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Lilamand M, Vrillon A, Gonzales-Marabal L, Sindzingre L, Götze K, Boddaert J, Pautas E, François-Fasille V, Dumurgier J, Paquet C. Lumbar puncture training with healthcare simulation improves self-confidence and practical skills of French medical residents in geriatrics. Eur Geriatr Med 2023:10.1007/s41999-023-00769-y. [PMID: 36976436 DOI: 10.1007/s41999-023-00769-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE To assess the skill level and self-confidence of medical residents in geriatrics with regard to conducting the lumbar puncture (LP) procedure and to study the potential benefits of training with simulation and virtual reality. METHODS First, a questionnaire survey was conducted among all French residents in geriatrics in the Paris area to assess their knowledge and self-confidence regarding the practice of LP in older adults. Second, we set up a simulation LP training session combined with virtual reality (3D video) training for selected respondents of the first survey. Third, we performed post-simulation survey for the attendees of the simulation training. Finally, a follow-up survey was conducted to examine the change in self-confidence and the success rate in clinical practice. RESULTS Fifty-five residents responded to the survey (response rate = 36.4%). The importance of mastering LP was fully recognized by the residents in geriatrics (95.3%), so most of them (94.5%) advocated for the need for additional practical training. Fourteen residents took part in the training (average rating = 4.7 on a 5-point scale). Simulation was regarded by 83% of the respondents as the most useful tool for their practice. We observed a significant pre/post-training mean improvement in self-estimated success of 20.6% (Wilcoxon matched-pairs signed-rank W = - 36, p = 0.008). The post-training success rate of the residents in real-life clinical practice was good (85.8%). CONCLUSION Residents were aware of the importance of mastering LP and requested additional training. Simulation may represent a major driver to improve their self-confidence and practical skills.
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Affiliation(s)
- Matthieu Lilamand
- Department of Geriatrics Hôpital Lariboisière Fernand-Widal, AP-HP.Nord Université Paris Cité, Paris, France.
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France.
- Université Paris Cité, INSERM, UMRS 1144, Paris, France.
| | - Agathe Vrillon
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
- Université Paris Cité, INSERM, UMRS 1144, Paris, France
| | | | - Louise Sindzingre
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Karl Götze
- Department of Geriatrics Hôpital Bretonneau, AP-HP.Nord Université Paris Cité, Paris, France
| | - Jacques Boddaert
- Department of Geriatrics Hôpital la Pitié Salpêtrière, AP-HP, Sorbonne Université, INSERM, UMR 1135, Paris, France
| | - Eric Pautas
- Department of Geriatrics Hôpital la Pitié Salpêtrière, AP-HP, Sorbonne Université, INSERM, UMR 1135, Paris, France
- Department of Geriatrics Hôpital Charles Foix, AP-HP, Sorbonne Université, Ivry-sur-Seine, France
| | - Véronique François-Fasille
- Department of Geriatrics Hôpital Lariboisière Fernand-Widal, AP-HP.Nord Université Paris Cité, Paris, France
| | - Julien Dumurgier
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
| | - Claire Paquet
- AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France
- Université Paris Cité, INSERM, UMRS 1144, Paris, France
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Courtois-Amiot P, Cloppet-Fontaine A, Poissonnet A, Benit E, Dauzet M, Raynaud-Simon A, Paquet C, Lilamand M. Hypnosis for pain and anxiety management in cognitively impaired older adults undergoing scheduled lumbar punctures: a randomized controlled pilot study. Alzheimers Res Ther 2022; 14:120. [PMID: 36056417 PMCID: PMC9438329 DOI: 10.1186/s13195-022-01065-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022]
Abstract
Background Core cerebrospinal fluid (CSF) amyloid and tau biomarker assessment has been recommended to refine the diagnostic accuracy of Alzheimer’s disease. Lumbar punctures (LP) are invasive procedures that might induce anxiety and pain. The use of non-pharmacological techniques must be considered to reduce the patient’s discomfort, in this setting. The objective of this study was to examine the efficacy of hypnosis on anxiety and pain associated with LP. Methods A monocentric interventional randomized-controlled pilot study is conducted in a university geriatric day hospital. Cognitively impaired patients aged over 70 were referred for scheduled LP for the diagnostic purpose (CSF biomarkers). The participants were randomly assigned either to a hypnosis intervention group or usual care. Pain and anxiety were both self-assessed by the patient and hetero-evaluated by the operator. Results We included 50 cognitively impaired elderly outpatients (women 54%, mean age 77.2 ± 5.0, mean Mini-Mental State Examination score 23.2 ± 3.5). Hypnosis was significantly associated with reduced self-assessed (p < 0.05) and hetero-assessed anxiety (p < 0.01). Hetero-evaluated pain was significantly lower in the hypnosis group (p < 0.05). The overall perception of hypnosis was safe, well-accepted, and feasible in all the participants of the intervention group with 68% perceiving the procedure as better or much better than expected. Conclusions This pilot study suggested that hypnosis was feasible and may be used to reduce the symptoms of discomfort due to invasive procedures in older cognitively impaired patients. Our results also confirmed the overall good acceptance of LP in this population, despite the usual negative perception. Trial registration ClinicalTrials.gov NCT04368572. Registered on April 30, 2020.
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Vrillon A, Gonzales-Marabal L, Ceccaldi PF, Plaisance P, Desrentes E, Paquet C, Dumurgier J. Using virtual reality in lumbar puncture training improves students learning experience. BMC MEDICAL EDUCATION 2022; 22:244. [PMID: 35379253 PMCID: PMC8981937 DOI: 10.1186/s12909-022-03317-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Lumbar puncture (LP) is a commonly performed medical procedure in a wide range of indications. Virtual reality (VR) provides a stimulating, safe and efficient learning environment. We report the design and the evaluation of a three dimensions (3D) video for LP training. METHODS We recorded a stereoscopic 180-degrees 3D video from two LPs performed in clinical settings in Fernand Widal Lariboisière University Hospital, Paris, France. The video was administered to third-year medical students as well as to a residents and attendings group during LP simulation-based training sessions. RESULTS On 168 participants (108 novice third-year medical students, and 60 residents and attendings with prior LP experience), satisfaction after video exposure was high (rated 4.7 ± 0.6 on a 5-point scale). No significant discomfort was reported (comfort score graded 4.5 ± 0.8 on 5). LP-naive students displayed higher satisfaction and perceived benefit than users with prior LP experience (overall, P < 0.05). Trainees evaluated favorably the 3D feature and supported the development of similar tutorials for other medical procedures (respectively, 3.9 ± 1.1 and 4.4 ± 0.9 on 5). CONCLUSION We report our experience with a 3D video for LP training. VR support could increase knowledge retention and skill acquisition in association to LP simulation training.
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Affiliation(s)
- Agathe Vrillon
- Cognitive Neurology Centre, GHU APHP Nord University Hospital Lariboisière Fernand-Widal, Paris, France.
- Université de Paris, INSERM U1144, Therapeutic Optimization in Neuropsychopharmacology, Paris, France.
| | | | | | - Patrick Plaisance
- Université de Paris, Simulation department, iLumens Paris Nord, Medical School, Paris, France
| | - Eric Desrentes
- Université de Paris, Simulation department, iLumens Paris Nord, Medical School, Paris, France
| | - Claire Paquet
- Cognitive Neurology Centre, GHU APHP Nord University Hospital Lariboisière Fernand-Widal, Paris, France
- Université de Paris, INSERM U1144, Therapeutic Optimization in Neuropsychopharmacology, Paris, France
| | - Julien Dumurgier
- Cognitive Neurology Centre, GHU APHP Nord University Hospital Lariboisière Fernand-Widal, Paris, France
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
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Gaubert S, Blet A, Dib F, Ceccaldi PF, Brock T, Calixte M, De Macédo L, Dujardin T, Jean-Louis L, Leghima D, Mouyal S, Tordjman DD, Plaisance P, Roos C, Remini SA, Roux D, Paquet C. Positive effects of lumbar puncture simulation training for medical students in clinical practice. BMC MEDICAL EDUCATION 2021; 21:18. [PMID: 33407416 PMCID: PMC7789333 DOI: 10.1186/s12909-020-02452-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 12/11/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND Lumbar puncture (LP) is an invasive medical procedure that can be done by any doctor. Several simulation-based trainings have been built however the evaluations of the theoretical knowledge and the impact of the simulation-based training have never been performed in real life. The objective was to evaluate the impact of a LP training on the theoretical knowledge improvement and the performance of a LP in clinical practice. METHODS Before and after medical students' training, theoretical knowledge and confidence level were assessed. Over a 6 months period, the impact of simulation training was evaluated by the success rate of students' first LP carried out in hospitalized patients and compared to the results of a no-training control. RESULTS Students' theoretical knowledge and confidence level showed significant improvement after simulation training on 115 students (p < 0.0001). The evaluation in real life based on 41 students showed that the success rate of the first LP in patients was higher in the LP simulation group compared to the control group (67% vs 14%, p = 0.0025). The technical assistance was also less frequently needed in the LP simulation group (19% vs 57%, respectively, p = 0.017). The rate of students who participated in this educational study was low. DISCUSSION Simulation-based teaching was an effective way to improve students' theoretical and practical knowledge. Whether this approach translates to other procedural skills in real clinical settings merits further study. The low participation rate in the study is due to the fact that students are not used to be included in educational studies and to the complexity of evaluation in routine clinical practice.
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Affiliation(s)
- Sinead Gaubert
- Université de Paris, Medical School, Paris, France
- Cognitive Neurology Center, AP-HP, Lariboisière Fernand-Widal Hospital, F-75010, Paris, France
| | - Alice Blet
- Université de Paris, Medical School, Paris, France
- Surgical intensive care unit, AP-HP, Lariboisière Fernand-Widal Hospital, F-75010, Paris, France
| | - Fadia Dib
- INSERM CIC 1417, F-CRIN, I REIVAC, AP-HP, Hôpital Cochin, F-75014, Paris, France
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - Pierre-François Ceccaldi
- Université de Paris, Medical School, Paris, France
- Department of Gynecology and Obstetrics, AP-HP, Beaujon-Bichat Hospital, F-92110, Clichy, France
| | - Thomas Brock
- Université de Paris, Medical School, Paris, France
| | | | | | | | | | | | | | | | - Patrick Plaisance
- Université de Paris, Medical School, Paris, France
- Emergency Unit, AP-HP, Lariboisière Fernand-Widal Hospital, F-75010, Paris, France
| | - Caroline Roos
- Université de Paris, Medical School, Paris, France
- Cephalalgia Center, AP-HP, Lariboisière Fernand-Widal Hospital, F-75010, Paris, France
| | | | - Damien Roux
- Université de Paris, Medical School, Paris, France
- Intensive Care Unit, AP-HP, Louis Mourier Hospital, F-92700, Colombes, France
| | - Claire Paquet
- Université de Paris, Medical School, Paris, France.
- Cognitive Neurology Center, AP-HP, Lariboisière Fernand-Widal Hospital, F-75010, Paris, France.
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Magnin E, Démonet JF, Wallon D, Dumurgier J, Troussière AC, Jager A, Duron E, Gabelle A, de la Sayette V, Volpe-Gillot L, Tio G, Evain S, Boutoleau-Bretonnière C, Enderle A, Mouton-Liger F, Robert P, Hannequin D, Pasquier F, Hugon J, Paquet C. Primary Progressive Aphasia in the Network of French Alzheimer Plan Memory Centers. J Alzheimers Dis 2018; 54:1459-1471. [PMID: 27589533 DOI: 10.3233/jad-160536] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Few demographical data about primary progressive aphasia (PPA) are available, and most knowledge regarding PPA is based on tertiary centers' results. OBJECTIVE Our aims were to describe demographical characteristics of the PPA population in a large sample of PPA patients from the network of French Alzheimer plan memory centers (Sample 1), and to describe the stratification of cerebrospinal fluid (CSF) biomarkers in two different samples of PPA patients (Samples 2 and 3). METHODS All registered PPA patients in the French Alzheimer's disease (AD) databank (Sample 1: n = 2,035) and a subsample (Sample 2: n = 65) derived from a multicentric prospective cohort with CSF biomarker analysis were analyzed. A multicentric retrospective cohort from language expert tertiary centers (Sample 3: n = 97) with CSF biomarker analysis was added. Sample 3 was added to replicate the CSF results of the Sample 2 and to evaluate repartition of AD pathology in the three variant of PPA according to the latest classification. RESULTS Non-Fluent/Agrammatic, Logopenic, and Unclassifiable PPA patients (NF/A-Logo-Unclass PPA) were older and more frequent than Semantic PPA patients (2.2 versus 0.8/100,000 inhabitants; p < 0.00001). Male predominance occurred after the age of 80 (p < 0.00001). A higher level of education was observed in the PPA population compared to a typical amnesic AD group. No demographical significant difference between PPA due to AD and not due to AD was observed. The Logopenic variant was most frequent with 85% of AD CSF biomarker profiles (35% in NF/A PPA; 20% in Semantic PPA). CONCLUSION PPA occurs also in an elderly population, especially in male patients over 80. CSF biomarkers are useful to stratify PPA. The epidemiology of PPA should be further investigated to confirm gender and cognitive reserve role in PPA to better understand the factors and mechanisms leading to this language-predominant deficit during neurodegenerative diseases.
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Affiliation(s)
- Eloi Magnin
- Centre Mémoire de Ressources et de Recherche (CMRR), Hôpital Universitaire de Besançon, Besançon, France
| | | | - David Wallon
- Service de Neurologie, Hôpital universitaire de Rouen, et INSERM UMR1079, Université de Rouen, Rouen, France
| | - Julien Dumurgier
- Centre Mémoire de Ressources et de Recherche (CMRR), Paris Nord Ile de France, APHP, Paris, France.,INSERM U942, Paris, France
| | | | - Alain Jager
- Centre de Neurologie, 6 place Luxembourg, Thionville, France
| | - Emmanuelle Duron
- Centre Mémoire de Ressources et de Recherche Paris Sud, Hôpital Broca APHP, Université Paris V, Paris, France
| | - Audrey Gabelle
- Centre Mémoire de Ressources et de Recherche (CMRR) de Montpellier, Hôpital Gui de Chauliac, Centre Hospitalo-Universitaire Montpellier et INSERM U1040, hôpital Saint Eloi, Montpellier, France
| | - Vincent de la Sayette
- Centre Mémoire de Ressources (CMRR) de Caen, Hôpital Universitaire de Caen, Caen, France
| | | | - Gregory Tio
- Centre Mémoire de Ressources et de Recherche (CMRR), Hôpital Universitaire de Besançon, Besançon, France
| | - Sarah Evain
- Centre mémoire de ressources et de recherche, Service de Neurologie, CHU Nantes, Nantes, France
| | | | - Adeline Enderle
- Inserm 1171, Univ. Lille, CHU Lille, Distalz, CMRR, CNR-MAJ, F-59000 Lille, France
| | - François Mouton-Liger
- Centre Mémoire de Ressources et de Recherche (CMRR), Paris Nord Ile de France, APHP, Paris, France.,INSERM U942, Paris, France.,Unité d'Histologie et de Biologie du Vieillissement, APHP, Paris, France
| | - Philippe Robert
- Centre Mémoire de Ressources et de Recherche/EA COBTEK, CHU, Université de Nice, Nice, France
| | - Didier Hannequin
- Service de Neurologie, Hôpital universitaire de Rouen, et INSERM UMR1079, Université de Rouen, Rouen, France
| | - Florence Pasquier
- Inserm 1171, Univ. Lille, CHU Lille, Distalz, CMRR, CNR-MAJ, F-59000 Lille, France
| | - Jacques Hugon
- Centre Mémoire de Ressources et de Recherche (CMRR), Paris Nord Ile de France, APHP, Paris, France.,INSERM U942, Paris, France.,Unité d'Histologie et de Biologie du Vieillissement, APHP, Paris, France
| | - Claire Paquet
- Centre Mémoire de Ressources et de Recherche (CMRR), Paris Nord Ile de France, APHP, Paris, France.,INSERM U942, Paris, France.,Unité d'Histologie et de Biologie du Vieillissement, APHP, Paris, France
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Magnin E, Dumurgier J, Bouaziz-Amar E, Bombois S, Wallon D, Gabelle A, Lehmann S, Blanc F, Bousiges O, Hannequin D, Jung B, Miguet-Alfonsi C, Quillard M, Pasquier F, Peoc’h K, Laplanche JL, Hugon J, Paquet C. Les biomarqueurs du liquide cérébro-spinal dans la maladie d’Alzheimer : un outil de recherche utile dans la pratique clinique courante des consultations mémoire pour les cas complexes. Rev Med Interne 2017; 38:250-255. [DOI: 10.1016/j.revmed.2016.10.383] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/19/2016] [Accepted: 10/18/2016] [Indexed: 01/08/2023]
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Paquet C, Magnin E, Wallon D, Troussière AC, Dumurgier J, Jager A, Bellivier F, Bouaziz-Amar E, Blanc F, Beaufils E, Miguet-Alfonsi C, Quillard M, Schraen S, Pasquier F, Hannequin D, Robert P, Hugon J, Mouton-Liger F. Utility of CSF biomarkers in psychiatric disorders: a national multicentre prospective study. ALZHEIMERS RESEARCH & THERAPY 2016; 8:27. [PMID: 27357952 PMCID: PMC4928321 DOI: 10.1186/s13195-016-0192-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/16/2016] [Indexed: 12/27/2022]
Abstract
Background Affective and psychotic disorders are mental or behavioural patterns resulting in an inability to cope with life’s ordinary demands and routines. These conditions can be a prodromal event of Alzheimer’s disease (AD). The prevalence of underlying AD lesions in psychiatric diseases is unknown, and it would be helpful to determine them in patients. AD cerebrospinal fluid (CSF) biomarkers (amyloid β, tau and phosphorylated tau) have high diagnostic accuracy, both for AD with dementia and to predict incipient AD (mild cognitive impairment due to AD), and they are sometimes used to discriminate psychiatric diseases from AD. Our objective in the present study was to evaluate the clinical utility of CSF biomarkers in a group of patients with psychiatric disease as the main diagnosis. Methods In a multicentre prospective study, clinicians filled out an anonymous questionnaire about all of their patients who had undergone CSF biomarker evaluation. Before and after CSF biomarker results were obtained, clinicians provided a diagnosis with their level of confidence and information about the treatment. We included patients with a psychiatric disorder as the initial diagnosis. In a second part of the study conducted retrospectively in a followed subgroup, clinicians detailed the psychiatric history and we classified patients into three categories: (1) psychiatric symptoms associated with AD, (2) dual diagnosis and (3) cognitive decline not linked to a neurodegenerative disorder. Results Of 957 patients, 69 had an initial diagnosis of a psychiatric disorder. Among these 69 patients, 14 (20.2 %) had a CSF AD profile, 5 (7.2 %) presented with an intermediate CSF profile and 50 (72.4 %) had a non-AD CSF profile. Ultimately, 13 (18.8 %) patients were diagnosed with AD. We show that in the AD group psychiatric symptoms occurred later and the delay between the first psychiatric symptoms and the cognitive decline was shorter. Conclusions This study revealed that about 20 % of patients with a primary psychiatric disorder diagnosis before undergoing a CSF exploration for cognitive disorder displayed a CSF biomarker AD profile. In memory clinics, it seems important to consider AD as a possible diagnosis before finalizing a diagnosis of a psychiatric disorder.
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Affiliation(s)
- Claire Paquet
- INSERM UMR-S942 Université Paris Diderot, 75010, Paris, France. .,Centre Mémoire (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 200, rue du Faubourg Saint Denis, 75010, Paris, France. .,Unité d'Histologie et de Biologie du Vieillissement, Groupe Hospitalier Lariboisiere FW Saint Louis APHP, Université Paris Diderot, 75010, Paris, France.
| | - Eloi Magnin
- Centre Mémoire (CMRR) de Besançon, Hôpital Universitaire de Besançon, 25000, Besançon, France
| | - David Wallon
- Centre Mémoire (CMRR) and INSERM UMR1079, Hôpital Universitaire de Rouen, 76000, Rouen, France
| | - Anne-Cécile Troussière
- Centre Mémoire (CMRR) de Lille, Université Lille Nord de France, UDSL, 59000, Lille, France
| | - Julien Dumurgier
- INSERM UMR-S942 Université Paris Diderot, 75010, Paris, France.,Centre Mémoire (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 200, rue du Faubourg Saint Denis, 75010, Paris, France.,Unité d'Histologie et de Biologie du Vieillissement, Groupe Hospitalier Lariboisiere FW Saint Louis APHP, Université Paris Diderot, 75010, Paris, France
| | - Alain Jager
- Centre de Neurologie, 6 place Luxembourg, 57100, Thionville, France
| | - Frank Bellivier
- INSERM UMR-S1144 and Service de Psychiatrie, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 75010, Paris, France
| | - Elodie Bouaziz-Amar
- Service de Biochimie, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 75010, Paris, France
| | - Frédéric Blanc
- Université de Strasbourg, CNRS, Laboratoire ICube UMR 7357 and Fédération de Médecine Translationnelle de Strasbourg (FMTS), 67000, Strasbourg, France.,Centre Mémoire (CMRR), Hôpital Universitaire de Strasbourg, Département de Gériatrie, Hôpital de Jour Gériatrique, 67000, Strasbourg, France
| | - Emilie Beaufils
- Centre Mémoire (CMRR) de Tours, Hôpital Universitaire Tours, 37000, Tours, France
| | | | - Muriel Quillard
- Service de Biochimie, Hôpital Universitaire de Rouen, 76000, Rouen, France
| | - Susanna Schraen
- Université Lille, CHU-Lille, Inserm, UF de Neurobiologie, CBPG, Lille, France
| | - Florence Pasquier
- Centre Mémoire (CMRR) de Lille, Université Lille Nord de France, UDSL, 59000, Lille, France
| | - Didier Hannequin
- Centre Mémoire (CMRR) and INSERM UMR1079, Hôpital Universitaire de Rouen, 76000, Rouen, France
| | - Philippe Robert
- CMRR COBTEK research unit, Université de Nice Sophia Antipolis, 06100, Nice, France
| | - Jacques Hugon
- INSERM UMR-S942 Université Paris Diderot, 75010, Paris, France.,Centre Mémoire (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 200, rue du Faubourg Saint Denis, 75010, Paris, France.,Unité d'Histologie et de Biologie du Vieillissement, Groupe Hospitalier Lariboisiere FW Saint Louis APHP, Université Paris Diderot, 75010, Paris, France
| | - François Mouton-Liger
- INSERM UMR-S942 Université Paris Diderot, 75010, Paris, France.,Centre Mémoire (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Université Paris Diderot, 200, rue du Faubourg Saint Denis, 75010, Paris, France
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Paquet C, Dumurgier J, Hugon J. Pro-Apoptotic Kinase Levels in Cerebrospinal Fluid as Potential Future Biomarkers in Alzheimer's Disease. Front Neurol 2015; 6:168. [PMID: 26300842 PMCID: PMC4523792 DOI: 10.3389/fneur.2015.00168] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 07/20/2015] [Indexed: 12/22/2022] Open
Abstract
Alzheimer’s disease (AD) is characterized by the accumulation of Aβ peptides, hyperphosphorylated tau proteins, and neuronal loss in the brain of affected patients. The causes of neurodegeneration in AD are not clear, but apoptosis could be one of the cell death mechanisms. According to the amyloid hypothesis, abnormal aggregation of Aβ leads to altered kinase activities inducing tau phosphorylation and neuronal degeneration. Several studies have shown that pro-apoptotic kinases could be a link between Aβ and tau anomalies. Here, we present recent evidences from AD experimental models and human studies that three pro-apoptotic kinases (double-stranded RNA kinase (PKR), glycogen synthase kinase-3β, and C-Jun terminal kinase (JNK) could be implicated in AD physiopathology. These kinases are detectable in human fluids and the analysis of their levels could be used as potential surrogate markers to evaluate cell death and clinical prognosis. In addition to current biomarkers (Aβ1–42, tau, and phosphorylated tau), these new evaluations could bring about valuable information on potential innovative therapeutic targets to alter the clinical evolution.
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Affiliation(s)
- Claire Paquet
- INSERM UMR-S942, Centre Mémoire de Ressources et de Recherche (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, AP-HP, Université Paris Diderot , Paris , France
| | - Julien Dumurgier
- INSERM UMR-S942, Centre Mémoire de Ressources et de Recherche (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, AP-HP, Université Paris Diderot , Paris , France
| | - Jacques Hugon
- INSERM UMR-S942, Centre Mémoire de Ressources et de Recherche (CMRR) Paris Nord Ile de France, Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, AP-HP, Université Paris Diderot , Paris , France
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Heitz C, Lorette A, Julian A, Roubaud C, Paquet C. Enquête d’opinions sur la pratique de la ponction lombaire non urgente chez des patients à risque hémorragiques/thrombotiques. Rev Neurol (Paris) 2014; 170:685-92. [DOI: 10.1016/j.neurol.2014.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 05/08/2014] [Accepted: 05/28/2014] [Indexed: 10/24/2022]
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Impact of cerebro-spinal fluid biomarkers of Alzheimer’s disease in clinical practice: a multicentric study. J Neurol 2013; 261:144-51. [PMID: 24162039 DOI: 10.1007/s00415-013-7160-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 10/12/2013] [Indexed: 10/26/2022]
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Rose C, Peoc'h K, Chasseigneaux S, Paquet C, Dumurgier J, Bourasset F, Calon F, Laplanche JL, Hugon J, Allinquant B. New highly sensitive rodent and human tests for soluble amyloid precursor protein alpha quantification: preclinical and clinical applications in Alzheimer's disease. BMC Neurosci 2012; 13:84. [PMID: 22824057 PMCID: PMC3418197 DOI: 10.1186/1471-2202-13-84] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 07/23/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Amyloid precursor protein (APP), a key molecule in Alzheimer's disease (AD), is metabolized in two alternative cleavages, generating either the amyloidogenic peptides involved in AD pathology or the soluble form of APP (sAPPα). The level of amyloidogenic peptides in human cerebrospinal fluid (CSF) is considered to be a biomarker of AD, whereas the level of sAPPα in CSF as a biomarker has not been clearly established. sAPPα has neurotrophic and neuroprotective properties. Stimulating its formation and secretion is a promising therapeutic target in AD research. To this end, very sensitive tests for preclinical and clinical research are required. METHODS The tests are based on homogenous time-resolved fluorescence and require no washing steps. RESULTS We describe two new rapid and sensitive tests for quantifying mouse and human sAPPα. These 20 μl-volume tests quantify the levels of: i) endogenous mouse sAPPα in the conditioned medium of mouse neuron primary cultures, as well as in the CSF of wild-type mice, ii) human sAPPα in the CSF of AD mouse models, and iii) human sAPPα in the CSF of AD and non-AD patients. These tests require only 5 μl of conditioned medium from 5 × 10(4) mouse primary neurons, 1 μl of CSF from wild-type and transgenic mice, and 0.5 μl of human CSF. CONCLUSIONS The high sensitivity of the mouse sAPPα test will allow high-throughput investigations of molecules capable of increasing the secretion of endogenous sAPPα in primary neurons, as well as the in vivo validation of molecules of interest through the quantification of sAPPα in the CSF of treated wild-type mice. Active molecules could then be tested in the AD mouse models by quantifying human sAPPα in the CSF through the progression of the disease. Finally, the human sAPPα test could strengthen the biological diagnosis of AD in large clinical investigations. Taken together, these new tests have a wide field of applications in preclinical and clinical studies.
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Affiliation(s)
- Christiane Rose
- INSERM UMR 894, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
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