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Nicolas G, Zaréa A, Lacour M, Quenez O, Rousseau S, Richard AC, Bonnevalle A, Schramm C, Olaso R, Sandron F, Boland A, Deleuze JF, Andriuta D, Anthony P, Auriacombe S, Balageas AC, Ballan G, Barbay M, Béjot Y, Belliard S, Benaiteau M, Bennys K, Bombois S, Boutoleau-Bretonnière C, Branger P, Carlier J, Cartz-Piver L, Cassagnaud P, Ceccaldi MP, Chauviré V, Chen Y, Cogez J, Cognat E, Contegal-Callier F, Corneille L, Couratier P, Cretin B, Crinquette C, Dauriat B, Dautricourt S, de la Sayette V, de Liège A, Deffond D, Demurger F, Deramecourt V, Derollez C, Dionet E, Doco Fenzy M, Dumurgier J, Dutray A, Etcharry-Bouyx F, Formaglio M, Gabelle A, Gainche-Salmon A, Godefroy O, Graber M, Gregoire C, Grimaldi S, Gueniat J, Gueriot C, Guillet-Pichon V, Haffen S, Hanta CR, Hardy C, Hautecloque G, Heitz C, Hourregue C, Jonveaux T, Jurici S, Koric L, Krolak-Salmon P, Lagarde J, Lanoiselée HM, Laurens B, Le Ber I, Le Guyader G, Leblanc A, Lebouvier T, Levy R, Lippi A, Mackowiak MA, Magnin E, Marelli C, Martinaud O, Maureille A, Migliaccio R, Milongo-Rigal E, Mohr S, Mollion H, Morin A, Nivelle J, Noiray C, Olivieri P, Paquet C, Pariente J, Pasquier F, Perron A, Philippi N, Planche V, Pouclet-Courtemanche H, Rafiq M, Rollin-Sillaire A, Roué-Jagot C, Saracino D, Sarazin M, Sauvée M, Sellal F, Teichmann M, Thauvin C, Thomas Q, Tisserand C, Turpinat C, Van Damme L, Vercruysse O, Villain N, Wagemann N, Charbonnier C, Wallon D. Assessment of Mendelian and risk-factor genes in Alzheimer disease: A prospective nationwide clinical utility study and recommendations for genetic screening. Genet Med 2024; 26:101082. [PMID: 38281098 DOI: 10.1016/j.gim.2024.101082] [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: 07/11/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/29/2024] Open
Abstract
PURPOSE To assess the likely pathogenic/pathogenic (LP/P) variants rates in Mendelian dementia genes and the moderate-to-strong risk factors rates in patients with Alzheimer disease (AD). METHODS We included 700 patients in a prospective study and performed exome sequencing. A panel of 28 Mendelian and 6 risk-factor genes was interpreted and returned to patients. We built a framework for risk variant interpretation and risk gradation and assessed the detection rates among early-onset AD (EOAD, age of onset (AOO) ≤65 years, n = 608) depending on AOO and pedigree structure and late-onset AD (66 < AOO < 75, n = 92). RESULTS Twenty-one patients carried a LP/P variant in a Mendelian gene (all with EOAD, 3.4%), 20 of 21 affected APP, PSEN1, or PSEN2. LP/P variant detection rates in EOAD ranged from 1.7% to 11.6% based on AOO and pedigree structure. Risk factors were found in 69.5% of the remaining 679 patients, including 83 (12.2%) being heterozygotes for rare risk variants, in decreasing order of frequency, in TREM2, ABCA7, ATP8B4, SORL1, and ABCA1, including 5 heterozygotes for multiple rare risk variants, suggesting non-monogenic inheritance, even in some autosomal-dominant-like pedigrees. CONCLUSION We suggest that genetic screening should be proposed to all EOAD patients and should no longer be prioritized based on pedigree structure.
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Affiliation(s)
- Gaël Nicolas
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France.
| | - Aline Zaréa
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
| | - Morgane Lacour
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
| | - Olivier Quenez
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France
| | - Stéphane Rousseau
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France
| | - Anne-Claire Richard
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France
| | - Antoine Bonnevalle
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France; Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
| | - Catherine Schramm
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France
| | - Robert Olaso
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - Florian Sandron
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - Jean-François Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - Daniela Andriuta
- Service de Neurologie CHU Amiens et Laboratoire de Neurosciences Fonctionnelles et Pathologies, Université de Picardie Jules Verne, Amiens, France
| | - Pierre Anthony
- Department of Neurology, Hôpitaux Civils de Colmar, F-68000 Colmar, France
| | - Sophie Auriacombe
- Univ. Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France
| | | | | | - Mélanie Barbay
- Service de Neurologie CHU Amiens et Laboratoire de Neurosciences Fonctionnelles et Pathologies, Université de Picardie Jules Verne, Amiens, France
| | - Yannick Béjot
- Department of Neurology, University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Serge Belliard
- Unité de recherche 1077 INSERM-EPHE-UNICAEN Neuropsychologie & Imagerie de la Mémoire Humaine (NIMH), Caen, France; Centre Mémoire Ressources et Recherche Haute Bretagne, CHU Rennes, Rennes, France
| | - Marie Benaiteau
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Karim Bennys
- Memory Ressources Research Center, Department of Neurology, University Hospital of Montpellier, Montpellier, France
| | - Stéphanie Bombois
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | | | - Pierre Branger
- Department of Neurology, Caen University Hospital, Caen, France
| | - Jasmine Carlier
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Leslie Cartz-Piver
- Memory Ressources Research Center, Department of Neurology, University Hospital of Limoges, France Inserm U1094, IRD U270, EPIMACT, Université of Limoges, Limoges, France
| | | | - Mathieu-Pierre Ceccaldi
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France
| | - Valérie Chauviré
- CMRR, CRMR Neurogénétique, Service de Neurologie, CHU d'ANGERS, Angers, France
| | - Yaohua Chen
- Univ Lille, CHU Lille, Inserm 1172, Memory center, CNRMAJ, LiCEND, Labex DistAlz 59000 Lille, France
| | - Julien Cogez
- Department of Neurology, Caen University Hospital, Caen, France
| | - Emmanuel Cognat
- Cognitive Neurology Center, AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Université Paris Cité, UMR-S 1144, INSERM, Paris, France
| | | | - Léa Corneille
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France
| | | | - Benjamin Cretin
- CMRR d'Alsace, Service de Neurologie, CHU Strasbourg, Strasbourg, France
| | | | - Benjamin Dauriat
- Service de Génétique Médicale, Hopital Mère-Enfant, CHU Limoges, Limoges, France
| | - Sophie Dautricourt
- CMRR Lyon, Department of Neurology, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Vincent de la Sayette
- Department of Neurology, Caen University Hospital, Caen, France; Normandie UNIV, UNICAEN, PSL Research University, EPHE, INSERM, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Astrid de Liège
- Service de Neurologie, APHP, Hôpital Avicenne, Université Sorbonne Paris Nord, Bobigny, France
| | - Didier Deffond
- CMRR Clermont-Ferrand, Service de Neurologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Vincent Deramecourt
- Univ Lille, CHU Lille, Inserm 1172, Memory center, CNRMAJ, LiCEND, Labex DistAlz 59000 Lille, France
| | | | - Elsa Dionet
- CMRR Clermont-Ferrand, Service de Neurologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Martine Doco Fenzy
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France; CHU Nantes, Service de Génétique, Nantes, France; CHU Reims, Service de Génétique, Reims, France
| | - Julien Dumurgier
- Cognitive Neurology Center, AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Université Paris Cité, UMR-S 1144, INSERM, Paris, France
| | - Anaïs Dutray
- Service de Neurologie, Centre Hospitalier Perpignan, Perpignan, France
| | | | - Maïté Formaglio
- CMRR Lyon, Department of Neurology, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Audrey Gabelle
- Memory Ressources Research Center, Department of Neurology, University Hospital of Montpellier, Montpellier, France
| | - Anne Gainche-Salmon
- Centre Mémoire Ressources et Recherche Haute Bretagne, CHU Rennes, Rennes, France
| | - Olivier Godefroy
- Service de Neurologie CHU Amiens et Laboratoire de Neurosciences Fonctionnelles et Pathologies, Université de Picardie Jules Verne, Amiens, France
| | - Mathilde Graber
- Centre mémoire ressources et recherche, CHU Dijon, Dijon, France
| | - Chloé Gregoire
- CHU de Bordeaux, Pôle de Neurosciences Cliniques, Centre Mémoire de Ressources et de Recherche, Bordeaux, France
| | - Stephan Grimaldi
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France
| | - Julien Gueniat
- Centre mémoire ressources et recherche, CHU Dijon, Dijon, France
| | - Claude Gueriot
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France
| | | | - Sophie Haffen
- Centre mémoire Recherche Ressources, Service de Neurologie, CHU Besançon, Besançon, France
| | - Cezara-Roxana Hanta
- Centre Mémoire Ressources et Recherche Haute Bretagne, CHU Rennes, Rennes, France
| | - Clémence Hardy
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
| | | | - Camille Heitz
- Institut du cerveau Trocadero, Paris, France; Neurology Department, Hôpital Universitaire de Nîmes, Nîmes, France
| | - Claire Hourregue
- Cognitive Neurology Center, AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France
| | - Thérèse Jonveaux
- Centre Mémoire de Ressources et de Recherche de Lorraine Service de Neurologie CHRU Nancy, Nancy, France; Laboratoire 2LPN EA 7489 Université de Lorraine, Nancy, France
| | - Snejana Jurici
- Consultation Mémoire, Service de Gériatrie, Centre Hospitalier Perpignan, Perpignan, France
| | - Lejla Koric
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France; Aix-Marseille Univ, UMR 7249, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France
| | - Pierre Krolak-Salmon
- CMRR Lyon, Department of Neurology, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Julien Lagarde
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | | | - Brice Laurens
- CHU de Bordeaux, Pôle de Neurosciences Cliniques, Centre Mémoire de Ressources et de Recherche, Bordeaux, France
| | - Isabelle Le Ber
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | | | - Amélie Leblanc
- Consultations neurologiques, HIA Clermont-Tonnerre, Brest, France; Service de neurologie, CHU Cavale-Blanche, Brest, France
| | - Thibaud Lebouvier
- Univ Lille, CHU Lille, Inserm 1172, Memory center, CNRMAJ, LiCEND, Labex DistAlz 59000 Lille, France
| | - Richard Levy
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | - Anaïs Lippi
- Service de Neurologie, Hopital Gui de Chauliac, CHU de Montpellier, Montpellier, France
| | | | - Eloi Magnin
- Laboratoire de neuroscience, Université de Franche-Comté UFC et Service de Neurologie, CMRR, CHU Besançon, Besançon, France
| | - Cecilia Marelli
- Service de Neurologie, Hopital Gui de Chauliac, CHU de Montpellier, Montpellier, France
| | - Olivier Martinaud
- Department of Neurology, Caen University Hospital, Caen, France; Normandie UNIV, UNICAEN, PSL Research University, EPHE, INSERM, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | | | - Raffaella Migliaccio
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | - Emilie Milongo-Rigal
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Sophie Mohr
- Centre mémoire ressources et recherche, CHU Dijon, Dijon, France
| | - Hélène Mollion
- CMRR Lyon, Department of Neurology, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Alexandre Morin
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France; Département de Psychiatrie, Centre Hospitalier du Rouvray, Université de Rouen, 76000, Sotteville-lès-Rouen, France
| | | | - Camille Noiray
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | - Pauline Olivieri
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | - Claire Paquet
- Cognitive Neurology Center, AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Université Paris Cité, UMR-S 1144, INSERM, Paris, France
| | - Jérémie Pariente
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Toulouse NeuroImaging Center (ToNIC), INSERM-University of Toulouse Paul Sabatier, Toulouse, France
| | - Florence Pasquier
- Univ Lille, CHU Lille, Inserm 1172, Memory center, CNRMAJ, LiCEND, Labex DistAlz 59000 Lille, France
| | - Alexandre Perron
- Department of Neurology, Hôpitaux Civils de Colmar, F-68000 Colmar, France
| | - Nathalie Philippi
- CMRR d'Alsace, Service de Neurologie, CHU Strasbourg, Strasbourg, France
| | - Vincent Planche
- Univ. Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France; CHU de Bordeaux, Pôle de Neurosciences Cliniques, Centre Mémoire de Ressources et de Recherche, Bordeaux, France
| | | | - Marie Rafiq
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Toulouse NeuroImaging Center (ToNIC), INSERM-University of Toulouse Paul Sabatier, Toulouse, France
| | | | - Carole Roué-Jagot
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | - Dario Saracino
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | - Marie Sarazin
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | - Mathilde Sauvée
- Centre Mémoire de Ressources et de Recherche, Pôle PReNeLe, CHU Grenoble Alpes CS 10226, 38043 Grenoble Cedex 9, France; Unité de recherche mixte Université Grenoble Alpes/Université Savoie Montblanc, CNRS UMR 5115, Laboratoire de Psychologie et Neurocognition (LPNC), 38000 Grenoble, France
| | - François Sellal
- Department of Neurology, Hôpitaux Civils de Colmar, F-68000 Colmar, France; University of Strasbourg, Medicine Faculty, INSERM, U-1118, Strasbourg, France
| | - Marc Teichmann
- AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | - Christel Thauvin
- Genetics Center, University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Quentin Thomas
- Department of Neurology, University Hospital of Dijon, University of Burgundy, Dijon, France; Genetics Center, University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Camille Tisserand
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Cédric Turpinat
- Service de Neurologie, Hopital Gui de Chauliac, CHU de Montpellier, Montpellier, France
| | - Laurène Van Damme
- Service de Neurologie, Centre Hospitalier Perpignan, Perpignan, France
| | | | - Nicolas Villain
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | | | - Camille Charbonnier
- Univ Rouen Normandie, Inserm U1245 and CHU Rouen, Department of Biostatistics and CNRMAJ, F-76000 Rouen, France
| | - David Wallon
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
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Pommier T, Duloquin G, Pinguet V, Comby PO, Guenancia C, Béjot Y. Atrial fibrillation and preexisting cognitive impairment in ischemic stroke patients: Dijon Stroke Registry. Arch Gerontol Geriatr 2024; 123:105446. [PMID: 38640772 DOI: 10.1016/j.archger.2024.105446] [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: 01/24/2024] [Revised: 03/22/2024] [Accepted: 04/13/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Atrial Fibrillation (AF) is a common cause of ischemic stroke (IS), and is associated with cognitive impairment in the general population. We aimed to compare the prevalence of preexisting cognitive impairment between IS patients with and without AF, and to assess whether prior brain damage could contribute to the observed differences. METHODS Patients with acute IS were prospectively identified from the population-based Dijon Stroke Registry, France. Patients who had a CT-scan as brain imaging modality were included in this analysis to assess the presence of preexisting leukoaraiosis, old vascular brain lesions, and cerebral atrophy. Characteristics of patients including prior-to-stroke cognitive status (normal cognition, mild cognitive impairment (MCI), or dementia) were compared between those with and without AF. RESULTS Among 916 IS patients, 288 (31.4 %) had AF, of whom 88 had newly diagnosed AF. AF patients had more frequent prior MCI (17.8 % versus 10.2 %) or dementia (22.4 % versus 13.1 %) (p = 0.001), vascular risk factors, and preexisting brain damage. In unadjusted model, preexisting cognitive impairment was associated with AF (OR=2.24; 95 % CI: 1.49-3.37, p < 0.001 for MCI; OR=2.20; 95 % CI: 1.52-3.18, p < 0.001 for dementia). After adjustment for clinical and imaging variables, preexisting mild cognitive impairment (OR=1.87; 95 % CI: 1.06-3.32, p = 0.032) and dementia (OR=1.98; 95 % CI: 1.15-3.40, p = 0.013) were independently associated with AF. CONCLUSION AF is a common condition in IS patients and is associated with preexisting cognitive impairment. Brain lesions visible on imaging did not seem to fully account for this association that may involve other mechanisms yet to be elucidated.
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Affiliation(s)
- Thibaut Pommier
- Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Cardiology, University Hospital of Dijon, France
| | - Gauthier Duloquin
- Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Neurology, University Hospital of Dijon, 14 rue Paul Gaffarel, BP 77908, Dijon cedex 21079, France
| | - Valentin Pinguet
- Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Neuroimaging, University Hospital of Dijon, France
| | - Pierre-Olivier Comby
- Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Neuroimaging, University Hospital of Dijon, France
| | - Charles Guenancia
- Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Cardiology, University Hospital of Dijon, France
| | - Yannick Béjot
- Dijon Stroke Registry, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, EA7460, France; Department of Neurology, University Hospital of Dijon, 14 rue Paul Gaffarel, BP 77908, Dijon cedex 21079, France.
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Naghavi M, Ong KL, Aali A, Ababneh HS, Abate YH, Abbafati C, Abbasgholizadeh R, Abbasian M, Abbasi-Kangevari M, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdollahifar MA, Abdoun M, Abdulah DM, Abdullahi A, Abebe M, Abebe SS, Abedi A, Abegaz KH, Abhilash ES, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Abolmaali M, Abouzid M, Aboye GB, Abreu LG, Abrha WA, Abtahi D, Abu Rumeileh S, Abualruz H, Abubakar B, Abu-Gharbieh E, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Accrombessi MMK, Adal TG, Adamu AA, Addo IY, Addolorato G, Adebiyi AO, Adekanmbi V, Adepoju AV, Adetunji CO, Adetunji JB, Adeyeoluwa TE, Adeyinka DA, Adeyomoye OI, Admass BAA, Adnani QES, Adra S, Afolabi AA, Afzal MS, Afzal S, Agampodi SB, Agasthi P, Aggarwal M, Aghamiri S, Agide FD, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad S, Ahmad S, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed LA, Ahmed MS, Ahmed MS, Ahmed MB, 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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00367-2. [PMID: 38582094 DOI: 10.1016/s0140-6736(24)00367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation.
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CCD, Iyer M, Jaan A, Jacob L, Jadidi-Niaragh F, Jafari M, Jafarinia M, Jafarzadeh A, Jahankhani K, Jahanmehr N, Jahrami H, Jaiswal A, Jakovljevic M, Jamora RDG, Jana S, Javadi N, Javed S, Javeed S, Jayapal SK, Jayaram S, Jiang H, Johnson CO, Johnson WD, Jokar M, Jonas JB, Joseph A, Joseph N, Joshua CE, Jürisson M, Kabir A, Kabir Z, Kabito GG, Kadashetti V, Kafi F, Kalani R, Kalantar F, Kaliyadan F, Kamath A, Kamath S, Kanchan T, Kandel A, Kandel H, Kanmodi KK, Karajizadeh M, Karami J, Karanth SD, Karaye IM, Karch A, Karimi A, Karimi H, Karimi Behnagh A, Kasraei H, Kassebaum NJ, Kauppila JH, Kaur H, Kaur N, Kayode GA, Kazemi F, Keikavoosi-Arani L, Keller C, Keykhaei M, Khadembashiri MA, Khader YS, Khafaie MA, Khajuria H, Khalaji A, Khamesipour F, Khammarnia M, Khan M, Khan MAB, Khan YH, Khan Suheb MZ, Khanmohammadi S, Khanna T, Khatab K, Khatatbeh H, Khatatbeh MM, Khateri S, Khatib MN, Khayat Kashani HR, Khonji MS, khorashadizadeh F, Khormali M, Khubchandani J, Kian S, Kim G, Kim J, Kim 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Manilal A, Mansouri V, Mansournia MA, Marasini BP, Marateb HR, Maroufi SF, Martinez-Raga J, Martini S, Martins-Melo FR, Martorell M, März W, Marzo RR, Massano J, Mathangasinghe Y, Mathews E, Maude RJ, Maugeri A, Maulik PK, Mayeli M, Mazaheri M, McAlinden C, McGrath JJ, Meena JK, Mehndiratta MM, Mendez-Lopez MAM, Mendoza W, Mendoza-Cano O, Menezes RG, Merati M, Meretoja A, Merkin A, Mersha AM, Mestrovic T, Mi T, Miazgowski T, Michalek IM, Mihretie ET, Minh LHN, Mirfakhraie R, Mirica A, Mirrakhimov EM, Mirzaei M, Misganaw A, Misra S, Mithra P, Mizana BA, Mohamadkhani A, Mohamed NS, Mohammadi E, Mohammadi H, Mohammadi S, Mohammadi S, Mohammadshahi M, Mohammed M, Mohammed S, Mohammed S, Mohan S, Mojiri-forushani H, Moka N, Mokdad AH, Molinaro S, Möller H, Monasta L, Moniruzzaman M, Montazeri F, Moradi M, Moradi Y, Moradi-Lakeh M, Moraga P, Morovatdar N, Morrison SD, Mosapour A, Mosser JF, Mossialos E, Motaghinejad M, Mousavi P, Mousavi SE, Mubarik S, Muccioli L, Mughal F, Mukoro GD, Mulita A, Mulita F, Musaigwa F, Mustafa A, Mustafa G, Muthu S, Nagarajan AJ, Naghavi P, Naik GR, Nainu F, Nair TS, Najmuldeen HHR, Nakhostin Ansari N, Nambi G, Namdar Areshtanab H, Nargus S, Nascimento BR, Naser AY, Nashwan AJJ, Nasoori H, Nasreldein A, Natto ZS, Nauman J, Nayak BP, Nazri-Panjaki A, Negaresh M, Negash H, Negoi I, Negoi RI, Negru SM, Nejadghaderi SA, Nematollahi MH, Nesbit OD, Newton CRJ, Nguyen DH, Nguyen HTH, Nguyen HQ, Nguyen NTT, Nguyen PT, Nguyen VT, Niazi RK, Nikolouzakis TK, Niranjan V, Nnyanzi LA, Noman EA, Noroozi N, Norrving B, Noubiap JJ, Nri-Ezedi CA, Ntaios G, Nuñez-Samudio V, Nurrika D, Oancea B, Odetokun IA, O'Donnell MJ, Ogunsakin RE, Oguta JO, Oh IH, Okati-Aliabad H, Okeke SR, Okekunle AP, Okonji OC, Okwute PG, Olagunju AT, Olaiya MT, Olana MD, Olatubi MI, Oliveira GMM, Olufadewa II, Olusanya BO, Omar Bali A, Ong S, Onwujekwe OE, Ordak M, Orji AU, Ortega-Altamirano DV, Osuagwu UL, Otstavnov N, Otstavnov SS, Ouyahia A, Owolabi MO, P A MP, Pacheco-Barrios K, Padubidri JR, Pal PK, Palange PN, Palladino C, Palladino R, Palma-Alvarez RF, Pan F, Panagiotakos D, Panda-Jonas S, Pandey A, Pandey A, Pandian JD, Pangaribuan HU, Pantazopoulos I, Pardhan S, Parija PP, Parikh RR, Park S, Parthasarathi A, Pashaei A, Patel J, Patil S, Patoulias D, Pawar S, Pedersini P, Pensato U, Pereira DM, Pereira J, Pereira MO, Peres MFP, Perico N, Perna S, Petcu IR, Petermann-Rocha FE, Pham HT, Phillips MR, Pinilla-Monsalve GD, Piradov MA, Plotnikov E, Poddighe D, Polat B, Poluru R, Pond CD, Poudel GR, Pouramini A, Pourbagher-Shahri AM, Pourfridoni M, Pourtaheri N, Prakash PY, Prakash S, Prakash V, Prates EJS, Pritchett N, Purnobasuki H, Qasim NH, Qattea I, Qian G, Radhakrishnan V, Raee P, Raeisi Shahraki H, Rafique I, Raggi A, Raghav PR, Rahati MM, Rahim F, Rahimi Z, Rahimifard M, Rahman MO, Rahman MHU, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmani Youshanlouei H, Rahmati M, Raj Moolambally S, Rajabpour-Sanati A, Ramadan H, Ramasamy SK, Ramasubramani P, Ramazanu S, Rancic N, Rao IR, Rao SJ, Rapaka D, Rashedi V, Rashid AM, Rashidi MM, Rashidi Alavijeh M, Rasouli-Saravani A, Rawaf S, Razo C, Redwan EMM, Rekabi Bana A, Remuzzi G, Rezaei N, Rezaei N, Rezaei N, Rezaeian M, Rhee TG, Riad A, Robinson SR, Rodrigues M, Rodriguez JAB, Roever L, Rogowski ELB, Romoli M, Ronfani L, Roy P, Roy Pramanik K, Rubagotti E, Ruiz MA, Russ TC, S Sunnerhagen K, Saad AMA, Saadatian Z, Saber K, SaberiKamarposhti M, Sacco S, Saddik B, Sadeghi E, Sadeghian S, Saeed U, Saeed U, Safdarian M, Safi SZ, Sagar R, Sagoe D, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahoo SS, Sahraian MA, Sajedi SA, Sakshaug JW, Saleh MA, Salehi Omran H, Salem MR, Salimi S, Samadi Kafil H, Samadzadeh S, Samargandy S, Samodra YL, Samuel VP, Samy AM, Sanadgol N, Sanjeev RK, Sanmarchi F, Santomauro DF, Santri IN, Santric-Milicevic MM, Saravanan A, Sarveazad A, Satpathy M, Saylan M, Sayyah M, Scarmeas N, Schlaich MP, Schuermans A, Schwarzinger M, Schwebel DC, Selvaraj S, Sendekie AK, Sengupta P, Senthilkumaran S, Serban D, Sergindo MT, Sethi Y, SeyedAlinaghi S, Seylani A, Shabani M, Shabany M, Shafie M, Shahabi S, Shahbandi A, Shahid S, Shahraki-Sanavi F, Shahsavari HR, Shahwan MJ, Shaikh MA, Shaji KS, Sham S, Shama ATT, Shamim MA, Shams-Beyranvand M, Shamsi MA, Shanawaz M, Sharath M, Sharfaei S, Sharifan A, Sharma M, Sharma R, Shashamo BB, Shayan M, Sheikhi RA, Shekhar S, Shen J, Shenoy SM, Shetty PH, Shiferaw DS, Shigematsu M, Shiri R, Shittu A, Shivakumar KM, Shokri F, Shool S, Shorofi SA, Shrestha S, Siankam Tankwanchi AB, Siddig EE, Sigfusdottir ID, Silva JP, Silva LMLR, Sinaei E, Singh BB, Singh G, Singh P, Singh S, Sirota SB, Sivakumar S, Sohag AAM, Solanki R, Soleimani H, Solikhah S, Solomon Y, Solomon Y, Song S, Song Y, Sotoudeh H, Spartalis M, Stark BA, Starnes JR, Starodubova AV, Stein DJ, Steiner TJ, Stovner LJ, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sun J, Sunkersing D, Sunny A, Susianti H, Swain CK, Szeto MD, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabai S, Tabish M, Taheri M, Tahvildari A, Tajbakhsh A, Tampa M, Tamuzi JJLL, Tan KK, Tang H, Tareke M, Tarigan IU, Tat NY, Tat VY, Tavakoli Oliaee R, Tavangar SM, Tavasol A, Tefera YM, Tehrani-Banihashemi A, Temesgen WA, Temsah MH, Teramoto M, Tesfaye AH, Tesfaye EG, Tesler R, Thakali O, Thangaraju P, Thapa R, Thapar R, Thomas NK, Thrift AG, Ticoalu JHV, Tillawi T, Toghroli R, Tonelli M, Tovani-Palone MR, Traini E, Tran NM, Tran NH, Tran PV, Tromans SJ, Truelsen TC, Truyen TTTT, Tsatsakis A, Tsegay GM, Tsermpini EE, Tualeka AR, Tufa DG, Ubah CS, Udoakang AJ, Ulhaq I, Umair M, Umakanthan S, Umapathi KK, Unim B, Unnikrishnan B, Vaithinathan AG, Vakilian A, Valadan Tahbaz S, Valizadeh R, Van den Eynde J, Vart P, Varthya SB, Vasankari TJ, Vaziri S, Vellingiri B, Venketasubramanian N, Verras GI, Vervoort D, Villafañe JH, Villani L, Vinueza Veloz AF, Viskadourou M, Vladimirov SK, Vlassov V, Volovat SR, Vu LT, Vujcic IS, Wagaye B, Waheed Y, Wahood W, Walde MT, Wang F, Wang S, Wang Y, Wang YP, Waqas M, Waris A, Weerakoon KG, Weintraub RG, Weldemariam AH, Westerman R, Whisnant JL, Wickramasinghe DP, Wickramasinghe ND, Willekens B, Wilner LB, Winkler AS, Wolfe CDA, Wu AM, Wulf Hanson S, Xu S, Xu X, Yadollahpour A, Yaghoubi S, Yahya G, Yamagishi K, Yang L, Yano Y, Yao Y, Yehualashet SS, Yeshaneh A, Yesiltepe M, Yi S, Yiğit A, Yiğit V, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Yusuf H, Zadey S, Zahedi M, Zakham F, Zaki N, Zali A, Zamagni G, Zand R, Zandieh GGZ, Zangiabadian M, Zarghami A, Zastrozhin MS, Zeariya MGM, Zegeye ZB, Zeukeng F, Zhai C, Zhang C, Zhang H, Zhang Y, Zhang ZJ, Zhao H, Zhao Y, Zheng P, Zhou H, Zhu B, Zhumagaliuly A, Zielińska M, Zikarg YT, Zoladl M, Murray CJL, Ong KL, Feigin VL, Vos T, Dua T. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23:344-381. [PMID: 38493795 PMCID: PMC10949203 DOI: 10.1016/s1474-4422(24)00038-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378-521), affecting 3·40 billion (3·20-3·62) individuals (43·1%, 40·5-45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7-26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6-38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5-32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7-2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. FUNDING Bill & Melinda Gates Foundation.
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Mitaine A, Duloquin G, Pommier T, Vergely C, Guenancia C, Béjot Y. Prevalence and characteristics of known versus newly detected atrial fibrillation in ischemic stroke: a population-based study. Neuroepidemiology 2024:000538249. [PMID: 38471479 DOI: 10.1159/000538249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is frequently diagnosed during the acute stage of ischemic (IS), and it may reflect undiagnosed AF before stroke, thus representing a missed opportunity for stroke prevention. This population-based study aimed to assess the prevalence of known AF (KAF) and AF diagnosed early after IS (AFDAS), and to compare clinical and brain/arterial imaging characteristics between patients. METHODS Among patients with acute IS recorded in the population-based Dijon Stroke Registry, France (2013-2020), we identified those with KAF or AFDAS. AFDAS was considered when AF was diagnosed during the initial work-up based on electrocardiograms, in-hospital continuous electrocardiographic and/or Holter monitoring. Clinical and imaging characteristics on brain CT-scan or angio-CT-scan when available including old parenchymal lesions, arterial territory of the index IS, and aortic arch, cervical and intracranial arteries atheroma were compared between groups (KAF versus AFDAS). Regression logistic models were used to assess factors associated with AFDAS (compared to KAF). RESULTS Among 1756 IS patients, 550 (31.3%) had AF (mean age: 83.6 ±10.3 years old, 60.5% women), of whom 367 (66.7%) presented with KAF and 183 (33.3%) had AFDAS. In multivariable model, hypertension (OR=0.37; 95% CI: 0.21-0.64, p<0.001), chronic heart failure (OR=0.34; 95% CI: 0.18-0.67, p=0.002), previous stroke (OR=0.42; 95% CI: 0.26-0.67, p<0.001), and preexisting dementia (OR=0.36; 95% CI: 0.21-0.63, p<0.001), were inversely associated with AFDAS, whereas NIHSS score was associated with AFDAS (OR=1.02; 95% CI: 1.00-1.05, p=0.012). CONCLUSIONS Our findings indicate a more advanced stage of the atrial cardiomyopathy in KAF as compared with AFDAS patients, and may thus contribute to the fact that in these latter patients AF had not been diagnosed prior to stroke. This group of patients undeniably represents a missed opportunity for stroke prevention.
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Ranta A, Kang J, Saad A, Wasay M, Béjot Y, Ozturk S, Giroud M, Reis J, Douwes J. Climate Change and Stroke: A Topical Narrative Review. Stroke 2024. [PMID: 38436104 DOI: 10.1161/strokeaha.123.043826] [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: 03/05/2024]
Abstract
The impacts of accumulating atmospheric greenhouse gases on the earth's climate are now well established. As a result, there have been increases in ambient temperatures and resultant higher frequency and duration of temperature extremes and other extreme weather events, which have been linked to a wide range of adverse health outcomes. This topical narrative review provides a summary of published evidence on the links between climate change and stroke. There is consistent evidence of associations between stroke incidence and mortality and increasing ambient temperature and air pollution. Associations have also been shown for changes in barometric pressure, wildfires, and desert dust and sandstorms, but current evidence is limited. Flooding and other extreme weather events appear to primarily cause service disruption, but more direct links to stroke may emerge. Synergies between dietary changes that reduce stroke risk and may also reduce carbon footprint are being explored. We also discuss the impact on vulnerable populations, proposed pathophysiologic mechanisms, mitigation strategies, and current research priorities. In conclusion, climate change increasingly impacts the stroke community, warranting elevated attention.
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Affiliation(s)
- Anna Ranta
- Department of Medicine, University of Otago, Wellington, New Zealand (A.R., J.K.)
- Department of Neurology, Wellington Regional Hospital, New Zealand (A.R.)
| | - Janice Kang
- Department of Medicine, University of Otago, Wellington, New Zealand (A.R., J.K.)
| | - Ali Saad
- Climate & Health Program, University of Colorado, Denver (A.S.)
| | - Mohammed Wasay
- Department of Medicine, Aga Khan University, Karachi, Pakistan (M.W.)
| | - Yannick Béjot
- Dijon Stroke Registry EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases, University Hospital of Dijon, University of Burgundy, France (Y.B., M.G.)
| | - Serefnur Ozturk
- Department of Neurology, Selcuk University Faculty of Medicine, Konya, Turkey (S.O.)
| | - Maurice Giroud
- Dijon Stroke Registry EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases, University Hospital of Dijon, University of Burgundy, France (Y.B., M.G.)
| | - Jacques Reis
- Faculty of Medicine, University of Strasbourg, France (J.R.)
- Association RISE, Oberhausbergen, France (J.R.)
| | - Jeroen Douwes
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand (J.D.)
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Philippe D, Bernard A, Ricolfi F, Béjot Y, Duloquin G, Comby PO, Guenancia C. Prevalence of major embolic findings and incidental findings on early cardiac CT in patients with suspected ischemic stroke. Diagn Interv Imaging 2024:S2211-5684(24)00047-0. [PMID: 38431431 DOI: 10.1016/j.diii.2024.02.012] [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: 01/20/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE The purpose of this study was to assess the type and prevalence of stroke and non-stroke-related findings diagnosed on early cardiac computed tomography (CT) in patients with suspected stroke. The secondary objective was to assess the clinical consequences on the management of patients with non-stroke-related conditions identified by early cardiac CT. MATERIALS AND METHODS This single-center, retrospective, observational study included 1111 consecutive patients with suspected ischemic stroke between November 2018 and March 2020 who underwent cardiac CT examination in addition to the usual brain CT protocol (i.e., non-enhanced brain CT, perfusion brain CT when needed, aortic arch and supra-aortic CT angiography, and post contrast brain CT). There were 562 women and 549 men with a median age of 74 years (range: 60-85 years). Of these, 415 (415/1111; 37.4%) patients had ischemic stroke and 692 (692/1111; 62.3%) had no stroke. Cardiac CT examinations were retrospectively reviewed for cardiac CT findings at high embolic risk and clinically significant extracardiac incidental findings. RESULTS Among 1111 included patients, 89 (89/1111; 8.0%) had a stroke-related condition identified on early cardiac CT. This was significantly more frequent in patients with ischemic stroke (66/415; 15.9%) by comparison with those without ischemic stroke (23/696; 3.3%) (P < 0.001), with 41 patients (41/415; 9.9%) diagnosed with left atrial thrombus. Cardiac CT revealed a clinically significant non-stroke-related finding in 173 patients (173/1111; 15.6%), including 17 pulmonary embolisms (1.5%), seven suspicious pulmonary lesions (0.6%), and three breast lesions suspected to be malignant (0.3%). Twenty out of 173 patients (20/173; 11.5%) with incidental findings on early cardiac CT had a change in their management. CONCLUSION This study shows that adding early cardiac CT to brain CT during the acute phase of an ischemic stroke leads to a higher rate of etiological diagnoses and highlights the major interest of looking at the bigger picture.
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Affiliation(s)
- Diane Philippe
- Department of Radiology, University Hospital, 21709 Dijon, France
| | | | - Frédéric Ricolfi
- Department of Radiology, University Hospital, 21709 Dijon, France
| | - Yannick Béjot
- PEC2 EA7460, Université de Bourgogne et de Franche-Comté, 21709 Dijon, France; Department of Neurology, University Hospital, 21709 Dijon, France
| | - Gauthier Duloquin
- PEC2 EA7460, Université de Bourgogne et de Franche-Comté, 21709 Dijon, France; Department of Neurology, University Hospital, 21709 Dijon, France
| | - Pierre-Olivier Comby
- Department of Radiology, University Hospital, 21709 Dijon, France; Department of Neurology, University Hospital, 21709 Dijon, France
| | - Charles Guenancia
- PEC2 EA7460, Université de Bourgogne et de Franche-Comté, 21709 Dijon, France; Department of Cardiology, University Hospital, 21709 Dijon, France.
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Duloquin G, Pommier T, Georges M, Giroud M, Guenancia C, Béjot Y, Laurent G, Rabec C. Is COVID-19 Infection a Multiorganic Disease? Focus on Extrapulmonary Involvement of SARS-CoV-2. J Clin Med 2024; 13:1397. [PMID: 38592697 PMCID: PMC10932259 DOI: 10.3390/jcm13051397] [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: 01/21/2024] [Revised: 02/20/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
First described in December 2019 in Wuhan (China), COVID-19 disease rapidly spread worldwide, constituting the biggest pandemic in the last 100 years. Even if SARS-CoV-2, the agent responsible for COVID-19, is mainly associated with pulmonary injury, evidence is growing that this virus can affect many organs, including the heart and vascular endothelial cells, and cause haemostasis, CNS, and kidney and gastrointestinal tract abnormalities that can impact in the disease course and prognosis. In fact, COVID-19 may affect almost all the organs. Hence, SARS-CoV-2 is essentially a systemic infection that can present a large number of clinical manifestations, and it is variable in distribution and severity, which means it is potentially life-threatening. The goal of this comprehensive review paper in the series is to give an overview of non-pulmonary involvement in COVID-19, with a special focus on underlying pathophysiological mechanisms and clinical presentation.
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Affiliation(s)
- Gauthier Duloquin
- Department of Neurology, CHU Dijon-Bourgogne, 21000 Dijon, France; (G.D.); (M.G.); (Y.B.)
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, University of Bourgogne, 21000 Dijon, France; (T.P.); (C.G.); (G.L.)
| | - Thibaut Pommier
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, University of Bourgogne, 21000 Dijon, France; (T.P.); (C.G.); (G.L.)
- Department of Cardiology, University Hospital of Dijon, 21000 Dijon, France
| | - Marjolaine Georges
- Department of Pneumology and Intensive Care Unit, Reference Centre for Rare Lung Diseases, Dijon University Hospital, 14 Boulevard Gaffarel, 21000 Dijon, France;
- Centre des Sciences du Goût et de l’Alimentation, INRA, UMR 6265 CNRS 1234, University of Bourgogne Franche-Comté, 21000 Dijon, France
| | - Maurice Giroud
- Department of Neurology, CHU Dijon-Bourgogne, 21000 Dijon, France; (G.D.); (M.G.); (Y.B.)
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, University of Bourgogne, 21000 Dijon, France; (T.P.); (C.G.); (G.L.)
| | - Charles Guenancia
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, University of Bourgogne, 21000 Dijon, France; (T.P.); (C.G.); (G.L.)
- Department of Cardiology, University Hospital of Dijon, 21000 Dijon, France
| | - Yannick Béjot
- Department of Neurology, CHU Dijon-Bourgogne, 21000 Dijon, France; (G.D.); (M.G.); (Y.B.)
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, University of Bourgogne, 21000 Dijon, France; (T.P.); (C.G.); (G.L.)
| | - Gabriel Laurent
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, University of Bourgogne, 21000 Dijon, France; (T.P.); (C.G.); (G.L.)
- Department of Cardiology, University Hospital of Dijon, 21000 Dijon, France
| | - Claudio Rabec
- Department of Pneumology and Intensive Care Unit, Reference Centre for Rare Lung Diseases, Dijon University Hospital, 14 Boulevard Gaffarel, 21000 Dijon, France;
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Grygorowicz C, Benali K, Serzian G, Mouhat B, Duloquin G, Pommier T, Didier R, Laurent G, Béjot Y, Maille B, Vuillier F, Badoz M, Guenancia C. Value of HAVOC and Brown ESUS-AF scores for atrial fibrillation on implantable cardiac monitors after embolic stroke of undetermined source. J Stroke Cerebrovasc Dis 2024; 33:107451. [PMID: 37995501 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107451] [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: 08/17/2023] [Revised: 10/13/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVES Up to 20 % of ischemic strokes are associated with overt atrial fibrillation (AF). Furthermore, silent AF was detected by an implantable cardiac monitor (ICM) in 1 in 3 cryptogenic strokes in the CRYSTAL AF study. An ESC position paper has suggested a HAVOC score ≥ 4 or a Brown ESUS-AF score ≥ 2 as criteria for ICM implantation after cryptogenic stroke, but neither of these criteria has been developed or validated in ICM populations. We assessed the performance of HAVOC and Brown ESUS-AF scores in a cohort of ICM patients implanted after embolic stroke of undetermined source (ESUS). METHODS All patients implanted with an ICM for ESUS between February 2016 and February 2022 at two French University Hospitals were retrospectively included. Demographic data, cardiovascular risk factors, and clinical and biological data were collected after a review of electronic medical records. HAVOC and Brown ESUS-AF scores were calculated for all patients. FINDINGS Among the 384 patients included, 106 (27 %) developed AF during a mean follow-up of 33 months. The scores performances for predicting AF during follow-up were: HAVOC= AUC: 68.5 %, C-Index: 0.662, and Brown ESUS-AF=AUC: 72.9 %, C-index 0.712. Compared with the CHA2DS2-VASc score, only the Brown ESUS-AF score showed significant improvement in NRI/IDI. Furthermore, classifying patients according to the suggested HAVOC and Brown ESUS-AF thresholds, only 24 % and 31 % of the cohort, respectively, would have received an ICM, and 58 (55 %) and 47 (44 %) of the AF patients, respectively, would not have been implanted with an ICM. CONCLUSION HAVOC and Brown ESUS-AF scores showed close and moderate performance in predicting AF on ICM after cryptogenic stroke, with a significant lack of sensitivity. Specific risk scores should be developed and validated in large ICM cohorts.
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Affiliation(s)
| | - Karim Benali
- Cardiology Department, University Hospital, Saint-Etienne, France
| | | | - Basile Mouhat
- Cardiology Department, University Hospital, Besançon, France
| | - Gauthier Duloquin
- PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France; Neurology Department, University Hospital, Dijon, France
| | - Thibaut Pommier
- Cardiology Department, University Hospital, Dijon, France; PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France
| | - Romain Didier
- Cardiology Department, University Hospital, Dijon, France; PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France
| | - Gabriel Laurent
- Cardiology Department, University Hospital, Dijon, France; PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France
| | - Yannick Béjot
- PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France; Neurology Department, University Hospital, Dijon, France
| | - Baptiste Maille
- Cardiology Department, University Hospital, Marseille, France
| | | | - Marc Badoz
- Cardiology Department, University Hospital, Besançon, France
| | - Charles Guenancia
- Cardiology Department, University Hospital, Dijon, France; PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France.
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10
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Pommier T, Lafont A, Didier R, Garnier L, Duloquin G, Meloux A, Sagnard A, Graber M, Dogon G, Laurent G, Vergely C, Béjot Y, Guenancia C. Factors associated with patent foramen ovale-related stroke: SAFAS study. Rev Neurol (Paris) 2024; 180:33-41. [PMID: 37777437 DOI: 10.1016/j.neurol.2023.05.007] [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: 01/28/2023] [Revised: 05/08/2023] [Accepted: 05/22/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Persistent foramen ovale (PFO) contributes to cryptogenic stroke and is associated with stroke recurrence, although the exact mechanism of ischemic events is not fully understood. Several biomarkers have been developed for the prediction of atrial fibrillation after stroke, but there are currently only limited data on their potential value for the diagnosis of PFO-related stroke. METHODS This study was a prospective single-center study that included all patients hospitalized between March 31, 2018, and January 18, 2020, in the stroke department of the Dijon University Hospital for ischemic stroke without obvious cause and without a history of atrial fibrillation. PFO was systematically screened by transthoracic echocardiography and images were reviewed by an independent cardiologist blinded from clinical data. PFO was defined according to the CLOSE trial criteria: PFO associated with interatrial septal aneurysm or significant interatrial shunt (> 30 microbubbles in the left atrium within three cardiac cycles after right atrial opacification). The potential association of PFO-related stroke with biomarkers of cardiac fibrosis and inflammation such as galectin-3, GDF-15, ST-2, osteoprotegerin and NT-proBNP was tested using multivariate backward stepwise logistic regression. RESULTS Of the 240 patients included in the SAFAS study, 229 had complete echocardiographic data, and 23 (10%) had PFO-related stroke. Patients with PFO-related stroke were significantly younger (58±14 vs. 69±14, P<0.001), had less frequent previous arterial hypertension (30 vs. 60%, P=0.008), and more frequent cerebellar territory involvement (26 vs. 9%, P=0.014) compared to the other patients. In addition, they had less frequently left atrial dilatation (left atrial index volume>34mL/m2 [9 vs. 35%, P=0.009]). After ROC curve analysis for definition of thresholds, PFO-related stroke patients more often had galectin-3<9.5ng/mL (59 vs. 27%, P=0.002), ST2<13380pg/ml (23 vs. 50%, P=0.007), GDF-15<1200ng/mL (59 vs. 27%, P=0.002), osteoprotegerin<1133pg/mL (82 vs. 58%, P=0.033) and NT-proBNP<300pg/mL (88 vs. 55%, P=0.009). After multivariate analysis, only galectin-3<9.5ng/mL (OR [95% CI] 3.4 [1.18; 9.8], P=0.024) and osteoprotegerin<1133pg/L (OR [95% CI] 5.0 [1.1; 22.9], P=0.038) were independently associated with PFO-related stroke. CONCLUSION Patients in whom cryptogenic stroke is attributed to a significant PFO have a specific clinical and biological phenotype. Low levels of galectin-3 and osteoprotegerin may help identify patients with PFO-related strokes.
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Affiliation(s)
- T Pommier
- Cardiology Department, University Hospital, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France; Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France
| | - A Lafont
- Cardiology Department, University Hospital, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France
| | - R Didier
- Cardiology Department, University Hospital, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France; Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France
| | - L Garnier
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France; Neurology Department, University Hospital, Dijon, France
| | - G Duloquin
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France; Neurology Department, University Hospital, Dijon, France
| | - A Meloux
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France
| | - A Sagnard
- Cardiology Department, University Hospital, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France
| | - M Graber
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France; Neurology Department, University Hospital, Dijon, France
| | - G Dogon
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France
| | - G Laurent
- Cardiology Department, University Hospital, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France; Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France
| | - C Vergely
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France
| | - Y Béjot
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France; Neurology Department, University Hospital, Dijon, France
| | - C Guenancia
- Cardiology Department, University Hospital, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France; Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (EA 7460), Faculty of Health Sciences, université de Bourgogne, université de Bourgogne Franche-Comté, Dijon, France.
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11
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Ranta A, Ozturk S, Wasay M, Giroud M, Béjot Y, Reis J. Environmental factors and stroke: Risk and prevention. J Neurol Sci 2023; 454:120860. [PMID: 37944211 DOI: 10.1016/j.jns.2023.120860] [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: 03/06/2023] [Revised: 06/01/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
Stroke is a leading cause of death and adult disability globally. In addition to traditional risk factors, environmental risk factors have emerged over the recent past and are becoming increasingly important. The disproportionate rise of stroke incidence in low- and middle-income countries has been attributed, at least in part, to environmental factors. This narrative review provides details on the interplay between the environment and health generally and stroke specifically, covering topics including air pollution, atmospheric brown clouds, desert dust storms, giant wildfires, chemical contamination, biological aggressors, urbanization, and climate change. It also covers some beneficial environmental effects such as can be harnessed from the exposure to green spaces. It concludes with a summary of pragmatic actions that can be taken to help address some of these challenges at individual, community, and political advocacy levels.
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Affiliation(s)
- Annemarei Ranta
- Department of Medicine, University of Otago, Wellington, New Zealand; Department of Neurology, Wellington Hospital, Wellington, New Zealand.
| | - Serefnur Ozturk
- Department of Neurology, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Mohammad Wasay
- Department of Medicine, Aga Khan University, Karachi, Pakistan.
| | - Maurice Giroud
- Department of Neurology, University Hospital of Dijon, France; Dijon Stroke Registry, Pathophysiology and Epidemiology of cerebrocardiovascular diseases (EA7460), University of Bourgogne, Dijon, France.
| | - Yannick Béjot
- Department of Neurology, University Hospital of Dijon, France; Dijon Stroke Registry, Pathophysiology and Epidemiology of cerebrocardiovascular diseases (EA7460), University of Bourgogne, Dijon, France.
| | - Jacques Reis
- Faculty of Medicine, University of Strasbourg, Strasbourg, France
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12
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Seystahl K, Martinez-Majander N, Salerno A, Beyeler M, Erdur H, Marto JP, Hametner C, Zedde M, Pezzini A, Leker R, Altersberger V, Costamagna G, Serôdio M, Migliaccio L, Pascarella R, Zini A, Mannismäki L, Béjot Y, Jung S, Gensicke H, Padjen V, Ringleb PA, Nolte C, Heldner MR, Michel P, Engelter ST, Curtze S, Weller M, Wegener S. IV Thrombolysis With or Without Endovascular Treatment for Suspected Ischemic Stroke in Patients With Intracranial Tumors. Neurology 2023; 101:e1241-e1255. [PMID: 37463747 PMCID: PMC10516283 DOI: 10.1212/wnl.0000000000207624] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/19/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES IV thrombolysis (IVT) for suspected ischemic stroke in patients with intracranial neoplasms is off-label. However, data on risks of intracranial hemorrhage (ICH) are scarce. METHODS In a multicenter registry-based analysis within the European Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration, we assessed frequencies of symptomatic and fatal ICH after IVT for suspected ischemic stroke in patients with intracranial tumors by descriptive statistics and analyzed associations with clinical and imaging characteristics by binary logistic regression. Definition of symptomatic ICH was based on the clinical criteria of the European Cooperative Acute Stroke-II trial including hemorrhage at any site in cranial imaging and concurrent clinical deterioration. RESULTS Screening data of 21,289 patients from 14 centers, we identified 105 patients receiving IVT; among them were 29 patients (28%) with additional endovascular treatment, with suspected, that is, imaging-based, or histologically confirmed diagnosis of intracranial tumors. Among 104 patients with CT or MRI after IVT available, symptomatic and fatal ICH were observed in 9 and 4 patients (9% and 4%, respectively). Among 82 patients with suspected or confirmed meningioma, symptomatic and fatal ICH occurred in 6 and 3 patients (7% and 4%), respectively. In 18 patients with intra-axial suspected or confirmed primary or secondary brain tumors, there was 1 symptomatic nonfatal ICH (6%). Of 4 patients with tumors of the pituitary region, 2 patients (50%) had symptomatic ICH including 1 fatal ICH (25%). Tumor size was not associated with the occurrence of symptomatic ICH (odds ratio 2.8, 95% CI 0.3-24.8, p = 0.34). DISCUSSION In our dataset from routine clinical care, we provide insights on the safety of IVT for suspected ischemic stroke in patients with intracranial tumors, a population that is commonly withheld thrombolysis in clinical practice and prospective trials. Except for a potential high risk of symptomatic ICH after IVT in patients with tumors of the pituitary region, frequencies of symptomatic ICH in patients with intracranial tumors in our cohort seem to be in the upper range of rates observed in previous studies within the TRISP cooperation. These results may guide individual treatment decisions in patients with acute stroke and intracranial tumors with potential benefit of IVT.
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Affiliation(s)
- Katharina Seystahl
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland.
| | - Nicolas Martinez-Majander
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Alexander Salerno
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Morin Beyeler
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Hebun Erdur
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - João Pedro Marto
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Christian Hametner
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Marialuisa Zedde
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Alessandro Pezzini
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Ronen Leker
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Valerian Altersberger
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Gianluca Costamagna
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Miguel Serôdio
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Ludovica Migliaccio
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Rosario Pascarella
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Andrea Zini
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Laura Mannismäki
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Yannick Béjot
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Simon Jung
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Henrik Gensicke
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Visnja Padjen
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Peter A Ringleb
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Christian Nolte
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Mirjam R Heldner
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Patrik Michel
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Stefan T Engelter
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Sami Curtze
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Michael Weller
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
| | - Susanne Wegener
- From the Department of Neurology (K.S., M.W., S.W.), Clinical Neuroscience Center, University Hospital and University of Zurich, Switzerland; Department of Neurology (N.M.-M., L. Mannismäki, S.C.), University of Helsinki and Helsinki University Hospital, Finland; Stroke Center (A.S., G.C., P.M.), Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne; Department of Neurology (M.B., S.J., M.R.H.), Inselspital, Bern University Hospital and University of Bern; Graduate School for Health Sciences (M.B.), University of Bern, Switzerland; Department of Neurology (H.E., C.N.), Charité-Universitaetsmedizin Berlin; Center for Stroke Research (CSB) (H.E., C.N.), Berlin; and Berlin Institute of Health (BIH) (H.E., C.N.), Germany; Department of Neurology (J.P.M., M.S.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal; Department of Neurology (C.H., P.A.R.), University Hospital Heidelberg, Germany; Neurology Unit (M.Z.), Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia; Department of Clinical and Experimental Sciences (A.P.), Neurology Clinic, University of Brescia, Neurology Unit, ASST Spedali Civili, Italy; Department of Neurology (R.L.), Hebrew University Hadassah Medical Center, Jerusalem, Israel; Stroke Center and Department of Neurology (V.A., H.G., S.T.E.), University Hospital Basel and University of Basel, Switzerland; IRCCS Istituto Delle Scienze Neurologiche Di Bologna (L. Migliaccio, A.Z.), Department of Neurology and Stroke Center, Maggiore Hospital, Bologna; Neuroradiology Unit (R.P.), Azienda Unità Sanitaria Locale di Reggio Emilia, Italy; Department of Neurology (Y.B.), University Hospital Dijon, France; Neurology Clinic (V.P.), University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia; Department of Neurology and Neurorehabilitation (S.T.E.), Center for Medicine of Aging and Rehabilitation, University of Basel and University, Felix Platter Hospital, Switzerland
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Béjot Y, Pinguet V, Duloquin G. Long-Term Survival of Ischemic Stroke Patients according to Prior Cognitive Status: Dijon Stroke Registry. Neuroepidemiology 2023; 57:345-354. [PMID: 37549648 DOI: 10.1159/000533389] [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: 07/12/2023] [Accepted: 08/03/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Understanding the influence of preexisting cognitive impairment on the poststroke outcome is a critical challenge in the context of current aging and growing population. This study aimed to assess long-term survival of patients with acute ischemic stroke (IS) according to their premorbid cognitive status and to identify contributing factors of death. METHODS Patients with IS were prospectively identified among residents of Dijon, France, using a population-based registry (2013-2017). The association between case fatality at 5 years and prestroke cognitive status was assessed by multivariable Cox models adjusted for other clinical characteristics and preexisting brain damage on the initial CT scan including leukoaraiosis, old vascular brain lesions, and cortical and central brain atrophy, as well as major arterial occlusion. RESULTS 1,049 patients were included (mean age ± SD: 76.3 ± 15.2 years old, 54% women). Case fatality rates at 5 years were 38.1% in patients without cognitive impairment, 65.9% in patients with prior mild cognitive impairment (MCI, n = 132, 12.6%), and 86.6% in patients with dementia (n = 164, 15.6%) (p < 0.001). MCI (HR = 1.39; 95% CI: 1.06-1.81, p = 0.016) and dementia (HR = 1.89; 95% CI: 1.45-2.46, p < 0.001) were both independently associated with higher case fatality after adjustment for clinical variables. The association remained significant after further adjustment for preexisting brain damage and major arterial occlusion (HR = 1.47; 95% CI: 1.10-1.98, p = 0.009, for MCI and HR = 1.90; 95% CI: 1.43-2.53, p < 0.001, for dementia) among patients with available data on the CT scan (n = 916). Factors associated with death were roughly similar across groups. CONCLUSION This study highlighted a poor long-term survival of IS patients with preexisting cognitive impairment, independently of other contributing factors of death. It is critical to better understand the trajectory of IS patients with preexisting cognitive impairment and to identify prognostic markers to guide clinicians in their management strategies.
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Affiliation(s)
- Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Valentin Pinguet
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Gauthier Duloquin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
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Béjot Y. Reader Response: Teaching NeuroImage: Reinhold Hemimedullary Syndrome. Neurology 2023; 101:239. [PMID: 37524528 PMCID: PMC10401686 DOI: 10.1212/wnl.0000000000207654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
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Amaral S, Duloquin G, Béjot Y. Symptomatic Intracranial Hemorrhage after Ischemic Stroke Treated with Bridging Revascularization Therapy. Life (Basel) 2023; 13:1593. [PMID: 37511968 PMCID: PMC10381185 DOI: 10.3390/life13071593] [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: 02/24/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: bridging revascularization therapy is now the standard of care in patients with ischemic stroke due to large vessel occlusion. This study aimed to determine the frequency of symptomatic intracranial hemorrhage (sICH) related to this treatment, and to assess contributing factors and patients' outcomes. (2) Methods: consecutive ischemic stroke patients treated with bridging therapy were prospectively enrolled. sICH (intracranial hemorrhage with an increase in NIHSS score of ≥4 points) was assessed on imaging at 24 h. The functional status of patients was measured at 6 months using the mRS score; (3) Results: 176 patients were included (mean age 68.7 ± 1.2 years, 52.3% women), among whom 15 (8.5%) had sICH. Patients with sICH had more frequent alcohol abuse (30.1% versus 9.7%, p = 0.023), prestroke use of dual antiplatelet therapy (14.3% versus 1.3%, p = 0.002), higher NIHSS scores at admission (median score 20.5 versus 15, p = 0.01), greater systolic blood pressure upon admission, more frequent vascular intracranial calcifications (p = 0.004), leukoaraiosis (p = 0.001), and intracranial atheroma (p = 0.02), and higher neutrophil-to-lymphocyte ratios (p = 0.02) and neutrophil-to-platelet ratios (p = 0.04). At 6-month follow-up, 9 (60%) patients with sICH died, versus 18% of patients without sICH (p < 0.001). Only 1 (7%) patient with sICH had a good functional outcome, defined as an mRS score of 0 to 2, versus 51% of patients without sICH. (4) Conclusions: one in twelve ischemic stroke patients treated with bridging therapy suffered sICH. Given the observed poor outcomes after sICH, further studies are required to better identify patients at risk to help clinicians in guiding therapeutic strategies.
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Affiliation(s)
- Simon Amaral
- Neurology Department, Dijon University Hospital, 21000 Dijon, France
- Dijon Stroke Registry, EA7460, University of Burgundy, 21078 Dijon, France
| | - Gauthier Duloquin
- Neurology Department, Dijon University Hospital, 21000 Dijon, France
- Dijon Stroke Registry, EA7460, University of Burgundy, 21078 Dijon, France
| | - Yannick Béjot
- Neurology Department, Dijon University Hospital, 21000 Dijon, France
- Dijon Stroke Registry, EA7460, University of Burgundy, 21078 Dijon, France
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Ruel S, Baptiste L, Duloquin G, Béjot Y. Functional outcomes of ischemic stroke patients aged over 80 years treated with acute revascularization therapy according to pre-morbid disability: a PARADISE study. Front Neurol 2023; 14:1186288. [PMID: 37426437 PMCID: PMC10325647 DOI: 10.3389/fneur.2023.1186288] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/16/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Aging population leads to changes in the profile of patients with acute ischemic stroke (IS), and older adults were largely excluded from randomized clinical trials of acute revascularization therapy. This study aimed to assess functional outcomes of treated IS patients > 80 years old according to prior disability and identify associated factors. Methods Consecutively older patients with acute IS treated with either IV thrombolysis and/or mechanical thrombectomy were enrolled between 2016 and 2019. Pre-morbid disability was assessed using the modified Rankin Scale (mRS) score, and patients were classified as being independent (mRS score, 0-2) or having pre-existing disability (mRS score, 3-5). A multivariable logistic regression analysis was performed to assess factors associated with a poor functional outcome (mRS score > 3) at 3 and 12 months in each group of patients. Results Among 300 included patients (mean age: 86.3 ± 4.6 years, 63% women, median NIHSS score: 14, IQR: 8-19), 100 had a pre-existing disability. In patients with a pre-morbid mRS score of 0-2, 51% had mRS >3 including 33% of deaths at 3 months. At 12 months, 50% had a poor outcome including 39% of deaths. In patients with a pre-morbid mRS score of 3-5, 71% had a poor outcome at 3 months including 43% of deaths, and at 12 months, 76% had mRS >3 including 52% of deaths. In multivariable models, the NIHSS score at 24 h was independently associated with poor outcomes at 3 and 12 months in both patients with (OR = 1.32; 95% CI: 1.16-1.51, p < 0.001 for 12 months outcome) or without (OR = 1.31; 95% CI: 1.19-1.44, p < 0.001 for 12 months outcome) pre-morbid disability. Conclusion Although a large proportion of older patients with a pre-existing disability had a poor functional outcome, they did not differ from their non-impaired counterparts regarding prognostic factors. This means that there were no factors in our study that would help clinicians identify patients at risk of poor functional outcomes after revascularization therapy among those with prior disability. Further studies are needed to better understand the post-stroke trajectory of older IS patients with a pre-morbid disability.
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Béjot Y, Olié V, Lailler G, Grave C, Regnault N, Duloquin G, Blacher J, Gabet A. Comparison of Stroke Recurrence, Cardiovascular Events, and Death Among Patients With Pregnancy-Associated vs Non-Pregnancy-Associated Stroke. JAMA Netw Open 2023; 6:e2315235. [PMID: 37285159 DOI: 10.1001/jamanetworkopen.2023.15235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Importance Women with pregnancy-associated stroke might have different risks of stroke recurrence, including during subsequent pregnancies, and other cardiovascular events due to pregnancy-specific stroke risk factors, such as gestational hypertension, preeclampsia, or gestational diabetes. Objective To estimate the rate of stroke recurrence, cardiovascular hospitalization, and death in women with pregnancy-associated stroke compared with women with non-pregnancy-associated stroke. Design, Setting, and Participants This cohort study included all women aged 15 to 49 years in France who were affiliated with the general scheme of French health care insurance (94% of women) and had a first hospitalization for stroke between January 1, 2010, and December 31, 2018. Women were followed up until December 31, 2020, with the registration of stroke recurrence, hospitalization for cardiovascular conditions, and death. Data were from the French health care database Système National des Données de Santé. Statistical analyses were conducted between December 2021 and September 2022. Exposure Pregnancy status at the time of stroke. Main Outcomes and Measures Poisson regressions were used to estimate incidence rates of these events with 95% CIs. We used Cox proportional hazards regression models to estimate the hazard ratios (HRs) of each event during the follow-up for women with a pregnancy-associated stroke vs women with a non-pregnancy-associated stroke. Results Among women aged between 15 and 49 years between 2010 and 2018 and living in France, 1204 had a pregnancy-associated stroke at a mean (SD) age of 31.5 (5.8) years, and 31 697 had a non-pregnancy-associated stroke at a mean age of 39.6 (8.2) years. Among the 1204 women with a pregnancy-associated stroke, the incidence rate was 11.4 (95% CI, 9.0-14.3) per 1000 person-years, with 2 recurrent events during a subsequent pregnancy. Compared with women with non-pregnancy-associated stroke, women with pregnancy-associated stroke had lower risks of ischemic stroke (adjusted HR, 0.53; 95% CI, 0.36-0.77), cardiovascular events (adjusted HR, 0.58; 95% CI, 0.49-0.69), and death (adjusted HR, 0.42; 95% CI, 0.22-0.79). In contrast, the risk of recurrent intracerebral hemorrhage and cerebral venous thrombosis did not differ significantly, whereas the risks of venous thromboembolism (HR, 2.02; 95% CI, 1.14-3.58) and acute coronary syndrome with ST-segment elevation (HR, 3.93; 95% CI, 1.10-14.0) were increased. Conclusions and Relevance In this cohort study, although the risks of ischemic stroke, overall cardiovascular events, and mortality were lower after a pregnancy-associated stroke than after a non-pregnancy-associated stroke, the risks of venous thromboembolism and acute coronary syndrome with ST-segment elevation were higher. Recurrent stroke during a subsequent pregnancy remained rare.
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Affiliation(s)
- Yannick Béjot
- Dijon Stroke Registry, University Hospital and Medical School of Dijon, University of Burgundy, Burgundy, France
| | | | | | | | | | - Gauthier Duloquin
- Dijon Stroke Registry, University Hospital and Medical School of Dijon, University of Burgundy, Burgundy, France
| | - Jacques Blacher
- Diagnosis and Therapeutic Center, Hotel Dieu, Assistance Publique-Hôpitaux de Paris, University Paris Descartes, Paris, France
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Duloquin G, Béjot Y. Nationwide projections of ischemic stroke with large vessel occlusion of the anterior circulation by 2050: Dijon Stroke Registry. Front Public Health 2023; 11:1142134. [PMID: 37304110 PMCID: PMC10248396 DOI: 10.3389/fpubh.2023.1142134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Data on the epidemiology of ischemic stroke (IS) with large vessel occlusion (LVO) are scarce although there is a need to better assess future demands for dedicated facilities in an aging population. This study aimed to estimate the number of expected cases of IS with LVO of the anterior circulation in the French population by 2050. Methods IS were retrieved from the population-based registry of Dijon, France (2013-2017). Patients with LVO were identified and age-and sex-standardized incidence rates were calculated to estimate the number of expected cases in the whole French population by 2050 according three scenarios: stable incidence; a decrease in incidence rates of 0.5%/year in people >65 years old; a decrease in incidence rates of 0.5%/year in overall population. Results 1,067 cases of IS with LVO were recorded in Dijon over the study period, corresponding to crude incidence rate of 22/100,000/year (95% CI: 18-25). By 2050, the number of cases is expected to increase by 51 to 81% according to the various scenarios, to reach between 22,457 cases (95% CI: 10,839 - 43,639) and 26,763 cases (95% CI: 12,918 - 52,008) annually. This increase will be mainly driven by patients >80 years old, with a rise of cases between +103% and +42% in this age group. The proportion of patients >80 years old among overall IS with LVO will increase from 43 to 57% approximately. Conclusion The expected massive increase in IS with LVO highlights the need for a rapid action to cover stroke care requirements.
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Traenka C, Lorscheider J, Hametner C, Baumgartner P, Gralla J, Magoni M, Martinez-Majander N, Casolla B, Feil K, Pascarella R, Papanagiotou P, Nordanstig A, Padjen V, Cereda CW, Psychogios M, Nolte CH, Zini A, Michel P, Béjot Y, Kastrup A, Zedde M, Kägi G, Kellert L, Henon H, Curtze S, Pezzini A, Arnold M, Wegener S, Ringleb P, Tatlisumak T, Nederkoorn PJ, Engelter ST, Gensicke H. Recanalization Therapies for Large Vessel Occlusion Due to Cervical Artery Dissection: A Cohort Study of the EVA-TRISP Collaboration. J Stroke 2023; 25:272-281. [PMID: 37282374 DOI: 10.5853/jos.2022.03370] [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: 10/26/2022] [Accepted: 02/27/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to investigate the effect of endovascular treatment (EVT, with or without intravenous thrombolysis [IVT]) versus IVT alone on outcomes in patients with acute ischemic stroke (AIS) and intracranial large vessel occlusion (LVO) attributable to cervical artery dissection (CeAD). METHODS This multinational cohort study was conducted based on prospectively collected data from the EVA-TRISP (EndoVAscular treatment and ThRombolysis for Ischemic Stroke Patients) collaboration. Consecutive patients (2015-2019) with AIS-LVO attributable to CeAD treated with EVT and/or IVT were included. Primary outcome measures were (1) favorable 3-month outcome (modified Rankin Scale score 0-2) and (2) complete recanalization (thrombolysis in cerebral infarction scale 2b/3). Odds ratios with 95% confidence intervals (OR [95% CI]) from logistic regression models were calculated (unadjusted, adjusted). Secondary analyses were performed in the patients with LVO in the anterior circulation (LVOant) including propensity score matching. RESULTS Among 290 patients, 222 (76.6%) had EVT and 68 (23.4%) IVT alone. EVT-treated patients had more severe strokes (National Institutes of Health Stroke Scale score, median [interquartile range]: 14 [10-19] vs. 4 [2-7], P<0.001). The frequency of favorable 3-month outcome did not differ significantly between both groups (EVT: 64.0% vs. IVT: 86.8%; ORadjusted 0.56 [0.24-1.32]). EVT was associated with higher rates of recanalization (80.5% vs. 40.7%; ORadjusted 8.85 [4.28-18.29]) compared to IVT. All secondary analyses showed higher recanalization rates in the EVT-group, which however never translated into better functional outcome rates compared to the IVT-group. CONCLUSION We observed no signal of superiority of EVT over IVT regarding functional outcome in CeAD-patients with AIS and LVO despite higher rates of complete recanalization with EVT. Whether pathophysiological CeAD-characteristics or their younger age might explain this observation deserves further research.
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Affiliation(s)
- Christopher Traenka
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Johannes Lorscheider
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Christian Hametner
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Philipp Baumgartner
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Gralla
- Institute of Diagnostic and Interventional Neuroradiology University Hospital Bern, University of Bern, Bern, Switzerland
| | - Mauro Magoni
- ASST Spedali Civili, Neurologia Vascolare, Brescia, Italy
| | | | - Barbara Casolla
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Stroke Unit, UR2CA-URRIS Neurology, CHU Pasteur 2, Nice Cote d'Azur University, Nice, France
| | - Katharina Feil
- Department of Neurology, Ludwig Maximilian University (LMU), Munich, Germany
- Department of Neurology, University Hospital Tübingen, Tübingen, Germany
| | - Rosario Pascarella
- Neuroradiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Annika Nordanstig
- Department of Neurology, Sahlgrenska University Hospital and Department of Clinical Neuroscience Institute for Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Visnja Padjen
- University of Belgrade, Faculty of Medicine, Neurology Clinic, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Carlo W Cereda
- Stroke Center, Department of Neurology, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Marios Psychogios
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Christian H Nolte
- Klinik für Neurologie mit experimenteller Neurologie, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin Berlin, Germany
| | - Andrea Zini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Stroke Center, Maggiore Hospital, Bologna, Italy
| | - Patrik Michel
- Stroke Service, Neurology Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Yannick Béjot
- Department of Neurology, University Hospital Dijon, Dijon, France
| | - Andreas Kastrup
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Marialuisa Zedde
- Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Georg Kägi
- Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lars Kellert
- Department of Neurology, Ludwig Maximilian University (LMU), Munich, Germany
| | - Hilde Henon
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
| | - Sami Curtze
- Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Alessandro Pezzini
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
| | - Marcel Arnold
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Susanne Wegener
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Peter Ringleb
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Turgut Tatlisumak
- Department of Neurology, Sahlgrenska University Hospital and Department of Clinical Neuroscience Institute for Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Paul J Nederkoorn
- Department of Neurology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Stefan T Engelter
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Henrik Gensicke
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
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Béjot Y, Soilly AL, Bardou M, Duloquin G, Pommier T, Laurent G, Cottin Y, Vadot L, Adam H, Boulin M, Giroud M. Efficiency and effectiveness of intensive multidisciplinary follow-up of patients with stroke/TIA or myocardial infarction compared to usual monitoring: protocol of a pragmatic randomised clinical trial. DiVa (Dijon vascular) study. BMJ Open 2023; 13:e070197. [PMID: 37185649 PMCID: PMC10151851 DOI: 10.1136/bmjopen-2022-070197] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION The ongoing ageing population is associated with an increase in the number of patients suffering a stroke, transient ischaemic attack (TIA) or myocardial infarction (MI). In these patients, implementing secondary prevention is a critical challenge and new strategies need to be developed to close the gap between clinical practice and evidence-based recommendations. We describe the protocol of a randomised clinical trial that aims to evaluate the efficiency and effectiveness of an intensive multidisciplinary follow-up of patients compared with standard care. METHODS AND ANALYSIS The DiVa study is a randomised, prospective, controlled, multicentre trial including patients >18 years old with a first or recurrent stroke (ischaemic or haemorrhagic) or TIA, or a type I or II MI, managed in one of the participating hospitals of the study area, with a survival expectancy >12 months. Patients will be randomised with an allocation ratio of 1:1 in two parallel groups: one group assigned to a multidisciplinary, nurse-based and pharmacist-based 2-year follow-up in association with general practitioners, neurologists and cardiologists versus one group with usual follow-up. In each group for each disease (stroke/TIA or MI), 430 patients will be enrolled (total of 1720 patients) over 3 years. The primary outcome will be the incremental cost-utility ratio at 24 months between intensive and standard follow-up in a society perspective. Secondary outcomes will include the incremental cost-utility ratio at 6 and 12 months, the incremental cost-effectiveness ratio at 24 months, reduction at 6, 12 and 24 months of the rates of death, unscheduled rehospitalisation and iatrogenic complications, changes in quality of life, net budgetary impact at 5 years of the intensive follow-up on the national health insurance perspective and analysis of factors having positive or negative effects on the implementation of the project in the study area. ETHICS AND DISSEMINATION Ethical approval was obtained and all patients receive information about the study and give their consent to participate before randomisation. Results of the main trial and each of the secondary analyses will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT04188457. Registered on 6 December 2019.
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Affiliation(s)
- Yannick Béjot
- Neurology, University Hospital Centre Dijon Bourgogne, Dijon, France
| | - Anne-Laure Soilly
- Department of Clinical Research and Innovation, Clinical Research Unit-Methodological Support Network (USMR), University Hospital Centre Dijon Bourgogne, Dijon, France
| | - Marc Bardou
- Gastroenterology, University Hospital Centre Dijon Bourgogne, Dijon, France
- CIC-Inserm 1432, University of Burgundy, Dijon, France
| | - Gauthier Duloquin
- Neurology, University Hospital Centre Dijon Bourgogne, Dijon, France
| | - Thibaut Pommier
- Cardiology, University Hospital Centre Dijon Bourgogne, Dijon, France
| | - Gabriel Laurent
- Cardiology, University Hospital Centre Dijon Bourgogne, Dijon, France
| | - Yves Cottin
- Cardiology, University Hospital Centre Dijon Bourgogne, Dijon, France
| | - Lucie Vadot
- Pharmacy, University Hospital Centre Dijon Bourgogne, Dijon, France
| | - Héloïse Adam
- Pharmacy, University Hospital Centre Dijon Bourgogne, Dijon, France
| | - Mathieu Boulin
- Pharmacy, University Hospital Centre Dijon Bourgogne, Dijon, France
| | - Maurice Giroud
- Neurology, University Hospital Centre Dijon Bourgogne, Dijon, France
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Jakubina P, Meloux A, Duloquin G, Aho S, Vergely C, Béjot Y. Plasma growth differentiation factor - 8 / Myostatin level as prognostic biomarker of patients with ischemic stroke and acute revascularization therapy. PARADISE study. J Neurol Sci 2023; 448:120611. [PMID: 36958132 DOI: 10.1016/j.jns.2023.120611] [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: 10/28/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Identifying biological markers of ischemic stroke (IS) is an important research approach to develop innovative therapeutic strategies. This study aimed to assess the association between plasma Growth Differentiation Factor-8 (GDF-8)/Myostatin levels and outcome of IS patients. METHODS Consecutive patients with acute IS treated with either intravenous thrombolysis and/or mechanical thrombectomy at Dijon University Hospital, France were prospectively included. Clinical variables were recorded, and plasma GDF-8 was collected just after the revascularization procedure. Primary endpoint was functional outcome at 3 months assessed by the modified Rankin Scale (mRS) score. Secondary endpoints included mRS scores at 6 and 12 months, and overall mortality over 1-year of follow-up. RESULTS Among the 173 included patients (median age: 76 years, Interquartile range (IQR): 66-85; 49% women), median plasma GDF-8 levels at admission were significantly lower in those with a poor outcome at 3 months defined as a mRS score > 2 (2073 (IQR: 1564-2757) pg/mL versus 1471 (1192-2241) pg/mL, p < 0.001). Lower GDF-8 levels at admission were associated with higher 3-months mRS score in multivariable ordinal logistic regression analysis (OR = 0.9995; 95% CI: 0.9991-0.9999, p = 0.011). The association was also observed with 6- and 12-month mRS scores. Although mortality was higher in patients with lower GDF-8 levels, the association was not significant in multivariable Cox analysis. CONCLUSION Lower plasma GDF-8 levels were associated with a poorer functional outcome in IS patients treated with acute revascularization therapy. Underlying pathophysiological mechanisms involving GDF-8 in post-stroke outcome remain to be elucidated.
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Affiliation(s)
- Pauline Jakubina
- Dijon Stroke Registry, Department of Neurology, University Hospital of Dijon, France.; EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, France
| | - Alexandre Meloux
- EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, France
| | - Gauthier Duloquin
- Dijon Stroke Registry, Department of Neurology, University Hospital of Dijon, France.; EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, France
| | - Serge Aho
- Department of Epidemiology and Biostatistics, University Hospital of Dijon, France
| | - Catherine Vergely
- EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, France
| | - Yannick Béjot
- Dijon Stroke Registry, Department of Neurology, University Hospital of Dijon, France.; EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, France.
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Delmas E, Bourredjem A, Nacher M, Cabie A, Mimeau E, Bonithon-Kopp C, Rochemont D, Lalanne-Mistrih ML, Misslin-Tritsch C, Joux J, Lannuzel A, Fournel I, Béjot Y. Impact of Smoking on Functional Prognosis after Ischemic Stroke according to Deprivation: A Prospective Cohort Study. Neuroepidemiology 2023; 56:443-451. [PMID: 36302341 DOI: 10.1159/000526894] [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: 05/06/2022] [Accepted: 07/14/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Smoking influence on poststroke prognosis remains controversial. These conflicting results could be due to some residual confounding factors not fully considered in previous studies, including social deprivation. This study aimed to assess the joint impact of deprivation and smoking on functional outcomes after ischemic stroke. METHODS Between 2011 and 2014, 1,573 patients with a first-ever stroke were prospectively included in the French multicenter INDIA ("Inegalites sociales et pronostic des accidents vasculaires cerebraux à Dijon et Antilles-Guyane") cohort study. Patients with ischemic stroke and available data on smoking, deprivation, and outcome were considered for the analysis (n = 1,242). Deprivation was assessed using the EPICES "Evaluation de la Précarité et des Inégalites de santé dans les Centres d'Examen de Santé" score. Primary outcome was functional outcome assessed with the modified Rankin Scale (mRS) score at 12 months. Association between smoking and moderate to severe disability (mRS score ≥3) was evaluated with logistic regression model. Interactions between smoking and deprivation were tested. RESULTS Smokers (n = 189, 15.2%) were younger and more often deprived (EPICES score ≥30.17) than nonsmokers. A significant interaction was found between smoking status and deprivation on disability (p = 0.003). In nondeprived patients, the odds of moderate to severe disability at 12 months were twice as high in smokers as in nonsmokers (adjusted OR = 2.08, 95% CI: 1.04-4.18). This association was not observed in deprived patients (adjusted OR = 0.89, 95% CI: 0.49-1.61). CONCLUSION The effect of smoking on functional prognosis after ischemic stroke varied according to deprivation status, with poorer outcomes observed in nondeprived patients.
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Affiliation(s)
- Emmanuel Delmas
- CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
| | - Abderrahmane Bourredjem
- CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
| | - Mathieu Nacher
- INSERM CIC1424, Hospital Andrée Rosemon, Cayenne, France
| | - André Cabie
- INSERM CIC1424, University Hospital of Martinique, Fort-de-France, France.,University des Antilles, Fort-de-France, France
| | | | - Claire Bonithon-Kopp
- CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
| | - Devi Rochemont
- INSERM CIC1424, Hospital Andrée Rosemon, Cayenne, France
| | - Marie-Laure Lalanne-Mistrih
- INSERM CIC1424, University Hospital of Pointe-à-Pitre, Pointe-à-Pitre, France.,University of West Indies, Pointe-à-Pitre, France.,Department of Nutrition, University Hospital of Guadeloupe, Abymes, France
| | | | - Julien Joux
- Neurology Department, University Hospital of Martinique, Fort-de-France, France
| | - Annie Lannuzel
- INSERM CIC1424, University Hospital of Pointe-à-Pitre, Pointe-à-Pitre, France.,Neurology Department, University Hospital of Guadeloupe, Pointe-à-Pitre, France.,University of West Indies, Pointe-à-Pitre, France.,INSERM U 1127, CNRS, UMR 7225, Paris Brain Institute, ICM, Sorbonne University, Paris, France
| | - Isabelle Fournel
- CHU Dijon Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
| | - Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
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Béjot Y, Olié V, Lailler G, Grave C, Regnault N, Blacher J, Duloquin G, Gabet A. Acute revascularization therapy for ischemic stroke during pregnancy and post-partum in France. Eur Stroke J 2023; 8:467-474. [DOI: 10.1177/23969873231156208] [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: 02/17/2023] Open
Abstract
Introduction: Intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) in women with ischemic stroke (IS) during pregnancy/post-partum is challenging, and recent guidelines claimed for additional information to better argue its effectiveness and safety. This observational national study aimed to describe characteristics, rates and outcomes of pregnant/post-partum women receiving acute revascularization therapy for IS compared to their non-pregnant counterparts, and pregnant women with IS not receiving such therapy. Patients and methods: In this cross-sectional study, all women aged 15–49 years hospitalized in France for IS between 2012 and 2018 were retrieved from the French hospital discharge databases. Pregnant or post-partum (⩽6 weeks after delivery) women were identified. Data about patients’ characteristics, risk factors, revascularization therapy, delivery, post-stroke survival, and recurrent vascular events during follow-up were recorded. Results: Over the study period, 382 women with pregnancy-related IS were registered. Among them, 7.3% ( n = 28) received a revascularization therapy, including nine cases during pregnancy, one the same day as delivery, and 18 during the post-partum period, compared with 8.5% ( n = 1285) in women with non-pregnancy-related IS ( n = 15,084). Treated pregnant/post-partum women had more severe IS than not-treated pregnant/post-partum. Compared with treated not-pregnant women, they were younger, but did not differ regarding other characteristics including stroke severity. There were no differences in systemic or intracranial hemorrhages or in the length of hospital stay between pregnant/post-partum women compared with treated not-pregnant women. All women receiving revascularization during pregnancy had a live baby. After a mean follow-up of 4.3 years, all pregnant/post-partum women were alive, one had recurrent IS and none had other vascular events. Discussion and conclusion: Only a few women with pregnancy-related IS were treated with acute revascularization therapy, but this was proportionately similar to their non-pregnant counterparts, from whom they did not differed regarding characteristics, survival, and risk of recurrent events. These findings suggest that stroke physicians applied treatment strategies of IS in a similar way regardless of pregnancy in France, and this attitude was an anticipation but consistent with the recently published guidelines on the topic.
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Affiliation(s)
- Yannick Béjot
- Dijon Stroke Registry, Department of Neurology, University Hospital of Dijon, EA7460, Pathophysiology and Epidemiology of Cardio-Cerebrovascular Disease (PEC2), University of Burgundy, Dijon, France
| | - Valérie Olié
- French Public Health Agency, Saint-Maurice, France
| | | | | | | | - Jacques Blacher
- Diagnosis and Therapeutic Center, Hotel Dieu, AP-HP, University Paris Descartes, Paris, France
| | - Gauthier Duloquin
- Dijon Stroke Registry, Department of Neurology, University Hospital of Dijon, EA7460, Pathophysiology and Epidemiology of Cardio-Cerebrovascular Disease (PEC2), University of Burgundy, Dijon, France
| | - Amélie Gabet
- French Public Health Agency, Saint-Maurice, France
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Béjot Y. Age gap between stroke patients included in randomized clinical trials of acute revascularization therapy and those in population-based studies. A review. Neuroepidemiology 2023; 57:65-77. [PMID: 36791688 DOI: 10.1159/000529552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The ongoing aging population in high-income countries is responsible for a dramatic rise in the number of elderly stroke patients in whom many questions remain regarding the use of acute revascularization therapy. This review aimed to compare stroke patients from population-based studies to those included in RCTs in terms of age. SUMMARY Population-based incidence studies conducted in high income that complied with the defined quality criteria were reviewed (period 1985-2020). RCTs of acute ischemic stroke therapy including intravenous thrombolysis (IVT) with either alteplase or tenecteplase and mechanical thrombectomy (MT) were retrieved from systematic reviews performed in recent guidelines from the European Stroke Organisation. When available, information on either mean and/or median age was extracted from each selected article. As a result, 36 population-based registries were included, 34 of which recorded patients with first-ever stroke over 63 distinct time periods with a total of 38,188 patients. Twenty-nine RCTs enrolling 11,666 patients were identified including 13 RCTs related to IVT with alteplase, 11 RCTs about MT, and 5 RCTs on IVT with tenecteplase. A gap in age between stroke patients in the RCTs and those in population-based studies was observed. With few exceptions, mean age of patients in the RCTs was about 4 years younger than in population-based studies, while the median age was approximately 7 years younger. Thirty-five (83%) population-based incidence studies and 8 RCTs (32%) reported a mean age of patients > 70 years old. Mean age ≥ 75 years was observed in 9 (21%) population-based studies and in only 1 (4%) RCT. All population-based studies and half of the RCTs reported a median age > 70 years. KEY MESSAGES The gap in age between patients enrolled in acute stroke therapy RCTs and those from population-based studies highlights an under-representation of elderly stroke patients in RCTs. With the current aging of the population, this trend is likely to increase in the coming years, and there is a need to promote the inclusion of older patients, particularly those with disabilities, in future trials to reflect the true population of stroke patients and to help clinicians have evidence-based data to guide their decision-making.
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Sabben C, Charbonneau F, Delvoye F, Strambo D, Heldner MR, Ong E, Ter Schiphorst A, Henon H, Ben Hassen W, Agasse-Lafont T, Legris L, Sibon I, Wolff V, Sablot D, Elhorany M, Preterre C, Nehme N, Soize S, Weisenburger-Lile D, Triquenot-Bagan A, Mione G, Aignatoaie A, Papassin J, Poll R, Béjot Y, Carrera E, Garnier P, Michel P, Saliou G, Mordasini P, Berthezene Y, Costalat V, Bricout N, Albers GW, Mazighi M, Turc G, Seners P. Endovascular Therapy or Medical Management Alone for Isolated Posterior Cerebral Artery Occlusion: A Multicenter Study. Stroke 2023; 54:928-937. [PMID: 36729389 DOI: 10.1161/strokeaha.122.042283] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: Whether endovascular therapy (EVT) added on best medical management (BMM), as compared to BMM alone, is beneficial in acute ischemic stroke with isolated posterior cerebral artery (PCA) occlusion is unknown. Methods: We conducted a multicenter international observational study of consecutive stroke patients admitted within 6hrs from symptoms onset in 26 stroke centers with isolated occlusion of the first (P1) or second (P2) segment of the PCA and treated either with BMM + EVT or BMM alone. Propensity score with inverse probability of treatment weighting was used to account for baseline between-groups differences. The primary outcome was 3-month good functional outcome (modified Rankin score [mRS] 0-2 or return to baseline mRS). Secondary outcomes were 3-month excellent recovery (mRS 0-1), symptomatic intracranial hemorrhage (sICH), and early neurological deterioration. Results: Overall, 752 patients were included (167 and 585 patients in the BMM + EVT and BMM alone groups, respectively). Median age was 74 (IQR 63-82) years, 329 (44%) patients were female, median NIHSS was 6 (IQR 4-10), and occlusion site was P1 in 188 (25%) and P2 in 564 (75%) patients. Baseline clinical and radiological data were similar between the two groups following propensity-score weighting. EVT was associated with a trend towards lower odds of good functional outcome (OR=0.81; 95%CI: 0.66-1.01; P=0.06) and was not associated with excellent functional outcome (OR=1.17; 95%CI: 0.95-1.43; P=0.15). EVT was associated with a higher risk of sICH (OR=2.51; 95%CI: 1.35-4.67; P=0.004) and early neurological deterioration (OR=2.51; 95%CI: 1.64-3.84; P<0.0001). Conclusions: In this observational study of patients with proximal PCA occlusion, EVT was not associated with good or excellent functional outcome as compared to BMM alone. However, EVT was associated with higher rates of sICH and early neurological deterioration. EVT should not be routinely recommended in this population, but randomization into a clinical trial is highly warranted.
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Affiliation(s)
- Candice Sabben
- Neurology Department (C.S., P.S.), Rothschild Foundation Hospital, Paris, France
| | | | - François Delvoye
- Interventional Neuroradiology Department (F.D., M.M.), Rothschild Foundation Hospital, Paris, France
| | - Davide Strambo
- Stroke Center, Neurology Service (D.S., P.M.), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Mirjam R Heldner
- Department of Neurology, University Hospital and University of Bern, Switzerland (M.R.H.)
| | - Elodie Ong
- Stroke Department, Hospices Civils de Lyon, France (E.O.)
| | | | - Hilde Henon
- Neurology department, Stroke Center, University of Lille, Inserm U1171, CHU Lille, LilNCog - Lille Neuroscience & Cognition, France (H.H.)
| | - Wagih Ben Hassen
- Neuroradiology Department, GHU Paris Psychiatrie and Neurosciences, Paris, France (W.B.H.)
| | | | - Loïc Legris
- Neurology Department, Stroke Unit, Grenoble Alpes University Hospital, University of Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, Grenoble, France (L.L.)
| | - Igor Sibon
- Stroke Unit, Bordeaux University Hospital, France (I.S.)
| | - Valérie Wolff
- Stroke Unit, Strasbourg University Hospital, France (V.W.)
| | - Denis Sablot
- Neurology Department, CH Perpignan, France (D.S.)
| | - Mahmoud Elhorany
- Interventional Neuroradiology Department, Pitié-Salpétrière Hospital, Paris, France (M.E.)
- Neurology Department, Faculty of Medicine, Tanta University, Egypt (M.E.)
| | | | - Nour Nehme
- Neurology Department, André Mignot Hospital, Versailles, France (N.N.)
| | | | | | - Aude Triquenot-Bagan
- Neurology Department, Rouen University Hospital, F-76000, Rouen, France (A.T.-B.)
| | - Gioia Mione
- Neurology Department, University Hospital of Nancy, France (G.M.)
| | | | - Jérémie Papassin
- Neurology Department, CH Metropole Savoie, Chambery, France (J.P.)
| | - Roxana Poll
- Neurology Department, Rene Dubois Hospital, Pontoise, France (R.P.)
| | | | - Emmanuel Carrera
- Neurology Department, Geneve University Hospital, Switzerland (E.C.)
| | - Pierre Garnier
- Neurology Department, Stroke Unit, CHU St Etienne, France (P.G.)
| | - Patrik Michel
- Stroke Center, Neurology Service (D.S., P.M.), Lausanne University Hospital and University of Lausanne, Switzerland
| | - Guillaume Saliou
- Diagnostic and Interventional Radiology Department (G.S.), Lausanne University Hospital and University of Lausanne, Switzerland
| | | | - Yves Berthezene
- Neuroradiology Department, Hospices Civils de Lyon, France (Y.B.)
| | - Vincent Costalat
- Neuroradiology Department, CHRU Gui de Chauliac, Montpellier, France (V.C.)
| | - Nicolas Bricout
- Interventional Neuroradiology Department, CHU Lille, France (N.B.)
| | - Gregory W Albers
- Stanford Stroke Center, Stanford University, Palo Alto, CA (G.W.A., P.S.)
| | - Mikael Mazighi
- Interventional Neuroradiology Department (F.D., M.M.), Rothschild Foundation Hospital, Paris, France
- Neurology Department, Lariboisière Hospital, APHP Nord, INSERM 1148, Université Paris Cité, Paris, France (M.M.)
- FHU Neurovasc (M.M., G.T.)
| | - Guillaume Turc
- FHU Neurovasc (M.M., G.T.)
- Neurology Department, GHU Paris Psychiatrie and Neurosciences, Paris, France (G.T.)
- Institut de Psychiatrie et Neurosciences de Paris, INSERM UMR_S1266, Université Paris Cité, France (G.T., P.S.)
| | - Pierre Seners
- Neurology Department (C.S., P.S.), Rothschild Foundation Hospital, Paris, France
- Stanford Stroke Center, Stanford University, Palo Alto, CA (G.W.A., P.S.)
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Pinguet V, Duloquin G, Thibault T, Devilliers H, Comby PO, Crespy V, Ricolfi F, Vergely C, Giroud M, Béjot Y. Pre-existing brain damage and association between severity and prior cognitive impairment in ischemic stroke patients. J Neuroradiol 2023; 50:16-21. [PMID: 35289302 DOI: 10.1016/j.neurad.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/10/2022] [Accepted: 03/03/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND We evaluated whether pre-existing brain damage may explain greater severity in cognitively-impaired patients with ischemic stroke (IS). METHODS IS patients were retrieved from the population-based registry of Dijon, France. Pre-existing damage (leukoaraiosis, old vascular brain lesions, cortical and central brain atrophy) was assessed on initial CT-scan. Association between prestroke cognitive status defined as no impairment, mild cognitive impairment (MCI), or dementia, and clinical severity at IS onset assessed with the NIHSS score was evaluated using ordinal regression analysis. Mediation analysis was performed to assess pre-existing brain lesions as mediators of the relationship between cognitive status and severity. RESULTS Among the 916 included patients (mean age 76.8 ± 15.0 years, 54.3% women), those with pre-existing MCI (n = 115, median NIHSS [IQR]: 6 [2-15]) or dementia (n = 147, median NIHSS: 6 [3-15]) had a greater severity than patients without (n = 654, median NIHSS: 3 [1-9]) in univariate analysis (OR=1.69; 95% CI: 1.18-2.42, p = 0.004, and OR=2.06; 95% CI: 1.49-2.84, p < 0.001, respectively). Old cortical lesion (OR=1.53, p = 0.002), central atrophy (OR=1.41, p = 0.005), cortical atrophy (OR=1.90, p < 0.001) and moderate (OR=1.41, p = 0.005) or severe (OR=1.84, p = 0.002) leukoaraiosis were also associated with greater severity. After adjustments, pre-existing MCI (OR=1.52; 95% CI: 1.03-2.26, p = 0.037) or dementia (OR=1.94; 95% CI: 1.32-2.86, p = 0.001) remained associated with higher severity at IS onset, independently of confounding factors including imaging variables. Association between cognitive impairment and severity was not mediated by pre-existing visible brain damages. CONCLUSION Impaired brain ischemic tolerance in IS patients with prior cognitive impairment could involve other mechanisms than pre-existing visible brain damage.
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Affiliation(s)
- Valentin Pinguet
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, 14 rue Paul Gaffarel, Dijon 21079, France; Department of Neuroimaging, University Hospital of Dijon, France
| | - Gauthier Duloquin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, 14 rue Paul Gaffarel, Dijon 21079, France; Department of Neurology, University Hospital of Dijon, France
| | - Thomas Thibault
- INSERM CIC-1432 Clinical Investigation Center, Clinical Epidemiology, University Hospital of Dijon, France; Internal Medicine and Systemic Diseases unit, University Hospital of Dijon, France
| | - Hervé Devilliers
- INSERM CIC-1432 Clinical Investigation Center, Clinical Epidemiology, University Hospital of Dijon, France; Internal Medicine and Systemic Diseases unit, University Hospital of Dijon, France
| | - Pierre-Olivier Comby
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, 14 rue Paul Gaffarel, Dijon 21079, France; Department of Neuroimaging, University Hospital of Dijon, France
| | - Valentin Crespy
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, 14 rue Paul Gaffarel, Dijon 21079, France; Department of Vascular Surgery, University Hospital of Dijon, France
| | - Frédéric Ricolfi
- Department of Neuroimaging, University Hospital of Dijon, France
| | - Catherine Vergely
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, 14 rue Paul Gaffarel, Dijon 21079, France
| | - Maurice Giroud
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, 14 rue Paul Gaffarel, Dijon 21079, France; Department of Neurology, University Hospital of Dijon, France
| | - Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cardio-cerebrovascular disease (PEC2), University of Burgundy, 14 rue Paul Gaffarel, Dijon 21079, France; Department of Neurology, University Hospital of Dijon, France.
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Braillon A, Bernard A, Leclercq T, Duloquin G, Pommier T, Benali K, Comby PO, Loffroy R, Midulla M, Ricolfi F, Béjot Y, Guenancia C. Incremental value of the combined brain-cardiac CT protocol on prediction of atrial fibrillation after stroke. Eur Stroke J 2022; 8:175-182. [PMID: 37021162 PMCID: PMC10069180 DOI: 10.1177/23969873221138197] [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] [Received: 09/02/2022] [Accepted: 10/21/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction: Atrial fibrillation (AF) is one of the most common causes of ischemic stroke. It is essential to target patients at highest risk of AF detected after stroke (AFDAS), who should benefit from a prolonged rhythm screening strategy. Cardiac-CT angiography (CCTA) was added to the stroke protocol used in our institution in 2018. We sought to assess, for AFDAS, the predictive value of atrial cardiopathy markers by a CCTA performed on admission for acute ischemic stroke. Patients and Methods: From November 2018 to October 2019, consecutive stroke patients with no history of AF were included. Let atrial volume (LAV), epicardial adipose tissue (EAT) attenuation and volume, and LAA characteristics were measured on CCTA. The primary endpoint was the presence of AFDAS at follow-up, diagnosed by continuous electrocardiographic monitoring, long-term external Holter monitoring during hospital stay, or implantable cardiac monitor (ICM). Results: Sixty of the 247 included patients developed AFDAS. Multivariable analysis shows independent predictors of AFDAS: age >80 years (HR 2.46; 95%CI (1.23–4.92), p = 0.011), indexed LAV >45 mL/m2 (HR 2.58; 95%CI (1.19–5.62), p = 0.017), EAT attenuation > −85HU (HR 2.16; 95%CI (1.13–4.15), p = 0.021) and LAA thrombus (HR 2.50; 95%CI (1.06–5.93), p = 0.037). Added consecutively to AFDAS prediction AS5F score (combining age and NIHSS >5), these markers had an incrementally better predictive value compared with the global Chi2 of the initial model ( p = 0.001, 0.035, and 0.015 respectively). Discussion and conclusion: Adding CCTA to the acute stroke protocol to assess markers of atrial cardiopathy associated with AFDAS may help to better stratify the AF screening strategy, including the use of an ICM.
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Affiliation(s)
| | | | | | | | - Thibaut Pommier
- Cardiology Department, University Hospital, Dijon, France
- PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France
| | - Karim Benali
- Cardiology Department, University Hospital, Dijon, France
| | | | | | - Marco Midulla
- Radiology Department, University Hospital, Dijon, France
| | | | - Yannick Béjot
- Neurology Department, University Hospital, Dijon, France
- PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France
| | - Charles Guenancia
- Cardiology Department, University Hospital, Dijon, France
- PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France
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Abstract
INTRODUCTION Although several variants of Guillain-Barré syndrome (GBS) have been described, they are uncommon, and the atypical clinical presentation of patients makes the diagnosis challenging. This article reports a case of acute bulbar palsy plus (ABPp) syndrome. CASE REPORT A 18-year-old patient was admitted to our hospital because of difficulty swallowing, slurred speech, tingling of the extremities of the 4 limbs, and diplopia. He reported abdominal pain and diarrhea 2 weeks earlier. Physical examination showed a low-pitched voice, palsy elevation of the soft palate and complete palsy of the abduction of the left eye. Electromyography and cerebrospinal fluid examination were unremarkable, but Campylobacter jejuni serology was positive, and we found an isolated immunoglobulin G (IgG) anti-GT1a antibodies positivity. A diagnosis of ABPp was finally made, and the patient fully recovered early after receiving polyvalent immunoglobulins infusion. CONCLUSIONS ABPp is classified as subtype of GBS. The most frequent clinical signs of ABPp are ophthalmoplegia, facial palsy, and ataxia. IgG anti-GT1a and/or anti-GQ1b are positive in a majority of patients with ABPp; however, these antibodies are not specific and can found in other subtypes of GBS.
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Affiliation(s)
- Gaël Brun
- Department of Neurology, University Hospital of Dijon, University of Burgundy, Dijon, France
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Mariet AS, Duloquin G, Benzenine E, Roussot A, Pommier T, Eicher JC, Baptiste L, Giroud M, Cottin Y, Béjot Y, Quantin C. Impact of the First COVID-19 Wave on French Hospitalizations for Myocardial Infarction and Stroke: A Retrospective Cohort Study. Biomedicines 2022; 10:biomedicines10102501. [PMID: 36289763 PMCID: PMC9598815 DOI: 10.3390/biomedicines10102501] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/22/2022] [Accepted: 10/05/2022] [Indexed: 01/09/2023] Open
Abstract
The COVID-19 pandemic modified the management of myocardial infarction (MI) and stroke. We aimed to evaluate the effect of the COVID-19 pandemic on the volume and spatial distribution of hospitalizations for MI and stroke, before, during and after the first nationwide lockdown in France in 2020, compared with 2019. Hospitalization data were extracted from the French National Discharge database. Patient’s characteristics were compared according to COVID-19 status. Changes in hospitalization rates over time were measured using interrupted time series analysis. Possible spatial patterns of over or under-hospitalization rates were investigated using Moran’s indices. We observed a rapid and significant drop in hospitalizations just before the beginning of the lockdown with a nadir at 36.5% for MI and 31.2% for stroke. Hospitalization volumes returned to those seen in 2019 four weeks after the end of the lockdown, except for MI, which rebounded excessively. Older age, male sex, elevated rate of hypertension, diabetes, obesity and mortality characterized COVID-19 patients. There was no evidence of a change in the spatial pattern of over- or under-hospitalization clusters over the three periods. After a steep drop, only MI showed a significant rebound after the first lockdown with no change in the spatial distribution of hospitalizations.
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Affiliation(s)
- Anne-Sophie Mariet
- Biostatistics and Bioinformatics (DIM), University Hospital of Dijon, 21000 Dijon, France
- Clinical Epidemiology/Clinical Trials Unit, Clinical Investigation Center, University Hospital of Dijon, CIC1432, 21000 Dijon, France
| | - Gauthier Duloquin
- Neurology Department, University Hospital of Dijon, 21000 Dijon, France
- Dijon Stroke Registry (Santé Publique France-Inserm), University of Burgundy, UFBC, 21000 Dijon, France
- EA 7460 (Pathophysiology and Epidemiology of Cerebro-CardioVascular Diseases), University of Burgundy, UFBC, 21000 Dijon, France
| | - Eric Benzenine
- Biostatistics and Bioinformatics (DIM), University Hospital of Dijon, 21000 Dijon, France
| | - Adrien Roussot
- Biostatistics and Bioinformatics (DIM), University Hospital of Dijon, 21000 Dijon, France
| | - Thibaut Pommier
- Cardiology Department, University Hospital of Dijon, 21000 Dijon, France
| | | | - Laura Baptiste
- Neurology Department, University Hospital of Dijon, 21000 Dijon, France
- Dijon Stroke Registry (Santé Publique France-Inserm), University of Burgundy, UFBC, 21000 Dijon, France
- EA 7460 (Pathophysiology and Epidemiology of Cerebro-CardioVascular Diseases), University of Burgundy, UFBC, 21000 Dijon, France
| | - Maurice Giroud
- Neurology Department, University Hospital of Dijon, 21000 Dijon, France
- Dijon Stroke Registry (Santé Publique France-Inserm), University of Burgundy, UFBC, 21000 Dijon, France
- EA 7460 (Pathophysiology and Epidemiology of Cerebro-CardioVascular Diseases), University of Burgundy, UFBC, 21000 Dijon, France
| | - Yves Cottin
- Cardiology Department, University Hospital of Dijon, 21000 Dijon, France
- Pathophysiology and Epidemiology of Cerebro-CardioVascular Diseases, University of Burgundy, 21000 Dijon, France
- Registre des Infarctus du Myocarde de Côte d’Or, University Hospital of Dijon, 21000 Dijon, France
| | - Yannick Béjot
- Neurology Department, University Hospital of Dijon, 21000 Dijon, France
- Dijon Stroke Registry (Santé Publique France-Inserm), University of Burgundy, UFBC, 21000 Dijon, France
- EA 7460 (Pathophysiology and Epidemiology of Cerebro-CardioVascular Diseases), University of Burgundy, UFBC, 21000 Dijon, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital of Dijon, 21000 Dijon, France
- Clinical Epidemiology/Clinical Trials Unit, Clinical Investigation Center, University Hospital of Dijon, CIC1432, 21000 Dijon, France
- Université Paris-Saclay, UVSQ, University of Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, 94800 Villejuif, France
- Correspondence: ; Tel.: +33-3-80-29-36-29
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Robelin F, Lenfant M, Ricolfi F, Béjot Y, Comby PO. [Idiopathic intracranial hypertension: From physiopathological mechanisms to therapeutic decision]. Rev Med Interne 2022; 43:661-668. [PMID: 36114039 DOI: 10.1016/j.revmed.2022.08.012] [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: 06/20/2022] [Revised: 08/16/2022] [Accepted: 08/28/2022] [Indexed: 11/30/2022]
Abstract
Clinical features include visual disturbances, headaches, and pulsatile tinnitus that can be associated with reduced quality of life, and a risk of irreversible visual impairment in some cases. Obese women of childbearing age represent the main at-risk population, and the incidence of the disease is increasing because of rising prevalence of obesity worldwide. In addition, an imbalance in sex hormones is reported as a contributing risk factor. The pathophysiology of idiopathic intracranial hypertension involves a disturbance of the evacuation pathway of intracranial fluids caused by the increase in intracranial venous pressure. Brain imaging is useful for diagnosis with several signs including bilateral stenosis of the transverse sinuses that plays a major role in the pathogenesis of the disease by creating a positive feedback loop that increases intracranial venous hypertension and contributes to clinical manifestations. Treatment aims to relieve symptoms and prevent permanent visual impairment. Drug therapies including acetazolamide and topiramate have moderate effectiveness. Among invasive treatments, transverse sinus stenting seems to be the most interesting option to consider in drug-resistant patients. Weight loss remains essential to achieve a sustainable improvement by reducing central venous pressure. Future randomized trials are expected to reach a consensus on this treatment.
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Affiliation(s)
- F Robelin
- Service de neuroradiologie, CHU François Mitterrand Dijon, 14, rue Paul Gaffarel, 21000 Dijon, France.
| | - M Lenfant
- Service de neuroradiologie, CHU François Mitterrand Dijon, 14, rue Paul Gaffarel, 21000 Dijon, France
| | - F Ricolfi
- Service de neuroradiologie, CHU François Mitterrand Dijon, 14, rue Paul Gaffarel, 21000 Dijon, France; Université de Bourgogne, BP 27877-21078, Dijon Cedex, France
| | - Y Béjot
- Service de neurologie, CHU François Mitterrand Dijon, 14, rue Paul Gaffarel, 21000 Dijon, France; Université de Bourgogne, BP 27877-21078, Dijon Cedex, France
| | - P-O Comby
- Service de neuroradiologie, CHU François Mitterrand Dijon, 14, rue Paul Gaffarel, 21000 Dijon, France; Université de Bourgogne, BP 27877-21078, Dijon Cedex, France
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Béjot Y, Laurent G, Léo P, Combes A, Pouchain M, Baille N, Giroud M. [A territory project for the follow-up of strokes and myocardial infarctions]. Soins 2022; 67:44-47. [PMID: 36442926 DOI: 10.1016/j.soin.2022.09.015] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The Dijon Vascular Project experiment aims to reduce the risk of unscheduled re-hospitalization for stroke and myocardial infarction. It involves hospital and private healthcare professionals working in the Côte-d'Or and South Haut-Marnais hospital grouping area. Within this system, hospital and private practice nurses are essential links in the patient's circle of care and fundamental contacts for post-stroke or post-MI follow-up: through their interventions, they contribute to preventing the risks of complications and recurrences.
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Affiliation(s)
- Yannick Béjot
- Centre hospitalier universitaire Dijon Bourgogne, 14 rue Paul-Gaffarel, 21000 Dijon, France; EA 7460 physiopathologie et épidémiologie cérébro-cardio-vasculaire, UFR sciences de santé Dijon, Université de Bourgogne, 7 boulevard Jeanne-d'Arc, 21000 Dijon, France.
| | - Gabriel Laurent
- Centre hospitalier universitaire Dijon Bourgogne, 14 rue Paul-Gaffarel, 21000 Dijon, France; Laboratoire ImViA, équipe IFTIM, Centre hospitalier universitaire Dijon Bourgogne, 64 rue Sully, 21000 Dijon, France
| | - Pauline Léo
- Centre hospitalier universitaire Dijon Bourgogne, 14 rue Paul-Gaffarel, 21000 Dijon, France
| | - Anabelle Combes
- Centre hospitalier universitaire Dijon Bourgogne, 14 rue Paul-Gaffarel, 21000 Dijon, France
| | - Marilyne Pouchain
- Centre hospitalier universitaire Dijon Bourgogne, 14 rue Paul-Gaffarel, 21000 Dijon, France
| | - Nadiège Baille
- Centre hospitalier universitaire Dijon Bourgogne, 14 rue Paul-Gaffarel, 21000 Dijon, France
| | - Maurice Giroud
- Centre hospitalier universitaire Dijon Bourgogne, 14 rue Paul-Gaffarel, 21000 Dijon, France
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Dawson J, Béjot Y, Christensen LM, De Marchis GM, Dichgans M, Hagberg G, Heldner MR, Milionis H, Li L, Pezzella FR, Taylor Rowan M, Tiu C, Webb A. European Stroke Organisation (ESO) guideline on pharmacological interventions for long-term secondary prevention after ischaemic stroke or transient ischaemic attack. Eur Stroke J 2022; 7:I-II. [PMID: 36082250 PMCID: PMC9446324 DOI: 10.1177/23969873221100032] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/25/2022] [Indexed: 11/17/2022] Open
Abstract
Recurrent stroke affects 9% to 15% of people within 1 year. This European Stroke Organisation (ESO) guideline provides evidence-based recommendations on pharmacological management of blood pressure (BP), diabetes mellitus, lipid levels and antiplatelet therapy for the prevention of recurrent stroke and other important outcomes in people with ischaemic stroke or transient ischaemic attack (TIA). It does not cover interventions for specific causes of stroke, including anticoagulation for cardioembolic stroke, which are addressed in other guidelines. This guideline was developed through ESO standard operating procedures and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The working group identified clinical questions, selected outcomes, performed systematic reviews, with meta-analyses where appropriate, and made evidence-based recommendations, with expert consensus statements where evidence was insufficient to support a recommendation. To reduce the long-term risk of recurrent stroke or other important outcomes after ischaemic stroke or TIA, we recommend: BP lowering treatment to a target of <130/80 mmHg, except in subgroups at increased risk of harm; HMGCoA-reductase inhibitors (statins) and targeting a low density lipoprotein level of <1.8 mmol/l (70 mg/dl); avoidance of dual antiplatelet therapy with aspirin and clopidogrel after the first 90 days; to not give direct oral anticoagulant drugs (DOACs) for embolic stroke of undetermined source and to consider pioglitazone in people with diabetes or insulin resistance, after careful consideration of potential risks. In addition to the evidence-based recommendations, all or the majority of working group members supported: out-of-office BP monitoring; use of combination treatment for BP control; consideration of ezetimibe or PCSK9 inhibitors when lipid targets are not achieved; consideration of use of low-dose DOACs in addition to an antiplatelet in selected groups of people with coronary or peripheral artery disease and aiming for an HbA1c level of <53 mmol/mol (7%) in people with diabetes mellitus. These guidelines aim to standardise long-term pharmacological treatment to reduce the burden of recurrent stroke in Europe.
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Affiliation(s)
- Jesse Dawson
- Institute of Cardiovascular and Medical
Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow,
Glasgow, UK
- Jesse Dawson, Institute of Cardiovascular
and Medical Sciences, College of Medical, Veterinary and Life Sciences,
University of Glasgow, Queen Elizabeth University Hospital, Glasgow G12 9QQ, UK.
| | - Yannick Béjot
- Dijon Stroke Registry, Department of
Neurology, University Hospital of Dijon, Dijon, France
- Pathophysiology and Epidemiology of
Cardio-Cerebrovascular disease (PEC2), University of Burgundy, Dijon, France
| | - Louisa M Christensen
- Dept of Neurology, Copenhagen
University Hospital Bispebjerg, Kobenhavn, Denmark
| | - Gian Marco De Marchis
- Department of Neurology and Stroke
Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Martin Dichgans
- Institute for Stroke and Dementia
Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology
(SyNergy), Munich, Germany
| | - Guri Hagberg
- Oslo Stroke Unit, Department of
Neurology, Oslo University Hospital, Ullevål, Norway
- Department of medical research, Bærum
Hospital Vestre Viken Hospital Trust, Drammen, Norway
| | - Mirjam R Heldner
- Stroke Research Center Bern,
Department of Neurology, University and University Hospital Bern, Bern,
Switzerland
| | - Haralampos Milionis
- Department of Internal Medicine,
School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina,
Greece
| | - Linxin Li
- Wolfson Centre for Prevention of
Stroke and Dementia, Department of Clinical Neurosciences, University of Oxford,
Oxford, UK
| | | | - Martin Taylor Rowan
- Institute of Cardiovascular and Medical
Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow,
Glasgow, UK
| | - Cristina Tiu
- Department of Clinical Neurosciences,
University of Medicine and Pharmacy ‘Carol Davila’, Bucuresti, Romania
- Department of Neurology, University
Hospital Bucharest, Bucharest, Romania
| | - Alastair Webb
- Wolfson Centre for Prevention of
Stroke and Dementia, Department of Clinical Neurosciences, University of Oxford,
Oxford, UK
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Garnier L, Duloquin G, Meloux A, Benali K, Sagnard A, Graber M, Dogon G, Didier R, Pommier T, Vergely C, Béjot Y, Guenancia C. Multimodal Approach for the Prediction of Atrial Fibrillation Detected After Stroke: SAFAS Study. Front Cardiovasc Med 2022; 9:949213. [PMID: 35911547 PMCID: PMC9326228 DOI: 10.3389/fcvm.2022.949213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIntensive screening for atrial fibrillation (AF) has led to a better recognition of this cause in stroke patients. However, it is currently debated whether AF Detected After Stroke (AFDAS) has the same pathophysiology and embolic risk as prior-to-stroke AF. We thus aimed to systematically approach AFDAS using a multimodal approach combining clinical, imaging, biological and electrocardiographic markers.MethodsPatients without previously known AF admitted to the Dijon University Hospital (France) stroke unit for acute ischemic stroke were prospectively enrolled. The primary endpoint was the presence of AFDAS at 6 months, diagnosed through admission ECG, continuous electrocardiographic monitoring, long-term external Holter during the hospital stay, or implantable cardiac monitor if clinically indicated after discharge.ResultsOf the 240 included patients, 77 (32%) developed AFDAS. Compared with sinus rhythm patients, those developing AFDAS were older, more often women and less often active smokers. AFDAS patients had higher blood levels of NT-proBNP, osteoprotegerin, galectin-3, GDF-15 and ST2, as well as increased left atrial indexed volume and lower left ventricular ejection fraction. After multivariable analysis, galectin-3 ≧ 9 ng/ml [OR 3.10; 95% CI (1.03–9.254), p = 0.042], NT-proBNP ≧ 290 pg/ml [OR 3.950; 95% CI (1.754–8.892, p = 0.001], OPG ≥ 887 pg/ml [OR 2.338; 95% CI (1.015–5.620), p = 0.046) and LAVI ≥ 33.5 ml/m2 [OR 2.982; 95% CI (1.342–6.625), p = 0.007] were independently associated with AFDAS.ConclusionA multimodal approach combining imaging, electrocardiography and original biological markers resulted in good predictive models for AFDAS. These results also suggest that AFDAS is probably related to an underlying atrial cardiopathy.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT03570060].
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Affiliation(s)
- Lucie Garnier
- Department of Neurology, University Hospital, Dijon, France
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
| | - Gauthier Duloquin
- Department of Neurology, University Hospital, Dijon, France
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
| | - Alexandre Meloux
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
| | - Karim Benali
- Department of Cardiology, University Hospital, Dijon, France
| | - Audrey Sagnard
- Department of Cardiology, University Hospital, Dijon, France
| | - Mathilde Graber
- Department of Neurology, University Hospital, Dijon, France
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
| | - Geoffrey Dogon
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
| | - Romain Didier
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
- Department of Cardiology, University Hospital, Dijon, France
| | - Thibaut Pommier
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
- Department of Cardiology, University Hospital, Dijon, France
| | - Catherine Vergely
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
| | - Yannick Béjot
- Department of Neurology, University Hospital, Dijon, France
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
| | - Charles Guenancia
- Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (EA 7460), Faculty of Health Sciences, Université de Bourgogne, Université de Bourgogne Franche-Comté, Dijon, France
- Department of Cardiology, University Hospital, Dijon, France
- *Correspondence: Charles Guenancia,
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Dawson J, Béjot Y, Christensen LM, De Marchis GM, Dichgans M, Hagberg G, Heldner MR, Milionis H, Li L, Pezzella FR, Taylor Rowan M, Tiu C, Webb A. Response to letter by Prof Christian Nolte and colleagues. Eur Stroke J 2022; 7:341-342. [PMID: 36082263 PMCID: PMC9446323 DOI: 10.1177/23969873221110378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jesse Dawson
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Yannick Béjot
- Dijon Stroke Registry, Department of Neurology, University Hospital of Dijon, Dijon, France
- Pathophysiology and Epidemiology of Cardio-Cerebrovascular disease (PEC2), University of Burgundy, Dijon, France
| | - Louisa M Christensen
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Kobenhavn, Denmark
| | - Gian Marco De Marchis
- Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Guri Hagberg
- Oslo Stroke Unit, Department of Neurology, Oslo University Hospital, Ullevål, Norway
- Department of Medical Research, Bærum Hospital Vestre Viken Hospital Trust, Drammen, Norway
| | - Mirjam R Heldner
- Stroke Research Center Bern, Department of Neurology, University and University Hospital Bern, Bern, Switzerland
| | - Haralampos Milionis
- Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Linxin Li
- Wolfson Centre for Prevention of Stroke and Dementia, Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Martin Taylor Rowan
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Cristina Tiu
- Department of Clinical Neurosciences, University of Medicine and Pharmacy ‘Carol Davila’, Bucuresti, Romania
- Department of Neurology, University Hospital Bucharest, Bucharest, Romania
| | - Alastair Webb
- Wolfson Centre for Prevention of Stroke and Dementia, Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Burkart K, Causey K, Cohen AJ, Wozniak SS, Salvi DD, Abbafati C, Adekanmbi V, Adsuar JC, Ahmadi K, Alahdab F, Al-Aly Z, Alipour V, Alvis-Guzman N, Amegah AK, Andrei CL, Andrei T, Ansari F, Arabloo J, Aremu O, Aripov T, Babaee E, Banach M, Barnett A, Bärnighausen TW, Bedi N, Behzadifar M, Béjot Y, Bennett DA, Bensenor IM, Bernstein RS, Bhattacharyya K, Bijani A, Biondi A, Bohlouli S, Breitner S, Brenner H, Butt ZA, Cámera LA, Cantu-Brito C, Carvalho F, Cerin E, Chattu VK, Chauhan BG, Choi JYJ, Chu DT, Dai X, Dandona L, Dandona R, Daryani A, Davletov K, de Courten B, Demeke FM, Denova-Gutiérrez E, Dharmaratne SD, Dhimal M, Diaz D, Djalalinia S, Duncan BB, El Sayed Zaki M, Eskandarieh S, Fareed M, Farzadfar F, Fattahi N, Fazlzadeh M, Fernandes E, Filip I, Fischer F, Foigt NA, Freitas M, Ghashghaee A, Gill PS, Ginawi IA, Gopalani SV, Guo Y, Gupta RD, Habtewold TD, Hamadeh RR, Hamidi S, Hankey GJ, Hasanpoor E, Hassen HY, Hay SI, Heibati B, Hole MK, Hossain N, Househ M, Irvani SSN, Jaafari J, Jakovljevic M, Jha RP, Jonas JB, Jozwiak JJ, Kasaeian A, Kaydi N, Khader YS, Khafaie MA, Khan EA, Khan J, Khan MN, Khatab K, Khater AM, Kim YJ, Kimokoti RW, Kisa A, Kivimäki M, Knibbs LD, Kosen S, Koul PA, Koyanagi A, Kuate Defo B, Kugbey N, Lauriola P, Lee PH, Leili M, Lewycka S, Li S, Lim LL, Linn S, Liu Y, Lorkowski S, Mahasha PW, Mahotra NB, Majeed A, Maleki A, Malekzadeh R, Mamun AA, Manafi N, Martini S, Meharie BG, Menezes RG, Mestrovic T, Miazgowski B, Miazgowski T, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mohajer B, Mohammed S, Mohan V, Mokdad AH, Monasta L, Moraga P, Morrison SD, Mueller UO, Mukhopadhyay S, Mustafa G, Muthupandian S, Naik G, Nangia V, Ndwandwe DE, Negoi RI, Ningrum DNA, Noubiap JJ, Ogbo FA, Olagunju AT, Onwujekwe OE, Ortiz A, Owolabi MO, P A M, Panda-Jonas S, Park EK, Pashazadeh Kan F, Pirsaheb M, Postma MJ, Pourjafar H, Radfar A, Rafiei A, Rahim F, Rahimi-Movaghar V, Rahman MA, Rai RK, Ranabhat CL, Raoofi S, Rawal L, Renzaho AMN, Rezapour A, Ribeiro D, Roever L, Ronfani L, Sabour S, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sahebkar A, Sahraian MA, Salimzadeh H, Salvi SS, Samy AM, Sanabria J, Sarmiento-Suárez R, Sathish T, Schmidt MI, Schutte AE, Sepanlou SG, Shaikh MA, Sharafi K, Sheikh A, Shigematsu M, Shiri R, Shirkoohi R, Shuval K, Soyiri IN, Tabarés-Seisdedos R, Tefera YM, Tehrani-Banihashemi A, Temsah MH, Thankappan KR, Topor-Madry R, Tudor Car L, Ullah I, Vacante M, Valdez PR, Vasankari TJ, Violante FS, Waheed Y, Wolfe CDA, Yamada T, Yonemoto N, Yu C, Zaman SB, Zhang Y, Zodpey S, Lim SS, Stanaway JD, Brauer M. Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM 2·5 air pollution, 1990-2019: an analysis of data from the Global Burden of Disease Study 2019. Lancet Planet Health 2022; 6:e586-e600. [PMID: 35809588 PMCID: PMC9278144 DOI: 10.1016/s2542-5196(22)00122-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. METHODS We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. FINDINGS In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68-4·83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49-17·5) of deaths and 13·6% (9·73-17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22-9·53) of deaths and 5·92% (3·81-8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. INTERPRETATION Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. FUNDING Bill & Melinda Gates Foundation.
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Armocida B, Monasta L, Sawyer S, Bustreo F, Segafredo G, Castelpietra G, Ronfani L, Pasovic M, Hay S, Perel P, Beran D, Monasta L, Sawyer SM, Bustreo F, Segafredo G, Castelpietra G, Ronfani L, Pasovic M, Hay SI, Abila DB, Abolhassani H, Accrombessi MMK, Adekanmbi V, Ahmadi K, Al Hamad H, Aldeyab MA, Al-Jumaily A, Ancuceanu R, Andrei CL, Andrei T, Arumugam A, Attia S, Aujayeb A, Ausloos M, Baker JL, Barone-Adesi F, Barra F, Barteit S, Basu S, Baune BT, Béjot Y, Belo L, Bennett DA, Bikbov B, Bikov A, Blyuss O, Breitner S, Brenner H, Carreras G, Carvalho M, Catapano AL, Chandan JS, Charalampous P, Chen S, Conde J, Cruz-Martins N, Damiani G, Dastiridou A, de la Torre-Luque A, Dianatinasab M, Dias da Silva D, Douiri A, Dragioti E, Engelbert Bain L, Fagbamigbe AF, Fereshtehnejad SM, Ferrara P, Ferreira de Oliveira JMP, Ferrero S, Ferro Desideri L, Fischer F, Fonseca DA, Gaewkhiew P, Gaihre S, Gallus S, Gaspar Fonseca M, Gill PS, Glasbey JC, Gorini G, Gupta VK, Gurara MK, Haro JM, Hasan MT, Havmoeller RJ, Heibati B, Hellemons ME, Herteliu C, Hussain S, Isola G, Johnson O, Jonas JB, Jozwiak JJ, Jürisson M, Kabir Z, Karch A, Kauppila JH, Kayode GA, Khan MAB, Khatab K, Kivimäki M, Klugar M, Klugarová J, Koly KN, Koyanagi A, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lallukka T, Lamnisos D, Langguth B, Larsson AO, Lauriola P, Lee PH, Leonardi M, Li A, Linehan C, López-Bueno R, Lorkowski S, Loureiro JA, Lunevicius R, Magee LA, Magnani FG, Majeed A, Makris KC, Mathioudakis AG, Mathur MR, McGrath JJ, Menezes RG, Mentis AFA, Meretoja A, Mestrovic T, Miao Jonasson J, Miazgowski T, Mirica A, Moccia M, Mohammed S, Molokhia M, Mondello S, Mueller UO, Mulita F, Munblit D, Negoi I, Negoi RI, Nena E, Noor NM, Nowak C, Ntaios G, Nwatah VE, Oancea B, Oguntade AS, Ortiz A, Otoiu A, Padron-Monedero A, Palladino R, Pana A, Panagiotakos D, Panda-Jonas S, Pardhan S, Patel J, Pedersini P, Peñalvo JL, Pensato U, Pereira RB, Perico N, Petcu IR, Polinder S, Postma MJ, Rabiee M, Rabiee N, Raggi A, Rahimzadeh S, Rawaf DL, Rawaf S, Rehman FU, Remuzzi G, Riad A, Rodriguez A, Sacco S, Saeb MR, Safdarian M, Sathian B, Sattin D, Saxena S, Scarmeas N, Schlee W, Schwendicke F, Shamsizadeh M, Sharew NT, Shiri R, Shivalli S, Shivarov V, Silva JP, Simpson CR, Skou ST, Socea B, Soyiri IN, Steiropoulos P, Straif K, Sun X, Tabarés-Seisdedos R, Thiyagarajan A, Topouzis F, Tovani-Palone MR, Truelsen TC, Unim B, Van den Eynde J, Vasankari TJ, Veroux M, Villafaina S, Vinko M, Violante FS, Volovici V, Wang Y, Westerman R, Yadegarfar ME, Yaya S, Zadnik V, Zumla A, Perel P, Beran D. Burden of non-communicable diseases among adolescents aged 10-24 years in the EU, 1990-2019: a systematic analysis of the Global Burden of Diseases Study 2019. Lancet Child Adolesc Health 2022; 6:367-383. [PMID: 35339209 PMCID: PMC9090900 DOI: 10.1016/s2352-4642(22)00073-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/20/2022] [Accepted: 02/28/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Disability and mortality burden of non-communicable diseases (NCDs) have risen worldwide; however, the NCD burden among adolescents remains poorly described in the EU. METHODS Estimates were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Causes of NCDs were analysed at three different levels of the GBD 2019 hierarchy, for which mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were extracted. Estimates, with the 95% uncertainty intervals (UI), were retrieved for EU Member States from 1990 to 2019, three age subgroups (10-14 years, 15-19 years, and 20-24 years), and by sex. Spearman's correlation was conducted between DALY rates for NCDs and the Socio-demographic Index (SDI) of each EU Member State. FINDINGS In 2019, NCDs accounted for 86·4% (95% uncertainty interval 83·5-88·8) of all YLDs and 38·8% (37·4-39·8) of total deaths in adolescents aged 10-24 years. For NCDs in this age group, neoplasms were the leading causes of both mortality (4·01 [95% uncertainty interval 3·62-4·25] per 100 000 population) and YLLs (281·78 [254·25-298·92] per 100 000 population), whereas mental disorders were the leading cause for YLDs (2039·36 [1432·56-2773·47] per 100 000 population) and DALYs (2040·59 [1433·96-2774·62] per 100 000 population) in all EU Member States, and in all studied age groups. In 2019, among adolescents aged 10-24 years, males had a higher mortality rate per 100 000 population due to NCDs than females (11·66 [11·04-12·28] vs 7·89 [7·53-8·23]), whereas females presented a higher DALY rate per 100 000 population due to NCDs (8003·25 [5812·78-10 701·59] vs 6083·91 [4576·63-7857·92]). From 1990 to 2019, mortality rate due to NCDs in adolescents aged 10-24 years substantially decreased (-40·41% [-43·00 to -37·61), and also the YLL rate considerably decreased (-40·56% [-43·16 to -37·74]), except for mental disorders (which increased by 32·18% [1·67 to 66·49]), whereas the YLD rate increased slightly (1·44% [0·09 to 2·79]). Positive correlations were observed between DALY rates and SDIs for substance use disorders (rs=0·58, p=0·0012) and skin and subcutaneous diseases (rs=0·45, p=0·017), whereas negative correlations were found between DALY rates and SDIs for cardiovascular diseases (rs=-0·46, p=0·015), neoplasms (rs=-0·57, p=0·0015), and sense organ diseases (rs=-0·61, p=0·0005). INTERPRETATION NCD-related mortality has substantially declined among adolescents in the EU between 1990 and 2019, but the rising trend of YLL attributed to mental disorders and their YLD burden are concerning. Differences by sex, age group, and across EU Member States highlight the importance of preventive interventions and scaling up adolescent-responsive health-care systems, which should prioritise specific needs by sex, age, and location. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Benedetta Armocida
- Division of Tropical and Humanitarian Medicine, University of Geneva, Geneva, Switzerland; Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Lorenzo Monasta
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
| | - Susan Sawyer
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital Melbourne, Melbourne, VIC, Australia
| | | | | | - Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy
| | - Luca Ronfani
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Maja Pasovic
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Pablo Perel
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Switzerland
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Béjot Y. Fourty years of descriptive epidemiology of stroke. Neuroepidemiology 2022; 56:157-162. [PMID: 35613541 DOI: 10.1159/000525220] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/22/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
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Pommier T, Benzenine E, Bernard C, Mariet AS, Béjot Y, Giroud M, Morgant MC, Steinmetz E, Guenancia C, Bouchot O, Quantin C. Trends of Myocarditis and Endocarditis Cases before, during, and after the First Complete COVID-19-Related Lockdown in 2020 in France. Biomedicines 2022; 10:biomedicines10061231. [PMID: 35740252 PMCID: PMC9219624 DOI: 10.3390/biomedicines10061231] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 01/09/2023] Open
Abstract
Background. The impact of the COVID-19 pandemic on hospitalization for cardiac infections is not well known. We aimed to evaluate the nationwide trends in hospital stays for myocarditis and endocarditis cases before, during and after the nationwide lockdown for the COVID-19 pandemic in France. We then aimed to describe the proportion of myocarditis and endocarditis patients with and without COVID-19 and their clinical characteristics. Methods. Hospitalized cases of cardiac infection were extracted from the French National Discharge database, which collects the medical records of all patients discharged from all public and private hospitals in France. Age, sex, and available cardiovascular risk factors were compared between stays with and without COVID-19 during the lockdown. Results. The number of myocarditis cases was 11% higher in 2020, compared to the average of the three prior years. In 2020, 439 of 3727 cases of myocarditis were associated with COVID-19. For endocarditis, there was an increase in cases by 7% in 2020 versus prior years. For endocarditis, 3% (240 of 8128 cases) of patients with endocarditis had COVID-19. For myocarditis, older age, hypertension, diabetes, obesity, and atrial fibrillation were more frequent in patients with COVID-19 than in those without. For endocarditis, only hypertension was more frequent in patients with COVID-19 than in those without. Conclusion. Our study reports an increase in hospitalizations for both myocarditis and endocarditis in 2020, possibly related to the COVID-19 pandemic. Interestingly, the trends differ according to the COVID-19 status. Knowledge of the factors associating myocarditis or endocarditis and COVID-19 may improve the quality and the type of monitoring for people with COVID-19, the identification of patients at risk of cardiac infections, and the treatment of COVID-19 patients.
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Affiliation(s)
- Thibaut Pommier
- Department of Cardiology, Dijon University Hospital, 21000 Dijon, France;
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, Health Sciences Faculty, University of Burgundy, 21000 Dijon, France; (Y.B.); (M.G.)
- Correspondence:
| | - Eric Benzenine
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, 21000 Dijon, France; (E.B.); (A.-S.M.); (C.Q.)
| | - Chloé Bernard
- Department of Cardiovascular and Thoracic Surgery, Dijon University Hospital, 21000 Dijon, France; (C.B.); (M.-C.M.); (E.S.); (O.B.)
| | - Anne-Sophie Mariet
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, 21000 Dijon, France; (E.B.); (A.-S.M.); (C.Q.)
- Inserm, CIC 1432, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, 21000 Dijon, France
| | - Yannick Béjot
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, Health Sciences Faculty, University of Burgundy, 21000 Dijon, France; (Y.B.); (M.G.)
- Department of Neurology, Dijon University Hospital, 21000 Dijon, France
| | - Maurice Giroud
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, Health Sciences Faculty, University of Burgundy, 21000 Dijon, France; (Y.B.); (M.G.)
- Department of Neurology, Dijon University Hospital, 21000 Dijon, France
| | - Marie-Catherine Morgant
- Department of Cardiovascular and Thoracic Surgery, Dijon University Hospital, 21000 Dijon, France; (C.B.); (M.-C.M.); (E.S.); (O.B.)
| | - Eric Steinmetz
- Department of Cardiovascular and Thoracic Surgery, Dijon University Hospital, 21000 Dijon, France; (C.B.); (M.-C.M.); (E.S.); (O.B.)
| | - Charles Guenancia
- Department of Cardiology, Dijon University Hospital, 21000 Dijon, France;
- Laboratory of Cerebro-Vascular Pathophysiology and Epidemiology (PEC2) EA 7460, Health Sciences Faculty, University of Burgundy, 21000 Dijon, France; (Y.B.); (M.G.)
| | - Olivier Bouchot
- Department of Cardiovascular and Thoracic Surgery, Dijon University Hospital, 21000 Dijon, France; (C.B.); (M.-C.M.); (E.S.); (O.B.)
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, 21000 Dijon, France; (E.B.); (A.-S.M.); (C.Q.)
- Inserm, CIC 1432, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, 21000 Dijon, France
- High-Dimensional Biostatistics for Drug Safety and Genomics, Paris-Saclay University, UVSQ, Inserm, CESP, 94800 Villejuif, France
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Olié V, Grave C, Tuppin P, Duloquin G, Béjot Y, Gabet A. Patients Hospitalized for Ischemic Stroke and Intracerebral Hemorrhage in France: Time Trends (2008-2019), In-Hospital Outcomes, Age and Sex Differences. J Clin Med 2022; 11:jcm11061669. [PMID: 35329995 PMCID: PMC8949281 DOI: 10.3390/jcm11061669] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/02/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Rates of patients hospitalized for stroke increased among people aged under 65 years in France, as has been found in other countries. Methods: To analyze time trends in the rates of patients hospitalized for ischemic stroke (IS) and intracerebral hemorrhage (ICH) in France between 2008 and 2019 and determine related short-term outcomes mainly, we selected all patients hospitalized for stroke using the French national hospital database. Results: The average annual percentage change in the rates of patients hospitalized for IS increased significantly in men and women aged 50–64 years (+2.0%) and in men aged 18–34 years (+1.5%) and 35–44 years (+2.2%). A decrease in the average annual percentage change was observed for IS among people aged over 75 years and among those over 50 years for ICH. After adjustment on confounding factors, women were less likely to die in hospital. Case fatality rates decreased overtime in all age groups for both sexes, with a more pronounced decrease for IS than ICH. Conclusions: The increasing trend of IS among adults under 65 years is ongoing, highlighting the urgent need for stroke prevention programs in that age. For the first time, we recorded a decrease in the rates of patients hospitalized for ICH among the population over 50 years.
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Affiliation(s)
- Valérie Olié
- Department of Non-Communicable Diseases, Santé Publique France, 94410 Saint-Maurice, France; (V.O.); (C.G.)
| | - Clémence Grave
- Department of Non-Communicable Diseases, Santé Publique France, 94410 Saint-Maurice, France; (V.O.); (C.G.)
| | - Philippe Tuppin
- Department of Health Studies and Statistics, Caisse Nationale de l’Assurance Maladie, 75020 Paris, France;
| | - Gauthier Duloquin
- Dijon Stroke Registry, University Hospital of Burgundy, 21000 Dijon, France; (G.D.); (Y.B.)
| | - Yannick Béjot
- Dijon Stroke Registry, University Hospital of Burgundy, 21000 Dijon, France; (G.D.); (Y.B.)
| | - Amélie Gabet
- Department of Non-Communicable Diseases, Santé Publique France, 94410 Saint-Maurice, France; (V.O.); (C.G.)
- Correspondence:
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Zabawa C, Cottenet J, Zeller M, Béjot Y, Quantin C. Réhospitalisations précoces après un accident vasculaire cérébral en France : étude des parcours de soins ambulatoires et des facteurs associés à partir des données du Système national des données de santé. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.01.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Nichols E, Steinmetz JD, Vollset SE, Fukutaki K, Chalek J, Abd-Allah F, Abdoli A, Abualhasan A, Abu-Gharbieh E, Akram TT, Al Hamad H, Alahdab F, Alanezi FM, Alipour V, Almustanyir S, Amu H, Ansari I, Arabloo J, Ashraf T, Astell-Burt T, Ayano G, Ayuso-Mateos JL, Baig AA, Barnett A, Barrow A, Baune BT, Béjot Y, Bezabhe WMM, Bezabih YM, Bhagavathula AS, Bhaskar S, Bhattacharyya K, Bijani A, Biswas A, Bolla SR, Boloor A, Brayne C, Brenner H, Burkart K, Burns RA, Cámera LA, Cao C, Carvalho F, Castro-de-Araujo LFS, Catalá-López F, Cerin E, Chavan PP, Cherbuin N, Chu DT, Costa VM, Couto RAS, Dadras O, Dai X, Dandona L, Dandona R, De la Cruz-Góngora V, Dhamnetiya D, Dias da Silva D, Diaz D, Douiri A, Edvardsson D, Ekholuenetale M, El Sayed I, El-Jaafary SI, Eskandari K, Eskandarieh S, Esmaeilnejad S, Fares J, Faro A, Farooque U, Feigin VL, Feng X, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fillit H, Fischer F, Gaidhane S, Galluzzo L, Ghashghaee A, Ghith N, Gialluisi A, Gilani SA, Glavan IR, Gnedovskaya EV, Golechha M, Gupta R, Gupta VB, Gupta VK, Haider MR, Hall BJ, Hamidi S, Hanif A, Hankey GJ, Haque S, Hartono RK, Hasaballah AI, Hasan MT, Hassan A, Hay SI, Hayat K, Hegazy MI, Heidari G, Heidari-Soureshjani R, Herteliu C, Househ M, Hussain R, Hwang BF, Iacoviello L, Iavicoli I, Ilesanmi OS, Ilic IM, Ilic MD, Irvani SSN, Iso H, Iwagami M, Jabbarinejad R, Jacob L, Jain V, Jayapal SK, Jayawardena R, Jha RP, Jonas JB, Joseph N, Kalani R, Kandel A, Kandel H, Karch A, Kasa AS, Kassie GM, Keshavarz P, Khan MAB, Khatib MN, Khoja TAM, Khubchandani J, Kim MS, Kim YJ, Kisa A, Kisa S, Kivimäki M, Koroshetz WJ, Koyanagi A, Kumar GA, Kumar M, Lak HM, Leonardi M, Li B, Lim SS, Liu X, Liu Y, Logroscino G, Lorkowski S, Lucchetti G, Lutzky Saute R, Magnani FG, Malik AA, Massano J, Mehndiratta MM, Menezes RG, Meretoja A, Mohajer B, Mohamed Ibrahim N, Mohammad Y, Mohammed A, Mokdad AH, Mondello S, Moni MAA, Moniruzzaman M, Mossie TB, Nagel G, Naveed M, Nayak VC, Neupane Kandel S, Nguyen TH, Oancea B, Otstavnov N, Otstavnov SS, Owolabi MO, Panda-Jonas S, Pashazadeh Kan F, Pasovic M, Patel UK, Pathak M, Peres MFP, Perianayagam A, Peterson CB, Phillips MR, Pinheiro M, Piradov MA, Pond CD, Potashman MH, Pottoo FH, Prada SI, Radfar A, Raggi A, Rahim F, Rahman M, Ram P, Ranasinghe P, Rawaf DL, Rawaf S, Rezaei N, Rezapour A, Robinson SR, Romoli M, Roshandel G, Sahathevan R, Sahebkar A, Sahraian MA, Sathian B, Sattin D, Sawhney M, Saylan M, Schiavolin S, Seylani A, Sha F, Shaikh MA, Shaji KS, Shannawaz M, Shetty JK, Shigematsu M, Shin JI, Shiri R, Silva DAS, Silva JP, Silva R, Singh JA, Skryabin VY, Skryabina AA, Smith AE, Soshnikov S, Spurlock EE, Stein DJ, Sun J, Tabarés-Seisdedos R, Thakur B, Timalsina B, Tovani-Palone MR, Tran BX, Tsegaye GW, Valadan Tahbaz S, Valdez PR, Venketasubramanian N, Vlassov V, Vu GT, Vu LG, Wang YP, Wimo A, Winkler AS, Yadav L, Yahyazadeh Jabbari SH, Yamagishi K, Yang L, Yano Y, Yonemoto N, Yu C, Yunusa I, Zadey S, Zastrozhin MS, Zastrozhina A, Zhang ZJ, Murray CJL, Vos T. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2022; 7:e105-e125. [PMID: 34998485 PMCID: PMC8810394 DOI: 10.1016/s2468-2667(21)00249-8] [Citation(s) in RCA: 983] [Impact Index Per Article: 491.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/17/2021] [Accepted: 10/28/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. METHODS We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. FINDINGS We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4-65·1) million cases globally in 2019 to 152·8 (130·8-175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [-7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64-1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52-1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41-67]) and western Europe (74% [58-90]), and the largest in north Africa and the Middle East (367% [329-403]) and eastern sub-Saharan Africa (357% [323-395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. INTERPRETATION Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. FUNDING Bill & Melinda Gates Foundation and Gates Ventures.
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Duloquin G, Crespy V, Jakubina P, Giroud M, Vergely C, Béjot Y. Large Vessel Occlusion in Patients With Minor Ischemic Stroke in a Population-Based Study. The Dijon Stroke Registry. Front Neurol 2022; 12:796046. [PMID: 35095739 PMCID: PMC8795366 DOI: 10.3389/fneur.2021.796046] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Strategy for the acute management of minor ischemic stroke (IS) with large vessel occlusion (LVO) is under debate, especially the benefits of mechanical thrombectomy. The frequency of minor IS with LVO among overall patients is not well established. This study aimed to assess the proportion of minor IS and to depict characteristics of patients according to the presence of LVO in a comprehensive population-based setting. Methods: Patients with acute IS were prospectively identified among residents of Dijon, France, using a population-based registry (2013–2017). All arterial imaging exams were reviewed to assess arterial occlusion. Minor stroke was defined as that with a National Institutes of Health Stroke Scale (NIHSS) score of <6. Proportion of patients with LVO was estimated in the minor IS population. The clinical presentation of patients was compared according to the presence of an LVO. Results: Nine hundred seventy-one patients were registered, including 582 (59.9%) patients with a minor IS. Of these patients, 23 (4.0%) had a LVO. Patients with minor IS and LVO had more severe presentation [median 3 (IQR 2–5) vs. 2 (IQR 1–3), p = 0.001] with decreased consciousness (13.0 vs. 1.6%, p<0.001) and cortical signs (56.5 vs. 30.8%, p = 0.009), especially aphasia (34.8 vs. 15.4%, p = 0.013) and altered item level of consciousness (LOC) questions (26.1 vs. 11.6%, p = 0.037). In multivariable analyses, only NIHSS score (OR = 1.45 per point; 95% CI: 1.11–1.91, p = 0.007) was associated with proximal LVO in patients with minor IS. Conclusion: Large vessel occlusion (LVO) in minor stroke is non-exceptional, and our findings highlight the need for emergency arterial imaging in any patients suspected of acute stroke, including those with minor symptoms because of the absence of obvious predictors of proximal LVO.
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Duloquin G, Graber M, Baptiste L, Mohr S, Garnier L, Ndiaye M, Thomas Q, Hervieu-Bègue M, Osseby GV, Giroud M, Béjot Y. [Acute management of spontaneous intracerebral hemorrhage]. Rev Med Interne 2021; 43:293-300. [PMID: 34953622 DOI: 10.1016/j.revmed.2021.11.004] [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: 10/28/2021] [Accepted: 11/14/2021] [Indexed: 11/16/2022]
Abstract
Intracerebral hemorrhage accounts for approximately 15% of the 115,000 strokes occurring each year in France. Although therapeutic strategies are more limited than for ischemic stroke, major points in the management of intracerebral hemorrhage can reduce short term morbidity and mortality by limiting the expansion of the hematoma and the occurrence of early complications, and long term patients' outcome by reducing the risk of recurrence. This article aims to update the key elements that contribute to improve of the prognosis of intracerebral hemorrhage patients.
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Affiliation(s)
- G Duloquin
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - M Graber
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - L Baptiste
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - S Mohr
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - L Garnier
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - M Ndiaye
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - Q Thomas
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - M Hervieu-Bègue
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - G-V Osseby
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - M Giroud
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - Y Béjot
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France.
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Duloquin G, Graber M, Garnier L, Mohr S, Giroud M, Vergely C, Béjot Y. Assessment of Clinical Scales for Detection of Large Vessel Occlusion in Ischemic Stroke Patients from the Dijon Stroke Registry. J Clin Med 2021; 10:jcm10245893. [PMID: 34945188 PMCID: PMC8708038 DOI: 10.3390/jcm10245893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/02/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The limited availability of thrombectomy-capable stroke centres raises questions about pre-hospital triage of patients with suspected stroke (IS) due to large vessel occlusion (LVO). Aims: This study aimed to evaluate the diagnostic accuracy of clinical stroke severity scales available for LVO detection. (2) Methods: Patients with IS were prospectively identified among residents of Dijon, France, using a population-based registry (2013–2017). Clinical signs and arterial imaging data were collected. LVO was defined as an occlusion site affecting the terminal intracranial internal carotid artery, the M1 segment of the middle cerebral artery (MCA), or the basilar artery (restricted definition). A wide definition of LVO also included the M2 segment of the MCA. For each of the 16 evaluated scales, a receiver operator characteristic (ROC) analysis was performed, and the c-statistic representing the area under the ROC curve was evaluated to assess discrimination for predicting LVO. (3) Results: 971 patients were registered, including 123 patients (12.7%) with an LVO according to the restricted definition. The c-statistic for LVO detection ranged between 0.66 and 0.80 according to the different scales, with a sensibility varying from 70% to 98% and a specificity from 33% to 86%. According to the wide definition of LVO (174 patients, 17.9%), the c-statistic was slightly lower, ranging between 0.64 and 0.79. The sensitivity was 59% to 93%, and the specificity was 34% to 89%. (4) Conclusion: The clinical scales failed to combine a high sensitivity and a high specificity to detect LVO. Further studies are needed to determine the best strategy for pre-hospital triage of IS patients.
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Affiliation(s)
- Gauthier Duloquin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Mathilde Graber
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Lucie Garnier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Sophie Mohr
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Maurice Giroud
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Catherine Vergely
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
- Correspondence:
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Siguret V, Boissier E, Maistre ED, Gouin-Thibault I, James C, Lasne D, Mouton C, Godon A, Nguyen P, Lecompte T, Ajzenberg N, Bauters A, Béjot Y, Crassard I, Dahmani B, Desconclois C, Flaujac C, Frère C, Godier A, Gruel Y, Hézard N, Jourdi G, Kuadjovi C, Laurichesse M, Mémier V, Mourey G, Reiner P, Tardy B, Toussaint-Hacquard M. GFHT Proposals On The Practical Use Of Argatroban - With Specifics Regarding Vaccine-Induced Immune Thrombotic Thrombocytopaenia (VITT). Anaesth Crit Care Pain Med 2021; 40:100963. [PMID: 34673303 DOI: 10.1016/j.accpm.2021.100963] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022]
Abstract
Argatroban is a direct anti-IIa (thrombin) anticoagulant, administered as a continuous intravenous infusion; it has been approved in many countries for the anticoagulant management of heparin-induced thrombocytopaenia (HIT). Argatroban was recently proposed as the non-heparin anticoagulant of choice for the management of patients diagnosed with Vaccine-induced Immune Thrombotic Thrombocytopaenia (VITT). Immunoglobulins are also promptly intravenously administered in order to rapidly improve platelet count; concomitant therapy with steroids is also often considered. An ad hoc committee of the French Working Group on Haemostasis and Thrombosis members has worked on updated and detailed proposals regarding the management of anticoagulation with argatroban, based on previously released guidance for HIT, and adapted for VITT. In case of VITT, the initial dose to be preferred is 1.0 µg x kg-1 x min-1, with further dose-adjustments based on iterative and frequent clinical and laboratory assessments. It is strongly advised to involve a health practitioner experienced in the management of difficult cases in haemostasis. The first laboratory assessment should be performed 4 hours after the initiation of argatroban infusion, with further controls at 2-4-hour intervals until steady state, and at least once daily thereafter. Importantly, full anticoagulation should be rapidly achieved in case of widespread thrombosis. Cerebral vein thrombosis (which is typical of VITT) should not call for an overly cautious anticoagulation scheme. Argatroban administration requires baseline laboratory assessment and should rely on an anti-IIa assay to derive argatroban plasma levels using a dedicated calibration, with a target range between 0.5 and 1.5 µg/mL. Target argatroban plasma levels can be refined based on meticulous appraisal of risk factors for bleeding and thrombosis, on frequent reassessments of clinical status with appropriate vascular imaging, and on the changes in daily platelet counts. Regarding the use of aPTT, baseline value and possible causes for alterations of the clotting time must be taken into account. Specifically, in case of VITT, an aPTT ratio (patient's / mean normal clotting time) between 1.5 and 2.5 is suggested, to be refined according to the sensitivity of the reagent to the effect of a direct thrombin inhibitor. The sole use of aPTT is discouraged: one has to resort to a periodical check with an anti-IIa assay at least, with the help of a specialised laboratory if necessary. Dose modifications should proceed in a stepwise manner with 0.1 to 0.2 µg x kg-1 x min-1 up- or downward changes, taking into account the initial dose, laboratory results, and the whole individual setting. Nomograms are available to adjust the infusion rate. Haemoglobin level, platelet count, fibrinogen plasma level and liver tests should be periodically checked, depending on the clinical status, the more so when unstable.
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Affiliation(s)
- Virginie Siguret
- Hématologie biologique - Hôpital Lariboisière (AP-HP), UMR_S1140, Université de Paris, Paris, France.
| | - Elodie Boissier
- Laboratoire d'hématologie, Hôpital Laënnec, CHU de Nantes, France
| | | | | | - Chloé James
- Laboratoire d'hématologie, CHU de Bordeaux, Pessac, France
| | - Dominique Lasne
- Hématologie biologique - Hôpital Necker-Enfants malades (AP-HP), Paris, UMR_S1176 Université Paris Saclay, Le Kremlin Bicêtre, France
| | | | | | | | - Thomas Lecompte
- Départements de médecine, Hôpitaux Universitaires de Genève, Unité d'hémostase, & Faculté de Médecine - GpG, Université de Genève, Genève, Suisse
| | | | - Anne Bauters
- Service d'hématologie et transfusion, Université de Lille, CHU de Lille, Lille, France
| | | | - Isabelle Crassard
- Neurologie, Hôpital Lariboisière (APHP), FHU NeuroVasculaire, Université de Paris, Paris, France
| | - Bouhadjar Dahmani
- Hémostase et Thrombose, Centre Hospitalier Princesse Grace de Monaco, Monaco
| | | | - Claire Flaujac
- Laboratoire de biologie médicale, secteur hémostase, CH de Versailles, Le Chesnay, France
| | - Corinne Frère
- Hématologie Biologique, Hôpital Pitié Salpêtrière (AP-HP); Sorbonne Université, UMRS 1166, Institut hospitalo-universitaire ICAN, Paris, France
| | - Anne Godier
- Département d'Anesthésie Réanimation, Hôpital Européen Georges Pompidou (AP-HP), Paris, France
| | - Yves Gruel
- Hématologie biologique, CHU Tours, Tours, France
| | | | - Georges Jourdi
- Centre de recherche, Institut de Cardiologie de Montréal, Faculté de Pharmacie, Université de Montréal, Canada
| | - Charlène Kuadjovi
- Laboratoire du GCS Nord-Ouest Val d'Oise, CH Pontoise, Pontoise, France
| | | | - Vincent Mémier
- Laboratoire d'Hématologie, CHU Toulouse, Toulouse, France
| | - Guillaume Mourey
- Laboratoire d'Hématologie et d'Immunologie, Établissement Français du Sang Bourgogne -Franche-Comté, Besançon, France
| | - Peggy Reiner
- Service d'hématologie et transfusion, Université de Lille, CHU de Lille, Lille, France
| | - Brigitte Tardy
- INSERM U1059, Université J Monnet, Saint Etienne, France
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Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, Abbasifard M, Abbasi-Kangevari M, Abd-Allah F, Abedi V, Abualhasan A, Abu-Rmeileh NME, Abushouk AI, Adebayo OM, Agarwal G, Agasthi P, Ahinkorah BO, Ahmad S, Ahmadi S, Ahmed Salih Y, Aji B, Akbarpour S, Akinyemi RO, Al Hamad H, Alahdab F, Alif SM, Alipour V, Aljunid SM, Almustanyir S, Al-Raddadi RM, Al-Shahi Salman R, Alvis-Guzman N, Ancuceanu R, Anderlini D, Anderson JA, Ansar A, Antonazzo IC, Arabloo J, Ärnlöv J, Artanti KD, Aryan Z, Asgari S, Ashraf T, Athar M, Atreya A, Ausloos M, Baig AA, Baltatu OC, Banach M, Barboza MA, Barker-Collo SL, Bärnighausen TW, Barone MTU, Basu S, Bazmandegan G, Beghi E, Beheshti M, Béjot Y, Bell AW, Bennett DA, Bensenor IM, Bezabhe WM, Bezabih YM, Bhagavathula AS, Bhardwaj P, Bhattacharyya K, Bijani A, Bikbov B, Birhanu MM, Boloor A, Bonny A, Brauer M, Brenner H, Bryazka D, Butt ZA, Caetano dos Santos FL, Campos-Nonato IR, Cantu-Brito C, Carrero JJ, Castañeda-Orjuela CA, Catapano AL, Chakraborty PA, Charan J, Choudhari SG, Chowdhury EK, Chu DT, Chung SC, Colozza D, Costa VM, Costanzo S, Criqui MH, Dadras O, Dagnew B, Dai X, Dalal K, Damasceno AAM, D'Amico E, Dandona L, Dandona R, Darega Gela J, Davletov K, De la Cruz-Góngora V, Desai R, Dhamnetiya D, Dharmaratne SD, Dhimal ML, Dhimal M, Diaz D, Dichgans M, Dokova K, Doshi R, Douiri A, Duncan BB, Eftekharzadeh S, Ekholuenetale M, El Nahas N, Elgendy IY, Elhadi M, El-Jaafary SI, Endres M, Endries AY, Erku DA, Faraon EJA, Farooque U, Farzadfar F, Feroze AH, Filip I, Fischer F, Flood D, Gad MM, Gaidhane S, Ghanei Gheshlagh R, Ghashghaee A, Ghith N, Ghozali G, Ghozy S, Gialluisi A, Giampaoli S, Gilani SA, Gill PS, Gnedovskaya EV, Golechha M, Goulart AC, Guo Y, Gupta R, Gupta VB, Gupta VK, Gyanwali P, Hafezi-Nejad N, Hamidi S, Hanif A, Hankey GJ, Hargono A, Hashi A, Hassan TS, Hassen HY, Havmoeller RJ, Hay SI, Hayat K, Hegazy MI, Herteliu C, Holla R, Hostiuc S, Househ M, Huang J, Humayun A, Hwang BF, Iacoviello L, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Iqbal U, Irvani SSN, Islam SMS, Ismail NE, Iso H, Isola G, Iwagami M, Jacob L, Jain V, Jang SI, Jayapal SK, Jayaram S, Jayawardena R, Jeemon P, Jha RP, Johnson WD, Jonas JB, Joseph N, Jozwiak JJ, Jürisson M, Kalani R, Kalhor R, Kalkonde Y, Kamath A, Kamiab Z, Kanchan T, Kandel H, Karch A, Katoto PDMC, Kayode GA, Keshavarz P, Khader YS, Khan EA, Khan IA, Khan M, Khan MAB, Khatib MN, Khubchandani J, Kim GR, Kim MS, Kim YJ, Kisa A, Kisa S, Kivimäki M, Kolte D, Koolivand A, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy V, Krishnamurthi RV, Kumar GA, Kusuma D, La Vecchia C, Lacey B, Lak HM, Lallukka T, Lasrado S, Lavados PM, Leonardi M, Li B, Li S, Lin H, Lin RT, Liu X, Lo WD, Lorkowski S, Lucchetti G, Lutzky Saute R, Magdy Abd El Razek H, Magnani FG, Mahajan PB, Majeed A, Makki A, Malekzadeh R, Malik AA, Manafi N, Mansournia MA, Mantovani LG, Martini S, Mazzaglia G, Mehndiratta MM, Menezes RG, Meretoja A, Mersha AG, Miao Jonasson J, Miazgowski B, Miazgowski T, Michalek IM, Mirrakhimov EM, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Mokhayeri Y, Molokhia M, Moni MA, Montasir AA, Moradzadeh R, Morawska L, Morze J, Muruet W, Musa KI, Nagarajan AJ, Naghavi M, Narasimha Swamy S, Nascimento BR, Negoi RI, Neupane Kandel S, Nguyen TH, Norrving B, Noubiap JJ, Nwatah VE, Oancea B, Odukoya OO, Olagunju AT, Orru H, Owolabi MO, Padubidri JR, Pana A, Parekh T, Park EC, Pashazadeh Kan F, Pathak M, Peres MFP, Perianayagam A, Pham TM, Piradov MA, Podder V, Polinder S, Postma MJ, Pourshams A, Radfar A, Rafiei A, Raggi A, Rahim F, Rahimi-Movaghar V, Rahman M, Rahman MA, Rahmani AM, Rajai N, Ranasinghe P, Rao CR, Rao SJ, Rathi P, Rawaf DL, Rawaf S, Reitsma MB, Renjith V, Renzaho AMN, Rezapour A, Rodriguez JAB, Roever L, Romoli M, Rynkiewicz A, Sacco S, Sadeghi M, Saeedi Moghaddam S, Sahebkar A, Saif-Ur-Rahman KM, Salah R, Samaei M, Samy AM, Santos IS, Santric-Milicevic MM, Sarrafzadegan N, Sathian B, Sattin D, Schiavolin S, Schlaich MP, Schmidt MI, Schutte AE, Sepanlou SG, Seylani A, Sha F, Shahabi S, Shaikh MA, Shannawaz M, Shawon MSR, Sheikh A, Sheikhbahaei S, Shibuya K, Siabani S, Silva DAS, Singh JA, Singh JK, Skryabin VY, Skryabina AA, Sobaih BH, Stortecky S, Stranges S, Tadesse EG, Tarigan IU, Temsah MH, Teuschl Y, Thrift AG, Tonelli M, Tovani-Palone MR, Tran BX, Tripathi M, Tsegaye GW, Ullah A, Unim B, Unnikrishnan B, Vakilian A, Valadan Tahbaz S, Vasankari TJ, Venketasubramanian N, Vervoort D, Vo B, Volovici V, Vosoughi K, Vu GT, Vu LG, Wafa HA, Waheed Y, Wang Y, Wijeratne T, Winkler AS, Wolfe CDA, Woodward M, Wu JH, Wulf Hanson S, Xu X, Yadav L, Yadollahpour A, Yahyazadeh Jabbari SH, Yamagishi K, Yatsuya H, Yonemoto N, Yu C, Yunusa I, Zaman MS, Zaman SB, Zamanian M, Zand R, Zandifar A, Zastrozhin MS, Zastrozhina A, Zhang Y, Zhang ZJ, Zhong C, Zuniga YMH, Murray CJL. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2021; 20:795-820. [PMID: 34487721 PMCID: PMC8443449 DOI: 10.1016/s1474-4422(21)00252-0] [Citation(s) in RCA: 1651] [Impact Index Per Article: 550.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/01/2021] [Accepted: 07/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. METHODS We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. FINDINGS In 2019, there were 12·2 million (95% UI 11·0-13·6) incident cases of stroke, 101 million (93·2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6·55 million (6·00-7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8-12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1-6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0-73·0), prevalent strokes increased by 85·0% (83·0-88·0), deaths from stroke increased by 43·0% (31·0-55·0), and DALYs due to stroke increased by 32·0% (22·0-42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0-18·0), mortality decreased by 36·0% (31·0-42·0), prevalence decreased by 6·0% (5·0-7·0), and DALYs decreased by 36·0% (31·0-42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0-24·0) and incidence rates increased by 15·0% (12·0-18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5-3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5-3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57-8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97-3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01-1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7-90·8] DALYs or 55·5% [48·2-62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3-48·6] DALYs or 24·3% [15·7-33·2]), high fasting plasma glucose (28·9 million [19·8-41·5] DALYs or 20·2% [13·8-29·1]), ambient particulate matter pollution (28·7 million [23·4-33·4] DALYs or 20·1% [16·6-23·0]), and smoking (25·3 million [22·6-28·2] DALYs or 17·6% [16·4-19·0]). INTERPRETATION The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. FUNDING Bill & Melinda Gates Foundation.
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Thomas Q, Vitobello A, Mau-Them FT, Duffourd Y, Fromont A, Giroud M, Daubail B, Jacquin-Piques A, Hervieu-Begue M, Moreau T, Osseby GV, Garret P, Nambot S, Delanne J, Bruel AL, Sorlin A, Callier P, Denomme-Pichon AS, Faivre L, Béjot Y, Philippe C, Thauvin-Robinet C, Moutton S. High efficiency and clinical relevance of exome sequencing in the daily practice of neurogenetics. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.117855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Background Atrial fibrillation (AF) represents a major indication for oral anticoagulants (OAC) that contribute to spontaneous intracerebral hemorrhage (ICH). This study evaluated AF prevalence among patients with ICH, temporal trends, and early functional outcomes and death of patients. Methods and Results Patients with first‐ever ICH were prospectively recorded in the population‐based stroke registry of Dijon, France, (2006–2017). Association between AF and early outcome of patients with ICH (ordinal modified Rankin Scale score and death at discharge) were analyzed using ordinal and logistic regressions. Among 444 patients with ICH, 97 (21.9%) had AF, including 65 (14.6%) with previously known AF treated with OAC, and 13 (2.9%) with newly diagnosed AF. AF prevalence rose from 17.2% (2006–2011) to 25.8% (2012–2017) (P‐trend=0.05). An increase in the proportion of AF treated with OAC (11.3% to 17.5%, P‐trend=0.09) and newly diagnosed AF (1.5% to 4.2%, P‐trend=0.11) was observed. In multivariable analyses, after adjustment for premorbid OAC, AF was not significantly associated with ordinal modified Rankin Scale score (odds ratio [OR], 1.29; 95% CI, 0.69–2.42) or death (OR, 0.89; 95% CI, 0.40–1.96) in patients with ICH. Nevertheless, adjusted premorbid OAC use remained highly associated with a higher probability of death (OR, 2.53; 95% CI, 1.11–5.78). Conclusions AF prevalence and use of OAC among patients with ICH increased over time. Premorbid use of OAC was associated with poor outcome after ICH, thus suggesting a need to better identify ICH risk before initiating or pursuing OAC therapy in patients with AF, and to develop acute treatment and secondary prevention strategies after ICH in patients with AF.
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Affiliation(s)
| | | | - Yannick Béjot
- Dijon Stroke Registry EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases University Hospital of DijonUniversity of BurgundyUniversité Bourgogne-Franche-Comté (UBFC) Dijon France
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Duloquin G, Graber M, Baptiste L, Mohr S, Garnier L, Ndiaye M, Blanc-Labarre C, Hervieu-Bègue M, Osseby GV, Giroud M, Béjot Y. [Management of ischemic stroke in the acute phase]. Rev Med Interne 2021; 43:286-292. [PMID: 34481684 DOI: 10.1016/j.revmed.2021.08.003] [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: 06/30/2021] [Accepted: 08/01/2021] [Indexed: 12/24/2022]
Abstract
Ischemic stroke accounts for 80% of overall stroke, and is one of the leading causes of death, disability and dementia in worldwide. Management of patients with acute ischemic stroke dramatically improved over time with the implementation of intensive care stroke units, the development of acute recanalization strategies, the optimization of the management of post-stroke complications, and the prevention of early stroke recurrence. The objective of this article is to provide a general overview of the current management of patients with acute ischemic stroke aiming at improving post-stroke outcome.
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Affiliation(s)
- G Duloquin
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - M Graber
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - L Baptiste
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - S Mohr
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - L Garnier
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - M Ndiaye
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - C Blanc-Labarre
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - M Hervieu-Bègue
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - G-V Osseby
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - M Giroud
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - Y Béjot
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France.
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Frison E, Proust-Lima C, Mangin JF, Habert MO, Bombois S, Ousset PJ, Pasquier F, Hanon O, Paquet C, Gabelle A, Ceccaldi M, Annweiler C, Krolak-Salmon P, Béjot Y, Belin C, Wallon D, Sauvee M, Beaufils E, Bourdel-Marchasson I, Jalenques I, Chupin M, Chêne G, Dufouil C. Diabetes Mellitus and Cognition: Pathway Analysis in the MEMENTO Cohort. Neurology 2021; 97:e836-e848. [PMID: 34210821 PMCID: PMC8397583 DOI: 10.1212/wnl.0000000000012440] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 12/06/2020] [Accepted: 05/25/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the role of biomarkers of Alzheimer disease (AD), neurodegeneration, and small vessel disease (SVD) as mediators in the association between diabetes mellitus and cognition. METHODS The study sample was derived from MEMENTO, a cohort of French adults recruited in memory clinics and screened for either isolated subjective cognitive complaints or mild cognitive impairment. Diabetes was defined based on blood glucose assessment, use of antidiabetic agent, or self-report. We used structural equation modeling to assess whether latent variables of AD pathology (PET mean amyloid uptake, Aβ42/Aβ40 ratio, and CSF phosphorylated tau), SVD (white matter hyperintensities volume and visual grading), and neurodegeneration (mean cortical thickness, brain parenchymal fraction, hippocampal volume, and mean fluorodeoxyglucose uptake) mediate the association between diabetes and a latent variable of cognition (5 neuropsychological tests), adjusting for potential confounders. RESULTS There were 254 (11.1%) participants with diabetes among 2,288 participants (median age 71.6 years; 61.8% women). The association between diabetes and lower cognition was significantly mediated by higher neurodegeneration (standardized indirect effect: -0.061, 95% confidence interval: -0.089, -0.032), but not mediated by SVD and AD markers. Results were similar when considering latent variables of memory or executive functioning. CONCLUSION In a large clinical cohort in the elderly, diabetes is associated with lower cognition through neurodegeneration, independently of SVD and AD biomarkers.
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Affiliation(s)
- Eric Frison
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Cecile Proust-Lima
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Jean-Francois Mangin
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Marie-Odile Habert
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Stephanie Bombois
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Pierre-Jean Ousset
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Florence Pasquier
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Olivier Hanon
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Claire Paquet
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Audrey Gabelle
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Mathieu Ceccaldi
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Cédric Annweiler
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Pierre Krolak-Salmon
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Yannick Béjot
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Catherine Belin
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - David Wallon
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Mathilde Sauvee
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Emilie Beaufils
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Isabelle Bourdel-Marchasson
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Isabelle Jalenques
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Marie Chupin
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Geneviève Chêne
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France
| | - Carole Dufouil
- From INSERM, UMR 1219 (E.F., C.P.-L., G.C., C.D.), and INSERM, CIC1401-EC (E.F., G.C., C.D.), Université de Bordeaux; Pole de Sante Publique Centre (E.F., G.C., C.D.) and Pole de Gérontologie Clinique (I.B.-M.), Hospitalier Universitaire (CHU) de Bordeaux; CATI Multicenter Neuroimaging Platform (J.-F.M., M.-O.H., M. Ceccaldi), Paris; Neurospin CEA Paris Saclay University (J.-F.M.), Gif-sur-Yvette; Laboratoire d'Imagerie Biomédicale (M.-O.H.), INSERM, CNRS, Sorbonne Université; Médecine Nucléaire (M.-O.H.), AP-HP, Hôpital Pitié-Salpêtrière; IM2A, AP-HP, INSERM, UMR-S975, Groupe Hospitalier, Pitié-Salpêtrière Institut de la Mémoire et de la Maladie d'Alzheimer (S.B.), and INSERM, U-1127, 3 CNRS, UMR 7225, CATI (M. Chupin), Institut du Cerveau et de la Moelle Épinière, Sorbonne Université, Paris; INSERM UMR1027 (P.-J.O.), Université de Toulouse III Paul Sabatier; Centre Mémoire (CMRR) Distalz (F.P.), CHU, INSERM 1171, Université de Lille; Service de Gériatrie (O.H.), Hôpital Broca, Université Paris Descartes; Centre de Neurologie (C.P.), INSERM U1144, Cognitive Hôpital Lariboisière, Université de Paris; Department of Neurology, INSERM U1061, Clinical and Research Memory Center of Montpellier (A.G.), Gui de Chauliac Hospital, University of Montpellier; Institut de Neurosciences des Systèmes, CMMR, PACA Ouest (M. Ceccaldi), INSERM, CHU Timone APHM and Aix Marseille Université; Department of Geriatric Medicine (C.A.), Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, University of Angers, France; Department of Medical Biophysics (C.A.), Robarts Research Institute, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Canada; Centre Mémoire Ressource et Recherche de Lyon (CMRR) (P.K.-S.), Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Hôpital des Charpennes, Hospices Civils de Lyon, Université de Lyon; Centre Mémoire de Ressources et de Recherches (Y.B.), CHU Dijon Bourgogne, EA7460, Université de Bourgogne, Dijon; Service de Neurologie Hôpital Saint-Louis AP-HP (C.B.), Paris; Departement de Neurologie (D.W.), UNIROUEN, INSERM U1245, CNR-MAJ, CHU de Rouen, Université de Normandie; CMRR Grenoble Arc Alpin (M.S.), CHU Grenoble; CMRR (E.B.), University Hospital Tours; Centre de Résonance Magnétique des Systèmes Biologiques (I.B.-M.), UMR 5536 Université de Bordeaux/CNRS; and Memory Resource and Research Centre of Clermont-Ferrand (I.J.), CHU de Clermont-Ferrand, Clermont Auvergne University, Clermont-Ferrand, France.
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