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Moreau C, Devos D, Gosset P, Brunaud-Danel V, Tonnel AB, Lassalle P, Defebvre L, Destée A. [Mechanisms of deregulated response to hypoxia in sporadic amyotrophic lateral sclerosis: a clinical study]. Rev Neurol (Paris) 2009; 166:279-83. [PMID: 19660777 DOI: 10.1016/j.neurol.2009.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Revised: 03/01/2009] [Accepted: 05/22/2009] [Indexed: 01/08/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder of upper and lower motorneurons, leading to death in 3 to 5 years. Respiratory insufficiency and hypoxemia are closely linked during the clinical course of ALS. Chronic respiratory insufficiency and hypoxemia generally occur late in the disease course but rapid episodes of intermittent hypoxemia followed by reoxygenation can occur early and insidiously. Two pathways are involved in the response to hypoxemia: (i) hypoxia inducible factor-1 (HIF-1) and VEGF/HIF-2 and an erythropoietin (EPO) mediated pathway, in response to prolonged hypoxemia; and (ii) nuclear factor kappa-B (NFkappa-B) during acute hypoxemia followed by reoxygenation episodes, inducing inflammatory mediators: interleukin-6 (IL-6), TNF-alpha, cyclo oxygenase-2 (COX-2) and prostaglandin E-2 (PGE-2). Our aim was to specify the role of the different functional pathways of response to hypoxemia in sporadic ALS patients, compared with neurological controls and according to the level of hypoxemia. We report the results of several studies of hypoxemic and/or inflammatory mediators in the cerebrospinal fluid (CSF) from ALS patients, according to their respiratory status, showing a selective defect of HIF-1 mediated angiogenic factors (VEGF and angiogenin [ANG]) during chronic hypoxia in sporadic ALS patients, compared to hypoxemic neurological controls; contrasting with an early activation of the NFkappa-B pathway since the isolated desaturation stage (IL-6, TNF-alpha, PGE-2, angiopoietin-2) in the same cohort of sporadic ALS patients. All these results are consistent with a selective impairment of the HIF-1 pathway during chronic hypoxemia in ALS patients. Inflammatory mediators were strongly elevated, since the early stage of the disease until chronic hypoxemia, suggesting a compensatory mechanism.
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Moreau C, Trussell J, Desfreres J, Bajos N. Patterns of contraceptive use before and after an abortion: results from a large nationally representative survey of women undergoing an abortion in France. Contraception 2009. [DOI: 10.1016/j.contraception.2009.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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103
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Moreau C, Bouyer J, Bajos N, Trussell J. Determinants of early contraceptive discontinuation for method-related reasons: results from a population-based cohort of French women. Contraception 2009. [DOI: 10.1016/j.contraception.2009.05.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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104
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Moreau C, Bajos N, Bouyer J. Evaluation of a mass media campaign on contraception in France. EUR J CONTRACEP REPR 2009. [DOI: 10.1080/ejc.7.2.105.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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105
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Defebvre L, Moreau C, Delval A. [Freezing of gait: clinical problems and therapy]. Rev Neurol (Paris) 2009; 165 Spec No 2:F66-F72. [PMID: 19593883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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106
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Ferreira Tojais N, Descamps B, Mione M, Moreau C, Daniel-Lamazière JM, Couffinhal T, Duplàa C, Dufourcq P. D008 First evidences of frizzled-7 involvement in vessel formation. Arch Cardiovasc Dis 2009. [DOI: 10.1016/s1875-2136(09)72218-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Descamps B, Ferreira Tojais N, Oses P, Moreau C, Daniel Lamaziere JM, Dufourcq P, Couffinhal T, Duplaa C. D009 Frizzled 4 regulates vascular formation in mice. Arch Cardiovasc Dis 2009. [DOI: 10.1016/s1875-2136(09)72219-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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108
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Moreau C, Bouyer J, Bajos N, Rodriguez G, Trussell J. Frequency of discontinuation of contraceptive use: results from a French population-based cohort. Hum Reprod 2009; 24:1387-92. [DOI: 10.1093/humrep/dep027] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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109
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Brozova H, Barnaure I, Alterman RL, Tagliati M, Moreau C, Defebvre L, Destee A, Bleuse S, Clement F, Blatt JL, Krystkowiak P, Devos D. STN-DBS FREQUENCY EFFECTS ON FREEZING OF GAIT IN ADVANCED PARKINSON DISEASE. Neurology 2009; 72:770; author reply 770-1. [DOI: 10.1212/01.wnl.0000339385.187472.7d] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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110
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Danel-Brunaud V, Laurier L, Parent K, Moreau C, Defebvre L, Jacquemin D, Destée A. Les enjeux de la loi Leonetti : participation des patients atteints de sclérose latérale amyotrophique à une discussion anticipée sur la réanimation respiratoire et les soins de fin de vie. Rev Neurol (Paris) 2009; 165:170-7. [DOI: 10.1016/j.neurol.2008.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Revised: 07/12/2008] [Accepted: 08/21/2008] [Indexed: 10/21/2022]
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111
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Moreau C, Gosset P, Brunaud-Danel V, Lassalle P, Degonne B, Destée A, Defebvre L, Devos D. Profils évolutifs des marqueurs angiogéniques et inflammatoires dans le liquide céphalorachidien au cours de la SLA sporadique. Rev Neurol (Paris) 2009. [DOI: 10.1016/s0035-3787(09)70015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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112
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Moreau C, Drui D, Arnault-Ouary G, Charbonnel B, Chaillous L, Cariou B. Fulminant type 1 diabetes in Caucasians: A report of three cases. DIABETES & METABOLISM 2008; 34:529-32. [PMID: 18829363 DOI: 10.1016/j.diabet.2008.05.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 05/27/2008] [Accepted: 05/29/2008] [Indexed: 11/16/2022]
Abstract
CONTEXT Fulminant type 1 diabetes is a new clinical entity in which the process of beta-cell destruction, and the subsequent progression of hyperglycaemia and ketoacidosis, are extremely rapid. Until now, this subtype of type 1 diabetes has only been reported in the Asian population, especially Japanese and Koreans. CASES We report here on three cases of fulminant type 1 diabetes in Caucasian French women. Both the clinical and biological characteristics of these patients are similar to those reported in Japanese studies. Notably, all patients experienced severe ketoacidosis (pH<7.1) that occurred abruptly after the onset of hyperglycaemic symptoms (<6 days), with near-normal HbA(1c) values at diagnosis (5.6, 6.4 and 6.8%). Patients were treated in the intensive care unit with basal-bolus insulin therapy with no remission of their diabetes; pancreatic islet-related autoantibodies were all negative. Fasting C-peptide levels were undetectable, suggesting complete destruction of pancreatic beta-cells. HLA phenotyping of these Caucasian patients did not find the specific HLA haplotype (DRB1*0405-DQB1*0401) previously found to be linked to fulminant type 1 diabetes in Japanese patients. CONCLUSION These are the first cases of fulminant type 1 diabetes reported in Caucasians. These cases reveal new perspectives as regards the worldwide distribution of this intriguing clinical entity.
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113
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Moreau C, Defebvre L, Bleuse S, Blatt JL, Duhamel A, Bloem BR, Destée A, Krystkowiak P. Externally provoked freezing of gait in open runways in advanced Parkinson's disease results from motor and mental collapse. J Neural Transm (Vienna) 2008; 115:1431-6. [PMID: 18726136 DOI: 10.1007/s00702-008-0099-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Accepted: 07/20/2008] [Indexed: 12/27/2022]
Abstract
Freezing of gait (FOG) in Parkinson's disease (PD) is defined as a sudden inability to maintain effective stepping movements. However, its pathophysiology remains unclear. The objectives are: (1) To assess the contribution of both spatial (walking speed, stride length) and temporal parameters (cadence, stride time) and their coefficients of variation to the genesis of FOG in PD. (2) To evaluate whether and how externally imposed modifications of self-determined gait would elicit FOG. We included ten patients with advanced PD, and with daily off drug FOG episodes. We focused on walking in an open runway. For each subject, we manipulated gait by externally imposing four changes in walking speed and four changes in cadence. FOG episodes, often with a long duration of more than 5-s, were observed mostly under conditions with a high imposed cadence. The steps that immediately preceded these episodes were mainly characterized by an increase in cadence and an increase in stride length variability. The results also underscore that FOG can be elicited in a laboratory setting when patients are placed under considerable strain, at least in advanced stages of PD. Patients were unable to adequately negotiate the extreme imposed cadence condition, and this resulted in frequent FOG episodes, even while walking in an open runway. Placing advanced PD patients into extreme imposed conditions leads to a motor wise and mental collapse response, culminating in FOG. Future work should establish the relevance of these findings for the more common forms of FOG, including brief episodes during turning or gait initiation.
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Moreau C, Bouyer J, Bajos N, Rodriguez G, Trussell J. Contraceptive discontinuation rates among French women: frequency and reasons for stopping a method of contraception. Contraception 2008. [DOI: 10.1016/j.contraception.2008.04.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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115
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Potter J, Bouyer J, Trussell J, Moreau C. Premenstrual syndrome prevalence and fluctuation over time: results from a French population–based survey. Contraception 2008. [DOI: 10.1016/j.contraception.2008.04.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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116
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Moreau C, Defebvre L, Destée A, Bleuse S, Clement F, Blatt JL, Krystkowiak P, Devos D. STN-DBS frequency effects on freezing of gait in advanced Parkinson disease. Neurology 2008; 71:80-4. [PMID: 18420482 DOI: 10.1212/01.wnl.0000303972.16279.46] [Citation(s) in RCA: 246] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Severe gait disturbances and freezing episodes (frequently resistant to optimal dopaminergic treatment) often appear in advanced Parkinson disease (PD). Even several years after initiation, high-frequency subthalamic nucleus deep brain stimulation (STN-DBS) is still very effective for controlling segmental symptoms. However, there are no long-term data on the management of gait disorders and freezing in STN-DBS. OBJECTIVES To compare the effects of various STN-DBS parameters on freezing of gait and to determine whether such effects are more related to stimulation energy (usual voltages vs high voltages at 130 Hz) or frequency (130 Hz vs approximately half this frequency: 60 Hz). METHODS We blindly assessed STN-DBS parameters in 13 PD patients reporting severe gait disorders. We compared the effects on gait of two different voltages (the patient's usual voltage [median 3 volts] and a high voltage [median 3.7 volts]) and two different frequencies (60 and 130 Hz, while maintaining the same total energy delivered) vs "off-stimulation" conditions. RESULTS The number of freezing episodes was significantly lower at the 60-Hz "high voltage/equivalent energy" and higher at the 130-Hz/high voltage than for "off stimulation." The slight improvement in the Unified Parkinson's Disease Rating Scale motor score observed (at 130 Hz) did not achieve statistical significance. CONCLUSIONS Our results prompt consideration of a new strategy for two-stage subthalamic nucleus deep brain stimulation (STN-DBS) frequency optimization, with stimulation at 130 Hz and the usual voltage during the initial years of STN-DBS and then at 60 Hz at a high voltage in Parkinson disease patients who develop severe gait disorders.
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Moreau C, Krystkowiak P, Bleuse S, Clement F, Blatt J, Destée A, Devos D, Defebvre L. P1.015 Gait improvement by 60 Hertz stimulation of the subthalamic nucleus in advanced Parkinson's disease: a double blind clinical study. Parkinsonism Relat Disord 2008. [DOI: 10.1016/s1353-8020(08)70112-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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118
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Deffebvre L, Moreau C, Bloem B, Bleuse S, Blatt J, Duhamel A, Destee A, Krystowiak P. P2.063 Freezing of gait in Parkinson's disease results from a combination of extreme hypokinesia and an increase in stride length variability. Parkinsonism Relat Disord 2008. [DOI: 10.1016/s1353-8020(08)70293-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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119
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Bodenant M, Moreau C, Sejourné C, Auvin S, Delval A, Cuisset JM, Derambure P, Destée A, Defebvre L. [Interest of the ketogenic diet in a refractory status epilepticus in adults]. Rev Neurol (Paris) 2008; 164:194-9. [PMID: 18358881 DOI: 10.1016/j.neurol.2007.08.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2007] [Revised: 08/07/2007] [Accepted: 08/17/2007] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Ketogenic diets have been employed for the treatment of intractable epilepsy in children since 1921, although underlying mechanism remains unknown. OBSERVATION We report the case of a 54-year-old man with partial refractory status epilepticus who exhibited a favourable outcome about seven days after introduction of a ketogenic diet in association with antiepileptic drugs. DISCUSSION Although its efficiency was largely demonstrated in children, little is known about the impact of a ketogenic diet in adults with refractory epilepsy. CONCLUSION Introduction of a ketogenic diet requires a multidisciplinary approach. Its usefulness in adult intractable epilepsy and/or refractory status epilepticus merits further study into its efficacy in reducing the frequency of seizures and a possible prolonged effect.
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Moreau C, Devos D, Krystkowiak P, Bleuse S, Clement F, Blatt J, Blond S, Defebvre L, Destée A. Effet des fréquences de la stimulation subthalamique (NST) sur les troubles sévères de la marche dans la maladie de Parkinson évoluée. Rev Neurol (Paris) 2008. [DOI: 10.1016/s0035-3787(08)70042-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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121
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Moreau C, Trussell J, Rodriguez G, Bajos N, Bouyer J. Contraceptive failure rates in France: results from a population-based survey. Hum Reprod 2007; 22:2422-7. [PMID: 17599942 DOI: 10.1093/humrep/dem184] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Despite the widespread use of highly effective contraceptive methods in France, one in every three pregnancies is unintended, of which 65% occur while using contraceptives. In the USA, 49% of pregnancies are unintended, half of which result from contraceptive failure. This study provides estimates of method-specific failure rates among French women. METHODS We use data from the 2000 Cocon Study, a population-based cohort, comprising a representative sample of 1689 women aged 18-44 years who described their contraceptive history. Piecewise-constant hazards models were used to estimate method-specific contraceptive failure rates during the first 5 years of contraceptive use. A random effect was introduced to take into account the fact that some women contribute more than 1 contraceptive episode. These same models were used to assess the effects of socio-demographic characteristics on the probability of contraceptive failure among pill, intrauterine device (IUD) and condom users. RESULTS Overall, 2.9% of women experienced a contraceptive failure in the first year of use and 8.4% in the first 5 years of use. The IUD had the lowest first year failure rate (1.1%), followed by the pill (2.4%), the condom (3.6%), fertility awareness methods (periodic abstinence or safe period by temperature) (7.7%), withdrawal (10.1%) and spermicides (21.7%). These failure rates varied little by user characteristics. CONCLUSIONS Lower failure rates among French women compared with those reported for US women suggest differences in contraceptive practices which need to be further explored.
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Moreau C, Devos D, Krystkowiak, Bleuse S, Clement F, Blatt J, Destée A, Defebvre L. D - 10 Influence des fréquences de stimulation subthalamique sur les troubles de la marche dans la maladie de Parkinson : intérêt de la stimulation à 60 Hz. Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)90808-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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123
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Moreau C, Devos D, Brunaud-Danel V, Lassalle P, Perez T, Just N, Defebvre L, Destée A. K - 1 Étude des mécanismes de dérégulation de la réponse à l’hypoxie dans la sclérose latérale amyotrophique (SLA) : approche clinique et biologique. Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)90693-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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124
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Just N, Moreau C, Lassalle P, Gosset P, Perez T, Brunaud-Danel V, Wallaert B, Destée A, Defebvre L, Tonnel AB, Devos D. High erythropoietin and low vascular endothelial growth factor levels in cerebrospinal fluid from hypoxemic ALS patients suggest an abnormal response to hypoxia. Neuromuscul Disord 2007; 17:169-73. [PMID: 17142042 DOI: 10.1016/j.nmd.2006.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Revised: 10/10/2006] [Accepted: 10/18/2006] [Indexed: 02/06/2023]
Abstract
Animal studies have highlighted the potentially neuroprotective role of vascular endothelial growth factor (VEGF). Low levels of this growth factor have been found in the cerebrospinal fluid (CSF) of patients with amyotrophic lateral sclerosis (ALS). VEGF (and other proteins, such as erythropoietin (EPO)) are produced in response to hypoxia via a common pathway involving a specific transcription factor (hypoxia-inducible factor, HIF) and a hypoxia responsive element (HRE) in the respective genes' promoter regions. In this study, we report finding the expected, high levels of VEGF and EPO in CSF from hypoxemic neurological controls, whereas EPO (but not VEGF) levels are high in the CSF from hypoxemic ALS patients. Hence, the VEGF levels in CSF from patients with ALS were significantly lower than those seen in hypoxemic controls. There was a trend towards higher CSF levels of EPO in hypoxemic ALS patients than in hypoxemic controls. Our results suggest that VEGF may not be produced in sufficient amounts in chronically hypoxic ALS patients and that this dysfunction may participate in the pathogenesis of the disease. The high EPO levels in hypoxemic ALS patients nevertheless suggest an intact common oxygen-sensor pathway.
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Bru P, Duplantier C, Fratu M, Bourrat M, Vaquette B, Moreau C, Lorillard R. [Cardioverter-defibrillator implantation and follow-up in a non-university hospital]. Ann Cardiol Angeiol (Paris) 2006; 55:342-5. [PMID: 17191594 DOI: 10.1016/j.ancard.2006.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Implantable cardioverter-defibrillators (ICD) have emerged as a major treatment for life threatening ventricular arrhythmias. This technique is available in France in all the university hospitals and, with the favor of the new regulation, in some qualified private centers. However, ICD implantation and follow-up in a non-university hospital is infrequent. This study reports long-term results following ICD implantation in 152 patients (age 61+/-13 years). The vast majority (49%) of the patients were implanted for post-infarction ventricular tachycardia and 17% in primary prevention for left ventricular dysfunction. An appropriate therapy was delivered in 83 patients including 68 (81%) treated by antitachycardia pacing without the need for a cardioversion shock. An inappropriate shock was observed in 13 patients (9%). Because of iterative shocks, catheter radiofrequency ablation was proposed among 9 patients, with a success in 8. In conclusion, the technique of the implantable defibrillator can be performed in a non-university hospital with acceptable results. The increase in the ICD number in France implies that there is a need for collaboration between non-university and university hospitals in managing routine and emergency follow-up.
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