Thomas F Münte

Universität zu Lübeck · Klinik für Neurologie

Background Anti-NMDA-receptor (anti-NMDAR) encephalitis is often associated with ovarian teratoma (OT). The best management of anti-NMDAR encephalitis patients with normal imaging studies (pelvic ultrasound/MRI) but clinically high risk of OT (e.g., female, adult, black) is unclear. We report on the surprising diagnostic quest in a young black woma...

Introduction: Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), formerly also called baboon syndrome, is characterized by symmetrical erythematous rash with typical localization in the gluteal and intertriginous areas. A type IV delayed hypersensitivity immune response is thought to be responsible for its development. CGRP m...

Background Cardioembolic stroke (CS) due to atrial fibrillation (AF) bears a high risk of unfavorable outcome. Treatment with a non-vitamin K antagonist oral anticoagulant (NOAC) reduces this risk. NOAC dosage occurs on a thin line during the acute phase of the stroke unit when the patient is threatened by both recurrent CS and a hemorrhagic stroke...

In many instances in life, our decisions’ outcomes hinge on someone else’s choices (i.e., under social uncertainty). Behavioral and pharmacological work has previously focused on different types of uncertainty, such as risk and ambiguity, but not so much on risk behaviors under social uncertainty. Here, in two different studies using a double-blind...

Invasive and transcutaneous vagus nerve stimulation [(t)-VNS] have been used to treat epilepsy, depression and migraine and has also shown effects on metabolism and body weight. To what extent this treatment shapes neural networks and how such network changes might be related to treatment effects is currently unclear. Using a pre-post mixed study d...

Background: Early diagnosis in patients with neurodegenerative disorders is crucial to initiate disease-modifying therapies at a time point where progressive neurodegeneration can still be modified. Objectives: The objective of this study was to determine whether motor or non-motor signs of the disease occur as indicators of a prodromal phase of...

Introduction: Despite a significant reduction in the quality of life in patients suffering from an essential tremor (ET), the pathophysiological background of this disease is largely unknown. The cerebellum seems to be involved in the pathological process and the modulation of motor output (Nitschke 2004⁽¹⁾, Popa 2013⁽²⁾). Previous functional imagi...

Daily activities like preparing a meal rely on the ability to arrange thoughts and actions in the right order. Patients with Parkinson’s disease have difficulties in sequencing tasks. Their deficits in sequential working memory have been associated with basal ganglia dysfunction. Here we demonstrate that altered parietal alpha and theta oscillation...

Between-subject variability in cognitive performance has been related to inter-individual differences in functional brain networks. Targeting the dorsal attention network (DAN) we questioned (i) whether resting-state functional connectivity (FC) within the DAN can predict individual performance in spatial attention tasks and (ii) whether there is s...

Background: An increase in body weight is observed in the majority of patients with Parkinson’s disease (PD) who undergo deep brain stimulation (DBS) of the subthalamic nucleus (STN) although the mechanisms are unclear. Objectives: To identify the stimulation-dependent effects on reward- and attention-associated neural networks, and to determine i...

Obesity is a major global health problem leading to serious complications. It has been consistently associated with alterations in brain structure. Diffusion tensor imaging is used to examine brain white matter microstructure by assessing the dynamics of water diffusion in white matter tracts. Fractional anisotropy and mean diffusivity are two para...

Background: Thyroid hormone action is mediated by two forms of thyroid hormone receptors (α,β) with differential tissue distribution. Thyroid hormone receptor β (TRβ) mutations lead to resistance to thyroid hormone action in tissues predominantly expressing the β form of the receptor (pituitary, liver). This study seeks to identify effects of mutan...

Background: Recently, antibodies against the alpha isoform of the glial-fibrillary-acidic-protein (GFAPα) were identified in a small series of patients with encephalomyelitis. Coexisting autoantibodies (NMDA receptor, GAD65 antibodies) have been described in a few of these patients. We describe a patient with rapidly progressive encephalomyeloradi...

Our increasing knowledge about gut-brain interaction is revolutionising the understanding of the links between digestion, mood, health, and even decision making in our everyday lives. In support of this interaction, the vagus nerve is a crucial pathway transmitting diverse gut-derived signals to the brain to monitor of metabolic status, digestive p...

Deficits in audiovisual speech perception have consistently been detected in patients with Autism Spectrum Disorder (ASD). Especially for patients with a highly functional subtype of ASD, it remains uncertain whether these deficits and underlying neural mechanisms persist into adulthood. Research indicates differences in audiovisual speech processi...

Background: Maintaining and manipulating sequences online is essential for language and memory. In Parkinson's disease (PD), poor performance in sequencing tasks has been associated with basal ganglia dysfunction, especially subthalamic hyperactivity. Objective: This study is aimed to investigate the impact of high-frequency subthalamic nucleus...

Present project is concerned with the possibility to modulate the neural regulation of food intake by non-invasive stimulation of the vagus nerve. This nerve carries viscero-afferent information from the gut and other internal organs and therefore serves an important role in ingestive behavior. The electrical stimulation of the vagus nerve (VNS) is...

Precise control of movement and timing play a key role in musical performance. This motor skill requires coordination across multiple joints, muscles, and limbs, which is acquired through extensive musical training from childhood on. Thus, making music can be a strong driver for neuroplasticity. We here present the rare case of a professional frenc...

IntroductionThe most frequently reported neurological adverse event of ChAdOx1 nCoV-19 (AZD1222) vaccine is headache in 57.5%. Several cases of cerebral venous thrombosis (CVT) have developed after vaccination. Headache is the leading symptom of CVT. For the differential diagnosis of headaches attributed to this vaccine and headaches attributed to...

The novel coronavirus SARS-CoV-2 causes the infectious disease Covid-19. Newly developed mRNA vaccines can prevent the spread of the virus. Headache is the most common neurological symptom in over 50% of those vaccinated. Detailed information about the clinical characteristics of this form of headache has not yet been described. The aim of the stud...

Objective To investigate the contribution of substantia nigra (SN) and locus coeruleus (LC) pathology to clinical signs and symptoms in Parkinson’s disease (PD) by applying neuromelanin-weighted imaging. Methods Forty-seven patients with PD and 53 matched controls underwent motor assessment, a neuropsychological test battery and neuromelanin-weigh...

Testing language abilities is common in the context of migration. It has been observed that approximately 6.2 million adults in Germany are low literate and that approximately 47% of this group does not have German as their L1. Similar findings have been reported for other modern Western societies with compulsory schooling and a well-developed educ...

Maintaining and manipulating sequences online is essential for daily activities such as scheduling a day. In Parkinson's disease (PD), sequential working memory deficits have been associated with altered regional activation and functional connectivity in the basal ganglia. This study demonstrates that the substantia nigra (SN) integrity correlated...

Background A widened temporal window of integration (TWI) in audiovisual processing has been detected for children with autism spectrum disorder. However, research indicates a narrowing of this TWI and an associated change in audiovisual integration in the course of development. Methods To further elucidate audiovisual integration processes in adu...

Disruption of resting-state functional connectivity (RSFC) between core regions of the dorsal attention network (DAN), including the bilateral superior parietal lobule (SPL), and structural damage of the right-lateralized ventral attention network (VAN), including the temporo-parietal junction (TPJ), have been described as neural basis for hemispat...

Previous studies have shown that persons with Parkinson’s disease (pwPD) share specific deficits in learning new sequential movements, but the neural substrates of this impairment remain unclear. In addition, the degree to which striatal dopaminergic denervation in PD affects the cortico-striato-thalamo-cerebellar motor learning network remains unk...

Motivational influences on cognitive control play an important role in shaping human behavior. Cognitive facilitation through motivators such as prospective reward or punishment is thought to depend on regions from the dopaminergic mesocortical network, primarily the ventral tegmental area (VTA), inferior frontal junction (IFJ), and anterior cingul...

Background Increasing familiarity and practice might free up mental resources during laparoscopic surgical skills training. The aim of the study was to track changes in mental resource allocation during acquisition of laparoscopic surgical skills. Methods Medical students with no previous experience in laparoscopic surgery took part in a 5-week la...

Limbic encephalitis (LE) is an encephalopathic syndrome caused by antineuronal antibodies against extracellular or intracellular neuronal structures. LE may present clinically with a variety of symptoms, including epileptic seizures, cognitive and memory deficits, and personality changes. Whereas LE mediated by antibodies against intracellular anti...

Aims The communication between brain and peripheral homeostatic systems is a central element of ingestive control. We set out to explore which parts of the brain have strong functional connections to peripheral signalling molecules in a physiological context. It was hypothesised that associations can be found between endocrine response to glucose i...

Cigarette smoking and other addictive behaviors are among the main preventable risk factors for several severe and potentially fatal diseases. It has been argued that addictive behavior is controlled by an automatic-implicit cognitive system and by a reflective-explicit cognitive system, that operate in parallel to jointly drive human behavior. The...

Passive listening to music is associated with several psychological and physical benefits in both, healthy and diseased populations. In this fMRI study, we examined whether preferred music has effects on the functional connectivity within resting-state networks related to consciousness. Thirteen patients in unresponsive wakefulness syndrome (UWS) a...

Background Residual motor deficits of the upper limb in patients with chronic stroke are common and have a negative impact on autonomy, participation and quality of life. Music-Supported Therapy (MST) is an effective intervention to enhance motor and cognitive function, emotional well-being and quality of life in chronic stroke patients. We have ad...

Acquired cerebellar ataxia is a rare, in many cases immune-modulated and paraneoplastic illness. Acute and slowly progredient processes are possible. An early treatment is important for a good clinical outcome. Here we present the case of female patient in her 60s with an antirecoverin associated cerebellitis without retinopathia and neoplasia. Aft...

Background: Making a correct diagnosis of a transient ischemic attack (TIA) is prone to errors because numerous TIA mimics exist and there is a shortage of evidence-based diagnostic criteria for TIAs. In this study, we applied for the first time the recently proposed explicit diagnostic criteria for transient ischemic attacks (EDCT) to a group of...

Previous studies have shown that persons with Parkinson’s disease (pwPD) share specific deficits in learning new sequential movements, but the neural substrates of this impairment remain unclear. In addition, the degree to which striatal dopaminergic denervation in PD affects the cortico-striato-cerebellar motor learning network remains unknown. We...

Introduction The presence of motor signs and symptoms in Parkinson’s disease (PD) is the result of a long-lasting prodromal phase with an advancing neurodegenerative process. The identification of PD patients in an early phase is, however, crucial for developing disease-modifying drugs. The objective of our study is to investigate whether Diffusion...

Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established therapy in advanced Parkinson’s disease (PD) with postoperative weight gain being an important side effect. Modulation of the STN may induce disruptions of brain circuits involved in cue-elicited reward-seeking behaviors and attentional control resulting...

The oxytocinergic system has been assumed to contribute to food intake, possibly via interactions with dopamine. However, so far it is unknown whether oxytocin influences underlying motivational behaviour towards food. Here we used a food‐based approach‐avoidance task (AAT) in a randomized placebo controlled double‐blind crossover design to compare...

Background Deficits in maintaining and manipulating sequential information online can occur even in patients with mild Parkinson's disease. The subthalamic nucleus may play a modulatory role in the neural system for sequential working memory, which also includes the lateral prefrontal cortex. Objectives The objective of this study was to investiga...

The constant internal monitoring of speech is a crucial feature to ensure the fairly error-free process of speech production. It has been argued that internal speech monitoring takes place through detection of conflict between different response options or “speech plans.” Speech errors are thought to occur because two (or more) competing speech pla...

Deceptive behavior, and the evaluation of others’ behavior as truthful or deceptive, are crucial aspects of human social interaction. We report a study investigating two participants in a social interaction, performing a deception task. The first participant, the “informant,” made true or false autobiographical statements. The second participant, t...

Background: The vagus nerve plays an important role in the regulation of food intake. Modulating vagal activity via electrical stimulation (VNS) in patients and animal studies caused changes in food intake, energy metabolism, and body weight. However, the moderating impact of cognitive processes on VNS effects on eating behavior has not been invest...

We as humans do not value lives consistently. While we are willing to act for one victim, we often become numb as the number of victims increases. The empathic ability to adopt others’ perspectives is essential for motivating help. However, the perspective-taking ability in our brains seems limited. Using functional MRI, we demonstrated that the co...

Trust is central to bonding and cooperation. In many social interactions, individuals need to trust another person exclusively on the basis of their subjective impressions of the other’s trustworthiness. Such impressions can be formed from social information from faces (e.g., facial trustworthiness and attractiveness) and guide trusting behaviors v...

Playing a musical instrument professionally has been shown to lead to structural and functional neural adaptations, making musicians valuable subjects for neuroplasticity research. Here, we follow the hypothesis that specific musical demands further shape neural processing. To test this assumption, we subjected groups of professional drummers, prof...

Rhodiola rosea extract is widely used to alleviate stress and improve cognition and mental resources. A total of 50 adult participants were treated with 2 × 200 mg R. rosea extract (Rosalin®, WS® 1,375) for 12 weeks and were subjected to a neuropsychological test battery as well as an event‐related brain potential measurement in a dual task paradig...

Background: About 6.2 million adults in Germany cannot read and write properly despite attending school for several years. They are considered to be functional illiterates (FI). Since the ability to read and write is crucial for being employed and socially accepted, we developed a special literacy training to overcome these deficits. Methods: In...

The hypothalamus and insular cortex play an essential role in the integration of endocrine and homeostatic signals and their impact on food intake. Resting-state functional connectivity alterations of the hypothalamus, posterior insula (PINS) and anterior insula (AINS) are modulated by metabolic states and caloric intake. Nevertheless, a deeper und...

The phosphodiesterase (PDE)-5 inhibitor sildenafil is a commonly used drug to treat erectile dysfunction. As its vascular relaxation effects might affect not only the corpus cavernosum, but as well vasculature in general, an association with bleeding incidents has been discussed. We report on a 55-year-old patient presenting with thunderclap headac...

During neuronal activation, a local decrease of deoxygenated hemoglobin concentration (deoxy‐Hb) occurs which is the basis of functional brain imaging with blood oxygenation level dependent functional magnetic resonance imaging (BOLD‐fMRI). Elevated intracranial pressure (eICP) has been shown to impair functional deoxy‐Hb changes. This study invest...

Resistance to thyroid hormone beta (RTHβ) is a syndrome of reduced responsiveness of peripheral tissue to thyroid hormone, caused by mutations in the thyroid hormone receptor beta (THRB). Its cognitive phenotype has been reported to be similar to attention deficit hyperactivity disorder (ADHD). This study used electrophysiological biomarkers of per...

The pleiotropic function of thyroid hormones (TH) is mediated by an organ specific expression of thyroid hormone transporters, deiodinases and TH receptors. In a series of studies we used the model of an experimentally induced hyper- or hypothyroidism in human volunteers to delineate TH action on the brain. A battery of neuropsychological testing p...

Music-based interventions have emerged as a promising tool in stroke motor rehabilitation as they integrate most of the principles of motor training and multimodal stimulation. This paper aims to review the use of music in the rehabilitation of upper extremity motor function after stroke. First, we review the evidence supporting current music-based...

Dopamine agonist (DA) medications commonly used to treat, or 'normalise', motor symptoms of Parkinson's disease (PD) may lead to cognitive-neuropsychiatric side effects, such as increased impulsivity in decision-making. Subject-dependent variation in the neural response to dopamine modulation within cortico-basal ganglia circuitry is thought to pla...

Focal brain lesions may induce dysfunctions in distant brain regions leading to behavioral impairments. Based on this concept of 'diaschisis', spatial neglect following stroke has been related to structural damage of the right-lateralized ventral attention network (VAN) and disrupted inter-hemispheric functional connectivity (FC) in the bilateral d...

Excessive video gaming has a number of psychological and social consequences. In this study, we looked at possible changes in gray and white matter and asked whether these changes are correlated to psychological measures. Twentynine players of violent videogames (mean daily playing time 4.7 h) and age matched controls were subjected to a battery of...

Background: In the emergency room, distinguishing between a migraine with aura and a transient ischemic attack (TIA) is often not straightforward and mistakes can be harmful to both the patient and to society. To account for this difficulty, the third edition of the International Classification of Headache disorders (ICHD-3) changed the diagnostic...

Generosity is a human behavior common in social contexts. However, humans are not equally generous to everyone alike. Instead, generosity decreases as a function of social distance, an effect called social discounting. Studies show that such social discounting effect depends on diverse factors including personality traits, cultures, stress or hormo...