Publications by authors named "Iris Lettow"

4 Publications

  • Page 1 of 1

Higher white matter hyperintensity lesion load is associated with reduced long-range functional connectivity.

Brain Commun 2020 20;2(2):fcaa111. Epub 2020 Jul 20.

Department of Neurology, University Medical Center Hamburg-Eppendorf, Germany.

Cerebral small vessel disease is a common disease in the older population and is recognized as a major risk factor for cognitive decline and stroke. Small vessel disease is considered a global brain disease impacting the integrity of neuronal networks resulting in disturbances of structural and functional connectivity. A core feature of cerebral small vessel disease commonly present on neuroimaging is white matter hyperintensities. We studied high-resolution resting-state EEG, leveraging source reconstruction methods, in 35 participants with varying degree of white matter hyperintensities without clinically evident cognitive impairment in an observational study. In patients with increasing white matter lesion load, global theta power was increased independently of age. Whole-brain functional connectivity revealed a disrupted network confined to the alpha band in participants with higher white matter hyperintensities lesion load. The decrease of functional connectivity was evident in long-range connections, mostly originating or terminating in the frontal lobe. Cognitive testing revealed no global cognitive impairment; however, some participants revealed deficits of executive functions that were related to larger white matter hyperintensities lesion load. In summary, participants without clinical signs of mild cognitive impairment or dementia showed oscillatory changes that were significantly related to white matter lesion load. Hence, oscillatory neuronal network changes due to white matter lesions might act as biomarker prior to clinically relevant behavioural impairment.
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http://dx.doi.org/10.1093/braincomms/fcaa111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585696PMC
July 2020

Clinical Characteristics and Outcome of Patients With Hemorrhagic Transformation After Intravenous Thrombolysis in the WAKE-UP Trial.

Front Neurol 2020 28;11:957. Epub 2020 Aug 28.

Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Hemorrhagic transformation (HT) is an important complication of intravenous thrombolysis with alteplase. HT can show a wide range from petechiae to parenchymal hematoma with mass effect with varying clinical impact. We studied clinical and imaging characteristics of patients with HT and evaluated whether different types of HT are associated with functional outcome. We performed a analysis of WAKE-UP, a multicenter, randomized, placebo-controlled trial of MRI-guided intravenous alteplase in unknown onset stroke. HT was assessed on follow-up MRI or CT and diagnosed as hemorrhagic infarction type 1 and type 2 (HI1 and HI2, combined as HI), and parenchymal hemorrhage type 1 and type 2 (PH1 and PH2, combined as PH). Severity of stroke symptoms was assessed using the National Institutes of Health Stroke Scale (NIHSS) at baseline. Stroke lesion volume was measured on baseline diffusion weighted imaging (DWI). Primary endpoint was a favorable outcome defined as a modified Rankin Scale score 0-1 at 90 days. Of 483 patients included in the analysis, 95 (19.7%) showed HI and 21 (4.4%) had PH. Multiple logistic regression analysis identified treatment with alteplase (OR, 2.08 [95% CI, 1.28-3.40]), baseline NIHSS score (OR, 1.11 [95% CI, 1.05-1.17]), DWI lesion volume (OR, 1.03 [95% CI, 1.01-1.05]), baseline glucose levels (OR, 1.01 [95% CI, 1.00-1.01]) and atrial fibrillation (OR, 3.02 [95% CI, 1.57-5.80]) as predictors of any HT. The same parameters predicted HI. Predictors of PH were baseline NIHSS score (OR, 1.11 [95% CI, 1.01-1.22]) and as a trend treatment with alteplase (OR, 2.40 [95% CI, 0.93-6.96]). PH was associated with lower odds of favorable outcome (OR 0.25, 95% [CI 0.05-0.86]), while HI was not. Our results indicate that HI is associated with stroke severity, cardiovascular risk factors and thrombolysis. PH is a rare complication, more frequent in severe stroke and with thrombolysis. In contrast to HI, PH is associated with worse functional outcome. The impact of HT after MRI-guided intravenous alteplase for unknown onset stroke on clinical outcome is similar as in the trials of stroke thrombolysis within a known early time-window.
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http://dx.doi.org/10.3389/fneur.2020.00957DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7483750PMC
August 2020

[Delayed neuropsychological sequelae after carbon monoxide poisoning].

Fortschr Neurol Psychiatr 2018 06 28;86(6):342-347. Epub 2018 Jun 28.

Asklepios Klinikum Harburg, Klinik für Neurologie.

Carbon monoxide poisoning is a very common intoxication worldwide. Its clinical manifestations vary from symptoms like mild headache and dizziness to more serious issues including death. Less well known are symptoms that occur with a delay of 2-40 days, such as movement disorders, cognitive impairment or affective disorders. In this article, we present a case of carbon monoxide poisoning with a delayed neurological sequela. The following review summarizes the literature on clinical presentation, diagnostic options, pathophysiology and therapy of this disease.
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http://dx.doi.org/10.1055/a-0599-0737DOI Listing
June 2018

A Duffy antigen receptor for chemokines (DARC) polymorphism that determines pro-fibrotic chemokine serum concentrations is not directly associated with severity of hepatitis C infection.

Hum Immunol 2011 Mar 13;72(3):273-7. Epub 2010 Dec 13.

Department of Medicine III, University Hospital, Aachen, Germany.

Genetic host factors influence the progression of hepatitis C infection (HCV). Chemokines play important roles in HCV-induced liver fibrosis. Recently, a single nucleotide polymorphism in the Duffy antigen receptor for chemokines (DARC) was identified which strongly determines the serum concentrations of pivotal pro-fibrotic chemokines, including CCL2. We here tested the hypothesis that this genetic variant (rs12075 A/G) is a risk factor for liver fibrosis in HCV infection. Overall, 880 patients with HCV from three cohorts and 108 controls were genotyped for rs12075. Although serum CCL2 levels were associated with early liver fibrosis, rs12075 itself was not associated with HCV infection or the severity of liver disease in any of the cohorts. The lack of association was evident in qualitative and quantitative analysis despite sufficient statistical power. We conclude that gene variations that strongly determine serum concentrations of chemokines are not necessarily risk markers of the disease traits in which these molecules play pathophysiological roles.
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http://dx.doi.org/10.1016/j.humimm.2010.12.002DOI Listing
March 2011