Carsten Buhmann

Carsten Buhmann
University of Hamburg | UHH · School of Medicine and University Hospital Hamburg-Eppendorf

Prof. Dr. med.

About

221
Publications
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Publications

Publications (221)
Article
Full-text available
The aim of this study was to assess the effects of novel stimulation algorithms of deep brain stimulation (short pulse and directional stimulation) in the ventrointermediate thalamus and posterior subthalamic area (VIM/PSA-DBS) on tremor in Parkinson’s disease (PD) and to compare the effects with those in essential tremor (ET). We recruited six PD...
Article
Introduction: Deep brain stimulation (DBS) represents the treatment of choice for advanced stages of Parkinson's disease (PD). In addition to careful patient selection and precise lead placement, postoperative programming of DBS devices is considered the most important factor for the individual patient. Despite expert-based recommendations for adju...
Article
Full-text available
Zusammenfassung Sialorrhoe, ein unkontrollierter, übermäßiger Speichelfluss aus dem Mund und in den Schlund, tritt als Begleitsymptom bei verschiedenen, v. a. neurologischen Erkrankungen im Kindes- und Erwachsenenalter auf. Mit IncobotulinumtoxinA (Xeomin, IncoBoNT/A, Merz Pharmaceuticals GmbH) steht seit 2019 ein zugelassenes Medikament für die Be...
Article
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The clinical presentation of Parkinson’s disease (PD) is both complex and heterogeneous, and its precise classification often requires an intensive work-up. The differential diagnosis, assessment of disease progression, evaluation of therapeutic responses, or identification of PD subtypes frequently remains uncertain from a clinical point of view....
Article
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Introduction The preoperative evaluation of Parkinson’s Disease (PD) patients for subthalamic nucleus deep brain stimulation (STN-DBS) includes the assessment of the neuropsychological status of the patient. A widely used preoperative test is the Mattis Dementia rating scale (MDRS). However, the Montreal cognitive assessment (MoCA) has also been pr...
Article
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Background: Diabetes is associated with incidence and prevalence of Parkinson's disease (PD). Furthermore, glycated hemoglobin (HbA1c) levels have been linked with motor function and progression. Objectives: We evaluated the relationship between prevalent diabetes and HbA1c levels with serum neurofilament light chain (NfL) levels as marker of ne...
Article
Full-text available
The PIGD (postural instability / gait difficulty) subtype of Parkinson´s disease (PD) is associated with faster cognitive and motor decline. So far, there are no quantifiable biomarkers to aid clinical subtyping. Neurofilament light chain (NfL) is a highly specific marker of neuro-axonal damage and can be assessed in blood. Here, we investigated if...
Article
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Background Freezing of gait (FoG) is a disabling burden for Parkinson’s disease (PD) patients with poor response to conventional therapies. Combined deep brain stimulation of the subthalamic nucleus and substantia nigra (STN+SN DBS) moved into focus as a potential therapeutic option to treat the parkinsonian gait disorder and refractory FoG. The me...
Chapter
Sexual dysfunction is one of the commonest non-motor symptoms in Parkinson's disease (PD) and has been found about twice as high in PD patients compared to age-matched controls. The quality of sexual life is reduced in PD patients compared to healthy peers and impairment affects wide aspects of physical sexual function as well as sexual desire, sex...
Article
Seit über 20 Jahren haben sich die COMT(Catechol-O-Methyltransferase)-Hemmer in der Therapie des Parkinson-Syndroms etabliert. Sie gelten als Mittel der Wahl bei motorischen Fluktuationen. Die verfügbaren Substanzen Entacapon, Opicapon und Tolcapon unterscheiden sich pharmakokinetisch hinsichtlich ihrer Halbwertszeiten, mit Folgen für die Einnahmef...
Article
Full-text available
Abstract: The Care4PD study examined the impact of the COVID-19 pandemic on the care situation of people (PwP) with Parkinson’s disease in Germany. A comprehensive, nationwide, anonymous questionnaire for PwP was distributed by the members’ journal of the German Parkinson’s Disease Association and in several PD specialized in- and outpatient instit...
Article
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Objective: Several guidelines recommend oral administration of nimodipine as vasospasm prophylaxis after aneurysmal subarachnoid hemorrhage (SAH). However, in clinical practice, the drug is administered orally and intravenously (i.v.), depending on clinical conditions and local treatment regimens. We have therefore investigated the safety and clini...
Conference Paper
Background McLeod syndrome (MLS) is an ultra-rare neurodegenerative X-linked disease caused by mutations in the XK gene, classified as one of the core neuroacanthocytosis syndromes. Together with the clinically very similar chorea-acanthocytosis it belongs to the heterogeneous group of ‘Huntington’s disease (HD) phenocopies’. Aims To characterize...
Article
Background: Gait disturbances and balance remain challenging issues in Parkinsonian patients (PD) with deep brain stimulation (DBS). Short pulse deep brain stimulation (spDBS) increases the therapeutic window in PD patients, yet the effect on gait and postural symptoms remains unknown. Objective: We assessed the efficacy of spDBS compared to con...
Article
Full-text available
Purpose: Dysphagia is common in patients with Parkinson's disease (PD) and often leads to pneumonia, malnutrition, and reduced quality of life. This study investigates the ability of the Eating Assessment Tool-10 (EAT-10), an established, easy self-administered screening tool, to detect aspiration in PD patients. This study aims to validate the ab...
Article
Introduction We aimed to study the various cardiac manifestations of the two core neuroacanthocytosis (NA syndromes, namely chorea-acanthocytosis (ChAc) and McLeod syndrome (MLS). So far, cardiac involvement has been described as specific feature only for MLS. Methods We studied six patients with ChAc (mean age 44.5 years, 5men, 1 woman) and six p...
Preprint
Full-text available
The aim of this study was to assess the effects of novel stimulation algorithms of deep brain stimulation (short pulse and directional stimulation) in the ventrointermediate thalamus and posterior subthalamic area (VIM/PSA-DBS) on tremor in Parkinson´s disease (PD) and to compare the effects with those in Essential tremor (ET). Methods: We recruite...
Chapter
In diesem Werk präsentieren ExpertInnen verschiedene "typische" komplexe Parkinsonfälle, setzen diese in den aktuellen wissenschaftlichen Kontext und beschreiben konkrete diagnostische und therapeutische Maßnahmen. Das Buch ist gegliedert in die Themengebiete "Patienten in verschiedenen Krankheitsstadien", "spezielle nicht-motorische Probleme" sowi...
Article
Objectives In prospective cohort studies different blood lipid fractions have been identified as risk factors of Parkinson’s disease (PD). However, data relating lipoproteins to disease phenotypes and progression in advanced PD patients are sparse. Therefore, we assessed the most common lipoproteins in a case-control design and evaluated their asso...
Article
Full-text available
Artificial intelligence (AI) has been introduced into medicine and an AI-assisted medicine will be the future that we should help to shape. In particular, supervised, unsupervised, and reinforcement learning will be the main methods to play a role in the implementation of AI. Severely ill patients admitted to the intensive care unit (ICU) are close...
Conference Paper
submission-click here to submit Preference for poster presentation Scientific Topic: Neurogenic Dysphagia: etiology, pathophysiology and clinical trials Career stage: Senior Investigator (more than 5 years of experience after PhD) Abstract INTRODUCTION Dysphagia is common in Parkinson's disease (PD) and can cause aspiration pneumonia, the leading c...
Article
Background: Little is known about the patients' view on treatment with medical cannabis (MC) for Parkinson's disease (PD). Objective: To assess the PD community's perception of MC and patients' experience with MC. Methods: Applying a questionnaire-based survey, we evaluated general knowledge and interest in MC as well as the frequency, modalit...
Article
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Background: Simple water-swallowing screening tools are not predictive of aspiration and dysphagia in patients with Parkinson's Disease (PD). We investigated the diagnostic accuracy of a multi-texture screening tool, the Gugging Swallowing Screen (GUSS) to identify aspiration and dysphagia/penetration in PD patients compared to flexible endoscopic...
Article
Introduction: Chorea-acanthocytosis (ChAc) is a rare hereditary neurodegenerative disease, characterized by hyper- and hypokinetic movement disorders, peripheral neuropathy and acanthocytosis. Biomarkers are not established; possible candidates include neurofilament reflecting neuroaxonal damage. Methods: We studied serum neurofilament light cha...
Article
Full-text available
Dopaminergic deficiency in Parkinson’s disease (PD) has been associated with underactivation of the supplementary motor area and a reduction of voluntary actions. In these patients, awareness of intention to act has been shown to be delayed. However, delayed awareness of intention to act has also been shown in patients with hyperdopaminergic states...
Article
Zusammenfassung Die vorliegende Arbeit gibt einen Überblick über die verschiedenen nuklearmedizinischen Verfahren in der Diagnostik bei neurodegenerativen Parkinson-Syndromen sowie ihre Evidenzlage und soll praxistaugliche Entscheidungshilfen in der Anwendung und Interpretation der Methoden und Befunde ermöglichen. Die Wertigkeit der Verfahren unte...
Article
Full-text available
Access to specialized care is essential for people with Parkinson´s disease (PD). Given the growing number of people with PD and the lack of general practitioners and neurologists, particularly in rural areas in Germany, specialized PD staff (PDS), such as PD nurse specialists and Parkinson Assistants (PASS), will play an increasingly important rol...
Article
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Background Parkinson’s disease is associated with severe nigro-striatal dopamine depletion, leading to motor dysfunction and altered reward processing. We previously showed that drug-naïve patients with Parkinson’s disease had a consistent attenuation of reward signalling in the mesolimbic and mesocortical system. Here, we address the neurobiologic...
Article
Full-text available
Changes in personality are one of the main concerns Parkinson's disease (PD) patients raise when facing the decision to undergo neurosurgery for deep brain stimulation (DBS) of the subthalamic nucleus (STN). While clinical instruments for monitoring functional changes following DBS surgery are well-established in the daily therapeutic routine, pers...
Article
Full-text available
Pain is a very frequent symptom with influence on the quality of life in Parkinson's disease (PD), but is still under diagnosed and commonly treated only unsystematically. Pain etiology and pain character are often complex and multi causal, and data regarding treatment recommendations are limited. Pain can be primarily related to PD but frequently...
Article
Full-text available
Background Deep brain stimulation (DBS) within the pallidum represents an effective and well-established treatment for isolated dystonia. However, clinical outcome after surgery may be variable with limited response in 10–25% of patients. The effect of lead location on clinical improvement is still under debate.Objective To identify stimulated brai...
Article
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Background We assessed if cardiac blood markers are associated with motor and cognitive function in patients with Parkinson's disease (PD). Methods High‐sensitivity troponin I and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) were evaluated in 285 PD patients. Furthermore, N‐terminal pro‐B‐type natriuretic peptide levels were analyzed in 5...
Article
In Germany, patients with severe diseases can be prescribed cannabis buds, extracts and synthetic cannabinoids whereby the costs can be covered by health insurance companies. The legislative authority did not restrict the prescription of cannabinoids to specific patient groups. Therefore, cannabinoids can be prescribed to every severely affected pa...
Article
Full-text available
Although our understanding of Parkinson´s disease (PD) has improved and effective treatments are available, caring for people with PD remains a challenge. The large heterogeneity in terms of motor symptoms, nonmotor symptoms, and disease progression makes tailored individual therapy and individual timing of treatment necessary. On the other hand, o...
Article
Background and Objectives The purpose of this study was to assess efficacy and safety of a new patterned theta burst stimulation algorithm of DBS with the aim of expanding the therapeutic window and clinical benefit in PD. Methods In this single‐center, randomized, double‐blind, clinical short‐term trial, unilateral conventional subthalamic DBS wa...
Article
Zusammenfassung Hintergrund Für Patienten mit komplexem Parkinson-Syndrom (PS), die einer durchgreifenden Umstellung von Medikation, Pumpeneinstellung oder Tiefer Hirnstimulation bedürfen, ist die ambulante Behandlung oft aufgrund limitierter zeitlicher und / oder fachlicher Ressourcen nicht ausreichend, die stationäre Versorgung bei fehlender Allt...
Article
Full-text available
Objectives Dysphagia is a frequent and highly relevant symptom in Parkinson's disease (PD) due to high associated morbidity and mortality. To compare the effect of simultaneous stimulation of the subthalamic nucleus (STN) and substantia nigra (SNr) with conventional STN‐stimulation on swallowing function in Parkinson's disease. Methods In this con...
Article
In Deutschland können schwerkranken Patienten, unabhängig von der Grunderkrankung, Cannabisblüten und -extrakte bzw. synthetische Cannabinoide zulasten der Krankenkassen verordnet werden, sofern keine geeigneten Therapien zur Verfügung stehen oder diese aufgrund von Kontraindikationen oder schweren Nebenwirkungen nicht zur Anwendung kommen können....
Article
Full-text available
Background: Pain is highly prevalent in patients with Parkinson's disease (PD), but underlying pathophysiological mechanisms are largely unclear. In many chronic pain syndromes deficits in endogenous pain inhibition have been detected that can be assessed using conditioned pain modulation paradigms. Previous studies employing this approach in medi...
Article
Background: Parkinsonian syndromes are classified by etiology mainly on clinical grounds, that is, on the basis of the clinical manifestations and with the aid of conventional ancillary studies. In most cases, the clinical diagnosis is clear. In up to 30% of cases, however, the etiological classification remains uncertain after completion of the b...
Article
Full-text available
Sexual dysfunction is a major non-motor feature of Parkinson’s disease (PD) that may affect the quality of life of many patients. In a Dutch survey, we demonstrated that neurologists often fail to discuss sexuality with their patients. Our objective was to determine to which extent neurologists in Spain and Germany address sexuality with their pati...
Article
Background: There is still a lack of a clinical test to reliably identify patients with Parkinson's disease (PD) being at risk for aspiration. Methods: In this prospective, controlled, cross-sectional study, we assessed if swallowing speed for water is a useful clinical test to predict aspiration proven by flexible endoscopic evaluation of swall...
Article
Introduction: Pain is a common symptom in Parkinson’s disease (PD), impairing quality of life. The clinical appearance and the underlying etiologies are diverse. Different subtypes of pain may occur, with musculoskeletal pain considered to be the most frequent. Often there is also a combination of different causes of pain. There is a lack of contro...
Article
Full-text available
In the differential diagnosis of Parkinson syndromes, the response to l-Dopa is an essential criterion for the diagnosis of idiopathic Parkinson’s syndrome (IPS), and the presence of l-Dopa-induced dyskinesia (LID) is considered a supportive criterion. This implies that in the presence of LID an atypical Parkinson-syndrome (APS) is unlikely. Howeve...
Article
Full-text available
Cannabis and synthetic cannabinoid formulations have now been legally approved in several countries for treatment of patients with Parkinson’s disease (PD). Hence, PD patients consult physicians more frequently for prescription of cannabinoids to alleviate symptoms that might not respond well to dopaminergic treatment. Despite the increasing volume...
Article
Full-text available
It is well documented that there is a strong relationship between gait asymmetry and the freezing of gait (FOG) in Parkinson’s Disease. The purpose of this pilot study was to find a “virtual reality (VR)- based” gait manipulation strategy to improve gait symmetry by equalizing step length. Fifteen male PD patients (mean age of 67.6 years) with FOG...
Article
Background: Stimulation of the subthalamic area (STA) is an effective treatment in essential tremor patients, but limited by stimulation induced adverse effects. The aim of this study was to determine the spatial distribution of stimulus related tremor suppression, ataxia induction and paresthesia of the upper limb in the subthalamic area (STA) of...
Preprint
There is still a lack of a clinical test to reliably identify patients with Parkinson’s disease (PD) being at risk for aspiration. In this prospective, controlled, cross-sectional study we assessed if swallowing speed for water is a useful clinical test to predict aspiration proven by flexible endoscopic evaluation of swallowing (FEES). Due to this...
Article
Background: Pain is highly prevalent in patients with Parkinson's disease (PD), but underlying pathophysiological mechanisms are largely unclear. Alterations in somatosensory processing might contribute to sensory abnormalities in PD. Objective: This study investigated sensory processing in PD patients. Methods: We used the standardized "Quant...
Article
Background: This study evaluates the prevalence, characteristics, and predictors of the difficulty of swallowing medication in Parkinson's disease (PD). Methods: In this prospective controlled, cross-sectional cohort study, the ability to swallow four different placebos was assessed using flexible endoscopic evaluation of swallowing (FEES) in 11...
Article
Synchronized oscillations within and between brain areas facilitate normal processing, but are often amplified in disease. A prominent example is the abnormally sustained beta-frequency (∼20 Hz) oscillations recorded from the cortex and subthalamic nucleus of Parkinson's disease patients. Computational modeling suggests that the amplitude of such o...
Article
Objective: To compare the effect of simultaneous deep brain stimulation of the subthalamic nucleus and substantia nigra pars reticulata (STN+SNr-DBS) to conventional subthalamic stimulation (STN-DBS) on sleep quality in Parkinson's disease (PD) patients. Methods: The study was a single-center, randomized, double-blind, cross-over clinical trial...
Article
Background: Dysphagia is common in Parkinson's disease (PD) and leads to pneumonia, malnutrition, and reduced quality of life. For detecting dysphagia-exposed PD patients, the Munich dysphagia test-Parkinson's disease (MDT-PD) is a patient self-reported tool that has been developed specifically for PD patients. The MDT-PD is available in both Germ...
Article
Full-text available
Background . Stress reduction and relaxation exercises are therapeutically suggested to patients with Parkinson’s disease (PD) and tremor, but data regarding efficacy or preferential methods are missing. Objective . To investigate the effect of a standardized stress management training (SMT) according to Kaluza on coping with tremor-boosting psycho...
Article
Full-text available
To close a gap between inpatient and outpatient care, the Hamburg Parkinson day-clinic (HPDC) has been developed as a new and comprehensive, individual, interdisciplinary type of treatment for patients with complex Parkinsonian syndromes (PS). First, we describe the HPDC concept, in which a multi-professional medical team of PD specialists provide...
Article
Full-text available
Background and objective To determine rates of adverse events (AEs) related to deep brain stimulation (DBS) surgery or implanted devices from a large series from a single institution. Sound comparisons with the literature require the definition of unambiguous categories, since there is no consensus on the reporting of such AEs. Patients and method...
Data
Forest plots indicating rates and 95% confidence intervals for intracranial AEs. Data from our institution (UKE Hamburg) have not been included into the meta-analysis. (TIF)
Data
Funnel plot analysis of intracranial AEs. The diagonal lines (dashed) indicate the expected 95% confidence intervals around the summary estimate. According to the trim-and-fill method 29 studies were added (open circles) to adjust for funnel plot asymmetry. (TIF)
Data
Forest plots indicating rates and 95% confidence intervals for lead revision. Data from our institution (UKE Hamburg) have not been included into the meta-analysis. (TIF)
Data
Plotting of study size (total pt.yrs) vs. rates for hardware removal (y axis). The blue line indicates a local polinomial regression fitting (loess estimator), and the grey shaded area indicates the 95% confidence interval. (TIF)
Data
Plotting of study size (total pt.yrs) vs. rates for lead revision (y axis). The blue line indicates a local polinomial regression fitting (loess estimator), and the grey shaded area indicates the 95% confidence interval. (TIF)
Data
Cohort analysis of adverse events related to DBS surgery or implanted hardware. (DOCX)
Data