Wolf-Dieter Heiss

Wolf-Dieter Heiss
Max Planck Institute for Metabolism Research | NF

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662
Publications
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28,236
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Publications

Publications (662)
Article
Full-text available
Background & objective Contralesional 1-Hz repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis combined with speech-language therapy (SLT) has shown positive results on the recovery of naming in subacute (5–45 days) post-stroke aphasia. NORTHSTAR-CA is an extension of the previously reported NORTHSTAR trial to chron...
Article
Full-text available
The main aim of this study is to systematically record Cerebrolysin treatment modalities and concomitant medication, according to local standards, in patients with moderate to severe neurological deficits after acute ischemic stroke and to assess the impact of these parameters on therapy outcome during early rehabilitation (day 21) and on day 90. A...
Article
Full-text available
Objective Accurate identification of the ischemic penumbra, the therapeutic target in acute clinical stroke, is of critical importance to identify patients who might benefit from reperfusion therapies beyond the established time windows. Therefore, we aimed to validate magnetic resonance imaging (MRI) mismatch–based penumbra detection against full...
Article
The concept of the ischemic penumbra was formulated on the basis of animal experiments showing functional impairment and electrophysiologic disturbances with decreasing flow to the brain below defined values (the threshold for function) and irreversible tissue damage with blood supply further decreased (the threshold for infarction). The perfusion...
Article
The diagnosis of cerebral small vessel disease (SVD) is difficult because there is no consensus on clinical criteria and therefore, imaging is important for diagnosis. Most patients undergo brain imaging by computed tomography (CT), which is able to detect ischemic strokes, hemorrhages and brain atrophy and may also indicate white matter changes. M...
Article
Full-text available
Background & objective: Vascular dementia is the second most common cause of dementia, with clinical features that depend on neural substrates affected by the vascular lesions. Like most neurological disorders, it involves alterations that range from the molecular level to neuronal networks. Such alterations begin as compensatory mechanisms that r...
Article
Full-text available
This meta-analysis combines the results of nine ischemic stroke trials, assessing efficacy of Cerebrolysin on global neurological improvement during early post-stroke period. Cerebrolysin is a parenterally administered neuropeptide preparation approved for treatment of stroke. All included studies had a prospective, randomized, double-blind, placeb...
Article
Full-text available
Prediction measures of recovery and outcome after stroke perform with only modest levels of accuracy if based only on clinical data. Prediction scores can be improved by including morphologic imaging data, where size, location, and development of the ischemic lesion is best documented by magnetic resonance imaging. In addition to the primary lesion...
Article
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This meta-analysis combines the results of two identical stroke studies (CARS-1 and CARS-2) assessing efficacy of Cerebrolysin on motor recovery during early rehabilitation. Cerebrolysin is a parenterally administered neuropeptide preparation approved for the treatment of stroke. Both studies had a prospective, randomized, double-blind, placebo-con...
Article
Full-text available
Background and purpose: Identification of salvageable penumbra tissue by dynamic susceptibility contrast magnetic resonance imaging is a valuable tool for acute stroke patient stratification for treatment. However, prior studies have not attempted to combine the different perfusion maps into a predictive model. In this study, we established a mult...
Conference Paper
Introduction For several years non invasive brain stimulation (NIBS) techniques like rTMS and tDCS were used in combination with speech and language therapy. There is evidence that both techniques are able to enhance behavioral treatment effects by inhibiting right Broca’s area and thereby facilitating reintegration of perilesional activation. Howe...
Article
Background and purpose: In acute stroke, arterial-input-function (AIF) determination is essential for obtaining perfusion estimates with dynamic susceptibility-weighted contrast-enhanced magnetic resonance imaging (DSC-MRI). Standard DSC-MRI postprocessing applies single AIF selection, ie, global AIF. Physiological considerations, however, suggest...
Article
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Post-stroke dementia (PSD) or post-stroke cognitive impairment (PSCI) may affect up to one third of stroke survivors. Various definitions of PSCI and PSD have been described. We propose PSD as a label for any dementia following stroke in temporal relation. Various tools are available to screen and assess cognition, with few PSD-specific instruments...
Article
Full-text available
The concept of the ischemic penumbra was formulated based on animal experiments showing functional impairment and electrophysiological disturbances with decreasing flow to the brain below defined values (the threshold for function) and irreversible tissue damage with blood supply further decreased (the threshold for infarction). The perfusion range...
Conference Paper
Full-text available
The European Master in Stroke Medicine (EMSM) is a postgraduate programme which covers all areas of cerebrovascular diseases and is provided by a faculty of leading European experts. The program is organized by the ESO and endorsed by the WSO. Currently on its fifth intake, the programme aims to establish evidence based knowledge standards of strok...
Article
Background: With regard to acute stroke, patients with unknown time from stroke onset are not eligible for thrombolysis. Quantitative diffusion weighted imaging (DWI) and fluid attenuated inversion recovery (FLAIR) MRI relative signal intensity (rSI) biomarkers have been introduced to predict eligibility for thrombolysis, but have shown heterogene...
Article
Introduction: Patients with unknown time from stroke onset, e.g. in wake-up stroke, are not eligible for thrombolyic treatment. Relative signal intensities (rSI) of DWI and FLAIR MRI are biomarkers for eligibility for thrombolysis, but have shown heterogeneous results to date. We investigated if the addition of available clinical parameters improve...
Article
Full-text available
Background: Cortical injections of the vasoconstrictor endothelin-1 (ET1) have widely been used to induce focal circumscribed ischemic lesions in the motor cortex of rodents in the context of stroke recovery studies. In order to apply this model correctly, it is essential to understand the time course of regional flow changes and of the developmen...
Article
Full-text available
Perfusion-weighted (PW) magnetic resonance imaging (MRI) is used to detect penumbral tissue in acute stroke, but the selection of optimal PW-maps and thresholds for tissue at risk detection remains a matter of debate. We validated the performance of PW-maps with 15O-water-positron emission tomography (PET) in a large comparative PET-MR cohort of ac...
Article
Full-text available
Background and purpose: The aim of this trial was to investigate whether stroke patients who receive Cerebrolysin show improved motor function in the upper extremities at day 90 compared with patients who receive a placebo. Methods: This study was a prospective, randomized, double-blind, placebo-controlled, multicenter, parallel-group study. Pat...
Article
The close relationship between stroke and dementia is an important health issue. Ischaemic stroke can facilitate the onset of vascular dementia as well as aggravate pre-existing cognitive decline. The onset of cognitive decline may become manifest immediately following the onset of ischaemic stroke, but often there is a delay in the development of...
Article
Full-text available
Ischemic stroke is caused by interruption or significant impairment of blood supply to the brain, which leads to a cascade of metabolic and molecular alterations resulting in functional disturbance and morphologic damage. The changes in regional cerebral blood flow and regional metabolism can be assessed by radionuclide imaging, especially SPECT an...
Article
Zusammenfassung Gliome, die 30% der intrakraniellen Tumoren darstellen, sind morphologische Veränderungen, sodass an erster Stelle der Diagnostik CT und MRT stehen, wobei MRT aufgrund der besseren Weichteilauflösung und zusätzlicher funktioneller Modalitäten (PWI, DWI, MRS) der Vorzug gegeben werden sollte. Mit diesen vor allem die Morphologie dars...
Article
Severe atherosclerosis in the aortic arch is associated with a high risk of recurrent vascular events, but the optimal antithrombotic strategy is unclear. This prospective randomized controlled, open-labeled trial, with blinded end point evaluation (PROBE design) tested superiority of aspirin 75 to 150 mg/d plus clopidogrel 75 mg/d (A+C) over warfa...
Article
Introduction Several small studies suggest that non-invasive repetitive transcranial magnetic stimulation (rTMS) of the non-dominant right Brodmann area might support recovery from aphasia in patients with leftsided stroke during conventional speech therapy.We evaluated the effect of this therapeutic regimen in patients with subacute stroke on cere...
Article
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PET and MRI provide complementary information in the study of the human brain. Simultaneous PET/MRI data acquisition allows the spatial and temporal correlation of the measured signals, creating opportunities impossible to realize using stand-alone instruments. This paper reviews the methodologic improvements and potential neurologic and psychiatri...
Article
Aging leads to a small loss of cortical neurons, but to a significant reduction of synapses, dendrites and myelinated fibers. These age-related changes may cause some cognitive impairment, brain atrophy and frontally accentuated diffuse decrease in metabolism. In pathological disorders leading to dementia, most frequently degenerative Alzheimer's d...
Article
An ischemic penumbra has the potential for functional recovery provided that local blood flow can be reestablished, but irreversible damage will develop without sufficient reperfusion, depending on the interaction of severity and duration of ischemia. With acute flows below the threshold required for maintenance of basic housekeeping, injury in the...
Chapter
Full-text available
Cerebrovascular diseases (CVDs) are caused by interruption or significant impairment of blood supply to the brain, which leads to a cascade of metabolic and molecular alterations resulting in functional disturbance and morphological damage. These pathophysiological changes can be assessed by positron emission tomography (PET), which permits to meas...
Article
The concept of the ischemic penumbra was formulated 30 years ago based on experiments in animal models showing functional impairment and electrophysiological disturbances with decreasing flow to the brain below defined values (the threshold for function) and irreversible tissue damage with the blood supply further decreased (the threshold for infar...
Article
Full-text available
Neuroimaging plays a significant role in the diagnosis of intracranial tumors, especially brain gliomas, and must consist of an assessment of location and extent of the tumor and of its biologic activity. Therefore, morphologic imaging modalities and functional, metabolic, or molecular imaging modalities should be combined for primary diagnosis and...
Article
Advances in resuscitation and critical care management have resulted in the survival of many patients despite severe brain damage. These patients may remain in coma or in vegetative state. The probability of recovery of conscious function is dependent on the extent of structural brain damage, which is difficult to assess by clinical, laboratory or...
Article
Full-text available
Original experimental studies in nonhuman primate models of focal ischemia showed flow-related changes in evoked potentials that suggested a circumferential zone of low regional cerebral blood flow with normal K(+) homeostasis, around a core of permanent injury in the striatum or the cortex. This became the basis for the definition of the ischemic...
Article
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In this study, we aimed to assess the detection of crossed cerebellar diaschisis (CCD) following stroke by perfusion-weighted magnetic resonance imaging (PW-MRI) in comparison with positron emission tomography (PET). Both PW-MRI and 15O-water-PET were performed in acute and subacute hemispheric stroke patients. The degree of CCD was defined by regi...
Article
Although functional imaging studies suggest that recruitment of contralesional areas hinders optimal functional reorganization in patients with aphasic stroke, only limited evidence is available on the efficacy of noninvasive brain stimulation such as repetitive transcranial magnetic stimulation aimed at suppression of contralateral overactivation....
Article
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In many brain disorders reduced binding of central benzodiazepine receptor ligands indicates irreversible neuronal damage. The data presented by Koizumi et al (2010) demonstrate that this is not the case in traumatic brain injury suggesting different pathogenetic mechanisms leading to tissue damage. The proof for this hypothesis requires further st...
Article
Die Lokalisation sowie das Ausmaß einer fokalen Hirnläsion bestimmen das funktionelle Defizit. Die Wiederherstellung der betroffenen Funktion hingegen hängt in 1. Linie von der Plastizität der intakten Hirnrindenanteile ab. Die Bedeutung bestimmter Regionen im funktionellen Sprachnetzwerk kann mittels funktioneller bildgebender Verfahren dargestell...
Article
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Although Parkinson disease with dementia (PDD) and dementia with Lewy bodies (DLB) show a wide clinical and neuropathologic overlap, they are differentiated according to the order and latency of cognitive and motor symptom appearance. Whether both are distinct disease entities is an ongoing controversy. Therefore, we directly compared patients with...
Chapter
The energy demand of the brain is very high and relies almost entirely on the oxidative metabolism of glucose. Glucose metabolized in neuronal cell bodies mainly supports cellular, vegetative and house-keeping functions, e.g., axonal transport, biosynthesis of nucleic acids, proteins, lipids, as well as other energy-consuming processes not related...
Article
Cerebrolysin has exhibited neuroprotective as well as neurotrophic properties in various animal models of cerebral ischaemia and has shown clinical efficacy and good safety in several small controlled clinical studies in ischaemic stroke. Therefore, a large double-blind placebo-controlled randomized clinical trial was launched in Asia to prove the...
Article
We studied the effect of partial aortic occlusion on cerebral perfusion and cardiac performance using the intra-aortic NeuroFlo catheter. Adult pigs were instrumented to determine cardiac parameters; unique isotope-labeled microspheres were used to determine cerebral blood flow (CBF) before, during and after sequential partial aortic occlusion. Six...
Article
We investigated the performance of FDG PET using an automated procedure for discrimination between Alzheimer's disease (AD) and controls, and studied the influence of demographic and technical factors. FDG PET data were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) [102 controls (76.0 +/- 4.9 years) and 89 AD patients (75.7 +...
Article
Background: The accuracy of perfusion weighted magnet resonance imaging (PW-MRI) based quantitative maps of cerebral blood flow (CBF-MRI), cerebral blood volume (CBV-MRI), mean transit time (MTT-MRI) and relative maps of time to peak (rTTP-MRI) remains a matter of debate. We validated CBF-, CBV-, MTT- and rTTP-PWI on quantitative CBF measurement by...
Article
Background: The accuracy of perfusion weighted MRI based quantitative maps of relative CBF, relative CBV, relative MTT and relative TTP remains a matter of debate. We validated PWI-maps on OEF measurement by quantitative 15O-water-PET with respect to the detection of elevated OEF (penumbra). Methods: PW-MRI was performed on a 1.5 Tesla scanner (Ph...
Article
Precise placement of transcranial magnetic stimulation (TMS) coils over target regions is crucial for correct interpretation of TMS effects. Modern frameless stereotaxic systems yield high accuracy, but require extensive equipment and cannot be used in every setting, for example, during functional imaging sessions. The aim of this study was the dev...
Article
Inconsistent changes of cognitive functioning have been reported in patients with Parkinson disease (PD) with deep brain stimulation (DBS) of the subthalamic nucleus (STN). To investigate the underlying pathomechanisms, we correlated alterations of cognitive test performance and changes of neuronal energy metabolism in frontal basal ganglia project...
Article
To determine the prognostic value of etiology and localization in spontaneous intracerebral hemorrhage, 896 patients with spontaneous intracerebral hemorrhage, as proven by CT, operation or autopsy, were retrospectively studied using univariate data analysis. Etiologies were hypertension in 63.5%, cerebrovascular malformations in 8.5% and abnormal...
Article
High resolution positron emission tomography (PET) with the newly developed HRRT scanner (Siemens/CTI) permits the reliable quantification of 18-Fluorodeoxyglucose (FDG) uptake as a marker of neuronal activity in small subcortical nuclei which are involved in the pathophysiology of Parkinson's disease (PD). We investigated the normalized cerebral m...
Article
We investigated associations between severity of cognitive impairment, cerebrospinal fluid (CSF) concentrations of total-tau (t-tau) protein and tau phosphorylated at threonin 181 (p-tau(181)) and regional glucose metabolism measured with 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) in patients with probable Alzheimer's disease...
Article
Full-text available
The penumbra--tissue perfused below the flow threshold for functional disturbance but above that for maintenance of morphological integrity--is the target for therapy in acute ischemic stroke. Irreversible tissue damage and penumbra can be reliably identified by multitracer positron emission tomography (PET) which has severe limitations due to comp...
Article
The immediate effects of deep brain stimulation (DBS) on subcortical neurons of its target region are controversial. We measured the regional normalized resting cerebral metabolic rate of glucose (nCMRGlc) with 18-fluorodeoxyglucose (FDG) and PET in 12 patients with Parkinson disease (PD) and bilateral DBS of the subthalamic nucleus (STN) compared...
Article
Radioiodinated 5-iodo-1-(2-fluoro-2-deoxy-beta-D-arabinofuranosyl)uracil (F *IAU) is most commonly used for noninvasive assessment of herpes simplex virus type 1 thymidine kinase (HSV-1-tk) gene expression. However, it does not permeate the intact blood-brain barrier (BBB) because of its moderate lipophilicity. In this work, three iodo-nucleosides,...
Article
Positron emission tomography with 11C-N-methyl-4-piperidyl-acetate (MP4A) was applied in eight healthy volunteers and two patients with mild Alzheimer's disease (AD) to assess acetylcholine esterase (AChE) activity in magnetic resonance imaging-identified brainstem nuclei. Uptake ratios in lateral dorsal tegmental and pedunculopontine nuclei relati...
Article
Over the past decade imaging technologies employed in clinical neurosciences have significantly advanced. Imaging is not only used for the diagnostic work-up of neurological disorders but also crucial to follow up on therapeutic efforts. Using disease-specific imaging parameters, as read-outs for the efficiency of individual therapies, has facilita...
Article
Recently, a combined repetitive transcranial magnetic stimulation (rTMS) and activation positron emission tomography (PET) study showed essential language function of the right inferior frontal gyrus (IFG) in some right-handed acute poststroke aphasics. We reexamined these patients in the chronic phase to test whether the right IFG remained essenti...