evaluate how efficient each of several techniques was in preventing infection after a total joint arthroplasty. The techniques that were studied were intraoperative irrigation with saline solution or with antimicrobial ... ...

Abstract	An experiment was done in dogs to evaluate how efficient each of several techniques was in preventing infection after a total joint arthroplasty. The techniques that were studied were intraoperative irrigation with saline solution or with antimicrobial solution, perioperative systemic administration of antibiotics, and the addition of an antibiotic to bone cement. Irrigation with saline solution did not reduce the incidence of infection. A slight reduction was found after irrigation with neomycin solution and after systemic administration of cefazolin solution. The use of bone cement containing gentamicin caused a statistically significant reduction in the rate of infection; in fact, no infection developed in any animal that was treated with bone cement containing gentamicin. There was excellent but not absolute correlation between findings on culture that indicated the presence of infection and histological evidence of inflammation.
MeSH term(s)	Animals ; Anti-Bacterial Agents/administration & dosage ; Bone Cements ; Cefazolin/administration & dosage ; Dogs ; Gentamicins/administration & dosage ; Hip Prosthesis ; Isotonic Solutions ; Neomycin/administration & dosage ; Sodium Chloride ; Surgical Wound Infection/prevention & control ; Therapeutic Irrigation/methods
Chemical Substances	Anti-Bacterial Agents ; Bone Cements ; Gentamicins ; Isotonic Solutions ; Neomycin (1404-04-2) ; Sodium Chloride (451W47IQ8X) ; Cefazolin (IHS69L0Y4T)
Language	English
Publishing date	1988-04
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
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Zs.MO 464: Show issues

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