TY - JOUR AU - Dreier, JP AU - Fabricius, M AU - Ayata, C AU - Sakowitz, OW AU - William, Shuttleworth C AU - Dohmen, C AU - Graf, R AU - Vajkoczy, P AU - Helbok, R AU - Suzuki, M AU - Schiefecker, AJ AU - Major, S AU - Winkler, MK AU - Kang, EJ AU - Milakara, D AU - Oliveira-Ferreira, AI AU - Reiffurth, C AU - Revankar, GS AU - Sugimoto, K AU - Dengler, NF AU - Hecht, N AU - Foreman, B AU - Feyen, B AU - Kondziella, D AU - Friberg, CK AU - Piilgaard, H AU - Rosenthal, ES AU - Westover, MB AU - Maslarova, A AU - Santos, E AU - Hertle, D AU - Sanchez-Porras, R AU - Jewell, SL AU - Balanca, B AU - Platz, J AU - Hinzman, JM AU - Lückl, János AU - Schoknecht, K AU - Scholl, M AU - Drenckhahn, C AU - Feuerstein, D AU - Eriksen, N AU - Horst, V AU - Bretz, JS AU - Jahnke, P AU - Scheel, M AU - Bohner, G AU - Rostrup, E AU - Pakkenberg, B AU - Heinemann, U AU - Claassen, J AU - Carlson, AP AU - Kowoll, CM AU - Lublinsky, S AU - Chassidim, Y AU - Shelef, I AU - Friedman, A AU - Brinker, G AU - Reiner, M AU - Kirov, SA AU - Andrew, RD AU - Farkas, Eszter AU - Guresir, E AU - Vatter, H AU - Chung, LS AU - Brennan, KC AU - Lieutaud, T AU - Marinesco, S AU - Maas, AI AU - Sahuquillo, J AU - Dahlem, MA AU - Richter, F AU - Herreras, O AU - Boutelle, MG AU - Okonkwo, DO AU - Bullock, MR AU - Witte, OW AU - Martus, P AU - van den Maagdenberg, AM AU - Ferrari, MD AU - Dijkhuizen, RM AU - Shutter, LA AU - Andaluz, N AU - Schulte, AP AU - MacVicar, B AU - Watanabe, T AU - Woitzik, J AU - Lauritzen, M AU - Strong, AJ AU - Hartings, JA TI - Recording, analysis, and interpretation of spreading depolarizations in neurointensive care: Review and recommendations of the COSBID research group JF - JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM J2 - J CEREBR BLOOD F MET VL - 37 PY - 2017 IS - 5 SP - 1595 EP - 1625 PG - 31 SN - 0271-678X DO - 10.1177/0271678X16654496 UR - https://m2.mtmt.hu/api/publication/3120851 ID - 3120851 N1 - Megjegyzés-26656987 N1 Funding details: DFG DR 323/6-1, DFG, Deutsche Forschungsgemeinschaft N1 Funding details: NS083858, NIH, National Institutes of Health N1 Funding details: WT094912/HICF-1010-080, ERDF, European Regional Development Fund N1 Funding text: This work was supported by Deutsche Forschungsgemeinschaft (DFG DR 323/6-1), the Bundesministerium für Bildung und Forschung (Center for Stroke Research Berlin, 01 EO 0801; BCCN 01GQ1001C B2), and Era-Net Neuron 01EW1212 to Dr Dreier, NeuroCure SESAH (EXC 257/2) to Drs Dreier and Heinemann, and DFG DR 323/5-1 to Drs Dreier, Woitzik, Vajkoczy, Sakowitz, Graf, Vatter, and Friedman. This work was supported by the Mayfield Education and Research Foundation to Dr Hartings and the Hungarian Scientific Research Fund (Grant No. K111923 to Farkas), the Bolyai János Research Scholarship of the Hungarian Academy of Sciences (BO/00327/14/5) to Dr Farkas, and the National Institutes of Health (NS083858) to Dr Kirov. Dr Sahuquillo is a recipient of a grant from the Fondo de Investigación Sanitaria (Instituto de Salud Carlos III) (FIS PI08/0480) cofinanced by the European Regional Development Fund (ERDF). This work was also supported by the Toyota Foundation to Drs Fabricius and Friberg. Dr Boutelle is supported by Wellcome Trust/UK Dept of Health under the HICF Scheme (WT094912/HICF-1010-080). Megjegyzés-26656994 N1 Funding details: DFG DR 323/6-1, DFG, Deutsche Forschungsgemeinschaft N1 Funding details: NS083858, NIH, National Institutes of Health N1 Funding details: WT094912/HICF-1010-080, ERDF, European Regional Development Fund N1 Funding text: This work was supported by Deutsche Forschungsgemeinschaft (DFG DR 323/6-1), the Bundesministerium für Bildung und Forschung (Center for Stroke Research Berlin, 01 EO 0801; BCCN 01GQ1001C B2), and Era-Net Neuron 01EW1212 to Dr Dreier, NeuroCure SESAH (EXC 257/2) to Drs Dreier and Heinemann, and DFG DR 323/5-1 to Drs Dreier, Woitzik, Vajkoczy, Sakowitz, Graf, Vatter, and Friedman. This work was supported by the Mayfield Education and Research Foundation to Dr Hartings and the Hungarian Scientific Research Fund (Grant No. K111923 to Farkas), the Bolyai János Research Scholarship of the Hungarian Academy of Sciences (BO/00327/14/5) to Dr Farkas, and the National Institutes of Health (NS083858) to Dr Kirov. Dr Sahuquillo is a recipient of a grant from the Fondo de Investigación Sanitaria (Instituto de Salud Carlos III) (FIS PI08/0480) cofinanced by the European Regional Development Fund (ERDF). This work was also supported by the Toyota Foundation to Drs Fabricius and Friberg. Dr Boutelle is supported by Wellcome Trust/UK Dept of Health under the HICF Scheme (WT094912/HICF-1010-080). Megjegyzés-26657007 N1 Funding details: DFG DR 323/6-1, DFG, Deutsche Forschungsgemeinschaft N1 Funding details: NS083858, NIH, National Institutes of Health N1 Funding details: WT094912/HICF-1010-080, ERDF, European Regional Development Fund N1 Funding text: This work was supported by Deutsche Forschungsgemeinschaft (DFG DR 323/6-1), the Bundesministerium für Bildung und Forschung (Center for Stroke Research Berlin, 01 EO 0801; BCCN 01GQ1001C B2), and Era-Net Neuron 01EW1212 to Dr Dreier, NeuroCure SESAH (EXC 257/2) to Drs Dreier and Heinemann, and DFG DR 323/5-1 to Drs Dreier, Woitzik, Vajkoczy, Sakowitz, Graf, Vatter, and Friedman. This work was supported by the Mayfield Education and Research Foundation to Dr Hartings and the Hungarian Scientific Research Fund (Grant No. K111923 to Farkas), the Bolyai János Research Scholarship of the Hungarian Academy of Sciences (BO/00327/14/5) to Dr Farkas, and the National Institutes of Health (NS083858) to Dr Kirov. Dr Sahuquillo is a recipient of a grant from the Fondo de Investigación Sanitaria (Instituto de Salud Carlos III) (FIS PI08/0480) cofinanced by the European Regional Development Fund (ERDF). This work was also supported by the Toyota Foundation to Drs Fabricius and Friberg. Dr Boutelle is supported by Wellcome Trust/UK Dept of Health under the HICF Scheme (WT094912/HICF-1010-080). Center for Stroke Research Berlin, Charité University Medicine Berlin, Charité Campus Mitte, Charitéplatz 1, Berlin, 10117, Germany Department of Neurology, Charité University Medicine Berlin, Berlin, Germany Department of Experimental Neurology, Charité University Medicine Berlin, Berlin, Germany Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark Neurovascular Research Laboratory, Department of Radiology, and Stroke Service and Neuroscience Intensive Care Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States Department of Neurosurgery, Klinikum Ludwigsburg, Ludwigsburg, Germany Department of Neurosurgery, University Hospital, Heidelberg, Germany Department of Neurosciences, University of New Mexico School of Medicine, Albuquerque, NM, United States Department of Neurology, University of Cologne, Cologne, Germany Multimodal Imaging of Brain Metabolism, Max-Planck-Institute for Metabolism Research, Cologne, Germany Department of Neurosurgery, Charité University Medicine Berlin, Berlin, Germany Department of Neurology, Neurocritical Care Unit, Medical University Innsbruck, Innsbruck, Austria Department of Neurosurgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan Department of Neurology and Rehabilitation Medicine, Neurocritical Care Division, University of Cincinnati College of Medicine, Cincinnati, OH, United States Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium Department of Neurology, Rigshospitalet, Copenhagen, Denmark Department of Neurosurgery, University Hospital and University of Bonn, Bonn, Germany Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom Inserm U10128, CNRS UMR5292, Lyon Neuroscience Research Center, Team TIGER, Lyon, France Université Claude Bernard, Lyon, France Department of Neurosurgery, Goethe-University, Frankfurt, Germany Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, United States Neuroscience Research Center, Charité University Medicine Berlin, Berlin, Germany Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany Neurological Center, Segeberger Kliniken, Bad Segeberg, Germany Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, Rigshospitalet, Copenhagen, Denmark Department of Neuroradiology, Charité University Medicine Berlin, Berlin, Germany Faculty of Health and Medical Sciences, Panum Institute, University of Copenhagen, Copenhagen, Denmark Neurocritical Care, Columbia University College of Physicians and Surgeons, New York, NY, United States Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM, United States Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Beer-Sheva, Israel Department of Neuroradiology, Soroka University Medical Center and Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel Department of Medical Neuroscience, Faculty of Medicine, Dalhousie University, Halifax, Canada Department of Neurosurgery, University of Cologne, Cologne, Germany Department of Neurosurgery and Brain and Behavior Discovery Institute, Medical College of Georgia, Augusta, GA, United States Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada Department of Medical Physics and Informatics, Faculty of Medicine, and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary Department of Neurology, University of Utah, Salt Lake City, UT, United States AniRA-Neurochem Technological Platform, Lyon, France Department of Neurosurgery, Neurotraumatology and Neurosurgery Research Unit (UNINN), Universitat Autònoma de Barcelona, Barcelona, Spain Department of Physics, Humboldt University, Berlin, Germany Institute of Physiology I/Neurophysiology, Friedrich Schiller University Jena, Jena, Germany Department of Systems Neuroscience, Cajal Institute-CSIC, Madrid, Spain Department of Bioengineering, Imperial College London, London, United Kingdom Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States Department of Neurological Surgery, University of Miami, Miami, FL, United States Hans Berger Department of Neurology, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany Institute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands Department of Neurology, Leiden University Medical Center, Leiden, Netherlands Center for Image Sciences, University Medical Center Utrecht, Utrecht, Netherlands Department of Critical Care Medicine and Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States Mayfield Clinic, Cincinnati, OH, United States Department of Spinal Surgery, St. Franziskus Hospital Cologne, Cologne, Germany Department of Psychiatry, University of British Columbia, Vancouver, Canada Lannister-Finn Corporation, Bryn Mawr, PA, United States Department of Neuroscience and Pharmacology, Panum Institute, University of Copenhagen, Copenhagen, Denmark Cited By :90 Export Date: 8 June 2020 CODEN: JCBMD Correspondence Address: Dreier, J.P.; Center for Stroke Research Berlin, Charité University Medicine Berlin, Charité Campus Mitte, Charitéplatz 1, Germany; email: jens.dreier@charite.de Funding details: Deutsche Forschungsgemeinschaft, DFG, DR 323/6-1 Funding details: Toyota Foundation Funding details: National Institutes of Health, NIH, NS083858 Funding details: WT094912/HICF-1010-080 Funding details: Hungarian Scientific Research Fund, OTKA, K111923 Funding details: Magyar Tudományos Akadémia, MTA, BO/00327/14/5 Funding details: Deutsche Forschungsgemeinschaft, DFG Funding details: Bundesministerium für Bildung und Frauen, BMBF, 01EW1212, BCCN 01GQ1001C B2, EXC 257/2, DR 323/5-1, 01 EO 0801 Funding details: European Regional Development Fund, FEDER Funding details: Instituto de Salud Carlos III, ISCIII, FIS PI08/0480 Funding text 1: This work was supported by Deutsche Forschungsgemeinschaft (DFG DR 323/6-1), the Bundesministerium f?r Bildung und Forschung (Center for Stroke Research Berlin, 01 EO 0801; BCCN 01GQ1001C B2), and Era-Net Neuron 01EW1212 to Dr Dreier, NeuroCure SESAH (EXC 257/2) to Drs Dreier and Heinemann, and DFG DR 323/5-1 to Drs Dreier, Woitzik, Vajkoczy, Sakowitz, Graf, Vatter, and Friedman. This work was supported by the Mayfield Education and Research Foundation to Dr Hartings and the Hungarian Scientific Research Fund (Grant No. K111923 to Farkas), the Bolyai J?nos Research Scholarship of the Hungarian Academy of Sciences (BO/00327/14/5) to Dr Farkas, and the National Institutes of Health (NS083858) to Dr Kirov. Dr Sahuquillo is a recipient of a grant from the Fondo de Investigaci?n Sanitaria (Instituto de Salud Carlos III) (FIS PI08/0480) cofinanced by the European Regional Development Fund (ERDF). This work was also supported by the Toyota Foundation to Drs Fabricius and Friberg. Dr Boutelle is supported by Wellcome Trust/UK Dept of Health under the HICF Scheme (WT094912/HICF-1010-080). AB - Spreading depolarizations (SD) are waves of abrupt, near-complete breakdown of neuronal transmembrane ion gradients, are the largest possible pathophysiologic disruption of viable cerebral gray matter, and are a crucial mechanism of lesion development. Spreading depolarizations are increasingly recorded during multimodal neuromonitoring in neurocritical care as a causal biomarker providing a diagnostic summary measure of metabolic failure and excitotoxic injury. Focal ischemia causes spreading depolarization within minutes. Further spreading depolarizations arise for hours to days due to energy supply-demand mismatch in viable tissue. Spreading depolarizations exacerbate neuronal injury through prolonged ionic breakdown and spreading depolarization-related hypoperfusion (spreading ischemia). Local duration of the depolarization indicates local tissue energy status and risk of injury. Regional electrocorticographic monitoring affords even remote detection of injury because spreading depolarizations propagate widely from ischemic or metabolically stressed zones; characteristic patterns, including temporal clusters of spreading depolarizations and persistent depression of spontaneous cortical activity, can be recognized and quantified. Here, we describe the experimental basis for interpreting these patterns and illustrate their translation to human disease. We further provide consensus recommendations for electrocorticographic methods to record, classify, and score spreading depolarizations and associated spreading depressions. These methods offer distinct advantages over other neuromonitoring modalities and allow for future refinement through less invasive and more automated approaches. LA - English DB - MTMT ER - TY - JOUR AU - Maegele, M AU - Schochl, H AU - Menovsky, T AU - Marechal, H AU - Marklund, N AU - Büki, András AU - Stanworth, S TI - Coagulopathy and haemorrhagic progression in traumatic brain injury: advances in mechanisms, diagnosis, and management JF - LANCET NEUROLOGY J2 - LANCET NEUROL VL - 16 PY - 2017 IS - 8 SP - 630 EP - 647 PG - 18 SN - 1474-4422 DO - 10.1016/S1474-4422(17)30197-7 UR - https://m2.mtmt.hu/api/publication/3250359 ID - 3250359 AB - Normal haemostasis depends on an intricate balance between mechanisms of bleeding and mechanisms of thrombosis, and this balance can be altered after traumatic brain injury (TBI). Impaired haemostasis could exacerbate the primary insult with risk of initiation or aggravation of bleeding; anticoagulant use at the time of injury can also contribute to bleeding risk after TBI. Many patients with TBI have abnormalities on conventional coagulation tests at admission to the emergency department, and the presence of coagulopathy is associated with increased morbidity and mortality. Further blood testing often reveals a range of changes affecting platelet numbers and function, procoagulant or anticoagulant factors, fibrinolysis, and interactions between the coagulation system and the vascular endothelium, brain tissue, inflammatory mechanisms, and blood flow dynamics. However, the degree to which these coagulation abnormalities affect TBI outcomes and whether they are modifiable risk factors are not known. Although the main challenge for management is to address the risk of hypocoagulopathy with prolonged bleeding and progression of haemorrhagic lesions, the risk of hypercoagulopathy with an increased prothrombotic tendency also warrants consideration. LA - English DB - MTMT ER - TY - JOUR AU - Thelin, EP AU - Zeiler, FA AU - Ercole, A AU - Mondello, S AU - Büki, András AU - Bellander, BM AU - Helmy, A AU - Menon, DK AU - Nelson, DW TI - Serial Sampling of Serum Protein Biomarkers for Monitoring Human Traumatic Brain injury Dynamics: A Systematic Review JF - FRONTIERS IN NEUROLOGY J2 - FRONT NEUR VL - 8 PY - 2017 PG - 23 SN - 1664-2295 DO - 10.3389/fneur.2017.00300 UR - https://m2.mtmt.hu/api/publication/3248575 ID - 3248575 N1 - Funding Agency and Grant Number: Swedish Society of Medicine [SLS-587221]; Cambridge Commonwealth Trust Scholarship; Royal College of Surgeons of Canada-Harry S. Morton Travelling Fellowship in Surgery; University of Manitoba Clinician Investigator Program, R. Samuel McLaughlin Research and Education Award; Manitoba Medical Service Foundation; University of Manitoba Faculty of Medicine Dean's Fellowship Fund; Hungarian Brain Research Program [KTIA_13_NAP-A-II/8]; National Institute for Healthcare Research (NIHR, UK) through the Acute Brain Injury and Repair theme of the Cambridge NIHR Biomedical Research Centre, an NIHR Senior Investigator Award; European Union Framework Program 7 grant [602150]; Medical Research Council; Cambridge Biomedical Research Centre; Royal College of Surgeons of England; National Institute for Health Research [NF-SI-0512-10090] Funding Source: researchfish Funding text: The following funding should be acknowledged: ET: Swedish Society of Medicine (Grant no. SLS-587221). FZ: Cambridge Commonwealth Trust Scholarship, the Royal College of Surgeons of Canada-Harry S. Morton Travelling Fellowship in Surgery, the University of Manitoba Clinician Investigator Program, R. Samuel McLaughlin Research and Education Award, the Manitoba Medical Service Foundation, and the University of Manitoba Faculty of Medicine Dean's Fellowship Fund. AB: Hungarian Brain Research Program-Grant No. KTIA_13_NAP-A-II/8. DM: National Institute for Healthcare Research (NIHR, UK) through the Acute Brain Injury and Repair theme of the Cambridge NIHR Biomedical Research Centre, an NIHR Senior Investigator Award to DM. The authors were also supported by a European Union Framework Program 7 grant (CENTER-TBI; Grant Agreement No. 602150). AH: Medical Research Council, Cambridge Biomedical Research Centre, Royal College of Surgeons of England. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. LA - English DB - MTMT ER - TY - JOUR AU - Cnossen, M.C. AU - Polinder, S. AU - Lingsma, H.F. AU - Maas, A.I.R. AU - Menon, D. AU - Steyerberg, E.W. 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Pullens, P. / Collaborator ED - Puybasset, L. / Collaborator ED - Ragauskas, A. / Collaborator ED - Raj, R. / Collaborator ED - Rambadagalla, M. / Collaborator ED - Rehorčíková, V. / Collaborator ED - Rhodes, J. / Collaborator ED - Richardson, S. / Collaborator ED - Ripatti, S. / Collaborator ED - Rocka, S. / Collaborator ED - Rodier, N. / Collaborator ED - Roe, C. / Collaborator ED - Roise, O. / Collaborator ED - Roks, G. / Collaborator ED - Romegoux, P. / Collaborator ED - Rosand, J. / Collaborator ED - Rosenfeld, J. / Collaborator ED - Rosenlund, C. / Collaborator ED - Rosenthal, G. / Collaborator ED - Rossaint, R. / Collaborator ED - Rossi, S. / Collaborator ED - Rostalski, T. / Collaborator ED - Rueckert, D.L. / Collaborator ED - Ruiz, De Arcaute F. / Collaborator ED - Rusnák, M. / Collaborator ED - Sacchi, M. / Collaborator ED - Sahakian, B. / Collaborator ED - Sahuquillo, J. / Collaborator ED - Sakowitz, O. / Collaborator ED - Sala, F. / Collaborator ED - Sanchez-Pena, P. / Collaborator ED - Sanchez-Porras, R. / Collaborator ED - Santos, E. / Collaborator ED - Sasse, N. / Collaborator ED - Sasu, L. / Collaborator ED - Savo, D. / Collaborator ED - Schipper, I. / Collaborator ED - Schlößer, B. / Collaborator ED - Schmidt, S. / Collaborator ED - Schneider, A. / Collaborator ED - Schoechl, H. / Collaborator ED - Schoonman, G. / Collaborator ED - Schou, R.F. / Collaborator ED - Schwendenwein, E. / Collaborator ED - Schöll, M. / Collaborator ED - Sir, O. / Collaborator ED - Skandsen, T. / Collaborator ED - Smakman, L. / Collaborator ED - Smeets, D. / Collaborator ED - Smielewski, P. / Collaborator ED - Stamatakis, E.L. / Collaborator ED - Stanworth, S. / Collaborator ED - Stegemann, K. / Collaborator ED - Steinbüchel, N. / Collaborator ED - Stevens, R. / Collaborator ED - Stewart, W. / Collaborator ED - Stocchetti, N. / Collaborator ED - Sundström, N. / Collaborator ED - Synnot, A. / Collaborator ED - Söderberg, J. / Collaborator ED - Taccone, F.S. / Collaborator ED - Tanskanen, P. / Collaborator ED - Tascu, A. / Collaborator ED - Taylor, M.S. / Collaborator ED - Te, Ao B. / Collaborator ED - Tenovuo, O. / Collaborator ED - Teodorani, G. / Collaborator ED - Theadom, A. / Collaborator ED - Thomas, M. / Collaborator ED - Tibboel, D. / Collaborator ED - Tolias, C. / Collaborator ED - Tshibanda, J.-F.L. / Collaborator ED - Tudora, C.M. / Collaborator ED - Vajkoczy, P. / Collaborator ED - Valeinis, E. / Collaborator ED - Van, Hecke W. / Collaborator ED - Van, Praag D. / Collaborator ED - Van, Roost D. / Collaborator ED - Van, Vlierberghe E. / Collaborator ED - Vande, Vyvere T. / Collaborator ED - Vanhaudenhuyse, A. / Collaborator ED - Vargiolu, A. / Collaborator ED - Vega, E. / Collaborator ED - Verheyden, J. / Collaborator ED - Vespa, P.M. / Collaborator ED - Vik, A. / Collaborator ED - Vilcinis, R. / Collaborator ED - Vizzino, G. / Collaborator ED - Vleggeert-Lankamp, C. / Collaborator ED - Volovici, V. / Collaborator ED - Vulekovic, P. / Collaborator ED - Wade, D. / Collaborator ED - Wang, K.K.W. / Collaborator ED - Wang, L. / Collaborator ED - Wildschut, E. / Collaborator ED - Williams, G. / Collaborator ED - Willumsen, L. / Collaborator ED - Wilson, A. / Collaborator ED - Wilson, L. / Collaborator ED - Winkler, M.K.L. / Collaborator ED - Ylén, P. / Collaborator ED - Younsi, A. / Collaborator ED - Zaaroor, M. / Collaborator ED - Zhang, Z. / Collaborator ED - Zheng, Z. / Collaborator ED - Zumbo, F. / Collaborator ED - De Lange, S. / Collaborator ED - De Ruiter, G.C.W. / Collaborator ED - Den Boogert, H. / Collaborator ED - Van, Dijck J. / Collaborator ED - Van, Essen T.A. / Collaborator ED - Van, Heugten C. / Collaborator ED - Van, Der Jagt M. / Collaborator ED - Van, Der Naalt J. / Collaborator ED - Amrein, Krisztina / Collaborator ED - Barzó, Pál / Collaborator ED - Büki, András / Collaborator ED - Czeiter, Endre / Collaborator ED - Ezer, Erzsébet / Collaborator ED - Kálovits, Ferenc / Collaborator ED - Kolumbán, Bálint / Collaborator ED - Kovács, Noémi / Collaborator ED - Melegh, Béla / Collaborator ED - Nyirádi, József / Collaborator ED - Sándor, János / Collaborator ED - Sorinola, Abayomi / Collaborator ED - Szabó, József / Collaborator ED - Tamás, Viktória / Collaborator ED - Vámos, Zoltán / Collaborator TI - Variation in structure and process of care in traumatic brain injury: Provider profiles of European Neurotrauma Centers participating in the CENTER-TBI study JF - PLOS ONE J2 - PLOS ONE VL - 11 PY - 2016 IS - 8 PG - 21 SN - 1932-6203 DO - 10.1371/journal.pone.0161367 UR - https://m2.mtmt.hu/api/publication/31999947 ID - 31999947 N1 - Funding Agency and Grant Number: European Commission 7th Framework program [602150]; National Institute for Health Research [NF-SI-0512-10090] Funding Source: researchfish Funding text: Data used in preparation of this manuscript were obtained in the context of CENTER-TBI, a large collaborative project with the support of the European Commission 7th Framework program (602150). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. LA - English DB - MTMT ER - TY - JOUR AU - Andrews, PJ AU - Sinclair, HL AU - Rodriguez, A AU - Harris, BA AU - Battison, CG AU - Rhodes, JK AU - Murray, GD ED - Noble, D / Collaborator ED - Galt, S / Collaborator ED - Taylor, J / Collaborator ED - Addison, J / Collaborator ED - Wallis, C / Collaborator ED - Paterson, R / Collaborator ED - Harris, G / Collaborator ED - Mullan, B / Collaborator ED - Quinn, V / Collaborator ED - Bannon, L / Collaborator ED - Gordon, A / Collaborator ED - Templeton, M / Collaborator ED - Wilson, R / Collaborator ED - Thomas, E / Collaborator ED - McMillan, H / Collaborator ED - Tantam, K / Collaborator ED - Gratrix, A / Collaborator ED - Smith, N / Collaborator ED - Martinson, V / Collaborator ED - Barrera-Groba, C / Collaborator ED - Littlejohn, I / Collaborator ED - Spurling, G / Collaborator ED - Hopkins, P / Collaborator ED - Casboult, S / Collaborator ED - Hadfield, D / Collaborator ED - McKinlay, J / Collaborator ED - Beardow, Z / Collaborator ED - Elliot, S / Collaborator ED - Jain, R / Collaborator ED - Bellini, A / Collaborator ED - McCluskey, T / Collaborator ED - Harvey, D / Collaborator ED - Chikhani, M / Collaborator ED - Bolland, A / Collaborator ED - Waldmann, C / Collaborator ED - Jacques, N / Collaborator ED - Prowse, H / Collaborator ED - Turnbull, D / Collaborator ED - Eapen, G / Collaborator ED - Birchall, K / Collaborator ED - Verma, V / Collaborator ED - Creary, T / Collaborator ED - Niebrzegowska, E / Collaborator ED - Owen, T / Collaborator ED - Baldwin, J / Collaborator ED - Williams, A / Collaborator ED - Thompson, C / Collaborator ED - Salt, R / Collaborator ED - Cartlidge, D / Collaborator ED - Vincent, A / Collaborator ED - Calder, V / Collaborator ED - Scott, C / Collaborator ED - Ferris, P / Collaborator ED - Roberts, J / Collaborator ED - Evans, T / Collaborator ED - Burgess, N / Collaborator ED - Della Torre, V / Collaborator ED - Mellinghoff, J / Collaborator ED - Stotz, M / Collaborator ED - Hauer, V / Collaborator ED - Ochelli-Okpue, A / Collaborator ED - McMahon, C / Collaborator ED - Tweedie, I / Collaborator ED - Murray, L / Collaborator ED - Bassford, C / Collaborator ED - Ward, G / Collaborator ED - McCauley, M / Collaborator ED - Wise, M / Collaborator ED - Palmer, N / Collaborator ED - Cole, J / Collaborator ED - Damas, F / Collaborator ED - Xavier, N / Collaborator ED - Dulière, GL / Collaborator ED - Simoens, G / Collaborator ED - Biston, P / Collaborator ED - Joosten, A / Collaborator ED - Simon, M / Collaborator ED - Antoine, A / Collaborator ED - Zieppen, B / Collaborator ED - Bulpa, P / Collaborator ED - Dive, A / Collaborator ED - Bouhon, S / Collaborator ED - Taccone, F / Collaborator ED - Vincent, JL / Collaborator ED - Durand, D / Collaborator ED - Spapen, H / Collaborator ED - Troubleyn, J / Collaborator ED - Van, Malderen C / Collaborator ED - Toome, V / Collaborator ED - Sillaots, P / Collaborator ED - Koger, I / Collaborator ED - Stuttmann, R / Collaborator ED - Jakubetz, J / Collaborator ED - Langer, S / Collaborator ED - Michalia, M / Collaborator ED - Clouva-Molyvdas, PM / Collaborator ED - Vassiliadis, I / Collaborator ED - Nanas, S / Collaborator ED - Douka, L / Collaborator ED - Dimopolous, S / Collaborator ED - Pneumatikos, I / Collaborator ED - Dragoumanis, C / Collaborator ED - Kouliatsis, G / Collaborator ED - Nakos, G / Collaborator ED - Kostanti, E / Collaborator ED - Zakynthinos, E / Collaborator ED - Makris, D / Collaborator ED - Palli, E / Collaborator ED - Koukoulitsios, G / Collaborator ED - Tsikritsaki, K / Collaborator ED - Kalogeromitros, A / Collaborator ED - Nagy, E / Collaborator ED - Lampiri, C / Collaborator ED - Valtoy, M / Collaborator ED - Barzó, Pál / Collaborator ED - Kis, D / Collaborator ED - Fulop, B / Collaborator ED - Gupta, D / Collaborator ED - Bindra, A / Collaborator ED - Breen, D / Collaborator ED - Barry, J / Collaborator ED - Neau, E / Collaborator ED - Spoto, M / Collaborator ED - Fusilli, N / Collaborator ED - Malossini, S / Collaborator ED - Antonelli, M / Collaborator ED - Caricato, A / Collaborator ED - Tersali, A / Collaborator ED - Seabra, F / Collaborator ED - Aragão, I / Collaborator ED - Antunes, R / Collaborator ED - Petrikov, S / Collaborator ED - Titova, J / Collaborator ED - Solodov, A / Collaborator ED - Al-Jabbary, A / Collaborator ED - Deeb, A / Collaborator ED - Richi, H / Collaborator ED - del, Campo MM / Collaborator ED - Casado, JM / Collaborator ED - Pérez, EB / Collaborator ED - Pérez, AZ / Collaborator ED - Diez, MA / Collaborator ED - Echeverri, SO / Collaborator ED - Blesa, A / Collaborator ED - Romero, F / Collaborator ED - Sanchez, M / Collaborator ED - van der Jagt, M / Collaborator ED - Haitsma, I / Collaborator ED - van Duijn, D / Collaborator ED - Dennesen, P / Collaborator ED - Koole, M / Collaborator ED - Krishnareddy, K / Collaborator ED - Hegazi, M / Collaborator ED - Sharma, BS / Collaborator TI - Hypothermia for Intracranial Hypertension after Traumatic Brain Injury JF - NEW ENGLAND JOURNAL OF MEDICINE J2 - NEW ENGL J MED VL - 373 PY - 2015 IS - 25 SP - 2403 EP - 2412 PG - 10 SN - 0028-4793 DO - 10.1056/NEJMoa1507581 UR - https://m2.mtmt.hu/api/publication/2995757 ID - 2995757 N1 - Eurotherm3235 Trial Collaborators AB - BACKGROUND: In patients with traumatic brain injury, hypothermia can reduce intracranial hypertension. The benefit of hypothermia on functional outcome is unclear. METHODS: We randomly assigned adults with an intracranial pressure of more than 20 mm Hg despite stage 1 treatments (including mechanical ventilation and sedation management) to standard care (control group) or hypothermia (32 to 35 degrees C) plus standard care. In the control group, stage 2 treatments (e.g., osmotherapy) were added as needed to control intracranial pressure. In the hypothermia group, stage 2 treatments were added only if hypothermia failed to control intracranial pressure. In both groups, stage 3 treatments (barbiturates and decompressive craniectomy) were used if all stage 2 treatments failed to control intracranial pressure. The primary outcome was the score on the Extended Glasgow Outcome Scale (GOS-E; range, 1 to 8, with lower scores indicating a worse functional outcome) at 6 months. The treatment effect was estimated with ordinal logistic regression adjusted for prespecified prognostic factors and expressed as a common odds ratio (with an odds ratio <1.0 favoring hypothermia). RESULTS: We enrolled 387 patients at 47 centers in 18 countries from November 2009 through October 2014, at which time recruitment was suspended owing to safety concerns. Stage 3 treatments were required to control intracranial pressure in 54% of the patients in the control group and in 44% of the patients in the hypothermia group. The adjusted common odds ratio for the GOS-E score was 1.53 (95% confidence interval, 1.02 to 2.30; P=0.04), indicating a worse outcome in the hypothermia group than in the control group. A favorable outcome (GOS-E score of 5 to 8, indicating moderate disability or good recovery) occurred in 26% of the patients in the hypothermia group and in 37% of the patients in the control group (P=0.03). CONCLUSIONS: In patients with an intracranial pressure of more than 20 mm Hg after traumatic brain injury, therapeutic hypothermia plus standard care to reduce intracranial pressure did not result in outcomes better than those with standard care alone. (Funded by the National Institute for Health Research Health Technology Assessment program; Current Controlled Trials number, ISRCTN34555414.). LA - English DB - MTMT ER - TY - JOUR AU - Maas, AI AU - Menon, DK AU - Steyerberg, EW AU - Citerio, G AU - Lecky, F AU - Manley, GT AU - Hill, S AU - Legrand, V AU - Sorgner, A ED - Barzó, Pál / Collaborator ED - Büki, András / Collaborator ED - Czeiter, Endre / Collaborator ED - Demeter, B / Collaborator ED - Kalovits, F / Collaborator ED - Sándor, János / Collaborator ED - Szabo, J / Collaborator TI - Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI): a prospective longitudinal observational study JF - NEUROSURGERY J2 - NEUROSURGERY VL - 76 PY - 2015 IS - 1 SP - 67 EP - 80 PG - 14 SN - 0148-396X DO - 10.1227/NEU.0000000000000575 UR - https://m2.mtmt.hu/api/publication/2906963 ID - 2906963 N1 - Funding Agency and Grant Number: Hannelore Kohl Foundation (Germany); Division Of Integrative Organismal Systems; Direct For Biological Sciences [1120912] Funding Source: National Science Foundation; Academy of Medical Sciences (AMS) [AMS-CSF4-Newcombe] Funding Source: researchfish; Medical Research Council [G9439390, G0601025, G0600986] Funding Source: researchfish; National Institute for Health Research [NF-SI-0512-10090, ACF-2009-14-007, 12/35/57, NIHR-RP-R3-12-013] Funding Source: researchfish; MRC [G0601025, G9439390, G0600986] Funding Source: UKRI Funding text: Funding of additional elements for this study has been provided by the Hannelore Kohl Foundation (Germany) and by the non-profit organization One Mind for Research (directly to International Neuroinformatics Coordinating Facility). The study registration is Clinicaltrials.gov: NCT02210221. AB - BACKGROUND: Current classification of traumatic brain injury (TBI) is suboptimal, and management is based on weak evidence, with little attempt to personalize treatment. A need exists for new precision medicine and stratified management approaches that incorporate emerging technologies. OBJECTIVE: To improve characterization and classification of TBI and to identify best clinical care, using comparative effectiveness research approaches. METHODS: This multicenter, longitudinal, prospective, observational study in 22 countries across Europe and Israel will collect detailed data from 5400 consenting patients, presenting within 24 hours of injury, with a clinical diagnosis of TBI and an indication for computed tomography. Broader registry-level data collection in approximately 20,000 patients will assess generalizability. Cross sectional comprehensive outcome assessments, including quality of life and neuropsychological testing, will be performed at 6 months. Longitudinal assessments will continue up to 24 months post TBI in patient subsets. Advanced neuroimaging and genomic and biomarker data will be used to improve characterization, and analyses will include neuroinformatics approaches to address variations in process and clinical care. Results will be integrated with living systematic reviews in a process of knowledge transfer. The study initiation was from October to December 2014, and the recruitment period was for 18 to 24 months. EXPECTED OUTCOMES: Collaborative European NeuroTrauma Effectiveness Research in TBI should provide novel multidimensional approaches to TBI characterization and classification, evidence to support treatment recommendations, and benchmarks for quality of care. Data and sample repositories will ensure opportunities for legacy research. DISCUSSION: Comparative effectiveness research provides an alternative to reductionistic clinical trials in restricted patient populations by exploiting differences in biology, care, and outcome to support optimal personalized patient management. LA - English DB - MTMT ER - TY - JOUR AU - Mondello, S AU - Schmid, K AU - Berger, RP AU - Kobeissy, F AU - Italiano, D AU - Jeromin, A AU - Hayes, RL AU - Tortella, FC AU - Büki, András TI - The Challenge of Mild Traumatic Brain Injury: Role of Biochemical Markers in Diagnosis of Brain Damage. JF - MEDICINAL RESEARCH REVIEWS J2 - MED RES REV VL - 34 PY - 2014 IS - 3 SP - 503 EP - 531 PG - 29 SN - 0198-6325 DO - 10.1002/med.21295 UR - https://m2.mtmt.hu/api/publication/2349651 ID - 2349651 N1 - Export Date: 11 January 2024 CODEN: MRRED AB - During the past decade there has been an increasing recognition of the incidence of mild traumatic brain injury (mTBI) and a better understanding of the subtle neurological and cognitive deficits that may result from it. A substantial, albeit suboptimal, effort has been made to define diagnostic criteria for mTBI and improve diagnostic accuracy. Thus, biomarkers that can accurately and objectively detect brain injury after mTBI and, ideally, aid in clinical management are needed. In this review, we discuss the current research on serum biomarkers for mTBI including their rationale and diagnostic performances. Sensitive and specific biomarkers reflecting brain injury can provide important information regarding TBI pathophysiology and serve as candidate markers for predicting abnormal computed tomography findings and/or the development of residual deficits in patients who sustain an mTBI. We also outline the roles of biomarkers in settings of specific interest including pediatric TBI, sports concussions and military injuries, and provide perspectives on the validation of such markers for use in the clinic. Finally, emerging proteomics-based strategies for identifying novel markers will be discussed. LA - English DB - MTMT ER - TY - JOUR AU - Zhang, Z AU - Zoltewicz, JS AU - Mondello, S AU - Newsom, KJ AU - Yang, Z AU - Yang, B AU - Kobeissy, F AU - Guingab, J AU - Glushakova, O AU - Robicsek, S AU - Heaton, S AU - Büki, András AU - Hannay, J AU - Gold, MS AU - Rubenstein, R AU - Lu, XC AU - Dave, JR AU - Schmid, K AU - Tortella, F AU - Robertson, CS AU - Wang, KK TI - Human Traumatic Brain Injury Induces Autoantibody Response against Glial Fibrillary Acidic Protein and Its Breakdown Products. JF - PLOS ONE J2 - PLOS ONE VL - 9 PY - 2014 IS - 3 PG - 16 SN - 1932-6203 DO - 10.1371/journal.pone.0092698 UR - https://m2.mtmt.hu/api/publication/2564842 ID - 2564842 N1 - Funding Agency and Grant Number: NIH [R01 NS049175-01, R01-NS052831-01, R01 NS051431-01]; Department of Defense [DAMD17-03-1-0772, DAMD17-03-1-0066] Funding text: This study was supported in part by the NIH (R01 NS049175-01, R01-NS052831-01 and R01 NS051431-01), and in part by the Department of Defense (DAMD17-03-1-0772 and DAMD17-03-1-0066). The funders provide financial support and infrastructure support to this work. AB - The role of systemic autoimmunity in human traumatic brain injury (TBI) and other forms of brain injuries is recognized but not well understood. In this study, a systematic investigation was performed to identify serum autoantibody responses to brain-specific proteins after TBI in humans. TBI autoantibodies showed predominant immunoreactivity against a cluster of bands from 38-50 kDa on human brain immunoblots, which were identified as GFAP and GFAP breakdown products. GFAP autoantibody levels increased by 7 days after injury, and were of the IgG subtype predominantly. Results from in vitro tests and rat TBI experiments also indicated that calpain was responsible for removing the amino and carboxyl termini of GFAP to yield a 38 kDa fragment. Additionally, TBI autoantibody staining co-localized with GFAP in injured rat brain and in primary rat astrocytes. These results suggest that GFAP breakdown products persist within degenerating astrocytes in the brain. Anti-GFAP autoantibody also can enter living astroglia cells in culture and its presence appears to compromise glial cell health. TBI patients showed an average 3.77 fold increase in anti-GFAP autoantibody levels from early (0-1 days) to late (7-10 days) times post injury. Changes in autoantibody levels were negatively correlated with outcome as measured by GOS-E score at 6 months, suggesting that TBI patients with greater anti-GFAP immune-responses had worse outcomes. Due to the long lasting nature of IgG, a test to detect anti-GFAP autoantibodies is likely to prolong the temporal window for assessment of brain damage in human patients. LA - English DB - MTMT ER - TY - JOUR AU - Tosetti, P AU - Hicks, RR AU - Theriault, E AU - Phillips, A AU - Koroshetz, W AU - Draghia-Akli, R ED - Büki, András / Collaborator TI - Toward an international initiative for traumatic brain injury research. JF - JOURNAL OF NEUROTRAUMA J2 - J NEUROTRAUM VL - 30 PY - 2013 IS - 14 SP - 1211 EP - 1222 PG - 12 SN - 0897-7151 DO - 10.1089/neu.2013.2896 UR - https://m2.mtmt.hu/api/publication/2424624 ID - 2424624 N1 - Funding Agency and Grant Number: National Institute for Health Research [NF-SI-0512-10090] Funding Source: researchfish AB - The European Commission (EC) and the National Institutes of Health (NIH) jointly sponsored a workshop on October 18-20, 2011 in Brussels to discuss the feasibility and benefits of an international collaboration in the field of traumatic brain injury (TBI) research. The workshop brought together scientists, clinicians, patients, and industry representatives from around the globe as well as funding agencies from the EU, Spain, the United States, and Canada. Sessions tackled both the possible goals and governance of a future initiative and the scientific questions that would most benefit from an integrated international effort: how to optimize data collection and sharing; injury classification; outcome measures; clinical study design; and statistical analysis. There was a clear consensus that increased dialogue and coordination of research at an international level would be beneficial for advancing TBI research, treatment, and care. To this end, the EC, the NIH, and the Canadian Institutes of Health Research expressed interest in developing a framework for an international initiative for TBI Research (InTBIR). The workshop participants recommended that InTBIR initially focus on collecting, standardizing, and sharing clinical TBI data for comparative effectiveness research, which will ultimately result in better management and treatments for TBI. LA - English DB - MTMT ER - TY - JOUR AU - Olesen, J AU - Gustavsson, A AU - Svensson, M AU - Wittchen, HU AU - Jonsson, B ED - Jordanova, A / Collaborator ED - Musayev, A / Collaborator ED - Gustavsson, A / Collaborator ED - Gabilondo, A / Collaborator ED - Maercker, A / Collaborator ED - Melin, B / Collaborator ED - Jönsson, B / Collaborator ED - Walder, B / Collaborator ED - Gannon, B / Collaborator ED - Schlehofer, B / Collaborator ED - Faravelli, C / Collaborator ED - Allgulander, C / Collaborator ED - Ljungcrantz, C / Collaborator ED - Jacobi, C / Collaborator ED - Muresanu, DF / Collaborator ED - Hilton, Jones D / Collaborator ED - Ehler, E / Collaborator ED - Beghi, E / Collaborator ED - Norwood, F / Collaborator ED - Aguilera, F / Collaborator ED - Jacobi, F / Collaborator ED - Jacobi, F / Collaborator ED - Kobelt, G / Collaborator ED - Meinlschmidt, G / Collaborator ED - Steinhausen, HC / Collaborator ED - Wittchen, HU / Collaborator ED - Verschuuren, J / Collaborator ED - Vallat, JM / Collaborator ED - Glaus, J / Collaborator ED - Reese, JP / Collaborator ED - Olesen, J / Collaborator ED - van Os, J / Collaborator ED - Bentzen, J / Collaborator ED - Alonso, J / Collaborator ED - Garcia-Ibanez, J / Collaborator ED - Dams, J / Collaborator ED - Rehm, J / Collaborator ED - Lauer, K / Collaborator ED - von Wild, K / Collaborator ED - Karampampa, K / Collaborator ED - Stovner, LJ / Collaborator ED - Vécsei, László / Collaborator ED - Fratiglioni, L / Collaborator ED - van den Berg, LH / Collaborator ED - Jönsson, L / Collaborator ED - Salvador-Carulla, L / Collaborator ED - Perrin, M / Collaborator ED - Milenkova, M / Collaborator ED - Knapp, M / Collaborator ED - Preisig, M / Collaborator ED - Moscarelli, M / Collaborator ED - Ekman, M / Collaborator ED - Linde, M / Collaborator ED - Pugliatti, M / Collaborator ED - Svensson, M / Collaborator ED - Rogers, MM / Collaborator ED - Tenovuo, O / Collaborator ED - Van, den Bergh P / Collaborator ED - Azouvi, P / Collaborator ED - Vos, P / Collaborator ED - Jennum, P / Collaborator ED - Martinez-Leal, R / Collaborator ED - Dodel, R / Collaborator ED - Simon, R / Collaborator ED - Lieb, R / Collaborator ED - Drabsch, S / Collaborator ED - Otero, S / Collaborator ED - Kurth, T / Collaborator ED - Xu, W / Collaborator ED - Winter, Y / Collaborator TI - The economic cost of brain disorders in Europe JF - EUROPEAN JOURNAL OF NEUROLOGY J2 - EUR J NEUROL VL - 19 PY - 2012 IS - 1 SP - 155 EP - 162 PG - 8 SN - 1351-5101 DO - 10.1111/j.1468-1331.2011.03590.x UR - https://m2.mtmt.hu/api/publication/2802038 ID - 2802038 AB - Background and purpose: In 2005, we presented for the first time overall estimates of annual costs for brain disorders (mental and neurologic disorders) in Europe. This new report presents updated, more accurate, and comprehensive 2010 estimates for 30 European countries. Methods: One-year prevalence and annual cost per person of 19 major groups of disorders are based on 'best estimates' derived from systematic literature reviews by panels of experts in epidemiology and health economics. Our cost estimation model was populated with national statistics from Eurostat to adjust to 2010 values, converting all local currencies to Euros (sic), imputing cost for countries where no data were available, and aggregating country estimates to purchasing power parityadjusted estimates of the total cost of brain disorders in Europe in 2010. Results: Total European 2010 cost of brain disorders was sic 798 billion, of which direct health care cost 37%, direct non-medical cost 23%, and indirect cost 40%. Average cost per inhabitant was sic 5.550. The European average cost per person with a disorder of the brain ranged between sic 285 for headache and sic 30 000 for neuromuscular disorders. Total annual cost per disorder (in billion sic 2010) was as follows: addiction 65.7; anxiety disorders 74.4; brain tumor 5.2; child/adolescent disorders 21.3; dementia 105.2; eating disorders 0.8; epilepsy 13.8; headache 43.5; mental retardation 43.3; mood disorders 113.4; multiple sclerosis 14.6; neuromuscular disorders 7.7; Parkinson's disease 13.9; personality disorders 27.3; psychotic disorders 93.9; sleep disorders 35.4; somatoform disorder 21.2; stroke 64.1; and traumatic brain injury 33.0. Conclusion: Our cost model revealed that brain disorders overall are much more costly than previously estimated constituting a major health economic challenge for Europe. Our estimate should be regarded as conservative because many disorders or cost items could not be included because of lack of data. LA - English DB - MTMT ER -