Wolfgang Freund

Ulm University | UULM · Clinic of Diagnostic and Interventional Radiology

Background: Good sleep is correlated with health. Primary insomnia is a common reason for consulting a primary care physician. It is usually treated with drugs despite clear evidence for the efficacy of behavioral therapy. Methods: We conducted a selective search of PubMed for German- and English-language reviews of the past decade that deal wit...

Background Sitting is known to be bad for your cardiovascular health. We furthermore hypothesized that sitting posture will reduce perfusion of the foot and increase edema, possibly predisposing to disease like osteochondritis. Methods We included 27 healthy volunteers and performed MRI measurements including arterial spin labelling (ASL) and intra...

Background A wide variety of metabolic changes, including an increased incidence of diabetes mellitus (DM) and dyslipidaemia, has been described in amyotrophic lateral sclerosis (ALS). The aim of this study was to investigate the associations of statin use and history of DM with onset of disease and survival in patients with ALS. Methods 501 patie...

Purpose Sudden unilateral peripheral vestibular deficit is mostly termed vestibular neuritis (VN), even if its cause or the exact location of the lesion remains unclear. Thus, therapy is mostly symptomatic. We aimed to prove if there is peripheral atrophy after VN with persistent canal paresis. Methods After approval by the ethics committee and acc...

Noch zu meinen Studienzeiten wurde mir die ärztliche Therapiefreiheit als wesentliche Grundlage der Arzt-Patienten-Beziehung gepredigt. Dieser Zahn wird einem in der ärztlichen Tätigkeit heutzutage rasch und ohne Lokalanästhesie gezogen. Im folgenden Beitrag soll auf das Spannungsfeld der Therapiewahl im Kontext mit wissenschaftlicher Evidenz, Ress...

Der Landesverband Baden-Württemberg des BVDN hat weiter erfolgreich an der Ausweitung des PNP-Vertrags nach § 73 c gearbeitet und setzt sich für Honorargerechtigkeit bei Doppelfachärzten ebenso ein wie für den Erhalt wichtiger BG-Ziffern sowie einen vernünftigen Umgang mit Arzneimittelprüfungen.

Der NeuroTransmitter hat die im Apple App-Store derzeit verfügbaren vier Apps zur Tremoranalyse einem kurzen Test unterzogen. Nur eine der Apps liefert für die Praxis brauchbare Ergebnisse.

Generika für bestimmte Indikationen können manchmal auch bei anderen Indikationen eingesetzt werden, für die sie aber nicht zugelassen sind. Von Pharma-Außendienstmitarbeitern werden oftmals die Haftungs- und Regressrisiken betont. Dürfen Generika für nicht zugelassene Indikationen verwendet werden?

Objective Angulated projections are used in radiography to show the cervical neural foramen. Imaging the coronal oblique planes in an MRI of the cervical spine should therefore improve visualization of neural foramen pathology. This has to be demonstrated. Patients and methods A multi-center investigation of 40 patients with monoradiculopathy and...

Angulated projections are standard in conventional radiography of the cervical spine, but rarely used in magnetic resonance imaging (MRI). As neuroforaminal pathology plays an important role in the etiology of radicular syndromes and may influence an operative approach, the utility of coronal oblique slices in MRI is explored. In a retrospective se...

Intramuscular or infiltrating lipomas are rare. We present a 58-year-old man with an intramuscular lipoma developing after decompression surgery for lumbar spinal canal stenosis. One year after macroscopically complete lipoma resection, an even bigger recurrent tumor had to be removed. The lumbar paraspinal musculature is a very uncommon site for a...

Objective To determine the effectiveness of cervical transforaminal injection of steroids (CTFIS) and to explore possible determinants of response in patients with cervical disc herniation. DesignRetrospective practice audit covering a time period of 6 months. SettingSingle spine center in which the patients underwent CTFIS, surgery, and subsequent...

During the 4,487 km ultra marathon TransEurope-FootRace 2009 (TEFR09), runners showed catabolism with considerable reduction of body weight as well as reversible brain volume reduction. We hypothesized that ultra marathon athletes might have developed changes to grey matter (GM) brain morphology due to the burden of extreme physical training. Using...

Evolution of regionally accentuated reversible brain grey matter reduction in ultra marathon runners detected by voxel based morphometry. Freund, Faust, Birklein, Billich, Wunderlich, Schütz Background During the 4,487km ultra marathon TransEurope-FootRace 2009 (TEFR09), runners showed catabolism with considerable reduction of body mass. We hypoth...

Introduction: Susceptibility to pain varies among individuals and may predispose to a higher risk for pain disorders. Thus, it is of interest to investigate subjects who exhibit higher resistance to pain. We therefore tested pain tolerance and assessed personality traits of ultra-marathon athletes who are able to run 4487 km (2789 mi) over 64 days...

Background: During the extremely challenging 4,487 km ultramarathon TransEurope-FootRace 2009, runners showed considerable reduction of body weight. The effects of this endurance run on brain volume changes but also possible formation of brain edema or new lesions were explored by repeated magnetic resonance imaging (MRI) studies. Methods: A tot...

Tables S1-3. Table S1: Fluid-attenuated inversion recovery (FLAIR) imaging of brain lesions. Observations from timepoint 1 (t1) to t2; only subjects with two consecutive measurements. The table contains single subject data for FLAIR lesion comparisons between timepoints 1 to 2. Table S2: FLAIR imaging of brain lesions. Observations from t2 to t3; o...

In a retrospective analysis with two readers blinded to the clinical information, coronal short tau inversion recovery (STIR) images were compared to contrast-enhanced fat-saturated T1-weighted imaging (T1 CEfs) in 51 cases of cervical lymphoma. Interrater reliability was good to excellent. Although sensitivity and subjective quality of the STIR se...

To compare different multidetector computed tomography (MDCT) protocols to optimize pancreatic contrast enhancement. Forty consecutive patients underwent contrast-enhanced biphasic MDCT (arterial and portal-venous phase) using a 64-slice MDCT. In 20 patients, the scan protocol was adapted from a previously used 40-channel MDCT scanner with arterial...

The TransEurope FootRace 2009 (TEFR09) was one of the longest transcontinental ultramarathons with an extreme endurance physical load of running nearly 4,500 km in 64 days. The aim of this study was to assess the wide spectrum of adaptive responses in humans regarding the different tissues, organs and functional systems being exposed to such chroni...

Ziele: Hirnodem und Enzephalopathie sind als Folgen von Elektrolytentgleisungen gefurchtete Folgen von Marathonlaufen. Ebenso sind reversible posteriore Encephalopathie und cerebrale Embolien beschrieben worden. Da die Belastungen des Transeuropalaufs mit kontinuierlicher Abfolge von Laufetappen an 64 Tagen uber insgesamt 4487km deutlich uber denen...

Ziele: Die Volumenverteilung der grauen Hirnsubstanz spiegelt funktionelle Anpassungen wieder. Es ist bekannt, dass beim Erlernen neuer Aufgaben die zuständigen Hirnregionen einen Volumenzuwachs erfahren.Der Transeuropalauf 2009 führte von Bari ans Nordkap. Auf den 4487km wurden die Läufer mit einem mobilen MR-Gerät (1,5T Magnetom Avanto, Siemens)...

67 runners participated in the Trans Europe FootRace 2009 (TEFR09), a 4487 km (2789 mi) multistage ultra-marathon covering the south of Europe (Bari, Italy) to the North Cape. Reports on ultra-marathons are lacking, but the literature reports overuse injuries in athletes, especially to the Achilles tendon (AT), ankle or hind foot. Bone oedema may b...

Focal hippocampal diffusion-weighted imaging (DWI) lesion patterns are detected in transient global amnesia (TGA) patients in different frequency. It has been speculated that acute diffusion restrictions are associated with a worse outcome. Therefore, we evaluated the influence of acute DWI lesions on the cognitive long-term outcome in TGA patients...

Femoroacetabular impingement has been shown to be an important cause for the development of osteoarthritis of the hip joint. Radial MRI of the hip has proven to be the diagnostic procedure of choice to differentiate which patient to operate. While examinations after instillation of contrast agents have been described, new papers have shown high acc...

Empty nose syndrome (ENS) patients have a persistent sense of impaired nasal patency despite radical resection of nasal turbinates. The aim of this study was to elucidate differences in cerebral activation during free breathing and after inhalation of a fragrance (lemonene) and a pseudodecongestant (menthol) over a nasofacial mask. Our hypothesis w...

Complex regional pain syndrome I (CRPS I) is a frequent and debilitating condition with unclear etiology. Hypothesizing that maladaptive central processes play a crucial role in CRPS, the current study set out to explore cerebral activation during a task to suppress the feeling of pain under constant painful stimulation. Ten individuals with CRPS I...

Marathon running is gaining in popularity. Its benefits regarding the cardiovascular system as well as the metabolism are beyond doubt. However, whether or not there are detrimental side effects to the musculoskeletal system such as wear and tear is an unsolved question. We therefore prospectively looked at beginners and experienced runners at a ci...

Supplementary material is available on the publishers Web site along with the published article.

Pain modulation is an integral function of the nervous system. It is needed to adapt to chronic stimuli. To gain insights into pain suppression mechanisms, two studies concerning the suppression of the feeling of pain with different stimulation modalities (heat vs. electrical stimuli) but using the same stimulation paradigms were compared: 15 subje...

Hippocampal sulcal cavities (HSC) have been speculated to contribute to a higher vulnerability of memory pathways and might be a possible etiological factor in transient global amnesia (TGA). Therefore, we evaluated the influence of HSC on cognitive long-term outcome in TGA-patients. Fourteen otherwise healthy patients with the clinical syndrome of...

Although the etiology of complex regional pain syndrome type 1 (CRPS 1) is still debated, many arguments favor central maladaptive changes in pain processing as an important causative factor. To look for the suspected alterations, 10 patients with CRPS affecting the left hand were explored with functional magnetic resonance imaging during graded el...

Hintergrund: Der Marathonlauf wird immer populärer und bei dem verbreiteten sitzenden Lebenswandel sind die positiven Auswirkungen auf Stoffwechsel und Herz-Kreislauf-system unbestritten. Unklar ist jedoch die Frage nach vorzeitigem Gelenk- und Sehnenverschleiß. Es wurden geübte und ungeübte Läufer in der Vorbereitungszeit und direkt nach einem Mar...

Pain can result from various sensory input modalities. To elucidate the differences of cortical responses to graded electrical and thermal stimulation, functional magnetic resonance imaging (fMRI) results of two studies using the same stimulation paradigms but different modalities with 15 healthy subjects each are compared. During painful electrica...

Chronic subjective tinnitus has been associated with aberrant activation of cortical areas involved in the perception of auditory information. This leads to the hypothesis that neural correlates of altered auditory perception may be found in tinnitus patients using functional magnetic resonance imaging. To study brain activation patterns due to aco...

Two neuroimaging studies using functional magnetic resonance imaging (fMRI) and thermally induced pain are presented. Fifteen healthy right-handed subjects were imaged while they had to discern different levels of thermal stimuli in the first study and while they disengaged from the feeling of pain during constant stimulation in the second study. I...

Stroke MRI protocols provide useful information about underlying vessel pathologies in the anterior circulation by means of intracranial time-of-flight angiography. However, these protocols mostly fail in the posterior circulation to differentiate between congenital variants and secondary thrombosis. Therefore, a high-resolution anatomic True Fast...

The aim of this study was to investigate whether the final displacement of conservatively treated distal radius fractures can be predicted after primary reduction. We analysed the radiographic documents of 311 patients with a conservatively treated distal radius fracture at the time of injury, after reduction and after bony consolidation. We measur...

Contrast-enhanced multidetector row helical computed tomography (MDCT) scanning is establishing itself as a rapid, noninvasive, and accurate diagnostic method in suspected acute gastrointestinal bleeding. Active bleeding can be depicted as an area of focal high attenuation within the bowel lumen on arterial phase MDCT images. New MDCT technologies...

Two neuroimaging studies using fMRI were conducted in order to assess the cortical processes involved in the perception and suppression of pain. In the first study, 15 healthy subjects were stimulated with variable intensities of electrical pulses during a discrimination task. In the second study, the same subjects had to try to suppress the feelin...

Radius fractures are frequent in adults, and the long-term results of conservative treatment remain disappointing. This study examines predictors for the clinical outcome in the initial radiograph. This will help to identify patients who will benefit from surgical treatment. A cohort study including a standardized telephone interview (Cooney score)...