F Gerstenbrand

Karl Landsteiner Institut, Wien, Vienna, Austria

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Publications (322)

  • A.B. Kunz · S. Golaszewski · T. Sieber · [...] · F. Gerstenbrand
    Article · Oct 2015 · Pravention und Rehabilitation
  • S.M. Golaszewski · M. Seidl · K.R. Frick · [...] · F. Gerstenbrand
    Article · Oct 2013 · Journal of the Neurological Sciences
  • M. Seidl · S.M. Golaszewski · A.B. Kunz · [...] · F. Gerstenbrand
    Article · Oct 2013 · Journal of the Neurological Sciences
  • S.M. Golaszewski · M. Seidl · A.B. Kunz · [...] · F. Gerstenbrand
    Article · Oct 2013
  • A.B. Kunz · S.M. Golaszewski · J. Hrdy · F. Gerstenbrand
    Article · Jul 2013 · Pravention und Rehabilitation
  • Source
    E S Tomilovskaya · M Berger · F Gerstenbrand · I B Kozlovskaya
    [Show abstract] [Hide abstract] ABSTRACT: The aim of the study was to examine effects of long-duration exposure to weightlessness on characteristics of the vertical gaze fixation reaction (GFR). The subjects were to perform the target acquisition task on visual stimuli that appeared at a distance of 16 deg. up- and down from the primary position in a random order. Experiments were performed before launch, during flight and after landing. Before flight time of gaze fixation reaction did not exceed 650 ms. During space flight (SF) it extended up to 900-1000 ms and more. The velocities of head movement in space decreased, but the velocities of eye counterrotation decreased to a lesser degree. This difference resulted in sharp increase of vertical vestibular ocular reflex (VOR) gain (up to 4.3 values in one of the cosmonauts) during the 1st month of flight; further it decreased reaching the values of 0.5-0.7 on the 5th month of SF. After landing vertical VOR gain increased greatly again. These results in the vertical axis are in agreement with the data of Kozlovskaya et al., which showed in experiments with monkeys that horizontal VOR gain increased together with redundant inadequate responses of vestibular nucleus on vestibular stimulation and that in the course of adaptation to these conditions central nervous system inhibited vestibular input from the motor control system.
    Full-text Article · Apr 2013 · Journal of Vestibular Research
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    K von Wild · S T Laureys · F Gerstenbrand · [...] · G Onose
    [Show abstract] [Hide abstract] ABSTRACT: In 2002, Bryan Jennett chose the caption “A syndrome in search of a name” for the first chapter of his book “The vegetative state - medical facts, ethical and legal dilemmas”, which, in summary, can be taken as his legacy. Jennett coined the term "VegetativeState" (VS), which became the preferential name for the syndrome of wakeful unresponsiveness in the English literature, with the intention to specify the concern and dilemmas in connection with the naming "vegetative", "persistent" and "permanent". In Europe, Apallic Syndrome (AS) is still in use. The prevalence of VS/AS in hospital settings in Europe is 0.5–2/100.000 population year; one-third traumatic brain damage, 70% following intracranial haemorrhages, tumours, cerebral hypoxemia after cardiac arrest, and end stage of certain progressive neurological diseases. VS/AS reflects brain pathology of (a) consciousness, self-awareness, (b) behaviour, and (c) certain brain structures, so that patients are awake but total unresponsive. The ambiguity of the naming “vegetative” (meant to refer to the preserved vegetative (autonomous nervous system) can suggest that the patient is no more a human but “vegetable” like. And “apallic” does not mean being definitively and completely anatomically disconnected from neocortical structures. In 2009, having joined the International Task Force on the Vegetative State, we proposed the new term “Unresponsive Wakefulness Syndrome” (UWS) to enable (neuro-)scientists, the medical community, and the public to assess and define all stages accurately in a human way. The Unresponsive Wakefulness Syndrome (UWS) could replace the VS/AS nomenclature in science and public with social competence.
    Full-text Article · Feb 2012 · Journal of medicine and life
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    [Show abstract] [Hide abstract] ABSTRACT: Traumatic Brain Injury (TBI) is among the most frequent neurological disorders. Of all TBIs 90% are considered mild with an annual incidence of 100-300/100.000. Intracranial complications of Mild Traumatic Brain Injury (MTBI) are infrequent (10%), requiring neurosurgical intervention in a minority of cases (1%), but potentially life-threatening (case fatality rate 0,1%). Hence, a true health management problem exists because of the need to exclude the small chance of a life threatening complication in large numbers of individual patients. The 2002 EFNS guidelines used a best evidence approach based on the literature until 2001 to guide initial management with respect to indications for CT, hospital admission, observation and follow up of MTBI patients. This updated EFNS guideline version for initial management in MTBI proposes a more selectively strategy for CT when major(dangerous mechanism, GCS<15, 2 points deterioration on the GCS, clinical signs of (basal) skull fracture, vomiting, anticoagulation therapy, post traumatic seizure) or minor(age, loss of consciousness, persistent anterograde amnesia, focal deficit, skull contusion, deterioration on the GCS) risk factors are present based on published decision rules with a high level of evidence. In addition clinical decision rules for CT now exist for children as well. Since 2001 recommendations, although with a lower level of evidence, have been published for clinical in hospital observation to prevent and treat other potential threads to the patient including behavioral disturbances (amnesia, confusion and agitation) and infection.
    Full-text Article · Feb 2012 · European Journal of Neurology
  • S. Golaszewski · M. Seidl · A. Kunz · [...] · F. Gerstenbrand
    Conference Paper · Sep 2011
  • Conference Paper · Sep 2011
  • [Show abstract] [Hide abstract] ABSTRACT: Although chronic sleepiness is common after head trauma, the cause remains unclear. Transcranial magnetic stimulation (TMS) represents a useful complementary approach in the study of sleep pathophysiology. We aimed to determine in this study whether post-traumatic sleep-wake disturbances (SWD) are associated with changes in excitability of the cerebral cortex. TMS was performed 3 months after mild to moderate traumatic brain injury (TBI) in 11 patients with subjective excessive daytime sleepiness (EDS; defined by the Epworth Sleepiness Scale ≥10), 12 patients with objective EDS (as defined by mean sleep latency <5 on multiple sleep latency tests), 11 patients with fatigue (defined by daytime tiredness without signs of subjective or objective EDS), 10 patients with post-traumatic hypersomnia "sensu strictu," and 14 control subjects. Measures of cortical excitability included central motor conduction time, resting motor threshold (RMT), short-latency intracortical inhibition (SICI), and intracortical facilitation to paired-TMS. RMT was higher and SICI was more pronounced in the patients with objective EDS than in the control subjects. In the other patients all TMS parameters did not differ significantly from the controls. Similarly to that reported in patients with narcolepsy, the cortical hypoexcitability may reflect the deficiency of the excitatory hypocretin/orexin-neurotransmitter system. These observations may provide new insights into the causes of chronic sleepiness in patients with TBI. A better understanding of the pathophysiology of post-traumatic SWD may also lead to better therapeutic strategies in these patients.
    Article · Mar 2011 · Journal of neurotrauma
  • S. M. Golaszewski · M. Kronbichler · J. Bergmann · [...] · F. Gerstenbrand
    Conference Paper · Sep 2010
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    G. Bauer · S. Golaszewski · Franz Gerstenbrand
    [Show abstract] [Hide abstract] ABSTRACT: 1966 prägten Plum und Posner [1] den Terminus Locked-In-Syndrom (LiS). „Locked in“ bedeutet Eingesperrtsein. Das LiS bezeichnet topologisch ein ventrales Brückensyndrom, das klinisch durch eine komplette Lähmung bei erhaltenem Bewusstsein gekennzeichnet ist. Lediglich vertikale Blick- und Blinzelbewegungen sind willentlich möglich. Vom LiS im eigentlichen Sinne sind Zustände weitgehender Immobilität wie bei schwerem Guillain-Barré-Syndrom, bei fortgeschrittener Amyotropher Lateralsklerose, bei Morbus Parkinson, bei Multipler Sklerose, bei Alzheimerscher Demenz und bei anderen progredienten neurologischen Erkrankungen zu unterscheiden. Die diagnostische Abgrenzung dieser Zustände vom LiS ist aufgrund der Krankengeschichte unschwer möglich und in prognostischer Hinsicht wichtig, da LiS in einigen Fällen vollständig oder teilweise reversibel und meist nicht progredient ist. Totale Immobilität bei erhaltenem Bewusstsein stellt eine existentielle Extrem-situation dar und hat dementsprechend großes mediales Interesse erfahren. Dabei ist die Abgrenzung zu Reintegrationsstufen eines apallischen Syndroms (vegetativer Zustand) im Sinne eines so genannten minimal bewussten Zustandes [2] zumindest in der veröffentlichten Meinung nicht genügend beachtet worden.
    Full-text Article · Jan 2010 · Psychopraxis
  • Conference Paper · Aug 2008
  • [Show abstract] [Hide abstract] ABSTRACT: The aim of the present was study to evaluate cortical and subcortical neural responses on vibrotactile stimulation of the food and to assess somatosensory evoked BOLD responses in dependence of vibration amplitude and stimulus waveform. Sixteen healthy male subjects received vibrotactile stimulation at the sole of the right foot. The vibration stimulus was delivered through a moving magnet actuator system (MMAS). In an event-related design, a series of vibration stimuli with a duration of 1 s and a variable interstimulus interval was presented. Four stimulation conditions were realized using a 2 (amplitudes 0.4 mm or 1.6 mm) x 2 (waveform sinusoidal or amplitude modulated) factorial design. Stimulating with 0.4 mm amplitude compared to 1.6 mm stimulus amplitude more strongly activated the pre- and postcentral gyrus bilaterally and the right inferior, medial and middle frontal gyrus. In the reverse comparison significant differences were observed within the left inferior parietal lobule, the left superior temporal gyrus, and the left temporal transverse gyrus. In the comparison of sinusoidal versus modulated waveform and vice versa no significant activation differences were obtained. The inter-subject variability was high but when all four stimulation conditions were jointly analyzed, a significant activation of S1 was obtained for every single subject. This study demonstrated that the BOLD response is modulated by the amplitude but not by the waveform of vibrotactile stimulation. Despite high inter-individual variability, the stimulation yielded reliable results for S1 on the single-subject level. Therefore, our results suggest that vibrotactile testing could evolve into a clinical tool in functional neuroimaging.
    Article · Jul 2008 · NeuroImage
  • Article · Jun 2008 · Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater
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    Full-text Chapter · Jan 2008
  • Source
    E S Tomilovskaya · M Berger · F Gerstenbrand · I B Kozlovskaya
    [Show abstract] [Hide abstract] ABSTRACT: The study was performed to explore effects of long-duration SF on the characteristics of horizontal gaze fixation reaction (hGFR). Changes in GFR observed in long-duration space flight (SF) point out to serious disturbances of the VOR system due to, apparently, altered vestibular activity. Two strategies of reaction adaptation to the microgravity conditions were discovered in cosmonauts of civic occupations and pilots.
    Full-text Article · Aug 2007 · Journal of gravitational physiology: a journal of the International Society for Gravitational Physiology
  • [Show abstract] [Hide abstract] ABSTRACT: Spasticity is often a handicap in paraplegics and interferes with quality of life. Medical therapeutic options (e.g. baclofen, tizanidin) lead to drowsiness, fatigue and loss in activity. On the other hand paraplegics are increasingly active in daily life and leisure (paralympics). Neurorehabilitation is effective in reduction of spasticity, gaining motor function and enhancing quality of life. Hippotherapy (Lechner et al 2003) and aquatic rehabilitation are additive methods. Already 15 years ago Madorsky et al pointed out SCUBA diving as a positive neurorehabilitation procedure. The study group around Stanghelle reported also beneficial aspects on spasticity of patients with spinal cord injuries. These references inspired to introduce a prospective study. After obtaining an ethic votum and evaluation assessment for diving permission 6 volunteers with paraplegia entered the pilot study. Medication was kept stable throughout the study time. Supervised by diving instructors and a diving trained doctor the volunteers dived to a platform in the depth of 7.2 meters. The daily diving time was exactly 30 minutes. Stabilized on the platform physiotherapeutic assessment took place in different positions to reduce spasticity. Ashworth Scale and spasm frequency scale were noted daily and at beginning and end of the study the WHO Quality of life Test had to be completed. For objective reasons a locomat training happened before, within a week after and 4 weeks after the study week. All patients did the daily dives without any difficulties. The statistics included the assessment of day 1 versus day 7 of 5 patients and showed a significant reduction of Modified Ashwoth Scale (p=0.04). Quality of life showed an improvement. The improvement rationale can only be supposed. A correlation to the ambient pressure suggests itself. Therefore deeper depths should increase the good spasticity results or manage to achieve those faster. Many questions remain, so further studies are necessary to ascertain the ideal standard options.
    Article · Feb 2007 · Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater
  • Klaus von Wild · Franz Gerstenbrand · Giuliano Dolce · [...] · George A. Zitnay
    [Show abstract] [Hide abstract] ABSTRACT: Introduction: Epidemiology in Europe shows constantly increasing figures for the apallic syndrome (AS)/vegetative state (VS) as a consequence of advanced rescue, emergency services, intensive care treatment after acute brain damage and high-standard activating home nursing for completely dependent end-stage cases secondary to progressive neurological disease. Management of patients in irreversible permanent AS/VS has been the subject of sustained scientific and moral-legal debate over the past decade. Methods: A task force on guidelines for quality management of AS/VS was set up under the auspices of the Scientific Panel Neurotraumatology of the European Federation of Neurological Societies to address key issues relating to AS/VS prevalence and quality management. Collection and analysis of scientific data on class II (III) evidence from the literature and recommendations based on the best practice as resulting from the task force members' expertise are in accordance with EFNS Guidance regulations. Findings: The overall incidence of new AS/VS full stage cases all etiology is 0.5–2/100.000 population per year. About one third are traumatic and two thirds non traumatic cases. Increasing figures for hypoxic brain damage and progressive neurological disease have been noticed. The main conceptual criticism is based on the assessment and diagnosis of all different AS/VS stages based solely on behavioural findings without knowing the exact or uniform pathogenesis or neuropathological findings and the uncertainty of clinical assessment due to varying inclusion criteria. No special diagnostics, no specific medical management can be recommended for class II or III AS treatment and rehabilitation. This is why sine qua non diagnostics of the clinical features and appropriate treatment of AS/VS patients of “AS full, remission, defect and end stages” require further professional training and expertise for doctors and rehabilitation personnel. Interpretation: Management of AS aims at the social reintegration of patients or has to guarantee humanistic active nursing if treatment fails. Outcome depends on the cause and duration of AS/VS as well as patient's age. There is no single AS/VS specific laboratory investigation, no specific regimen or stimulating intervention to be recommended for improving higher cerebral functioning. Quality management requires at least 3 years of advanced training and permanent education to gain approval of qualification for AS/VS treatment and expertise. Sine qua non areas covering AS/VS institutions for early and long-term rehabilitation are required on a population base (prevalence of 2/100.000/year) to quicken functional restoration and to prevent or treat complications. Caring homes are needed for respectful humane nursing including basal sensor-motor stimulating techniques. Passive euthanasia is considered an act of mercy by physicians in terms of withholding treatment; however, ethical and legal issues with regard to withdrawal of nutrition and hydration and end of life discussions raise deep concerns. The aim of the guideline is to provide management guidance (on the best medical evidence class II and III or task force expertise) for neurologists, neurosurgeons, other physicians working with AS/VS patients, neurorehabilitation personnel, patients, next-of-kin, and health authorities.
    Article · Jan 2007 · European Journal of Trauma and Emergency Surgery

Publication Stats

3k Citations

Institutions

  • 2013
    • Karl Landsteiner Institut
      Wien, Vienna, Austria
  • 2010
    • Medizinische Universität Innsbruck
      • Department of Neurology
      Innsbruck, Tyrol, Austria
  • 1991-2007
    • University of Innsbruck
      Innsbruck, Tyrol, Austria
    • Vienna University of Technology
      Wien, Vienna, Austria
  • 2006
    • Ludwig Boltzmann Institute for Osteology
      Wien, Vienna, Austria
  • 1964-1983
    • University of Vienna
      • Department of Medicinal Chemistry
      Wien, Vienna, Austria