1
|
Rouaud T, Corbillé AG, Leclair-Visonneau L, de Guilhem de Lataillade A, Lionnet A, Preterre C, Damier P, Derkinderen P. Pathophysiology of Parkinson's disease: Mitochondria, alpha-synuclein and much more…. Rev Neurol (Paris) 2020; 177:260-271. [PMID: 33032797 DOI: 10.1016/j.neurol.2020.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 12/21/2022]
Abstract
Parkinson's disease (PD) is a complex, age-related, neurodegenerative disease whose pathogenesis remains incompletely understood. Here, we give an overview of the progress that has been made over the past four decades in our understanding of this disorder. We review the role of mitochondria, environmental toxicants, alpha-synuclein and neuroinflammation in the development of PD. We also discuss more recent data from genetics, which strongly support the endosomal-lysosomal pathways and mitophagy as being central to PD. Finally, we discuss the emerging role of the gut-brain axis as a modulator of PD progression. This article is intended to provide a comprehensive, general and practical review of PD pathogenesis for the general neurologist.
Collapse
Affiliation(s)
- T Rouaud
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | - A-G Corbillé
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | | | | | - A Lionnet
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | - C Preterre
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | - P Damier
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | - P Derkinderen
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| |
Collapse
|
2
|
Marelli C, Badiou S, Genestet S, Larrieu L, Damier P, Camu W, Planes M, Koenig M, Guissart C. Autosomal dominant SPG9: intrafamilial variability and onset during pregnancy. Neurol Sci 2020; 41:1931-1933. [PMID: 32221810 DOI: 10.1007/s10072-020-04341-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/13/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The ALDH18A1 gene, encoding delta-1-pyrroline-5-carboxylate synthase (P5CS), is responsible for an autosomal recessive disease with severe developmental delay; more recently, ALDH18A1 was found to be responsible for SPG9, an autosomal dominant (AD) spastic paraplegia. CASE REPORT We report a three-generation family with AD SPG9, initially suspected because of low citrulline on fasting plasma amino acid chromatography (AAC). Interestingly, in two patients, the spastic paraplegia appeared during pregnancy. One subject presented a severe childhood-onset form while another subject had a mild late-onset disease. CONCLUSION The description of this family is of particular interest: it highlights the possibility of transient or permanent aggravation of spastic paraplegia due to SPG9 during pregnancy, suggesting a direct link between neurological symptoms and amino acid defect in a period of higher requirements and the potential benefit of amino acid supplementation; it underscores the value of plasma citrulline on fasting plasma AAC as a biomarker for this disease; it shows the variable expression of the disease.
Collapse
Affiliation(s)
- C Marelli
- Department of Neurology, Expert Centre for Neurogenetic Diseases and Adult Mitochondrial and Metabolic Diseases, Gui de Chauliac University Hospital Montpellier, 80, Avenue A Fliche, 34295, Montpellier, France. .,Laboratoire de Génétique de Maladies Rares EA7402, Institut Universitaire de Recherche Clinique, Université de Montpellier, Montpellier, France. .,Inserm U1198 MMDN, Montpellier, France.
| | - S Badiou
- Biochemistry Laboratory, Lapeyronie Hospital, Montpellier, France.,PhyMedExp, INSERM, CNRS, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - S Genestet
- Hôpital de la Cavale Blanche, Service d'Explorations Fonctionnelles Neurologiques, CHRU de Brest, 29609, Brest, France
| | - L Larrieu
- Institut Universitaire de Recherche Clinique, Laboratoire de Génétique de Maladies Rares EA7402, Laboratoire de Génétique Moléculaire, University Hospital, Université de Montpellier, Montpellier, France
| | - P Damier
- Service de Neurologie, CHU de Nantes, Nantes, France
| | - W Camu
- Expert Center for Motor Neuron Diseases, Explorations Neurologiques, CHU and Université de Montpellier, Montpellier, France
| | - M Planes
- Service de Genetique Clinique, CHRU Morvan, 29609, Brest, France
| | - M Koenig
- Institut Universitaire de Recherche Clinique, Laboratoire de Génétique de Maladies Rares EA7402, Laboratoire de Génétique Moléculaire, University Hospital, Université de Montpellier, Montpellier, France
| | - C Guissart
- Institut Universitaire de Recherche Clinique, Laboratoire de Génétique de Maladies Rares EA7402, Laboratoire de Génétique Moléculaire, University Hospital, Université de Montpellier, Montpellier, France
| |
Collapse
|
3
|
Elsayed W, Damier P, Al Hashel J. Bumetanide to treat Parkinson's disease patients suffering from freezing of gait resistant to both dopamine replacement treatment and STN DBS: An open-label pilot study (BUMFOG). J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
4
|
Kamel WA, Al Hashel JY, Damier P. How do Parkinson's disease patients manage Ramadan fasting? An observational study. Rev Neurol (Paris) 2019; 175:560-563. [PMID: 31176513 DOI: 10.1016/j.neurol.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 10/26/2022]
Abstract
Twenty-four Parkinson's disease (PD) patients who had planned to fast during the 2016 Ramadan were included in this observational study. Twenty patients fasted during the whole Ramadan. Six were able to abstain from drug intakes from dawn to dusk; the others needed 1 or 2 intakes of L-DOPA during the day. There were no serious side effects reported during the Ramadan period. Compared to before Ramadan, there were no significant changes after the fasting period in quality of life (PDQ 39), non-motor symptom scale or clinical impression of severity index scores.
Collapse
Affiliation(s)
- W A Kamel
- Ibn Sina Hospital, Department of Neurology, Kuwait city, Kuwait; Beni-Suef University, Department of Neurology, Beni-Suef, Egypt
| | - J Y Al Hashel
- Ibn Sina Hospital, Department of Neurology, Kuwait city, Kuwait; University of Kuwait, Kuwait City, Kuwait
| | - P Damier
- Inserm, CIC 1413, clinique neurologique, hôpital Laennec, CHU de Nantes, 44093 Nantes, France; University of Nantes, 44035 Nantes, France.
| |
Collapse
|
5
|
Villafane G, Thiriez C, Audureau E, Straczek C, Kerschen P, Cormier-Dequaire F, Van Der Gucht A, Gurruchaga JM, Quéré-Carne M, Evangelista E, Paul M, Defer G, Damier P, Remy P, Itti E, Fénelon G. High-dose transdermal nicotine in Parkinson's disease patients: a randomized, open-label, blinded-endpoint evaluation phase 2 study. Eur J Neurol 2017; 25:120-127. [PMID: 28960663 DOI: 10.1111/ene.13474] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 09/06/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Studies of the effects of nicotine on motor symptoms in Parkinson's disease (PD) brought out discordant results. The aim of the present study was to evaluate the efficacy and safety of high doses of transdermal nicotine on motor symptoms in PD. METHODS Forty PD patients were randomly assigned to a treated and untreated arm in an open-label study. Treated patients received increasing doses of nicotine to reach 90 mg/day by 11 weeks. This dosage was maintained for 28 weeks (W39) and then reduced over 6 weeks. Final evaluation was performed 6 weeks after washout. The main outcome measure was the OFF-DOPA Unified Parkinson's Disease Rating Scale (UPDRS) motor score measured on video recordings by raters blinded to the medication status of the patients. RESULTS There was no significant difference in OFF-DOPA UPDRS motor scores between the nicotine-treated and non-treated groups, neither at W39 (19.4 ± 9.3 vs. 21.5 ± 14.2) nor considering W39 differences from baseline (-1.5 ± 12.1 vs. +0.9 ± 12.1). The 39-item Parkinson's disease questionnaire scores decreased in nicotine-treated patients and increased in non-treated patients, but the difference was not significant. Overall tolerability was acceptable, and 12/20 treated patients reached the maximal dosage. CONCLUSIONS High doses of transdermal nicotine were tolerated, but our study failed to demonstrate significant improvement in UPDRS motor scores. Improvement in unblinded secondary outcomes (UPDRS-II, UPDRS-IV, doses of l-DOPA equivalents) suggest a possible benefit for patients treated with nicotine, which should be confirmed in larger double blind, placebo-controlled studies.
Collapse
Affiliation(s)
- G Villafane
- Department of Neurology, APHP, CHU Henri Mondor, Créteil, France
| | - C Thiriez
- Department of Neurology, APHP, CHU Henri Mondor, Créteil, France.,Centre Expert Parkinson Henri Mondor, Créteil, France
| | - E Audureau
- Department of Public Health, APHP, CHU Henri Mondor, Créteil, France.,CEpiA EA7376, UPEC, Créteil, France
| | - C Straczek
- Clinical Research Unit, APHP, CHU Henri Mondor, Créteil, France.,Pharmacy Department, CHU Henri Mondor, Créteil, France
| | - P Kerschen
- Department of Neurology, APHP, CHU Henri Mondor, Créteil, France
| | | | - A Van Der Gucht
- Department of Nuclear Medicine, APHP, CHU Henri Mondor, Créteil, France.,UPEC, Créteil, France
| | - J-M Gurruchaga
- Department of Neurosurgery, APHP, CHU Henri Mondor, Créteil, France.,Equipe 14, Inserm U955, Créteil, France
| | - M Quéré-Carne
- Clinical Research Unit, APHP, CHU Henri Mondor, Créteil, France
| | - E Evangelista
- Department of Nuclear Medicine, APHP, CHU Henri Mondor, Créteil, France
| | - M Paul
- Pharmacy Department, CHU Henri Mondor, Créteil, France
| | - G Defer
- Neurology, CHU Caen, Caen, France.,INSERM U919 GIP Cyceron, Normandie Université, Caen, France
| | - P Damier
- CIC 004, CHU Nantes, INSERM, Nantes, France
| | - P Remy
- Department of Neurology, APHP, CHU Henri Mondor, Créteil, France.,Centre Expert Parkinson Henri Mondor, Créteil, France.,MIRCen, CEA/DSV and NeuRATRIS, Fontenay-aux-Roses, France
| | - E Itti
- Department of Nuclear Medicine, APHP, CHU Henri Mondor, Créteil, France.,UPEC, Créteil, France
| | - G Fénelon
- Department of Neurology, APHP, CHU Henri Mondor, Créteil, France.,Centre Expert Parkinson Henri Mondor, Créteil, France.,Département d'Etudes Cognitives, Ecole Normale Supérieure, PSL Research University, Paris, France.,Inserm U955, Equipe E01 Neuropsychologie Interventionnelle, Créteil, France
| |
Collapse
|
6
|
Perez-Lloret S, Negre-Pages L, Damier P, Delval A, Derkinderen P, Destée A, Meissner WG, Tison F, Rascol O. L-DOPA-induced dyskinesias, motor fluctuations and health-related quality of life: the COPARK survey. Eur J Neurol 2017; 24:1532-1538. [PMID: 28940893 DOI: 10.1111/ene.13466] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/18/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Studies assessing the correlations between L-DOPA-induced dyskinesias (LIDs) and motor fluctuations with health-related quality of life (HRQoL) in Parkinson's disease (PD) have yielded conflicting results. This study aimed to assess the relationship between LIDs and motor fluctuations with HRQoL in patients with PD, and to assess the relative contribution of their severity and duration in a large sample of patients with PD. METHODS A total of 683 patients with PD from the COPARK survey were evaluated. HRQoL was assessed using the 39-Item Parkinson's Disease Questionnaire (PDQ-39) (primary outcome) and 36-Item Short Form Survey (SF-36). The daily duration and severity of LIDs were obtained from Unified Parkinson's Disease Rating Scale (UPDRS) IV items 32 and 33, respectively. The daily duration of motor fluctuations was obtained from UPDRS IV item 36 and severity was estimated as the difference between the UPDRS 2 (Activities of Daily Living) score in 'OFF' versus 'ON' condition. RESULTS A total of 235 patients with PD (35%) experienced motor fluctuations and 182 (27%) experienced LIDs. The PDQ-39 total and SF-36 physical scores were significantly worse in patients with LIDs, after adjusting for the presence of motor fluctuations. The PDQ-39 total score and SF-36 physical and mental score were significantly worse in patients with motor fluctuations, after adjusting for the presence of LIDs. The severity of LIDs and the duration of motor fluctuations significantly and independently affected PDQ-39 scores. The SF-36 physical score was affected only by the severity of motor fluctuations, whereas the mental score was not affected by any of the aforementioned variables. CONCLUSION Our findings suggest that LIDs (mainly their severity) and motor fluctuations (mainly their duration) correlate independently with HRQoL in patients with PD.
Collapse
Affiliation(s)
- S Perez-Lloret
- INSERM, Services de Pharmacologie Clinique et Neurosciences, Centre d'Investigation Clinique CIC 1436, NS-Park/FCRIN Network, NeuroToul COEN Center, Université de Toulouse UPS, CHU de Toulouse, Toulouse, France.,Institute of Cardiology Research, University of Buenos Aires, National Research Council (CONICET-ININCA), Buenos Aires, Argentina
| | - L Negre-Pages
- LN Pharma, Toulouse.,Département d'Information Médicale, Unité de Recherche Clinique et Epidémiologie, Hôpital la Colombière, Montpellier
| | - P Damier
- Department of Neurology, INSERM, NS-Park/FCRIN Network, Université de Nantes, CHU de Nantes, Nantes
| | - A Delval
- Department of Neurology, INSERM, NS-Park/FCRIN Network, Université de Lille, CHU de Lille, U 837 Eq6, Lille
| | - P Derkinderen
- Department of Neurology, INSERM, NS-Park/FCRIN Network, Université de Nantes, CHU de Nantes, Nantes
| | - A Destée
- Department of Neurology, INSERM, NS-Park/FCRIN Network, Université de Lille, CHU de Lille, U 837 Eq6, Lille
| | - W G Meissner
- CNRS, CHU de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Service de Neurologie, NS-Park/FCRIN Network, Université de Bordeaux, Bordeaux, France
| | - F Tison
- CNRS, CHU de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Service de Neurologie, NS-Park/FCRIN Network, Université de Bordeaux, Bordeaux, France
| | - O Rascol
- INSERM, Services de Pharmacologie Clinique et Neurosciences, Centre d'Investigation Clinique CIC 1436, NS-Park/FCRIN Network, NeuroToul COEN Center, Université de Toulouse UPS, CHU de Toulouse, Toulouse, France
| | | |
Collapse
|
7
|
Schuepbach WMM, Rau J, Knudsen K, Volkmann J, Krack P, Timmermann L, Hälbig TD, Hesekamp H, Navarro SM, Meier N, Falk D, Mehdorn M, Paschen S, Maarouf M, Barbe MT, Fink GR, Kupsch A, Gruber D, Schneider GH, Seigneuret E, Kistner A, Chaynes P, Ory-Magne F, Brefel Courbon C, Vesper J, Schnitzler A, Wojtecki L, Houeto JL, Bataille B, Maltête D, Damier P, Raoul S, Sixel-Doering F, Hellwig D, Gharabaghi A, Krüger R, Pinsker MO, Amtage F, Régis JM, Witjas T, Thobois S, Mertens P, Kloss M, Hartmann A, Oertel WH, Post B, Speelman H, Agid Y, Schade-Brittinger C, Deuschl G. Neurostimulation for Parkinson's disease with early motor complications. N Engl J Med 2013; 368:610-22. [PMID: 23406026 DOI: 10.1056/nejmoa1205158] [Citation(s) in RCA: 851] [Impact Index Per Article: 77.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Subthalamic stimulation reduces motor disability and improves quality of life in patients with advanced Parkinson's disease who have severe levodopa-induced motor complications. We hypothesized that neurostimulation would be beneficial at an earlier stage of Parkinson's disease. METHODS In this 2-year trial, we randomly assigned 251 patients with Parkinson's disease and early motor complications (mean age, 52 years; mean duration of disease, 7.5 years) to undergo neurostimulation plus medical therapy or medical therapy alone. The primary end point was quality of life, as assessed with the use of the Parkinson's Disease Questionnaire (PDQ-39) summary index (with scores ranging from 0 to 100 and higher scores indicating worse function). Major secondary outcomes included parkinsonian motor disability, activities of daily living, levodopa-induced motor complications (as assessed with the use of the Unified Parkinson's Disease Rating Scale, parts III, II, and IV, respectively), and time with good mobility and no dyskinesia. RESULTS For the primary outcome of quality of life, the mean score for the neurostimulation group improved by 7.8 points, and that for the medical-therapy group worsened by 0.2 points (between-group difference in mean change from baseline to 2 years, 8.0 points; P=0.002). Neurostimulation was superior to medical therapy with respect to motor disability (P<0.001), activities of daily living (P<0.001), levodopa-induced motor complications (P<0.001), and time with good mobility and no dyskinesia (P=0.01). Serious adverse events occurred in 54.8% of the patients in the neurostimulation group and in 44.1% of those in the medical-therapy group. Serious adverse events related to surgical implantation or the neurostimulation device occurred in 17.7% of patients. An expert panel confirmed that medical therapy was consistent with practice guidelines for 96.8% of the patients in the neurostimulation group and for 94.5% of those in the medical-therapy group. CONCLUSIONS Subthalamic stimulation was superior to medical therapy in patients with Parkinson's disease and early motor complications. (Funded by the German Ministry of Research and others; EARLYSTIM ClinicalTrials.gov number, NCT00354133.).
Collapse
Affiliation(s)
- W M M Schuepbach
- Assistance Publique–Hôpitaux de Paris, Centre d'Investigation Clinique (CIC) 9503, Institut du Cerveau et de la Moelle Épinière, Département de Neurologie, Université Pierre et Marie Curie–Paris 6 and INSERM, Centre Hospitalier Universitaire (CHU) Pitié–Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Meyniel C, Derkinderen P, Giumelli B, Damier P. Continuous buccolingual masticatory dyskinesia in Parkinson's disease. Case Reports 2012; 2012:bcr.09.2008.0910. [DOI: 10.1136/bcr.09.2008.0910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
9
|
Paillusson S, Lebouvier T, Pouclet H, Coron E, Bruley des Varannes S, Damier P, Neunlist M, Derkinderen P. Système nerveux entérique et maladie de Parkinson. Rev Med Interne 2012; 33:335-8. [DOI: 10.1016/j.revmed.2012.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 01/05/2012] [Indexed: 12/13/2022]
|
10
|
Perez-Lloret S, Nègre-Pagès L, Ojero-Senard A, Damier P, Destée A, Tison F, Merello M, Rascol O. Oro-buccal symptoms (dysphagia, dysarthria, and sialorrhea) in patients with Parkinson’s disease: preliminary analysis from the French COPARK cohort. Eur J Neurol 2011; 19:28-37. [DOI: 10.1111/j.1468-1331.2011.03402.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
11
|
Dolbeau G, Lombard A, Youssov K, Dürr A, Charles P, Verny C, Azulay JP, Krystkowiak P, Simonin C, Tranchant C, Goizet C, Damier P, Supiot F, Broussolle E, Démonet JF, Marie RM, Verin M, Bachoud-Lévi AC, Maison P. L03 Use and impact of neuroleptics in Huntington's disease: a prospective cohort study of the Huntington French speaking group. J Neurol Neurosurg Psychiatry 2010. [DOI: 10.1136/jnnp.2010.222687.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
12
|
Negre-Pages L, Perez Lloret S, Damier P, Destee A, Tison F, Sampaio C, Ferreira J, Martinez Martin P, Rascol O. P3.135 Predictive factors for PD progression – preliminary results of PARKMIP/COPARK cohort after 24-months follow up. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70699-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Deligny C, Drapier S, Verin M, Lajat Y, Raoul S, Damier P. BILATERAL SUBTHALAMOTOMY THROUGH DBS ELECTRODES: A RESCUE OPTION FOR DEVICE-RELATED INFECTION. Neurology 2009; 73:1243-4. [DOI: 10.1212/wnl.0b013e3181bbfedd] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
14
|
Sevin M, Kutalik Z, Bergman S, Vercelletto M, Renou P, Lamy E, Vingerhoets FJ, Di Virgilio G, Boisseau P, Bezieau S, Pasquier L, Rival JM, Beckmann JS, Damier P, Jacquemont S. Penetrance of marked cognitive impairment in older male carriers of the FMR1 gene premutation. J Med Genet 2009; 46:818-24. [DOI: 10.1136/jmg.2008.065953] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
15
|
Damier P, Destée A, Tison F, Rascol O. Suivi prospectif d’une population de patients parkinsoniens (cohorte CoPark). Rev Epidemiol Sante Publique 2009. [DOI: 10.1016/j.respe.2009.02.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
16
|
Perez Lloret S, Nègre-Pagès L, Cochen V, Debs R, Damier P, Destée A, Tison F, Rascol O. Hallucinations et rêves animés dans la maladie de Parkinson : données préliminaires de l’étude PARKMIP/COPARK. Rev Epidemiol Sante Publique 2009. [DOI: 10.1016/j.respe.2009.02.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
17
|
Lesage S, Condroyer C, Lannuzel A, Lohmann E, Troiano A, Tison F, Damier P, Thobois S, Ouvrard-Hernandez AM, Rivaud-Péchoux S, Brefel-Courbon C, Destée A, Tranchant C, Romana M, Leclere L, Dürr A, Brice A. Molecular analyses of the LRRK2 gene in European and North African autosomal dominant Parkinson's disease. J Med Genet 2009; 46:458-64. [PMID: 19357115 DOI: 10.1136/jmg.2008.062612] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Mutations in the leucine-rich-repeat kinase 2 (LRRK2) gene have been identified in families with autosomal dominant Parkinson's disease (ADPD), the most common of which is the p.G2019S substitution that has been found at varying frequencies worldwide. Because of the size of the LRRK2 gene, few studies have analysed the entire gene in large series of ADPD families. METHODS We performed extensive mutation analyses of all 51 coding exons of the LRRK2 gene in index cases from 226 Parkinson's disease families compatible with autosomal dominant inheritance, mostly from France (n = 182) and North Africa (n = 14). RESULTS We found 79 sequence variants, 29 of which were novel. Eight potentially or proven pathogenic mutations were found in 22 probands (9.7%). There were four novel amino acid substitutions that are potentially pathogenic (p.S52F, p.N363S, p.I810V, p.R1325Q) and two novel variants, p.H1216R and p.T1410M, that are probably not causative. The common p.G2019S mutation was identified in 13 probands (5.8%) including six from North Africa (43%). The known heterozygous p.R1441H and p.I1371V mutations were found in two probands each, and the p.E334K variant was identified in one single patient. Most potentially or proven pathogenic mutations were located in the functional domains of the Lrrk2 protein. CONCLUSION This study leads us to conclude that LRRK2 mutations are a common cause of autosomal dominant Parkinson's disease in Europe and North Africa.
Collapse
|
18
|
Derkinderen P, Lebouvier T, Chaumette T, Coron E, Bruley des Varannes S, Neunlist M, Damier P. Les biopsies coliques obtenues par endoscopie : un outil pour étudier l’atteinte du système nerveux entérique dans la maladie de Parkinson. Rev Neurol (Paris) 2009. [DOI: 10.1016/s0035-3787(09)70005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Nègre-Pagès L, Cochen V, Debs R, Damier P, Destée A, Tison F, Rascol O. Prévalence et facteurs associés aux hallucinations dans la maladie de Parkinson : données préliminaires de l’étude COPARK dans la Région Midi-Pyrénées (PARKMIP). Rev Neurol (Paris) 2009. [DOI: 10.1016/s0035-3787(09)70003-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
20
|
Lebouvier T, Chaumette T, Damier P, Coron E, Touchefeu Y, Vrignaud S, Naveilhan P, Galmiche JP, Bruley des Varannes S, Derkinderen P, Neunlist M. Pathological lesions in colonic biopsies during Parkinson's disease. Gut 2008; 57:1741-3. [PMID: 19022934 DOI: 10.1136/gut.2008.162503] [Citation(s) in RCA: 170] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
21
|
Damier P, Viallet F, Ziegler M, Bourdeix I, Rerat K. Levodopa/DDCI and entacapone is the preferred treatment for Parkinson's disease patients with motor fluctuations in routine practice: a retrospective, observational analysis of a large French cohort. Eur J Neurol 2008; 15:643-8. [PMID: 18582341 DOI: 10.1111/j.1468-1331.2008.02165.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Levodopa is the gold standard drug for the symptomatic control of Parkinson's disease (PD). However, long-term treatment with conventional formulations [levodopa and a dopa decarboxylase inhibitor (DDCI)], is associated with re-emergence of symptoms because of wearing-off and dyskinesia. Treatment with levodopa/DDCI and entacapone extends the half-life of levodopa, avoiding deep troughs in levodopa plasma levels and providing more continuous delivery of levodopa to the brain. In this open-label, retrospective, observational study we investigated the effects of levodopa/DDCI and entacapone therapy in 800 PD patients with motor fluctuations. Levodopa/DDCI and entacapone treatment was assessed as good/very good in improving motor fluctuations (64%) and activities of daily living (ADL; 62%). The therapeutic utility was considered to be good/very good in 70% of cases. Moreover, there was a reduction in levodopa dose in 20% of patients. Neurologists preferred levodopa/DDCI and entacapone compared with increasing levodopa dosage, dose-fractionation or addition of a dopamine agonist (63%, 29% and 23% of patients respectively). Reasons included achieving more continuous dopaminergic stimulation (40%), reducing motor fluctuations (54%) and improving ADL (41%). This analysis reveals the preference of neurologists for levodopa/DDCI and entacapone over conventional levodopa-modification strategies for the effective treatment of PD motor fluctuations in clinical practice.
Collapse
Affiliation(s)
- P Damier
- INSERM, CIC04, Nantes, France and CHU Nantes, Clinique Neurologique, Nantes, France.
| | | | | | | | | |
Collapse
|
22
|
Néel A, Auffray-Calvier E, Guillon B, Agard C, Damier P, Hamidou M. Syndrome de vasoconstriction cérébrale réversible (RCVS) versus angéite du système nerveux central : étude rétrospective de 15 artériopathies intracrâniennes diffuses. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.03.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
23
|
Roze E, Apartis E, Clot F, Dorison N, Thobois S, Guyant-Marechal L, Tranchant C, Damier P, Doummar D, Bahi-Buisson N, André-Obadia N, Maltete D, Echaniz-Laguna A, Pereon Y, Beaugendre Y, Dupont S, De Greslan T, Jedynak CP, Ponsot G, Dussaule JC, Brice A, Dürr A, Vidailhet M. Myoclonus-dystonia: clinical and electrophysiologic pattern related to SGCE mutations. Neurology 2008; 70:1010-6. [PMID: 18362280 DOI: 10.1212/01.wnl.0000297516.98574.c0] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To clarify the clinical and neurophysiologic spectrum of myoclonus-dystonia patients with mutations of the SGCE gene. METHODS We prospectively studied 41 consecutive patients from 22 families with documented mutations of the SGCE gene. The patients had a standardized interview, neurologic examination, and detailed neurophysiologic examination, including surface polymyography, long-loop C-reflex studies, and EEG jerk-locked back averaging. RESULTS We noted a homogeneous electrophysiologic pattern of myoclonus of subcortical origin with short jerks (mean 95 msec, range 25 to 256 msec) at rest, during action, and during posture; there were no features of cortical hyperexcitability (specifically no abnormal C-reflex response and no short-latency premyoclonic potential on back-averaging studies). Myoclonus was either isolated or associated with mild to moderate dystonia, and predominated in the neck/trunk or proximal upper limbs in most cases. We found that 22% of the patients had a spontaneous improvement in their dystonia before reaching adulthood and that hypotonia can occasionally be a presenting symptom of the disorder. CONCLUSION We describe the myoclonus in patients with mutations in the SGCE gene and characterize the electrophysiologic pattern of this myoclonus. This pattern may help to improve the sensitivity of molecular tests and to define homogeneous populations suitable for inclusion in therapeutic trials.
Collapse
Affiliation(s)
- E Roze
- Service de Neurologie, Hôpital Saint Antoine, 184 rue du Faubourg Saint-Antoine, 75571 Paris cedex 12, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Sévin M, Kutalik Z, Bergmann S, Vercelletto M, Renou P, Lamy E, Boisseau P, Bezieau S, Pasquier L, Rival J, Beckmann J, Damier P, Jacquemont S. Prévalence des troubles cognitifs chez les sujets porteurs de la prémutation du gène fmr1. Rev Neurol (Paris) 2008. [DOI: 10.1016/s0035-3787(08)70029-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
25
|
Néel A, Guillon B, Auffray-Calvier E, Damier P, Hamidou M. Angiopathie cérébrale aiguë bénigne du post-partum: à propos de deux cas. Rev Med Interne 2007. [DOI: 10.1016/j.revmed.2007.03.157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
26
|
Maiga Y, Wiertlewski S, Desal H, Marjolet M, Damier P. [Presentation of cerebral toxocariasis with mental confusion in an adult: case report and review of the literature]. Bull Soc Pathol Exot 2007; 100:101-4. [PMID: 17727029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Toxocariasis is usually responsible for visceral larva migrans syndroms. Nervous system involvement is a rare complication. In this report, we describe one case of meningoencephalitis due to Toxocara canis in a 73-year-old man presenting with mental confusion. The diagnosis of cerebral toxocariasis was confirmed by immunodiagnosis in both serum and cerebro-spinal fluid. Cerebral toxocariasis may be suspected in patients presenting with some neurological patterns including: confusion, meningitis, meningo-encephalitis, meningo-myelitis, when the etiological assessment remains negative and the environmental context is favourable. Finding evidence of specific antibodies in both cerebro spinal fluid and serum is mandatory for the diagnosis. The main clinical features concerning cerebral toxocariasis, diagnostic tools, and therapeutic measures are discussed.
Collapse
Affiliation(s)
- Y Maiga
- Clinique Neurologique, CHU Nantes, Hôpital Laënnec, Saint-Herblain, France
| | | | | | | | | |
Collapse
|
27
|
Damier P. Parkinson plus (AMS-PSP) : mythe ou réalité de la neuroprotection ? Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)91004-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
28
|
Ziegler M, Damier P, Fenelon G, Nachit-Ouinekh F. 2.260 TEAM: A French cross-sectional study on the time-related evolution of the scores of the “Handipark”, in relation to the duration of the Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70672-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
29
|
Lanctin C, Wiertlewski S, Moreau C, Verny C, Derkinderen P, Damier P, Dubas F. Myélite aiguë transverse idiopathique : application des nouveaux critères diagnostiques à une cohorte de 17 patients. Rev Neurol (Paris) 2006; 162:980-9. [PMID: 17028566 DOI: 10.1016/s0035-3787(06)75108-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Idiopathic Acute Transverse Myelitis (ATM) is an inflammatory and immune-mediated disorder, distinct from infectious ATM, ATM of systemic lupus erythematosus or Sjögren's syndrome, and medullary manifestation of multiple sclerosis. Prognosis is not well-known. OBJECTIVE To evaluate clinical, paraclinical and pronognosis data in patients selected with new diagnosis criteria, classically described in idiopathic ATM. METHODS Seventeen patients with diagnosis criteria were retrospectively (1996-2005) studied. A telephone investigation was conducted in 2005 to obtained data on the clinical course. RESULTS Seven men and 10 women, ranging in age from 15 to 75 years (mean: 39.8 years) met these new criteria. Our study showed that epidemiological and clinical findings as well as laboratory results were in agreement with those presented in the literature. Conversely, prognosis was better since 76p.cent of the patients could walk without assistance. The clinical presentation of some of our patients and/or their progression towards other multifocal inflammatory disorders, suggests there might be links between ATM, neuromyelitis optica (NMO) and Acute Dissemined Encephalomyelitis (ADEM). CONCLUSION Patients with idiopathic ATM, selected with new criteria, have a rather good prognosis. ATM seems to be part of a continuum of neuroimmunologic disorders including NMO or ADEM although reasons explaining distinct focal disorders remain unclear.
Collapse
Affiliation(s)
- C Lanctin
- Pôle de Neurologie médicale et chirurgicale, Hôpital Laennec, CHU de Nantes, Saint-Herblain, France.
| | | | | | | | | | | | | |
Collapse
|
30
|
Douaud G, Gaura V, Ribeiro MJ, Lethimonnier F, Maroy R, Verny C, Krystkowiak P, Damier P, Bachoud-Levi AC, Hantraye P, Remy P. Distribution of grey matter atrophy in Huntington’s disease patients: A combined ROI-based and voxel-based morphometric study. Neuroimage 2006; 32:1562-75. [PMID: 16875847 DOI: 10.1016/j.neuroimage.2006.05.057] [Citation(s) in RCA: 196] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2005] [Revised: 03/29/2006] [Accepted: 05/23/2006] [Indexed: 11/24/2022] Open
Abstract
The striatum, a subcortical structure, is the principal target of the neurodegenerative process in Huntington's disease (HD). The measurement of striatal atrophy using the bicaudate ratio on CT scanner images has therefore been used for years to assess disease progression, but this measure only takes into account unidimensional changes in the head of the caudate nucleus. Recently, voxel-based morphometry (VBM), which permits automated statistical comparisons of whole-brain MRI images, has been proposed to quantify striatal atrophy. However, VBM was not originally designed to study subcortical structures, and severe deep brain deformations that occur in HD may hamper the automatic processing of VBM. Here, we validate the use of the optimised protocol of VBM to quantify subcortical atrophy in HD by comparing results obtained with this method to those provided by manual segmentation of subcortical structures. We studied 20 patients with early HD and 12 controls matched for age, sex and handedness using an improved T1-weighted sequence that eased grey matter segmentation. Both manual and automated methods evidenced the dorso-ventral gradient of striatal atrophy, a loss of grey matter in the globus pallidus and the thalamus, and similar correlations between clinical scores and subcortical atrophy. Furthermore, we were able to detect with VBM grey matter loss in the substantia nigra, the hypothalamus, the amygdala, the insular cortex and the premotor and sensorimotor cortices. Finally, VBM provided results consistent with previous post mortem results and proved to be a sensitive biomarker capable of correctly managing subcortical distortions throughout HD patients' brains.
Collapse
Affiliation(s)
- G Douaud
- URA CNRS-CEA 2210, Service Hospitalier Frédéric Joliot, 4, place du Général Leclerc, 91 401 Orsay, and Département de Neurologie, CHU Angers, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Abstract
BACKGROUND Early diagnosis of fronto-temporal dementia (FTD) is often difficult because of the non-specific presentation. Saccadic eye movements, which are mainly controlled by the frontal areas, may provide a powerful tool for the analysis of frontal lobe dysfunction. The pattern of saccadic abnormalities has not previously been investigated in patients with FTD. OBJECTIVE To study saccade tasks in a group of 23 patients with FTD and compare the results with aged matched healthy controls. METHODS Triggering and inhibition of reflexive prosaccades were evaluated in a prosaccade and an antisaccade task, respectively, while the ability to withhold an antisaccade during a delay was explored in a delayed antisaccade task. Patients with progressive supranuclear palsy (PSP), in whom the pattern of eye movement deficit is well documented, were studied with the same protocol. To characterise the frontal lobe dysfunction in FTD more precisely, a battery of neuropsychological tests was carried out in these patients. RESULTS Patients with FTD showed impaired reflexive saccade inhibition, similar to that observed in patients with PSP, and a decreased ability to withhold an antisaccade. CONCLUSIONS Inhibition of reflexive and voluntary saccades appears to be independently processed. A delayed antisaccade task could be useful for the early diagnosis of FTD.
Collapse
Affiliation(s)
- C Meyniel
- Service de Neurologie, CHU de Nantes, France
| | | | | | | |
Collapse
|
32
|
Tezenas du Montcel S, Clot F, Vidailhet M, Roze E, Damier P, Jedynak CP, Camuzat A, Lagueny A, Vercueil L, Doummar D, Guyant-Maréchal L, Houeto JL, Ponsot G, Thobois S, Cournelle MA, Durr A, Durif F, Echenne B, Hannequin D, Tranchant C, Brice A. Epsilon sarcoglycan mutations and phenotype in French patients with myoclonic syndromes. J Med Genet 2005; 43:394-400. [PMID: 16227522 PMCID: PMC2564513 DOI: 10.1136/jmg.2005.036780] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Myoclonus dystonia syndrome (MDS) is an autosomal dominant movement disorder caused by mutations in the epsilon-sarcoglycan gene (SGCE) on chromosome 7q21. METHODS We have screened for SGCE mutations in index cases from 76 French patients with myoclonic syndromes, including myoclonus dystonia (M-D), essential myoclonus (E-M), primary myoclonic dystonia, generalised dystonia, dystonia with tremor, and benign hereditary chorea. All coding exons of the SGCE gene were analysed. The DYT1 mutation was also tested. RESULTS Sixteen index cases had SGCE mutations while one case with primary myoclonic dystonia carried the DYT1 mutation. Thirteen different mutations were found: three nonsense mutations, three missense mutations, three splice site mutations, three deletions, and one insertion. Eleven of the SGCE index cases had M-D and five E-M. No SGCE mutations were detected in patients with other phenotypes. The total number of mutation carriers in the families was 38, six of whom were asymptomatic. Penetrance was complete in paternal transmissions and null in maternal transmissions. MDS patients with SGCE mutation had a significantly earlier onset than the non-carriers. None of the patients had severe psychiatric disorders. CONCLUSION This large cohort of index patients shows that SGCE mutations are primarily found in patients with M-D and to a lesser extent E-M, but are present in only 30% of these patients combined (M-D and E-M).
Collapse
Affiliation(s)
- S Tezenas du Montcel
- Service de Biostatistique et Information Medicale, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Houeto JL, Karachi C, Mallet L, Pillon B, Yelnik J, Mesnage V, Welter ML, Navarro S, Pelissolo A, Damier P, Pidoux B, Dormont D, Cornu P, Agid Y. Tourette's syndrome and deep brain stimulation. J Neurol Neurosurg Psychiatry 2005; 76:992-5. [PMID: 15965209 PMCID: PMC1739716 DOI: 10.1136/jnnp.2004.043273] [Citation(s) in RCA: 220] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In this prospective double blind randomised "N of 1" study, a patient with a severe form of Tourette's syndrome was treated with bilateral high frequency stimulation of the centromedian-parafascicular complex (Ce-Pf) of the thalamus, the internal part of the globus pallidus (GPi), or both. Stimulation of either target improved tic severity by 70%, markedly ameliorated coprolalia, and eliminated self injuries. Severe forms of Tourette's syndrome may benefit from stimulation of neuronal circuits within the basal ganglia, thus confirming the role of the dysfunction of limbic striato-pallido-thalamo-cortical systems in this disorder.
Collapse
Affiliation(s)
- J L Houeto
- Centre d'Investigation Clinique, Hôpital de la Salpêtrière, 47 boulevard de l'Hôpital, 75013 Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Derkinderen P, Valjent E, Darcel F, Damier P, Girault JA. Cannabis et récepteurs cannabinoïdes : de la physiopathologie aux possibilités thérapeutiques. Rev Neurol (Paris) 2004; 160:639-49. [PMID: 15247852 DOI: 10.1016/s0035-3787(04)71013-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although cannabis has been used as a medicine for several centuries, the therapeutic properties of cannabis preparations (essentially haschich and marijuana) make them far most popular as a recreational drugs. STATE OF THE ART Scientific studies on the effects of cannabis were advanced considerably by the identification in 1964 of cannabinoid D9-tetrahydrocannadinol (THC), recognized as the major active constituent of cannabis. Cloning of the centrally located CB1 receptor in 1990 and the identification of the first endogenous ligand of the CB1 receptor, anandamide, in 1992 further advanced our knowledge. PERSPECTIVE AND CONCLUSIONS Progress has incited further research on the biochemistry and pharmacology of the cannabinoids in numerous diseases of the central nervous system. In the laboratory animal, cannabinoids have demonstrated potential in motion disorders, demyelinizing disease, epilepsy, and as anti-tumor and neuroprotector agents. Several clinical studies are currently in progress, but therapeutic use of cannabinoids in humans couls be hindered by undesirable effects, particularly psychotropic effects. CB1 receptor antagonists also have interesting therapeutic potential.
Collapse
Affiliation(s)
- P Derkinderen
- Service de Neurologie et Centre d'investigations cliniques, CHU de Nantes, Hôpital Laënnec, Nantes.
| | | | | | | | | |
Collapse
|
35
|
Mesnage V, Houeto JL, Bonnet AM, Clavier I, Arnulf I, Cattelin F, Le Fur G, Damier P, Welter ML, Agid Y. Neurokinin B, Neurotensin, and Cannabinoid Receptor Antagonists and Parkinson Disease. Clin Neuropharmacol 2004; 27:108-10. [PMID: 15190231 DOI: 10.1097/00002826-200405000-00003] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The neuropeptides neurokinin B, neurotensin, and anandamide, the endogenous ligands of NK3, NT1, and CB1 receptors respectively, are known to interact with brain dopaminergic transmission. This study evaluated the effects of these three antagonists of the NK3 (SR 142801), neurotensin (SR 48692), and cannabinoid (SR 141716) receptors on the severity of motor symptoms and levodopa-induced dyskinesias after administration of a single dose of levodopa in 24 patients with Parkinson disease. In this exploratory randomized, double-blind, placebo-controlled study, at the dose used, the drugs tested were well tolerated and could not improve parkinsonian motor disability.
Collapse
Affiliation(s)
- V Mesnage
- Centre d'Investigation Clinique, Fédération de Neurologie and Inserm, Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Ziégler M, de Broucker T, Damier P, Humbert R, Clerson P, Richard-Berthe C. [Handipark: a simple test of the impact of Parkinson's disease on activities of daily living]. Rev Neurol (Paris) 2003; 159:767-74. [PMID: 13679719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Handipark, a new score for measuring the impact of Parkinson's disease on daily life activities is presented. The global score ranging from 1 to 10 (without half points) is easy to determine. For a given patient, the score takes into account 5 items describing the global impact of the disease;Inter- and intra-observer reproducibility were determined. The reliability of the score was tested during two sessions separated by a 3-week interval. Five qualified neurologists scored 30 Parkinson's patients presented randomly for scoring using a semi-structured video-recorded interview. Intra-observer reproducibility was good (concordance coefficient; k=0.74, Spearman's correlation coefficient; r=0.88). Inter-observer reproducibility was also good: r=0.96 (first session), r=0.87 (second session); the agreement coefficient between the 5 observers was k=0.85 (first session), k=0.82 (second session). Distribution curves of the Hanipark score was described in 150 Parkinson's disease patients to study the correlation with items of other scales specific for Parkinson's disease (UPDRS, Hoehn & Yahr). A number significant correlations were found. Handipark is a reliable tool easy to use in clinical practice by a large panel of physicians caring for Parkinson's disease patients to assess the impact of Parkinson's disease. Further studies are needed to assess its usefulness for the follow-up of patients and assess the therapeutic impact.
Collapse
Affiliation(s)
- M Ziégler
- Service de Neurologie, Hôpital Léopold Bellan, Paris
| | | | | | | | | | | |
Collapse
|
37
|
Vercelletto M, Belliard S, Wiertlewski S, Venisse T, Magne C, Duyckaerts C, Damier P. [Neuropsychological and scintigraphic aspects of frontotemporal dementia preceding amyotrophic lateral sclerosis]. Rev Neurol (Paris) 2003; 159:529-42. [PMID: 12773898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Between 1993 and 2001, we observed fifteen patients (ten men and five women, mean age 63 years) with frontotemporal dementia (FTD) which preceded signs of amyotrophic lateral sclerosis (ALS) which developed 21 months later. Mean disease duration in the fourteen deceased patients was 38 months. FTD associated with ALS is characterized by rapid course, predominance of disinhibited forms (orbito-basal), presence of aphasia with neologisms, and semantic memory disorders. Performed in all patients, single-photon emission computed tomography demonstrated a bifrontal pattern of low uptake, sometimes associated with low uptake in the anterior temporal region. In one patient, neuropathology revealed neuron atrophy and loss in the frontotemporal region, the anterior horns, and the hypoglossal nucleus. Ubiquitin-positive inclusions were visible in the dentate gyrus of the hippocampus and in the anterior horns. The dementia/ALS association is classically described is uncommon. It belongs to the FTD group since the Lund and Manchester consensus. Approximately 15 p.100 of patient with FTD can be expected to develop ALS. About 250 cases have been reported in the literature, half of them in the Pacific area where the incidence of ALS is high (55/100,000 inhabitants versus 1/100,000 in the rest of the world). Intermediary forms of FTD, semantic dementia, and progressive non-fluent aphasia are discussed since several cases of non-fluent progressive aphasia associated with ALS are reported in the literature. The links between these two degenerative diseases are discussed.
Collapse
Affiliation(s)
- M Vercelletto
- Clinique Neurologique, Hôpital R. et G. Laënnec, Nantes.
| | | | | | | | | | | | | |
Collapse
|
38
|
Agid Y, Arnulf I, Bejjani P, Bloch F, Bonnet AM, Damier P, Dubois B, François C, Houeto JL, Iacono D, Karachi C, Mesnage V, Messouak O, Vidailhet M, Welter ML, Yelnik J. Parkinson's disease is a neuropsychiatric disorder. Adv Neurol 2003; 91:365-70. [PMID: 12442695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
- Y Agid
- Centre d'Investigation Clinique, INSERM U289, Hôpital de la Salpêtrière, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Magot A, Wiertlewski S, Boutoleau C, Guiheneuc P, Fève JR, Damier P. [Ptosis and mastication disorders revealing concurrent myasthenia gravis and chronic polyradiculoneuritis]. Rev Neurol (Paris) 2002; 158:741-3. [PMID: 12486907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Although myasthenia gravis (MG) has frequently been associated with other autoimmune disorders, it has only rarely been reported in conjunction with diseases of the nervous system. A 74-year-old patient with hypertension suddenly presented left unilateral ptosis and mastication disorders. Clinical examination showed a concomitant loss of strength distally and reduced deep tendon reflex. Electrophysiologic data indicated a diagnosis of MG and chronic inflammatory demyelinating polyneuropathy; acetylcholine receptor antibody was elevated at 4.1 nmol/L (normal < 2 nmol/L). Improvement was rapid after initiation of pyridostigmine in association with corticosteroid (1 mg/kg/day). One month later, the cranial nerve deficit disappeared and strength was normal. It is likely that a basic abnormality of immune regulation was responsible for the emergence of diseases with different clinical presentations, but similar immunopathogenesis. Corticosteroid seemed to be the most effective treatment.
Collapse
Affiliation(s)
- A Magot
- Clinique Neurologique, CHU Nantes
| | | | | | | | | | | |
Collapse
|
40
|
Bejjani BP, Arnulf I, Houeto JL, Milea D, Demeret S, Pidoux B, Damier P, Cornu P, Dormont D, Agid Y. Concurrent excitatory and inhibitory effects of high frequency stimulation: an oculomotor study. J Neurol Neurosurg Psychiatry 2002; 72:517-22. [PMID: 11909914 PMCID: PMC1737848 DOI: 10.1136/jnnp.72.4.517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To describe a reversible neurological condition resembling a crossed midbrain syndrome resulting from high frequency stimulation (HFS) in the midbrain. METHODS Postoperative evaluation of quadripolar electrodes implanted in the area of the subthalamic nucleus of 25 patients with Parkinson's disease (PD) successfully treated by HFS. RESULTS Four of the 25 patients experienced reversible acute diplopia, with dystonic posture and tremor in the contralateral upper limb when the white matter between the red nucleus and the substantia nigra was stimulated. The motor signs resembled those caused by lesions of the red nucleus. The ipsilateral resting eye position was "in and down" (three patients) or "in" (one patient). Enophthalmos was seen. Abduction was impaired and vertical eye movements were limited, but adduction was spared. The movements of the controlateral eye were normal. The ocular signs could be best explained by sustained hyperactivity of the extrinsic oculomotor nerve. Simultaneous tonic contraction of the superior rectus, the inferior rectus, and inferior oblique may cause the enophthalmos and partial limitation of upward and downward eye movements. Antagonist tonic contraction of the ipsilateral medial rectus severely impairs abduction. CONCLUSION This crossed midbrain syndrome, possibly resulting from simultaneous activation of oculomotor nerve and lesion-like inhibition of the red nucleus suggests that high frequency stimulation has opposite effects on grey and white matter.
Collapse
Affiliation(s)
- B-P Bejjani
- Centre d'Investigation Clinique, Fédération de Neurologie, and INSERM U289, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Damier P. [What strategies are recommended for early stage disease? Other treatments]. Rev Neurol (Paris) 2001; 156 Suppl 2 Pt 2:105-8. [PMID: 10916044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- P Damier
- Clinique neurologique, INSERM U437, CHU Nantes, 44093 Nantes Cedex.
| |
Collapse
|
42
|
Yelnik J, Damier P, Bejjani BP, Francois C, Gervais D, Dormont D, Arnulf I, M Bonnet A, Cornu P, Pidoux B, Agid Y. Functional mapping of the human globus pallidus: contrasting effect of stimulation in the internal and external pallidum in Parkinson's disease. Neuroscience 2001; 101:77-87. [PMID: 11068138 DOI: 10.1016/s0306-4522(00)00364-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Our objective was to elaborate a functional map of the globus pallidus by correlating the intrapallidal localization of quadripolar electrodes implanted in parkinsonian patients with the clinical effect of the stimulation of each contact. Five patients with L-DOPA-responsive Parkinson's disease presenting severe motor fluctuations and L-DOPA-induced dyskinesias were treated by continuous bilateral high-frequency stimulation of the globus pallidus. The effects of stimulation on parkinsonian disability were tested through each of the four stimulating contacts of each electrode. The anatomical localization of each of the stimulating contacts was determined by confronting the pre- and post-operative magnetic resonance imaging with the anatomical atlas of Schaltenbrand and Wharen.(34) The registration procedure comprised digitization of the atlas, the use of deformation tools to fit atlas sections with magnetic resonance imaging sections, and three-dimensional reconstruction of both the atlas and the magnetic resonance imaging sections. Analysis of the 32 stimulating contacts tested did not reveal a somatotopic organization in the pallidal region investigated but demonstrated that high-frequency stimulation had contrasting effects depending on whether it was applied to the external or the internal pallidum. Akinesia was improved by stimulation of the external pallidum but worsened by stimulation of the internal pallidum. In contrast, parkinsonian rigidity was improved by stimulation of either part of the pallidum. The areas in the internal pallidum where stimulation worsened akinesia were those in which stimulation reduced or suppressed L-DOPA-induced dyskinesias. Conversely, stimulation applied to the external pallidum induced dyskinesias. The fact that rigidity was improved by stimulation of the internal and external pallidum suggests that the neuronal bases of parkinsonian rigidity are different from those of akinesia and dyskinesias. The effect on akinesia and dyskinesias is in agreement with the current model of basal ganglia circuitry(10) if high-frequency stimulation activates rather than inhibits pallidal neurons, a possibility which is very likely since there are marked anatomical, biochemical and electrophysiological differences between the globus pallidus and the subthalamic nucleus. This study demonstrates that high-frequency stimulation of the globus pallidus in parkinsonian patients has contrasting effects depending on whether it is applied to the external or the internal part of this nucleus. The effect on akinesia and dyskinesias suggests that stimulation activates pallidal neurons, a result which challenges the generally accepted concept that high-frequency stimulation inactivates neurons in the region stimulated.
Collapse
Affiliation(s)
- J Yelnik
- INSERM U289, Hôpital de la Salpêtrière, 47 boulevard de l'H opital, F-75013 Paris, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Damier P, Houeto JL, Bejjani BP, Arnulf I, Bonnet AM, Miloudy M, Agid Y. The role of the pallidum in Parkinson's disease gait. Lessons from pallidal stimulation. Adv Neurol 2001; 87:283-8. [PMID: 11347233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- P Damier
- Department of Neurology, Faculty of Medicine, University Hospital of Nantes, Nantes F-44035, France
| | | | | | | | | | | | | |
Collapse
|
44
|
Arnulf I, Bejjani BP, Garma L, Bonnet AM, Houeto JL, Damier P, Derenne JP, Agid Y. Improvement of sleep architecture in PD with subthalamic nucleus stimulation. Neurology 2000; 55:1732-4. [PMID: 11113233 DOI: 10.1212/wnl.55.11.1732] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
High-frequency stimulation of the subthalamic nucleus (STN) was used to investigate the relationship of sleep disorders with motor handicap in PD. In 10 insomniac patients with PD, stimulation reduced nighttime akinesia by 60% and completely suppressed axial and early morning dystonia, but did not alleviate periodic leg movements (n = 3) or REM sleep behavior disorders (n = 5). Total sleep time increased by 47%; wakefulness after sleep onset decreased by 51 minutes. Insomnia in patients with PD may predominantly result from nighttime motor disability.
Collapse
Affiliation(s)
- I Arnulf
- Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U289, Paris, France.
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Houeto JL, Bejjani PB, Damier P, Staedler C, Bonnet AM, Pidoux B, Dormont D, Cornu P, Agid Y. Failure of long-term pallidal stimulation corrected by subthalamic stimulation in PD. Neurology 2000; 55:728-30. [PMID: 10980748 DOI: 10.1212/wnl.55.5.728] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Bilateral high-frequency continuous stimulation of the internal globus pallidus or subthalamic nucleus constitutes a new therapeutic approach for the treatment of patients with severe PD. The authors report two patients in whom stimulation of the globus pallidus failed to give long-term relief and was successfully replaced by bilateral subthalamic stimulation. The results emphasize the reversibility of deep brain stimulation therapy and suggest that the subthalamic target is preferable to the pallidal target.
Collapse
Affiliation(s)
- J L Houeto
- Centre d'Investigation Clinique, Fédération de Neurologie and INSERM 289, Hôpital de la Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Bejjani BP, Arnulf I, Vidailhet M, Pidoux B, Damier P, Papadopoulos S, Bonnet AM, Cornu P, Dormont D, Agid Y. Irregular jerky tremor, myoclonus, and thalamus: a study using low-frequency stimulation. Mov Disord 2000; 15:919-24. [PMID: 11009200 DOI: 10.1002/1531-8257(200009)15:5<919::aid-mds1024>3.0.co;2-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
High-frequency thalamic stimulation alleviates tremor in Parkinson's disease (PD) and essential tremor (ET). The origin of thalamic myoclonus is unexplained and the effects of low-frequency thalamic stimulation on movement control are still unknown. We studied the effects of stimulation at a low frequency of 15 Hz in five drug-free patients (3 PD, 2 ET) 6 months after thalamic implantation of quadripolar electrodes (unilateral in four patients, bilateral in one patient). Clinical, electrophysiological, and videotaped assessment, using a monopolar 15 Hz frequency (3 V, 90 micros) stimulation current applied simultaneously through two adjacent contacts of the electrode, was performed. We observed myoclonus and irregular jerky tremor in the upper limb contralateral to the site of stimulation. The jerks lasted less than 200 ms, were irregular and not synchronous with stimulation, were superimposed on rest or postural tremor, and increased in response to tactile, proprioceptive, or vibratory stimuli. The fact that this complex movement disorder can be induced by low-frequency stimulation in the ventral intermediate nucleus (Vim) of the thalamus suggests that it results, at least partly, from dysfunction of the Vim and possibly adjacent nuclei of the thalamus.
Collapse
Affiliation(s)
- B P Bejjani
- Centre d'Investigation Clinique--Inserm U289, Fédération de Neurologíe, Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Pillon B, Ardouin C, Damier P, Krack P, Houeto JL, Klinger H, Bonnet AM, Pollak P, Benabid AL, Agid Y. Neuropsychological changes between "off" and "on" STN or GPi stimulation in Parkinson's disease. Neurology 2000; 55:411-8. [PMID: 10932277 DOI: 10.1212/wnl.55.3.411] [Citation(s) in RCA: 249] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In a previous study on a consecutive series of 62 patients with PD, the authors showed that bilateral subthalamic or pallidal continuous high-frequency deep brain stimulation (DBS) affects neither memory nor executive functions 3 to 6 months after surgery. OBJECTIVE To investigate the specific effects of DBS by comparing the performance of patients with the stimulator turned "on" and "off." METHODS The performance of 56 patients on clinical tests of executive function was compared after 3 and 12 months of DBS of the subthalamic nucleus (STN; n = 48) or the internal globus pallidus (GPi; n = 8) with the stimulator "on" or "off." Global intellectual efficiency, verbal learning, and mood were also evaluated with the stimulator "on." The performance of another group of 20 patients was compared after 6 months of DBS of the STN (n = 15) or the GPi (n = 5) with the stimulator "on" or "off" on more experimental tests recently shown to be more sensitive to l-dopa therapy. RESULTS When the stimulator was "on," STN patients showed a mild but significant improvement in psychomotor speed and working memory. In comparison with the presurgical state, STN patients had no cognitive deficit at 12 months, except for lexical fluency. There was no differential effect of STN or GPi stimulation. CONCLUSIONS 1) The specific effect of DBS seems to mimic the action of l-dopa treatment in the cognitive as in the motor domain; 2) the surgery associated with DBS does not appear to affect the cognitive performance of patients with PD 12 months later, except for a mild deficit in lexical fluency.
Collapse
Affiliation(s)
- B Pillon
- INSERM EPI 007 and U 289, Fédération de Neurologie and Centre d'Investigation Clinique, Hôpital de la Salpêtrière, Paris, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Arnulf I, Bonnet AM, Damier P, Bejjani BP, Seilhean D, Derenne JP, Agid Y. Hallucinations, REM sleep, and Parkinson's disease: a medical hypothesis. Neurology 2000; 55:281-8. [PMID: 10908906 DOI: 10.1212/wnl.55.2.281] [Citation(s) in RCA: 237] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patients with PD can have disabling visual hallucinations associated with dopaminergic therapy. Sleep disorders, including vivid dreams and REM sleep with motor behaviors (RBD), are frequent in these patients. METHODS The association of hallucinations and REM sleep both at night and during the day was examined in 10 consecutive nondemented patients with long-standing levodopa-responsive PD and hallucinations. Seven patients presented with paranoia and paranoid delusions. Overnight sleep recordings and standard multiple daytime sleep latency test were performed. The results were compared to those of 10 similar patients with PD not experiencing hallucinations. RESULTS RBD was detected in all 10 patients with hallucinations and in six without. Although nighttime sleep conditions were similar in both groups, hallucinators tended to be sleepier during the day. Delusions following nighttime REM period and daytime REM onsets were observed in three and eight of the hallucinators, and zero and two of the others. Daytime hallucinations, coincident with REM sleep intrusions during periods of wakefulness, were reported only by hallucinators. Postmortem examination of the brain of one patient showed numerous Lewy bodies in neurons of the subcoeruleus nucleus, a region that is involved in REM sleep control. CONCLUSION The visual hallucinations that coincide with daytime episodes of REM sleep in patients who also experience post-REM delusions at night may be dream imagery. Psychosis in patients with PD may therefore reflect a narcolepsy-like REM sleep disorder.
Collapse
Affiliation(s)
- I Arnulf
- Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U 289.
| | | | | | | | | | | | | |
Collapse
|
49
|
Bejjani BP, Arnulf I, Demeret S, Damier P, Bonnet AM, Houeto JL, Agid Y. Levodopa-induced dyskinesias in Parkinson's disease: is sensitization reversible? Ann Neurol 2000; 47:655-8. [PMID: 10805339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Levodopa-induced dyskinesias (LIDs) in patients with Parkinson's disease are considered to result from the severity of dopaminergic denervation in the striatum, which is an irrevocable phenomenon, and sensitization induced by long-term intermittent administration of levodopa. Taking advantage of the 64% reduction of levodopa treatment allowed in 12 Parkinson's disease patients by continuous high-frequency stimulation of the subthalamic nucleus, we evaluated the severity of parkinsonian motor disability and LIDs during two levodopa challenges performed before the surgical implantation of the stimulation electrodes and after 8.8 months of continuous bilateral subthalamic nucleus stimulation that was interrupted 2 hours before the levodopa test. Motor disability during the "off" and "on" drug periods was unchanged. The severity of LIDs during the "on" period and dystonia during the "off" period decreased by 54% and 62%, respectively. The reduced severity of LIDs in the absence of subthalamic nucleus stimulation demonstrates that the sensitization phenomenon resulting from long-term intermittent levodopa administration is partially reversible.
Collapse
Affiliation(s)
- B P Bejjani
- Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U289, Groupe-Hospitalier Pitié-Salpêtrière, Paris, France
| | | | | | | | | | | | | |
Collapse
|
50
|
Bejjani BP, Gervais D, Arnulf I, Papadopoulos S, Demeret S, Bonnet AM, Cornu P, Damier P, Agid Y. Axial parkinsonian symptoms can be improved: the role of levodopa and bilateral subthalamic stimulation. J Neurol Neurosurg Psychiatry 2000; 68:595-600. [PMID: 10766889 PMCID: PMC1736917 DOI: 10.1136/jnnp.68.5.595] [Citation(s) in RCA: 168] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the effects of high frequency stimulation of the subthalamic nucleus (STN) on axial symptoms occurring in advanced stages of Parkinson's disease (PD). METHODS The efficacy of STN stimulation on total motor disability score (unified Parkinson's disease rating scale (UPDRS) part III) were evaluated in 10 patients with severe Parkinson's disease. The subscores were then studied separately for limb akinesia, rigidity, and tremor, which are known to respond to levodopa, and axial signs, including speech, neck rigidity, rising from a chair, posture, gait, and postural stability, which are known to respond less well to levodopa. Patients were clinically assessed in the "off" and "on" drug condition during a levodopa challenge test performed before surgical implantation of stimulation electrodes and repeated 6 months after surgery under continuous STN stimulation. A complementary score for axial symptoms from the "activities of daily living" (ADL)-that is, speech, swallowing, turning in bed, falling, walking, and freezing-was obtained from each patient's questionnaire (UPDRS, part II). RESULTS Improvements in total motor disability score (62%), limb signs (62%), and axial signs (72%) obtained with STN stimulation were statistically comparable with those obtained with levodopa during the preoperative challenge (68%, 69%, and 59%, respectively). When levodopa and STN stimulation were combined there was a further improvement in total motor disability (80%) compared with preoperative levodopa administration. This consisted largely of an additional improvement in axial signs (84%) mainly for posture and postural stability, no further improvement in levodopa responsive signs being found. Axial symptoms from the ADL showed similar additional improvement when levodopa and STN stimulation were combined. CONCLUSION These findings suggest that bilateral STN stimulation improves most axial features of Parkinson's disease and that a synergistic effect can be obtained when stimulation is used in conjunction with levodopa treatment.
Collapse
Affiliation(s)
- B P Bejjani
- Centre d'Investigation Clinique, Fédération de Neurologie and INSERM U289, France
| | | | | | | | | | | | | | | | | |
Collapse
|