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Research focus:  

Neurologische Klinik und Poliklinik
Josef-Schneider-Str. 11, 97080 Würzburg
Mail: Toyka_K@klinik.uni-wuerzburg.de
Url: http://www.neurologie.uni-wuerzburg.de/

Scientific members:

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   Other participating persons and organisations:

Research foci (and basic equipment-based research projects):
The study group is dealing with the analysis of disease progression and the diagnosis of accompanying autonomic dysfunctions in ALS. It evaluates innovative causal treatment strategies and symptomatic treatment of autonomic dysfunction. Besides statistical epidemiological analyses of documented disease cases different methods of muscle strength measurements are compared and different methods for the evaluation of autonomic dysfunctions are used. The main focus is on the evaluation of salivary gland function using scintigraphy and on the diagnosis of progressive sudomotor dysfunctions in ALS by an objective tool for quantification of the dermal water loss.

The effect and tolerability of a continuous intrathecal application of brain derived neurotrophic factor in ALS is evaluated. Moreover, the intraglandulary injections of botulinum toxin into the salivary glands are tested as an innovative symptomatic therapeutic tool for the treatment of the disease related pseudohypersalivation.

Results:
A retrospective analysis of ALS cases showed a significant longer survival in younger patients and in patients with a limb onset in contrast to patients with bulbar onset. The dynamics of worsening of commonly used progression parameters was predictive for the degree of disease progression.
The comparison of a simple manual measurement method to a computer based tool showed no statistically significant differences and favours the simple dynamometric method for bed-side testing in clinical practice. The hand-held dynamometry can be used as an objective tool for the evaluation of the muscle strength with disease progression, e.g. also in clinical studies.
A dysfunction of the salivary glands and a progressive sudomotoric dysfunction was shown using scintigraphy and by quantification of sweat secretion in ALS. The results support the hypothesis of a multisystemic neurodegenerative disorder.
The tolerability of continuous intrathecal BDNF administration was shown by an international 2 center study. The results of the study were the basis for the following international multicenter phase III effectivity study in ALS.
Botulinum toxin injection into the salivary glands is able to reduce sialorrhea in ALS as shown in an open label study. Quality of life could be ameliorated. A retrospective study on Clenbuterol in the literature failed to show persuading effects for a clinical use as symptomatic therapy for amelioration of muscle strength in ALS.

Rewards and prizes:
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Equipment:
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