Scholars@Duke
Christopher Paul Eckstein

Christopher Paul Eckstein

Associate Professor of Neurology
Neurology, MS & Neuroimmunology

Selected Publications

Beyond biopsy for neurosarcoidosis: A review of blood and CSF biomarkers.

Journal Article J Neuroimmunol · August 15, 2024 Neurosarcoidosis, a rare granulomatous disease, causes inflammation and damage to the central nervous system (CNS). A major diagnostic challenge in neurosarcoidosis is the absence of well-defined biomarkers. The need for biopsy to make the diagnosis can le ... Full text Link to item Cite

Adalimumab as treatment for neurosarcoidosis: A case series.

Journal Article J Neurol Sci · May 15, 2024 Sarcoidosis is a disease characterized by non-caseating granulomas that can involve the central nervous system as neurosarcoidosis. This challenging disease is currently managed with high dose steroids, and sometimes the addition of infliximab. Other TNA-a ... Full text Link to item Cite

Catatonia in anti-NMDA receptor encephalitis: a case series and approach to improve outcomes with electroconvulsive therapy.

Journal Article BMJ Neurol Open · 2024 BACKGROUND: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis has been recognised to present with the syndrome of catatonia. In severe cases dysautonomia is representative of malignant catatonia. The treatment with benzodiazepines (BZDs) and electroco ... Full text Link to item Cite

Neurosarcoidosis causing hydrocephalus: A case series.

Journal Article J Neuroimmunol · August 15, 2023 Sarcoidosis is a granulomatous inflammatory disease that rarely affects the central nervous system as neurosarcoidosis. Neurosarcoidosis can affect any part of the nervous system causing a wide variety of clinical presentations ranging from seizures to opt ... Full text Link to item Cite

Neuromyelitis optica: Clinical course and potential prognostic indicators.

Journal Article Mult Scler Relat Disord · January 2023 BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune neurological disorder associated with antibodies to aquaporin-4 (AQP4). NMOSD has been thought to follow a progressive disease course, with step-wise accumulation of disability ... Full text Open Access Link to item Cite

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease: Presentation and outcomes of adults at a single center.

Journal Article J Neuroimmunol · December 15, 2022 BACKGROUND/INTRODUCTION: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a chronic demyelinating disorder that has been increasingly recognized since the serum antibody became commercially available in 2017. The most common clini ... Full text Open Access Link to item Cite

Profiling serum neurofilament light chain and glial fibrillary acidic protein in primary progressive multiple sclerosis.

Journal Article J Neuroimmunol · May 15, 2021 This study examined the utility of serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) as biomarkers in primary progressive multiple sclerosis in context with clinical severity, progression, and treatment. Using a single-mole ... Full text Link to item Cite

Genetic or Autoimmune: POLG-Related Epilepsy Initially Treated as an Autoimmune Encephalitis, a Case Report.

Journal Article Neurohospitalist · January 2021 Hospital neurologists participate at the forefront of managing fulminant acute and subacute onset epilepsy, frequently attributed to autoimmune encephalitis (AE). As the recognition of antibody-mediated AE grows, there is a growing number of patients who a ... Full text Link to item Cite

The clinical presentation and treatment of MOG antibody disease at a single academic center: A case series.

Journal Article J Neuroimmunol · December 15, 2019 OBJECTIVES: To describe the clinical presentation of MOG antibody disease (MOG-AD) in a series of patients at a single academic center. METHODS: We performed a retrospective review of patients with MOG antibodies. RESULTS: We review the clinical presentati ... Full text Link to item Cite

B cell depletion and pregnancy: Review and applications for MS treatment.

Journal Article Mult Scler Relat Disord · August 2019 Multiple sclerosis (MS) is a chronic autoimmune condition primarily affecting young adults. As there are numerous uncertainties faced by young women of childbearing age who are living with this chronic condition and the gender ratio is increasingly skewed ... Full text Link to item Cite

Immunotherapy in selected patients with Down syndrome disintegrative disorder.

Journal Article Dev Med Child Neurol · July 2019 Down syndrome disintegrative disorder (DSDD) is an increasingly identified condition characterized by cognitive decline, autistic characteristics, insomnia, catatonia, and psychosis in adolescents and young adults with Down syndrome. Previously we reported ... Full text Link to item Cite

Recurrent schilder's disease.

Journal Article Mult Scler Relat Disord · November 2018 Schilder's disease is a rare and aggressive central nervous system demyelinating disorder that is typically monophasic and steroid responsive. Here, we present an unusual case of a teenager with Schilder's disease who was treated with corticosteroids and h ... Full text Link to item Cite

Neurosarcoidosis following Immune Checkpoint Inhibition.

Journal Article Case Rep Oncol · 2018 Recently, immune checkpoint inhibitors have revolutionized cancer care by enhancing anti-tumor immunity. However, by virtue of stimulating the immune system, they can lead to immune-related adverse events (irAEs). Neurologic irAEs are uncommon but are beco ... Full text Open Access Link to item Cite

Safety and immunologic effects of high- vs low-dose cholecalciferol in multiple sclerosis.

Journal Article Neurology · January 26, 2016 OBJECTIVE: To study the safety profile and characterize the immunologic effects of high- vs low-dose cholecalciferol supplementation in patients with multiple sclerosis (MS). METHODS: In this double-blind, single-center randomized pilot study, 40 patients ... Full text Link to item Cite

Currently approved and emerging oral therapies in multiple sclerosis: An update for the ophthalmologist.

Journal Article Surv Ophthalmol · 2016 Although our understanding of multiple sclerosis (MS) has grown substantially, its cause remains unknown. Nonetheless, in the past 3 decades, there have been tremendous advancements in the development of disease-modifying drugs (DMDs). In July 1993, the Un ... Full text Link to item Cite

Relationships between retinal axonal and neuronal measures and global central nervous system pathology in multiple sclerosis.

Journal Article JAMA Neurol · January 2013 OBJECTIVE: To determine the relationships between conventional and segmentation-derived optical coherence tomography (OCT) retinal layer thickness measures with intracranial volume (a surrogate of head size) and brain substructure volumes in multiple scler ... Full text Link to item Cite

Active MS is associated with accelerated retinal ganglion cell/inner plexiform layer thinning.

Journal Article Neurology · January 1, 2013 OBJECTIVE: To determine the effect of clinical and radiologic disease activity on the rate of thinning of the ganglion cell/inner plexiform (GCIP) layer and the retinal nerve fiber layer in patients with multiple sclerosis (MS) using optical coherence tomo ... Full text Link to item Cite

In vivo assessment of retinal neuronal layers in multiple sclerosis with manual and automated optical coherence tomography segmentation techniques.

Journal Article J Neurol · October 2012 Macular optical coherence tomography (OCT) segmentation, enabling quantification of retinal axonal and neuronal subpopulations, may help elucidate the neuroretinal pathobiology of multiple sclerosis (MS). This study aimed to determine the agreement, reprod ... Full text Link to item Cite

Detection of clinical and subclinical retinal abnormalities in neurosarcoidosis with optical coherence tomography.

Journal Article J Neurol · July 2012 The aim of this work was to determine if neurosarcoidosis (NS) patients exhibit quantitative and/or qualitative in vivo evidence of retinal abnormalities on optical coherence tomography (OCT). Retinal imaging was performed using spectral-domain Cirrus HD-O ... Full text Link to item Cite

A differential diagnosis of central nervous system demyelination: beyond multiple sclerosis.

Journal Article J Neurol · May 2012 Although multiple sclerosis (MS) is the most common demyelinating disorder of the central nervous system (CNS), it lacks any definitive diagnostic test. Instead, diagnosis of MS primarily depends upon clinical criteria, supported by abnormalities character ... Full text Link to item Cite

Etiology of sarcoidosis: does infection play a role?

Journal Article Yale J Biol Med · March 2012 Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology, which is known to affect multiple organ systems including the lungs, heart, skin, central nervous system, and eyes, among others. For this reason, sarcoidosis represents a systemic m ... Link to item Cite

New and emerging disease modifying therapies for multiple sclerosis.

Journal Article Ann N Y Acad Sci · January 2012 Several disease-modifying drugs (DMDs) are currently approved for the treatment of multiple sclerosis (MS). Recently, there has been increased identification and development of potential new treatments that may modulate the MS disease process, including or ... Full text Link to item Cite

Differential diagnosis of longitudinally extensive transverse myelitis in adults

Journal Article European Neurological Journal · November 11, 2011 Longitudinally extensive transverse myelitis (LETM), characterized by spinal cord inflammation extending three or more vertebral segments in length, may be caused by a multitude of disorders. LETM is most commonly associated with neuromyelitis optica (NMO) ... Cite

Novel mechanisms of immune modulation of natalizumab in multiple sclerosis patients.

Journal Article J Neuroimmunol · June 2011 The goal of this study was to investigate the effects of natalizumab therapy on the immune cell composition and phenotype in the blood of relapsing MS patients treated over the course of 12 months. We collected peripheral blood from 26 RRMS patients before ... Full text Link to item Cite

Primary retinal pathology in multiple sclerosis as detected by optical coherence tomography.

Journal Article Brain · February 2011 Optical coherence tomography studies in multiple sclerosis have primarily focused on evaluation of the retinal nerve fibre layer. The aetiology of retinal changes in multiple sclerosis is thought to be secondary to optic nerve demyelination. The objective ... Full text Link to item Cite

Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness

Journal Article Multiple Sclerosis Journal · January 1, 2011 Background: Post-mortem analyses of multiple sclerosis (MS) eyes demonstrate prominent retinal neuronal ganglion cell layer (GCL) loss, in addition to related axonal retinal nerve fiber layer (RNFL) loss. Despite this, clinical correlations of retinal neur ... Full text Cite

Neurocysticercosis.

Journal Article Headache · May 2007 Full text Link to item Cite

Sodium 4-phenylbutyrate protects against liver ischemia reperfusion injury by inhibition of endoplasmic reticulum-stress mediated apoptosis.

Journal Article Surgery · August 2005 BACKGROUND: Evidence is emerging that the endoplasmic reticulum (ER) participates in initiation of apoptosis induced by the unfolded protein response and by aberrant Ca(++) signaling during cellular stress such as ischemia/reperfusion injury (I/R injury). ... Full text Link to item Cite

Cytoprotection of PEG-modified adult porcine pancreatic islets for improved xenotransplantation.

Journal Article Biomaterials · February 2005 Functional poly(ethylene glycol) (PEG) derivatives, including monosuccinimidyl PEG (MSPEG) with molecular weight (MW) of 2000 (2 kDa) as well as 5 kDa and disuccinimidyl PEG (DSPEG) with MW of 3 and 6 kDa, were synthesized and characterized. They were used ... Full text Link to item Cite

17beta-estradiol differentially activates mitogen-activated protein-kinases and improves survival following reperfusion injury of reduced-size liver in mice.

Journal Article Transplant Proc · 2005 Ischemia-reperfusion injury (I/R-I), which is unavoidable in liver transplantation, impairs liver regeneration and predisposes to liver failure. The three major mitogen-activated protein-kinases (MAPKs): ERK, p38, and JNK, are critical in the transmission ... Full text Link to item Cite

Activated protein C preserves functional islet mass after intraportal transplantation: a novel link between endothelial cell activation, thrombosis, inflammation, and islet cell death.

Journal Article Diabetes · November 2004 Clinical studies indicate that significant loss of functional islet mass occurs in the peritransplant period. Islets are injured as a result of detrimental effects of brain death, pancreas preservation, islet isolation, hypoxia, hyperglycemia, and immune-m ... Full text Link to item Cite

A novel approach to xenotransplantation combining surface engineering and genetic modification of isolated adult porcine islets.

Journal Article Surgery · September 2004 BACKGROUND: Effective cytoprotection to xenoislets would circumvent the major tissue limitation for pancreatic islet transplantation (PIT). Cell-surface engineering with poly[ethylene glycol] (PEG) derivatives can successfully prevent antibody binding to t ... Full text Link to item Cite

Caspase-8 and caspase-3 small interfering RNA decreases ischemia/reperfusion injury to the liver in mice.

Journal Article Surgery · August 2004 BACKGROUND: Ischemia/reperfusion injury (I/R injury) of the liver remains a significant problem during liver surgery and transplantation. I/R injury is associated with liver apoptosis, which is mediated by death receptors such as Fas and tumor necrosis fac ... Full text Link to item Cite

Enhanced isolated pancreatic islet recovery and functionality in rats by 17beta-estradiol treatment of brain death donors.

Journal Article Surgery · August 2004 BACKGROUND: Current isolation techniques recover only 20% to 50% of the pancreatic islets. Brain death (BD) is characterized by activation of proinflammatory cytokines (PICs) with reduced islet yields and functionality. We previously reported that 17beta-e ... Full text Link to item Cite

Brain death significantly reduces isolated pancreatic islet yields and functionality in vitro and in vivo after transplantation in rats.

Journal Article Diabetes · December 2003 Although approximately 1 million islets exist in the adult human pancreas, current pancreas preservation and islet isolation techniques recover <50%. Presently, cadaveric donors remain the sole source of pancreatic tissue for transplantation. Brain death i ... Full text Link to item Cite

Peripheral mobilization of recipient bone marrow-derived endothelial progenitor cells enhances pancreatic islet revascularization and engraftment after intraportal transplantation.

Journal Article Surgery · August 2003 BACKGROUND: Pancreatic islet transplantation has been validated as a treatment for type 1 diabetes. However, a high number of islets is required to establish euglycemia. Transplantation of islets leads to loss of islet vasculature, which requires revascula ... Full text Link to item Cite

Suppression of the c-Jun N-terminal kinase pathway by 17beta-estradiol can preserve human islet functional mass from proinflammatory cytokine-induced destruction.

Journal Article Surgery · August 2003 BACKGROUND: The c-Jun N-terminal kinase (JNK) activation occurs after islet isolation, oxidative stress, and proinflammatory cytokine (PIC) exposure to beta-cells. Previous studies demonstrated that 17beta-estradiol modulates the activity of JNK; therefore ... Full text Link to item Cite

Double genetic modification of adenovirus fiber with RGD polylysine motifs significantly enhances gene transfer to isolated human pancreatic islets.

Journal Article Transplantation · July 15, 2003 BACKGROUND: New strategies for improving durable functional islet mass will be instrumental in facilitating islet transplantation as a cure for type 1 diabetes mellitus. The ability to transfer immunoregulatory or cytoprotective genes into pancreatic islet ... Full text Link to item Cite

Coupling endoplasmic reticulum stress to cell death program in isolated human pancreatic islets: effects of gene transfer of Bcl-2.

Journal Article Transpl Int · July 2003 A variety of toxic insults can result in endoplasmic reticulum (ER)-stress that ultimately leads to apoptosis. beta-cells have a highly developed ER due to a great commitment to insulin production. The present study was carried out to determine the role of ... Full text Link to item Cite