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  1. Article ; Online: Epidemiologische Untersuchung zu möglichen Auswirkungen öffentlicher Kommunikation im Rahmen der COVID-19-Pandemie auf Notfallvorstellungen von Kopfschmerzpatient*innen.

    Wittayer, Matthias / Sandikci, Vesile / Ebert, Anne / Koehler, Clemens / Szabo, Kristina / Hoyer, Carolin

    Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))

    2023  Volume 86, Issue 3, Page(s) 232–236

    Abstract: Headache is a frequent presenting symptom in the emergency department. While most cases are of benign aetiology, it is crucially important to identify potentially dangerous underlying disorders. We hypothesized an increase in headache-related emergency ... ...

    Title translation Potential Impact of Public Communication on Emergency Presentations due to Headache during the Covid-19 Pandemic.
    Abstract Headache is a frequent presenting symptom in the emergency department. While most cases are of benign aetiology, it is crucially important to identify potentially dangerous underlying disorders. We hypothesized an increase in headache-related emergency presentations after venous thrombosis of cerebral sinuses had been identified as a rare side effect of vaccination with adenovirus vector-based Coronavirus-disease 2019 (COVID-19) vaccines and that information had been publicly communicated by the Paul Ehrlich Institute. Data from patients with the diagnosis of primary headache disorders or unspecified headache presenting to the Interdisciplinary Emergency Department of the University Medicine Mannheim were retrospectively analysed. Based on vaccination dashboard data published by the Federal Ministry of Health, calendar weeks 14-30 and 47-48, on the one hand, and 1-13 and 31-46, on the othe, were categorized into a variable "vaccination epoch" (14-30, 47-48: high vaccination activity if≥3 million weekly vaccinations in Germany; 1-13, 31-46: low vaccination activity if<3 million weekly vaccinations). The number of patients with headache was the dependent variable. A Poisson regression was performed to analyze whether the frequency of events, i. e., patient presentations, was a function of year (2019, 2021), epoch (high, low) and an interaction of year and epoch - the latter reflecting an impact of vaccination activity during the pandemic and expressed as incidence rate ratio. Compared to 2019, there was a more than 70% increase in presentations due to headache during periods of high vaccination activity in 2021 (p<0.001; 95% confidence interval 1.272-2.316), in 25% of presentations in 2021, patients considered their headache as vaccination-associated. Public communication and resulting nocebo effects may, among other factors, have contributed to our observation of increased numbers of emergency headache presentations, illustrating the impact of public distribution of medical information on practical aspects of emergency care during crises.
    MeSH term(s) Humans ; COVID-19/epidemiology ; Pandemics ; Retrospective Studies ; Germany ; Headache/diagnosis ; Headache/epidemiology ; Headache/etiology ; Vaccination ; Communication ; Emergency Service, Hospital
    Language German
    Publishing date 2023-12-08
    Publishing country Germany
    Document type English Abstract ; Journal Article
    ZDB-ID 1101426-x
    ISSN 1439-4421 ; 0941-3790 ; 0949-7013
    ISSN (online) 1439-4421
    ISSN 0941-3790 ; 0949-7013
    DOI 10.1055/a-2146-6286
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Short-term brain atrophy evolution after initiation of immunotherapy in a real-world multiple sclerosis cohort.

    Nold, Ann-Kathrin / Wittayer, Matthias / Weber, Claudia E / Platten, Michael / Gass, Achim / Eisele, Philipp

    Journal of neuroimaging : official journal of the American Society of Neuroimaging

    2023  Volume 33, Issue 6, Page(s) 904–908

    Abstract: Background and purpose: In multiple sclerosis (MS), brain atrophy measurements have emerged as an important biomarker reflecting neurodegeneration and disability progression. However, due to several potential confounders, investigation of brain atrophy ... ...

    Abstract Background and purpose: In multiple sclerosis (MS), brain atrophy measurements have emerged as an important biomarker reflecting neurodegeneration and disability progression. However, due to several potential confounders, investigation of brain atrophy in clinical routine and even in controlled clinical studies can be challenging. The aim of this study was to investigate the short-term dynamics of brain atrophy development after initiation of disease-modifying therapy (DMT) in a "real-world setting."
    Methods: In this retrospective study, we included MS patients starting DMT (natalizumab, fingolimod, dimethyl fumarate, or interferon-ß1a) or without DMT, availability of a baseline MRI, and two annual follow-up scans on the same MRI system. Two-timepoint percentage brain volume changes (PBVCs) were calculated.
    Results: Fifty-five MS patients (12 patients starting DMT with natalizumab, 7 fingolimod, 14 dimethyl fumarate, 11 interferon-ß1a, and 11 patients without DMT) were included. We found the highest PBVCs in the first 12 months after initiation of natalizumab treatment. Furthermore, the PBVCs in our study were very much comparable to the results observed by other groups, as well as for fingolimod, dimethyl fumarate, and interferon-ß1a.
    Conclusion: We found PBVCs that are comparable to the results of previous studies, suggesting that brain atrophy, assessed on 3D MRI data sets acquired on the same 3T MRI, provides a robust MS biomarker.
    MeSH term(s) Humans ; Multiple Sclerosis/diagnostic imaging ; Multiple Sclerosis/drug therapy ; Multiple Sclerosis/pathology ; Fingolimod Hydrochloride/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Natalizumab/therapeutic use ; Dimethyl Fumarate/therapeutic use ; Retrospective Studies ; Brain/diagnostic imaging ; Brain/pathology ; Interferons/therapeutic use ; Immunotherapy ; Atrophy/pathology ; Biomarkers ; Multiple Sclerosis, Relapsing-Remitting/pathology
    Chemical Substances Fingolimod Hydrochloride (G926EC510T) ; Immunosuppressive Agents ; Natalizumab ; Dimethyl Fumarate (FO2303MNI2) ; Interferons (9008-11-1) ; Biomarkers
    Language English
    Publishing date 2023-07-25
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1071724-9
    ISSN 1552-6569 ; 1051-2284
    ISSN (online) 1552-6569
    ISSN 1051-2284
    DOI 10.1111/jon.13146
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Impact of disease-modifying therapies on evolving tissue damage in iron rim multiple sclerosis lesions.

    Eisele, Philipp / Wittayer, Matthias / Weber, Claudia E / Platten, Michael / Schirmer, Lucas / Gass, Achim

    Multiple sclerosis (Houndmills, Basingstoke, England)

    2022  Volume 28, Issue 14, Page(s) 2294–2298

    Abstract: We investigated the impact of disease-modifying therapies (DMTs) on the evolving tissue damage in iron rim multiple sclerosis lesions using a novel post-processing magnetic resonance imaging (MRI) approach, the T1/T2 ratio. In this study, on baseline and ...

    Abstract We investigated the impact of disease-modifying therapies (DMTs) on the evolving tissue damage in iron rim multiple sclerosis lesions using a novel post-processing magnetic resonance imaging (MRI) approach, the T1/T2 ratio. In this study, on baseline and 1-year follow-up, T1/T2 ratios of iron rim lesions (IRLs) in patients starting DMT (dimethyl fumarate, fingolimod, ocrelizumab) did not statistically differ compared to patients without DMT. At the second follow-up, T1/T2 ratios were significantly lower in IRLs in patients without DMT (
    MeSH term(s) Humans ; Multiple Sclerosis/diagnostic imaging ; Multiple Sclerosis/drug therapy ; Multiple Sclerosis/pathology ; Iron ; Fingolimod Hydrochloride ; Dimethyl Fumarate ; Magnetic Resonance Imaging
    Chemical Substances Iron (E1UOL152H7) ; Fingolimod Hydrochloride (G926EC510T) ; Dimethyl Fumarate (FO2303MNI2)
    Language English
    Publishing date 2022-07-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 1290669-4
    ISSN 1477-0970 ; 1352-4585
    ISSN (online) 1477-0970
    ISSN 1352-4585
    DOI 10.1177/13524585221106338
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Sex-Specific Differences in Pre-Stroke Characteristics Reveal Vulnerability of Elderly Women.

    Hoyer, Carolin / Schlenker, Jan / Sandikci, Vesile / Ebert, Anne / Wittayer, Matthias / Platten, Michael / Szabo, Kristina

    Journal of personalized medicine

    2022  Volume 12, Issue 3

    Abstract: While the sexually dimorphic character of ischemic stroke has been acknowledged along several dimensions, age-specific sex disparities regarding pre-stroke characteristics in particular have received comparatively little attention. This study aimed to ... ...

    Abstract While the sexually dimorphic character of ischemic stroke has been acknowledged along several dimensions, age-specific sex disparities regarding pre-stroke characteristics in particular have received comparatively little attention. This study aimed to identify age-dependent associations between sex and risk factors, premorbidity, and living situation in patients with ischemic stroke to foster the continuing development of dedicated preventative strategies. In a retrospective single-center study, data of patients with acute ischemic stroke (AIS) admitted to the Department of Neurology, University Hospital Mannheim, Germany, between June 2004−June 2020 were included; AIS frequency, vascular risk factors, premorbidity, living situation, and stroke etiology were analyzed across sexes and different age spectra. From a total of 11,003 patients included in the study, 44.1% were female. Women aged >70−≤90 years showed a pronounced increase in stroke frequency, lived alone significantly more frequently, and had a significantly higher degree of pre-stroke disability than men; however, only hypertension and atrial fibrillation were more prevalent in women in this age segment. The seventh and eighth decades are a critical time in which the pre-stroke risk profile changes resulting in an increase in stroke morbidity in women. This emphasizes the relevance of and need for an approach to stroke prevention that is both targeted and integrative.
    Language English
    Publishing date 2022-02-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm12030344
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Multiple sclerosis iron rim lesions are linked to impaired cervical spinal cord integrity using the T1/T2-weighted ratio.

    Wenzel, Nicolas / Wittayer, Matthias / Weber, Claudia E / Platten, Michael / Gass, Achim / Eisele, Philipp

    Journal of neuroimaging : official journal of the American Society of Neuroimaging

    2022  Volume 33, Issue 2, Page(s) 240–246

    Abstract: Background and purpose: In multiple sclerosis (MS), iron rim lesions (IRLs) are characterized by pronounced tissue matrix damage. The T1/T2-weighted (T1/T2w) ratio represents a postprocessing MRI approach to investigate tissue integrity, but studies ... ...

    Abstract Background and purpose: In multiple sclerosis (MS), iron rim lesions (IRLs) are characterized by pronounced tissue matrix damage. The T1/T2-weighted (T1/T2w) ratio represents a postprocessing MRI approach to investigate tissue integrity, but studies investigating spinal cord pathology are missing until now. The aim of this study was to characterize tissue integrity using the T1/T2w ratio in lesions and the normal-appearing white and gray matter (NAWM, NAGM) in the spinal cord and brain in MS patients with and without brain IRLs.
    Methods: Forty MS patients (20 patients with at least one brain IRL and 20 age- and sex-matched patients without IRLs) were included. Normalized cross-sectional area (nCSA) of the upper cervical cord was calculated in addition to T1/T2w values and standard brain and spinal cord MRI parameters.
    Results: Patients with IRLs had higher disability scores, a smaller nCSA, and a higher cervical T2 lesion volume. T1/T2w values of brain IRLs were significantly lower compared to non-IRLs (p < .001). Furthermore, T1/T2w values of lesions were significantly lower compared to the NAGM and NAWM, both in the brain and the spinal cord (p < .05 for all comparisons). T1/T2w values of the NAGM and NAWM in the brain and spinal cord did not statistically differ between the IRL group and the non-IRL group.
    Conclusion: IRLs constitute an imaging marker of disease severity. T1/T2w ratio maps represent an interesting technique to capture diffuse tissue properties. Calculation of T1/T2w ratio maps of the spinal cord might provide additional insights into the pathophysiological processes of MS.
    MeSH term(s) Humans ; Multiple Sclerosis/pathology ; Cervical Cord/pathology ; Spinal Cord/pathology ; Magnetic Resonance Imaging/methods ; Brain/pathology
    Language English
    Publishing date 2022-12-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1071724-9
    ISSN 1552-6569 ; 1051-2284
    ISSN (online) 1552-6569
    ISSN 1051-2284
    DOI 10.1111/jon.13076
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Hippocampal subfield involvement in patients with transient global amnesia.

    Wittayer, Matthias / Hoyer, Carolin / Roßmanith, Christina / Platten, Michael / Gass, Achim / Szabo, Kristina

    Journal of neuroimaging : official journal of the American Society of Neuroimaging

    2022  Volume 32, Issue 2, Page(s) 264–267

    Abstract: Background and purpose: Transient global amnesia (TGA) is a rare neurological disorder causing a transient disturbance of episodic long-term memory. Its etiology remains yet to be identified; the only consistently reported findings in patients with TGA ... ...

    Abstract Background and purpose: Transient global amnesia (TGA) is a rare neurological disorder causing a transient disturbance of episodic long-term memory. Its etiology remains yet to be identified; the only consistently reported findings in patients with TGA are small hyperintense lesions in the hippocampus on diffusion-weighted magnetic resonance imaging (DWI). The aim of this study was to define whether these lesions are subfield specific, as suggested previously.
    Methods: High-resolution multiplanar reformation T1 and DWI of the hippocampus were acquired in 25 patients after TGA with a total of 43 hippocampal lesions. Hippocampal subfields were determined using the FreeSurfer software and the location of the DWI lesions was transformed to the T1 images after data co-registration. Additionally, hippocampal subfield volumes in each patient were calculated and compared with that of 20 healthy controls.
    Results: Hippocampal lesions were most frequently detected in the cornu ammonis area 1 (CA1) subfield (30.2%), the hippocampal tail (28.0%), and the subiculum (21.0%); however, lesions were also found in other subfields. There was no significant difference between patients and controls concerning the volumes of the hippocampal subfields.
    Conclusions: Contrasting previous assumptions, we found DWI hyperintense lesions not to be restricted to the CA1 subfield. The visualization of focal hippocampal lesions on diffusion imaging located to several different hippocampal subfields suggests a potential pathophysiology of TGA independent of microstructural hippocampal anatomy and subfield-specific vulnerability.
    MeSH term(s) Amnesia, Transient Global/diagnostic imaging ; Diffusion Magnetic Resonance Imaging ; Hippocampus/diagnostic imaging ; Hippocampus/pathology ; Humans ; Magnetic Resonance Imaging/methods
    Language English
    Publishing date 2022-02-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1071724-9
    ISSN 1552-6569 ; 1051-2284
    ISSN (online) 1552-6569
    ISSN 1051-2284
    DOI 10.1111/jon.12973
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  7. Article ; Online: Spatial distribution of multiple sclerosis iron rim lesions and their impact on disability.

    Wittayer, Matthias / Weber, Claudia E / Platten, Michael / Schirmer, Lucas / Gass, Achim / Eisele, Philipp

    Multiple sclerosis and related disorders

    2022  Volume 64, Page(s) 103967

    Abstract: Background: In multiple sclerosis (MS), iron rim lesions (IRLs) on magnetic resonance imaging (MRI) have been suggested as an imaging marker of disease progression. However, the exact mechanisms how they contribute to disability are yet not completely ... ...

    Abstract Background: In multiple sclerosis (MS), iron rim lesions (IRLs) on magnetic resonance imaging (MRI) have been suggested as an imaging marker of disease progression. However, the exact mechanisms how they contribute to disability are yet not completely known. Strategic lesion location may be an important factor concerning the impact of focal lesions on clinical disability. Therefore, the aim of this study was to investigate the spatial distribution of IRLs compared to non-IRLs and their impact on disability.
    Methods: We retrospectively identified 67 patients with at least one IRL on MRI and 67 age- and sex-matched patients without IRLs. We compared the spatial distribution of lesions between both groups and between IRLs and non-IRLs in patients with IRLs. Furthermore, we assessed the relationship between lesion localisation and disability on a voxel-by-voxel basis and investigated the impact on structural network disruptions.
    Results: Patients with IRLs had higher disability scores (median Expanded Disability Status Scale score (range): 3.0 (0 - 8.5) versus 1.5 (0 - 6.5); p = 0.001; median pyramidal functional system score (range): 1.0 (0 - 5) versus 0 (0 - 4); p = 0.003), significantly lower brain volumes (mean normal-appearing grey matter volume: 749.66 ± 60.58 versus 785.83 ± 53.71 mL; mean normal-appearing white matter volume: 723.58 ± 60.13 versus 753.25 ± 69.61 mL; mean deep grey matter volume: 33.21 ± 4.19 versus 35.85 ± 4.89 mL; p < 0.05 for all comparisons) and a significantly higher total T2 lesion volume (mean: 9.96 ± 11.6 versus 4.31 ± 8.9 mL; p < 0.001). We found no neuroanatomical regions that were more often affected by IRLs. Furthermore, comparing the overall network disruption in the IRL group, IRLs caused less network disruption/mL lesion size compared to non-IRLs (1.54% / mL versus 2.0% / mL; p < 0.05).
    Conclusion: IRLs are associated with higher disability scores. However, our results suggest that a higher disability is not explained by the sheer topography of IRLs or their network disruption.
    MeSH term(s) Brain/diagnostic imaging ; Brain/pathology ; Humans ; Iron ; Magnetic Resonance Imaging/methods ; Multiple Sclerosis/diagnostic imaging ; Multiple Sclerosis/pathology ; Retrospective Studies ; White Matter/pathology
    Chemical Substances Iron (E1UOL152H7)
    Language English
    Publishing date 2022-06-15
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2645330-7
    ISSN 2211-0356 ; 2211-0348
    ISSN (online) 2211-0356
    ISSN 2211-0348
    DOI 10.1016/j.msard.2022.103967
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Consistency of the "central vein sign" in chronic multiple sclerosis lesions.

    Reichl, Matthias / Wittayer, Matthias / Weber, Claudia E / Platten, Michael / Gass, Achim / Eisele, Philipp

    Multiple sclerosis and related disorders

    2022  Volume 58, Page(s) 103530

    Abstract: Background: In recent years, there has been an increasing interest in the central vein sign (CVS) as a new imaging marker and previous cross-sectional studies demonstrated that the CVS has the potential to discriminate multiple sclerosis (MS) lesions ... ...

    Abstract Background: In recent years, there has been an increasing interest in the central vein sign (CVS) as a new imaging marker and previous cross-sectional studies demonstrated that the CVS has the potential to discriminate multiple sclerosis (MS) lesions from non-MS lesions. The aim of this study was to investigate the consistency of the CVS in a longitudinal magnetic resonance imaging (MRI) data set.
    Methods: 3T MRI datasets from seventy-one people with MS acquired at baseline and after 12 months-follow-up were analyzed. Chronic lesions were identified on fluid-attenuated inversion recovery (FLAIR) images. Co-registered susceptibility-weighted/FLAIR images were analyzed for the presence of a CVS at baseline and follow-up.
    Results: A total of 183 chronic lesions were included in the final analysis. At baseline MRI, a CVS was detectable in 141/183 (77%) lesions. Overall, the CVS was consistent in 114/141 (81%) lesions (Cohen's kappa = 0.46, standard error = 0.07).
    Conclusion: The CVS is a rather stable feature in chronic MS lesions and therefore represents a robust imaging marker that could increase the specificity of MRI in MS.
    MeSH term(s) Biomarkers ; Brain/diagnostic imaging ; Brain/pathology ; Cross-Sectional Studies ; Humans ; Magnetic Resonance Imaging/methods ; Multiple Sclerosis/diagnosis ; Veins/pathology
    Chemical Substances Biomarkers
    Language English
    Publishing date 2022-01-15
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2645330-7
    ISSN 2211-0356 ; 2211-0348
    ISSN (online) 2211-0356
    ISSN 2211-0348
    DOI 10.1016/j.msard.2022.103530
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Cerebrospinal fluid-related tissue damage in multiple sclerosis patients with iron rim lesions.

    Wittayer, Matthias / Weber, Claudia E / Kittel, Maximilian / Platten, Michael / Schirmer, Lucas / Tumani, Hayrettin / Gass, Achim / Eisele, Philipp

    Multiple sclerosis (Houndmills, Basingstoke, England)

    2023  Volume 29, Issue 4-5, Page(s) 549–558

    Abstract: Background: In multiple sclerosis (MS), iron rim lesions (IRLs) are associated with pronounced tissue damage, higher disease severity and have been suggested as an imaging marker of chronic active inflammation behind the blood-brain barrier indicating ... ...

    Abstract Background: In multiple sclerosis (MS), iron rim lesions (IRLs) are associated with pronounced tissue damage, higher disease severity and have been suggested as an imaging marker of chronic active inflammation behind the blood-brain barrier indicating progression. Furthermore, chronic intrathecal compartmentalized inflammation has been suggested to be a mediator of a cerebrospinal fluid (CSF)-related tissue damage.
    Objective: To investigate CSF markers of intrathecal inflammation in patients with at least one IRL compared to patients without IRLs and to investigate tissue damage in lesions and normal-appearing white matter (NAWM) with proximity to CSF spaces.
    Methods: A total of 102 patients (51 with at least 1 IRL and 51 age-/sex-matched patients without IRL) scanned with the same 3T magnetic resonance imaging (MRI) and having CSF analysis data were included.
    Results: Patients with at least one IRL had higher disability scores, higher lesion volumes, lower brain volumes and a higher intrathecal immunoglobulin G (IgG) synthesis. Apparent diffusion coefficient (ADC) values in IRLs were higher compared to non-IRLs. We observed a negative linear correlation of ADC values in all tissue classes and distance to CSF, which was stronger in patients with high IgG quotients.
    Conclusion: IRLs are associated with higher intrathecal IgG synthesis. CSF-mediated intrathecal smouldering inflammation could explain a CSF-related gradient of tissue damage.
    MeSH term(s) Humans ; Multiple Sclerosis/complications ; Multiple Sclerosis/diagnostic imaging ; Multiple Sclerosis/cerebrospinal fluid ; Iron ; Magnetic Resonance Imaging ; Immunoglobulin G ; Inflammation/pathology ; Brain/pathology
    Chemical Substances Iron (E1UOL152H7) ; Immunoglobulin G
    Language English
    Publishing date 2023-02-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 1290669-4
    ISSN 1477-0970 ; 1352-4585
    ISSN (online) 1477-0970
    ISSN 1352-4585
    DOI 10.1177/13524585231155639
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: [No title information]

    Wittayer, Matthias / Sandikci, Vesile / Ebert, Anne / Koehler, Clemens / Szabo, Kristina / Hoyer, Carolin

    Das Gesundheitswesen

    2023  Volume 86, Issue 03, Page(s) 232–236

    Abstract: Kopfschmerzerkrankungen sind häufige Vorstellungsgründe in der Notaufnahme. Wichtig ist hierbei das Erkennen von potenziell gefährlichen Grunderkrankungen, die mit Kopfschmerzen einhergehen. Wir ...

    Abstract Kopfschmerzerkrankungen sind häufige Vorstellungsgründe in der Notaufnahme. Wichtig ist hierbei das Erkennen von potenziell gefährlichen Grunderkrankungen, die mit Kopfschmerzen einhergehen. Wir hypothetisierten, dass es zu einer verstärkten Inanspruchnahme der Notaufnahme aufgrund von Kopfschmerzen kam, nachdem die venöse Thrombose zerebraler Sinus, die oft starke Kopfschmerzen bedingt, als seltene Nebenwirkung der Impfung mit Adenovirus-Vektor-basierten Coronavirus-disease 2019 (COVID-19)-Impfstoffen identifiziert und durch das Paul-Ehrlich-Institut öffentlich kommuniziert worden war. Es erfolgte eine retrospektive Analyse der Daten von Patient*innen mit der Abschlussdiagnose einer primären Kopfschmerzerkrankung oder eines nicht näher spezifizierten Kopfschmerzes der Jahre 2019 und 2021, die sich in der Zentralen Notaufnahme der Universitätsmedizin Mannheim vorgestellt hatten. Auf Grundlage der Daten des vom Bundesministerium für Gesundheit herausgegebenen Impfdashboards wurden die Kalenderwochen 14–30 und 47–48 einerseits sowie 1–13 und 31–46 andererseits in eine Variable „Impfepoche“ kategorisiert (14–30, 47–48: hohe Impfaktivität bei bundesweit≥3 Mio. Impfungen/Woche; 1–13, 31–46: niedrige Impfaktivität bei bundesweit<3 Mio. Impfungen/Woche). Abhängige Variable waren die Anzahl der Vorstellungen. Mittels Poisson-Regression wurde geprüft, ob die Häufigkeit der Ereignisse sich als Funktion des Jahres (2019, 2021), der Impfepoche (niedrig, hoch) und einer Interaktion von Jahr und Epoche – letzteres den Effekt der Impfaktivität vor dem Hintergrund der Pandemie reflektierend und als Inzidenzratenverhältnis angegeben – darstellt. Im Vergleich zu 2019 ergab sich eine über 70%ige Zunahme von Vorstellungen aufgrund von Kopfschmerzen in Phasen hoher Impfaktivität im Jahr 2021 (p<0.001; 95%-Konfidenzintervall 1.272–2.316), 25% der Vorstellungen im Jahr 2021 erfolgten aufgrund einer patient*innenseitig vermuteten Assoziation mit stattgehabter Impfung. Neben anderen Faktoren, welche im Rahmen der Pandemiesituation zu einer veränderten Vorstellungssituation führen, mögen die öffentliche Informationsverbreitung und dadurch induzierte Noceboeffekte Ursachen der in unserer Analyse zutage gekommenen Unterschiede in den Vorstellungszahlen zwischen den Epochen mit unterschiedlich starker Impfaktivität sein. Dies illustriert die Auswirkungen der Kommunikation medizinischer Fakten und Informationen in Krisensituationen auf praktische Aspekte notfallmedizinischer Versorgung.
    Keywords Notaufnahme ; Kopfschmerzen ; COVID-19 ; COVID-19-Impfung ; headache ; emergency department ; COVID-19 ; COVID-19 vaccination
    Language German
    Publishing date 2023-12-08
    Publisher Georg Thieme Verlag
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1101426-x
    ISSN 1439-4421 ; 0941-3790 ; 0949-7013
    ISSN (online) 1439-4421
    ISSN 0941-3790 ; 0949-7013
    DOI 10.1055/a-2146-6286
    Database Thieme publisher's database

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