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Lemogne C, Gouraud C, Ouazana Vedrines C, Pritschkat C, Rotenberg L, Horn M, Cathébras P, Kachaner A, Scherlinger M, de Broucker T, Pignon B, Chauvet-Gelinier JC, Günther S, Gocko X, Pitron V, Ranque B. National committee statement as a missed opportunity to acknowledge the relevance of a biopsychosocial approach in understanding long COVID. J Psychosom Res 2024:111596. [PMID: 38272788 DOI: 10.1016/j.jpsychores.2024.111596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 01/27/2024]
Affiliation(s)
- Cédric Lemogne
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris 75004, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Clément Gouraud
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Charles Ouazana Vedrines
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris 75004, France; Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Caroline Pritschkat
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Léa Rotenberg
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Mathilde Horn
- Université de Lille, INSERM, CHU de Lille, U1172, Lille Neuroscience & Cognition, Lille 59000, France.
| | - Pascal Cathébras
- Service de Médecine interne, CHU de Saint-Étienne, hôpital Nord, Saint-Étienne 42055, France.
| | - Alexandra Kachaner
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France; Service de Médecine interne, AP-HP, Hôpital Européen Georges-Pompidou, Paris 75015, France.
| | - Marc Scherlinger
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, Strasbourg 67098, France.
| | - Thomas de Broucker
- Service de Neurologie, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis 93200, France.
| | - Baptiste Pignon
- Université Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Créteil, France.
| | - Jean-Christophe Chauvet-Gelinier
- Service de Psychiatrie Adultes, CHU de Dijon, Dijon, France; INSERM U-1231, Center for Translational and Molecular medicine, University of Burgundy, Dijon, France.
| | - Sven Günther
- Unité d'Explorations Fonctionnelles Respiratoires et du Sommeil, AP-HP, Hôpital Européen Georges-Pompidou, Paris 75015, France; Université Paris Cité, Innovative Therapies in Haemostasis, INSERM UMR_S1140, Paris 75006, France.
| | - Xavier Gocko
- Department of general practice, Faculty of medicine Jacques Lisfranc, University of Lyon, Saint-Etienne, France; INSERM UMR 1059, Sainbiose DVH, University of Lyon, Saint-Etienne 42000, France; INSERM CIC-EC 1408, University of Lyon, Saint-Etienne 42000, France.
| | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris 75004, France; Centre du Sommeil et de la Vigilance-Pathologie Professionnelle, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Brigitte Ranque
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris 75004, France; Service de Médecine interne, AP-HP, Hôpital Européen Georges-Pompidou, Paris 75015, France; Unité CASPer, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
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Kachaner A, Lemogne C, Ranque B, Meppiel E, de Broucker T. Response to 'Functional neurological disorder in people with long COVID: A systematic review'. Eur J Neurol 2023; 30:2949-2950. [PMID: 37294977 DOI: 10.1111/ene.15911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/06/2023] [Indexed: 06/11/2023]
Affiliation(s)
- Alexandra Kachaner
- Department of Neurology, Centre Hospitalier de Saint-Denis, Saint Denis, France
| | - Cédric Lemogne
- Department of Psychiatry, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), AP-HP, Hôpital Hôtel-Dieu, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
| | - Brigitte Ranque
- Department of Internal Medicine, Hôpital Européen Georges Pompidou (Assistance Publique-Hôpitaux de Paris), Paris, France
| | - Elodie Meppiel
- Department of Neurology, Centre Hospitalier de Saint-Denis, Saint Denis, France
| | - Thomas de Broucker
- Department of Neurology, Centre Hospitalier de Saint-Denis, Saint Denis, France
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de Broucker T. [COVID-19: Neurological manifestations and complications during the acute phase of the disease]. Bull Acad Natl Med 2023; 207:S0001-4079(23)00190-5. [PMID: 38620177 PMCID: PMC10293933 DOI: 10.1016/j.banm.2023.02.014] [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] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/28/2023] [Indexed: 04/17/2024]
Abstract
The neurological manifestations and complications of the acute phase of COVID-19 are numerous. They mainly concern the central nervous system in the frequent forms of encephalopathy, encephalitis and neurovascular pathologies. Peripheral neurological manifestations mainly include acute polyneuropathies such as Guillain-Barré syndrome and intensive care neuromyopathies. Most of these manifestations were described during the first wave of the pandemic. The epidemiological, clinical, paraclinical, pathophysiological and therapeutic aspects are addressed in this general review of the literature published from 2020 to early 2023.
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Allard J, Delvoye F, Pop R, Labreuche J, Maier B, Marnat G, Sibon I, Zhu F, Lapergue B, Consoli A, Spelle L, Denier C, Richard S, Piotin M, Gory B, Mazighi M, Redjem H, Escalard S, Dessilles JP, Delvoye F, Smajda S, Maier B, Solène H, Mazighi M, Obadia M, Sabben C, Pierre S, Igor R, Corabianu O, de Broucker T, Manchon E, Taylor G, Maacha MB, Thion LA, Augustin L, Julien S, Wang A, Evrard S, Tchikviladze M, Ajili N, WeisenburgerLile D, Gorza L, Buard G, Coskun O, Di Maria F, Rodesh G, Zimatore S, Leguen M, Gratieux J, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Marinier S, Barreau X, Berge J, Menegon P, Lucas L, Olindo S, Renou P, Sagnier S, Poli M, Debruxelles S, Rouanet F, Tourdias T, Liegey JS, Briau P, Pangon N, Coussy A, Papillon L, Papaxanthos J, Detraz L, Daumas-Duport B, Alexandre PL, Roy M, Lenoble C, Desal H, Guillon B, de Gaalon S, Preterre C, Bracard S, Anxionnat R, Braun M, Derelle AL, Tonnelet R, Liao L, Zhu F, Schmitt E, Planel S, Humbertjean L, Lacour JC, Riou-Comte N, Voicu M, Alb L, Reitter M, Brezeanu M, Masson A, Tabarna A, Podar I, Macian-Montoro F, Saleme S, Mounayer C, Rouchaud A, Costalat V, Arquizan C, Dargazanli C, Gascou G, Lefèvre PH, Derraz I, Riquelme C, Gaillard N, Mourand I, Corti L, Cagnazzo F, Ter Schiphorst A, Ferre JC, Raoult H, Ronziere T, Lassale M, Paya C, Gauvrit JY, Tracol C, Langnier-Lemercier S. 24-Hour Carotid Stent Patency and Outcomes After Endovascular Therapy: A Multicenter Study. Stroke 2023; 54:124-131. [PMID: 36542074 DOI: 10.1161/strokeaha.122.039797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Management of extracranial internal carotid artery steno-occlusive lesion during endovascular therapy remains debated. Stent occlusion within 24 hours of endovascular therapy is a frequent event after acute carotid artery stenting, and we currently lack large population results. We investigated the incidence, predictors, and clinical impact of stent occlusion after acute carotid artery stenting in current clinical practice. METHODS Patients treated by endovascular therapy with acute carotid artery stenting between 2015 and 2019 in 5 large-volume endovascular-capable centers were retrospectively analyzed. Patients were separated in 2 groups according to the stent patency at 24 hours after carotid artery stenting. We compared baseline characteristics, treatment modalities, and clinical outcome depending on 24-hour stent patency. Primary end point was favorable outcome, defined as a modified Rankin Scale score 0-2 at 3 months. RESULTS A stent occlusion was observed in 47/225 patients (20.9%). Patients with stent patency had a lower baseline National Institutes of Health Stroke Scale (median [interquartile range]: 13 [7-17] versus 18 [12-21]) and had more often stroke of atherothrombotic origin (77.0% versus 53.2%). A higher stent patency rate was found for patients treated with P2Y12 antagonists at the acute phase (odds ratio [OR]' 2.95 [95% CI' 1.10-7.91]; P=0.026) and treated with angioplasty (OR' 2.42 [95% CI' 1.24-4.67]; P=0.008). A better intracranial angiographic reperfusion was observed in patients with 24-hour stent patency compared with patients without stent patency (OR' 8.38 [95% CI' 3.07-22.78]; P<0.001). Patients with a stent patency at 24 hours had a higher chance of favorable outcome (OR' 3.29 [95% CI, 1.66-6.52]; P<0.001) and a lower risk of death (OR' 0.32 [95% CI, 0.13-0.76]; P=0.009). CONCLUSIONS One out of 5 patients treated with carotid artery stenting during endovascular therapy presented a stent occlusion within 24 hours. This event was associated with worse functional outcome. Stroke etiology, P2Y12 antagonist administration, quality of intracranial reperfusion, and angioplasty were associated with 24-hour stent patency.
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Affiliation(s)
- Julien Allard
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (J.A., F.D., B.M., MP, M.M.).,University of Paris' France (J.A., M.M.)
| | - François Delvoye
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (J.A., F.D., B.M., MP, M.M.)
| | - Raoul Pop
- Department of Neuroradiolology, CHU Strasbourg, France (R.P.).,Institut de Chirurgie Minime Invasive Guidée par l'Image, Strasbourg, France (R.P.).,University of Strasbourg, INSERM UMR-S1255, France (R.P.)
| | - Julien Labreuche
- Department of Biostatistics, CHU Lille, University of Lille, France (J.L.)
| | - Benjamin Maier
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (J.A., F.D., B.M., MP, M.M.).,LVTS, INSERM U1148, University of Paris, France (BM., M.M.)
| | - Gaultier Marnat
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Bordeaux, France (G.M.)
| | - Igor Sibon
- Department of Neurology, Stroke Center, University Hospital of Bordeaux, France (I.S.)
| | - François Zhu
- Department of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Université de Lorraine, France (B.G., F.Z.)
| | - Bertrand Lapergue
- Department of Neurology, Foch Hospital, Versailles Saint-Quentin en Yvelines University, Suresnes, France (B.L.)
| | - Arturo Consoli
- Diagnostic and Interventional Neuroradiology, Foch Hospital, Versailles Saint-Quentin en Yvelines University, Suresnes, France (A.C.)
| | - Laurent Spelle
- Department of Neuroradiolology, CHU Kremlin-Bicêtre, Le Kremlin Bicêtre, France (L.S.)
| | - Christian Denier
- Department of Neurology, CHU Kremlin-Bicêtre, Le Kremlin Bicêtre, France (C.D.)
| | - Sébastien Richard
- Department of Neurology, Stroke Unit, Université de Lorraine, CHRU-Nancy, France (S.R.).,CIC-P 1433, INSERM U1116, CHRU-Nancy, France (S.R.)
| | - Michel Piotin
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (J.A., F.D., B.M., MP, M.M.)
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, CHRU-Nancy, Université de Lorraine, France (B.G., F.Z.).,IADI, INSERM U1254, Université de Lorraine, Nancy, France (B.G.)
| | - Mikael Mazighi
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (J.A., F.D., B.M., MP, M.M.).,LVTS, INSERM U1148, University of Paris, France (BM., M.M.).,University of Paris' France (J.A., M.M.)
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Kachaner A, Lemogne C, Dave J, Ranque B, de Broucker T, Meppiel E. Somatic symptom disorder in patients with post-COVID-19 neurological symptoms: a preliminary report from the somatic study (Somatic Symptom Disorder Triggered by COVID-19). J Neurol Neurosurg Psychiatry 2022; 93:jnnp-2021-327899. [PMID: 36008115 DOI: 10.1136/jnnp-2021-327899] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 08/09/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To assess the diagnosis of somatic symptom disorder (SSD) in patients with unexplained neurological symptoms occurring after SARS-CoV-2 infection, also referred to as long COVID. DESIGN Single-centre observational study. PARTICIPANTS Adult patients experiencing unexplained long-lasting neurological symptoms after mild COVID. Of the 58 consecutive patients referred in our centre, 50 were included. INTERVENTION Patients were contacted for a standardised psychometric evaluation by phone, followed by a self-survey. MAIN OUTCOME Positive diagnosis of SSD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). RESULTS Although the patients did not meet the DSM-5 criteria for a functional neurological symptom disorder specifically, SSD diagnosis based on DSM-5 criteria was positive in 32 (64%) patients. In the remaining 18 patients, SSD was considered possible given the high score on diagnostic scales. Physical examination were normal for all. Brain MRI showed unspecific minor white matter hyperintensities in 8/46 patients. Neuropsychological assessment showed exclusively mild impairment of attention in 14 out of 15 tested patients, in discrepancy with their major subjective complaint. Forty-five (90%) patients met criteria for Chronic Fatigue Syndrome. Seventeen (32%) patients were screened positive for mood-anxiety disorders, 19 (38%) had a history of prior SSD and 27 (54%) reported past trauma. Additional self-survey highlighted post-traumatic stress disorder in 12/43 (28%), high levels of alexithymia traits and perfectionism. Long-lasting symptoms had a major impact with a high rate of insomnia (29/43, 67%), psychiatric follow-up (28/50, 56%) and work or pay loss (25/50, 50%). CONCLUSION A majority of patients with unexplained long-lasting neurological symptoms after mild COVID met diagnostic criteria for SSD and may require specific management. TRIAL REGISTRATION NUMBER NCT04889313.
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Affiliation(s)
| | - Cédric Lemogne
- Psychiatry, Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, Paris, France
- , Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
| | - Julie Dave
- Neurology, Centre Hospitalier de Saint Denis, Saint Denis, France
| | - Brigitte Ranque
- Internal Medicine, Internal Medicine Department, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Cité, Inserm UMR S970, Paris, France
| | | | - Elodie Meppiel
- Neurology, Centre Hospitalier de Saint Denis, Saint Denis, France
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Olivot J, Finitsis S, Lapergue B, Marnat G, Sibon I, Richard S, Viguier A, Cognard C, Mazighi M, Gory B, Piotin M, Blanc R, Redjem H, Escalard S, Desilles J, Delvoye F, Smajda S, Maïer B, Hebert S, Mazighi M, Obadia M, Sabben C, Seners P, Raynouard I, Corabianu O, de Broucker T, Manchon E, Taylor G, Maacha MB, Thion L, Lecler A, Savatovsjy J, Wang A, Evrard S, Tchikviladze M, Ajili N, Lapergue B, Weisenburger‐Lile D, Gorza L, Buard G, Coskun O, Consoli A, Di Maria F, Rodesh G, Zimatore S, Leguen M, Gratieux J, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Marinier S, Nighoghossian N, Riva R, Eker O, Turjman F, Derex L, Cho T, Mechtouff L, Lukaszewicz A, Philippeau F, Cakmak S, Blanc‐Lasserre K, Vallet A, Marnat G, Gariel F, Barreau X, Berge J, Menegon P, Sibon I, Lucas L, Olindo S, Renou P, Sagnier S, Poli M, Debruxelles S, Rouanet F, Tourdias T, Liegey J, Briau P, Pangon N, Bourcier R, Detraz L, Daumas‐Duport B, Alexandre P, Roy M, Lenoble C, Desal H, Guillon B, de Gaalon S, Preterre C, Gory B, Bracard S, Anxionnat R, Braun M, Derelle A, Liao L, Zhu F, Schmitt E, Planel S, Richard S, Humbertjean L, Mione G, Lacour J, Douarinou M, Audibert G, Voicu M, Alb I, Reitter M, Brezeanu M, Masson A, Tabarna A, Podar I, Bourst P, Beaumont M, Chen (Mitchelle) B, Guy S, Georges V, Bechiri F, Macian‐Montoro F, Saleme S, Mounayer C, Rouchaud A, Gimenez L, Cosnard A, Costalat V, Arquizan C, Dargazanli C, Gascou G, Lefèvre P, Derraz I, Riquelme C, Gaillard N, Mourand I, Corti L, Cagnazzo F, ter Schiphorst A, Alias Q, Boustia F, Ferre J, Raoult H, Gauvrit J, Vannier S, Guillen M, Ronziere T, Lassalle V, Tracol C, Malrain C, Boinet S, Clarençon F, Shotar E, Sourour N, Lenck S, Premat K, Samson Y, Léger A, Crozier S, Baronnet F, Alamowitch S, Bottin L, Yger M, Degos V, Spelle L, Denier C, Chassin O, Chalumeau V, Caroff J, Chassin O, Venditti L, Sarov M, Legris N, Naggara O, Hassen WB, Boulouis G, Rodriguez‐Régent C, Trystram D, Kerleroux B, Turc G, Domigo V, Lamy C, Birchenall J, Isabel C, Lun F, Viguier A, Cognard C, Januel A, Olivot J, Raposo N, Bonneville F, Albucher J, Calviere L, Darcourt J, Bellanger G, Tall P, Touze E, Barbier C, Schneckenburger R, Boulanger M, Cogez J, Guettier S, Gauberti M, Timsit S, Gentric J, Ognard J, Merrien FM, Wermester OO, Massardier E, Papagiannaki C, Triquenot A, Lefebvre M, Bourdain F, Bernady P, Lagoarde‐Segot L, Cailliez H, Veunac L, Higue D, Wolff V, Quenardelle V, Lauer V, Gheoca R, Pierre‐Paul I, Pop R, Beaujeux R, Mihoc D, Manisor M, Pottecher J, Meyer A, Chamaraux‐Tran T, Le Bras A, Evain S, Le Guen A, Richter S, Hubrecht R, Demasles S, Barroso B, Sablot D, Farouil G, Tardieu M, Smadja P, Aptel S, Seiler I. Parenchymal hemorrhage rate is associated with time to reperfusion and outcome. Ann Neurol 2022; 92:882-887. [DOI: 10.1002/ana.26478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Bertrand Lapergue
- Department of Neurology Foch Hospital Versailles Saint‐Quentin en Yvelines University Suresnes France
| | - Gaultier Marnat
- Department of Diagnostic and Interventional Neuroradiology University Hospital of Bordeaux France
| | - Igor Sibon
- Department of Neurology, Stroke Center University Hospital of Bordeaux France
| | - Sebastien Richard
- Université de Lorraine, CHRU‐Nancy, Department of Neurology, Stroke Unit F‐54000 Nancy France
- CIC‐P 1433 , INSERM U1116, CHRU‐Nancy, F‐54000 Nancy France
| | - Alain Viguier
- Acute Stroke Unit‐ CIC 1436‐UMR 1214, CHU Toulouse France
| | - Christophe Cognard
- Department of Interventional and Diagnostic Neuroradiolology CHU Toulouse France
| | - Mikael Mazighi
- Department of Interventional Neuroradiology FHU Neurovasc, INSERM 1148, Université de Paris Cité Rothschild Foundation, Paris France
- Diagnostic and Therapeutic Neuroradiology, F‐54000 Nancy France
| | - Benjamin Gory
- Université de Lorraine, IADI, INSERM U1254 F‐54000 Nancy France
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Akroum S, Tubiana S, de Broucker T, Dournon N, Varon E, Ploy MC, Mourvillier B, Oziol E, Lacassin F, Laurichesse H, Hoen B, Duval X, Burdet C. Long-term neuro-functional disability in adult patients with community-acquired bacterial meningitis. Infection 2022; 50:1363-1372. [PMID: 35657529 DOI: 10.1007/s15010-022-01855-2] [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: 09/21/2021] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the prevalence of neuro-functional disability and its determinants 12 months after community-acquired bacterial meningitis (CABM) in adult patients. METHODS In a prospective multicenter cohort study (COMBAT), all consecutive cases of CABM were enrolled and followed up for 12 months. Neuro-functional disability at 12 months was evaluated using a combination of the Glasgow Outcome Scale (functional disability), and the modified Rankin Disability Scale (physical disability). Factors associated with neuro-functional disability were identified by multivariate logistic regression. RESULTS Among 281 patients, 84 (29.9%) patients exhibited neuro-functional disability at 12 months: 79 (28.1%) with functional disability and 51 (18.1%) with physical disability. Overall, 6 patients (2.1%) died during the follow-up. The most common pathogen identified was Streptococcus pneumoniae (131/272, 48.2%); 77/268 patients (28.7%) had a physical disability at hospital discharge. Factors independently associated with 12-month neuro-functional disability were a pneumococcal meningitis (adjusted OR = 2.8; 95% confidence interval (CI) = [1.3; 6.7]), the presence of a physical disability at hospital discharge (aOR = 2.3; 95%CI = [1.2; 4.4]) and the presence of behavioral disorders at hospital-discharge (aOR = 5.9; 95%CI = [1.6; 28.4]). Dexamethasone use was not significantly associated with neuro-functional disability (OR = 0.2; 95%CI = [< 0.1;1.3]). CONCLUSION Neuro-functional disability is frequently reported 12 months after CABM. Detailed neurological examination at discharge is needed to improve the follow-up. TRIAL REGISTRATION NCT01730690.
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Affiliation(s)
- Souade Akroum
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France
| | - Sarah Tubiana
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France.,Université Paris Cité, IAME, INSERM, 75018, Paris, France.,Centre de Ressources Biologiques, AP-HP, Hôpital Bichat, 75018, Paris, France
| | | | - Nathalie Dournon
- Service de maladies infectieuses et tropicales, dermatologie, médecine interne, Centre Hospitalier Universitaire de Pointe-à-Pitre, 97159, Pointe-à-Pitre, France
| | - Emmanuelle Varon
- Centre Hospitalier Intercommunal de Créteil, Centre National de Référence des Pneumocoques, 94010, Créteil, France
| | - Marie Cécile Ploy
- Centre Hospitalier Universitaire de Limoges, Observatoire Régional des Pneumocoques, 87000, Limoges, France
| | - Bruno Mourvillier
- Service de Médecine Intensive et Réanimation Polyvalente, CHU Reims, 51100, Reims, France
| | - Eric Oziol
- Service de Médecine Interne, Centre Hospitalier de Béziers, 34500, Béziers, France
| | - Flore Lacassin
- Service de Médecine Interne, Centre Hospitalier Territorial de Nouméa, 98849, Nouméa, France
| | - Henri Laurichesse
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Clermont-Ferrand, 63003, Clermont-Ferrand, France
| | - Bruno Hoen
- Service de Maladies Infectieuses et Tropicales, CHU de Nancy, Hôpitaux de Brabois, 54511, Vandoeuvre-lès-Nancy, France
| | - Xavier Duval
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France. .,Université Paris Cité, IAME, INSERM, 75018, Paris, France.
| | - Charles Burdet
- Centre d'Investigation Clinique, Hôpital Bichat Claude Bernard, AP-HP, Hôpital Bichat, Inserm CIC 1425, 46, rue Henri Huchard, 75018, Paris, France.,Université Paris Cité, IAME, INSERM, 75018, Paris, France.,Département d'Epidémiologie, Biostatistique et Recherche, AP-HP, Hôpital Bichat, 75018, Paris, France
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8
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Dumonceau AG, Ameli R, Rogemond V, Ruiz A, Joubert B, Muñiz-Castrillo S, Vogrig A, Picard G, Ambati A, Benaiteau M, Rulquin F, Ciron J, Deiva K, de Broucker T, Kremer L, Kerschen P, Sellal F, Bouldoires B, Genet R, Biberon J, Bigot A, Duval F, Issa N, Rusu EC, Goudot M, Dutray A, Devoize JL, Hopes L, Kaminsky AL, Philbert M, Chanson E, Leblanc A, Morvan E, Andriuta D, Diraison P, Mirebeau G, Derollez C, Bourg V, Bodard Q, Fort C, Grigorashvili-Coin I, Rieul G, Molinier-Tiganas D, Bonnan M, Tchoumi T, Honnorat J, Marignier R. Glial Fibrillary Acidic Protein Autoimmunity: A French Cohort Study. Neurology 2021; 98:e653-e668. [PMID: 34799461 PMCID: PMC8829963 DOI: 10.1212/wnl.0000000000013087] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/12/2021] [Indexed: 11/21/2022] Open
Abstract
Background and Objectives To report the clinical, biological, and imaging features and clinical course of a French cohort of patients with glial fibrillary acidic protein (GFAP) autoantibodies. Methods We retrospectively included all patients who tested positive for GFAP antibodies in the CSF by immunohistochemistry and confirmed by cell-based assay using cells expressing human GFAPα since 2017 from 2 French referral centers. Results We identified 46 patients with GFAP antibodies. Median age at onset was 43 years, and 65% were men. Infectious prodromal symptoms were found in 82%. Other autoimmune diseases were found in 22% of patients, and coexisting neural autoantibodies in 11%. Tumors were present in 24%, and T-cell dysfunction in 23%. The most frequent presentation was subacute meningoencephalitis (85%), with cerebellar dysfunction in 57% of cases. Other clinical presentations included myelitis (30%) and visual (35%) and peripheral nervous system involvement (24%). MRI showed perivascular radial enhancement in 32%, periventricular T2 hyperintensity in 41%, brainstem involvement in 31%, leptomeningeal enhancement in 26%, and reversible splenial lesions in 4 cases. A total of 33 of 40 patients had a monophasic course, associated with a good outcome at last follow-up (Rankin Score ≤2: 89%), despite a severe clinical presentation. Adult and pediatric features are similar. Thirty-two patients were treated with immunotherapy. A total of 11/22 patients showed negative conversion of GFAP antibodies. Discussion GFAP autoimmunity is mainly associated with acute/subacute meningoencephalomyelitis with prodromal symptoms, for which tumors and T-cell dysfunction are frequent triggers. The majority of patients followed a monophasic course with a good outcome.
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Affiliation(s)
- Alice Gravier Dumonceau
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France
| | - Roxana Ameli
- Service d'imagerie médicale, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France
| | - Veronique Rogemond
- Centre de référence des syndromes neurologiques paranéoplasiques et encéphalites auto-immunes, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France ; Institut NeuroMyoGène, INSERM 1217 et CNRS UMR5310, 69008 Lyon, France ; Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69008 Lyon, France
| | - Anne Ruiz
- Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR5292, 69003 Lyon, France
| | - Bastien Joubert
- Centre de référence des syndromes neurologiques paranéoplasiques et encéphalites auto-immunes, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France ; Institut NeuroMyoGène, INSERM 1217 et CNRS UMR5310, 69008 Lyon, France ; Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69008 Lyon, France
| | - Sergio Muñiz-Castrillo
- Centre de référence des syndromes neurologiques paranéoplasiques et encéphalites auto-immunes, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France ; Institut NeuroMyoGène, INSERM 1217 et CNRS UMR5310, 69008 Lyon, France ; Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69008 Lyon, France
| | - Alberto Vogrig
- Centre de référence des syndromes neurologiques paranéoplasiques et encéphalites auto-immunes, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France ; Institut NeuroMyoGène, INSERM 1217 et CNRS UMR5310, 69008 Lyon, France ; Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69008 Lyon, France
| | - Geraldine Picard
- Centre de référence des syndromes neurologiques paranéoplasiques et encéphalites auto-immunes, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France ; Institut NeuroMyoGène, INSERM 1217 et CNRS UMR5310, 69008 Lyon, France ; Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69008 Lyon, France
| | - Aditya Ambati
- Stanford University Center for Sleep Sciences and Medecine, Palo Alto, CA, USA
| | - Marie Benaiteau
- Service de neurologie cognitive, épilepsie, sommeil et mouvements anormaux, Hôpital Pierre-Paul Riquet, Hôpitaux de Toulouse, 31059 Toulouse, France
| | - Florence Rulquin
- Service de neurologie inflammatoire et neuro-oncologie, Hôpital Pierre-Paul Riquet, Hôpitaux de Toulouse, 31059 Toulouse, France
| | - Jonathan Ciron
- Service de neurologie inflammatoire et neuro-oncologie, Hôpital Pierre-Paul Riquet, Hôpitaux de Toulouse, 31059 Toulouse, France
| | - Kumaran Deiva
- Service de neuropédiatrie, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 94270 Le Kremlin-Bicêtre, France
| | - Thomas de Broucker
- Service de neurologie, Hôpital Delafontaine, Centre Hospitalier de Saint-Denis, 93205 Saint-Denis, France
| | - Laurent Kremer
- Service de neurologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67200 Strasbourg, France
| | - Philippe Kerschen
- Service de neurologie, Centre Hospitalier de Luxembourg, 1210 Luxembourg, Luxembourg
| | - François Sellal
- Service de neurologie, Hôpitaux Civils de Colmar, 68000 Colmar, France ; Unité INSERM U-1118, Faculté de Médecine, Université de Strasbourg
| | - Bastien Bouldoires
- Service de médecine interne, Hôpitaux civils de Colmar, 68000 Colmar, France
| | - Roxana Genet
- Service de médecine interne, Hôpital d'Instruction des Armées Legouest, 57000 Metz, France
| | - Jonathan Biberon
- Service de neurologie, Centre Hospitalier Régional Universitaire de Tours, 37044 Tours, France
| | - Adrien Bigot
- Service de médecine interne et immunologie clinique, Centre Hospitalier Régional Universitaire de Tours, 37044 Tours, France
| | - Fanny Duval
- Service de neurologie et maladies neuromusculaires, Groupe Hospitalier Pellegrin, Hôpitaux de Bordeaux, 33000 Bordeaux, France
| | - Nahema Issa
- Service de médecine intensive et réanimation, Hôpital Saint André, 33000 Bordeaux, France
| | - Elena-Camelia Rusu
- Service de neurologie, Hôpital Sainte Musse, Centre Hospitalier Intercommunal de Toulon, 83056 Toulon, France
| | - Mathilde Goudot
- Service de neurologie, Hôpital Emile Muller, 68100 Mulhouse, France
| | - Anais Dutray
- Service de neurologie, Centre Hospitalier de Perpignan, 66046 Perpignan, France
| | - Jean Louis Devoize
- Pôle Cardio-vasculaire et métabolique, Centre hospitalier de Cayenne, 97300 Cayenne, France
| | - Lucie Hopes
- Service de neurologie, Hôpital Central, CHRU Nancy, 54035 Nancy, France
| | - Anne-Laure Kaminsky
- Service de neurologie, CHU de Saint-Etienne, 42270 Saint-Priest-en-Jarez, France
| | - Marion Philbert
- Service de neuropédiatrie, Site Mère Enfant, CHU Martinique, 97200 Fort-de-France, France
| | - Eve Chanson
- Service de neurologie, CHU Gabriel-Montpied, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Amelie Leblanc
- Service de neurologie, Hôpital d'Instruction des Armées Clermont-Tonnerre, 29240 Brest, France
| | - Erwan Morvan
- Service de neurologie, Hôpital Fondation Adolphe de Rothschild, 75019 Paris, France
| | - Daniela Andriuta
- Service de Neurologie et Laboratoire de Neurosciences Fonctionnelles et Pathologies, Centre Hospitalier universitaire d'Amiens et Université de Picardie Jules Verne, Amiens, France
| | - Philippe Diraison
- Service de neurologie, Hôpital Laënnec, Centre Hospitalier de Cornouaille, 29107 Quimper, France
| | - Gabriel Mirebeau
- Service de neurologie, Centre Hospitalier Universitaire de La Réunion, 97410 Saint Pierre, France
| | - Celine Derollez
- Service de neurologie, Hôpital Roger Salengro, Centre Hospitalier Universitaire de Lille, 59037 Lille, France
| | - Veronique Bourg
- Service de neurologie, Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, 06000 Nice, France
| | - Quentin Bodard
- Service de médecine interne et maladies infectieuses, Centre Hospitalier d'Angoulême, 16959 Angoulême, France
| | - Clementine Fort
- Service de neurologie pédiatrique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69677 Lyon/Bron, France
| | | | - Guillaume Rieul
- Service de réanimation, Centre Hospitalier de Saint-Brieuc, 22027 Saint-Brieuc, France
| | - Daniela Molinier-Tiganas
- Service de médecine polyvalente et de médecine interne, Centre Hospitalier Le Mans, 72037 Le Mans, France
| | - Mickaël Bonnan
- Service de neurologie, Centre Hospitalier de Pau, 64046 Pau, France
| | - Thierry Tchoumi
- Service de neurologie/UNV, Centre Hospitalier de Saintonge, 17100 Saintes, France
| | - Jérôme Honnorat
- Centre de référence des syndromes neurologiques paranéoplasiques et encéphalites auto-immunes, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France ; Institut NeuroMyoGène, INSERM 1217 et CNRS UMR5310, 69008 Lyon, France ; Université Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69008 Lyon, France
| | - Romain Marignier
- Service de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677 Lyon/Bron, France.,Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR5292, 69003 Lyon, France
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9
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Chantran Y, Capron J, Doukhi D, Felix J, Féroul M, Kruse F, Chaigneau T, Dorothée G, Allou T, Ayrignac X, Barrou Z, de Broucker T, Cret C, Turc G, Peres R, Wacongne A, Sarazin M, Renard D, Cordonnier C, Alamowitch S, Aucouturier P. Letter to the editor: Serum anti-Aβ antibodies in cerebral amyloid angiopathy. Autoimmun Rev 2021; 20:102870. [PMID: 34118456 DOI: 10.1016/j.autrev.2021.102870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Yannick Chantran
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France; Département d'Immunologie Biologique, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Jean Capron
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France; Service de Neurologie et d'Urgences Neurovasculaires, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Diana Doukhi
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France
| | - Johanna Felix
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France
| | - Mélanie Féroul
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France
| | - Florian Kruse
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France
| | - Thomas Chaigneau
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France
| | - Guillaume Dorothée
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France
| | | | - Xavier Ayrignac
- Service de Neurologie, CHU Montpellier, Hôpital Guy de Chauliac, Montpellier, France
| | - Zina Barrou
- Service de Gériatrie, Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Thomas de Broucker
- Service de Neurologie, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Corina Cret
- Service de Neurologie, Centre Hospitalier de Meaux, Meaux, France
| | - Guillaume Turc
- Service de Neurologie, GHU Paris Psychiatrie et Neurosciences, Université de Paris, INSERM U1266, FHU NeuroVasc, Paris, France
| | - Roxane Peres
- Service de Neurologie, Hôpital Lariboisière, AP-HP, Paris, France
| | - Anne Wacongne
- Service de Neurologie, CHU Nîmes, Hôpital Caremeau, Nîmes, France
| | - Marie Sarazin
- Service de Neurologie de la Mémoire et du Langage, Centre Hospitalier Sainte-Anne, Université Sorbonne Paris Cité, Paris, France
| | - Dimitri Renard
- Service de Neurologie, CHU Nîmes, Hôpital Caremeau, Nîmes, France
| | - Charlotte Cordonnier
- U1172 - LilNCog - Lille Neuroscience & Cognition, Inserm, CHU Lille, Univ. Lille, Lille, France
| | - Sonia Alamowitch
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France; Service de Neurologie et d'Urgences Neurovasculaires, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Pierre Aucouturier
- UMRS 938, Hôpital St-Antoine, Sorbonne Université, Inserm, Paris, France; Département d'Immunologie Biologique, Hôpital Saint-Antoine, AP-HP, Paris, France.
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10
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Muñiz-Castrillo S, Hedou JJ, Ambati A, Jones D, Vogrig A, Pinto AL, Benaiteau M, de Broucker T, Fechtenbaum L, Labauge P, Murnane M, Nocon C, Taifas I, Vialatte de Pémille C, Psimaras D, Joubert B, Dubois V, Wucher V, Desestret V, Mignot E, Honnorat J. Distinctive clinical presentation and pathogenic specificities of anti-AK5 encephalitis. Brain 2021; 144:2709-2721. [PMID: 33843981 DOI: 10.1093/brain/awab153] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 01/12/2021] [Revised: 03/10/2021] [Accepted: 03/28/2021] [Indexed: 11/12/2022] Open
Abstract
Limbic encephalitis (LE) with antibodies against adenylate kinase 5 (AK5) has been difficult to characterize because of its rarity. In this study, we identified 10 new cases and reviewed 16 previously reported patients, investigating clinical features, IgG subclasses, human leukocyte antigen (HLA), and CSF proteomic profiles. Patients with anti-AK5 LE were mostly men (20/26, 76.9%) of median age 66 years old (range 48-94). Predominant symptom was severe episodic amnesia in all patients, frequently associated with depression (17/25, 68.0%). Weight loss, asthenia, and anorexia were also highly characteristic, being present in 11/25 (44.0%) patients. Although epilepsy was always lacking at disease onset, seizures developed later in a subset of patients (4/25, 16.0%). All patients presented CSF abnormalities, such as pleocytosis (18/25, 72.0%), oligoclonal bands (18/25, 72.0%), and increased Tau (11/14, 78.6%). Temporal lobe hyper-intensities were almost always present at disease onset (23/26, 88.5%), evolving nearly invariably toward a severe atrophy in subsequent MRIs (17/19, 89.5%). This finding was in line with a poor response to immunotherapy, with only 5/25 (20.0%) patients responding. IgG1 was the predominant subclass, being the most frequently detected and the one with highest titres in nine CSF-serum paired samples. Temporal biopsy from one of our new cases showed massive lymphocytic infiltrates dominated by both CD4+ and CT8+ T-cells, intense granzyme B expression, and abundant macrophages/microglia. HLA analysis in 11 patients showed a striking association with HLA-B*08:01 (7/11, 63.6%; OR = 13.4, 95% CI [3.8-47.4]), C*07:01 (8/11, 72.7%; OR = 11.0, 95% CI [2.9-42.5]), DRB1*03:01 (8/11, 72.7%; OR = 14.4, 95% CI [3.7-55.7]), DQB1*02:01 (8/11, 72.7%; OR = 13.5, 95% CI [3.5-52.0]), and DQA1*05:01 (8/11, 72.7%; OR = 14.4, 95% CI [3.7-55.7]) alleles, which formed the extended haplotype B8-C7-DR3-DQ2 in 6/11 (54.5%) patients (OR = 16.5, 95% CI [4.8-57.1]). Finally, we compared the CSF proteomic profile of five anti-AK5 patients with that of 40 controls and 10 cases with other more common non-paraneoplastic LE (five with antibodies against leucine-rich glioma inactivated 1 and five against contactin-associated protein-like 2), as well as 10 cases with paraneoplastic neurological syndromes (five with antibodies against Yo and five against Ma2). These comparisons revealed, respectively, 31 and seven significantly up-regulated proteins in anti-AK5 LE, mapping to apoptosis pathways and innate/adaptive immune responses. These findings suggest that the clinical manifestations of anti-AK5 LE result from a distinct T-cell mediated pathogenesis, with major cytotoxicity-induced apoptosis leading to a prompt and aggressive neuronal loss, likely explaining the poor prognosis and response to immunotherapy.
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Affiliation(s)
- Sergio Muñiz-Castrillo
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France.,SynatAc Team, Institute NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | | | - Aditya Ambati
- Stanford University Center for Narcolepsy, Palo Alto, CA, USA
| | - David Jones
- Pathology and Laboratory Medicine, Albany Medical Center Hospital, Albany, NY, USA
| | - Alberto Vogrig
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France.,SynatAc Team, Institute NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Anne-Laurie Pinto
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France.,SynatAc Team, Institute NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Marie Benaiteau
- Neurology Department, Hôpital Pierre-Paul Riquet, Toulouse, France
| | - Thomas de Broucker
- Neurology Department, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Laura Fechtenbaum
- Neurology Department, Centre Hospitalier Henri Mondor, Paris, France
| | - Pierre Labauge
- Neurology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Matthew Murnane
- Neurology Department, Albany Medical Center Hospital, Albany, NY, USA
| | - Claire Nocon
- Neurology Department, Centre Hospitalier de Dax, Dax, France
| | - Irina Taifas
- Neurology Department, Hôpital d´Instruction des Armées Percy, Clamart, France
| | | | - Dimitri Psimaras
- Neurology Department 2-Mazarin, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, APHP, Paris, France.,Brain and Spinal Cord Institute, INSERM U1127/CNRS UMR 7255, Université Pierre-et-Marie-Curie, Universités Sorbonnes, Paris, France
| | - Bastien Joubert
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France.,SynatAc Team, Institute NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Valérie Dubois
- HLA Laboratory, French Blood Service, EFS Auvergne-Rhône-Alpes, Lyon, France
| | - Valentin Wucher
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France.,SynatAc Team, Institute NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Virginie Desestret
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France.,SynatAc Team, Institute NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Emmanuel Mignot
- Stanford University Center for Narcolepsy, Palo Alto, CA, USA
| | - Jérôme Honnorat
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France.,SynatAc Team, Institute NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
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11
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Meppiel E, Peiffer-Smadja N, Maury A, Bekri I, Delorme C, Desestret V, Gorza L, Hautecloque-Raysz G, Landre S, Lannuzel A, Moulin S, Perrin P, Petitgas P, SellaI F, Wang A, Tattevin P, de Broucker T. Neurologic manifestations associated with COVID-19: a multicentre registry. Clin Microbiol Infect 2021; 27:458-466. [PMID: 33189873 PMCID: PMC7661948 DOI: 10.1016/j.cmi.2020.11.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To provide an overview of the spectrum, characteristics and outcomes of neurologic manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS We conducted a single-centre retrospective study during the French coronavirus disease 2019 (COVID-19) epidemic in March-April 2020. All COVID-19 patients with de novo neurologic manifestations were eligible. RESULTS We included 222 COVID-19 patients with neurologic manifestations from 46 centres in France. Median (interquartile range, IQR) age was 65 (53-72) years and 136 patients (61.3%) were male. COVID-19 was severe or critical in 102 patients (45.2%). The most common neurologic diseases were COVID-19-associated encephalopathy (67/222, 30.2%), acute ischaemic cerebrovascular syndrome (57/222, 25.7%), encephalitis (21/222, 9.5%) and Guillain-Barré syndrome (15/222, 6.8%). Neurologic manifestations appeared after the first COVID-19 symptoms with a median (IQR) delay of 6 (3-8) days in COVID-19-associated encephalopathy, 7 (5-10) days in encephalitis, 12 (7-18) days in acute ischaemic cerebrovascular syndrome and 18 (15-28) days in Guillain-Barré syndrome. Brain imaging was performed in 192 patients (86.5%), including 157 magnetic resonance imaging (70.7%). Among patients with acute ischaemic cerebrovascular syndrome, 13 (22.8%) of 57 had multiterritory ischaemic strokes, with large vessel thrombosis in 16 (28.1%) of 57. Brain magnetic resonance imaging of encephalitis patients showed heterogeneous acute nonvascular lesions in 14 (66.7%) of 21. Cerebrospinal fluid of 97 patients (43.7%) was analysed, with pleocytosis found in 18 patients (18.6%) and a positive SARS-CoV-2 PCR result in two patients with encephalitis. The median (IQR) follow-up was 24 (17-34) days with a high short-term mortality rate (28/222, 12.6%). CONCLUSIONS Clinical spectrum and outcomes of neurologic manifestations associated with SARS-CoV-2 infection were broad and heterogeneous, suggesting different underlying pathogenic processes.
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Affiliation(s)
- Elodie Meppiel
- Department of Neurology, Centre Hospitalier de Saint-Denis, Hôpital Delafontaine, Saint-Denis, France.
| | - Nathan Peiffer-Smadja
- Department of Infectious Diseases, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France; Université de Paris, IAME, INSERM, Paris, France
| | - Alexandra Maury
- Department of Neurology, Centre Hospitalier de Saint-Denis, Hôpital Delafontaine, Saint-Denis, France
| | - Imen Bekri
- Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Cécile Delorme
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Virginie Desestret
- Department of Neuro-cognition and Neuro-ophthalmology, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France
| | - Lucas Gorza
- Department of Neurology, Hôpital Foch, Suresnes, France
| | | | - Sophie Landre
- Department of Infectious Diseases, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France
| | - Annie Lannuzel
- Department of Neurology, Centre Hospitalier Universitaire de la Guadeloupe, Faculté de médecine de l'université des Antilles, Centre d'investigation clinique Antilles Guyane, Inserm CIC 1424, Pointe-à-Pitre, France
| | - Solène Moulin
- Department of Neurology, Centre Hospitalier Universitaire Reims, Hôpital Maison Blanche, Reims, France
| | - Peggy Perrin
- Department of Nephrology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Paul Petitgas
- Department of Infectious Diseases and Intensive Care Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - François SellaI
- Department of Neurology, Hôpitaux civils de Colmar, Colmar, France
| | - Adrien Wang
- Department of Neurology, Hôpital Foch, Suresnes, France
| | - Pierre Tattevin
- Department of Infectious Diseases and Intensive Care Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Thomas de Broucker
- Department of Neurology, Centre Hospitalier de Saint-Denis, Hôpital Delafontaine, Saint-Denis, France
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12
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Marnat G, Lapergue B, Sibon I, Gariel F, Bourcier R, Kyheng M, Labreuche J, Dargazanli C, Consoli A, Blanc R, Piotin M, Mazighi M, Richard S, Gory B, Redjem H, Escalard S, Desilles JP, Redjem H, Ciccio G, Smajda S, Fahed R, Obadia M, Sabben C, Corabianu O, de Broucker T, Smadja D, Alamowitch S, Ille O, Manchon E, Garcia PY, Taylor G, Ben Maacha M, Bourdain F, Decroix JP, Wang A, Evrard S, Tchikviladze M, Coskun O, Di Maria F, Rodesh G, Leguen M, Tisserand M, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Nighoghossian N, Riva R, Eker O, turjman F, Derex L, Cho TH, Mechtouff L, Claire Lukaszewicz A, Philippeau F, Cakmak S, Blanc-Lasserre K, Vallet AE, Barreau X, Berge J, Menegon P, Lucas L, Olindo S, Renou P, Sagnier S, Poli M, Debruxelles S, Rouanet F, Tourdias T, Liegey JS, Detraz L, Daumas-Duport B, Alexandre PL, Roy M, Lenoble C, L’allinec V, Girot JB, Desal H, Bracard S, Anxionnat R, Braun M, Derelle AL, Tonnelet R, Liao L, Zhu F, Schmitt E, Planel S, Humbertjean L, Mione G, Lacour JC, Bonnerot M, Riou-Comte N, Costalat V, Gascou G, Lefèvre PH, Derraz I, Riquelme C, Arquizan C, Gaillard N, Mourand I, Corti L, Cagnazzo F, Anadani M, Spiotta A, Alawieh A, Turjman F, Haussen D, Nogueira R, Papanagiotou P, Siddiqui AH, Dorn F, Cognard C, Ribo M, Psychogios M, Labeyrie MA, Biondi A, Andrew Grossberg J, Guenego A, Darcourt J, Vukasinovic I, Pomero E, Davies J, Renieri L, Hecker C, Muchada Muchada M, Houdart E, Turner R, Turk A, Chaudry I, Lockau J, Kastrup A, Behme D, Shallwani H, Christopher M, Mione G. Safety and Outcome of Carotid Dissection Stenting During the Treatment of Tandem Occlusions. Stroke 2020; 51:3713-3718. [DOI: 10.1161/strokeaha.120.030038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background and Purpose:
The efficacy of endovascular therapy in patients with acute ischemic stroke due to tandem occlusion is comparable to that for isolated intracranial occlusion in the anterior circulation. However, the optimal management of acute cervical internal carotid artery lesions is unknown, especially in the setting of carotid dissection, but emergency carotid artery stenting (CAS) is frequently considered. We investigated the safety and efficacy of emergency CAS for carotid dissection in patients with acute stroke with tandem occlusion in current clinical practice.
Methods:
We retrospectively analyzed a prospectively maintained database composed of 2 merged multicenter international observational real-world registries (Endovascular Treatment in Ischemic Stroke and Thrombectomy in Tandem Lesion). Data from endovascular therapy performed in the treatment of tandem occlusions related to acute cervical carotid dissection between January 2012 and January 2019 at 24 comprehensive stroke centers were analyzed.
Results:
The study assessed 136 patients with tandem occlusion due to dissection, including 65 (47.8%) treated with emergency CAS and 71 (52.2%) without. The overall rates of favorable outcome (90-day modified Rankin Scale score, 0–2) and successful reperfusion (modified Thrombolysis in Cerebral Infarction, 2b–3) were 58.0% (n=76 [95% CI, 49.6%–66.5%]) and 77.9% (n=106 [95% CI, 71.0%–85.0%]), respectively. In subgroup analyses, the rate of successful reperfusion (89.2% versus 67.6%; adjusted odds ratio, 2.24 [95% CI, 1.33–3.77]) was higher after CAS, whereas the 90-day favorable outcome (54.3% versus 61.4%; adjusted odds ratio, 0.84 [95% CI, 0.58–1.22]), symptomatic intracerebral hemorrhage (sICH; 10.8% versus 5.6%; adjusted odds ratio, 1.59 [95% CI, 0.79–3.17]), and 90-day mortality (8.0% versus 5.8%; adjusted odds ratio, 1.00 [95% CI, 0.48–2.09]) did not differ. In sensitivity analyses of patients with successful intracranial reperfusion, CAS was not associated with an improved clinical outcome.
Conclusions:
Emergency stenting of the dissected cervical carotid artery during endovascular therapy for tandem occlusions seems safe, whatever the quality of the intracranial reperfusion.
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Affiliation(s)
- Gaultier Marnat
- Department of Neuroradiology, University Hospital of Bordeaux, France (G.M., F.G.)
| | - Bertrand Lapergue
- Department of Neurology, Foch Hospital, Versailles Saint-Quentin-en-Yvelines University, Suresnes, France (B.L.)
| | - Igor Sibon
- Department of Neurology, University Hospital of Bordeaux, France (I.S.)
| | - Florent Gariel
- Department of Neuroradiology, University Hospital of Bordeaux, France (G.M., F.G.)
| | - Romain Bourcier
- Department of Neuroradiology, University Hospital of Nantes, France (R.B.)
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (R.B., M.P., M.M.)
| | - Maeva Kyheng
- Université Lille, CHU Lille, EA 2694-Santé Publique: Épidémiologie et Qualité des Soins—Lille—France (M.K., J.L.)
| | - Julien Labreuche
- Université Lille, CHU Lille, EA 2694-Santé Publique: Épidémiologie et Qualité des Soins—Lille—France (M.K., J.L.)
| | - Cyril Dargazanli
- Department of Neuroradiology, CHRU Gui de Chauliac, Montpellier, France (C.D.)
| | - Arturo Consoli
- Department of Neuroradiology, Foch Hospital, Versailles Saint-Quentin en Yvelines University, Suresnes, France (A.C.)
| | | | - Michel Piotin
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (R.B., M.P., M.M.)
| | - Mikael Mazighi
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (R.B., M.P., M.M.)
| | - Sebastien Richard
- Université de Lorraine, CHRU-Nancy, Department of Neurology, Stroke Unit, F-54000 Nancy, France (S.R.)
- INSERM U1116, CHRU-Nancy, F-54000 Nancy, France (S.R.)
| | - Benjamin Gory
- Université de Lorraine, CHRU-Nancy, Department of Diagnostic and Therapeutic Neuroradiology, F-54000 Nancy, France (B.G.)
- Université de Lorraine, IADI, INSERM U1254, F-54000 Nancy, France (B.G.)
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Drouard-de Rousiers E, Lucas L, Richard S, Consoli A, Mazighi M, Labreuche J, Kyheng M, Gory B, Dargazanli C, Arquizan C, Marnat G, Blanc R, Desal H, Bourcier R, Sibon I, Lapergue B, Piotin M, Blanc R, Redjem H, Escalard S, Desilles JP, Redjem H, Ciccio G, Smajda S, Mazighi M, Fahed R, Obadia M, Sabben C, Corabianu O, de Broucker T, Smadja D, Alamowitch S, Ille O, Manchon E, Garcia PY, Taylor G, Maacha MB, Wang A, Evrard S, Tchikviladze M, Afanasiev V, Ajili N, Sensenbrenner B, Lapergue B, Coskun O, Consoli A, Di Maria F, Rodesch G, Del Sette B, Russo R, Mizutani K, Leguen M, Gratieux J, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Nighoghossian N, Riva R, Eker O, Turjman F, Derex L, Cho TH, Mechtouff L, Lukaszewicz AC, Philippeau F, Cakmak S, Blanc-Lasserre K, Vallet AE, Marnat G, Gariel F, Barreau X, Berge J, Veunac L, Menegon P, Sibon I, Lucas L, Olindo S, Renou P, Sagnier S, Poli M, Debruxelles S, Bourcier R, Detraz L, Daumas-Duport B, Alexandre PL, Roy M, Lenoble C, L’allinec V, Girot JB, Desal H, de Gaalon S, Guillon B, Gory B, Bracard S, Anxionnat R, Braun M, Derelle AL, Tonnelet R, Liao L, Zhu F, Schmitt E, Planel S, Richard S, Humbertjean L, Mione G, Lacour JC, Bonnerot M, Riou-Comte N, Costa I, Chatelain A, Costalat V, Arquizan C, Dargazanli C, Gascou G, Lefèvre PH, Derraz I, Riquelme C, Gaillard N, et Lucas Corti IM, Francois E, Vannier S. Impact of Reperfusion for Nonagenarians Treated by Mechanical Thrombectomy. Stroke 2019; 50:3164-3169. [DOI: 10.1161/strokeaha.119.026448] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Nonagenarians represent a growing stroke population characterized by a higher frailty. Although endovascular therapy (ET) is a cornerstone of the management of acute ischemic stroke related to large vessel occlusion, the benefit of reperfusion among nonagenarians is poorly documented. We aimed to assess the impact of ET-related reperfusion on the functional outcome of reperfusion in this elderly population.
Methods—
A retrospective analysis of clinical and imaging data from all patients aged over 90 included in the ETIS (Endovascular Treatment in Ischemic Stroke) registry between October 2013 and April 2018 was performed. Association between post-ET reperfusion and favorable (modified Rankin Scale [0–2] or equal to prestroke value) and good (modified Rankin Scale [0–3] or equal to prestroke value) outcome were evaluated. Demographic and procedural predictors of functional outcome, including the first-pass effect, were evaluated. Results were adjusted for center, admission National Institutes of Health Stroke Scale, and use of intravenous thrombolysis.
Results—
Among the 124 nonagenarians treated with ET, those with successful reperfusion had the lowest 90-day modified Rankin Scale (odds ratio, 3.26; 95% CI, 1.04–10.25). Only patients with successful reperfusion after the first pass (n=53, 56.7%) had a reduced 90-day mortality (odds ratio, 0.15; 95% CI, 0.05–0.45) and an increased rate of good outcome (odds ratio, 4.55; 95% CI, 1.38–15.03). No increase in the rate of intracranial hemorrhage was observed among patients successfully reperfused.
Conclusions—
Successful reperfusion improves the functional outcome of nonagenarians who should not be excluded from ET. The first-pass effect should be considered in the procedural management of this frail population.
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Affiliation(s)
- Eve Drouard-de Rousiers
- From the Department of Neurology, Stroke Center (E.D.-d.R., B.L.), Foch Hospital, Suresnes, France
| | - Ludovic Lucas
- Department of Neurology, Stroke Unit, Bordeaux University Hospital, France (L.L.)
| | | | - Arturo Consoli
- Department of Interventional Neuroradiology (A.C), Foch Hospital, Suresnes, France
| | - Mikaël Mazighi
- Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France (M.M., R. Blanc)
| | - Julien Labreuche
- University of Lille, University Hospital of Lille, EA2694 -Santé publique: épidémiologie et qualité des soins, France (J.L., M.K.)
| | - Maéva Kyheng
- University of Lille, University Hospital of Lille, EA2694 -Santé publique: épidémiologie et qualité des soins, France (J.L., M.K.)
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, France (B.G.)
| | - Cyril Dargazanli
- Department of Interventional Neuroradiology (C.D.), CHRU Gui de Chauliac, Montpellier, France
| | - Caroline Arquizan
- Department of Neurology (C.A.), CHRU Gui de Chauliac, Montpellier, France
| | - Gaultier Marnat
- Department of Diagnostic and Interventional Neuroradiology (G.M.), University Hospital of Bordeaux, France
| | - Raphaël Blanc
- Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France (M.M., R. Blanc)
| | - Hubert Desal
- Department of Neuroradiology, University Hospital of Nantes, France (H.D., R. Bourcier)
| | - Romain Bourcier
- Department of Neuroradiology, University Hospital of Nantes, France (H.D., R. Bourcier)
| | - Igor Sibon
- Department of Neurology, Stroke Center (I.S.), University Hospital of Bordeaux, France
| | - Bertrand Lapergue
- From the Department of Neurology, Stroke Center (E.D.-d.R., B.L.), Foch Hospital, Suresnes, France
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Landon-Cardinal O, Gallay L, Dubourg O, Maisonobe T, Léonard-Louis S, Beniken D, Simon A, Behin A, Stojkovic T, Duyckaerts C, Breton G, Rigolet A, Fain O, Meyohas MC, Leport C, Valantin MA, Vittecoq D, Bergmann JF, Hanslik T, Chauveheid MP, Amoura Z, de Broucker T, Eymard B, Beaudequin N, Benveniste O, Allenbach Y. Expanding the spectrum of HIV-associated myopathy. J Neurol Neurosurg Psychiatry 2019; 90:1296-1298. [PMID: 30975823 DOI: 10.1136/jnnp-2018-319419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 03/03/2019] [Accepted: 03/24/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Océane Landon-Cardinal
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Laure Gallay
- Department of Internal Medicine, Edouard Herriot University Hospital, Hospices Civils de Lyon, University Claude Bernard, Lyon, France
| | - Odile Dubourg
- Département de Neuropathologie, Sorbonne Université Pierre, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Thierry Maisonobe
- Département de Neuropathologie, Sorbonne Université Pierre, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Sarah Léonard-Louis
- Département de Neuropathologie, Sorbonne Université Pierre, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Dalila Beniken
- Service de Maladie Infectieuse, Hôpital Pitié-Salpêtrière, Paris, France
| | - Anne Simon
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Anthony Behin
- Paris-Est Neuromuscular Center, APHP, Centre de Référence Maladies Neuromusculaires Paris-Est, Institut de Myologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Tanya Stojkovic
- Paris-Est Neuromuscular Center, Neuromuscular Disease Centre, Hôpital de la Pitié-Salpétrière, APHP, Paris, France
| | - Charles Duyckaerts
- Département de Neuropathologie Raymond Escourolle, GH Pitié-Salpêtrière, Faculté de médecine Sorbonne Université, Paris, France
| | - Guillaume Breton
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Aude Rigolet
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Olivier Fain
- Médecine Interne, APHP, DHUi2B, Centre de Référence associé sur les angiœdèmes à kinines, Hôpital Saint-Antoine, Université Paris 6, Paris, France
| | - Marie-Caroline Meyohas
- AP-HP, Hôpital Saint-Antoine, Service des Maladies Infectieuses et Tropicales, Paris, France
| | - Catherine Leport
- IAME, UMR 1137, Inserm, université Paris Diderot, Sorbonne Paris Cité, Paris, France.,Mission COREB nationale, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Marc-Antoine Valantin
- Service de Maladie Infectieuse et Tropicales, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Daniel Vittecoq
- Department of Infectious and Tropical Diseases, AP-HP Bicetre hospital, Le-Kremlin-Bicêtre, France
| | - Jean-François Bergmann
- Médecine Interne, APHP, Hôpital Lariboisière, Service de Médecine Interne, Paris, France
| | - Thomas Hanslik
- Médecine Interne, Hôpital Ambroise Paré, service de médecine interne, Paris, France
| | - Marie-Paule Chauveheid
- Department of Internal Medicine, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Zahir Amoura
- Department of Internal Medicine 2, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Bruno Eymard
- Paris-Est Neuromuscular Center, APHP, Centre de Référence Maladies Neuromusculaires Paris-Est, Institut de Myologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Nausicaa Beaudequin
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Yves Allenbach
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
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Coutelier M, Hammer MB, Stevanin G, Monin ML, Davoine CS, Mochel F, Labauge P, Ewenczyk C, Ding J, Gibbs JR, Hannequin D, Melki J, Toutain A, Laugel V, Forlani S, Charles P, Broussolle E, Thobois S, Afenjar A, Anheim M, Calvas P, Castelnovo G, de Broucker T, Vidailhet M, Moulignier A, Ghnassia RT, Tallaksen C, Mignot C, Goizet C, Le Ber I, Ollagnon-Roman E, Pouget J, Brice A, Singleton A, Durr A. Efficacy of Exome-Targeted Capture Sequencing to Detect Mutations in Known Cerebellar Ataxia Genes. JAMA Neurol 2019; 75:591-599. [PMID: 29482223 DOI: 10.1001/jamaneurol.2017.5121] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [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
Importance Molecular diagnosis is difficult to achieve in disease groups with a highly heterogeneous genetic background, such as cerebellar ataxia (CA). In many patients, candidate gene sequencing or focused resequencing arrays do not allow investigators to reach a genetic conclusion. Objectives To assess the efficacy of exome-targeted capture sequencing to detect mutations in genes broadly linked to CA in a large cohort of undiagnosed patients and to investigate their prevalence. Design, Setting, and Participants Three hundred nineteen index patients with CA and without a history of dominant transmission were included in the this cohort study by the Spastic Paraplegia and Ataxia Network. Centralized storage was in the DNA and cell bank of the Brain and Spine Institute, Salpetriere Hospital, Paris, France. Patients were classified into 6 clinical groups, with the largest being those with spastic ataxia (ie, CA with pyramidal signs [n = 100]). Sequencing was performed from January 1, 2014, through December 31, 2016. Detected variants were classified as very probably or definitely causative, possibly causative, or of unknown significance based on genetic evidence and genotype-phenotype considerations. Main Outcomes and Measures Identification of variants in genes broadly linked to CA, classified in pathogenicity groups. Results The 319 included patients had equal sex distribution (160 female [50.2%] and 159 male patients [49.8%]; mean [SD] age at onset, 27.9 [18.6] years). The age at onset was younger than 25 years for 131 of 298 patients (44.0%) with complete clinical information. Consanguinity was present in 101 of 298 (33.9%). Very probable or definite diagnoses were achieved for 72 patients (22.6%), with an additional 19 (6.0%) harboring possibly pathogenic variants. The most frequently mutated genes were SPG7 (n = 14), SACS (n = 8), SETX (n = 7), SYNE1 (n = 6), and CACNA1A (n = 6). The highest diagnostic rate was obtained for patients with an autosomal recessive CA with oculomotor apraxia-like phenotype (6 of 17 [35.3%]) or spastic ataxia (35 of 100 [35.0%]) and patients with onset before 25 years of age (41 of 131 [31.3%]). Peculiar phenotypes were reported for patients carrying KCND3 or ERCC5 variants. Conclusions and Relevance Exome capture followed by targeted analysis allows the molecular diagnosis in patients with highly heterogeneous mendelian disorders, such as CA, without prior assumption of the inheritance mode or causative gene. Being commonly available without specific design need, this procedure allows testing of a broader range of genes, consequently describing less classic phenotype-genotype correlations, and post hoc reanalysis of data as new genes are implicated in the disease.
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Affiliation(s)
- Marie Coutelier
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France.,Laboratory of Human Molecular Genetics, de Duve Institute, Université Catholique de Louvain, Brussels, Belgium.,Ecole Pratique des Hautes Etudes, Paris Sciences et Lettres Research University, Paris, France
| | - Monia B Hammer
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Giovanni Stevanin
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France.,Ecole Pratique des Hautes Etudes, Paris Sciences et Lettres Research University, Paris, France.,Centre de Référence de Neurogénétique, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Marie-Lorraine Monin
- Centre de Référence de Neurogénétique, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Claire-Sophie Davoine
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France.,Ecole Pratique des Hautes Etudes, Paris Sciences et Lettres Research University, Paris, France
| | - Fanny Mochel
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France.,Centre de Référence de Neurogénétique, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Pierre Labauge
- Service de Neurologie, Hopital Gui de Chauliac, Centre Hospitalier Universitaire (CHU) de Montpellier, Montpellier, France
| | - Claire Ewenczyk
- Centre de Référence de Neurogénétique, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Jinhui Ding
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - J Raphael Gibbs
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Didier Hannequin
- Service de Génétique, Service de Neurologie, INSERM U1079, Rouen University Hospital, Rouen, France
| | - Judith Melki
- UMR 1169, INSERM and University Paris Saclay, Le Kremlin Bicêtre, France.,Medical Genetics Unit, Centre Hospitalier Sud-Francilien, Corbeil Essonnes, France
| | - Annick Toutain
- Service de Génétique, Centre Hospitalier Universitaire de Tours, INSERM U930, Faculté de Médecine, Université François Rabelais, Tours, France
| | - Vincent Laugel
- Service de Pédiatrie 1, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Sylvie Forlani
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France
| | - Perrine Charles
- Centre de Référence de Neurogénétique, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Emmanuel Broussolle
- Service de Neurologie C, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron, France.,Centre de Neurosciences Cognitives, Centre National de la Recherche Scientifique (CNRS)-UMR 5229, Bron, France.,Université de Lyon, Université Claude-Bernard-Lyon I, Villeurbanne, France
| | - Stéphane Thobois
- Service de Neurologie C, Hôpital Neurologique Pierre-Wertheimer, Hospices Civils de Lyon, Bron, France.,Centre de Neurosciences Cognitives, Centre National de la Recherche Scientifique (CNRS)-UMR 5229, Bron, France.,Université de Lyon, Université Claude-Bernard-Lyon I, Villeurbanne, France
| | - Alexandra Afenjar
- Service de Génétique et Centre de Référence Pour les Malformations et les Maladies Congénitales du Cervelet, AP-HP, Paris, France
| | - Mathieu Anheim
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France.,Département de Neurologie, Hôpital de Hautepierre, CHU de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM U964, CNRS-UMR 7104, Université de Strasbourg, Illkirch, France
| | - Patrick Calvas
- Service de Génétique Médicale, CHU de Toulouse, Hôpital Purpan, Toulouse, France
| | | | - Thomas de Broucker
- Service de Neurologie, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Marie Vidailhet
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France.,Département des Maladies du Système Nerveux, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
| | - Antoine Moulignier
- Service de Neurologie, Fondation Ophtalmologique A. de Rothschild, Paris, France
| | | | - Chantal Tallaksen
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France.,currently affiliated with Department of Neurology, Oslo University Hospital; and Faculty of Medicine, Oslo University, Oslo, Norway
| | - Cyril Mignot
- Département de Génétique and Centre de Référence Déficiences Intellectuelles de Causes Rares, Groupe Hospitalier Pitié Salpêtrière, AP-HP, Paris, France
| | - Cyril Goizet
- Laboratoire Maladies Rares, Génétique et Métabolisme, Université de Bordeaux, Bordeaux, France.,Service de Génétique Médicale, CHU Pellegrin, Bordeaux, France
| | - Isabelle Le Ber
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France
| | | | - Jean Pouget
- Centre de Référence des Maladies Neuromusculaires et de la Sclérose Latérale Amyotrophique, Assistance Publique-Hôpitaux de Marseille, Aix Marseille Université, Hôpital de La Timone, Marseille, France
| | - Alexis Brice
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France.,Centre de Référence de Neurogénétique, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Andrew Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Alexandra Durr
- Institut National de la Santé et de la Recherche Medicale (INSERM) U1127, Paris, France.,Centre National de la Recherche Scientifique, Unité Mixte de Recherche (UMR) 7225, Paris, France.,Unité Mixte de Recherche en Santé 1127, Université Pierre et Marie Curie (Paris 06), Sorbonne Universités, Paris, France.,Institut du Cerveau et de la Moelle Epinière, Paris, France.,Centre de Référence de Neurogénétique, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
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Panni P, Gory B, Xie Y, Consoli A, Desilles JP, Mazighi M, Labreuche J, Piotin M, Turjman F, Eker OF, Bracard S, Anxionnat R, Richard S, Hossu G, Blanc R, Lapergue B, Redjem H, Escalard S, Redjem H, Ciccio G, Smajda S, Fahed R, Obadia M, Sabben C, Corabianu O, de Broucker T, Smadja D, Alamowitch S, Ille O, Manchon E, Garcia PY, Taylor G, Maacha MB, Bourdain F, Decroix JP, Wang A, Evrard S, Tchikviladze M, Coskun O, Di Maria F, Rodesh G, Leguen M, Tisserand M, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Nighoghossian N, Labeyrie PE, Riva R, Derex L, Cho TH, Mechtouff L, Claire Lukaszewicz A, Philippeau F, Cakmak S, Blanc-Lasserre K, Vallet AE. Acute Stroke With Large Ischemic Core Treated by Thrombectomy. Stroke 2019; 50:1164-1171. [DOI: 10.1161/strokeaha.118.024295] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Pietro Panni
- From the Department of Neuroradiology, Division of Interventional Neuroradiology, Department of Neurosurgery, San Raffaele University Hospital, Milan, Italy (P.P.)
| | - Benjamin Gory
- Department of Diagnostic and Therapeutic Neuroradiology, INSERM U12542, University Hospital of Nancy, France (B.G., S.B., R.A.)
| | - Yu Xie
- Department of Neuroradiology, University of Lorraine, IADI, INSERM U1254, Nancy, F-54000, France (Y.X., G.H.)
| | - Arturo Consoli
- Department of Diagnostic and Interventional Neuroradiology, Foch Hospital, Suresnes, France (A.C.)
| | - Jean-Philippe Desilles
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (J.-P.D., M.M., M.P., R.B.)
| | - Mikael Mazighi
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (J.-P.D., M.M., M.P., R.B.)
| | - Julien Labreuche
- Department of Biostatistics, EA2694-Santé publique: épidémiologie et qualité des soins, Lille University, France (J.L.)
| | - Michel Piotin
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (J.-P.D., M.M., M.P., R.B.)
| | - Francis Turjman
- Department of Interventional Neuroradiology, Hospices Civils de Lyon, France (F.T., O.F.E.)
| | - Omer Faruk Eker
- Department of Interventional Neuroradiology, Hospices Civils de Lyon, France (F.T., O.F.E.)
| | - Serge Bracard
- Department of Diagnostic and Therapeutic Neuroradiology, INSERM U12542, University Hospital of Nancy, France (B.G., S.B., R.A.)
| | - René Anxionnat
- Department of Diagnostic and Therapeutic Neuroradiology, INSERM U12542, University Hospital of Nancy, France (B.G., S.B., R.A.)
| | - Sébastien Richard
- Department of Neurology, Stroke Unit, INSERM U1116, University Hospital of Nancy, France (S.R.)
| | - Gabriela Hossu
- Department of Neuroradiology, University of Lorraine, IADI, INSERM U1254, Nancy, F-54000, France (Y.X., G.H.)
| | - Raphael Blanc
- Department of Interventional Neuroradiology, Rothschild Foundation, Paris, France (J.-P.D., M.M., M.P., R.B.)
| | - Bertrand Lapergue
- Department of Neurology, Foch Hospital, Versailles Saint-Quentin en Yvelines University, Suresnes, France (B.L.)
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17
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Ahle G, Uro-Coste E, Taieb G, de Broucker T. Primary lymphomatoid granulomatosis in the central nervous system: A report of three cases. Neuropathology 2019; 39:168-169. [PMID: 30828876 DOI: 10.1111/neup.12546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/15/2019] [Accepted: 02/05/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Guido Ahle
- Department of Neurology, Hôpitaux Civils de Colmar, Colmar, France
| | - Emmanuelle Uro-Coste
- Departments of Pathology, Neurosurgery, Oncopediatry, Genetics and Molecular Biology, Toulouse University Hospital & INSERM U1037, Toulouse, France
| | - Guillaume Taieb
- Department of Neurology, CHU Montpellier, Hôpital Guy de Chauliac, Montpellier, France
| | - Thomas de Broucker
- Department of Neurology, Centre Hospitalier de Saint-Denis, Hôpital Delafontaine, Saint-Denis, France
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18
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El Nawar R, Lapergue B, Piotin M, Gory B, Blanc R, Consoli A, Rodesch G, Mazighi M, Bourdain F, Kyheng M, Labreuche J, Pico F, Piotin M, Blanc R, Redjem H, Escalard S, Desilles JP, Ciccio G, Smajda S, Mazighi M, Fahed R, Obadia M, Sabben C, Corabianu O, de Broucker T, Smadja D, Alamowitch S, Ille O, Manchon E, Garcia PY, Taylor G, Ben Maacha M, Bourdain F, Decroix JP, Wang A, Evrard S, Tchikviladze M, Lapergue B, Coskun O, Consoli A, Di Maria F, Rodesch G, Leguen M, Tisserand M, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Gory B, Labeyrie PE, Riva R, Turjman F, Nighoghossian N, Derex L, Cho TH, Mechtouff L, Lukaszewicz AC, Philippeau F, Cakmak S, Blanc-Lasserre K, Vallet AE. Higher Annual Operator Volume Is Associated With Better Reperfusion Rates in Stroke Patients Treated by Mechanical Thrombectomy. JACC Cardiovasc Interv 2019; 12:385-391. [DOI: 10.1016/j.jcin.2018.12.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/26/2018] [Accepted: 12/04/2018] [Indexed: 01/02/2023]
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Dargazanli C, Arquizan C, Gory B, Consoli A, Labreuche J, Redjem H, Eker O, Decroix JP, Corlobé A, Mourand I, Gaillard N, Ayrignac X, Charif M, Duhamel A, Labeyrie PE, Riquelme C, Ciccio G, Smajda S, Desilles JP, Gascou G, Lefèvre PH, Mantilla-García D, Cagnazzo F, Coskun O, Mazighi M, Riva R, Bourdain F, Labauge P, Rodesch G, Obadia M, Bonafé A, Turjman F, Costalat V, Piotin M, Blanc R, Lapergue B, Wang A, Evrard S, Tchikviladzé M, Gonzalez-Valcarcel J, Di Maria F, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Corabianu O, de Broucker T, Smadja D, Alamowitch S, Ille O, Manchon E, Garcia PY. Mechanical Thrombectomy for Minor and Mild Stroke Patients Harboring Large Vessel Occlusion in the Anterior Circulation. Stroke 2017; 48:3274-3281. [DOI: 10.1161/strokeaha.117.018113] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 08/16/2017] [Accepted: 09/18/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Cyril Dargazanli
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Caroline Arquizan
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Benjamin Gory
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Arturo Consoli
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Julien Labreuche
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Hocine Redjem
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Omer Eker
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Jean-Pierre Decroix
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Astrid Corlobé
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Isabelle Mourand
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Nicolas Gaillard
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Xavier Ayrignac
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Mahmoud Charif
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Alain Duhamel
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Paul-Emile Labeyrie
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Carlos Riquelme
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Gabriele Ciccio
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Stanislas Smajda
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Jean-Philippe Desilles
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Grégory Gascou
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Pierre-Henri Lefèvre
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Daniel Mantilla-García
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Federico Cagnazzo
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Oguzhan Coskun
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Mikael Mazighi
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Roberto Riva
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Frédéric Bourdain
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Pierre Labauge
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Georges Rodesch
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Michael Obadia
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Alain Bonafé
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Francis Turjman
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Vincent Costalat
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Michel Piotin
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Raphaël Blanc
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
| | - Bertrand Lapergue
- From the Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier, France (C.D., O.E., C.R., G.G., P.-H.L., D.M.-G., F.C., A.B., V.C.); Department of Neurology, Gui de Chauliac Hospital, Montpellier, France (C.A., A.C., I.M., N.G., X.A., M.C., P.L.); Department of Interventional Neuroradiology, Pierre Wertheimer Hospital, Lyon-Bron, France (B.G., P.-E.L., R.R., F.T.); Department of Interventional Neuroradiology (A.C., O.C., G.R.) and Department of Neurology (J.-P.D., F.B., B.L.), Foch
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Desilles JP, Consoli A, Redjem H, Coskun O, Ciccio G, Smajda S, Labreuche J, Preda C, Ruiz Guerrero C, Decroix JP, Rodesch G, Mazighi M, Blanc R, Piotin M, Lapergue B, Wang A, Evrard S, Tchikviladzé M, Bourdain F, Gonzalez-Valcarcel J, Di Maria F, Pico F, Rakotoharinandrasana H, Tassan P, Poll R, Corabianu O, de Broucker T, Smadja D, Alamowitch S, Obadia M, Ille O, Manchon E, Garcia PY. Successful Reperfusion With Mechanical Thrombectomy Is Associated With Reduced Disability and Mortality in Patients With Pretreatment Diffusion-Weighted Imaging–Alberta Stroke Program Early Computed Tomography Score ≤6. Stroke 2017; 48:963-969. [DOI: 10.1161/strokeaha.116.015202] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/10/2016] [Accepted: 12/29/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
In acute ischemic stroke patients, diffusion-weighted imaging (DWI)–Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is correlated with infarct volume and is an independent factor of functional outcome. Patients with pretreatment DWI-ASPECTS ≤6 were excluded or under-represented in the recent randomized mechanical thrombectomy trials. Our aim was to assess the impact of reperfusion in pretreatment DWI-ASPECTS ≤6 patients treated with mechanical thrombectomy.
Methods—
We analyzed data collected between January 2012 and August 2015 in a bicentric prospective clinical registry of consecutive acute ischemic stroke patients treated with mechanical thrombectomy. Every patient with a documented internal carotid artery or middle cerebral artery occlusion with pretreatment DWI-ASPECTS ≤6 was eligible for this study. The primary end point was a favorable outcome defined by a modified Rankin Scale score ≤2 at 90 days.
Results—
Two hundred and eighteen patients with a DWI-ASPECTS ≤6 were included. Among them, 145 (66%) patients had successful reperfusion at the end of mechanical thrombectomy. Reperfused patients had an increased rate of favorable outcome (38.7% versus 17.4%;
P
=0.002) and a decreased rate of mortality at 3 months (22.5% versus 39.1%;
P
=0.013) compared with nonreperfused patients. The symptomatic intracranial hemorrhage rate was not different between the 2 groups (13.0% versus 14.1%;
P
=0.83). However, in patients with DWI-ASPECTS <5, favorable outcome was low (13.0% versus 9.5%;
P
=0.68) with a high mortality rate (45.7% versus 57.1%;
P
=0.38) with or without successful reperfusion.
Conclusions—
Successful reperfusion is associated with reduced mortality and disability in patients with a pretreatment DWI-ASPECTS ≤6. Further data from randomized studies are needed, particularly in patients with DWI-ASPECTS <5.
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Affiliation(s)
- Jean-Philippe Desilles
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Arturo Consoli
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Hocine Redjem
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Oguzhan Coskun
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Gabriele Ciccio
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Stanislas Smajda
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Julien Labreuche
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Cristian Preda
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Clara Ruiz Guerrero
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Jean-Pierre Decroix
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Georges Rodesch
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Mikael Mazighi
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Raphaël Blanc
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Michel Piotin
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Bertrand Lapergue
- From the Department of Interventional Neuroradiology, Fondation Rothschild, Paris, France (J.-P. Desilles, H.R., G.C., S.S., C.R.G., M.M., R.B., M.P.); Department of Neurology, Division of Neurology, Stroke Center (J.-P. Decroix, B.L.) and Department of Interventional Neuroradiology (A.C., O.C., G.R.), Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France; Laboratory of Vascular Translational Science, U1148 Institut National de la Santé et de la Recherche Médicale (INSERM)
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21
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Carteaux G, Maquart M, Bedet A, Contou D, Brugières P, Fourati S, Cleret de Langavant L, de Broucker T, Brun-Buisson C, Leparc-Goffart I, Mekontso Dessap A. Zika Virus Associated with Meningoencephalitis. N Engl J Med 2016; 374:1595-6. [PMID: 26958738 DOI: 10.1056/nejmc1602964] [Citation(s) in RCA: 340] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | - Marianne Maquart
- French Armed Forces Biomedical Research Institute, Marseille, France
| | | | - Damien Contou
- Assistance Publique-Hôpitaux de Paris, Créteil, France
| | | | - Slim Fourati
- Assistance Publique-Hôpitaux de Paris, Créteil, France
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22
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de Broucker T, Leclercq D, Jarquin S, Henry C. Acute leukoencephalopathy due to pyrimethamine. An insight into methotrexate neurotoxicity? J Neurol Sci 2013; 335:201-3. [PMID: 24157308 DOI: 10.1016/j.jns.2013.09.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 07/28/2013] [Revised: 09/22/2013] [Accepted: 09/23/2013] [Indexed: 10/26/2022]
Abstract
A unique case of pyrimethamine-related stroke-like leukoencephalopathy is described. The imputability of the drug is discussed as well as the similarities with the well-known methotrexate neurotoxicity. Owing to the same mode of action of both drugs by inhibition of the enzyme dihydrofolate reductase, this case is highly suggestive of the pathogenetic role of methylation pathway blockade on myelin synthesis resulting in delayed demyelination. This complication could be avoided by a concurrent folinic acid supplementation.
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Affiliation(s)
- Thomas de Broucker
- Service de Neurologie, Hôpital Delafontaine, 2, rue du Dr Delafontaine, 93200 Saint-Denis, France.
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23
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Senova S, Jarraya B, Iwamuro H, Tani N, Ouerchefani N, Lepetit H, Gurruchaga JM, Brugières P, Apartis E, de Broucker T, Palfi S. Unilateral thalamic stimulation safely improved fragile X-associated tremor ataxia: A case report. Mov Disord 2012; 27:797-9. [DOI: 10.1002/mds.24923] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 12/27/2011] [Accepted: 01/03/2012] [Indexed: 11/09/2022] Open
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24
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Tattevin P, Bruneel F, Clair B, Lellouche F, de Broucker T, Chevret S, Bédos JP, Wolff M, Régnier B. Bacterial brain abscesses: a retrospective study of 94 patients admitted to an intensive care unit (1980 to 1999). Am J Med 2003; 115:143-6. [PMID: 12893401 DOI: 10.1016/s0002-9343(03)00292-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Pierre Tattevin
- Intensive Care Unit, Bichat-Claude Bernard Hospital, Paris, France.
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