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Ouattara E, Bruandet A, Borde A, Tezenas du Montcel S, Gilleron V, de travail COVIDIM G. Facteurs de risque de mortalité chez des patients COVID-19 hospitalisés avec ou sans passage en soins critiques - Etude nationale COVIDIM. Rev Epidemiol Sante Publique 2022. [PMCID: PMC8907819 DOI: 10.1016/j.respe.2022.01.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Méthodes Résultats Discussion/Conclusion
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Saïe C, Wassermann J, Mathy E, Chereau N, Leenhardt L, Tezenas du Montcel S, Buffet C. Impact of age on survival in radioiodine refractory differentiated thyroid cancer patients. Eur J Endocrinol 2021; 184:667-676. [PMID: 33667193 DOI: 10.1530/eje-20-1073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Received: 09/18/2020] [Accepted: 03/05/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objectives of our study were to analyze the influence of age on the survival of patients with RAIR-DTC and to determine their prognostic factors according to age. METHODS This single-center, retrospective study enrolled 155 patients diagnosed with RAIR-DTC. The primary end point was overall survival (OS) according to different cutoff (45, 55, 65, 75 years). Secondary endpoints were progression free survival (PFS) and prognostic factors in patients under and over 65 years. RESULTS Median OS after RAIR diagnosis was 8.2 years (95% IC: 5.3-9.6). There was no difference according to age with a 65 (P = 0.47) and 55 years old cutoff (P = 0.28). Median OS improved significantly before 45 years old (P = 0.0043). After 75 years old, median OS significantly decreased (P = 0.0008). Median PFS was 2.1 years (95% CI: 0.8-3) in patients < 65 years old, and 1 year in patients ≥ 65 years old (95% CI: 0.8-1.55) with no statistical difference (P = 0.22). There was no impact of age on PFS with any cutoff. In both groups, progressive disease despite 131I treatment reduced OS. In patients < 65 years old, an interval of less than 3 years between the initial diagnosis and the diagnosis of RAIR metastatic disease was predictive of poor survival. In patients > 65 years old, the presence of a mediastinum metastasis was a significant factor for mortality (HR: 4.55, 95% CI: 2.27-9.09). CONCLUSION In RAIR-DTC patients, a cut-off age of 65 years old was not a significant predictive factor of survival. Forty-five and 75-years-old cutoff were predictive for OS but not PFS.
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Affiliation(s)
- C Saïe
- Thyroid and Endocrine Tumors Unit, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
| | - J Wassermann
- Oncology Department, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
- GRC n°16, GRC Tumeurs Thyroïdiennes, Sorbonne Universite, Paris, Ile de France, France
| | - E Mathy
- Thyroid and Endocrine Tumors Unit, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
| | - N Chereau
- GRC n°16, GRC Tumeurs Thyroïdiennes, Sorbonne Universite, Paris, Ile de France, France
- Department of Surgery, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
| | - L Leenhardt
- Thyroid and Endocrine Tumors Unit, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
- GRC n°16, GRC Tumeurs Thyroïdiennes, Sorbonne Universite, Paris, Ile de France, France
| | - S Tezenas du Montcel
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, Ile de France, France
| | - C Buffet
- Thyroid and Endocrine Tumors Unit, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
- GRC n°16, GRC Tumeurs Thyroïdiennes, Sorbonne Universite, Paris, Ile de France, France
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Poirier E, Fraitag S, Tezenas du Montcel S, Moguelet P, Charlotte F, Lortholary O, Hermine O, Canioni D, Barete S. CD30 expression in cutaneous lesions of systemic mastocytosis: clinical, biological and histopathological analysis of 27 patients. J Eur Acad Dermatol Venereol 2019; 33:e344-e347. [DOI: 10.1111/jdv.15633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- E. Poirier
- Unité Fonctionnelle de Dermatologie Groupe Hospitalier Pitié‐Salpêtrière, AP‐HP UPMC Université Paris 06 Sorbonne Université Paris France
| | - S. Fraitag
- Centre National de Référence des Mastocytoses AP‐HP CEREMAST Paris France
- Service d'Anatomopathologie Hôpital Necker AP‐HP Université Paris‐Sorbonne Paris France
| | - S. Tezenas du Montcel
- UMR S 1136, INSERM U 1136 Institut Pierre Louis d’Épidémiologie et de Santé Publique UPMC Université Paris 06 Sorbonne Université Paris France
- Unité de Biostatistiques Groupe Hospitalier Pitié‐Salpêtrière AP‐HP Paris France
| | - P. Moguelet
- Service d'Anatomopathologie Hôpital Tenon, AP‐HP UPMC Université Paris 06 Sorbonne Universités Paris France
| | - F. Charlotte
- Service d'Anatomopathologie Groupe Hospitalier Pitié Salpêtrière, AP‐HP UPMC Université Paris 06 Sorbonne Université Paris France
| | - O. Lortholary
- Centre National de Référence des Mastocytoses AP‐HP CEREMAST Paris France
- Service d'Infectiologie Hôpital Necker AP‐HP Université Paris‐Sorbonne Paris France
| | - O. Hermine
- Centre National de Référence des Mastocytoses AP‐HP CEREMAST Paris France
- Service d'Hématologie Hôpital Necker AP‐HP Université Paris‐Sorbonne Paris France
| | - D. Canioni
- Centre National de Référence des Mastocytoses AP‐HP CEREMAST Paris France
- Service d'Anatomopathologie Hôpital Necker AP‐HP Université Paris‐Sorbonne Paris France
| | - S. Barete
- Unité Fonctionnelle de Dermatologie Groupe Hospitalier Pitié‐Salpêtrière, AP‐HP UPMC Université Paris 06 Sorbonne Université Paris France
- Centre National de Référence des Mastocytoses AP‐HP CEREMAST Paris France
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Brice S, Jabouley A, Reyes S, Machado C, Rogan C, Gastellier N, Chabriat H, Tezenas du Montcel S. Profil évolutif cognitif au cours de l’angiopathie Cadasil. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.085] [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: 11/25/2022] Open
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Lejoyeux R, Diwo E, Vallet H, Saadoun D, Tezenas du Montcel S, Bodaghi B, LeHoang P, Fardeau C. INFLIXIMAB and ADALIMUMAB in Uveitic Macular Edema. Ocul Immunol Inflamm 2018; 26:991-996. [DOI: 10.1080/09273948.2018.1498110] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- R. Lejoyeux
- Ophthalmology Department, Reference Center for Rare Diseases OPTHARA, Pitié-Salpétrière Hospital, Paris VI University, Paris, France
| | - E. Diwo
- Ophthalmology Department, Reference Center for Rare Diseases OPTHARA, Pitié-Salpétrière Hospital, Paris VI University, Paris, France
| | - H. Vallet
- Department of Internal Medicine, Pitié-Salpétrière Hospital, Paris VI University, Paris, France
| | - D. Saadoun
- Department of Internal Medicine, Pitié-Salpétrière Hospital, Paris VI University, Paris, France
| | - S. Tezenas du Montcel
- Department of Biostatistics, Public Health and Medical Informatics, Pitié-Salpétrière Hospital, Paris VI University, Paris, France
| | - B. Bodaghi
- Ophthalmology Department, Reference Center for Rare Diseases OPTHARA, Pitié-Salpétrière Hospital, Paris VI University, Paris, France
| | - P. LeHoang
- Ophthalmology Department, Reference Center for Rare Diseases OPTHARA, Pitié-Salpétrière Hospital, Paris VI University, Paris, France
| | - C. Fardeau
- Ophthalmology Department, Reference Center for Rare Diseases OPTHARA, Pitié-Salpétrière Hospital, Paris VI University, Paris, France
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Geerts B, Leclercq D, Tezenas du Montcel S, Law-ye B, Gerber S, Bernardeschi D, Galanaud D, Dormont D, Pyatigorskaya N. Characterization of Skull Base Lesions Using Pseudo-Continuous Arterial Spin Labeling. Clin Neuroradiol 2017; 29:75-86. [DOI: 10.1007/s00062-017-0623-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/19/2017] [Indexed: 10/18/2022]
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Diallo A, Jacobi H, Klockgether T, Tezenas du Montcel S. La diminution au cours du temps de l’indice de masse corporelle est liée à la progression d’ataxie spinocérébelleuse. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.03.010] [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] Open
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Ambrogi V, Tezenas du Montcel S, Collin E, Coutaux A, Bourgeois P, Bourdillon F. Care-related pain in hospitalized patients: severity and patient perception of management. Eur J Pain 2015; 19:313-21. [PMID: 25055764 DOI: 10.1002/ejp.549] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hospitalized patients commonly undergo painful procedures, but little is known about care-related pain (CRP) in the overall population of inpatients. We conducted a cross-sectional 1-day survey to assess the prevalence and characteristics of CRP and its management in all units of a university hospital in Paris and determined the factors linked to severe CRP. METHODS All patients who were able to communicate and were hospitalized for at least 24 h but not in a day-care or neonatal unit were included. RESULTS From 938 patients who completed the questionnaire, 554 patients reported pain within the previous 24 h, for a 59% prevalence of pain, and 540 (58%) had experienced CRP in the previous 15 days (51% males; mean [SD] age 54 [18] years). Of 907 procedures, 330 (37%) resulted in severe pain. The most-often reported painful procedures were vascular punctures and patient mobilization. Severe CRP was associated with long hospitalization; non-vascular invasive punctures, catheterization, mobilization or radiological examination; or pain during the previous 24 h due to surgery or treatment. Only half of the patients declared that they had received information regarding the painful procedure. Treatment for pain was proposed and delivered in less than one quarter of cases. CONCLUSIONS Our results of a survey of pain management in hospitalized patients relate to a wide variety of medical conditions and procedures. Health-care workers should be more systematic in managing CRP, and attention should be paid to patients at greatest risk of severe CRP.
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Affiliation(s)
- V Ambrogi
- Public Health Department, Pitié-Salpêtrière Hospital, Paris, France
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Moltό A, Tezenas du Montcel S, Wendling D, Dougados M, Vanier A, Gossec L. SAT0332 Disease Activity Trajectories in Early Axial Spondyloarthritis: Results from the Desir Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2057] [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: 11/04/2022]
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Isnard Bagnis C, Rouvier P, Tezenas du Montcel S, Fernandes P, Sonikian M, Tourret J, Agher R, Valantin M, Deray G, Tubiana R, Katlama C. Histologie rénale et infection par le VIH : et si les lésions vasculaires conditionnaient le pronostic rénal ? Nephrol Ther 2013. [DOI: 10.1016/j.nephro.2013.07.096] [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: 10/26/2022]
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Welter ML, Demain A, Westby M, Bonneville F, Do MC, Tezenas du Montcel S, Dormont D, Agid Y, Fernandez-Vidal S, Chastan N. Higher Level Gait Disorders in the Elderly Subject: Postural Instability, Cortical and Subcortical Abnormalities (P06.077). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.077] [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] Open
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Jacobi H, Bauer P, Giunti P, Labrum R, Sweeney MG, Charles P, Dürr A, Marelli C, Globas C, Linnemann C, Schöls L, Rakowicz M, Rola R, Zdzienicka E, Schmitz-Hübsch T, Fancellu R, Mariotti C, Tomasello C, Baliko L, Melegh B, Filla A, Rinaldi C, van de Warrenburg BP, Verstappen CCP, Szymanski S, Berciano J, Infante J, Timmann D, Boesch S, Hering S, Depondt C, Pandolfo M, Kang JS, Ratzka S, Schulz J, Tezenas du Montcel S, Klockgether T. The natural history of spinocerebellar ataxia type 1, 2, 3, and 6: a 2-year follow-up study. Neurology 2011; 77:1035-41. [PMID: 21832228 DOI: 10.1212/wnl.0b013e31822e7ca0] [Citation(s) in RCA: 156] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To obtain quantitative data on the progression of the most common spinocerebellar ataxias (SCAs) and identify factors that influence their progression, we initiated the EUROSCA natural history study, a multicentric longitudinal cohort study of 526 patients with SCA1, SCA2, SCA3, or SCA6. We report the results of the 1- and 2-year follow-up visits. METHODS As the primary outcome measure we used the Scale for the Assessment and Rating of Ataxia (SARA, 0-40), and as a secondary measure the Inventory of Non-Ataxia Symptoms (INAS, 0-16) count. RESULTS The annual increase of the SARA score was greatest in SCA1 (2.18 ± 0.17, mean ± SE) followed by SCA3 (1.61 ± 0.12) and SCA2 (1.40 ± 0.11). SARA progression in SCA6 was slowest and nonlinear (first year: 0.35 ± 0.34, second year: 1.44 ± 0.34). Analysis of the INAS count yielded similar results. Larger expanded repeats and earlier age at onset were associated with faster SARA progression in SCA1 and SCA2. In SCA1, repeat length of the expanded allele had a similar effect on INAS progression. In SCA3, SARA progression was influenced by the disease duration at inclusion, and INAS progression was faster in females. CONCLUSIONS Our study gives a comprehensive quantitative account of disease progression in SCA1, SCA2, SCA3, and SCA6 and identifies factors that specifically affect disease progression.
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Affiliation(s)
- H Jacobi
- Department of Neurology, University Hospital of Bonn, Bonn, Germany
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Tran Ba Loc P, du Montcel ST, Duron JJ, Levard H, Suc B, Descottes B, Desrousseaux B, Hay JM. Elderly POSSUM, a dedicated score for prediction of mortality and morbidity after major colorectal surgery in older patients. Br J Surg 2010; 97:396-403. [PMID: 20112252 DOI: 10.1002/bjs.6903] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Several scores have been developed to evaluate surgical unit mortality and morbidity. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and derivatives use preoperative and intraoperative factors, whereas the Surgical Risk Scale (SRS) and Association Française de Chirurgie (AFC) score use four simple factors. To allow for advanced age in patients undergoing colorectal surgery, a dedicated score-the Elderly (E) POSSUM-has been developed and its accuracy compared with these scores. METHODS From 2002 to 2004, 1186 elderly patients, at least 65 years old, undergoing major colorectal surgery in France were enrolled. Accuracy was assessed by calculating the area under the receiver operating characteristic curve (AUC) (discrimination) and calibration. RESULTS The mortality and morbidity rates were 9 and 41 per cent respectively. The E-POSSUM had both a good discrimination (AUC = 0.86) and good calibration (P = 0.178) in predicting mortality and a reasonable discrimination (AUC = 0.77) and good calibration (P = 0.166) in predicting morbidity. The E-POSSUM was significantly better at predicting mortality and morbidity than the AFC score (P(c) = 0.014 and P(c) < 0.001 respectively). CONCLUSION The E-POSSUM is a good tool for predicting mortality, and the only efficient scoring system for predicting morbidity after major colorectal surgery in the elderly.
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Affiliation(s)
- P Tran Ba Loc
- Biostatistics and Medical Information Unit, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
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Schmitz-Hübsch T, Fimmers R, Rakowicz M, Rola R, Zdzienicka E, Fancellu R, Mariotti C, Linnemann C, Schöls L, Timmann D, Filla A, Salvatore E, Infante J, Giunti P, Labrum R, Kremer B, van de Warrenburg BPC, Baliko L, Melegh B, Depondt C, Schulz J, du Montcel ST, Klockgether T. Responsiveness of different rating instruments in spinocerebellar ataxia patients. Neurology 2010; 74:678-84. [PMID: 20177122 DOI: 10.1212/wnl.0b013e3181d1a6c9] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.7] [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 determine the longitudinal metric properties of recently developed clinical assessment tools in spinocerebellar ataxia (SCA). METHODS A subset of 171 patients from the EUROSCA natural history study cohort (43 SCA1, 61 SCA2, 37 SCA3, and 30 SCA6) were examined after 1 year of follow-up. Score changes and effect size indices were calculated for clinical scales (Scale for the Assessment and Rating of Ataxia [SARA], Inventory of Non-Ataxia Symptoms [INAS]), functional tests (SCA Functional Index [SCAFI] and components), and a patient-based scale for subjective health status (EQ-5D visual analogue scale [EQVAS]). Responsiveness was determined in relation to the patient's global impression (PGI) of change and reproducibility described as retest reliability for the stable groups and smallest detectable change. RESULTS Within the 1-year follow-up period, SARA, INAS, and SCAFI but not EQVAS indicated worsening in the whole group and in the groups with subjective (PGI) worsening. SCAFI and its 9-hole pegboard (9HPT) component also deteriorated in the stable groups. Standardized response means were highest for 9HPT (-0.67), SARA (0.50), and SCAFI (-0.48) with accordingly lower sample size estimates of 143, 250, or 275 per group for a 2-arm interventional trial that aims to reduce disease progression by 50%. SARA and EQVAS performed best to distinguish groups classified as worse by PGI. All scales except EQVAS reached the criterion for retest reliability. CONCLUSION While both the Scale for the Assessment and Rating of Ataxia and the SCA Functional Index (SCAFI) (and its 9-hole pegboard component) had favorable measurement precision, the clinical relevance of SCAFI and 9-hole pegboard score changes warrants further exploration. The EQ-5D visual analogue scale proved insufficient for longitudinal assessment, but validly reflected patients' impression of change.
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Affiliation(s)
- T Schmitz-Hübsch
- Department of Neurology, University Hospital of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany.
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Lavault S, Leu-Semenescu S, Tezenas du Montcel S, Cochen de Cock V, Vidailhet M, Arnulf I. Does clinical rapid eye movement behavior disorder predict worse outcomes in Parkinson’s disease? J Neurol 2010; 257:1154-9. [DOI: 10.1007/s00415-010-5482-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 12/22/2009] [Accepted: 01/20/2010] [Indexed: 11/24/2022]
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Lohmann E, Thobois S, Lesage S, Broussolle E, du Montcel ST, Ribeiro MJ, Remy P, Pelissolo A, Dubois B, Mallet L, Pollak P, Agid Y, Brice A. A multidisciplinary study of patients with early-onset PD with and without parkin mutations. Neurology 2008; 72:110-6. [PMID: 18987353 DOI: 10.1212/01.wnl.0000327098.86861.d4] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [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 establish phenotype-genotype correlations in early-onset Parkinson disease (EOPD), we performed neurologic, neuropsychological, and psychiatric evaluations in a series of patients with and without parkin mutations. BACKGROUND Parkin (PARK2) gene mutations are the major cause of autosomal recessive parkinsonism. The usual clinical features are early-onset typical PD with a slow clinical course, an excellent response to low doses of levodopa, frequent treatment-induced dyskinesias, and the absence of dementia. METHODS A total of 44 patients with EOPD (21 with and 23 without parkin mutations) and 9 unaffected single heterozygous carriers of parkin mutations underwent extensive clinical, neuropsychological, and psychiatric examinations. RESULTS The neurologic, neuropsychological, and psychiatric features were similar in all patients, except for significantly lower daily doses of dopaminergic treatment and greater delay in the development of levodopa-related fluctuations (p < 0.05) in parkin mutation carriers compared to noncarriers. There was no major difference between the two groups in terms of general cognitive efficiency. Psychiatric manifestations (depression) were more frequent in patients than in healthy single heterozygous parkin carriers but did not differ between the two groups of patients. CONCLUSION Carriers of parkin mutations are clinically indistinguishable from other patients with young-onset Parkinson disease (PD) on an individual basis. Severe generalized loss of dopaminergic neurons in the substantia nigra pars compacta in these patients is associated with an excellent response to low doses of dopa-equivalent and delayed fluctuations, but cognitive impairment and special behavioral or psychiatric symptoms were not more severe than in other patients with early-onset PD.
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Affiliation(s)
- E Lohmann
- INSERM UMR S_679, Hôpital Pitié-Salpêtrière, Paris, France
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Schmitz-Hübsch T, Coudert M, Bauer P, Giunti P, Globas C, Baliko L, Filla A, Mariotti C, Rakowicz M, Charles P, Ribai P, Szymanski S, Infante J, van de Warrenburg BPC, Dürr A, Timmann D, Boesch S, Fancellu R, Rola R, Depondt C, Schöls L, Zdienicka E, Kang JS, Döhlinger S, Kremer B, Stephenson DA, Melegh B, Pandolfo M, di Donato S, du Montcel ST, Klockgether T. Spinocerebellar ataxia types 1, 2, 3, and 6: disease severity and nonataxia symptoms. Neurology 2008; 71:982-9. [PMID: 18685131 DOI: 10.1212/01.wnl.0000325057.33666.72] [Citation(s) in RCA: 194] [Impact Index Per Article: 12.1] [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 identify factors that determine disease severity and clinical phenotype of the most common spinocerebellar ataxias (SCAs), we studied 526 patients with SCA1, SCA2, SCA3. or SCA6. METHODS To measure the severity of ataxia we used the Scale for the Assessment and Rating of Ataxia (SARA). In addition, nonataxia symptoms were assessed with the Inventory of Non-Ataxia Symptoms (INAS). The INAS count denotes the number of nonataxia symptoms in each patient. RESULTS An analysis of covariance with SARA score as dependent variable and repeat lengths of the expanded and normal allele, age at onset, and disease duration as independent variables led to multivariate models that explained 60.4% of the SARA score variance in SCA1, 45.4% in SCA2, 46.8% in SCA3, and 33.7% in SCA6. In SCA1, SCA2, and SCA3, SARA was mainly determined by repeat length of the expanded allele, age at onset, and disease duration. The only factors determining the SARA score in SCA6 were age at onset and disease duration. The INAS count was 5.0 +/- 2.3 in SCA1, 4.6 +/- 2.2 in SCA2, 5.2 +/- 2.5 in SCA3, and 2.0 +/- 1.7 in SCA6. In SCA1, SCA2, and SCA3, SARA score and disease duration were the strongest predictors of the INAS count. In SCA6, only age at onset and disease duration had an effect on the INAS count. CONCLUSIONS Our study suggests that spinocerebellar ataxia (SCA) 1, SCA2, and SCA3 share a number of common biologic properties, whereas SCA6 is distinct in that its phenotype is more determined by age than by disease-related factors.
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Affiliation(s)
- T Schmitz-Hübsch
- Department of Neurology, University Hospital of Bonn, Bonn, Germany
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Schöls L, Globas C, Schmitz-Hübsch T, Timmann D, Szymanski S, Dürr A, Dupont C, Melegh B, Mariotti C, Boesch S, van de Warrenburg B, Filla A, Rakowicz M, Klockgether T, Tezenas du Montcel S, Bauer P. Early symptoms in spinocerebellar ataxia type 1, 2, 3, and 6. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086589] [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: 10/21/2022]
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Ourahma S, Mercadal L, Tezenas du Montcel S, Assogba D, Bitker MO, Mallet A, Barrou B. Anemia in the Period Immediately Following Renal Transplantation. Transplant Proc 2007; 39:1446-50. [PMID: 17580158 DOI: 10.1016/j.transproceed.2006.12.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Revised: 10/26/2006] [Accepted: 12/13/2006] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Anemia remains frequent in the first month following renal transplantation and is a risk factor for cardiovascular accidents. The purpose of this study was to analyze the prevalence of anemia during this period notably among different immunosuppressive treatment groups. METHODS In this study, we entered the patients who had received a renal allograft in our transplant unit from 1993 to 2003, including patients who had received azathioprine (AZA) from 1993 to 1996 and mycophenolate mofetil (MMF) from 1996 to 2003. No patient received rHu-erythropoietin after transplantation during that period. A mathematical model normalized the hemoglobin (Hb) threshold level at which blood transfusion was decided and Hb on admission. RESULTS One hundred and eighty-eight patients on AZA and 223 on MMF were included in the analysis. The mean age +/- SD was 41 +/- 12 years in the AZA group, and 45 +/- 12 years in the MMF group (P < .006). Before the transplantation, Hb was higher in the MMF group (11.4 +/- 1.9 vs 10.2 +/- 2 g/dL, P < .0001). After normalization at a threshold level of transfusion of 7 g/dL, transfusions were more frequent among the MMF group (72% vs 48%, P < .0001). Double therapy with MMF (1500 mg/d) + steroids or therapy with MMF (750 mg/d) + tacrolimus + steroids increased the risk of transfusion compared to the AZA group. MMF (750 mg/d) + cyclosporine conferred a similar risk of transfusion compared with the AZA group. CONCLUSION MMF alone or in association with tacrolimus is associated with an increased risk of anemia and transfusion in the immediate posttransplantation period.
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Affiliation(s)
- S Ourahma
- Department of Anesthesiology and Intensive Care, Pitié-Salpêtrière's Hospital, Assistance Publique-Hôpitaux de Paris, 83 boulevard de l'hôpital, 75013 Paris, France
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20
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Schüpbach WMM, Maltête D, Houeto JL, du Montcel ST, Mallet L, Welter ML, Gargiulo M, Béhar C, Bonnet AM, Czernecki V, Pidoux B, Navarro S, Dormont D, Cornu P, Agid Y. Neurosurgery at an earlier stage of Parkinson disease: A randomized, controlled trial. Neurology 2006; 68:267-71. [PMID: 17151341 DOI: 10.1212/01.wnl.0000250253.03919.fb] [Citation(s) in RCA: 155] [Impact Index Per Article: 8.6] [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: 11/15/2022] Open
Abstract
BACKGROUND Stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson disease (PD) and is currently performed after a mean disease duration of 14 years, when severe motor complications have resulted in marked loss of quality of life. We examined whether surgery at an early stage would maintain quality of life as well as improve motor function. METHODS Twenty patients with PD of short duration (time elapsed since first symptom +/- SD: 6.8 +/- 1.0 years) with mild to moderate motor signs (Unified Parkinson's Disease Rating Scale III "off" medication: 29 +/- 12) who responded well to levodopa treatment were included in pairs, matched for age, duration and severity of disease, and impairment in socioprofessional functioning. Patients were prospectively randomized to undergo bilateral subthalamic nucleus stimulation (n = 10) or receive optimized medical treatment (n = 10). Parkinsonian motor scores, quality of life, cognition, and psychiatric morbidity were assessed at inclusion and at 6, 12, and 18 months after randomization. RESULTS Quality of life was improved by 24% in surgical and 0% in nonsurgical patients (p < 0.05). After 18 months, the severity of parkinsonian motor signs "off" medication, levodopa-induced motor complications, and daily levodopa dose were reduced by 69%, 83%, and 57% in operated patients and increased by 29%, 15%, and 12% in the group with medical treatment only (p < 0.001). Adverse events were mild or transient, and overall psychiatric morbidity and anxiety improved in the surgical group. CONCLUSIONS Subthalamic nucleus stimulation should be considered a therapeutic option early in the course of Parkinson disease.
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Affiliation(s)
- W M M Schüpbach
- Centre d'Investigation Clinique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Bloch F, Houeto JL, Tezenas du Montcel S, Bonneville F, Etchepare F, Welter ML, Rivaud-Pechoux S, Hahn-Barma V, Maisonobe T, Behar C, Lazennec JY, Kurys E, Arnulf I, Bonnet AM, Agid Y. Parkinson's disease with camptocormia. J Neurol Neurosurg Psychiatry 2006; 77:1223-8. [PMID: 16754693 PMCID: PMC2077378 DOI: 10.1136/jnnp.2006.087908] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [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] [Received: 01/10/2006] [Revised: 05/09/2006] [Accepted: 05/26/2006] [Indexed: 11/04/2022]
Abstract
BACKGROUND Camptocormia is defined as an abnormal flexion of the trunk that appears when standing or walking and disappears in the supine position. The origin of the disorder is unknown, but it is usually attributed either to a primary or a secondary paravertebral muscle myopathy or a motor neurone disorder. Camptocormia is also observed in a minority of patients with parkinsonism. OBJECTIVE To characterise the clinical and electrophysiological features of camptocormia and parkinsonian symptoms in patients with Parkinson's disease and camptocormia compared with patients with Parkinson's disease without camptocormia. METHODS Patients with parkinsonism and camptocormia (excluding patients with multiple system atrophy) prospectively underwent a multidisciplinary clinical (neurological, neuropsychological, psychological, rheumatological) and neurophysiological (electromyogram, ocular movement recording) examination and were compared with age-matched patients with Parkinson's disease without camptocormia. RESULTS The camptocormia developed after 8.5 (SD 5.3) years of parkinsonism, responded poorly to levodopa treatment (20%) and displayed features consistent with axial dystonia. Patients with camptocormia were characterised by prominent levodopa-unresponsive axial symptoms (ie, axial rigidity, gait disorder and postural instability), along with a tendency for greater error in the antisaccade paradigm. CONCLUSION We suggest that (1) the salient features of parkinsonism observed in patients with camptocormia are likely to represent a specific form of Parkinson's disease and camptocormia is an axial dystonia and (2) both camptocormia and parkinsonism in these patients might result from additional, non-dopaminergic neuronal dysfunction in the basal ganglia.
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Affiliation(s)
- F Bloch
- Centre d'Investigation Clinique-Fédération des Maladies du Système Nerveux, Groupe-Hospitalier Pitié-Salpêtrière, Paris, France
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22
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Schmitz-Hübsch T, du Montcel ST, Baliko L, Berciano J, Boesch S, Depondt C, Giunti P, Globas C, Infante J, Kang JS, Kremer B, Mariotti C, Melegh B, Pandolfo M, Rakowicz M, Ribai P, Rola R, Schöls L, Szymanski S, van de Warrenburg BP, Dürr A, Klockgether T, Fancellu R. Scale for the assessment and rating of ataxia: development of a new clinical scale. Neurology 2006; 66:1717-20. [PMID: 16769946 DOI: 10.1212/01.wnl.0000219042.60538.92] [Citation(s) in RCA: 1249] [Impact Index Per Article: 69.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To develop a reliable and valid clinical scale measuring the severity of ataxia. METHODS The authors devised the Scale for the Assessment and Rating of Ataxia (SARA) and tested it in two trials of 167 and 119 patients with spinocerebellar ataxia. RESULTS The mean time to administer SARA in patients was 14.2 +/- 7.5 minutes (range 5 to 40). Interrater reliability was high, with an intraclass coefficient (ICC) of 0.98. Test-retest reliability was high with an ICC of 0.90. Internal consistency was high as indicated by Cronbach's alpha of 0.94. Factorial analysis revealed that the rating results were determined by a single factor. SARA ratings showed a linear relation to global assessments using a visual analogue scale, suggesting linearity of the scale (p < 0.0001, r(2) = 0.98). SARA score increased with the disease stage (p < 0.001) and was closely correlated with the Barthel Index (r = -0.80, p < 0.001) and part IV (functional assessment) of the Unified Huntington's Disease Rating Scale (UHDRS-IV) (r = -0.89, p < 0.0001), whereas it had only a weak correlation with disease duration (r = 0.34, p < 0.0002). CONCLUSIONS The Scale for the Assessment and Rating of Ataxia is a reliable and valid measure of ataxia, making it an appropriate primary outcome measure for clinical trials.
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Affiliation(s)
- T Schmitz-Hübsch
- Department of Neurology, University Hospital of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
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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).
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Affiliation(s)
- S Tezenas du Montcel
- Service de Biostatistique et Information Medicale, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.
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Bonneville F, Welter ML, Elie C, du Montcel ST, Hasboun D, Menuel C, Houeto JL, Bonnet AM, Mesnage V, Pidoux B, Navarro S, Cornu P, Agid Y, Dormont D. Parkinson disease, brain volumes, and subthalamic nucleus stimulation. Neurology 2005; 64:1598-604. [PMID: 15883323 DOI: 10.1212/01.wnl.0000160401.24880.83] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [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: 11/15/2022] Open
Abstract
BACKGROUND High-frequency stimulation of the subthalamic nucleus (STN) is an effective treatment for advanced Parkinson disease (PD). The clinical and preoperative predictive factors of the best postoperative outcome have been identified. Radiologic predictive factors were investigated. METHODS Forty patients with PD underwent surgery for bilateral STN stimulation. MRI was performed in stereotactic conditions before surgery. Brain parenchyma, caudate nucleus, putamen, pallidum, and red nucleus volumes and the surface of the mesencephalon were measured and normalized as percentages of the intracranial volume. Clinical evaluation was performed 1 month before and 6 months after surgery. RESULTS The normalized brain parenchyma volume was lower in patients who were older and had a longer disease duration or a lower frontal score and was not predictive of the postoperative outcome. The residual scores for activities of daily living and parkinsonian motor disability were higher in patients with a smaller normalized mesencephalon. The normalized caudate nucleus volume was predictive of the pre- and postoperative levodopa-equivalent dosage. CONCLUSIONS Brain atrophy is not an exclusion criterion for neurosurgery, indicating that patients' neurologic, psychiatric, and neuropsychological characteristics are the best predictive factors for neurosurgery. The fact that a smaller normalized mesencephalon surface was associated with a lower beneficial effect of the subthalamic nucleus stimulation on the parkinsonian motor disability suggests that the normalized mesencephalon surface is a predictive factor of the postoperative outcome.
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Affiliation(s)
- F Bonneville
- Service de Neuroradiologie, Centre d'Investigation Clinique, Hôpital de la Salpêtrière, Assistance-Publique-Hôpitaux de Paris, France
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Sibbing D, Asmus F, König IR, Tezenas du Montcel S, Vidailhet M, Sangla S, Oertel WH, Brice A, Ziegler A, Gasser T, Bandmann O. Candidate gene studies in focal dystonia. Neurology 2003; 61:1097-101. [PMID: 14581671 DOI: 10.1212/01.wnl.0000090560.20641.ab] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [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 Genetic susceptibility factors for focal idiopathic torsion dystonia (F-ITD) are not established. Mutations in the DYT1 gene can cause focal dystonia, and an association with a polymorphism in the D5 receptor gene (DRD5) has been reported but not confirmed. OBJECTIVE To investigate a possible role of DYT1 polymorphisms, a CA repeat in the D5 receptor gene (DRD5), the human leukocyte antigen (HLA)-DRB locus, and four polymorphisms in the homocysteine metabolism in the pathogenesis of F-ITD. METHODS Initially, 100 German patients and 100 matched control subjects were investigated. A second French population with 121 F-ITD patients and matched control subjects was also studied. RESULTS Two polymorphisms of the beta-cystathionine synthase gene were associated with F-ITD in the German population, but this finding was not replicated in a second independent F-ITD patient and control group of French origin. None of the other investigated polymorphisms was associated with F-ITD. The authors failed to confirm a previously reported association with a polymorphism in DRD5. CONCLUSION No evidence for an involvement of DYT1, DRD5, HLA-DRB, or polymorphisms in the homocysteine pathway in the pathogenesis of F-ITD was found.
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Affiliation(s)
- D Sibbing
- Department of Neurology, Philipps University, Marburg, Germany
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Welter ML, Houeto JL, Tezenas du Montcel S, Mesnage V, Bonnet AM, Pillon B, Arnulf I, Pidoux B, Dormont D, Cornu P, Agid Y. Clinical predictive factors of subthalamic stimulation in Parkinson's disease. Brain 2002; 125:575-83. [PMID: 11872614 DOI: 10.1093/brain/awf050] [Citation(s) in RCA: 251] [Impact Index Per Article: 11.4] [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: 11/14/2022] Open
Abstract
High-frequency stimulation of the subthalamic nucleus (STN) constitutes one of the most effective treatments for advanced forms of Parkinson's disease. The cost and potential risks of this procedure encourage the determination of clinical characteristics of patients that will have the best postoperative outcome. Forty-one Parkinson's disease patients underwent surgery for bilateral STN stimulation. The selection criteria were severe parkinsonian motor disability, clear response of symptoms to levodopa, occurrence of disabling levodopa-related motor complications and the absence of dementia and significant abnormalities on brain MRI. Clinical evaluation was performed 1 month before and 6 months after surgery. The improvement in the activities of daily living subscale of the Unified Parkinson's Disease Rating Scale, Part II (UPDRS II) and parkinsonian motor disability (UPDRS III) was greater when the preoperative scores for activities of daily living and parkinsonian motor disability, in particular axial symptoms, such as gait disorders and postural instability assessed at the time of maximal clinical improvement (on drug), were lower. Age and disease duration were not predictive, but parkinsonian motor disability tended to be more improved in patients with younger age and shorter disease duration. The severity of levodopa-related motor complications was not a predictive factor. The outcome of STN stimulation was excellent in levodopa-responsive forms of Parkinson's disease, i.e. in patients with selective brain dopaminergic lesions, and moderate in patients with axial motor symptoms and cognitive impairment known to be less responsive or unresponsive to levodopa treatment, i.e. when brain non-dopaminergic lesions develop in addition to the degeneration of the nigrostriatal dopaminergic system. The results are consistent with the classical inclusion criteria for STN stimulation, but imply that the decision to operate on the oldest patients and/or patients with gait and postural disorders, who are poorly responsive to levodopa, should be weighed carefully.
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Affiliation(s)
- M L Welter
- Centre d'Investigation Clinique and INSERM U 289, Hôpital de la Salpêtrière, Paris, France
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Abstract
Intermittent lung ventilation is a respiratory pattern wherein breaths occur in clusters. Intermittent lung ventilation is common in amphibians and can occur in mammals. Isolated brainstems from postmetamorphic tadpoles exhibiting episodic lung ventilatory bursts were superfused with baclofen, a potent gamma-aminobutyric acid (GABA)(B) receptor agonist. At moderate concentrations (0.125 to 0.5 microM), the number of lung bursts per episode decreased but their overall frequency was unchanged. At 0.5 microM, only 1.22+/-0.24 lung bursts occurred per episode, indicating virtually no clustering. Only at higher concentrations was overall breathing frequency decreased. Therefore, at moderate concentrations of baclofen continuous ventilation replaced episodic ventilation, suggesting that a GABA(B) receptor-dependent pathway may regulate the clustering of lung breaths.
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Affiliation(s)
- C Straus
- Respiratory Research Group, Department of Medical Physiology, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Alberta, T2N 4N1, Calgary, Canada.
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Reviron D, Tezenas du Montcel S, Foutrier C, Guis S, Benazet JF, Auquier P, Busson M, Roux H, Mercier P, Roudier J. HLA DRB1, DMA, and DMB gene polymorphisms in rheumatoid arthritis. Hum Immunol 1999; 60:245-9. [PMID: 10321961 DOI: 10.1016/s0198-8859(98)00116-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 10/18/2022]
Abstract
OBJECTIVE To study the influence of DMA and DMB genes on susceptibility to Rheumatoid Arthritis (RA). METHODS HLA-DRB1, DMA and DMB polymorphisms were defined by PCR SSOP in 203 European Mediterranean RA patients and 181 unrelated healthy controls. RESULTS No significant difference in the phenotype frequencies of DMA and DMB alleles was observed between patients and controls. We found decreased frequencies of DMA*0102 and DMB*0104 in patients but this did not reach significance. These decreased frequencies could be due to a positive linkage disequilibrium with DRB1*0701, an allele which is underrepresented in RA patients. In stratified analysis with RA susceptibility Epitope positive (SE) DRB1 alleles, there was no significant difference in DMA and DMB phenotype frequencies between SE/SE, SE/X, and X/X patients versus controls. Among SE/X subjects, no significant difference in DM distribution frequencies was observed in DRB1*0101/X, 0102/X, 0401/X, 0404/X and 0405/X groups. CONCLUSION DMA and DMB polymorphism does not seem to influence susceptibility to develop RA. Differences in DMA phenotype frequencies between patients and controls are secondary to linkage disequilibrium with DRB1 alleles.
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Affiliation(s)
- D Reviron
- Department of Immunogenetics, Etablissement de Transfusion Sanguine Alpes-Provence, Marseille, France
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