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Hyperhidrosis

Tanja Schlereth
2009 Deutsches Ärzteblatt International  
Tanja Schlereth, Marianne Dieterich, Frank Birklein SUMMARY Background: Basically two types of sweating exist: thermoregulatory and emotional sweating.  ...  REVIEW ARTICLE Hyperhidrosis-Causes and Treatment of Enhanced Sweating Tanja Schlereth, Marianne Dieterich, Frank Birklein FIGURE 1 1 FIGURE 1 Therapeutic algorithm for axillary hyperhidrosis (adapted  ... 
doi:10.3238/arztebl.2009.0032 pmid:19564960 pmcid:PMC2695293 fatcat:5qyogrmw7fbb3mzmxj5zfpknyi

Mast Cells

Tanja Schlereth, Frank Birklein
2012 Anesthesiology  
Tanja Schlereth, M.D., Frank Birklein, M.D., Ph.D., Department of Neurology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany. schleret@uni-mainz.de Fig. 1 . 1 Proposed  ... 
doi:10.1097/aln.0b013e31824bb143 pmid:22314295 fatcat:24chr5pghjgt5e6f4643thmzb4

Complex regional pain syndrome—significant progress in understanding

Frank Birklein, Tanja Schlereth
2015 Pain  
Schlereth · 156 (2015) S94-S103 PAIN ® What do rodent models tell us? It is crucial to prove hypotheses in animal models.  ...  Schlereth · 156 (2015) S94-S103 PAIN ® the implantation of an intrathecal pump for baclofen must be restricted to specialized centers.  ... 
doi:10.1097/01.j.pain.0000460344.54470.20 pmid:25789441 fatcat:xqj4mxtakzcqliyapafpd5dg4a

Inflammation in CRPS: Role of the sympathetic supply

Tanja Schlereth, Peter D. Drummond, Frank Birklein
2014 Autonomic Neuroscience: Basic & Clinical  
., 2004; A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT CGRP and SP -Schlereth et al. 6 et al., 2012) which constitute a major part of the cellular immune system in the skin and are an important  ...  A small uncontrolled trial found improvement of pain by the use of phenoxybenzamine, which induces a noncompetitive A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT CGRP and SP -Schlereth et  ... 
doi:10.1016/j.autneu.2013.12.011 pmid:24411269 fatcat:54osmxkjt5cdzaddq5nqgfhtii

Clonidine induces nitric oxide- and prostaglandin-mediated vasodilation in healthy human skin

Daniel Hermann, Tanja Schlereth, Thomas Vogt, Frank Birklein
2005 Journal of applied physiology  
Birklein. Clonidine induces nitric oxide-and prostaglandin-mediated vasodilation in healthy human skin. Sustained sympathetic activation not only leads to vasoconstriction but also might induce paradox vasodilation. This study was performed to explore whether and how ␣ 2-receptor stimulation mediates this vasodilation. We investigated 11 healthy subjects in 33 dermal microdialysis (MD) sessions. After nerve trunk blockade, MD fibers were inserted and perfused with physiological saline until
more » ... trauma-related vasodilation subsided. Thereafter, fibers were perfused with either clonidine solutions (10 Ϫ3 , 5 ϫ 10 Ϫ4 , 10 Ϫ4 mol/l), N Gmonomethyl-l-arginine (L-NMMA; nitric oxide synthase blocker), acetylsalicylic acid (ASA; cyclooxygenase blocker), or combinations of these. Laser-Doppler scanning of the investigated skin revealed that clonidine not only induces vasoconstriction but subsequently also vasodilation with higher concentrations (P Ͻ 0.001). In contrast, both L-NMMA and ASA induced vasoconstriction (P Ͻ 0.001). By coapplication of 10 Ϫ3 mol/l clonidine with L-NMMA or ASA, vasodilation was partially prevented (P Ͻ 0.001). Our results demonstrate that sustained ␣ 2-receptor stimulation induces vasodilation in a dosedependent way, which is mediated by nitric oxide and prostaglandin mechanisms in human skin. dermal microdialysis; sympathetic nervous system; alpha-adrenoreceptors; laser-Doppler imaging
doi:10.1152/japplphysiol.00271.2005 pmid:16037407 fatcat:tiarbc6fircj7nwmtl2efkrfvi

Development of a severity score for CRPS

Norman R. Harden, Stephen Bruehl, Roberto S.G.M. Perez, Frank Birklein, Johan Marinus, Christian Maihofner, Timothy Lubenow, Asokumar Buvanendran, Sean Mackey, Joseph Graciosa, Mila Mogilevski, Christopher Ramsden (+3 others)
2010 Pain  
The clinical diagnosis of Complex Regional Pain Syndrome (CRPS) is a dichotomous (yes/no) categorization necessary for clinical decision-making. However, such dichotomous diagnostic categories do not convey an individual's subtle and temporal gradations in severity of the condition, and have poor statistical power when used as an outcome measure in research. This study evaluated the validity and potential utility of a continuous type score to index severity of CRPS. Psychometric and medical
more » ... uations were conducted in 114 CRPS patients and 41 non-CRPS neuropathic pain patients. Based on the presence/absence of 17 clinically-assessed signs and symptoms of CRPS, an overall CRPS Severity Score (CSS) was derived. The CSS discriminated well between CRPS and non-CRPS patients (p<.001), and displayed strong associations with dichotomous CRPS diagnoses using both IASP diagnostic criteria (Eta=0.69) and proposed revised criteria (Eta=0.77-0.88). Higher CSS was associated with significantly higher clinical pain intensity, distress, and functional impairments, as well as greater bilateral temperature asymmetry and thermal perception abnormalities (p's<.05). In an archival prospective dataset, increases in anxiety and depression from pre-surgical baseline to 4 weeks post-knee arthroplasty were found to predict significantly higher CSS at 6- and 12-month follow-up (p's<.05). Results indicate the CSS corresponds with and complements currently accepted dichotomous diagnostic criteria for CRPS, and support its validity as an index of CRPS severity. Its utility as an outcome measure in research studies is also suggested, with potential statistical advantages over dichotomous diagnostic criteria.
doi:10.1016/j.pain.2010.09.031 pmid:20965657 fatcat:mieuo54jzngsre6r3djx3tfvfi

Guideline "diagnosis and non interventional therapy of neuropathic pain" of the German Society of Neurology (deutsche Gesellschaft für Neurologie)

Tanja Schlereth
2020 Neurological Research and Practice  
Schlereth Neurological Research and Practice(2020) 2:16 Page 6 of 19 Schlereth Neurological Research and Practice (2020) 2:16 Page 7 of 19 Schlereth Neurological Research and Practice(2020) 2  ...  :16 Schlereth Neurological Research and Practice(2020) 2:16 Page 9 of 19  ... 
doi:10.1186/s42466-020-00063-3 pmid:33324922 pmcid:PMC7650069 fatcat:hixcfz6bjnf7ncfafqahyfpmra

Activation of Cutaneous Immune Responses in Complex Regional Pain Syndrome

Frank Birklein, Peter D. Drummond, Wenwu Li, Tanja Schlereth, Nahid Albrecht, Philip M. Finch, Linda F. Dawson, J. David Clark, Wade S. Kingery
2014 Journal of Pain  
The pathogenesis of complex regional pain syndrome (CRPS) is unresolved, but tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) are elevated in experimental skin blister fluid from CRPS-affected limbs, as is tryptase, a marker for mast cells. In the rat fracture model of CRPS, exaggerated sensory and sympathetic neural signaling stimulate keratinocyte and mast cell proliferation, causing the local production of high levels of inflammatory cytokines leading to pain behavior. The
more » ... investigation used CRPS patient skin biopsies to determine whether keratinocyte and mast cell proliferation occur in CRPS skin and to identify the cellular source of the up-regulated TNF-α, IL-6, and tryptase observed in CRPS experimental skin blister fluid. Skin biopsies were collected from the affected skin and the contralateral mirror site in 55 CRPS patients and the biopsy sections were immunostained for keratinocyte, cell proliferation, mast cell markers, TNF-α, and IL-6. In early CRPS, keratinocytes were activated in the affected skin, resulting in proliferation, epidermal thickening, and up-regulated TNF-α and IL-6 expression. In chronic CRPS, there was reduced keratinocyte proliferation, leading to epidermal thinning in the affected skin. Acute CRPS patients also had increased mast cell accumulation in the affected skin, but there was no increase in mast cell numbers in chronic CRPS.
doi:10.1016/j.jpain.2014.01.490 pmid:24462502 pmcid:PMC4011956 fatcat:wipicp35ora2xdydkzp3mbvney

The Rodent Tibia Fracture Model: A Critical Review and Comparison With the Complex Regional Pain Syndrome Literature

Frank Birklein, Alaa Ibrahim, Tanja Schlereth, Wade S. Kingery
2018 Journal of Pain  
Bruehl S, Maihofner C, Stanton-Hicks M, Perez RS, Vatine JJ, Brunner F, Birklein F, Schlereth T, Mackey S, Mailis-Gagnon A, Livshitz A, Harden RN.  ...  Birklein F, Drummond PD, Li W, Schlereth T, Albrecht N, Finch PM, Dawson LF, Clark JD, Kingery WS. Activation of cutaneous immune responses in complex regional pain syndrome.  ... 
doi:10.1016/j.jpain.2018.03.018 pmid:29684510 pmcid:PMC6163066 fatcat:gwipndqupjgwxhqf4hui5sfnoi

Neuropeptide regulation of adaptive immunity in the tibia fracture model of complex regional pain syndrome

Wen-Wu Li, Tian-Zhi Guo, Xiaoyou Shi, Frank Birklein, Tanja Schlereth, Wade S. Kingery, J. David Clark
2018 Journal of Neuroinflammation  
Both dysfunctional neuropeptide signaling and immune system activation are characteristic of complex regional pain syndrome (CRPS). Unknown is whether substance P (SP) or calcitonin gene-related peptide (CGRP) support autoantibody production and, consequently, nociceptive sensitization. Methods: These experiments involved the use of a well-characterized tibia fracture model of CRPS. Mice deficient in SP expression (Tac1 −/− ) and CGRP signaling (RAMP1 −/− ) were used to probe the neuropeptide
more » ... pendence of post-fracture sensitization and antibody production. The deposition of IgM in the spinal cord, sciatic nerves, and skin was followed using Western blotting, as was expression of the CRPS-related autoantigen cytokeratin 16 (Krt16). Passive serum transfer to B-cell-deficient muMT mice was used to assess the production of functional autoantibodies in CRPS model mice. The use of immunohistochemistry allowed us to assess neuropeptide-containing fiber distribution and Langerhans cell abundance in mouse and human CRPS patient skin, while Langerhans cell-deficient mice were used to assess the functional contributions of these cells. Results: Functional SP and CGRP signaling were required both for the full development of nociceptive sensitization after fracture and the deposition of IgM in skin and neural tissues. Furthermore, the passive transfer of serum from wildtype but not neuropeptide-deficient mice to fractured muMT mice caused enhanced allodynia and postural unweighting. Langerhans cells were increased in number in the skin of fracture mice and CRPS patients, and those increases in mice were reduced in neuropeptide signaling-deficient animals. Unexpectedly, Langerhans cell-deficient mice showed normal nociceptive sensitization after fracture. However, the increased expression of Krt16 after tibia fracture was not seen in neuropeptide-deficient mice. Conclusions: Collectively, these data support the hypothesis that neuropeptide signaling in the fracture limb of mice is required for autoantigenic IgM production and nociceptive sensitization. The mechanism may be related to neuropeptide-supported autoantigen expression.
doi:10.1186/s12974-018-1145-1 pmid:29642930 pmcid:PMC5896028 fatcat:udxa4ce4hvealfdr6byra433iu

Osteoprotegerin: A new biomarker for impaired bone metabolism in complex regional pain syndrome?

Heidrun H. Krämer, Lorenz C. Hofbauer, Gabor Szalay, Markus Breimhorst, Tatiana Eberle, Katja Zieschang, Martina Rauner, Tanja Schlereth, Matthias Schreckenberger, Frank Birklein
2014 Pain  
Osteoprotegerin (OPG) is important for bone remodeling and may contribute to complex regional pain syndrome (CRPS) pathophysiology. We aimed to assess the value of OPG as a biomarker for CRPS and a possible correlation with radiotracer uptake in 3-phase bone scintigraphy (TPBS). OPG levels were analyzed in 23 CRPS patients (17 women; mean age 50±9.0 years; disease duration: 12 weeks [IQR 8-24]), 10 controls (6 women; mean age 58±9.6 years) and 21 patients after uncomplicated fractures (12
more » ... mean age: 43±15 years; time after fracture: 15 weeks [IQR: 6-22]). The CRPS and control patients also underwent TPBS. OPG in CRPS patients was significantly increased by comparison with both control groups (P=0.001; Kruskal-Wallis test; CRPS patients: 74.1 pg/mL [IQR: 47.1-100.7]; controls: 46.7 pg/mL [IQR: 35.5-55.0]; P=0.004; fracture patients: 45.9 pg/mL [IQR: 37.5-56.7]; P=0.001). As a diagnostic test for CRPS, OPG had a sensitivity of 0.74, specificity of 0.80, positive predictive value of 68% and negative predictive value of 84%. Receiver operating characteristic curve analysis showed an area under the curve of 0.80 (CI: 0.68-0.91). For the CRPS-affected hand, a significant correlation between OPG and TPBS region of interest analysis in phase III was detected (carpal bones; r=0.391; P=0.03). The persistent OPG increase in CRPS indicates enhanced osteoblastic activity shown by increased radiotracer uptake in TPBS phase III. A contribution of bone turnover to CRPS pathophysiology is likely. OPG might be useful as a biomarker for CRPS.
doi:10.1016/j.pain.2014.01.014 pmid:24447513 fatcat:v2gwjlxdq5eshe2bowmeqks5ba

In vivorelease of non-neuronal acetylcholine from the human skin as measured by dermal microdialysis: effect of botulinum toxin

Tanja Schlereth, Frank Birklein, Katrinan Haack, Susanne Schiffmann, Heinz Kilbinger, Charles James Kirkpatrick, Ignaz Wessler
2006 British Journal of Pharmacology  
., 2003; Schlereth et al., 2005) .  ...  Schlereth et alAcetylcholine release by dermal microdialysis  ... 
doi:10.1038/sj.bjp.0706451 pmid:16273117 pmcid:PMC1615863 fatcat:m4emgefh3fchxplxty37fp4vfq

Page 3769 of Psychological Abstracts Vol. 88, Issue 9 [page]

2001 Psychological Abstracts  
., 26219 Schlereth, Tanja , 26087 Schlicht, Christian, 28301 Schliebner, Scott D., 26355 Schmechel, Donald E., 2 Schmeidler, James, 2 Schmidt, Louis A., 26500 Schmidt, Lyle, 25918 Schmidt, Martin H., 27373  ... 

Thank you to our reviewers 2016

2017 BMJ Open  
Grimes Tammy Clifford Tammy Hoffmann Tania Huedo-Medina Tania King Tanja Roy Tanja Schlereth Tanya Murphy Tara Gomes Tara Mills Tarang Sharma Tasha Stanton Tasneem Motiwala Tatjana Rundek  ... 
doi:10.1136/bmjopen-2017-reviewers fatcat:aq6ur6zrmvdm7irf2amzehyyey

Page 209 of Psychological Abstracts Vol. 88, Issue Author Index [page]

Psychological Abstracts  
., 20548, 36720 Schlereth, Tanja , 26087 Schlesinger, Mark, 23962 Schlesinger, Matthew, 17036 Schlesser, Michael, 23860 Schlicht, Christian, 28301 Schlicht, Jeffrey Schlichter, Lyanne, 1354 Schlidt, Andrea  ... 
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