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1. Safety and efficacy of evobrutinib in relapsing multiple sclerosis (evolutionRMS1 and evolutionRMS2): two multicentre, randomised, double-blind, active-controlled, phase 3 trials

Author

Carra, Adriana Josefa, Deri, Norma Haydee, Jose, Jorge Gustavo, del Valle Liwacki, Susana, Mainella, Carolina Natalia, Pagani, Fatima, Povedano, Guillermo, Alfici, Alberto Rodriguez, Tavolini, Dario Raul, Buonanotte, Carlos Federico, Burgos, Marcos, Giugni, Juan Carlos, Artesi, Juan Jose Martin, Rojas, Juan Ignacio, Zuin, Daniel Raul, Videla, Hugo Osvaldo, Correale, Jorge Daniel, Luetic, Geraldine G., Hodgkinson, Suzanne, Lechner-Scott, Jeannette, Parratt, John, Saines, Noel, Reddel, Stephen, Wijeratne, Tissa, Taylor, Bruce, Deisenhammer, Florian, Traxler, Gerhard, Leutmezer, Fritz, Wipfler, Peter, Weber, Joerg R., Lampl, Christian, Bartholome, Emmanuel, Dive, Dominique, Glibert, Nele, Perrotta, Gaetano, Pesch, Vincent, Buyle, Maarten, Wijmeersch, Bart, Willekens, Barbara, Basagic, Edin, Mehmedika Suljic, Enra, Klupka-Sarić, Inge, Danovska, Maya, Dimitrova, Maria, Genov, Krasimir, Izmaylov, Alim, Mavrov, Radoslav, Milanov, Ivan, Naydenov, Valcho, Shotekov, Penko, Tarnev, Ivaylo, Traykov, Latchezar, Emond, Francois, Selchen, Daniel, Rivest, Donald, Sabella, Lisa, Witkowski, Ludivine, Saveriano, Alexander, Bolano Solano, Addinson Rene, Ruiz, Cesar Augusto Franco, Nassar Tobon, Andrea Catalina, Cardozo, Carlos Alberto Navas, Schlesenger, Antonio, Triana, Javier Dario, Sarabia, Osvaldo Elias Lara, Montero, Luis Alfonso Zarco, Arango, Jorge Andres Jimenez, Basic, Silvio, Pasic, Marija Bosnjak, Soldo, Silva Butkovic, Habek, Mario, Kidjemet-Piskac, Spomenka, Matijaca, Meri, Vuletic, Vladimira, Ampapa, Radek, Dufek, Michal, Grunermelova, Marketa, Mares, Jan, Martinkova, Alena, Peterka, Marek, Stetkarova, Ivana, Stourac, Pavel, Talab, Radomir, Tyblova, Michaela, Marta, Vachova, Valis, Martin, Hradilek, Pavel, Rockova, Petra, Gross-Paju, Katrin, Haldre, Sulev, Airas, Laura, Karppa, Mikko, Bourre, Bertrand, Casez, Olivier, Ciron, Jonathan, Kwitakowski, Arnaud, Labauge, Pierre, Lebrun Frenay, Christine, Michel, Laure, Derache, Nathalie, Vukusic, Sandra, Laplaud, David-Axel, Beridze, Maia, Chakhava, George, Gauarashvili, Ann, Giorgadze, Gvantsa, Guldedava, Nana, Janelidze, Marina, Kiziria, Marina, Shakarishvili, Roman, Tsiskaridze, Alexander, Chkhikvishvili, Shalva, Albert, Christian, Berthele, Achim, Yalachkov, Yavor, Pitarokoili, Kalliopi, Kallmann, Boris-Alexander, Klotz, Luisa, Oschmann, Patrick, Pul, Refik, Rau, Daniela, Skripuletz, Thomas, Chan, Koon Ho, Lau, Alexander Yuk Lun, Li, Jessica Tsz Ching, Wong, Wa Tai, Maria, Biro Zita, Bokor, Magdolna, Dobos, Eniko, Janszky, Jozsef, Kovacs, Krisztina, Lazarcsik, Ildiko, Piros, Palma, Rozsa, Csilla, Satori, Maria, Simo, Magdolna, Nagy, Ferenc, Behari, Madhuri, Kulkarni, Rahul, Kumar, Radhakrishanan Suresh, Dwivedee, Shamsher, Iype, Thomas, Baviskar, Rahul, Mathukumalli, Neeharika L., Gilad, Ronit, Karussis, Dimitrios, Milo, Ron, Shahien, Radi, Vaknin, Adi, Weller, Boaz, Wilf-Yarkoni, Adi, Achiron, Anat, Aguglia, Umberto, Di Gregorio, Maria, Calabrese, Massimiliano, Cordioli, Cinzia, Sessa, Edoardo, Tomassini, Valentina, Inglese, Matilde, Castro Farfan, Freddy Guillermo, Roldan, Giovana Femat, Gonzalez Guardado, Antonio, Lopez Meza, Elmer, Maldonado, Jair Fernando, Boschetti, Laura Ordonez, Partida Medina, Luis Roberto, Frequin, Stephan, Hupperts, Raymond, Schrijver, Hans, Smolders, Joost, Diaz, Cesar Abel Castaneda, Pretell, Edwin, Boczarska-Jedynak, Magdalena, Bonek, Robert, Brola, Waldemar, Darda-Ledzion, Lidia, Fryze, Waldemar, Maciejowski, Maciej, Rejdak, Konrad, Rosciszewska-Zukowska, Iwona, Selmaj, Krzysztof, Szymanska, Malgorzata, Zajda, Małgorzata, Zielinski, Tomasz, Beata, Zakrzewska-Pniewska, Adam, Stepien, Swiat, Maciej, Kim, Byoung Joon, Kim, Ho-Jin, Kim, Kwang-Kuk, Shin, Ha Young, Kim, Sung Min, Kim, Woojun, Oh, Jeeyoung, Bakhtiyarova, Klara Z., Belova, Anna N., Davydovskaya, Maria V., Dudin, Viacheslav A., Erina, Olesya V., Evdoshenko, Evgeny P., Greshnova, Irina V., Khabirov, Farit A., Kotov, Sergey V., Makarov, Nikolay S., Maslova, Natalia, Mishin, Gennadiy N., Pokhabov, Dmitry V., Smagina, Inna V., Spirin, Nikolay N., Trushnikova, Tatiana N., Volkova, Larisa I., Zaslavskiy, Leonid G., Zhukova, Natalia G., Ceranic, Mirjana, Cvijanovic, Vera, Drulovic, Jelena, Gavric Kezic, Mira, Jovanovic, Dragoslava, Milicevic, Svetlana K., Raicevic, Ranko, Suknjaja, Vesna, Boskovic Matic, Tatjana, Vojinovic, Slobodan, Ruiz, Luis Brieva, Castillo Trivino, Tamara, Costa-Frossard Franca, Lucienne, Eichau Madueno, Sara, Forero Diaz, Lucia, Martinez, Jose Enrique, Martinez Yelamos, Sergio, Meca Lallana, Virginia, Oreja Guevara, Celia, Ramio i Torrenta, Lluis, Arroyo Gonzalez, Rafael, Guo, Yuh-Cherng, Ro, Long-Sun, Tsai, Nai-Wen, Wang, Kai-Chen, Yang, Fu-Chi, Cherkez, Alla, Deineka, Natalia, Delva, Mykhaylo, Goloborodko, Alla, Hovbakh, Iryna, Khavunka, Marta, Kmyta, Oleksii, Kozyolkin, Olexandr, Lekomtseva, Yevgeniya, Litovchenko, Tetyana, Moskovko, Sergii, Pashkovskyy, Valeriy, Riabichenko, Tetiana, Tovazhnyanska, Olena, Voloshyna, Nataliya, Hrebeniuk, Hanna, Sokolova, Larysa, Arun, Tarunya, Constantinescu, Cris, Harrower, Timothy, Mattoscio, Miriam, Paling, David, Pearson, Owen, Robertson, Neil, Webb, Stewart, Cottrell, David, Nicholas, Richard, Duddy, Martin, Anadani, Nidhiben, Belkin, Martin, Bernitsas, Evanthia, Borazanci, Aimee, Clark, David, Costell, Brian, Delgado, Silvia, Fox, Edward, Gudesblatt, Mark, Gupta, Vipan, Harel, Asaff, Harrison, Daniel, Herrman, Craig, Honeycutt, William David, Hua, Le, Hunter, Samuel, Katsamakis, George, Kilgo, William, Koffman, Boyd, Lindsey, William, Lynch, Sharon G., Mateen, Farrah J., McAllister, Peter, Farahmand, Arya, Morales, Idanis Berrios, Rahmlow, Megan, Naismith, Robert, Napoli, Salvatore, Newman, Stephen, Pardo, Gabriel, Patel, Nirav, Scott, James, Purino, Lorraine, Vasquez, Alberto B., Weisman, David, Wray, Sibyl, Wynn, Daniel, Dihenia, Bhupesh, Obeidat, Ahmed, Ayala, Ricardo, Erwin, April, Betz, Michelle, DeAngelis, Teresa, Osborne Dusan Stefoski, Benjamin, Giang, Daniel, Hendin, Barry, Nagaraj, Arun, Saltis, Lawrence, Singer, Barry, Balabanov, Roumen, Bromley, Steven Michael, Puente, John, Tran, Duc, Kojan, Suleiman, Graves, Jennifer, Fishman, Simon, Maher, Leo, Londono, Diana, Sadiq, Mohamed, Alekseenko, Yuri, Fedulau, Aliaksandr, Kulesh, Sergey, Mikhailova, Elena, Navumava, Halina, Aragon deVecino, Maria Cecilia, Callegaro, Dagoberto, Daccach Marques, Vanessa, Finkelsztejn, Alessandro, Guerreiro, Alexandre, Kleinpaul, Rodrigo, Koiti Sato, Henry, Luiz Longo, Alexandre, Papais Alvarenga, Regina Maria, Pereira Damasceno, Benito, Pereira Gomes Neto, Antonio, Diniz Carneiro, Denise S., Tauil, Carlos Bernardo, Maciel Dias, Ronaldo, Olival, Guilherme, Zago Melo Dias, Paula, de Jesus Carvalho, Margarete, Sato, Douglas Kazutoshi, Forcelini, Cassiano Mateus, Pelov, Plamen, Haralanov, Lyubomir, Ikonomov, Rosen, Ivanov, Ivan, Kastrev, Sasho, Kirilov, Krasimir, Lilovski, Hristo, Maslarov, Dimitar, Staikov, Ivan, Zhelyazkov, Petko, Freedman, Mark, MacLean, Gregg, Marriott, James, McKelvey, John Roger, Girard, Jean-Marc, Vorobeychik, Galina, Morrow, Sarah, Clavelou, Pierre, de Seze, Jerome, Louapre, Celine, Maurousset, Aude, Ruet, Aurelie, Thouvenot, Eric, Morel, Nathalie, Montcuquet, Alexis, Rouhart, Francois, Angstwurm, Klemens, Bayas, Antonios, Bittner, Stefan, Heesen, Christoph, Kowarik, Markus, Marckmann-Boenke, Silke, Muller, Thomas, Zimmermann, Julian, Nelles, Gereon, Paul, Friedemann, Then Bergh, Florian, Wildemann, Brigitte, Zettl, Uwe Klaus, Ziemssen, Tjalf, Doerr, Jan-Marcus, Chroni, Elisabeth, Dardiotis, Efthymios, Doskas, Triantafyllos, Gatzonis, Stylianos, Grigoriadis, Nikolaos, Karageorgiou, Klimentini, Kouremenos, Evangelos, Mitsias, Panayiotis, Spengos, Konstantinos, Kimiskidis, Vasilios, Evangelopoulos, Maria E., Fakas, Nikolaos, Karanasios, Panagiotis, Kyritsis, Athanasios, Maltezou, Maria, Sotirli, Stefania, Tsolaki, Magda, Rohtagi, Anshu, Mukherjee, Joy, Nellikunja, Shankara, Srinivasa, Rangashetty, Sharma, Arvind, Chowdhury, Debashish, Kalita, Jayantee, Brescia Morra, Vincenzo, Centonze, Diego, Gasperini, Claudio, Grimaldi, Luigi, Maniscalco, Giorgia Teresa, Patti, Francesco, Salemi, Giuseppe, Trojano, Maria, Amato, Maria Pia, Malucchi, Simona, Brambilla, Laura, Pozzilli, Carlo, Al Roughani, Raed, Karelis, Guntis, Kalnina, Jolanta, Millers, Andrejs, Mickeviciene, Dalia, Giedraitiene, Natasa, Kazlauskas, Andrius, Malciene, Lina, Joseph, Joyce Pauline, Chung, Law Wan, Looi, Irene, Remli, Rabani, Binti Sapuan, Sapiah, Abdullah, Suhailah, Carbajal Ramirez, Angelica, Espino Ojeda, Alba, Silvestre Bejar Medina, Jesus, Quinones Aguilar, Sandra, Rivas Alonso, Veronica, de la Rosa, Rogelio Francisco, San Juan Orta, Daniel, Misic, Octavian, Odainic, Olesea, Torkildsen, Oivind, Schuler, Stephan, Broch, Line, Canete, Ma. Teresa, Hiyadan, John Harold, Hormillosa, Mary Pauline, Rosales, Raymond L., Adamczyk Sowa, Monika, Bartosik-Psujek, Halina, Berkowicz, Tomasz, Czarnecki, Maciej, Kłodowska, Gabriela, Klosek, Agata, Koscielniak, Jozef, Lisewski, Pawel, Mielcarek, Bartlomiej, Piasecka-Stryczynska, Karolina, Potemkowski, Andrzej, Stasiołek, Mariusz, Krzystanek, Ewa, Lasek-Bal, Anetta, Sikorska, Swietlana, Szczudlik, Andrzej, Gospodarczyk-Szot, Krystyna, Wierzchowska-Cioch, Ewa, K. Jastrzebska, Iwona, Capela, Carlos, Cerqueira, Joao, Correia, Ana Sofia, Correia, Filipe, Ferreira, Joaquim J., Gouveia, Raquel, Mendes, Irene, Nunes, Carla Cecilia, Timoteo, Angela, Veira, Carlos, Martins da Silva, Ana, Domingues, Joana, Chinea, Angel R, Tiu, Cristina, Balasa, Rodica, Chiru, Mirela, Dulamea, Adriana Octaviana, Silviu Manescu, Emilian, Mitrea, Dan, Mitu, Cristina, Nicolae, Silvia Maria, Filip, Carmen Corina Roman, Sabau, Monica, Vanghelie, Doinita, Varga, Ioana, Nunkoo, Vharoon, Agafina, Alina S., Gennadevna, Arefeva Elena, Alexeeva, Tatiana M., Bogdanov, Enver, Dorogov, Nikolay, Doronina, Olga, Goncharova, Zoya, Khasanova, Dina, Korobko, Denis, Pankratov, Evgeny V., Parshina, Elena, Poverennova, Irina, Prokopenko, Semyion V., Sazonov, Denis V., Shkilnyuk, Galina, Sivertseva, Stella, Stolyarov, Igor, Totolyan, Natalia A., Tsukurova, Larisa A., Vorobyeva, Olga V., Voznyuk, Igor A., Zakharova, Maria, Ardashev, Igor V., Boyko, Alexey, Alshehri, Ebtesam, Alkhawajah, Nuha M, Alfugham, Nora, Quek, Amy, Kevin, Tan, Dupejova, Beata, Feketova, Sona, Hancinova, Viera, Jurcaga, Frantisek, Turcani, Peter, Krastev, Georgi, Cimprichova, Andrea, Perichtova, Magdalena, Hojs-Fabjan, Tanja, Horvat Ledinek, Alenka, Savsek, Lina, Bateman, Kathleen, Frost, Andrew Charles, Henning, Franclo, Retief, Chris Francois, Aguado Valcarcel, Marta, Morales, Eduardo Aguera, Alonso Torres, Ana Maria, Borrega Canelo, Laura, Casanova Estruch, Bonaventura, Gascon Gimenez, Francisco, Ayuso, Guillermo I, Martinez Gines, Maria Luisa, Eustasio Meca Lallana, Jose, Rodriguez Antiguedad, Alfredo, Blasco Quilez, Rosario, Brieva Ruiz, Luis, Piehl, Fredrik, Lycke, Jan, Katsarogiannis, Evangelos, Nilsson, Christer, Hoepner, Robert, Zecca, Chiara, Findling, Oliver, Asawavichienjinda, Thanin, Kasemsap, Narongrit, Prayoonwiwat, Naraporn, Mhiri, Chokri, Ağan Yıldırım, Kadriye, Boz, Cavit, Efendi, Husnu, Soysal, Aysun, Terzi, Murat, Uygunoglu, Ugur, Gümüş, Haluk, Mungan, Semra, Ozakbas, Serkan, Serhan Sevim, Mustafa, Tamam, Yusuf, Kale, Nilufer, Karabudak, Rana, Bachinskaya, Natalia, Buchakchyiska, Nataliia, Chmyr, Galyna, Dzyak, Ludmyla, Ivashchenko, Svitlana, Kalbus, Oleksandr, Kareta, Serhiy, Korolova, Oksana, Kostiuchenko, Andrii, Kruchkevych, Zhanna, Larysa, Kadina, Mishchenko, Tamara, Moroz, Olena, Neryanova, Yuliya, Pasiura, Ihor, Pohrebnyak, Oleksandr, Pryshchepa, Volodymyr, Sanotskyy, Yanosh, Shkrobot, Svitlana, Shulga, Olga, Smolanka, Volodymyr, Tomakh, Nataliya, Zhuravlyova, Natalia, Allen, Alison B., Armstrong, Robert, Antezana, Ariel, Baker, Matthew, Bass, Ann, Benenati, Diana, Benson, Dalton, Beretich, Biljana, Burke, Deborah, Calkwood, Jonathan, Carpenter, Adam, Drake, Ryan, Dujmovic Basuroski, Irena, Gupta, Ajay, Hentati, Afif, Kaplan, Jeffrey, Katsafanas, Constance, Keegan, Andrew, Khatri, Bhupendra, Luzzio, Christopher, Malik, Maheen, Bennette, Myers, Miravalle, Augusto, Montoya, Liliana, Nash, Marshall, Poole Pharr, Emily, Sater, Richard A., Scagnelli, John, Schulman, Alan, Shafer, Stuart, Stein, Lee, Vandersluis, Joel, Williams, Armistead, Winkley, James, Berkovich, Regina, Cerghet, Mirela, Horton, Lindsay, Jacobs, Daniel H., Laurin, Nida, Liow, Kore, Robertson, Derrick, Mattson, David, Cabrera, Alicia V., Leist, Thomas, Negroski, Donald, Royter, Vladimir, LaGanke, Christopher, Winner, Paul, Sweeney, Michael, Weinberg, Lawrence A., Smith, Andrew, Rivas-Rodriguez, Erica, Wagner, Kimberly, Montalban, Xavier, Vermersch, Patrick, Arnold, Douglas L, Bar-Or, Amit, Cree, Bruce A C, Cross, Anne H, Kubala Havrdova, Eva, Kappos, Ludwig, Stuve, Olaf, Wiendl, Heinz, Wolinsky, Jerry S, Dahlke, Frank, Le Bolay, Claire, Shen Loo, Li, Gopalakrishnan, Sathej, Hyvert, Yann, Javor, Andrija, Guehring, Hans, Tenenbaum, Nadia, and Tomic, Davorka

Published
2024
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3. Predicting Outcome in Guillain-Barré Syndrome: International Validation of the Modified Erasmus GBS Outcome Score

Author

Doets, Alex Y, Lingsma, Hester F, Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Yamagishi, Yuko, Kusunoki, Susumu, Dimachkie, Mazen M, Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H, Chavada, Govindsinh, Willison, Hugh J, Casasnovas, Carlos, Bateman, Kathleen, Miller, James AL, van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E, Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A, Shahrizaila, Nortina, Galassi, Giuliana, Péréon, Yann, Bürmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P, Marchesoni, Cintia, Sedano Tous, María J, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H, Lehmann, Helmar C, Granit, Volkan, Cavaletti, Guido, Gutiérrez-Gutiérrez, Gerardo, Barroso, Fabio A, Visser, Leo H, Katzberg, Hans D, Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J, Eftimov, Filip, Wirtz, Paul W, Samijn, Johnny PA, Gilhuis, H Jacobus, Hadden, Robert DM, Holt, James KL, Sheikh, Kazim A, Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E, Faber, Catharina G, Gijsbers, Cees J, Busby, Mark, Roberts, Rhys C, Silvestri, Nicholas J, Fazio, Raffaella, van Dijk, Gert W, Garssen, Marcel PJ, Straathof, Chiara SM, Gorson, Kenneth C, and Jacobs, Bart C

Published
2021
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4. CSF Findings in Relation to Clinical Characteristics, Subtype, and Disease Course in Patients With Guillain-Barré Syndrome

Author

Al-Hakem, Helle, Doets, Alex Y, Stino, Amro Maher, Zivkovic, Sasha A, Andersen, Henning, Willison, Hugh J, Cornblath, David R, Gorson, Kenneth C, Islam, Zhahirul, Mohammad, Quazi Deen, Sindrup, Søren Hein, Kusunoki, Susumu, Davidson, Amy, Casasnovas, Carlos, Bateman, Kathleen, Miller, James A L, van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E, Arends, Samuel, Luijten, Linda W G, Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A, Shahrizaila, Nortina, Galassi, Giuliana, Pereon, Yann, Bürmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P, Marchesoni, Cintia, Sedano Tous, María J, Querol, Luis, Martín-Aguilar, Lorena, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H, Waheed, Waqar, Lehmann, Helmar C, Granit, Volkan, Stein, Beth, Samijn, Johnny P A, van Dijk, Gert W, Jacobs, Bart C, Neurology, Medical Microbiology & Infectious Diseases, Public Health, and Immunology

Subjects
Neurology (clinical)
Abstract

BACKGROUND AND OBJECTIVES: To investigate CSF findings in relation to clinical and electrodiagnostic subtypes, severity, and outcome of Guillain-Barré syndrome (GBS) based on 1,500 patients in the International GBS Outcome Study. METHODS: Albuminocytologic dissociation (ACD) was defined as an increased protein level (>0.45 g/L) in the absence of elevated white cell count (4 days 84%. High CSF protein levels were associated with a demyelinating subtype, proximal or global muscle weakness, and a reduced likelihood of being able to run at week 2 (odds ratio [OR] 0.42, 95% CI 0.25-0.70; p = 0.001) and week 4 (OR 0.44, 95% CI 0.27-0.72; p = 0.001). Patients with the Miller Fisher syndrome, distal predominant weakness, and normal or equivocal nerve conduction studies were more likely to have lower CSF protein levels. CSF cell count was

Published
2023

5. Diagnosis and management of Guillain–Barré syndrome in ten steps

Author

Leonhard, Sonja E., Mandarakas, Melissa R., Gondim, Francisco A. A., Bateman, Kathleen, Ferreira, Maria L. B., Cornblath, David R., van Doorn, Pieter A., Dourado, Mario E., Hughes, Richard A. C., Islam, Badrul, Kusunoki, Susumu, Pardo, Carlos A., Reisin, Ricardo, Sejvar, James J., Shahrizaila, Nortina, Soares, Cristiane, Umapathi, Thirugnanam, Wang, Yuzhong, Yiu, Eppie M., Willison, Hugh J., and Jacobs, Bart C.

Published
2019
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6. Clinical metagenomics in a resource-limited setting

Author

Marais, Gert, primary, Valley-Omar, Ziyaad, additional, Marais, Suzaan, additional, McMullen, Kate, additional, Bateman, Kathleen, additional, der Westhuizen, Diederick van, additional, Maseko, Moepeng, additional, Hardie, Diana, additional, and Brink, Adrian, additional

Published
2023
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7. Cerebrospinal Fluid Findings in Relation to Clinical Characteristics, Subtype, and Disease Course in Patients With Guillain-Barré Syndrome

Author

Al-Hakem, Helle, primary, Doets, Alex Y, additional, Stino, Amro Maher, additional, Zivkovic, Sasha A., additional, Andersen, Henning, additional, Willison, Hugh J, additional, Cornblath, David R, additional, Gorson, Kenneth C, additional, Islam, Zhahirul, additional, Mohammad, Quazi Deen, additional, Sindrup, Søren Hein, additional, Kusunoki, Susumu, additional, Davidson, Amy, additional, Casasnovas, Carlos, additional, Bateman, Kathleen, additional, Miller, James AL, additional, van den Berg, Bianca, additional, Verboon, Christine, additional, Roodbol, Joyce, additional, Leonhard, Sonja E, additional, Arends, Samuel, additional, Luijten, Linda W G, additional, Benedetti, Luana, additional, Kuwabara, Satoshi, additional, Van den Bergh, Peter, additional, Monges, Soledad, additional, Marfia, Girolama A, additional, Shahrizaila, Nortina, additional, Galassi, Giuliana, additional, Pereon, Yann, additional, Bürmann, Jan, additional, Kuitwaard, Krista, additional, Kleyweg, Ruud P, additional, Marchesoni, Cintia, additional, Sedano Tous, María J, additional, Querol, Luis, additional, Martín-Aguilar, Lorena, additional, Wang, Yuzhong, additional, Nobile-Orazio, Eduardo, additional, Rinaldi, Simon, additional, Schenone, Angelo, additional, Pardo, Julio, additional, Vermeij, Frederique H, additional, Waheed, Waqar, additional, Lehmann, Helmar C, additional, Granit, Volkan, additional, Stein, Beth, additional, Cavaletti, Guido, additional, Gutiérrez-Gutiérrez, Gerardo, additional, Barroso, Fabio A, additional, Visser, Leo H, additional, Katzberg, Hans D, additional, Dardiotis, Efthimios, additional, Attarian, Shahram, additional, van der Kooi, Anneke J, additional, Eftimov, Filip, additional, Wirtz, Paul W, additional, PA Samijn, Johnny, additional, Gilhuis, H Jacobus, additional, DM Hadden, Robert, additional, Holt, James KL, additional, Sheikh, Kazim A, additional, Kolb, Noah, additional, Karafiath, Summer, additional, Vytopil, Michal, additional, Antonini, Giovanni, additional, Feasby, Thomas E, additional, Faber, Catharina, additional, Kramers, Hans, additional, Busby, Mark, additional, Roberts, Rhys C, additional, Silvestri, Nicholas J, additional, Fazio, Raffaella, additional, van Dijk, Gert W, additional, Garssen, Marcel PJ, additional, Verschuuren, Jan, additional, Harbo, Thomas, additional, and Jacobs, Bart C, additional

Published
2023
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9. Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

Author

Ndondo, Alvin Pumelele, Eley, Brian, Wilmshurst, Jo Madeleine, Kakooza-Mwesige, Angelina, Giannoccaro, Maria Pia, Willison, Hugh J., Cruz, Pedro M. Rodríguez, Heckmann, Jeannine M., Bateman, Kathleen, Vincent, Angela, Ndondo, Alvin Pumelele, Eley, Brian, Wilmshurst, Jo Madeleine, Kakooza-Mwesige, Angelina, Giannoccaro, Maria Pia, Willison, Hugh J, Cruz, Pedro M Rodríguez, Heckmann, Jeannine M, Bateman, Kathleen, and Vincent, Angela

Subjects
Adult, Central Nervous System, Immunology, Àfrica, Communicable Diseases, COVID-19 (Malaltia), Communicable Disease, encephaliti, Central Nervous System Diseases, peripheral nervous system, Humans, Malalties transmissibles, Immunology and Allergy, neurological disorder, Child, Brain Diseases, post-infectiou, autoimmunity, Brain Disease, COVID-19, Peripheral Nervous System Diseases, encephalopathy, immunity, Sistema nerviós -- Malalties, Immunitat, Central Nervous System Disease, Africa, Encephalitis, Human
Abstract

The direct impact and sequelae of infections in children and adults result in significant morbidity and mortality especially when they involve the central (CNS) or peripheral nervous system (PNS). The historical understanding of the pathophysiology has been mostly focused on the direct impact of the various pathogens through neural tissue invasion. However, with the better understanding of neuroimmunology, there is a rapidly growing realization of the contribution of the innate and adaptive host immune responses in the pathogenesis of many CNS and PNS diseases.The balance between the protective and pathologic sequelae of immunity is fragile and can easily be tipped towards harm for the host. The matter of immune privilege and surveillance of the CNS/PNS compartments and the role of the blood-brain barrier (BBB) and blood nerve barrier (BNB) makes this even more complex. Our understanding of the pathogenesis of many post-infectious manifestations of various microbial agents remains elusive, especially in the diverse African setting. Our exploration and better understanding of the neuroimmunology of some of the infectious diseases that we encounter in the continent will go a long way into helping us to improve their management and therefore lessen the burden.Africa is diverse and uniquely poised because of the mix of the classic, well described, autoimmune disease entities and the specifically “tropical” conditions. This review explores the current understanding of some of the para- and post-infectious autoimmune manifestations of CNS and PNS diseases in the African context. We highlight the clinical presentations, diagnosis and treatment of these neurological disorders and underscore the knowledge gaps and perspectives for future research using disease models of conditions that we see in the continent, some of which are not uniquely African and, where relevant, include discussion of the proposed mechanisms underlying pathogen-induced autoimmunity. This review covers the following conditions as models and highlight those in which a relationship with COVID-19 infection has been reported: a) Acute Necrotizing Encephalopathy; b) Measles-associated encephalopathies; c) Human Immunodeficiency Virus (HIV) neuroimmune disorders, and particularly the difficulties associated with classical post-infectious autoimmune disorders such as the Guillain-Barré syndrome in the context of HIV and other infections. Finally, we describe NMDA-R encephalitis, which can be post-HSV encephalitis, summarise other antibody-mediated CNS diseases and describe myasthenia gravis as the classic antibody-mediated disease but with special features in Africa.

Published
2022
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10. Cognitive Impairment in Tuberculous Meningitis

Author

Davis, Angharad G, primary, Dreyer, Anna J, additional, Albertyn, Christine, additional, Maxebengula, Mpumi, additional, Stek, Cari, additional, Wasserman, Sean, additional, Marais, Suzaan, additional, Bateman, Kathleen, additional, Solms, Mark, additional, Joska, John, additional, Wilkinson, Robert J, additional, and Nightingale, Sam, additional

Published
2022
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12. An International Perspective on Preceding Infections in Guillain-Barre Syndrome The IGOS-1000 Cohort

Author

Leonhard, Sonja E., van der Eijk, Annemiek A., Andersen, Henning, Antonini, Giovanni, Arends, Samuel, Attarian, Shahram, Barroso, Fabio A., Bateman, Kathleen J., Batstra, Manou R., Benedetti, Luana, van den Berg, Bianca, Van den Bergh, Peter, Burmann, Jan, Busby, Mark, Casasnovas, Carlos, Cornblath, David R., Davidson, Amy, Doets, Alex Y., van Doorn, Pieter A., de la Cour, Charlotte Dornonville, Feasby, Thomas E., Fehmi, Janev, Garcia-Sobrino, Tania, Goldstein, Jonathan M., Gorson, Kenneth C., Granit, Volkan, Hadden, Robert D. M., Harbo, Thomas, Hartung, Hans-Peter, Hasan, Imran, Holbech, Jakob, V, Holt, James K. L., Jahan, Israt, Islam, Zhahirul, Karafiath, Summer, Katzberg, Hans D., Kleyweg, Ruud P., Kolb, Noah, Kuitwaard, Krista, Kuwahara, Motoi, Kusunoki, Susumu, Luijten, Linda W. G., Kuwabara, Satoshi, Pan, Edward Lee, Lehmann, Helmar C., Maas, Marijke, Martin-Aguilar, Lorena, Al Miller, James, Mohammad, Quazi Deen, Monges, Soledad, Nedkova-Hristova, Velina, Nobile-Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Querol, Luis, Reisin, Ricardo, Van Rijs, Wouter, Rinaldi, Simon, Roberts, Rhys C., Roodbol, Joyce, Shahrizaila, Nortina, Sindrup, Soren Hein, Stein, Beth, Cheng-Yin, Tan, Tankisi, Hatice, Tio-Gillen, Anne P., Tous, Maria J. Sedano, Verboon, Christine, Vermeij, Frederique H., Visser, Leo H., Huizinga, Ruth, Willison, Hugh J., Jacobs, Bart C., Leonhard, Sonja E., van der Eijk, Annemiek A., Andersen, Henning, Antonini, Giovanni, Arends, Samuel, Attarian, Shahram, Barroso, Fabio A., Bateman, Kathleen J., Batstra, Manou R., Benedetti, Luana, van den Berg, Bianca, Van den Bergh, Peter, Burmann, Jan, Busby, Mark, Casasnovas, Carlos, Cornblath, David R., Davidson, Amy, Doets, Alex Y., van Doorn, Pieter A., de la Cour, Charlotte Dornonville, Feasby, Thomas E., Fehmi, Janev, Garcia-Sobrino, Tania, Goldstein, Jonathan M., Gorson, Kenneth C., Granit, Volkan, Hadden, Robert D. M., Harbo, Thomas, Hartung, Hans-Peter, Hasan, Imran, Holbech, Jakob, V, Holt, James K. L., Jahan, Israt, Islam, Zhahirul, Karafiath, Summer, Katzberg, Hans D., Kleyweg, Ruud P., Kolb, Noah, Kuitwaard, Krista, Kuwahara, Motoi, Kusunoki, Susumu, Luijten, Linda W. G., Kuwabara, Satoshi, Pan, Edward Lee, Lehmann, Helmar C., Maas, Marijke, Martin-Aguilar, Lorena, Al Miller, James, Mohammad, Quazi Deen, Monges, Soledad, Nedkova-Hristova, Velina, Nobile-Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Querol, Luis, Reisin, Ricardo, Van Rijs, Wouter, Rinaldi, Simon, Roberts, Rhys C., Roodbol, Joyce, Shahrizaila, Nortina, Sindrup, Soren Hein, Stein, Beth, Cheng-Yin, Tan, Tankisi, Hatice, Tio-Gillen, Anne P., Tous, Maria J. Sedano, Verboon, Christine, Vermeij, Frederique H., Visser, Leo H., Huizinga, Ruth, Willison, Hugh J., and Jacobs, Bart C.

Abstract

Background and Objectives Infections play a key role in the development of Guillain-Barre syndrome (GBS) and have been associated with specific clinical features and disease severity. The clinical variation of GBS across geographical regions has been suggested to be related to differences in the distribution of preceding infections, but this has not been studied on a large scale. Methods We analyzed the first 1,000 patients included in the International GBS Outcome Study with available biosamples (n = 768) for the presence of a recent infection with Campylobacter jejuni, hepatitis E virus, Mycoplasma pneumoniae, cytomegalovirus, and Epstein-Barr virus. Results Serologic evidence of a recent infection with C. jejuni was found in 228 (30%), M. pneumoniae in 77 (10%), hepatitis E virus in 23 (3%), cytomegalovirus in 30 (4%), and Epstein-Barr virus in 7 (1%) patients. Evidence of more than 1 recent infection was found in 49 (6%) of these patients. Symptoms of antecedent infections were reported in 556 patients (72%), and this proportion did not significantly differ between those testing positive or negative for a recent infection. The proportions of infections were similar across continents. The sensorimotor variant and the demyelinating electrophysiologic subtype were most frequent across all infection groups, although proportions were significantly higher in patients with a cytomegalovirus and significantly lower in those with a C. jejuni infection. C. jejuni-positive patients were more severely affected, indicated by a lower Medical Research Council sum score at nadir (p = 0.004) and a longer time to regain the ability to walk independently (p = 0.005). The pure motor variant and axonal electrophysiologic subtype were more frequent in Asian compared with American or European C. jejuni-positive patients (p < 0.001, resp. p = 0.001). Time to nadir was longer in the cytomegalovirus-positive patients (p = 0.004). Discussion Across geographical regions, the distribution o

Published
2022

13. Predicting Outcome in Guillain-Barre Syndrome International Validation of the Modified Erasmus GBS Outcome Score

Author

Doets, Alex Y., Lingsma, Hester F., Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Kusunoki, Susumu, Dimachkie, Mazen M., Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H., Chavada, Govindsinh, Willison, Hugh J., Casasnovas, Carlos, Bateman, Kathleen, Miller, James A. L., van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E., Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A., Shahrizaila, Nortina, Galassi, Giuliana, Pereon, Yann, Burmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P., Marchesoni, Cintia, Tous, Maria J. Sedano, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H., Lehmann, Helmar C., Granit, Volkan, Cavaletti, Guido, Gutierrez-Gutierrez, Gerardo, Barroso, Fabio A., Visser, Leo H., Katzberg, Hans D., Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J., Eftimov, Filip, Wirtz, Paul W., Samijn, Johnny P. A., Gilhuis, H. Jacobus, Hadden, Robert D. M., Holt, James K. L., Sheikh, Kazim A., Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E., Faber, Catharina G., Gijsbers, Cees J., Busby, Mark, Roberts, Rhys C., Silvestri, Nicholas J., Fazio, Raffaella, van Dijk, Gert W., Garssen, Marcel P. J., Straathof, Chiara S. M., Gorson, Kenneth C., Jacobs, Bart C., Doets, Alex Y., Lingsma, Hester F., Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Kusunoki, Susumu, Dimachkie, Mazen M., Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H., Chavada, Govindsinh, Willison, Hugh J., Casasnovas, Carlos, Bateman, Kathleen, Miller, James A. L., van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E., Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A., Shahrizaila, Nortina, Galassi, Giuliana, Pereon, Yann, Burmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P., Marchesoni, Cintia, Tous, Maria J. Sedano, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H., Lehmann, Helmar C., Granit, Volkan, Cavaletti, Guido, Gutierrez-Gutierrez, Gerardo, Barroso, Fabio A., Visser, Leo H., Katzberg, Hans D., Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J., Eftimov, Filip, Wirtz, Paul W., Samijn, Johnny P. A., Gilhuis, H. Jacobus, Hadden, Robert D. M., Holt, James K. L., Sheikh, Kazim A., Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E., Faber, Catharina G., Gijsbers, Cees J., Busby, Mark, Roberts, Rhys C., Silvestri, Nicholas J., Fazio, Raffaella, van Dijk, Gert W., Garssen, Marcel P. J., Straathof, Chiara S. M., Gorson, Kenneth C., and Jacobs, Bart C.

Abstract

Background and Objectives The clinical course and outcome of the Guillain-Barre syndrome (GBS) are diverse and vary among regions. The modified Erasmus GBS Outcome Score (mEGOS), developed with data from Dutch patients, is a clinical model that predicts the risk of walking inability in patients with GBS. The study objective was to validate the mEGOS in the International GBS Outcome Study (IGOS) cohort and to improve its performance and region specificity. Methods We used prospective data from the first 1,500 patients included in IGOS, aged >= 6 years and unable to walk independently. We evaluated whether the mEGOS at entry and week 1 could predict the inability to walk unaided at 4 and 26 weeks in the full cohort and in regional subgroups, using 2 measures for model performance: (1) discrimination: area under the receiver operating characteristic curve (AUC) and (2) calibration: observed vs predicted probability of being unable to walk independently. To improve the model predictions, we recalibrated the model containing the overall mEGOS score, without changing the individual predictive factors. Finally, we assessed the predictive ability of the individual factors. Results For validation of mEGOS at entry, 809 patients were eligible (Europe/North America [n = 677], Asia [n = 76], other [n = 56]), and 671 for validation of mEGOS at week 1 (Europe/North America [n = 563], Asia [n = 65], other [n = 43]). AUC values were >0.7 in all regional subgroups. In the Europe/North America subgroup, observed outcomes were worse than predicted; in Asia, observed outcomes were better than predicted. Recalibration improved model accuracy and enabled the development of a region-specific version for Europe/North America (mEGOS-Eu/NA). Similar to the original mEGOS, severe limb weakness and higher age were the predominant predictors of poor outcome in the IGOS cohort. Discussion mEGOS is a validated tool to predict the inability to walk unaided at 4 and 26 weeks in patients with GBS, a

Published
2022

14. Predicting Outcome in Guillain-Barré Syndrome: International Validation of the Modified Erasmus GBS Outcome Score

Author

Doets, A, Lingsma, H, Walgaard, C, Islam, B, Papri, N, Davidson, A, Yamagishi, Y, Kusunoki, S, Dimachkie, M, Waheed, W, Kolb, N, Islam, Z, Mohammad, Q, Harbo, T, Sindrup, S, Chavada, G, Willison, H, Casasnovas, C, Bateman, K, Miller, J, van den Berg, B, Verboon, C, Roodbol, J, Leonhard, S, Benedetti, L, Kuwabara, S, Van den Bergh, P, Monges, S, Marfia, G, Shahrizaila, N, Galassi, G, Péréon, Y, Bürmann, J, Kuitwaard, K, Kleyweg, R, Marchesoni, C, Sedano Tous, M, Querol, L, Illa, I, Wang, Y, Nobile-Orazio, E, Rinaldi, S, Schenone, A, Pardo, J, Vermeij, F, Lehmann, H, Granit, V, Cavaletti, G, Gutiérrez-Gutiérrez, G, Barroso, F, Visser, L, Katzberg, H, Dardiotis, E, Attarian, S, van der Kooi, A, Eftimov, F, Wirtz, P, Samijn, J, Gilhuis, H, Hadden, R, Holt, J, Sheikh, K, Karafiath, S, Vytopil, M, Antonini, G, Feasby, T, Faber, C, Gijsbers, C, Busby, M, Roberts, R, Silvestri, N, Fazio, R, van Dijk, G, Garssen, M, Straathof, C, Gorson, K, Jacobs, B, Doets, Alex Y, Lingsma, Hester F, Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Yamagishi, Yuko, Kusunoki, Susumu, Dimachkie, Mazen M, Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H, Chavada, Govindsinh, Willison, Hugh J, Casasnovas, Carlos, Bateman, Kathleen, Miller, James A L, van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E, Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A, Shahrizaila, Nortina, Galassi, Giuliana, Péréon, Yann, Bürmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P, Marchesoni, Cintia, Sedano Tous, María J, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H, Lehmann, Helmar C, Granit, Volkan, Cavaletti, Guido, Gutiérrez-Gutiérrez, Gerardo, Barroso, Fabio A, Visser, Leo H, Katzberg, Hans D, Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J, Eftimov, Filip, Wirtz, Paul W, Samijn, Johnny P A, Gilhuis, H Jacobus, Hadden, Robert D M, Holt, James K L, Sheikh, Kazim A, Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E, Faber, Catharina G, Gijsbers, Cees J, Busby, Mark, Roberts, Rhys C, Silvestri, Nicholas J, Fazio, Raffaella, van Dijk, Gert W, Garssen, Marcel P J, Straathof, Chiara S M, Gorson, Kenneth C, Jacobs, Bart C, Doets, A, Lingsma, H, Walgaard, C, Islam, B, Papri, N, Davidson, A, Yamagishi, Y, Kusunoki, S, Dimachkie, M, Waheed, W, Kolb, N, Islam, Z, Mohammad, Q, Harbo, T, Sindrup, S, Chavada, G, Willison, H, Casasnovas, C, Bateman, K, Miller, J, van den Berg, B, Verboon, C, Roodbol, J, Leonhard, S, Benedetti, L, Kuwabara, S, Van den Bergh, P, Monges, S, Marfia, G, Shahrizaila, N, Galassi, G, Péréon, Y, Bürmann, J, Kuitwaard, K, Kleyweg, R, Marchesoni, C, Sedano Tous, M, Querol, L, Illa, I, Wang, Y, Nobile-Orazio, E, Rinaldi, S, Schenone, A, Pardo, J, Vermeij, F, Lehmann, H, Granit, V, Cavaletti, G, Gutiérrez-Gutiérrez, G, Barroso, F, Visser, L, Katzberg, H, Dardiotis, E, Attarian, S, van der Kooi, A, Eftimov, F, Wirtz, P, Samijn, J, Gilhuis, H, Hadden, R, Holt, J, Sheikh, K, Karafiath, S, Vytopil, M, Antonini, G, Feasby, T, Faber, C, Gijsbers, C, Busby, M, Roberts, R, Silvestri, N, Fazio, R, van Dijk, G, Garssen, M, Straathof, C, Gorson, K, Jacobs, B, Doets, Alex Y, Lingsma, Hester F, Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Yamagishi, Yuko, Kusunoki, Susumu, Dimachkie, Mazen M, Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H, Chavada, Govindsinh, Willison, Hugh J, Casasnovas, Carlos, Bateman, Kathleen, Miller, James A L, van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E, Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A, Shahrizaila, Nortina, Galassi, Giuliana, Péréon, Yann, Bürmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P, Marchesoni, Cintia, Sedano Tous, María J, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H, Lehmann, Helmar C, Granit, Volkan, Cavaletti, Guido, Gutiérrez-Gutiérrez, Gerardo, Barroso, Fabio A, Visser, Leo H, Katzberg, Hans D, Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J, Eftimov, Filip, Wirtz, Paul W, Samijn, Johnny P A, Gilhuis, H Jacobus, Hadden, Robert D M, Holt, James K L, Sheikh, Kazim A, Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E, Faber, Catharina G, Gijsbers, Cees J, Busby, Mark, Roberts, Rhys C, Silvestri, Nicholas J, Fazio, Raffaella, van Dijk, Gert W, Garssen, Marcel P J, Straathof, Chiara S M, Gorson, Kenneth C, and Jacobs, Bart C

Abstract

Background and objectives: The clinical course and outcome of the Guillain-Barré syndrome (GBS) are diverse and vary among regions. The modified Erasmus GBS Outcome Score (mEGOS), developed with data from Dutch patients, is a clinical model that predicts the risk of walking inability in patients with GBS. The study objective was to validate the mEGOS in the International GBS Outcome Study (IGOS) cohort and to improve its performance and region specificity. Methods: We used prospective data from the first 1,500 patients included in IGOS, aged ≥6 years and unable to walk independently. We evaluated whether the mEGOS at entry and week 1 could predict the inability to walk unaided at 4 and 26 weeks in the full cohort and in regional subgroups, using 2 measures for model performance: (1) discrimination: area under the receiver operating characteristic curve (AUC) and (2) calibration: observed vs predicted probability of being unable to walk independently. To improve the model predictions, we recalibrated the model containing the overall mEGOS score, without changing the individual predictive factors. Finally, we assessed the predictive ability of the individual factors. Results: For validation of mEGOS at entry, 809 patients were eligible (Europe/North America [n = 677], Asia [n = 76], other [n = 56]), and 671 for validation of mEGOS at week 1 (Europe/North America [n = 563], Asia [n = 65], other [n = 43]). AUC values were >0.7 in all regional subgroups. In the Europe/North America subgroup, observed outcomes were worse than predicted; in Asia, observed outcomes were better than predicted. Recalibration improved model accuracy and enabled the development of a region-specific version for Europe/North America (mEGOS-Eu/NA). Similar to the original mEGOS, severe limb weakness and higher age were the predominant predictors of poor outcome in the IGOS cohort. Discussion: mEGOS is a validated tool to predict the inability to walk unaided at 4 and 26 weeks in patients with

Published
2022

17. Cognitive Impairment in Tuberculous Meningitis.

Author

Davis, Angharad G, Dreyer, Anna J, Albertyn, Christine, Maxebengula, Mpumi, Stek, Cari, Wasserman, Sean, Marais, Suzaan, Bateman, Kathleen, Solms, Mark, Joska, John, Wilkinson, Robert J, and Nightingale, Sam

Subjects
COGNITION disorders diagnosis, HIV infection complications, CLINICAL drug trials, COGNITION disorders, FUNCTIONAL assessment, COMPARATIVE studies, RESEARCH funding, DESCRIPTIVE statistics, COGNITIVE testing, PATIENT compliance, PSYCHOLOGY of HIV-positive persons
Abstract

Background Cognitive impairment is reported as a common complication in adult tuberculous meningitis (TBM), yet few studies have systematically assessed the frequency and nature of impairment. Moreover, the impact of impairment on functioning and medication adherence has not been described. Methods A cognitive test battery (10 measures assessing 7 cognitive domains) was administered to 34 participants with human immunodeficiency virus (HIV)–associated TBM 6 months after diagnosis. Cognitive performance was compared with that a comparator group of 66 people with HIV without a history of tuberculosis. A secondary comparison was made between participants with TBM and 26 participants with HIV 6 months after diagnosis of tuberculosis outside the central nervous system (CNS). Impact on functioning was evaluated, including through assessment of medication adherence. Results Of 34 participants with TBM, 16 (47%) had low performance on cognitive testing. Cognition was impaired across all domains. Global cognitive performance was significantly lower in participants with TBM than in people with HIV (mean T score, 41 vs 48, respectively; P <.001). These participants also had lower global cognition scores than those with non-CNS tuberculosis (mean global T score, 41 vs 46; P =.02). Functional outcomes were not significantly correlated with cognitive performance in the subgroup of participants in whom this was assessed (n = 19). Conclusions Low cognitive performance following HIV-associated TBM is common. This effect is independent of, and additional to, effects of HIV and non-CNS tuberculosis disease. Further studies are needed to understand longer-term outcomes, clarify the association with treatment adherence, a key predictor of outcome in TBM, and develop context-specific tools to identify individuals with cognitive difficulties in order to improve outcomes in TBM. [ABSTRACT FROM AUTHOR]

Published
2023
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18. Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa

Author

Boulle, Andrew, Davies, Mary-Ann, Hussey, Hannah, Ismail, Muzzammil, Morden, Erna, Vundle, Ziyanda, Zweigenthal, Virginia, Mahomed, Hassan, Paleker, Masudah, Pienaar, David, Tembo, Yamanya, Lawrence, Charlene, Isaacs, Washiefa, Mathema, Hlengani, Allen, Derick, Allie, Taryn, Bam, Jamy-Lee, Buddiga, Kasturi, Dane, Pierre, Heekes, Alexa, Matlapeng, Boitumelo, Mutemaringa, Themba, Muzarabani, Luckmore, Phelanyane, Florence, Pienaar, Rory, Rode, Catherine, Smith, Mariette, Tiffin, Nicki, Zinyakatira, Nesbert, Cragg, Carol, Marais, Frederick, Mudaly, Vanessa, Voget, Jacqueline, Davids, Jody, Roodt, Francois, van Zyl Smit, Nellis, Vermeulen, Alda, Adams, Kevin, Audley, Gordon, Bateman, Kathleen, Beckwith, Peter, Bernon, Marc, Blom, Dirk, Boloko, Linda, Botha, Jean, Boutall, Adam, Burmeister, Sean, Cairncross, Lydia, Calligaro, Gregory, Coccia, Cecilia, Corin, Chadwin, Daroowala, Remy, Dave, Joel A, De Bruyn, Elsa, De Villiers, Martin, Deetlefs, Mimi, Dlamini, Sipho, Du Toit, Thomas, Endres, Wilhelm, Europa, Tarin, Fieggan, Graham, Figaji, Anthony, Frankenfeld, Petro, Gatley, Elizabeth, Gina, Phindile, Govender, Evashan, Grobler, Rochelle, Gule, Manqoba Vusumuzi, Hanekom, Christoff, Held, Michael, Heynes, Alana, Hlatswayo, Sabelo, Hodkinson, Bridget, Holtzhausen, Jeanette, Hoosain, Shakeel, Jacobs, Ashely, Kahn, Miriam, Kahn, Thania, Khamajeet, Arvin, Khan, Joubin, Khan, Riaasat, Khwitshana, Alicia, Knight, Lauren, Kooverjee, Sharita, Krogscheepers, Rene, Kruger, Jean Jacque, Kuhn, Suzanne, Laubscher, Kim, Lazarus, John, Le Roux, Jacque, Lee Jones, Scott, Levin, Dion, Maartens, Gary, Majola, Thina, Manganyi, Rodgers, Marais, David, Marais, Suzaan, Maritz, Francois, Maughan, Deborah, Mazondwa, Simthandile, Mbanga, Luyanda, Mbatani, Nomonde, Mbena, Bulewa, Meintjes, Graeme, Mendelson, Marc, Möller, Ernst, Moore, Allison, Ndebele, Babalwa, Nortje, Marc, Ntusi, Ntobeko, Nyengane, Funeka, Ofoegbu, Chima, Papavarnavas, Nectarios, Peter, Jonny, Pickard, Henri, Pluke, Kent, Raubenheimer, Peter J, Robertson, Gordon, Rozmiarek, Julius, Sayed, A, Scriba, Matthias, Sekhukhune, Hennie, Singh, Prasun, Smith, Elsabe, Soldati, Vuyolwethu, Stek, Cari, van den berg, Robert, van der Merwe, Le Roux, Venter, Pieter, Vermooten, Barbra, Viljoen, Gerrit, Viranna, Santhuri, Vogel, Jonno, Vundla, Nokubonga, Wasserman, Sean, Zitha, Eddy, Lomas-Marais, Vanessa, Lombard, Annie, Stuve, Katrin, Viljoen, Werner, Basson, De Vries, Le Roux, Sue, Linden-Mars, Ethel, Victor, Lizanne, Wates, Mark, Zwanepoel, Elbe, Ebrahim, Nabilah, Lahri, Sa’ad, Mnguni, Ayanda, Crede, Thomas, de Man, Martin, Evans, Katya, Hendrikse, Clint, Naude, Jonathan, Parak, Moosa, Szymanski, Patrick, Van Koningsbruggen, Candice, Abrahams, Riezaah, Allwood, Brian, Botha, Christoffel, Botha, Matthys Henndrik, Broadhurst, Alistair, Claasen, Dirkie, Daniel, Che, Dawood, Riyaadh, du Preez, Marie, Du Toit, Nicolene, Erasmus, Kobie, Koegelenberg, Coenraad F N, Gabriel, Shiraaz, Hugo, Susan, Jardine, Thabiet, Johannes, Clint, Karamchand, Sumanth, Lalla, Usha, Langenegger, Eduard, Louw, Eize, Mashigo, Boitumelo, Mhlana, Nonte, Mnqwazi, Chizama, Moodley, Ashley, Moodley, Desiree, Moolla, Saadiq, Mowlana, Abdurasiet, Nortje, Andre, Olivier, Elzanne, Parker, Arifa, Paulsen, Chané, Prozesky, Hans, Rood, Jacques, Sabela, Tholakele, Schrueder, Neshaad, Sithole, Nokwanda, Sithole, Sthembiso, Taljaard, Jantjie J, Titus, Gideon, Van Der Merwe, Tian, van Schalkwyk, Marije, Vazi, Luthando, Viljoen, Abraham J, Yazied Chothia, Mogamat, Naidoo, Vanessa, Wallis, Lee Alan, Abbass, Mumtaz, Arendse, Juanita, Armien, Rizqa, Bailey, Rochelle, Bello, Muideen, Carelse, Rachel, Forgus, Sheron, Kalawe, Nosi, Kariem, Saadiq, Kotze, Mariska, Lucas, Jonathan, McClaughlin, Juanita, Murie, Kathleen, Najjaar, Leilah, Petersen, Liesel, Porter, James, Shaw, Melanie, Stapar, Dusica, Williams, Michelle, Aldum, Linda, Berkowitz, Natacha, Girran, Raakhee, Lee, Kevin, Naidoo, Lenny, Neumuller, Caroline, Anderson, Kim, Begg, Kerrin, Boerlage, Lisa, Cornell, Morna, de Waal, Renée, Dudley, Lilian, English, René, Euvrard, Jonathan, Groenewald, Pam, Jacob, Nisha, Jaspan, Heather, Kalk, Emma, Levitt, Naomi, Malaba, Thoko, Nyakato, Patience, Patten, Gabriela, Schneider, Helen, Shung King, Maylene, Tsondai, Priscilla, Van Duuren, James, van Schaik, Nienke, Blumberg, Lucille, Cohen, Cheryl, Govender, Nelesh, Jassat, Waasila, Kufa, Tendesayi, McCarthy, Kerrigan, Morris, Lynn, Hsiao, Nei-yuan, Marais, Ruan, Ambler, Jon, Ngwenya, Olina, Osei-Yeboah, Richard, Johnson, Leigh, Kassanjee, Reshma, and Tamuhla, Tsaone

Subjects
sub-Saharan Africa, 0301 basic medicine, Microbiology (medical), Adult, Male, Tuberculosis, antiretroviral, 030106 microbiology, Population, HIV Infections, HIV Infections/complications, Cohort Studies, South Africa, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Major Article, Medicine, Humans, 030212 general & internal medicine, education, Proportional Hazards Models, education.field_of_study, South Africa/epidemiology, business.industry, Proportional hazards model, SARS-CoV-2, Hazard ratio, HIV, Correction, COVID-19, medicine.disease, Confidence interval, AcademicSubjects/MED00290, Infectious Diseases, Standardized mortality ratio, tuberculosis, Attributable risk, business, Viral load, Demography
Abstract

Background Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. Methods We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates. Results Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1). Conclusions While our findings may overestimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both living with HIV and having current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex, and other comorbidities and COVID-19 mortality were similar to those in other settings.

Published
2021
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19. Guía basada en la evidencia. Diagnóstico y manejo del síndrome de Guillain-Barré en diez pasos = Evidence based guidelines. Diagnosis and management of Guillain-Barré syndrome in ten steps

Author

Leonhard, Sonja E., Mandarakas, Melissa R., de Assis Aquino Gondim, Francisco, Bateman, Kathleen, Brito Ferreira, Maria L., Cornblath, David R., Van Doorn, Pieter A., Dourado, Mario E., Hughes, Richard A.C., Islam, Badrul, Kusunoki, Susumu, Pardo, Carlos A., Reisin, Ricardo, Sejvar, James J., Shahrizaila, Nortina, Soares, Cristiane, Umapathi, Thirugnanam, Wang, Yuzhong, Yiu, Eppie M., Willison, Hugh J., and Jacobs, Bart C.

Abstract

Guillain-Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and in 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. We first provide an introduction to the diagnostic criteria, clinical variants and differential diagnoses of GBS. The ten steps then cover early recognition and diagnosis of GBS, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae.

Published
2021

20. Second IVIg course in Guillain-Barré syndrome with poor prognosis:the non-randomised ISID study

Author

Verboon, Christine, van den Berg, Bianca, Cornblath, David R, Venema, Esmee, Gorson, Kenneth C, Lunn, Michael P, Lingsma, Hester, Van den Bergh, Peter, Harbo, Thomas, Bateman, Kathleen, Pereon, Yann, Sindrup, Søren H, Kusunoki, Susumu, Miller, James, Islam, Zhahirul, Hartung, Hans-Peter, Chavada, Govindsinh, Jacobs, Bart C, Hughes, Richard A C, and van Doorn, Pieter A

Subjects
second IVIg course, treatment, hemic and lymphatic diseases, poor prognosis, Guillain-Barré syndrome
Abstract

OBJECTIVE: To compare disease course in patients with Guillain-Barré syndrome (GBS) with a poor prognosis who were treated with one or with two intravenous immunoglobulin (IVIg) courses.METHODS: From the International GBS Outcome Study, we selected patients whose modified Erasmus GBS Outcome Score at week 1 predicted a poor prognosis. We compared those treated with one IVIg course to those treated with two IVIg courses. The primary endpoint, the GBS disability scale at 4 weeks, was assessed with multivariable ordinal regression.RESULTS: Of 237 eligible patients, 199 patients received a single IVIg course. Twenty patients received an 'early' second IVIg course (1-2 weeks after start of the first IVIg course) and 18 patients a 'late' second IVIg course (2-4 weeks after start of IVIg). At baseline and 1 week, those receiving two IVIg courses were more disabled than those receiving one course. Compared with the one course group, the adjusted OR for a better GBS disability score at 4 weeks was 0.70 (95%CI 0.16 to 3.04) for the early group and 0.66 (95%CI 0.18 to 2.50) for the late group. The secondary endpoints were not in favour of a second IVIg course.CONCLUSIONS: This observational study did not show better outcomes after a second IVIg course in GBS with poor prognosis. The study was limited by small numbers and baseline imbalances. Lack of improvement was likely an incentive to start a second IVIg course. A prospective randomised trial is needed to evaluate whether a second IVIg course improves outcome in GBS.

Published
2020
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21. Guía basada en la evidencia. Diagnóstico y manejo del síndrome de guillain-barré en diez pasos

Author

Leonhard, Sonja E., Mandarakas, Melissa R., Gondim, Francisco De Assis Aquino, Bateman, Kathleen, Ferreira, Maria L.Brito, Cornblath, David R., Van doorn, Pieter A., Dourado, Mario E., Hughes, Richard A.C., Islam, Badrul, Kusunoki, Susumu, Pardo, Carlos A., Reisin, Ricardo, Sejvar, James J., Shahrizaila, Nortina, Soares, Cristiane, Umapathi, Thirugnanam, Wang, Yuzhong, Yiu, Eppie M., Willison, Hugh J., Jacobs, Bart C., Leonhard, Sonja E., Mandarakas, Melissa R., Gondim, Francisco De Assis Aquino, Bateman, Kathleen, Ferreira, Maria L.Brito, Cornblath, David R., Van doorn, Pieter A., Dourado, Mario E., Hughes, Richard A.C., Islam, Badrul, Kusunoki, Susumu, Pardo, Carlos A., Reisin, Ricardo, Sejvar, James J., Shahrizaila, Nortina, Soares, Cristiane, Umapathi, Thirugnanam, Wang, Yuzhong, Yiu, Eppie M., Willison, Hugh J., and Jacobs, Bart C.

Abstract

Guillain-Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and in 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. We first provide an introduction to the diagnostic criteria, clinical variants and differential diagnoses of GBS. The ten steps then cover early recognition and diagnosis of GBS, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae.

Published
2021

22. Diretrizes Baseadas em Evidências Diagnóstico e manejo da Síndrome de Guillain–Barré em dez etapas

Author

Leonhard, Sonja E., primary, Mandarakas, Melissa R., additional, Gondim, Francisco A.A., additional, Bateman, Kathleen, additional, Ferreira, Maria L.B., additional, Cornblath, David R., additional, Van Doorn, Pieter A., additional, Dourado, Mario E., additional, Hughes, Richard A.C., additional, Islam, Badrul, additional, Kusunoki, Susumu, additional, Pardo, Carlos A., additional, Reisin, Ricardo, additional, Sejvar, James J., additional, Shahrizaila, Nortina, additional, Soares, Cristiane, additional, Umapathi, Thirugnanam, additional, Wang, Yuzhong, additional, Yiu, Eppie M., additional, Willison, Hugh J., additional, and Jacobs, Bart C., additional

Published
2021
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23. Conceptual framework for establishing the African Stroke Organization

Author

Akinyemi, Rufus, primary, Sarfo, Fred, additional, Abd-Allah, Foad, additional, Ogun, Yomi, additional, Belo, Mofou, additional, Francis, Patty, additional, Mateus, M Bettencourt, additional, Bateman, Kathleen, additional, Naidoo, Pamela, additional, Charway-Felli, Augustina, additional, Akpalu, Albert, additional, Wahab, Kolawole, additional, Napon, Christian, additional, Arulogun, Oyedunni, additional, Ebenezer, Ad Adams, additional, Ekeng, Gloria, additional, Scola, George, additional, Hamzat, Kolapo, additional, Zimba, Stanley, additional, Ossou-Nguiet, Paul Macaire, additional, Ademokoya, Julius, additional, Adebayo, Philip, additional, Ayele, Biniyam Alemayehu, additional, Vaz, Deise Catamo, additional, Ogbole, Godwin, additional, Barasukan, Patrice, additional, Melifonwu, Rita, additional, Onwuekwe, Ikenna, additional, Belson, Sarah, additional, Damasceno, Albertino, additional, Okubadejo, Njideka, additional, Njamnshi, Alfred K, additional, Ogeng’o, Julius, additional, Walker, Richard W, additional, Diop, Amadou Gallo, additional, Ogunniyi, Adesola, additional, Kalaria, Rajesh, additional, Sandercock, Peter, additional, Davis, Stephen, additional, Brainin, Michael, additional, Ovbiagele, Bruce, additional, and Owolabi, Mayowa, additional

Published
2020
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24. An International Perspective on Preceding Infections in Guillain-Barré Syndrome

Author

Leonhard, Sonja E., van der Eijk, Annemiek A., Andersen, Henning, Antonini, Giovanni, Arends, Samuel, Attarian, Shahram, Barroso, Fabio A., Bateman, Kathleen J., Batstra, Manou R., Benedetti, Luana, van den Berg, Bianca, Van den Bergh, Peter, Bürmann, Jan, Busby, Mark, Casasnovas, Carlos, Cornblath, David R., Davidson, Amy, Doets, Alex Y., van Doorn, Pieter A., Dornonville de la Cour, Charlotte, Feasby, Thomas E., Fehmi, Janev, Garcia-Sobrino, Tania, Goldstein, Jonathan M., Gorson, Kenneth C., Granit, Volkan, Hadden, Robert D.M., Harbo, Thomas, Hartung, Hans-Peter, Hasan, Imran, Holbech, Jakob V., Holt, James K.L., Jahan, Israt, Islam, Zhahirul, Karafiath, Summer, Katzberg, Hans D., Kleyweg, Ruud P., Kolb, Noah, Kuitwaard, Krista, Kuwahara, Motoi, Kusunoki, Susumu, Luijten, Linda W.G., Kuwabara, Satoshi, Lee Pan, Edward, Lehmann, Helmar C., Maas, Marijke, Martín-Aguilar, Lorena, Miller, James A.L., Mohammad, Quazi Deen, Monges, Soledad, Nedkova-Hristova, Velina, Nobile-Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Querol, Luis, Reisin, Ricardo, Van Rijs, Wouter, Rinaldi, Simon, Roberts, Rhys C., Roodbol, Joyce, Shahrizaila, Nortina, Sindrup, Søren Hein, Stein, Beth, Cheng-Yin, Tan, Tankisi, Hatice, Tio-Gillen, Anne P., Sedano Tous, María J., Verboon, Christine, Vermeij, Frederique H., Visser, Leo H., Huizinga, Ruth, Willison, Hugh J., and Jacobs, Bart C.

Published
2022
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25. Second IVIg course in Guillain-Barré syndrome with poor prognosis: the non-randomised ISID study.

Author

UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de neurologie, Verboon, Christine, van den Berg, Bianca, Cornblath, David R, Venema, Esmee, Gorson, Kenneth C, Lunn, Michael P, Lingsma, Hester, Van den Bergh, Peter, Harbo, Thomas, Bateman, Kathleen, Pereon, Yann, Sindrup, Søren H, Kusunoki, Susumu, Miller, James, Islam, Zhahirul, Hartung, Hans-Peter, Chavada, Govindsinh, Jacobs, Bart C, Hughes, Richard A C, van Doorn, Pieter A, IGOS Consortium, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de neurologie, Verboon, Christine, van den Berg, Bianca, Cornblath, David R, Venema, Esmee, Gorson, Kenneth C, Lunn, Michael P, Lingsma, Hester, Van den Bergh, Peter, Harbo, Thomas, Bateman, Kathleen, Pereon, Yann, Sindrup, Søren H, Kusunoki, Susumu, Miller, James, Islam, Zhahirul, Hartung, Hans-Peter, Chavada, Govindsinh, Jacobs, Bart C, Hughes, Richard A C, van Doorn, Pieter A, and IGOS Consortium

Abstract

OBJECTIVE: To compare disease course in patients with Guillain-Barré syndrome (GBS) with a poor prognosis who were treated with one or with two intravenous immunoglobulin (IVIg) courses. METHODS: From the International GBS Outcome Study, we selected patients whose modified Erasmus GBS Outcome Score at week 1 predicted a poor prognosis. We compared those treated with one IVIg course to those treated with two IVIg courses. The primary endpoint, the GBS disability scale at 4 weeks, was assessed with multivariable ordinal regression. RESULTS: Of 237 eligible patients, 199 patients received a single IVIg course. Twenty patients received an 'early' second IVIg course (1-2 weeks after start of the first IVIg course) and 18 patients a 'late' second IVIg course (2-4 weeks after start of IVIg). At baseline and 1 week, those receiving two IVIg courses were more disabled than those receiving one course. Compared with the one course group, the adjusted OR for a better GBS disability score at 4 weeks was 0.70 (95%CI 0.16 to 3.04) for the early group and 0.66 (95%CI 0.18 to 2.50) for the late group. The secondary endpoints were not in favour of a second IVIg course. CONCLUSIONS: This observational study did not show better outcomes after a second IVIg course in GBS with poor prognosis. The study was limited by small numbers and baseline imbalances. Lack of improvement was likely an incentive to start a second IVIg course. A prospective randomised trial is needed to evaluate whether a second IVIg course improves outcome in GBS.

Published
2020

26. Preceding infections in Guillain-Barre syndrome: Results from the IGOS-1000 cohort

Author

Leonhard, Sonja, van der Eijk, Annemiek, Arends, Samuel, Bateman, Kathleen, Batstra, Manou, Van den Bergh, Peter, Chavada, Govindsinh, Cornblath, David, Doets, Alex, Van Doorn, Pieter, Efthimios, Dardiotis, Feasby, Tom, Gorson, Ken, Harbo, Thomas, Hartung, Hans-Peter, Huizinga, Ruth, Hshieh, Sung-Tsang, Hughes, Richard, Islam, Zhahirul, Kusunoki, Susumu, Lehmann, Helmar, Maas, Marijke, Mohammad, Quazi Deen, Nobile-Orazio, Eduardo, Pereon, Yann, Querol, Luis, Reddel, Stephen, Reisin, Ricardo, Shahrizaila, Nortina, Willison, Hugh, Jacobs, Bart, Leonhard, Sonja, van der Eijk, Annemiek, Arends, Samuel, Bateman, Kathleen, Batstra, Manou, Van den Bergh, Peter, Chavada, Govindsinh, Cornblath, David, Doets, Alex, Van Doorn, Pieter, Efthimios, Dardiotis, Feasby, Tom, Gorson, Ken, Harbo, Thomas, Hartung, Hans-Peter, Huizinga, Ruth, Hshieh, Sung-Tsang, Hughes, Richard, Islam, Zhahirul, Kusunoki, Susumu, Lehmann, Helmar, Maas, Marijke, Mohammad, Quazi Deen, Nobile-Orazio, Eduardo, Pereon, Yann, Querol, Luis, Reddel, Stephen, Reisin, Ricardo, Shahrizaila, Nortina, Willison, Hugh, and Jacobs, Bart

Published
2020

28. Original research: Second IVIg course in Guillain-Barré syndrome with poor prognosis: the non-randomised ISID study

Author

Verboon, Christine, primary, van den Berg, Bianca, additional, Cornblath, David R, additional, Venema, Esmee, additional, Gorson, Kenneth C, additional, Lunn, Michael P, additional, Lingsma, Hester, additional, Van den Bergh, Peter, additional, Harbo, Thomas, additional, Bateman, Kathleen, additional, Pereon, Yann, additional, Sindrup, Søren H, additional, Kusunoki, Susumu, additional, Miller, James, additional, Islam, Zhahirul, additional, Hartung, Hans-Peter, additional, Chavada, Govindsinh, additional, Jacobs, Bart C, additional, Hughes, Richard A C, additional, and van Doorn, Pieter A, additional

Published
2019
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29. A single-blinded trial of methotrexate versus azathioprine as steroid-sparing agents in generalized myasthenia gravis

Author

Renison Rudi, Bateman Kathleen, Rawoot Amanullah, Heckmann Jeannine M, and Badri Motasim

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

Abstract Background Long-term immunosuppression is often required in myasthenia gravis (MG). There are no published trials using methotrexate (MTX) in MG. The steroid-sparing efficacy of azathioprine (AZA) has been demonstrated after 18-months of starting therapy. However, AZA is considered expensive in Africa. We evaluated the steroid-sparing efficacy of MTX (17.5 mg weekly) compared with AZA (2.5 mg/kg daily) in subjects recently diagnosed with generalized MG by assessing their average monthly prednisone requirements. Methods The primary outcome was the average daily prednisone requirement by month between the two groups. Prednisone was given at the lowest dose to manage MG symptoms and adjusted as required according to protocol. Single-blinded assessments were performed 3-monthly for 2-years to determine the quantitative MG score and the MG activities of daily living score in order to determine those with minimal manifestations of MG. Results Thirty-one subjects (AZA n = 15; MTX n = 16) satisfied the inclusion criteria but only 24 were randomized. Baseline characteristics were similar. There was no difference between the AZA- and MTX-groups in respect of prednisone dosing (apart from months 10 and 12), in quantitative MG Score improvement, proportions in sustained remission, frequencies of MG relapses, or adverse reactions and/or withdrawals. The MTX-group received lower prednisone doses between month 10 (p = 0.047) and month 12 (p = 0.039). At month 12 the prednisone dose per kilogram bodyweight in the MTX-group (0.15 mg/kg) was half that of the AZA-group (0.31 mg/kg)(p = 0.019). Conclusions This study provides evidence that in patients with generalized MG methotrexate is an effective steroid-sparing agent 10 months after treatment initiation. Our data suggests that in generalized MG methotrexate has similar efficacy and tolerability to azathioprine and may be the drug of choice in financially constrained health systems. Trial registration SANCTR:DOH-27-0411-2436

Published
2011
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30. Predicting Outcome in Guillain-Barré Syndrome

Author

Doets, Alex Y., Lingsma, Hester F., Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Yamagishi, Yuko, Kusunoki, Susumu, Dimachkie, Mazen M., Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H., Chavada, Govindsinh, Willison, Hugh J., Casasnovas, Carlos, Bateman, Kathleen, Miller, James A.L., van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E., Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A., Shahrizaila, Nortina, Galassi, Giuliana, Péréon, Yann, Bürmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P., Marchesoni, Cintia, Sedano Tous, María J., Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H., Lehmann, Helmar C., Granit, Volkan, Cavaletti, Guido, Gutiérrez-Gutiérrez, Gerardo, Barroso, Fabio A., Visser, Leo H., Katzberg, Hans D., Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J., Eftimov, Filip, Wirtz, Paul W., Samijn, Johnny P.A., Gilhuis, H. Jacobus, Hadden, Robert D.M., Holt, James K.L., Sheikh, Kazim A., Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E., Faber, Catharina G., Gijsbers, Cees J., Busby, Mark, Roberts, Rhys C., Silvestri, Nicholas J., Fazio, Raffaella, van Dijk, Gert W., Garssen, Marcel P.J., Straathof, Chiara S.M., Gorson, Kenneth C., Jacobs, Bart C., Hughes, R.A.C., Cornblath, D.R., Hartung, H.P., van Doorn, P.A., de Koning, L.C., van Woerkom, M., Mandarakas, M., MPhty, BHIthSci(Hons), Reisin, R.C., Reddel, S.W., Ripellino, P., Hsieh, S.T., Addington, J.M., Ajroud-Driss, S., Andersen, H., Badrising, U.A., Bella, I.R., Bertorini, T.E., Bhavaraju-Sanka, R., Bianco, M., Brannagan, T.H., Briani, Chiara, Butterworth, S., Chao, C.C., Chen, S., Claeys, K.G., Conti, M.E., Cosgrove, J.S., Dalakas, M.C., Dornonville de la Cour, C., Echaniz-Laguna, A., Fehmi, J., Fokke, C., Fujioka, T., Fulgenzi, E.A., García-Sobrino, T., Gilchrist, J.M., Goldstein, J.M., Goyal, N.A., Grisanti, S.G., Gutman, L., Holbech, J.V., Homedes, C., Htut, M., Jellema, K., Pascual, I. Jericó, JimenoMontero, M.C., Kaida, K., Khoshnoodi, M., Kiers, L., Kimpinski, K., Köhler, A.A., Kokubun, N., Kuwahara, M., Kwan, J.Y., Ladha, S.S., Lassen, L. Landschoff, Lawson, V., Pan, E.B. Lee, Cejas, L. Léon, Lunn, M.P.T., Magot, A., Manji, H., Infante, C. Márquez, Martín-Aguilar, L., Hernandez, E. Martinez, Mataluni, G., Mattiazzi, M.G., McDermott, C.J., Meekins, G.D., Morís de la Tassa, G., Nascimbene, C., Nowak, R.J., Osei-Bonsu, M., Pascuzzi, R.M., Prada, V., Rojas-Marcos, I., Rudnicki, S.A., Sachs, G.M., Samukawa, M., Santoro, L., Savransky, A.G., Schwindling, L., Sekiguchi, Y., Sommer, C.L., Spyropoulos, A., Stein, B., Stino, A.M., Tan, C.Y., Tankisi, H., Twydell, P.T., van Damme, P., van der Ree, T., van Koningsveld, R., Varrato, J.D., Xing, C., Zhou, L., and Zivkovic, S.

Published
2022
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31. Truth, Lies and Fried Chicken

Author

Bateman, Kathleen and Bateman, Kathleen

Abstract

One ordinary nurse faces a big hospital bureaucracy and a powerful physician's assault; only when a truth from the past reveals a lie from the present can justice finally overcome the wrong. But will it?

Published
2018

32. Regional variation of Guillain-Barré syndrome

Author

Doets, Alex Y., Verboon, Christine, Van Den Berg, Bianca, Harbo, Thomas, Cornblath, David R., Willison, Hugh J., Islam, Zhahirul, Attarian, Shahram, Barroso, Fabio A., Bateman, Kathleen, Benedetti, Luana, Van Den Bergh, Peter, Casasnovas, Carlos, Cavaletti, Guido, Chavada, Govindsinh, Claeys, Kristl G., Dardiotis, Efthimios, Davidson, Amy, Van Doorn, Pieter A., Feasby, Tom E., Galassi, Giuliana, Gorson, Kenneth C., Hartung, Hans-Peter, Hsieh, Sung-Tsang, Hughes, Richard A. C., Illa, Isabel, Islam, Badrul, Kusunoki, Susumu, Kuwabara, Satoshi, Lehmann, Helmar C., Miller, James A. L., Mohammad, Quazi Deen, Monges, Soledad, Nobile Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Rinaldi, Simon, Querol, Luis, Reddel, Stephen W., Reisin, Ricardo C., Shahrizaila, Nortina, Sindrup, Soren H., Waqar, Waheed, Jacobs, Bart C., Jacobs, Bc, Hughes, Rac, Cornblath, Dr, Gorson, Kc, Hartung, Hp, Kusunoki, S, van Doorn PA, Willison, Hj, van Woerkom, M, van den Berg, B, Verboon, C, Doets, Ay, Roodbol, J, Reisin, Rc, Reddel, Sw, Islam, Z, Islam, B, Mohammad, Qd, van den Bergh, P, Feasby, Te, Harbo, T, Péréon, Y, Lehmann, Hc, Dardiotis, E, Nobile-Orazio, E, Shahrizaila, N, Bateman, K, Illa, I, Querol, L, Hsieh, St, Chavada, G, Davidson, A, Addington, Jm, Ajroud-Driss, S, Andersen, H, Antonini, G, Ariatti, A, Attarian, S, Badrising, Ua, Barroso, Fa, Benedetti, L, Beronio, A, Bianco, M, Binda, D, Briani, C, Bunschoten, C, Bürmann, J, Bella, Ir, Bertorini, Te, Bhavaraju-Sanka, R, Brannagan, Th, Busby, M, Butterworth, S, Casasnovas, C, Cavaletti, G, Chao, Cc, Chetty, S, Claeys, Kg, Conti, Me, Cosgrove, Js, Dalakas, Mc, Derejko, Ma, Dimachkie, Mm, Doppler, K, Dornonville de la Cour, C, Echaniz-Laguna, A, Eftimov, F, Faber, Cg, Fazio, R, Fujioka, T, Fulgenzi, Ea, Galassi, G, Garcia-Sobrino, T, Garnero, M, Garssen, Mpj, Gijsbers, Cj, Gilchrist, Jm, Goldstein, Jm, Granit, V, Grapperon, A, Gutiérrez, G, Hadden, Rdm, Holbech, Jv, Holt, Jkl, Homedes Pedret, C, Htut, M, Jericó Pascual, I, Kaida, K, Karafiath, S, Katzberg, Hd, Kiers, L, Kieseier, Bc, Kimpinski, K, Kleyweg, Rp, Kokubun, N, Kolb, Na, Kuitwaard, K, Kuwabara, S, Kwan, Jy, Ladha, Ss, Landschoff Lassen, L, Lawson, V, Ledingham, D, Léon Cejas, L, Lucy, St, Lunn, Mpt, Magot, A, Manji, H, Marchesoni, C, Marfia, Ga, Márquez Infante, C, Martinez Hernandez, E, Mataluni, G, Mcdermott, Cj, Meekins, Gd, Miller, Jal, Monges, Ms, Montero, Mcj, Morís de la Tassa, G, Mozzoni, J, Nascimbene, C, Nowak, Rj, Orizaloa Balaguer, P, Osei-Bonsu, M, Lee Pan EB, Pardo, J, Pasnoor, M, Rajabally, Ya, Rinaldi, S, Ritter, C, Roberts, Rc, Rojas-Marcos, I, Rudnicki, Sa, Ruiz, M, Sachs, Gm, Samijn, Jpa, Santoro, L, Schenone, A, Schwindling, L, Sedano Tous MJ, Sekiguchi, Y, Sheikh, Ka, Silvestri, Nj, Sindrup, Sh, Sommer, Cl, Stein, B, Stino, Am, Spyropoulos, A, Srinivasan, J, Suzuki, H, Tankisi, H, Tigner, D, Twydell, Pt, van Damme, P, van der Kooi AJ, van Dijk GW, van der Ree, T, van Koningsveld, R, Varrato, Jd, Vermeij, Fh, Visser, Lh, Vytopil, Mv, Waheed, W, Wilken, M, Wilkerson, C, Wirtz, Pw, Yamagishi, Y, Zhou, L, Zivkovic, S., Doets, A, Verboon, C, van den Berg, B, Harbo, T, Cornblath, D, Willison, H, Islam, Z, Attarian, S, Barroso, F, Bateman, K, Benedetti, L, van den Bergh, P, Casasnovas, C, Cavaletti, G, Chavada, G, Claeys, K, Dardiotis, E, Davidson, A, van Doorn, P, Feasby, T, Galassi, G, Gorson, K, Hartung, H, Hsieh, S, Hughes, R, Illa, I, Islam, B, Kusunoki, S, Kuwabara, S, Lehmann, H, Miller, J, Mohammad, Q, Monges, S, Nobile Orazio, E, Pardo, J, Pereon, Y, Rinaldi, S, Querol, L, Reddel, S, Reisin, R, Shahrizaila, N, Sindrup, S, Waqar, W, Jacobs, B, Neurology, AII - Infectious diseases, AII - Inflammatory diseases, ANS - Neuroinfection & -inflammation, Immunology, UCL - SSS/IONS/NEUR - Clinical Neuroscience, and UCL - (SLuc) Service de neurologie

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, clinical course, Guillain-Barre Syndrome, 03 medical and health sciences, Young Adult, 0302 clinical medicine, axonal degeneration, demyelination, outcome, polyradiculoneuropathy, Internal medicine, Severity of illness, medicine, Humans, 030212 general & internal medicine, Young adult, Child, Geographic difference, Aged, Aged, 80 and over, Guillain-Barre syndrome, Polyradiculoneuropathy, Overlap syndrome, Middle Aged, medicine.disease, Regional variation, Child, Preschool, neurology, Settore MED/26 - Neurologia, Female, Neurology (clinical), 030217 neurology & neurosurgery, Cohort study, polyradiculoneuropathy, demyelination, axonal degeneration, clinical course, outcome
Abstract

Guillain-Barré syndrome is a heterogeneous disorder regarding the clinical presentation, electrophysiological subtype and outcome. Previous single country reports indicate that Guillain-Barré syndrome may differ among regions, but no systematic comparative studies have been conducted. Comparative studies are required to identify factors determining disease susceptibility, variation and prognosis, and to improve diagnostic criteria. The International Guillain-Barré Syndrome Outcome Study is a prospective, observational cohort study including all patients within the diagnostic spectrum, aiming to describe the heterogeneity of Guillain-Barré syndrome worldwide. The current study was based on the first 1000 inclusions with a follow-up of at least 1 year and confirmed the variation in clinical presentation, course and outcome between patients. The full clinical spectrum of Guillain-Barré syndrome was observed in patients from all countries participating in the International Guillain-Barré Syndrome Outcome Study, but the frequency of variants differed between regions. We compared three regions based on geography, income and previous reports of Guillain-Barré syndrome subtypes: 'Europe/Americas', 'Asia' (without Bangladesh), and 'Bangladesh'. We excluded 75 (8%) patients because of alternative diagnoses, protocol violations, or missing data. The predominant clinical variant was sensorimotor in Europe/Americas (n = 387/562, 69%) and Asia (n = 27/63, 43%), and pure motor in Bangladesh (n = 74/107, 69%). Miller Fisher syndrome and Miller Fisher-Guillain-Barré overlap syndrome were more common in Asia (n = 14/63, 22%) than in the other two regions (Europe/Americas: n = 64/562, 11%; Bangladesh: n = 1/107, 1%) (P < 0.001). The predominant electrophysiological subtype was demyelinating in all regions (Europe/Americas: n = 312/573, 55%; Asia: n = 29/65, 45%; Bangladesh: n = 38/94, 40%). The axonal subtype occurred more often in Bangladesh (n = 34/94, 36%) than in Europe/Americas (n = 33/573, 6%) and other Asian countries (n = 4/65, 6%) (P < 0.001). In all regions, patients with the axonal subtype were younger, had fewer sensory deficits, and showed a trend towards poorer recovery compared to patients with the demyelinating subtype. The proportion of patients able to walk unaided after 1 year varied between Asia (n = 31/34, 91%), Europe/Americas (n = 334/404, 83%) and Bangladesh (n = 67/97, 69%) (P = 0.003). A similar variation was seen for mortality, being higher in Bangladesh (n = 19/114, 17%) than in Europe/Americas (n = 23/486, 5%) and Asia (n = 1/45, 2%) (P < 0.001). This study showed that factors related to geography have a major influence on clinical phenotype, disease severity, electrophysiological subtype, and outcome of Guillain-Barré syndrome.

Published
2018
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33. Conceptual framework for establishing the African Stroke Organization.

Author

Akinyemi, Rufus, Sarfo, Fred, Abd-Allah, Foad, Ogun, Yomi, Belo, Mofou, Francis, Patty, Mateus, M Bettencourt, Bateman, Kathleen, Naidoo, Pamela, Charway-Felli, Augustina, Akpalu, Albert, Wahab, Kolawole, Napon, Christian, Arulogun, Oyedunni, Ebenezer, Ad Adams, Ekeng, Gloria, Scola, George, Hamzat, Kolapo, Zimba, Stanley, and Ossou-Nguiet, Paul Macaire

Subjects
STROKE, UBUNTU (Philosophy), AFRICAN philosophy, CAPACITY building, TEAMS in the workplace
Abstract

Africa is the world's most genetically diverse, second largest, and second most populous continent, with over one billion people distributed across 54 countries. With a 23% lifetime risk of stroke, Africa has some of the highest rates of stroke worldwide and many occur in the prime of life with huge economic losses and grave implications for the individual, family, and the society in terms of mental capital, productivity, and socioeconomic progress. Tackling the escalating burden of stroke in Africa requires prioritized, multipronged, and inter-sectoral strategies tailored to the unique African epidemiological, cultural, socioeconomic, and lifestyle landscape. The African Stroke Organization (ASO) is a new pan-African coalition that brings together stroke researchers, clinicians, and other health-care professionals with participation of national and regional stroke societies and stroke support organizations. With a vision to reduce the rapidly increasing burden of stroke in Africa, the ASO has a four-pronged focus on (1) research, (2) capacity building, (3) development of stroke services, and (4) collaboration with all stakeholders. This will be delivered through advocacy, awareness, and empowerment initiatives to bring about people-focused changes in policy, clinical practice, and public education. In the spirit of the African philosophy of Ubuntu "I am because we are, " the ASO will harness the power of diversity, inclusiveness, togetherness, and team work to build a strong, enduring, and impactful platform for tackling stroke in Africa. [ABSTRACT FROM AUTHOR]

Published
2021
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35. Regional variation of Guillain-Barré syndrome.

Author

UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de neurologie, Doets, Alex Y, Verboon, Christine, van den Berg, Bianca, Harbo, Thomas, Cornblath, David R, Willison, Hugh J, Islam, Zhahirul, Attarian, Shahram, Barroso, Fabio A, Bateman, Kathleen, Benedetti, Luana, Van den Bergh, Peter, Casasnovas, Carlos, Cavaletti, Guido, Chavada, Govindsinh, Claeys, Kristl G, Dardiotis, Efthimios, Davidson, Amy, van Doorn, Pieter A, Feasby, Tom E, Galassi, Giuliana, Gorson, Kenneth C, Hartung, Hans-Peter, Hsieh, Sung-Tsang, Hughes, Richard A C, Illa, Isabel, Islam, Badrul, Kusunoki, Susumu, Kuwabara, Satoshi, Lehmann, Helmar C, Miller, James A L, Mohammad, Quazi Deen, Monges, Soledad, Nobile Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Rinaldi, Simon, Querol, Luis, Reddel, Stephen W, Reisin, Ricardo C, Shahrizaila, Nortina, Sindrup, Soren H, Waqar, Waheed, Jacobs, Bart C, IGOS Consortium, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de neurologie, Doets, Alex Y, Verboon, Christine, van den Berg, Bianca, Harbo, Thomas, Cornblath, David R, Willison, Hugh J, Islam, Zhahirul, Attarian, Shahram, Barroso, Fabio A, Bateman, Kathleen, Benedetti, Luana, Van den Bergh, Peter, Casasnovas, Carlos, Cavaletti, Guido, Chavada, Govindsinh, Claeys, Kristl G, Dardiotis, Efthimios, Davidson, Amy, van Doorn, Pieter A, Feasby, Tom E, Galassi, Giuliana, Gorson, Kenneth C, Hartung, Hans-Peter, Hsieh, Sung-Tsang, Hughes, Richard A C, Illa, Isabel, Islam, Badrul, Kusunoki, Susumu, Kuwabara, Satoshi, Lehmann, Helmar C, Miller, James A L, Mohammad, Quazi Deen, Monges, Soledad, Nobile Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Rinaldi, Simon, Querol, Luis, Reddel, Stephen W, Reisin, Ricardo C, Shahrizaila, Nortina, Sindrup, Soren H, Waqar, Waheed, Jacobs, Bart C, and IGOS Consortium

Abstract

Guillain-Barré syndrome is a heterogeneous disorder regarding the clinical presentation, electrophysiological subtype and outcome. Previous single country reports indicate that Guillain-Barré syndrome may differ among regions, but no systematic comparative studies have been conducted. Comparative studies are required to identify factors determining disease susceptibility, variation and prognosis, and to improve diagnostic criteria. The International Guillain-Barré Syndrome Outcome Study is a prospective, observational cohort study including all patients within the diagnostic spectrum, aiming to describe the heterogeneity of Guillain-Barré syndrome worldwide. The current study was based on the first 1000 inclusions with a follow-up of at least 1 year and confirmed the variation in clinical presentation, course and outcome between patients. The full clinical spectrum of Guillain-Barré syndrome was observed in patients from all countries participating in the International Guillain-Barré Syndrome Outcome Study, but the frequency of variants differed between regions. We compared three regions based on geography, income and previous reports of Guillain-Barré syndrome subtypes: 'Europe/Americas', 'Asia' (without Bangladesh), and 'Bangladesh'. We excluded 75 (8%) patients because of alternative diagnoses, protocol violations, or missing data. The predominant clinical variant was sensorimotor in Europe/Americas (n = 387/562, 69%) and Asia (n = 27/63, 43%), and pure motor in Bangladesh (n = 74/107, 69%). Miller Fisher syndrome and Miller Fisher-Guillain-Barré overlap syndrome were more common in Asia (n = 14/63, 22%) than in the other two regions (Europe/Americas: n = 64/562, 11%; Bangladesh: n = 1/107, 1%) (P < 0.001). The predominant electrophysiological subtype was demyelinating in all regions (Europe/Americas: n = 312/573, 55%; Asia: n = 29/65, 45%; Bangladesh: n = 38/94, 40%). The axonal subtype occurred more often in Bangladesh (n = 34/94, 36%) than in Europe/Americas (

Published
2018

36. Regional variation of Guillain-Barre syndrome

Author

van den Berg, Bianca, Doets, Alex, Verboon, Christine, Harbo, Thomas, Cornblath, David, Willison, Hugh, Islam, Zhahir, Attarian, Shahram, Barroso, Fabio, Bateman, Kathleen, Benedetti, Luana, Van den Bergh, Peter, Casasnovas, Carlos, Cavaletti, Guido, Chavada, Govind, Claeys, Kristl, Dardiotis, Efthimios, Davidson, Amy, Van Doom, Pieter, Feasby, Tom, Galassi, Guliana, Gorson, Ken, Hartung, Hans-Peter, Hsieh, Sung-Tsang, Hughes, Richard A. C., Illa, Isabel, Islam, Badrul, Kusunoki, Susumu, Kuwabara, Satoshi, Lehmann, Helmar, AL Miller, James, Mohammad, Quazi Deen, Monges, Soledad, Nobile Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Rinaldi, Simon, Querol, Luis, Reddel, Stephen, Reisin, Ricardo, Shahrizaila, Nortina, Sindrup, Soren, Waqar, Waheed, Jacobs, Bart, van den Berg, Bianca, Doets, Alex, Verboon, Christine, Harbo, Thomas, Cornblath, David, Willison, Hugh, Islam, Zhahir, Attarian, Shahram, Barroso, Fabio, Bateman, Kathleen, Benedetti, Luana, Van den Bergh, Peter, Casasnovas, Carlos, Cavaletti, Guido, Chavada, Govind, Claeys, Kristl, Dardiotis, Efthimios, Davidson, Amy, Van Doom, Pieter, Feasby, Tom, Galassi, Guliana, Gorson, Ken, Hartung, Hans-Peter, Hsieh, Sung-Tsang, Hughes, Richard A. C., Illa, Isabel, Islam, Badrul, Kusunoki, Susumu, Kuwabara, Satoshi, Lehmann, Helmar, AL Miller, James, Mohammad, Quazi Deen, Monges, Soledad, Nobile Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Rinaldi, Simon, Querol, Luis, Reddel, Stephen, Reisin, Ricardo, Shahrizaila, Nortina, Sindrup, Soren, Waqar, Waheed, and Jacobs, Bart

Published
2018

37. Original research: Second IVIg course in Guillain-Barré syndrome with poor prognosis: the non-randomised ISID study

Author

Verboon, Christine, van den Berg, Bianca, Cornblath, David R, Venema, Esmee, Gorson, Kenneth C, Lunn, Michael P, Lingsma, Hester, Van den Bergh, Peter, Harbo, Thomas, Bateman, Kathleen, Pereon, Yann, Sindrup, Søren H, Kusunoki, Susumu, Miller, James, Islam, Zhahirul, Hartung, Hans-Peter, Chavada, Govindsinh, Jacobs, Bart C, Hughes, Richard A C, and van Doorn, Pieter A

Abstract

ObjectiveTo compare disease course in patients with Guillain-Barré syndrome (GBS) with a poor prognosis who were treated with one or with two intravenous immunoglobulin (IVIg) courses.MethodsFrom the International GBS Outcome Study, we selected patients whose modified Erasmus GBS Outcome Score at week 1 predicted a poor prognosis. We compared those treated with one IVIg course to those treated with two IVIg courses. The primary endpoint, the GBS disability scale at 4 weeks, was assessed with multivariable ordinal regression.ResultsOf 237 eligible patients, 199 patients received a single IVIg course. Twenty patients received an ‘early’ second IVIg course (1–2 weeks after start of the first IVIg course) and 18 patients a ‘late’ second IVIg course (2–4 weeks after start of IVIg). At baseline and 1 week, those receiving two IVIg courses were more disabled than those receiving one course. Compared with the one course group, the adjusted OR for a better GBS disability score at 4 weeks was 0.70 (95%CI 0.16 to 3.04) for the early group and 0.66 (95%CI 0.18 to 2.50) for the late group. The secondary endpoints were not in favour of a second IVIg course.ConclusionsThis observational study did not show better outcomes after a second IVIg course in GBS with poor prognosis. The study was limited by small numbers and baseline imbalances. Lack of improvement was likely an incentive to start a second IVIg course. A prospective randomised trial is needed to evaluate whether a second IVIg course improves outcome in GBS.

Published
2020
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38. Outcomes of mechanical thrombectomy at a single-centre tertiary level public healthcare hospital in South Africa

Author

Kiriinya, Martin Muthinja, Bateman, Kathleen, Qureshi, Aamir, Feuvre, David Le, and Taylor, Allan

Abstract

Introduction Mechanical thrombectomy (MT) is standard of care for acute ischaemic stroke from large vessel occlusion following randomised controlled trials performed largely in high-income countries. Limited data exists on its effectiveness in the setting of low-and-middle-income countries. We aimed to evaluate the safety and efficacy of MT in a tertiary level public hospital in Cape Town, South Africa.Methods Patients with acute ischaemic stroke presenting consecutively to Groote Schuur Hospital between 1 January 2018 to 1 January 2022 with proximal intracranial occlusion in the anterior circulation treated with MT within 6 h from onset using computed tomography (CT) and CT angiography imaging-based protocols were evaluated. Demographic, clinical, radiological and procedural data were obtained from the stroke unit database. Recanalisation was evaluated post-procedure by modified Treatment in Cerebral Infarction score (mTICI). Functional independence (modified Rankin scores 0–2) and mortality at 90 days were also assessed.Results Thrombectomies were performed in 84 patients during the study period. The median age was 56 years (interquartile range, IQR) and 51% of participants were female. Median National Institute of Health Stroke Score was 18 and median baseline Alberta Stroke Programme Early CT score was 8. Bridging thrombolysis was given to 65% of participants. Median time from symptom onset to reperfusion was 339 min (IQR). Successful recanalisation (mTICI 2b/3) was obtained in 62%. At 90 days, 34% of participants gained functional independence and mortality was 34%.Conclusion This study demonstrated similar rates of recanalisation and functional independence to that seen in trials in high-income countries using basic imaging despite a higher mortality and longer median time to reperfusion. This data supports the effectiveness of MT in a tertiary level public hospital in South Africa despite the challenges of providing emergent stroke care in a resource-constrained setting.

Published
2024
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40. Outcomes of mechanical thrombectomy at a single-centre tertiary level public healthcare hospital in South Africa.

Author

Kiriinya, Martin Muthinja, Bateman, Kathleen, Qureshi, Aamir, Feuvre, David Le, and Taylor, Allan

Abstract

Mechanical thrombectomy (MT) is standard of care for acute ischaemic stroke from large vessel occlusion following randomised controlled trials performed largely in high-income countries. Limited data exists on its effectiveness in the setting of low-and-middle-income countries. We aimed to evaluate the safety and efficacy of MT in a tertiary level public hospital in Cape Town, South Africa.Patients with acute ischaemic stroke presenting consecutively to Groote Schuur Hospital between 1 January 2018 to 1 January 2022 with proximal intracranial occlusion in the anterior circulation treated with MT within 6 h from onset using computed tomography (CT) and CT angiography imaging-based protocols were evaluated. Demographic, clinical, radiological and procedural data were obtained from the stroke unit database. Recanalisation was evaluated post-procedure by modified Treatment in Cerebral Infarction score (mTICI). Functional independence (modified Rankin scores 0–2) and mortality at 90 days were also assessed.Thrombectomies were performed in 84 patients during the study period. The median age was 56 years (interquartile range, IQR) and 51% of participants were female. Median National Institute of Health Stroke Score was 18 and median baseline Alberta Stroke Programme Early CT score was 8. Bridging thrombolysis was given to 65% of participants. Median time from symptom onset to reperfusion was 339 min (IQR). Successful recanalisation (mTICI 2b/3) was obtained in 62%. At 90 days, 34% of participants gained functional independence and mortality was 34%.This study demonstrated similar rates of recanalisation and functional independence to that seen in trials in high-income countries using basic imaging despite a higher mortality and longer median time to reperfusion. This data supports the effectiveness of MT in a tertiary level public hospital in South Africa despite the challenges of providing emergent stroke care in a resource-constrained setting. [ABSTRACT FROM AUTHOR]

Published
2023
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43. The Great Diseases Project

Author

Jacque, Berri, primary, Malanson, Katherine, additional, Bateman, Kathleen, additional, Akeson, Bob, additional, Cail, Amanda, additional, Doss, Chris, additional, Dugan, Matt, additional, Finegold, Brandon, additional, Gauthier, Aimee, additional, Galego, Mike, additional, Roundtree, Eugene, additional, Spezzano, Lawrence, additional, and Meiri, Karina F., additional

Published
2013
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45. Osmotic Demyelination Syndrome in an Adolescent with Neuromyelitis Optica.

Author

Kariv, Sarah, Bateman, Kathleen, and Neurol, F. C.

Subjects
DEMYELINATION, NEUROMYELITIS optica, MAGNETIC resonance imaging, QUADRIPLEGIA, VOMITING, DISEASE management, TREATMENT effectiveness, DIAGNOSIS, THERAPEUTICS
Abstract

A 17-year-old girl presented with intractable vomiting due to area postrema involvement in the first presentation of seronegative neuromyelitis optica (NMO). During the course of her illness, she developed mild hyponatremia, and magnetic resonance imaging revealed abnormalities consistent with the co-occurrence of osmotic demyelination syndrome (ODS). This combination of imaging features is novel, and this case expands the spectrum of brain abnormalities seen in NMO and NMO spectrum disorders. It was suspected that NMO may predispose to ODS by causing astrocyte dysfunction involving aquaporin 4 water channels, which are implicated in both conditions. [ABSTRACT FROM AUTHOR]

Published
2018
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47. Guidelines for the management of acute meningitis in children and adults in South Africa.

Author

Boyles, Tom H., Bamford, Colleen, Bateman, Kathleen, Blumberg, Lucille, Dramowski, Angela, Karstaedt, Alan, Korsman, Stephen, le Roux, David M., Maartens, Gary, Madhi, Shabir, Naidoo, Reené, Nuttall, James, Reubenson, Gary, Taljaard, Jantjie, Thomas, Juno, van Zyl, Gert, von Gottberg, Anne, Whitelaw, Andrew, and Mendelson, Marc

Subjects
MENINGITIS in children, DISEASES in youths, EARLY death, ETIOLOGY of diseases, CEREBROSPINAL fluid, STEROIDS, BRAIN tomography
Abstract

This guideline provides a rational and cost-effective approach to patients with acute meningitis, which causes considerable morbidity and mortality, predominantly in children. There are many aetiologies, but a small number of bacteria and viruses account for the majority of cases. There should be a low threshold for suspecting acute meningitis, which is a medical emergency and antibiotics should not be delayed. Blood culture and cerebrospinal fluid (CSF) analysis are the most important diagnostic tests and should be performed whenever it is safe and practical. Contraindications to lumbar puncture are discussed and an algorithm is given regarding administering empiric antibiotics and antivirals, performing blood cultures, computer tomography brain scanning and cerebrospinal fluid analysis, depending on the clinical features and availability of resources. Administration of steroids is not recommended. Guidelines are provided for definitive therapy whenever a causative organism is identified. When no organism is identified, treatment and further investigation should be guided by laboratory results and clinical response. An approach to this process is outlined in a second algorithm. The epidemiology of resistance to common pathogens is described and advice given regarding special groups, including those with recurrent meningitis or base-of-skull fractures. Advice regarding infection control, post-exposure prophylaxis and vaccination is provided. [ABSTRACT FROM AUTHOR]

Published
2013
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48. Original research: Second IVIg course in Guillain-Barré syndrome with poor prognosis: the non-randomised ISID study.

Author

Hughes, Richard A. C., Verboon, Christine, van den Berg, Bianca, Cornblath, David R, Venema, Esmee, Gorson, Kenneth C, Lunn, Michael P, Lingsma, Hester, Van den Bergh, Peter, Harbo, Thomas, Bateman, Kathleen, Pereon, Yann, Sindrup, Søren H, Kusunoki, Susumu, Miller, James, Islam, Zhahirul, Hartung, Hans-Peter, Chavada, Govindsinh, Jacobs, Bart C, and van Doorn, Pieter A

Subjects
GUILLAIN-Barre syndrome, ZIKA virus infections, MOTOR neuron diseases, PATHOLOGY, NEUROMUSCULAR diseases, THERAPEUTIC use of immunoglobulins, COMPARATIVE studies, NEUROLOGIC examination, DRUG administration, IMMUNOGLOBULINS, IMMUNOLOGICAL adjuvants, RESEARCH methodology, MEDICAL cooperation, PROGNOSIS, RESEARCH, TIME, EVALUATION research, TREATMENT effectiveness
Abstract

Objective: To compare disease course in patients with Guillain-Barré syndrome (GBS) with a poor prognosis who were treated with one or with two intravenous immunoglobulin (IVIg) courses.Methods: From the International GBS Outcome Study, we selected patients whose modified Erasmus GBS Outcome Score at week 1 predicted a poor prognosis. We compared those treated with one IVIg course to those treated with two IVIg courses. The primary endpoint, the GBS disability scale at 4 weeks, was assessed with multivariable ordinal regression.Results: Of 237 eligible patients, 199 patients received a single IVIg course. Twenty patients received an 'early' second IVIg course (1-2 weeks after start of the first IVIg course) and 18 patients a 'late' second IVIg course (2-4 weeks after start of IVIg). At baseline and 1 week, those receiving two IVIg courses were more disabled than those receiving one course. Compared with the one course group, the adjusted OR for a better GBS disability score at 4 weeks was 0.70 (95%CI 0.16 to 3.04) for the early group and 0.66 (95%CI 0.18 to 2.50) for the late group. The secondary endpoints were not in favour of a second IVIg course.Conclusions: This observational study did not show better outcomes after a second IVIg course in GBS with poor prognosis. The study was limited by small numbers and baseline imbalances. Lack of improvement was likely an incentive to start a second IVIg course. A prospective randomised trial is needed to evaluate whether a second IVIg course improves outcome in GBS. [ABSTRACT FROM AUTHOR]

Published
2020
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50. The viral protein R in HIV-associated acute ischaemic stroke: a case-control study

Author

McMullen, Kate and Bateman, Kathleen

Subjects
virus diseases, Medicine, cardiovascular diseases
Abstract

Background: HIV-1 viral proteins have been implicated in endothelial dysfunction, which is a major determinant of ischaemic stroke risk in HIV-infected individuals. Polymorphisms in HIV-1 viral protein R (Vpr) may alter its potential to promote endothelial dysfunction, by modifying its effects on viral replication, reactivation of latent cells, upregulation of proinflammatory cytokines and infection of macrophages. Methods: We analysed Vpr polymorphisms and their association with acute ischaemic stroke by comparing Vpr signature amino acids between 54 HIV-infected individuals with acute ischaemic stroke, and 80 age-matched HIV-infected non-stroke controls. Results: Isoleucine at position 22 and serine at position 41 were associated with ischaemic stroke in HIV. Individuals with stroke had lower CD4 counts and CD4 nadirs than controls. These polymorphisms are more common in individuals with stroke compared to South African subtype C and the control group consensus sequences. Conclusions: Signature Vpr polymorphisms have been identified that are more common in people with acute ischaemic stroke in HIV compared to HIV-infected individuals without acute ischaemic stroke. These may be involved in increased stroke risk by promoting endothelial dysfunction and susceptibility to opportunistic infections, as well as more advanced HIV disease. Therapeutic targeting of HIV-1 viral proteins may present an additional mechanism of decreasing stroke risk in HIV-infected individuals.

Published
2021

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