Elisabeth KaufmannLudwig-Maximilians-Universität in Munich | LMU · Department of Neurology
Elisabeth Kaufmann
P.D. Dr. med.
About
103
Publications
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Introduction
Elisabeth Kaufmann works at the Department of Neurology, Ludwig-Maximilians-University of Munich. Elisabeth does research in the fields of Epilepsy, Sleep Medicine as well as sports related brain injuries. Her current projects focus on diagnostic and therapy of drug-resistant epilepsy, including the acute and long-term consequences of epileptic seizures. She is an expert on deep brain stimulation and focal cortical stimulationfor epilepsy and explores tDCS as a potential future therapy option.
Additional affiliations
October 2012 - present
Education
March 2019 - March 2020
December 2017 - May 2018
October 2005 - May 2012
Publications
Publications (103)
Objective
People with epilepsy (PwE) suffer from progressive brain atrophy, which is reflected as neuroaxonal loss on the retinal level. This study aims to provide initial insight into the longitudinal dynamics of the retinal neuroaxonal loss and possible driving factors.
Methods
PwE and healthy controls (HC; 18–55 years of age) underwent spectral...
The new S2k guideline “First epileptic seizure and epilepsies in adulthood” provides recommendations on clinically relevant issues in five major topics: management of first epileptic seizures, pharmacotherapy, epilepsy surgery, complementary and supportive treatment, and psychosocial aspects.
For the topic management of first epileptic seizures, th...
Memory consolidation relies in part on the reactivation of previous experiences during sleep. The precise interplay of sleep-related oscillations (slow oscillations, spindles and ripples) is thought to coordinate the information flow between relevant brain areas, with ripples mediating memory reactivation. However, in humans empirical evidence for...
Objective
Short‐term outcomes of deep brain stimulation of the anterior nucleus of the thalamus (ANT‐DBS) were reported for people with drug‐resistant focal epilepsy (PwE). Because long‐term data are still scarce, the Medtronic Registry for Epilepsy (MORE) evaluated clinical routine application of ANT‐DBS.
Methods
In this multicenter registry, PwE...
Background
Intimate partner violence (IPV) perpetration is highly prevalent among veterans. Suggested risk factors of IPV perpetration include combat exposure, post-traumatic stress disorder (PTSD), depression, alcohol use, and mild traumatic brain injury (mTBI). While the underlying brain pathophysiological characteristics associated with IPV perp...
The widespread accessibility of smart devices, even if not designated as medical devices, coupled with the critical need for ongoing monitoring of patients taking anti-seizure medication or undergoing new stimulation therapies highlights the urgent need for collaborative research across disciplines. These therapies, while beneficial, may cause spor...
Information about heading direction is critical for navigation as it provides the means to orient ourselves in space. However, given that veridical head-direction signals require physical rotation of the head and most human neuroimaging experiments depend upon fixing the head in position, little is known about how the human brain is tuned to such h...
Zusammenfassung
In der neuen S2k-Leitlinie „Erster epileptischer Anfall und Epilepsien im Erwachsenenalter“ werden Empfehlungen zu klinisch relevanten Fragestellungen in fünf großen Themenblöcken gegeben: Management erster epileptischer Anfall, Pharmakotherapie, Epilepsiechirurgie, komplementäre und supportive Therapieverfahren und psychosoziale As...
Background and objective:
Patients with presumed nonlesional focal epilepsy-based on either MRI or histopathologic findings-have a lower success rate of epilepsy surgery compared with lesional patients. In this study, we aimed to characterize a large group of patients with focal epilepsy who underwent epilepsy surgery despite a normal MRI and had...
Objective
Thinning of the peripapillary retinal nerve fiber layer (p‐RNFL), as measured by optical coherence tomography (OCT), was recently introduced as a promising marker for cerebral neuronal loss in people with epilepsy (PwE). However, its clinical implication remains to be elucidated. We thus aimed to (1) systematically characterize the extent...
The gray matter/white matter (GM/WM) boundary of the brain is vulnerable to shear strain associated with mild traumatic brain injury (mTBI). It is, however, unknown whether GM/WM microstructure is associated with long-term outcomes following mTBI. The diffusion and structural MRI data of 278 participants between 18 and 65 years of age with and with...
Background
In Europe, anterior thalamic stimulation, vagus nerve stimulation, and focal cortex stimulation are the only approved neurostimulation therapies for drug-resistant epilepsy. However, they are invasive and have limited availability and effectiveness. First reports on the use of transcranial direct current stimulation (tDCS) in epilepsy ar...
Background
Besides the data of the phase III study (SANTE), the results of the MORE registry on the use of anterior thalamic deep brain stimulation (ANT-DBS) have recently become available.Objectives
In which aspects do the phase III study and the MORE registry differ?MethodsA literature-based comparison was performed for the 2‑year outcomes of the...
Importance:
For the large population of people with drug-refractory epilepsy, alternative treatment approaches are needed. Clinical trial outcomes of a novel stimulation device, which is newly available in Europe for the treatment of patients with a predominant seizure focus, are reported for the first time.
Objective:
To perform a pooled analys...
Background
and Objectives
The efficacy of deep brain stimulation of the anterior nucleus of the thalamus (ANT DBS) in drug resistant epilepsy (DRE) patients was demonstrated in the double-blind Stimulation of the
Anterior Nucleus of the Thalamus for Epilepsy (SANTE) randomized controlled trial. The Medtronic Registry for Epilepsy (MORE) aims to und...
Sleep disturbances are strongly associated with mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD). PTSD and mTBI have been linked to alterations in white matter (WM) microstructure, but whether poor sleep quality has a compounding effect on WM remains largely unknown. We evaluated sleep and diffusion magnetic resonance im...
Zusammenfassung
Hintergrund
In Europa sind derzeit nur die Thalamusstimulation, die Vagusnervstimulation und die fokale Kortexstimulation als Neurostimulationsverfahren für die Behandlung von Patienten mit pharmakoresistenter Epilepsie zugelassen. Diese sind jedoch invasiv, begrenzt verfügbar und in ihrer Wirksamkeit limitiert. Erste Daten zur Anw...
Background
Besides the data of the phase III study (SANTE), the results of the MORE registry on the use of anterior thalamic deep brain stimulation (ANT-DBS) have recently become available.Objectives
In which aspects do the phase III study and the MORE registry differ?MethodsA literature-based comparison was performed for the 2‑year outcomes of the...
Spatial navigation and memory are thought to rely on common neuronal mechanisms, enabling us to travel in physical and mental space. Seminal findings in animal models support this assumption. However, how navigation and memory processes interact in humans is not well understood. Here we tested whether real-world head orientations act as spatial con...
Information about heading direction is critical for navigation as it provides the means to orient ourselves in space. However, given that veridical head direction signals require physical rotation of the head and most human neuroimaging experiments depend upon fixing the head in position, little is known about how the human brain is tuned to such h...
Introduction:
Neurological soft signs (NSS) are minor deviations from the norm in motor performance that are commonly assessed using neurological examinations. NSS may be of clinical relevance for evaluating the developmental status of adolescents. Here we investigate whether quantitative force plate measures may add relevant information to observe...
Durch die rasante Entwicklung digitaler Computertechniken und neuer Analysemethoden hat sich ein neuer Ansatz zur Analyse der Hirnströme (quantitatives EEG) ergeben, die in verschiedenen klinischen Bereichen der Neurologie und Psychiatrie bereits Ergebnisse zeigen. Die neuen Möglichkeiten der Analyse des EEG durch Einsatz künstlicher Intelligenz (D...
Neurological soft signs (NSS) are minor deviations in motor performance. During childhood and adolescence, NSS are examined for functional motor phenotyping to describe development, to screen for comorbidities, and to identify developmental vulnerabilities. Here, we investigate underlying brain structure alterations in association with NSS in physi...
Background:
Military service members are at increased risk for mental health issues and comorbidity with mild traumatic brain injury (mTBI) is common. Largely overlapping symptoms between conditions suggest a shared pathophysiology. The present work investigates the associations between white matter microstructure, psychological functioning, and s...
Importance
Military service members returning from theaters of war are at increased risk for mental illness, but despite high prevalence and substantial individual and societal burden, the underlying pathomechanisms remain largely unknown. Exposure to high levels of emotional stress in theaters of war and mild traumatic brain injury (mTBI) are pres...
A hallmark of non-rapid eye movement sleep is the coordinated interplay of slow oscillations (SOs) and sleep spindles. Traditionally, a cortico-thalamo-cortical loop is suggested to coordinate these rhythms: neocortically-generated SOs trigger spindles in the thalamus that are projected back to neocortex. Here, we used intrathalamic recordings from...
We describe a man in his 30s who presented with paroxysmal right-sided dyskinesias of the arm and neck, misdiagnosed with drug-resistant focal epilepsy. Two months earlier he had undergone surgery for chronic sinusitis. Immediately after this procedure, he developed hemiparesis, hemiataxia, paresthesias and disturbances in verbal fluency. Cranial M...
A hallmark of non-rapid eye movement (NREM) sleep is the coordinated interplay of slow oscillations (SOs) and sleep spindles. Traditionally, a cortico-thalamo-cortical loop is suggested to coordinate these rhythms: neocortically-generated SOs trigger spindles in the thalamus that are projected back to neocortex. Here, we used direct intrathalamic r...
To study the neuroanatomical correlate of involuntary unilateral blinking in humans, using the example of patients with focal epilepsy. Patients with drug resistant focal epilepsy undergoing presurgical evaluation with stereotactically implanted EEG-electrodes (sEEG) were recruited from the local epilepsy monitoring unit. Only patients showing icta...
Objective
To evaluate the safety and temporal dynamic of the antiepileptic effect of spaced transcranial direct current stimulation (tDCS) in different focal epilepsies.
Methods
Cathodal tDCS with individual electrode placement was performed in 15 adults with drug resistant focal epilepsy. An amplitude of 2 mA was applied twice for 9 minutes, with...
Background
Exposure to repetitive head impacts (RHI) is associated with an increased risk of later-life neurobehavioral dysregulation and neurodegenerative disease. The underlying pathomechanisms are largely unknown.
Purpose
To investigate whether RHI exposure is associated with later-life corpus callosum (CC) microstructure and whether CC microstr...
Younger age at first exposure (AFE) to repetitive head impacts while playing American football increases the risk for later-life neuropsychological symptoms and brain alterations. However, it is not known whether AFE is associated with cortical thickness in American football players. Sixty-three former professional National Football League players...
Zusammenfassung
Epilepsiepatienten leiden überdurchschnittlich häufig unter Kopfschmerzen. Dies gilt insbesondere für Patienten mit idiopathisch generalisierten und parietookzipitalen Epilepsien. Die Häufigkeit des gemeinsamen Auftretens von Kopfschmerzen und Epilepsie überschreitet dabei die rechnerische Koinzidenz, sodass von einer Komorbidität b...
OBJECTIVE In the absence of a standard or guideline for the treatment of epilepsy patients with deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT), systematic single-center investigations are essential to establish effective approaches. Here, the authors report on the long-term results of one of the largest single-center ANT...
In this proof-of-concept investigation, we demonstrate a marker-free video-based method to detect nocturnal motor seizures across a spectrum of motor seizure types, in a nighttime setting with a single adult female with refractory epilepsy. In doing so, we further explore the intermediate biosignals, visually mapping seizure “fingerprints” to seizu...
Background
Surgery is a widely accepted treatment option for drug-resistant focal epilepsy. A detailed analysis of longitudinal postoperative seizure outcomes and use of antiepileptic drugs for different brain lesions causing epilepsy is not available. We aimed to analyse the association between histopathology and seizure outcome and drug freedom u...
Objective:
To assess hemispheric differences in the duration of focal onset seizures and its association with clinical and demographic factors.
Methods:
A retrospective analysis was performed on adult patients with drug-resistant unifocal epilepsy, who underwent intracranial EEG recording between 01/2006 and 06/2016. Seizure duration was determi...
Introduction
Although deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) represents an established third-line therapy for patients with drug-resistant focal epilepsy, guiding reports on practical treatment principles remain scarce.
Methods
An Expert Panel (EP) of 10 European neurologists and 4 neurosurgeons was assembled to s...
Objective
To investigate the impact of clinical and demographic parameters on the duration of focal onset seizures with and without secondary generalization using precise duration measurements from intracranial electroencephalographic (iEEG) recordings.
Methods
Patients with unifocal epilepsy syndromes and iEEG recording were retrospectively ident...
Posttraumatic stress disorder (PTSD) co-occurring with mild traumatic brain injury (mTBI) is common in veterans. Worse clinical outcome in those with PTSD has been associated with decreased serum neurosteroid levels. Furthermore, decreased cortical thickness has been associated with both PTSD and mTBI. However, it is not known whether decreased neu...
Background:
Post-traumatic stress disorder (PTSD) is a psychiatric disorder that afflicts many individuals, yet the neuropathological mechanisms that contribute to this disorder remain to be fully determined. Moreover, it is unclear how exposure to mild traumatic brain injury (mTBI), a condition that is often comorbid with PTSD, particularly among...
Self‐stimulation is a normal part of development and a common behaviour in children before puberty, but very rare in adults. The stereotyped semiology can sometimes raise the suspicion of epilepsy. We present a 30‐year‐old patient who came to our epilepsy monitoring unit for differential diagnosis of nocturnal episodes, interpreted elsewhere as hyp...
Epilepsy is one of the most common neurological disorders, affecting up to 1% of the World population. Patients with epilepsy may suffer from severe consequences from seizures (e.g. injuries) when not monitored. Automatic seizure detection systems could mitigate this problem, improving seizure tracking and alerting a caregiver during a seizure. Exi...
Purpose:
To systematically evaluate the duration of focal onset seizures under medication withdrawal as a function of drug half-life.
Methods:
Adults with drug resistant focal epilepsy and invasive electroencephalographic (iEEG) recording between 01/2006 and 06/2016 (n = 128) were identified. Patients with multifocal or unknown epileptic foci we...
Pure ictal non-speech vocalisation occurs in frontal and temporal lobe epilepsies. Electrical stimulation of supplementary motor areas is reported to evoke vocalisation in selected patients. Here, we report a patient with focal epilepsy of the left anterior insula who had isolated monotonous vocalisation elicited by electrical stimulation of the le...
Background: Previous research has shown evidence for transient neuronal loss after repetitive head impacts (RHI) as demonstrated by a decrease in N-acetylaspartate (NAA). However, few studies have investigated other neuro-metabolites that may be altered in the presence of RHI; furthermore, the relationship of neuro-metabolite changes to neurocognit...
Purpose:
To investigate the frequency, localizing significance, and intensity characteristics of ictal vocalization in different focal epilepsy syndromes.
Methods:
Up to four consecutive focal seizures were evaluated in 277 patients with lesional focal epilepsy, excluding isolated auras and subclinical EEG seizure patterns. Vocalization was cons...
Zusammenfassung
Die EEG-Kommission der DGKN hat Richtlinien für die Durchführung und die Auswertung der EEG-Untersuchung formuliert, mit dem Ziel der Sicherung von Qualität und Vergleichbarkeit von Befunden [1]. Diese Mindestanforderungen umfassen definitionsgemäß nicht das gesamte für eine qualifizierte Ausführung erforderliche Wissen. Eine umfass...
Efficient sampling of visual information requires a coordination of eye movements and ongoing brain oscillations. Using intracranial and magnetoencephalography (MEG) recordings, we show that saccades are locked to the phase of visual alpha oscillations and that this coordination is related to successful mnemonic encoding of visual scenes. Furthermo...
Pre- and postsaccade phase locking locked to saccade offset.
(A) Phase-locking difference (later remembered–later forgotten) on occipital depth electrodes prior to saccade offset (time = 0 s). There was no significant difference in phase locking between later-remembered and later-forgotten trials (p > 0.21; 2-sided test, fixed-effects statistics, 1...
Presaccade power.
(A) Topography of magnetoencephalography (MEG) sensor-level statistics (planar gradients) for power averaged over 12–14 Hz at −0.25 s (corresponding to the phase-locking index [PLI] effect); no significant difference (cluster-based permutation statistic, no clusters found). The bar plot (error bars represent SEM; dots indicate ind...
Phase locking and power after saccade onset.
(A) Topography of magnetoencephalography (MEG) sensor-level statistics (planar gradients) for phase locking averaged over 12–14 Hz at 250 ms; no significant difference (cluster-based permutation statistic, all clusters p > 0.72). (B) Topography of MEG sensor-level statistics (planar gradients) for power...
Presaccadic phase locking for 200-ms minimum fixation duration.
Magnetoencephalography (MEG) sensor (planar gradients) analysis shows significantly higher phase locking (phase-locking index [PLI]) for later-remembered than forgotten trials at 10 Hz (corresponding to a frequency range of 7.5 to 12.5 Hz), averaged in the −0.2- to 0-s interval prior t...
Presaccade phase locking on parahippocampal leads of depth electrodes.
(A) Electrode locations of parahippocampal depth electrodes in 3 participants (color coded). (B) Phase-locking difference (later remembered–later forgotten) on parahippocampal depth electrodes prior to saccade onset (time = 0). Significantly higher phase locking in later-remembe...
Condition-specific phase-locking index (PLI) contrasts.
(A) Difference between later-remembered trials and surrogate data at 12–14 Hz, −250 ms. (B) Difference between later-forgotten trials and surrogate data at 12–14 Hz, −250 ms. Significant sensors are highlighted (p < 0.05, 2-sided). The data set used to generate the analyses shown in this figur...
Phase locking and power after stimulus onset.
(A) Cluster-based permutation statistics showed no significant differences in phase locking between later-remembered and later-forgotten scenes at 12–14 Hz, controlling for multiple comparisons over time (0 to 4 s) and sensors (p cluster > 0.9). There were also no significant differences after averaging...
Objective
Repetitive subconcussive head impacts (RSHI) may lead to structural, functional, and metabolic alterations of the brain. While differences between males and females have already been suggested following a concussion, whether there are sex differences following exposure to RSHI remains unknown. The aim of this study was to identify and to...
Background
Detailed neuropathological information on the structural brain lesions underlying seizures is valuable for understanding drug-resistant focal epilepsy.
Methods
We report the diagnoses made on the basis of resected brain specimens from 9523 patients who underwent epilepsy surgery for drug-resistant seizures in 36 centers from 12 European...
Epileptische Anfälle können sich mit verschiedensten klinischen Symptomen äußern. Je nach vordringlichem Symptom kommt eine Reihe an Differenzialdiagnosen in Betracht, deren Unterscheidung v. a. bei erstmaligem Ereignis eine Herausforderung darstellen kann. Diese Übersichtsarbeit fasst die häufigsten Differenzialdiagnosen und deren Charakteristika...
Objective:
To investigate the occurrence of ictal and postictal aphasia in different focal epilepsy syndromes.
Methods:
We retrospectively analyzed the video-electroencephalographic monitoring data of 1,118 patients with focal epilepsy for seizure-associated aphasia (SAA). Statistical analysis included chi-square analysis and Fisher's exact test...
Efficient sampling of visual information requires a coordination of eye movements and ongoing brain oscillations. Using intracranial and MEG recordings, we show that saccades are locked to the phase of visual alpha oscillations, and that this coordination supports mnemonic encoding of visual scenes. Furthermore, parahippocampal and retrosplenial co...
Objective:
To evaluate the characteristics of visual auras (VA) in epilepsy and migraine.
Background:
Both disorders are usually diagnosed on clinical grounds, but differentiation might be challenging in isolated auras or because of the similar presentation in migraine and epilepsy.
Methods:
A retrospective study of two cohorts was performed t...
Background:
Periodic discharges (PDs) are well established as either periodic lateralized epileptiform discharges (LPDs) or generalized discharges. However, PDs in the midline can currently not be adequately classified as they are not generalized and not lateralized.
Aims of the study:
To propose a modification of the current LPD classification....
Background
Patients with cryptogenic focal epilepsy (cFE), where conventional MRI does not show any structural lesion represent the fastest growing number of epilepsy surgery candidates in most tertiary referral centers. The absence of a visible surgical target challenges presurgical evaluation and requires complementary diagnostic methods to guide...