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Koubiyr I, Yamamoto T, Blyau S, Kamroui RA, Mansencal B, Planche V, Petit L, Saranathan M, Casey R, Ruet A, Brochet B, Manjón JV, Dousset V, Coupé P, Tourdias T. Vulnerability of Thalamic Nuclei at CSF Interface During the Entire Course of Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm 2024; 11:e200222. [PMID: 38635941 DOI: 10.1212/nxi.0000000000200222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Thalamic atrophy can be used as a proxy for neurodegeneration in multiple sclerosis (MS). Some data point toward thalamic nuclei that could be affected more than others. However, the dynamic of their changes during MS evolution and the mechanisms driving their differential alterations are still uncertain. METHODS We paired a large cohort of 1,123 patients with MS with the same number of healthy controls, all scanned with conventional 3D-T1 MRI. To highlight the main atrophic regions at the thalamic nuclei level, we validated a segmentation strategy consisting of deep learning-based synthesis of sequences, which were used for automatic multiatlas segmentation. Then, through a lifespan-based approach, we could model the dynamics of the 4 main thalamic nuclei groups. RESULTS All analyses converged toward a higher rate of atrophy for the posterior and medial groups compared with the anterior and lateral groups. We also demonstrated that focal MS white matter lesions were associated with atrophy of groups of nuclei when specifically located within the associated thalamocortical projections. The volumes of the most affected posterior group, but also of the anterior group, were better associated with clinical disability than the volume of the whole thalamus. DISCUSSION These findings point toward the thalamic nuclei adjacent to the third ventricle as more susceptible to neurodegeneration during the entire course of MS through potentiation of disconnection effects by regional factors. Because this information can be obtained even from standard T1-weighted MRI, this paves the way toward such an approach for future monitoring of patients with MS.
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Affiliation(s)
- Ismail Koubiyr
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Takayuki Yamamoto
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Simon Blyau
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Reda A Kamroui
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Boris Mansencal
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Vincent Planche
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Laurent Petit
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Manojkumar Saranathan
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Romain Casey
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Aurélie Ruet
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Bruno Brochet
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - José V Manjón
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Vincent Dousset
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Pierrick Coupé
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Thomas Tourdias
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
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Baynat L, Yamamoto T, Tourdias T, Zhang B, Prevost V, Infante A, Klein A, Caid J, Cadart O, Dousset V, Gatta Cherifi B. Quantitative MRI biomarkers measure changes in targeted brain areas in patients with obesity. J Clin Endocrinol Metab 2024:dgae014. [PMID: 38195765 DOI: 10.1210/clinem/dgae014] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/14/2023] [Accepted: 01/08/2024] [Indexed: 01/11/2024]
Abstract
CONTEXT Obesity is accompanied by damages to several tissues, including the brain. Pathological data and animal models have demonstrated an increased inflammatory reaction in hypothalamus and hippocampus. OBJECTIVE We tested whether we could observe such pathological modifications in vivo through quantitative MRI metrics. DESIGN This prospective study was conducted between May 2019 and November 2022. SETTING The study was conducted in the Specialised Center for the Care of Obesity in a French Universitary Hospital. PATIENTS Twenty seven patients with obesity and 23 age and gender-paired normal-weight controls were prospectively recruited. INTERVENTIONS All participants were explored on brain MRI. Anthropometric and biological data, eating behavior, anxiety, depression and memory performance were assessed on both groups. MAIN OUTCOME MEASURE The main outcome measure was brain MRI with the following parametric maps: quantitative susceptibility mapping (QSM), mean diffusivity (MD), fractional anisotropy (FA), magnetization transfer ratio map (MTR) and T2 relaxivity map (R2). RESULTS In the hypothalamus, patients with obesity had higher FA, lower QSM compared to normal-weight controls. In the hippocampus, patients with obesity had higher FA and lower MD. There was no correlation between imaging biomarkers and eating behavior or anxiety. CONCLUSION Our findings are consistent with the presence of neuro-inflammation in brain regions involved in food intake. In vivo brain biomarkers from quantitative MRI appear to provide an incremental information for the assessment of brain damages in patients with obesity.
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Affiliation(s)
- Louise Baynat
- Univ. Bordeaux, INSERM U1215, Neurocentre Magendie, Bordeaux, France
- CHU Bordeaux, Hôpital Haut Lévêque Service Endocrinologie, Diabétologie, Nutrition, Pessac, France
| | - Takayuki Yamamoto
- Univ. Bordeaux, INSERM U1215, Neurocentre Magendie, Bordeaux, France
| | - Thomas Tourdias
- Univ. Bordeaux, INSERM U1215, Neurocentre Magendie, Bordeaux, France
- CHU Bordeaux, Hôpital Pellegrin, Service de Neuroimagerie diagnostique et thérapeutique, Bordeaux, France
| | - Bei Zhang
- Canon Medical Systems Europe, Zoetermeer, Netherlands
| | | | - Asael Infante
- CHU Bordeaux, Hôpital Haut Lévêque Service Endocrinologie, Diabétologie, Nutrition, Pessac, France
| | - Achille Klein
- CHU Bordeaux, Hôpital Haut Lévêque Service Endocrinologie, Diabétologie, Nutrition, Pessac, France
| | - Julien Caid
- CHU Bordeaux, Hôpital Haut Lévêque Service Endocrinologie, Diabétologie, Nutrition, Pessac, France
| | - Olivier Cadart
- Centre Hospitalier d'Angoulême, Endocrinolology, Rond point Girac, Angouleme, France
| | - Vincent Dousset
- Univ. Bordeaux, INSERM U1215, Neurocentre Magendie, Bordeaux, France
- CHU Bordeaux, Hôpital Pellegrin, Service de Neuroimagerie diagnostique et thérapeutique, Bordeaux, France
| | - Blandine Gatta Cherifi
- Univ. Bordeaux, INSERM U1215, Neurocentre Magendie, Bordeaux, France
- CHU Bordeaux, Hôpital Haut Lévêque Service Endocrinologie, Diabétologie, Nutrition, Pessac, France
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Sagnier S, Catheline G, Dilharreguy B, Linck PA, Coupé P, Munsch F, Bigourdan A, Poli M, Debruxelles S, Renou P, Olindo S, Rouanet F, Dousset V, Tourdias T, Sibon I. Microstructural Gray Matter Integrity Deteriorates After an Ischemic Stroke and Is Associated with Processing Speed. Transl Stroke Res 2023; 14:185-192. [PMID: 35437660 DOI: 10.1007/s12975-022-01020-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 11/26/2022]
Abstract
Microstructural changes after an ischemic stroke (IS) have mainly been described in white matter. Data evaluating microstructural changes in gray matter (GM) remain scarce. The aim of the present study was to evaluate the integrity of GM on longitudinal data using mean diffusivity (MD), and its influence on post-IS cognitive performances. A prospective study was conducted, including supra-tentorial IS patients without pre-stroke disability. A cognitive assessment was performed at baseline and 1 year, including a Montreal Cognitive Assessment, an Isaacs set test, and a Zazzo cancelation task (ZCT): completion time and number of errors. A 3-T brain MRI was performed at the same two time-points, including diffusion tensor imaging for the assessment of GM MD. GM volume was also computed, and changes in GM volume and GM MD were evaluated, followed by the assessment of the relationship between these structural changes and changes in cognitive performances. One hundred and four patients were included (age 68.5 ± 21.5, 38.5% female). While no GM volume loss was observed, GM MD increased between baseline and 1 year. The increase of GM MD in left fronto-temporal regions (dorsolateral prefrontal cortex, superior and medial temporal gyrus, p < 0.05, Threshold-Free Cluster Enhancement, 5000 permutations) was associated with an increase time to complete ZCT, regardless of demographic confounders, IS volume and location, GM, and white matter hyperintensity volume. GM integrity deterioration was thus associated with processing speed slowdown, and appears to be a biomarker of cognitive frailty. This broadens the knowledge of post-IS cognitive impairment mechanisms.
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Affiliation(s)
- Sharmila Sagnier
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France.
- Unité Neuro-Vasculaire, CHU de Bordeaux, Bordeaux, France.
- INCIA Université, Bordeaux 2, 146 rue Léo Saignat Zone Nord, Bâtiment 2A, 2e étage, 33076, Bordeaux, France.
| | - Gwenaëlle Catheline
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
| | - Bixente Dilharreguy
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
| | | | - Pierrick Coupé
- UMR 5800, Univ. Bordeaux, CNRS, INP, LaBRI, 33400, Talence, Bordeaux, France
| | - Fanny Munsch
- Beth Israel Deaconess Medical Center, Harvard University, Boston, USA
| | | | - Mathilde Poli
- Unité Neuro-Vasculaire, CHU de Bordeaux, Bordeaux, France
| | | | - Pauline Renou
- Unité Neuro-Vasculaire, CHU de Bordeaux, Bordeaux, France
| | | | | | - Vincent Dousset
- Neuroradiologie, CHU de Bordeaux, Bordeaux, France
- INSERM-U862, Neurocentre Magendie, Bordeaux, France
| | - Thomas Tourdias
- Neuroradiologie, CHU de Bordeaux, Bordeaux, France
- INSERM-U862, Neurocentre Magendie, Bordeaux, France
| | - Igor Sibon
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
- Unité Neuro-Vasculaire, CHU de Bordeaux, Bordeaux, France
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Blyau S, Koubiyr I, Saranathan M, Coupé P, Deloire M, Charré-Morin J, Saubusse A, Zhang B, Rutt B, Dousset V, Brochet B, Ruet A, Tourdias T. Differential vulnerability of thalamic nuclei in multiple sclerosis. Mult Scler 2023; 29:295-300. [PMID: 35959722 DOI: 10.1177/13524585221114247] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Investigating differential vulnerability of thalamic nuclei in multiple sclerosis (MS). METHODS In a secondary analysis of prospectively collected datasets, we pooled 136 patients with MS or clinically isolated syndrome and 71 healthy controls all scanned with conventional 3D-T1 and white-matter-nulled magnetization-prepared rapid gradient echo (WMn-MPRAGE) and tested for cognitive performance. T1-based thalamic segmentation was compared with the reference WMn-MPRAGE method. Volumes of thalamic nuclei were compared according to clinical phenotypes and cognitive profile. RESULTS T1- and WMn-MPRAGE provided comparable segmentations (0.84 ± 0.13 < volume-similarity-index < 0.95 ± 0.03). Medial and posterior thalamic groups were significantly more affected than anterior and lateral groups. Cognitive impairment related to volume loss of the anterior group. CONCLUSION Thalamic nuclei closest to the third ventricle are more affected, with cognitive consequences.
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Affiliation(s)
- Simon Blyau
- Neuroimagerie diagnostique et thérapeutique, CHU de Bordeaux, Bordeaux, France
| | - Ismail Koubiyr
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
| | | | - Pierrick Coupé
- University of Bordeaux, CNRS, Bordeaux INP, LABRI, UMR5800, Talence, France
| | | | | | | | - Bei Zhang
- Canon Medical Systems Europe, Zoetermeer, The Netherlands
| | - Brian Rutt
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Vincent Dousset
- Neuroimagerie diagnostique et thérapeutique, CHU de Bordeaux, Bordeaux, France/University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
| | - Bruno Brochet
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
| | - Aurélie Ruet
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France/Service de neurologie, CHU de Bordeaux, Bordeaux, France
| | - Thomas Tourdias
- Neuroimagerie diagnostique et thérapeutique, CHU de Bordeaux, Bordeaux, France/University of Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
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Fukutomi H, Yamamoto T, Sibon I, Christensen S, Raposo N, Marnat G, Albucher JF, Olindo S, Calvière L, Sagnier S, Viguier A, Renou P, Guenego A, Poli M, Darcourt J, Debruxelles S, Drif A, Thalamas C, Sommet A, Rousseau V, Mazighi M, Bonneville F, Albers GW, Cognard C, Dousset V, Olivot JM, Tourdias T. Location-weighted versus Volume-weighted Mismatch at MRI for Response to Mechanical Thrombectomy in Acute Stroke. Radiology 2023; 306:e220080. [PMID: 36194114 PMCID: PMC9885343 DOI: 10.1148/radiol.220080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/06/2022] [Accepted: 08/16/2022] [Indexed: 01/28/2023]
Abstract
Background A target mismatch profile can identify good clinical response to recanalization after acute ischemic stroke, but does not consider region specificities. Purpose To test whether location-weighted infarction core and mismatch, determined from diffusion and perfusion MRI performed in patients with acute stroke, could improve prediction of good clinical response to mechanical thrombectomy compared with a target mismatch profile. Materials and Methods In this secondary analysis, two prospectively collected independent stroke data sets (2012-2015 and 2017-2019) were analyzed. From the brain before stroke (BBS) study data (data set 1), an eloquent map was computed through voxel-wise associations between the infarction core (based on diffusion MRI on days 1-3 following stroke) and National Institutes of Health Stroke Scale (NIHSS) score. The French acute multimodal imaging to select patients for mechanical thrombectomy (FRAME) data (data set 2) consisted of large vessel occlusion-related acute ischemic stroke successfully recanalized. From acute MRI studies (performed on arrival, prior to thrombectomy) in data set 2, target mismatch and eloquent (vs noneloquent) infarction core and mismatch were computed from the intersection of diffusion- and perfusion-detected lesions with the coregistered eloquent map. Associations of these imaging metrics with early neurologic improvement were tested in multivariable regression models, and areas under the receiver operating characteristic curve (AUCs) were compared. Results Data sets 1 and 2 included 321 (median age, 69 years [IQR, 58-80 years]; 207 men) and 173 (median age, 74 years [IQR, 65-82 years]; 90 women) patients, respectively. Eloquent mismatch was positively and independently associated with good clinical response (odds ratio [OR], 1.14; 95% CI: 1.02, 1.27; P = .02) and eloquent infarction core was negatively associated with good response (OR, 0.85; 95% CI: 0.77, 0.95; P = .004), while noneloquent mismatch was not associated with good response (OR, 1.03; 95% CI: 0.98, 1.07; P = .20). Moreover, adding eloquent metrics improved the prediction accuracy (AUC, 0.73; 95% CI: 0.65, 0.81) compared with clinical variables alone (AUC, 0.65; 95% CI: 0.56, 0.73; P = .01) or a target mismatch profile (AUC, 0.67; 95% CI: 0.59, 0.76; P = .03). Conclusion Location-weighted infarction core and mismatch on diffusion and perfusion MRI scans improved the identification of patients with acute stroke who would benefit from mechanical thrombectomy compared with the volume-based target mismatch profile. Clinical trial registration no. NCT03045146 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Nael in this issue.
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Affiliation(s)
- Hikaru Fukutomi
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Takayuki Yamamoto
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Igor Sibon
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Soren Christensen
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Nicolas Raposo
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Gaultier Marnat
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Jean-François Albucher
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Stéphane Olindo
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Lionel Calvière
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Sharmila Sagnier
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Alain Viguier
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Pauline Renou
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Adrien Guenego
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Mathilde Poli
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Jean Darcourt
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Sabrina Debruxelles
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Amel Drif
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Claire Thalamas
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Agnès Sommet
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Vanessa Rousseau
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Mikael Mazighi
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Fabrice Bonneville
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Gregory W. Albers
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Christophe Cognard
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Vincent Dousset
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Jean Marc Olivot
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
| | - Thomas Tourdias
- From the Institut de Bio-Imagerie IBIO (H.F., T.Y., V.D., T.T.),
CNRS, UMR-5287 (I.S., S.S.), and INSERM, Neurocentre Magendie, U1215 (V.D.,
T.T.), Université Bordeaux, 146 rue Léo Saignat, F-33000 Bordeaux
Cedex, France; Unité Neurovasculaire (I.S., S.O., S.S., P.R., M.P., S.D.)
and Neuroimagerie Diagnostique et Thérapeutique (G.M., V.D., T.T.), CHU
de Bordeaux, Bordeaux, France; Stanford Stroke Center, Stanford University,
Stanford, Calif (S.C., G.W.A.); Unité Neurovasculaire (N.R., J.F.A.,
L.C., A.V., J.M.O.), Service de Neuroradiologie (A.G., J.D., F.B., C.C.), and
Centre d'Investigation Clinique (A.D., C.T., A.S., V.R.), CHU de
Toulouse, Toulouse, France; and Fondation Ophtalmologique Adolphe de Rothschild,
Paris, France (M.M.)
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Courret T, Tourdias T, Papaxanthos J, Labreuche J, Gariel F, Liegey JS, Olindo S, Renou P, Berge J, Barreau X, Sagnier S, Menegon P, Lucas L, Briau P, Poli M, Debruxelles S, Rouanet F, Dousset V, Sibon I, Marnat G. Etiologic and prognostic value of external carotid artery thrombus detection during endovascular therapy for anterior circulation proximal occlusions. Eur J Neurol 2023; 30:380-388. [PMID: 36325682 PMCID: PMC10100328 DOI: 10.1111/ene.15623] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND PURPOSE An early understanding of stroke mechanism may improve treatment and outcome in patients presenting with large vessel occlusion stroke (LVOS) treated with mechanical thrombectomy (MT). We aimed to investigate whether spontaneous external carotid artery (ECA) embolism detection during MT is associated with stroke etiology and clinical outcome. METHODS We retrospectively reviewed our prospectively maintained institutional database including consecutive patients with anterior circulation LVOS treated with MT between January 2015 and August 2020. RESULTS An ECA embolus was detected in 68 of 1298 patients (5.2%). The kappa coefficient for interobserver agreement was 0.89 (95% confidence interval [CI] 0.82-0.95). ECA embolism was significantly associated with intracranial internal carotid artery (ICA) occlusion (p < 0.001), cardioembolic etiology (p < 0.001) and a lower clot burden score (p < 0.001). Day-1 variation of National Institutes of Health Stroke Scale score (adjusted odds ratio [OR] -2.7, 95% CI -4.9 to 0.3; p = 0.021) and delta Alberta Stroke Program Early Computed Tomography Score (adjusted OR 0.9, 95% CI 0.2 to 1.5; p = 0.004) were worse among patients with ECA emboli. There was no significant difference in 90-day functional outcome between groups (adjusted OR 0.8, 95% CI 0.42 to 1.52; p = 0.50). CONCLUSION In patients with anterior circulation LVOS treated with MT, ECA embolism was significantly associated with cardioembolic etiology, high thrombus burden and proximal intracranial ICA occlusions. This underexplored angiographic pattern might provide a valuable etiologic clue to the underlying cause of anterior circulation LVOS and may also help determine the appropriate revascularization strategy.
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Affiliation(s)
- Thomas Courret
- Neuroradiology Department, CHU Bordeaux, Bordeaux, France
| | - Thomas Tourdias
- Neuroradiology Department, CHU Bordeaux, Bordeaux, France
- INSERM-U862, Neurocentre Magendie, Bordeaux, France
| | | | - Julien Labreuche
- Department of Biostatistics, Université de Lille, CHU de Lille, Lille, France
| | - Florent Gariel
- Neuroradiology Department, CHU Bordeaux, Bordeaux, France
| | | | | | - Pauline Renou
- Neurology Department, CHU Bordeaux, Bordeaux, France
| | - Jerome Berge
- Neuroradiology Department, CHU Bordeaux, Bordeaux, France
| | - Xavier Barreau
- Neuroradiology Department, CHU Bordeaux, Bordeaux, France
| | - Sharmila Sagnier
- Neurology Department, CHU Bordeaux, Bordeaux, France
- UMR-5287-CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
| | | | - Ludovic Lucas
- Neurology Department, CHU Bordeaux, Bordeaux, France
| | - Pierre Briau
- Neurology Department, CHU Bordeaux, Bordeaux, France
| | - Mathilde Poli
- Neurology Department, CHU Bordeaux, Bordeaux, France
| | | | | | - Vincent Dousset
- Neuroradiology Department, CHU Bordeaux, Bordeaux, France
- INSERM-U862, Neurocentre Magendie, Bordeaux, France
| | - Igor Sibon
- Neurology Department, CHU Bordeaux, Bordeaux, France
- UMR-5287-CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
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7
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Yamamoto T, Lacheret C, Fukutomi H, Kamraoui RA, Denat L, Zhang B, Prevost V, Zhang L, Ruet A, Triaire B, Dousset V, Coupé P, Tourdias T. Validation of a Denoising Method Using Deep Learning-Based Reconstruction to Quantify Multiple Sclerosis Lesion Load on Fast FLAIR Imaging. AJNR Am J Neuroradiol 2022; 43:1099-1106. [PMID: 35902124 PMCID: PMC9575422 DOI: 10.3174/ajnr.a7589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/13/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Accurate quantification of WM lesion load is essential for the care of patients with multiple sclerosis. We tested whether the combination of accelerated 3D-FLAIR and denoising using deep learning-based reconstruction could provide a relevant strategy while shortening the imaging examination. MATERIALS AND METHODS Twenty-eight patients with multiple sclerosis were prospectively examined using 4 implementations of 3D-FLAIR with decreasing scan times (4 minutes 54 seconds, 2 minutes 35 seconds, 1 minute 40 seconds, and 1 minute 15 seconds). Each FLAIR sequence was reconstructed without and with denoising using deep learning-based reconstruction, resulting in 8 FLAIR sequences per patient. Image quality was assessed with the Likert scale, apparent SNR, and contrast-to-noise ratio. Manual and automatic lesion segmentations, performed randomly and blindly, were quantitatively evaluated against ground truth using the absolute volume difference, true-positive rate, positive predictive value, Dice similarity coefficient, Hausdorff distance, and F1 score based on the lesion count. The Wilcoxon signed-rank test and 2-way ANOVA were performed. RESULTS Both image-quality evaluation and the various metrics showed deterioration when the FLAIR scan time was accelerated. However, denoising using deep learning-based reconstruction significantly improved subjective image quality and quantitative performance metrics, particularly for manual segmentation. Overall, denoising using deep learning-based reconstruction helped to recover contours closer to those from the criterion standard and to capture individual lesions otherwise overlooked. The Dice similarity coefficient was equivalent between the 2-minutes-35-seconds-long FLAIR with denoising using deep learning-based reconstruction and the 4-minutes-54-seconds-long reference FLAIR sequence. CONCLUSIONS Denoising using deep learning-based reconstruction helps to recognize multiple sclerosis lesions buried in the noise of accelerated FLAIR acquisitions, a possibly useful strategy to efficiently shorten the scan time in clinical practice.
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Affiliation(s)
- T Yamamoto
- From the Institut de Bio-imagerie (T.Y., H.F., L.D., V.D., T.T.), University Bordeaux, Bordeaux, France
| | - C Lacheret
- Neuroimagerie Diagnostique et Thérapeutique (C.L., V.D., T.T.)
| | - H Fukutomi
- From the Institut de Bio-imagerie (T.Y., H.F., L.D., V.D., T.T.), University Bordeaux, Bordeaux, France
| | - R A Kamraoui
- Laboratoire Bordelais de Recherche en Informatique (R.A.K., P.C.), University Bordeaux, Le Centre National de la Recherche Scientifique, Bordeaux Institut National Polytechnique, Talence, France
| | - L Denat
- From the Institut de Bio-imagerie (T.Y., H.F., L.D., V.D., T.T.), University Bordeaux, Bordeaux, France
| | - B Zhang
- Canon Medical Systems Europe (B.Z.), Zoetermeer, the Netherlands
| | - V Prevost
- Canon Medical Systems (V.P., B.T.), Tochigi, Japan
| | - L Zhang
- Canon Medical Systems China (L.Z.), Beijing, China
| | - A Ruet
- Service de Neurologie (A.R.), Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - B Triaire
- Canon Medical Systems (V.P., B.T.), Tochigi, Japan
| | - V Dousset
- From the Institut de Bio-imagerie (T.Y., H.F., L.D., V.D., T.T.), University Bordeaux, Bordeaux, France.,Neuroimagerie Diagnostique et Thérapeutique (C.L., V.D., T.T.).,NeurocentreMagendie (V.D., T.T.), University of Bordeaux, L'Institut National de la Santé et de la Recherche Médicale, Bordeaux, France
| | - P Coupé
- Laboratoire Bordelais de Recherche en Informatique (R.A.K., P.C.), University Bordeaux, Le Centre National de la Recherche Scientifique, Bordeaux Institut National Polytechnique, Talence, France
| | - T Tourdias
- From the Institut de Bio-imagerie (T.Y., H.F., L.D., V.D., T.T.), University Bordeaux, Bordeaux, France .,Neuroimagerie Diagnostique et Thérapeutique (C.L., V.D., T.T.).,NeurocentreMagendie (V.D., T.T.), University of Bordeaux, L'Institut National de la Santé et de la Recherche Médicale, Bordeaux, France
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8
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Courret T, Gariel F, Tourdias T, Labreuche J, Liegey JS, Olindo S, Renou P, Berge J, Barreau X, Sagnier S, Ménégon P, Lucas L, Briau P, Poli M, Debruxelles S, Rouanet F, Dousset V, Sibon I, Marnat G. Valeurs étiologique et pronostique de la détection de thrombus dans le territoire carotidien externe lors du traitement endovasculaire des occlusions aiguës de la circulation antérieure. J Neuroradiol 2022. [DOI: 10.1016/j.neurad.2022.01.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Sagnier S, Catheline G, Dilharreguy B, Linck PA, Coupé P, Munsch F, Bigourdan A, Poli M, Debruxelles S, Renou P, Olindo S, Rouanet F, Dousset V, Tourdias T, Sibon I. Normal-Appearing White Matter Deteriorates over the Year After an Ischemic Stroke and Is Associated with Global Cognition. Transl Stroke Res 2022; 13:716-724. [PMID: 35106712 DOI: 10.1007/s12975-022-00988-8] [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: 10/02/2021] [Revised: 11/19/2021] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
Normal-appearing white matter (NAWM) is a hub of plasticity, but data relating to its influence on post-ischemic stroke (IS) outcome remain scarce. The aim of this study was to evaluate the relationship between NAWM integrity and cognitive outcome after an IS. A longitudinal study was conducted including supra-tentorial IS patients. A 3-Tesla brain MRI was performed at baseline and 1 year, allowing the analyses of mean fractional anisotropy (FA) and mean diffusivity (MD) in NAWM masks, along with the volume of white matter hyperintensities (WMH) and IS. A Montreal Cognitive Assessment (MoCA), an Isaacs set test, and a Zazzo's cancellation task were performed at baseline, 3 months and 1 year. Mixed models were built, followed by Tract-based Spatial Statistics (TBSS) analyses. Ninety-five patients were included in the analyses (38% women, median age 69 ± 20). FA significantly decreased, and MD significantly increased between baseline and 1 year, while cognitive scores improved. Patients who decreased their NAWM FA more over the year had a slower cognitive improvement on MoCA (β = - 0.11, p = 0.05). The TBSS analyses showed that patients who presented the highest decrease of FA in various tracts of white matter less improved their MoCA performances, regardless of WMH and IS volumes, demographic confounders, and clinical severity. NAWM integrity deteriorates over the year after an IS, and is associated with a cognitive recovery slowdown. The diffusion changes recorded here in patients starting with an early preserved white matter structure could have long term impact on cognition.
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Affiliation(s)
- Sharmila Sagnier
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France. .,CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France. .,INCIA Université Bordeaux 2, 146 rue Léo Saignat Zone Nord, Bâtiment 2A, 2e étage, 33076, Bordeaux, France.
| | - Gwenaëlle Catheline
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
| | - Bixente Dilharreguy
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
| | | | - Pierrick Coupé
- UMR-5800, CNRS, Université de Bordeaux, LaBRI, Talence, France
| | - Fanny Munsch
- Beth Israel Deaconess Medical Center, Harvard University, Boston, USA
| | | | - Mathilde Poli
- CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
| | | | - Pauline Renou
- CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
| | | | | | - Vincent Dousset
- CHU de Bordeaux, Neuroradiologie, Bordeaux, France.,INSERM-U1215, Neurocentre Magendie, Bordeaux, France
| | - Thomas Tourdias
- CHU de Bordeaux, Neuroradiologie, Bordeaux, France.,INSERM-U1215, Neurocentre Magendie, Bordeaux, France
| | - Igor Sibon
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France.,CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
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Galmiche C, Moal B, Marnat G, Sagnier S, Schweitzer C, Dousset V, Sibon I, Tourdias T. Delayed Gadolinium Leakage in Ocular Structures: A Potential Marker for Age- and Vascular Risk Factor-Related Small Vessel Disease? Invest Radiol 2021; 56:425-432. [PMID: 33481460 DOI: 10.1097/rli.0000000000000757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Gadolinium leakage in ocular structures (GLOS) was recently observed in fluid-attenuated inversion recovery (FLAIR) images obtained the day after an initial gadolinium injection in stroke patients. The specificity of GLOS to stroke and its mechanisms remain unclear. OBJECTIVE We investigated the factors associated with GLOS in a cohort of patients presenting with acute neurological deficits. MATERIALS AND METHODS This retrospective study included consecutive patients admitted to our stroke unit for acute neurological deficit between July 2017 and August 2018 who underwent baseline brain magnetic resonance imaging with the injection of a macrocyclic gadolinium agent and another scan without injection within 72 hours. The patients were separated into a stroke group and a stroke mimic group based on diffusion-weighted images. Gadolinium leakage in ocular structures was defined as a bright signal in the vitreous in follow-up FLAIR compared with baseline FLAIR (pregadolinium). Clinical data were collected together with imaging features from the baseline scans, including the volume of the infarct and of hypoperfusion if applicable, white matter hyperintensities, the number of lacunes, and the number of microbleeds, which were combined to yield a small vessel disease (SVD) score. We compared the prevalence of GLOS in both groups using the χ2 test. In the entire cohort, univariate and multivariate regression models were used to test the associations between GLOS and the collected data. RESULTS Among the 467 patients included in the study, GLOS was observed in similar proportions in the stroke group (32.2%, 136/422) and the stroke mimic group (28.9%, 13/45; mean difference, 3.3%; 95% confidence interval, -10.9 to 17.6; P = 0.65). In univariate analysis, GLOS was associated with older age, increased prevalence of vascular risk factors, brain imaging features of SVD (white matter hyperintensities, lacunes, microbleeds), as well as with impairment of renal function and increased dose of gadolinium. No associations were found with factors related to stroke, such as its volume, acute treatment, or rate of recanalization. Multivariate analyses showed that aging (P < 0.001), diabetes (P = 0.010), severe renal failure (P = 0.004), and increased dose of gadolinium (P < 0.001) were independent contributors to GLOS. CONCLUSIONS Gadolinium leakage in ocular structures, which occurs more commonly at higher concentrations of gadolinium, is not specific to stroke and may represent increased permeability of the blood-retinal barrier associated with age- and vascular risk factor-related SVD.
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Affiliation(s)
- Chloé Galmiche
- From the Service de Neuroimagerie Diagnostique et Thérapeutique
| | - Bertrand Moal
- Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique
| | - Gaultier Marnat
- From the Service de Neuroimagerie Diagnostique et Thérapeutique
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11
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Sagnier S, Catheline G, Munsch F, Bigourdan A, Poli M, Debruxelles S, Renou P, Olindo S, Rouanet F, Dousset V, Tourdias T, Sibon I. Severity of Small Vessel Disease Biomarkers Reduces the Magnitude of Cognitive Recovery after Ischemic Stroke. Cerebrovasc Dis 2021; 50:456-463. [PMID: 33827075 DOI: 10.1159/000513916] [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: 09/07/2020] [Accepted: 12/16/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the impact of radiological biomarkers suggestive of cerebral small vessel disease (SVD) on the evolution of cognitive performances after an ischemic stroke (IS). METHODS We studied patients with a supratentorial IS recruited consecutively to a prospective monocentric longitudinal study. A cognitive assessment was performed at baseline, 3 months, and 1 year and was based on a Montreal Cognitive Assessment, an Isaacs set test of verbal fluency (IST), and a Zazzo's cancellation task (ZCT) for the evaluation of attentional functions and processing speed. The following cerebral SVD biomarkers were detected on a 3-T brain MRI performed at baseline: white matter hyperintensities (WMHs), deep and lobar microbleeds, enlarged perivascular spaces in basal ganglia and centrum semiovale, previous small deep infarcts, and cortical superficial siderosis (cSS). Generalized linear mixed models were used to evaluate the relationship between these biomarkers and changes in cognitive performances. RESULTS A total of 199 patients (65 ± 13 years, 68% male) were analyzed. Overall, the cognitive performances improved, more significantly in the first 3 months. Severe WMH was identified in 34% of the patients, and focal cSS in 3.5%. Patients with severe WMH and focal cSS had overall worse cognitive performances. Those with severe WMH had less improvement over time for IST (β = -0.16, p = 0.02) and the number of errors to ZCT (β = 0.19, p = 0.02), while those with focal cSS had less improvement over time for ZCT completion time (β = 0.14, p = 0.01) and number of errors (β = 0.17, p = 0.008), regardless of IS volume and location, gray matter volume, demographic confounders, and clinical and cardiovascular risk factors. CONCLUSION The severity of SVD biomarkers, encompassing WMH and cSS, seems to reduce the magnitude of cognitive recovery after an IS. The detection of such SVD biomarkers early after stroke might help to identify patients with a cognitive vulnerability and a higher risk of poststroke cognitive impairment.
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Affiliation(s)
- Sharmila Sagnier
- UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France.,CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
| | - Gwenaëlle Catheline
- UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
| | - Fanny Munsch
- Beth Israel Deaconess Medical Center, Harvard University, Boston, Massachusetts, USA
| | | | - Mathilde Poli
- CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
| | | | - Pauline Renou
- CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
| | | | | | - Vincent Dousset
- INSERM-U1215, Neurocentre Magendie, Bordeaux, France.,CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France
| | - Thomas Tourdias
- INSERM-U1215, Neurocentre Magendie, Bordeaux, France.,CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France
| | - Igor Sibon
- UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France.,CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
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Coutureau J, Asselineau J, Perez P, Kuchcinski G, Sagnier S, Renou P, Munsch F, Lopes R, Henon H, Bordet R, Dousset V, Sibon I, Tourdias T. Cerebral Small Vessel Disease MRI Features Do Not Improve the Prediction of Stroke Outcome. Neurology 2020; 96:e527-e537. [PMID: 33184231 DOI: 10.1212/wnl.0000000000011208] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 09/11/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether the total small vessel disease (SVD) score adds information to the prediction of stroke outcome compared to validated predictors, we tested different predictive models of outcome in patients with stroke. METHODS White matter hyperintensity, lacunes, perivascular spaces, microbleeds, and atrophy were quantified in 2 prospective datasets of 428 and 197 patients with first-ever stroke, using MRI collected 24 to 72 hours after stroke onset. Functional, cognitive, and psychological status were assessed at the 3- to 6-month follow-up. The predictive accuracy (in terms of calibration and discrimination) of age, baseline NIH Stroke Scale score (NIHSS), and infarct volume was quantified (model 1) on dataset 1, the total SVD score was added (model 2), and the improvement in predictive accuracy was evaluated. These 2 models were also developed in dataset 2 for replication. Finally, in model 3, the MRI features of cerebral SVD were included rather than the total SVD score. RESULTS Model 1 showed excellent performance for discriminating poor vs good functional outcomes (area under the curve [AUC] 0.915), and fair performance for identifying cognitively impaired and depressed patients (AUCs 0.750 and 0.688, respectively). A higher SVD score was associated with a poorer outcome (odds ratio 1.30 [1.07-1.58], p = 0.0090 at best for functional outcome). However, adding the total SVD score (model 2) or individual MRI features (model 3) did not improve the prediction over model 1. Results for dataset 2 were similar. CONCLUSIONS Cerebral SVD was independently associated with functional, cognitive, and psychological outcomes, but had no clinically relevant added value to predict the individual outcomes of patients when compared to the usual predictors, such as age and baseline NIHSS.
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Affiliation(s)
- Juliette Coutureau
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Julien Asselineau
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Paul Perez
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Gregory Kuchcinski
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Sharmila Sagnier
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Pauline Renou
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Fanny Munsch
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Renaud Lopes
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Hilde Henon
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Regis Bordet
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Vincent Dousset
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Igor Sibon
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France
| | - Thomas Tourdias
- From the Neuroimagerie Diagnostique et Thérapeutique (J.C., V.D., T.T.), Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), and Unité Neurovasculaire (S.S., P.R., I.S.), CHU de Bordeaux; Université de Bordeaux (J.C., S.S., V.D., I.S., T.T.); Département de Neuroradiologie (G.K., R.L.) and Unité Neurovasculaire (H.H.), CHU de Lille; Université de Lille (G.K., R.L., H.H., R.B.); INSERM U1171 (G.K., R.L., H.H., R.B.), Troubles Cognitifs Dégénératifs et Vasculaires, Lille; UMR 5287 (S.S., I.S.), CNRS, Neuroimagerie et Cognition, Bordeaux, France; Division of MRI Research (F.M.), Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and INSERM (V.D., T.T.), U1215, Neurocentre Magendie, Bordeaux, France.
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Brisset JC, Kremer S, Hannoun S, Bonneville F, Durand-Dubief F, Tourdias T, Barillot C, Guttmann C, Vukusic S, Dousset V, Cotton F, Ameli R, Anxionnat R, Audoin B, Attye A, Bannier E, Barillot C, Ben Salem D, Boncoeur-Martel MP, Bonhomme G, Bonneville F, Boutet C, Brisset J, Cervenanski F, Claise B, Commowick O, Constans JM, Cotton F, Dardel P, Desal H, Dousset V, Durand-Dubief F, Ferre JC, Gaultier A, Gerardin E, Glattard T, Grand S, Grenier T, Guillevin R, Guttmann C, Krainik A, Kremer S, Lion S, Champfleur NMD, Mondot L, Outteryck O, Pyatigorskaya N, Pruvo JP, Rabaste S, Ranjeva JP, Roch JA, Sadik JC, Sappey-Marinier D, Savatovsky J, Stankoff B, Tanguy JY, Tourbah A, Tourdias T, Brochet B, Casey R, Cotton F, De Sèze J, Douek P, Guillemin F, Laplaud D, Lebrun-Frenay C, Mansuy L, Moreau T, Olaiz J, Pelletier J, Rigaud-Bully C, Stankoff B, Vukusic S, Debouverie M, Edan G, Ciron J, Lubetzki C, Vermersch P, Labauge P, Defer G, Berger E, Clavelou P, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Bakchine S, Maurousset A, Patry I, De Broucker T, Pottier C, Neau JP, Labeyrie C, Nifle C. New OFSEP recommendations for MRI assessment of multiple sclerosis patients: Special consideration for gadolinium deposition and frequent acquisitions. J Neuroradiol 2020; 47:250-258. [DOI: 10.1016/j.neurad.2020.01.083] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 01/04/2023]
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14
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Sagnier S, Catheline G, Dilharreguy B, Linck PA, Coupé P, Munsch F, Bigourdan A, Debruxelles S, Poli M, Olindo S, Renou P, Rouanet F, Dousset V, Berthoz S, Tourdias T, Sibon I. Normal-Appearing White Matter Integrity Is a Predictor of Outcome After Ischemic Stroke. Stroke 2020; 51:449-456. [PMID: 31906830 DOI: 10.1161/strokeaha.119.026886] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- The aim of the present study was to evaluate the relationship between normal-appearing white matter (NAWM) integrity and postischemic stroke recovery in 4 main domains including cognition, mood, gait, and dependency. Methods- A prospective study was conducted, including patients diagnosed for an ischemic supratentorial stroke on a 3T brain MRI performed 24 to 72 hours after symptom onset. Clinical assessment 1 year after stroke included a Montreal Cognitive Assessment, an Isaacs set test, a Zazzo cancelation task, a Hospital Anxiety and Depression scale, a 10-meter walking test, and a modified Rankin Scale (mRS). Diffusion tensor imaging parameters in the NAWM were computed using FMRIB (Functional Magnetic Resonance Imaging of the Brain) Diffusion Toolbox. The relationships between mean NAWM diffusion tensor imaging parameters and the clinical scores were assessed using linear and ordinal regression analyses, including the volumes of white matter hyperintensities, gray matter, and ischemic stroke as radiological covariates. Results- Two hundred seven subjects were included (66±13 years old; 67% men; median National Institutes of Health Stroke Scale score, 3; interquartile range, 2-6). In the models including only radiological variables, NAWM fractional anisotropy was associated with the mRS and the cognitive scores. After adjusting for demographic confounders, NAWM fractional anisotropy remained a significant predictor of mRS (β=-0.24; P=0.04). Additional path analysis showed that NAWM fractional anisotropy had a direct effect on mRS (β=-0.241; P=0.001) and a less important indirect effect mediating white matter hyperintensity burden. Similar results were found with mean diffusivity, axial diffusivity, and radial diffusivity. In further subgroup analyses, a relationship between NAWM integrity in widespread white matter tracts, mRS, and Isaacs set test was found in right hemispheric strokes. Conclusions- NAWM diffusion tensor imaging parameters measured early after an ischemic stroke are independent predictors of functional outcome and may be additional markers to include in studies evaluating poststroke recovery.
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Affiliation(s)
- Sharmila Sagnier
- From the UMR-5287-CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., S.B., I.S.).,CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Gwenaëlle Catheline
- From the UMR-5287-CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., S.B., I.S.)
| | - Bixente Dilharreguy
- From the UMR-5287-CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., S.B., I.S.)
| | | | - Pierrick Coupé
- UMR-5800-CNRS, Université de Bordeaux, LaBRI, Talence, France (P.C.)
| | - Fanny Munsch
- Beth Israel Deaconess Medical Center, Harvard University, Boston, MA (F.M.)
| | - Antoine Bigourdan
- CHU de Bordeaux, Neuroradiologie, France (P.-A.L., A.B., V.D., T.T.)
| | - Sabrina Debruxelles
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Mathilde Poli
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Stéphane Olindo
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Pauline Renou
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - François Rouanet
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Vincent Dousset
- CHU de Bordeaux, Neuroradiologie, France (P.-A.L., A.B., V.D., T.T.).,INSERM-U862, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Sylvie Berthoz
- From the UMR-5287-CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., S.B., I.S.).,Département de Psychiatrie de l'Adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, Paris, France (S.B.)
| | - Thomas Tourdias
- CHU de Bordeaux, Neuroradiologie, France (P.-A.L., A.B., V.D., T.T.).,INSERM-U862, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Igor Sibon
- From the UMR-5287-CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., S.B., I.S.).,CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
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15
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Olivier A, Moal O, Moal B, Munsch F, Okubo G, Sibon I, Dousset V, Tourdias T. Active learning strategy and hybrid training for infarct segmentation on diffusion MRI with a U-shaped network. J Med Imaging (Bellingham) 2019; 6:044001. [PMID: 31592439 PMCID: PMC6777650 DOI: 10.1117/1.jmi.6.4.044001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 09/16/2019] [Indexed: 11/14/2022] Open
Abstract
Automatic and reliable stroke lesion segmentation from diffusion magnetic resonance imaging (MRI) is critical for patient care. Methods using neural networks have been developed, but the rate of false positives limits their use in clinical practice. A training strategy applied to three-dimensional deconvolutional neural networks for stroke lesion segmentation on diffusion MRI was proposed. Infarcts were segmented by experts on diffusion MRI for 929 patients. We divided each database as follows: 60% for a training set, 20% for validation, and 20% for testing. Our hypothesis was a two-phase hybrid learning scheme, in which the network was first trained with whole MRI (regular phase) and then, in a second phase (hybrid phase), alternately with whole MRI and patches. Patches were actively selected from the discrepancy between expert and model segmentation at the beginning of each batch. On the test population, the performances after the regular and hybrid phases were compared. A statistically significant Dice improvement with hybrid training compared with regular training was demonstrated ( p < 0.01 ). The mean Dice reached 0.711 ± 0.199 . False positives were reduced by almost 30% with hybrid training ( p < 0.01 ). Our hybrid training strategy empowered deep neural networks for more accurate infarct segmentations on diffusion MRI.
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Affiliation(s)
| | | | | | - Fanny Munsch
- Université de Bordeaux, Neurocentre Magendie, Inserm U1215, Bordeaux, France
| | - Gosuke Okubo
- Université de Bordeaux, Neurocentre Magendie, Inserm U1215, Bordeaux, France
| | - Igor Sibon
- Université Bordeaux Segalen, CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
- Université de Bordeaux, UMR 5287 CNRS, Bordeaux, France
| | - Vincent Dousset
- Université de Bordeaux, Neurocentre Magendie, Inserm U1215, Bordeaux, France
- CHU Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France
| | - Thomas Tourdias
- Université de Bordeaux, Neurocentre Magendie, Inserm U1215, Bordeaux, France
- CHU Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France
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Sagnier S, Okubo G, Catheline G, Munsch F, Bigourdan A, Debruxelles S, Poli M, Olindo S, Renou P, Rouanet F, Dousset V, Tourdias T, Sibon I. Chronic Cortical Cerebral Microinfarcts Slow Down Cognitive Recovery After Acute Ischemic Stroke. Stroke 2019; 50:1430-1436. [DOI: 10.1161/strokeaha.118.024672] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sharmila Sagnier
- From the UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., I.S.)
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Gosuke Okubo
- INSERM-U1215, Neurocentre Magendie, Bordeaux, France (G.O., A.B., V.D., T.T.)
| | - Gwenaëlle Catheline
- From the UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., I.S.)
| | - Fanny Munsch
- CHU de Bordeaux, Neuroimagerie diagnostique et thérapeutique, France (F.M., V.D., T.T.)
| | - Antoine Bigourdan
- INSERM-U1215, Neurocentre Magendie, Bordeaux, France (G.O., A.B., V.D., T.T.)
| | - Sabrina Debruxelles
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Mathilde Poli
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Stéphane Olindo
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Pauline Renou
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - François Rouanet
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
| | - Vincent Dousset
- INSERM-U1215, Neurocentre Magendie, Bordeaux, France (G.O., A.B., V.D., T.T.)
- CHU de Bordeaux, Neuroimagerie diagnostique et thérapeutique, France (F.M., V.D., T.T.)
| | - Thomas Tourdias
- INSERM-U1215, Neurocentre Magendie, Bordeaux, France (G.O., A.B., V.D., T.T.)
- CHU de Bordeaux, Neuroimagerie diagnostique et thérapeutique, France (F.M., V.D., T.T.)
| | - Igor Sibon
- From the UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., I.S.)
- CHU de Bordeaux, Unité Neuro-vasculaire, France (S.S., S.D., M.P., S.O., P.R., F.R., I.S.)
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Sagnier S, Munsch F, Bigourdan A, Debruxelles S, Poli M, Renou P, Olindo S, Rouanet F, Dousset V, Tourdias T, Sibon I. The Influence of Stroke Location on Cognitive and Mood Impairment. A Voxel-Based Lesion-Symptom Mapping Study. J Stroke Cerebrovasc Dis 2019; 28:1236-1242. [DOI: 10.1016/j.jstrokecerebrovasdis.2019.01.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/04/2019] [Accepted: 01/15/2019] [Indexed: 10/27/2022] Open
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Clouzeau B, Caujolle M, San-Miguel A, Pillot J, Gazeau N, Tacaille C, Dousset V, Bazin F, Vargas F, Hilbert G, Molimard M, Gruson D, Boyer A. The sustainable impact of an educational approach to improve the appropriateness of laboratory test orders in the ICU. PLoS One 2019; 14:e0214802. [PMID: 31042718 PMCID: PMC6493704 DOI: 10.1371/journal.pone.0214802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 03/20/2019] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Few studies described strategies to improve the use of diagnostic tests in intensive care units (ICU). No study assessed whether their impact was sustained or not. In this study, we assessed whether a multi-faceted intervention for more appropriate use of laboratory testing can decrease the number of tests, is sustainable, is not associated with additional morbidity and represents a potential cost saving. MATERIAL AND METHODS An open-label prospective cohort study in two separated units of the same medical intensive care unit (ICU) including respectively 3315 and 2392 consecutive patients. After the observation period (2010), a reduction in ICU A of unnecessary diagnostics tests as part of a program including senior supervisory of juniors' orders, encouragements for orders containment at each everyday round discussions (period 2; 2011). Period 3 (2012) consisted in the prolongation of the protocol as a routine care without supervision; Period 4 (2013) was a new period of observation without intervention. No modification was implemented in ICU B in periods 2-4. RESULTS After the intervention, a decrease in the overall number of tests per ICU-patient-days (37.3±5.5 (baseline) to 15.2±3.2 (- 59%); p<0.0001) was observed. The total cost of the tests decreased from 239±41 to 104±28 euros per ICU-patient days; p<0.0001. The effect on laboratory test orders was sustainable in period 3 (-49%) and 4 (-30%). No significant secondary effect of the intervention was observed in period 2. In ICU B, there was no significant change in the overall laboratory test orders in between the periods. CONCLUSIONS Laboratory test containment is effective, likely safe and sustainable provided that an educational program is repeatedly promoted, that it makes sense for the whole team, that senior and junior physicians are both committed in the program, and that encouragements for laboratory orders containment at each everyday round discussions.
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Affiliation(s)
- Benjamin Clouzeau
- Department of Intensive Care Medicine, Pellegrin Hospital, Bordeaux, France
| | - Marie Caujolle
- Department of Intensive Care Medicine, Pellegrin Hospital, Bordeaux, France
| | - Aurelie San-Miguel
- Department of Intensive Care Medicine, Pellegrin Hospital, Bordeaux, France
| | - Jerome Pillot
- Department of Intensive Care Medicine, Pellegrin Hospital, Bordeaux, France
| | - Nathalie Gazeau
- Economic and Financial Department, Pellegrin Hospital, Bordeaux, France
- Departments of Laboratories, Pellegrin Hospital, Bordeaux, France
| | | | - Vincent Dousset
- Department of Radiology, Pellegrin Hospital, Bordeaux, France
| | - Fabienne Bazin
- INSERM, U657 Pharmaco-Epidémiologie et Evaluation de l'Impact des Produits de Santé sur les Populations, France
| | - Frederic Vargas
- Department of Intensive Care Medicine, Pellegrin Hospital, Bordeaux, France
| | - Gilles Hilbert
- Department of Intensive Care Medicine, Pellegrin Hospital, Bordeaux, France
| | - Mathieu Molimard
- Departments of Laboratories, Pellegrin Hospital, Bordeaux, France
- INSERM, U657 Pharmaco-Epidémiologie et Evaluation de l'Impact des Produits de Santé sur les Populations, France
| | - Didier Gruson
- Department of Intensive Care Medicine, Pellegrin Hospital, Bordeaux, France
| | - Alexandre Boyer
- Department of Intensive Care Medicine, Pellegrin Hospital, Bordeaux, France
- INSERM, U657 Pharmaco-Epidémiologie et Evaluation de l'Impact des Produits de Santé sur les Populations, France
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Linck PA, Kuchcinski G, Munsch F, Griffier R, Lopes R, Okubo G, Sagnier S, Renou P, Asselineau J, Perez P, Dousset V, Sibon I, Tourdias T. Neurodegeneration of the Substantia Nigra after Ipsilateral Infarct: MRI R2* Mapping and Relationship to Clinical Outcome. Radiology 2019; 291:438-448. [PMID: 30860451 DOI: 10.1148/radiol.2019182126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background The substantia nigra (SN) is suspected to be affected after remote infarction, in view of its large array of connections with the supratentorial brain. Whether secondary involvement of SN worsens overall clinical outcome after a supratentorial stroke has not previously been studied. Purpose To assess longitudinal changes in SN R2* by using MRI in the setting of ipsilesional supratentorial infarct and the relationship of SN signal change to clinical outcome. Materials and Methods Participants prospectively included from 2012 to 2015 were evaluated at 24-72 hours (baseline visit) and at 1 year with MRI to quantify R2*. The SN was segmented bilaterally to calculate an R2* asymmetry index (SN-AI); greater SN-AI indicated greater relative R2* in the ipsilateral compared with contralateral SN. The 95th percentile of R2* (hereafter, SN-AI95) was compared according to infarct location with mixed linear regression models. We also conducted voxel-based comparisons of R2* and identified individual infarcted voxels associated with high SN-AI95 through voxel-based lesion-symptom mapping. Multivariable regression models tested the association between SN-AI95 and clinical scores. Results A total of 181 participants were evaluated (127 men, 54 women; mean age ± standard deviation, 64.2 years ± 13.1; 75 striatum infarcts, 106 other locations). Visual inspection, SN-AI95, and average maps consistently showed higher SN R2* at 1 year if ipsilateral striatum was infarcted than if it was not (SN-AI95, 4.25 vs -0.88; P < .001), but this was not observed at baseline. The striatal location of the infarct was associated with higher SN-AI95 at 1 year independently from infarct volume, SN-AI95 at baseline, microbleeds, age, and sex (β = 4.99; P < .001). Voxel-based lesion-symptom mapping confirmed that striatum but also insula, internal capsule, and external capsule were associated with higher SN-AI95 at 1 year. SN-AI95 was an independent contributor of poor motor outcome (Box and Block Test, β = -.62 points; P = .01). Conclusion In patients with stroke, greater substantia nigra R2*, likely reflective of greater iron content, can be observed at 1 year ipsilateral from remote infarcts of specific location, which is associated with worse motor function. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Vernooij in this issue.
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Affiliation(s)
- Pierre Antoine Linck
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Gregory Kuchcinski
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Fanny Munsch
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Romain Griffier
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Renaud Lopes
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Gosuke Okubo
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Sharmila Sagnier
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Pauline Renou
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Julien Asselineau
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Paul Perez
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Vincent Dousset
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Igor Sibon
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
| | - Thomas Tourdias
- From the Centre Hospitalier Universitaire (CHU) de Bordeaux, Department of Radiology and Diagnostic Neuroimaging, Bordeaux, France (P.A.L., F.M., V.D., T.T.); University of Bordeaux, Bordeaux, France (P.A.L., F.M., G.O., S.S., V.D., I.S., T.T.); CHU de Lille, Department of Neuroradiology, Lille, France (G.K., R.L.); University of Lille, Lille, France (G.K., R.L.); CHU de Bordeaux, Public Health Center, Methodological Support Unit for Clinical and Epidemiological Research, Bordeaux, France (R.G., J.A., P.P.); CHU de Bordeaux, Neurovascular Unit, Bordeaux, France (S.S., P.R., I.S.); and Institut National de la Santé et de la Recherche Médicale, Neurocentre Magendie, Bordeaux, France (V.D., T.T.)
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Planche V, Su JH, Mournet S, Saranathan M, Dousset V, Han M, Rutt BK, Tourdias T. White-matter-nulled MPRAGE at 7T reveals thalamic lesions and atrophy of specific thalamic nuclei in multiple sclerosis. Mult Scler 2019; 26:987-992. [PMID: 30730233 DOI: 10.1177/1352458519828297] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Investigating the degeneration of specific thalamic nuclei in multiple sclerosis (MS) remains challenging. METHODS White-matter-nulled (WMn) MPRAGE, MP-FLAIR, and standard T1-weighted magnetic resonance imaging (MRI) were performed on MS patients (n = 15) and matched controls (n = 12). Thalamic lesions were counted in individual sequences and lesion contrast-to-noise ratio (CNR) was measured. Volumes of 12 thalamic nuclei were measured using an automatic segmentation pipeline specifically developed for WMn-MPRAGE. RESULTS WMn-MPRAGE showed more thalamic MS lesions (n = 35 in 9 out of 15 patients) than MP-FLAIR (n = 25) and standard T1 (n = 23), which was associated with significant improvement of CNR (p < 0.0001). MS patients had whole thalamus atrophy (p = 0.003) with lower volumes found for the anteroventral (p < 0.001), the pulvinar (p < 0.0001), and the habenular (p = 0.004) nuclei. CONCLUSION WMn-MPRAGE and automatic thalamic segmentation can highlight thalamic MS lesions and measure patterns of focal thalamic atrophy.
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Affiliation(s)
- Vincent Planche
- Institut des Maladies Neurodégénératives, CNRS UMR 5293, Bordeaux, France; University of Bordeaux, Bordeaux, France; CHU de Bordeaux, Bordeaux, France
| | - Jason H Su
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | | | | | - Vincent Dousset
- University of Bordeaux, Bordeaux, France; CHU de Bordeaux, Bordeaux, France; INSERM U1215, Neurocentre Magendie, Bordeaux, France
| | - May Han
- Department of Neurology, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Brian K Rutt
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Thomas Tourdias
- University of Bordeaux, Bordeaux, France; CHU de Bordeaux, Bordeaux, France; INSERM U1215, Neurocentre Magendie, Bordeaux, France
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Hannoun S, Heidelberg D, Hourani R, Nguyen TTT, Brisset JC, Grand S, Kremer S, Bonneville F, Guttmann CR, Dousset V, Cotton F. Diagnostic value of 3DFLAIR in clinical practice for the detection of infratentorial lesions in multiple sclerosis in regard to dual echo T2 sequences. Eur J Radiol 2018; 102:146-151. [DOI: 10.1016/j.ejrad.2018.03.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 02/19/2018] [Accepted: 03/13/2018] [Indexed: 11/16/2022]
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Langlet B, Barreau X, Marnat G, Dousset V. Eagle's syndrome: A rare cause of cervical internal carotid pseudo-aneurysmal dissection. J Neuroradiol 2018; 45:155-156. [DOI: 10.1016/j.neurad.2017.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/12/2017] [Accepted: 11/12/2017] [Indexed: 11/28/2022]
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Cazayus M, Berge J, Marnat G, Menegon P, Gariel F, Dousset V, Barreau X. Efficacy and safety of ticagrelor versus clopidogrel associated with aspirin for dual antiplatelet therapy in cerebral aneurysm stenting treatment: Monocentric cohort experience. J Neuroradiol 2018. [DOI: 10.1016/j.neurad.2017.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gariel F, Rooryck-Thambo C, Marnat G, Barreau X, Ménégon P, Jecko V, Penchet G, Dousset V, Tourdias T, Blanco P, Berge J. Is there any intra-aneuvrysmal blood marker of aneuvrysm wall inflammation? Crossed analysis between transcriptomic and proteomic data. J Neuroradiol 2018. [DOI: 10.1016/j.neurad.2017.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Crombe A, Planche V, Raffard G, Bourel J, Dubourdieu N, Panatier A, Fukutomi H, Dousset V, Oliet S, Hiba B, Tourdias T. Deciphering the microstructure of hippocampal subfields with in vivo DTI and NODDI: Applications to experimental multiple sclerosis. Neuroimage 2018; 172:357-368. [PMID: 29409838 DOI: 10.1016/j.neuroimage.2018.01.061] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 09/03/2017] [Revised: 01/16/2018] [Accepted: 01/24/2018] [Indexed: 12/23/2022] Open
Abstract
The hippocampus contains distinct populations of neurons organized into separate anatomical subfields and layers with differential vulnerability to pathological mechanisms. The ability of in vivo neuroimaging to pinpoint regional vulnerability is especially important for better understanding of hippocampal pathology at the early stage of neurodegenerative disorders and for monitoring future therapeutic strategies. This is the case for instance in multiple sclerosis whose neurodegenerative component can affect the hippocampus from the early stage. We challenged the capacity of two models, i.e. the classical diffusion tensor imaging (DTI) model and the neurite orientation dispersion and density imaging (NODDI) model, to compute quantitative diffusion MRI that could capture microstructural alterations in the individual hippocampal layers of experimental-autoimmune encephalomyelitis (EAE) mice, the animal model of multiple sclerosis. To achieve this, the hippocampal anatomy of a healthy mouse brain was first explored ex vivo with high resolution DTI and NODDI. Then, 18 EAE mice and 18 control mice were explored 20 days after immunization with in vivo diffusion MRI prior to sacrifice for the histological quantification of neurites and glial markers in each hippocampal layer. Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) maps were computed from the DTI model while the orientation dispersion index (ODI), the neurite density index (NDI) and the volume fraction of isotropic diffusivity (isoVF) maps were computed from the NODDI model. We first showed in control mice that color-coded FA and ODI maps can delineate three main hippocampal layers. The quantification of FA, AD, RD, MD, ODI, NDI and isoVF presented differences within these 3 layers, especially within the molecular layer of the dentate gyrus which displayed a specific signature based on a combination of AD (or MD), ODI and NDI. Then, the comparison between EAE and control mice showed a decrease of AD (p = 0.036) and of MD (p = 0.033) selectively within the molecular layer of EAE mice while NODDI indices did not present any difference between EAE and control mice in any layer. Histological analyses confirmed the differential vulnerability of the molecular layer of EAE mice that exhibited decreased dendritic length and decreased dendritic complexity together with activated microglia. Dendritic length and intersections within the molecular layer were independent contributors to the observed decrease of AD (R2 = 0.37 and R2 = 0.40, p < 0.0001) and MD (R2 = 0.41 and R2 = 0.42, p < 0.0001). We therefore identified that NODDI maps can help to highlight the internal microanatomy of the hippocampus but NODDI still presents limitations in grey matter as it failed to capture selective dendritic alterations occurring at early stages of a neurodegenerative disease such as multiple sclerosis, whereas DTI maps were significantly altered.
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Affiliation(s)
- Amandine Crombe
- INSERM, U1215, Neurocentre Magendie, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France; CNRS UMR 5536, Centre de Résonance Magnétique des Systèmes Biologiques, F-33000, Bordeaux, France; CHU de Bordeaux, F-33000, Bordeaux, France
| | - Vincent Planche
- INSERM, U1215, Neurocentre Magendie, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Gerard Raffard
- Univ. Bordeaux, F-33000, Bordeaux, France; CNRS UMR 5536, Centre de Résonance Magnétique des Systèmes Biologiques, F-33000, Bordeaux, France
| | - Julien Bourel
- INSERM, U1215, Neurocentre Magendie, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Nadège Dubourdieu
- INSERM, U1215, Neurocentre Magendie, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Aude Panatier
- INSERM, U1215, Neurocentre Magendie, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Hikaru Fukutomi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Vincent Dousset
- INSERM, U1215, Neurocentre Magendie, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France; CHU de Bordeaux, F-33000, Bordeaux, France
| | - Stephane Oliet
- INSERM, U1215, Neurocentre Magendie, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Bassem Hiba
- Univ. Bordeaux, F-33000, Bordeaux, France; CNRS UMR 5229, Centre de Neurosciences Cognitives, F-69675, Bron, France.
| | - Thomas Tourdias
- INSERM, U1215, Neurocentre Magendie, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France; CHU de Bordeaux, F-33000, Bordeaux, France.
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Munsch F, Sibon I, Dousset V, Tourdias T, Schlaug G. Abstract 21: Motor Tract Impairment is an Independent Predictor of Lower Limb Motor Recovery. Stroke 2018. [DOI: 10.1161/str.49.suppl_1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
Introduction:
Initial motor impairment assessed in the acute stroke phase (as measured by the Fugl-Meyer (FM) Assessment) is a strong predictor of lower extremity (LE) motor impairment at 3 months (Smith et al., 2017). The predictive value of measures of motor tract integrity, lesion size and location is not known. For our analysis we combined two motor tracts that might be particularly important in the control of proximal leg muscles to create a canonical tract of the corticospinal tract proper (CST) and the corticorubrospinal tract (CRST)(Lindenberg et al., 2010; Rueber et al., 2012). In previous work (Feng et al., 2015) we have shown that weighted CST-Lesion Load (a combined variable of lesion size and location) is a significant predictor of 3 months outcome for the UE.
Hypothesis:
Weighted CST-CRST Lesion-Load (wCST/CRST-LL) can improve the FM-based predictions of lower limb motor recovery.
Methods:
Ischemic stroke patients with a upper limb paresis (UE-FM<66) and lower limb paresis (LE-FM<34) were assessed between 48-72h and 3 months poststroke with the FM scale. Lesion maps drawn on diffusion-weighted images were used to calculate lesion loads of a combined CST-CRST probabilistic tract derived from matched elderly healthy control subjects. Then, several variables that have been shown to predict outcome (e.g., FM, lesion load, age, hemisphere) were subjected to individual regression analyses. Significant variables (at p<0.05) were entered into a multiple regression model to assess predictors of lower limb motor recovery (i.e., actual difference in LE-FM between 3 months and initial stroke phase assessment).
Results:
Both baseline and 3-months follow-up were available for 134 patients. Initial motor impairment (FM-LE) and wCST/CRST-LL were independent strong predictors of lower limb motor recovery (respectively p<0.0001 and p=0.0005). Combining initial motor impairment and wCST/CRST lesion load was a much better model than FM-LE by itself (respectively R2=0.43 and R2=0.46, p=0.003) which was confirmed by the Akaike Information Criterion (AIC).
Conclusion:
wCST/CRST-LL, a combined measure of lesion size/location, adds significant power to a combined model with FM, but is also a strong predictor of lower limb motor recovery by itself.
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Affiliation(s)
| | - Igor Sibon
- Cntr Hospier Universitaire de Bordeaux, Bordeaux, France
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Planche V, Koubiyr I, Romero JE, Manjon JV, Coupé P, Deloire M, Dousset V, Brochet B, Ruet A, Tourdias T. Regional hippocampal vulnerability in early multiple sclerosis: Dynamic pathological spreading from dentate gyrus to CA1. Hum Brain Mapp 2018; 39:1814-1824. [PMID: 29331060 DOI: 10.1002/hbm.23970] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [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: 09/25/2017] [Revised: 01/03/2018] [Accepted: 01/04/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Whether hippocampal subfields are differentially vulnerable at the earliest stages of multiple sclerosis (MS) and how this impacts memory performance is a current topic of debate. METHOD We prospectively included 56 persons with clinically isolated syndrome (CIS) suggestive of MS in a 1-year longitudinal study, together with 55 matched healthy controls at baseline. Participants were tested for memory performance and scanned with 3 T MRI to assess the volume of 5 distinct hippocampal subfields using automatic segmentation techniques. RESULTS At baseline, CA4/dentate gyrus was the only hippocampal subfield with a volume significantly smaller than controls (p < .01). After one year, CA4/dentate gyrus atrophy worsened (-6.4%, p < .0001) and significant CA1 atrophy appeared (both in the stratum-pyramidale and the stratum radiatum-lacunosum-moleculare, -5.6%, p < .001 and -6.2%, p < .01, respectively). CA4/dentate gyrus volume at baseline predicted CA1 volume one year after CIS (R2 = 0.44 to 0.47, p < .001, with age, T2 lesion-load, and global brain atrophy as covariates). The volume of CA4/dentate gyrus at baseline was associated with MS diagnosis during follow-up, independently of T2-lesion load and demographic variables (p < .05). Whereas CA4/dentate gyrus volume was not correlated with memory scores at baseline, CA1 atrophy was an independent correlate of episodic verbal memory performance one year after CIS (ß = 0.87, p < .05). CONCLUSION The hippocampal degenerative process spread from dentate gyrus to CA1 at the earliest stage of MS. This dynamic vulnerability is associated with MS diagnosis after CIS and will ultimately impact hippocampal-dependent memory performance.
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Affiliation(s)
- Vincent Planche
- Univ. Bordeaux, Bordeaux, F-33000, France.,Inserm U1215 - Neurocentre Magendie, Bordeaux, F-33000, France.,CHU de Bordeaux, Bordeaux, F-33000, France
| | - Ismail Koubiyr
- Univ. Bordeaux, Bordeaux, F-33000, France.,Inserm U1215 - Neurocentre Magendie, Bordeaux, F-33000, France
| | - José E Romero
- Instituto Universitario de Tecnologías de la Información y Comunicaciones (ITACA), Universitat Politècnica de València, Camino de Vera s/n, Valencia, 46022, España
| | - José V Manjon
- Instituto Universitario de Tecnologías de la Información y Comunicaciones (ITACA), Universitat Politècnica de València, Camino de Vera s/n, Valencia, 46022, España
| | - Pierrick Coupé
- Laboratoire Bordelais de Recherche en Informatique, UMR CNRS 5800, PICTURA, Talence, F-33405, France
| | | | - Vincent Dousset
- Univ. Bordeaux, Bordeaux, F-33000, France.,Inserm U1215 - Neurocentre Magendie, Bordeaux, F-33000, France.,CHU de Bordeaux, Bordeaux, F-33000, France
| | - Bruno Brochet
- Univ. Bordeaux, Bordeaux, F-33000, France.,Inserm U1215 - Neurocentre Magendie, Bordeaux, F-33000, France.,CHU de Bordeaux, Bordeaux, F-33000, France
| | - Aurélie Ruet
- Univ. Bordeaux, Bordeaux, F-33000, France.,Inserm U1215 - Neurocentre Magendie, Bordeaux, F-33000, France.,CHU de Bordeaux, Bordeaux, F-33000, France
| | - Thomas Tourdias
- Univ. Bordeaux, Bordeaux, F-33000, France.,Inserm U1215 - Neurocentre Magendie, Bordeaux, F-33000, France.,CHU de Bordeaux, Bordeaux, F-33000, France
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28
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Yrondi A, Aouizerate B, El-Hage W, Moliere F, Thalamas C, Delcourt N, Sporer M, Taib S, Schmitt L, Arlicot N, Meligne D, Sommet A, Salabert AS, Guillaume S, Courtet P, Galtier F, Mariano-Goulart D, Champfleur NMD, Bars EL, Desmidt T, Lemaire M, Camus V, Santiago-Ribeiro MJ, Cottier JP, Fernandez P, Meyer M, Dousset V, Doumy O, Delhaye D, Capuron L, Leboyer M, Haffen E, Péran P, Payoux P, Arbus C. Assessment of Translocator Protein Density, as Marker of Neuroinflammation, in Major Depressive Disorder: A Pilot, Multicenter, Comparative, Controlled, Brain PET Study (INFLADEP Study). Front Psychiatry 2018; 9:326. [PMID: 30087626 PMCID: PMC6066663 DOI: 10.3389/fpsyt.2018.00326] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 06/29/2018] [Indexed: 12/28/2022] Open
Abstract
Background: Major depressive disorder (MDD) is a serious public health problem with high lifetime prevalence (4.4-20%) in the general population. The monoamine hypothesis is the most widespread etiological theory of MDD. Also, recent scientific data has emphasized the importance of immuno-inflammatory pathways in the pathophysiology of MDD. The lack of data on the magnitude of brain neuroinflammation in MDD is the main limitation of this inflammatory hypothesis. Our team has previously demonstrated the relevance of [18F] DPA-714 as a neuroinflammation biomarker in humans. We formulated the following hypotheses for the current study: (i) Neuroinflammation in MDD can be measured by [18F] DPA-714; (ii) its levels are associated with clinical severity; (iii) it is accompanied by anatomical and functional alterations within the frontal-subcortical circuits; (iv) it is a marker of treatment resistance. Methods: Depressed patients will be recruited throughout 4 centers (Bordeaux, Montpellier, Tours, and Toulouse) of the French network from 13 expert centers for resistant depression. The patient population will be divided into 3 groups: (i) experimental group-patients with current MDD (n = 20), (ii) remitted depressed group-patients in remission but still being treated (n = 20); and, (iii) control group without any history of MDD (n = 20). The primary objective will be to compare PET data (i.e., distribution pattern of neuroinflammation) between the currently depressed group and the control group. Secondary objectives will be to: (i) compare neuroinflammation across groups (currently depressed group vs. remitted depressed group vs. control group); (ii) correlate neuroinflammation with clinical severity across groups; (iii) correlate neuroinflammation with MRI parameters for structural and functional integrity across groups; (iv) correlate neuroinflammation and peripheral markers of inflammation across groups. Discussion: This study will assess the effects of antidepressants on neuroinflammation as well as its role in the treatment response. It will contribute to clarify the putative relationships between neuroinflammation quantified by brain neuroimaging techniques and peripheral markers of inflammation. Lastly, it is expected to open innovative and promising therapeutic perspectives based on anti-inflammatory strategies for the management of treatment-resistant forms of MDD commonly seen in clinical practice. Clinical trial registration (reference: NCT03314155): https://www.clinicaltrials.gov/ct2/show/NCT03314155?term=neuroinflammation&cond=depression&cntry=FR&rank=1.
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Affiliation(s)
- Antoine Yrondi
- Service de Psychiatrie et de Psychologie Médicale de l'Adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hôpital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Bruno Aouizerate
- Pôle de Psychiatrie Générale et Universitaire, Centre Expert Dépression Résistante FondaMental, CH Charles Perrens, UMR INRA 1286, NutriNeuro, Université de Bordeaux, Bordeaux, France
| | - Wissam El-Hage
- CHRU de Tours, Centre Expert Dépression Résistante FondaMental, Inserm U1253 iBrain, Inserm CIC 1415, Tours, France
| | - Fanny Moliere
- Department of Emergency Psychiatry and Postacute Care, Lapeyronie Hospital, CHU Montpellier, Expert Center for Resistant Depression, Fondation Fondamental, Montpellier, France
| | - Claire Thalamas
- CIC 1436, Service de Pharmacologie Clinique, CHU de Toulouse, INSERM, Université de Toulouse, UPS, Toulouse, France
| | - Nicolas Delcourt
- Centre Anti Poison CHU Toulouse Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Marie Sporer
- Service de Psychiatrie et de Psychologie Médicale de l'Adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hôpital Purpan, Toulouse, France
| | - Simon Taib
- Service de Psychiatrie et de Psychologie Médicale de l'Adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hôpital Purpan, Toulouse, France
| | - Laurent Schmitt
- Service de Psychiatrie et de Psychologie Médicale de l'Adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hôpital Purpan, Toulouse, France
| | - Nicolas Arlicot
- CHRU de Tours, Unité de Radiopharmacie, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,INSERM CIC 1415, University Hospital, Tours, France
| | - Deborah Meligne
- Institut des handicaps des Handicaps Neurologiques, Psychiatriques et Sensoriels, FHU HoPeS, CHU Toulouse, France
| | - Agnes Sommet
- CIC 1436, Service de Pharmacologie Clinique, CHU de Toulouse, INSERM, Université de Toulouse, UPS, Toulouse, France.,Unité de Soutien Méthodologique à la Recherche Clinique (USMR), CHU de Toulouse, Toulouse, France
| | - Anne S Salabert
- Departement de Médecine Nucléaire, CHU Toulouse, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Sebastien Guillaume
- Department of Emergency Psychiatry and Postacute Care, Lapeyronie Hospital, CHU Montpellier, Expert Center for Resistant Depression, Fondation Fondamental, Montpellier, France.,INSERM U1061, Université de Montpellier, Montpellier, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Postacute Care, Lapeyronie Hospital, CHU Montpellier, Expert Center for Resistant Depression, Fondation Fondamental, Montpellier, France.,INSERM U1061, Université de Montpellier, Montpellier, France
| | - Florence Galtier
- Centre Hospitalier Régional Universitaire Montpellier, Montpellier, France
| | - Denis Mariano-Goulart
- PhyMedExp, Université de Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France.,Département de Médecine Nucléaire, CHU de Montpellier, Montpellier, France
| | - Nicolas Menjot De Champfleur
- Département de Neuroradiologie, Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France.,Institut d'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France.,Laboratoire Charles Coulomb, CNRS UMR 5221, Université de Montpellier, Montpellier, France.,Département d'Imagerie Médicale, Centre Hospitalier Universitaire Caremeau, Nîmes, France
| | - Emmanuelle Le Bars
- Département de Neuroradiologie, Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France.,Institut d'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France
| | - Thomas Desmidt
- CHRU de Tours, INSERM U1253, Université François Rabelais de Tours, Tours, France
| | - Mathieu Lemaire
- CHRU de Tours, INSERM U1253, Université François Rabelais de Tours, Tours, France
| | - Vincent Camus
- CHRU de Tours, INSERM U1253, Université François Rabelais de Tours, Tours, France
| | - Maria J Santiago-Ribeiro
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,INSERM CIC 1415, University Hospital, Tours, France.,Service de Médecine Nucléaire, CHRU Tours, Tours, France
| | - Jean P Cottier
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,Service de Neuro radiologie, CHRU Tours, Tours, France
| | - Philippe Fernandez
- Departement de Médecine Nucléaire, Hopital Pellegrin, Bordeaux, France.,Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (UMR-5287), Université de Bordeaux, Bordeaux, France
| | - Marie Meyer
- Departement de Médecine Nucléaire, Hopital Pellegrin, Bordeaux, France.,Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (UMR-5287), Université de Bordeaux, Bordeaux, France
| | - Vincent Dousset
- CHU Bordeaux Neurocentre Magendie, INSERM U1215, Université de Bordeaux, Bordeaux, France
| | - Olivier Doumy
- Pôle de Psychiatrie Générale et Universitaire, Centre Expert Dépression Résistante FondaMental, CH Charles Perrens, UMR INRA 1286, NutriNeuro, Université de Bordeaux, Bordeaux, France
| | - Didier Delhaye
- Pôle de Psychiatrie Générale et Universitaire, Centre Expert Dépression Résistante FondaMental, CH Charles Perrens, Bordeaux, France
| | - Lucile Capuron
- INRA, Nutrition and Integrative Neurobiology (NutriNeuro), UMR 1286, University of Bordeaux, Bordeaux, France
| | - Marion Leboyer
- Pôle de Psychiatrie des Hôpitaux Universitaires, Centre Expert Dépression Résistante FondaMental, Hôpital Henri Mondor-Albert Chenevier, AP-HP, Créteil, France.,INSERM U955, Translational Psychiatry, Paris-Est University, Créteil, France
| | - Emmanuel Haffen
- Department of Clinical Psychiatry, Clinical Investigation Center 1431-INSERM, EA 481 Neurosciences, University of Bourgogne Franche-Comté, University Hospital of Besancon and FondaMental Foundation, Créteil, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Pierre Payoux
- Departement de Médecine Nucléaire, CHU Toulouse, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Christophe Arbus
- Service de Psychiatrie et de Psychologie Médicale de l'Adulte, Centre Expert Dépression Résistante FondaMental, CHRU de Toulouse, Hôpital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
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Van Ombergen A, Wuyts F, Jeurissen B, Sijbers J, Vanhevel F, Jillings S, Parizel P, Sunaert S, Van De Heyning P, Dousset V, Laureys S, Demertzi A. Changes in intrinsic functional brain connectivity after first-time exposure to parabolic flight. Front Physiol 2018. [DOI: 10.3389/conf.fphys.2018.26.00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Moroso A, Ruet A, Lamargue-Hamel D, Munsch F, Deloire M, Ouallet JC, Cubizolle S, Charré-Morin J, Saubusse A, Tourdias T, Dousset V, Brochet B. Preliminary evidence of the cerebellar role on cognitive performances in clinically isolated syndrome. J Neurol Sci 2017; 385:1-6. [PMID: 29406885 DOI: 10.1016/j.jns.2017.11.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 01/26/2017] [Revised: 11/02/2017] [Accepted: 11/29/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND Cerebellar and cognitive dysfunction can occur early in clinically isolated syndrome (CIS). Eye tracking is a reliable tool for the evaluation of both subtle cerebellar symptoms and cognitive impairment. OBJECTIVES To investigate the early cognitive profile using neuropsychological and ocular motor (OM) testing in CIS with and without cerebellar dysfunction with OM testing compared to healthy subjects (HS). METHODS Twenty-eight patients and 12 HC underwent OM and neuropsychological testing. Cerebellar impairment was defined by the registration of saccadic intrusions and/or at least 10% of dysmetria during ocular motor recording. Visually guided saccade (VGS), memory-guided saccade (MGS) and antisaccade (AS) paradigms were compared to neuropsychological assessments. RESULTS The group of patients with cerebellar dysfunction (n=16) performed worse on MGS latencies and error rates, and had worse working memory, executive function and information processing speed (IPS) z scores than patients without cerebellar dysfunction. IPS was correlated with the AS error rate in all patients and with the VGS error rate and the MGS final eye position ratio in cerebellar patients. CONCLUSION Eye tracking is a sensitive tool to assess cognitive and cerebellar dysfunctions in CIS. In CIS patients, cerebellar impairment is associated with working memory, executive functions and IPS slowness.
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Affiliation(s)
- Amandine Moroso
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Aurélie Ruet
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Delphine Lamargue-Hamel
- Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Fanny Munsch
- Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Mathilde Deloire
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | | | - Stéphanie Cubizolle
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | - Julie Charré-Morin
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | - Aurore Saubusse
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France
| | - Thomas Tourdias
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Vincent Dousset
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France
| | - Bruno Brochet
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, Service de Neurologie, Bordeaux F-33076, France; Université de Bordeaux, Bordeaux F-33076, France; Neurocentre Magendie, INSERM U1215, Team Glia-neuron Interactions, Bordeaux F-33077, France.
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Fougerouse A, Abou-Rahal J, Richert B, Dousset V, Beylot-Barry M, Cogrel O. Facteurs prédictifs de douleur postopératoire en chirurgie unguéale : étude prospective de 320 cas. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kuchcinski G, Munsch F, Lopes R, Bigourdan A, Su J, Sagnier S, Renou P, Pruvo JP, Rutt BK, Dousset V, Sibon I, Tourdias T. Thalamic alterations remote to infarct appear as focal iron accumulation and impact clinical outcome. Brain 2017; 140:1932-1946. [PMID: 28549087 DOI: 10.1093/brain/awx114] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 12/07/2016] [Accepted: 03/28/2017] [Indexed: 11/12/2022] Open
Abstract
See Duering and Schmidt (doi:10.1093/awx135) for a scientific commentary on this article.Thalamic alterations have been observed in infarcts initially sparing the thalamus but interrupting thalamo-cortical or cortico-thalamic projections. We aimed at extending this knowledge by demonstrating with in vivo imaging sensitive to iron accumulation, one marker of neurodegeneration, that (i) secondary thalamic alterations are focally located in specific thalamic nuclei depending on the initial infarct location; and (ii) such secondary alterations can contribute independently to the long-term outcome. To tackle this issue, 172 patients with an infarct initially sparing the thalamus were prospectively evaluated clinically and with magnetic resonance imaging to quantify iron through R2* map at 24-72 h and at 1-year follow-up. An asymmetry index was used to compare R2* within the thalamus ipsilateral versus contralateral to infarct and we focused on the 95th percentile of R2* as a metric of high iron content. Spatial distribution within the thalamus was analysed on an average R2* map from the entire cohort. The asymmetry index of the 95th percentile within individual nuclei (medio-dorsal, pulvinar, lateral group) were compared according to the initial infarct location in simple and multiple regression analyses and using voxel-based lesion-symptom mapping. Associations between the asymmetry index of the 95th percentile and functional, cognitive and emotional outcome were calculated in multiple regression models. We showed that R2* was not modified at 24-72 h but showed heterogeneous increase at 1 year mainly within the medio-dorsal and pulvinar nuclei. The asymmetry index of the 95th percentile within the medio-dorsal nucleus was significantly associated with infarcts involving anterior areas (frontal P = 0.05, temporal P = 0.02, lenticular P = 0.01) while the asymmetry index of the 95th percentile within the pulvinar nucleus was significantly associated with infarcts involving posterior areas (parietal P = 0.046, temporal P < 0.001) independently of age, gender and infarct volume, which was confirmed by voxel-based lesion-symptom mapping. The asymmetry index of the 95th percentile within the entire thalamus at 1 year was independently associated with poor functional outcome (P = 0.04), poor cognitive outcome (P = 0.03), post-stroke anxiety (P = 0.04) and post-stroke depression (P = 0.02). We have therefore identified that iron accumulates within the thalamus ipsilateral to infarct after a delay with a focal distribution that is strongly linked to the initial infarct location (in relation with the pattern of connectivity between thalamic nuclei and cortical areas or deep nuclei), which independently contributes to functional, cognitive and emotional outcome.
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Affiliation(s)
- Grégory Kuchcinski
- University of Lille, CHU Lille, Department of Neuroradiology, F-5900 Lille, France
| | - Fanny Munsch
- University of Bordeaux, CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, F-33076 Bordeaux, France.,INSERM, U1215, Neurocentre Magendie, F-33076 Bordeaux, France
| | - Renaud Lopes
- University of Lille, CHU Lille, Department of Neuroradiology, F-5900 Lille, France
| | - Antoine Bigourdan
- University of Bordeaux, CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, F-33076 Bordeaux, France
| | - Jason Su
- Richard M. Lucas Center for Imaging, Radiology Department, Stanford University, Stanford, CA 94305-5488, USA
| | - Sharmila Sagnier
- University of Bordeaux, CHU de Bordeaux, Unité neurovasculaire, F-33076 Bordeaux, France
| | - Pauline Renou
- University of Bordeaux, CHU de Bordeaux, Unité neurovasculaire, F-33076 Bordeaux, France
| | - Jean-Pierre Pruvo
- University of Lille, CHU Lille, Department of Neuroradiology, F-5900 Lille, France
| | - Brian K Rutt
- Richard M. Lucas Center for Imaging, Radiology Department, Stanford University, Stanford, CA 94305-5488, USA
| | - Vincent Dousset
- University of Bordeaux, CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, F-33076 Bordeaux, France.,INSERM, U1215, Neurocentre Magendie, F-33076 Bordeaux, France
| | - Igor Sibon
- University of Bordeaux, CHU de Bordeaux, Unité neurovasculaire, F-33076 Bordeaux, France
| | - Thomas Tourdias
- University of Bordeaux, CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, F-33076 Bordeaux, France.,INSERM, U1215, Neurocentre Magendie, F-33076 Bordeaux, France
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Moroso A, Ruet A, Lamargue-Hamel D, Munsch F, Deloire M, Coupé P, Charré-Morin J, Saubusse A, Ouallet JC, Planche V, Tourdias T, Dousset V, Brochet B. Microstructural analyses of the posterior cerebellar lobules in relapsing-onset multiple sclerosis and their implication in cognitive impairment. PLoS One 2017; 12:e0182479. [PMID: 28792528 PMCID: PMC5549727 DOI: 10.1371/journal.pone.0182479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 07/19/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The posterior cerebellar lobules seem to be the anatomical substrate of cognitive cerebellar processes, but their microstructural alterations in multiple sclerosis (MS) remain unclear. OBJECTIVES To correlate diffusion metrics in lobules VI to VIIIb in persons with clinically isolated syndrome (PwCIS) and in cognitively impaired persons with MS (CIPwMS) with their cognitive performances. METHODS Sixty-nine patients (37 PwCIS, 32 CIPwMS) and 36 matched healthy subjects (HS) underwent 3T magnetic resonance imaging, including 3D T1-weighted and diffusion tensor imaging (DTI). Fractional anisotropy (FA) and mean diffusivity (MD) were calculated within each lobule and in the cerebellar peduncles. We investigated the correlations between cognitive outcomes and the diffusion parameters of cerebellar sub-structures and performed multiple linear regression analysis to predict cognitive disability. RESULTS FA was generally lower and MD was higher in the cerebellum and specifically in the vermis Crus II, lobules VIIb and VIIIb in CIPwMS compared with PwCIS and HS. In hierarchical regression analyses, 31% of the working memory z score variance was explained by FA in the left lobule VI and in the left superior peduncle. Working memory was also associated with MD in the vermis Crus II. FA in the left lobule VI and right VIIIa predicted part of the information processing speed (IPS) z scores. CONCLUSION DTI indicators of cerebellar microstructural damage were associated with cognitive deficits in MS. Our results suggested that cerebellar lobular alterations have an impact on attention, working memory and IPS.
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Affiliation(s)
- Amandine Moroso
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Aurélie Ruet
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | | | - Fanny Munsch
- Univ. Bordeaux, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Mathilde Deloire
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Pierrick Coupé
- Univ. Bordeaux, Bordeaux, France
- LaBRI, UMR 5800, PICTURA, Talence, France
| | - Julie Charré-Morin
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Aurore Saubusse
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Jean-Christophe Ouallet
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
| | - Vincent Planche
- Univ. Bordeaux, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Thomas Tourdias
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Vincent Dousset
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Bruno Brochet
- Univ. Bordeaux, Bordeaux, France
- CHU de Bordeaux, INSERM-CHU CIC-P 0005, & Services de Neurologie et Neuroradiologie, Bordeaux, France
- Neurocentre Magendie, INSERM U1215, Bordeaux, France
- * E-mail:
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Sagnier S, Catheline G, Dilharreguy B, Munsch F, Bigourdan A, Poli M, Debruxelles S, Olindo S, Renou P, Rouanet F, Dousset V, Tourdias T, Sibon I. Admission Brain Cortical Volume. Stroke 2017. [DOI: 10.1161/strokeaha.117.017646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sharmila Sagnier
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Gwenaëlle Catheline
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Bixente Dilharreguy
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Fanny Munsch
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Antoine Bigourdan
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Mathilde Poli
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Sabrina Debruxelles
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Stéphane Olindo
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Pauline Renou
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - François Rouanet
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Vincent Dousset
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Thomas Tourdias
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
| | - Igor Sibon
- From the Unité Neuro-vasculaire (S.S., M.P., S.D., S.O., P.R., F.R., I.S.) and Neuroradiologie (F.M., A.B., V.D., T.T.), CHU de Bordeaux, France; UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University, France (S.S., G.C., B.D., I.S.); and INSERM-U862, Neurocentre Magendie, Bordeaux, France (F.M., A.B., V.D., T.T.)
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Van Ombergen A, Wuyts FL, Jeurissen B, Sijbers J, Vanhevel F, Jillings S, Parizel PM, Sunaert S, Van de Heyning PH, Dousset V, Laureys S, Demertzi A. Intrinsic functional connectivity reduces after first-time exposure to short-term gravitational alterations induced by parabolic flight. Sci Rep 2017; 7:3061. [PMID: 28607373 PMCID: PMC5468234 DOI: 10.1038/s41598-017-03170-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 12/12/2016] [Accepted: 04/26/2017] [Indexed: 11/16/2022] Open
Abstract
Spaceflight severely impacts the human body. However, little is known about how gravity and gravitational alterations affect the human brain. Here, we aimed at measuring the effects of acute exposure to gravity transitions. We exposed 28 naïve participants to repetitive alterations between normal, hyper- and microgravity induced by a parabolic flight (PF) and measured functional MRI connectivity changes. Scans were acquired before and after the PF. To mitigate motion sickness, PF participants received scopolamine prior to PF. To account for the scopolamine effects, 12 non-PF controls were scanned prior to and after scopolamine injection. Changes in functional connectivity were explored with the Intrinsic Connectivity Contrast (ICC). Seed-based analysis on the regions exhibiting localized changes was subsequently performed to understand the networks associated with the identified nodes. We found that the PF group was characterized by lower ICC scores in the right temporo-parietal junction (rTPJ), an area involved in multisensory integration and spatial tasks. The encompassed network revealed PF-related decreases in within- and inter-hemispheric anticorrelations between the rTPJ and the supramarginal gyri, indicating both altered vestibular and self-related functions. Our findings shed light on how the brain copes with gravity transitions, on gravity internalization and are relevant for the understanding of bodily self-consciousness.
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Affiliation(s)
- Angelique Van Ombergen
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Antwerp, Belgium
| | - Floris L Wuyts
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Antwerp, Belgium.
| | - Ben Jeurissen
- Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
| | - Jan Sijbers
- Vision Lab, Department of Physics, University of Antwerp, Antwerp, Belgium
| | - Floris Vanhevel
- Department of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium
| | - Steven Jillings
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Antwerp, Belgium
| | - Paul M Parizel
- Department of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium
| | - Stefan Sunaert
- KU Leuven - University of Leuven, Department of Imaging & Pathology, Translational MRI, Leuven, Belgium
| | - Paul H Van de Heyning
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Antwerp, Belgium
| | - Vincent Dousset
- University of Bordeaux, CHU de Bordeaux, INSERM Magendie, Bordeaux, France
| | - Steven Laureys
- Coma Science Group, GIGA-Research & Neurology Department, University and University Hospital of Liège, Liège, Belgium
| | - Athena Demertzi
- Coma Science Group, GIGA-Research & Neurology Department, University and University Hospital of Liège, Liège, Belgium
- Institut du Cerveau et de la Moelle Epinière - Brain and Spine Insititute, Hôpital Pitié-Salpêtrière, Paris, France
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36
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Teyssonneau D, Daste A, Dousset V, Hoepffner JL, Ravaud A, Gross-Goupil M. Metastatic non-muscle invasive bladder cancer with meningeal carcinomatosis: case report of an unexpected response. BMC Cancer 2017; 17:323. [PMID: 28494780 PMCID: PMC5425980 DOI: 10.1186/s12885-017-3309-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 05/01/2017] [Indexed: 11/17/2022] Open
Abstract
Background Non-muscle invasive bladder cancer (NMIBC) is usually treated with local therapy including transurethral resection of the bladder tumor and intravesical therapy depending on the stage of the tumor. NMIBC is a rarely a metastatic diseases with lymph node invasion in less of 10%. In the other hand meningeal carcinomatosis is a rare location for metastases with extremely poor outcomes. We described a case report of a patient presenting a metastatic disease to bones and meninges, several years after the treatment of NMIBC, which had been in complete response (CR) for 4 years after chemotherapy treatment. Case presentation A 63-years old men was treated by TURBT in 2008 for a high grade NMIBC, pT1b. Three years later he presented an acute binocular diplopy with right trochlear nerve paralysis, and labial hypoesthesia. Brain scan and MRI were performed finding a clivus infiltration and a pachymeningitis. A vertebral biopsy was performed finding an invasive carcinoma, CK7+/CK20+, TTF1-, PSA-, Thyroglobulin- and GATA3+. The metastatic event was in relation to the high grade NMIBC treated 3 years previously. Palliative chemotherapy was started with cisplatin gemcitabine. After 6 cycles and to date, 4 years later, the patient is therefore considered in complete response. Conclusion Metastasis in non-muscle invasive urothelial carcinoma is rare. Meningeal carcinomatosis outcome is poor, usually appearing in widely metastatic and progressive cancers but also because most systemic agents fail to pass the blood-brain barrier and penetrate into the cerebrospinal fluid. We described an unexpected response with complete response after chemotherapy for meningeal carcinomatosis of non muscle invasive urothelial carcinoma.
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Affiliation(s)
- Diego Teyssonneau
- Department of Medical Oncology, Saint-André hospital, University Hospital-CHU Bordeaux, 1 Rue Jean Burguet, 33000, Bordeaux, France
| | - Amaury Daste
- Department of Medical Oncology, Saint-André hospital, University Hospital-CHU Bordeaux, 1 Rue Jean Burguet, 33000, Bordeaux, France. .,University of Bordeaux, Bordeaux, France.
| | - Vincent Dousset
- University of Bordeaux, Bordeaux, France.,Neuroradiology Department, Bordeaux University Hospital, CHU Bordeaux, 33000, Bordeaux, France
| | | | - Alain Ravaud
- Department of Medical Oncology, Saint-André hospital, University Hospital-CHU Bordeaux, 1 Rue Jean Burguet, 33000, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Marine Gross-Goupil
- Department of Medical Oncology, Saint-André hospital, University Hospital-CHU Bordeaux, 1 Rue Jean Burguet, 33000, Bordeaux, France
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Frasca M, Burucoa B, Domecq S, Robinson N, Dousset V, Cadenne M, Sztark F, Floccia M. Validation of the Behavioural Observation Scale 3 for the evaluation of pain in adults. Eur J Pain 2017; 21:1475-1484. [DOI: 10.1002/ejp.1049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 11/10/2022]
Affiliation(s)
- M. Frasca
- Department of Palliative Care; University Hospital of Bordeaux; France
| | - B. Burucoa
- Department of Palliative Care; University Hospital of Bordeaux; France
| | - S. Domecq
- CCECQA Coordination and Clinical Evaluation of Quality in Aquitaine; Bordeaux France
| | - N. Robinson
- CCECQA Coordination and Clinical Evaluation of Quality in Aquitaine; Bordeaux France
| | - V. Dousset
- Centre of Evaluation and Treatment of the Pain; University Hospital of Bordeaux; France
| | - M. Cadenne
- Centre of Evaluation and Treatment of the Pain; University Hospital of Bordeaux; France
| | - F. Sztark
- Department of Anaesthesia and Resuscitation; University Hospital of Bordeaux; France
| | - M. Floccia
- Department of Geriatrics; University Hospital of Bordeaux; France
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38
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Moroso A, Ruet A, Lamargue-Hamel D, Munsch F, Deloire M, Coupé P, Ouallet JC, Planche V, Moscufo N, Meier DS, Tourdias T, Guttmann CRG, Dousset V, Brochet B. Posterior lobules of the cerebellum and information processing speed at various stages of multiple sclerosis. J Neurol Neurosurg Psychiatry 2017; 88:146-151. [PMID: 27789541 DOI: 10.1136/jnnp-2016-313867] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/20/2016] [Accepted: 10/08/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cerebellar damage has been implicated in information processing speed (IPS) impairment associated with multiple sclerosis (MS) that might result from functional disconnection in the frontocerebellar loop. Structural alterations in individual posterior lobules, in which cognitive functioning seems preponderant, are still unknown. Our aim was to investigate the impact of grey matter (GM) volume alterations in lobules VI to VIIIb on IPS in persons with clinically isolated syndrome (PwCIS), MS (PwMS) and healthy subjects (HS). METHODS 69 patients (37 PwCIS, 32 PwMS) and 36 HS underwent 3 T MRI including 3-dimensional T1-weighted MRIs. Cerebellum lobules were segmented using SUIT V.3.0 to estimate their normalised GM volume. Neuropsychological testing was performed to assess IPS and main cognitive functions. RESULTS Normalised GM volumes were significantly different between PwMS and HS for the right (p<0.001) and left lobule VI (p<0.01), left crus I, right VIIb and entire cerebellum (p<0.05 for each comparison) and between PwMS and PwCIS for all lobules in subregions VI and left crus I (p<0.05). IPS, attention and working memory were impaired in PwMS compared with PwCIS. In the whole population of patients (PwMS and PwCIS), GM loss in vermis VI (R2=0.36; p<0.05 when considering age and T2 lesion volume as covariates) were associated with IPS impairment. CONCLUSIONS GM volume decrease in posterior lobules (especially vermis VI) was associated with reduced IPS. Our results suggest a significant impact of posterior lobules pathology in corticocerebellar loop disruption resulting in automation and cognitive optimisation lack in MS. TRIAL REGISTRATION Clinicaltrail NCT01207856, NCT01865357; Pre-results.
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Affiliation(s)
- Amandine Moroso
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Aurélie Ruet
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | | | - Fanny Munsch
- University Bordeaux, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Mathilde Deloire
- Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France
| | - Pierrick Coupé
- University Bordeaux, Bordeaux, France.,LaBRI, UMR 5800, PICTURA, Talence, France
| | - Jean-Christophe Ouallet
- Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France
| | - Vincent Planche
- University Bordeaux, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Nicolas Moscufo
- Department of Radiology, Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Dominik S Meier
- Department of Radiology, Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas Tourdias
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Charles R G Guttmann
- Department of Radiology, Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Vincent Dousset
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
| | - Bruno Brochet
- University Bordeaux, Bordeaux, France.,Services de Neurologie et Neuroradiologie, CHU de Bordeaux, INSERM-CHU CIC-P 0005, Bordeaux, France.,Neurocentre Magendie, INSERM U1215, Bordeaux, France
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39
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Tellouck L, Durieux M, Coupé P, Cougnard-Grégoire A, Tellouck J, Tourdias T, Munsch F, Garrigues A, Helmer C, Malet F, Dartigues JF, Dousset V, Delcourt C, Schweitzer C. Optic Radiations Microstructural Changes in Glaucoma and Association With Severity: A Study Using 3Tesla-Magnetic Resonance Diffusion Tensor Imaging. ACTA ACUST UNITED AC 2016; 57:6539-6547. [DOI: 10.1167/iovs.16-19838] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Laury Tellouck
- CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France 2University of Bordeaux, Bordeaux, France 3INSERM, U1219-Bordeaux Population Health Research Center, Bordeaux, France
| | - Muriel Durieux
- CHU de Bordeaux, Service de Neuro-Imagerie, Bordeaux, France
| | - Pierrick Coupé
- Université de Bordeaux, LaBRI, UMR 5800, PICTURA, Talence, France 6CNRS, LaBRI, UMR 5800, PICTURA, Talence, France
| | - Audrey Cougnard-Grégoire
- University of Bordeaux, Bordeaux, France 3INSERM, U1219-Bordeaux Population Health Research Center, Bordeaux, France
| | - Joy Tellouck
- CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France
| | - Thomas Tourdias
- University of Bordeaux, Bordeaux, France 4CHU de Bordeaux, Service de Neuro-Imagerie, Bordeaux, France 7INSERM, U1215, Neurocentre Magendie, Bordeaux, France
| | - Fanny Munsch
- CHU de Bordeaux, Service de Neuro-Imagerie, Bordeaux, France
| | | | - Catherine Helmer
- University of Bordeaux, Bordeaux, France 3INSERM, U1219-Bordeaux Population Health Research Center, Bordeaux, France
| | | | - Jean-François Dartigues
- University of Bordeaux, Bordeaux, France 3INSERM, U1219-Bordeaux Population Health Research Center, Bordeaux, France
| | - Vincent Dousset
- University of Bordeaux, Bordeaux, France 4CHU de Bordeaux, Service de Neuro-Imagerie, Bordeaux, France 7INSERM, U1215, Neurocentre Magendie, Bordeaux, France
| | - Cécile Delcourt
- University of Bordeaux, Bordeaux, France 3INSERM, U1219-Bordeaux Population Health Research Center, Bordeaux, France
| | - Cédric Schweitzer
- CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France 2University of Bordeaux, Bordeaux, France 3INSERM, U1219-Bordeaux Population Health Research Center, Bordeaux, France
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40
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Crombe A, Alberti N, Hiba B, Uettwiller M, Dousset V, Tourdias T. Cervical Spinal Cord DTI Is Improved by Reduced FOV with Specific Balance between the Number of Diffusion Gradient Directions and Averages. AJNR Am J Neuroradiol 2016; 37:2163-2170. [PMID: 27365330 DOI: 10.3174/ajnr.a4850] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/25/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Reduced-FOV DTI is promising for exploring the cervical spinal cord, but the optimal set of parameters needs to be clarified. We hypothesized that the number of excitations should be favored over the number of diffusion gradient directions regarding the strong orientation of the cord in a single rostrocaudal axis. MATERIALS AND METHODS Fifteen healthy individuals underwent cervical spinal cord MR imaging at 3T, including an anatomic 3D-Multi-Echo Recombined Gradient Echo, high-resolution full-FOV DTI with a NEX of 3 and 20 diffusion gradient directions and 5 sets of reduced-FOV DTIs differently balanced in terms of NEX/number of diffusion gradient directions: (NEX/number of diffusion gradient directions = 3/20, 5/16, 7/12, 9/9, and 12/6). Each DTI sequence lasted 4 minutes 30 seconds, an acceptable duration, to cover C1-C4 in the axial plane. Fractional anisotropy maps and tractograms were reconstructed. Qualitatively, 2 radiologists rated the DTI sets blinded to the sequence. Quantitatively, we compared distortions, SNR, variance of fractional anisotropy values, and numbers of detected fibers. RESULTS Qualitatively, reduced-FOV DTI sequences with a NEX of ≥5 were significantly better rated than the full-FOV DTI and the reduced-FOV DTI with low NEX (N = 3) and a high number of diffusion gradient directions (D = 20). Quantitatively, the best trade-off was reached by the reduced-FOV DTI with a NEX of 9 and 9 diffusion gradient directions, which provided significantly fewer artifacts, higher SNR on trace at b = 750 s/mm2 and an increased number of fibers tracked while maintaining similar fractional anisotropy values and dispersion. CONCLUSIONS Optimized reduced-FOV DTI improves spinal cord imaging. The best compromise was obtained with a NEX of 9 and 9 diffusion gradient directions, which emphasizes the need for increasing the NEX at the expense of the number of diffusion gradient directions for spinal cord DTI contrary to brain DTI.
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Affiliation(s)
- A Crombe
- From the Centre Hospitalier Universitaire de Bordeaux (A.C., V.D., T.T.), Service de NeuroImagerie Diagnostique de Thérapeutique, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale U1215 (A.C., V.D., T.T.), Physiopathologie de la Plasticité Neuronale, Bordeaux, France
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
| | - N Alberti
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
- Centre de Résonance Magnétique des Systèmes Biologiques (N.A., B.H.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5536, Bordeaux, France
| | - B Hiba
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
- Centre de Résonance Magnétique des Systèmes Biologiques (N.A., B.H.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5536, Bordeaux, France
- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (B.H.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5287, Bordeaux, France
| | - M Uettwiller
- GE Healthcare (M.U.), Vélizy-Villacoublay, France
| | - V Dousset
- From the Centre Hospitalier Universitaire de Bordeaux (A.C., V.D., T.T.), Service de NeuroImagerie Diagnostique de Thérapeutique, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale U1215 (A.C., V.D., T.T.), Physiopathologie de la Plasticité Neuronale, Bordeaux, France
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
| | - T Tourdias
- From the Centre Hospitalier Universitaire de Bordeaux (A.C., V.D., T.T.), Service de NeuroImagerie Diagnostique de Thérapeutique, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale U1215 (A.C., V.D., T.T.), Physiopathologie de la Plasticité Neuronale, Bordeaux, France
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
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Planche V, Ruet A, Coupé P, Lamargue-Hamel D, Deloire M, Pereira B, Manjon JV, Munsch F, Moscufo N, Meier DS, Guttmann CR, Dousset V, Brochet B, Tourdias T. Hippocampal microstructural damage correlates with memory impairment in clinically isolated syndrome suggestive of multiple sclerosis. Mult Scler 2016; 23:1214-1224. [PMID: 27780913 DOI: 10.1177/1352458516675750] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We investigated whether diffusion tensor imaging (DTI) could reveal early hippocampal damage and clinically relevant correlates of memory impairment in persons with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS). METHODS A total of 37 persons with CIS, 32 with MS and 36 controls prospectively included from 2011 to 2014 were tested for cognitive performances and scanned with 3T-magnetic resonance imaging (MRI) to assess volumetric and DTI changes within the hippocampus, whole brain volume and T2-lesion load. RESULTS While there was no hippocampal atrophy in the CIS group, hippocampal fractional anisotropy (FA) was significantly decreased compared to controls. Decrease in hippocampal FA together with increased mean diffusivity (MD) was even more prominent in MS patients. In CIS, hippocampal MD was correlated with episodic verbal memory performance ( r = -0.57, p = 0.0002 and odds ratio (OR) = 0.058, 95% confidence interval (CI) = 0.0057-0.59, p = 0.016 adjusted for age, gender, depression and T2-lesion load), but not with cognitive tasks unrelated to hippocampal functions. Hippocampal MD was the only variable discriminating memory-impaired from memory-preserved persons with CIS (area under the curve (AUC) = 0.77, sensitivity = 90.0%, specificity = 70.3%, positive predictive value (PPV) = 52.9%, negative predictive value (NPV) = 95.0%). CONCLUSION DTI alterations within the hippocampus might reflect early neurodegenerative processes that are correlated with episodic memory performance, discriminating persons with CIS according to their memory status.
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Affiliation(s)
- Vincent Planche
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Aurélie Ruet
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Pierrick Coupé
- Laboratoire Bordelais de Recherche en Informatique (LaBRI), Talence, France
| | - Delphine Lamargue-Hamel
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France
| | - Mathilde Deloire
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Bruno Pereira
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - José V Manjon
- Universitat Politècnica de València, Valencia, Spain
| | - Fanny Munsch
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France
| | - Nicola Moscufo
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dominik S Meier
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Charles Rg Guttmann
- Universite de Bordeaux, Bordeaux, France/Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Vincent Dousset
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Bruno Brochet
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - Thomas Tourdias
- Universite de Bordeaux, Bordeaux, France/Inserm U1215, Neurocentre Magendie, Bordeaux, France/Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
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Radat F, Creac'h C, Swendsen JD, Lafittau M, Irachabal S, Dousset V, Henry P. Psychiatric Comorbidity in the Evolution From Migraine to Medication Overuse Headache. Cephalalgia 2016; 25:519-22. [PMID: 15955038 DOI: 10.1111/j.1468-2982.2005.00910.x] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We set out to study the role of psychiatric comorbidity in the evolution of migraine to medication overuse headache (MOH) by a comparative study of 41 migraineurs (MIG) and 41 patients suffering from MOH deriving from migraine. There was an excess risk of suffering from mood disorders [odds ratio (OR) = 4.5, 95% confidence interval (CI) 1.5, 13.5], anxiety (OR = 5, 95% CI 1.2, 10.7) and disorders associated with the use of psychoactive substances other than analgesics (OR = 7.6, 95% CI 2.2, 26.0) in MOH compared with MIG. Retrospective study of the order of occurrence of disorders showed that in the MOH group, psychiatric disorders occurred significantly more often before the transformation from migraine into MOH than after. There was no crossed-family transmission between MOH and psychiatric disorders, except for substance-related disorders. MOH patients have a greater risk of suffering from anxiety and depression, and these disorders may be a risk factor for the evolution of migraine into MOH. Moreover, MOH patients have a greater risk of suffering from substance-related disorders than MIG sufferers. This could be due to the fact that MOH is part of the spectrum of addictive disorders.
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Affiliation(s)
- F Radat
- Chronic Pain Treatment Unit, Centre Hospitalo-universitaire, Bordeaux, France.
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Bigourdan A, Munsch F, Coupé P, Guttmann CRG, Sagnier S, Renou P, Debruxelles S, Poli M, Dousset V, Sibon I, Tourdias T. Early Fiber Number Ratio Is a Surrogate of Corticospinal Tract Integrity and Predicts Motor Recovery After Stroke. Stroke 2016; 47:1053-9. [PMID: 26979863 DOI: 10.1161/strokeaha.115.011576] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [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: 09/20/2015] [Accepted: 02/18/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The contribution of imaging metrics to predict poststroke motor recovery needs to be clarified. We tested the added value of early diffusion tensor imaging (DTI) of the corticospinal tract toward predicting long-term motor recovery. METHODS One hundred seventeen patients were prospectively assessed at 24 to 72 hours and 1 year after ischemic stroke with diffusion tensor imaging and motor scores (Fugl-Meyer). The initial fiber number ratio (iFNr) and final fiber number ratio were computed as the number of streamlines along the affected corticospinal tract normalized to the unaffected side and were compared with each other. The prediction of motor recovery (ΔFugl-Meyer) was first modeled using initial Fugl-Meyer and iFNr. Multivariate ordinal logistic regression models were also used to study the association of iFNr, initial Fugl-Meyer, age, and stroke volume with Fugl-Meyer at 1 year. RESULTS The iFNr correlated with the final fiber number ratio at 1 year (r=0.70; P<0.0001). The initial Fugl-Meyer strongly predicted motor recovery (≈73% of initial impairment) for all patients except those with initial severe stroke (Fugl-Meyer<50). For these severe patients (n=26), initial Fugl-Meyer was not correlated with motor recovery (R(2)=0.13; p=ns), whereas iFNr showed strong correlation (R(2)=0.56; P<0.0001). In multivariate analysis, the iFNr was an independent predictor of motor outcome (β=2.601; 95% confidence interval=0.304-5.110; P=0.031), improving prediction compared with using only initial Fugl-Meyer, age, and stroke volume (P=0.026). CONCLUSIONS Early measurement of FNr at 24 to 72 hours poststroke is a surrogate marker of corticospinal tract integrity and provides independent prediction of motor outcome at 1 year especially for patients with severe initial impairment.
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Affiliation(s)
- Antoine Bigourdan
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Fanny Munsch
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Pierrick Coupé
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Charles R G Guttmann
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Sharmila Sagnier
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Pauline Renou
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Sabrina Debruxelles
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Mathilde Poli
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Vincent Dousset
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Igor Sibon
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.)
| | - Thomas Tourdias
- From the Université de Bordeaux, Bordeaux, France (A.B., F.M., P.C., C.R.G.G., V.D., I.S., T.T.); CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, Bordeaux, France (A.B., F.M., V.D., T.T.); INSERM, U1215, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); LaBRI, UMR 5800, PICTURA, Talence, France (P.C.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.G.); CHU de Bordeaux, Unité Neurovasculaire, Bordeaux, France (S.S., P.R., S.D., M.P., I.S.); and INCIA, UMR 5287, Bordeaux, France (I.S.).
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Marnat G, Berge J, Barreau X, Menegon P, Gariel F, Dousset V. First experience of combined penumbra occlusion device (POD) associated to pc-400 coils in carotid artery sacrifice: Efficacy, safety and technical note. J Neuroradiol 2016. [DOI: 10.1016/j.neurad.2016.01.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bigourdan A, Munsch F, Coupé P, Guttmann C, Sagnier S, Renou P, Debruxelles S, Poli M, Dousset V, Sibon I, Tourdias T. Prédiction de la récupération motrice après un infarctus cérébral : apport de l’imagerie en tenseur de diffusion. J Neuroradiol 2016. [DOI: 10.1016/j.neurad.2016.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tourdias T, Dousset V. Faut-il injecter ? J Neuroradiol 2016. [DOI: 10.1016/j.neurad.2016.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Marnat G, Berge J, Barreau X, Menegon P, Renou P, Olindo S, Rouanet F, Debruxelles S, Poli M, Sibon I, Dousset V. Effet du volume d’activité sur les performances organisationnelles et techniques en thrombectomie : appréciation de la courbe d’apprentissage. À propos de l’expérience du CHU de Bordeaux. J Neuroradiol 2016. [DOI: 10.1016/j.neurad.2016.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Berge J, Gariel F, Marnat G, Dousset V. PC400 volumetric coils minimize radiation, reduce procedure time and optimize packing density during endovascular treatment in medium sized cerebral aneurysms. J Neuroradiol 2015; 43:37-42. [PMID: 26687722 DOI: 10.1016/j.neurad.2015.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 09/27/2015] [Accepted: 10/28/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The Penumbra Coil 400 (PC400) is designed to improve endovascular filling for intracranial aneurysms. The aim of this retrospective, single-operator study was to compare the use of the PC400 with conventional 0.010inch coils in procedure time, X-ray exposure and packing density. METHODS We collected data from 31patients with 6 to 10mm diameter aneurysms embolized using the PC400, from May 2012 to November 2013. This group was compared with a control group of 27patients treated with conventional 0.010inch coils by the same operator. In both groups, clinical events, number of coils used, duration and cost of procedure, time of fluoroscopy and packing density were studied. RESULTS No serious adverse events were found in either group. Asymptomatic prolapse of coil loop into the parent artery were noted in two patients. Number of coils used was 4.45/6.35 in PC400 and control groups, respectively. Duration of procedure was 29.8/49.2minutes respectively (P-value=0.0002), and time of fluoroscopy was 28/41minutes (P-value=0.0109). Total radiation was 6098/6876cGy.cm(2) respectively. Comparison of packing densities after the first coil showed respectively 22.7%/10.6%, and after the final imaging, 53%/28.5% (P-values<0.0001). Complete or near complete occlusion on follow-up at 3months was 100% for PC400 versus 92% in the control group. Using 0.010inch coils may result in a 56% increase in treatment cost. CONCLUSION PC400 coils save procedural time and time of fluoroscopy, are cost saving and allow dramatic improvement of packing density on final imaging.
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Affiliation(s)
- Jérôme Berge
- Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France.
| | - Florent Gariel
- Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
| | - Gauthier Marnat
- Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
| | - Vincent Dousset
- Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
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Munsch F, Sagnier S, Asselineau J, Bigourdan A, Guttmann CR, Debruxelles S, Poli M, Renou P, Perez P, Dousset V, Sibon I, Tourdias T. Stroke Location Is an Independent Predictor of Cognitive Outcome. Stroke 2015; 47:66-73. [PMID: 26585396 DOI: 10.1161/strokeaha.115.011242] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [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: 08/24/2015] [Accepted: 10/20/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE On top of functional outcome, accurate prediction of cognitive outcome for stroke patients is an unmet need with major implications for clinical management. We investigated whether stroke location may contribute independent prognostic value to multifactorial predictive models of functional and cognitive outcomes. METHODS Four hundred twenty-eight consecutive patients with ischemic stroke were prospectively assessed with magnetic resonance imaging at 24 to 72 hours and at 3 months for functional outcome using the modified Rankin Scale and cognitive outcome using the Montreal Cognitive Assessment (MoCA). Statistical maps of functional and cognitive eloquent regions were derived from the first 215 patients (development sample) using voxel-based lesion-symptom mapping. We used multivariate logistic regression models to study the influence of stroke location (number of eloquent voxels from voxel-based lesion-symptom mapping maps), age, initial National Institutes of Health Stroke Scale and stroke volume on modified Rankin Scale and MoCA. The second part of our cohort was used as an independent replication sample. RESULTS In univariate analyses, stroke location, age, initial National Institutes of Health Stroke Scale, and stroke volume were all predictive of poor modified Rankin Scale and MoCA. In multivariable analyses, stroke location remained the strongest independent predictor of MoCA and significantly improved the prediction compared with using only age, initial National Institutes of Health Stroke Scale, and stroke volume (area under the curve increased from 0.697-0.771; difference=0.073; 95% confidence interval, 0.008-0.155). In contrast, stroke location did not persist as independent predictor of modified Rankin Scale that was mainly driven by initial National Institutes of Health Stroke Scale (area under the curve going from 0.840 to 0.835). Similar results were obtained in the replication sample. CONCLUSIONS Stroke location is an independent predictor of cognitive outcome (MoCA) at 3 months post stroke.
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Affiliation(s)
- Fanny Munsch
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Sharmila Sagnier
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Julien Asselineau
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Antoine Bigourdan
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Charles R Guttmann
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Sabrina Debruxelles
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Mathilde Poli
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Pauline Renou
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Paul Perez
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Vincent Dousset
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Igor Sibon
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.)
| | - Thomas Tourdias
- From the Université de Bordeaux, Bordeaux, France (F.M., C.R.G., V.D., I.S., T.T.); Neuroimagerie diagnostique et thérapeutique (F.M., A.B., V.D., T.T.), Unité neurovasculaire (S.S., S.D., M.P., P.R., I.S.), and Pôle de santé publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique (J.A., P.P.), CHU de Bordeaux, Bordeaux, France; INSERM, U862, Neurocentre Magendie, Bordeaux, France (F.M., V.D., T.T.); Center for Neurological Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.R.G.); and INCIA, Bordeaux, France (I.S.).
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Marnat G, Gimbert E, Berge J, Rougier MB, Molinier S, Dousset V. Chiasmatic cavernoma haemorrhage: To treat or not to treat? Concerning a clinical case. Neurochirurgie 2015; 61:343-6. [DOI: 10.1016/j.neuchi.2015.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/15/2015] [Accepted: 05/23/2015] [Indexed: 11/27/2022]
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