Albeit the sudden onset of stroke, post-stroke inflammatory, regenerative and repair processes are active over weeks and months. To date, little is known about long-term effects of these processes on neurodegeneration and cognitive decline. In my group, we seek to gain more insights into mechanisms and potential preventive strategies using clinical and pre-clinical studies. We have a special focus on:

• Preventive vascular mechanisms (endothelial function, physical activity, pharmacology)
• Mechanisms of cell death (cell cycle activation, DNA damage and repair, apoptosis)
• Regeneration and functional outcome (cellular plasticity, neurogenesis)
• Clinical studies on post-stroke dementia, stroke prophylaxis, telemedicine

At the DZNE study side Berlin I am coordinating the DZNE - Mechanisms of Dementia After Stroke (DEMDAS) Study and the Association of High Troponin levels and Cognitive Impairment: Results from the Berlin Aging Study II (BASE-II). More information on these studies and the substudies coordinated in Berlin can be found below.

For more information on the Endres group please visit our Homepage.

At the DZNE study side Berlin I coordinate the following projects:

Project 1:

The DZNE - Mechanisms of Dementia After Stroke (DEMDAS) Study

This study is coordinated by Prof. Dichgans and Berlin is one of the active recruiting sites of this intersite cohort study. I contribute as Co-PI and together with colleagues from Berlin we will coordinate several substudies. The scientific questions of these substudies include: Role of lipoprotein-associated phospholipase A2 and lipoprotein (A) and the risk of dementia and cognitive decline following stroke; role of pathogeneic autoantibodies in dementia after stroke; role of high-sensitivity cardiac troponin for prediction of stroke-stroke dementia and cognitive decline (see Project 2).

Project 2:

Association of High Troponin levels and Cognitive Impairment: Results from the Berlin Aging Study II (BASE-II).

Here, we test the hypothesis whether higher levels of cardiac troponin T levels are independently associated with cognitive impairment and are a risk factor for future dementia (Nolte and Endres, 2014). The Berlin Aging Study II (BASE-II) is a community-dwelling study of the greater metropolitan area of Berlin comprising 2,200 well-characterized residents with 500 individuals aged younger than 40 years and the others older than 60 years. We hypothesize that subclinical troponin levels are associated with cognitive impairment and cognitive decline over time.

Project 3: The Prediction of Acute Coronary Syndrome in acute ischemic stroke (PRAISE) study - a multicenter, prospective observational study.

The overall objective of the study is to establish a clinical algorithm that enables the prediction of acute coronary syndrome in stroke patients. Patients with acute ischemic stroke and troponin elevation or dynamic troponin progression are enrolled. In addition to our work in the BASE-II study, a goal of the PRAISE study is to better understand the relationship between elevated troponin levels and neurocognitive impairment in stroke patients. Study centers are spread across Germany and include neurological as well as cardiological centers. This study is the first to be conducted in a cooperation between the German Center for Cardiovascular Research (DZHK) and the German Center for Neurodegenerative Diseases (DZNE. The study is coordinated at the Center for Stroke Research of the Charité - Universitätsmedizin Berlin.

Project 4: DZNE Innovation to Application – Development of novel compounds for prevention of chemotherapy induced neurotoxicity

Neurological side effects are amongst the most common complications of chemotherapy. Besides toxic effects on the peripheral nervous system, leading to numbness starting in fingers and toes, 17-33 % of all patients receiving chemotherapy report memory problems. Neurological side effects often command changes in the treatment plan and lead to a sustained reduction in quality of life. To date, all available treatments only address symptom relief but no treatment affords an effective prevention of these serious side effect. Building on previous work – particularly the ongoing study on chemotherapy induced cognitive decline in patients with breast cancer and ovarian cancer (CICARO-Study, NCT02753036) – we develop novel therapeutic strategies for prevention and treatment of chemotherapy induced neurotoxicity in cooperation with the DZNE.