Monday 17 May 2010

This free weekly bulletin lists the latest research on cerebral palsy (CP), as indexed in the NCBI, PubMed (Medline) and Entrez (GenBank) databases. These articles were identified by a search using the key term "cerebral palsy". To subscribe, please email Robyn Cummins rcummins@tscnsw.org.au with Subscribe to CP Research News in the subject line, and your name and email address in the body of the email. You may unsubscribe at any time by emailing Robyn with your unsubscribe request.

Interventions

1. Am J Phys Med Rehabil. 2010 May 11. [Epub ahead of print] Factors Related to Physical Activity in Adults with Cerebral Palsy May Differ for Walkers and Nonwalkers. Maltais DB, Dumas F, Boucher N, Richards CL. From the Department of Rehabilitation, Laval University (DBM, FD, CLR) and Centre for Interdisciplinary Research in Rehabilitation and Social Integration (DBM, FD, NB, CLR), Qubec City, Canada. OBJECTIVE: To explore what factors besides walking ability, e.g., additional health problems or complications, general health, and sociodemographic status, may be related to physical activity in adults with cerebral palsy. DESIGN: We administered a questionnaire regarding sociodemographic and health-related factors of potential relevance to physical activity to 66 men (20-41 yrs) and 66 women (18-39 yrs) with various types of cerebral palsy. Data were analyzed using logistic regression. RESULTS: Use of walking as the primary means of self-transport (walking ability) was associated with a higher odds of being physically active (odds ratio = 3.75; P = 0.002). Among those who could walk, being younger and having a positive perception of health were also associated with a higher odds of being active (odds ratios of 2.6 and 3.0, respectively). This was not true among nonwalkers. For individuals who walked, inactivity was associated with an increase in the severity (during the past 3 yrs) of several additional health problems or complications. For the nonwalkers, inactivity was most clearly associated with perceived range-of-motion limitations. CONCLUSIONS: Among adults with cerebral palsy, the ability to walk, as expected, is associated with being physically active. The factors additionally related to physical activity differ between walkers and nonwalkers. PMID: 20463567 [PubMed - as supplied by publisher]
2. Res Dev Disabil. 2010 May 5. [Epub ahead of print] Action planning in typically and atypically developing children (unilateral cerebral palsy). Craj C, Aarts P, Nijhuis-van der Sanden M, Steenbergen B. Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, The Netherlands; Radboud University Nijmegen, Behavioural Science Institute, The Netherlands. In the present study, we investigated the development of action planning in children with unilateral Cerebral Palsy (CP, aged 3-6 years, n=24) and an age matched control group. To investigate action planning, participants performed a sequential movement task. They had to grasp an object (a wooden play sword) and place the sword in a hole in a wooden block. Our main dependent variable was the grip type that participants used, i.e., did they adapt their initial grip choice such that they would reach a comfortable posture at the end of the action? This end-state comfort effect has been abundantly shown in research on action planning, and is taken as evidence for anticipa-

CP Research News ~ Monday 17 May 2010
tory planning. The first aim of the study was to investigate the development of action planning in the unilateral CP group and the control group. Our hypothesis was that action planning improves with age in the control group, but not in the unilateral CP group. The results showed that planning was impaired in the unilateral CP group compared with the control group. Consistent with our hypothesis, we found an age effect in the control group, but not in the unilateral CP group. In the control group 5 and 6 years olds showed more anticipatory planning compared with the 3 and 4 years olds. The second aim of this study was to examine whether an intervention for children with unilateral CP (i.e., constrained induced movement therapy combined with bimanual training) affected action planning. The children with unilateral CP were therefore measured on the experimental task before and after an 8-week intervention period. The results showed that planning improved after the intervention. This finding suggests that action planning ability in young children with unilateral CP may be sensitive to improvement. These findings are discussed within the context of typical and atypical development of action planning and further guidelines for intervention in children with unilateral CP are given. Copyright 2010 Elsevier Ltd. All rights reserved. PMID: 20451346 [PubMed - as supplied by publisher]
3. Arch Dis Child. 2010 May 10. [Epub ahead of print] The impact of menstruation in adolescents with disabilities related to cerebral palsy. Zacharin M, Savasi I, Grover S. Department of Endocrinology and Diabetes, The Royal Children's Hospital, Melbourne, Victoria, Australia. Background: Information regarding menstrual difficulties for adolescents with developmental disabilities and their families is limited. Aim: To assess the impact of menstruation on adolescents with developmental disabilities and their families, and to compare this to previously reported experiences of age-matched normal girls. Methods: Families of girls aged 12-18 years with known disabilities, attending the Royal Children's Hospital, Melbourne, were recruited into a questionnaire based study evaluating issues of menstruation and associated problems, together with the consequent psychological, social and emotional impact on their families and carers. Information was sought regarding menstrual management strategies, outcome satisfaction and specific areas of family concern. Results: 103 questionnaires were completed. The average age of participating girls was 15.11 years, mean menarchal age 12.3 years. 79 girls were postmenarchal. The severity of menstrual problems was similar to a normal population. 59 (76%) were happy with the impact of menses on their social activities. More than 50% sought menstrual advice before menarche. Advice seeking strongly correlated with disability severity (p=0.01) and impact of menses on social activities (p=0.01), which in turn were highly predictive of seeking assistance (p=0.005). Carer satisfaction with current management inversely correlated with treatment seeking behaviour (p=0.034). Conclusions: Menstrual characteristics in this population are similar to those without disabilities. There is a high level of parental anxiety regarding the impact of menses, particularly when disability is severe. Medical therapies may be required but information for families is lacking. Clinicians should play a proactive and educational role with families and adolescents with disabilities. PMID: 20457697 [PubMed - as supplied by publisher]

4. Disabil Rehabil. 2010 May 10. [Epub ahead of print] Quantifying the physical, social and attitudinal environment of children with cerebral palsy. Dickinson HO, Colver A. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK. Purpose. To develop an instrument to represent the availability of needed environmental features (EFs) in the physical, social and attitudinal environment of home, school and community for children with cerebral palsy. Method. Following a literature review and qualitative studies, the European Child Environment Questionnaire (ECEQ) was developed to capture whether EFs needed by children with cerebral palsy were available to them: 24, 24 and 12 items related to the physical, social and attitudinal environments, respectively. The ECEQ was administered to parents of 818 children with cerebral palsy aged 8-12 years, in seven European countries. A domain structure was developed using factor analysis. Results. Parents responded to 98% of items. Seven items were omitted
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from statistical models as the EFs they referred to were available to most children who needed them; two items were omitted as they did not fit well into plausible domains. The final domains, based on 51 items, were: Transport, Physical - home, Physical - community, Physical - school, Social support - home, Social support - community, Attitudes - family and friends, Attitudes - teachers and therapists, Attitudes - classmates. Conclusion. ECEQ was acceptable to parents and can be used to assess both the access children with cerebral palsy have to the EFs that they need and how available individual EFs are. PMID: 20455710 [PubMed - as supplied by publisher]
5. Pediatrics. 2010 May 10. [Epub ahead of print] The Early Motor Repertoire of Children Born Preterm Is Associated With Intelligence at School Age. Bruggink JL, Van Braeckel KN, Bos AF. Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands. Objectives: The goal was to determine whether the quality of general movements (GMs) for preterm children had predictive value for cognitive development at school age. Methods: In this prospective cohort study, 60 preterm infants (gestational age, median: 30.0 weeks [range: 25-33 weeks]; birth weight, median: 1130 g [range: 595-1800 g]) without cerebral palsy were studied. The quality of GMs was assessed prospectively as normal or abnormal, from video recordings that were made at regular intervals until 17 weeks after term. At 7 to 11 years, intelligence was tested by using the Wechsler Intelligence Scale for Children III, Dutch version. Total IQ (TIQ), verbal IQ (VIQ), and performance IQ (PIQ) scores were calculated. Results: The median TIQ was 93 (range: 67-113), VIQ 96 (range: 68-117), and PIQ 92 (range: 65-119). Fifteen children (25%) had low TIQ scores (<85). When the quality of GMs normalized before 8 weeks after term, TIQ, VIQ, and PIQ scores were in the normal range. Consistently abnormal GMs to 8 weeks after term were associated with lower TIQ, VIQ, and PIQ scores. With correction for male gender and the educational levels of the parents, the likelihood ratio of consistently abnormal GMs for a low TIQ was 4.9 (95% confidence interval: 1.3-17.6). The model explained 22.4% of the variance. Conclusions: The quality of GMs during the early postterm period is a marker for intelligence at school age. Abnormal GMs during the early postterm period may reflect injury or developmental disruptions of brain areas involved in cognitive development. PMID: 20457678 [PubMed - as supplied by publisher]

6. Disabil Rehabil. 2010 May 8. [Epub ahead of print] Using the manual ability classification system in young adults with cerebral palsy and normal intelligence. van Meeteren J, Nieuwenhuijsen C, de Grund A, Stam HJ, Roebroeck ME. Department of Rehabilitation Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. Purpose. The study aimed to establish whether the manual ability classification system (MACS), a valid classification system for manual ability in children with cerebral palsy (CP), is applicable in young adults with CP and normal intelligence. Subjects. The participants (n = 83) were young adults with CP and normal intelligence and had a mean age of 19.9 years. Method. In this study, inter observer reliability of the MACS was determined. We investigated relationships between the MACS level and patient characteristics (such as the gross motor function classification system (GMFCS) level, limb distribution of the spastic paresis and educational level) and with functional activities of the upper extremity (assessed with the Melbourne assessment, the Abilhand questionnaire and the domain selfcare of the functional independence measure (FIM)). Furthermore, with a linear regression analysis it was determined whether the MACS is a significant determinant of activity limitations and participation restrictions. Results. The reliability was good (intraclass correlation coefficient 0.83). The Spearman correlation coefficients with GMFCS level, limb distribution of the spastic paresis and educational level were 0.53, 0.46, and 0.26, respectively. MACS level correlated moderately with outcome measures of functional activities (correlations ranging from -0.38 to -0.55). MACS level is, in addition to the GMFCS level, an important determinant for limitations in activities and restrictions in participation. Conclusion. We conclude that the MACS is a feasible method to classify manual ability in young adults with CP and normal intelligence with a good manual ability.
PMID: 20450460 [PubMed - as supplied by publisher]
7. Child Neuropsychol. 2010 May 7:1-13. [Epub ahead of print] Predictors of Reading Comprehension in Children with Cerebral Palsy and Typically Developing Children. Asbell S, Donders J, Van Tubbergen M, Warschausky S. Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA. Predictors of reading comprehension were evaluated in 41 children with cerebral palsy and 74 typically developing children between the ages of 6 and 12 years. Regression analyses were conducted to determine the relative contributions of measures of phonemic awareness, receptive vocabulary, and general reasoning to variance in reading comprehension. All three independent variables were statistically significant predictors of reading comprehension in both groups of participants. The impact of phonemic awareness on reading comprehension was moderated by age, but only in the typically developing group. Within the group with cerebral palsy, there was an indirect effect of functional expressive ability on reading comprehension, mediated by phonemic awareness. It is concluded that largely the same variables predict reading comprehension in children with cerebral palsy as in typically developing children, but that children with cerebral palsy continue to rely on phonological processing for a more protracted period of time. PMID: 20455127 [PubMed - as supplied by publisher]

8. Arch Dis Child. 2010 May;95(5):393-5. Question 1. Do Lycra garments improve function and movement in children with cerebral palsy? Coghill JE, Simkiss DE. SpR Neonatology, Addenbrooke's Hospital, Cambridge, UK. joanna.coghill@gmail.com PMID: 20457706 [PubMed - in process]
9. Arch Dis Child. 2010 May;95(5):387-90. Recent skin injuries in children with motor disabilities. Newman CJ, Holenweg-Gross C, Vuillerot C, Jeannet PY, Roulet-Perez E. Paediatric Neurology and Neurorehabilitation Unit, University Hospital Lausanne, Lausanne, Switzerland. christopher.newman@chuv.ch OBJECTIVE: To determine the frequency of recent skin injuries in children with neuromotor disabilities and its association with disability. DESIGN: Cross-sectional study of 168 children with neuromotor disabilities aged 2-16 years. SETTING: Two outpatient child rehabilitation centres. MAIN OUTCOME MEASURES: Children were classified as unrestricted walkers, restricted walkers or wheelchair dependent. Each participant's body surface was systematically examined for recent skin injuries with the exception of the anal-genital area. RESULTS: The mean age of our sample was 7.8 (SD 3.7) years with a 3:2 male/female ratio. Overall, 64% had cerebral palsy, 17% a neuromuscular disease and 19% other motor disabilities. Participants had on average 5.3 (SD 4.5) recent skin injuries (max 19), of which 2.5 were bruises (SD 3.3, max 16), 2.4 were abrasions, scratches or cuts (SD 3.0, max 16) and 0.4 were pressure lesions (SD 0.8, max 4). There was a significant decrease in the frequency of recent skin injuries and of bruises with increasing severity of motor disability. Most of this variation was accounted for by injuries to the lower limbs. There were no significant effects of gender, learning disabilities or other comorbidities. CONCLUSIONS: Children with neuromotor disabilities present a progressive reduction in the number of skin injuries with decreasing mobility. Therefore, recent skin injuries in this population which are unusual by their number, appearance or distribution, should raise at least the same level of suspicion for physical abuse as in children without disabilities.
PMID: 20457703 [PubMed - in process]
10. J Dev Behav Pediatr. 2010 May;31(4):357-9. Significant sleep dysregulation in a toddler with developmental delay. Stein MT, Owens J, Abbott M. Division of Child Development and Community Health, University of California San Diego, Rady Children's Hospital, San Diego, CA, USA. CASE: Derrick's parents made an appointment with a new pediatrician for a second opinion about disordered sleep. Now 22-months old, he was evaluated at 18 months of age for developmental delay when he was found to have "a regulatory disorder associated with delays in language and motor development, hypotonia and significant sleep problems." The parents are now most concerned about his sleeping pattern. Prolonged sleep onset and frequent night awaking occur each night since 6-months of age. These problems are more severe in the past few months when he awakes screaming and cannot be settled. The awakening episodes occur 2 to 4 times each night when "he screams and thrashes his body for up to an hour." Daytime tantrums increased. After the parents read a book about sleep in young children, they provided a calm atmosphere at bedtime including a dark room and singing a quiet lullaby. When these changes did not alter sleep, they purchased a vibrating mattress which was also unsuccessful. Derrick was born full term after an uncomplicated prenatal and perinatal course. He sat at 10 months, crawled at 12 months, and walked at 18 months. He currently drinks from a sippy cup and he can use a utensil to eat. He has few words saying only "no" and "mama" in the past month. Imitation of some words occurred recently. He has responded to simple directions in the past 2 months. Derrick passed the newborn audiology screen. He does not have difficulty swallowing and he does not drool. He plays with many different toys and he plays in parallel with his older brother who also experienced delays in motor and language development. His brother is now doing very well in school. There is no family history of cognitive delay, seizure disorder, cerebral palsy, early developmental delay (other than the brother) or a significant sleep problem.P hysical examination: head circumference, length and weight (75th percentile). He had mild generalized hypotonia, mild weakness, 2+ symmetrical deep tendon reflexes, and absence of ankle clonus. His gait was slightly wide based, steady, and without a limp. Neither ataxia nor drooling was observed. He was easily engaged in play with the examiner without evidence of irritability. The remainder of the examination was normal. PMID: 20453583 [PubMed - in process]

11. Acta Neurol Scand. 2010 Apr 26. [Epub ahead of print] Efficacy and safety of NT 201 for upper limb spasticity of various etiologies - a randomized parallel-group study. Barnes M, Schnitzler A, Medeiros L, Aguilar M, Lehnert-Batar A, Minnasch P. 14 Rake House Farm, North Shields, UK. Objective - To assess efficacy and safety of two dilutions of botulinum neurotoxin type A NT 201 (Xeomin((R))) in patients with upper limb spasticity of diverse etiology. Methods - Changes in functional disability and muscle tone from baseline to week 4 after NT 201 treatment. Results - One hundred ninety-two patients with stroke, brain injury, multiple sclerosis, or cerebral palsy were randomized to either 50 or 20 U/ml NT 201 dilutions. The maximum total NT 201 dose was 495 units. Four weeks post-injection, a >/= 1-point reduction was observed on the Disability Assessment Scale in 57.1%, and on the Ashworth scale in >/= 62.2% of patients. The 20 U/ml NT 201 dilution was non-inferior to the 50 U/ml NT 201 dilution. Global improvement was rated high by patients (80.2%) and investigators (89.0%). Conclusions - NT 201 improved functional disability and muscle tone and was well tolerated in patients with upper limb spasticity of diverse etiology in both dilutions. PMID: 20456248 [PubMed - as supplied by publisher]
12. Ann Neurol. 2010 Apr;67(4):516-25. Developmental and degenerative features in a complicated spastic paraplegia. Manzini MC, Rajab A, Maynard TM, Mochida GH, Tan WH, Nasir R, Hill RS, Gleason D, Al Saffar M, Partlow JN, Barry BJ, Vernon M, LaMantia AS, Walsh CA. Department of Neurology, Howard Hughes Medical Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA. OBJECTIVE: We sought to explore the genetic and molecular causes of Troyer syndrome, one of several complicated hereditary spastic paraplegias (HSPs). Troyer syndrome had been thought to be restricted to the Amish; however, we identified 2 Omani families with HSP, short stature, dysarthria and developmental delay-core features of Troyer syndrome-and a novel mutation in the SPG20 gene, which is also mutated in the Amish. In addition, we analyzed SPG20 expression throughout development to infer how disruption of this gene might generate the constellation of developmental and degenerative Troyer syndrome phenotypes. METHODS: Clinical characterization of 2 non-Amish families with Troyer syndrome was followed by linkage and sequencing analysis. Quantitative polymerase chain reaction and in situ hybridization analysis of SPG20 expression were carried out in embryonic and adult human and mouse tissue. RESULTS: Two Omani families carrying a novel SPG20 mutation displayed clinical features remarkably similar to the Amish patients with Troyer syndrome. SPG20 mRNA is expressed broadly but at low relative levels in the adult brain; however, it is robustly and specifically expressed in the limbs, face, and brain during early morphogenesis. INTERPRETATION: Null mutations in SPG20 cause Troyer syndrome, a specific clinical entity with developmental and degenerative features. Maximal expression of SPG20 in the limb buds and forebrain during embryogenesis may explain the developmental origin of the skeletal and cognitive defects observed in this disorder. PMID: 20437587 [PubMed - indexed for MEDLINE]

13. Scand J Med Sci Sports. 2010 Mar 10. [Epub ahead of print] Physical fitness, everyday physical activity, and fatigue in ambulatory adults with bilateral spastic cerebral palsy. Nieuwenhuijsen C, van der Slot WM, Dallmeijer AJ, Janssens PJ, Stam HJ, Roebroeck ME, van den Berg-Emons HJ; the Transition Research Group South West Netherlands. Department of Rehabilitation Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands. This study assessed physical fitness and its relationships with everyday physical activity (PA) and fatigue in cerebral palsy (CP). Participants were 42 adults with ambulatory bilateral spastic CP (mean age 36.4 +/- 5.8 years; 69% males; 81% with good gross motor functioning). Progressive maximal aerobic cycle tests determined VO(2peak) (L/ min). Objective levels of everyday PA were measured with accelerometry and self-reported levels of everyday PA with the Physical Activity Scale for Individuals with Physical Disabilities. Fatigue was assessed with the Fatigue Severity Scale. The average aerobic capacity of adults with CP was 77% of Dutch reference values. Participants were physically active during 124 min/day (85% of Dutch reference values), and half experienced fatigue. In women, lower physical fitness was related to lower self-reported levels of PA (R(p)=0.61, P=0.03), and in men to higher levels of fatigue (R(p)=-0.37, P=0.05). Other relationships were not significant. Results suggest that ambulatory adults with CP have low levels of physical fitness, are less physically active than able-bodied age mates and often experience fatigue. We found little evidence for relationships between the level of physical fitness and everyday PA or fatigue. PMID: 20459469 [PubMed - as supplied by publisher]
14. Zhen Ci Yan Jiu. 2010 Feb;35(1):56-60. Effect of penetrative needling of otopoints combined with body acupuncture on limb myodynamia and neurofunction in patients with acute cerebral infarction [Article in Chinese] Li CF, Jia CS, Li XF, Shi J, Dou ZZ, Sun P. Section of Acu-moibustion of the 3rd Hospital, Department of Acu-moxibustion, College of Chinese Medicine, China. OBJECTIVE: To compare the therapeutic effects of different acupuncture methods in improving the myodynamia and neuronfunction of patients with acute cerebral infarction (ACI). METHODS: A total of 90 ACI patients were randomized into ear-acupuncture, scalp-acupuncture and body-acupuncture groups, with 30 cases in each. For patients of ear-acupuncture group, the main otopoints used for penetrative needling were Zhen(MA-AT)-Nie(MA-AT)E(MA-AT) on the affected side in combination with Jian(MA-SF 4)-Suogu(MA-SF 5) and Zhou(MA-SF 3)-Wan(MASF 2)-Zhi(MA-SF 1) for upper-limb paralysis, and with Tun (MA-AH 5)-Zuogushenjing(MA-AH 6), Kuan(MA-AH 4)Xi(MA-AH 3), and Xi(MA-AH 3)-Huai(MA-AH 2)-Zhi(MA-AH 1) for lower-limb paralysis, and body acupoints as Jianyu(LI 15), Hegu(LI 4), Huantiao(GB 30), Taixi(KI 3), etc. For patients of scalp-acupuncture group, scalp-points used were Dingnie Qianxiexian(MS 6) and Dingnie Houxiexian(MS 7) on the healthy side, and combined with body acupoints (the same as those mentioned above). For patients of body-acupuncture group, only body acupoints were used. The treatment was given once daily for 14 days. RESULTS: Comparison among 3 groups showed that the increased myodynamia of both upper and lower limbs in ear-acupuncture and scalp-acupuncture groups was significantly superior to that of body-acupuncture group (P < 0.01). The neurofunctional deficit scores of earacupuncture and scalp-acupuncture groups were significantly lower than that of body-acupuncture group (P < 0.01) after the treatment. In comparison with pre-acupuncture, the neurofunctional deficit scores of the 3 groups lessened considerably after the treatment (P < 0.01). Of the 30 cases in each of earacupuncture, scalp-acupuncture and body-acupuncture groups, 0, 1 and 0 were cured basically, 21, 18 and 4 experienced marked improvement, 9, 11 and 20 were improved, 0, 0 and 6 failed, respectively. The therapeutic effects of ear-acupuncture and scalpacupuncture were obviously superior to that of body-acupuncture group (P < 0.01). No significant differences were found between ear-acupuncture and scalp-acupuncture groups in myodynamia improvement, neurofunctional deficit scores and clinical curative effect (P > 0.05). CONCLUSION: Acupuncture can effectively improve ACI patients' clinical symptoms and the therapeutic effect of ear-acupuncture and scalp-acupuncture was superior to that of simple body acupuncture. PMID: 20458909 [PubMed - in process]

15. BMC Pediatr. 2010 Jan 15;10:1. Clinical profile and treatment of infantile spasms using vigabatrin and ACTH--a developing country perspective. Ibrahim S, Gulab S, Ishaque S, Saleem T. Medical College, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan. BACKGROUND: Infantile spasms represent a serious epileptic syndrome that occurs in the early infantile age. ACTH and Vigabatrin are actively investigated drugs in its treatment. This study describes the comparison of their efficacy in a large series of patients with infantile spasms from Pakistan. METHODS: All patients with infantile spasms who presented to Aga Khan University Hospital, Karachi, Pakistan from January, 2006 to April, 2008 were included in this study. Inclusion criteria were clinical symptoms of infantile spasms, hypsarrythmia or modified hyparrythmia on electroencephalography, at least six months of follow-up period and receipt of any of the two drugs mentioned above. The type of drug distribution was random according to the availability, cost and ease of administration. RESULTS: Fifty six cases fulfilled the inclusion criteria. 62.5% were males. Mean age at onset of seizures was 5 +/- 1.4 months. Fifty two (92.8%) patients demonstrated hypsarrythmia on electroencephalography. 64.3% cases were identified as symptomatic while 19.6% were cryptogenic and 16.1% were idiopathic. Eighteen patients received ACTH while 38 patients received Vigabatrin as first line therapy. Initial response to first line therapy was similar (50% for ACTH and 55.3% for Vigabatrin). Overall, the symptomatic and idiopathic groups responded better to Vigabatrin. The relapse rate was higher for ACTH as compared to Vigabatrin (55.5% vs. 33.3%) when considering the first line therapy. Four patients evolved to Lennox-Gastaut variant; all of these patients had initially received
Vigabatrin and then ACTH. CONCLUSION: Vigabatrin and ACTH showed no significant difference in the initial treatment of infantile spasms. However, patients receiving ACTH were 1.2 times more likely to relapse as compared to the patients receiving Vigabatrin when considering monotherapy. We suggest that Vigabatrin should be the initial drug of choice in patients presenting with infantile spasms. However, larger studies from developing countries are required to validate the therapeutic trends observed in this study. PMID: 20078871 [PubMed - indexed for MEDLINE]PMCID: PMC2820464
16. Dev Neurorehabil. 2010;13(3):182-91. Rehabilitation after multilevel surgery in ambulant spastic children with cerebral palsy: children and parent experiences. Capjon H, Bjrk IT. Rikshospitalet, Oslo University Hospital, Department of Child Neurology, Oslo, Norway. hilde.capjon@rikshospitalet.no PURPOSE: This study explores post-operative family situation, rehabilitation and interdisciplinary cooperation for ambulant children with cerebral palsy (CP), after multilevel surgery. METHODS: Eight ambulant spastic children with varied severity of CP and their parents were included. Qualitative, semi-structured interviews were carried out separately with children and parents. RESULTS: Children experiencing a low degree of post-operative pain were satisfied due to improved strength and ambulation, leading to increased social participation. A few experienced severe pain and modest physical improvement. Most families experienced a lack of information and communication between rehabilitation levels. Rehabilitation was considered strenuous because of complex and intense training programmes. Schools were mostly responsive to children's extra post-operative needs, but some examples of serious neglect and bullying occurred. CONCLUSION: Results imply the need for systematic securing of interdisciplinary knowledge transfer regionally and locally by the university hospital, aiming at empowering families and health professionals involved in this complex rehabilitation. PMID: 20450468 [PubMed - in process]

Epidemiology / Aetiology / Diagnosis & Early Treatment
Please note: This is not yet a comprehensive outline of cerebral palsy prevention literature. It is expected that more research will be included when the search terms are expanded to include key terms other than "cerebral palsy". It is a work-in-progress and it will be expanded in coming months. 17. BMJ. 2010 May 13;340:c1471. doi: 10.1136/bmj.c1471. Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis. Malin GL, Morris RK, Khan KS. Department of Obstetrics, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham. g.l.malin@bham.ac.uk Comment in: BMJ. 2010;340:c1720. OBJECTIVE: To evaluate the association between umbilical cord pH at birth and long term outcomes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline (1966-August 2008), Embase (1980-August 2008), the Cochrane Library (2008 issue 8), and Medion, without language restrictions; reference lists of selected articles; and contact with authors. STUDY SELECTION: Studies in which cord pH at birth was compared with any neonatal or long term outcome. Cohort and case-control designs were included. RESULTS: 51 articles totalling 481
753 infants met the selection criteria. Studies varied in design, quality, outcome definition, and results. Metaanalysis carried out within predefined groups showed that low arterial cord pH was significantly associated with neonatal mortality (odds ratio 16.9, 95% confidence interval 9.7 to 29.5, I(2)=0%), hypoxic ischaemic encephalopathy (13.8, 6.6 to 28.9, I(2)=0%), intraventricular haemorrhage or periventricular leucomalacia (2.9, 2.1 to 4.1, I(2) =0%), and cerebral palsy (2.3, 1.3 to 4.2, I(2)=0%). CONCLUSIONS: Low arterial cord pH showed strong, consistent, and temporal associations with clinically important neonatal outcomes that are biologically plausible. These data can be used to inform clinical management and justify the use of arterial cord pH as an important outcome measure alongside neonatal morbidity and mortality in obstetric trials. PMID: 20466789 [PubMed - in process]
18. Brain. 2010 May 11. [Epub ahead of print] Dominant mutations in the cation channel gene transient receptor potential vanilloid 4 cause an unusual spectrum of neuropathies. Zimon M, Baets J, Auer-Grumbach M, Berciano J, Garcia A, Lopez-Laso E, Merlini L, Hilton-Jones D, McEntagart M, Crosby AH, Barisic N, Boltshauser E, Shaw CE, Landour G, Ludlow CL, Gaudet R, Houlden H, Reilly MM, Fischbeck KH, Sumner CJ, Timmerman V, Jordanova A, Jonghe PD. 1 Neurogenetics Group, VIB Department of Molecular Genetics, University of Antwerp, 2610 Antwerpen, Belgium. Hereditary neuropathies form a heterogeneous group of disorders for which over 40 causal genes have been identified to date. Recently, dominant mutations in the transient receptor potential vanilloid 4 gene were found to be associated with three distinct neuromuscular phenotypes: hereditary motor and sensory neuropathy 2C, scapuloperoneal spinal muscular atrophy and congenital distal spinal muscular atrophy. Transient receptor potential vanilloid 4 encodes a cation channel previously implicated in several types of dominantly inherited bone dysplasia syndromes. We performed DNA sequencing of the coding regions of transient receptor potential vanilloid 4 in a cohort of 145 patients with various types of hereditary neuropathy and identified five different heterozygous missense mutations in eight unrelated families. One mutation arose de novo in an isolated patient, and the remainder segregated in families. Two of the mutations were recurrent in unrelated families. Four mutations in transient receptor potential vanilloid 4 targeted conserved arginine residues in the ankyrin repeat domain, which is believed to be important in protein-protein interactions. Striking phenotypic variability between and within families was observed. The majority of patients displayed a predominantly, or pure, motor neuropathy with axonal characteristics observed on electrophysiological testing. The age of onset varied widely, ranging from congenital to late adulthood onset. Various combinations of additional features were present in most patients including vocal fold paralysis, scapular weakness, contractures and hearing loss. We identified six asymptomatic mutation carriers, indicating reduced penetrance of the transient receptor potential vanilloid 4 defects. This finding is relatively unusual in the context of hereditary neuropathies and has important implications for diagnostic testing and genetic counselling. PMID: 20460441 [PubMed - as supplied by publisher]

19. Acta Paediatr. 2010 May 6. [Epub ahead of print] Impact of chorioamnionitis and preeclampsia on neurodevelopmental outcome in preterm infants below 32 weeks gestational age. Schlapbach LJ, Ersch J, Adams M, Bernet V, Bucher HU, Latal B. Department of Pediatrics, University of Bern, 3010 Bern, Switzerland. Aim: Intrauterine conditions may interfere with fetal brain development. We compared the neurodevelopmental outcome between infants <32 weeks gestational age after maternal preeclampsia or chorioamnionitis and controls. Methods: Case-control study on infants with maternal preeclampsia, chorioamnionitis and controls (each n = 33) matched for gestational age. Neurodevelopment at two years was assessed with the Bayley Scales of Infant Development II. Results: Ninety-nine infants were included with a median gestational age of 29 weeks (range 25-32). Median mental developmental index (MDI) was 96 in the control, 90 in the chorioamnionitis and 86 in the preeclampsia group. Preeclampsia infants had a lower MDI compared with the control group (univariate p = 0.021, multivariate p
= 0.183) and with the chorioamnionitis group (univariate p = 0.242; multivariate p = 0.027). Median psychomotor index was 80.5 in the control, 80 in the preeclampsia and 85 in the chorioamnionitis group, and was not different between these three groups (p > 0.05). Chorioamnionitis or preeclampsia exposure was not associated with major neurodevelopmental impairments (cerebral palsy, MDI<70, PDI<70). Conclusion: The results of this preliminary study suggest that preeclampsia and chorioamnionitis play a relatively minor role among risk factors for adverse neurodevelopment outcome. Postnatal factors such as ventilation and bronchopulmonary dysplasia may have a greater impact on neurodevelopmental outcome. PMID: 20456275 [PubMed - as supplied by publisher]
20. Eur J Paediatr Neurol. 2010 May 5. [Epub ahead of print] Cerebral palsy in children born after in vitro fertilization. Is the risk decreasing? Klln AJ, Finnstrm OO, Lindam AP, Nilsson EM, Nygren KG, Otterblad Olausson PM. Tornblad Institute, University of Lund, Biskopsgatan 7, SE-Lund, Sweden.
BACKGROUND: Infants born after in vitro fertilization (IVF) differ from spontaneously conceived infants in a number of aspects which could increase the risk for future cerebral palsy (CP), e.g., multiple births, preterm births, neonatal complications. AIMS: To follow up children conceived by IVF with respect to risk for CP. METHODS: Infants born after IVF were identified from all IVF clinics in Sweden 1982-2007. Perinatal characteristics were obtained by linkage with the Medical Birth Register. The presence of CP in children born after IVF and in other children was identified from the Patient Register which contains diagnoses given at hospitalizations or specialist outpatient clinics. The risk for CP after IVF was studied after adjustment for year of birth, maternal age, parity, and smoking, all factors which co-vary both with IVF and with CP. Stratification was made for singletons and multiple births and for various neonatal outcomes. RESULTS: The adjusted odds ratio for CP after IVF was 1.81 (95% confidence interval, 95% CI 1.52-2.13), lower and not statistically significant when singletons or when unlike-sexed twins were analyzed. Stratification for various neonatal characteristics also reduced odds ratios to non-significant levels. For the last few years of the study (2004-2007) when the twinning rate after IVF was <10%, the odds ratio for CP was 0.97 (95% CI 0.57-1.66). CONCLUSIONS: The moderately increased risk for CP was most likely a consequence of an increased risk of neonatal morbidity, notably associated with multiple births. Copyright 2010 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved. PMID: 20451428 [PubMed - as supplied by publisher]

21. Neonatology. 2010 May 4;98(4):289-296. [Epub ahead of print] Dexamethasone Treatment after the First Week of Life for Bronchopulmonary Dysplasia in Preterm Infants: A Systematic Review. Doyle LW, Ehrenkranz RA, Halliday HL. Department of Obstetrics and Gynaecology, and Paediatrics, University of Melbourne, The Royal Women's Hospital, and Murdoch Children's Research Institute, Melbourne, Vic., Australia. Background: Dexamethasone has powerful anti-inflammatory effects and has been used to treat established bronchopulmonary dysplasia (BPD), but it is uncertain whether the benefits outweigh the risks of treatment. Objectives: To determine the effect of late (>7 days) postnatal dexamethasone treatment compared with control (placebo or nothing) to prevent or treat BPD in the preterm infant. Methods: Randomised controlled trials (RCTs) of late postnatal dexamethasone therapy to treat or prevent BPD were sought using methods of the Cochrane Collaboration. Data regarding clinical outcomes including mortality, BPD, death or BPD, complications during the primary hospitalisation, and long-term outcome were ed and analysed using RevMan 5. Results: 19 RCTs enrolling 1,345 participants were eligible for this review. Late dexamethasone treatment reduced neonatal mortality, but not later mortality. Benefits of late dexamethasone included reductions in failure to extubate, BPD and the combined outcome of death or BPD. There were clear short-term complications, including hyperglycaemia and hypertension, but not intestinal perforation. Trends of an increase in cerebral palsy or abnormal neurological examination were partly offset
by a trend in the opposite direction in death before late follow-up. Conclusions: The benefits of late dexamethasone may not outweigh actual or potential adverse effects. Given the evidence of both benefits and harms of treatment, and the limitations of the evidence at present, it appears prudent to reserve the use of late dexamethasone to infants who cannot be weaned from mechanical ventilation, and to minimise the dose and duration of any course of treatment. Copyright 2010 S. Karger AG, Basel. PMID: 20453523 [PubMed - as supplied by publisher]Free Article
22. Acta Paediatr. 2010 Apr 30. [Epub ahead of print] Congenital cytomegalovirus infection; the impact of cerebral cortical malformations. Engman ML, Lewensohn-Fuchs I, Mosskin M, Malm G. Dept of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden. Aim: Cytomegalovirus has been suggested to have a teratogenous influence during the migration of neural cells from the ventricular zones to the cortex during the gestational period. The aim of this study was to investigate the prevalence of congenital cytomegalovirus infections in a cohort of children with neurological disability and cerebral cortical malformations recognised by neuroimaging. Methods: Twenty-six children with neurological disability and cerebral cortical malformations were investigated retrospectively for congenital cytomegalovirus infection by analysing the dried blood spot samples for cytomegalovirus deoxynucleic acid using qualitative polymerase chain reaction. Results: CMV DNA in the dried blood spot samples was found in four out of 26 children. Two of these four had severe disabilities with mental retardation, autism, spastic cerebral palsy, epilepsy and deafness. A third child had epilepsy and unilateral cerebral palsy, while the fourth had a mild motor coordination dysfunction and hearing deficit. Conclusion: In our study the number of congenital cytomegalovirus infections in children with cerebral cortical malformations was higher (4/26) than expected with reference to the birth prevalence (0.2-0.5%) of congenital cytomegalovirus infection in Sweden. We thus conclude that congenital cytomegalovirus infection, should be considered in children with cortical malformations of unknown origin. PMID: 20456271 [PubMed - as supplied by publisher]

Carbon Disclosure Project 2010 Deutschland 200 Bericht
Im Namen von weltweit 534 institutionellen Investoren mit einem Gesamtanlagevermgen von 64 Billionen US-Dollar
Bericht verfasst fr das Carbon Disclosure Project von:
Carbon Disclosure Project info@cdproject.net www.cdproject.net
Carbon Disclosure Project
Carbon Disclosure Project 2010 Dieser Bericht und alle ffentlichen Antworten der Unternehmen knnen kostenlos heruntergeladen werden unter www.cdproject.net.

MITGLIEDER 2010

ABRAPP - Associao Brasileira das Entidades Fechadas de Previdncia Complementar Aegon N.V. Akbank T.A.S. Allianz Global Investors AG ATP Group Aviva Investors AXA Group Banco Bradesco S.A. Bank of America Merrill Lynch BBVA BlackRock BP Investment Management Limited California Public Employees Retirement System California State Teachers Retirement System Calvert Group Catholic Super CCLA Investment Management Ltd Co-operative Asset Management Essex Investment Management, LLC Ethos Foundation Generation Investment Management HSBC Holdings plc ING
KLP Insurance Legg Mason, Inc. The London Pensions Fund Authority Mergence Africa Investments (Pty) Limited Mitsubishi UFJ Financial Group (MUFG) Morgan Stanley National Australia Bank Limited Neuberger Berman Newton Investment Management Limited Nordea Investment Management Northwest and Ethical Investments LP PFA Pension Raiffeisen Schweiz RBS Group Robeco Rockefeller & Co. SRI Group Russell Investments Schroders Second Swedish National Pension Fund (AP2) Sompo Japan Insurance Inc. Standard Chartered PLC Sun Life Financial Inc. TD Asset Management Inc. TDAM USA Inc. The Wellcome Trust Zurich Cantonal Bank

CDP Signatories

Carbon Disclosure Project 2010
534 Investoren mit einem Vermgenswert von ber 64 Billionen US-Dollar waren zum 1. Februar 2010 Unterzeichner der CDP Informationsanfrage. Dazu gehren:
Aberdeen Asset Managers Aberdeen Immobilien KAG Active Earth Investment Management Acuity Investment Management Addenda Capital Inc. Advanced Investment Partners Advantage Asset Managers (Pty) Ltd AEGON Magyarorszg Befektetsi Alapkezelo Zrt. Aegon N.V. AEGON-INDUSTRIAL Fund Management Co., Ltd Aeneas Capital Advisors AGF Management Limited AIG Asset Management Akbank T.A.S. Alberta Investment Management Corporation (AIMCo) Alberta Teachers Retirement Fund Alcyone Finance Allianz Global Investors AG Allianz Group Altshuler Shaham AMP Capital Investors AmpegaGerling Investment GmbH Amundi Asset Management ANBIMA - Brazilian Financial and Capital Markets Association APG Asset Management Aprionis ARIA (Australian Reward Investment Alliance) Arma Portfy Ynetimi A.S. ASB Community Trust ASM Administradora de Recursos S.A. ASN Bank Assicurazioni Generali Spa ATP Group Australia and New Zealand Banking Group Limited Australian Central Credit Union incorporating Savings & Loans Credit Union Australian Ethical Investment Limited AustralianSuper AVANA Invest GmbH Aviva Investors Aviva plc AvivaSA Emeklilik ve Hayat A.S. AXA Group Baillie Gifford & Co. Bakers Investment Group Banco Bradesco S.A. Banco de Crdito del Per BCP Banco de Galicia y Buenos Aires S.A. Banco do Brazil Banco Santander Banco Santander (Brasil) Banesprev Fundo Banespa de Seguridade Social Banesto (Banco Espaol de Crdito S.A.) Bank of America Merrill Lynch Bank Sarasin & Co, Ltd Bank Vontobel
Bankhaus Schelhammer & Schattera Kapitalanlagegesellschaft m.b.H. BANKINTER S.A. BankInvest Banque Degroof Barclays Group BBC Pension Trust Ltd BBVA Bedfordshire Pension Fund Beutel Goodman and Co. Ltd BioFinance Administrao de Recursos de Terceiros Ltda BlackRock Blue Marble Capital Management Limited Blue Shield of California Group Blumenthal Foundation BMO Financial Group BNP Paribas Investment Partners BNY Mellon Boston Common Asset Management, LLC BP Investment Management Limited Brasilprev Seguros e Previdncia S/A. British Columbia Investment Management Corporation (bcIMC) BT Investment Management The Bullitt Foundation Busan Bank CAAT Pension Plan Cadiz Holdings Limited Caisse de dpt et placement du Qubec Caisse des Dpts Caixa de Previdncia dos Funcionrios do Banco do Nordeste do Brasil (CAPEF) Caixa Econmica Federal Caixa Geral de Depsitos Caja de Ahorros de Valencia, Castelln y Valencia, BANCAJA Caja Navarra California Public Employees Retirement System California State Teachers Retirement System California State Treasurer Calvert Group Canada Pension Plan Investment Board Canadian Friends Service Committee (Quakers) CAPESESP Capital Innovations, LLC CARE Super Pty Ltd Carlson Investment Management Carmignac Gestion Catherine Donnelly Foundation Catholic Super Cbus Superannuation Fund CCLA Investment Management Ltd Celeste Funds Management Limited The Central Church Fund of Finland Central Finance Board of the Methodist Church Ceres, Inc. Cheyne Capital Management (UK) LLP Christian Super Christopher Reynolds Foundation CI Mutual Funds Signature Advisors CIBC Clean Yield Group, Inc. ClearBridge Advisors Climate Change Capital Group Ltd Close Brothers Group plc The Collins Foundation Colonial First State Global Asset Management

Comite syndical national de retraite Btirente Commerzbank AG CommInsure Companhia de Seguros Aliana do Brasil Compton Foundation, Inc. Connecticut Retirement Plans and Trust Funds Co-operative Asset Management Co-operative Financial Services (CFS) The Co-operators Group Ltd Corston-Smith Asset Management Sdn. Bhd. Crdit Agricole S.A. Credit Suisse Daegu Bank Daiwa Securities Group Inc. The Daly Foundation de Pury Pictet Turrettini & Cie S.A. DekaBank Deutsche Girozentrale Deutsche Asset Management Deutsche Bank AG Deutsche Postbank Vermgensmanagement S.A., Luxemburg Development Bank of Japan Inc. Development Bank of the Philippines (DBP) Dexia Asset Management DnB NOR ASA Domini Social Investments LLC Dongbu Insurance Co., Ltd. DWS Investment GmbH Earth Capital Partners LLP East Sussex Pension Fund Ecclesiastical Investment Management Economus Instituto de Seguridade Social The Edward W. Hazen Foundation EEA Group Ltd Element Investment Managers ELETRA - Fundao Celg de Seguros e Previdncia Environment Agency Active Pension Fund Epworth Investment Management Ltd Equilibrium Capital Group Erste Group Bank AG Essex Investment Management, LLC Ethos Foundation Eureko B.V. Eurizon Capital SGR Evangelical Lutheran Church in Canada Pension Plan for Clergy and Lay Workers Evli Bank Plc F&C Management Ltd FAELCE - Fundao Coelce de Seguridade Social FASERN Fundao Cosern de Previdncia Complementar Fdris Gestion dActifs FIDURA Capital Consult GmbH FIM Asset Management Ltd Financire de Champlain FIRA. - Banco de Mexico First Affirmative Financial Network First Swedish National Pension Fund (AP1) FirstRand Ltd. Five Oceans Asset Management Florida State Board of Administration (SBA) Folketrygdfondet Folksam Fondaction CSN Fondation de Luxembourg Fonds de Rserve pour les Retraites FRR Forward Management, LLC Fourth Swedish National Pension Fund, (AP4) 1
Frankfurter Service Kapitalanlage-Gesellschaft mbH FRANKFURT-TRUST Investment Gesellschaft mbH Friends Provident Holdings (UK) Limited Front Street Capital Fukoku Capital Management, Inc. Fundao AMPLA de Seguridade Social Brasiletros Fundao Atlntico de Seguridade Social Fundao Banrisul de Seguridade Social Fundao Codesc de Seguridade Social FUSESC Fundao de Assistncia e Previdncia Social do BNDES - FAPES Fundao Forluminas de Seguridade Social Fundao Itasa Industrial Fundao Promon de Previdncia Social Fundao So Francisco de Seguridade Social Fundao Vale do Rio Doce de Seguridade Social - VALIA FUNDIGUA - Fundao de Previdncia da Companhia de Saneamento e Ambiental do Distrito Federal Futuregrowth Asset Management Gartmore Investment Management Limited Generali Deutschland Holding AG Generation Investment Management Genus Capital Management Gjensidige Forsikring GLG Partners LP GLS Gemeinschaftsbank eG, Germany Goldman Sachs & Co. GOOD GROWTH INSTITUT fr globale Vermgensentwicklung mbH Governance for Owners LLP Government Employees Pension Fund (GEPF), Republic of South Africa Green Cay Asset Management Green Century Funds Groupe Investissement Responsable Inc. GROUPE OFI AM Grupo Banco Popular Gruppo Monte Paschi Guardian Ethical Management Inc Guardians of New Zealand Superannuation Guosen Securities Co., LTD. Hang Seng Bank HANSAINVEST Hanseatische Investment GmbH Harbourmaster Capital Harrington Investments, Inc The Hartford Financial Services Group, Inc. Hastings Funds Management Limited Hazel Capital LLP HDFC Bank Ltd Health Super Fund Henderson Global Investors Hermes Fund Managers HESTA Super Hospitals of Ontario Pension Plan (HOOPP) HSBC Global Asset Management (Deutschland) GmbH HSBC Holdings plc HSBC INKA Internationale Kapitalanlagegesellschaft mbH Hyundai Marine & Fire Insurance IDBI Bank Limited Illinois State Treasurer Ilmarinen Mutual Pension Insurance Company Impax Asset Management Ltd Industrial Bank 2

Industrial Bank of Korea Industry Funds Management Infrastructure Development Finance Company Ltd. (IDFC) ING Insight Investment Management (Global) Ltd Instituto de Seguridade Social dos Correios e Telgrafos - Postalis Instituto Infraero de Seguridade Social INFRAPREV Insurance Australia Group Investec Asset Management Irish Life Investment Managers Ita Unibanco Banco Mltiplo S.A. J.P. Morgan Asset Management Janus Capital Group Inc. The Japan Research Institute, Limited Jarislowsky Fraser Limited The Joseph Rowntree Charitable Trust Jubitz Family Foundation Jupiter Asset Management K&H Investment Fund Management / K&H Befektetsi Alapkezelo Zrt KB Asset Management KB Financial Group KB Kookmin Bank KBC Asset Management NV KCPS and Company KDB Asset Management Co., Ltd. Kennedy Associates Real Estate Counsel, LP KEPLER-FONDS Kapitalanlagegesellschaft m.b.H. KfW Bankengruppe KLP Insurance Korea Investment & Trust Management Korea Technology Finance Corporation KPA Pension Kyobo AXA Investment Managers La Banque Postale Asset Management La Financire Responsable Landsorganisationen i Sverige LBBW - Landesbank Baden-Wrttemberg LBBW Asset Management Investmentgesellschaft mbH LD Lnmodtagernes Dyrtidsfond Legal & General Group plc Legg Mason, Inc. Lend Lease Investment Management Light Green Advisors, LLC Living Planet Fund Management Company S.A. Local Authority Pension Fund Forum The Local Government Pensions Institution Local Government Super Lombard Odier Darier Hentsch & Cie The London Pensions Fund Authority Lothian Pension Fund Macif Gestion Macquarie Group Limited Magnolia Charitable Trust Maine State Treasurer Man Group plc Maple-Brown Abbott Limited Marc J. Lane Investment Management, Inc. Maryland State Treasurer Matrix Asset Management McLean Budden MEAG Munich Ergo Asset Management GmbH Meeschaert Gestion Prive Meiji Yasuda Life Insurance Company Merck Family Fund
Mergence Africa Investments (Pty) Limited Meritas Mutual Funds MetallRente GmbH Metzler Investment GmbH MFS Investment Management Midas International Asset Management Miller/Howard Investments Mirae Asset Global Investments Co. Ltd. Mistra, The Swedish Foundation for Strategic Environmental Research Mitsubishi UFJ Financial Group (MUFG) Mitsui Sumitomo Insurance Co.,Ltd Mizuho Financial Group, Inc. Mn Services Monega Kapitalanlagegesellschaft mbH Morgan Stanley Motor Trades Association of Australia Superannuation Fund Pty Ltd Mutual Insurance Company Pension-Fennia Natcan Investment Management The Nathan Cummings Foundation National Australia Bank Limited National Bank of Canada National Bank of Kuwait National Grid Electricity Group of the Electricity Supply Pension Scheme National Grid UK Pension Scheme National Pensions Reserve Fund of Ireland National Union of Public and General Employees (NUPGE) Natixis Nedbank Limited Needmor Fund Nelson Capital Management, LLC Nest Sammelstiftung Neuberger Berman New Amsterdam Partners LLC New Jersey Division of Investment New Mexico State Treasurer New York City Employees Retirement System New York City Teachers Retirement System New York State Common Retirement Fund (NYSCRF) Newton Investment Management Limited NFU Mutual Insurance Society NGS Super NH-CA Asset Management Nikko Asset Management Co., Ltd. Nissay Asset Management Corporation NORD/LB Kapitalanlagegesellschaft AG Nordea Investment Management Norfolk Pension Fund Norges Bank Investment Management (NBIM) Norinchukin Zenkyouren Asset Management Co., Ltd North Carolina State Treasurer Northern Ireland Local Government Officers Superannuation Committee (NILGOSC) Northern Trust Northwest and Ethical Investments LP Oddo & Cie Old Mutual plc OMERS Administration Corporation Ontario Teachers Pension Plan OP Fund Management Company Ltd Oppenheim Fonds Trust GmbH Opplysningsvesenets fond (The Norwegian Church Endowment) OPSEU Pension Trust Oregon State Treasurer

Orion Asset Management LLC OTP Fund Management Plc. Pax World Funds Pensioenfonds Vervoer Pension Fund for Danish Lawyers and Economists The Pension Plan For Employees of the Public Service Alliance of Canada Pension Protection Fund Pensionsmyndigheten PETROS - The Fundao Petrobras de Seguridade Social PFA Pension PGGM Phillips, Hager & North Investment Management Ltd. PhiTrust Active Investors Pictet Asset Management SA The Pinch Group Pioneer Alapkezelo Zrt. PKA Pluris Sustainable Investments SA Pohjola Asset Management Ltd Portfolio 21 Investments Portfolio Partners Porto Seguro S.A. PRECE Previdncia Complementar The Presbyterian Church in Canada PREVI Caixa de Previdncia dos Funcionrios do Banco do Brasil PREVIG Sociedade de Previdncia Complementar Principle Capital Partners Psagot Investment House Ltd PSP Investments Q Capital Partners Co. Ltd QBE Insurance Group Limited Rabobank Raiffeisen Schweiz Railpen Investments Rathbones / Rathbone Greenbank Investments RBS Group Real Grandeza Fundao de Previdncia e Assistncia Social Rei Super Resona Bank, Limited Reynders McVeigh Capital Management Rhode Island General Treasurer RLAM Robeco Robert Brooke Zevin Associates, Inc Rockefeller & Co. SRI Group Rose Foundation for Communities and the Environment Royal Bank of Canada RREEF Investment GmbH The Russell Family Foundation Russell Investments SAM Group Sampension KP Livsforsikring A/S Samsung Fire & Marine Insurance Samsung Life Insurance Sanlam Investment Management Santa F Portfolios Ltda Sauren Finanzdienstleistungen GmbH & Co. KG Schroders Scotiabank Scottish Widows Investment Partnership SEB
SEB Asset Management AG Second Swedish National Pension Fund (AP2) Seligson & Co Fund Management Plc Sentinel Investments SERPROS Fundo Multipatrocinado Service Employees International Union Benefit Funds Seventh Swedish National Pension Fund (AP7) The Shiga Bank, Ltd. Shinhan Bank Shinhan BNP Paribas Investment Trust Management Co., Ltd Shinkin Asset Management Co., Ltd Siemens Kapitalanlagegesellschaft mbH Signet Capital Management Ltd SIRA Asset Management SMBC Friend Securities Co., LTD Smith Pierce, LLC SNS Asset Management Social(k) Sociedade Ibgeana de Assistncia e Seguridade (SIAS) Solaris Investment Management Limited Sompo Japan Insurance Inc. Sopher Investment Management SPF Beheer bv Sprucegrove Investment Management Ltd Standard Bank Group Standard Chartered PLC Standard Life Investments State Street Corporation Storebrand ASA Strathclyde Pension Fund Stratus Group Sumitomo Mitsui Banking Corporation Sumitomo Mitsui Card Company, Limited Sumitomo Mitsui Finance & Leasing Co., Ltd Sumitomo Mitsui Financial Group Sumitomo Trust & Banking Sun Life Financial Inc. Superfund Asset Management GmbH Sustainable Capital Svenska Kyrkan, Church of Sweden Swedbank Ab (publ) Swiss Reinsurance Company Swisscanto Holding AG Syntrus Achmea Asset Management TD Asset Management Inc. TDAM USA Inc. Teachers Insurance and Annuity Association College Retirement Equities Fund (TIAACREF) Tempis Capital Management Co., Ltd. Terra Forvaltning AS TfL Pension Fund The University of Edinburgh Endowment Fund Third Swedish National Pension Fund (AP3) Threadneedle Asset Management Tokio Marine & Nichido Fire Insurance Co., Ltd. Toronto Atmospheric Fund The Travelers Companies, Inc. Trillium Asset Management Corporation TRIODOS BANK TrygVesta UBS AG Unibanco Asset Management UniCredit Group Union Asset Management Holding AG Unipension UNISON staff pension scheme UniSuper

Bayer AG BMW AG CeWe Color AG & Co. OHG Deutsche Bank AG Deutsche Brse AG Deutsche Post AG Deutsche Telekom AG E.ON AG EADS N.V. Fraport AG Henkel AG & Co. KGaA HOCHTIEF AG K + S AG Kontron AG Linde AG MAN SE Merck KGaA Metro AG Munich Re Puma AG Q-Cells SE RWE AG SAP Deutschland AG & Co. KG Siemens AG ThyssenKrupp AG TUI AG Volkswagen AG CPLI Deutschland 2010 BASF SE
HCR ATO CD FIN FIN TRA TLS UTI IND TRA CS IND MAT IT MAT IND HCR CD FIN CD UTI UTI IT IND IND CD ATO
AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ
AQ AQ / AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ NR AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ AQ
" " " " " " " " " " " " " " " " " " " " " " " " " " "
A A D B C A A A B B B B C C B C C B A B C B B A B A B
4.570.000 357.793 3.712 36.938 4.900.000 397.878 159.559.934 550.500 39.056 364.600 76.355 948.5.400.000 142.739 157.600 692.887 59.760 6.300 3.829 149.100.000 131.000 1.509.736 15.280.906 6.343.292 1.510.950
3.530.000 847.500 8.574 422.113 21.732 900.000 2.963.217 5.191.968 444.000 224.594 384.100 60.423 235.264 11.389 9.000.000 259.349 148.686 2.757.457 186.942 24.500 101.000 1.862.254 5.100.000 353.537 5.005.084

"

27.523.000

4.108.000

120.007.100 BT&C, C&A, RM&PP, Sub, TP, USP, Wa 21.802.937 1.850.013 18.830.000 91.587 213.443.012 34.153 894.310 50.184 BT&C, RM&PP, TP, Wa, NS BT&C, TP, USP BT&C, Sub BT&C, NS BT&C, RM&PP, Sub, TP, USP BT&C, RM&PP, Wa BT&C, TP BT&C, RM&PP
Bayer AG BMW AG Deutsche Post AG Deutsche Telekom AG E.ON AG Munich Re Siemens AG TUI AG
MAT ATO TRA TLS UTI FIN IND CD

AQ AQ AQ AQ AQ AQ AQ AQ

" " " " " " " "

A A A A A A A A

4.570.000 357.793 4.900.000 397.878 159.559.934 59.760 1.509.736 6.343.292
3.530.000 847.500 900.000 2.963.217 5.191.968 186.942 1.862.254 353.537

CDP-Daten ffentlich

Carbon Performance Gruppe
Scope 1 Emissionen in t CO2-e
Scope 2 Emissionen in t CO2-e
Scope 3 Emissionen in t CO2-e
Alle weiteren Unternehmen Aareal Bank AG Air Berlin Aixtron AG Alstria Office Reit AG Altana AG Asian Bamboo AG Audi AG Aurubis AG Axel Springer AG Bauer AG BayWa AG BB BIOTECH AG Bechtle AG Beiersdorf AG Bertrandt AG Bijou Brigitte modische Accessoires AG Bilfinger Berger AG Biotest AG Bosch Solar Energy AG C.A.T. oil AG Camera Work AG Carl Zeiss Meditec AG Celesio AG Centrotec Sustainable AG Centrotherm Photovoltaics AG Commerzbank AG CompuGroup Holding AG Conergy AG Continental AG CTS EVENTIM AG D+S europe AG Dahlbusch AG - jetzt Pilkington Deutschland Daimler AG Delticom AG Demag Cranes AG Deutsche Beteiligungs AG Deutsche EuroShop AG Deutsche Lufthansa AG Deutsche Postbank AG Deutsche Wohnen AG DEUTZ AG Dialog Semiconductor GmbH DIC Asset AG Dinkelacker AG Douglas Holding AG Drgerwerk AG Drillisch AG Drr AG Dyckerhoff AG Eisen- und Httenwerke AG ElringKlinger AG EnBW Energie Baden-Wrttemberg AG EPCOS AG ERGO Versicherungsgruppe AG Evotec AG F. Reichelt AG Fielmann AG freenet AG Fresenius Medical Care AG & Co. KGaA Fresenius SE FUCHS PETROLUB AG GAGFAH M Immobilien-Management GmbH GEA Group AG Generali Deutschland Holding AG Gerresheimer AG GERRY WEBER INTERNATIONAL AG GfK Group FIN TRA IT FIN MAT MAT ATO MAT CD IND IND HCR IT CS ATO CD IND HCR UTI ENE CD HCR HCR IND IT FIN IT UTI ATO CD CD CD ATO ATO IND FIN FIN TRA FIN FIN IND IT FIN FIN CD HCR TLS IND MAT MAT ATO UTI IT FIN HCR HCR CD TLS HCR HCR MAT FIN IND FIN HCR CD IND DP IN AQ DP AQ NR SA-AQ AQ AQ AQ DP DP AQ AQ DP DP DP AQ DP DP NR DP AQ AQ DP IN NR AQ AQ DP AQ DP AQ DP DP AQ AQ AQ AQ DP DP AQ AQ DP AQ AQ AQ AQ SA-DP SA-AQ AQ AQ SA-NR SA-AQ AQ DP NR DP AQ AQ AQ DP AQ AQ AQ DP AQ NR IN AQ NR AQ / AQ AQ AQ IN NR NR NR AQ NR DP DP DP / / / NR AQ NR NR AQ NR / AQ NR AQ / AQ NR NR NR AQ AQ AQ / DP / NR / AQ AQ / AQ NR AQ AQ AQ AQ AQ / / DP NR AQ AQ AQ / AQ AQ AQ NR AQ "

34.964

99.143

29.885

BT&C, TP

316.000

433.500

21.165

44.960
" " " "

23.483

" "

304.552

412.152
Quelle der Scope 3Emissionen

Antwortstatus 2010

Antwortstatus 2009

Carbon Disclosure Score

GFKL Financial Services AG Gildemeister AG GRENKELEASING AG H&R WASAG AG HAMBORNER REIT AG Hamburger Hafen und Logistik AG Hannover Rckversicherung AG Hawesko Holding AG HeidelbergCement AG Heidelberger Druckmaschinen AG Highlight Communications AG Holcim (Deutschland) AG Homag Holzbearbeitungsssysteme AG Hornbach Holding AG HORNBACH-Baumarkt-AG Hugo Boss AG IBS Group IDS Scheer AG IMW Immobilien AG INDUS Holding AG Infineon Technologies AG INTERSEROH SE IVG Immobilien AG Jenoptik AG Jungheinrich AG KIZOO AG Klckner & Co SE Klckner-Werke AG Knig & Bauer AG Krones AG KSB AG KUKA AG KWS SAAT AG Lanxess AG Leoni AG LHS Telekommunikation GmbH & Co. KG Lions Gate Entertainment Manz Automation AG MediGene AG MEDION AG MLP AG MorphoSys AG MTU Aero Engines Holding AG MVV Energie AG Nordex SE Nrnberger Beteiligungs-AG OVB Holding AG Patrizia Immobilien AG PAUL HARTMANN AG Pfeiffer Vacuum Technology AG Pfleiderer AG Phoenix Solar AG Porsche AG Praktiker Bau- und Heimwerkermrkte Holding AG ProSiebenSat.1 Media AG Qiagen QSC AG Rational AG REpower Systems AG Rheinmetall AG RHN-KLINIKUM AG ROFIN-SINAR Technologies, Inc. Roth & Rau AG Saint-Gobain Oberland AG Salzgitter AG Sartorius AG SCA Hygiene Products SE Sedlmayr Grund und Immobilien KGaA SGL CARBON SE
FIN IND FIN MAT FIN TRA FIN CD MAT IND CD MAT IND CD CD CD IT IT FIN IND IT MAT FIN IND IND IT MAT IND IND IND IND IND CS MAT ATO TLS CD IND HCR CD FIN HCR IND UTI UTI FIN FIN FIN HCR IND MAT UTI ATO CD CD HCR TLS IND UTI IND HCR IT IND MAT MAT HCR CS FIN MAT
DP AQ IN AQ DP AQ AQ NR AQ DP DP SA-AQ NR AQ SA-AQ DP NR DP DP AQ AQ AQ AQ AQ DP AQ AQ NR AQ AQ AQ AQ DP AQ AQ SA-AQ NR DP AQ AQ AQ AQ AQ AQ AQ NR AQ IN DP AQ AQ AQ AQ AQ DP DP DP AQ DP IN DP AQ AQ SA-AQ IN DP SA-AQ DP DP
/ NR NR AQ / AQ AQ NR AQ NR / / AQ NR NR NR / AQ NR DP NR AQ AQ AQ NR AQ AQ NR NR AQ AQ AQ NR AQ AQ AQ NR NR / NR AQ AQ AQ AQ AQ NR AQ / / AQ AQ / AQ DP NR / NR AQ NR IN AQ / NR AQ IN DP AQ / NR

54.827

32.627

46.614.432

4.179.378

13.337

140.441
" " " " "

23.444 500.000

26.789 120.000

BT&C, RM&PP, TP

7.850 3.353 3.056

19.300 30.154 5.978

114.099

105.379

" " " " " 303 230.000 23.010 5.727

53.896

17.751

BT&C

Simona AG Sixt AG Sky Deutschland AG SMA Solar Technology AG SMARTRAC N.V. Software AG Solar Millennium AG SolarWorld AG Stada Arzneimittel AG Stinag Stuttgart Invest AG Sto AG Strabag SE Stratec Biomedical Systems AG Sd-Chemie AG Sdzucker AG Mannheim/Ochsenfurt Symrise AG TAKKT AG Tipp24 AG Tognum AG United Internet AG Vattenfall Group VBH Holding AG Villeroy & Boch AG Vizrt Vossloh AG VTG AG Wacker Chemie AG Wacker Neuson SE Wella AG Wincor Nixdorf AG Wirecard AG WMF Wrttembergische Metallwarenfabrik AG Wstenrot & Wrttembergische AG Xing AG
MAT TRA CD IND TLS IT UTI UTI HCR FIN IND TRA HCR MAT CS MAT CD CD IND IT UTI MAT CD IT TRA TRA MAT IND CS IT IT CD FIN IT
DP NR NR NR NR AQ NR AQ DP NR DP AQ DP NR IN AQ AQ NR AQ AQ AQ DP DP NR AQ NR AQ NR SA-AQ AQ AQ NR AQ AQ
NR NR / NR / AQ / AQ NR NR / NR NR / DP AQ AQ / AQ NR AQ NR / NR AQ DP AQ / AQ AQ NR NR NR /

90.500.000

395.000

" " 985.018

Abkrzungsverzeichnis
Abkrzungen AUM CDLI CDM CDP CEO CPLI DCF Assets under Management Carbon Disclosure Leadership Index Clean Development Mechanism Carbon Disclosure Project Chief Executive Officer Carbon Performance Leadership Index Discounted Cash Flow Branchen-Krzel ATO CD CS ENE FIN HCR IND IT MAT TLS TRA UTI Automobiles Consumer Discretionary (ex Automobiles) Consumer Staples Energy Financials Health Care Industrials (ex Transportation) Information Technology Materials Telecommunication Services Transportation Utilities TP NS Scope 3 Quellen: BT&C Business Travel & Commuting Geschftsreisen und Pendeln der Mitarbeiter C&A Capital & Assets Kapitalund Anlagevermgen (inklusive Franchises, Leased Assets, Capital Equipment und Investment) Not specified nicht erlutert
CO2-e Kohlendioxid-quivalente
RM&PP Raw Materials & PreProducts Rohstoffe und Vorprodukte Sub Subcontractd products & services an Subunternehmen ausgelagerte Produkte & Dienstleistungen Transportation of sold products Transport der verkauften Produkte Use of sold goods and services Nutzung der verkauften Gter & Dienstleistungen Waste generated in ope-rations produzierter Abfall
EBITDA Earnings before Interest, Tax, Depreciation, Amortisation EUA European Union Allowances EU ETS Emissionshandelssystem der Europischen Union (EU Emissions Trading System) GHG GICS JI KPI Greenhouse Gas Global Industry Classification Standard Joint Implementation Key Performance Indicator