Abstracts of the German Congress on Parkinson's Disease and Movement Disorders (Deutscher Kongress für Parkinson und Bewegungsstörungen), 7–9 March 2019, Düsseldorf, Germany

2019 Journal of neural transmission  
Title: Quantitative ultrasound in spasticity-inter-rater-reliability and muscular changes (Quantitative Sonographie bei Spastizität-Inter-Rater-Reliabilität und Muskelveränderungen) Abstract Text: Introduction: Spasticity is associated with secondary muscular changes (especially atrophy and increase of connective tissue) that might have implications for the efficacy of botulinum toxin (BTX) treatment. These changes could be visualized by ultrasound, nevertheless the reliability of this method
more » ... d the degree and distribution of muscular alterations is not clear up to now. Target: We therefore aimed to assess the inter-rater reliability of ultrasound in spasticity and to evaluated muscular changes in a quantitative way. Methods: Patients with spastic hemiparesis due to intracerebral ischemia or bleeding (n = 14, age 56.6 years (20-76), duration of spasticity 8.5 years (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), duration of BTX treatment 4.3 years (1.8-7.5)) were examined by 5 neurologist using ultrasound. Assessed muscles at the upper limb included flexor carpi ulnaris (FCU), flexor dig. prof./superf. (index finger; FDP/FDS), extensor dig. com. (EDC) and at the lower limb medial gastrocnemius (MG) and tibialis anterior (TA) muscle. We assessed cross sectional area or a-p diameter and echogenicity using offline grey scale analysis and compared measurements of the affected side to the non-affected side. Results: We found an excellent inter-rater reliability (ICC (2,5) 86-96%) concerning all parameters. At the upper limb we found a statistically significant increase in echogenicity on the affected side vs. the non-affected side (EDC 64 vs. 57, p = 0.002; FCU 71 vs. 56, p \ 0.001; FDP 69 vs. 54, p = 0.022; FDS 65 vs. 52, p = 0.003) as well as a significant atrophy on the affected side (EDC 16.7 vs. 20.4, p \ 0.001; FCU 8.2 vs. 10.6, p = 0.002; FDP 3.7 vs. 5.0, p \ 0.001; FDS 5.5 vs. 7.9, p = 0.001). On the other hand, we did not find significant differences at the lower limb. Conclusion: Ultrasound is an easy, quick and reliable method to examine muscular changes in spasticity which confirmed significant atrophy and hyperechogenicity at least at the upper spastic limb. Individual changes might have implications for botulinum toxin treatment concerning selection of muscles and efficacy. Nevertheless, larger and longitudinal studies are needed to assess the influence of duration of spasticity and BTX treatment on these muscular changes and to correlate them with efficacy of BTX treatment. Abstract No.: 258 Abstract Title: Bidirectional conversions of DemTect, MoCA and MMSE in the context of Parkinson's disease screening (Bidirektionale Konversionen von DemTect, MoCA und MMST im Kontext des Parkinson-Screenings) Abstract Text: Introduction: For a comprehensive specification and quantification of neuropsychological deficits in Parkinson's disease as well as other neurological and psychiatric disorders, extensive neuropsychological assessment is needed. Due to its time intensiveness, this cannot be realised in every clinical setting. Therefore, screening instruments provide a first step. Because their selection differs between and sometimes even within clinics, a comparison of results in different screenings would be helpful for maintaining continuity and for follow-up studies. Target: This study aimed at creating conversion tables for the German-speaking area including sum scores on one screening instrument as well as their equivalent sum scores on another one. For this purpose, the three mostly used screening instruments Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Dementia Detection Test (DemTect) were used. Methods: In the Department of Neurology at the University Hospital of Cologne, 8240 patients suffering from neurological disorders including Parkinson's disease patients were examined between 2008 and 2017. MMSE and DemTect were conducted with 6287, MoCA and MMSE with 536 as well as MoCA and DemTect with 543 patients. Conversion scores using total scores on these screenings were then computed by using the equipercentile equating method implemented in R Statistical Software. This method has already been J Neural Transm https://doi.org/10.1007/s00702-019-01978-1 used in English-speaking but not German-speaking countries with different patient populations (e.g. Parkinson's disease or Stroke) and smaller sample sizes. It assumes equivalence of two scores on different tests if their percentile rank is similar (e.g. if in the same cohort a score of 21 in the MMSE and a score of 26 in the MoCA is at the 45th percentile, these two scores would be considered as being equivalent). Results: Total scores on the MMSE and MoCA (r = 0.74), DemTect and MoCA (r = 0.70) as well as DemTect and MMSE (r = 0.67) were highly correlated (p \ 0.01, respectively). The calculated bidirectional conversion tables enable quick and easy comparisons between the three most frequently used screening instruments. Additionally, they are in agreement with those obtained in previous studies in English-speaking countries. Conclusion: The results enable an enhanced longitudinal assessment of cognitive functions in different clinical settings, provide comparability as well as continuity, and offer more flexibility for determination of patient status. Additionally, communication between clinics is improved. An extension of the study might be the transfer of the method presented to other cognitive or affective screenings measuring for example executive dysfunctions or depressive symptoms that have a high prevalence in Parkinson's disease. Abstract No.: 260 Abstract Title: Exosomes: novel biomarkers for the clinical diagnosis of neurodegenerative diseases (Exosomen: neue Biomarker für die Diagnostik neurodegenerativer Erkrankungen) Abstract Text: Introduction: Exosomes are vesicles of 40-120 nm diameter which are secreted by many cells. These extracellular vesicles can serve two major functions, (1) clearance of toxic or superfluous cellular content and (ii) to facilitate cell-cell communication by transfer of (signalling) proteins, lipids and RNA between cells. Exosomes from various origins are abundantly present in biofluids, including blood and are therefore accessible as biomarkers. Parkinson's disease is characterized by abnormal intraneuronal aggregation of alpha-Synuclein. Exosomes may transfer pathological alpha-Synuclein aggregates from diseased to so far unaffected neurons to induce misfolding and aggregate formation, thus contributing to propagation of disease pathology. We have previously shown that exosomes from cerebrospinal fluid of patients with alpha-Synuclein related neurodegeneration carry a pathogenic seed which can induce alpha-Synuclein aggregation in vitro. Target: Here, we investigated the potential of plasma exosomes as a fluid biomarker to detect Parkinson's disease by quantifying exosome numbers and exosomal alpha-Synuclein content in 2 independent cohorts of patients with Parkinson's disease, Lewy body dementia and controls. Methods: We first established and optimized standard operating procedures (SOPs) for the purification of plasma-derived exosomes by size exclusion chromatography. This purification methods results in preparations of superior purity, high reproducibility and and easy performance without expensive equipment, thus enabling this method to move to diagnostic routine. Exosomes were prepared from plasma and exosome numbers were quantified by nanoparticle tracking. Exosomal alpha-Synuclein content was quantified by a well-established electrochemiluminescence assay. Results: We find that plasma exosomal alpha-Synuclein detects Parkinson's disease with high sensitivity and specificity. We could replicate these findings in an independent patient cohort. Conclusion: Our results indicate that the quantification of plasma exosomal alpha-Synuclein may be a promising and easily accessible biomarker for the detection of Parkinson's diseases. Abstract No.: 261 Abstract Title: Das "Trockene Auge" bei Parkinson-Syndromen und seine Folgen-Möglichkeiten der Therapie Abstract Text: Abstract No.: 278 Abstract Title: Training of working memory in Parkinson's Disease: neural correlates of pure storage and manipulation (Arbeitsgedächtnistraining bei Parkinson: neuronale Korrelate der Speicherung und Manipulation von Information) Abstract Text: Introduction: Working memory (WM) describes a cognitive resource of limited capacity, which enables us to temporarily maintain and manipulate relevant information. Impairments of WM and especially its executive aspects (i.e. manipulation of information within WM) are early cognitive symptoms in Parkinson's Disease. Thus, maintaining high WM function is essential. Training of WM has been proven beneficial in non-PD populations, with positive effects also transferring to other cognitive abilities. Whether such training can also be beneficial for patients with PD and which effect such an intervention may have on the correlates of different aspects of WM in this cohort remains a weakly investigated question so far. Target: This study aimed to investigate the neural correlates of different WM aspects (manipulation vs. maintenance) in a cohort of PD patients without cognitive impairment using a newly designed WM paradigm and functional magnetic resonance imaging (fMRI). Further, we aimed to evaluate the change of these correlates as a function of a computerized 5 week WM training. Methods: 29 patients (13 female; mean age = 65y ± 10y) with idiopathic PD were recruited. All patients underwent an fMRI session on a 3T Philipps Ingenia while performing a newly designed WM paradigm before and after a 5 week WM training scheme. In order to disentangle pure WM storage from manipulation within WM, patients had to either memorize a sequence of letters or to memorize and reverse the letter order. After pre-processing, first and second level group analyses were performed for contrasts of interest (maintain [ rest, manipulate [ rest and manipulate [ maintain) using SPM12. Results were considered significant on cluster-level when p \ 0.05 (FWE-corrected). Results: Pure maintenance in WM (maintain [ rest) activated regions typically involved in WM such as vlPFC, dlPFC, OFC, anterior insula, premotor cortex, angular gyrus and cerebellum. Manipulating items within WM (manipulate [ rest) required largely the same regions, however also relied on the striatum and left parietal lobe. This was even more apparent in the specific manipulate [ maintain contrast, where also a strong activation of the precuneus was observed. As a function of training, PD patients showed increased activation in WM related areas, especially when manipulation of information was required. Conclusion: Using this paradigm allowed us to successfully disentangle the differential regions involved in pure WM maintenance and WM manipulation and further allowed to estimate the functional change in these areas associated with WM training. Abstract No.: 279 Abstract Title: Association between non-motor symptoms and cognitive-driven activity of daily living impairment in Parkinson's Disease Abstract Text: Introduction: In Parkinson's Disease (PD), it is becoming increasingly evident that the frequency and severity of non-motor symptoms (NMS) considerably influences not only motor progression, but also the rate of cognitive decline. Behavioral symptoms that can indicate an early development of Parkinson's disease dementia (PDD) include depression, anxiety, sleep disturbances and hallucinations. These four symptoms can be summarized into a comprehensive DASH score. Moreover, there is evidence that mild activity of daily living (ADL) impairments primarily caused by cognitive dysfunction are also present in the prodromal stage of PDD. To date, the association of both risk factors has been sparsely investigated. Target: Aim of the current research was to validate the DASH score in a large cohort of non-demented PD patients as well as to examine its association to other known risk factors for PDD, especially cognitive-driven ADL impairment. We hypothesized that higher DASH scores are associated to more impaired cognition and ADL function, especially in PD patients with mild cognitive impairment (PD-MCI), characterizing a risk group for PDD. Methods: Data of 226 PD patients assessed with comprehensive nonmotor, motor and neuropsychological assessments was analyzed. Patients were diagnosed with PD-MCI according to the Level-II recommendations of the Movement Disorder Task Force; patients who did not meet these criteria were classified as cognitively normal (PD-CN). Using the corresponding items of the PD NMS-Scale, the DASH-NMS score was constructed. Two sub-scores of the Functional Activities Questionnaire (FAQ) were constructed to primarily reflect both cognitive-driven (FAQC) and motor-driven ADL impairments (FAQM). Results: Of all patients, 132 (58.4%) were characterized as PD-NC, and 94 (41.6%) as PD-MCI. Results showed that the DASH-NMS score was higher in the PD-MCI compared to the PD-NC group (p = 0.037). Higher values of the DASH-NMS score were correlated to worse neuropsychological test performance assessing attention/working memory (p = 0.006), visuo-spatial functions (p = 0.005), and language (p = 0.050). A linear regression with the DASH-NMS (dependent variable) and all variables significantly correlated to it (independent predictors), showed that the only statistically significant predictor of the DASH-NMS score was cognitive-driven ADL impairment (p = 0.009). Conclusion: Our results show that the DASH-NMS score is related to the severity of cognitive impairment, and is primarily associated to cognitive-driven ADL impairment. Both factors may define a group of patients at risk for conversion to PDD; however, long-term studies are needed to evaluate the predictive value of the FAQ sub-score as well as the DASH-NMS score in terms of cognitive worsening and PDD development. Abstract Abstract No.: 300 Abstract Title: Clinical and biomarker characteristics of patients with multiple system atrophy treated with epigallocatechin gallate for anti-aggregation of a-synuclein Abstract Text: Introduction: Intracellular a-synuclein aggregates are the pathological hallmark of multiple system atrophy (MSA). Inhibition of asynuclein aggregation therefore appears to be a rational approach for developing a disease modifying treatment for MSA. Epigallocatechin gallate (EGCG) is an orally bioavailable small molecule that inhibits a-synuclein aggregation and shows efficacy in several in vitro and animal models of synucleinopathies. Due to rapid disease progression and lack of potent symptomatic treatments, there is a high and unmet need for a disease modifying therapy for MSA. Target: To evaluate the safety and tolerability of epigallocatechin gallate (EGCG) in high doses (800-1200 mgs/day) and its efficacy to slow down disease progression in patients with MSA. Methods: A double-blind placebo-controlled parallel-group phase III study including 92 participants meeting clinical criteria for MSA was conducted. Treatment with EGCG or placebo (randomized 1:1) was administered orally for 48 weeks followed by a 4-week washout phase. The primary endpoint was the change in motor symptoms assessed by the Unified MSA Rating Scale (UMSARS-ME) from baseline up to 52 weeks. In addition to the general study procedures, a subset of patients was examined by MRI. Results: 127 participants were screened, 92 were randomized and 67 (72.8%) completed treatment. There was no statistically significant difference in UMSARS scores between EGCG (mean: 5.7; 95% confidence interval: 3.7-7.6) and placebo groups (6.6; 4.65-8.54) at the end of the study. Despite the negative clinical endpoint, we observed a significantly reduced loss in striatal volume in EGCGtreated MSA patients compared to controls. Significantly more liver toxicity was observed in the EGCG group. Conclusion: Treatment with EGCG in high doses over 52 weeks did not slow the progression of MSA. Cases of hepatotoxicity in the EGCG group show that the limit of maximum tolerable EGCG doses has been reached. Reduced atrophy in MRI (exploratory endpoint) indicates that treatment approaches with more effective anti-aggregative compounds may be considered for future disease modifying studies in MSA. Abstract No.: 301 Abstract Title: Effects of opicapone at different times of the evening (Effekte von Opicapon zu unterschiedlichen Zeiten des Abends) Abstract Text: Introduction: L-Dopa is still the gold standard in Parkinson therapy. Some approaches target on optimization of L-Dopa therapy, that is, a better and steadier effect and improved tolerance of the drug. One major progress was the introduction of COMT-inhibitors 2 decades ago. Opicapone, a peripheral, selective COMT-inhibitor, was approved in 2016. According to the manufacturer's recommendations, Abstract No.: 302 Abstract Title: Computerized working memory training improves executive functions in patients with Parkinson's Disease (Digitales Arbeitsgedächtnistraining verbessert Exekutivfunktionen bei Patientinnen und Patienten mit Morbus Parkinson) Abstract Text: Introduction: Progressive cognitive impairments are a frequent and debilitating symptom of Parkinson's Disease (PD). Amongst the most common and earliest cognitive impairments in PD are dysfunctions of working memory, a capacity-limited memory system (visuospatial vs. numerical-verbal) that is responsible for the short-term storage and manipulation of information. Therefore, it is central to the execution of other cognitive processes. Previous studies with healthy young and elderly individuals and different patient groups, but not yet in PD, suggest that specific working memory training may lead to increased working memory performance. Moreover, transfer effects of the training to other cognitive domains have been described. Target: The aim of this study was to investigate whether an adaptive computerized working memory training (CWMT) has an effect on cognition and motor impairment in patients with PD without cognitive impairment and to investigate predictors of training outcomes. Abstract 123 Methods: N = 75 patients with PD (46% women; age: M = 63.98, SD = 8.42; UPDRS: Md = 29, 10-53) without cognitive impairment (MoCA: M = 27.33, SD = 1.57) were included in this single-blind randomized controlled trial evaluating effects of a 5-week adaptive CWMT with selected tasks of the brain training program NeuroNation (Synaptikon GmbH, Berlin, Germany) against a passive control group. Patients were examined clinically and neuropsychologically including five cognitive domains (executive functions, memory, attention, visuospatial cognition, and language) at baseline, after training, and at 3-months follow-up. Training and experimental group were comparable regarding age, sex, education, global cognition and disease characteristics (disease duration; UPDRS; H&Y LEDD). Results: To examine the effects of the CWMT compared to the control group, multivariate analyses of variance (MANOVAs) were performed for each cognitive domain and motor impairment, with follow-up ANOVAs for each assessment separately in case of significance. The MANOVA yielded a significant time 9 group interaction for executive functions, Pillai's trace V = 0.19, F(5,68) = 3.13, p = 0.013, partial eta2 = 0.19, indicating a positive training effect in the CWMT group, especially in the subtests of semantic verbal fluency and logical reasoning. No other significant effects were found. Conclusion: A 5-week specific CWMT may significantly improve executive functions in PD patients without cognitive impairment. Follow-up analyses are necessary to analyze whether long-term effects are also observable and whether CWMT may thus be an effective approach to prevent cognitive decline in patients with PD with (yet) no cognitive impairment in the long-term. Abstract No.: 303 Abstract Title: Health-related quality of life subdomains in patients with Parkinson's Disease: the role of gender (Subdomänen gesundheitsbezogener Lebensqualität bei Patient*Innen mit Morbus Parkinson: die Rolle des Geschlechts) Abstract No.: 305 Abstract Title: Validation of the Erlangen test of activities of daily living in mild dementia and mild cognitive impairment in Parkinson's Disease (Validierung des ETAM bei Morbus Parkinson) Abstract Text: Introduction: Besides cognitive dysfunctions, problems in activities in daily living (ADL) are mandatory for the diagnosis of Parkinson's disease (PD) dementia (PDD). There is evidence that some PD patients with mild cognitive impairment (PD-MCI) already show mild difficulties in ADL, especially in instrumental ADL tasks, and might therefore be at higher risk for the development of PDD. In clinical practice, ADL functions are often assessed using questionnaires or interviews. However, self-and caregiver-reported ADL performance indicative for PDD is often confounded by motor dysfunctions and mood. Therefore, objective and time-economic performance-based measurements are needed to assess cognitive-related ADL functions in PD. Target: The aim of this study was to evaluate the Erlangen Test of Activities of Daily Living in Mild Dementia and Mild Cognitive Impairment (ETAM) in a non-demented PD cohort. Methods: Data of 21 PD patients with no cognitive impairment (PD-NC), 24 PD-MCI patients, and 17 healthy controls (HC) were analyzed. Apart from the ETAM, participants completed a comprehensive neuropsychological test battery and further ADL, mood, and motor measurements. A non-parametric test statistic was applied. Test reliability was calculated by means of interrater reliability (IRR, intraclass correlation), internal consistency (Cronbach's alpha), item-total correlation, and item difficulty. Construct validity was evaluated with the Spearman's rho correlation coefficient (rs). Results: Analysis confirmed a very high IRR for the ETAM total score (r = 0.96). Item-total correlations indicated little redundancy amongst all items and item difficulty showed that most participants scored high on the ETAM subtests (Pi [ 90.98). Correlation analysis revealed a significant association of the ETAM total score with selfrated ADL functions (rs = -0.44) and cognitive performance (rs = 0.44); however, mood (rs = 0.05), and motor function (rs = -0.19) did not interfere with the ETAM performance. A score of 27 was chosen as a cut-off to define affected ADL performance (lowest value in HC). No patients of the PD-NC group achieved a score below this cut-off compared to 26.1% of the PD-MCI group (p = 0.012). Conclusion: The ETAM provides a good reliability and validity in PD. We were able to identify a subgroup of PD-MCI patients with pathological ADL dysfunctions, who we hypothesize will further progress towards PDD in the near future. To validate this assumption longitudinal investigations are needed to follow patients' cognitive progression, which are currently ongoing. Abstract No.: 306 Abstract Title: Guidelines for the neuropsychological assessment in Parkinson's disease Abstract Text: Abstract No.: 307 Umut stable within at least 12 months and well tolerated. Our findings confirm previous result of pivotal clinical studies. Abstract No.: 310 Abstract Title: Detection of nigro-striatal pathway disruption in Parkinson's Disease patients using a multimodal imaging approach (Detektion von Korrelaten der Degeneration nigro-striataler Bahnen bei Parkinson Patienten mittels multimodaler Bildgebung) Abstract No.: 312 Abstract Title: Activity of cerebral networks, amyloid and microglia in corticobasal syndrome: a prospective biomarker study (Zerebrale Netzwerkdegeneration, Amyloid und Mikroglia bei Corticobasalem Syndrom: eine prospektive Biomarkerstudie) Abstract Text: Introduction: Corticobasal Syndrome (CBS) is a rare form of atypical Parkinsonism with heterogeneous phenotypes and poor prognosis. It is defined clinically on symptoms related to dysfunction of cortex and basal ganglia. The most frequent neuropathological diagnoses of Abstract Abstract No.: 317 Abstract Title: Entacapone induced diarrhea can lead to severe electrolyte imbalance (Entacaponinduzierte Diarrhoe kann zu lebensbedrohlichen Elektrolytengleisungen führen) Abstract Text: Introduction: Entacapone as adjunct to Levodopa has been shown to be an effective strategy in treatment of Parkinson patients experiencing motor fluctuations. Diarrhoea, a non-dopaminergic side effect of entacapone can lead to severe electrolyte imbalance and deterioration of quality of life, if the drug is not withdrawn or replaced. Target: We want to demonstrate that entacapone-induced diarrhea sometimes lasts for weeks until the drug is discontinued, which can lead to life threatening hypokalemia, even though it is a well-known side effect of entacapone (as well of tolcapone). Abstract 341 Abstract Title: Clock Drawing Test vs Montreal Cognitive Assessment-How comparable are these two cognitive tests in Parkinson patients? Abstract Text: Introduction: The Montreal Cognitive Assessment (MoCA) is accepted as efficient for diagnosis of cognitive deficits in Parkinson's disease. The sensitivity is superior to the Mini-Mental State Examination (MMSE), especially for mild cognitive impairments. Another widely used test is the CLOX-also known as clock drawing test (CDT), as a fast clinical test to evaluate cognitive function in patients with Parkinson's disease. The test consists of two assignments: first, the patient is instructed to draw a clock showing a given time on an empty piece of paper; for example 11:10 AM (Command clock). The second task is for the patient to draw the same time (11:10 AM) into the outline of an already drawn clock (Copy clock). Target: The purpose of our study was to evaluate the comparability of the CDT and the MOCA, and if the CDT is sufficient enough as screening tool for cognitive impairments. Methods: We examined 106 (male 55) patients with Parkinson's disease; MoCA and CDT scores were obtained. We computed the correlation between CDT and MoCA test scores. Since both tests are employed in dementia screening, we hypothesized good comparability. Results: The average age of patients was 72.28 (SD 9.62, 34-84 y), with 8.66 years since their initial diagnosis of Parkinson's disease. Overall, our results showed a significant negative correlation between MoCA und CDT (r = -0.547). Conclusion: Our data suggest that the CDT is a fairly valid test, with at least moderate comparability with the more time-demanding MoCA test battery. The CDT might not be sufficient to replace the MoCA, but its results could provide useful information to judge cognitive functional disabilities. Larger sample sizes may be necessary to determine if the test is useful for the dementia screening process in general. Abstract No.: 342 Abstract Title: Recognition of subjects with early-stage Parkinson from free-living unilateral wrist-sensor data using a hierarchical machine learning model Abstract No.: 351 Abstract Title: i-PROGNOSIS: development of a speech enhancement algorithm for the intervention of Parkinson's disease (i-PROGNOSIS: Entwicklung eines Sprachverständlichkeitsverbesserungs-Algorithmus zur Intervention bei der Parkinson-Erkrankung) Abstract Text: Introduction: Parkinson's disease is a disease of the nervous system that manifests itself through motor dysfunctions as a result of neurodegenerative processes. Since Parkinson's disease cannot be cured, Abstract AAV1/2-A53T-aSyn mouse model for PD. Abstract No.: 356 Abstract Title: Abnormal plasticity, stress-dependent dopaminergic and glutamatergic dysregulation in the striatum of a DYT12 mouse model (Abnormale Plastizität, dopaminerge und glutamaterge Dysregulation im Striatum eines DYT12 Mausmodels) Abstract No.: 358 Abstract Title: Video-based tutorial on the clinical diagnosis of progressive supranuclear palsy based on the MDS-PSP criteria (Video-basiertes Tutorial über die klinische Diagnose der PSP nach den MDS-PSP-Kriterien) Abstract Text: Introduction: Progressive supranuclear palsy (PSP) is defined neuropathologically by the intracerebral aggregation of tau. A correct and Abstract 363 Abstract Text: Introduction: Throughout the last years an increasing number of basic and clinical research studies have provided continuous knowledge for an improved treatment of Parkinson's disease (PD). Comprehensive multidisciplinary care network may enhance the Abstract Abstract No.: 378 Abstract Title: Predicting delayed neuromodulation side effects using the connectome Abstract Text: Introduction: Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease and essential tremor but can be complicated by side-effects such as cognitive decline and gait ataxia. There is often a delay before these side-effects are apparent and their Abstract Abstract No.: 388 Abstract Title: The impact of a social context on risk-seeking behavior and selfestimation in Parkinson's disease (Der Einfluss des sozialen Kontexts auf Risikoverhalten und Selbsteinschätzung bei Morbus Parkinson) Abstract Text: Introduction: Previous research has demonstrated that patients with Parkinson's disease (PD) frequently show risky decisions. However, the commonly used paradigms typically neglect the social context. Furthermore, to what extent individuals with PD can correctly estimate themselves in such a social setting is largely under-investigated. Target: We aimed at investigating risky decision making and selfestimation in a social competitive experimental task. We Abstract Abstract No.: 393 Authors: Abstract Title: Automated dissemination of DBS research findings using a Twitter bot (Automatisierte Verbreitung von DBS-Forschungsergebnissen mithilfe eines Twitter-Bots) Abstract Text: Introduction: Social media platforms such as Twitter, which has 335 million monthly active users, have immense potential to directly disseminate research findings to scientists, clinicians and patients interested in the field of deep brain stimulation (DBS), thereby Abstract Abstract No.: 396 Abstract Title: A highly sensitive and specific biochemical diagnostic test of Parkinson's disease based on detection of alpha-synuclein oligomers in cerebrospinal fluid Abstract No.: 414 Abstract Title: How to implement available DBS innovations in clinical routine of STN-DBS in Parkinson's disease Abstract Text: Introduction: Over the last years, the field of DBS has seen many technical innovations like current steering, short pulse width, directional DBS, anodal stimulation or multiple frequencies. Target: To guide the DBS beginner thorough the jungle of increasing possibility to optimize STN-DBS in real-life Methods: Summary of available evidence and eminence (!) of the mentioned new programming possibilities and their application. Results: Novel programming options offer possibilities to individually fine-tune DBS and can yield better clinical outcomes. Conclusion: While the complexity of programming is increased at first glance, a systematic approach is a key strategy to optimize DBS and to balance time-burden for programming with the chance to improve patient outcomes. Abstract No.: 415 Abstract Title: Programming DBS in dystonia: new aspects from a multi center study Abstract No.: 441 Abstract Title: Removal of tDCS-related artefacts in a simultaneous tDCS-EEG study in Parkinson's disease Abstract Text: Introduction: Transcranial direct current stimulation (tDCS) may alleviate motor symptoms in Parkinson's disease (PD). However, the neurophysiological effects of tDCS on cortical activation, synchronization, and the relation to clinical motor symptoms in PD need characterization. Target: We aimed to explore the real-time effect of tDCS over the left sensorimotor area on cortical activity and synchronization in Abstract
doi:10.1007/s00702-019-01978-1 fatcat:qd4vebobrjcxxma7tqtlu63xoq